FINAL EXAM - PSYC 3303 - Abnormal Psychology CU Boulder

Section One

S1- Important People and their major accomplishments

Pinel- father of modern psychiatry

Freud- studies of unconscious mind, dream interpretation, desire

Mesmer- hypnosis/ hypnotherapy

Pavlov- "conditioned response"

Watson- Helped found behaviorism

Skinner- developing behaviorism

Wolpe- Behavior therapy, reciprocal inhibition and systematic desensitization

Rush- father of American psychiatry

Dix- established mental hospitals

Wundt- laboratory work

Kraepelin- founder of modern psychiatry and psychopharmacology

S1. Operant Conditioning Mechanisms

Positive vs. Negative Reinforcement- increases likely hood of behavior

Positive vs. Negative Punishment- decreases likely hood of behavior

Extinction- disappearance of a previously learned behavior when the behavior is not reinforced

Generalization- being unable to discriminate between stimuli. (fear of great heights/flashback occurs on small bridge)

Discrimination- being able to tell the difference between different stimuli

Shaping- reinforcing successive approximates- potty training --> reward --> desired behavior

S1. Cognitive Theory

mental processes as they are influenced by both intrinsic and extrinsic factors, which eventually bring about learning in an individual. we learn via our perceptions of relationships, from which arise appraisal and inner predictions.

S1. Biopsychosocial Model

Bio Factors- genetics, neurobiological, neurotransmitters, sympathetic vs parasympathetic, limbic system, neurotransmitters, hormonal imbalances and body's response to stress, genetic vulnerabilities

Psych Factors- early deprivation or trauma, inadequate parenting styles, marital discord or divorce, maladaptive peer relationships

Social Factors- economic status, unemployment, prejudice, discrimination, social change/uncertainty, urban stressors/violence and homlessness

Necessary vs. sufficient vs. contributory causes

Necessary = you must have x for y to happen

Sufficient = if cause x occurs then y will happen

Contributory= ___ can contribute to ____

Diathesis-stress model

predisposed vulnerability to a disorder, strong stressors can induce disorder, disorder ins't exposed until stressors exist.

Protective factors

attachment, nurturing, reassurance

Resilience

build a resistance due to past experience, helicopter parents decrease resiliency.

Neural plasticity

compensation for disability- blindness increases hearing

correlational vs. an experimental study?

In correlational studies a researcher looks for associations among naturally occurring variables.

In experimental studies the researcher introduces a change and then monitors its effects.

Analog studies

attempts to replicate or simulate, under controlled conditions, a situation that occurs in real life, create conditions analogous to real life, 48 hours for baseline to return

Double-blind studies

in which neither the subjects nor the researchers know which subjects are receiving the active medication, treatment, etc., and which are not: a technique for eliminating subjective bias from the test results.

Epidemiological studies

prevalence of study, The prevalence, incidence, distribution patterns, and treatment of disease are all components in epidemiology.

Longitudinal studies

data is gathered for the same subjects repeatedly over a period of time.

Cross-sectional design

look at multiple age groups (different subjects) to assess disorder over long period of time

Case studies

not generalizable, method of evaluating and describing rare disorders.

Single case experimental designs

subject serves as his/her own control, rather than using another individual/group

Genotypes, phenotypes, endophenotypes

G- The total set of genes contained within an organisms cells

P- the physical and psychological characteristics of an organism from both genetics and environment

E- separate behavioral symptoms into more stable phenotypes with a clear genetic connection

Assesment

Assessment- procedures used to identify symptoms and prevalence.

Diagnosis- the formal classification of the symptoms using a specific system like the DSM

Broad to Narrow focus

Principles of assessment= reliability, validity, standardization.

present problem, behavioral history, intellectual functioning, personality characteristics, environmental pressures, medication health history, prior treatment.

Behavioral Assesment

target behavior, A-B-C antecedents, behaviors, consequences. behavioral orientation, self monitoring.

DSM Prototypical Approach

groups people/symptoms into categories and makes them attributable to multiple individuals

Problems with the DSM

PSTD, acute stress and adjustment-

...To have PTSD you must have acute stress for 30+ days

prolonged exposure

risk factors in development

SECTION 2 - anxiety and panic

panic disorders

recurrent unexpected panic attacks

panic attaks

abrupt surge of discomfort or fear, , palpitations, pounding heart and increased heart rate, sweating.

Interoceptive cues- person becomes afraid of symptoms of panic attack , panic attack becomes what they are truly afraid of

not everyone who has panic attacks have a panic disorder.

cognitions- selective attention, stressful life event,

genetic vulnerability to anxiety/ neuroticism, abnormally sensitive fear networks involving the amygdala. serotonin and norephniphrine fight or flight

treatments

gradual exposure, panic control treatment, medications, combined treatment- relapse rates

CBT

agoraphobia

afraid of having a panic attack in public

GAD

OCD

mechanisms of OCD (negative reinforcement)

Exposure and response prevention

body dysmorphic disorder

...involves belief that one's own appearance is unusually defective, while one's thoughts about it are pervasive and intrusive, although the perceived flaw might be nonexistent.

Major Depressive disorder

symptoms- depressed mood, diminished interest in pleasure and changes in weightm insomnia or hypersomnia, psycho motor change, fatigure, feelings of worthlessness or guilt, trouble making decisions.

You can have a major depressive episode, if youve ever had a manic episode you will be diagnosed with bipolar 2 not MDD,

BiPolar 1

major depressive episode + manic episode (typically) can have mixed episodes

BiPolar 2

major depressive episode and hypomanic episode

Double Depression

Major depressive episode occurs typically after individual has had persistent depressive disorder for at least 2 years, associated with poor prognosis. 79% of individuals with persistent depressive disorder also have major depression

symptoms of negative affect

Causal factors of mood disorders

genetic vulnerability, neurobiological factors, stressful life events, behavioral deficits, cognitive errors, social support factors including relationship distress

Bipolar- genetic influences polygenic and vulnerability to mania and depression seems to be inherited separately. dysregulation of norephineprin, dopamine, and serotonin. Dysregulation of the HPA or HPT axis, dysregulation in PFC limbic system. sleep rhythm difficulties

treatment

CBT- activity scheduling, increase pleasent activities

cognitive rehearsal of steps, assertivness training. role playing. identify automatic thoughts, re attribute blame of negative consequences. help search for alternative solutions.

Behavioral Activation- life events including trauma, loss, biological predisposition lead to lower levels of positive reinforcement. short term coping strategies may be detremental in the long run. BT targets through scheduling activities and task assignments. encourages and structures activities to get people involved in their lives.

classes and medications

Eating Disorders

Anorexia Nerviosa

prevelance is up to 1% of adolecent girls and young women, onset 12-18 patients may be overweight initially. Highest mortality rate of any DSM disorder. 20% of anorexics die, 50% of deaths are suicide.

Symptoms-

restriction of energy intake and significantly low body weight in the context of age and gender development. intense fear of gaining weight, distorted view of body,

Types- restricting and binge/purge

avoiding eating with others, unusual eating habits, compulsive exercise, hyperactivity and fatigue. isolation.

dry skin, shallow complexion, brittle hair, nails, purple nail beds. sensitivity or intolerance for cold. low blood pressure, electrolyte imbalnces

Comorbidity- depression 60%, anxiety disorders especially OCD, substance abuse, diagnostic crossover between subtypes

Bulimia Nerviosa

symptoms-

maintain body weight, recurrent episodes of binge eating, sense of lack of control during binge, recurrent compensatory behaviors (vomiting, purging, exercise)

1 time a week for 3 months

disturbed body image, dont meet criteria for anorexia

90% are women,

salivary/lymph gland enlargement, electrolyte imbalance, cardica arhthmia, headaches fatigue

Biopsychosocial

highly responsive to stress, negative evaluation from others. binge priming, women= apetite influenced by monthly increase in body fat, low levels of serotonin associated with impulsively.

genetic factors- twin and family, studies show increased likelihood.

Psycho-

stress, low sense of personal control

poor self image,

disturbed body image

social-

family environment

lack of communication- low support

high pressure over ambitious

apperance focused, intrusive and critical parents, discomfort handling conflict

Treatment-

Anorexia- hospitalization, weight gain using h=behavioral methods, attend to dysfunctional anxious cognitions about becoming obese, losing control of eating, family therapy maudsley model

Bulimia- first step admit problem seek help, medications, antidepressants, interpersonal therapy, combined treatment, self help manuals

Schizophrenia

domains of functioning

symptoms

disorganized symptoms

DSM criteria

phases and symptoms

theories of causation-

medication and treatment

ADHD

phisiology of schizophrenia

Broad array of cognitive and emotional dysfunctions, including hallucinations and delusions, disorganized speech and behavior, inappropriate emotions.

Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3):

delusions

hallucinations

disorganized speech

grossly disorganized/catatonic behavior

negative symptoms

Functional impairment

Not something else

Positive Symptoms of Schizophrenia-

Something is there that shouldn't be

Delusions - of grandeur, of persecution, irrational beliefs about self or world. May be adaptive.

Hallucinations - Auditory more common than visual, olfactory, gustatory, etc. Broca's area active.

Negative Symptoms-

Avolition - apathy - inability to initiate and persist in activities

Alogia - relative absence of speech

Anhedonia

Affective flattening - difficulty expressing emotion

Disorganized Symptoms-

In speech: illogical, incoherent, tangentiality, loose associations or derailment, clanging

In behavior: inappropriate affect, disorganized behavior or catatonia

cortical type schizophrenia

Cortical Type

20% of subjects

Symptoms: poor attention, disorganized thinking, poor recall, many false memories, poor recognition memory, but lacked serious delusions/negative symptoms.

Physical findings: Temporal lobes of cerebral cortex and hippocampus smaller and less active

ventricle type schizophrenia

Ventricle Type

50% of subjects

Symptoms: Mild memory problems, mild symptoms.

Physical findings: More enlargement of ventricles, (suggesting general atrophy of brain tissue) than the cortical group, more tissue loss in the temporal lobes than the subcortical group.

subcortical type

Subcortical Type

30%

Symptoms: Limited speech, poor attention, disordered thinking, positive and negative symptoms

PET scans normal, but MRI revealed thinning in the gray matter of the frontal cortex (governs planning, judgment and initiative). Normal temporal lobes.

phases of schizophrenia

Prodromal

Active

Residual

causal factors

Schizophrenogenic mother/double bind

Genetic vulnerability

Neurotransmitters

Neuroanatomy

Prenatal environment

Disrupted neurodevelopment

Neurotransmitters-

Dopamine hypothesis -

Positive symptoms: excess of dopamine in limbic system

Negative symptoms: deficit of dopamine in cortical areas

Serotonin deficits (same as depression?)

GABA and glutamate associated with cognitive deficits

Elevated cortisol production

Prenatal environment-

Maternal genital or reproductive infections during conception

Nutritional deprivation in early gestation

Lead exposure in 2nd trimester

Rh incompatibility (Rh- mom, Rh+ baby)

Bleeding during pregnancy

Severe prenatal maternal stress

Influenza in 2nd trimester

schizophrenia treatment

Pharmacological Treatment

Older antipsychotics (neuroleptics)

Newer antipsychotics (atypicals)

Issues related to medications:

Dosage levels, breakthrough symptoms, compliance (NIMH study 60% stopped meds), interactions and long-term side effects

(New drug stimulates glutamate receptors)

Psychosocial Treatment Strategies

Family intervention

Case Management

Cognitive Remediation

Individual Treatment

Sheltered living environments

Social skills training

Cognitive-Behavior Therapy

Cognitive Behavior Therapy

Learn to distinguish between hallucinations and real people

Highlight importance of taking meds

Discuss obstacles to compliance

Develop effective coping strategies (like how to move forward with activities despite delusions)