Psychopathology

How do we define psychological abnormality?

The scientific study of abnormal behavior undertaken to describe, predict, explain, and change abnormal psychological patterns of functioning

Distress

 Unpleasant and upsetting to the person

Danger

risk of harm to self or others

Deviance

Different, extreme, unusual, bizarre, outside of cultural norms

Dysfunction

Interfering with the ability to constructively conduct daily actions

List and describe Jerome Frank’s essential features of treatment.

A sufferer (client) who seeks relief from the healer (clinician)

A trained, socially accepted healer (clinician)

 A series of contact between healer (clinician) and sufferer (client)

How was mental illness viewed/treated in The Stone Age?

Utilized trephination (a procedure where a circular section of the skull was cut away with a stone instrument called a trephine) to treat abnormal behavior by releasing evil spirits/demons

How was mental illness viewed/treated in Ancient Greece/Rome?

Hippocrates taught that mental illness was caused by internal, physical problems

Imbalance of four humors: Yellow bile, Black bile, blood phlegm

How was mental illness viewed/treated in The Middle Ages?

Scientific exploration or alternative explanations for mental illness were discouraged by the clergy and the church

Demonological explanations of mental illness increased

Mass Madness outbreaks occurred where large groups experienced similar hallucinations and delusions

How was mental illness viewed/treated in The Renaissance?

Demonological views of mental illness declined and came for mental disorders improved

Asylums were created to care for individuals with mental illness, poor treatment

What is moral treatment? How has its popularity changed throughout history?

Pinel and Tuke’s methods were called moral treatment. Moral treatment declined by the end of the 1800s due to a lack of resources resulting from how fast the movement spread, the lack of “cured” patients, and the increased stigma around mental illness.

Compare and contrast the somatogenic and psychogenic perspectives.

The Somatogenic Perspective is the view that abnormal psychological functioning has physical causes and the psychogenic perspective is the view that the main causes of abnormal functioning are psychological

How did the use of psychotropic medication affect institutionalization?

It is an effective medication that led to deinstitutionalization (released from hospital) and more outpatient treatments.

How is treatment today different than it was a century ago?

Hospitalization is brief and followed by outpatient care and medication. Outpatient care is the primary mode of treatment. Focus on prevention.

What are the common characteristics of treatment today?

Urgent psychiatric care. Residential treatment programs. Treatment style housing

How does insurance impact treatment?

Most plans cover private psychotherapy. Managed care programs. Insurance company determines key issues like choice of therapist. Length of sessions, type of therapy, and the cost.

Case studies

detailed accounts of a specific person’s life and mental health struggles/treatment.

Correlational studies

One time point, large sample sizes, can observe, and explain the relationship.

Experimental studies

have independent variables and dependent variables. A variable is manipulated and its effect and another variable is observed. Confound is a variable that also affects the DV

What types of abnormal neurological activity are associated with mental disorders?

Abnormal levels of neurotransmitters. Low levels of serotonin (Depression), norepinephrine (Anxiety), and glutamate (Insomnia)

Explain one theory about the source of biological abnormalities associated with mental disorders.

A mutation- an abnormal form of appropriate gene emerges by accident.

What are the three forces that Freud hypothesized shape personality? ID

Pleasure Principle. Always seeks gratification and is driven by sexual energy

What are the three forces that Freud hypothesized shape personality? Superego

Morality Principle. Sense what is wrong and based on learned ethics and morals

What are the three forces that Freud hypothesized shape personality? Ego

Mediator Reality Principle. The knowledge of when it is or isn’t acceptable to express id Impulses.

What does psychodynamic therapy look like today?

Seeks to uncover past traumas and resultant inner conflict. Free association- examining thoughts, feelings, or images that come to the patient’s mind

Describe the history of the cognitive-behavioral model.

Focuses on the interplay between behaviors and thoughts as well as the impact it has on the person's feelings and emotions. Albert Ellis and Aaron Beck proposed that abnormal functioning is best treated by cognition and behaviors.

Compare and contrast the three different forms of conditioning. Classical conditioning

Learning through temporal associations

Compare and contrast the three different forms of conditioning. Operant Conditioning

Learning through consequences

Compare and contrast the three different forms of conditioning. Modeling

Learned by watching others experience the consequences.

What are the four different forms of operant conditioning? Name and describe each. Positive Reinforcement

Increase a behavior by adding a stimulus

What are the four different forms of operant conditioning? Name and describe each. Negative Reinforcement

Increase a behavior by taking away a stimulus

What are the four different forms of operant conditioning? Name and describe each. Positive Punishment

Decrease a behavior by adding a stimulus

What are the four different forms of operant conditioning? Name and describe each. Negative Punishment

Decrease a behavior by taking away the stimulus

Describe how thoughts, behaviors, and actions are intertwined according to CBT.

The event plays a role in the thoughts, behaviors, and feelings. They all affect each other

Name and describe two new-wave cognitive behavioral therapies. Acceptance and Commitment Therapy (ACT)

Accepting problematic thoughts without judging them, acting on them, or trying to change them.

Name and describe two new-wave cognitive behavioral therapies. Mindfulness Meditation

Teaching individuals to pay attention to their thoughts and feelings as they flow through their mind without judging them

Compare and contrast the humanistic and existential models. Humanistic Model

Believe that people are good (friendly, cooperative, and constructive) and have the drive to self-actualize (fulfill their potential for goodness and growth) through honest evaluation of strengths and weaknesses

Compare and contrast the humanistic and existential models. Existential Model

Believe in the importance of authenticity (having an accurate awareness of oneself and living meaningfully) freedom of choice, self-determination, and responsibility

What are the different stages of prevention in community treatment? Name and describe each.

Emphasizes Primary, Secondary, and Tertiary Prevention

Why are multicultural treatments important?

Two features of treatment can increase effectiveness among minority clients.

Greater sensitivity to cultural issues

Inclusion of cultural morals and models in treatment.

Name and describe two specific multicultural treatments. Culture- sensitive therapy

Approached that are designed to help address the unique issues faced by members of cultural minority groups

Name and describe two specific multicultural treatments. Gender-sensitive therapy

Approaches geared to the pressure of being a female or gender minority in society

How does the developmental psychopathology perspective integrate all the models?

Developmental Psychopathology utilizes a development framework to understand how variables and principles from the various models may collectively account for human functioning

Provide one example of equifinality and one example of multifinality. Equifinality

Many pathways to get the same psychological disorder

Depressive symptoms in one person can be because of low serotonin levels while the other person can be going through a divorce.

Provide one example of equifinality and one example of multifinality. Multifinality

One Stressor can lead to different outcomes

Trauma can lead to one developing PTSD, depression anxiety, nothing, etc.

What is the purpose of clinical assessment? Clinical Assessment-

Utilize to determine whether, how, and why someone is behaving abnormally and how they can be helped 

What are the three main clinical assessment techniques? Name and describe each.

Clinical interviews, Test , and observations

What is the purpose of standardization?

The process in which a test is administered to a large group of people whose performance then serves as a standard or norm against which any individual’s score can be measured

Compare and contrast reliability and validity. Reliability:

A measure of the consistency of test or research results

Compare and contrast reliability and validity. Validity

A measure of the accuracy of the results of a test or study

Name and describe two different types of reliability. Test-Retest Reliability:

Produces similar results each time it’s administered to the same person

Name and describe two different types of reliability. Interrater (interjudge) reliability:

Different judges/ raters score and interpret the test similarly

Name and describe three different types of validity. Face validity

Appears to make sense and seems reasonable

Name and describe three different types of validity. Predictive Validity

Able to predict future characteristics or behavior

Name and describe three different types of validity. Concurrent validity

The degree to which the measures gathered from one tool agree with measured gathered from other assessment techniques

What is the difference between a structured and unstructured clinical interview? Unstructured

Primarily open-ended questions. Questions generated during the interview

What is the difference between a structured and unstructured clinical interview? Structured

Specific, pre-prepared questions.

Name three limitations of clinical interviews.

May lack validity/ accuracy

Interviewer may be bias may lead to judgment errors

May lack reliability

Name and describe each of the six primary types of clinical tests. For each type of clinical test, list strengths and weaknesses of the clinical test and provide at least one example. Projective Test

A test consisting of ambiguous material that people interpret or respond to

Name and describe each of the six primary types of clinical tests. For each type of clinical test, list strengths and weaknesses of the clinical test and provide at least one example. Thematic Apperception Test:

Clients often identify with one of the characters and their story reflects the client’s circumstances, needs, and emotions (black and white photos)

Name and describe each of the six primary types of clinical tests. For each type of clinical test, list strengths and weaknesses of the clinical test and provide at least one example. Sentence Completion Test:

Participants complete a series of unfinished sentences to generate discussion and relevant topics

Name and describe each of the six primary types of clinical tests. For each type of clinical test, list strengths and weaknesses of the clinical test and provide at least one example. Rorschach test

Hermann Rorschach dropped ink on paper, folded it in half, and asked what clients saw. Responses correspond with condition

Name and describe each of the six primary types of clinical tests. For each type of clinical test, list strengths and weaknesses of the clinical test and provide at least one example. Draw-A-Person Test (DAP):

Client is asked to draw a person and then to draw a person of the opposite sex

Name and describe each of the six primary types of clinical tests. For each type of clinical test, list strengths and weaknesses of the clinical test and provide at least one example. Psychophysiological Test

A test that measures physical responses as possible indicators of psychological problems

Compare and contrast four different neuroimaging techniques. Electroencephalogram (EEG):

Records brain waves, can’t pinpoint where brain activity happens

Compare and contrast four different neuroimaging techniques. Computerized axial tomography (CAT scan):

Computerized axial tomography (CAT scan): X-rays of brain structure are taken at different angles and combines

Compare and contrast four different neuroimaging techniques. Positron emission tomography (PET scan):

Provides a computer-produced motion picture of chemical activity through the brain

Compare and contrast four different neuroimaging techniques. Magnetic resonance imaging (MRI):

A procedure that uses the magnetic property of certain hydrogen atoms in the brain to create a detailed picture of the brain's structure.

Name and describe the three types of clinical observations. Overload

The observer is unable to see or record all important behaviors and events

Name and describe the three types of clinical observations. Observer drift

A steady decline in accuracy as a result of fatigue or of a gradual unintentional change in the standards used when an observation continues for a long time

Name and describe the three types of clinical observations. Observer bias

The observer’s judgments may be influenced by information and expectations they already have about the person

How do clinicians make a diagnosis?

Assessment data and clinical picture are utilized to make a diagnosis

Compare and contrast the two major mental illness classification systems. DSM5

Most widely used classification system in North America. The current edition is the DSM-5-TR

Compare and contrast the two major mental illness classification systems. ICD11

Lists both medical and psychological disorders. Developed by World Health Organization.

The DSM-5-TR includes categorical and dimensional information. What does this mean?

The name of distinct category (disorder) indicated by the client’s symptoms. Anxiety and depressive disorders are most frequently diagnosed. May receive multiple diagnoses

Why is evidence-based treatment important?

A movement in the clinical field that seeks to identify which therapies have received clear research support for each disorder. To develop corresponding treatment guidelines, and to spread such information to clinicians.

What are the three questions that therapy outcome studies primarily investigate? What have we learned about the efficacy of research while investigating these questions?

1.     Is therapy in general effective? Therapy often is more helpful than no treatment or placebos

2.     Are particular therapies generally effective? Research indicates that the major forms of therapy are superior to no treatment or placebo treatment

3.     Are particular therapies effective for particular problems? Different disorders often respond to differently to certain types of therapy

What barriers are there to accessing clinical assessment tools?

Rising costs and economic factors often prohibit people from using clinical assessment tools.

What is the difference between fear and anxiety?

Fear is a response to immediate threat

Anxiety is anticipatory, out of proportion to environmental threats, a sense of being in danger (worry)

What are the key features of Generalized Anxiety Disorder (GAD)?

Excessive unrelated to panic attacks or obsessions that the individuals has difficulty controlling

Must be accompanied by at least 3 of the following: Restlessness/agitation, poor concentration, irritability, muscle tensions/headaches, poor sleep

Symptoms last at least 6 months

How do the sociocultural, psychodynamic, humanistic, cognitive-behavioral, and biological perspectives conceptualize and treat Generalized Anxiety Disorder? Sociocultural

Result of living in dangerous or stressful situations

How do the sociocultural, psychodynamic, humanistic, cognitive-behavioral, and biological perspectives conceptualize and treat Generalized Anxiety Disorder? Psychodynamic:

 

Freud’s beliefs; Unresolved anxiety or inadequate defense mechanisms developed in childhood

Treatment: Applying general psychodynamic techniques to GAD is only modestly effective (psychodynamic therapies)

How do the sociocultural, psychodynamic, humanistic, cognitive-behavioral, and biological perspectives conceptualize and treat Generalized Anxiety Disorder? Humanistic:

Denial of true thoughts, emotions, and behaviors. Lack of unconditional positive regard, overly critical of self, harsh-self standards. Self-judgments break through and cause anxiety.

Treatment: Client-centered therapy

How do the sociocultural, psychodynamic, humanistic, cognitive-behavioral, and biological perspectives conceptualize and treat Generalized Anxiety Disorder? Cognitive-behavioral:

Anxiety caused by dysfunctional ways of thinking and problematic behavior

Treatment: Rational-emotive therapy helps clients identify and change irrational assumptions and thinking that contribute to GAD.

New-wave CBT: Provides psychoeducation on role of worrying and general observation of physiological arousal and the corresponding cognitive responses

How do the sociocultural, psychodynamic, humanistic, cognitive-behavioral, and biological perspectives conceptualize and treat Generalized Anxiety Disorder? Biological

People with GAD have overactive fear circuits.

Treatment: Drug therapies- Benzodiazepines

What perspectives most effectively treat Generalized Anxiety Disorder?

Cognitive-behavioral Therapy

Which disorder is associated with irregularity in the fear circuit?

Generalized Anxiety Disorder (GAD)

What are the key features of phobias?

Persistent and unreasonable fears of particular objects, activities, or situations

List three ways that phobias differ from regular fears.

More intense and persistent, greater desire to avoid, distress interferes with functioning.

What does it mean if a phobia is “specific?”

Most phobias are “specific,” but there are a few broad categories.

Specific objects or situations, immediate fear upon presentation of the phobic stimulus

Name and describe two different causal explanations of phobias from the cognitive-behavioral perspective.

Classical conditioning: People learn to fear objects through classical conditioning. Individuals avoid feared objects, which worsens their feelings

Modeling: People observe that other people are afraid of objects/events and imitate that fear

What does the behavioral-evolutionary explanation posit that phobias evolved?

Genetic predisposition might have been passed down through an evolutionary process, as those who feared certain things might have been more likely to survive and reproduce

What is the gold standard treatment for phobias?

Cognitive-behavioral approaches are the gold standard

Compare and contrast desensitization, flooding, and modeling. Desensitization

Learn to relax while faced with a feared object or situation

Compare and contrast desensitization, flooding, and modeling. Flooding:

Forced, non-gradual exposure

Compare and contrast desensitization, flooding, and modeling. Modeling:

Therapist models interaction with feared stimulus and client may be encouraged to join

What are the key features of agoraphobia?         

Fear to get into situations that will make them feel unsafe or if there is no escape if one becomes panicked or incapacitated

What does treatment for agoraphobia look like?

Cognitive-behavioral therapy is most effective

What are the key features of social anxiety disorder?

Severe, persistent, irrational anxiety about social or performance situations, in  which they may face scrutiny by others and possibly feel embarrassment

How does the cognitive-behavioral perspective causally conceptualize social anxiety disorder?

Dysfunction cognitions and behaviors are associated with genetic predispositions, trait tendencies, biological abnormalities, traumatic childhood experiences, and overprotective parent-child interactions