Abnormal Psychology
Psychological Disorder
Psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typical or culturally expected
Psychological Dysfunction
Breakdown in cognitive, emotional, or behavioral functioning
Distress/Impairment
Extremely upset, impaired functioning, extreme expressions of emotions, behaviors, and cognitive processes
Atypical or Not Culturally Expected
Occurs infrequently, a deviation or violation of social norms
Prototype
Typical profile of a disorder
Psychopathology
Study of psychological disorders
Clinical description
Unique combination of behaviors, thoughts, and feelings that make up a specific disorder
Prevalence
Number of people in the population as a whole have the disorder
Incidence
Number of new cases during a given period
Course
Individual pattern of a disorder
Chronic
Tend to last a long time, sometimes a lifetime
Episodic
Likely to recover within a few months only to suffer a recurrence at a later time
Time-limited
Disorder will improve without treatment in a relatively short period
Onset
Period in which symptoms of a disease or disorder first appear in an individual
Acute Onset
Begins suddenly
Insidious
Symptoms appear gradually over extended period
Prognosis
Anticipated course of a disorder
Life-span developmental psychopathology
Study of abnormal behavior across the entire age span
Etiology
Study of the origins of a disorder which includes biological, psychological, and social dimensions
Nicholas Oresme
Suggested that the disease of melancholy was the source of some bizarre behavior rather than demons
Mass hysteria
Phenomenon of emotion contagion where the experience of an emotion seems to spread to those around us
Paracelsus
Suggested that the movements of moon and stars had effect on people's psychological functioning
Hippocrates
Suggested that psychological disorders could be treated like any other disease
Galen
Assumed that normal functioning was related to four bodily fluids or humors
Sanguine
(Blood) Ruddy in complexion, cheerful and optimistic
Melancholic
(Black bile) Depressive
Phlegmatic
(Phlegm) Apathy and sluggishness or being calm under stress
Choleric
(Yellow bile) Hot tempered
Hysteria
Thought of as wandering uterus, now known as somatic symptom disorders
Psychosis
Psychological disorders characterized in part by beliefs and perceptions not based in reality
John P. Grey
Believed that the cause of insanity was always physical so mentally ill patients should be treated as physically ill
Manfred Sakel
Proponent of insulin shock therapy, used increasingly higher dosage of insulin until patients convulsed and became temporarily comatose
Benjamin Franklin
Discovered that a mild and modest electric shock to the head produced brief convulsion and memory loss but otherwise did little harm
Joseph von Meduna
Followers induced brain seizures to cure schizophrenia
Ugo Cerletti and Lucio Bini
Treated a depressed patient by sending six small shocks directly through his brain
Reserpine and Neuroleptics
Found to decrease hallucinatory and delusional thought processes in some patients
Benzodiazepines
Found to reduce anxiety
Emil Kraepelin
One of the founding fathers of modern psychiatry, one of the first to distinguish among various psychological disorders
Psychosocial Treatment
Focused not only on psychological factors but also on social and cultural ones
Moral Therapy
Involves treating institutionalized patients as normally as possible in a setting that encouraged and reinforced normal social interaction
Mental Hygiene Movement
Reform for the conditions imposed on patients with insanity
Multidimensional Integrative Approach
Involves biological, psychological, emotional, social, and other dimensions in a psychological disorder
Systematic Perspective
Any particular influence cannot be considered out of context
Linear Causal Model
Focusing only on one single dimension
Genes
Long molecules of DNA at various locations or chromosomes
Genome
Complete set of genes
Quantitative genetics
Tiny effects across many genes
Molecular genetics
Study of actual structure of genes
Eric Kandel
Proposed that genetic structure of cells may change through learning
Diathesis-Stress Model
Individuals inherit tendencies to express certain traits or behaviors activated with stress
5-HTT Gene
Chemical transporter that affects serotonin transmission
Gene-Environment Correlation Model
Genetically determined tendency to create the very environmental risk factors that trigger genetic vulnerability
Epigenetics
Environmental factors can affect genetic material
Excitatory Neurotransmitters
Increase the likelihood that the connecting neuron will fire
Inhibitory Neurotransmitters
Decrease the likelihood that the connecting neuron will fire
Forebrain
Part of the brain that is more advanced and has recently evolved
Hindbrain
Regulates many automatic activities
Cerebellum
Controls balance and maintains muscle coordination
Midbrain
Coordinates movements with sensory input
Reticular activating system
Contributes to processes of arousal and tension
Hypothalamus
Regulates the amount of fear, thirst, sexual drive, and aggression we feel
Pituitary Gland
Regulates other endocrine glands
Hippocampus
Plays a role in our learning, memory, and ability to compare sensory information to expectations
Medulla
Part of the hindbrain that controls heartbeat, breathing, and swallowing
Corpus callosum
Connects left and right hemisphere of the brain
Cerebral cortex
Controls complex thought processes; provides us with our distinctly human qualities, allowing us to look to the future and plan, to reason, and to create
Thalamus
Part of the forebrain that relays information from sensory organs to the cerebral cortex
Pons
Part of the hindbrain that relays messages between the cerebellum and the cortex
What forms the limbic system?
Hippocampus, cingulate gyrus, septum, amygdala
Amygdala
Influences our motivation, emotional control, fear response and interpretations of nonverbal emotional expressions
Cingulate cortex
Primary cortical component of the limbic system, involved in emotional and cognitive processing
Temporal lobe
Associated with recognizing various sights and sounds and with long-term memory storage
Parietal lobe
Associated with recognizing various sensations of touch and monitoring body positioning
Occipital lobe
Associated with integrating and making sense of various visual inputs
Frontal lobe
Area responsible for higher cognitive functions such as thinking and reasoning
Autonomic nervous system
Automatically regulates glands, internal organs and blood vessels, pupil dilation, digestion, and blood pressure
Somatic nervous system
Carries sensory information and controls movement of the skeletal muscles
Parasympathetic Division
Maintains body functions under ordinary conditions; saves energy
Sympathetic Division
Prepares the body to react and expend energy in times of stress
Sensory system
Carries messages from senses to CNS
Motor system
Carries messages from CNS to muscles and glands
HPA Axis
System that produces cortisol which has been implicated in several psychological disorders
Telomeres
Structures that cap the ends of the chromosomes to protect them from deteriorating or getting entangled with neighboring chromosomes
Agonists
Increase activity of neurotransmitters by mimicking effects
Antagonists
Decrease/block neurotransmitters
Inverse agonist
Produces opposite effects to those produced by neurotransmitter
Acetylcholine
NT involved in arousal, attention, memory, and controls muscle contractions
Norepinephrine
Excitatory NT; involved in arousal, mood, and behavioral tendencies
Dopamine
NT involved in control of movement and sensations of pleasure; its circuits merge and cross with 5-HT
Serotonin
NT involved in behavior, mood, and thought processes
Gaba-aminobutyric acid
Major inhibitory neurotransmitter involved in sleep and inhibits movement
Glutamate
Major excitatory neurotransmitter involved in learning, memory formation, nervous system development, and synaptic plasticity
Endorphins
Inhibitory neural regulators involved in pain relief
Precision medicine
Tailoring treatment to individual patient
Learned helplessness
Occurs when rats or other animals encounter conditions over which they they have no control and they give up attempting to cope and seem to develop the animal equivalent of depression
Learned optimism
People faced with considerable stress and difficulty in their lives nevertheless display an optimistic, upbeat attitude, they are likely to function better psychologically and physically
Modeling/observational learning
Organisms learn as much by observing what happens to others in a given situation
Prepared learning
We become highly prepared for learning about knowledge that contributes to survival
Implicit memory
Acting on the basis of past events but could not remember the events themselves
Black box
Refers to unobservable feelings and cognitions inferred from an individual's self-report or behaviors
Emotion
Tendency to behave in a certain way, elicited by external event, a feeling state, accompanied by a characteristic physiological response; short-lived/temporary
Mood
More persistent period of effect or emotionality
Susto
Latin American disorder with anxiety based and somatic symptoms; belief of being the object of black magic or the evil eye
Tend and Befriend
Refers to protecting themselves and their young through nurturing behavior and forming alliances with larger social groups, particularly other females
End of History
Thinking that we will change very little in the years to come
Equifinality
We must consider a number of paths to a given outcome
Clinical Assessment
Systematic evaluation of measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder
Diagnosis
Process of determining whether the particular problem afflicting the individual meets all criteria
Reliability
Degree of consistency
Validity
Measures what it is designed to measure
Standardization
Determining a set of standards or norms
Mental Status Exam (MSE)
Appearance and behavior, thought processes, mood and affect, intellectual functioning, sensorium
Appearance and Behavior
Overt behavior, attire, posture, expressions
Thought Processes
Rate of speech, continuity of speech, and content
Mood and Affect
Predominant feeling state and appropriateness to context
Intellectual Functioning
Type of vocabulary, use of abstractions and metaphors
Sensorium
Awareness of person, place, and time
Behavioral Assessment
Direct observation
Target Behaviors
Goal of determining the factors that seem to influence them
Informal Observation
Based on the observer's recollection
Formal Observation
Done by identifying specific and measurable behaviors
Reactivity
Change of behavior by being in the presence of observers
Projective Testing
Use of ambiguous stimuli, less useful as diagnostic tests
John Exner
Developed the Comprehensive System: standardized version of the Rorschach inkblot test
Thematic Apperception Test
Consists of a series of 31 cards--30 pictures and 1 blank card; ask the person to tell a dramatic story about the picture
Personality Inventories
Self-report questionnaires that assess personal traits
Paul Meehl
Pointed out that what is necessary is what the answers to the questions predict
Minnesota Multiphasic Personality Inventory (MMPI)
Empirical test consists of 550 items, review pattern of responses from groups of people with specific disorders
Intelligence Quotient (IQ)
Mental age divided by chronological age
Neuropsychological Testing
Measure abilities in language, attention and concentration, memory, performance and possible existence of brain impairment
Bender Visual-Motor Gestalt Test
Children copy what is drawn on the card compared to their age group
Computerized Axial Tomography (CAT)
Multiple X-ray exposures useful in locating tumors, injuries, and abnormalities, risk of cell damage due to radiation
Magnetic Resonance Imaging (MRI)
Radio frequency signals, measures alterations of protons for brain structure
Positron Emission Tomography (PET)
Inject a tracer substance which interacts with blood, oxygen, glucose, and supplement MRI & CT
Single Photon Emission Computed Tomography
Uses a different tracer substance and is less accurate but less expensive
Functional MRI
Advanced method, can measure functioning of the brain
Blood Oxygenation Level Dependent Functional MRI (BOLD fMRI)
Most common fMRI technique used to study psychological disorder
Psychophysiological Assessment
Measure changes in the nervous system that reflect emotional/psychological events
Electroencephalogram (EEG)
Electrodes record low-voltage currents
Event-Related Potential
Patterns recorded in response to specific events
Idiographic Strategy
Tailor treatment to the person based on what is unique about an individual's personality, cultural background, or circumstances
Nomothetic Strategy
Determining a general class of problems to which the presenting problem belongs
Taxonomy
Classification of entities for scientific purposes
Nosology
Applying taxonomic system to clinical areas
Nomenclature
Names or labels of the disorders
Classical Categorical Approach
Every diagnosis has a clear cause, only one set of causative factors that do not overlap with other disorders
Dimensional Approach
Note the variety of cognitions, moods, and behaviors present and quantify them on a scale
Prototypical Approach
Identifies certain essential characteristics of an entity to be classified but allows certain nonessential variations that do not change the classification
Familial Aggregation
Extent to which the disorder would be found among patients' relatives
Hypothesis
Educated guess or statement
Research Design
Plan for testing hypothesis
Dependent Variable
Measured and expected to be changed by IV
Independent Variable
Manipulated or thought to influence change in DV
Internal Validity
Extent to which results can be attributed to IV
External Validity
Extent to which results can be generalized or applied outside the study
Testability
Ability to support the hypothesis
Control Group
Not exposed to the IV
Randomization
Process of assigning with equal chance of being placed in any group
Analogue Models
Create in the lab controlled conditions comparable to phenomenon in study
Statistical Significance
Mathematical calculation about difference between groups
Clinical Significance
Whether or not the difference was meaningful for those affected
Effect Size
How large these differences are
Social Validity
Involves obtaining input from the person being treated and significant others about importance of the changes that occurred
Patient Uniformity Myth
Tendency to see all participants as one homogeneous group
Epidemiology
Study of incidence, distribution, and consequences of a particular problem or set of problems in one or more populations
Comparative Treatment Research
Assess different treatments
Process Research
Focus on mechanism responsible for behavior change
Treatment Process
Finding out how or why your treatment works
Treatment Outcome
Finding out what changes occur after treatment
Single-Case Experimental Designs
Repeated measurement of 1) level or degree of behavior change 2) variability over time 3) trend or direction of change
Withdrawal Design
IV is responsible for changes in behavior
Drug Holidays
Periods when medication is withdrawn
Multiple Baseline
Treatment at different times across settings
Endophenotypes
Genetic mechanisms that ultimately contribute to underlying problems causing symptoms and difficulties from psychological disorder
Proband
Family member with trait singled out
Health Promotion
Skill-building for entire populations to prevent later problems
Universal Prevention Strategies
Target specific risk factors in populations
Selective Prevention
Targets whole groups at risk
Indicated Prevention
Individuals beginning to show signs of problems
Cross-sectional Design
Cohorts across different age groups are compared
Longitudinal Design
Follow one group over time
Sequential Design
Repeated study of different cohorts over time
Anxiety
Negative mood state characterized by bodily symptoms of physical tension and apprehension of the future
Fear
Immediate emotional reaction to current danger
Panic Attack
Abrupt experience of intense fear/acute discomfort that reaches a peak within minutes
What distinguishes panic attack from ongoing anxiety?
Time to peak intensity, discrete nature, and typically greater severity
Limited-symptom Attacks
Attacks that meet all other criteria but have fewer than four physical and/or cognitive symptoms
Expected Panic Attacks
Attacks for which there is an obvious cue or trigger such as situations in which panic attacks have typically occurred
Unexpected Panic Attacks
Those for which there is no obvious cue or trigger at the time of occurrence
Nocturnal Panic Attack
Waking up from sleep in a state of panic
Behavioral Inhibition System
Activated by signals from the brain stem of unexpected events such as major changes in body functioning that might signal danger
Anxiety Sensitivity
General tendency to respond fearfully to anxiety symptoms
Triple Vulnerability Theory
Generalized biological, generalized psychological, specific psychological
What is the difference between general and specific psychological vulnerability?
Generalized is a sense that events are uncontrollable/unpredictable while specific refers to physical sensations that are potentially dangerous
Meta-Cognitions
Cognitions about cognitions
Panic Disorder
Individuals experience severe, unexpected panic attacks
Agoraphobia
Fear and avoidance of situations that feel unsafe or they are unable to escape from
Agoraphobic Avoidance
One way of coping with unexpected panic attacks
Interoceptive Avoidance
Avoidance of internal physical sensations or avoiding situations and activities that could produce arousal similar to panic attack
Learned Alarms
Cues become associated with a number of different internal and external stimuli
Panic Control Treatment
Exposes patients with panic disorder to cluster of interoceptive sensations that remind them of their panic attacks, followed by relaxation, breathing, and retraining
Specific Phobia
Irrational fear of a specific object or situation that markedly interferes with an individual's ability to function
Information Transmission
Developing a phobia by being warned repeatedly about a potential danger
Separation Anxiety Disorder
Characterized by children's unrealistic and persistent worry that something will happen to their parents or other important people in their life or something will happen to them that will separate them from their parents
Social Anxiety Disorder
Marked fear or anxiety focused on one or more social or performance situations
Selective Mutism
Rare childhood disorder characterized by a lack of speech in one or more settings in which speaking is socially expected
Posttraumatic Stress Disorder
Disorder that develops in some people who have experienced a threatening or traumatic event
PTSD with Delayed Onset
Show few or no symptoms immediately or for months after a trauma, but at least 6 months later or years after develop full-blown disorder
Catharsis
In psychoanalytic therapy, this is reliving emotional trauma to relieve emotional suffering
Imaginal Exposure
Content of the trauma and the emotions associated with it are worked through systematically
Fear Memory Reconsolidation
Fear memory is reactivated and stored back into long-term memory again
Adjustment Disorders
Anxious or depressive reactions to life stress that are generally milder than the acute stress disorder or PTSD but nevertheless impairing
Attachment Disorders
Disturbed and developmentally inappropriate behaviors in children in which they are unable or unwilling to form normal attachment relationships with caregiving adults
Reactive Attachment Disorder
Child will very seldom seek out caregiver and seldom respond to offers from caregivers to provide this kind of care
Disinhibited Social Engagement Disorder
Child shows no inhibitions to approaching adults
Obsessive Compulsive Disorder
Dangerous event is a thought or impulse that they attempt to avoid or are suppressed by acting on compulsions
Obsessions
Intrusive and mostly nonsensical thoughts, images, or urges that the individual tries to resist or eliminate
Compulsions
Thoughts or actions used to suppress the obsessions and provide relief
What are the four major types of obsessions?
Symmetry
Forbidden thoughts or actions
Cleaning and contamination
Hoarding
Thought-Action Fusion
When clients with OCD equate thoughts with the specific actions or activity represented by the thoughts
Exposure and Ritual Prevention
Process where rituals are actively prevented and the patient is systematically and gradually exposed to the feared thoughts or situations
Body Dysmorphic Disorder
Preoccupation with one or more defects or flaws in physical appearance that are not observable or appear slight to others
Ideas of Reference
Thinking that everything that goes on in their own world is related to them
Hoarding Disorder
Excessive acquisition of things, difficulty discarding anything, and living with excessive clutter under conditions described as gross disorganization
Trichotillomania
Urge to pull out one's own hair from anywhere on the body
Excoriation
Repetitive and compulsive picking of the skin
Habit Reversal Training
Patients are carefully taught to be more aware of their repetitive behavior and substitute a different behavior
Somatic Symptom Disorders
Excessive or maladaptive response to physical symptoms or associated health concerns
Conversion Hysteria
Unexplainable physical symptoms are manifestations of unconscious mental conflicts into more acceptable form
Illness Anxiety Disorder
Severe anxiety is focused on the possibility of having or developing a serious disease
Disease Conviction
A difficult to shake belief about having a disease
Koro
Belief, accompanied by severe anxiety and sometimes panic, that the genitals are retracting into the abdomen.
Dhat
Anxious concern about semen loss
What are the three factors that may contribute to development of Somatic Symptom Disorders?
Stressful life event
Disproportionate incidence of disease in the family as a child
Learning that an ill person gets a lot of attention
Psychological Factors Affecting Medical Condition
Medical condition adversely affected by one or more psychological factors
Conversion Disorders
Physical malfunctioning without any physical or organic pathology to explain this malfunction
Depersonalization
Altered perception and losing sense of your own reality
Derealization
Sense of reality of the external world is lost
Depersonalization-Derealization Disorder
Severe and frightening feelings of unreality that dominates an individual's life and affects functioning
Dissociative Amnesia
Inability to recall autobiographical information, commonly of a stressful or traumatic event, that is inconsistent with ordinary forgetting
Dissociative Fugue
Memory loss revolves around a specific event such as an unexpected trip
Dissociative Identity Disorder (DID)
Multiple partially independent identities all simultaneously coexisting
Autohypnotic Model
People who are suggestible may use dissociation as defense against extreme trauma