Psych Final Exam

Sources and possible causes of stress

• Major Life events (weddings, having a baby, graduation) 

• Catastrophes (natural disasters, crime, death) 

• Daily hassles 

  • Frustration, pressure 

• Conflict 

  • Approach-avoidance conflict 

Approach-avoidance conflict

Deciding whether to adopt a pet is a good example of an approach-avoidance conflict. Having a cute and cuddly companion sounds amazing (approach). In contrast, dealing with the responsibilities like cleaning up messes and taking care of the pet can become tedious (avoidance). This kind of conflict has both pros and cons in one decision, which makes it pretty stressful and thought provoking when figuring it out. 

Physical reactions to stress

Sympathetic nervous system 

• Immunosuppression 

  • Stress messes with the immune system. When you're stressed, your body releases hormones that temporarily suppress immune function. This can be helpful in short bursts, but chronic stress weakens your immune system over time, making you more prone to infections and illnesses. Studies have shown that during stressful times, like exams or emotional events, your immune response drops. Managing stress is crucial because it helps keep your immune system strong and more effective at fighting off diseases. 

Psychological reactions to stress

• Changes in emotions, motivations, cognitions 

• Anxiety 

• Depression 

• Anger, irritability 

• Change in appetite and interest for sex 

How stressful; an event is depends on

• Whether it is desirable. 

• Whether it is involuntary or a choice (having control over something) 

• Whether it is scheduled or unexpected.  

• Age/experience 

• Gender (women ruminate/overthink, socialized as more stressed) 

• Education level (better resources) 

• Race 

• Social support

Assessing Stress

Primary Appraisal – how you think about or interpret the stressful event 

• Irrelevant 

• Positive 

• Threat, harmful, challenge-emotions follow 

Secondary Appraisal – take into account the resources available to cope with stressor 

Effective ways of coping w/ stress

Exercise – Imagine a calm environment – Develop social support 

Progressive relaxation – Try to be optimistic – talk with friends 

Meditation – Be spiritual, Laugh, Manage time wisely – Find community 

• Problem-focused: aimed at controlling or altering the environment 

• Cognitive coping w/ reappraisal – alter our interpretation of the event 

  • Reframe problem: manage emotional reactions 

Ineffective ways of coping w/ stress

• Withdrawal 

• Aggression 

• Self-medication 

• Defense mechanisms (Denial/Repression Rationalization Displacement) 

Abnormal behavior

Actions, thoughts, and feelings that are harmful to the person or others 

• Cause psychological discomfort 

• Cause lack of functioning 

• Is not culturally expected 

Doesn’t necessarily mean unusual or strange 

• e.g. cigarette smoking: common, but harmful

Continuous vs. Discontinuous hypothesis of abnormal behavior

Discontinuity Hypothesis – you have it or you don’t 

Behavior may be viewed on a continuum (continuity hypothesis) 

Historical views of mental illness: supernatural theory

Resulted in harmful treatments 

Historical views of mental illness: biological theory

• Ancient Greece: four humors of body 

• Made effective drug therapies possible 

Historical views of mental illness: psychological theory

Freud revived the theory; able to compete with supernatural and biological approaches 

DSM

The Diagnostic and Statistical Manual (DSM-5) 

• Published in 2013 

  • List 20 categories of disorders 

  • Covers more than 300 disorders 

  • Lists diagnostic criteria for each disorder 

  • Continues to show improved reliability and validity 

• Note that having standards does not guarantee a correct diagnosis 

Panic Anxiety Disorder

Acute physiological response, fear of places where escape is difficult 

Ex: Alan was rushed to the emergency room last night because all of the sudden he couldn’t breathe.  He felt like the walls were closing in on him and he was going to die. 

Post Traumatic Stress Disorder (PTSD)

DSM Criteria: 

1. Exposure to a traumatic event 

2. Persistent re-experience of that event 

3. Avoid cues to that event 

4. Symptoms of sympathetic nervous system arousal 

5. Disturbance causes interference in daily functioning 

   • Keeping a job 

   • Social difficulties 

   • Physical Symptoms 

   Ex: Rufus was the victim of a horrible violent crime. Since that night he has been unable to sleep or concentrate.  Sometimes being in that neighborhood takes his mind back to that night and horrific things that unfolded there. 

Obsessive Compulsive Disorder (OCD)

Ex: Sally can’t let her purse touch the floor of the restaurant. She must hold it in her lap to keep it from being contaminated by all of the germs.  She will take it home and wash it again just in case something touched it.  She should shower too—you never know, germs are everywhere!  

Obsessions

continuous anxiety-provoking thoughts

• are thoughts

Compulsions

irresistible urges to engage in behaviors

• are behaviors/actions to reduce the anxiety associated with obsessions

Somatization

Physical pain with no cause 

Ex: Ashley has severe back pain, but she’s been to 7 doctors and no one can tell her why her back hurts.  She’s had tons of medical tests and procedures, but nothing seems to emerge as the reason why she’s in pain.  

Illness Anxiety Disorder

Believe they have disease they don’t have (hypochondriasis) 

Ex: “Do you feel this lump on my knee?  I know it’s a tumor, I bet I have less than a month to live.  That stupid doctor doesn’t know anything; he says it’s just a bruise”. 

Dissociative Amnesia

Memory loss due to a psychological cause (typically recover memory over time)

Ex: Diane was a victim of domestic abuse.  After one incident, she lost her memory of the incident and several hours afterward.  

Dependent Personality

Excessive need to be cared for by others, denies own thoughts and feelings 

Ex: Leigh is unable to make important decisions on her own, she is always having to ask others for help and support for every little thing.   

Agoraphobia

Acute physiological response, fear of places where escape is difficult 

Ex: Robert stays at home all of the time because is scared of crowds.  He is afraid if he goes out he will get in a situation where he cannot escape and get away safely, therefore he stays home.  

Major Depression

• Physical symptoms – loss of interest, sleep/appetite changes, fatigue, sluggish 

• Cognitive symptoms – inability to concentrate, feelings of worthlessness/guilt, thoughts of suicide 

• Symptoms must last at least 2 weeks 

Dysthymia – less severe, but more chronic form of depression (must last 2 years) 

Ex: Katherine has no joy in her life.  She used to love soccer, now she doesn’t care.  Life is a chore, getting out of bed is a chore, eating is a chore, she just wants to crawl in a hole and sleep.   

Bipolar

Involves a shift in mood between two states 

• Depression 

• Mania – euphoric state, lots of energy, high self-esteem, highly distractible, impulsive 

  • Can have delusions or hallucinations in severe forms 

Ex: To say Theresa is moody is an understatement.  Sometimes he feels on top of the world, like he can accomplish anything.  But a week later he can’t get out of bed to face his horrible life. 

Dissociative Identity Disorder

Once known as multiple personality disorder; very controversial issue

Ex: Brenda is told by her family that she acts very strangely, sometimes acting like a child and other times like a motorcycle gang member.  She has large chunks or her day and many incidents that others say happen that she cannot remember herself.  

Schizophrenia

• Uncommon disorder affecting men and women equally; genetic component 

• Usually appears in late adolescence/early adulthood. Gradually or with sudden break 

Symptoms: 

• Delusions 

• Hallucinations 

• Disordered behavior 

• Flat effect 

• Alogia (lessened speech) 

• Avolition (not following through on behavior) 

Ex: Dee thinks everyone is out to get her.  She’s sure that if she goes out in her yard at night she will be abducted by aliens.  That’s what happened to her cat, she saw the aliens in the garage and heard them communicating with the mother ship. 

Attention Deficit Hyperactivity Disorder (ADHD)

Ex: Sonya is always on the go.  She has trouble sitting still or doing any activity that requires a lot of mental focus. 

ADHD

Inattention 

• Cannot focus 

• Fails to see details 

• Careless mistakes 

• Highly distractible 

• Incomplete tasks 

• Often loses items 

• Disorganized 

Impulsivity/Hyperactivity 

• Often fidgets or squirms 

• Often leaves seat when should remain seated 

• Runs/climbs excessively 

• Difficult engaging in play/leisure quietly 

• Often interrupts/intrudes 

Antisocial Personality Disorder

Lack of impulse control, lie, manipulate, hurt others 

Ex: Scott is 27 years old, but has been arrested 14 times, living a life of crime even before he was 18 years old.  He feels very little remorse for his hurtful acts. 

Borderline Personality Disorder

Unstable/intense mood and interpersonal relationships 

Ex: Elizabeth has a record of very unstable relationships.  She started cutting herself when her last boyfriend broke up with her.  She has threatened to commit suicide multiple times in an attempt to keep him in the relationship. 

Dissociative Fugue

Complete loss of memory (even identity)

Ex: Matt used to have a wife and kids in Seattle, but he’s been arrested in NYC and can’t recall his former life at all.

Narcissistic Personality Disorder

Preoccupation with self importance, think they’re better than everyone else 

Ex: Debbie thinks she is better than everyone else.  She alienates people because she has a feeling that she is the most important person in every situation.  No one else’s opinion matters, but her own.  

Generalized Anxiety Disorder

Always anxious, many cues 

Ex: Nathan worries constantly about every little thing in his life.  Even the smallest confrontation makes him very stressed out.  He can’t deal with all of the worry brought on by the hassles in his everyday life. 

Specific Phobia

Certain trigger 

Ex: Susan is so afraid of doctors that she is unable to get the required physical and medical tests to get a job in her field.  Therefore, she is unemployed.    

Depersonalization

Distorted, unreal feelings, out of body experiences

Ex: Jimmy feels disconnected from himself, he feels like he is watching his life go by from the outside.

Conversion Disorder

Dysfunction of body system (e.g. blind, paralysis) 

Ex: After being violently sexually assaulted, Dee reports that she can no longer see.  Doctors have confirmed that she has nothing wrong with her eyes to cause her blindness. 

Factitious Disorder

(self or others): create symptoms that are not real 

Ex: Crystal drinks poisonous cleaners to make herself sick so that she can be admitted into the hospital and feel loved and cared for by the medical staff. 

Autism

Ex: Brooke has severe deficits in her communication skills. She doesn’t have friends at school and just prefers to sit by herself and rock back and forth. 

DSM Criteria for Autism

1. Severe impairments in reciprocal social interactions 

• Don’t seek interaction from others/lack of peer relationships 

• People treated like objects 

• Limited eye contact or interactive postures/gestures 

2. Significant language impairments 

• No language  

• Limited use and understanding of gestures/nonverbal cues 

• Echolalia 

3. Restricted and stereotypical behaviors related to a need for sameness in daily routine 

• Self-stimulating (rocking, hand-flapping) 

• Self-injury 

• Object fixation 

T1: Psychoanalysis psychotherapy

Founded by Freud 

• Root of all problems is in unconscious conflicts 

• Imbalance in id, ego, and superego 

  - Special therapy techniques may be used 

• Free association 

  • You’re given a word/sentence and can freely fill in the blank quickly with whatever comes to your mind. 

• Dream interpretation 

  • Sent home with a dream journal – interpret dream meanings 

T2: Humanistic psychotherapy

Founded by Carl Rogers 

Client-centered therapy 

• Emphasis on client’s ability to help self, feels emotionally safe enough to explore own hidden emotions 

• Therapist creates unconditional atmosphere (warmth, genuine positive regard, empathy) 

  -Technique:  

• Reflection – therapist makes statements to clarify client’s feelings and emotions 

T3: Cognitive-Behavior Therapy (CBT) psychotherapy

• Abnormal behavior is learned from inappropriate experiences 

• Goal is to “unlearn” these behaviors/break the cycle 

  -Examples: 

  • Graded exposure: series of increasingly fearful situations experienced 

  • Change faulty cognitions: maladaptive beliefs, expectations, and thinking 

  • Social skills training: teach use of adaptive skills enough to handle real-life situations 

Group therapy

Carried out with groups of 4 to 8 clients 

• Receives encouragement from others 

• Sees problem experienced by others 

• Learn from others’ advice 

• Learn new ways to interact with others 

Family therapy

Therapists’ goal to resolve problems by improving functioning of family system 

• Give family members insights 

• Increase warmth and intimacy in family 

• Improve communication 

• Help members establish reasonable set of rules for family regulation 

Ethical expectations for psychotherapy

• Rules and laws of confidentiality followed: if you’re a danger to yourself or others 

• Goals of treatment understood/agreed to by client; in best interest of client and society 

• Careful consideration given to alternatives 

• Therapist treats only within limits of expertise 

• Effectiveness of treatment must be evaluated 

• No abuse of therapist-client relationship 

Biomedical treatments: drug therapy

• SSRI – selective serotonin reuptake inhibitors for depression and anxiety (antidepression) comorbid disorders 

• Benzo (xanax) for anxiety 

• Mood stabilizers (lithium) for bipolar 

• Atypical antipsychotics for schizophrenia 

• There’s no pills for Narcissistic Disorders, Somatization, Conversion 

Biomedical treatments: ECT

passing an electrical current through the brain to induce seizures used to treat severe mental illnesses, primarily severe depression, but also schizophrenia, bipolar disorder, and catatonia.

Biomedical treatments: psychosurgery

Psychosurgery is a type of surgery used in rare cases to treat severe mental health problems, when all other treatments have failed. It's primarily used for obsessive-compulsive disorder (OCD), major depressive disorder (MDD), and generalized anxiety disorder (GAD).