PSYC 334 Exam 1

Study Guide

What is Psychopathology?

The scientific study of psychological disorders of the mind and psychological dysfunction.

What defines a psychological disorder?

“Behavioral, psychological, or biological dysfunctions that are unexpected in their cultural context and associated with present distress and/or impairment in functioning, or increased risk of suffering, death, pain, or impairment.”

How is normal behavior compared to abnormal behavior?

Normal behavior refers to thoughts and feelings that are typical in a social context, whereas abnormal behavior is deemed unusual, distressing, or dangerous in that environment.

What are the 4 D’s in abnormal behavior?

dysfunction (disturbance in daily functioning); distress (emotional or physical suffering associated with thoughts, feelings, or behaviors); deviance (behavior that is atypical or deviates from normal behavior); dangerousness (behavior that can pose a risk to oneself and/or others)

Briefly describe the DSM

The DSM describes “typical” presentations of different psychological discord and is used for diagnostic purposes

Explain he difference between the two different types of psychopathology Onset

Acute onset refers to symptoms occurring very suddenly and unexpectedly. Insidious onset refers to symptoms gradually developing over time.

Explain the difference between the two different types of psychopathology Course

With chronic course, symptoms are persistent or continuously present over time (even if severity fluctuates). With episodic course, symptoms occur during distinct periods or episodes.

What is the difference between Prevalence and Incidence?

Prevalence describes how many people in the whole population have the disorder, whereas incidence describes how many new cases occur during a specific period of time.

What is the focus of psychoanalytic theory?

Psychoanalytic theory focuses on how unconscious conflicts, early childhood experiences, and internal psychological processes shape thoughts, emotions, and behavior

A student just received a poor score on an exam and immediately thinks they are terrible at the subject matter and can’t improve their performance moving forward, which results in less studying and worse performance. What psychological theory is this situation referencing?

cognitive theory, which focuses on how people think and interpret events, specifically distorted thinking in this example

What is the main difference between Classical and Operant Conditioning in Behavioral Theory?

Classical - learning in which a neutral stimulus is paired with a response until it elicits that response (pavlov’s dogs)'; Operant - learning in which behavior changes as a function of what follows the behavior (reinforcement)

A man is in a casino and plays the slot machine for an hour, he is rewarded with the jackpot inconsistently. What type of reinforcement is being used here?

variable ratio

Which movement provided coordinated mental health services for those in community mental health centers? What were the consequences of this movement?

Community Mental Health movement. A major consequence was deinstitutionalization: many people were discharged from the state psychiatric hospitals, but community services were often underfunded or insufficient, contributing to gaps in care, homelessness, and involvement with the criminal legal system.

What are the three types of stigma, and how do they affect individuals with mental health disorders in society?

Stigma is a set of negative or unfair beliefs that people in a society have about something. Public stigma refers to discrimination and devaluation by others (e.g., someone being made fun of for having an anxiety disorder). Systemic stigma refers to reduced access to care and resources due to policies. Self-stigma refers to internalization of negative stereotypes (e.g., when you hear negative things about people with anxiety, you might internalize those things and feel bad about yourself).

Explain the differences between a One-dimensional model and multidimensional model.

A 1D model explains behavior in terms of a single type of cause. A MD model explains behavior from multiple influences. We focused on MD mostly.

In the MD Model, list examples of influences that can affect behavior.

biological, behavioral, emotional, social/cultural, environmental, and developmental

What are the three different approaches to understanding psychopathology we covered in class?

We covered the biological (disorders are the result of abnormal genes or neurobiological dysfunction [proposed solution: medication]), psychological (disorders are the result of thinking processes, personality styles, emotions, and conditioning [proposed solution: psychotherapy]), and sociocultural (disorders are the result of environmental conditions and cultural norms [proposed solution: changes in social policies]) approaches.

Given an example of the Diathesis-Stress Model.

suggests that disorders are the result of underlying risk factors combining with life stressors, which causes a disorder to emerge - a student with a genetic vulnerability to depression develops depressive symptoms after experiencing significant stress from starting college and struggling academically

Identical twins share the same genetic code, but different experiences and environments allow their genes to be expressed differently in personality and cognitive abilities. This is an example of what concept?

Epigenetics! Epigenetics refers to how environmental influences affect expression of certain genes both for the individual and for their descendants

What are the two parts of the PNS?

somatic nervous system, autonomic nervous system (para and sympa)

Imagine you are in 2 classes: in one class, you study for an exam, while in the other class you do not. You receive a 50% on both exams, as a result you conclude that you don’t need to study for the exams. This is an example of:

Learned helplessness: repeated exposure to uncontrollable negative events leaves a person feeling powerless to change their situation.

Which of the three approaches to psychopathology is the “correct” one?

all of them = Biopsychosocial model to get the best picture

Why do we classify behaviors as mental disorders?

We classify behaviors as mental disorders to identify patterns of symptoms, communicate consistently among providers, validate individuals’ lived experience, guide treatment decisions, and support research into causes and effective interventions.

What are the benefits of classifying mental disorders; are there any drawbacks?

Benefits include classification to support treatment, providing a shared language for providers, supporting research on etiology and treatment, and ensuring insurance reimbursement. Drawbacks include risking reducing people to “simple” labels, possibility of impacting others’ beliefs or expectations about one’s aptitude, and unrelated concerns being incorrectly attributed to the disorder.

What is the difference between categorical and dimensional classifications?

categorical classifications focus on qualitative differences (no or yes to depression) while dimensional classifications focus on quantitative differences (mild, moderate, severe)

Name factors that clinicians think about when disgnosing an individual?

#/type of symptoms, how long the symptoms have lasted, and whether the symptoms cause distress or functional impairment

What is a clinical assessment?

a systematic approach to the evaluation measurement of biopsychosocial factors in an individual presenting with a possible mental health disorder.

What is reliability?

The degree to which a measurement is consistent. Interrater reliability is consistency among multiple raters. test-retest reliability is consistent across multiple times taking a test.

What is validity?

the degree to which a measurement measures what it is supposed to measure. Concurrent validity is how well a new measure aligns with the gold standard. predictive validity’s how well a score predicts future outcomes.

Describe the process of standardization?

Standardization is the process of administering and scoring a test in the same way for everyone and comparing an individual’s score to scores from a representative group (norms).

What is the goal of a clinical interview?

A clinical interview is meant to gather relevant information for making a diagnosis and planning for treatment.

What categories does a licensed clinician note when performing a Mental Status Exam?

Appearance, though processes, mood and affect, intellectual functioning, and orientation

What is the difference between Mood and Affect?

Mood is a persistent emotional state (emotions are more passing, situation dependent). Affect is an observable expression of emotion (it can be congruent or incongruent as someone’s mood.

What are the ABC’s used in a behavioral assessment?

Antecedents (what happened before the behavior), behavior (what is the behavior), and consequences (what happened after the behavior)

Give an example of a self-monitoring behavioral assessment.

There are a variety of possible “correct” answers. Think about the antecedents and consequences of smoking.

What are the common types of clinical scales?

self-report scales, informant-report scales, and clinician-rated scales

What is the point validity of scales?

validity scales help determine whether a person’s responses are accurate and interpretable, by detecting response patterns such as exaggerating or minimizing symptoms, responding inconsistently, or answering randomly.

what are some issues with projective tests?

some common issues with projective tests include subjective interpretation and scoring, poor reliability, questionable validity, and limited evidence that they accurately assess personality or psychopathology

If you were taking a questionnaire regarding which marvel character you are, what type of validity would be most strongly associated?

personality test, strong face validity

the stroop test has an individual read colored words in different colored ink, what could this be measuring?

neuropsychological test that measures things like cognitive flexibility and selective attention

How is the cultural formulation interview used in clinical assessment? can it really be used as a diagnostic tool?

The Cultural Formulation Interview (CFI) is used to understand how a person’s cultural background, identity, beliefs, supports, and experiences shape how they understand and experience their mental health concerns and treatment. It is not a diagnostic tool on its own; rather, it provides cultural context that can help clinicians make more accurate and culturally informed diagnostic and treatment decisions.

What can be criticized when looking at the DSM?

Example criticisms include: prioritization of reliability over validity; perpetuation of definitions over time, even if they might be flawed; unclear or “fuzzy” boundaries between diagnostic categories; possibility of diagnoses being misused.

What are the benefits and drawbacks of having too little or too much anxiety?

If you have too little anxiety, you may have little to no motivation to do something. If you have too much anxiety it can be harmful and decrease performance. The right amount of anxiety can be adaptive and produce an optimal level of performance for tasks.

Difference between fear and anxiety.

fear is associated with facing an immediate danger (present-oriented); anxiety is associated with anticipation of future possible events (future-oriented)

A woman has to catch a flight and is currently stuck trying to get her bags checked. Her breath becomes very heavy and her heart is racing fast, since she doesn’t know if she will catch her flight back home to Delaware. What type of response is being displayed for anxiety?

She is demonstrating a physiological response (activation of the sympathetic nervous system that triggers a fight or flight or freeze response)

A person is at work and makes a small mistake in a report. Instead of seeing it as a minor error, they think, “I must have messed up everything. My boss will fire me, and I’ll lose my job.” What kind of thinking trap is this person cognitively displaying?

catastrophizing (imagine worst case scenario instead of the most likely scenario)

An individual comes into therapy after having been very anxious for almost a year. They report being anxious about schoolwork, performing well on their swim team, and other day-to-day things. They have had trouble focusing on their schoolwork, getting proper sleep, and have been feeling very fatigued for almost a year. This could be an example of which disorder?

Generalized anxiety disorder

What is the difference between Cued and Un-Cued panic?

Cued panic is expected and occurs in an expected context (specific phobia or social anxiety); un-cued panic is unexpected and occurs in seemingly random contexts (panic disorder)

What criteria are needed in order to be diagnosed with panic disorder?

recurrent, un-cued panic attacks; at least one of the panic attacks is followed by worrying about having another panic attack or its consequences; and changes in behavior in order to avoid future panic attacks; these symptoms must last at least 1 month

What are the differences between panic attacks and panic disorder?

panic attacks are intense episodes of fear that come up suddenly. panic disorder is having persistent panic attacks that are unexpected AND having a consistent fear of having another panic attack that can change your behavior.

An individual feels extreme distress when going out in public; they try to avoid leaving home and entering crowded spaces because they fear not being able to get back home safely. This has become an issue for the last 6 months; this is an example of:

Agoraphobia

A middle schooler named Bill has entered a talent show but decides to drop out at the last minute; he does not enter due to perceived fear and anxiety of evaluation from others. This example best aligns with:

Social anxiety disorder

A young kid displays excessive worry and distress that their parent may pass away immediately when he goes into school. This example best aligns with:

separation anxiety disorder

What are the steps used in exposure therapy?

creating a fear hierarchy and ranking order of exposures from easiest to hardest; practicing exposures from easier > harder for habituation

Imagine an individual is experiencing forms of anxiety; to calm themselves down they take note of 5 things they see, 4 things they feel, 3 things they can hear, 2 things they can smell, and 1 thing they can taste. What technique is being used when managing anxiety?

Grounding

What group of individuals is most likely to experience anxiety disorders? What is the most prevalent among the anxiety disorders we talked about, and what is the least?

Women are about two times as likely to experience specific phobias, panic disorder, and GAD. The most prevalent are specific phobias, while OCD is the least common among anxiety disorders.

What are the differences between an Obsession and a Compulsion?

Obsessions are unwanted thoughts and urges that create distress or anxiety. Compulsions are repetitive behaviors that a person feels they must perform in relation to an obsession according to rigid rules. They are aimed at reducing distress/anxiety or preventing a feared outcome (but they are not logically connected to the feared outcome)

What is the example of an obsession followed by the compulsion of repeatedly washing their hands to reduce their anxiety.

a person has the obsession that their hands are contaminated with dangerous germs, followed by the compulsion of repeatedly washing their hands to reduce their anxiety

An individual has an excessive urge to actively pull his own hair out from anywhere on his body; what OCD-related disorder is mentioned here

trichotillomania

What is the gold standard treatment for OCD?

Exposure and Response Prevention. ERP treats OCD gradually exposing a person to situations that trigger their obsessions while helping them resist engaging in compulsions, allowing them to learn that anxiety/distress can decrease without performing the compulsion.

What is a Potentially Traumatic Event? Give an example.

A PTE is an event involving actual or threatened death, serious injury, or sexual violence that has the potential to result in a traumatic stress response. Examples may include a serious car accident, physical assault, or witnessing community violence.

Why are children more likely to develop PTSD than adults?

Children may be more vulnerable to developing PTSD because their brains and coping skills are still developing, they have less control over their environments, and they often depend on caregivers to help them understand and cope with traumatic experiences.

When thinking of PTSD, what parts of the brain do we think about when discussing the Disorder on a biological level?

hippocampus (memory) and amygdala (fear response)

What is a major protective factor against developing PTSD?

social support

What are the five symptom clusters associated with a diagnosis of PTSD?

Intrusive symptoms; dissociative reactions; persistent avoidance; negative alterations in mood and cognitions; changes in arousal and reactivity

Ho is acute stress disorder different than PTSD?

the main difference is timing: acute stress disorder (ASD) occurs 3 days to 1 month after a traumatic event, whereas PTSD involves symptoms that persist for more than 1 month

How is complex PTSD different from PTSD?

complex PTSD includes the core symptoms of PTSD plus persistent difficulties with emotion regulation, negative self-concept, and relationships, often following prolonged or repeated trauma

An individual is diagnosed with PTSD and seeks immediate treatment to reduce distress from the traumatic memory of a car crash they were involved in with their mom. He talks with a therapist and is told to tell the story over and over again; then they gain exposure to any triggers that might expose the event. This is an example of what type of treatment?

prolonged exposure

Mental health conditions that can be characterized by persistent changes in an individual’s mood, emotion, and behavior are known as:

mood disorders

What are some of the diagnostic criteria for someone with major depressive disorder? What symptoms should someone look for?

Five (or more) of a set of symptoms present during the same two-week period and represent a change from previous functioning AND at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. The set of symptoms includes: depressed mood; diminished interest/pleasure in activities; significant weight loss or gain; recurrent thoughts of death; worthlessness; insomnia/hypersomnia

A persistent state of low mood characterized by unease, depression, irritability, and fatigue is known as what?

dysphoria

Alex is an 18-year-old college student who has a loving family, does well in the classroom, and has friends he hangs out with regularly. However, most days of the week, he has felt feelings of hopelessness and low self-esteem, and these feelings seem to have appeared out of nowhere a little over two years ago. This description aligns most with what disorder?

persistent depressive disorder (chronic, long-term form of depression characterized by a low or sad mood lasting most of the time for at least two years)

How is perinatal (postpartum) depression different from the “baby blues”?

“Baby blues” are common, mild mood changes (e.g., sadness, irritability, tearfulness) that typically resolve within about 2 weeks, whereas perinatal/postpartum depression involves more severe, persistent depressive symptoms that cause significant distress or impairment and may require treatment. “Postpartum depression” is not a diagnosis in the DSM; rather, someone would be diagnosed with major depressive disorder with perinatal onset.

What is premenstrual dysphoric disorder?

PMDD involves severe mood and emotional symptoms that occur before menstruation, improve shortly after menstruation begins, and cause significant distress or impairment

What are some thinking traps that are specific to depression?

Minimizing (downplaying the importance of any success); self-blaming (blaming yourself when things gos wrong); mental filtering (hyper-focusing on negative details in a situation); should and must thinking (believing things can only be a certain way); labeling (applying a negative label to yourself)

What are the 3 types of depressogenic attributional styles?

Internal (it’s bc of something about me); global (everything in my life is a failure); stable (I will always be like this)

What is rumination?

excessive, repetitive thinking about an event

What are examples of medications that treat depression?

Tricyclic antidepressants (more side effects than SSRIs); selective serotonin- reuptake inhibitors (side effects include sexual dysfunction and weight gain); serotonin and norepinephrine reuptake inhibitors (side effects include nausea and fatigue); and monoamine oxidase inhibitors (dietary restrictions needed to avoid dangerously high blood pressure).

When someone has treatment-resistant depression (meds have not worked) what kinds of alternative treatments are there?

Transcranial magnetic stimulation, electroconvulsive therapy, deep brain stimulation

Give an example of behavioral activation?

Behavioral activation involves increasing activities that are associated with positive experiences/engagement. Examples may include: exercising, going to walk around a garden, reading a book, or spending time with friends or loved ones.

What are some common techniques used when using interpersonal therapy?

clarifying communication, exploring emotions in relationships, problem-solving strategies for role transitions/disputes, and building social supports

Whats the difference between a manic episode and a hypomanic episode?

A manic episode is a mood disturbance associated with persistently increased activity or energy lasting at least 1 week. The mood disturbance must be severe (e.g., marked impairment, hospitalization, psychotic features). A hypomanic episode is a change in functioning (increased activity/energy) that is observable by others but not severe enough for hospitalization and lasting for at least 4 days.

What is the difference between bipolar I and bipolar II?

For Bipolar I Disorder, episodes meeting full criteria for mania are necessary for diagnosis; major depressive episodes and hypomanic episodes can occur but are not required for diagnosis. For Bipolar II Disorder, both major depressive episodes and hypomanic episodes are necessary for diagnosis.

What are the criteria for cyclothymic disorder?

For at least 2 years there are numerous periods with hypomanic symptoms that do not meet the criteria for a hypomanic episode and numerous periods with depressive symptoms that do not meet the criteria for a major depressive episode. Symptoms must be present for at least half the time and no symptom-free periods longer than 2 months.

Who is most at risk of having a bipolar disorder?

People with a family history of bipolar disorder are at greatest risk, particularly those with a first-degree relative (such as a parent or sibling) with the disorder. Onset typically occurs in late adolescence or early adulthood.

What are some social factors that can cause mood disorders?

For depressions, examples might be interpersonal loss, or major role disruption (job loss). For bipolar disorder, examples might be schedule-disrupting events, goal attainment, or substance use.

The ________ of stressors and the ________ to stressful event increase the risk for mood disorders.

length of time, number of exposures

Why do some uncontrollable event affect some people more than others, leading to mood disorders?

Some people may have cognitive vulnerabilities, which can contribute to maladaptive coping mechanisms or thinking traps/cognitive distortions.

What part of the brain may increase rumination when there is increased activity in that area?

Anterior cingulate cortex (ACC), which handles the connection between emotion and attention; increased activity may mean the person with depression has a harder time distracting themselves onto other tasks/topics.

A woman who was born into a family with a history of depression recently went through a divorce. She is now experiencing persistent feelings of sadness and hopelessness. This is an example of our:

genes interacting with the environment

How would you define suicidal ideation?

suicidal ideation refers to thoughts about suicide

Asking about suicidality increases the risk of suicide

false

What are the things a patient can put down on a saftey plan if they are experiencing thoughts and/or are at risk of suicide?

Warning signs, internal coping strategies, people or social environments that can provide distraction, emergency contacts (both personal contacts and professional contacts), and a plan to make the environment safe.