Psychopathology Exam 1 PSYC2351 SMU

Risk Factors that leave people predisposed to mental disorders

Biological, psychological, sociocultural

Four D's (criteria to defining psychological disorders)

Deviance, distress, dysfunction, danger

Deviance

Having different, extreme, unusual, or bizarre behaviors, thoughts and emotions compared to social norms, judgements are culturally based

Distress

Upsetting to the individual

Dysfunction

Interferes with ADL's and other functions

Danger

Harmful to self or others

Trephination

An operation where a hole is drilled in the skull

Hippocrates

Father of modern medicine

Hippocrates continued

Humors - the problem is within the individual

Yellow bile: frenzied activity

Black bile: deep and lasting sadness

Blood: overly optimistic

Phlegm: lethargy, calm

Emil Kraepelin

Identified manic depression, dementia praecox and later termed schizophrenia as distinct forms of psychosis

Phillipe Pinel

Advocate of humanitarian methods to treat the mentally ill and developed a type of psychotherapy known as moral treatment

Dorothea Dix

Created the first hospital to treat the mentally ill

Sigmund Freud

Founder of psychoanalysis

Ivan Pavlov

Discovery of classical conditioning, experiment with dogs and salivating

Avicenna

Proposed that humans have 7 inner senses to compliment the outer senses

BF Skinner

Behaviorist that developed the theory of operant conditioning by training pigeons and rats

Believed that using punishment as a consequence is relatively ineffective in the long run and the primary way to develop new behavior is to positively reinforce desired behavior

John Watson

The beginnings of behavior therapy little albert experiment

Joseph Wolpe

Best known technique: systematic desensitization - gradually exposing people to their fears in order to get over them

Biopsychological model

a model that addresses how biological, psychological, and social factors interact and affect psychological health

Diathesis-Stress model

Theory that physical disorders develop from genetic or biological predisposition for that illness combined with stressful conditions

Experimental Research

To what degree one thing affects another

independent variable: what I change

dependent variable: what is observed or measured

Correlational Research

The relationship between variables

Incidence - new cases

Prevalence - total number of cases during a time period

Case Studies

May provide new insights, opportunity to study more unusual problems, subject to observer bias

low internal validity

low external validity

Defense Mechanisms

Defense Mechanisms

Denial

Refuses to acknowledge some aspect of objective reality or subjective experience that is apparent to others

Displacement

Transfers a feeling about, or a response to, an object that causes discomfort onto another, usually less threatening, object or person

Projection

Falsely attributes own unacceptable feelings, impulses, or thoughts to another individual or object

Rationalization

Conceals the true motivations for actions, thoughts, or feelings through elaborate reassuring or self-serving but incorrect explanations

Reaction Formation

Substitutes behavior, thoughts, or feelings that are the direct opposite of unacceptable ones

Repression

Blocks disturbing wishes, thoughts, or experiences from conscious awareness

Sublimation

Directs potentially maladaptive feelings or impulses into socially acceptable behavior

Can be good when the energy from conflict is redirected into a more efficient and constructive outlet such as work

Classical Conditioning

A type of learning in which a neutral stimulus is paired with a response until it elicits that response

Operant Conditioning

A type of learning in which behavior changes as a function of what follows the behavior

Reinforcement: can make a behavior more likely to occur, central to operant conditioning

Law of Effect

Thorndike - states that behavior is either strengthened (likely to be repeated) or weakened (likely to occur less frequently) depending on the consequences of that behavior

Shaping

Process of reinforcing successive approximations to a final behavior or set of behaviors

3 Core Principles of Ethics (Belmont Report)

Respect for others, benefiance, justice

Informed Consent Process

Makes sure all participants understand the study, participation is optional, selected through a fair process, aware of benefits and risks

Is overseen by IRB also known as ERB

CNS vs PNS

CNS: Central Nervous System, brain and spinal cord

PNS: Peripheral Nervous System, somatic nervous system that controls sensation, muscle movement and the autonomic nervous system

Limbic System

Amygdala, cingulate gyrus, and hippocampus

Deals mainly with emotions and impulses

Basal Ganglia: structures that inhibit movement

Cerebral Cortex

Largest part of the forebrain

Function: Reasoning, abstract thought, perception of time, creativity, and other uniquely human abilities

Divided in two hemispheres with 4 lobes: Parietal, temporal, occipital, and frontal

ANS Sympathetic vs Parasympathetic (Autonomic Nervous System)

ANS: Controls involuntary movements

Sympathetic: Nervous system, activates a state of physical readiness (fight or flight)

Parasympathetic: Nervous system, returns body to resting state (calms us back down)

MRI vs CT

MRI is superior to CT because it does not use radiation to examine the neuroanatomy

Two neuroimaging techniques that detect brain function

Positron Emission Tomography (PET) Scan: detects emission of positrons

Functional MRI: detects increase in blood flow

3 Primary Goals of Assessment

Screening, diagnosis and treatment planning, outcome evaluation

Differential Diagnosis

Determining which diagnosis most accurately describes the patients symptoms

Reliability

Consistency, how well the measure produces the same results each time

Interrater Reliability

Measurement of consistency between different raters

Validity

Degree to which a test measures what it is intended to measure

Unstructured Interviews

Clinician determines what questions to ask and how to ask them

Structured Interview

Clinicians ask same standard set of questions

Cultural factors that can affect test performance on clinical assessment

Age and developmental status, language, educational background, beliefs and/or values

Comorbidity

The presence of more than one disorder

Almost half of people with one disorder have symptoms that meet criteria of another

Why is a diagnostic system harmful?

People with the same diagnoses might not react the same to the same treatment, can encourage stereotypes, can create stigmas

Anxiety

A future oriented response that usually occurs when people encounter a new situation or anticipate a life changing event

Anxiety vs Fear

Fear: Involves an instant reaction to an upcoming threat

Anxiety: Involves apprehensiveness, avoidance, and cautiousness regarding a potential threat

3 Components of Anxiety

Physiological: Increased heart rate, ringing in ears, shortness of breath, sweating, dizziness, blushing, irritability, fatigue, muscle tension, gastrointestinal distress, need to pee

Cognitive: Worry about specific thoughts, ideas, images, impulses

Behavioral: Avoidance or escape

Normal Anxiety

Serves to improve people's functioning of well-being

Abnormal Anxiety

Chronic condition that impairs people's functioning and well-being

Panic Attacks

Discrete period of intense fear and physical arousal

develops abruptly, peaks in minutes, somatic and cognitive symptoms

Panic Disorder

Person has had a panic attack and is worried about having more attacks

Panic Disorder Symptoms and Treatment

Symptoms: Accelerated heart rate, sweating, trembling, choking sensations, hot and cold flashes, fear of dying, fear of losing control

Treatment: Psychotherapy (CBT) or medication (SSRI's, SNRI's, beta blockers, benzodiazepines)

Agoraphobia

Intense fear or anxiety about two or more of these things: public transportation, open spaces, lines, crowds, being outside of home alone

General Anxiety Disorder (GAD) Symptoms and Treatment

Frequent excessive worry and anxiety out of proportion to the actual situation

Symptoms: On-edge, easily fatigued, difficulty concentrating, being irritable, muscle tension, difficulty controlling feelings of worry, trouble sleeping

Treatment: Cognitive-behavioral therapy, Psychotropic medications

5 Specifiers of Specific Phobia

Animal phobia, situational phobia, blood and injection phobia, natural environment phobia, other (unrelated to other groups)

Contrast the psychodynamic, behavioral, and cognitive theories of the onset of anxiety and PTSD

Contrast the psychodynamic, behavioral, and cognitive theories of the onset of anxiety and PTSD

Obsessions

Recurrent, persistent, and intrusive thoughts

Compulsions

Repetitive behaviors that are extensive, time consuming, and distressful

Trichotillomania

Repeated hair pulling resulting in noticeable hair loss, sometimes considered to be on the spectrum of obsessive compulsive behaviors

Hoarding Disorder vs OCD

Hoarding Disorder: Have difficulty getting rid of and parting with possessions due to a perceived need to save the items

OCD: Reoccurring thoughts, images, or urges and having a compulsion to try and remove them

Difference: Hoarding you don't have an obsession with the item just a difficulty of letting things go

Diagnostic criteria and clinical features of kleptomania

Follows one of three patterns of stealing: brief episodes of stealing with intermittent and long periods of remission, longer periods of stealing with brief periods of remission, or chronic and continuous episodes of stealing with only minor fluctuation in frequency

Anxiety or guilt or depression may follow

No cure but therapy can help and antidepressant drugs

Conversion Disorder

Symptoms of altered motor or sensory dysfunction

Symptoms not intentionally produced and cannot be explained by any medical condition

Glove anesthesia: loss of sensitivity in the hands or wrist

La belle indifference: emotional indifference despite the presence of significant physical symptoms

Illness Anxiety Disorder

Fears or concerns about having an illness persist despite medical reassurance

High level of worry about health

Previously known as hypochondriasis

Factitious Disorder (imposed on self)

Intentional falsification of symptoms with intent to assume sick role, may fake or produce sick or psychological symptoms on purpose,

Also known as Munchausen syndrome

Peregrination: Patient seeks treatment at different hospitals using fake names

Factitious Disorder (imposed on others)

Person induces illness symptoms on someone else, usually mother producing symptoms on a child or the elderly

Malingering

Falsification or exaggerated symptoms to obtain secondary gain such as avoiding work or prosecution

Dissassociative Disorders

Disruption in the usually integrated functions of consciousness, memory, identity, emotions, perception, body representation, motor control, and behavior

Types of Dissociative Disorder

Depersonalization, Derealization, Amnesia, Identity Confusion, Identity Alteration

Depersonalization

Feeling detached from one's body

Derealization

Feeling of unfamiliarity of reality of one's environment

(described as feeling like a dream)

Amnesia

Inability to remember personal information or significant periods of time

Identity Confusion

Unclear or conflicted about personal identity

Identity Alteration

Overt behaviors of assuming an alternate identity

Dissociative Amnesia

Inability to recall important information, usually personal in nature

When this occurs after a traumatic events the cause is considered psychological rather than biological

Considered a reversible amnesia

Localized Amnesia

Failure to recall events during a certain period of time

Generalized Amnesia

Total inability to recall aspects of one's life

Selective Amnesia

Person forgets some elements of a traumatic experience

Dissociative Fugue (flight)

Includes travel or bewildered wandering associated with the amnesia

Suddenly wandering away from one's home, experiencing confusion about identity and sometimes assumes a new one

Bipolar Disorder

Mania is different from elated mood, often accompanied by inappropriate and potentially dangerous behavior, irritability, pressured or rapid speech, and a false sense of well-being

Bipolar I

Involves full blown mania with episodes of major depression

Bipolar II

"hypomania" or mild mania with episodes of major depression

at least one episode of major depression and at least one episode of hypomania

Hypomania

May be overly talkative, excitable or irritable, but there is no impulsive acts or gross lapse of judgement

Lasts at least four days, more common than bipolar I

Mixed State

Simultaneous mania and depression

Persistent Depressive Disorder

Also known as Dysthymia (symptoms last 2 or more years) - chronic state of depression

Some Developmental Factors for Depressive Disorders

Hormones, bodily changes during puberty, socioeconomic disadvantages, victimization or chronic life stressors, self-esteem, higher reactivity to stress, neuroticism

Parasuicide

Acts such as superficial cutting or overdoses of nonlethal amounts of medication

Psychodynamic Theory

Explains depression as "anger turned inward", occurs after a real or imagined loss, melancholia, depression and mania are interlinked

Behavioral Theories

Withdrawal of reinforcement for healthy behavior, learned helplessness, external and internal uncontrollable environments are inescapable

Cognitive Theory

Beck - negative cognitive schemas, automatic thoughts, self-fulfilling prophecies, negative thoughts about yourself, the world, and the future

Treatments of Bipolar Disorder

Medications are the primary treatment (lithium), Electroconvulsive therapy, Cognitive Behavioral therapy, interpersonal and social rhythm therapy