Adult Psychopathology Exam 1

Psychological Disorder

Psychological disfunction within an individual associated with distress or impairment in functioning and a response that is not typical or culturally expected ex. Girl who fainted at the sight of blood

Psychological Dysfunction

Refers to a breakdown in cognitive (your train of thought, what your telling yourself ie. I am a failure if you get a bad test score), emotional (feeling distressed or anxious), or behavioral functioning (ie. people with OCD may go back to the stove every 2 hours to make sure its off)

Ex. if you are on a date, it should be fun but if you experence severe fear all evening and just want to go home, even though there is nothing to be afraid of , and the severe fear happens on every date, your emotions are not functioning properly

Distress or impairment

Distress: when the individual is clearly upset, but by itself this doesnt define a problematic behavior

Impairment: impacts daily life (ex. If you are so shy that you find it impossible to date or even interact with people and you make every attempt to avoid interationgs even though you would like to have friends, then your social functioning is impaired

Atypical

deviating from the norm, not sufficient enough to diagnose

Ex. lady gagas meat dress was atypical but that doesnt mean she has a mental health diagnosis

Ex. in mexican culture people talk to thier dead relatives

Not culturally expected

violating social norms

Ex. the practive of committing political dissidents to mental institutuons becuase they protest the policies of their government. Although such dissident behavior clearly violates social norms, it should not alone be sauce for commitment

The DSM (the diagnostic and statistical manual of mental disorders)

Describes behavioral, psychological, or biological dysfunctions that are unexpected in their cultural context and associated with present distress and impairment in functioning, or increased risk of suffering, death, pain, or impairment

prototypes/typical profiles

Psychopathology

The scientific study of psychological disorders

The scientists practitioner model

It combines best scientific evidence, patient values, and clinical experience

The scientist-practitioner model urges clinicians to allow empirical research to influence their applied practice; while simultaneously, allowing their experiences during applied practice to shape their future research questions

Types of careers

Clinical and counseling psychologists

Psychiatrists

Social workers

Psychiatric nurses

Marriage and family therapists

Mental health counselors

Evidence based practice

Consumer of the science

Enhancing the practice

Evaluator of science

Determining the effectiveness of the practice

Creator of science

Conducting research that leads to new procedures useful in practice

Clinical description

unique combination of behaviors, thoughts, and feelings that make up a specific disorder

presenting problem, statistics, course, onset, prognosis

Course

individual pattern ( ex. Schizophrenia follow a chronic course meaning they tend to last a long time, sometimes a lifetime

Onset

Acute onset: they begin suddenly

insidious onset: develop gradually over time

Prognosis

The anticipate course of a disorder (ex. The prognosis is good meaning the individual will recover)

Etiology

Study of orgins, has to do with why disorders begin and includes biological, psychological, and social dimensions

Causation

Correlation does not equal causation, it is often impossible to predict a single cause of something

Presenting problem

what the patient comes in with

Prevalence

how many people in the population have a specific disorder (%)

Statistical data: what makes a disorder different from normal behavior (ex. How many people in population as a whole have the disorder?)

The super natural tradition

Deviant behavior has been considered a reflection of the battle between good and evil

All physical and mental disorders were consided the work of the devil

The super natural tradition: treatments

Excorcism: various religious rituals were performed in an effort to rid the victim of evil spirits

Shaving the pattern of a cross in the hair of the victim

Torture and crude surgeries

The super natural tradition: Possession

Not always connected with sin but may be seen as involuntary and the possessed individual as blameless

The supernatural tradition: The moon and stars

Rejected notions of possessions by the devil suggesting instead that the movements of the moon and stars had profound effects on peoples psychological functioning (lunatic)

The super natural tradition: Stress and melancholy

Insanity was a natural phenomenon caused by mental or emotional stress and it was curable

Rest

Sleep

And a happy and healthy environment

Melancholy was the source of some bizarre behavior rather than demons

The biological tradition: Hippocrates

Hippocrates corpus: suggest that psychological disorders could be treated like any other disease

Psychological disorders may be casued by brain pathology or head trauma and could be influences by genetics

Considered the brain to be a seat of wisdom, consciousness, intelligence, and emotion

Precursor to somatoform disorders

the physical symptoms appear to be the result of a medical problem for which no physcial cause can be found, such a paralysis and some kinds of blindness

Hysteria and the wandering uterus

Wandered to various parts of the body in search of conception

cure=marriage

The biological tradition: Galen

Humoral theory of disorders

Normal brain functioning was related to four bodily fluids (humors

The biological tradition: humors

Blood: heart/ Sanguine (ruddy in complexion, presumable from copious blood flowing through the body and cheerful and optimistic, although insomnia and delirum were thought to be caused by excessive blood in the brain)

Black bile: spleen/ Melancholic (depressive→ caused by black bule flooding the brain)

Yellow bile: liver/ Choleric person (hot tempered)

Phlegm: brain/ Phlegmatic personality (indicated apathy and sluggishness but can also mean being calm under stress)

Discolor resulted from too much or too little of one of the humors (ex. Too much black bile was thought to cause melancholy

Treatments: environmental changes (heat, dryness, moisture, cold)

Early US Bio treatments: john Grey

Causes of insanity were always physical, therefore mentally ill should be treated as physically ill

Hospital conditions were greatly imporved but no individual care

Early US Bio treatments

Electrial shock was used and brain surgeries

Insulin schock therapy

Induced brain seizures for patients with schizophrenia

ECT→mini shocks to the brain producing convulsions

Psychotropic medications

Neuroleptics

Tranquilizers

Importance of syphilis

Believing everyone is plotting against you or that you are god, as well as other bizarre behaviors

Injected patients with malara virus

Tuskegee experiement

Inhumane syphilis experiement

Consequences of the biological tradition

Increased hospitalization

Untreatable conditions

Emil Kraepelin

Advocating the major ideas of biological traditions but he was little involved in treatment

Improved diagnosis and classification

The psychological tradition: Moral therapy

treating institutionalized patients as normally as possible in a setting that encourages and reinforces normal social interactions

Providing them with many opportunities for appropriate social and interpersonal contact

The psychological tradition: Dorothea Dix

Mental health hygiene movement

Improving standards of care

Made sure that everyone who needed care received it including homeless people

Unfortunately a unforeseen consequence was the number of mental patients

Origins of psychoanalysis: Anton Meser

suggested that the problem was casued by an undetectable fluid found in all living organisms called "animal magnetism" which could become blocked

Make patients sit in a room around a large vat of chemicals with rods extending from it and touching them

Mesmerism and hypnosis

Origins of psychoanalysis: Jean Charcot

Hypnosis as a treatment

Mentor to freud

Origins of psychoanalysis:

Furthered hypnosis treatments

Collaborator with freud

Found that patients often became extremely emotional as they talked and felt quite relieved and improved after emerging from hynotic state

Second found seldom would they have gained an understanding of the relationship between their emotional problems and their psychological disorder

Psychoanalysis

Unconscious mind

Cartarsis: release of emotional materal

The structure of the mind

The defense mechanisms

The stages of early psychosexual development that provide grist for the mill of out inner conflicts

Psychoanalysis: structure of the mind

The id: the source of our stong sexual and aggressive feelings or energies

Operates the pleausre principle with an overriding goal of maximizing pleasure and eliminating any associated tension or conflicts

Type of thinking: emotional, irrational, illogical, filled with fantasies and preoccupied with sex

Driven by: pleasure principle

The ego: ensures that we act realistically

Operates according to the realistic principle

Type of thinking: logic and reason

Driven by: reality principle

The superego: conscience, represents the moral principle

Nags us when we are doing something wrong

Counteract the potentially dangerous, aggressive, and sexual drives of the id

Type of thinking: conscience

Driven by: moral principles

If the go cannot mediate then intrapsychic conflicts will take over

Psychoanalysis: defense mechanisms (6)

Defense mechanisms: unconscious protective processes that keep primitive emotions unconscious with conflicts in check to that the ego can continue it's coordinating function

The ego fights to stay on top of the id and superego, conflicts sometimes produce anxiety that threatens the ego to ignite these defenese mechanisms

Ex. getting a bad grade on a test, you will blame the teacher for grading to hard then go yell at a store clerk

Repression: Blocks disturbing wished, thoughts, or experiences from conscious awareness (A child, who faced abuse by a parent, later has no memory of the events but has trouble forming relationships)

Denial: involves blocking external events from awareness (smoker refusing to admit to themselves it's bad for their health)

Projection: invloved indivisuals attributing thier own unacceptable thoughts, feeling and motives to another person (you might hate someone, but your superego tells you that such hatered is unacceptable. You can "solve" the problem by believing that they hate you

Displacement: satisfying an impulse with a substitue object (someone who is frustrated by their boss at work may go home and kick the dog)

Regression: this is a movement back in psychological time when one is faces with stress ( a child may begin to suck their thumb again or wet the bed when they need to spend time in the hospital)

Sublimation: satisfying an impulse with a substitute object in a social acceptable way ( sports is an example of putting our emotions into something constructive)

Psychoanalysis: psychosexual stages of development

Oral→ age: 0-1, focus of libido: mouth, tongue, lips, major development: weaning off breast feeding or formula ( adult fixation: smoking or overeating)

Anal→ age: 1-3, focus of libido: anus, major development: toilet training (adult fixation: orderliness, messiness)

Phallic→ age: 3-6, focus of libido:genitials, major development: resolving oedipus/electra complex (adult fixation:deviancy, sexual dysfunction)

Latency→ age: 6-12, focus of libido: none, mejor development:developing defence mechanisms (adult fixation: none)

Genital→ age:12+, focus of libido:genitals, major development:reaching full sexual maturity, (adult fixation: if all stages were successfully completes then the person should be sexually matured and mentally healthy

Psychoanalysis: then and now

Then: unearth inrapsychic conflicts

Long-term treatment model

Free association: patients are instructed to say whatever comes to mind without the ususal socially required cencoring

Dream analysis: interprets dreams, supposedly related the dreams to symbolic aspects of unconscious conflicts

Transference: patients come to relate to the therapist much as they did to important figures in their childhood

Now: Psychodynamic psychotherapy

Psychoanalysis: criticisms and contributions

Criticisms:

Pejorative terms (neurosis)

Unscientific

Untested

Contributions:

Unconscious processes

Emotions triggered by cues

Therapeutic alliance

Defence mechanisms

Humanism

Theoretical constructs:

Intrinsic goodness

Striving for self actualization: all of us could reach our highest potential, in all areas of functioning, if only we have the freedom to grow

Blocked growth: block our actualization bc of things like living conditions, stress, or interpersonal experiences

Humanism: Carl rogers

Client centerest therapy (person centered therapy): the therapist takes a passive role, making as few interpretationgs as possible, giving the individual a chance to develop during the course of therapy

Unconditional postive regard: the complete and almost unqualified acceptance of most of the clients feelings and actions

Empathy: sympathetic understanding of the individuals particular view of the word

Humanism: Abraham maslow

Hierarchy of needs

Bottom→ physiological (food, water, sex, sleep)

saftey/security (security of body, employment)

love/belonging (friendship, family, sexual intimacy)

Esteem ( self esteem, confidence, achievement)

Self actualization (morality, creativity, spontaneity, problem solving)

Behaviorism

basics of classical and operant and how they apply

Behaviorism: Pavlov

classical conditioning: a type of learning in which a neutral stimulus is paired with a response until it elicits that response (ex. UCS-UCR, CS-CR)

Stimulus generalization: response generalizes to similar stimuli

Ex. UCS=food/chemo, UCR=salvation/nausea, CS=chemo nurse, CR=nausea when seeing the nurse

Extinction: elimination of the CR

Behaviorism: John B Watson

Considered the founder of behaviorism

Little albert study: presented little albert with a harmless fluffy rat to play with, every time he would reach for the rat a loud sound would go off, he presented fear when the rat would come and eventually displayed fear around any white furry object, even a santa claus mask

Systematic desensitization: individuals were gradually introduced to the objects or situations they feared so that their fear could deline: that is they could test reality and see that nothing bad happened in the presence of the phobic object or sense

Behaviorism: BF skinner

operant conditioning: a type of learning in which behavior changes as a function of what follows the behavior

Reinforcement and shaping

Ex. if you want a pigeon to play pingpong first you provide it with a pellet of food every time it moves it's head slightly toward a pingpong ball until it touches it, finally receiving the food pellet it contingent on the pigeon hitting the ball back with it's head

Positive reinforcement: add something to increase behavior

Negative reinforcement: remove something to increase behavior

Positive punishment: add something to decrease behavior

Negative punishment: remove something to decrease behavior

Multiculturalism

the presence of, or support for the presence of several distinct cultural or ethnic groups within a society

Multicultural psychology

focuses on identity and its social context to help students view culture not as a minority issue, but a way of understanding all human experiences

Cultural competence

being aware of your own cultural beliefs and values and how these may be different from other cultures

Cultural humility

a personal lifelong commitment to self-evaluation and self-critque where by the individual not only learns about another's culture, but one starters with an examination of her/his own beliefs and cultural identities

Liberation Psych

a body of thought and practice centrally concerned with the experience, knowledge and action of those who have been excluded and marginalized.

Interactive approach

including biological, psychological, social factors

Multidimensional (biopsychosocial) model

any one component of the system inevitable affects the other components (biological, cognitive, emotional, behavioral, social, cultural environment)

One dimensional model

explains behavior in terms of single cause

Behavioral Genetics

Role of genes in psychological disorders

Genetic contributions cannot be studies in the absence of interactions with events in the environment that trigger genetive vulnerability or "turn on" specific genes

Diathesis Stress model

Diathesis(vulnerability) stress model: individuals inherit tendencies to express certain traits or behaviors, which may then be activated under conditions (environments) of stress

Diathesis: inherited tendency to express traits/behaviors→genetics

Stress: life events or contextual variables→enviroment

Combining both yields activations under the right conditions

Ex. janelle inherited a tendency to faint at the sight of blood

Gene enviroment correlation model

people behave in ways influenced by their genetic background, which affects exposure to a range of environmental risks that affect the development of psychopathology

Ex. some people with depression may seek out difficult relationships or other circumstances that lead to depression

Epgenetics: the study of how your behaviors and environment can cause changes that affect the way your genes work

Polygenetics: a characteristic, such as height or skin color, that is influenced by two or more genes

central nervous system

brain and spinal cord

parasympathetic nervous system

rest and digest" conditions

conserve energy

ex. Salivation: As part of its rest-and-digest function, the PSNS stimulates the production of saliva, which contains enzymes to help your food digest

Sympathetic nervous system

a network of nerves that helps your body activate its "fight-or-flight" response

ex. Heart: Increase your heart rate to improve the delivery of oxygen to other parts of your body

Somatic nervous system

controls voluntary muscles and conveys sensory information to the CNS (walking, lifting weights)

Autonomic nervous system

a component of the peripheral nervous system that regulates involuntary physiologic processes including heart rate, blood pressure, respiration, digestion, and sexual arousal

Parts of the central nervous system

Forebrain (cerebral cortex)

Most sensory, emotional, and cognitive processing

Two specialized hemispheres (left and right)

Frontal lobe: executive functioning (planning, focus, tasks)

Parietal lobe (touch, taste, temp)

Occipital lobe (vision)

Cerebellum (balance coordination)

Temporal lobe (hearing, memory, language)

Limbic system

Emotions (ex. by activating the fight or flight response, the limbic system triggers a physical response to emotional experiences such as fear)

Basic drives

Impulse control

Hypothalamus

acts as your body's smart control coordinating center. Its main function is to keep your body in a stable state called homeostasis. if the hypothalamus receives a signal that the internal temperature is too high, it will tell the body to sweat

Basal Ganglia

Motor activity, reward

Amygdala

We process threat, alerting to threat

Much more active in someone with PTSD

Hypocampus

short term to long term memory (It has a major role in learning and memory)

Olfactory

smell

Cingulate gyrus

helps regulate emotions and pain/physical response like touching something hot

Parts of the parasympathetic nervous system

Endocrine (Hormones, cortisol)

Sympathetic (fight or flight)

Parasympathetic (rest and digest)

Both divisions regulate

Cardiovascular system/body temp

Endocrine system/ digestion

HPA axis (hypothalamic-pituitary-adrenal axis)

mediates the effects of stressors by regulating numerous physiological processes, such as metabolism, immune responses, and the autonomic nervous system (ANS)

Neurotransmitters: reuptake

after a neurotransmitter is releases its broked down and brought back from the synaptic cleft into the same neuron that released it

Neurotransmitters: functions

Chemical messengers

Agonists: effectively increase the activity of a neurotransmitter my mimicking its effects

Antagonists: decrease or block a neurotransmitters

Neurotransmitters: Serotonin (5HT)

Widespread, complex circuits

Regulates: behavior, moods, thought processes

Low levels: low inhibition, instability, impulsivity

Neurotransmitters: Glutamate

Excitory transmitter that turns on many different neurons leading to action

Neurotransmitters: GABA

Inhibitory neurotransmitters (slows down brain), job is to inhibit or regulate the transmission of information and action potentials

Implicated in anxiety

Neurotransmitters: Norepinephrine

Stimulation of adrenaline

respiration , reactions, alarm response

Implicated in panic

Neurotransmitters: Dopamine

Implicated in schizophrenia, parkinson's disease

Pleasure seeking "feel good"

Implications in neuroscience

Treatments for mental health problems may now focus on the brain regions found to be relevant for these problems

Learned helplessness

When rats or other animals encounter conditions over which they have no control

But if the animals learn their behavior has no effect on their environment—sometimes they get shocked and sometimes they don't, no matter what they do—they become "helpless." In other words, they give up attempting to cope and seem to develop the animal equivalent of depression.

Learned optimism

if people faced with considerable stress and dif-ficulty in their lives nevertheless display an optimistic, upbeat attitude, they are likely to function better psychologically and physically.

Social Learning

learn just as much by observing what happens to someone else in a given situation. This fairly obvious discovery came to be known as modeling (or observational learning)

Prepared learning

we have become highly prepared for learning about certain types of objects or situations over the course of evolution because this knowledge contributes to the survival of the species

Ex. Even without any contact, we are more likely to learn to fear snakes or spiders than rocks or flowers, even if we know rationally that the snake or spider is harmless

Implicit memory

Acting on the basis of experienced that are not recalled

Nature of emotions

To elicit or evoke action

Related to physical health

Emotion

action tendeny to behave in a certain way (ex. escape), elicited by an external event and a feeling state and accompanied by a characteristic physiological response

Mood

more persisten period of affect or emotionality

Affect

(what you show on your face or body language) valence dimensions (pleasent or positive versus unpleasant or negative) of an emotion

For example, positive affect is experienced during joy, whereas negative affect is experienced during anger and fear.

Emotion parts: Behavior

basic patterns of emotion differ from one another in fundamental ways; for example, anger may differ from sadness not only in how it feels but also behaviorally and physio-logically. These scientists also emphasize that emotion is a way of communicating between one member of the species and another.

Ex. One function of fear is to motivate immediate and decisive action, such as running away. But if you look scared, your facial expression will quickly communicate the possibility of danger to your friends, who may not have been aware that a threat is imminent. Your facial communication increases their chance for survival because they can now respond more quickly to the threat when it occurs.

Emotion parts: physiology:

Emotion is a brain function involving (generally) the more primitive brain areas. Direct connection between these areas and the eyes may allow emotional processing to bypass the influence of higher cognitive processes.

Emotion parts: cognition

Appraisals, attributions, and other ways of processing the world around you that are fundamental to emotional experience

Ex. For example, if someone sees a person holding a gun in a dark alley, they will probably appraise the sit-uation as dangerous and experience fear. But they would likely make a different appraisal if they saw a tour guide displaying an antique gun in a museum.

Emotion issues

basic emotions of fear, anger, sadness or distress, and excitement may contribute to many psychological disorders and may even define them.

Healthy expression--> ex. we all feel anger, some of us bottle it up and some people say that they are angry. Healthy expression=the middle range, expressing it in a way that's healthy for you

Timing of emotional responses--> ex. panic, when panic attacks happen it can be right response wrong time

Degree of response--> too much, mania is when you are too over the moon and grandiose

Relationship between mood and cognitions --> reciprocal cycle ex. if you wave to someone in the dining hall and they don't see you you might think they didn't see you or they are mad at you. if you think they are mad at you you might respond stressed, or anxious, you might check in on them the next time you see them

ex. someone cuts you off when your driving, you think: they are in a rush, i almost crashed, they broke the law, your behaviors are based on how you interpret the situation

Social effects on health and behavior

Social effects on health and behavior:

- Frequency and quality of social contact or critical (doesn't mean you have to have 100 friends)

Low social contacts:

- Higher mortality/lower life expectancy

- Higher psychopathology (mental health issues)

Problems with social stigma

Social taboo about having a mental illness

May limit the degree to which people express mental health problems

May discourage treatment-seeking

Maintains the cycle of pathology

Global Incidence of Psychological Disorders

- disorders are common across cultures accounting for 13% of global burden of disease

- rates and expression vary

- treatment depends on views and provider availability

Cultural impacts on expression/mental illness

Cultural factors:

Influence form and expression of behavior

Influence on objects of fear

in communities of color we tend to see higher rates of somatic symptoms