psychopathology exam #1

who are people licensed to practice mental health?

• psychologists (PHD, Psy. D)

• psychiatrists (MD)

• social worker (SW)

• nurse practicioners

• marriage and family therapists (MFT)

• LMHC

• pastural counselor

shortage in US

329.5 mill people

1.2 mil practicioners

liscense

completed what the state wants you to - meaning you are able to practice (degree, hours, internship, residency, exam)

public safety

primary, secondary teritary care

case study of king george

blamed for the war, weird mental state (woke up at 4am, spoke to trees, ran around grounds in pjs, trouble sleeping, spoke for long periods, forgot loved ones)

he was medicated by being burned

psychological disorders

psychological conditions that depart from the norm (maladaptive +cause personal distress)

• identified through abnormal/unusual behavior

abnormal behavior

conduct that differs from typical development, cultural, or social norms (created distress and impaires functioning)

psychopathology

the science of diagnosing + understanding all psychological disorders (causes , descriptions, treatments - peoples functioning problems)

constructs to whether behavior is normal vs abnormal (mental health def. of what abnormal behavior is)

1. deviance/devaite (weakest one) - depart from typical standard (cultural standards)

2. dangers - doesn’t have to be intentional (tendency towards violence)

3. distress (pain/anxiety)

4. dysfunction (behaviors, emotions, thoughts outside the ordinary - result in person being impaired/distressed)

measured on a scale/continuum

subjective judgments made (cultural relativism)

abnormality - variation of unfunctional behaviors, thoughts feelings

continuum

range of severity from mild-disruptive

culture

shared customs, institutions, values, and habits that distinguish a group

cultural relativism

idea that our understanding of psychopathology should be based on a persons culture rather than on one universal definition of the term

empathy

willingness to understand another persons inner world

culture-bound syndromes

some disorders are specific to certain populations

thomas szas

societies label marginalized people in order to control/silence them

ex. slaves in south america - their problem is they wanted to be free, the fix was abusing them

theories that explain abnormal behavior (in history)

biological - disorder caused by human physiology - (medicine/diet = fix)

supernatural - caused by demons - (exorcism, higher moral = fix)

psychological - environmental factors (stress, trauma) - (change environment = fix)

etiology

presumed cause of a disorder

exorcism

religious ritual treated abnormalities by coaxing spirits such as demons from body - could kill someone

trephination

stone ages - drilling holes in skulls to expel demons (or treat blood clots)

(note - in history “wandering uterus” was also a thing - explanation of womans symptoms)

what did china believe cause P.D

imbalance of yin and yang

hippocrates

greeks 1st recognized trauma (humors)

P.D treated like physical disorders

brain = center of consciousness (vs. usual heart) - chest = me spot

humors - bodily fluids thought to connected to mental func. (blood - heart, brain = phlegmm - choler/yellowbile (liver), black bile (spleen)) - also can link to behaviors/personality

Abnormal behavior - epilepsy, mania, melancholia, brain fever

paracelsus

how the planet change/stars effects us

luna (moon) - lunatic

Teresa of Avila

spanish nun, thoughts P.D was caused from physical illness

john weyer

mind has illness in the same way the body does

founder of psychopathology

asylums

17th century (medieval times), impatient institutions created to provide care for peop;le with psychological disorders

clifford beers

wrote a book about being mistreated in mental institutions (depressed)

elizabeth cochrane

went undercover and wrote a book about the horrible conditions in a mental institution

pen name Neille bly

mental hygiene movement - 18/19th century

theory of psychopathology purposed that P.D was a result of people being separated from nature (b/c people worked at factories and industrial mills - industrial revolution)

moral treatment (w/ MHM)

moral discipline and humane care - prayers, rest, serene environment

lead to asylum reform

philippe pinel and william tuke

suggested people in asylums be better taken care of

dorothea lyn dix

got government funding and regulations for asylums

(didn’t fully work, too fast, prejudice)

documented horrible asylum conditions

insulin use (manfred sakel)

would use insulin to calm patient and higher appetite

lots of people died

emily kraepelin

biological factors are central to P.D - foundation of modern diagnosis system

made a classification system

franz anton mesmer (mezmerize)

animal magnetism - invisible fluids that were blocked were causes of P.D

to fix they must unblock - rods in body

jean charcot

hypnoses - reduce hysteria, numbness

sigmund frued

charcots students, unconscious

josef breur

worked with frued, hypnosis cured hysteria (neo-fruedian work)

imipramine

1st antidepressant in the 1950s

in 68 years, 25 more followed

deinstitutionalization

meant to replace impatient psychiatrict care with community services

1955-1998 - 90% of reduction in patients

not good, people had no where to go, most went to prison, homeless, halfway houses, nursing homes, etc

managed care - 80s/90s

health care system where insurance companies controlled and coordinated medical and psychological services

only 50-60% people received care (more money for insurance)

psychiatry

branch of medicine that treats mental and behavioral conditions

70-90% of anxiety and depression medications prescribed out of psychiatry (through primary care - where they don’t know much about medication)

psychiatric DNP

advances nurses - mental health services, diagnose and prescribe, manage medications, therapy, assesments

counseling psychologists

mental health professional helps with difficulty adjusting to life stressors to achieve greater wellbeing

advice - psychotherapy

clinical psychology

mental health professionals who research, evaluate, treat psych. cond.

4 models of clinical psych

boulder model - scientist practitioner - balanced clinical psych program students learn clinical and research skills

vail model - practitioner scholar method - clinical psych program, clinical practice

clinical research model - clinical psych research over direct client work

psychopharmacology - treatment of psychological conditions using medication

case study

extensive examination of the experience of a single ind./group - allows researchers a deeper look at the subject

variables

characteristics of behavior or experiences

correlational method

research design - 2+ conditions vary in relation to each other

correlation coefficient

numerical description of direction and strength b/t 2 variables

pos corr: association b/t 2 variables - move in same direction

neg corr: variables move in opp. direction

uncorrelated - no pattern

experiment

method where 1 or more ind. var. is manipulated by researchers - result is measured through 1 or more dep. var

ind var: factor experimenters manipulate (has causality)

dep var: measurements collected - determines effect or no of ind. var.

experimental group

group recieves treatment

control group

no treatment (or placebo)

confounding var.

outside factor that effects dep. var.

random assignment

assigning participants to the experiment an control group by chance - no bias, equal likelihood

experimenter bias

innacurate measurments due to the researchers expectations

placebo

medication w/out active ingrediants

double-blind study

experiment where neither subject or experimenters knows which conditions subjects assigned to

meta-analysis

research technology, many studies on 1 topic are together and conclusion drawn about current knowledge

epidemiology

study of frequency and distribution of health conditions

1. incident: # of ind. who develop a specific disease or event within a period of time

2. recover: # of people who no longer have symptoms

3. mortality: # of deaths

4. prevalence: proportion of a populations who have a disease at a specific time (%)

diagnosis

hypothesis till further evaluation

determines treatment

benjamin rush

APA, honored for father of american psychiatry

bethlem

famous asylum

1774 - madhouse act

made asylums have license to operate - inspecting, reason to put in asylum, only for wealthy

bio method and psychopharmacology

1950

lobotomies

how medicine affects the mind

1st treatments

sleep and appetite disturbances w/ P.D

nervous system

network of organs, nerves, and support system

sends and receives neurons and electrical chemicals to and from parts of body

biological psych

neuropsych

branch of psych that examines that connectioned between bodily system and behavior

good to understand body and behavior and psychopathology and symptoms

medications

neurons (nerve sells communication w/ blood stream and hormones)

• brain dysfunction, biochemical, imbalance, genetic abnormalities as a source of p.p

connection b/t brain and body

nervous syst, communication with neurons, use of medications, endocrine syst.

limits - tends to ignore thoughts and motivations - ignore env. influences, medications have bad side effects

mental health parity - ‘96 bill clinton

cannot discriminate against P.D - have to call and talk about mental health issues to get medicine (embarrassing - stigma)

stigma

discriminating against people with x P.D

why do we study psychopathology

to decide what a diagnosis is what isn’t

course of disorders, started, occur, and to reduce suffering and stop illness

why is psych.path. imp?

can’t make things up and pople wont get better in info is fake

no diagnosis = no treatments

who benefits from P.P

everyone

who pays for P.P

we pay with taxes given to federal gov.

(medicine 5 year monopoly- only that comp. can sell drug for 5 years, makes lots of money)

ethica of P.P

human and animal research ethics lots

types of studies in P.P

case study, correlational study (corr does not = causation), epidemiology (disease trends) - mortality, prevalence (when rates go up question that)

4/5 homeless pop. is mentally ill

diathesis + stress = disorder model

diathesis (biological facotrs/social factors/psych factors) + stress (trauma, disease, etc) = psych. disorder

check page 10 for more specfics

central nervous syst.

a division of the nervous system that comprises the brain and spinal cord

control bodies actions + reactions

brain and spinal cord

connects and controls the body

peripheral nervous syst

a division of nervous system that joins the rest of the body to the centras nervous system

brain sits in cerebrospinal fluid - reduces brian weight, moves hormones around, washes waste from cells

control bodies actions + reactions

all other parts outside brain

spinal cord secretes stress hormones

endocrine syst and sympathetic syst.

any nerve cells that are not CNS - joins rest of body to CNS

forebrain

largest part

(thalamus - relay piint for sensor info - notice and react to stim,

cerebrum - largest forebrain part - think, plan, memories, imagine, compacted,

hypothalamus - fight.flight, regulates pituatary hormone, regulates drinking, sleeping, eating

limbic syst - emotions, amygdala (pos +neg emotions - hippocampus (memory recall goals, intigrates info to cortical and limbic syst,) - nucleus accumbens

cerebrum

4 lobes

left hemisphere - form words

right h. - abstracted reasoning

communcates through corpus callosum - made of nerve fibers

cerebral cortex

1. occipital - images

2. temporal - auditory

3. frontal lobes - planning, organizing, functions, movements, controlling

4. parietal - body sensations (somatosensory cortex)

cells

glia

neurons - standard cell of nervous system

87 bill neurons

neuron parts

dendrite - recieves messages from other neurons

soma - body of cell, cell func., genetic material

axon - carry messages to other dendrites in neurons

synapse - area between 2 neurons

message process b/t neurons:

• axon terminal - neuron that sends messages

• synaptic gap - space between

• next dendrite - neuron recieves message

neurotransmitters

molecules that communication, transmit messages from 1 neuron to the next and neurons in areas of the brain

endocrine syst

hormones regulates emotions and behaviors

interacts w/ nervous syst - automatic and not, para and symp.

synthesized and releases hormones into the bloodstream

nervous syst. - specific parts

sympathetic fight vs flights

somatic - voluntary

automatic - breathing

parasympathetic - slows heart rate

dom. vs. recess. genes

alleles (two same verions of genes)

family studies

test hypothesis about weight of genetics and environmental factors by examining the family

Adverse childhood experiences (ACES)

1. categories of adverse childhood experiences (psychological, physical/sexual, abuse, violence against mothers, living in a household w/ substance abusers, mentally ill/suicidal or imprisioned

2. people who had 4 aces or more had a 4-12x greater risk of alcoholism, drug abuse, depression and suicidal attempts, 4x higher smoking, poor self0rated helath, more than 50 sexual partners (+ STD 1.4-1.6x higher in acitivty) and severe obesity

3. also related to heart disease, cancer, chronic lung disease, fractures + liver disease

   1. 23.5% sample grew up with alcohol abuser

   2. sexual abuse reported by 22% (28% w, 16% men)

4. helps us understand who might be at greater risk for certain mental and physical illnesses

transdiagnostic

something that makes mental illness rates higher (poverty)

NAMT

nation aliance mental illness - infographicss on mental illness, 1in 5 people in US have MI

1 in 25 have severe

6-17 years - 17% have MI

made to reduce stigma about mental illness

some illness = up to 10% mortality rate

symptom onset vs treatment = 11 year delay

differences in MI in different subgroups (race,gender, class, etc)

43% get treatment

64% severe MI get treatment

51% 6-17 get treatment

ripple effect treatment: leading cause of disability is depression (effect → person → family → community → world)

hindbrain

breathing, sleeping, attention, coordination

midbrain

sensory info, reward syst., goals

reuptake

slows down or speeds up neurotransmitters

neurotransmitters

effects the body

acetylcholine - memory reward and muscle function

dopamine - movement and reward system

GABA - inhibition of action

Norepinephrine - learning and memory

seratonine - sleep, anxiety, mood, appetite

SSRI

doesn’t only effect seratonine effects a lot more - not precise

biological treatments

psychotropic medications: most common (antipsychotics (mood), anticonvolsits (stabilizer), antianxiety - depression)

non-medication techniques - psychosurgery, TMS, PBS, electroconvulsive treatment, good for depression that won’t go away)

PCP prescribed 60% of medication - not good b/c not trained for it

biomedical therapies: using therapy, medication, surgery, or other psychological interventions for treatment of psych. cond.

drugs

page 15

psych theories on p.p

what causes p.d

1. psychodynamic

2. humanistic

3. behavioral

4. cognititve

5. sociocultural

6. biopsychosocial

psychodynamic theories

family of theories focused on the unconscious, freud, and the internal conflict

frued

neurologist (nervous syst) - got impossible cases - wanted to explain them

3 parts (some unconscious - some conscious)

Id, ego, superego

being ill = subconscious, inability to manage - id-superego

use defesive stategies to deal with conflict

must make unconscious - conscious

id , ego, superego

id= inner, pleasure - unconscious, animalistic

ego - conscious, everday being, awareness

superego - morals, unconscious (shame if not achieved)

life instincs - eros

thanatos - unconscious desire to be dead - reduces tensions that are aggressive and destructive

defense mechanisms

unconscious arrangements that ego uses to satisfy id instincs indirectly

1. repression

2. regression

3. rationalization

4. sublimation

5. denial

6. projection