Final exam - Lecture notes 1-15 PDF

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combined notes for cumulative final exam...

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Personaity disorders

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Clusters of personality o Cluster A  Paranoid  Distrust and suspiciousness of others such that their motives are interpreted as malevolent o Preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates o Reluctant to confide in others because of fear that the information will be used against them  Schizoid  Detachment from social relationships and a restricted range of expression of emotions (flat affect) o Either desires nor enjoys close relationships, this sometimes includes family o Almost always choses solitary activities o Takes pleasure in few, if any activities o Shows emotional coldness, detachment, flattened affectivity  Schizotypal  Unusual and eccentric thoughts and behaviors, interpersonal detachment, and suspiciousness o Odd beliefs or magical thinking o Paranoia o Ideas of reference o Similar to schizophrenia o Cluster B  Antisocial  Disregard for the rights of others o Pattern or irresponsible behavior o Impulsivity o Lack empathy  Etiology o Family environment  Lack of warmth, high negativity, and parental inconsistency predict APD  Can also be known as psychopathy o Skin conductance of psychopaths is less reactive when encountering aversive stimuli

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Borderline  Impulsive, self-damaging behaviors o Unstable, intense relationships o Emotional reactivity  Emotions are intense, erratic, shift abruptly – often from passionate idealization to contemptuous anger o Fear abandonment o Unstable sense of self  Etiology o Genetic component  High heritable o Parental separation, verbal and emotional abuse during childhood o Linehan’s diathesis stress theory  Primary features are: emotional dysregulation and experiences of invalidation  Treatment o Difficult to treat  Interpersonal problems play out in therapy  Tries to manipulate therapy o Dialectical behavioral therapy  Acceptance and empathy plus cognitive behavioral therapy o Goal: repair the therapeutic relationship between client and therapist Histrionic  Excessive emotionality and attention seeking o Uncomfortable in situations in which he or she is not the center of attention o Inappropriate sexually, seductive, or provocative behavior o Consistently uses physical appearance to draw attention to self o Shows self-dramatization, theatricality, and exaggerated expression of yogurt Narcissistic  Grandiose view of self o Preoccupied with fantasies of success  Self-centered o Lacks empathy o Feelings arrogance, envy, entitlement  Sensitivity to criticism o Enraged when not admired

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Seek high status partners

o Cluster C  Avoidant  Fears criticism, rejection, inadequacy and disapproval o Avoid interpersonal situations o Low self esteem o Desire acceptance o Avoid taking risks or trying new activities o Highly comorbid with social anxiety disorder  Dependent  Need to be taken care of that leads to submissive, clingy behavior and fears of separation o Has difficulty making everyday decisions without reassurance from others o Needs other to assume responsibility for most major areas of their life o Difficulty disagreeing with others because of fear of loss of approval  Obsessive-compulsive  Preoccupied with rules, details, schedules, and organizations – need for order and control o Perfectionists o Overly focused on work o Rigid and inflexible idea/rules/morals/values o Indecisive o Anxious about thinking harmful thoughts  Most comorbid with avoidant PD  Differs from OCD, not obsessions or compulsions

Late Life and Neurocognitive Disorders

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Myths about late life o Aging involes great cognitive decline o Late life is a lonely time Older people o Normally have mild cognitive losses o Less negative emotion o Social selectivity – focusing only on the most important relationships in their lives o Depression  medical illness Problems in research o Cohort effects – effects of having grown up during a particular time period

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 People of the same age group – EX: studying people all born in 50s o Time of measurement effect – effects of testing people at a particular time in history  Testing people after event, could be different ages o Methodological issues  Attrition – participants drop out of the study due to death immobility of lack of interest Alzheimer’s disease o Irreversible brain tissue deterioration o Usually begins with  Difficulty remembering recent events  Difficulty learning new material o As disease progresses  Language problems intensify  Disorientation  Depression o Protective factors  Exercise cognitive skills  Physical exercise  Social interaction o Brain changes  Plaques  Beta-amyloid deposits (makes too many, or does not get cleared)  Primarily found in frontal cortex  Neurofibrillary tangles  Protein filaments composed of tau in axons of neurons  Primarily found in hippocampus but later spread throughout the brain Frontotemporal dementia o Loss of neurons in frontal and temporal lobes o Deterioration in three or more of the following that leads to function of impairment  Empathy  Executive function  Compulsive behavior o Caused by multiple genetic pathways  Pick’s disease  High levels of tau proteins Vascular dementia o Typically results from stroke (cerebrovascular)  Usually series of strokes  Clot forms and impairs circulation  Cells die

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o Risk factors: smoking, high LDL cholesterol Dementia with Lewy Bodies o Two types  With Parkinson’s  No Parkinson’s o Symptoms similar to Parkinson’s and Alzheimer’s disease (but not the same) o Loss of dopamine producing neurons ( in substania nigra) similar to seen in Parkinson’s Prevention and treatment of dementia o No drug reverses Alzheimer’s o Some drugs produce slightly less decline o Antidepressants for depression o Antipsychotic medication for agitation o Psychological treatments  Supportive psychoptherapy for family and patient  Cognitive interventions Parkinson’s Disease o Symptoms  Tremors, rigidity, shuffling walk, loss of control of speech and loss of facial expression  Half of patients have mild dementia in later stages o Destruction of the substantia nigra in the basal ganglia, controls body movement o Treatment  Implants from person’s adrenal gland  Fetal-tissue transplants  Drug treatments Inappropriate relations with clients o Most complaints are filed by women against men o 4-10% of male therapists have sexual relations with clients o Women later rates their relationships with their supervisors as negative o Outcomes  Can cause similar symptoms to PTSD in clients  Therapists continue to charge clients  The counselor-client relationship continues for longer duration tha necessary

Ethics

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Insanity defense

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o The legal argument that a defendant should not be held responsible for an illegal act if it is attributable to mental illness or intellectual disability that interferes with rationality o Irresistible impulse  If a pathological impulse or uncontrollable drive compelled the person to commit the criminal act, an insanity defense is legitimate More terms o Competency to stand trial  Legal to decision as to whether a person can participate meaningfully in his or her own defense o Not guilty by reason of insanity  Insanity plea that specifies an individual is not to be held legally responsible for the crime because the persona as a mental illness at the time of the crime  Place in psychiatric hospital until ready to reenter society o Guilty but mentally ill  Insanity plea in which a mentally ill person can be held morally and legally responsible for a crime but can then be sent to prison and psychiatric treatment is included during carination Tarasoff Case o Requires clinicians, in deciding when to violate confidentiality, to predict the dangerousness of a client  Must warn the victim of the clients threat is therapist believes they are in danger o ** discussed in text book The homeless o Rates of homeless have increased among the mentally ill, especially following deinstitutionalization

Cumulative - Know the difference between PTSD and Acute Stress Disorder o PTSD  Human caused traumas cause more PTSD than things such as natural disasters  The severity of the trauma influences whether or not a person will develop PTSD  Women who dissociate after an attack are more likely to develop PTSD  Women who did not get treatment for rape-related PTSD are at more risk for internalizing grief, anger, blame, and re-victimization o Acute stress disorders  Very similar to PTSD  Only lasts 3-31 days - Therapists/treatments used for PTSD such as Imagery Rescripting

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Numbing pole  Some individuals react by numbing themselves to the environment o Avoidance/blocking out thoughts  Intrusion pole  Intrusive related thoughts, flashbacks, or nightmares  Factors relevant to development of PTSD  Fear circuit o Amygdala o Medial prefrontal cortex (less activity) o Serotonin and GABA deficiency o Locus coeruleus  Child trauma  Selectively attending to threat cues  Neuroticism  Negative affectivity - If someone has physical brain symptoms neurologist FIRST, not a therapist - Theorists and contributions Psychodynamic Perspective - Freud’s three structures of the mind o ID (pleasure principle/childish urge) devil o Ego (reality principle/mediator) mediator o Superego (conscience/morality) angel Freud’s psycho sexual stages - Oral (0-18 months) o Pleasure centers on the mouth, sucking, biting and chewing - Anal (18-36) o Pleasure focuses on bowel and bladder eliminations; coping with demands for control - Phallic (3-6yrs) o Pleasure zone is the genitals; coping with incestuous sexual feelings - Latency (6 to puberty) o Dormant sexual feelings Freud’s defense mechanisms - Repression o Pushing threatening things out of your mind and into subconscious  Ex can’t remember father’s funeral - Projection o Attributing your own unacceptable thoughts or feelings onto someone else  You get really mad at roommate but scream that she’s the one mad at you - Regression

o Retreating to behavioral patterns of an earlier stage of development  You and roommate get into argument and you stomp off into another room and pout - Sublimation o Converting unacceptable aggressive or social impulses into socially acceptable behavior  You redirect your anger in the form of participation in a sport like boxing or football - Displacement o Reassigning aggression  Getting in fight with parents but you take it out on one of your friends - Denial o Blocking reality  Get arrested for drunk driving several times but you do not believe that you have an alcohol problem - Intellectualization o Over analysis of an event  A person who has been given a terminal medical diagnosis focuses on details of medical procedure instead of expressing their sadness Neo- Freudians -Jung - collective unconscious - part of the unconscious that is common to all human beings and consists of basic categories that all human beings use in conceptualizing about the world - archetypes (the shadow): the components in our collective unconscious - anima: female part in males - animus: male part in females - Adler - purpose of therapy was to gain social interest - the higher degree of your social interest the more healthy you are - strove for a superior culture Karen Horney - 1st cultural therapist rejected Oedipus complex and id, ego, superego - Triad of ways people react to the world o Moving toward- too nice easy to be taken advantage of o Moving against- control everything never have tender relationships o Moving away- never get close to anyone so you never get hurt - Healthy person has all 3 Erikson - Developmental stages, first person to say you kept growing after childhood

George Kelly Constructs  Beliefs or models of how the world works o Fixed role therapy*  You design a description of a person that you hope to be and then go out and pretend to be that person Albert Ellis o Rational emotive therapy  People’s emotional reactions are caused by internal sentences that people repeat to themselves  Therapy: talk people out of irrational beliefs, unhappiness causes these irrational beliefs Humanistic Perspective - Optimistic, future oriented view - Abraham Maslow o Hierarchy of needs - Carl Rodgers o The actualizing tendency (master motive that causes person to grow) o The need for positive regard (we all have a need to feel valued) o The incongruent person  The person isn’t totally whole, they aren’t perfect and you have to work with that -

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Effects of stress o Immune system and cardiovascular damage o Models for understanding stress  HPA Axis  Hypothalamus releases CRH/CRF which stimulates pituitary to make ACTH  ACTH tells adrenal cortex to release steroids which suppress the immune system  Sympathetic nervous system causes adrenal cortex to release cortisol which elevates arousal levels Multiple chemical sensitivity o Chemical stressors *  Pesticide exposure  Causes Parkinson’s, can cause cancer, decrease in intellectual abilities o Can affect individuals before birth o Studies linked to autism o Lead exposure  Affects IQ, CNS damage, mental delays, leaning disabilities o Organic solvent exposure

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Anxiety disorder, neurological damage, sleep problems, disrupt auditory and visual attention Effects of chemical stressors - Decrease in age of puberty for females o Breast development by 10 o Later high risk behaviors  Unprotected sex o More likely to suffer psychopathologies (depression and anxiety) o Increase risk of breast cancer - Cognitive developmental issues o Autism o Behavior problems - Chemical sensitivities o Impacts all aspects of life o Some people develop intolerances to everyday chemicals  Asthma, reactive airways dysfunction Exposure - Timing is crucial o Prenatal exposure can be particularly dangerous - Mixtures of chemicals can be “potentiative” (the effect of every chemical combination is unknown) o Chemicals are only studied in isolation o 80,000 chemicals in use currently and counting, but we only have safety data for 7% o - Mania vs Hypomania o Mania is more intense while hypomania is not full blown mania - Alcohol and tobacco o Know how it affects people - Alcohol use disorder o Often associated with other drug use o Alcohol and nicotine are cross-tolerant o Alcohol does not have a consistent effect upon stress  Antabuse  Medication  Vomiting when alcohol is ingested  GABA  Implicated in alcohol tolerance - Tobacco use disorder o Single most prevalent cause of premature death o Smoking is more prevalent among white and Hispanic adolescence o Scheduled smoking reduces smoking intake  Set a time for smoke breaks and little by little reduce intake

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o E-cigarettes are viewed as safer because they do not contain the tar and carbon monoxide that cigarettes contain What is GAD o Generalized anxiety disorder (GAD)  Worries are similar to worries of most people just more excessive  Highly comorbid with other anxiety disorders Functions of thalamus, cerebellum, hypothalamus, amygdala o Thalamus: sensory integration and relay station for all sensory pathways o Cerebellum: balance, motor o Hypothalamus: link the nervous system to the endocrine system via pituitary gland o Amygdala: emotional and behavioral functions, triggers fight or flight response What does the research say on men viewing violent sexual videos against women Neuroticism definition o person experiences the world as distressing, threatening, and

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Slaves o Slavery - Samuel Cartwright - 2 forms of psychopathology o Drapetomania: slaves running away o Dyasthesia aethiopica  Slaves destroying property and talking back to masters- seen as mental illness - Old ways of promoting the use of slavery o Fabricated census data o Freedom causes mental illness o Black people were not mature enough to be free o Theories justifying segregation after the war were supported by main stream psychologists o Many thought brain disease caused urban riots -Cultural universality -fixed set of disorders existing across cultures that manifest similarity in spite of culture (anxiety and depression) - Culture relativism - symptoms and deviant behavior are culturally influenced and reflect the lifestyle and values of a culture (Taijin Kyofushi social anxiety in Japan) -

Questions on disability videos o Know the treatment used...