(Textbook Chapters 14.1-14.6; Page #’s 539 - 553)

*all term pg #’s found in the chapter summary*

• Psychological disorders: characterized by abnormal thoughts, feelings, and behaviors that cause significant distress or impairment in functioning.

• Maladaptive behavior: behavior in a society that deviates from the normal culture, is self-destructive, or causes discomfort to oneself or others.

  • It is only maladaptive if it affects:

    • one’s work

    • relationships

    • self-care

• Emotional distress: can manifest in various forms, including persistent sadness, excessive worry, or feelings of hopelessness, which can hinder daily activities and overall quality of life.

• Observer distress: behavior exhibited by an individual that causes the ones around them distress or discomfort.

• Psychopathology: an illness of the mind and/or brain

• Etiology: factors that contribute or lead to the development of a disorder

  • commonality between patients with the same disorder

• Self-diagnosis: the phenomenon of learning about an illness followed by experiencing phantom symptoms due to hyper fixation

  • i.e.: confirmation bias for doctors or psychologists

• Factors in diagnosis:

  • does a person deviate from the norm?

  • is the person’s behavior maladaptive?

  • does the behavior impair interpersonal distress?

• DSM 5: A standardized classification system used by mental health professionals to diagnose psychological disorders, providing criteria for various conditions and facilitating communication regarding mental health.

  • The DSM is categorically based

• APA: The American Psychological Association; provides guidelines for ethical practices in psychology, including publishing and disseminating research findings related to psychological disorders.

• Categorical approach: the idea that a disorder either is or isn’t, there is no in-between.

  • Cons: fails to account for differences in the severity of a disorder

• Dimensional approach: the notion that disorders fall on a spectrum rather than black-and-white diagnoses allows for a more nuanced understanding of an individual's symptoms and the potential for varying treatment needs.

  • cons: where a person lands on a spectrum of a disorder shifts from person to person and culture to culture

• Comorbidity: the idea that multiple disorders can co-occur in an individual, complicating diagnosis and treatment as these overlapping conditions may influence each other.

  • Example: substance abuse is common across many psychological disorders, but determining what a person has purely based on substance abuse is impossible

• The biopsychosocial influence is an integrative approach considering biological, psychological, and social factors influencing mental health.

  • Bio(one’s genes) - Psycho(one’s mentality) - Social(one’s environment)

• p-factor: A general factor that underlies various psychological disorders, suggesting that some individuals are more predisposed to mental health issues based on this overarching vulnerability.

  • high scores = a greater risk of developing multiple psychological disorders and greater life impairment

• Assessments: Tools and methods used to evaluate mental health conditions, including clinical interviews, self-report questionnaires, and standardized tests.

  • finds behaviors indicating the presence of disorder or brain region activation associated with mental disorders

• The diathesis-stress model: the idea that psychological disorders develop due to the interaction between a predisposition vulnerability (diathesis) and external stressors interacting.

  • high environmental stress + pre-existing condition/predisposition = increased likelihood of developing a psychological disorder.

• Family system model: the approach that emphasizes the role of family dynamics, relationships, and genetics in the development and treatment of psychological disorders.

  • i.e.: “If you're screwed in the head, you’re family’s also probably screwed in the head.”

  • i.e.: used to determine if the family is either productive or counter-productive in treatment

• Social-culture model: A framework that examines how societal and cultural factors, including socioeconomic status, cultural norms, and community support, impact mental health and the manifestation of psychological disorders

  • i.e.: mental health cannot be fully understood without considering the broader social context.

• Cognitive-behavior approach: A therapeutic method that focuses on identifying and changing negative thought patterns and behaviors, emphasizing the connection between thoughts, feelings, and actions.

  • i.e.: if a psychological disorder is a learned behavior, it can also be unlearned.

• Anxiety disorder: mental disorder categorized by fear and anxiety even in the absence of danger

• Specific phobias: fear or anxiety based solely on an object, animal, environment, etc

  • fear of heights, spiders, clowns, long words

• Social anxiety disorder: intense fear of social situations where one might be judged or scrutinized by others

  • i.e.: public speaking events, presentations in front of others

• Generalized anxiety disorder: excessive worry about various aspects of daily life, often without a specific cause.

• Panic disorder: characterized by recurrent and unexpected panic attacks lasting seconds to minutes

• Agoraphobia: fear of being put into an environment or situations in which it is very hard or impossible to escape

  • i.e.: shark cage

• Two Stages of Anxiety Disorders:

  • 1st: bias thinking: believing something bad is about to happen

  • 2nd: learning/observing: witnessing others in fearful situations can lead to the development of anxiety through modeling behavior

• Obsessive Compulsive Disorder: a disorder characterized by intrusive thoughts (obsessions) that produce anxiety and repetitive behaviors (compulsions) that the individual feels driven to perform to reduce that anxiety.

  • i.e.: washing hands repeatedly to alleviate the fear of germs or checking locks multiple times to ensure safety

• Catastrophe: a cognitive symptom associated with OCD in which one has a loss of control over their thoughts and behaviors.

• OCD vs. Anxiety: people with OCD recognize their compulsions while those with anxiety may not have awareness of their irrational fears.

• Bipolar disorder: a mental health condition characterized by extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).

• Schizophrenia: a severe mental disorder that affects how a person thinks, feels, and behaves, often leading to distorted perceptions of reality, hallucinations, and delusions.

Who Provides Therapy?

• Autism Spectrum Disorder review(missed from last lecture):

  • Sensory sensitivities: over or under-sensitivity to sensory input

    • light, sound texture, etc

  • Restricted interests and repetitive behaviors

  • Divergent social communication: engaging with the world differently

  • Varied presentations: intellectual abilities, average or above-average intelligence

  • no single cause: various genetic, environmental, and neurological factors contribute to the development of these disorders.

  • Early signs: i.e. signs in infanthood, different people diagnosed at different ages

• Clinical psychologist: PhD or PsyD

• Psychiatrist: MD or DO

• counseling: MA, MS, MFT

  • doctorate or masters-level training; often school department, treating less severe disorders(school counselors, for example)

    • marital/family psychologist

• social worker: BSW, MSW from school

  • doctoral or master level training; emphasized social systems for than psychology; needs a license to practice

• psychiatric nurse: varies, however usually schools of nursing

• paraprofessionals

• Difference between clinical vs psychiatrist

  • Clinical: doctorate level training(Ph.D or Psy.D), must complete research training, dissertation, internship + supervised training, licensed by the state, practices psychotherapy, most DONT prescribe drugs or treatment

  • Psychiatrist: M.D.; CAN prescribe drugs, licensed to practice medicine, trained to give psychotherapy

  • What is a psychoanalyst?

    • someone who practices classic Freudian practices

      • Psychodynamic, psychoanalysis, etc

• Prescribing Medications?

  • Psychiatrists and psychiatric nurses most often

  • 5 states: clinical psych can

• Scope of Intervention:

  • individual, familial, community + institutions

• Treating conditions: psychiatrists and clinical treat the most severe

• Paraprofessionals: clergy, religious leaders, community mentors, pastor, etc

  • some training; unlicensed, no real training, even if they do help people

  • peer groups: still provide genuine help; life coaches, AAA, Dr. Phil

Psychotherapy?

• Psychotherapy treats abnormal behavior with interactions between the patient/client and a professional

  • Most fall under:

    • psychodynamic

    • behavior therapy

    • cognitive therapy

• Insight: “bringing the unconscious to the conscious”

  • free association

  • interpretation(dreams, projective tests, ink blot test)

  • analysis of resistance and transference(when do you show defense mechanisms?)

  • usually ineffective

• Behavioral Therapy:

  • Learned through modeling

  • Classical conditioning

    • Baby Albert

  • Operant conditioning

    • Neg/Pos + Reinforcement/Punishment

      • Pavlovs dog

  • “Everything is learned, therefore everything can be unlearned”

  • Exposure therapy: exposing a patient to fear(phobia, for ex), can be very effective

    • OCD: works for OCD so much better in combination with drug

      • Figure 15.14 in Textbook

• Cognitive Therapy:

  • “How do you think about things?”

    • “What’s the maladaptive behavior?”

  • Cognitive restructuring: recognizing maladaptive behaviors and reframing/looking at them from a new angle

  • Rational-emotive therapy: the therapist acts as the teacher explaining errors in the patient’s way of thinking + introducing new more adaptive ways to think

• Cognitive Behavioral Therapy: just a combination of both types of therapy

  • Often most effective therapy

Biological Therapies?

• Three Types:

  • Mechanical(take away parts), Chemical(drugs), Electromagnetic(magnets/electric pulses)

• treating abnormal behaviors as a product of bodily behavior

  • “The devils literally inside your head”

• Mechanical interventions: removing parts of the brain causing irregular behavior

  • Lobotomy: surgery to sever the connections to the prefrontal cortex

    • leads to “amotional” behavior(not a typo)

• Modern Psychosurgery: usually used as a last resort to extreme cases of disorders

  • involves cutting/lesioning fibers inside the limbic structure

  • anterior cingulatemptomy: severing connection between anterior cingulate

• Psychotropic medications: drugs that affect mental processes

• Anti-anxiety drugs(tranquilizers): used for treatment of anxiety disorders

  • benzodiazepines

    • increases the activity of GABA

    • induces drowsiness

    • very addictive

  • antidepressants:

    • used for depression, anxiety, bipolar disorder(rarely)

    • MAOI(monoamine oxidase inhibitors)

    • SSRI(selective serotonin reuptake inhibitors)

      • Prozac, Zoloft, Paxil

    • Antipsychotics: psychotropic medications used for the treatment of disorders involving psychosis/neuroleptics

      • schizophrenia

      • Side-effects: dyskinesia

        • involuntary twitching/spasms, usually in the neck and face

• Psychosocial Treatments:

  • medication alone does not work very well

  • involves the use of social skills training

    • Meds + social skills + family therapy = prevents relapse

    • EX: drugs, family, and social settings most effectively help a person with a disorder involving psychosis

• Mood Stabilizers: mood swings made much less extreme

  • Lithium: used to be most prescribed for bipolar disorder

• Anti-convulsants: prevention of seizures

• TMS(Transcranial Magnetite Stimulation): induces an electrical current in the brain region below the coil, disrupting the region below the coil

  • Single pulse: disruption of brain activity for a brief time

  • Repeated pulse: disruption for an extended period

• Deep Brain Stimulation: used often for Parkinson’s disease

Knowing What Works?

• Efficacy vs Effectiveness

  • treatments that work in a controlled environment(efficacy) and treatment that work in the real world(effectiveness)

• Comorbidity

  • overlap among disorders and mental illnesses

• Compliance

  • people are or are not going to follow through with the treatment

    • missing days of drugs, etc

• iatrogenic effects(side effects)

  • adverse effects and complications

  • things that make the condition worse

  • might help the majority, might harm the minority

  • not usually tested in behavioral treatment

    • ex: making a depressed person mindful through meditation, they might figure out a way to commit suicide

• “Regression to The Mean”

  • when looking at two variables, they tend to be more extreme on one and less extreme on the other

  • ex: Sports Illustrated Curse:

    • Ducks went undefeated in 2013, got a cover page on the magazine

    • After: lost to Stanford

    • Results: After doing extremely well, you can’t go anywhere but down

  • Related to Psych how?

    • Results of treatments may look deceivingly good(undefeated ducks) due to CHANCE and after moving closer to less extreme(losing once), often blame the uncorrelated source(“sports illustrated curse”)

      • Skewed results due to chance

        • medical oils, faith healers, etc

• Randomized Clinical Trial

  • people are randomly assigned to two groups to make findings objective

    • Control group vs Treatment group

• Evidence-Based treatments:

  • Anxiety disorders: CBT

  • Depression: Drugs, CBT, or both

  • Schizophrenia: drugs for acute symptoms, psychosocial treatment for recovery + relapse

Types of Treatments, Drugs, and Their Uses

1. Psychotherapy

• Psychodynamic Therapy: Engaging the unconscious.

  • Techniques: Free association, interpretation, analysis of resistance, and transference.

• Behavioral Therapy: Learning through modeling and conditioning.

  • Techniques: Classic conditioning (e.g., Baby Albert), operant conditioning (reinforcement/punishment), and exposure therapy.

• Cognitive Therapy: Focusing on changing thought patterns.

  • Techniques: Cognitive restructuring, rational-emotive therapy, Cognitive Behavioral Therapy (CBT).

2. Biological Therapies

• Mechanical Therapies: Surgical interventions.

  • Purpose: Removing parts of the brain (e.g., lobotomy).

• Chemical Therapies: Psychotropic medications.

  • Anti-anxiety Drugs (e.g., benzodiazepines): Treat anxiety disorders, increase GABA activity, and induce drowsiness (addictive).

  • Antidepressants: Treat depression and anxiety.

    • Types: MAOI, SSRI (e.g., Prozac, Zoloft).

  • Antipsychotics: Used for psychosis (e.g., schizophrenia).

    • Side-effect: Dyskinesia (involuntary movements).

• Electromagnetic Therapies: Inducing electrical currents.

  • Transcranial Magnetic Stimulation (TMS): Disrupts brain activity.

  • Deep Brain Stimulation: Often used for Parkinson’s disease.

3. Psychiatric Treatments

• Mood Stabilizers: Reduce mood swings.

  • Lithium: Prescribed for bipolar disorder.

  • Anti-convulsants: Help prevent seizures.

4. Additional Supportive Treatments

• Involves using social skills training, and family therapy for better outcomes (meds + social skills).

Key Terms

• Efficacy: Treatments that work in a controlled setting.

• Effectiveness: Treatments that work in the real world.

• Comorbidity: Overlap among disorders.

• Iatrogenic Effects: Adverse effects from treatment.

• Regression to The Mean: Extreme outcomes tend to return towards the average.

• Randomized Clinical Trial: Objective findings through random assignments.

• Psychoanalyst: A professional who practices classic Freudian psychoanalysis.

• Clinical Psychologist: Holds a PhD or PsyD; provides psychotherapy but typically does not prescribe medication.

• Psychiatrist: Has an MD or DO; licensed to prescribe medication and conduct psychotherapy.

• Counselor: Holds a master's degree (MA, MS, MFT); often treats less severe disorders; may work in school settings.

• Social Worker: Holds a BSW or MSW; focuses on social systems; requires a license to practice.

• Paraprofessionals: Individuals with some training but not licensed, such as clergy or community mentors.

• Psychotherapy: Treatment of abnormal behavior through interaction between patient and professional.

• Compliance: The extent to which patients follow through with treatment recommendations.

• Ineffectiveness: Treatment not achieving desired outcomes; may be linked to random chance.

• Evidence-Based Treatments: Interventions supported by research, proving effectiveness in clinical settings.

• Comorbidity: The presence of multiple disorders in a patient.

• Iatrogenic Effects: Side effects or complications arising from medical treatment.