Abnormal Psychology Book Notes

Abnormal Psychology Book Notes - Chapter 1-­‐ Abnormal...

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Unformatted text preview: Chapter 1-­‐ Abnormal behavior: psychological dysfunction within individual associated with distress or impairment in functioning/response-­‐ not typical or culturally accepted MUST HAVE ALL 3 TO QUALIFY Psychological dysfunction: breakdown in cognitive, emotional or behavioral functioning Psychopathology: scientific study of psychological disorders-­‐ clinical and counseling psychologists Scientist-­‐practitioners: scientific approach to clinical work—keep up with newest developments in science and integrate that research into their approach to their practice Studying psychological disorders: presenting problem, clinical description, causation (etiology), treatment (look at incidence and prevalence and course of disorder), acute and insidious onsets (instant or over time), eventual prognosis Correlation does not imply causation! supernatural, psychological and biological traditions in diagnosis: witches and demons, stress and melancholy, mass hysteria, the moon and stars (lunatic comes from luna), humoral theory—Hippocratic-­‐Galenic theory (4 humors: blood, black bile, yellow bile, phlegm), syphilis—general paresis moral therapy (within psychological tradition)-­‐ meant emotional or psychological, not code of conduct-­‐ obvious that small, comfortable places of rejuvenation were more effective than large asylums, that were more like prisons mental hygiene movement-­‐ Dorothea Dix-­‐ push toward humane treatment of mental health patients—decline of the asylum-­‐ more people in treatment centers, not enough staff mental issues rendered as problems with brain pathology-­‐ incurable dormant until 20 century-­‐ Psychopathology (Freud) and Behaviorism (Watson, Pavlov, Skinner) Mesmer and “animal magnetism”-­‐ fluid was blocked in patients and he hypnotized them to cure them-­‐ Charcot proved the effectiveness of mesmerizing and Freud came to study under him Psychoanalytic model-­‐ most comprehensive theory yet constructed on development and structure of personality-­‐ emotional release (catharsis), the unconscious, defense mechanisms, psychosexual development Intrapsychic conflicts-­‐ when the id or the superego seem to overpower and the conflict overtakes us-­‐ development of mental disorder Ego psychology-­‐ Anna Freud—mental disorders arise when the ego does not manage conflict properly Self psychology-­‐ formation of self-­‐concept in order to move toward a healthy life-­‐ Kohut-­‐ object relations—how objects and environmental things are integrated into our childhood by way of self concepts in order to build a self-­‐ image-­‐ things that at the foundation of identity and have emotional significance-­‐ introjection Collective unconscious-­‐ Jung—deep ingrained wisdom passed down from th generation to generation Techniques of psychoanalysis-­‐ free association, dream analysis, the problem of transference when conducting therapy Humanistic-­‐ Jung and Adler—positive perspective of human development and improvement—self-­‐actualization, person-­‐centered with unconditional positive regard for the patient, best application with non-­‐afflicted people (mental illness wise) Behavioral model-­‐ classical conditioning and Pavlov, Titchener and introspection-­‐ inner thoughts after a certain stimuli, Watson and Little Albert (father of Behav.), Wolpe and systematic desensitization, Skinner and operant conditioning-­‐ ex. Bird and food experiment Chapter 2-­‐ Multidimensional model-­‐ biological/behavioral/emotional/cognitive/social/developmental influences Genes and chromosomes very important-­‐ some things caused by one gene (PKU for example) and some are polygenic (like IQ) Eric Kandel-­‐ genes interact with environment and become active-­‐ the brain and its functions are plastic (diathesis-­‐stress model and reciprocal gene-­‐ environment model) Diathesis-­‐stress model-­‐ vulnerability to do something, but it doesn’t come to fruition unless something in the environment triggers it Gene-­‐environment model-­‐ people seek out triggers Some traits are passed down merely through environment (independent of genetic influence) CNS-­‐ brain and spinal chord-­‐-­‐(PNS-­‐ Autonomic (sympathetic and parasympathetic) and somatic nervous systems) Hindbrain-­‐ basic functions-­‐ abnormalities in the cerebellum are linked with autism Limbic system in midbrain responsible for sexual drives, hunger, thirst, aggression Basil ganglia-­‐ base of forebrain-­‐ OCD (deals with movement) Cerebral cortex-­‐ 80% of neurons, different hemispheres with different disorders-­‐ dyslexia (left can’t function, right tries to compensate with pictures), prefrontal cortex-­‐ higher processing PNS-­‐ endocrine system-­‐ hormones Neurotransmitters-­‐ agonists-­‐ increase activity of neurotransmitters (mimic effects), antagonists decrease neuro., inverse agonists produce opposite effects of the neuro. two types of neurotransmitters are linked to psychopathology-­‐ monoamines (norepinephrine, serotonin, dopamine) and amino acids (GABA-­‐ inhibitory and glutamate-­‐excitatory) GABA-­‐ reduce anxiety and emotional responses in general Serotonin-­‐ behavior, moods and thought processes Norepinephrine-­‐ stimulates two groups-­‐ alpha and beta adrenergic receptors-­‐ major circuits-­‐-­‐ to hindbrain (basic bodily functions) and emergency reactions (stress hormone) Dopamine-­‐ addiction and schizophrenia, ADHD, very much pleasure-­‐seeking, outgoing structure, balances out serotonin Naturally occurring neurotransmitter have different effects depending on psychosocial experience Cognitive science-­‐ how we acquire, process and store/retrieve information learned-­‐helplessness-­‐ actions don’t have an effect on environment-­‐ eventually give up in trying to act positive attitudes are healthy for us mentally and physically Bandura and modeling/observational learning Prepared learning-­‐ we have an evolutionary and genetic predisposition to learn in certain contexts and situations because it benefits our survival Unconscious vision and implicit memory-­‐ being able to do something but not have a conscious process about the activity/experience Emotion, short lived; mood, persistent Affect-­‐ emotional tone that accompanies what we say or do Gender and psychopathology-­‐ fear-­‐ more accepted in women than men, women have phobias, men deal with fear normally through alcohol. Equifinality-­‐ every result’s causes are looked at equally as routes to the disorder Chapter 3-­‐ Clinical assessment-­‐ reliability, validity, standardization Mental status exam-­‐ appearance and behavior, thought processes, mood and affect, intellectual functioning, sensorium (awareness of surroundings) Semistructured interviews-­‐ certain questions ordered and phrased so as to get the most information from the patient to diagnose and treat Physical required, so as to get any obvious physical causes out of the way Behavioral assessment if an interview gives unclear insight or isn’t appropriate for situation-­‐-­‐ Antecedent-­‐behavior-­‐consequence Reactivity-­‐ changes behavior of person being watched because they know they are being watched Projective tests-­‐ ambiguous stimuli used to assess a patient-­‐ Rorschach ink blot tests, Thematic Apperception Test (pictures with a story) Personality inventories-­‐ looking at what the answers to the questions predict MMPI-­‐ opposite of projective tests, asks very straightforward questions, looking for empirical data (q’s like ‘cries readily’) IQ-­‐ Binet and Simon—initially for mental age, now is done by deviation from the norm What is intelligence? Idiographic strategy-­‐ find out what is unique about the person’s circumstance Nomothetic strategy-­‐ attempting to classify the problem Classical categorical approach-­‐ biological tradition in psychopathology Dimensional approach-­‐ note variety of factors influencing the patient and quantify them Prototypal approach-­‐ general overarching characteristics described, but not specific tendencies DSM-­‐III-­‐ multiaxial system-­‐ 5 axes Comorbidity within the diagnoses Spectra of disorders (e.g. Asperger’s into a mild form of autism) Chapter 4-­‐ Analog models-­‐ used to simulate the real world experience, but in the lab, so as to eliminate confounding variables Statistical/clinical significance Effect size and social validity-­‐ more subjective way of calculating clinical significance Patient uniformity myth-­‐ that group differences are more important than the differences between the individuals in that group Case studies Correlational studies-­‐ attempting to see if two things coincide and possibly see causation Directionality-­‐ we can see a relationship, but not causation, and so although we see a certain direction, it doesn’t mean that the two variables imply causation Epidemiology-­‐ study of incidence, distribution and consequence of problem or set thereof in one or more populations Experiment-­‐ manipulate a variable to analyze the outcomes (clinical trials, comparative treatment research-­‐ administer different drugs to comparable groups) Single case experimental designs-­‐ repeated measurement beforehand Withdrawal design-­‐ baseline established, introduce treatment, extract treatment Multiple baseline-­‐ baseline made at home and work and then treatment introduced in each environment, but at different times. Phenotypes-­‐ observable behaviors/characteristics Genotypes-­‐ unique genetic make-­‐up Endophenotypes-­‐ genetic mechanisms that ultimately contribute to the underlying problems causing the symptoms experienced by people with psychological disorders Family study-­‐ behavioral/emotional trait examined at home-­‐ person with the trait singled out-­‐ the proband Adoption studies-­‐ looking at genetic similarities in different upbringings Twin studies-­‐ see similarities in development of psychological issues (e.g. antisocial)-­‐ more commonalities among identical than fraternal twins Genetic linkage analysis-­‐ using the presence of genetic markers and certain disorders to find a linkage—normally a failure to replicate the findings in these studies Association studies-­‐ like genetic linkage, but instead compare those with the disorder to those without it Cross-­‐sectional designs, with some retrospective information Longitudinal designs-­‐ follow person and survey them in waves over time-­‐ cross-­‐ generational effect -­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐ -­‐-­‐ Chapter 7 Mood disorders-­‐ “depressive” “affective” “depressive neuroses”-­‐ gross deviations in mood-­‐ fundamental experiences of depression and mania Major depressive episode-­‐ most common and severe-­‐ more than two weeks of depressed mood state (Anhedonia-­‐ inability to have fun, is also present) or 1 week of manic state; hypomanic episode is less severe but should only last 4 days Unipolar mood disorder-­‐ only experience one of the two states (stay at one “pole”) Dysphoric or mixed manic episodes-­‐ manic disorder with a feelings of depression or anxiety occurring at the same time (does not like feeling of not being in control) those who have strictly manic episodes are likely to develop bipolar dysthemic disorder-­‐ same symptoms as MDD, but milder and a more consistent direction, rather than randomly recurring episodes (must continue at least 2 years) rating severity of disorders-­‐ mild, moderate, severe six basic specifiers describing latest episode-­‐ 1. Psychotic features specifiers-­‐ hallucinations, delusions (mood-­‐congruent or incongruent) 2. Chronic features specifier-­‐ only if full criteria for MDE been met for at least 2 years 3. Catatonic features-­‐ absence of movement (catalepsy) 4. Melancholic features-­‐ severe type of depressive episode. 5. Atypical features-­‐ consistently oversleep/eat during depressive episodes and gain weight-­‐ greater percentage of women and those with early onset 6. Postpartum onset-­‐ 13% of women giving birth meet criteria for an episode of MD, baby blues are normal Difference in course of disorder 1. Longitudinal course-­‐ look at past events to see if there was a full recovery or not in the past 2. Seasonal pattern-­‐ the onset is correlated with certain seasons (e.g. Seasonal affective disorder, happens in the winter-­‐ might be connected to melatonin levels) SAD more prevalent in northern and southern lats Incidence and consequent suicide is steadily rising Dysthymic disorder-­‐ onset normally 20 years old; early onset associated with: greater chronicity, relatively poor prognosis, stronger likelihood of disorder running in the family, 20-­‐30 years or more Pathological or impacted grief reaction bipolar disorder II-­‐ major depressive with hypomania bipolar I-­‐ MD with full manic episode specifiers for bipolar-­‐ rapid cycling specifier (quickly in and out of different episodes), onset and duration (e.g. cylothymia mood swings into full blown bipolar) 16%-­‐ Major Depressive in life; 6%-­‐ MDD in past year same prevalence over both genders with bipolar women-­‐ rapid cycling and anxiety lower among blacks than whites 1.5% of children have depression imbalance and spike comes at adolescence-­‐ higher in girls than boys for MDD childhood depression-­‐ misdiagnosed as ADD or ADHD because of oscillating moods general comorbidity of bipolar (esp. depression state) with ADHD older adults-­‐ depression could be seen as physical illness or rather dementia Native Americans-­‐ high prevalence of MDD Variability in depression due to genetics-­‐ 40% for women, 20% for men Balance of neurotransmitters is VERY important-­‐ if serotonin is low, then moods are irregular, AND the imbalance leads to other consequences as well Neurohormones-­‐ hormones that affect the HPA axis Long-­‐term overproduction of stress hormones-­‐ results in lack of neurogenesis and shrinkage of hippocampus MDD enter REM cycle sooner than normal Depriving sleep in second half of night-­‐ can improve depressed condition Greater right side anterior activation in depressed brain Learned helplessness theory of depression-­‐ internal, stable, global Depression out of negative thinking of daily things (negative cognitive styles) Arbitrary inference-­‐ look more at the negative than the positive Overgeneralization-­‐ think that one negative thing will cause you to fail, despite many positive signals Depressive cognitive triad-­‐ think negatively about themselves, immediate world and future Dysfunctional attitudes-­‐ negative outlook Hopeless attributes-­‐ explain things negatively Women-­‐ higher for panic disorders, mood disorders, generalized anxiety and phobias Treating mood disorders Antidepressants-­‐ selective-­‐serotonin reuptake inhibitors (block presynaptic reuptake of serotonin-­‐temp. raises levels of serotonin-­‐ Prozac), mixed reuptake inhibitors (block reuptake of norepinephrine and serotonin-­‐ Effexor, Serzone), tricyclic antidepressants (most common before SSRIs-­‐ block norepinephrine; T and E), monoamine oxidase inhibitors (block MAO enzyme that breaks down norepinephrine and serotonin-­‐ effect of tricyclics, less side effects, good for depression with atypical symptoms-­‐ normally prescribed when something else doesn’t work) Lithium-­‐ effective in preventing and treating manic episodes-­‐ mood-­‐stabilizing drug; Valproate is a current competitor in the market (effective for bipolar and rapid cycling) Electroconvulsive therapy-­‐ seems to work for 50% of those that do not respond to treatment, yet 60% relapse; more effective than Transcranial magnetic stimulation (blocks stress hormones) Cognitive-­‐ behavior therapy-­‐ cognition leads us to depression-­‐ works on changing behaviors to change connections in brain Interpersonal psychotherapy-­‐ resolve issues in current relationships and how to form important and new interpersonal relationships (interpersonal role disputes, adjusting to loss of relationship, acquiring new relationships, acquire social skills) Can use the psychotherapy to PREVENT these conditions-­‐ also seem to be best to prevent further episodes Combined treatments seems to give some advantage Interpersonal and social rhythm therapy-­‐ for those with bipolar, keeping a schedule to live by and keep up on medication better Suicide is 11 highest cause of death, overwhelmingly white Women attempt suicide more, men accomplish suicide more (ideation, plan, attempt) Altruistic, egoistic, fatalistic suicides CHAPTER 8 Major eating disorders-­‐ bulimia nervosa (binges), anorexia nervosa Binge-­‐eating disorder Drive to be thin Anorexia has highest mortality rate of psychological disorders Bulimia-­‐ purging and non-­‐purging (over exercising, fasting); develop more body fat Salivary gland enlargement, electrolyte imbalance, erosion 75% head either anxiety or mood disorder or social phobia or generalized anxiety depression follows bulimia normally within 10% of their normal weight Anorexia-­‐ have better control on eating and lose a ton of weight Restricting and binge-­‐eating-­‐puring Stop menstruating, heart problems, dry skin High rate of OCD and suicide Binge-­‐eating disorder-­‐ associated with more severe obesity Number of overweight kids tripled in past 25 years Promotion of sedentary, inactive lifestyle Dyssomnias-­‐ difficulties in getting enough sleep, problems with sleeping when you want to, complaints with quality Parasomina-­‐ abnormal behavioral/physiological event that occur during sleep Polysomnographic (PSG) evaluation-­‐ looks at airflow, leg movements, brain wave activity, eye movements, muscle movements, and heart activity Actigraph-­‐ wristwatch that collects arm movements during sleep Sleep efficiency-­‐ percent of time actually asleep Microsleeps 33% of population reports insomnia problems per year insomnia-­‐ body temperature delay (higher body temp. on avg.) sleeping pills-­‐ rebound insomnia hypersomnia (some previously had viral infections) narcolepsy (cataplexy) th obtrusive and central sleep apneas suprachiasmatic nucleus-­‐ contains biological clock CHAPTER 10-­‐ Sexual and Gender Identity Disorders gender identity disorder-­‐ dissatisfaction with one’s biological sex sexual dysfunction-­‐ difficult to function during sexual intercourse paraphilia-­‐ sexual arousal from inappropriate objects or individuals men show more sexual desire and arousal than women women emphasize committed relationships as a context for sex more than men men’s sexual self-­‐concept, unlike women’s, is characterized partly by power, independence, and aggression women’s sexual beliefs are more plastic-­‐ easily shaped by cultural, social and situational factors gender identity disorder-­‐ sexual satisfaction by wearing clothes and attaining role of opposite gender gender nonconformity hypoactive sexual desire disorder sexual aversion disorder-­‐ fear or anxiety from sexual touching, thoughts dyspareunia-­‐ for no medical reason there is pain vaginismus-­‐ involuntary vaginal spasms frotteurism voyeurism-­‐ observing and being aroused exhibitionism-­‐ exposing oneself and being aroused S&M CLASS NOTES Thursday September 20 Depressed Mood-­‐ bleak, pessimistic, despairing, anger, paranoia, anxiety, hopelessness Feeling that it will never end, and just get worse Inability to feel emotions even Cognition and perception-­‐ mental activity profoundly slowed, magnification of ordinary fears, suicidal thinking, hypochondriac fears Activity and behavior-­‐ also almost always slowed, fatigue, lack of activity, impairment of will, altered sleep and eating, psychotic depressions Obvious physical signs of depression-­‐ placid look, almost a barrier between the individual and others Mixed states-­‐ simultaneous manic and depressive symptomatology, transitional states or independent clinical states-­‐ symptomatology is anything BUT static Can manifest both states...
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