Mental & Physical Health - AP Psychology Unit 5 PDF

Mental & Physical Health AP Psychology Unit Five Learning Target Checklist Explain how health psychology addresses issues of physical health and wellness as they apply to behavior and mental processes. Explain how stress applies to behavior and mental processes. Explain...

Mental & Physical Health AP Psychology Unit Five Learning Target Checklist Explain how health psychology addresses issues of physical health and wellness as they apply to behavior and mental processes. Explain how stress applies to behavior and mental processes. Explain how reactions to stress apply to behavior and mental processes. Explain how the ways that people cope with stress applies to behavior and mental processes. Explain how positive psychology approaches the study of behavior and mental processes. Explain how positive subjective experiences apply to behavior and mental processes. Describe the approaches used to define behaviors and mental processes as psychological disorders. Explain how psychological perspectives define psychological disorders. Explain how interaction models define psychological disorders. Describe the symptoms and possible causes of selected neurodevelopmental disorders. Describe the symptoms and possible causes of selected schizophrenic spectrum disorders. Describe the symptoms and possible causes of selected depressive disorders. Describe the symptoms and possible causes of selected bipolar disorders. Describe the symptoms and possible causes of selected anxiety disorders. Describe the symptoms and possible causes of selected obsessive-compulsive disorders and related disorders. Describe the symptoms and possible causes of selected dissociative disorders. Describe the symptoms and possible causes of selected trauma and stressor-related disorders. Describe the symptoms and possible causes of selected feeding and eating disorders. Describe the symptoms and possible causes of selected personality disorders. Describe research and trends in the treatment of psychological disorders. Describe ethical principles in the treatment of psychological disorders. Describe techniques used with psychological therapies. Explain how group therapy is different from individual therapy. Describe effective uses of hypnosis. Describe interventions derived from the biological perspective.  Module 5.1 Introduction to Health Psychology Studying Stress Health psychology is a subfield of psychology that provides psychology’s contribution to behavioral medicine. Psychoneuroimmunology is the study of how psychological, neural, and endocrine processes together affect the immune system and resulting health. From these, we have learned the following about stress: Stress diverts energy from the immune system, inhibiting the activities of its B and T lymphocytes, macrophages, and NK cells. ○ B lymphocytes, which release antibodies that fight bacterial infections; ○ T lymphocytes, which attack cancer cells, viruses, and foreign substances; ○ Macrophage cells (“big eaters”), which identify, pursue, and ingest harmful invaders and worn-out cells; and ○ Natural killer cells (NK cells), which attack diseased cells (such as those infected by viruses or cancer). Stress does not cause illnesses or diseases, but by altering our immune functioning it may make us more vulnerable to them and influence their progression. What is stress? Stress is the process of appraising and responding to a threatening or challenging event. Stress can take many forms, known as stressors: Catastrophes - unpredictable large-scale events, such as natural disasters Significant Life Changes - moving, marriage, divorce, pregnancy, death of a loved one Daily Hassles - traffic, dead cell phone, no Wifi, strained budgets, deadlines Stress & Conflict Conflict is perceived as an incompatibility of actions, goals, or ideas. Approach-approach conflict: occurs when you must choose between two desirable outcomes. Avoidance-avoidance conflict: occurs when you must choose between two unattractive outcomes. Approach-avoidance conflict: exists when one event or goal has both attractive and unattractive features. Multiple approach-avoidance conflicts: here you must choose between two or more things, each of which has both desirable and undesirable features. Hans Selye & General Adaptation Syndrome Hans Selye’s studies of animals’ reactions to various stressors, such as electric shock and surgery, helped make stress a major concept in both psychology and medicine. Selye proposed that the body’s adaptive response to stress is so general that, like a single burglar alarm, it sounds, no matter what intrudes. He named this response the general adaptation syndrome (GAS), and he saw it as a three-phase process. Let’s say you suffer a physical or an emotional trauma: In Phase 1, you have an alarm reaction, as your sympathetic nervous system is suddenly activated. Your heart rate zooms. Blood is diverted to your skeletal muscles. You feel the faintness of shock. With your resources mobilized, you are now ready to fight back. During Phase 2, resistance, your temperature, blood pressure, and respiration remain high. Your adrenal glands pump hormones into your bloodstream. You are fully engaged, summoning all your resources to meet the challenge. As time passes, with no relief from stress, your body’s reserves begin to dwindle. You have reached Phase 3, exhaustion. With exhaustion, you become more vulnerable to illness or even, in extreme cases, collapse and death. Impact of Stress Although the human body copes well with temporary stress, prolonged stress can damage it. Severe childhood stress gets under the skin, leading to greater adult stress responses and disease risk. The brain’s production of new neurons also slows and some neural circuits degenerate. One study found shortened telomeres (DNA pieces at the ends of chromosomes) in those who suffered severe childhood stressors. Telomere shortening is a normal part of the aging process; when telomeres get too short, the cell can no longer divide and it ultimately dies. Severe stress seems to prematurely age people. Facing stress, women may have a tend-and- befriend response(providing or gaining support from others), while men may withdraw socially, turn to alcohol, or become aggressive.  Why are some people more prone to coronary heart disease than others? Coronary heart disease, the United States’ number one cause of death, has been linked with the competitive, hard-driving, impatient, verbally aggressive, and (especially) anger-prone Type A personality. Compared with relaxed, easygoing Type B personalities, who are less likely to experience heart disease, Type A people secrete more stress hormones. Catharsis (release of aggressive energy to relieve pent up frustration) doesn’t work to reduce the anger that can be so harmful to our health, but waiting, distracting, and distancing do. Chronic stress also contributes to persistent inflammation, which is associated with heart and other health problems, including depression. Adaptation & Comparison Two psychological principles explain why, for those who are not poor, more money buys little more than temporary happiness and why our emotions seem attached to elastic bands that pull us back from highs or lows. In its own way, each principle suggests that happiness is relative. Adaptation-level Phenomenon: our tendency to form judgments relative to a neutral level defined by prior experience ○ Example: As a kid, you were thrilled when your grandparents sent you $5 for your birthday. Now that you’re older, you are less impressed by $5. Relative Deprivation: the perception that one is worse off than those with whom one compares themself to ○ Example: You were thrilled when your parents bought you a used car until your friend’s parents bought him a brand new high-end car.  Module 5.2 Positive Psychology Positive Psychology While psychology has a history of focusing on understanding and treating problems, recent research has pushed for a focus on human flourishing. positive psychology: the scientific study of human flourishing, with the goals of discovering and promoting strengths and virtues that help individuals and communities thrive Effects of Happiness Positive psychologists use scientific methods to study human flourishing, with the goals of discovering and promoting strengths and virtues that help individuals and communities to thrive. Subjective well-being is your perception of being happy or satisfied with life. Happiness is relative to our own experiences and to others’ success. A good mood brightens people’s perceptions of the world. Happy people tend to be healthy, energized, and satisfied with life, which makes them more willing to help others (the feel-good, do-good phenomenon). The moods triggered by good or bad events seldom last beyond that day. Even significant good events, such as sudden wealth, seldom increase happiness for long. Impact of Outlook & Support Studies of people with an optimistic outlook show that their immune system is stronger, their blood pressure does not increase as sharply in response to stress, their recovery from heart bypass surgery is faster, and their life expectancy is longer. Social support promotes health by calming us, by reducing blood pressure and stress hormones, and by fostering stronger immune functioning. We can significantly reduce our stress and increase our health by building and maintaining relationships with family and friends, and by finding meaning even in difficult times. How to Be Happy Take control of your time. Act happy. Seek work and leisure that engage your skills. Buy shared experiences rather than things. Exercise. Give your body the sleep it wants. Give priority to close relationships. Focus beyond self. Count your blessings and record your gratitude.  Researchers Have Found That However, Happiness Seems Not Much Happy People Tend to Related to Other Factors, Such as Have high self-esteem (in individualist Age. countries). Be optimistic, outgoing, and agreeable. Gender (women are more often depressed, but also more often joyful). Have close, positive, and lasting Physical attractiveness. relationships. Have work and leisure that engage their skills. Have an active religious faith (especially in more religious cultures). Sleep well and exercise. Aerobic Exercise & Meditation Aerobic exercise is sustained, oxygen-consuming activity that increases heart and lung fitness. It increases arousal, leads to muscle relaxation and sounder sleep, triggers the production of neurotransmitters, and enhances self-image. It can relieve depression and is associated with longer life and better cognitive functioning in later life. Relaxation and meditation have been shown to reduce stress by relaxing muscles, lowering blood pressure, improving immune functioning, and lessening anxiety and depression. Mindfulness meditation is a reflective practice of attending to current experiences in a nonjudgmental and accepting manner. Massage therapy also relaxes muscles and reduces depression.  Module 5.3 Explaining & Classifying Psychological Disorders Defining Disorders A psychological disorder is a syndrome (collection of symptoms) marked by a clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior. This loose definition of disorders is broken down into the 3 D’s: dysfunctional, deviant, and distressing. Dysfunctional: interfering with normal day- to-day functioning Deviant: behavior is abnormal Distressing/Maladaptive: behavior causes significant psychological, emotional, physical, or social harm DSM-V In the United States, the most common tool for describing and estimating the prevalence of mental illness is the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders or DSM, which is currently in its fifth edition. Each edition is edited to provide more information and update existing disorders. Comorbidity: the presence of more than one psychological disorder, often because they are linked Ex. Anxiety & depression Stigma & Stereotypes Many people think a diagnostic label means being seen as tainted, weak, and weird. Because of this, many psychologists believe we should use extreme caution in diagnosing and labeling. However, negative views/stigma come from popular cultural views of mental illness, and not from the DSM. [Does a diabetes diagnosis create stigma? No. Bipolar diagnosis? Yes.] The DSM may contain the information to correct inaccurate perceptions of mental illness. Specific Phobia- DSM-V Diagnostic Criteria Diagnostic Criteria A. Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood). a. Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, or clinging. B. The phobic object or situation almost always provokes immediate fear or anxiety. C. The phobic object or situation is actively avoided or endured with intense fear or anxiety. D. The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context. E. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more. F. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. G. The disturbance is not better explained by the symptoms of another mental disorder,including fear, anxiety, and avoidance of situations associated with panic-like symptoms or other incapacitating symptoms (as in agoraphobia): objects or situations related to obsessions (as in obsessive-compulsive disorder); reminders of traumatic events (as in posttraumatic stress disorder); separation from home or attachment Criticisms of DSM-V The DSM calls too many people “disordered.” The border between diagnoses, or between disorder and normal, seems arbitrary. Decisions about what is a disorder seem to include value judgments; is depression necessarily deviant? Diagnostic labels direct how we view and interpret the world, telling us which behavior and mental states to see as disordered. ○ Disorders don’t equal danger The Medical Model The discovery that the disease of syphilis causes mental symptoms (by infecting the brain) suggested a medical model for mental illness. Medical model: concept that psychological disorders have physical causes that can be diagnosed, treated, and, in most cases, cured often through treatment in a hospital Psychological disorders can be seen as psychopathology, an illness of the mind. Disorders can be diagnosed, labeled as a collection of symptoms that tend to go together. People with disorders can be treated, attended to, given therapy, all with a goal of restoring mental health. Clinical psychologists work Biopsychosocial Approach Although the medical model views a mental illness as a physical condition. Other areas also influence our behavior, thoughts and feelings. Biological Psychological Social-Cultural Depression and schizophrenia occur worldwide, while other disorders vary from culture to culture. Culture-bound syndromes are disorders which only seem to exist within certain cultures; they demonstrate how culture can play a role in both causing and defining a disorder. Susto: (Latin America) severe anxiety, restlessness and a fear of black magic. Tajin-kyofusho: (Japan)social anxiety about one’s appearance leading to social withdrawal. Eating Disorders: (USA) Bulimia and Anorexia Amok: (Malaysia) sudden outburst of violent behavior. Diathesis-Stress Model Epigenetics The biopsychosocial approach gave way to the stress vulnerability model, which suggests that individual characteristics combine with environmental stressors to increase or decrease the likelihood of developing a psychological disorder. Epigenetics: the study of environmental influences on gene expression that occur without a DNA change For example, schizophrenia has a genetic component, but the gene can lay dormant unless switched on by environmental factors, like a traumatic event. This is often why schizophrenia doesn’t present itself until adolescence or early adulthood.  Psychological Cause of the Disorder School/Perspective Psychoanalytic/PsychodynamicInternal, unconscious drives Humanistic Failure to strive to one’s potential or being out of touch with one’s feelings. Behavioral Reinforcement history, the environment. Cognitive Irrational, dysfunctional thoughts or ways of thinking. Sociocultural Dysfunctional Society Biomedical/Neuroscience Organic problems, biochemical imbalances, genetic Suicide Each year, over 800,000 despairing people worldwide will elect a permanent solution to what might have been a temporary problem. For those that have been anxious, the risk of suicide is tripled. For those that have been depressed, the threat is quintupled. Contrary to popular belief, the risk of suicide is greatest is not when they are in the depths of depression, but rather when people begin to rebound. Prevalence of Suicide National Differences In Britain, Italy, & Spain, suicide rates are half of what is seen in the US, Canada, and Australia. Racial Differences In the US, whites and native Americans are twice as likely to commit suicide as African Americans and Hispanics. Age Differences The risk of suicide is highest among people 45-64 years of age. (85+ is 2nd.) Gender Differences Women are more likely to attempt suicide, while men are more likely to end their lives. Time Differences Suicide rates are highest on Wednesdays and during the months of April and May. How to Help If a friend or family member talks about suicide: Take it seriously. ○ Killing yourself isn’t something to joke about. Math homework is not your “13th reason”. Listen and sympathize. Connect the person with a professional: counselor or suicide prevention agency. Find a trusted adult to help the person. Prevalence Phobias: Major Depressive Disorder: Social Anxiety Disorder: ADHD: PTSD: Bipolar Disorder: Generalized Anxiety Disorder: OCD: Schizophrenia: Risk Factors  Module 5.4 Selection of Categories of Psychological Disorders What is an anxiety disorder? The anxiety disorders are marked by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety. For example, social anxiety disorder is extreme fear and avoidance of social settings. Many patients fear something awful will happen to them, thus they are in a state of intense apprehension, uneasiness, uncertainty, or fear. Specific anxiety disorders include the following: Generalized Panic Phobia OCD PTSD Generalized Anxiety Disorder Generalized anxiety disorder (or GAD) is an anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal. The patient is constantly tense and worried, feels inadequate, is oversensitive, can’t concentrate and suffers from insomnia; all of this without any apparent reason. Panic Disorder Panic disorder is an anxiety disorder marked by unpredictable, minutes-long episodes of intense dread in which a person may experience terror and accompanying chest pain, choking, or other frightening sensations often followed by worry over a possible next attack. Some with panic disorder experience agoraphobia, or the fear and avoidance of situations, such as crowds or wide open places, where one has felt loss of control or panic. Phobias A phobia is a persistent, irrational fear and avoidance of a specific object, activity, or situation. We all have fears, but it is not classified as a phobia unless we have an extreme reaction to it. Fear of spiders, or arachnophobia, is relatively common. If you see a live spider, scream, and urge someone to kill it, that’s not a phobia. If you bolt from the room when someone draws a cartoon spider during Pictionary, it’s a phobia. Obsessive-Compulsive Disorder Obsessive-compulsive disorder, or OCD, is an anxiety disorder marked by unwanted repetitive thoughts (obsessions), actions (compulsions), or both. Can your foods touch? Do you have to check the locks a certain number of times before leaving the house? Is there a nighttime ritual that must be followed exactly or you can’t sleep? These behaviors are characteristic of those suffering from OCD. Post-Traumatic Stress Disorder Post-traumatic stress disorder (or PTSD) is characterized by haunting memories, nightmares, hypervigilance, social withdrawal, jumpy anxiety, numbness of feeling, and/or insomnia that lingers for four weeks or more after a traumatic experience. Let’s say you get into a serious car accident. Thankfully, you’re okay, but your car was destroyed and the paramedics tell you you’re lucky to be alive. For weeks after the accident, you refuse to drive a car, are ill with anxiety as a passenger, have nightmares reliving the accident, and start trembling at the sound of car horns. This would be an example of PTSD. Understanding Anxiety Disorders: Explanations from Different Perspectives Psychodynam Classical Operant ic/ conditioning: conditioning Freudian: overgeneralizin g a conditioned : rewarding repressed avoidance impulses response Cognitive Observation appraisals: Evolutionary al learning: uncertainty : surviving by worrying like and the avoiding mom unknown danger equals danger What is a mood disorder? A mood disorder is characterized by extreme or inappropriate emotions. Major Depressive Disorder Bipolar Disorder Depressive Disorders vs. Bipolar Disorders Major Depressive Disorder Major Depressive Disorder (aka depression) is a mood disorder in which a person experiences, in the absence of drugs or another medical condition, two or more weeks with five or more symptoms, at least one of which must be either depressed mood or loss of interest/please (anhedonia). DSM-V: Major Depressive Disorders Must have one or both of the following: – Depressed mood most of the day, and/or – Markedly diminished interest or pleasure in activities PLUS three or more of these listed below: – Significant increase or decrease in appetite or weight – Insomnia, sleeping too much, or disrupted sleep – Lethargy, or physical agitation – Fatigue or loss of energy nearly every day – Worthlessness, or excessive/inappropriate guilt – Daily problems in thinking, concentrating, and/or making decisions – Recurring thoughts of death and suicide Depression is more than it seems Some people make an unfair criticism of themselves or others with major depression: “There is nothing to be depressed about.” If someone with asthma has an attack, do we say, “what do you have to be gasping about?”. It is bad enough to have MDD that persists even under “good” circumstances. Don’t add criticism by implying the depression is an exaggerated response. Depression is the #1 reason people seek mental health services. Depression appears worldwide: ○ Per year, depressive episodes happen to about 6 percent of men and about 9 percent of women. ○ Over the course of a lifetime, 12 percent of Canadians and 17 percent of Americans experience depression. Other Types of Depression Postpartum depression - Seasonal Affective Disorder - type of depression that occurs Depression that is experienced after childbirth due to changes in during the winter months. Based hormones; often a mild form of not on temperature, but on sadness called the “Baby Blues” amount of sunlight.; treated with light therapy. Bipolar Disorder Bipolar disorder (formerly known as manic-depressive disorder) is when a person alternates between the hopelessness and lethargy of depression and the overexcited state of mania. When a depressive episode ends, a euphoric, overly talkative wildly energetic and extremely optimistic state called mania follows, after which the person goes back to depression or returns to normal.  Bipolar I and II Bipolar I Bipolar II More Severe Less Severe – many aren’t Marked with swings of Mania diagnosed until years after and Low Depression episodes. Treated with Mood Stabilizers Swings of hypomania and a – Lithium and Antidepressants depression. (SSRIs) Zoloft, Paxil, etc. Same treatments as Bipolar I Influences on Mood Disorders Genetic Both depressive and bipolar disorders run in families. Neuroscientific Neurotransmitters like serotonin and norepinephrine influence mood and behavior. Nutrition Those who follow the “Mediterranean Diet”, which is heavy on vegetables and fish, have a lowered risk of heart disease, stroke, cognitive decline, and depression. Social-Cognitive Women have a higher chance of developing depression. Surrounding oneself with positive influences and a positive environment can minimize the risk of developing depression. Depression’s Vicious Cycle What is schizophrenia? Schizophrenia (literally translates to “split mind”) is a disorder characterized by delusions (false beliefs), hallucinations (false sensory experiences), disorganized thoughts, and/or inappropriate emotional expression. Psychotic disorders: a group of disorders marked by irrational ideas, distorted perceptions, and a loss of contact with reality Understanding Schizophrenia Schizophrenia is one of the most heavily researched psychological disorders, yet scientists disagree on its root cause. Dopamine Overactivity Abnormal Brain Activity & Anatomy Prenatal Environment Genetics Symptoms Paranoia: fear that someone or something is out to get you Disturbed perceptions & beliefs Disorganized speech (a.k.a. “word salad”) Diminished or inappropriate emotions ○ Flat affect: displaying no apparent feeling/emotion Positive vs. Negative Symptoms Positive Symptoms - an addition of inappropriate emotions and/or behaviors Hallucinations Delusions Disorganized thought/speech Bizarre movements/actions Negative Symptoms - a lack of appropriate emotions and/or behaviors Flat affect Reduced social interaction Anhedonia Alogia (speaking less or not at all) Catatonia (moving less or not at all) Onset & Development of Schizophrenia About 1 in every 100 people are diagnosed with schizophrenia. Onset usually in late adolescence or early adulthood- usually 19-21. Men experience schizophrenic symptoms earlier, more severely, and more often than women. Most do not realize they are mentally ill. Chronic schizophrenia is when schizophrenic symptoms appear in adolescence in early adulthood, but psychotic episodes become more frequent and severe as they age. Acute schizophrenia can begin at any age and is usually in response to a traumatic event. Dissociative Disorders Dissociative disorders are controversial and rare disorders in which conscious awareness becomes separated from previous memories, thoughts, and/or feelings. Dissociative Amnesia - sudden loss of memory or change in identity due to memory loss Dissociative Identity Disorder - a.k.a. multiple personality disorder Dissociative Identity Disorder Dissociative Identity Disorder is a rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities. commonly have a history of childhood abuse or trauma often misdiagnosed or exaggerated → Sybil Alternate theories of DID: Role playing Cultural perception (“evil spirits”) Therapy makes it worse Personality Disorders Personality disorders are inflexible and enduring patterns of behavior that impair social functioning. There are three clusters of personality disorders: Cluster A - odd/eccentric Cluster B - dramatic/erratic Cluster C - anxious/fearful  Types of Personality Disorders Avoidant Personality Disorder (C): Extreme shyness, feelings of inadequacy, sensitivity to rejection/evaluation; individuals feel inferior to others, avoid activities that involve interpersonal contact; feels socially inept, reluctant to take risks to avoid embarrassment Borderline Personality Disorder (B): pervasive pattern of instability in interpersonal relationships, self-image and emotions very impulsive, often demonstrating self-injurious behaviors; frantic efforts to avoid real or imagined abandonment, related to an intolerance of being alone, need to have other people with them at all times; inappropriate anger, chronic feelings of emptiness Schizoid Personality Disorder (A): uncommon condition in which people avoid social activities, shy away from interaction with others; lack desire/skills to form close personal relationships; To others, appears dull or humorless, doesn't tend to show emotion, may appear as though they don’t care; may seem aloof but actually feel lonely Histrionic Personality Disorder (B): uncomfortable when not the center of attention; Inappropriate sexual seductive or provocative behavior; Displays rapidly shifting and shallow emotions; Show self dramatization, theatricality, exaggerated expression of emotion; Considers relationships to be more intimate than reality Narcissistic Personality Disorder (B): Having an unwarranted sense of self-importance; Lacks empathy, overly self involved; Preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love; Can only associate with equally “special” individuals; Sense of entitlement Antisocial Personality Disorder(B): Lack of empathy, morality; Disobeys laws, ethical rules, lacks conscience; Little or no regard for other people’s feelings; Manipulative, impulsive, lacks sense of Eating Disorders Anorexia Nervosa: an eating disorder in which a person (usually an adolescent female) maintains a starvation diet despite being significantly underweight; sometimes engaging in excessive exercise Bulimia Nervosa: an eating disorder in which a person’s binge eating (usually of high calorie foods) is followed by inappropriate weight loss behavior, such as purging, laxative use, and/or excessive exercise Binge Eating Disorder: significant episodes of excessive eating followed by distress, disgust, or guilt (but without the compensatory behavior seen in bulimia nervosa) Review of Feeding & Eating Disorders Specific Learning Disorders Attention-Deficit/Hyperactivity Disorder (ADD/ADHD): Dyslexia: Dysgraphia*: Motor Disorders Developmental coordination disorder: Stereotypic movement disorder: Tourette’s disorder: Autism Autism Spectrum Disorder: ○ Asperger Syndrome:  Module 5.5 Treatment of Psychological Disorders What is Therapy? Psychotherapy is a treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth. Biomedical therapy is the use of prescribed medications or procedures that act directly on the person’s physiology. The eclectic approach to psychotherapy uses techniques from a variety of different therapies to treat a patient. Psychotherapy & Biomedical Therapy Deinstitutionalization: Psychoanalysis Championed by Sigmund Freud, psychoanalysis is a therapeutic approach which involves techniques to uncover content from the patient’s unconscious mind. These techniques include free association and dream interpretation to release previously repressed feelings, allowing the patient to gain self-insight. Psychoanalysts will use interpretation (notes on hidden meanings or repressed content) to help patients achieve this. Challenges to Psychoanalysis: Resistance: blocking from consciousness of anxiety-laden material Transference: misplaced feelings for one’s therapist (anger, resentment, love, lust, etc.) Psychodynamic therapy is derived from psychoanalysis and views the individuals as responding to unconscious forces and childhood Humanistic Approaches The humanistic approach to therapy was championed by Carl Rogers and emphasizes people’s innate potential for self-fulfillment. To achieve this goal, humanistic therapists try to give clients new insights, thus their techniques are often referred to as insight therapies (aim to improve psychological functioning by increasing a person’s awareness of underlying motives and defenses). Carl Rogers developed the widely-used technique of client-centered therapy, in which the therapist uses techniques such as active listening (hearing a client without providing judgment, opinion, or interruption while repeating or clarifying key points to demonstrate you have been paying attention) within an accepting, genuine, and empathetic environment to facilitate a client’s growth. Rogers also encouraged therapists to demonstrate unconditional positive regard (a caring, Behavior Therapies Behavior therapy applies learning principles to the elimination of unwanted behaviors. This can involve counterconditioning, or procedures that use classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors, or operant conditioning procedures, such as modeling, positive reinforcement, or token economies, where patients earn points or tokens for exhibiting desired behaviors that can be exchanged for rewards. Social Skills Training Cognitive-Behavioral Therapy A popular integrative therapy combines the technique of changing one’s thinking with techniques to change one’s actions known as cognitive-behavioral therapy (CBT). Like cognitive therapy, CBT works to make patients aware of their negative thinking while also practicing more positive behavior, as seen in behavior therapies. Helps patients act out their new and improved ways of thinking and behaving before putting it into practice Helpful for the treatment of OCD, depression, and eating disorders Cognitive Therapy Cognitive therapy teaches people new, more adaptive ways of thinking. This approach is based on the assumption that thoughts intervene between events and our emotional reactions. Rational-emotive behavior therapy (REBT) is a confrontational cognitive therapy developed by Albert Ellis that vigorously challenges people’s illogical, self-defeating attitudes and assumptions. Aim of Technique Technique Therapists’ Directives Reveal beliefs Question your interpretations Explore your beliefs, revealing faulty assumptions such as “I need to be liked by everyone.” Rank thoughts and emotions Gain perspective by ranking your thoughts and emotions from mildly to extremely upsetting. Test beliefs Examine consequences Explore difficult situations, assessing possible consequences and challenging faulty reasoning. Decatastrophize thinking Work through the actual worst-case consequences of the situation you face (it is often not as bad as imagined). Then determine how to cope with the real situation you face. Change beliefs Take appropriate responsibility Challenge total self-blame and negative thinking, noting aspects for which you may be truly responsible, as well as aspects that aren’t your responsibility. Resist extremes Develop new ways of thinking and feeling to replace maladaptive habits. For example, change from thinking “I am a total failure” to “I got a failing grade on that paper, and I can make these changes to succeed next time.” Group Therapy Group therapy, or treatment conducted in with several patients at once, can provide benefits through group interaction. Shows patients they’re not alone or abnormal Saves time & money Allows for patients to practice and develop social skills Gives variety of feedback Family Therapy A special type of group therapy is family therapy, which treats people in the context of their family system, viewing an individual’s unwanted behaviors as influenced by and/or a by-product of the family dynamic. Does psychotherapy work? Confirmation bias: Three Elements: Evidence-based practice: Therapeutic alliance: Classical Conditioning in Therapy Exposure therapy: forcing patients to confront their fears ○ Virtual Reality ○ Ex. Forcing someone with a fear of spiders to hold one Systematic desensitization: in a relaxed state incrementally expose the person to the object of anxiety ○ Ex. Slowly reducing a fear of dogs through increasing steps of exposure. First they have to hold a picture of a dog, then a stuffed animal, then be in the same room as a live dog, until finally they can pet a dog without extreme fear. Aversive conditioning: substitute a negative response with a positive one by pair undesirable behavior with Personal Factors Influencing Psychotherapy Seeking Therapy  Type Therapy Description Clinical Psychiatrist s Social Workers Counselors Therapy Presumed Problem Therapy Aim Therapy Technique Psychodynamic Unconscious conflicts from Reduce anxiety through self- Interpret patients’ memories and childhood experiences insight. feelings. Client-centered Barriers to self- Enable growth via Listen actively and reflect clients’ understanding and self- unconditional positive feelings. acceptance regard, acceptance, genuineness, and empathy. Behavior Dysfunctional behaviors Learn adaptive behaviors; Use classical conditioning (via extinguish problem ones. exposure or aversion therapy) or operant conditioning (as in token economies). Cognitive Negative, self-defeating Promote healthier thinking Train people to dispute negative thinking and self-talk. thoughts and attributions. Cognitive- Self-harmful thoughts and Promote healthier thinking Train people to counter self-harmful behavioral behaviors and adaptive behaviors. thoughts and to act out their new ways of thinking. Group and family Stressful relationships Heal relationships. Develop an understanding of family and other social systems, explore Biomedical Therapies Since the 1950s, discoveries in psychopharmacology (the study of the effects of drugs on the mind and behavior) have revolutionized the treatment of people with severe disorders. There are two types of biomedical treatment - medication and procedures. Medications: Procedures: Antipsychotics Transcranial Electrical Anti-anxiety Stimulation Antidepressants Magnetic Stimulation Mood stabilizers Deep-brain stimulation Psychosurgery Psychopharmacology Drug Purpose Side Examples Used for… Effects/Risks Antipsychotic Calm Tardive dyskinesia Thorazine Schizophrenia & hallucinations (involuntary tics) Risperdal psychosis and delusions Increased risk of Zyprexa obesity & diabetes Anti-anxiety Depress central Increased anxiety Xanax Anxiety nervous system Insomnia Ativan disorders activity Addiction Valium Antidepressan Elevate arousal Weight gain Prozac Depression t and mood Hypertension Zoloft OCD/PTSD Dizziness Anxiety Mood Levels the Lack of emotion Lithium Bipolar disorder stabilizer extreme emotional highs/ Procedures Treatment Description Used for… Electroconvulsive Use of brief electrical Severe depression (ECT) currents on targeted areas of a patient’s brain Transcranial Magnetic Application of repeated Depression Stimulation (TMS) pulses of magnetic energy Test for lesioning/ to the brain to depress or lobotomy stimulate brain activity Deep Brain Stimulation Use of implanted electrodes Parkinson’s (DBS) to send signals to targeted Depression areas of the brain Lobotomy/Lesioning The removal or destruction Severe cases of anxiety of brain tissue or depression; Therapy Presumed Problem Therapy Aim Therapy Technique Therapeutic Stress and unhealthy Restore healthy Alter lifestyle through lifestyle change lifestyle biological state. adequate exercise, sleep, nutrition, and other changes. Drug therapies Neurotransmitter Control symptoms Alter brain chemistry malfunction of psychological through drugs. disorders. Brain stimulation Depression (ECT is Alleviate Stimulate brain through used only for severe, depression, electroconvulsive shock, treatment-resistant especially when it mild electrical depression.) is unresponsive to stimulation, magnetic drugs or other impulses, or deep-brain forms of therapy. stimulation. Psychosurgery Brain malfunction Relieve severe Remove or destroy brain disorders. tissue. Hypnosis Social influence theory: Dissociation theory: Posthypnotic suggestion: Posthypnotic amnesia*:  Therapy Presumed Problem Aim Technique Drug Therapies Brain Stimulation Psychosurgery Therapeutic Lifestyle Change Hypnosis Preventing Psychological Disorders Resilience & Post-Traumatic Growth Miscellaneous History of “Treating” Mental Illness Stone Age skulls show evidence of trephination - drilling holes into the skull to “release evil spirits”. In the Middle Ages, psychological illness was often written off as demonic possession, and people were caged, beaten, mutilated, or suffered through transfusions and exorcisms. In the 1700’s, Philippe Pinel worked to reform brutal treatment by promoting a new understanding of the nature of mental disorders. Pinel proposed that mental disorders were not caused by demonic possession, but by environmental factors such as stress and inhumane conditions. Pinel’s “moral treatment” involved improving the environment and replacing the asylum beatings with patient dances. While more humane, they were not very effective. In the 1800’s, disturbed people were no longer thought of as mad men, but as mentally ill. They were put in hospitals, which were nothing more than barbaric prisons. The patients were chained and locked away. Some hospitals, like Bedlam in England, charged admission for the public to see the patients. Looking at ADD/ADHD The DSM has broadened the diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD): a psychological disorder marked by extreme inattention and/or hyperactivity and impulsivity. This inclusion has been a point of debate: Is it deviant? Do some people have a level of inattentiveness, impulsiveness, or restlessness that goes beyond laziness or immaturity? Is it distressful? Is the person enjoying being energetic, or are they frustrated that they can’t sustain focus? Is there dysfunction? Are the symptoms harmless fun, or do they negatively impact work and relationships? Insanity When reviewing criminal cases, there is often a discussion of the mental health of the suspects to determine if a psychological disorder had anything to do with their behavior. While this is typically done by a medical professional, the idea of insanity is a legal term and not a medical or psychological one. Bipolar Disorder in Children and Adolescents Many young people have cycles from depression to extended rage rather than mania. So in cases where bipolar symptoms are present in adolescents and children, the DSM-V have a new diagnosis for these kids: Disruptive Mood Dysregulation Disorder. Subtypes of Schizophrenia Paranoid ○ Preoccupation with delusions or hallucinations. ○ Ex. Johnny Depp in The Secret Window Catatonic ○ Either motionless or repetitive, purposeless movements ○ If irritated, can briefly display frenzied, dangerous behavior. ○ Parrot like repeating of another’s speech and movements ○ Ex. Johnny Depp as Willy Wonka Disorganized ○ Disorganized speech or behavior. ○ Flat or inappropriate emotion. ○ Jump topics in the same sentence. ○ Ex. Johnny Depp as Jack Sparrow Undifferentiated ○ Many and varied symptoms ○ Genetic-10 times more likely to have relatives who have had the condition. ○ Ex. Johnny Depp as the Mad Hatter Somatoform Disorders Somatic symptom disorder is a psychological disorder in which the symptoms take a bodily form without apparent physical cause. Conversion Illness Anxiety Disorder Conversion Disorder Conversion disorder is a somatic symptom disorder in which a person experiences very specific, physical symptoms that are not compatible with recognized medical or neurological conditions. This condition is often triggered by trauma. Ex. Reporting loss of sight despite nothing being wrong with your eyes or visual processing. Illness Anxiety Disorder Illness Anxiety Disorder (a.k.a. Hypochondriasis) is a somatic symptom disorder in which a person interprets normal physical sensations as symptoms of a disease. Ex. I’ve got the sniffles? Obviously it’s cancer! Aaron Beck’s Treatment for Depression Aaron Beck challenged traditional treatment of depression by shifting from a focus on one’s past to that of one’s thinking. He found that depressed people often report dreams with negative themes of loss, rejection, and abandonment, which then transmitted into their waking life as feelings of hopelessness and failure. He would use a line of questioning to reveal the flawed logic of these thoughts, thus helping the patient realize the illegitimacy of these thoughts and feelings. Self-Help Groups More than 100 million people have belonged to small religious, interest, or support groups that meet regularly which allows members to support each other, often with conflicts or issues that have some sort of stigma - addiction, grief, infertility, etc. These groups depend on each other, rather than therapists, for support and direction. Other Therapies Eye Movement Desensitization and Reprocessing (EMDR) Francine Shapiro developed it to treat trauma. Noticed that anxiety diminished when eyes were darting around. She has people recall traumatic scenes while she moves her finger in front of their eyes. They release previously frozen memories. Light Exposure Therapy -Daily Dose of Intense Light Exposed people to the morning or artificial light. Used to treat Seasonal Affective Disorder and depression These are a few of CB’s favorite things… Schizophrenia Systematic desensitization Different treatment options based on approach  AP Psychology. AP Psychology – AP Students | College Board. (n.d.). https://apstudents.collegeboard.org/c ourses/ap-psychology Myers, David G. and Nathan DeWall. Exploring Psychology. 11th edition. Citations 2019. New York: Worth. Myers, David G. and Nathan DeWall. Psychology. 12th edition. 2018. New York: Worth. Weiten, Wayne. Psychology: Themes and Variations. 10th edition. 2017. Belmont, CA: Wadsworth, Cengage Learning.