ASU PSY 366 Unit Exam 1

Four criteria used to define abnormality:

Deviation, dysfunction, distress, and dangerousness

Cultural Relativism

there are no universal standards; culture influences what is normal and what is not

The continuum model of abnormality

there is no clear line between what is normal and what is abnormal, requiring subjective decisions about when a person has a disorder or not

Prevalence

Number or percentage of cases of a disorder in a population at any specific time.

Incidence

Number or percentage of new cases that have appeared within a specific time.

What are some ways prevalence and incidence estimates can be biased?

They can be biased based on:

-Sample (clinic vs. community) *community is more accurate*

-Measures (how administered, who responds)

-Diagnostic criteria (version of DSM, strictness)

Trephination

the process in which holes were drilled in the skulls of people displaying abnormal behavior, presumably to allow evil spirits to depart their bodies; performed in the stone age and into the middle ages

Psychic epidemics

phenomena in which large numbers of people begin to engage in unusual behaviors that appear to have a psychological origin

Deinstitutionalization

movement in which thousands of mental patients were released from mental institutions; a result of the patient's rights movement, which was aimed at stopping the dehumanization of mental patients and at restoring their basic legal rights. Advocates argued that patients could recover more fully or live more satisfying lives if they are integrated into the community, with the support of community-based treatment facilities.

Psychiatrists (MD or DO)

-Education: 4 years of medical school, 4-5 years of residency in psychiatry

-Powers: prescribe medications and perform biological interventions (ECT, etc.)

Psychiatric Nurse Practitioners (PNP)

-Education: 3-4 years graduate training post BSN, including clinical hours (700+)

-Powers: Prescribe medications and provide some psychotherapy

Clinical and Counseling Psychologists (Ph. D or Psy. D)

-Education: 4-6 years graduate school, including greater than or equal to 1500 hours of clinical training. 1 year full time clinical internship (>1500 hours) plus 1 year postdoctoral clinical training (>1500 hours)

-Powers: Conduct psychotherapy, psychological testing, research (can provide meds in 3 states with specialized training; Illinois, Louisiana, New Mexico)

Social Workers (MSW or LCSW)

-Education: 2 years graduate school including greater than or equal to 900 hours of clinical training

-Powers: Provide psychotherapy; connect people to resources

Licensed Professional Counselors (LPC)

-Education: 2 years graduate school including greater than or equal to 600 hours of clinical internship

-Powers: Provide psychotherapy, vocational counseling (occupation and skills), school therapy, etc.

Licensed Marriage and Family Therapist (LMFT)

-Education: 2 years graduate school plus 2 years supervised clinical experience

-Practice is generally focused on relationship (marital, parenting, sibling) counseling

Life Coaches, Spiritual Counselors, Life-Transition Therapists

-Education: None, no specific training required

-Not licensed

-No quality control

When is the median age of onset of psychological disorders?

Median age of onset: 14 years old

What is the median delay in treatment?

Median delay in treatment: 10 years

According to lecture and [MW] what percentage of people with psychological disorders receive treatment?

80% receive treatment

What percentage of those receive treatment from specialists in the area of psychological disorders?

Only 20% of those who receive treatment receive if from a mental health specialist

What is confirmation bias?

tendency to favor information that confirms (and ignores/minimizes information that does not confirm) one's perceptions or hypotheses; look for and accept information that affirms/suppose pre-existing beliefs and disregarding information that contradicts those beliefs, regardless whether that information is true

What is skepticism?

Process of subjecting claims to scientific scrutiny

What is a random sample? Why is it important?

Each individual is chosen entirely by chance and each member of the population has an equal chance of being included in the sample. It does not allow for bias and give a more representation/will be more similar to that of the population

What is a control group?

group of subjects whose experience resembles that of the experimental group in all ways except that they do not receive the key manipulation; acts as a comparison tool and allows for internal validity

Types of control groups?

no treatment control, wait list control, placebo control (strongest)

ABAB (reversal design)

single-case experimental design; intervention is introduced, withdrawn, and then reinstated and the behavior of the participant is examined both on and off the treatment. A=baseline, B=treatment; EX: depression medication, is depression level lower when patient was taking drug or not

Multiple baseline

type of study in which an intervention is given to the same individual but begun in different setting or is given to different individuals but at different point in time and in which the effects of the intervention are systematically observed. EX: testing if meditation reduced depression by teaching how to do at work and then at home

Case

in-depth analyses of individuals

Correlational

method in which researchers assess only the relationship between two variables and do not manipulate one variable to determine its effects on another variable

Epidemiological

study of the frequency and distribution of a disorder, or a group of disorders, in a population

Treatment outcome

experimental studies designed to test whether a specific therapy, a psychological therapy or a biological therapy, reduces psychopathology in individuals who receive it

Experimental design

studies in which the independent variables are directly manipulated and the effects on the dependent variable are examined

Single-case experimental design

experimental design in which an individual or a small number of individuals are studied intensively; the individual is put through some sort of manipulation or intervention, and his or her behavior is examined before and after the manipulation to determine the effects

Random assignment

assignment of participants in an experiment to groups based on a random process

Matching

process of finding participants who match characteristics and distributing them among groups

Meta-analysis

statistical technique for summarizing results across several studies

Strengths of Meta-analysis

overcome some of the problems resulting from small numbers of participants in an individual study by pooling the data from thousands of study participants

Weaknesses of Meta-analysis

methodological flaws, file-drawer effect

Effect size

statistic that indicates how big the differences are between two groups or how strong the relationship is between two continuous variables

File drawer effect

studies that do not support the hypothesis they are designed to test are less likely to get published than studies that do

Double-blind experiment

study in which both the researchers and the participants are unaware of which experimental condition the participants are in, in order to prevent demand effects

Clinical significance

practical importance of a treatment effect - whether it has a real genuine, palpable, noticeable effect on daily life.

Statistical significance

likelihood that a study's results have occurred only by chance

How is clinical significance different from statistical significance?

A correlation can be statistically significant because of the large sample, but it is so small as to suggest cause and effect on a general scale, or clinical significance

What kind of replication provides the strongest support of a particular treatment approach: replication by the same researchers or replication by other researchers?

Replication by other researchers provide the strongest support because it shows that the results can be obtained by others without bias and can be repeated without the use of the ones who created it or originally performed it. It removes bias performed from the original researcher.

Pseudoscience

consists of statements, beliefs, or practices that are claimed to be scientific and factual in the absence of evidence gathered and constrained by appropriate scientific methods. Pseudoscience is often characterized by the following: contradictory, exaggerated or unfalsifiable claims; reliance on confirmation bias rather than rigorous attempts at refutation; lack of openness to evaluation by other experts; and absence of systematic practices when developing theories.

Validity

degree of correspondence between a measurement and the phenomenon under study; the accuracy of a testing in assessing what it is supposed to measure

Face validity

on face value, the items seem to measure what the test is intended to measure

Content validity

the extent to which a test assesses all the important aspects of a phenomenon that is purports to measure

Concurrent (or convergent) validity

the extent to which a test yields the same results as other, established measures of the same behavior, thoughts, or feelings

Predictive validity

a test has this if it is good at predicting how a person will think, act, or feel in the future

Construct validity

the extent to which a test measures what it is supposed to measure and not something else altogether

Reliability

degree of consistency in a measurement, this is, the extent to which it yields accurate measurements of a phenomenon across several trials, across different populations, and in different forms; indicates consistency in measuring what it is supposed to measure

Test-retest reliability

describes how consistent the results of a test are over time

Alternate form reliability

when people's answers to different forms of a test are similar

Internal reliability

when there is similarity in people's answers to among different parts of the same test

Interrater (or interjudge) reliability

different rates or judges who administer and score the interview or test should come to similar conclusions when they are evaluating the same people; consistency of observations between raters

What is standardization?

standardizing the administration and interpretation of tests to improve validity and reliability; prevents extraneous factors from affecting a person's response

Symptom questionnaires

questionnaire that assess what symptoms patient is experiencing; Individual self-reports on various symptoms of psychological disorders

- Generally good reliability; limited validity

- Quick & inexpensive to administer & score

- Good for tracking symptoms throughout the course of treatment

Objective personality tests

Structured, self-report questionnaires containing multiple choice or true/false questions.

- Person's responses compared against responses of people with different personality issues or problems

- Strong reliability & validity

Projective personality tests

Individual is asked to respond to ambiguous stimuli

- Assumption: people will project feelings, needs, etc. onto the ambiguous stimuli. Based on assumption that when people are presented with an ambiguous stimulus, such as an oddly shaped inkblot or a captionless picture, they will interpret the stimulus in line with their current concerns and feelings.

- Very limited reliability & validity

Behavioral observation/Self-monitoring: B.O.

Observe client(s) interacting in certain situations; S.M.: Have client record incidents of problematic behaviors, including situations, thoughts, feelings, etc.

- Highly subject to biases, but potentially useful tool in helping to increase self knowledge & tracking changes

Neuropsychological test

Assess cognitive functioning, including multiple aspects of memory, attention, concentration, auditory & visual processing, sensory motor skills, that attempt to differentiate people with deficits in these areas from normal subjects.

- Bender-Gestalt Test

- Halstead-Reitan test

- Luria-Nebraska test

Biomedical assessments

Techniques that assess physiological functioning

- Computerized Tomography (CT)

- Magnetic Resonance Imaging (MRI)

- Positron-emission tomography (PET) -

- Electroencephalogram (EEG)

Strengths of DSM

- Increasingly atheoretical

- Increased specificity of criteria have led to improved reliability (r > .70 in the DSM-5)

- Construct validity (accuracy) of disorders is improving

- Increased focus on research and continual revision

Weaknesses of DSM

- Based on superficial descriptions of symptoms

- Questionable validity of some disorders

- Comorbidity

- Disorders of infancy/childhood:not well developed (some improvement)

- Lack of emphasis on situational & contextual factors

- Views psychological disorders as individual psychopathology, minimal recognition of impact of age, gender, & culture on expression of psych disorders

Controversies of DSM-5

- Secrecy surrounded developmental process

- Pathologizes normal variation in behaviors

- How long is "normal" grief

- Reifying Diagnoses

- Assuming a group of behavioral

symptoms is a tangible phenomenon

- Brain tumor vs. Depression

List and describe the different dangers of labeling or diagnosing

- Can be stigmatizing

- Can cause bias when observing behavior

- Can create self-fulfilling prophecies

- Can limit information that we seek and/or prevent

us from considering alternative hypothesis

- Individual is NOT the disorder

- Overgeneralization (disorders are

heterogeneous)

- Minimizes attention to social/interpersonal

context

What is the mini mental status exam?

briefly assesses client's orientation to person/place/time, memory, judgment, etc. (appearance/behavior, thought processes, mood/affect, intellectual functioning, appropriate orientated x3)

Structured interview

meeting between a clinician and a client or a client's associate in which the clinician asks questions that are standardized and are usually designed to determine whether a diagnosis is warranted

Semi-structured interview

interviewers can ask participants to explain, briefly

Unstructured interview

asks questions differently, ask for clarification

Biopsychosocial Model

Psychopathology develops from an interaction of biological, psychological and social factors

Diathesis-Stress Model

Predisposition/vulnerability (diathesis) + stress (e.g., stress, alcohol, drugs, etc.) → psychopathology

Neurotransmitter

biochemicals, released from a sending neuron that transmits messages to a receiving neuron in the brain and nervous system; biochemicals that act as messengers carrying impulses from one neuron, or nerve cell, to another in the brain and nervous system (about 100 different types, 3 main categories)

Reuptake

occurs when the initial neuron releasing the neurotransmitter into the synapse reabsorbs the neurotransmitter, decreasing the amount left in the synapse

Degradation

occurs when the receiving neuron releases an enzyme into the synapse that breaks down the neurotransmitter into other biochemicals

Serotonin

emotional well-being (particularly in depression and anxiety), dysfunctional behaviors (aggressive impulses)

Dopamine

associated with our experience of reinforcements or rewards, and is affected by substance such as alcohol that we find rewarding; functioning of muscle systems and plays a role in disorders involving control over muscles (Parkinson's disease)

Norepinephrine (noradrenaline)

cocaine and amphetamine prolong the action by slowing its reuptake process, causing the receiving neurons to be activated longer, causing the stimulating effect of these drugs; too little can lead to depressed mood

GABA

plays role in anxiety symptoms

Behavior genetics

the study of the genetics of personality and abnormality, is concerned with two questions (1) to what extent are behaviors or behavioral tendencies inherited? (2) what are the processes by which genes affect behavior?

How many chromosomes do humans typically have?

Humans typically have 46 chromosomes, 23 pairs

Alleles

coding sequences

Multi-gene or polygenic process

combination of many genes, each of which makes a small contribution to an inherited trait. Alterations in a # of genes leads to disorder.

Epigenetics

indicates that environmental conditions can affect the expression of genes. Study of how environmental conditions can change the expression of genes without changing the gene sequence

What are the four major types of psychotropic medications, and what do they generally do?

Antipsychotic drugs: help reduce the symptoms of psychosis (hallucinations, loss of reality, delusions)

Antidepressant drugs: reduce symptoms of depression (sadness, loss of appetite, sleep disturbances)

Lithium: reduces symptoms of mania (agitation, excitement, grandiosity)

Antianxiety drugs: treatment of anxiety (fearfulness, worry, tension)

Escape conditioning

person in an aversive situation and is rewarded for leaving (escaping) by experiencing relief; is already in situation

Avoidance conditioning

person is rewarded for avoiding an aversive situation by experiencing relief; is not in direct situation, but is going to avoid it

According to the cognitive model, what three elements are proposed to interact in order to cause psychological problems?

Thoughts, behaviors, feelings

How do family systems therapists conceptualize psychological disorders?

They see the family as a complex interpersonal system, with its own hierarchy and rules that govern family members' behavior. When a member family has a psychological disorder, they see it not as a problem within the individual, but as an indication of a dysfunctional family system.

According to the [N] text, what are the different characteristics of families that can be problematic?

Different characteristics:

- Enmeshed: overly involved in lives of others

- Disengaged: family members pay no attention to each other and operate as independent units, isolated from other family members

- Pathological triangular: parents avoid dealing with conflicts with each other by always keeping their children involved in their conversations and activities

DBT (dialectical behavior therapy)

ocuses on difficulties in managing negative emotions and in controlling impulsive behaviors through behavioral and cognitive techniques and mindfulness exercises aimed at increasing problem-solving skills, interpersonal skills, and skill at managing negative emotions

ACT (acceptance and commitment therapy)

assumes that experiential avoidance (avoidance of painful thoughts, memories, and feelings) is at the heart of many mental health problems. Accepting one's feelings, thoughts, and past history and learning to be present in the moment is key to achieving positive change.

Culture-bound syndromes

a combination of psychiatric and somatic symptoms that are considered to be a recognizable disease only within a specific society or culture