Psychopathology Notes-Chapters 1-4 PDF

lOMoARcPSD|40294110 Psychopathology Notes-Chapters 1-4 Psychopathology (Baylor University) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by Geisha Peduhan ([email protected]) ...

lOMoARcPSD|40294110 Psychopathology Notes-Chapters 1-4 Psychopathology (Baylor University) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 Chapter 1: Abnormal Behavior in Historical Context Understanding Psychopathology Psychological disorder: a psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typically or culturally expected ○ Ex: Phobia; a psychological disorder characterized by marked and persistent fear of an object or situation Psychological dysfunction: a breakdown in cognitive, emotional, or behavioral functioning ○ Problems can be on a continuum or a dimension Distress or Impairment ○ Defining psychological disorders by distress alone can be harmful (ex: someone may not be distressed but manic instead) but it contributes to a good definition ○ Impairment is useful but not completely satisfactory ○ Most psychological disorders are extreme expressions of otherwise normal emotions, behaviors, and cognitive processes Atypical or Not Culturally Expected ○ Abnormal: it deviates from the average Not substantial Ex: some stray from the average but would be called talented or eccentric An accepted definition ○ Psychological disorder: behavioral, psychological, or biological dysfunctions that are unexpected in their cultural context and associated with present distress and impairment in functioning, or increased risk of death, pain, or impairment (DSM-5) ○ The best we can do is consider how the apparent disease or disorder matches a “typical” profile of a disorder The Science of Psychopathology Psychopathology: the scientific study of psychological disorders ○ Specially trained professionals, clinical and counseling psychologists, psychiatrists, psychiatric social workers, psychiatric nurses, marriage and family therapists, and mental health counselors The Scientist-Practitioner ○ Scientist practitioner: mental health professionals that take a scientific approach to their clinical work Keep up w the latest scientific developments Evaluate their own assessments or treatment procedures to see whether they work Might conduct research Clinical Description ○ Presenting problem: indicating why the person came to the clinic Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 ○ Clinical description: represents the unique combination of behaviors, thoughts, and feelings that make up a specific disorder Clinical: both the types of problems or disorders that you would find in a clinic or hospital and the activities connected with assessment and treatment Prevalence: how many people have a disorder Incidence: how many new cases occur during a given period ○ Chronic course: they tend to last a long time, sometimes a lifetime ○ Episodic course: likely to recover within a few months only to suffer a recurrence of the disorder later ○ Acute onset: occur suddenly ○ Insidious onset: develop gradually over time ○ Prognosis: the anticipated course of a disorder Causation. Treatment, and Etiology Outcomes ○ Etiology: the study of origins, why a disorder begins (what causes it) and includes biological, psychological, and social dimensions Historical Conceptions of Abnormal Behavior Supernatural Tradition ○ Historically physical and mental disorders were considered the work of the devil ○ Demons and witches Last quarter of 14th cent. Religious people thought that psychological disorders came from the devil and witches and people were possessed Treatments: exorcism, shaving the pattern of a cross in the hair of the victim’s head, and securing sufferers to a wall near the front of a church so they could hear mass ○ Stress and Melancholy The view that Insanity was a natural phenomenon caused by mental or emotional stress and it was curable Treatments: rest, sleep, and a healthy and happy environment ○ Conflicting crosscurrents of natural and supernatural explanations for mental disorders were represented in different works ○ Mass Hysteria During the middle ages, they lent support to the notion of possession by the devil ○ Paracelsus (Swiss physician) suggested that the movements of the moon and stars had profound effects on people’s psychological functioning Inspired the work lunatic The Biological Tradition ○ Hippocrates and Galen Hippocrates (460-377 B.C.)= father of modern Western medicine Wrote body of work Hippocratic Corpus that suggested that psychological disorders be treated like any other disease Believed that psychological disorders might also be caused by brain pathology or head trauma that was influenced by heredity Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 Considered the bran to be a seat of wisdom, consciousness, intelligence, and emotion and therefore disorders involving these functions would logically be in the brain Recognize the importance of psychological and interpersonal contributions to psychopathology Humoral theory of disorders ○ Normal brain functioning was related to four bodily fluids or humors Blood, black bile, yellow bile, and phlegm Too much black bile = depression (melancholia) Too much yellow bile= hot-tempered Too much phlegm= sluggish but calm under stress blood= cheerful and optimistic but can deal w insomnia and delirium ○ Perhaps the first example of associating psychological disorders with a “chemical imbalance” ○ Excess to one or more humors were treated by regulating the environment to increase/decrease heat, dryness, moisture, or cold Coined the word hysteria to describe somatic symptom disorders ○ Physical symptoms appear to be the result of a medical problem for which no physical cause can be found Roman physician Glen created a school of thought within the biological tradition that extended into the 19th century ○ The 19th Century Syphilis: a sexually transmitted disease caused by a bacterial microorganism entering the brain Symptoms: delusion of persecution or delusion of grandeur 1835: a designated disease called general paresis bc it has consistent symptoms and a consistent course that resulted in the death 1870: Lous Pasteur’s germ theory of disease facilitated the identification of the specific bacterial microorganisms that caused syphilis A cure was found and this suggested to mental health professionals that comparable causes and cures may be discovered for all psychological disorders John P. Grey His position was that the causes of insanity were always physical ○ Treatment emphasized rest, diet, and proper room temp and ventilation Conditions in hospitals began to improve until they became super large and impersonalized ○ The Development of Biological Treatments Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 1930’s: physical interventions of electric shock and brain surgery were often used 1750’s: Benjamin Franklin made the discovery that mild electric shocks produce slight and brief memory loss which led to a different form of treatment 1920’s: Joseph von Meduna found that patients with schizophrenia rarely had epilepsy 1950’s: first effective drugs for severe psychotic disorders were developed in a systematic way Rauwolfia serpentine and neuroleptics (major tranquilizers) Benzodiazepines (minor tranquilizers) reduced anxiety Drugs began to come and go due to the side effects involved ○ Consequences of the Biological Tradition Late 19th-century focus turned on diagnosis instead of treatment Emil Kraepelin: influential in advocating the major ideas of the biological tradition Was one of the first to distinguish among disorders Late 19th century a scientific approach to psychological disorders and their classification had begun Treatment based on humane principles Disadvantages: active intervention and treatment were all but eliminated in some settings despite the availability of some effective approaches The Psychological Tradition ○ Plato believed that the two causes of maladaptive behavior were the social and cultural influences ○ Psychosocial treatment: focus not only on psychological factors but also social and cultural ones ○ Aristotle emphasized the influence of social environment and early learning on later psychopathology Focused on fantasies, dreams, and cognitions ○ Moral Therapy Moral therapy: treating institutionalized patients as normally as possible in a setting that encouraged and reinforced normal social interaction Date back to plato Originated as a system with french psychiatrist Philippe Pinel and Jean-Baptiste Pussin Began by taking away chains used to restrain patients Asylums (appeared in 16th century) only became habitable once moral therapy began ○ Asylum reform and the Decline of Moral Therapy Moral therapy is most effective with 200 or fewer people Patients increased to 1000 or 2000 people and were then not given moral treatments Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 Dorothea Dix (1802-1887) Campaigned for reform in the treatment of insanity Mental hygiene movement She worked to make sure everyone who needed care received it. Including the homeless Humane treatment became more widely available in U.S. institutions Dix’ efforts led to a substantial increase in # of patients which caused the transition from moral therapy to custodial care due to understaffed Psychoanalysis: based on Freud’s elaborate theory of the structure of the mind and the role of unconscious processes in determining behavior behaviorism: associated w John B. Watson, Pavlov, and Skinner which focuses on how learning and adaptation affect the development of psychopathology ○ Psychoanalytic theory Mesmer believed problems were caused by an undetectable fluid called “animal magnetism” Charcot validated some of mesmers techniques Freud and Josef Breuer “discovered” the unconscious mind and its apparent influence on the production of psychological disorders Discovered that it is therapeutic to recall and relive emotional trauma that has been made unconscious and to release the accompanying tension ○ Catharsis: release of emotional material Insight: fuller understanding of the relationship between current emotions and earlier events Psychoanalytic model: the most comprehensive theory yet constructed on the development and structure of our personalities 1) the structure of the mind and the distinct functions of personality that sometimes clash with one another 2) the defense mechanism with which the mind defends itself from these clashes or conflicts 3) the stages of early psychosexual development that provide grist for the mill of our inner conflicts The Structure of the Mind Id: the source of our strong sexual and aggressive feelings or energies ○ Basically the animal within us ○ The energy or drive within the id is the libido Less important energy is the death instinct; or Thanatos Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 ○ Operates according to the pleasure principle: maximizing pleasure and eliminating any associated tension or conflicts Pleasure often conflicts with social rules and regulations ○ Primary process: type of thinking that is emotional, irrational, illogical, filled with fantasies, and preoccupied with sex, aggression, selfishness, and envy Ego: the part of our mind that ensures that we act realistically ○ Operates on the reality principle ○ Secondary process: characterized by logic and reason ○ The role is to mediate conflict between the id and the superego Superego: a conscience that represents the moral principles instilled in us by our parents and our culture ○ The purpose is to counteract the potentially dangerous drives of the id Intrapsychic conflicts: conflicts within the mind Id and the superego are almost entirely unconscious Defense Mechanisms Defense mechanisms: unconscious protective processes that keep primitive emotions associated with conflicts in check so that the ego can continue its coordinating function Displacement: the ego decides to express primitive anger at someone other than the target that made you upset Sublimation: redirection of anger into a constructive outlet such as work Coping styles continues to be important to the study of psychopathology Denial: Refuses to acknowledge some aspect of objective reality or subjective experience that is apparent to others Displacement: Transfers a feeling about, or a response to, an object that causes discomfort onto another, usually less-threatening, object or person Projection: Falsely attributes own unacceptable feelings, impulses, or thoughts to another individual or object Rationalization: Conceals the true motivations for actions, thoughts, or feelings through elaborate reassuring or self-serving but incorrect explanations Reaction formation: Substitutes behavior, thoughts, or feelings that are the direct opposite of unacceptable ones Repression: Blocks disturbing wishes, thoughts, or experiences from conscious awareness Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 Sublimation: Directs potentially maladaptive feelings or impulses into socially acceptable behavior Psychosexual Stages of Development Freud hypothesized that if we did not receive appropriate gratification during a specific stage or if a stage left a strong impression, an individual’s personality would reflect the stage throughout adult life Oral stage: extends two years from birth, characterized by a central focus on the need for food ○ Sucking, focus on the lips and tongue Phallic stage: (3-6 years old) characterized by early genital stimulation ○ Castration anxiety: fear that your father may cut your peepee off ○ Oedipus complex: boy complex ○ Electra complex: young girl wanting to replace mother and desire for penis to be more like her father Penis envy All nonpsychotic psychological disorders resulted from underlying unconscious conflicts, the anxiety that resulted from those conflicts, and the implementation of an ego defense mechanism ○ He called these neuroses or neurotic disorders The Behavioral Model (cognitive-behavioral model or social learning model) ○ Pavlov and Classical Conditioning Classical conditioning: a type of learning in which a neutral stimulus is paired with a response until it elicits that response Conditioning: one way in which we acquire new information, particularly info that is somewhat emotional in nature Stimulus generalization: the strength of the response to similar objects or people is usually a function of how similar these objects or people are The classical conditioning process begins with a stimulus that would elicit a response in almost anyone and requires no learning; no conditions must be present for the response to occur Extinction: presentation of the CS without the reward for a given period of time eliminates the CR ○ Watson and the Rise of Behaviorism John B. Watson is the founder of behaviorism Believed science should not be based on introspection and should be scientific Psychology is viewed as an objective experiential branch of natural science Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 ○ The Beginnings of Behavior Therapy Joseph Wolpe created the systematic desensitization technique Individuals are gradually introduced to the objects or situations they feared so that their fears are extinguished ○ Also had patients do something incompatible with fear in front of the dreaded object or situation ○ Called this approach behavior therapy ○ B.F. Skinner and Operant Conditioning B.F Skinner wrote The Behavior of Organisms Operant conditioning: type of learning in which behavior changes as a function of what follows behavior Influenced by Thorndike Law of effect: behavior is either strengthened or weakened depending on the consequences of that behavior Most things we do socially provide the context for other people to respond to us in one way or another, therefore, providing consequences for our behavior Reinforcement: skinner’s word for reward Believed punishment as a consequence is relatively ineffective in the long run and that the primary way to develop new behavior is to positively reinforce desired behavior Shaping: a process of reinforcing successive approximations to a final behavior or a set of behaviors Pavlov, Watson, and Skinner contributed to behavior therapy; scientific principles of psychology are applied to clinical problems Chapter 2: An integrative Approach to Psychopathology One-Dimensional versus Multidimensional Models One dimensional: traces the origins of behavior to a single cause Multidimensional model: any one component of the system inevitably affects the other components ○ Systemic: any particular influence contributing to psychopathology cannot be considered out of context ○ Biology and behavior of the individual as well as the cognitive, emotional, social, and cultural environment Genetic Contributions to Psychopathology Genes: long molecules of DNA at various locations on chromosomes within the cell nucleus About half of our enduring personality traits and cognitive abilities to genetic influence Other studies show that heritability calculation for personality traits such as shyness or activity levels ranges from 30-50% Adverse life events can overwhelm the influence of genes Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 Evidence suggests that genetic factors make some contribution to all disorders but account for less than half of the explanation The interaction of Genes and the Environment ○ Diathesis-stress model Individuals inherit tendencies to express certain traits or behaviors, which may then be activated under conditions of stress Diathesis (vulnerability): an inherited tendency ○ Does not become prominent until certain environmental events occurred Caspi et al. study suggested that the 5-HTT gene is implicated in depression ○ The Gene-Environment Correlation Model (reciprocal gene-environment model) A genetic endowment may increase the probability that an individual will experience stressful life events Epigenetics and the Nongenomic “inheritance” of Behavior ○ Some reports suggest that studies overemphasize the extent of genetic influence on our personalities ○ Environmental effects of early parenting seem to override any genetic contribution to be anxious, emotional, or reactive to stress ○ Environmental influences such as peer groups and school affect gene expression but the strongest influences are early parenting and other early experiences Neuroscience and Its Contributions to Psychopathology Neuroscience: knowing how the nervous system and how the brain works The Central Nervous System: processes all info received from our sense organs and reacts as necessary ○ Neurons: transmit info throughout the nervous system Info is transmitted thru electrical impulses called action potentials Terminal button: end of the axon Synaptic cleft: space between the terminal button of one neuron and the dendrite of another ○ Neurotransmitters: chemicals stored in vesicles in the terminal buttons ○ Glial cells: play an active role in neural activity Specific functions some of which serve to modulate neurotransmitter activity Neurotransmitters ○ Neurons that are sensitive to one type of neurotransmitter cluster together and form paths from one part of the brain to the other Brain circuits: the paths neurotransmitters take Neuroscientists have identified several neural pathways that seem to play roles in various psychological disorders ○ Agonists: effectively increase the activity of a neurotransmitter by mimicking its effects ○ Antagonists: decrease or block a neurotransmitter or substances called inverse agonists that produce effects opposite to those produced by the neurotransmitter Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 ○ Norepinephrine, serotonin, dopamine, gamma-aminobutyric acid (GABA), and glutamate are most relevant to psychopathology Low levels of GABA= associated w extreme anxiety Increased dopamine= schizophrenia High norepinephrine= depression Low serotonin= depression ○ Excitatory: increase the likelihood that the connecting neuron will fire ○ Inhibitory: decrease the likelihood that the connecting neuron will fire ○ Glutamate and GABA Amino acids Glutamate: an excitatory transmitter that “turns on” many different neurons, leading to action Gamma-aminobutyric acid (GABA): an inhibitory transmitter that inhibits the transmission of info and action potentials Reduces postsynaptic activity which inhibits certain behaviors and emotions Reduces anxiety Benzos make it easier for GABA becomes attached to specialized neuron receptors and the calmer we become Seems to reduce overall arousal and tempers emotional responses Can treat insomnia Reduces levels of anger, hostility, aggression, and even positive emotional states such as eager anticipation and pleasure Composed of a number of subsystems ○ Only one has an affinity for benzo receptors Considered “chemical brothers” bc they work together to balance functioning in the brain Fast-acting ○ Serotonin (5-hydroxytryptamine 5HT) Monoamine Regulates our behavior, moods, and thought processes Low levels are associated with less inhibition, instability, impulsivity, aggression, suicide, impulsive overeating, excessive sexual behavior, and the tendency to overreact to situations Make us more vulnerable to certain problematic behavior without directly causing it High levels may interact with GABA to counteract glutamate 15 different receptors in the serotonin system SSRIs affect serotonin more directly than other drugs ○ Norepinephrine (noradrenaline) Monoamine Part of the endocrine system Stimulates alpha-adrenergic and beta-adrenergic receptors Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 ○ Dopamine Monoamine Catecholamine bc of similarity to epinephrine and norepinephrine Implicated in schizophrenia and depression and ADHD Dopamine receptors too active in schizophrenia patients Dopamine circuits merge and cross with serotonin circuits and thus influence some of the same behaviors High activity associated with exploratory, outgoing, pleasure-seeking behaviors 5 different receptor sites L-dopa affects dopamine circuits Dopamine deficiencies= Parkinsons Placebos ○ Not usually effective as active medication, but good for treating the patient psychologically by inducing positive expectations for change which changes brain function ○ The anterior cingulate cortex is in part responsible for the control of the pain response in the brain stem Psychosocial effects on neurotransmission ○ Psychosocial factors directly affect the functioning and structure of the CNS Change activity levels of many neurotransmitter systems Behavioral and Cognitive Science Cognitive science: concerned with how we acquire and process info and how we store and ultimately retrieve it Learned helplessness: occurs when rats or other animals encounter conditions over which they have no control and they give up attempting to cope and seem to develop the animal equivalent of depression Social learning ○ People can learn simply by observation (observational learning) Prepared learning: we have become highly prepared for learning about certain types of objects or situations over the course of evolution bc this knowledge contributes to the survival of the species ○ More likely to fear snakes than flowers or rocks Unconscious ○ Implicit memory: apparent when someone clearly acts on the basis of things that have happened in the past but cant remember the events Emotional phenomena ○ Emotion: a tendency to behave in a certain way (ex: escape), elicited by an external event ( a threat) and a feeling state (terror) and accompanied by a (possibly) characteristic physiological response ○ Mood: a more persistent period of affect or emotionality ○ Affect: refers to the valence dimensions (i.e. pleasant or positive vs. unpleasant or negative) of an emotion Mood + affect = circumplex model Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 Gender ○ Having a particular phobia is influenced by your gender It May have to do with gender roles Global Incidence of Psychological Disorders ○ Mental disorders account for 13% of the global burden of disease ○ Many countries don't have proper mental health services Developmental psychology ○ Equifinality: we must consider a number of paths to a given outcome *REFER TO PG 45 IF YOU HAVE TIME TO READ OVER BRAIN STRUCTURE Chapter 3: Clinical Assessment and Diagnosis Assessing Psychological Disorders Clinical assessment: the systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder Diagnosis: the process of determining whether the particular problem afflicting the individual meets all criteria for a psychological disorder Key Concepts in Assessment ○ Assessment works in funnel format (broad to narrow) ○ Reliability: the degree to which a measurement is consistent Inter-rater reliability: two or more raters arrive at the same diagnosis Test-retest reliability: determine whether the assessment techniques are stable over time ○ Validity: whether something measures what it is designed to measure Concurrent or descriptive validity: comparing the results of an assessment measure under consideration with the results of others that are better known Predictive validity: how well your assessment tells you what will happen in the future ○ Standardization: the process by which a certain set of standards or norms is determined for a technique to make its use consistent across different measurements The Clinical Interview ○ Gathers info on current and past behavior, attitudes, emotions, interpersonal and social history, upbringing, info on sexual development, religious attitudes, relevant cultural concerns, educational history, and a detailed history of the individual’s life in general and of the presenting problem ○ Mental status exam: involves systematic observation of an individuals behavior, occurs when any one person interacts with another; covers 5 categories Appearance and behavior: physical behaviors, general appearance, posture, facial expressions Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 Thought process: rate or flow of speech, continuity of speech, organization (ex: loose association or derailment), the context of a convo (evidence of delusions) Mood and affect: the mood is the predominant feeling state of the individual, affect refers to the feeling state that accompanies what we say at a given point Intellectual functioning: reasonable vocabulary, can they use abstractions and metaphors, memory, etc. Sensorium: awareness of our surroundings, does the person know the date and time? Who they are? ○ Semistructured clinical interviews Made up of questions that have been carefully phrased and tested to elicit useful info in a consistent manner so that clinicians can be sure they have inquiries about the most important aspects of disorders Clinicians may depart from set questions to follow up on specific issues (hence semi-structured) May inhibit the patient from volunteering useful info that is not directly relevant to the questions Physical Exam ○ Many patients go to a physician before a mental health professional There are sicknesses that have psychological symptoms, ex: hyperthyroidism can produce depression symptoms Behavioral Assessment ○ Direct observation to formally assess an individual’s thoughts, feelings, and behavior in specific situations or contexts ○ More appropriate for people who are not olf enough or skilled enough to report their problems and experiences ○ Helpful when the patient doesn't want to disclose info ○ Target behaviors are identified and observed with the goal of determining the factors that seem to influence them ○ The ABCs of Observation Attention is directed to the immediate behavior, its antecedents (what happened just before the behavior), and its consequences Antecedent-behavior-consequence Informal observation: relies on the observer’s recollection, as well as interpretation, of the events Formal observation: identifying specific behaviors that are observable and measurable (operational definition) ○ Self-Monitoring Self-monitoring: people can observe their own behavior to find patterns Helps clients monitor their behavior more conveniently Essential when behaviors only occur in private Behavior can be observed w checklists and behavior rating scales Es: brief psychiatric rating scale Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 Reactivity: when the mere presence of another person affects their behavior Can distort observational data ○ Psychological Testing Include specific tools to determine cognitive, emotional, or behavioral responses that might be associated with a specific disorder and more general tools that assess long-standing personality features Projective testing Ambiguous stimuli (ex: pics of people or things) are presented to people who are asked to describe what they see ○ The theory is that people will project their own personalities onto these things Based on psychoanalytic theory so is controversial yet used quite often Ex: Rorschach inkblot test EX: Thematic Apperception Test (TAT) is the best known projective test after the Rorschach test ○ Tell a dramatic story about a picture Lack of reliability and validity makes them less useful as diagnostic tests Personality Inventories Face validity: the wording of the questions seems to fit the type of info desired Personality inventories: self-report questionnaires that assess personal traits ○ Meehl suggested that it is not whether the questions make sense on the surface but rather what the questions predict Most used is the Minnesota Multiphasic Personality Inventory (MMPI) ○ Based on an empirical approach ○ Little room for interpretation ○ 567 items so it is very long ○ Patterns are what are assessed ○ Includes additional scales that determine the validity of each administration ○ Reliable and valid ○ However, does not necessarily change how clients are treated and may not improve their outcomes Intelligence Testing Stanford-Binet Test (intelligence test) ○ Provides an intelligence quotient or IQ ○ WAS calculated by Mental age/chronological age X 100= IQ ○ NOW calculated by a deviation IQ Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 Weschler Intelligencee Scale ○ Neuropsychological Testing Neuropsychological tests: measure abilities in areas such as receptive and expressive language, attention and concentration, memory, motor skills, perceptual abilities, and learning and abstraction in a way that a clinician can make an educated guess about a possible brain impairment EX: Bender Visual-Motor Gestalt Test Children must copy what is drawn on a card and errors are compared False positives: tests show a problem when none exist False negatives: tests shoe no problem when one exists Neuroimaging: Pictures of the Brain Images of Brain Structure ○ X-rays: CAT or CT scan Esp useful in locating brain tumors, injuries, and other anatomical abnormalities Cell damage is associated with repeated x-ray radiation ○ Magnetic resonance imaging (MRI) Images of Brain Functioning ○ Positron emission tomography (PET) scan Injected w a tracer substance We can see what parts of the brain are working and which ones are not Useful in supplementing MRI and CT scans when localizing the sites of trauma resulting from a head injury or stroke PET scans are used to look at varying patterns of metabolism that might be associated with different disorder Expensive ○ Single-photon emission computed tomography (SPECT) Uses a different tracer from PET scan Less expensive and less accurate ○ Functional MRI or fMRI Allow researchers to the immediate response of the brain to a brief event such as seeing a new face ○ Psychophysiological Assessment Psychophysiological assessment: measurable changes in the nervous system that reflect emotional or psychological events Electroencephalogram (EEG): measures electrical activity in the head related to the firing of a specific group of neurons reveals brain wave activity Meaningful stimulus creates an evoked potential or event-related potential Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 Delta waves: slower and more irregular waves Also used with many sexual dysfunctions and disorders Also important in the assessment and treatment of conditions such as headaches and hypertension Form basis for treatment we call biofeedback Requires a great deal of skill and some technical expertise Can produce inconsistent results due to the technology Diagnosing Psychological Disorders ○ The clinician forms a prognosis; the likely future course of a disorder under certain conditions ○ Idiographic strategy: used if we want to determine what is unique about an individual’s personality, cultural background, or circumstances ○ Nomothetic strategy: we must be able to determine a general class of problems to which the presenting problem belongs ○ When we identify a specific psychological disorder, such as a mood disorder, in the clinical setting we are making a diagnosis ○ Classification: any effort to construct groups or categories and to assign objects or people to these categories on the basis of their shared attributes or relations- a nomothetic strategy ○ Taxonomy: classification of entities for scientific purposes, such as insects, rocks, or behaviors ○ Nosology: if you apply the taxonomic system to psychological or medical phenomena or other clinical areas ○ Nomenclature: describes the names or labels of the disorders that make up the noslogy ○ Most people in North America use the DSM-5 as their classification system ○ Classification Issues Is it ethical to classify human behavior? Categorical and Dimensional Approaches Classical (or pure) categorical approach: we assume that every diagnosis has a clear underlying pathophysiological cause and that each disorder is unique ○ Causes could be psychological or cultural instead of pathophysiological ○ Only one set of defining criteria Dimensional approach: we note the variety of cognitions, moods, and behaviors with which the patient presents and quantify them on a scale ○ Relatively unsatisfactory Hard to agree on the dimensions Prototypical approach: identifies certain essential characteristics of an entity so that you (and others) can classify it, but it also allows certain nonessential variations that do not necessarily change the classification Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 ○ Many possible features or properties of the disorder are listed and any candidate must meet enough of them to fall into that category ○ Reliability Unreliable classification systems are subject to bias by clinicians making diagnoses One of the most unreliable categories in the current classification is the area of personality disorders Patients who were white, female, or poor, were diagnosed w BPD more often than the criteria indicated ○ Validity Construct validity: signs and symptoms chosen as criteria for the diagnostic category are consistently associated and what they identify differs from other categories Familial aggregation: the extent to which the disorder would be found among the patient’s relatives DSM-III and DSM-III-R ○ 1980 ○ A theoretical approach to diagnosis relying on precise descriptions ○ Increased specificity and detail in criteria DSM-IV and DSM-IV-R ○ Changes based on scientific data ○ Distinction between organically based disorders and psychologically based disorders DSM-5 ○ 2013 ○ New disorders introduced and others reclassified ○ Three sections introduces manual and describes how to use it Presents disorders themselves Includes descriptions of disorders and conditions that need further research ○ Uses dimensional axes for rating severity, intensity, frequency, or duration of specific disorders ○ Cross-cutting dimensional symptom measures ○ Included plan for integrating important social and cultural influences on diagnosis ○ Criticisms “Fuzzy” categories making diagnosis hard Comorbidity: having more than one disorder at a time Reliable at the expense of validity Methods of constructing a nosology of mental disorders have a way of perpetuating definitions handed down to us from past decades even if they are fundamentally flawed Subject to misuse Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 ○ Caution about labeling and stigma Labeling: tendency to characterize the totality of an individual Creating a Diagnosis ○ Mixed anxiety-depression Chapter 4: Research Methods Examining Abnormal Behavior Basic Components of a Research Study ○ Hypothesis: An educated guess or statement to be supported by data Testability: the ability to support the hypothesis ○ Research design: includes the aspects you want to measure in the people you are studying ○ Dependent variable: what is measured ○ Independent variable: factors thought to affect the dependent variable and are directly manipulated ○ Internal validity: the extent to which you can be confident that the independent variable is causing the dependent variable to change Confound: any factor occurring in a study that makes the results uninterpretable bc a variable other than the independent variable may also affect the dependent variable Control group: not exposed to the independent variable Randomization: the process of assigning people to different research groups in such a way that each person has an equal chance of being placed in any group Analogue models: create in the controlled conditions of the laboratory aspects that are comparable to the phenomenon under study ○ External validity: refers to how well the results relate to things outside your study Generalizability: the extent to which results apply to everyone in a certain population Statistical versus Clinical SIgnificance ○ Statistical significance: a mathematical calculation about the difference between groups ○ Clinical significance: whether or not the difference was meaningful for those affected ○ Effect size: the difference between groups ○ Social validity: obtaining input from the person being treated as well as from significant others, about the importance of the changes that have occurred The “Average” Client ○ Patient uniformity myth: the tendency to see all participants as one homogenous group This leads to inaccurate generalizations about disorders and their treatments Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 Types of Research Methods Studying Individual Cases ○ Case study method: investigating intensively one or more individuals who display the behavioral and physical patterns Does not use the scientific method Typically many confounds are present Relies on clinicians observations of differences among one person or one group w a disorder and people w no disorder Sometimes coincidences occur that are irrelevant to the condition under study Research by Correlation ○ Correlation: a statistical relationship between two variables Positive correlation: great strength or quantity in one variable is associated with great strength or quantity in the other variable (or low with low) Negative correlation: as one increases the other decreases Directionality: whether either variable causes the effects ○ Correlation does not equal causation ○ Epidemiological research Epidemiology: the study of the incidence, distribution, and consequences of a particular problem or set of problems in one or more populations Prevalence: the # of people w a disorder at any one time Incidence: the estimated # of new cases during a specific period Research by Experiment ○ Experiment: involves the manipulation of an independent variable and the observation of its effects Purpose to find causality ○ Group Experimental Designs Researchers change an independent variable to see how a group is affected Clinical trial: an experiment used to determine the effectiveness and safety of a treatment/s Follows rules Clinical Trial Categories ○ Within the “clinical trial” category are “randomized clinical trials” which are experiments that employ randomization of participants into each experimental group ○ There are also “controlled clinical trials” which are experiments that rely on control conditions to be used for comparison ○ Randomized controlled trial: uses both randomization and control conditions ○ Control groups Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 Placebo effect: when behavior changes as a result of an expectation of change rather than actual manipulation Frustro effect: people in the control group are frustrated to be in the control group Mediated by placebo control groups: placebo pills are given to those in the control group so they believe they are receiving treatment Double-blind control: participants in the study are “blind” or unaware of what group they are in and so are the researchers Allegiance effect: the researcher has a bias towards one result ○ Comparative Treatment Research The researcher gives different treatments to two or more comparable groups of people with a particular disorder and can assess each treatment Process research: focuses on the mechanisms responsible for behavior change or “why does it work?” Outcome research: focuses on the positive, negative, or both results of treatment or “does it work?” Treatment process: why or how your treatment works Treatment outcome: what changes actually occur Single-Case Experimental Designs ○ Involves the systematic study of individuals under a variety of experimental conditions Formalized by Skinner ○ Diff than case studies bc they have strategies to improve internal validity ○ Repeated measurements Behavior is measured several times instead of only once before you change the independent variable and once afterward The level or degree of behavior change with diff interventions The variability or degree of change over time The trend or direction of change ○ Withdrawal Designs The researcher tries to determine whether the independent variable is responsible for changes in behavior 1) a person condition is established before treatment to have a baseline 2) change in the independent variable 3) treatment is withdrawn and the researcher assesses Diff than case study bc it aims to see if a certain treatment causes a change in behavior It May not be ethical to remove treatment Unsuitable if treatment cant be removed ○ Multiple Baseline The researcher starts treatment at diff times across settings, behaviors, or people Downloaded by Geisha Peduhan ([email protected])  lOMoARcPSD|40294110 ○ Researchers can use them with several people at once to help address issues w external validity Genetics and Behavior across Time and Cultures Studying Geneticsz Downloaded by Geisha Peduhan ([email protected])