Psych 223 Test 1

1. What is meant by “normal” and “abnormal?” What is meant by dysfunction? How

about malfunction?

• Normal: 

  • Statistically Normal - The average/mean or mode 

  • Socially Normal - Conforming to the standard or the common type; usual for a particular context (socially normal) or person

• Abnormal:

  • Statistically Abnormal - ex. Low or high IQ

  • Socially Abnormal - ex. Philately (collection of postage stamps)

• Dysfunction:

  • An impairment in the function that is making it not happen (e.g. a heart attack is caused by the heart being impaired of its normal/regular functions)

• Malfunction:

  • When a function is happening, but it's the wrong one (e.g. cancer, cells doing things that they shouldn’t)

a. In what situations does the dysfunction account of psychopathology fall

short?

• Ex. Hallucinations in a cultural context (not a behavior disorder)

b. What is meant by the subjective distress account of psyIndividual’s verbal and

• Non-verbal reports of pain, suffering, upset, etc

c. What might be one problem with relying on one’s report of distress to

categorize someone as mentally ill or not? Be sure to know what malingering is and in what situations it is likely to occur

• Distress is not always considered a symptom of disorder

• Ex. intense physical activity or reacting to bad news

• Malingering - an individual who is pretending to have a disorder that they do not have

2. How do social norms influence the definition and diagnosis of mental illness?

• Social norms evolve over time, leading to changes in what is considered a mental illness (ex. Homosexuality used to be in DSM)

• “Normal” and “abnormal” mean different things in different cultures

• Stigma surrounding mental illnesses

a. What functions do social and political factors serve?

• Societies set norms for what is acceptable behavior

  • (ex. hyperactivity in children may be seen as normal in some cultures but as a symptom of ADHD in others)

• Decisions on what constitutes a disorder often involve social and political debate

  • (ex. homosexuality was removed from the DSM in 1973 due to activism and shifting social attitudes rather than scientific discovery)

3. What is neurodiversity and how does it factor into our understanding of behavior

Disorders?

• Neurodiversity: Variation in the human brain with respect to learning, attention, mood, sociability, and other mental processes and operations 

  • Traditional models classify conditions like ADHD and autism as deficits based on deviations from the "normal" brain. The neurodiversity movement argues that these conditions are variations in cognitive processing rather than inherently pathological

  • Instead of seeing traits like hyperfocus in ADHD or intense pattern recognition in autism as impairments, neurodiversity highlights how these traits can be strengths in the right environments

4. What are the two components of the harmful dysfunction model and what are

some of the problems with this model? What term did Widiger and Sankis (2000)

propose instead and what does it mean?

• Behavior disorders are comprised of two components

  • Harmfulness (Social): The impairment in function is seen to be harmful to the individual and/or society

  • Dysfunction (Biological): Breakdown or impairment in the natural function of behavior 

    • Problems: Who decides what is harmful?

  • Widiger and Sankis proposed instead “Dyscontrolled Maladaptivity” 

5. What is the purpose of classification; that is, why do we need a classification

system for behavior disorders?

• Regarding mental health, classification systems provide:

  • Nomenclature for practitioners, to be able to define and speak to one another in the same language

  • Descriptive psychopathology - looking at the phenomenon and observing (have to be observing the same thing, talking about the same thing)

  • Epidemiology - to whom is this happening and where (could give us a sense of why)

  • Etiological theories - how does this start and develop over time?

  • Sociopolitical functions

  • Basis for diagnosis, prognosis and treatment

  • Ultimate goal is utility

6. Understand the different models of behavior disorders throughout time (e.g.,

biological, moral, supernatural), how they have influenced classification and their

current standing in terms of how they inform our understanding of behavior

disorders

• Biological:

  • Suggests that behavioral disorders are caused by biological abnormalities, such as genetics, brain chemistry, and neuroanatomy

    • Led to DSM, diagnosis based on medical symptoms

• Moral: 

  • Developed in response to harsh asylum conditions, this model emphasized treating individuals with kindness, compassion, and humane care

    • Advocated for the removal of cruel and unusual treatments 

• Supernatural: 

  • Behavioral disorders were believed to be caused by supernatural forces, such as demonic possession, witchcraft, or divine punishment

    • People did not get medical care, used religious practices etc. 

7. Know the distinction between psychosis and neurosis

• Psychosis: A severe mental disorder characterized by a break with reality

  • Individual may not know where they are at a given place in time

  • Individual may experience delusional thinking

  • These include manifestations of biological problems

• Neurosis: A milder mental disorder characterized by distortions of reality

  • Consists of psychological disorders

  • Your sense of reality is still intact

  • More in the psychological realm not biological

8. What did Kreaplin view as the origin/cause of mental illness? What were the

guiding principles behind Kreaplin’s classification system? What did he

ultimately conclude with respect to this approach and why?

• Caused by biological and genetic factors

• Wanted to move beyond symptom approach

• Instead use anatomical pathology and etiology

• Ultimately concluded it’s nearly impossible

9. What was the history around the development of the DSM? Be able to discuss the

major discrepancies between the DSM-I/II and later editions of the DSM (starting

with DSM-III) including the influence of the neo-Kraepelinians

• Four separate classification systems were around in the US, which American psychiatrists found embarrassing

• Classification was inconsistent

10. Who were the neo-Kraepelinians and what did they stand for?

• The neo-Kraepelinians were a group of psychiatrists in the late 20th century who sought to revive and modernize the work of Emil Kraepelin, a German psychiatrist known for his emphasis on empirical observation, classification, and biological explanations of mental illness

• Wanted to reaffirm mental illness as under the purview of psychiatry and reaffirm 

psychiatry as a new branch of medicine 

11. What were the main critiques of the DSM?

• Conception of mental illness

• Co-occurrence of different diagnoses

• Not therapeutically useful

• Lengthy consultation process 

12. What is aversive conditioning and how does it factor into anxiety?

• Aversive conditioning terms:

• US: unconditioned stimulus

  • Ex: hot pan

• UR: unconditioned response (reflexive)

  • Ex: pulling your hand away if hot oil splashes on it

• CS: conditioned stimulus

  • Ex: sound of food sizzling in pan

• CR: conditioned response

  • Ex: jumping at the sound of food sizzling even if you don’t get splashed with hot oil

• This process is classical conditioning for aversive (unpleasant) stimuli 

1. What differentiates anxiety from an anxiety disorder?

• Anxiety: A normal, adaptive response to stress/danger

• Anxiety Disorder: Chronic, excessive, irrational anxiety

  • Usually without cause

  • Interferes with daily life

13. What are the two-factors of Mowrer’s two-factor theory of anxiety? What are

some of the problems that two-factor theory has in accounting for specific

phobias?

• Two factor theory (classical + operant conditioning = learned associations and maintenance of behavior)

• Factor 1 - Classical Conditioning

  • Ex: you pet dog and it bites you. You now learn that dogs bite. So the next time you see a dog, it will elicit a fear response

• Factor 2 - Operant Conditioning

  • Ex: a dog bit you and you learned to fear them. Now, you avoid being in situations where dogs are present to maintain a sense of safety. This acts as a positive reinforcer for the avoidance behavior

a. Be able to identify the different pathways to fear acquisition

15. What is the difference between lumping and splitting with respect to anxiety

disorders? What is the rationale for lumping all anxiety disorders into one? What

would be lost in terms of information about specific disorders if this was done?

What is it that ultimately creates different topographies across the anxiety

disorders?

• Lumping: Combining similar disorders into broader categories based on shared characteristics

• Splitting: Separating disorders into distinct categories based on their unique features

• Rationale: All anxiety disorders share key features (excessive fear, worry, physical arousal, avoidance behaviors)

• What would be lost:

  • Differences in treatment response

  • Different triggers and fears

  • Comorbidity 

• Different anxiety disorders have different behavioral patterns, physiological response, neurobiological differences

16. What is the preparedness account of phobias and in what ways does it address

problems with two-factor theory accounts? How can two-factor theory also

account for these problems?

• Often offered as an additional theory of fear acquisition with an evolutionary advance, makes a lot of evolutionary assumptions (whereas two-factor theory does not)

  • Preparedness Theory: Individuals are predisposed to fear certain things over others due to evolutionary pressures

17. What characteristics of the first panic attack may predispose individuals to future

attacks? What is meant by panic disorder being a “fear of fear”?

• If you had panic attack in a place where there’s: 

  • Impaired functioning (e.g., driving)

  • Entrapment (e.g., air travel)

  • Negative social evaluation (e.g., Mr. Holt thought it would be bad to explain to everyone what’s going on)

• If you had one in the past where you distant from home, and you’re distant from home it’s a cue for anxiety

18. What aspects of an initial panic attack are associated with the development of

agoraphobia?

• Agoraphobia: Conceptualized as a fear of being in places in which escape might be difficult/help unavailable incase of a panic attack; or symptom development that might be

• incapacitating or embarrassing

• “I’m afraid I’m gonna have panic in a place I don’t want to have panic”

19. What is the key feature of GAD (not just the label, be sure to understand the

phenomenon and its function)?

• THE INDIVIDUAL EXPERIENCES CHRONIC AND UNCONTROLLABLE WORRY THAT IS EXCESSIVE (IN RESPONSE TO A MINOR EVENT) AND UNREALISTIC (UNFOUNDED CONCERNS

• Has 3 primary functions

  • Problem-solving

  • Motivation

  • Emotional Processing 

20. Know the information linking temperament and attachment style to Social

Anxiety Disorder

• Infants with an inhibited temperament more frequently develop into children and adolescents who avoid novel or unfamiliar people, objects, and situations

• Leads to insecure attachment and avoidant behavior

Diagnostic Criteria for each Disorder

GAD

• EXCESSIVE ANXIETY AND WORRY (APPREHENSIVE EXPECTATION),

• OCCURRING MORE DAYS THAN NOT FOR AT LEAST 6 MONTHS, ABOUT A

• NUMBER OF EVENTS OR ACTIVITIES (SUCH AS WORK OR SCHOOL PERFORMANCE)

• INDIVIDUAL FINDS IT DIFFICULT TO CONTROL THE WORRY

• ASSOCIATED WITH THREE (OR MORE) OF THE FOLLOWING SIX SYMPTOMS (Only 1 symptom needs to be present for children)

  • RESTLESSNESS, OR FEELING KEYED UP OR ON EDGE

  • BEING EASILY FATIGUED

  • DIFFICULTY CONCENTRATING OR MIND GOING BLANK

  • IRRITABILITY

  • MUSCLE TENSION

  • SLEEP DISTURBANCE

Panic Disorder

• RECURRENT AND UNEXPECTED (“OUT OF THE BLUE”) PANIC ATTACKS*

• AT LEAST ONE OF THE ATTACKS HAS BEEN FOLLOWED BY 1 MONTH (OR MORE) OF 1 (OR MORE) OF THE FOLLOWING:

  • PERSISTENT CONCERN ABOUT HAVING ADDITIONAL ATTACKS

  • WORRY ABOUT THE IMPLICATIONS OF THE ATTACK OR ITS CONSEQUENCES (E.G., LOSING CONTROL, “GOING CRAZY”)

  • A SIGNIFICANT CHANGE IN BEHAVIOR RELATED TO THE ATTACKS

• SETTING FOR INITIAL PANIC ATTACK CRITICAL

  • LIKELY RESULT OF IMPAIRED FUNCTIONING (E.G., DRIVING)

  • ENTRAPMENT (E.G., AIR TRAVEL)

  • NEGATIVE SOCIAL EVALUATION (E.G., IN THE THEATRE, RESTAURANT, ETC.)

  • DISTANCE FROM SAFETY (E.G., UNFAMILIAR LOCALES)

• BARLOW’S (1998) “ALARM THEORY”

  • IF THE PANIC ATTACK IS A TRUE ALARM, THEN THE RECURRENCE OF PANIC ATTACKS IS LESS LIKELY

  • IF THE PERSON CANNOT IDENTIFY THE SOURCE OF THE THREAT THAT INDUCED PANIC (A FALSE ALARM), THE RECURRENCE OF A PANIC ATTACK BECOMES MORE LIKELY

SAD

• Median age is 13 years, onset occurring between 8 and 15 for 75% of cases

• A marked fear or anxiety about one or more social or performance situations in which the person is exposed to possible scrutiny by others (e.g., social

• interactions, performing)

• Individual fears acting in embarrassing or humiliating ways (e.g., showing symptoms of anxiety)

• Exposure to feared social situation almost invariably provokes anxiety

• Feared social or performance situations are avoided or endured with intense anxiety or distress

• The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context

• Fear causes significant distress or impairment in the person’s normal routine, occupation, social activities/relationships, or there is marked distress about phobia

• Fear, anxiety, or avoidance is persistent (typically lasting for 6 months or more).

Phobias

• MARKED AND OUT OF PROPORTION FEAR WITHIN AN ENVIRONMENTAL OR SITUATIONAL CONTEXT TO THE PRESENCE OR ANTICIPATION OF A SPECIFIC OBJECT OR SITUATION

• EXPOSURE TO THE PHOBIC STIMULUS PROVOKES AN IMMEDIATE ANXIETY RESPONSE, WHICH MAY TAKE THE FORM OF A SITUATIONALLY BOUND OR SITUATIONALLY PREDISPOSED PANIC ATTACK

• THE PERSON RECOGNIZES THAT THE FEAR IS OUT OF PROPORTION

• THE PHOBIC SITUATION(S) IS AVOIDED OR ELSE IS ENDURED WITH INTENSE ANXIETY OR DISTRESS

• THE AVOIDANCE, ANXIOUS ANTICIPATION OR DISTRESS IN THE FEARED SITUATION(S) INTERFERES SIGNIFICANTLY WITH THE PERSON'S NORMAL ROUTINE, OCCUPATIONAL (OR ACADEMIC) FUNCTIONING, OR SOCIAL ACTIVITIES OR RELATIONSHIPS, OR THERE IS MARKED DISTRESS ABOUT HAVING THE PHOBIA

Review Session Questions

Anxiety Disorders:

1. Fear of negative evaluation and scrutiny by others are crucial parts of this diagnosis

   1. Social Anxiety Disorder

2. When stimulus response pairings are learned slowly over time 

   1. Insidious Acquisition 

3. Mowrer’s idea (if you can experience it, it can be conditioned and behaviors are maintained through reinforcement and punishment)

   1. Two Factor Theory 

4. Idea that all anxieties are developed by same processes

   1. Lumping 

5. People fear procedures that have bodily sensations similar to the ones experienced during panic attacks 

   1. Cognitive Feature 

Defining Behavior Disorders:

1. The model that says behavior disorders are a choice

   1. The Moral Model 

2. Potential components of behavior disorder, none of them necessary

   1. Subjective distress, abnormality, dysfunction

3. The difference between malfunction and dysfunction

   1. In notes

History of Classification and Diagnosis

1. What is the ultimate goal of a classification system?

   1. Utility 

2. Conflict between different schools of psychiatry led to the DSM 3 being described as

   1. Theoretically Agnostic 

3. Researcher that sent assistants to psych wards to show 

   1. David Rosenhan

4. A function of classification, looking at or observing a phenomenon 

   1. Descriptive Pathology

5. Access to insurance coverage is an example of this purpose of classification

   1. Sociopolitical 

Conditioning and Learning: 

1. Fear can develop without direct experience with the given stimulus

   1. Vicarious Conditioning (modeling)

2. Parents told you fast food was poisonous, you never eat fast food

   1. Instructional Transference 

3. When bodily sensations become conditioned and elicit further arousal 

   1. Interoceptive Conditioning 

4. An initially neutral stimulus that first has no associated response then becomes

   1. Conditioned Stimulus 

5. A stimulus that elicits a reflexive response

   1. Unconditioned Stimulus 

Other:

1. An individual who is pretending to have a disorder they don’t have 

   1. Malingering 

2. Normal and natural differences in brain functioning from person to person

   1. Neurodiversity 

3. Disorder that changed the trajectory of psychiatry during the 1800s by providing empirical evidence against assumptions about mental illness (found syphilis in the brain)

   1. Dementia Paralytica

4. Idea of defense mechanisms are associated with this psychiatrist

   1. Freud

5. Biological impulses give rise to behavioral motivations and behavior disorders represent defense mechanisms 

   1. Kraeplinian