Psych test 4

Psychological disorders

Disorders reflecting abnormalities of the mind

-Disturbances in thoughts, feelings, and emotions are persistant and uncontrollable

-Associated with significant stress or impairment

-From internal dysfunction (biological, psychological, both…not external sources like drugs)

Medical student disease

The tendency to diagnose everyone you know

Medical model

The conceptualization of psychological abnormalities as diseases: have symptoms, causes, and possible cures

-Diagnosis, symptoms, syndrome

Intervention-causation fallacy

The assumption that if a treatment is effective, it must address the cause of the problem

DSM-V

Diagnostic and statistical manual of mental disorders

-A classification system describing diagnostic criteria, symptoms, ways to distinguish one disorder from another

Comorbidity

The co-occurence of two or more disorders in a single individual

WHODAS

World Health Organization Disability Assessment Scale

-Assesses the impact of impairment of a disorder

-36 items, self-administered, measure of illness disability over past 30 days, applicable to any illness

-Tracks progress, helps with communication with psychologist

Problems with DSM-V

-Danger of overdiagnosis (ADHD is diagnosed 10x more in the US than in Europe)

-Power of diagnostic labels (diagnoses follow individuals. Expectations influence perception)

-Confusion of serious mental disorders with less significant problems (schizophrenia versus caffeine-induced sleep disorder)

-Illusion of objectivity and universality (different cultures affect what is seen as typical vs atypical behaviors and how symptoms are displayed. Some disorders are historically bound (Drapetomania))

Diathesis

Stress model

A model suggesting that a person may be predisposed for a mental disorder that remains unexpressed until triggered by stress (nature vs nuture)

Generalized Anxiety Disorder

Long-lasting feelings of apprehension and doom

-Chronic, excessive worry accompanied by ≥3 of the following symptoms:

Restlessness, fatigue, concentration problems/blank mind, irritability, muscle tension, sleep disturbance

Panic Disorder

Recurring attacks of intense fear/panic/terror

-Followed by ≥1 of these symptoms for ≥1 month:

Attacks followed by persistent concern about having another attack, worry about implications of attacks, significant change of behavior related to attacks

Agoraphobia

Fear of public places

-Anxiety in places or situations where escape might be hard or embarrassing or where help may not be available if you have a panic attack

-Situations are avoided or endured with marked distress/panic attacks

Panic Attack

Discrete period of time of panic in which ≥4 symptoms develop and reach peak by 10 minutes:

Heart rate increase, sweating, shortness of breath, feeling of choking, chest pain, nausea, dizziness or lightheadedness, feeling of unreality or being detached from oneself, fear of losing control or going crazy, fear of dying, numbness or tingling, chills or hot flashes

Anxiety Sensitivity Model

A model for why people develop panic disorders

Interpretation of physiological symptoms determines whether or not you will have a panic attack

Phobic Disorders

Disorders characterized by marked, persistent, and excessive fear and avoidance of specific objects, activities, or situations

Specific Phobia

Irrational fear of a particular object or situation that markedly interferes with an individual’s ability to function

Animals; natural environments (heights, dark, storms); situations (bridges, elevators); blood, injections, illness, dying

Preparedness Theory

The idea that people are instinctively predisposed toward certain fears

Social phobias

Irrational fear of being publicly humiliated or embarrassed

-Situations where they are being observed, like eating in a restaurant, public speaking, at a party, or performance

-Fear they will say or do something embarrassing

Obsessive-Compulsive Disorder (OCD)

A disorder where obsessions and compulsions significantly interfere with one’s functioning

Obsessions

Recurrent, persistent, unwanted thoughts or images

-Contamination, death, sex, disease, orderliness, disfigurement, aggression

Compulsions

Repetitive, ritualized, stereotyped behaviors that a person feels must be carried out to avoid disaster

-Cleaning, checking, repeating, ordering, counting

Power of Labelling (Study)

1950’s: 3 women, 5 men, 12 hospitals

Psychologists went to inpatient hospitals and said they had auditory hallucinations. All were admitted and acted normally for the rest of their visits. All were diagnosed with schizophrenia. Average stay was 19 days.

Post-Traumatic Stress Disorder (PTSD)

-Need trauma (threatens life/causes physical harm, or witnesses trauma)

Characterized by:

recurrent, intrusive thoughts

Negative alterations in cognitions or mood (negative beliefs about oneself or world, feeling alienated, blame of self or others, diminished interest)

-Alterations in arousal and reactivity (insomnia, irritability, impaired concentration)

-Avoidance

Symptoms impair functioning

You are more likely to develop PTSD if…

Poor coping skills, previous trauma, low social support, lower IQ, smaller hippocampus, low socioeconomic status

Treatment for PTSD

Exposure therapy (revisiting place, creating trauma narratives)

Depressive Disorders

Characterized by extreme and persistent periods of depressed mood

Major Depression

Disorder characterized by ≥5 symptoms:

-Significant weight loss/gain OR decease/increase in appetite

-Insomnia or hypersomnia

-Psychomotor agitation or retardation (restless, slowed down)

-Fatigue or loss of energy

-Feelings of worthlessness or excessive inappropriate guilt

-Inability to concentrate, make decisions

-Recurrent thoughts of death, suicidal ideation with plan,

suicide attempt

!Must have depressed mod OR loss of interest in previously pleasurable activities

*2x more often diagnosed in women

Dysthymia

The same cognition and bodily problems of depression, but they are less severe and last longer (persisting for at least 2 years)

Double depression

Periodic major depression and dysthymia

Postpartum Depression

After giving birth; biological, social, and responsibility changes

Seasonal Affective Disorder (SAD)

Recurrent depressive episodes in a seasona pattern

Why do people develop depression

-Genetic component, runs in families

-Neurotransmitter differences (low serotonin)

-Brain structure differences (but correlated not necessarily causal)

-Stress, Trauma

Helplessness Theory

attribute negative experiences to causes that are internal (their fault), stable (unlikely to change), and global (widespread).

Beck’s Cognitive Triad

Self, future, world

Cognitive Behavioral Therapy Triangle

Relationship between thoughts, emotions, behaviors

*you don’t need motivation to change (behavior activation)

Suicide Statistics

#3 cause of death in high school and college students

In US, women attempt 3-4x more, but men are 3-4x more likely to succeed (men are more likely to use a violent method)

Bipolar Disorder

An unstable emotional condition characterized by cycles of abnormal, persistent high mood (mania) and low mood (depression)

Bipolar I

Major depression + manic episode

Bipolar II

Major depression + hypomanic episode (not severe enough to cause marked impairment)

Rapid Cycling Bipolar Disorder

Characterized by at least 4 mood episodes

Manic Episode

Abnormally high state of exhilaration, feeling powerful, full of plans based on delusional ideas, impulsive, high-risk behaviors

-inflated self-esteem, decreased need for sleep, racing thoughts, easily distractable

Dissociative Disorder

A condition in which normal cognitive processes are severely disjointed and fragmented, creating significant disruptions in memory, awareness, or personality that can vary in length from a matter of minutes to many years

Dissociative Identity Disorder (DID)

The presence within an individual of two or more distinct identities that, at different times, take control of the individual’s behavior. Inability to recall important personal information too extensive to be ordinary forgetfulness

-emerges as a means to cope with trauma

-people generally unaware of alters until therapy

-controversial rise in diagnosis generated by clinicians, true rates are probably low

Schizophrenia

“Personality loses its unity”, a disorder characterized by the profound disruption of basic psychological processes; a distorted perception of reality; altered or blunted emotion; and disturbances in thought, motivation, and behavior

Addiction

State of psychological and/or physical dependence on the use of substances or on activities/behaviors →addiction is measured by behavior

Different types of substance use

use (trying occasionally), abuse (using in harmful ways), dependence (body adapts to drug), addiction (complete loss of control)

Tolerance use disorder

Marked by tolerance (requiring higher dosage for same symptoms) and withdrawal

Biopsychological model

Risk factors that increase the likelihood of addiction

-biology (genetics, family history)

-social (peer pressure, availability of drug)

-psychological (trauma, anxiety, depression)

Vietnam Heroin Study

During Vietnam War: high stress, high availability

-30 - 40% of veterans used and were addicted to heroin…90% quit easily back home

-shows that environment changes outcome of addiction

Substance use disorders

Using chemicals that alter brain function (alcohol, cannabis, stimulants, etc)

Behavioral addictions

Addictions to behaviors that act on the same reward systems of substances (gambling, social media, gaming, etc)

Mesolimbic reward system

Controls what behaviors should be increased to increase motivation/dopamine

-When substances are introduced, the prefrontal cortex (rational) and mesolimbic system (rewards) battle. With the introduction of addictive substances, mesolimbic releases too much dopamine, and everything else becomes secondary

-Connects to emotions/memories

Treatments for addiction

-Cognitive behavioral therapy (challenges negative thoughts to promote behavior change)

-Group/social support (brings people out of isolation)

-Medication-mediated recovery (often an option for opiod addictions)

Positive symptoms of schizophrenia

Additions to normal behavior

-delusions (beliefs), hallucinations (sensory experiences), disorganized/incoherent speech, disorganized/inappropriate behaviors

Negative symptoms

Loss of normal traits/behaviors

-emotional flatness, unable to speak fluently, unable to care for self, catatonic stupor

Dopamine hypothesis

People with schizophrenia have an abnormally high number of dopamine receptors

Brain structure hypothesis

People with schizophrenia have enlarged ventricles, which causes increased brain tissue loss over time

Genetic predisposition to schizophrenia

1% lifetime risk in general population, 50% in identical twins, 40% for those with two schizophrenic parents, 12% for those with one schizophrenic parent

*schizophrenia has a very high genetic component

Diathesis-stress model

Predisposition + Disturbed Home Environment Example:

• Bio mom Sz + disturbed adoptive home → high risk of Sz

• Bio mom Sz + healthy adoptive home → moderate risk

• Bio mom NO Sz + disturbed adoptive home → low risk

Prenatal environment hypothesis

Malnutrition, viral infection, or birth complications increase the risk a child will develop schizophrenia

Psychodynamic psychotherapies

Assumes that humans are born with urges that are suppressed through defense mechanisms

-Goal is to bring repressed conflicts to consciousness to understand them and reduce their influence

Psychodynamic techniques

Free association, dream analysis, interpretation, analysis of resistance, transference, countertransference

Free association

Psychodynamic technique in which the patient talks without interference until they stop self-censoring

Dream analysis

Psychodynamic technique in which therapist interprets dreams as unconscious desires

Interpretation

Psychodynamic technique in which clinicians explain the hidden meanings behind a patient's behaviors, thoughts, or emotions

Analysis of resistance

Psychodynamic technique that if a patient resists a diagnosis/explanation that that explanation was close to home/correct

Transference

A psychological phenomenon where an individual unconsciously redirects feelings, desires, and expectations from past significant relationships onto their therapist (asks question: does that pattern exist beyond therapy?)

Countertransference

A therapist's unconscious emotional, cognitive, or behavioral reaction to a patient, often stemming from the therapist's own history or as a response to the patient's transference

Behavior therapy

Assumes that disordered behavior is learned

Symptom relief is achieved through changing overt maladaptive behaviors into more constructive behaviors

-Goal: eliminate unwanted behaviors (by changing consequences), promote desired behaviors, reduce unwanted emotional responses

Behavioral therapy techniques

Behavioral self-monitoring, token economy, skills training, exposure therapy, systematic desensitizing

Behavioral self-monitoring

Behavioral therapy technique wherein a patient tracks experiences and notices patterns behind them

Token economy

Behavioral therapy technique wherein behavior is motivated by positive reinforcement (such as a gold star)

Skills training

Behavioral therapy technique wherein emotional skills are taught (belief that people are doing the best they can but do not have the techniques to do better)

Exposure therapy

Confronting emotionally arousing stimulous continously until emotional response decreases

Systematic desensitizing

Relaxing body while imagining increasingly distressing stimuli

Cognitive Therapy

Involves helping a client identify and correct any distorted thinking about the self, others, and the world

Cognitive restructuring

Teaches clients to question the automatic beliefs, assumptions, and predictions that often lead to negative emotions and to replace negative thinking with more realistic and positive beliefs

All or nothing thinking

Cognitive distortion in which a person views situations, oneself, or others in extreme, black-and-white categories with no middle ground (if it’s not perfect, it’s a failure)

Overgeneralization

Cognitive distortion in which a single negative event is viewed as an unending, universal pattern of failure as a person

Mental filter

Cognitive distortion in which an individual focuses exclusively on negative details while ignoring positive aspects of a situation, leading to a skewed, pessimistic view of reality

Cognitive behavioral therapy

Blend of cognitive and behavioral therapeutic strategies

-Assumes thoughts and behaviors influence each other

-Problem focused, action orientated, transparent

Humanistic therapy

Uses unconditional positive regard and assumes patients will move themselves towards self-actualization

-Emerged in 1950s-1960s

Carl Rogers

Famous humanistic psychologist

Person(Client)-focused therapy

Assumes all individuals have a tendency towards growth that can be facilitated by acceptance and genuine reactions from the therapist

-With adequate support, client will recognize the right things to do and increase self-regard

Humanistic therapy techniques

Nondirective, cognizance, empathy, unconditional positive regard

Nondirective

A humanistic technique in which no direct advice from the therapist is given. Patient is leading the session: therapist reflects back what they say

Empathy

A humanistic technique in which the therapist understands and identifies with client

Cognizance

A humanistic technique in which the therapist communicates honesty and openness at all levels (eye contact, tone of voice, body language)

Unconditional positive regard

A humanistic technique in which the therapist creates a non-judgmental environment

Fritz and Laura Perls (1940s-1950s)

Existential therapists. Left Germany during WWII, moved to US. Fritz moved to California, Laura stayed in New York and published books (did not receive credit)

Gestalt/Existential Therapy

Help clients become aware of their thoughts, behaviors, experiences, and feelings, and to “own” or take responsibility for them

Greater awareness of “here and now” will lead to a full and meaningful life

-Goal: Cope with inescapable realities of life, death, and the struggle for meaning

Gestalt techniques

Therapist is warm and enthusiastic to clients

Emphasize experiences in the present therapy session (here and now)

-Focusing: as client describes stressful events, therapist asks how it feels to talk about it today

-Somatic sensations: Discuss body movements and feelings in therapy (clenched fists, shaky legs, etc)

Empty chair technique

a Gestalt therapy method where a patient dialogues with an empty chair representing an absent person, a part of themselves, or an emotion

Group therapy

Multiple participants work on individual problems in a group atmosphere

Encourage participants to talk to each other, practice relating to others, feel less alone, share insights on how to cope

Self-help and support groups

Often run by peers who have struggled with the same issues (Al-anon (for those with loved ones with addictions), AA)

Couples therapy

Break repetitive difficult patterns

Family therapy

Problem in one family member is associated with dysfunction in entire family

Psychopharmacology

The study of drugs effects on psychological states and symptoms

Antipsychotic drugs

Medications used to treat schizophrenia and related psychological disorders

Conventional or typical antipsychotics

Haldol

-Blocks dopamine receptors

-Side effects: tardive dykenesia - involuntary movement of face, mouth, extremities