Abnormal Psych Exam Review Topics.pdf

Module 1: Defining Abnormality; History of Abnormal Psychology (Chapter 1 and Lecture) · Defining Abnormality: o Psychopathology: formal study of nature of development of abnormal behavior o The 4 Ds of abnormality: dysfunction: interfere with...

Module 1: Defining Abnormality; History of Abnormal Psychology (Chapter 1 and Lecture) · Defining Abnormality: o Psychopathology: formal study of nature of development of abnormal behavior o The 4 Ds of abnormality: dysfunction: interfere with functioning in daily life, distress: causes stress to the person or to the people around them, deviance: is deviant from societal norms, dangerousness: is dangerous to themselves or to others o Cultural relativism: normal and abnormal behavior varies across cultures vs. cultural universality: disorders are the same across cultures o Critiques of Abnormal Psychology - Thomas Sasz: mental health is a myth and it is used to control and change people, ex. Slaves that long for freedom are mentally ill - Rosenhan (1973): “on being in insane places” you might be fine and detail one symptom to a hospital, they will admit you and continue to put you in the insane category simply because you mentioned one symptom Prevalence vs. Incidence: Prevalence → proportion of people with a disorder at a given time Incidence → onset or occurrence over a recent period of time of a disease Module 2: Theories and Treatment of Abnormality – Chapter 2 reading and lecture Biological Perspective – elements and evaluation/critiques o Divisions of the brain Hindbrain: primitive functions, heart rate, etc. ○ Cerebellum: balance and movement ○ Pons: sleep and arousal ○ Reticular formation: network of neurons related to sleep, arousal, and attention ○ Medulla: unconscious processes like breathing, circulation, etc. Midbrain: production of neurotransmitters with necessary functions  Forebrain: cerebral cortex → advanced thinking process, thalamus → handles incoming signals from cerebral cortex, hypothalamus → biological need regulation (hunger, thirst, sexual drive, etc.), pituitary gland → master gland regulating all other glands. Left hemisphere: language and auditory processing Hypothalamus, pituitary, adrenal gland (HPA Axis) → hypothalamus senses the stress, pituitary tells adrenal gland about stress, adrenal gland will release the stress hormones in response to this Corpus callosum → bridge of fibers passing information between hemispheres Dysfunction of HPA axis can cause stress disorders Limbic system → amygdala → emotions, hippocampus → memory o Neurons, neurotransmitters, communication between neurons Neuron parts: cell body, dendrites, axons, terminal buttons Neurotransmitters: inhibitory (tell to stop firing), excitatory (tell to fire) Postsynaptic neuron: has receptor sites from nt to bond (synapse is the cleft where nts can travel to next neuron) Reuptake of excess neurotransmitters Degradation of neurotransmitters GABA (gamma amino-butyric acid): relaxation NT, Xanax increases this to stop stress Norepinephrine: stress response to go, go, go (cocaine and meth) SSRIs o Genetics and behavior: study degree to which heredity plays a role in characteristics and behavior Genotype vs. phenotype Family method: more cases in immediate family, less cases the further away we go from immediate family Twin method: monozygotic twins (identical), dizygotic twins (two zygotes but at the same time, share 50% of DNA and 100% of experiences ○ Concordance: one has the disorder, and other does as well (monozygotic is more common with concordance than dizygotic) Adoptees method: nature vs. nurture? Evidence of genetic predisposition to certain conditions No disorder is only genetic, the environment has an influence. If one parent has it, then you are more likely to have it, but it is not 100% because your environment matters. o Endocrine system: HPA axis, hormone regulation, pituitary gland is the master gland for this  o Diathesis-stress model: predisposition to a disorder + stress (difficult experiences) = interact to create disorders (nature and nurture), polygenic processes → multiple predispositions together create a disorder o Treatments – drug therapies, ECT, surgery These treat symptoms, not the root cause Psychoactive drugs Brain stimulation techniques ○ Electroconvulsive therapy (ECT): electrodes deliver shocks to the brain ○ Repetitive transcranial magnetic stimulation: magnetic stimulation to the brain ○ Deep brain stimulation: electrode stimulation deep brain parts ○ Vagus nerve stimulation: electrode stimulate headaches, non invasive vagus nerve ○ Psychosurgery: tumors, structural abnormalities ○ Downsides: side effects, treats only symptoms and not the cause, Reductionist view → too simplistic and ignores the environment Psychological Perspectives Psychodynamic perspective § Unconscious, preconscious, conscious Unconscious: thoughts, feelings, urges, wishes that are difficult to bring to conscious awareness (with Id) Preconscious: Information that can be easily made conscious (Superego) Conscious: information in your immediate awareness (Ego) § Id: irrational, illogical, impulsive personality Ego: rational, planful, mediating personality Superego: moralistic, judgemental, mediating personality § Psychosexual stages of development 1. Oral (birth - 1 year): mouth fixation 2. Anal (1-3 years): anus, controlling bowels, anal retentive → things have to be controlled and rageful 3. Phallic (3-6 years): genital fascination  ○ Oedipus complex: boys see mom as ideal mate, but dad is in the way. They both share penises, so if they were to fight they would be afraid to lose their penis in a fight because that’s what makes them manly (macho) ○ Electra complex: girl wants dad, recognizing women are not as prideful as men because they don’t have a penis → penis envy (both wish they had penises, overdependent) very sexist 4. Latency (6-11 years): school, friends, not much happens 5. Genital (14 years +): sexual desire § Psychoanalysis and its techniques Based off concepts of undesirable urges, unconscious conflicts, and maladaptive coping Free association: finding patterns in random speech, no censoring, couch look away to avoid influence Resistance: not wanting to talk about a specific topic Dream analysis: analyzing dreams ○ Latent content: what it means ○ Manifest content: what was actually in the dream Transference: defer your hate towards someone safer than the actual person you hate Hypnosis: different state of consciousness, some unconscious bits might slip out Working through: get out of the unconscious to stop anxiety, etc. § Strengths/Critiques More critiques than strengths ○ Cannot testing psychoanalysis scientifically, no empirical evidence to show any improvement ○ Very unaffordable Humanistic perspective § Basic assumptions and views of human nature Each person sees the world from a unique perspective We have a capacity for self awareness Humans are basically good Humans are self-directed  Our goal is self-actualization § Carl Rogers and his theory · Self-actualization: our best state of self · Congruence: we match what we think about ourselves Incongruence: cause of psychopathology, when what you think doesn’t match your actual actions § Client-centered therapy: goal is to discover potential through self-exploration · Therapeutic conditions: therapist must be genuine, unconditional positive regard, empathy (i am with you with your emotions) § Strengths: promotes healthy personality and creativity Critiques: difficult to test scientifically, too optimistic and minimizes human nature Behavioral approaches § Classical conditioning (know what each part of process is called, how it works) Learning by association; new association can be made related when they are not already related Unconditioned stimulus: something that does produces a response, an unconditioned response (UR) Unconditioned response: response to an unconditioned stimulus Neutral stimulus: add this to the US that will create a UR Conditioned stimulus: neutral stimulus becomes this after some time, CS → UR (onion breath → sexual stimulation) § Operant conditioning (types of consequences) Behaviors have consequences, shaping through successive approximations Positive reinforcement: adding something desirable to reward a behavior  Negative reinforcement: removing something bad to reward a behavior Punishment: taking something away or adding to discourage a behavior § Behavior change techniques (See Table 2 in the chapter) Types of counterconditioning (learning a new response) ○ Relaxation exercises: for stressful situations ○ Systematic desensitization: relaxation → ranking list of fears → being exposed to fears from the least scary to the most scary (seeing a picture of a dog to being in a room with a dog) ○ Aversive conditioning: adding something undesirable to when you do something (adding hot pepper to a dish to get you to stop eating it) Only tells you what not to do, but not what to do ○ Removal of reinforcements: taking away good things to discourage a behavior ○ Exposure therapy: get put in a situation and nothing bad happens (flooding is preventing avoidant behavior) ○ Modeling: watching someone do something and copying them ○ Distraction techniques: divert and distract from manifestations of anxiety ○ Behavioral contracting: provides rewards for reaching proximal goals § Strengths/Critiques Cognitive (or Cognitive Behavioral) approaches § Interaction of cognitions and behaviors Problems are caused by maladaptive thoughts Choose your mental response to change how you feel, and therefore, change your behavior § Cognitive/Cognitive Behavioral therapies  Beck’s Cognitive Therapy for Depression ○ Cognitive distortions: “nothing good ever happens to me” fixes these distortions Ellis’s Rational Emotive Behavior Therapy ○ Irrational beliefs, perfectionism is not rational “I must be loved by everyone.” § Strengths: empirical evidence to support Critiques: lacks emotion, and difficult to prove the cause of the thoughts Sociocultural Approaches/Variables § Influences of family, culture Family as a system ○ One person changes, everyone else has to change as well to accommodate the change ○ Treat the family system rather than the individual (more appropriate for collectivist societies) ○ Effective with children because it is directed at the parents ○ Similar to group therapy or couple/marital therapy Influence of society and culture ○ All behavior and treatment is best understood in the context of culture ○ Collectivistic vs. Individualistic § Cross cultural issues in treatment Enmeshment: improper boundaries between family members (too close) Role of discrimination and social structure: is it a problem in the person or the society? Module 3: Assessment and Diagnosis – Chapter 3 reading and lecture Issues in assessment o Reliability: consistency test-retest: similar results when retaking after certain period of time interrater: multiple people administer the same test and get the same conclusion Alternates forms: make sure test forms are all consistent Validity: make sure its measuring what it is supposed to measure Face validity: at first glance, you know what they are trying to ask (easier to fake answers) Content Validity: make sure it asks every type of category that would pertain to that Concurrent Validity: if you come up with a new measure, make sure both old and new measures come to the same conclusion Construct validity: in practice, the people who score a certain way should accurately show that it means something Standardization: have comparison groups (what is normal and what isn’t normal) o Purpose of assessment Assessment methods – what are they? What are the pros/cons? o Observation Behavioral assessment: what they are doing, why they are, patient may not know that they are being observed ○ Reactivity: someone may change their behavior if they know you are observing them Self-monitoring: trying to monitor and stop your own behaviors o Interviews (structured vs unstructured) Analyze verbal behavior, nonverbal behavior, content, process (free-flowing, difficult to keep going?) o Mental status exam: are they aware of where they are, who they are, what they are here for, if they know basic information like their name, etc. o Psychological tests § Self-report inventories: written questions and you self-report and choose a response Ex. Minnesota Multiphasic Personality Disorder (MMPI2) ○ Mostly widely used, lacks face validity, asks seemingly random questions Beck Depression Inventory (BDI): cognitive distortions Limitations: fixed # of choices, some question wording can be emotionally-charged, bias § Symptom checklists § Personality measures: Ex. Minnesota Multiphasic Personality Disorder (MMPI2) ○ Mostly widely used, lacks face validity, asks seemingly random questions § Intelligence tests Tests current mental abilities, diagnoses learning disabilities, and identify intellectually gifted children Limitations: “innate intelligence” your body is already wired with everything to help you survive which is intelligent, more about cultural factors, historical misuse for eugenics and slavery § Neuropsychological Assessments Tests for cognitive impairment Organicity: damage/deterioration of CNS ○ Ex. Bender - Gestalt Visual Motor Test: shown image, asked to copy the image § Brain Imaging procedures: increase diagnostic accuracy in conjunction with psychological tests (ex, scans, x-rays, etc.) o DSM-5 and Diagnosis: APA published, symptoms/criteria/progression, categorial and dimensional imfornation  § Pros/cons, different ideas for diagnostic systems Pros DSM: creates known system of guidelines to diagnose Cons DSM: very broad descriptions, not specific enough leading to overdiagnosis OVERALL CONS ○ Confidentiality of clients records ○ Invasion of privacy when observing without their consent ○ Client welfare: make sure you’re following up and consistently and taking care of client, not just a one and done situation ○ Cultural bias ○ Unethical practices ○ Potential for undesirable social consequences § Culture and diagnosis: because people come from cultural backgrounds, they may not be able to have their voices heard by the therapist who may not understand the specific cultural circumstance they are going through, which can lead to judging and misdiagnosis (or no diagnosis). Module 4: Anxiety and OCD Related Disorders (Reading and Lecture) Anxiety Disorders · What is anxiety? How does it differ from anxiety experienced as part of a disorder? Normal anxiety is a response to a stressor, and usually subsides after the stressful event. Disordered anxiety is maladaptive, disruptive, irrational, and uncontrollable. · What is a panic attack? A panic attack is a period of intense fear or discomfort Rapidly occurs, peaks within a minute Calm to anxious Expected to unexpected · Symptoms/Diagnosis/Explanations of the following: o Phobias  Intense, irrational fear triggered by specific object or situation Fear, anxiety, avoidance 6 months or more Specifiers: animal, natural environment, blood-injection injury, situational, other 7-9%, 2x in women o Social Anxiety Disorder Fear of a situation where they may be scrutinized by others (embarrassed) Fear, anxiety, avoidance 6 months or more Specifier: performance only 7%-12% More in women than men Age of onset can be preschool or adolescence o Panic Disorder Recurrent and unexpected panic attacks After attack at least 1 month of ○ Persistent concern and worry about attack ○ Change in behavior Onset in young adulthood 2% men, %5 women In the past it used to be with or without agoraphobia o Agoraphobia Intense fear or avoidance of at least 2 of the following ○ Being outside or home alone ○ Traveling in public transportation ○ Being in open spaces ○ Being in sores or theatres ○ Standing in a line or being in a crowd ○ 6 months or more o Generalized Anxiety Disorder: excessive anxiety, worry, uncontrollable  · What are the treatments?: SSRIs, meds, CBT (relaxation, symptom-induction, change thoughts, coping strategies) o Systematic desensitization: ranking fears, exposed to each one systematically until fear is gone o Exposure o Barlow’s Panic Control Therapy (PCT): relaxation training, identify catastrophic thoughts, self-induce physiological symptoms (like run to increase heart rate), use coping statements, identify antecedents (what comes before a panic attack), reinterpret cues Obsessive-Compulsive and Related Disorders o What are the symptoms/causes/explanations of the following disorders? § Obsessive Compulsive Disorder Obsessions, intrusive images, bothersome Compulsions, repetitive behaviors Time-consuming Distressing “Magical thinking”: connection between obsessions and compulsions (stepping on a sidewalk crack to protect family) 1% 12 months Age of onset: childhood or adolescence Intrusive thoughts are normal but shouldn’t be consistent or accompanied by overbearing shame § Body Dysmorphic Disorder Preoccupation with imagined or exaggerated defects in physical appearance Repetitive behaviors: checking, picking, etc distress § Trichotillomania Recurrent and compulsive hair pulling Attempts to stop Distress or impairment  Trance-like state Symptoms start before 17 4% of the population 4x higher in women § Excoriation Disorder Resulting in lesions Attempts to stop but cannot Distress or impairment 1.4% prevalence (75% are women) o What are the treatments? § Medications: SSRIs (Prozac, Paxil), 60% respond § Exposure and response prevention (ERP): expose to obsession and prevent compulsive response, anxiety will decrease through habituation Trauma Related Disorders (Reading and Lecture) Trauma and PTSD · How does the body respond to stress? What parts of the nervous system, brain, endocrine system are involved in the response? Response is activated by the HPA axis, hypothalamus will send signal to pituitary which will tell adrenal gland to fire ANS, epi, norepi, stress Sympathetic NS Endocrine system Fight or flight or freeze · What is a traumatic event? Actual or threatened death, injury, sexual violence ○ Experienced, witnessed, learned of close friend, repeated exposure to trauma details (work, police) Not on TV or media · What are some typical outcomes after exposure to traumatic events?  Resilience Recovery (initial distress, symptom reduction over time) Delayed symptoms Chronic symptoms PTSD o Symptoms, diagnostic criteria Intrusion symptom (1+): flashback popping up Avoidance (1-2): memories or feelings that they do not want to remember Changes in cognition or mood (2+): maladaptive thinking, cannot feel positive Arousal (2+): stress response is high, extreme emotions All a month or longer Causes distress or impairment o Etiology/Risk factors § Cultural and gender differences Being female Previous trauma Preexisting disorder Early separation from parents Family history Trauma severity Ex of cultural (hurricane paulina and hurricane andrew: mexico was much more traumatized by it) § Physical, psychological, social factors Sensitized ANS Increased amygdala activation Deficient function in medial prefrontal cortex Hippocampus abnormalities genetics o Treatments CBT (most effective)  ○ Exposure: reexperience traumatic event, overcome avoidance, memories cannot hurt me ○ Systematic desensitization ○ Cognitive restructuring (challenging irrational thoughts) ○ Eye movement desensitization and repressing (EMDR): talking about traumatic events while moving eyes back and forth (not very effective) Meds: antidepressants, anxiolytics, sleep aids Acute Stress Disorder o Symptoms, diagnostic criteria 3 days - 1 month of PTSD symptoms Dissociative symptoms as well o Differences from PTSD Dissociative symptoms Only 3 days - 1 month of symptoms as opposed to longer than a month