Final Study Guide

Chapter 15: Psychological Disorders

• Mental Disorders: any behavior or emotional state that:

  • Causes an individual great suffering 

  • Is self-destructive

  • Seriously impairs the person’s ability to work or get along with others 

  • Makes a person unable to control the impulse to en danger others

• Diagnostic and Statistical Manual of Mental Disorders (DSM): APA’s standard reference manual used to diagnose mental disorders 

• Critics: inherent problems of DSM

  • The danger of overdiagnosis 

  • The power of diagnostic labels 

  • Confusion of serious mental disorders with normal problems 

  • The illusion of objectivity 

• Supporters: it is important to help clinicians distinguish among disorders that share certain symptoms, such as irratability or delusions so they can be diagnosed reliably and treated properly

• Generalized anxiety disorder: a continuous state of anxiety marked by:

  • Feelings of worry and dread

  • Apprehension 

  • Difficulties in concentration 

  • Signs of motor tension

• Panic disorder: an anxiety disorder in which a person experiences recurring panic attacks, periods of intense fear, and feelings of impending doom or death accompanied by physiological symptoms such as rapid heart rate and dizziness 

• Phobia: an exaggerated, unrealistic fear of a specific situation, activity, or object

  • Social phobia: individuals become extremely anxious in situations in which they will be observed by others

  • Agoraphobia: a set of phobias often set off by a panic attack, involving the basic fear of being away from a safe place or person: a “fear of fear”

• Posttraumatic Stress Disorder: a disorder in which a person who has experienced a traumatic or life-threatening event has symptoms such as nightmares, flashbacks, insomnia, reliving of the trauma, and increased physiological arousal 

  • Diagnosed if symptoms persist for one month or longer 

• Obsessive-compulsive disorder (OCD): an anxiety disorder in which a person feels trapped in repetitive, persistent thoughts (obsessions) and repetitive ritualized behaviors (complusions) designed to reduce anxiety 

  • Person understands that the ritual behavior is senseless but guilt mounts if the behavior is not performed 

• Major depression: a disorder involving disturbances in:

  • Emotion (excessive sadness)

  • Behavior (loss of interest in one’s usual activities)

  • Cognition (thoughts of hopelessness)

  • Body function (fatigue and loss of appetite)

• Origins of Depression:

  • Vulnerability-stress model: approaches that emphasize how individual vulnerabilities interact with external stresses or circumstances to produce specific mental disorders, such as depression 

    • Genetic predipositions 

    • Violence, childhood physical abuse, and parental neglect 

    • Losses of important relationships 

    • Cognitive habits

• When an infant is separated from a primary attachment figure:

  • Despair

  • Passivity

  • Harm to immune system

• Many depressed people have a hisotry of: 

  • Separations 

  • Losses 

  • Rejections 

  • Impaired, insecure attachments 

• Cognitive habits:

  • Depression: involves specific, negative ways of thinking about one’s situation 

  • Depressed people believe their situation is:

    • Permanent

    • Uncontrollable 

  • Rumination: brooding about negative aspects of one’s life | more common in women 

• Bipolar disorder: mood disorder in which episodes of both depression and mania (excessive euphoria occur)

• Personality disorder: impairments in personality that cause great distress or an inability to get along with others 

  • Borderline personality disorder: characterized extreme negative emotionality and inability to regulate emotions 

• Antisocial personabilty disorder: characterized by a lifelong pattern of irresponsible, antisocial behavior such as law-breaking, violence and other impulsive, restless acts 

• Psychopathy: a personality disorder characterized by:

  • Fearlessness 

  • Lack of empathy, guilt, and remorse 

  • The use of deceit 

  • Coldheartedness

    • It is not the same as benign violent and sadistic 

    • It is not the same as being psychotic 

    • “Born, not made” appears to be wrong 

    • The belief that psychopaths cannot change is wrong 

• Biological model: addiction is due primarily to a person’s neurology and genetic predisposition:

  • Begins in early adolescence 

  • Is linked to impulsivity, antisocial behavior, criminality 

    • Genes affect sensitivity to alcohol 

    • Heavy drug abuse changes the brain and makes addication more likely 

  • Addiction patterns vary accordion to cultural practices

  • Policies of total abstinence tend to increase addiction rates rather than reduce them 

  • Not all addicts have withdrawal symptoms when they stop taking a drug 

  • Addication does not depend on properties of the drug alone but also on the reason for taking it 

• The biological model

  • Addiction is genetic, biological or a chronic relapsing disease caused by changes in the brain produced by drug use 

  • Once an addict, always an addict 

  • An addict must abstain from the drug forever 

  • A person is either addicated or not 

  • The solution is medical treatment and membership in groups that reinforce one’s permanent identity as recovering addict 

  • An addict needs the same treatment and group support forever 

• Dissociative Identity Disorder: a controversial disorder marked by the appearance within one person of two or more distinct personalities, each with its own name and traits 

  • Formerly known as Multiple Personality Disorder (MPD)

• Symptoms of Schizoprenia: psychotic disorder marked by delusions, halluciations, disorganized and incoherent speech, inappropriate behavior, and cognitive impairments 

  • Bizarre delusions 

  • Hallucinations 

  • Disorganized, incoherent speech 

  • Grossly disorganized or catatonic behavior

  • Negative symptoms 

    • Genetic predispositions 

    • Prenatal problems or birth complications 

    • Biological events during adolescence 

• Damage to the fetal brain increases likelihood of schizophrenia later in life 

  • May occur as a function of a maternal malnutrition or illness 

  • May also occur if brain injury or oxygen depriviation occurs at birth

  • There are other nongentic prenatal factors 

Chapter 16: Therapy and Treatment 

• Dorthea Dix: was a social reformer who became an advocate for the indigent insane and was instrumental in creating the first American mental asylum. She did this by relentlessy lobbying state legislatures and Congress to set up and fund such insitutoins

• The Question of Drugs 

  • Antipsychotic drugs

    • Used primarily in treatment of schizoprenia and other psychotic disorders 

    • Designed to block or reduce the sensitivity of brain receptors that respond to dopamine 

    • Some also block serotonin

    • Can cause troubling side effects such as muscle rigidity, hand tremors, involuntary muscle movements 

  • Antidepressant drugs

    • Used primarily in treatment of depression, anxiety, phobias, OCD 

    • Monoamine oxidase inhibators (MAOIs) : Elevate norepinephrine and serotonin in brain by blocking an enzyme that deactiviates these neurotransmitter 

    • Tricyclic antidepressants: boost norepinephrine and serotonin by preventing reuptake

    • Selective serotinin reuptake inhibitors (SSRIs): work on the same principle as tricyclics but specifically target serotonin  

  • Anti-anxiety drugs 

    • Drugs commonly presribed for patients who complain of unhappiness, anxiety, or worry 

    • Increase the activity of GABA 

    • May temporarily help but are not considered a treatment of choice over time 

  • Lithium carbonate 

    • Used to treat bipolar disorder 

    • Must be given in exactly the right dose 

    • Bloodstream levels must be carefully monitored 

    • Too little will not help 

    • Too much is toxic 

• Some cautions about drug treaments:

  • Placebo effect:

    • The apparent success of a medication or treatment due to the patient’s expectations or hopes rather than to the drug or treatment itself 

    • After a while, when placebo effects decline, many drugs turn out to be neither s effective as promised nor widely applicable  

  • High relpase and dropout rates:

    • There may be short-term success, but 50-66% of patients stop taking medication due to side-effects 

    • When they do, they are likely to relapse, especially if they have not learned how to cope with their disorders 

  • Disregarded for effective, possibly better nonmedical treatments

    • The popularity of drugs has been fueled by pressure from managed-care organiztions and by drug companies’ marketing and adverstising efforts

    • Research shows that nonmedical treatments may work as well or even better  

  • Unknown risks over time and drug interactions 

  • Untested off-labels uses 

• Prefrontal lobotomy: instrument is used to crush nerve fibers running from prefrontal lobes to other areas 

• Electroconclusive therapy: brief brain seizure is induced

• Transcranial magnetic stimulation: involves use of pulsing magnetic coli held to a person’s skull over the left prefrontal cortex 

• Deep brain stimulation: requires surgery to implant electrodes into the brain and to embed a small box, like a pacemaker under the collarbone 

• Major schools of psychotherapy 

  • Humanist and existential therapy 

  • Family and couples therapy 

  • Psychdynamic therapy 

  • Behavior and cognitive therapy 

• Psychoanalysis: a therapy of personality and a method of psychotherapy developed by Sgmund Freud that emphasizes the exploration of unconscious motives and conflicts, modern psychodynamic therapies share this emphasis but differ from Freudian analysis in various ways 

• Transference: in psychodynamic therapies, a critical process in which the client transfers unconscious emotions or reactions, such emotional feelings about his or her parents onto the therapist

• Behavior and Cognitve Therapy:

  • Graduated exposure: person suffering from a phobia or panic attacks is gradually taken into the feared situation or exposed to a traumatic memory until the anxiety subsides 

  • Flooding: client is taken directly into a feared situation until his or her panic subsides

  • Systematic desensitization: a step-by-step process of desensitizing a client to a feared object or experience; based on counterconditioning 

  • Behavioral self-monitoring: keep careful data on the frequency and consequences of the behavior to be changed 

  • Skills training: an effort to teach a client skills or new constructive behaviors to replace self-defeating ones 

  • Graduated exposure: person suffering from a phobia or panic attacks is gradually taken into the feared situation or exposed to traumatic memory until the anxiety subsides 

• Cognitive therapy: a form of therapy designed to identify and change irrational, unproductive ways of thinking and hence to reduce negative emotions 

• Rational emotive behavior therapy: a form of cognitive therapy devised by Albert Ellis, designed to challenge the client’s unrealistic thoughts 

• Cognitive-behavioral Therapy: thoughts and behavior influence each other 

  • More common than either cognitive or behavior therapy alone 

• Family therapy: individual problems develop in the context of the family, are sustained by the dynamics of the family, and any change will affect all members of the family 

• Family-systems perspectives: an approach to doing therapy with individuals or families by identifying how each family membor forms part of a larger interacting system 

• In couples therapy, the therapists usually sees both partners in a relationship to help them 

  • Cut through blaming and attacking 

  • Resolve their differences

  • Get over hurt and blame 

  • Make behavioral changes 

• Integrative approach: in practice, most therapists integrative, drawing on methods and ideas and avoiding any strong allegiances to any one theory 

  • Family and couples therapy

  • Behavioral and cognitive therapy 

  • Humanist and existential therapy 

  • Psychotherapy

• Therapeutic alliance: the bond of confidence and mutual understanding established between therapists and client, which allows them to work together to solve the client’s problems 

• The scientist-practioner gap: different assumptions are held by researchers and many clinicians regarding the value of empirical research for doing doing psychotherapy and for assigning and for assessing its effective 

  • The gap has widened because of the proliferation of unvalidated therapies in a crowded market 

• How treating the mind changes the brain 

  • The fact that a disorder appears to have biological origins or involve biochemical abnormalities does not mean thay biological treatments are the only or most appropriate ones

  • Psychotherapy or simply having other new experiences an change brain patterns just as medication can