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Hippocrates • Classical Greek physician known as the “Father of Medicine” for his contributions • E.g., systematic categorization of diseases • Was ahead of his time in having a biological orientation toward understanding abnormal behavior • Linked abnormality with brain chemical imbalances (like n...

Hippocrates • Classical Greek physician known as the “Father of Medicine” for his contributions • E.g., systematic categorization of diseases • Was ahead of his time in having a biological orientation toward understanding abnormal behavior • Linked abnormality with brain chemical imbalances (like neurotransmitters discussed in Chapter 2) • However, also had some highly inaccurate views • Hysteria = “the wandering uterus”, was thought to be the result of the uterus moving around in a woman’s body Theories of abnormal behavior • Psychoanalytic theory (Freud) • Humanistic theory (Maslow, Rogers) • Behaviorism (Pavlov, Skinner) Psychoanalytic theory • Lasting contribution is the recognition that much of psychic like is not consciously experienced • Structure of the mind in psychoanalytic theory: • Id – pleasure principle, unconscious drives • Ego – rational, mediator • Superego – morals/norms Defense Mechanisms in Psychoanalytic theory • Defense mechanism = ego’s attempt to manage anxiety of conflict between the id and superego • Seven defense mechanisms to know: • Displacement – redirecting thoughts and feelings about one person/object toward another person • Denial – refusal to accept reality • Rationalization – offering different explanations for one’s thoughts or behaviors • Reaction formation– converting unwanted thoughts into their opposite • Projection – misattributing undesired feelings or thoughts onto another person • Repression – unconscious blocking of unacceptable thoughts • Sublimation - channeling undesired thoughts and feelings into more acceptable ones Humanistic theory • Major themes are that people are essentially good and striving toward selfactualization • Maslow’s hierarchy of needs Behaviorism • Pioneered scientific approach to studying psychology and psychopathology • Classical conditioning vs. operant conditioning Prevalence and Incidence • Prevalence = the total number of individuals in a population who have a disease or health condition during a broad time period, usually expressed as a percentage of the population. • Incidence = the number of individuals who develop a specific disease or experience a specific health-related event during a particular time period (such as a month or year). Structure of the brain • Hindbrain • Cerebellum, pons, medulla • Midbrain • Thalamus, hypothalamus, hippocampus • Forebrain • Cerebral cortex The Nervous System Neurons and Neurotransmitters • Neurons = primary components of the nervous system, communicate with one another electrochemically • Neurotransmitters = chemicals sent across synapses to either excite or inhibit activation in other neurons Neurotransmitters to know • Dopamine – “reward” chemical important for learning, but also associated with certain psychopathologies (ADHD, schizophrenia, Parkinson’s disease) • Serotonin – influences many things, including mood and behavior • SSRIs – antidepressant, increases postsynaptic serotonin absorption by blocking presynaptic serotonin reuptake • Norepinephrine – involved in alarm responses and unconscious bodily process (e.g., breathing) • Glutamate - main excitatory neurotransmitter in the vertebrate nervous system • GABA - main inhibitory neurotransmitter in the vertebrate nervous system Diathesis-Stress Model • Diathesis = an individual’s baseline (i.e., inherited) tendency or condition that makes them susceptible to developing a disorder. • Stress = conditions or stressors in an environment that can trigger a disorder • Psychopathology emerges from the interaction of an inherited tendency and events in an individual’s life. • Ex: drug use and emergence of schizophrenia Learned helplessness • Studies originally conducted by Martin Seligman • In laboratory studies, created aversive stimuli (e.g., electrical shocks) for animals that the animals could not control • Results in decreased motivation and behavior to change one’s circumstances Approaches to diagnostic classification • Classical categorical approach – strict categories, one either has a psychopathology or they do not (black & white approach) • E.g., early versions of the DSM • Dimensional approach – classifications along dimensions, one can demonstrate some aspects of a psychopathology but not others • E.g., neurodiversity, challenges to current DSM • Prototypical approach – combines aspects of both classical categorial and dimensional approaches • E.g., the current DSM-V (which is largely similar to the DSM-IV) Clinical interviews • Structured or semi-structured interview conducted by a mental health professional familiar with diagnostic criteria • Used to assess patients and/or make a diagnosis • E.g., Structured Clinical Interview for DSM-5 (SCID) Types of psychological testing • Projective tests – based in psychoanalytic tradition, attempt to assess unconscious processes • E.g., Thematic apperception tests (TAT) • Mixed evidence of validity and reliability • Objective & Personality tests – roots in empirical tradition, minimal clinical expertise required to disseminate and score • E.g., IQ tests, MMPI for personality, Big 5 • Neuropsychological tests – assess broad range of skills and abilities to understand brain-behavior connections • E.g., tests of attention, memory, and motor skills in individuals suspected of having dementia Research designs Statistical vs Clinical significance • Statistical significance = claim about the likelihood that a research finding was due to chance/randomness • If a research finding is statistically significant, it means that it was unlikely to have resulted from mere chance • Clinical significance = claim about the meaningfulness & applicability of a given research finding • If a research finding is clinically significant, it means that it would be impactful in treating patients • Examples from clinical research on MDMA and magic mushrooms as treatments for certain psychopathologies • Sometimes statistical & clinical significance are aligned (e.g., large effect size), sometimes they are not (e.g., small effect size) Anxiety Disorders Anxiety, fear, and panic ● Often used interchangeably, but are characterized quite differently Similarities: ○ Characterized by negative affect ○ Often result in avoidant behaviors ○ Accompanied with physical symptoms Anxiety Disorders Anxiety, fear, and panic Differences: Anxiety ● Future-oriented ● Somatic feeling of tension Panic attack Fear ● Fear occurring at ● Present-oriented inappropriate time ● Strong activation of sympathetic system ● E.g., absence of stimulus in response to stimulus Anxiety Disorders Anxiety, fear, and panic ● Causes = Childhood development may play a role ○ Uncertainty in childhood ○ Fear/anxiety as learned responses ● Comorbidity is common across anxiety disorders ○ Most commonly Major Depressive Disorder Anxiety Disorders Generalized Anxiety Disorder (GAD) ● Characterized by extreme worry and difficulty controlling worry ● More common in females ● Treatment includes: ○ Psychological interventions (CBT) ○ Pharmacotherapy (e.g., benzodiazepines) ○ Meditation therapy Anxiety Disorders Panic Disorder ● Characterized by experiencing unexpected panic attacks, and fear of future attacks ● Common comorbidity with agoraphobia ● More common in females ● Treatments: ○ Psychological (Panic Control Treatment = CBT for panic) ○ Pharmacotherapy (SSRIs or benzodiazepines) ○ CBT therapies are most effective Anxiety Disorders Specific phobias ● Characterized by irrational fear of an object or situation that interferes with ability to function ● More common in females ● Treatments: ○ CBT therapies with exposure Anxiety Disorders Social phobias ● Characterized by fear or discomfort in social situations that often leads to avoidance ● More common in females ● Treatments: ○ CBT therapies are highly effective ○ Pharmacotheraphy (SSRIs or benzodiazepines) Trauma and Stressor-Related Disorders PTSD, acute stress, adjustment and attachment disorders ● Shared origin = life stressors ● New classification to DSM-5 Trauma and Stressor-Related Disorders PTSD ● Characterized by response to trauma exposure, including flashbacks, nightmares, avoidance, emotional numbing, and interpersonal problems ● Diagnosed when symptoms persist for more than one month following trauma ● Social support post-trauma reduces risk of developing PTSD Trauma and Stressor-Related Disorders Acute Stress Disorder ● Similar to PTSD, but occurs immediately following trauma, and lasts up to one month Obsessive Compulsive Disorders OCD ● Obsessions = intrusive thoughts, images, or urges ● Compulsions = thoughts or actions to neutralize anxious thoughts ● Equal gender distribution ● Treatments: ○ CBT with exposure component is highly effective ○ Pharmacotherapy (SSRIs) Somatic Symptom Disorders Somatic Symptom Disorder ● Characterized by presence of symptoms without medical explanation ● Onset = adolescents ● Causes = sensitivity to physical sensations, life stressors, family history of illness ● Treatment = CBT Somatic Symptom Disorders Illness Anxiety Disorder ● Characterized by physical complaints with no known cause and severe anxiety of a serious disease ● Onset = any age ● Causes = cognitive perceptual distortions, family history of illness ● Treatment = CBT, stress management, possible medication (antidepressants) Somatic Symptom Disorders Conversion Disorder ● Characterized by malfunctioning sensory or motor skills without known pathology ● Onset = adolescence ● Causes not well known ● Treatment = similar to Somatic Symptom Disorder (mostly CBT) Somatic Symptom Disorders Factitious Disorder ● Characterized by purposefully faking symptoms ● Different from malingering → with this disorder, there are no clear external gains ● May be externally induced → a caregiver induces symptoms in a child Dissociative Disorders Dissociative Identity Disorder (DID) ● Characterized by dissociation from identity and adoption of several new identities ● Much more common in females ● Onset = childhood or adolescence ● Causes = linked to childhood trauma or chronic trauma; mechanism to escape trauma ● Treatment = confront trauma, reintegrate identities Dissociative Disorders Dissociative Identity Disorder (DID) ● Characterized by dissociation from identity and adoption of several new identities ● Much more common in females ● Onset = childhood or adolescence ● Causes = linked to childhood trauma or chronic trauma; mechanism to escape trauma ● Treatment = confront trauma, reintegrate identities