AW Psychopathology & Mental Health Exam #1 Flashcards

Syndrome

A group of symptoms that appear together and are assumed to represent a specific type of disease

Mental disorders defined as...

Persistent maladaptive behaviors, meaning:
1. duration of symptoms is important!
2. impairment of ability to perform social and occupational roles

Harmful dysfunction approach (Wakefield)

Conditions defined as mental disorders when:
1. The condition results from the inability of some internal mechanism (mental or physical) to perform its natural function
2. The condition causes some harm to the person as judged by the standards of the person's culture (measured in terms of the person's difficulty performing expected social or occupational roles)

Epidemiology

the scientific study of the frequency and distribution of disorders within a population

Incidence

The number or rate of new cases of a particular condition during a specific time.

Prevalence

number of total cases of a disease in a given area during a given period of time

lifetime prevalence

the proportion of living persons in a population who have ever had a disorder up to the time of the epidemiological assessment

Comorbidity

presence of two or more disorders in an individual at the same time

Disease burden

Usually measured by epidemiologists by looking at mortality and disability (lost years of healthy life (compared to standard life expectancy)) or living with a disability (weighted for severity)

Disease burden of mental disorders

Responsible for only 1% of deaths, but produce 47% of disability in economically developed countries and 28% of disability worldwide

Psychiatry

a branch of medicine dealing with psychological disorders; practiced by physicians who sometimes provide medical (for example, drug) treatments as well as psychological therapy

Clinical psychology

concerned with the application of psychological science to the assessment and treatment of mental disorders

The DSM 5 definition of mental disorder

1. Syndrome characterized by disturbance of a person's cognition, emotion regulation, or behavior
2. Clinically significant distress or disability as a consequence
3. Reflects dysfunction in processes associated with mental functioning
4. Cannot be an expectable response to common stressors (ex. Tragedy)
5. That is not primarily a result of social deviance or conflicts with society

Culture and diagnostic practice

Impact of behaviors and experiences on a person's adjustment depends on the culture they live in (ex. homosexuality being considered a disorder in early versions of the DSM)

PSR Workers (psychosocial rehabilitation)

Work in crisis, residential and care management programs for people with severe forms of disorder such as schizophrenia (usually high school education or bachelors degree)

Hippocratic Concept of Health

Common until middle of 19th century
Viewed "disease" as overarching concept and didn't distinguish between mental disorders and other types of illness
All problems considered to be the result of an imbalance of body fluids

Creation of the asylum

In European Middle Ages, people w/mental illnesses were frequently kept at home and cared for by families, or roamed freely as beggars
Mentally disturbed ppl who were violent were imprisoned with criminals

In 1600s and 1700s, insane asylums established —> belief that community was responsible for care became common alongside urbanization

In 19th century, moral treatment movement led to some improved conditions at mental hospitals

By 1800s, physicians (psychiatrists) were superintendents of asylums

APA founded in 1844

Worchester lunatic hospital

1833 asylum in Mass. that became a modem for psychiatric care on which other 19th century hospitals were based on
—> Woodward was superintendent
Woodward believed that disorders were caused by physical and lifestyle factors
Treatment included physical and moral procedures (ex. Foster self control paired with drugs)

null hypothesis

A prediction that there is no difference between groups or conditions, or a statement or an idea that can be falsified, or proved wrong (analogous to assumption of innocence)
Can never prove, just fail to reject

Case study

Careful description and analysis of problems experienced by one person

Limitations: can be viewed from multiple perspectives, not conclusive, risky to draw general conclusions about a disorder from a single example

Paradigm

a set of shared assumptions that includes both the substance of a theory and beliefs about how scientists should collect data and test hypotheses

Four paradigms of 20th century: biological, psychodynamic, cognitive-behavioral, and humanistic paradigms

Contemporary paradigm: biopsychosocial model

Biopsychosocial model

a model of health that integrates the effects of biological, behavioral, and social factors on health and illness

Biological paradigm

The view of (abnormal) behavior that emphasizes the importance of (abnormal) biological processes and how to study them.

Closely connected to the general paresis: in 1798, physician started diagnosing ppl with a specific type of lunacy called general paresis (which resulted in death). 100 years later, it was discovered that people diagnosed with this also had contacted syphilis. It was later found that this could be cured by penicillin — prompting scientists to start looking for biological causes for other mental disorders

Medical model

1. Diagnosing accurately
2. Identifying a specific biological cause for the disease
3. Developing treatments that prevent or alter the cause

DSM focuses on symptoms but not cause!!

didn't know how to make this into a flashcard, but just know it!

psychodynamic pardigm

view of behavior rooted in Freudian theory asserting that much of behavior is ruled by subconscious mental processes

hysteria

an outdated term referring to excessive or uncontrollable emotion, sometimes resulting in somatic symptoms (such as blindness or paralysis) that have no apparent physical cause --> initial theory said it was unique to women and caused by sexual frustration

hysteria and freud

Freud thought that patients of hysteria did not fake or consciously associate their symptoms with emotional distress, but that instead psychological distress was unconsciously converted into physical somatic symptoms. Freud then theorized that many psychological processes were unconscious

psychoanalytic theory

A paradigm for conceptualizing abnormal behavior based on the concepts and writings of Sigmund Freud. Highlights unconscious processes and conflicts as causing abnormal behavior and emphasizes psychoanalysis as the treatment of choice.
(note: term psychodynamic theory includes both freud and the revisions of his followers)

the id

- present at birth
- houses biological drives (hunger, etc.) and two key psychological drives: sex and aggression (which freud believes are akin to hunger)
- operates according to pleasure principle
- impulses of id seek immediate gratification and create discomfort until they are satisfied

the ego

the largely conscious, "executive" part of personality that, according to Freud, mediates among the demands of the id, superego, and reality. The ego operates on the reality principle, satisfying the id's desires in ways that will realistically bring pleasure rather than pain.
- starts to develop in first year of life
- mostly resides in conscious awareness

superego

the part of personality that, according to Freud, represents internalized ideals and provides standards for judgment (the conscience) and societal standards for behavior - including rules that kids learn from parents in preschool
- efforts to govern id's sexual and behavioral impulses

moral anxiety

conflict between ego and superego

neurotic anxiety

conflict between ID and EGO; fear of punishment

defense mechanisms

ego's protection against neurotic anxiety
reduce conscious anxiety by distorting anxiety-producing memories, emotions, and impulses

include projection, displacement, denial, rationalization, reaction formation, repression and sublimation

freud's theory of psychosexual development

different stages of childhood are marked by different sexual conflicts (ex. oedipus conflict, electra complex)

cognitive-behavioral paradigm

view of behavior that emphasizes the importance of learning in development of normal and abnormal behavior (wilhem wundt, bf skinner, ivan pavlov)

classical conditioning

a learning process that occurs when two stimuli are repeatedly paired; a response that is at first elicited by the second stimulus is eventually elicited by the first stimulus alone.

extinction generally occurs when a conditioned stimulus is no longer paired with an unconditioned stimulus

operant conditioning

a type of learning in which behavior is strengthened if followed by a reinforcer or diminished if followed by a punisher

behaviorism

the view that psychology (1) should be an objective science that (2) studies behavior without reference to mental processes. Most research psychologists today agree with (1) but not with (2).

humanistic paradigm

argues that human behavior is the product of free will, and that we control, choose, and are responsible for our actions --> contrasts with idea of determinism, which essentially says that human behavior is caused by knowable factors
-- explicitly positive view of human nature (blames abnormal behavior on society instead of human nature)

comparison of paradigms

see image -->

systems theory

the idea that the brain is equal to more than the sum of its parts and emphasizes interconnectivity of systems

two approaches:
holism: holistic approach to abnormal behavior views mental illness in context of personality, interpersonal relationships, and society

reductionist approach: attempts to understand problems by focusing on smaller and smaller units, suggesting that smallest account is "true" ( in this case, neurochemistry)

equifinality

a basic principle of developmental psychopathology that holds that one symptom can have many causes

Multifinality

A basic principle of developmental psychopathology that holds that one cause can have many (multiple) final manifestations (inverse of equifinality)

reciprocal causality

mutual influences where "cause" and "effect" sometimes is a matter of perspective

diathesis-stress model

diathesis: predisposition towards developing a disorder
stress: environmental influence, difficult experiences
model states that risk of developing a disorder stems from a combination of these

risk factors

factors correlated with increased likelihood of a specific disorder, but that do not cause it

correlation coefficient

a statistical measure of the extent to which two factors vary together, and thus of how well either factor predicts the other (from -1 to +1)
- if there is a positive correlation coefficient, as one factor goes up so does the other one (inverse for negative: as one gets bigger other gets smaller)

reverse causality

a situation in which the researcher believes that A results in a change in B, but B, in fact, is causing A

third variable problem

A problem that occurs when the researcher cannot directly manipulate variables; as a result, the researcher cannot be confident that another, unmeasured variable is not the actual cause of differences in the variables of interest.

developmental psychology

an approach to abnormal psychology that emphasizes the importance of normal development in understanding abnormal behavior

premorbid history

pattern of behavior that. precedes behavior (linked to dev. psych)

prognosis

predictions about the course of a disease with or without treatment

neurotransmitters and psychopathology

common ones include:
- dopamine and schizophrenia
- depression and serotonin

mind-body dualism

psychology could not exist apart from biology
dualism is the common flawed belief that mind and body can be separated

anatomy of brain

broadly defined in terms of midbrain, hindbrain, and forebrain
hindbrain: regulates basic bodily functions --> rarely linked to psychopathology.

midbrain: control of some motor activities, like fighting and having sex

forebrain: most of the brain --> site of most sensory, cognitive, and emotional processes
- linked to rest of the brain by the limbic system, which includes the amygdala and hypothalamus

forebrain composed of...

two cerebral hemispheres, which are connected by the corpus callosum
-- left cerebral hemisphere: language and related functions
-- right cerebral hemisphere: spatial organization and analysis

ventricles:
-- four canals in the forebrain that contain cerebrospinal fluid. can be enlarged in some psychological and neurological disorders


cerebral cortex:
-- controls integration of memory, sensory, and motor functions
-- composed of 4 lobes:
frontal lobe: reasoning, planning, speech
parietal lobe: sensory processing, spatial info
temporal lobe: smell, sound, emotional regulation
occipital lobe: visual info

Psychophysiology

the study of changes in the functioning of the body that result from psychological experiences (ex. tears, pounding heart, etc.)

autonomic nervous system

the part of the peripheral nervous system that controls the glands and the muscles of the internal organs (such as the heart). Its sympathetic division arouses; its parasympathetic division calms.
-- regulates functions of different organs, such as the heart and stomach
-- responsible for psychophysiological reactions (reactions that occur with little/no conscious control)

family incidence studies

-- ask whether diseases run in families
-- work by identifying ill "probands" (index cases) and tabulating the frequency of other families suffering from the same disorder
-- because families share environments and genes, doesn't go super far in determining firm conclusions about role of genes vs env.

adoption studies

assess hereditary influence by examining the resemblance between adopted children and both their biological and their adoptive parents

twin studies

can provide strong evidence about genetic and environmental contributions
MZ twins: identical (share 100% of genes)
DZ: share 50% of genes
differ in genetic similarity, but are alike in their environmental influences --> thus, can help to explain role of genes

concordance rate (twins)

concordant: both twins have disorder or are free from the disorder

discordant: one twin has disorder and the other does not

if disorder is purely genetic, concordance rate should be 100% for MZ twins and 50% for DZ

gene-environment interaction

genetic predispositions and environmental experiences combining to produce more than their separate influences

gene-environment correlation

our experience is correlated with our genetic makeup

--> anxious parents give their kids an anxious upbringing and anxious genes

experience is not genetically random

Epigenetics

the study of environmental influences on gene expression that occur without a DNA change

psychological factors on human behavior

1. human nature
2. temperament
3. emotion
4. learning and cognition
5. sense of self
6. human development

evolutionary psychology

the study of the evolution of behavior and the mind, using principles of natural selection
focus on species-typical characteristics (motivations people genetically share in common) and individual differences

principles of evolution

- natural selection
- sexual selection (intra- and inter-sexual)

attachment theory.

Infants need secure relationships with an adult caregiver in order for healthy emotional development to occur (think insecure/anxious attachment).

dominance

social hierarchies observed both in humans and in animals in the wild --> can serve as motivation for antisocial behavior

modeling

the process of observing and imitating a specific behavior (when parents display abnormal behavior, kids may model)

labeling theory

Suggests that people become "deviant" because certain labels are attached to their behavior by political authorities and others. (in other words, a self-fulfilling prophecy) --> ex. does labeling someone as depressed have a negative impact on them?

categorical approach to classification

assumes that distinctions between different categories are qualitative. differences reflect kind (disease) vs quantity (how much of that disease)
- all or none decisions

dimensional approach to classification

-- describes objects of classification in terms of continuous dimensions
-- how much of the characteristic it exhibited?

need a classification system bc...

1. it's useful to clinicians, who must match their clients' problems with the form of intervention most likely to be effective
2. a classification system must be used in the search for new knowledge

DSM-5

the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; a widely used system for classifying psychological disorders.
-- 250 diagnostic categories
-- disorders that present with similar symptoms are grouped together (ex. anxiety disorders, depressive disorders)

dsm 5 addresses relationship between cultural issues and psychopathology by

1. encouraging clinicians to consider the influence of cultural factors
2. sensitizing clinicians to cultural issues
-- glossary in DSM-5 describes several cultural concepts of distress, or unusual patterns of behavior unique to certain societies

ataque de nervios

cultural concept of distress unique to Puerto Rico and other carribean countries in which symptoms include:
- a loss of control
- inability to interrupt the dramatic sequence of emotional behavior
- trouble eating and sleeping
- bodily sensations
- agression
generally ataques occur shortly after a close family member has died, after divorce, or after serious conflict with a child
--> especially common when social role is threatened... signals to other community members that the woman needs social support

reliability

the extent to which a test yields consistent results, as assessed by the consistency of scores on two halves of the test, on alternate forms of the test, or on retesting

validity

the extent to which a test measures or predicts what it is supposed to

etiological validity

concerned with factors that cause or contribute to the onset of the disorder --> ex. did it run in a family? what's happened in the past?

concurrent validity

the degree to which the measures gathered from one tool agree with the measures gathered from other assessment techniques (ex. do psychological tests and biological measurements (if possible) agree?)

predictive validity

The success with which a test predicts the behavior it is designed to predict; it is assessed by computing the correlation between test scores and the criterion behavior.

problems with DSM 5

-categorical diagnosis: either/or, not on a continuum (doesn't convey how much)
-doesn't account for overlap or co-morbidity between disorders
-diagnosis can be subjective
-based on symptoms, not underlying causes
- criteria of "significant impairment/distress" without defining how to measure this
- conceptual issues --> may be better to focus on homogeneous dimensions of disfunctions (such as anxiety) rather than syndromes

the barnum effect

People have the tendency to see themselves in vague, stock descriptions of personality, failing to understand that these descriptions apply to everyone --> psychological assessment should be held to a higher standard than this

split-half reliability test

A measure of reliability in which a test is split into two parts and an individual's scores on both halves are compared.

making a diagnosis

usually based on info collected from interviews, which is sometimes supplemented by info from records/info obtained from friends and family
psychological/biological testing isn't used to define anything in the DSM 5 except for intellectual disability

benefits of clinical interviews

1. subjective symptoms: opportunity to ask people for their own descriptions of their problems
2. allows clinician to observe nonverbal behavior
3. interviewer can control interaction and further probe when necessary
4. lots of info in short period of time

limitations of clinical interviews

1. patients may not be willing/unable to provide an accurate account of their problems
2. people may be reluctant to admit embarrassing or frightening experiences
3. info provided by client is solely filtered through the client's eyes
4. interviewers can influence clients' accounts based on the way they frame questions

observational procedures

formal observations:

- artificial situations that attempt to replicate the real environment in which a client's behavior manifests

- info is controlled for and could be used as an index of change as treatment progresses

informal observations:

- primarily qualitative

- occur usually in natural environment

rating scales:

- observer is asked to make judgements that place the subject somewhere along a dimension (can also be made on basis of info collected during interview)

- provide abstract descriptions of a person's behavior rather than a specific record of exactly what a person has done

- observer must make judgements and compare the subject to other people who demonstrate the "ideal" behavior

personality inventory

consists of a series of objective statements that a person must endorse as being true or not applying to them

MMPI (Minnesota Multiphasic Personality Inventory)

the most widely researched and clinically used of all personality tests. Originally developed to identify emotional disorders in 1940s (still considered its most appropriate use), this test is now used for many other screening purposes.
-- person reads a statement and marks it as true or false

actuarial interpretation

analyzing test results based on an explicit set of rules based on empirical research (ex. highest scores were on scales x and y and so look up the category of traits common to people who score high on x and y to make a prediction (NOT a claim)

advantages of MMPI-2

-Provides information about a person's test-taking attitude
-Covers a wide range of problems directly and efficiently
-Scored objectively
-Can be interpreted in an actuarial fashion

limitations of the MMPI-2

length, reading requirement, attention requirement, and emphasis on pathology/abnormality, profiles aren't stable over time

projective tests

personality assessments that present ambiguous visual stimuli to the client and ask the client to respond with whatever comes to mind
-- impressionistic scoring
-- low reliability and validity

mri vs ct scanning

mri uses magnetic fields
cts use radiation
mri is more detailed for the brain and so has largely replaced ct scans

PET scan

EXPENSIVE
radioactive
reflect changes in brain activity as person responds to certain tasks