Study Guide - Final Exam Guide PDF

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Study Guide - Final Exam Guide...

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Etiology Class notes ● ● ●

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Etiology = the study of the development of diseases psych disorders are caused by all kinds of factors Levels of analysis ○ Social/environmental, behavioral, cognitive/emotional, traits, neural/hormonal, genetic Developmental period ○ Prenatal, birth, early childhood, middle childhood, adolescence, early adulthood, middle adulthood, late adulthood

Genetic level ● ADHD, schizophrenia, and bipolar disorder are highly heritable Neural/hormonal ● Presynaptic neuron receives a signal, its resting potential is -70mV ○ Positively charged ions are outside the neuron ● Some positively charged ions flow into the presynaptic neuron’s axon ○ When it reaches about -55mV, it fires ● Glial cells surround the myelin sheath ○ Structurally hold up neurons ● Neurotransmitters are released and are receipted by postsynaptic cell ○ Neurotransmitters are either excitatory or inhibitory Normal Distributions ● Intelligence, height, Trait Impulsivity ● Has a lot to do w/ dopamine ● Nucleus accumbens is a part of the reward pathway ○ ~50% of neurons in the nucleus accumbens are dopamine receptors ● PFC can help regulate impulsivity ○ When alcohol is consumed, the PFC can’t actively regulate other parts of the brain Basal Ganglia ● Associated w voluntary movement Trait Anxiety ● Works on almost a completely diff brain network than trait impulsivity ● Keeps ppl away from things, like gambling and risk-taking ● Affected mostly by GABA and serotonin ● Cortex ● Hypothalamus ○ Related to rxn to fear ○ First part of HPA axis ○ Sympathetic nervous system rxn, Ex) Hank Green scaring you in the video

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Amygdala ○ Ppl w anxiety have more reactive amygdala responses ○ Not only associated w fear and anger ○ Involved in emotion generation ○ Helps you figure out emotional salience, or what is environmentally important ○ Next to hippocampus Hippocampus ○ Consolidating short-term memories into long-term memories ○ Next to amygdala ■ Things that are most emotionally salient, we remember pretty well

Executive Functioning ● PFC ○ Involved w emotion regulation ● Deals w regulating impulsivity, planning, stopping yourself from doing something you know is bad, shifting attention ○ Switch cost, ex) doing homework and watching TV, every time you switch tasks ● Stroop task ○ Reading the color of font, not reading the word ○ More PFC activity to inhibit urge to just read the word Personality Traits ● Big 5 traits, OCEAN or CANOE ● Openness ● Conscientiousness ● Extraversion/Introversion ● Agreeableness ● Neuroticism ○ Affected a lot by negative emotion Classical Conditioning ● Stimuli + involuntary responses to the stimuli ● Ex) ppl conditioned to avoid new social interactions bc of bad experiences w/ past social awkwardness ● Ex) food poisoning ● Discrimination ○ Discriminating b/t different stimuli ○ Ex) is someone afraid of all dogs? Just Rottweilers? Just white dogs? ○ Ppl w anxiety disorders can be worse at discrimination b/t anxiety-inducing stimuli and non anxiety-inducing stimuli Operant Conditioning ● Voluntary behaviors and the consequences of them ● positive reinforcement

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○ Giving a cat a treat to make them sit on the floor more Negative reinforcement ○ Ex) taking away someone’s phone to make them get A’s Positive punishment ○ Spraying a cat to make them stop opening doors Negative punishment Reinforcement = making the behavior more likely to happen Punishment = making the behavior less likely to happen Negative = take something away Positive = add something

Operant and Classical Conditioning is Combined in Anxiety ● step 1) classical ○ Develops a specific phobia ● Step 2) operant ○ Once phobia is established, ppl feel anxious/bad when they see their phobia, so they get out of those situations, feel better, but reinforce themselves to keep fearing dogs ■ Prevents someone from counterconditioning Cognitive Model ● Actions —> Behaviors —> Cognitions ● They all influence each other ● Cognitions are probably always skewed Automatic Thoughts ● think about evidence for why that thought was true or untrue Alternative Thoughts ● think about evidence as well Psychopathology Disorders can be affected by ● Family ● Relationships ● Stressors ● SES Minority Stress Model ● General stressors ○ Would stress anybody out, most ppl experience from time to time ● Minority-specific stressors ○ Stressors from other ppl that are specific towards a minority ○ Ex) being gay and seeing a protestor with a homophobic sign ● Internalized stressors

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Over time, if minority-specific stressors and stereotypes (microaggressions) keep coming up, minorities can internalize and it may affect their skills and thoughts, further stressing them out Can affect social functioning, mental health Using unnecessary nrg

Identity is important!

Anxiety OCD & Anxiety Disorders ● We tend to minimize disorders, using them as nicknames for things ppl do, think, or say ● Psychological disorder ○ A deviant, distressful, and dysfunctional pattern of thoughts, feelings, or behaviors that interferes w the ability to function in a healthy way ● Anxiety disorders aren’t just caused by fear ○ Characterized by distressing, persistent anxiety, also by the dysfunctional behaviors that reduce that anxiety ● At least 20% of all ppl will experience a diagnosable anxiety disorder ● Obsessive-Compulsive Disorder (OCD) ○ Unwanted repetitive thoughts, which become obsessions ○ Sometimes accompanied by actions, which become compulsions ○ Often use compulsive, ritualistic behaviors to relieve intense/unbearable anxiety ○ Can be treated w psychotherapy and/or drugs ● Generalized Anxiety Disorder (GAD) ○ Continually tense + apprehensive, experiencing unfocused, negative, and out-ofcontrol feelings ○ Cause of anxiety is often unknown to patients ● Panic Disorder ○ Panic attacks ■ Sudden episodes of intense dread or sudden fear that come w/out warning. Can make you feel like you’re dying ■ Can have genetic predisposition or get them from a trigger ■ Common trigger is simply the fear of having another panic attack ● Phobia ○ Fear of anxiety ○ Persistent, irrational fear of specific objects, activities, or situations ○ Leads to avoidance ○ Gephyrophobia - fear of bridges ○ Social phobia/social anxiety disorder ■ Anxiety related to interacting or being seen by others Learning & Biology ● Learning - things like conditioning, cognition, and observational learning best explain the source of our anxiety ○ Stimulus generalization ■ Anxiety expands to other similar objects or situations ■ Anxiety is solidified thru reinforcement ● Every time you avoid an unwanted thing, you feel better ○ Cognition ■ Determines how we interpret stimuli - as either scary or normal ○ Observational learning ■ Acquired anxiety

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Biological perspectives ○ Natural selection ■ More fearful of snakes, + heights ○ Genetics + brain chemistry ■ Twins are more likely to develop the same phobias even if they’re raised apart ■ Ppl who are more prominent in anxiety symptoms show overarousal in brain areas dealing w impulse control + habitual behaviors ○ Everything psychological is biological

New Mother w OCD ● She is afraid that someone will kidnap her new baby ● She looks at him at stoplights and stop signs ● She sets ‘traps’ in her house to see if anyone came in ● “It’s so pathetic” :( Hoarding Disorder ● Hoarders usually don’t recognize or admit that they’re hoarders ● Ppl w OCD might also be hoarders bc they have fears about letting go of certain items ○ “What if I don’t keep this but my son needs it and if I don’t have it he’ll die?” Exposure (and Response Prevention) Therapy - (EXRP) ● “What’s the intention of the practice?” ○ “To say ‘I can handle this’” ● Moving up in increments to more and more difficult phobia-related things Bad Dog Exposure - Tough Guy Afraid of a Puppy ● Not enough steps taken to reach the most frightening thing ● The man w a phobia is in more control than the ‘authority’ (not a therapist?) ● This is obviously too much for him at once ● The woman is forcing him to engage in an anxiety-inducing behavior Good Dog Exposure ● Validating patient’s feelings, being accepting ● Patient makes small steps to overcome her fear Exposure Therapy for Panic Disorder and Agoraphobia ● Patient drinks a bottle of caffeinated water to heighten her anxiety?? ● Why would the therapist encourage her to have a panic attack? ○ Wouldn’t that make the patient associate more fear w closed/small spaces? ● Then goes unsupervised? ● Only good thing is that she kept doing it to get used to it Social Anxiety/Panic Symptom Simulation ● “It’s worse than death, bc death only happens once”

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Man leaves store after a short while, reinforcing his behavior

Modifying Automatic Thoughts ● “What do you think is the likelihood of these fears happening?” ●

Letting patient have concrete example of fear → evidence for/against → change of thought

PTSD - Trauma and Addiction ● JRR Tolkien fought in a war, had PTSD, writing helped him work through it ● Sometimes traumas can lead to addictions ● Post-traumatic growth ● Patients might not return to how they were before the trauma, but they can still be healthy + happy ● Can manifest as: nightmares, flashbacks, avoidance, fear, guilt, anxiety, rage, insomnia ○ Used to be called ‘shellshock’ PTSD ● A psych disorder generated by either witnessing or experiencing a traumatic event ○ Symptoms ■ Reliving the event through intrusive memories, nightmares, flashbacks ■ Avoiding situations like the event ■ Excessive arousal ■ Pervasive neg(-) changes in emotions ■ Can also experience numbing - periods of feeling emotionless and dissociation ● Similar to other anxiety disorders ○ Cortisol gets released when thinking/experiencing triggering event ● Sufferers can end up self-medicating, leading to addiction Addiction/Substance Abuse ● Compulsive, excessive, and difficult-to-control substance use or other, initially pleasurable behavior that begins to interfere w ordinary life, work, health, or relationships ● More than 2/10 vets w PTSD also struggle w addiction ● Physical dependence ○ A physiological need for a drug that reveals itself through unpleasant withdrawal symptoms if the use stops or reduces ● Psychological Dependence ○ A psychological need to use a drug, or complete an activity to relieve neg(-) emotions ● Fear conditioning - memory of being in danger and the learned responses associated w that memory ● Moral injury - violence done to a person, also what a person did or did not do to others ● Addiction relates to how ppl deal w stress and/or difficult emotions ● Dual Diagnoses Model of treatment

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Treating both the “hardware” (physical disease - biology/genetics) and the “software” (mental illness) Why do some ppl develop PTSD but others don’t? ● Genetic predisposition ○ Smaller hippocampi related to developing PTSD ■ Are they born that way? ■ Neuroimaging suggests that traumas might damage + shrink the hippocampus ● Nurture Positives ● Post-traumatic growth ○ The pos(+) psych changes resulting from the struggle w challenging circumstances and life crises PTSD Student Film ● Vivid flashbacks ● Nightmares, night sweats ● Smokes cigs ● Thinking of army friends ● Daily routine is like gearing up ● Hallucinations ● Anger/aggression ● Vets need support ● It can be silent, go unnoticed Prolonged Exposure for PTSD ● “I can’t” rules ○ I can’t leave the house at night ○ I can’t be in a large crowd ● Prolonged exposure ○ Can help you do safe things you’ve been avoiding ○ Challenge your “I can’t” rules ○ Talking through PTSD w your therapist ○ Helps keep your traumatic exposure from affecting your life ○ Can last for about 3 months, afterwards PTSD can go away ● No matter how long you’ve had PTSD, you can get better Cognitive Processing Theory (CPT) ● Stuck points ○ Keep you stuck in your PTSD ○ “I’m to blame” ○ “I don’t deserve to be happy” ●

Cognitions → feelings → behaviors

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CPT

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Helps you challenge those stuck points Consider ‘what ifs’ ■ Small changes in thinking can really impact how you feel Can write about your trauma Group therapy Usually takes ~3 months of weekly visits

What Is Depression? ● Leading cause of disability in the world ○ 10% of US adults ● Difference b/t having depression and feeling depressed ● Lasts for at least 2 weeks, interferes ability to work/love ● Symptoms ○ Low mood, loss of interest, changes in appetite, feeling worthless or guilty, sleeping too much or too little, lack of concentration, restlessness or slowness, loss of nrg, thoughts of suicide ○ Have to have at least 5 for depression diagnosis ○ Smaller frontal lobes and hippocampi ○ Low serotonin, norepinephrine, and dopamine \ ○ Altered circadian rhythms ○ High cortisol, deregulation of thyroid hormones ● Takes the average person struggling w mental illness over 10 years to ask for help ● Treatments ○ Therapy ○ Medication ○ Electroconvulsive therapy ○ Transcranial magnetic stimulation ● Asking someone about suicidal thoughts can actually lower their risk of committing suicide RUOK Australian Ad ● Are signs of depression always that obvious? ● Realistic depiction of trying hard to smile in social settings but going to cry in bathroom later ● Important to ask ppl how they are! More than once! 7 Ways to Maximize Misery ● 1. Remain indoors/inactive ○ Guides you towards medical problems which can keep you more inactive ○ Most effective ● 2. Alter sleep patterns ○ Takes at least 3 days to establish a stable sleep pattern ● 3. Maximize screen time ○ Screen time keeps you entertained so as not to exercise, and up at night to prolong sleep ● 4. Use screen time to fuel negative emotions ○ Focus on the bad ○ ex) participate in social change facebook pages and be disappointed by lack of change ● 5. Set your brain on vague goals ○ Vapid

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■ Vague, Amorphous, Pie in the Sky, Irrelevant, Delayed ○ Wait for motivation rather than setting a time 6. Pursue happiness directly ○ Happiness becomes an unreachable feeling 7. Follow your instincts ○ You’ll want to stay indoors, want to sleep in, not want to exercise

Other Risk Factors for Depression ● Smaller hippocampus, depression + cortisol damages this area ● Drugs that contain serotonin can help stimulate neurogenesis ● A variation in the serotonin transporter gene leads ppl more vulnerable to depression ○ Gene can either be short or long ○ Short genes make ppl more vulnerable to depression ● Depression and bipolar disorder are highly heritable Learned Helplessness ● Despite having the power to change a situation, one has learned that it’s useless to try Behavioral Activation ● Not exercising can make you feel sad/disappointed ● If you schedule and engage in activities you once enjoyed, you can start to feel better and really enjoy them again ○ Don’t wanna be too ambitious in the beginning ● Therapists ask specific questions so client can visualize their success ● Think of adaptive response “this is tough, but it will help me” The Suicide Detective ● Developing a risk calculator for suicide behavior ● Using medical history, response to suicidal stimuli, and a questionnaire to formulate risk

Treatment Getting Help - Psychotherapies ● Psychotherapy - involves a therapist using a range of techniques to help a patient overcome troubles, gain insight, and achieve personal growth ● Many ways to treat conditions, some are tailored for certain conditions ● Grouped into 4 major schools/orientations ○ Psychodynamic/psychoanalysis ■ ex) Freud ‘laying-on-the-couch’ technique ■ Repressed feelings, memories and unconscious thoughts, free association and dream analysis, interpretations, self-insight ■ Hard to prove helpful, involves many sessions ■ Psychoanalysis is Freud’s thing, psychodynamic therapy stemmed from that ■ Psychodynamic theory ● Unconscious internal forces, early relationships, critical childhood experiences ● Strays away from id, ego, superego, and sexual themes ○ Existential-humanistic ■ Emphasized ppl’s inherent capacity for making rational choices, achieving self-acceptance, and attaining their maximum potential ■ Insight-oriented ■ Promoting growth > curing ailments ■ ppl/clients > patients ■ Client-centered therapy ● Therapists provide an empathetic, genuine, accepting environment, using active listening ● A safe, nonjudgmental place ● Promotes self-acceptance, value, and self-actualization ■ Existentialist perspective ● Anxiety + personal limits are driven by the human tendency to deny the fact that we will all die ● Overcome existential fears by maximizing potential + meaning in life, accessing “genuine self” ○ Behavioral ■ Suggests that the problem behavior is the issue ■ Get rid of unwanted behavior with learning functional behavior ■ Aims to change behavior in order to change emotions/moods ■ Pavlov dog experiment ■ BF Skinner operant conditioning ■ Might use counterconditioning ● A behavior therapy procedure that uses classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors

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Exposure ● Treat anxiety by having a person face their fears by exposing them to real or imagined situations that they typically avoid ■ Systematic desensitization ● A type of exposure therapy that associates a relaxed state of mind w gradually increasing anxiety-inducing stimuli ■ Aversive conditioning ● Pairing an unpleasant stimulus w the targeted behavior ■ Works well for GAD, major depression, and specific phobias ○ Cognitive ■ Focuses on thoughts rather than behaviors ■ Pioneered by Aaron Beck ■ Changing what we say to ourselves is a very effective way to cope w our anxieties and modify our behavior ■ Cognitive + behavioral schools have combines Group therapy ○ Therapy conducted w groups, permitting therapeutic benefits from group interaction Family therapy ○ Treats the family as a system. Views an individual’s unwanted behaviors as influenced by, or directed at, other family members

Biomedical Treatments ● Examples) Medications, magnetic stimulation, neural implants, electroshock therapy ● Therapists assess how clients are by asking them, and rating their perceptions of the client, along w outcome research ● Treatment outcome research ○ A way of systematically measuring which therapies work best for which problems ○ Best = randomized clinical trial (RCT) ■ Randomly selected + assigned participants, a control group, and 1 or more experimental groups ○ Effectiveness ■ Whether or not a given therapy works in a “real world setting” ○ Efficacy ■ Whether a therapy works better than some other, comparable intervention, or a control ○ Psychotherapy is both effective and efficacious ● Major depressive disorder ○ Best = Cognitive, behavioral, and psychodynamic interventions ● Best therapies ○ Instill hope, getting a new perspective, genuine empathy, trusting, caring relationship, clear + positive communication ● Biomedical therapies

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Aim to physiologically change the brain’s electrochemical state w psychotropic drugs, magnetic impulses, or even electrical currents and surgery Pharmacotherapy ■ Most common ■ Take drugs ■ 4 major categories ● Antipsychotics ○ Treat schizo, + other severe thought disorders ○ Aripiprazole (Abilify), clozapine (Clozaril), olanzapine (Zyprexa), risperidone (Risperdal), perphenazine (Trilafon), haloperidol (Haldol) ○ ●

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Alter dopamine receptor sites + uptake, → bad side effects

Anxiolytics ○ Depress activity in the central nervous system ○ Alprazolam (Xanax), chlordiazepoxide (Librium), diazepam (Valium), hydroxyzine (Atarax), buspirone (Buspar) ○ Not good to mix w alcohol ○ Addictive ● Antidepressants ○ Treat depression along w some anxiety disorders ○ Citalopram (Celexa), fluoxetine (Prozac), duloxetine (Cymbalta), clomipramine (Anafranil), ○ Effects ability of serotonin + norepinephrine ■ SSRIs = Selective serotonin reuptake inhibitors (Zoloft, Paxil, Prozac) ○ Most effective w psychotherapy ● Mood stabi...