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Unformatted text preview: LAST LECTURE LAST LECTURE Power Review • Based on 6 primary approaches 1.Free associations 2.Interpretation 3.Dream analysis 4.Resistance 5.Transference 6.Working through • Emphasis on the development of potential o o Humanistic – self-actualization occurs naturally, unless roadblocks hamper it Existential – struggle, pain, and self-discipline inevitably occur along the road to personal fulfillment • Both utilize a phenomenological approach – therapists encounter patients in terms of the subjective phenomena (thoughts, feelings) they experience in the present • Person-centered therapy – centered on the patient’s goals and ways of solving problems Carl Rogers Therapists don’t tell the patient how to solve their problems, and patients can use their time however they choose o Therapists exhibit unconditional positive regard to elicit a more positive self-concept o o • Gestalt therapy – aims to integrate different, and sometimes opposing aspects of personality, into a unified sense of self o o Two-chair technique to promote self-awareness Considered an experiential therapy because it recognizes the importance of awareness, acceptance, and expression of feelings • Logotherapy – therapeutic approach that helps people find meaning in their lives Victor Frankl – believed that humans can preserve freedom of mind through even the worst conditions imaginable o Discourages patients from blaming past circumstances, other people, and adverse situations for their difficulties o • Behavioral therapy – focuses on specific problem behaviors, and current variables that maintain problematic thoughts, feelings, and behaviors o Seeks to identify and assess the problem, then design and implement a strategy for behavior change • Exposure therapy – confronts patients with their fears, with the goal of reducing that fear o Systematic desensitization – patients are taught to relax as they are gradually exposed to what they fear, in a stepwise manner o Flooding – patients immediately experience their greatest fear, with no aversive consequences • Flooding • Based on the idea that fears are maintained by avoidance (negative reinforcement) • Flooding provokes anxiety in the absence of negative consequences, so that extinction can proceed o o Response prevention is critical - therapists prevent patients from performing their typical avoidance behaviors Can be done with virtual reality • Dismantling Desensitization • Dismantling – research procedure for examining the effectiveness of isolated components of a larger treatment • Dismantling studies show that each component of desensitization (relaxation, imagery, anxiety hierarchy) can be eliminated without affecting the treatment o Placebo effect or extinction of fear? • Participant modeling – therapist first models a problematic situation, and then guides the patient through steps to cope with it unassisted o Important component of assertion training and behavioral rehearsal • Operant procedures – using reward and punishment to shape behavior o Token economy – desirable behaviors are rewarded with tokens that patients can exchange for tangible rewards o Aversion therapy – uses punishment to decrease the frequency of undesirable behaviors • Cognitive-behavior therapy – attempts to replace maladaptive or irrational cognitions with more adaptive, rational ones • Core assumptions: o Cognitions can be identified and measured o Cognitions are the key player in both healthy and unhealthy psychological functioning o Irrational beliefs can be replaced by more rational and adaptive cognitions o o At least as effective as psychodynamic, personcentered, or drug therapies Can be effectively combined with drug therapies or marital counseling • Pharmacotherapy – use of medications to treat psychological problems Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to treat depression o Drug companies claim these drugs fix a “chemical imbalance” in the brain, but the fact is that they likely work through complex mechanisms yet to be discovered o • Side effects are usually reversible when the drug is discontinued, but some are not o Tardive dyskinesia (TD) – irreversible side effect of some antipsychotic drugs causing involuntary movements of facial muscles and twitching of the neck, arms, and legs • Different patients require different doses o Sex, ethnicity, body weight can alter response • Electroconvulsive therapy (ECT) – brief electrical pulses to the brain which produce a seizure and treat serious psychological problems (last resort) o Effective: 80-90% improvement rates o Not as uncomfortable as it sounds 98% of patients said they would have ECT again if their depression returned Adverse side effects: • Vagus nerve stimulation – electrical pulses to treat major depression o Large scale study has not been done Memory and attention problems can persist 6 months after treatment • brain surgery to treat psychological problems o 1950s - researchers claimed that prefrontal lobotomies were effective treatments for a range of disorders Heavy criticism of this practice Surgeries became more targeted to decrease side effects Today psychosurgery is used as an absolute last resort Few well-controlled studies have been performed The Big Five ► Lexical approach ► Five Factors most crucial aspects of personality are embedded in language Openness to experience Conscientiousness Extraversion Agreeableness Neuroticism Openness to experience Openness to experience ► Intellectually curious and unconventional ► appreciation for art, emotion, adventure, unusual ideas, imagination, curiosity, and variety of experience. Conscientiousness Conscientiousness ► a tendency to show self­discipline, act dutifully, and aim for achievement ► planned rather than spontaneous behavior Extraversion Extraversion ► energy, positive emotions, and the tendency to seek stimulation and the company of others. Agreeableness Agreeableness ► a tendency to be compassionate and cooperative rather than suspicious and antagonistic towards others Neuroticism Neuroticism ► a tendency to experience unpleasant emotions easily, such as anger, anxiety, depression, or vulnerability ► sometimes called emotional instability Psychosexual Stages Psychosexual Stages ► 5 stages ► Unresolved conflict fixation Age­related personality development Each stage = focus on an erogenous zone Try to achieve pleasure as an adult in ways equivalent to that stage Oral Stage (birth – 1 year) Oral Stage (birth – 1 year) ► Mouth associated with sexual pleasure ► Improper weaning fixation ► Fixation oral activities in adulthood Smoking, nail biting Anal Stage (1 – 3 years) Anal Stage (1 – 3 years) ► Anus associated with pleasure ► Improper toilet training fixation ► Fixation anal retentive or expulsive behaviors in adulthood Phallic Stage (3 – 5 years) Phallic Stage (3 – 5 years) ► Focus of pleasure shifts to genitals ► Fixation Difficulty with authority Inability to maintain stable love relationship Issues in Phallic Stage Issues in Phallic Stage ► Oedipus/ Electra complex ► Boys experience castration anxiety ► Girls experience penis envy Child develops sexual attraction to parent of opposite sex, and hostility toward same­sex parent Realization that father is physically powerful; fears punishment by castration Realizes penis is a symbol of power and transfers her love to her father Resolving the Conflict Resolving the Conflict ► Identification ► Boys identify with father Person models behavior of another to reduce anxiety ► Girls wait until they give birth to a boy with a penis!! Psychosexual Stages Psychosexual Stages ► Latency stage (7­11) ► Genital stage (adolescence) Sexual urges repressed Strong desire to associate with same­sex peers Sexual pleasure in heterosexual relationships Sex­partners like opposite­sex parent Resolve Oedipus complex Social Learning Theories ► Locus of control – extent to which people believe that reinforcers and punishers lie inside or outside of their control Internal ­ outcomes are influenced by personal effort and personal characteristics External ­ life events are the products of chance and fate. ► Structured personality tests Personality Personality Assessment ► Minnesota Multiphasic Personality Inventory (MMPI) widely used structured test designed to assess symptoms of mental disorders Built using empirical method of test construct ►begin with two or more criterion groups ►examine which items best distinguish them ►low face validity – the extent to which respondents can tell what the items are measuring Basic tendencies vs. Basic tendencies vs. Characteristic adaptations •Basic Tendency - the underlying trait •Characteristic Adaptation - How the trait is expressed. What do you see here? What do you see here? Projective tests Projective tests ► Consist of ambiguous stimuli that examinees must interpret Rorschach Inkblot Test Thematic Apperception Test (TAT) Human figure drawings Graphology Thematic Apperception Test Thematic Apperception Test ► Sudden attack of physical symptoms: What is a Panic Attack? What is a Heart palpitations Shortness of breath Choking sensation Trembling or shaking Dizziness Sweating De­realization ► Common (25% of college students have had at least one) Panic Disorder Panic Disorder ► frequent & unexpected panic attacks physical symptoms leading to intense fear that something terrible is happening ► physical sensations cause great distress ► often with agoraphobia Generalized Anxiety Disorder (GAD) Generalized Anxiety Disorder (GAD) ► free floating anxiety (unfocused) ► excessive, long­lasting Symptoms: anxiety, worry, irritability, fatigue, inability to concentrate, tension ► more common in women ► tends to occur to people who are “worry warts” ► often occurs with other problems like depression Obsessive­Compulsive Disorder Obsessive­Compulsive Disorder ► OCD characterized by… Obsessions: unwanted repetitive, irrational, and/or disturbing thoughts Compulsions: repetitive actions performed to alleviate obsessions Obsessions Compulsions ► “bigger”, more intrusive than worries often viewed as irrational, “crazy”, by subject COMMON THEMES contamination safety unintentional injury of others being prepared sex / aggressive impulse ► may consume MASSIVE amounts of time (15+ hrs) done to alleviate anxiety of O’s COMMON FORMS counting checking hoarding useless items elaborate rituals arrangement of items washing / cleaning ► ► ► ► ► ► ► ► ► ► ► ► ► Bipolar disorder Bipolar disorder Extreme mood swings over an extended period of time (lasting several days) 1. Manic episodes – extreme euphoria, physical energy, rapid thoughts and speech need less sleep grandiose delusions Risky behavior Manic Phase 1. Depressive episodes Schizophrenia Schizophrenia severely distorted beliefs, perceptions, thought processes John Nash, Jr., as in the movie “A Beautiful Mind” David Helfgott, as in the movie “Shine” Psychotic Symptoms Psychotic Symptoms ► serious, profound distortions of reality gerald Delusions: falsely held beliefs persist despite contradictory evidence e.g. others are talking about you; supremely powerful; under mind control Hallucinations: false or distorted perceptions that seem real can be visual/auditory may contribute to delusions Other Symptoms Other Symptoms Disorganized speech ► probably a thought disorder (not brain damage) though may resemble “word salad” Disorganized behavior ► diminished self­care, hygiene; inappropriate emotional outbursts; strange clothing Catatonic symptoms ► movement problems and immobility ► echolalia: repeating words over and over Types of Schizophrenia Types of Schizophrenia ► Paranoid delusions, hallucinations, or both little or no cognitive impairment or behavioral disorganization ► Catatonic extremely disturbed movements or actions ► Disorganized disorganized speech and behavior inappropriate or flat affect Paranoid type Paranoid type ► Delusions, hallucinations, or both little or no cognitive impairment or behavioral disorganization Schizophrenia and Genetics Risk increases with genetic similarity Lifetime risk of developing schizophrenia for relatives of a schizophrenic Brain Abnormalities Brain Abnormalities Enlarged ventricles ► Loss of gray matter tissue ► Temporal lobes – positive symptoms Frontal lobes – negative symptoms Brain Chemistry Brain Chemistry Dopamine hypothesis – symptoms caused by excesses in dopamine ► Antipsychotics reduce/block dopamine activity ► Drugs that enhance dopamine activity produce schizophrenia­like symptoms ► Vulnerability Theory Vulnerability Theory ► Consistent with Stress­Diathesis Vulnerability + Stress = Schizophrenia ► NEW QUESTION: Sean frequently conned others, including elderly relatives, friends, and charities, to get whatever he wanted. After getting to know the real Sean, many considered him manipulative, self­centered, and lacking in empathy. Sean is likely to have ____________. ► CORRECT RESPONSE: Psychopathic Personality Disorder Personality Disorders Personality Disorders ► Cluster A (odd, eccentric) ► Cluster B (dramatic, erratic) ► Cluster C (anxious, fearful) Cluster A Cluster A ► Schizoid ► Schizotypal ► Paranoid Cluster B (dramatic/erratic)** Cluster B (dramatic/erratic)** ► Borderline Personality Disorder ► Antisocial/psychopathic personality ► Narcissistic Personality Disorder ► Histrionic Personality Disorder Ted Bundy Ted Bundy ► Honors student, psych major, boy scout, Vice president of the Methodist student association. He maintained a facade of social activity, but he had no natural sense of how to get along with other people, saying: "I didn't know what made things tick. I didn't know what made people want to be friends. I didn't know what made people attractive to one another. I didn't know what underlay social interactions." Serial Killer confessed to 30 murders (strangulation/rape), suspected of up to 100. ► ► Cluster C (anxious/Fearful) Cluster C (anxious/Fearful) ► Obsessive­compulsive ► Dependent ► Avoidant ...
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