Psychopathology Midterm #1 Study Set

For Dr. Natsuaki's PSYC 152 Class - Good luck everyone :D

Who is Thomas Szasz (1920-2012)?

Psychologist who argued that societies invented the concept of mental illness to control, change, or silence people who threaten the social order

What is Drapetomania? (1851)

A form of psychosis characterized by “an irrestrainable propensity to run away.”

What is the DSM-5TR’s definition of mental disorder?

Occurs within the individual, involves clinically significant difficulties in thinking, feeling, or behavior; involves personal distress of some sort; involves dysfunction in psychological, developmental, and/or neurobiological processes that support mental functioning

What are the three main historical perspectives on psychopathology?

Supernatural theories (divine intervention, curses, demonology, personal sin), Biological theories (Similar to physical disease, breakdown of some systems in the body), Psychological theories (disorder being the result of trauma(s)

In Hippocrates’ biological explanations of mental disorders, what are the 4 bodily humors and what do they stand for?

Blood (sanguine, cheerful), Phlegm (Stubborn), Black bile (melancholic, sad), Yellow bile (choleric, temperamental)

What was the Patient’s Rights Movements?

Movement that advocated for least restrictive environment for those in institutions

What was the Community Mental Health Movement?

Launched by Kennedy in 1963, it led to the 90% decline in the number of people in institutions and the increase of people in prisons

What is Stigma?

Destructive beliefs and attitudes held by a society that are ascribed to groups considered different in some manner (such as people believing children with ADHD are likely to be dangerous)

What did D.L. Rosenhan’s article “On Being Sane in Insane Places” find?

It was very easy to get institutionalized and very hard to get out of an institution once you were in it

Who was Phineas Gage?

A man who had a stake driven through his brain and survived

What are the biological perspectives of the causes of mental disorder?

Neuroscience: Structural Models, Neuroscience: Biological Models, and Genetic Models

What does the Neuroscience: Structural Model say causes mental disorder?

Abnormalities in the structure of the brain cause mental disorders

What does the Neuroscience: Biochemical Model say causes mental disorder?

Imbalances in neurotransmitters (within-brain communication) or hormones (brain-body communication) cause mental disorders

What does the Genetic Model say causes mental disorder?

Disordered genes lead to mental disorders

What are Neurotransmitters?

Chemicals that carry “information” across neurons

How do neurons transmit neurotransmitters?

The action potential of the neuron triggers the release of neurotransmitters into the synapse where they bind to receptors on another neuron, which sends the message across neurons

What changes in the levels of neurotransmitters can cause disorder?

In reuptake there can be too much/too little absorption back into the presynpatic terminal and in the synapse, there can be too much or too little neurotransmitter breakdown

What changes in neurotransmitter receptor density and sensitivity can cause disorder?

If there are too many receptors, there can be too much of the neurotransmitters effect, and if there are too few receptors, there can be too little of the neurotransmitters effect

What are the key neurotransmitters?

Serotonin (5-HT), Dopamine (DA), Norepinephrine (NE), Gamma-Aminobutryic Acid (GABA)

What does Serotonin (5-HT) do?

It is widely distributed through many areas of the brain and is important for emotion, impulse control, and information processing. It is implicated in anxiety, depression, and violence

What does Dopamine (DA) do?

Activity of this is associated with reward pathways in the brain, is affected by substances such as alcohol, and is implicated in addictive processes, schizophrenia, and motor disorders

What does Norepinephrine (NE) do?

Tends to increase activity. Cocaine and speed act on this system, and it is implicated in depression, anxiety, and stress responses

What does Gamma-Aminobutyric Acid (GABA) do?

Tends to reduce activity. Tranquilizers act on this system and activation of this reduces anxiety and aggression

What is the the Neuroendocrine System?

The relation between brain activity and glandular functioning in the body via hormones

What is the Hypothalamic Pituitary Adrenal (HPA) Axis?

Comprised of the Hypothalamus (controls the secretion pattern of the pituitary gland), the Pituitary Gland (lies below the hypothalamus, considered the “master gland” that regulates the secretion of hormones), and the Adrenal Glands (lies just above the kidney, hormones from the pituitary gland stimulate these to release cortisol

What is Behavioral Genetics?

The study of individual differences in behavior and personality that can be attributed, at least in part, to individual differences in genetics

What is a Genotype?

Genetic endowment (unobservable)

What is a Phenotype?

Genetic endowment + environmental influence (observable)

What is Molecular Genetics?

The study of candidate genes, DNA sequences, and mechanisms at the molecular levels to identify how specific genes are associated with behaviors

What is a Prefrontal Lobotomy?

Used to “calm” individuals with severe disorders (especially schizophrenia and individuals with violent behavior), it is a procedure in which the frontal lobes of the brain are severed from deeper centers underlying them

What is Repetitive Transcranial Magnetic Stimulation (rTMS)?

A procedure in which magnets are used to stimulate neural activity. Used for depression with left frontal magnetic stimulation

What is Electroconvulsive Therapy (ECT)?

A procedure in which an electric current is passed through the brain either unilaterally or bilaterally. Seems to reduce severe depressive episodes and possibly works by correcting imbalances in NT and endocrine systems

What are the main ways drugs change neurotransmission at the synapse?

Increases reuptake of neurotransmitter/blocks it, increases enzyme degradation of neurotransmitter/blocks it, activates the neurotransmitter receptor via a receptor agonist or blocks the receptor via a receptor antagonist

What are the main types of psychotropic medications?

Antidepressants, mood stabilizers, anxiolytics, antipsychotics

What is reductionism?

The view that whatever is being studied can and should be reduced to its most basic elements or constituents. It ignores the more complex view of behavior

What are the psychological perspectives of the causes of mental disorders?

Psychoanalytic, Psychodynamic/Neo-Analytic, Humanistic, Family Systems, Behavioral, Cognitive

Who were the founders of psychoanalytic theory?

Franz Anton Mesmer (“mesmerizing”), Jean Martin Charcot (hypnosis rendered valid form of treatment), Josef Breuer (Anna O. & The Talking Cure), Sigmund Freud (we should all know this guy at this point)

What does psychoanalytic theory believe about the structure of the personality?

All people have libido (basic drive). There are three parts of a person beyond that: Id (Pleasure principle), Ego (Reality principle), and Superego (Moral principle)

What does psychoanalytic theory believe about the structure of the mind?

There are three parts: Conscious (what you are aware of at the moment), Preconscious (what you can readily bring to mind), and Unconscious (things that are not (easily) accessible)

What is psychoanalysis?

A form of therapy in which a person goes through very intense treatment to access the person’s unconscious conflicts. Therapists who practice this believe that when the conflict is resolved, the symptoms will dissipate. Techniques to access the unconscious include free association and dream analysis)

What are the similarities and differences between neoanalytic and psychoanalytic models?

Similar in how they recognize unconscious determinants of behavior and emphasize early childhood experiences. Neoanalytic diverges in how it pays more attention to current life experiences + symptoms, places less emphasis on sexual determinants of behavior, views development as less deterministic, and focuses more on the “ego” than on the Id and Superego

Who pioneered Ego Psychology?

Anna Freud (daughter of Sigmund Freud)

What is Object Relations Theory and who pioneered it?

Theory that stresses the importance of long-standing patterns in close relationships, particularly within the family, that both shape and are shaped by the ways people think and feel. Pioneered by John Bowlby with the Attachment Theory

What is attachment theory?

Theory that early exchanges with caregivers form the basis of future relationships via internalized representations of relationships (i.e. inner working models). There are two classifications of attachment: secure and insecure

What does the humanistic perspective focus on?

Self-actualization (Fulfillment of one’s inherent potential for love, creativity, and meaning. Human motivation is driven by the need to achieve self-actualization and if this cannot be achieved it will cause anxiety) and client-centered therapy

What are the strengths and weaknesses of the humanistic model?

Strengths: Emphasis on competence and strength rather than disease and deficit, useful for those who are worried about themselves but are otherwise “well”
Weaknesses: Practically impossible to test, not very useful for those with significant psychiatric disturbance

What is family systems therapy comprised of?

Based on the belief that an individual’s problems are always rooted in interpersonal systems (particularly in family systems), the individual may not actually have a problem but has become the “identified patient” in the family that carries responsibility or blame for the dysfunction of the family system.

What are the strengths and weaknesses of family systems therapy?

Strengths: Useful for children
Weakness: Difficult to observe “in the lab”

What do behavioral models focus on?

Focuses on how people learn behavior (including symptoms), rejects the notion of unconscious forces (e.g. drives, conflicts) motivating behavior). Introduced the concept of maladaptive behavior.

What is maladaptive behavior?

The result of failure to learn adaptive behaviors and/or of learning maladaptive behaviors. These are behaviors that are not healthy.

How do behavioral models explain abnormal behavior?

They use learning theories: classical conditioning (Pavlov), operant (or instrumental) conditioning (Skinner), and social (or observational) learning (Bandura)

What is classical conditioning and who pioneered it?

Emphasizes associations between stimuli and response, pioneered by Pavlov

What is operant conditioning and who pioneered it?

Stresses the functional relation between behavior and rewards/punishments (e.g., addiction, gambling), pioneered by Skinner

What is Social Learning and who pioneered it?

Emphasizes the role of observing patterns of reward and punishment in the behavior of others (i.e., modeling), pioneered by Bandura

What does behavioral therapy entail?

Goal is to change a behavior by identifying the problematic behavior, discovering what reinforces the behavior, and then modifying the environment to extinguish the reinforcer for the unwanted behavior in order to begin reinforcing a more adaptive behavior. Tactics to decrease behavior include systematic desensitization and modeling. Tactics to increase behavior include token economy and response shaping.

What are the strengths and weaknesses of behavioral models?

Strengths: Very clear hypothesis with the capacity for empirical evaluation
Weaknesses: What about the person, their free will and agency, their thoughts and feelings?

What do cognitive models focus on?

Focuses on the idea that we actively construct our experience, fitting information into our understanding of the world (i.e., our cognitive schema). Key cognitions include causal attributions (how we explain why things happen), control theory (How much a person feels they can control their experience + self efficacy vs learned helplessness), and global assumptions (our beliefs about how things work or should be)

What are the different types of causal attributions, and which ones are problematic?

Location (Internal vs External), Temporal (Stable vs Temporary), and Global (Global vs Specific). Global, Stable, and Internal are problematic.

What does cognitive therapy entail?

Goal is to help the client identify, evaluate, and challenge their causal attributions, control theory, and global assumptions or beliefs, and to modify the schema to a more adaptive one. There are three main therapies under this umbrella: Rational Emotive (Behavior) Therapy (by Albert Ellis), Cognitive Therapy (for Depression, by Aaron Beck), and Cognitive-Behavioral Therapy (CBT)

What is Rational Emotive (Behavior) Therapy, and who pioneered it?

Therapy that focuses on irrational and illogical beliefs and attempts to modify the beliefs so that they are more rational and functional. Goal is to correct negative self-statements and self-defeating beliefs. Pioneered by Albert Ellis

What is Cognitive Therapy, and who pioneered it?

Therapy for Depression where the goal is to challenge ANTS (Automatic Negative Thoughts) by identifying the problematic thoughts and challenging the thoughts + considering alternatives. Pioneered by Aaron Beck who argued that depressed people have a negative bias/schema in their recall, attention, and interpretation of events.

What are the strengths and weaknesses of cognitive models?

Strengths: Efficacy rates can be measured and treatment tends to be shorter term. Has an appealing representation of humans as agentic rather than passive victims of stimulus-response associations or drives/instincts
Weaknesses: Lack of clear support for the core assertion that maladaptive cognitions cause psychopathology, need to understand where distortions come from in the first place, has a risk of blaming the victim, and how we think can change our behavior and feelings but also our behavior and feelings can change how we think so it can be confusing

What is the Integrative Model of Disorder?

A model that states that disorder is caused by any combination of two out of three factors, those factors being Biology, Psychology, and Social

What is the Diathesis-Stress/Differential Susceptibility Model?

A model that says disorder is comprised of three main ideas: That you can have an underlying predisposition (biological or psychological) that increases risk of developing disorder, stressors in your environment or life that can contribute to developing a disorder, and that psychopathology is unlikely to result from one single factor

What is Assessment?

The process of gathering information about people’s symptoms and the possible causes of these symptoms. Information gathered in an assessment is used to determine the appropriate diagnosis for a person’s problems

What is a diagnosis?

A label for a set of symptoms that often occur together

What does the value of an assessment depend on?

Reliability (degree to which a measurement is consistent), Validity (degree to which a technique measures what it is designed to measure), and Standardization (application of certain standards to ensure consistency across different measurements)

What are the 5 different types of validity?

Face Validity (Test appears to measure what it is supposed to measure), Content Validity (Test assesses all important aspects of a phenomenon), Predictive Validity (Test predicts the behavior it is supposed to measure), Construct Validity (Test measures what it is supposed to measure, not something else), and Concurrent Validity (Test yields the same results as other measures of the same behavior, thoughts, or feelings)

What are the 4 types of reliability?

Test-Retest Reliability (Test produces similar results when given at two points in time), Alternate Form Reliability (Two versions of the same test produce similar results), Internal Reliability (Different parts of the same test produce similar results), and Interrater/Interjudge Reliability (Two or more raters/judges who administer and score a test come to similar conclusions)

What are the 5 common types of assessments?

Interviews, Biological + Psychophysiological, Neuropsychological, Psychological, and Observational

What are interviews comprised of?

A series of either structured, semi-structured, or unstructured questions that aim to determine the presenting complaint, the duration of symptoms, the situations those symptoms occur in, the triggers that lead to symptoms, the impact that the symptoms have, and the context of the person’s life and the symptoms that may affect said person (those being social support, economic contexts, and cultural contexts)

What are biological assessments comprised of?

Physical exams, blood work, neurological exams (reflexes, perception, motor), imaging (tumor, brain activity)

What are psychophysiological assessments comprised of?

Electroencephalogram (EEG)(Brain wave activity), Cardiorespiratory activity (heart rate, blood pressure, respiration), Electrodermal response and levels (sweat gland activity)

What are neuroimaging assessments comprised of?

Assess the structure, the function, or both at once within the brain. Computerized Axial Tomography (CT), Magnetic Resonance Imaging (MRI) are structure assessments, Positron Emission Tomography (PET) scans are function assessments, and Functional MRIs (fMRI) assess both structure and function

What are neurophysiological assessments comprised of?

Tests used to detect specific deficits (such as a memory problem), tests used to assess a broad range of motor, cognitive, and memory skills + abilities, the Bender-Gestalt test

What are Psychological assessments comprised of?

Behavioral observation, Self-monitoring (tracking using modern technology, daily diaries, Ecological Momentary Assessment (EMA)), objective tests (Intelligence Tests, symptom questionnaires, personality inventories), projective tests (association tests (Rorschach Inkblot Test), construction (thematic apperception test, drawings), completion (sentence completion, story completion), expressive (play, handwriting))

What are the challenges we face in assessment?

Resistance and inability to provide information, difficulties in communication and reporting when it comes to evaluating children, training of interviewers and examiners, language barriers, translation issues, different cultural experiences of psychological disorders, cultural bias, cultural stereotyping

What are the reasons for and against diagnosis?

For: Description & Identification of symptoms, communication of symptoms, research, etiology, prognosis, treatment planning ,resource allocation
Against: Rigid, artificial/arbitrary, discrimination

Who pioneered diagnostic systems as a whole?

Emil Kraepelin, who introduced the first classification of schizophrenia and bipolar disorder, he based classification on common patterns/groups of symptoms (syndromes) and encouraged focus on course of illness to tease apart superficially similar syndromes

What are the differences between categorical and dimensional systems of diagnosis?

Categorical: Either you have a disorder or you don’t
Dimensional: You have a sliding scale of severity of a disorder

What is the DSM and what are the differences between the 1st edition and the 5th edition?

Stands for Diagnostic and Statistical Manual of Mental Disorders, the 1st edition was written in 1952, was 132 pages long, and have 128 categories of diagnoses. Costed $3, had a strong psychoanalytic emphasis, no explicit criteria for disorders, and was not very reliable or valid. The 5th edition was written in 2013 with 5-TR being written in 2022). There are 1050 pages in 5TR, it is research-oriented, aims to align with the WHO’s ICD system, makes efforts to be more culturally inclusive and sensitive, and has dimensional measures of symptoms

What is a mood disorder?

Also called “affective disorders,” these are mental disorders characterized by discrete periods of time where behavior is dominated by depressed (sadness, anhedonia, low energy, feelings of worthless, sleep/appetite disturbance) or manic (elevated, expansive, or irritable mood, inflated self-esteem, decreased sleep, increased activity) mood.

What are the Depressive Disorders (that we cover) and what are they characterized by?

Characterized by only depression, they are Major Depressive Disorder (MDD) and Persistent Depressive Disorder (dysthymia)

What are the Bipolar Disorders and what are they characterized by?

Characterized by Mania & usually Depression, they are Bipolar I, Bipolar II, and Cyclothymia

What are the symptoms of Major Depressive Disorder (MDD) and how long must they be present?

MUST HAVE: Depressed mood or loss of interest or pleasure in usual activities
Plus: Significant weight loss/gain or decrease/increase in appetite, insomnia or hypersomnia, psychomotor agitation or retardation, feelings of worthlessness or excessive guilt, fatigue or loss of energy, diminished concentration and trouble making decisions, recurrent suicidal ideation
Time Period: 5 or more symptoms must be present nearly every day over the same 2-week period

Is Grief MDD?

No, it may include symptoms of MDD but it is important to distinguish the normal process of bereavement. Self-esteem is preserved, intensity wanes over time, there is both sadness + pain and positive memories, there is a desire to “join” the deceased, and thoughts center around the deceased

What are the symptoms of Persistent Depressive Disorder (aka Dysthymia) and how long must they be present?

Time: Depressed mood most of the day and more than half the time for at least two years (1 year for children + adolescents), with no symptom-free period longer than 2 months
Must have 2 of the following: decrease or increase in appetite, insomnia or hypersomnia, fatigue or low energy, low self-esteem, diminished concentration, hopelessness

What are the symptoms of Manic Episodes and how long must they be present?

Time: Distinct period of abnormally and persistently elevated, expansive, or irritable mood AND persistently goal-directed activity or energy lasting most of every day for at least one week
Must have 3 or more of the following (but 4 if irritable): Inflated self-esteem or grandiosity, decreased need for sleep without feeling tired, more talkative than usual or pressure to keep talking, flight of ideas or feeling that thoughts are racing, increased distractibility, increased goal-directed activity or marked psychomotor agitation, excessive involvement in pleasurable activities that have a high potential for painful consequences

Hypomania has the same symptoms with shorter duration (at least 4 days) and milder intensity

What are the requirements to be diagnosed with Bipolar I?

At least one manic episode with major depressive episodes likely but not required

What are the requirements to be diagnosed with Bipolar II?

At least one major depressive episode, at least one episode of hypomania, and NO lifetime episode of mania

What are the requirements to be diagnosed with Cyclothymia?

Have more chronic yet less severe symptoms (2 years for adult, 1 year for children) of hypomania and mild depression, but NO lifetime history of MDD

What is Comorbidity?

The presence of two or more disorders in one person

What parts of the brain are affected by depression and what about them is affected?

The dorsolateral prefrontal cortex, the hippocampus, the amygdala, the anterior cingulate cortex, the subgenual anterior cingulate, and the striatum are all affected. Functioning of the dorsolateral prefrontal cortex, hippocampus, and striatum are diminished while functioning of the amygdala, anterior cingulate cortex, and subgenual anterior cingulate are elevated

What parts of the brain are affected by mania and what about them are affected?

The dorsolateral prefrontal cortex, the hippocampus, the amygdala, the anterior cingulate cortex, the subgenual anterior cingulate, and the striatum are all affected. Functioning of the dorsolateral prefrontal cortex and hippocampus are diminished while functioning of the amygdala, anterior cingulate cortex, subgenual anterior cingulate, and striatum are elevated.

When you have depression, what neurotransmitters are affected by low receptor sensitivity?

Dopamine (DA), Norepinephrine (NE), and Serotonin (5-HT)(Only for those with family history)

When you have mania, what neurotransmitters are affected by high receptor sensitivity?

Dopamine (DA) and Norepinephrine (NE)

How is the Hypothalamic-Pituitary-Adrenal (HPA) axis affected by depression and mania?

Will be overly reactive and slows to stabilize in depression and bipolar disorders, and cortisol spikes more easily in response to stress and takes longer to return to baseline levels. High levels of cortisol may inhibit neurotransmitter receptors for NE, 5-HT, and DA and excess cortisol can damage hippocampal neurons

What is the classic psychoanalysis view of depression?

Depression is anger (often toward others who have abandoned or hurt the individual) turned inward

What is the psychodynamic (neoanalytic) view of depression?

In the absence of true feelings of self-worth, those with insecure attachments believe that obtaining care is dependent on their behaviors. Dysfunctional beliefs follow from early experience. Insecure attachments lead to feelings of dependency and hypersensitivity to relationship loss, which leads to excessive reassurance seeking and perhaps increased rejection

What is the behavioral view of depression?

Emphasizes learned patterns of depression as a function of too many negative experiences and/or too few positive experiences. Depression follows from a reduction in events → withdrawal → fewer positive events. Uncontrollable negative events → learn that one cannot control situation → depression