Abnormal Psychology Notes PDF

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Notes for Katie Rowinski, first exam...

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Chapter 1 ●

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Deviant ○ Strange, bizarre, odd ○ Statistically uncommon ○ BUT… ■ Not all “weird” behavior is abnormal ■ Not all mental dxs are deviant ■ Deviant does not mean abnormal ● Ex: Eccentricity ○ Odd/different, nonconformity, creativity, idealism ○ Lower interest in others’ opinions, higher intelligence ○ Have fewer emotional problems ● Some mental disorders are common ○ 1 in 4 people will experience some kind of mental problem in their lifetime ○ Consider ■ Social norms ● What is socially acceptable? Socially unacceptable? ■ Culture ● Ex: Eating disorders, Koro ■ Context ● The context in which the symptoms appear ○ Ex: grief vs. depression ○ Ex: intense fear in a scary situation vs. panic attacks Distressing ○ Mental suffering, emotional discomfort ■ Internalizing symptoms ■ Ego-dystonic ○ BUT, sometimes distressing to others ■ Externalizing symptoms ■ Ego-syntonic ○ Just because you’re in therapy does not mean you have a mental disorder Dysfunctional ○ Interferes with daily functioning (home, school, work, relationships) ■ When might this NOT be a good criterion? Dangerous ○ To oneself or others ○ Careless, impulsive, hostile, reckless ○ But this is often the EXCEPTION (availability heuristic) History of Clinical Psychology ○ Importance of understanding where we’ve been in the past ○ Historical conceptions behind mental illnesses ■ Supernatural ● Influences of evil spirits, demonic possession, cursed

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Somatogenic ● Caused by internal physical problems ● Imbalance of bodily fluids, unhealthy lifestyle ○ Hippocrates’ 4 humours → Blood, phlegm, black bile, yellow bile ■ Treatment: healthy diet, exercise, celibacy ■ Psychogenic ● Psychological causes of mental illnesses ● Trauma, stress, psychological deceptions ○ Treatments → Hypnotism, psychoanalysis ○ Ancient Views ■ Spiritual theories (demonic possession) ● Treatment → punishment or casting out demons ○ Trephination: Skulls drilled to release the demonic spirits out ○ Exorcisms: Forcing the spirits out of the body Psychosurgery ○ “Ice pick lobotomies” 1946-1960 ○ Walter Freeman (Neurologist with surgical training) ■ Transorbital lobotomy ● Stylus is pushed through the eye socket then it is rotated to cut the brain ■ 3500 in 23 different states (traveled in his lobotomobile) ■ Freeman’s license was revoked when a patient he was lobotomizing died 1950s and on ○ WWII veterans forced new attention and better tx ■ Believed PTSD was a physical condition called “shell shock” (symptoms from physical shell of bullet) ○ 1950 = 1st psychiatric med (THorazine) ○ 1955 = “deinstitutionalization” (+/-) Current Trends ○ We are FAR from perfect ■ General ignorance ■ Stigma that still exists ■ Seek after a quick/easy fix ○ But MAJOR improvements ■ DSM changes ■ Better knowledge of brain, psychological function ■ Better treatments ■ More info, research and experts ○ TX: meds, therapy, community intervention, prevention Harmful effects of stigma ○ Reluctance to seek help or treatment ○ Lack of understanding by family, friends, co-workers or others you know

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Fewer opportunities for work, school or social activities or trouble finding housing Bullying, physical violence or harassment Health insurance that doesn’t adequately cover your mental illness treatment The belief that you’ll never be able to succeed at certain challenges or that you can’t improve your situation Solution? ○ Avoid negative terms ■ Retarded, crazy, psycho, etc. ○ Don’t define someone by their diagnosis ■ Schizophrenic vs. person suffering from schizophrenia ○ Don’t make jokes about mental illnesses ○ Talk to someone with mental illnesses (get to know them) ○ Don’t make assumptions (and be aware of your assumptions)/educate yourself, educate others! ○ Increase your empathy for these individuals, advocate for them and support them Clinical research ○ Case Study ■ Cons ● Can’t assume from one case and apply it to a group of people ● Bias of the observer ○ Correlational Study ■ Pros ● Generalizable ● Notice patterns ● Easily replicated ■ Cons ● Cannot prove causation ● Correlation could be by chance ○ Experiments ■ Pros ● Very controlled procedures ● Double-blind design ● Control group → Placebo to compare ■ Cons ● Not very realistic due to the settings and conditions Research ○ Scientific method = systematically collecting info, evaluating it and critically analyzing it ○ What makes a research study GOOD/BAD? ■ Reputable source? ■ Who funds it? Are there any secondary motives/gains? ■ Replication of findings? ■ In-line with previous knowledge/research? ■ Peer-review?

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The actual methods/analyses used

Chapter 2: ●

Theoretical Models ○ How do we explain mental illness? ■ Biological ● Physical structures of the brain ● Brain chemistry and biochemical functions ● Genetics and biological illnesses ○ Inherited: ■ Physical and temperamental traits ■ Proneness/vulnerability to physical/mental disease ○ Some traits may get passed on because it aids survival ■ Harry Stack Sullivan’s “Reactance Theory” ● We bring into adulthood our childhood defense mechanisms. Many children go through extreme traumas, so they develop defenses to keep themselves safe and alive. These are beneficial initially, but other time can become extremely maladaptive, dysfunctional and pathological. ○ Viral infections (pre/post-natal) ○ Physical conditions that exacerbate mental illness ○ Poor health habits ■ Stress, sleep, diet, exercise ○ Biological treatments ■ Healthier diet, sleep, exercise, minimize stress ■ Genetic counseling - pros and cons? ■ Medications ● Antipsychotics ● Antidepressants ● Anxiolytics ● Mood stabilizers ■ ECT (Electroconvulsive Shock Treatment) ● Used for serious cases ■ Psychosurgery ■ Deep brain stimulation ● Nervous system ○ Central nervous system → brain and spinal cord ○ Peripheral nervous system → nerve bundles outside of the brain and spinal cord ■ Somatic nervous system → Controls skins/muscles ■ Autonomic nervous system → “Automatic” (involuntary) control of heart, lungs, etc.

Sympathetic nervous system → stress response ● Parasympathetic nervous system → helps you relax c: ○ Endocrine system → hormones ■ Hormones: chemical messengers outside the brain ● Growth, reproduction, sexual activity, heart rate, body temperature, energy, response to stress Brain anatomy ○ 85-100 billion neurons (brain cells) ○ 25,000 genes → proteins and neurotransmitters ○ Brain lobes ■ Frontal lobe ● Movement, personality, concentration, planning, problem-solving, understanding, things/words, emotional reaction, inhibiting impulses, speech, smell ■ Parietal lobe ● Touch, pressure, taste, body awareness ■ Temporal lobe ● Hearing, recognizing faces, emotion, longterm memory ■ Occipital lobe ● Sigh ■ Cerebellum ● Fine motor control, balance, coordination, keep from falling ■ Limbic system ● Emotions, happy, sad, love, fear, anger, memory, drives ● Amygdala ○ Aggression, fear, sexual behavior ● Hippocampus ○ Memory, emotions ● Hypothalamus ○ Hunger, thirst, metabolism, body temperature, sexual behavior, communicates with pituitary gland → hormones ○ *Messages are transmitted through the brain electrically and chemically ■ “Action potential” = release of neurotransmitters ○ Structures ●

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Pros and Cons ○ Huge medical advances → effective treatment! ○ BUT: ■ Not all behavior can be explained biologically ■ Sometimes this theory is too simple/reductionistic ■ Fails to account for other factors (environment) ■ Treatments are far from perfect (ex: side effects) Psychodynamic ● Behavior = unconscious psychological forces ○ Internal forces that interact ○ Conflicts cause mental illness ○ Past experience and early relationships ● Freud ○ ID - We are driven to feel good (Devil) ○ Ego - Reality demands (balances both the ID and superego) ○ Superego - Everything society tells you that you should do/beliefs and morals (Angel) ● Treatments ○ Talk therapy (insight-based) ○ Uncover past traumas and inner conflicts ○ Focus on early childhood experiences and relationships with parents/early caregivers ○ Pros and Cons ■ Safer than medical treatments! ■ Focuses on the individual and validating their experiences ■ BUT… ● Difficult to research ● Depends on the therapist ● Doesn’t work for everyone Behavioral ● Focus on the observable and measurable causes of behavior ● Most (abnormal) behavior is learned (3 types of learning) ○ Classical conditioning ○ Operant conditioning ○ Modeling (social learning) ● Behavioral treatments ○ Applied behavioral analysis ■ Antecedents → Behaviors → Consequences ○ Behavior modification ■ Setting goals, tracking/journaling behavior, changing it o-o ○ Aversion treatment

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Making someone go through an unpleasant stimulus to stop behavior Behavioral training ■ Social skills ■ Assertiveness ■ Role-playing Token economies ■ Giving patient a token for good behavior + they get to trade tokens in for reward Pros and cons ■ It can be observed and measured ■ Helps to explain many psychological symptoms ■ BUT… ● It’s too simple ● Humans are unique and react differently ● We have the ability to think/decide to act ● Doesn’t mean long-term success

Cognitive ● Ex: What are some common incorrect assumptions that college students make? ○ What effects might this have on a person? ● Cognitive Model = internal thoughts and beliefs that influence feelings and behaviors ○ Irrational beliefs and “cognitive distortions” ■ All-or-none thinking, catastrophizing, comparing, emotion reasoning, selective abstraction, fortunetelling, mind-reading, overgeneralization, perfectionism, acceptance of critics ● Treatments ○ Cognitive therapy ■ “Cognitive restructuring” ○ Cognitive behavioral therapy ○ Rational emotive therapy ○ Acceptance and commitment therapy ● Pros and cons ○ It is proven to be VERY effective in treating certains mental illnesses ○ Can be very direct, quick, easy to administer, and helpful for certain types of clients ○ BUT… ■ Doesn’t work for everyone ■ Sometimes it’s TOO direct (invalidating) ■ May not be helpful for more complex problems Humanistic-existential

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Importance of: ○ Interpersonal connection ○ Human freedom ○ Personal choice ● Humanistic theory ○ We are all driven to reach our full potential ● Existential theory ○ Everyone must realize that the individual is solely responsible for giving his or her own life meaning in spite of many existential obstacles ■ Face these facts and create a meaningful life by accepting responsibility ○ Psychopathology = failure to accept these facts, resulting in feeling anxious, inauthentic, and depressed ● Treatments ○ Client-centered theory ■ Unconditional positive regard ■ Empathic understanding ■ Genuineness ○ Gestalt therapy ○ Positive psychology ○ Help the patient face truths, develop courage, and find meaning ● Pros and cons ○ Extremely validating ○ Empathy is an essential part of ANY kind of therapy ○ BUT… ■ Does it DO anything? ■ It’s hard to measure in research ■ Depends on the patient-therapist relationship ■ Sociocultural ● Consider the many broad social and cultural factors that influence who we are ● Family systems theory (family therapy) ● Group therapy ● Couples therapy ● Community MH treatment ● Public policy ● Pros and Cons ○ Holistic and comprehensive ○ BUT… ■ Very broad and hard to pinpoint specific factors ■ It’s hard to implement change at larger levels What’s the most important issue?

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How your friend thinks about herself and her future What she does and doesn’t do She might have a neurochemical imbalance or physical disorder Her problem stems from her past and perhaps she’s not even aware of it She should realize what a good person she is and that she has the potential to do anything she wants

Chapter 3: ● Clinical assessment ○ The process of gathering information to diagnose and understand an individual’s problems ○ Helpful for… ■ How and why a person is behaving a certain way ■ How that person might be helped ■ Is a patient making progress in therapy ○ Why do an “assessment”? ■ First appointment ● To diagnose the patient and form treatment plan ■ Legal settings (forensic psych) ● Is the individual “competent to stand trial”? ● Was the person “not guilty by reason of insanity”? ■ Disability evaluations ■ Educational purposes (school psych) ● Learning disability, intellectual disability, ADHD, etc. ■ Brain damage? ● Neuropsych tests ■ Custody evaluations ■ Occupational tests ■ Track progress in therapy and/or research ○ Types of assessment ■ Clinical interview ● Structured ○ Follows a predetermined script ○ Consistency = ^ reliability ○ Example: SCID, MSE ● Unstructured ○ Client chooses topics and elaborates on problems ○ WHAT patient says (HOW, WHEN, WHY patient says it) ○ Create a safe, trusting relationship ● Semi-structured ○ Follow script but then lets the patient elaborate on topics ● Pros and Cons ○ The potential to gather a lot of information ○ BUT the patient might: ■ Intentionally mislead you or avoid embarrassing

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topics Not be able to give an accurate report The interviewer might make assumptions or be biased Unstructured interviews is not reliable

Tests ● Symptom and personality questionnaires ○ Self-report or “objective” tests ○ Answer T/F or Agree/Disagree to questions about thoughts/feelings/behaviors ○ Beck Depression Inventory ○ Minnesota Multiphasic Personality Inventory ○ Big Five (NEO) ○ Myer Briggs ● Projective tests ○ Responding to vague, ambiguous stimuli ○ People will project their personality characteristics onto ambiguous stimuli ○ Could help people reveal themselves more fully than they normally would (feelings, needs, and traits) ○ Thematic Apperception Test (TAT) ■ Tell me a story about this picture ■ Describe what is happening ■ What led up to scene? ■ What will happen in the future? ○ Projective drawings (DAP, KFD, etc.) ○ Sentence-completion test ○ Rorschach Inkblot ■ 10 ambiguous inkblots ■ What you answer gives insight to your personality and emotional functioning ● Cognitive tests ○ Aptitude tests ■ Ability to learn, expected ability, “intelligence” ○ Achievement tests ■ Current knowledge usually in a particular subject, actual ability, “academic performance” ● Biological tests ○ Helpful for diagnosing mental disorders relating to an actual biological abnormality ■ Head injury, brain tumors, stroke, alcoholism, infections, sleep disorders, ADHD ○ Brain scans: fMRI, CAT, PET ■ Physical structure and functioning metabolism brain

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Psychophysiological tests ■ EEG, polygraph, neurofeedback

Observations ● Self-monitoring ● Observation by others ● Examples: ○ Journals/record ○ “Functional analysis of behavior” Characteristics of “good” tests: ● Standardization ● Reliability = “consistency” ○ Test-retest ○ Interrater ● Validity = “accuracy” ○ Face, predictive, concurrent What does it mean to classify? ● Why classify something? ○ Communication among caregivers ○ Research purposes ○ To predict its course and determine appropriate treatment ○ Hospitals, clinics, and insurance companies Why not classify disorders? ● Vague (fails to capture individuality of patient) ● Oversimplified and stigmatizing labels → dehumanize ○ Ex: Depression ■ With psychotic features? ■ With a co-occurring substance abuse? ■ Due to loss of a loved one? ■ With or without self-mutilation (cutting)? Things to look for: ● Symptoms, onset, course, major life events, abusing drugs/alcohol, medical conditions Classification of abnormality ● Diagnostic and statistical manual of mental disorders (DSM-5) ○ Similar to medical disorders (ICD-10): other countries use ICD How do we develop a good classification system? ● DSM history ● Dimensional AND categorical ○ Dimensional - does not attempt to place into diagnostic categories ■ Asks “how much?” Instead of “present or not” ○ Categorical - conceptualizes mental disorders into discreet syndromes

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One defining criteria everybody in the group should meet Is 300+ diagnoses a reflection of our increasing knowledge of mental illness or are we creating disorders that don’t really exist? ○ Comorbidity - mental illnesses meet required diagnostic for multiple conditions AND, how do we distinguish “symptoms” from normal variations in human life? ○ Threshold - sets boundaries between disorder and nondisorder

Chapter 4: ● Anxiety disorder ○ Symptoms ■ Fear, dread, expecting the worst case scenario, avoidance, angsty, nervous ticks, restlessness, pupils dilated, sweating ○ Why do we have this “ability”? ■ Safer (staying out of things/at home) ○ A few things about anxiety ■ It can be illogical ■ Debilitating ■ It provokes a REAL N.S. response ● It’s important and has a purpose! (evolutionary) ● PFC gets on hold, amygdala takes over ● Some people are more prone to anxiety ● Don’t tell someone “it’s gonna be okay” ● ;w; ask daniel for rest ○ Abnormal anxiety ■ Irrational, debilitating, long-lasting, frequent, unpredictable, maladaptive behavior ■ Most common mental health problem ■ 10% of general population; 30% in lifetime ■ High comorbidity with depression ■ Early diagnosed ■ Good prognosis with effective treatment ○ Normal anxiety ■ Reaction to stressor, protective, time-limited, occasionally, predictable, return to homeostasis ○ Causes of anxiety disorders ■ Genetics, brain chemistry, personality, life experience, stress, physical illness, avoidance ● Anxiety and obsessive-compulsive disorders ○ Phobia ■ Causes ● Behavioral/learning

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Classical conditioning Operant conditioning Modeling ■ Parents/family

Biology ○ Abnormal fight/flight response ○ Genetics ● Past experiences ○ Overprotective parents ○ Trauma/bad experiences ■ Persistent, irrational fear of object or situation ■ Exposure provokes intense anxiety ■ Person recognizes fear is excessive/unreasonable ● Except for kids ■ Object/situation is avoided ● This reinforces the phobia ■ Avoidance, anticipation, or worry about the feared object/situation causes distress and impairment ■ Treatment ● Relaxation training ○ PMR (flex muscles then relax), deep-breathing, visualization, meditation ● Exposure ○ Systematic desensitization (progressive) ○ Flooding (rapid) ○ In-vivo (directly facing feared stimulus) ○ Modeling (therapist models interaction with stimulus) ● Cognitive therapy ○ CBT (cognitive behavioral therapy) Social anxiety disorder ■ 7% of adults (but onset typically in childhood) ■ Intense fear in social situations ■ May avoid eating in public, using public toilets, being the center of attention, asking questions, speaking on the telephone Generalized anxiety disorder ■ Unfocused, chronic (>6 months) and pervasive worry ■ Uneasy, tense, jumpy, constantly worried ■ 3 or more symptoms: ● Restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance ■ Causes distress and/or impairment ■ Not due to meds, drugs, or a medical condition ■ Runs in families (⅓ of variance = genetics) ■ Life stressors can increase risk

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Long-term alcohol and benzodiazepine use worsens anxiety Stimulants can also trigger anxiety ● ADHD meds, caffeine, nicotine ■ Treatment: Cognitive behavioral therapy Panic disorder ■ Episodes of intense panic, including 4 or more ■ Pounding heart, sweating, shaking, shortness of breath, chills or hot flashes, feeling of choking, chest pain, nausea, dizziness, fear of losing control, fear of dying, numbness/tingling ■ Persistent worry about having another attack ■ 3 types: ● Unexpected (random/un-cued) ● Situationally-bound (situation or thought of situation immediately causes attack) ● Situationally-predisposed (situation or thought of situation increases likelihoo...