Abnormal Psych Reviewer PDF

Abnormal Psychology - response is atypical or not culturally expected Mental Disorder and Classification - occurs infrequently; deviates from...

Abnormal Psychology - response is atypical or not culturally expected Mental Disorder and Classification - occurs infrequently; deviates from the average Psychological Disorder - the more productive you are in the Mental disorder: a condition society, the more eccentricities the characterized by thoughts, feelings, society will tolerate and behaviors that create Criteria 4: Dangerousness dysfunction. - when behavior represents a threat to Psychopathology: the study of the safety of the person or others psychological disorders and their symptoms. Ancient Views of Mental Illness Etiology: the causes of disorders Biological Theories: - Supernatural theories: attribute “Four D’s’”- deviance, dysfunction, distress, mental illness to possession by evil and danger or demonic spirits, displeasure of gods, eclipses, planetary gravitation, According to the APA, a psychological curses, and sin. disorder consist of - Somatogenic theories: identify Reflect some kind of biological, disturbances in physical functioning psychological, or developmental resulting from either illness, genetic dysfunction. inheritance, or brain damage or lead to significant distress or imbalance. disability in one’s life. - Psychogenic theories: focus on do not reflect expected or culturally traumatic or stressful experiences. approved responses to Maladaptive learned associations certain events. and cognitions, or distorted perceptions Defining Abnormality Criteria 1: Psychological Dysfunction Supernatural Theories - refers to a breakdown in cognitive, - A reflection of the battle between emotional, or behavioral functioning. good and evil - considered to be in a continuum (not - Demons and Witches categories) - The moon and the Stars (lunatic) - not enough to meet the criteria for a Treatment: psychological disorder - Trephination: as early as 6500 BC Criteria 2: Distress and Impairment has identified surgical drilling of - must be associated with personal holes in the skull. distress - Exorcism shaving: the hair in a - still not enough to meet the criteria cross pattern, shock treatments for a psychological disorder (hydrotherapy, snake pits), chaining - extreme expressions of otherwise to walls of the church, and the normal Salem witch hunt of the 17th Criteria 3: Deviance century. Mass Hysteria humane treatment of the mentally ill - Contagious dissociative phenomena (Moral Therapy) that take place in large groups of - In the 19th century, Dorothea Dix led people of institutions under reform efforts for mental health care conditions of anxiety. in the United States (Mental Hygiene - Taking place in schools, where Movement). episodes of illness or fainting appear Emil Kraepelin: founder of modern to spread rapidly throughout the scientific psychiatry, psychopharmacology, school. and psychiatric genetics and believed the - The whole communities are affected chief origin of psychiatric disease to be when this escalates into full-blown biological and genetic malfunction. panic. - Dementia praecox: kraepelin’s - AKA Mob (Crowd) Psychology definition for what we now call schizophrenia; the “sub-acute Somatogenic/Biological Theories development of a peculiar simple Hysteria: physical symptoms appear to be condition of mental weakness the result of a medical problem for which no occurring at a youthful age.” physical cause can be found (paralysis, blindness). Psychogenic/Psychological Theories - Mistakenly assumed to be exclusive Psychoanalytic Theory to women - Sigmund Freud and Joseph Breuer - “The wandering Uterus/Womb) (1885) - Somatic symptoms disorders - Patients became extremely Galen: Humoral Theory of Disorders emotional as they talked and felt - Blood- heart (sanguine) relieved and improved after - Black bile- spleen (melancholic) emerging from the hypnotic state. - Phlegm- brain (phlegmatic) - The discovery of catharsis and the - Choler or yellow bile- liver (choleric) unconscious Chinese Counterparts Three Major Facets: - Movement of wind - Structure of the mind (dynamics of - Yin=cold, dark wind personality) - Yang=warm, life sustaining wind - Defense Mechanisms - Common treatment= acupuncture - Stages of Psychosexual development Deinstitutionalization Humanistic Theory Asylum: the first institutions created for the - The positive, optimistic side of specific purpose of housing people with human nature psychological disorders. Carl Rogers Person-Centered Therapy - The focus was ostracizing them from - Relationships (including the patient society rather than treating their and clinician) are the most positive disorders. influence in facilitating human - Late 1700s, a french physician, growth Philippe Pinel, argued for the more - Unconditional Positive Regard Abraham Maslow  - Hierarchy of Needs - includes many categories of disorders (e.g., anxiety disorders, Behavioral Theory depressive disorders, and dissociative Ivan Pavlov and Classical Conditioning disorders). - A type of learning in which a neutral - Including an overview of the disorder stimulus is paired with a response (diagnosis features), specific until it elicits that response symptoms required for diagnosis - Stimulus generalization a response (diagnosis criteria), prevalence generalizes to similar stimuli (a information (what percent of the nurse vs. all nurses/ anyone in population is thought to be afflicted uniform) with the disorder), and risk factors - Extinction associated with disorder. B.F. Skinner and Operational Comorbidity: the co-occurrence of two Conditioning disorders. - A type of learning in which behavior changes as a function of what Major Disorder Categories of DSM-5 follows the behavior (rewards and punishment) The DSM-5 begins with - Shaping neurodevelopmental disorders and is John Watson divided into 22 chapters that include sets of - 11 month old “Albert” related disorders. Mary Cover Jones - Internalizing problems: - The case of 2 year old peter depression, anxiety. Social anxiety. - Systematic desensitization Somatic complaints, post traumatic symptoms and obsession Biopsychosocial Model: model compulsion. emphasizing the various factors influencing - Externalizing problems: disruptive, disorders. While some have a genetic impulse control, conduct disorders predisposition for a certain psychological and substance use. disorder, certain psychological stressors Internal Classification of diseases need to be present for them to develop the - ICD-11: the 11th revision of the disorder. international classification of - Involuntary treatment- therapy that diseases and will eventually replace is not the individual’s choice. the ICD-10 as the global standard - Voluntary treatment- the individual for coding health information and chooses to attend therapy to obtain cause of death. relief from symptoms. - Will officially come into effect on January 1, 2022. DSM Classification - The ICD is more frequently used for clinical diagnosis whereas the DSM DSM-5 Basic Features: Diagnostic and is more valued for research. Statistical Manual of Mental Disorders - Etiology and treatment of (DSM-5): published by the American psychological disorders are based Psychiatric Association in 2013. on criteria set forth in the DSM.  The APA then compromised, removing Modifications in DSM-5 and DSM-5-TR homosexuality from the - DSM-5: including Asperger’s DSM but replacing it, in effect, with "sexual disorder within the autism spectrum. orientation disturbance" for people "in Modifications of terminology, such as conflict with" their sexual orientation. replacing use of “mental retardation” Not until 1987 did homosexuality completely with “intellectual disability” fall out of the DSM. - DSM-5-TR: published in March 2022, text revision of DSM-5, History of DSM: DSM-III updates to ICD-11-CM codes - Published in 1980, this dramatically - If features a new disorder: prolonged changed the field of psychology. grief disorder - Five part multiaxial diagnostic system, first appeared in DSM-III. History of DSM: DSM-1 - 265 diagnoses - The APA published the diagnostic - Anxiety disorders were lumped and statistical manual of mental together as one diagnosis of anxiety disorders in 1952; it was based off of neurosis. The DSM-III broke that the ICD-6 and the military system. broad diagnosis down to include - 60 disorders and was based on many different anxiety disorders theories of abnormal psychology and such as generalized anxiety disorder psychopathology. (GAD), panic disorder, agoraphobia, - Reliability and validity. The major and social phobia. limitation of the DSM was that the - In fact the term “neurosis” was concept had not been scientifically removed from the DSM-II altogether. tested. - PTSD was added to the DSM at this History of DSM: DSM-II time. Also the DSM-II category of - The DSM-II was published in 1968 “sexual attention disturbance” was but still had criticism over its validity changed to “ego dystonic and reliability. Changes in the homosexuality”. DSM-8 included eleven major diagnostic categories, with 185 total History of DSM: DSM-III-R diagnoses for mental disorders. - The revision for DSM-III was - In 1974, the seventh printing of the published in 1987. DSM-II no longer listed - 297 diagnoses homosexuality as a disorder. History of DSM: DSM-IV - The DSM-IV was published in 1994. In 1973, the American Psychiatric - This edition was more research Association (APA) asked all members based as far as criteria and attending its convention to vote on whether diagnoses are concerned. they believed homosexuality to be a mental - 365 diagnoses. disorder. 5,854 psychiatrists voted to History of DSM: DSM-IV-TR remove homosexuality from the DSM, and - The text revision of the DSM was 3,810 to retain it. published in 2000.  - This volume is heavily research Classification: is the way in which they are based and includes information organized or categorized. about the etiologies of disorder Nomenclature: names or labels of the disorders (body system of names) APA VS APA VS PAP. Epidemiology: the method used to find the causes of health outcomes and diseases in American Psychological Association (APA) populations. = membership Prognosis: is the anticipated course the Psychological Association of the Philippines mental disorder will take. (PAP) = membership in the PH. Course: American Psychiatric Association (APA) = - Acute meaning that it lasts a short publisher of the Diagnostic and Statistical period of time Manual of Mental Disorders. - Chronic meaning it lasts a long period of time Evaluation and Assessment of Mental - Time limited meaning that recovery Disorders will occur in a short period of time regardless of whether any treatment Classifying Mental Disorder occurs. Clinical Assessment: systematic evaluation and measurement of Clinical Interviews and Mental Status psychological, biological and social factors Examine in an individual presenting with a possible Clinical interview: a face to face encounter psychological disorder. between a mental health professional and - Clinician: a professional who works patient in which the former observes the directly with patients of clients and latter and gathers data about the person’s may diagnose, treat, and otherwise behavior, attitudes, current situation, care for them. personality. - Diagnosis: commonly refers to the Types of Interviews: identification of the nature and cause - Unstructured: questions are open- of an illness. ended and not prearranged. - Structured: a specific set of Principal diagnosis: determining the single questions according to an interview diagnosis that is most relevant to the schedule are asked. person’s chief complaint or need for - Semi structured: a list of questions treatment. are pre set but clinician are able to Clinical formulation: a theoretically based follow up any specific issues that explanation of the information obtained from catch their attention. a clinical assessment Mental status examination: a medical Cultural formulation: the systematic review process where a clinician working in the of a person’s cultural background and the field of mental health systematically role of culture in the manifestation of examines a patient’s mind and the way they symptoms and dysfunction. look, think and behave. Mental Status Examination Appearance and Behavior - Wechsier adult intelligence scale - Note any overt behavior (twitch, (wais): made up of a pool of specific closing eyes) abilities and assesses people’s - Attire ability to remember, - General appearance/posture compute,understand language, Thought Process reason well. - Rate of speech - Wechsler intelligence scale for - Continuity of speech children (wisc): an individually - Evidence of delusions and administered intelligence test for hallucinations children between the ages of 6 and Mood and Affect 16. - Mood- the predominant feeling of the - Kaufman assessment battery for individual children (kabc): a clinical instrument - Anxious mood for assessing cognitive development - Affect- the feeling state that and incorporates several recent accompanies what we say at a given developments in both psychological point. theory and statistical methodology. Intellectual Functioning - Reasonable vocabulary Personality tests: aim to describe patterns - Below or average intelligence? of behavior, thoughts, and feelings. Needs standardized test - Self report inventories: a kind of Sensorium objective test used to assess - Date and time personality. - Who are you? Who am I? Why did - Minnesota multiphasic personality you come here? inventory (MMPI): the original MMPI was based on a small, limited Types and Purposes of Psychological sample, composed mostly of Assessment Minnesota formers and psychiatric patients. Psychological Test: written, visual, or - Projective testing: sometimes called verbal evaluations administered to assess performance based testing the cognitive and emotional functioning of - Rorschach inkblot test: a series of clients or patients. symmetrical inkblot cards that are presented to a client by a Standardized tests: are administered and psychologist. scared in a consistent manner and the - Thematic apperception (TAT): a questions, conditions for administering, person taking the TAT is shown 8-12 scoring procedures, and interpretations are ambiguous pictures and is asked to consistent and are administered and scored tell a story about each picture. in a predetermined, standard manner. - Rotter incomplete sentence blank (RISB): there are three forms of this Intelligence & achievement tests: test for use with different age designed to measure certain specific kinds groups: the school form, the college of cognitive functioning. form, and the adult form.  Antecedent-behavior-consequence Cognitive and Behavioral Assessments sequence (ABCs) might suggest that the boy was being reinforced for his violent Cognitive assessments:are useful to test outburst by not having to clean up his mess. for cognitive or neurological impairments, And because there was no negative deficiencies in knowledge, thought process, consequence for his behavior (his mother or judgment. didn’t scold or reprimand him), he will - MMSE: usually takes less than ten probably act violently the next time he minutes to administer but is now doesn’t want to do something. used less frequently due to copyright laws and additional costs. Research and Ethics in Abnormal - MoCA: a popular screening tool that Psychology evaluates visuospatial skills, attention, language, abstract Scientific Research and the Scientific reasoning, delayed recall, executive Method function, and orientation. - Theory is a well developed set of - Mini-Cog: one of the faster cognitive ideas that propose an explanation assessment screens used. Test for observed phenomena that can be memory, while the clock drawing test used to make predictions about evaluates cognitive function, future observations. language, executive function, and - Hypothesis is a testable prediction visuospatial skills. that is arrived at logically from a Behavioral assessment: involves the theory. identification and measurement of particular behaviors and the variables affecting their Descriptive Research: studies used to occurrence (Antecedent behavior describe general or specific behaviors and consequence). attributes that are observed and measured. - Child behavior checklist (CBCL): a widely used caregiver report form Case studies: intensive studies of identifying problem behavior in individuals children and examines: Aggressive - Fruitful way to come up with behavior, anxious/depressed, hypotheses and generate theories. attention problems, rules breaking - Do not lend themselves to behavior, withdrawn/depressed. generalizability. Single case experimental design: the Behavioral Assessment: The ABC’s of same research participant serves as the Observation subject in both the experimental and control 1. His mother asking him to put his conditions. glass in the sink (antecedent) - Particularly useful for studies of 2. The boy throwing the glass treatment effectiveness. (behavior) 3. His mother;s lack of response Naturalistic observation: observing (consequence) behavior in its natural settling. Surveys: lists of questions to be answered Prevalence rates: the overall number of by research participants. cases of a disorder existing in the - Can be delivered as population during a given period of time. paper-and-pencil questionnaires, - Point prevalence: indicates the administered electronically, or proportion of a population that has conducted verbally the characteristic at a specific point Sample: is a subset of individuals selected in time in other words, it the number from a population, which is the overall group of active cases. of individuals that the researchers are - Period prevalence: indicates the interested in. proportion of a population that has the characteristic at any point during Archival, Longitudinal, Cross-Sectional a given period of time, typically the and Epidemiological Research past year - Lifetime prevalence: indicates the - Archival research: relies on looking proportion of a population that has at past records or data sets to look had the characteristics at any time for interesting patterns or during their lives. relationships. - Longitudinal research: a research Correlation Research design in which data gathering is administered repeatedly over an - Correlation: there is a relationship extended period of time. between two or more variables (such - Cross sectional research: a between the variables of negative researcher compares multiple thinking and depressive symptoms), segments of the population at the but this relationship does not same time. necessarily imply cause and effect. - Epidemiological method: - Correlation coefficient: is a examines rates of occurrence at number from -1 to +1 that indicates abnormal behavior in the population the strength and direction of the as a whole and in various relationship between variables. subgroups, classified according to - A positive correlation means that the factors such as race, ethnicity, variables move in the same direction gender, or social class. - A negative correlation means that the variables move in opposite Prevalence and Incidence directions. Often, the occurrence of a single disease Experimental Process in Abnormal entity is set as an event. Events can be Psychology characterized by: - Scientific experiment: the only way to establish that there is a cause and Incidence rates: the number of new cases effect relationship between two occurring during a specific period of time. variables. - Independent variable: manipulated or controlled by the experimenter.  - Dependent variable: what the - Informed consent: form provides a researcher measures to see how written description of what much effect the independent participants can expect during the variable had. experiment, including potential risks - Experimental group: gets the and implications of the research. experimental manipulation or the - Deception: involves purposely treatment or variable being tested. misleading experiment participants - Control group: does not get in order to maintain the integrity of experimental manipulation. the experiment, but not to the point - Operational definition: a where the deception could be description of how we will measure considered harmful. our variables - Debriefing: complete, honest - Placebo effect: occurs when information about the purpose of the people’s expectations or beliefs experiment that participants must influence or determine their receive upon conclusion of the study experience in a given situation. - Institutional Animal Care and Use Committee (IACUC): committee is Reliability and Validity charged with ensuring that all Reliability and validity are two important experimental proposals require the considerations that must be made with any human treatment of animal research type of data collection. subjects. - Reliability refers to the ability to consistently produce a given result Etiology and Treatment of Mental and any instruments or tools used to Disorders collect data do so in reproducible ways. Insufficient Unidimensional Explanations - Validity refers to the extent to which of Mental Disorders a given instrument or tool accurately - System: a set of elements that measures what it’s supposed to interact or are interdependent on measure. one another, but form a coherent whole that interacts with its Ethical Standards and Concerns in environment and/or other systems. Abnormal Psychology - Multidimensional models: consider how multiple systems interact in Human and Animal Research contributing to mental disorders. Regulations - Unidimensional: explanations of - Institutional review board (IRB): is mental disorders such as that they a committee of individuals often are caused by a “chemical made up of members of the imbalance” or alternatively, that they institution’s administration, are caused by a negative scientists, and community members. relationship with one’s mother are - The purpose of the IRB is to review inadequate to fully understand the proposals for research that involves disorder and its causes. human participants.  - Epigenetics: a newer field of study defenses cannot manage their level shedding light on how social, of life stress psychological, and environmental - Gene- environment correlation influences can actually change model (rGE): is defined as the which genes in a person;s DNA may tendency of individuals to select and activate or may be turned off. generate their environment based on genetic features that influence Biopsychosocial model (BPS): instead of behavior, thoughts, and feelings. the medical model that emphasizes mental illness as disease, this model strives for a Polygenic Inheritance and Genetic more holistic approach by recognizing that Heritability each patient has their own thoughts, - All mental disorders have polygenic feelings, and history. inheritance: there is no single gene - Biological: genetic inheritance that causes depression, related to risk of developing a schizophrenia, or anorexia nervosa disorder, malfunctions or disruptions - Heritability: is a statistic that of the system of neural transmission estimates the degree of variation of between neurons in the brain. a phenotypic trait in a population, - Psychological: thoughts, feelings, such as the presence of a mental and behaviors including learned disorder, that is due to genetic behaviors (conditioning or observed variation between individuals from behaviors), thoughts patterns that that population. increase or intensify emotions like sadness or anxiety. Neural Communication and - social /cultural: external situations Neurotransmitters that can shape how people respond - The soma has branching extensions to events and other people, often by known as dendrites. influencing the degree of stress a - These signals are transmitted person experiences in their life. electrically across the some and down a major extension from the Diathesis-Stress and Gene-Environment some known as the axon, which Models ends at multiple terminal buttons. - diathesis -stress model: helps us - Receptors, proteins on the cell understand why one person might surface where neurotransmitters develop a disorder, or why two attach, vary in shape, with different people from similar backgrounds shapes “matching” different might develop different disorders neurotransmitters - Diathesis (usually genetic or - The neuron exists in a fluid biological) and environmental stress, environment it is surrounded by are necessary in the development of extracellular fluid and contains a disorder intracellular fluid. - Threshold: a point at which the person;s coping abilities and social, psychological, and biological Between signals, the neuron membrane;s organs and glands including potential is held in a state of readiness, “involuntary” muscle movement. called the resting potential. - Sympathetic activation: related to energy use and maintaining This positive spike constitutes the action homeostasis such as our body potential: the electrical signal that typically temperature. moves from the cell body down the axon to - Parasympathetic activation: axon terminals associated with normal functioning - Dopamine: related to movement, under relaxed conditions, sometimes memory, and as part of the brain’s referred to as governing “feed and pleasure or reward center. breed” and then - Serotonin: is also relevant to pain, “Rest and digest” sleep, digestion, and mood= Endocrine system: consists of a series of depression, mania, and glands that produce chemical substances schizophrenia. known as hormones. - Norepinephrine: also related to mood, pain, heart rate, and blood Areas and Lobes of the Brain pressure= anxiety and other stress The two hemispheres of the cerebral cortex related disorders are part of the forebrain, which is the largest - GABA: major inhibitory part of the brain, accounting for about 80% neurotransmitter, often believed to of the neurons in the central nervous be related to calming down system relaxation - Hindbrain: the lower part of the - Glutamate: an excitatory brainstem and regulates ongoing, neurotransmitter, related to learning mostly automatic systems in the and memory and other functions. body including heart rate, breathing, digestion, and other processes we Functions of Areas of the Brain and don’t often consciously think about. Endocrine System - Mindbrain: handles input from our senses and uses this to help Central nervous system (CNS): consists coordinate movement and parts of of the brain and spinal cord the reticular activating system which is involved in managing our Peripheral nervous system (PNS): further sleep/wake cycle and other subdivided into the somatic and autonomic processes related to tension and nervous system arousal. - Somatic nervous system: transmit sensory and motor signals to and Frontal lobe: located in the forward part of from the central nervous system; it is the brain and is involved in reasoning, how we control our “voluntary” abstract thinking and planning, creativity, muscle movements. motor control. Emotion, and language. - Autonomic nervous system: - Also has the prefrontal cortex, which controls the functioning of our is responsible for higher level cognitive functioning including major  inhibitory pathways of neurons that Psychotropic or psychoactive help us regulate our behaviors and drugs are any type of drug or reactions; Broca’s area, which is chemical that influences the way a essential for language production. person thinks, feels, or behaves. Parietal lobe: located immediately behind - Agonists: chemicals that mimic a the frontal lobe and is involved in neurotransmitter at the receptor site processing information from the body’s and, thus, strengthen its effects. senses. - Antagonists: impede the normal activity of a neurotransmitter at the Temporal lobe: located with healing, postsynaptic receptor. memory, emotion, and some aspects of Repetitive transcranial magnetic language. stimulation (rTMS): uses a magnet - The auditory cortex, the main area to activate neurons in the brain. responsible for processing auditory Electroconvulsive therapy: the information, is located within the best studied brain stimulation temporal lobe. therapy and has the longest history - Wernicke’s area, important for of use. speech comprehension, is also Deep brain stimulation (DBS): first located here. developed as a treatment for Occipital lobe: located at the very back of parkinson’s disease to reduce the brain, and contains the primary visual tremor, stiffness, walking problems cortex, which is responsible for interpreting and uncontrolled movements. incoming visual information. Freud’s Unconscious Theory Phineas Gage’s Brain Injury Freud said that only about one tenth of our - The man who began neuroscience mind is conscious or self-aware, and the - Experienced traumatic brain injury rest of our mind is unconscious. when an iron rod was driven through his entire skull, destroying his frontal Our Unconscious refers to mental activity lobe. (emotional reactions,motivations) of which we are unaware and are unable to access Biomedical Therapies and Brain - Id: contains our most primitive drives Stimulation Treatment or urges, and is present from birth, It directs impulses for hunger, thirst, Lobotomy: a form of psychosurgery aggression, and sex. in which parts of the frontal lobe of - Superego: develops as a child the brain are destroyed or their interacts with others, learning the connections to other parts of the social rules for right and wrong. brain severed. - Ego: the rational part of our Biomedical therapy: medications personality. used to treat mental disorders are called psychotropic or psychoactive Psychosexual Development and Defense medications. Mechanism Psychosexual Development States: associated with the patient’s other Oral stage (birth to 1 year): pleasure is relationship to the psychoanalyst. focused on the mouth Psychodynamic perspective: Anal stage (1–3 years): so it makes sense approach to therapy remains that the conflict in this stage is over toilet centered on the role of people's training internal drives and forces, but Phallic stage (3–6 years): corresponding to treatment is less intensive than the age when children become aware freud’s original model. of their bodies and recognize the differences between boys and girls Humanistic Approach Psychopathology Latency period (6 years to puberty): This Existentialism: a philosophical period is not considered a stage, because approach emphasizing a holistic sexual feelings are dormant as children view of human beings, validating the focus on other pursuits, such as school, nature of human emotions,thought, friendships, hobbies, and sports behavior, and choices. Genital stage (from puberty on): In this The goal of person-centered therapy stage, there is a sexual reawakening as the (PCT), created by carl rogers, os to incestuous urges resurface. create conditions under which clients can discover their self worth, feel Defense Mechanism: freud believed that comfortable exploring their own feelings of anxiety result from the ego’s identity, and alter their behavior to inability to mediate the conflict between the better reflect this identity. id and superego. Unconditional positive regard: refers Freud believed that the ego seeks to restore to the fact that the therapist accepts balance by reducing anxiety through various their client for who they are, without protection measures. condition. Nondirective therapy: the therapist Psychoanalysis and Psychodynamic does not give advice or provide Treatment interpretations but helps the person Psychotherapy: a type of treatment for to identify conflicts and understand mental disorders that is mostly focused on feelings so they can take psychogenic models of the etiology of responsibility for their own direction psychopathology. in life and for their choices. Free association: the patient relaxes and then says whatever comes to Cognitive and Behavioral Methods mind at the moment without attempting to edit or worry how the Behavioral Approach therapist might react. Behavioral approach: emphasize Dream analysis: dreams contain not actual behaviors by animals and only manifest (or literal) content, but human beings rather than trying to also latent (or symbolic) content. study or evaluate things that could Transference: the patient transfers not be seen or tested. all the positive or negative emotions Classical conditioning:  - Unconditioned stimulus (UCS): s their anxiety with the idea that due to stimulus that elicits a reflexive extinction they will eventually get used to it response in an organism. Extinction: the gradual disconnection of - Unconditioned response (UCR): a the relationship between the unconditioned natural (unlearned) reaction to a stimuli and the conditioned stimuli given stimulus. Ex. the dogs’ Systematic desensitization: wherein a salivation calm and pleasant state is gradually - Neutral stimulus: presented associated with increasing levels of immediately before an unconditioned anxiety-inducing stimuli. stimulus. - Conditioned (learned stimulus (CS): Cognitive Approach to Psychotherapy a stimulus that elicits a response Rational emotive behavioral therapy after repeatedly being paired with an (REBT): “irrational thinking” or irrational unconditioned stimulus. thoughts to refer to dysfunctional thoughts - Conditioned response (CR): the that tended to produce significant negative behavior caused by the conditioned emotions and consequently, maladaptive stimulus. behaviors. Operant Conditioning: organisms An REBT therapist would help the client learn to associate a behavior with its analyze the situation this way, A B C: consequence A= the activating event, the situation - reinforcement/reinforcer: or stressor that triggered the consequences that increase the emotion. frequency of a behavior. B= the beliefs or negative thoughts - punishment/punisher: consequences pattern (irrational thinking) that decrease how often a behavior C= the emotional consequence of occurs. the belief. - Observational learning: is essentially a cognitive process involving Aaron Beck used the term “automatic perception and interpretation of thoughts” to refer to the thoughts these behaviors. patients reported experiencing spontaneously Exposure Treatment and Systematic Desensitization Cognitive therapy: a form of psychotherapy Counterconditioning: a client learns a new that focuses on how a person’s thoughts response to a stimulus that has previously lead to feelings of distress. elicited undesirable behavior. The self- “I’m worthless and ugly” The world- “ no one values me”, Aversive conditioning: uses an unpleasant people ignore me all the time” stimulus to stop an undesirable behavior The future- “things will never Exposure therapy: a therapist seeks to change”, “things can only get worse” treat clients’ fears or anxiety by presenting them with the object or situation that causes Cognitive Behavioral Therapy  Cognitive behavioral therapy (CBT) 2. Orientation toward the present is a large group of moment psychotherapeutic approaches that help clients examine how their Emerging Forms in Psychotherapy thoughts affect their behavior. - Change cognitive distortions and self Internet and mobile delivered therapies defeating behaviors make psychological treatments more - Make adaptive, instead of available, through smartphones and online maladaptive, appraisals. access. Results of Psychotherapy and Clinician supervised online CBT modules Integrative/Ecclectic allow patients to access treatment from Interpersonal psychotherapy (IPT): home on their own schedule and focuses on coping with or improving opportunity particularly important for relationships, dealing with grief, life patients. transitions such as retirement or - Cognitive bias modification: patients divorce, and resolving conflict with are given exercise, often through the others. use of video games, aimed at - Technical eclecticism: the specific changing their problematic thought and intentional use of different processes. psychotherapy techniques and - CBT enhancing pharmaceutical methods, seeking to match the agents: drugs used to improve the client's unique struggles and effects of therapeutic interventions. background with treatments that have been shown to be effective in Treatment Modalities in that context. Psychopathology - Theoretical integration: this approach blends two or more Treatment modalities are not based on any models of therapy, both theory specific theory or model of psychotherapy; techniques in an attempt to find a instead, they are different environments in more effective approach to helping which treatment takes place. clients. - Intake assessment: therapist gathers - Combination therapy: used to specific information to address the describe situations where physicians client’s immediate needs and to or psychiatrists prescribe several arrive at a diagnosis, such as different medications in a patient's presenting problems, symptoms, the treatment. client’s support system, and insurance status. Mindfulness: a process that tries to - Confidentiality: means the therapist cultivate a nonjudgmental, yet attentive, cannot disclose confidential mental state communications to any third party - There are two important components without the client;s consent. of mindfulness: 1. Self-regulation of attention, and  - Individual therapy: a clinician meets Population meets the criteria for at least one together with several clients with anxiety disorder during their similar problems. lifetime. - Psychoeducation group: a group for More common in women children who have a parent with Within a 12-month period, around 23% of cancer. women and 14% of men will - Couples therapy: involves two experience at least one anxiety disorder people in an intimate relationship who are having difficulties and are DSM-V Diagnosis: Generalized Anxiety trying to resolve them. Disorder - Family therapy: a special form of group therapy consisting of one or Generalized anxiety disorder: is more families. marked by excessive anxiety or worry for most days (for at Impact of Culture on Treatment least 6 months) about personal Availability health, work, social Cultural competence: the ability to interactions, and daily routines. understand and honestly and openly address issues of race, culture and - People must experience at least ethnicity. three symptoms that are not Sociocultural perspective: accepts associated with another anxiety and integrates the impact of cultural disorder. and social norms, starting at the Symptoms of GAD beginning of treatment. - Feeling restless, wound up or on edge Anxiety Disorders - Being easily fatigued - Having difficulty concentrating; mind Fear vs. Anxiety going blank. Although anxiety is closely related to fear, - Having muscle tension the two states possess important - Having sleep problems, such as differences: difficulty falling or staying asleep, Fear involves an instantaneous restlessness, or unsatisfying sleep reaction to an imminent threat Treatment of GAD Anxiety involves apprehension, - Cognitive behavioral therapy (CBT): avoidance, and cautiousness has shown to be effective in treating regarding a potential threat, danger, GAD or other negative event. - Psychotropic medications (such as While anxiety is unpleasant to most people, SSRIs, SNRIs, and anti- anxiety it is important to our health, safety, and well medications) have been shown to be being. effective in reducing anxiety. - A comparison of overall outcomes of Anxiety Disorders CBT and medication on anxiety did As a group, anxiety disorders are not show statistically significant common: approximately 25–30% of the U.S. differences. DSM-V Diagnosis: Panic Disorder - Neurobiological theories of panic disorder suggest that a region of the Panic Disorder: a person must experience brain called the locus coeruleus may both panic attacks (e.g., extreme play a role in this disorder. Located physiological sensations) and intense in the brainstem, the locus coeruleus anxiety and avoidance for at least one (when triggered produces panic-like Month. symptoms) is the brain’s major source of norepinephrine, a Symptoms of Panic Disorder neurotransmitter that triggers the body’s fight-or-flight response. Panic Attack: a period of extreme fear or discomfort that develops abruptly and Agoraphobia reaches a peak within 10 minutes. - which literally means “fear of the marketplace,” is characterized by Symptoms Include: intense fear, anxiety, Accelerated heart rate - and avoidance of situations in which Sweating it might be difficult to escape or Trembling receive help if one experiences Choking sensations symptoms of a panic attack. These Hot flashes or chills situations include public Dizziness or lightheadedness transportation, open spaces (parking Fears of losing control or going crazy lots), enclosed spaces (stores), Fears of dying crowds, or being outside the home alone. Panic Attacks - Common Fears: crowded places, - Panic attacks themselves are not public transportation, driving mental disorders and are fairly - Comorbidity and DD: Panic Disorder common in the United states. or Panic Attacks - Panic disorder is, of course, much less common, afflicting 4.7%of Treatments for Panic Disorder americans during their lifetime Panic disorder is generally treated with - Many people with panic disorder psychotherapy, medication, or both. develop agoraphobia, where they - CBT teaches different ways of experience fear and avoidance of thinking, behaving, and reacting to situations where it is difficult to or to the feelings that come on with a access help during a panic attack. panic attack, which can begin to disappear once a patient learns to Causes of Panic Disorder react differently to the physical - Children are at a higher risk of sensations of anxiety and fear that developing panic disorder if their occur during panic attacks. parents have the disorder, and family and twins studies indicate that Some types of medications to help treat the heritability of panic disorder is panic disorder include: around 43% Selective serotonin reuptake inhibitors (SSRIs) and persistent fear or anxiety Serotonin-norepinephrine reuptake and avoidance of social inhibitors situations in which the person (SNRIs) could potentially be evaluated Beta-blockers negatively by others. Benzodiazepines Social anxiety disorder is Phobias and Other Anxiety Disorders common in the United States; a little over 12% of all Specific Phobias: A person diagnosed with Americans experience social a specific phobia (formerly known as simple anxiety disorder during their phobia) experiences excessive, distressing, Lifetime. and persistent fear or anxiety about a specific object or situation (such Treatment for Social Anxiety Disorder as animals, enclosed spaces, elevators, or Specific Treatments Include: flying). SSRIs (Zoloft or Paxil) Treatments for Specific Phobias CBT Exposure-based Cognitive Cognitive behavioral therapy (CBT) Therapy and exposure therapy are commonly used to treat specific phobias. Separation Anxiety Disorder CBT: helps to diffuse unhelpful is a disorder in which an individual emotional responses by helping experiences excessive anxiety people consider them differently or regarding separation from home change their behavior and/or from people to whom the effective in treating specific individual has a strong emotional phobias. attachment (e.g., a parent, a caregiver, a Exposure therapy: is a particularly significant other, or siblings) called effective form of CBT for specific the attachment figure. Phobias. DSM-V Diagnosis: Epidemiology The duration of this problem must - The usual age of onset is childhood persist for for at least four weeks to adolescence. and must present itself before a child - Women are twice as likely to suffer is eighteen years of age to be from specific phobias than men. diagnosed as a separation anxiety disorder in children Social Anxiety Disorder But can now be diagnosed in adults with a duration typically lasting six Social anxiety disorder months in adults. (formerly called social phobia) is characterized by extreme Separation Anxiety Disorder: Diagnostic Causes of Separation Anxiety Disorder: Criteria Risk Factors and Biological and To be diagnosed with separation anxiety Environmental Contributions disorder, one must display at least three of Children are more likely to develop the following criteria: separation anxiety disorder if one or both their parents were diagnosed with A Recurrent excessive distress when psychological disorder. anticipating or experiencing separation from Early or traumatic separation from a home or from major attachment figures central caregiver in a child’s life can Persistent and excessive worry about increase the likelihood of them being losing major attachment figures diagnosed with separation anxiety Persistent and excessive worry about disorder, school phobia, and experiencing an untoward event depressive-spectrum disorders. Persistent reluctance or refusal to go out, Most often, the onset of separation anxiety away from home, to school, to work, or disorder is caused by a stressful life event. elsewhere because of fear of separation Separation anxiety disorder in children Persistent and excessive fear of or may be heritable. Heritability was estimated reluctance about being alone at 73% in a community sample of 6-year-old Persistent reluctance or refusal to sleep twins, with higher rates in girls. away from home or to go to sleep Repeated nightmares Treatments for Separation Anxiety Repeated complaints of physical Disorder symptoms The first choice of treatment for people with a separation anxiety disorder are non-medication based methods, Epidemiology of Separation Anxiety including psychoeducational intervention for Disorders the child and their family and psychotherapeutic intervention. Affecting from 5%-25% of children worldwide. Common psychotherapeutic Adult separation anxiety disorder affects interventions include: roughly 7% of adults. behavioral (e.g., exposure Research suggests that 4.1% of children therapy) will experience a clinical level of separation CBT, contingency (e.g., anxiety and 1.6% of adolescents. Of that contingency management) 4.1%, it is calculated that nearly a third of all psychodynamic cases will persist into adulthood if left psychotherapy untreated. family therapy Common comorbidities can include specific phobias, PTSD, panic disorder, Selective Mutism obsessive-compulsive disorder, and personality disorders Selective mutism (SM), also known as situational mutism, is an anxiety disorder in which a person normally capable of speech Treatment of Selective Mutism cannot speak in specific situations There are two primary domains for or to specific people if triggered. treatment of selective mutism: Selective mutism usually non-medication and medication-based coexists with social anxiety interventions. disorder. People with selective mutism The non-medication based treatment stay silent even when the focuses on therapeutic approaches consequences of their silence including psychotherapeutic, include shame, social psychodynamic, behavioral, and family ostracism, or punishment. therapies. Specific strategies used in therapy also feature self-modeling, self- Selective Mutism: Diagnostic Criteria reinforcement, and contingency To be diagnosed with selective mutism, one must display the following criteria: management. Consistent failure to speak in specific Children with selective mutism who were social situations (in which there is an given SSRIs have shown improvements in expectation for speaking, e.g., at school) their communication and anxiety. despite speaking in other situations. The duration of the disturbance is at least Perspectives and Treatment For Anxiety 1 month (not limited to the first month of Disorders school). The failure to speak is not due to a lack of Biological Perspective on Anxiety knowledge of the spoken language required The biological perspective seeks to in the social situation. understand the neurological and biological The disturbance is not better accounted connections to anxiety. for by a communication disorder (e.g., childhood-onset fluency disorder) and does Researchers have concluded that several not occur exclusively in people with autism specific neurotransmitters are also spectrum disorders or psychotic disorders connected with anxiety: GABA, serotonin, such as schizophrenia. and norepinephrine (noradrenalin). Etiology Anti-anxiety medications help reduce the symptoms of anxiety, such as panic attacks, The incidence of selective mutism is or extreme fear and worry. not certain. Due to the poor understanding of this condition by Cognitive and Behavioral Perspective on the general public, many cases are Anxiety likely undiagnosed. Because anxiety disorders are Based on the number of reported connected to the way people cases, the figure is commonly perceive situations, cognitive estimated to be one in 1,000, or therapies are particularly effective in around 0.1%. thinking about and treating anxiety disorders.  and fearful objects and situations. Cognitive theories suggest that anxiety disorders develop through In the case of panic disorder or social thought patterns that overestimate anxiety disorder, benzodiazepines are threats to safety, therefore anxiety is usually second-line treatments, behind caused by cognitive SSRIs misinterpretations and can be or SNRIs or other antidepressants. They treated by developing strategies to include: combat these thoughts. Clonazepam Alprazolam Humanistic Perspective on Anxiety Lorazepam According to the humanistic perspective, Behavioral Therapies anxiety may develop if people do not see themselves honestly or do not practice Cognitive therapy (CBT) and exposure self-acceptance. therapy, a type of behavior therapy, are the Client-centered therapy is encouraged to two most commonly used interventions in help patients accept themselves and not be the treatment of anxiety disorders. so self-judgmental. One humanistic type of treatment for Exposure therapy has its roots in classical anxiety is motivational interviewing. conditioning. In exposure therapy, patients make contact with the feared stimuli and Sociocultural Perspective on Anxiety this contact is maintained until the anxiety associated with the contact subsides. Globally, in 2010, approximately 273 million (4.5% of the population) had an Systematic desensitization (SD) is on the anxiety disorder. Anxiety is more common in gentler part of the spectrum. SD is based on females (5.2%) than males (2.8%). the idea of reciprocal inhibition proposing In Europe, Africa, and Asia, lifetime rates that two opposite emotions can not co-exist of anxiety disorders are between 9 and (e.g. fear and relaxation are mutually 16%, and yearly rates are between 4 and exclusive). 7%. In the United States, the lifetime prevalence of anxiety disorders is about 29% and between 11 and 18% of adults have the condition in a given year. Treatments for Anxiety Disorders Cognitive Behavioral Therapy (CBT) is an example of one type of psychotherapy that can help people with anxiety disorders. CBT teaches people different ways of thinking, behaving, and reacting to anxiety producing