Psyc 3082 Exam 1 - Gros

what is a psychological disorder?

what is a psychological disorder?

dysfunction associated with distress or impairment that is not typical or culturally expected

what are the 3 components of a psychological disorder?

- psychological dysfunction: breakdown in emotional, behavioral, or cognitive function

- typically causes some degree of distress or impairment

- atypical response

what is dysfunctional distress?

occurs when a person is much more distressed than other would be; impairment must be pervasive and/or significant

what is psychopathology?

scientific study of psychological dysfunction

what is a scientist practitioner?

practicing mental health professional; do treatment, consultations etc based on scientific information so licensed professionals must keep up to date on the latest information

what are the 3 branches of a scientist practitioner?

- consumer of science

- evaluator of science

- creator of science

what 3 categories make up the study of psychological disorders?

- clinical description

- causation (etiology)

- treatment and outcome

what is a clinical description?

- begins with he presenting problem, which is the chief complaint, or what brought the patient there

- includes symptoms

- aims to distinguishes common human experience from significant dysfunction

- also describes prevalence, incidence, onset, course, and prognosis

what is prevalence?

the rate of a disorder; how common this disorder is; pre-existing cases

what is incidence?

the number of new cases in a specific time period

describe onset and its types

- when the disorder began

- acute: sudden

- insidious: gradual

describe the course of a disorder

- what pattern the disorder takes

- episodic: comes and goes in episodes

- time-limited: only lasts certain amounts of time

- chronic: long term/stays

what is a prognosis?

anticipated outcome

- guarded: unsure/cautious of outcomes

- good: certain it will work out

define etiology

the origin or root of the disorder

what is the difference in a psychiatrist and psychologist?

psychiatrist can prescribe medicine/ has an MD, psychologist cannot

- Louisiana has special rules though

what are the 3 dominant traditions that have existed to explain abnormal behavior?

supernatural, biological, psychological

what was the basic belief of the supernatural tradition, and its treatments?

- battle of good vs evil

- believed to be caused by demonic possession, witchcraft, sorcery

- treatments include exorcism, torture, religious rituals, death

what was the competing view with the supernatural tradition?

-"insanity" caused by emotional stress, not supernatural forces

- treatments: rest, sleep, healthy environment, baths, potions

what are a few examples of mass hysteria believed by the supernatural tradition?

- Saint Vitus's Dance: involuntary movements in most areas of the body - originally viewed as possession, later recognized as sever untreated strep throat/fever that would spread to the people around them

- tarantism: mass hysteria in Italy with involuntary that was inflicted by a spider bite, not possession

what are some examples of modern mass hysteria?

emotional contagion, mob psychology

what was another view of the super natural tradition created by Paracelsus?

- swiss physician that suggested that mental health problems are affected by the pull of moon and stars (almost like a horoscope)

- inspired the term "lunatic" because its root is lunar, like the moon

who was the father of modern western medicine and what where his ideas?

- Hippocrates (460-377 BC)

- mental disorders understood as physical/medical disease

- hysteria of the wandering uterus: women get hysterical because their uterus is out of place

- linked abnormality with brain chemical imbalances

- first to say mental illnesses could be treated as medical disease

who extended Hippocrates's work, and what were his ideas?

-Galen

- humeral theory of disorders: functioning is related to having too much or too little of the 4 key bodily fluids (humors)

- blood, phlegm, black bile, yellow bile

how did Galen treat mental disorders based on his humor theory?

- changing environmental conditions (like reducing heat) or bloodletting/vomiting, nutrition, rest

what link was created in the later biological advances with general paresis (late stage syphilis)?

- linked with madness/dementia

- includes psychological and behavioral symptoms

- caused by a bacterium

- bolstered idea that mental illness=physical illness

who believed that mental illness is always due to physical disease and should be treated as such?

- John P. Grey and the reformers

- mental illness had physical roots

- championed biological tradition in the US

- led to reforms or hospitals to give psychiatric patients better care

what were some biological treatments from the biological tradition?

-insulin shock therapy

- electric shock

- crude surgery

- medication (available starting mid-20th century) like neuroleptics (major tranquilizers) aka antipsychotics and minor tranquilizers for anxiety and related disorders

what were some consequences of the biological tradition?

when meds wouldn't work, the disorder was deemed untreatable and patients were permanently hospitalized

who is the father of the classification of mental disorders?

Emil Kraepelin; done through observation of patients, consultations etc to publish a roughly 2500 page classification system

what 2 major groups did Kraepelin's system have for mental disorders?

- dementia praecox psychosis

- manic depressive psychosis

- further divided into 18 mental disorders

what French psychiatrist came before kraepelin that turned 5 forms of insanity? what are the 5 forms?

- Philip Pinel

- mania, melancholy with delirium, melancholy without delirium, dementia, idiotism

- increased role of science in psychopathology

describe moral therapy

- treated institutionalized patients as normally as possible in a setting that encouraged and reinforced normal social interaction

- created because other models quit trying to treat patients if they weren't getting better so this created more humane living treatments, though there weren't more effective treatments

why did the use of moral therapy decline?

due to to size and composition of the institutionalized population

what was the mental hygiene movement and who pioneered it?

- focused on providing care to everyone who needed it, causing a large influx in patients (both institutionalized and in the community)

- led by Dorothea Dix who opened metal hygiene and mental guidance clinics and wanted moral guidance

who is the father of psychoanalytic theory?

Sigmund Freud

what were Freud's 3 levels of awareness in the structure of the mind?

- 1st level: conscious: things, thoughts, feelings, behaviors, that one is readily aware of at any given point in time

- 2nd level: preconscious: thoughts, feelings, internal conflicts that one is not consciously aware of but readily available to be brought to conscious (have to really think to notice)

- 3rd level: unconscious/subconscious: deeply rooted internal conflicts and feelings and drives that we are unaware of and its extremely difficult to being there into one's level of conscious awareness; most thoughts etc reside

what are the 3 structures of the mind according to freud?

- id: operates on emotions/illogical/irrational and is motivated by the pleasure principle; not good at delaying gratification and not guided by morals

- ego: logical and rational, and operates on reality principle; uses reason

- superego: operates on conscience and moral principles

according to freud, how can someone be mentally healthy?

have to resolve the conflicts between the id, ego, and superego

- intrapsycic because it happens within the mind

what are defense mechanisms according to Freuds psychoanalytic theory?

egos attempts to manage anxiety resulting from id/superego conflict

what is self-psychology?

focused on the formation of self-concept and the crucial attributes of the self that allow an individual to progress toward health or neurosis

describe psychoanalytic psychotherapy

- designed to reveal the nature of unconscious mental processes and conflicts through catharsis and inside

- used free association, dream analysis, and analysis of transference

- research doesn't support the effectiveness of this, but support therapy in general

describe psychodynamic psychotherapy

- most supported

- derrived from psychoanalytic approach

- focus on affect and expression of emotion, past experiences, interpersonal experiences

- identification of patterns in actions, thoughts, feelings, experiences and relationships

describe the overall idea of the humanistic theory

- people are innately good and have morals and would naturally strive to become a better person

what did Abraham Maslow create?

hierarchy of need beginning with out most basic physical needs and ranging upward to needs for self-actualization, love, and self-esteem

- followed humanistic theory

what did carl rogers do?

- father of person/client centered therapy

- humanistic therapy emphasizing unconditional positive regard (no judgment - accepting as they are), empathy, and innate tendency towards growth

- people are naturally good and fully capable of feeling themselves

- emphasis on empathy so they can show they understand and are in tune with the persons feelings

who is the humanistic theory most effective for?

individuals without psychological disorders who are dealing with the stresses of life

what are the parts to Pavlov's classical conditioning?

- learning in which a neutral stimulus is paired with a response until it elicits that response

- unconditioned stimulus: stimulus that would naturally cause a response

- unconditioned response: response that would naturally happen in response to unconditioned stimulus

- neutral stimulus: paired with unconditioned response

- conditioned stimulus: same as neutral stimulus

- conditioned response: same as unconditioned response, but now its in response to neutral stimulus

-

what did John Watson do?

little Albert experiment with the baby and the rabbit

- psychology is a purely objective experimental branch of natural science with foals of prediction and control of behavior

what did Jospeh wolpe do?

- behavior therapy

- systematic desensitization

what did B.F. Skinner create?

operant conditioning

- learning in which behavior changes as a function of what follows the behavior (reinforcement)

- influenced by Watson and thorndike

- all voluntary behaviors are a function of reinforcement and reward

describe negative reinforcement

- a behavior occurs to avoid or remove something negative

what were 2 crucial developments in the 1990s in terms of the scientific method and integrative approach?

- increasing sophistication of scientific tools and methodology

- realization that no one influence - biological, behavioral, cognitive, emotional, or social- ever occurs in isolation

- no unidimensional approach to treatment

describe the one-dimensional model

- explain behavior in terms of a single type of cause

- tend to ignore information from the areas

- like if someone develops a phobia of spiders because of one negative interaction with a spider

describe the multidimensional integrative approach

- interdisciplinary, eclectic, and integrative system

- abnormal behavior results from multiple influences (biopsychosocial model)

what are the parts of the biopsychosocial model?

biological, behavioral, emotional, social/cultural, developmental

describe genes

- deoxyribonucleic acid (DNA) 46 chromosomes in 23 pairs

- dominant vs recessive genes that determine parts of physical and mental characteristics

- internal, coded, inheritable information

describe inheritability factors

- scale ranging from 0-1.0 that expresses how likely a trait is to be inherited vs developed because of environment

- 0 means its all environmental

- 1 means its all genetic

- accent and language spoken are both a 0 on the scale

what are almost always polygenetic? what percentage of variations in psychopathology are genes responsible for?

- development and behavior

- less than 50%

what happens as a result of learning experiences?

genetic structures of cells actually change

what is the diathesis-stress model?

- disorders are the result of underlying risk factors combining with life stressors that cause a disorder to emerge

- the greater the underlying vulnerability, the less stress is needed to trigger a disorder

describe the 2 parts of the diathesis-stress model

- diathesis: one may inherit a genetic predisposition to developing a disorder; underlying genetic risk factor

- stress: something in the environment like a stressful life event

describe the reciprocal gene-environment model

- assumed ones genetic makeup makes it more likely that the person would engage in certain behaviors and those behaviors make it more likely that a mental disorder would develop

- outcomes are a result of interactions between genetic vulnerabilities and experience

what is epigenetics?

environmental influences affect the expression of certain genes both for the individual and descendants

what are the key systems and structures in neuroscience?

- CNS and PNS

- neurons

- brain and its structures

- endocrine system

what are the parts of the nervous system?

- CNS: brain and spinal cord

- PNS: somatic and autonomic branches

what processes everything in the body?

nerves

what are the pars of a neuron and what they do?

- soma: cell body

- dendrites: branches that receive messages from other neurons

- axon: trunk of neuron that sends messages to other neurons

- axon terminals: buds at the end of axon from which chemical messages are sent

- synapses/synaptic cleft: small gaps that separate neurons

how do neurons work?

- operate electrically, but communicate chemically through neurotransmitters

what is reuptake?

- recycling of neurotransmitters that are absorbed back into the axon terminals

what are the 2 main parts of the brain structure?

brainstem and forebrain

what are the parts of the brainstem?

hindbrain, midbrain, thalamus, hypothalamus (between brainstem and forebrain)

- hindbrain is primitive

- primitive functioning is in brain stem because that's where the brain first started developing

what are the parts of the forebrain?

contains limbic system, basal ganglia, cerebral cortex (largest part of the brain, wrinkled outer structure)

what are the parts of the hindbrain?

- regulates automatic processes

- medulla: regulates heat rate, blood pressure, and respiration

- pons: regulates sleep stages

- cerebellum: involved in physical coordination

what does the midbrain do?

- coordinates movements with sensory input

- contains parts of the reticular activating system (RAS) which contributes to arousal and tension, which influences sleep and wakefulness

how does the PNS communicate?

bundles of axons

- somatic branch communicates with skin and muscles

what does the somatic branch of PNS do?

controls voluntary muscles and movement

what does the autonomic branch of the PNS do?

- involuntary processes like heart beat, stomach, internal organs, adrenaline

- sympathetic: fight/flight

- parasympathetic: rest/conservation

-regulates cardiovascular system and body temp, endocrine system and aids digestion

describe the thalamus and hypothalamus

- thalamus: major relay center for neurotransmission

- hypothalamus: just under thalamus and controls motivated behaviors like eating, drinking, sexual behaviors, fight/flight response

what does the limbic system do?

- just above thalamus and hypothalamus that helps regulate emotions and includes hippocampus that is specific for memory

describe the functions of neurotransmitters in general

- chemical messengers: transmit messages between brain cells

what are other types of chemical substances in the brain?

agonists, inverse agonists, antagonists

- most drugs are either agonistic or antagonistic

what are agonists?

- increase activity of a neurotransmitter by mimicking its effects

what are antagonists?

- inhibit or block the production of neurotransmitter or function indirectly to prevent the chemical from reaching the next neuron by closing or occupying the receptors; not blocking reuptake, just blocking it

what are inverse agonists?

produce effects opposite to a given neurotransmitter

what are the major neurotransmitters?

- serotonin (5-HT)

- glutamate

- gamma aminobutyric acid (GABBA)

- norepinephrine

- dopamine

what happens to neurotransmitters when there's an issue?

- they aren't being created more of, they are becoming more available by blocking reuptake

describe serotonin

- also known as 5-hydroxytryptamine (5-HT)

- influences information processing behavior, mood, and thoughts

- dysregulated serotonin may contribute to depression

- very low serotonin linked to instability and impulsivity

describe norepinephrine

- also called noradrenaline

- involved in alarm responses and basic bodily processes (like breathing)

describe dopamine

- implicates in depression and ADHD

- link between excess dopamine and schizophrenia

- link between reduced dopamine and Parkinson's disease

what is clinical assessment?

- systematic evaluation and measurement of psychological, biological, and social factors in a patient presenting with psychological issues

- typically leads to a diagnosis

what is a diagnosis?

- identification of a mental illness or other problem by examination of the symptoms

- degree of fit between symptoms and diagnostic criteria

- determination if a person meets the criteria for a mental disorder

what are the purposes of clinical assessment?

1. To understand the individual

2. To predict behavior

3. To plan treatment

4. To evaluate treatment outcome/progress

how is clinical assessment analogous to a funnel?

-starts broad

-multidimensional approach

-narrows to specific problems and ruling out other diagnoses

what are the 3 key concepts of clinical assessment?

reliability, validity, standardization

describe reliability and the 2 types

- degree of consistency of a measurement

- inter-rater reliability: consistent between scores generated by different evaluators

- test-retest reliability: consistency in scores when test is administered repeatedly

what is validity?

does the test measure what it's supposed to?

- comparison with other assessment

- how well the assessment predicts outcomes

describe standardization

- process by which a certain set of standards or norms is determines for a technique to make its use consistent (reliable) across different measurements

- helps with reliability

- provides population benchmarks for a comparison

- ex: structured administration, scoring, and evaluation procedures

describe the core of clinical work

- clinical interviews: most common clinical assessment method

- multifocal

what are the domains the clinical interview addresses?

- presenting problem

- current and past behavior

- detailed history

- attitudes and emotions

what is the mental status exam?

- involves systematic observation of an individuals behavior in an organized manner and includes:

- appearance and behavior

- thought processes

- mood and affect

- intellectual functioning

-sensorium/orientation