PSY 242 EXAM 1 CONTENT

phenomenology

experience of psychology within the person

etiology

the course of it/timeline (mostly episodic)

diagnosis

What it looks like on paper. Definition/listing of the specific criteria

Course/prognosis

outcome/likelihood of recovery

treatment

different avenue’s that the patient can go through (medicine, psychotherapy, lifestyle changes)

Prevalence

Commonality

what is the importance of prevalence ?

High rates increase societal burden, need for mental infrastructure, treatment availability, impairment of societal members.

Point prevalence

The proportion of a population that has the disorder at a single specific point in time.

What are some factors of point prevalence?

Can shift dramatically, especially for episodic conditions (MDD). Highly sensitive to current environment, crisis, or acute stressors.

Example of bad point prevalence usage

Major Depressive disorder: measures active episodes “do you current meet criteria today” so MDD yields very different numbers with this type.

Example of good point prevalence usage

PTSD in conflict zones/disaster response. PTSD jumps dramatically following natural disaster or acute conflict.

Period Pervalence

The proportion of a population that meets criteria for the disorder at any point during a defined time frame (typically 1 year)

Example of period prevalence

Substance use disorder, ADHD in adults vs. children (remiss w/ maturity so it is lower in adults then children)

Incidence

The rate of new cases that develop in a specified population during a specific time period. Related to risk of onset. Helps identify critical developmental windows, etiology, and etiology driven prevention opportunities.

example of incidence

Schizophrenia - spike in adolescence to early adulthood

Anxiety vs. mood disorders

Necessary cause

condition that must be present for a disorder to occur BUT a does NOT guarantee a disorder will develop (not everyone who experiences trauma will develop PTSD)

example of necessary cause

trauma is needed cause for the diagnosis of PTSD, you cannot have PTSD without a traumatic event

sufficient cause

a condition that guarantees the occurrence of a disorder BUT it may not be the ONLY reason or cause of a disorder

example of sufficient cause

If someone is hopeless, it will develop into depression however, not all people who have depression feel hopeless.

Contributory Cause

Increases the probability or likelihood of the disorder to develop. These ones can work in tandem to increase risk

Example of contributory cause

Genetic predisposition is a BLANK cause for schizophrenia, it significantly increases the risk, but many people with the gene do NOT develop schizophrenia and some people without a family history will develop the disorder.

smoking weed

Example of contributory cause for developing schizophrenia along side having genetic predisposition

types of contributory factors

distal, proximal (acute), and maintaining.

Distal factors

• occur early in life and create vulnerability years later

• create foundation of risk/vulnerability

• predispose to proximal triggers

• doesn’t have to be genetic but can be

Types of distal factors

• adversity and environment

• biological and prenatal

• developmental/cognitive

• relational/intergenerational

distal factors - biological & prenatal

• genetic disposition

• prenatal exposures to toxins, viruses, or substances

• accelerated biological aging (from trauma)

distal factors - developmental & cognitive

• insecure attachment style

• temperament, traits

• neurodevelopment

Rather than viewing mental health conditions as a flaw in a single isolated structure, modern neuroscientists frequently evaluate how multiple interconnected structures communicate to regulate mood and behavior. These functional networks are generally called:

Brain circuits

Neuroimaging shows structural localized damage to Saul’s amygdala following a severe stroke. In a clinical intake, which symptom profile would a neuropsychologist be most likely to observe as a direct result of this specific lesion?

Difficulty recognizing threat signals or accurately processing basic emotions like fear in others.

Marcus, a 34-year-old software developer, has been struggling with debilitating social anxiety before team presentations. His psychiatrist prescribes a medication that enhances GABA activity in the brain. Mechanistically, how is this medication believed to help calm Marcus's nervous system?

It reduces neural excitability by acting as the brain's primary inhibitory neurotransmitter.

Jon, a 28-year-old graphic designer, notices he has intense, persistent cravings for chocolate donuts that feel difficult to control. His nutritionist notes that complex behavioral traits like food cravings are often "polygenic." What does this characterization suggest about Jon's cravings?

Multiple genes likely work together to influence the expression of the trait.

How do advocates within the Consumer and Service-User movements generally approach traditional psychiatric diagnosis and medical models?

They place strong emphasis on the lived experiences and subjective perceptions of individuals navigating the psychiatric system.

A humanistic therapist is consulting on a case with a behavioral colleague. Which assumption most distinctly sets humanistic psychotherapy approaches apart from traditional psychodynamic or behavioral perspectives?

Humans possess an innate drive toward self-actualization and an internal organismic valuing process.

In a graduate seminar on integrative treatment, students are asked to demonstrate how different models overlap. Which scenario best exemplifies an integration of biological and sociocultural perspectives?

Examining how chronic exposure to systemic poverty and discrimination can elevate physiological stress hormones (cortisol) and alter stress-response pathways in the brain.

After receiving a B-minus on her first college mid-term, Ricardo’s classmate Maya immediately thinks, "I'm going to fail this entire course, lose my scholarship, and get kicked out of university." According to cognitive therapy, Maya's automatic thought is best categorized as:

Catastrophizing

A community mental health center adopts a sociocultural perspective in its treatment programs. Which clinical policy or belief is most aligned with this approach?

Directing attention toward cultural inequalities, discrimination, and systemic barriers rather than treating pathology solely as an isolated individual issue.

In Object Relations Therapy, David, a 40-year-old architect, views his partner as "perfect and flawless" one week, but after a minor disagreement, views her as "completely evil and uncaring," struggling to integrate both positive and negative qualities into a unified view. David is exhibiting what is commonly termed:

Splitting

Displacement

Redirecting an emotional reaction or impulse from its original source to a safer surrogate target (e.g., getting angry at a boss and coming home to yell at a pet).

Oedipal resolution

A classical psychodynamic developmental milestone involving the resolution of unconscious childhood romantic rivalry with the same-sex parent, leading to healthy gender and superego identification.

reaction formation

Converting an unacceptable, uncomfortable internal feeling or impulse into its exact opposite outward behavior (e.g., acting excessively overly sweet toward someone you secretly intensely dislike).

Unconditional regard

A humanistic concept (pioneered by Carl Rogers) referring to non-judgmental acceptance in therapy, not a cognitive distortion.

diathesis

= distal factor/ pre-existing vulnerability

Dr. Aris, Dr. Chen, and Dr. Patel independently evaluate the same client using a structured clinical interview. Which outcome demonstrates high interrater reliability?

All three doctors independently arrive at the same diagnosis of Borderline Personality Disorder based on the evaluation. 

A researcher using the HiTOP framework is studying a patient who exhibits social withdrawal, generalized worry, and sad mood. How does HiTOP conceptualize these co-occurring features?

As specific manifestations of a broader, underlying "Internalizing" spectrum dimension. 

How did Emil Kraepelin’s early work laying the groundwork for modern diagnostic systems like the DSM and ICD differ from earlier approaches to mental illness?

He systematically grouped co-occurring symptoms into distinct medical syndromes based on their long-term progression. 

A behaviorally oriented clinician is assessing a client with severe agoraphobia. Which assessment procedure is characteristic of a behavioral assessment approach?

Having the client keep a self-monitoring log tracking situational triggers, avoidance behaviors, and immediate outcomes. 

During an emergency department intake, a clinician conducts a Mental Status Examination (MSE). Which clinical domain is explicitly evaluated as part of this immediate observational assessment?

The patient's current appearance, motor activity, speech characteristics, mood, affect, and thought content. 

A standardized cognitive test administered to elementary students includes a subtest that requires children to explain the rules of American football. An immigrant child who arrived three weeks ago fails this subtest despite possessing superior general reasoning skills and knowledge of soccer. This scenario illustrates how test performance can be invalidated by:

cultural bias in assessment.

In the 4P formulation model, how are predisposing factors distinguished from precipitating factors?

Predisposing factors are underlying vulnerabilities (e.g., genetics) that set the stage for illness, whereas precipitating factors are immediate triggers (e.g., a breakup) that prompt symptom onset. 

During a case conference, a psychologist notes: "We need to account for this patient's comorbidity when planning treatment." What is the psychologist referring to?

The co-occurrence of two or more distinct mental health diagnoses in this single patient. 

A standardized cognitive test administered to elementary students includes a subtest that requires children to explain the rules of American football. An immigrant child who arrived three weeks ago fails this subtest despite possessing superior general reasoning skills and knowledge of soccer. This scenario illustrates how test performance can be invalidated by:

Cultural bias embedded within the test content. 

A patient who suffered a traumatic brain injury undergoes an EEG to measure electrical brain waves directly, followed by the Halstead-Reitan Battery to assess perceptual and motor task performance. In this evaluation, the EEG is a ________ test, while the Halstead-Reitan Battery is a ________ test.

neurological; neuropsychological 

Protective factors

influences that modify a person’s response to environmental stressors, making it less likely that they will experience the adverse consequences of the stressors

examples of protective factors

individual, relational & family, community and structural

individual protective factors

self-efficacy & self-esteem (I can fix it, I have the ability to create change), emotion regulation skills, optimism & positive attribution, cognitive flexibility, good physical health

relational and family protective factors

secure attachment - strong nurturing bond with one reliable caregiver

social support networks - friends, partners, mentors

parental monitoring and support - warmth, clear expectations, rules

community and structural protective factors

sense of belonging - sports team, cultural group, faith-based community

safe and stable environments - neighborhoods without violence, stable housing, economic opportunities

cultural and spiritual factors - cultural identity, sense of cultural heritage and pride, spirituality or meaning-making (sense of purpose in life)

proximal factors (acute)

• operate shortly before the symptoms appear

• occur shortly before onset of the disorder

• the “trigger” that activates any vulnerability, and elicits the initial symptoms of the disorder

example of proximal factors

severe marital problems leads to onset depression in women (agitation and isolation)

Maintaining factors

• Not always casual or etiological

• perpetuating factos

• keep mental disorder active once it develops

• unlike etiological, explain why people have difficulty recovering

Maintaining example

“falling into a hole” during depression, not attempting to get out of hole

Example of perpetuation factor (maintaining)

Feels good when doing it, bad for you. Sleeping all the time bc depressed or putting bills to the side because it’s triggering for your anxiety.

Identifying treatment targets

Any contributory factor that can be modified is a potential target for intervention

• non-modifiable (fixed markers)

• indirectly modifiable (distal factors)

• Directly modifiable (proximal and maintaining)

Directly modifiable

Where do you want to intervene? Stopping the forward motion or “build up” of anxiety and then reverse it to lower anxiety - exposure therapy (avoidance[maintaining] vs. exposure)

non-modifiable (fixed markers)

Age, race, prev. history, traumatic event, death of loved one (since these are genetic they are NOT modifiable but can be helped with meds)

indirectly modifiable (distal factors)

child abuse is an example, can’t change that it happened but ways to work on it and modify emotion deregulation. Not usually apart of treatment but prevention towards it. Trying to figure out where it stems from

Leveraging protective factors in treatment

• protective factor = resources

  • acute crisis intervention (if someone is really under stress/overwhelmed and feels like harming themselves)

  • exposure/intervention exercises

• treatment isn’t just about reducing risk factor (reducing the bad), it’s equally about building and leveraging protective factors (amplifying the good - replacing bad w good experiences, not just reducing)

bio-psycho-social model

neurotransmitters → ways of thinking/stress levels → social roles/relationships/culture → disorders

types of diathesis

• adversity & environment (toxins in water)

• biological & prenatal factors

• developmental/cognitive factors

• relational/intergenerational factors

diathesis - stress model

diathesis/vulnerability (distal factor) → interaction/stressor (proximal factor) → disorder

diathesis stress model example

A college student has an anxious temperament and high sensitivity to stress. While they manage fine during normal semesters, the heavy pressure of final exams and a sudden family illness acts as the stressor that sparks a severe panic disorder

types of stressors

• life events and transitions, traumatic events (going to college, death, having a baby)

• environmental and social: work or school pressure, economic strain, social rejection

• biological or cognitive: physical conditions, substance use(cause other disorders & other disorders cause sub. use), cognitive states

• if stressor is really strong diathesis doesn’t have to be and vis/versa

defining psychopathology

elements of abnormality

• deviancy (diff from the norm)

• violation of societal standards

• suffering

• social discomfort

• maladaptiveness

• irrationality or unpredictability

no single element sufficient for defining abnormal

what must always be present when something is diagnosed

suffering and maladaptiveness (behaviors, thoughts, or coping strategies that interfere with daily functioning, personal growth, and long-term well-being)

defining abnormal (DSM-5)

• clinically significant disturbance in behavior

• distress or disability (impaired functioning)

• not culturally sanctioned

• considered to reflect behavioral, psychological, or biological dyfunction

Incidence

Number of new cases occurring within a specific time period.

Point Prevalence

Proportion of active cases at a single given moment in time.

Past-Year Prevalence

Proportion of active cases at any point during a 12-month period.

Lifetime Prevalence

Proportion of people in a population who have developed the disorder at any point in their lives.

Biological treatment approaches

medications, ECT

psychotherapy treatment approaches

behavioral activation therapy, cognitive therapy

social/interpersonal treatment approaches

family or couples therapy, system approaches

behavioral activation therapy

Focuses on breaking the vicious cycle of depression through action. It helps you schedule and gradually increase enjoyable, mastery-oriented, or social activities, even when motivation is low

cognitive therapy

Focuses on examining thoughts. It teaches you to spot cognitive distortions (like automatic negative thoughts) and actively challenge or reframe them into more balanced thinking

CBT

cognitive behavioral therapy

cognitive behavioral therapy

teaches you how to change unhelpful thinking patterns and behaviors to improve how you feel

Hippocrates (460-377 BC)

• Father of modern western medicine

• wanted to look at factors causing it/etiology = physical disease

• hysteria “the wandering uterus” - psychological symptoms were a result of the uterus moving around in the body

• linked the abnormality with brain chemical imbalances (neurotransmitters that were effected which lead to anxiety)

  • foreshadowed modern views

• galen (129 -198 AD) extended hippocrates work

Emil Kraeplin (1856-1926)

• compendum der psychiatrie (1883)

• emphasized brain pathology in mental disorders

• created a system for classifying mental disorders

• each type of mental disorder was considered distinct from others

• looked at same symptoms overtime (course)

general paresis (syphilis) and the biological link with madness

if not treated, moves to brain and will end with dementia

syphilis

also known as general paresis

• several unusual psychological and behavioral symptoms

• pasteur discovered the cause, a bacterial microorganism

• led to penicillin as a successful treatment

• bolstered the view that mental illness = physical illness

dev. of biological treatments

• psychotropic meds increasingly available in 1950s

• electric shock

• crude surgery (lobotomy)

• insulin

• major tranquilizers (neuroleptics = antipsychotic drugs)

• minor tranquilizers (klonopin/benzodiazepines)

what biological treatment(s) is still available?

• psychotropic medications

• ECT

• minor tranquilizers

consequences of biological tradition (1950)

People thought mental illness to have physical roots meaning many thought it was appropriate to hospitalize people but really wasn’t. Mental illness often seen as “untreatable.” There was improved diagnosis and classification

emil kraeplin was father of

classification