Psychopathology exam 2

Holmes and Rahe’s Social Readjustment Rating Scale

• contributed to dev of stress research; assigns stress values to life events based on judgments of large group of normal adults (more life change units = more stress)

  • BUT: stress checklists rely on retrospective reports, not generalizable stressors for diff ages and ethnic backgrounds, positive + neg events both considered stressors, doesn’t distinguish between short lived and chronic stressors and treats event as same amount of stress for everyone

Fight or flight vs tend-befriend

• Fight or flight response may be specifically male; primate females may tend and befriend instead (caring for offspring/finding social affiliation and safety in numbers)

  • From Taylor et al.

Longitudinal study

• when you study ppl repeatedly over time

  • Common goal: if hypothesized causes come before their assumed effects (longitudinal studies help rule out reverse causality)

  • costly

Retrospective study

• when researchers ask participants to recall past events or examine records from the past (less expensive but memories can be distorted and records can be limited)

Prospective study

• (follow forwards study; more expensive option): supposed causes are assessed in the present, subjects followed longitudinally to see if hypothesized effects develop over time

• When a finding is supported in prospective longitudinal research you can have greater confidence in causal hypothesis than cross-sectional research

• NOT EXPERIMENTAL

Cross sectional study

• opposite of longitudinal; ppl only studied at one time point

secondary victimization

• Learning about the violence of a loved one OR repeated, extreme exposure (e.g. Robby The Pitt)

Meaning making

• finding some value/reason for having endured trauma (e.g. educating others about SA after having been assaulted)

  • SEARCHING for meaning correlated with more PTSD symptoms, but FINDING meaning correlated w better adjustment

Critical incident stress debriefing

• a single 1-5hr group meeting offered 1-3 days after a disaster

  • Participants share experiences and reactions and group leader offers education, assessment, and referral if necessary

  • Difficult to research, but research provides no evidence that this prevents future PTSD and some studies find that it’s harmful because it may provoke too much emotion after a trauma

    • it is also unnatural: offered by ppl not part of victim’s world (outsiders)

imagery rehearsal therapy

• Involves reliving nightmares while awake but rewriting nightmare script in any way client wishes

Eye movement desensitization and reprocessing

• Francine Shapiro noticed that rapid back and forth eye moments reduced anxiety; tried on clients and benefits were seen (but we don’t know why)

• Now ppl use this as a relaxation technique while patients relive vivid images of trauma, but effectiveness may just be prolonged exposure

Preventative PTSD treatment for vets

• Need immediate treatment near the battlefield with expecting to return to front lines after recovery (soldiers with expectation of return/treated on front lines experienced lower rates of PTSD than those who did not)

Prolonged exposure

Therapeutic re-exposure to trauma (can confront feared situations irl or in one’s imagination or by talking abt events in therapy)

MOST STRONGLY SUPPORTED TREATMENT FOR PTSD

Hysteria

• means uterus in greek; Ancient Greek view that frustrated seggual desires (i.e. to have a baby) caused dissociative disorders

hypnosis

• where subjects experience loss of control over actions in response to hypnotist’s suggestions 

  • some ppl think it’s a dissociative experience, others think its a social role

explicit memory

conscious recollection

implicit memory

unconscious, evident only bc past experience can change behavior

dissociative identity disorder

• 2+ personalities exist within individual (if true then mind can function on multiple lvls of consciousness)

  • At least some loss of recall between personalities/alters

  • Argued that it could be caused by trauma (especially chronic physical or sexual child abuse)

  • Controversy on if its real or not

depersonalization

• ppl feel detached from themselves (e.g. out of body experience, floating outside oneself)

  • Persistent and recurrent

  • “As-if” feelings (not delusions)

derealization

• experiencing the world as more dreamlike than real

  • Persistent and recurrent

  • “As-if” feelings (not delusions)

dissociative amnesia

• partial/complete loss of recall for particular events or for a particular period of time (from severe emotional distress)

  • Can sometimes be accompanied by dissociative fugue (sudden unplanned travel, can have memory loss/assume new identity)

state dependent learning

• a process where learning that takes place in one state/affect or consciousness is best recalled when in the same state

  • Experiences that occur within a dissociated state may be more easily recalled within the same state of consciousness

iatrogenesis

• manufacture of a disorder by its treatment

  • Many cases of DID were created by expectations/leading questions of therapists (Mersky argues that DID is a social role)

somatic symptom disorder

• at least one (usually more) somatic complaints accompanied by excessive concern abt symptoms

  • May be presented in a histrionic manner (dramatic, self-centered, seductive)

  • May be presented la belle indifference-ly (explaining symptoms offhand)

  • These are only in a minority of cases

  • Often begins in adolescence

conversion disorder

• altered motor/sensory function that typically mimics neurological problems except it doesn't make senseeeee

illness anxiety disorder

• belief that person is ill but they don’t have any (or just very minor) symptoms

  • Preoccupying, enduring, impairment in functioning, etc

body dysmorphic disorder

• preoccupation with an imagined defect in appearance (e.g. facial feature)

  • Under OCD umbrella

malingering

• pretending to have an illness for some external gain (disability payment)

factitious disorder

• similar to malingering but it is done bc person desires to be in a sick role (can take drugs that mimic sick symptoms)

Munchausen syndrome

factitious disorder except it’s a pattern

extrapyramidal symptoms

• affects neural pathways that connect brain to motor neurons in spinal cord, symptoms: rigidity, tremors, restless agitation, peculiar involuntary postures, motor inertia

tardive dyskinesia

• more severe motor symptoms; abnormal involuntary movements of mouth and face and involuntary movements of limbs/trunk of the body

  • Irreversible in some

expressed emotion

• A collection of negative or intrusive attitudes sometimes displayed by relatives of patients who are being treated for a disorder

  • If 1+ relatives are hostile, critical, or emotionally overinvolved (extreme anxiety or self-sacrifice), then enviro is high in this

comparaison groups

groups that are compared w another group of ppl that already have the disorder

• If investigators find a significant difference between groups, then DV is correlated with disorder

  • However: assuming causality is risky

• Questions: does “normal” mean not having the disorder in question or any type of psychopathology? What if comparison participants have fam history of disorder?

• Can also compare specific disorder group to group that has another disorder

stress

challenging life event

stressor

response to challenging life event

v-codes

• Not a diagnosis, but other factors that may be the focus of clinical attention (e.g. unemployment, poverty)

Alarm, resistance, exhaustion

stages to GAS

Seyle

GAS; “a car that has run out of gas where the damage comes from repeated attempts to start it” (harm comes from exhaustion/depletion of resources)

Cannon

homeostasis; Compared to a car engine continues to race instead of idling down (harm comes from continued fight or flight response, not exhaustion)

Sapolsky

• Reallocation of resources with stress

  • Energy sapped

  • Body loses ability to perform routine functions (healing, storing energy)

  • Makes body vulnerable

  • Compared to a car running constantly/at such energy lvls that cooling/lubricant systems can’t keep up (running with too high energy; cooling systems can’t keep up)

    • E.g. anxiety → depression comorbidity: going at high energy for longer, systems for regulation aren’t working and causes depression onset

McEwen

allostasis, allostatic load

allostasis

• process of adapting/achieving stability through change

  • The process (how you respond)

  • Change in baseline or “set points” (lowering baseline stress so then if stress hits it won’t be too much)

allostatic load

• results in wear and tear on the body (wear and tear from chronic overactivity/underactivity)

  • The thing

  • E.g. rubber band gets stretched too many times

Ohio state medical studies

• Done in 1970s, researching stress (studying medical students)

• Measuring immune system, t-cells, etc

• Big finding: t-cells elevated, immune system bad right after exam season

  • Medical students getting sick right after exam season

behavioral medicine/health psychology

• Reducing stress response in body to help with serious medical issues

type A personality

• competitive, high achiever, hostility

  • Most detrimental attributes: competitiveness and hostility (when it’s unhealthy)

type B personality

• less rigid, “go with the flow,” laid-back, flexible

• Understanding of behavioral medicine gives us holistic way of helping people

problem focused coping

• change effect of stressor

emotion focused coping

• attempt to alter internal distress

westinghouse studies

•  people working in a factory; stressed out and productivity was waning

  • Put dials in workspaces to “turn down noise” (didn’t actually work) but people reported less stress

PTSD

• Can have delayed onset (symptoms appear 6 months or later)

• Criteria:

  • Exposure to actual/threatened death, serious injury, or violence (directly experienced, witnessed, learning fam member/close friend experienced it, repeated exposure to details of event)

    • For fam member/close friend experiencing it: fam member getting hit by drunk driver

    • For last one: vietnam veterans whose only job was collecting human remains (NOT TELEVISION EXPOSURE)

    • DSM DOESN’T SPECIFY CAUSE EXCEPT IN CASE OF PTSD

ASD

• lasts 3-30 days

  • Having acute disorder symptoms more likely to have a good long-term outcome

Intrusions, avoidance, negative alterations (cog/mood), alterations in arousal

clinical features of PTSD

abreaction

• reliving of past traumatic events or hypnosis as a treatment of dissociative disorders (treatment)

repression

• a (mal)adaptive form of emotion focused coping (defenses)

dissociation

• the disruption of the normally integrated mental processes involved in memory, consciousness, identity, or perception (defenses)

peritraumatic dissociation

• Dissociative symptoms around/during traumatic event

• Relationship between dissociation during a traumatic event and the later development of of PTSD

Haslam

SZ is disruptions in thinking (pneumatic air loom)

Morel

deterioration of functioning; hypothesized irrecoverable brain degeneration of hereditary origin (Démence précoce)

Kraeplin

• Said SZ expression so varied that fundamental symptoms are not recognized

  • Anxiety (clouding of consciousness)

  • Hallucinations  

  • Attention (innability to control)

  • Anhedonia

  • Activity (voluntary disappears, impulsive acts)

  • BUT: all of these led to dementia (dementia praecox)

Bleuler

four As; didn’t believe in dementia praecox def of SZ (ppl can still be high-functioning)

Association, Affectivity, Ambivalence, Autism

Bleuler’s four As

cognitive exoskeleton

ppl that can’t tell difference between hallucinations and reality need to have “bones outside of their body” to have a structure for their thinking

perseveration

• persistently repeating same word/phrase over and over 

catatonia

• immobility and marked muscular rigidity OR excitement and overactivity

  • Also associated w a stuporous state (reduced responsiveness)

  • Wax movements (can move patients a certain way and they stay like that; coglike movements)

neologisms

• “new words” aka pneumatic air loom

schizoaffective disorder

•  schizophrenia with depressive disorder, also includes periods of schizophrenia with no mood disorder

anhedonia

lack of pleasure in activities

avoliton

reduced motivation