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model

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A set of assumptions or concepts that help scientists explain and interpret observations

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Biological model

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based on: Brain Anatomy Brain Chemistry (NTs) Genetics Evolution Viral Infections

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Psychodynamic model

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Known as the "First Force"

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Freud

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Creator of Psychodynamic model

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Freud's main ideas

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-Actions, emotions, behaviors are determined by UNCONSCIOUS drives and underlying conflict -THREE PARTS OF THE MIND -DEFENSE MECHANISMS -DEVELOPMENTAL STAGES

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Examples of psychodynamic treatments

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Free association Therapist Interpretation (resistance, transference, Countertransference, dreamwork) Catharsis Working through

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Behavioral model

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Known as the "second force"

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Major concept for behavioral model

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Actions, emotions, behaviors are determined by are life experiences and learning

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Classical conditioning

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UCS --> UCR UCS + NS --> UCR NS becomes the Conditioned stimulus CS --> CR

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Pavlov and Watson

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Two people behind classical conditioning (under the BEHAVIORAL Model)

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Discrimination and generalization

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two concepts Watson observed/defined

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Operant conditioning

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B.F. Skinner

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Skinner's philosophy (w/ operant conditioning)

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Basic idea that If you want a behavior to increase, you reward it. If you want a behavior to decrease, you do not reward it.

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Skinner's focus

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Focus on the environment; no biology taken into account

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Bandura

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Modeling

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4 types of exposure

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gradual vs. flooding in vivo vs. imaginal

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systematic desensitization

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the accepted best treatment for phobias

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counter-conditioning

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the relaxation response method of treatment; putting something else in the place of the phobia that came from classical conditioning (diaphragmatic breathing example)

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exposure and response prevention

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the accepted best treatment for OCD

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contingency and reward

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individualized plan to reinforce behavior that you want and do not reward behaviors you don't want

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Humanist Model

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known as the third force

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Theory behind the humanist model

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Person is as essentially GOOD or at least neutral. Abnormal emotions, behaviors, actions occur when self-actualization is prevented

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Carl Rogers

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He believed that people were pretty good or at least neutral

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unconditional positive regard

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Your idea about a person is not changed; not judging

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Prizing

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placing value judgment on certain things over others (ex: preference for certain traits/qualities as a parent in kids over others)

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Client centered therapy

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HUMANIST MODEL therapy to get the client to focus on what may be morally wrong with them

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Positive psychology

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Under the HUMANIST MODEL; to get the client to talk about the good things about themselves instead of focusing solely on their disease

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Empty chair technique

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under the HUMANIST MODEL; patient expresses feelings to an empty chair

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Two chair technique

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under the HUMANIST MODEL; patient gets up and responds back to themselves in opposite chair

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Cognitive model

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-Actions, emotions, behaviors are based on our thoughts, cognitions, and INTERPRETATIONS of events -Based on how we interpret things; what we expect to happen next; it is not the event but how we feel and think about it

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Ellis and Beck

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Two people assoc. with the cognitive model

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Ellis' therapy

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Rational emotive therpay

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Ellis

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He said that there are very few things in life that should, must, always happen

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Beck's therapy

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Cognitive therapy

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Beck's claim

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He said we are all subject to automatic dysfunctional thoughts that are not nice

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Sociocultural model

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-Actions, emotions, behaviors are based on BROAD FORCES influencing an individual in their family, society, culture

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Family systems approach

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Under the SOCIOCULTURAL MODEL; the client is the family; the person with the diagnosis is not the person who is ill; the family is considered ill This is the only therapy that is really effective for anorexia (and some other eating disorders)

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Group therapy

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Under the SOCIOCULTURAL MODEL; based on principle of making social connections/ support from other people who are going through something similar

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Couples therapy

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the relationship is the client not the person

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Community therapy

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public health changes (take a long time to happen)

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Multicultural approach

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The acknowledgement that symptoms look different in various cultural groups; we often misdiagnose people because we misunderstand based on what the person is saying Ex: nerviosas - attack of the nerves (really talking about anxiety)

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Integrative approach / Contemporary view

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IMPORTANCE OF MULTIPLE SOURCES Strong evidence for dynamic reciprocal influence between biological, psychological, and social influences

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Couples therapy

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the relationship is the client not the person

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DSM

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Diagnostic and Statistical Manual of Mental Disorders

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assessment

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Clinical assessment is the gathering of relevant information used to determine if, how and why a person is behaving abnormally and how that person may be treated

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Validity

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"How well the test is measuring what we say it is measuring / what its supposed to"

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Reliability

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how consistent the results are

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clinical utility

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the information you think you can get from that assessment tool should be worth it.

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pragmatics

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all the non-verbal stuff; eye contact; interaction/expressiveness; tone of language; how you sit/positioning

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structured or unstructured

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two types of interviews (general)

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intake interview

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interview where you are determining if the practitioner is good for the patient and vice versa

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diagnostic interview

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interview where you want to come to a formal diagnosis for a reason (such as when doing research

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crisis interview

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interview where you have to determine if the patient is at imminent risk to themselves? Do they need to be hospitalized? Hx of impulsivity?

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Mental status exam (interview)

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interview/exam where patient's status (alert, oriented) is determined and determining whether their affect is the same as what they are reporting

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problems/benefits of structured vs. unstructured interview

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Problems with unstructured: might miss something important Problem with structured: limits what the pt. may be able to express (like the reason they came) Structured is good: directs the pt. to help with how they are feeling; if they're not sure

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Projective tests

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Give the person a neutral/ambiguous stimuli and the person's expressions/feelings about it, can determine what's going on in their life

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three types of projective tests

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Rorschach Inkblot Test Thematic Apperception Test -CAT, SAT Rotter Sentence Completion

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objective tests

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MMPI (Minnesota Multiphasic Inventory) NEO-FFI (Big Five Factor Inventory) CPI (California Personality Inventory

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MMPI

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Series of statements that are True or false of you. (500 items) Highly reliable, valid, and standardized. 3 validity scales K scale - you KNOW too much F scale - you are trying to look sick L scale - you are pretending to look good

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BDI (beck Depression Inventory)

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a response inventory Wont "diagnosis" depression but it could give you a place to start

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Hamilton Scale of Depression

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a response inventory 10 question screening for depression

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Connor Behavior Checklist

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a response inventory Child for ADHD Can not be used alone to diagnosis ADHD

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psychophysiological test

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Heart Rate BP Galvanized Skin Response Muscle contraction Temperature

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Cognitive test

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Achievement Tests = ACHIEVEMENT questions that you should know due to what your development is in life - Woodcock Johnson Intelligence tests = ABILITY ; only way to test for ADHD; one or two tests don't match the others -WISC, WAIS Neurological and Neuropsychological tests = FUNCTION - MRI, fMRI, EEG, PET, CT

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Behavioral Observations

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-usually best for kids either naturalistic or structured: -naturalistic - child is in their normal environment acting how they would, not asking them to do anything -structured - (ex: Bobo doll situation)

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Three main methods of investigation

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Case Study Correlational Study Experimental Method

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Case study

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-Getting a lot of information about a specific case (one person); and use the assessment tools we talked about in order to assess -the main reason: when you are studying something rare, you might bring light to it and others who may also have this disorder/problem/disease -another reason: there is an opportunity to do a perfect study that cannot be done; the "forbidden" study -the main drawback: case studies are bad because they cannot be generalized to a population; is a specific case; (might only apply to a narrow scope of individuals)

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Correlational studies

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Describe but DO NOT EXPLAIN relationships External validity (generalizability): Correlational studies have mixed generalizability depending on who is tested... Epidemiological studies: Attempting to get an answer for the whole large population (such as those from CDC); getting thousands and thousands of people that are representative of the entire population -ex: schizophrenia occurs in less than 1% Longitudinal studies: following the same GROUP OF PEOPLE over a LONG PERIOD OF TIME; this is how we know things changing over time -we can say something about the cause (following from the child to adult)... not if it is retrospective study - problems: money, time, and energy in tracking people -for academia: you have to produce results, not the case with longitudinal studies -*******cohort effect: influences like peers, surroundings, place in time

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+ / - correlation

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-1.0 = a perfect negative correlation + 1.0 = a perfect positive correlation

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experimental method

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results can only be applied to the same "group/condition" of people who were tested ex: dependent variable: (what you are measuring) independent variable: type of treatment confounding variable: inherent differences between subjects control group blind design: people who are being tested do not know double blind design: people being tested and people testing them don't know random assignment* between control and tested group*

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quasi experimental design

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alternative design when you cannot use random assignment -MATCHED CONTROLS and NO RANDOM ASSIGNMENT ...sometimes, you cannot FORCE a certain environment on someone (incarceration, mental hosp.) ... instead!!! We take ALREADY people who are in these environments and then MATCH them to others (the matched controls)

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Natural experiments

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alternative design when you step into a disaster (katrina, 9/11) and use the situation to study the effects now...

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Analogue experiments

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alternative design when you see what the effects are on other animals/species

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Single subject design - ABAB

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a research design that focuses on one person in order to come up with the right treatment for someone First, identify the behavior that is concerning you that you want to increase or decrease Monitor in first A phase. First B phase: implement the treatment and monitor and see what happens to the behavior....cannot conclude that the treatment is what is working. Second A phase: take away the treatment, and monitor. If the behavior comes back to the original state, then you know that the treatment is working. Second B phase: re-implement again to prove the result.

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Anxiety

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a very human emotion, it is worry about something that is going to happen in the future. We are thinking about it. We tense our muscles. Frontal part of the brain!!!!

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Fear

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a PRESENT emotion; This is our alarm reaction to something that we perceive is dangerous. It is the physiological response in the present, is necessary for survival. Sudden release of cortisol, adrenaline.. As a result, it completely differs from anxiety (where we are thinking about it)... Brainstem part of the brain!!!!!

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panic

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an emotion that is an overreaction/abrupt intense amount of fear, not rational, but still fairly normal.. -a "fear" response occurs, so the body pumps out adrenaline but there is nothing for it to do 1. situationally bound: they only happen in a particular circumstance with a particular cue. (ex: only when see a dog) 2. Unexpected or uncued: they can happen anytime for no reason, or an unknown reason. 3. Situationally predisposed: most likely to lead to a disorder, the most difficult to treat. Now you begin to worry you are going to encounter one; now it is more than one place. Multiple different environments where you are likely to have one (i.e. some place that is crowded, at night time). This can lead to agoraphobia - fear of leaving a certain, limited area. (home, neighborhood, town, etc... different levels)

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biological causes of anxiety

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1. Genetics: Polygenetic Inherit a tendency Same groups of genes linked to depression 2. NTs Too little serotonin, too much GABA 3. Limbic system Decides what gets transferred from one to the other (b/t primitive brain stem and the frontal cortex) Things in environment that may increase/decrease Children who smoked young while their limbic sys or cerebral cortex was still developing ... introduction of nicotine makes them more prone as adults to anxiety disorders Childhood trauma - may not develop any anxiety disorder or PTSD but it might put you more at risk later on in life Starvation/malnutrition - for young children (esp. first 2 years of life) who experience starvation/malnutrition, are much more likely to develop anxiety disorders as adults; if small things happen, they overreact More factors are sensitizing these factors more

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Psychological causes of anxiety

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Helicopter parents: teaching the child they can't "handle it", that getting a minor injury is the end of the world, lack of dependence Parents who don't give their kids room teach them that 1. Perception of control (including helicopter parents) also comes from media - the % of people who are abusing others, and the % of pedophiles, hasn't changed.... Now we just see it.... Chances of something happening are small, and we're going to go through with doing this anyway 2. Classical conditioning - ways that phobias can develop (ex: little albert) HR and BP goes up: excitement (butterflies in the stomach), exercising, sex An internal trigger - misinterpreting the physiology of increased HR and BP -- Anteroceptive panic - misinterpreting the cues for panic... like having panic during sex or HIIT 3. Operant conditioning 4.Modeling - the things that we are phobic of can be those of our parents; We model our parents fears, how we cope, whether they avoid things Going to be difficult to know whether it is biological trait or if it is modeling

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social causes of anxiety

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Stressful events can trigger biological and psychological vulnerabilities Social or interpersonal events Physical events Ex: having a severe illness as a child can lead to having anxiety about getting a disease when older (hyper vigilant of body symptoms)

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Integrated model for cause of anxiety = triple vulnerability theory

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includes biological, psychological, and social

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comorbidity assoc with anxiety

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50% of all people with anxiety disorders have another disorder = comorbidity 50% of the time, that disorder is a form of depression Substance abuse is also highly comorbid

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Generalized anxiety disorder

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CLINICAL DESCRIPTION: Excessive worry and apprehensive expectation CRITERIA: More than half the time, for at least 6 months Difficulty concentrating, difficulty controlling worry Main physical symptom = Muscle tension Worry about minor and major life events ONSET = early , insidious (gradually developed over time) COURSE = Chronic, waxing and waning of symptoms

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treatment of Generalized anxiety disorder

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MEDICAL BENZODIAZEPINE - effective but only in short term Motor and cognitive impairment ... Short half life, once they are out of the system, you may be worse off DEPENDENCE Withdrawal = depressive symptoms SSRIs (Zoloft, Prozac) PSYCHOLOGICAL Focus on worry process CBT ACCEPTANCE and COMMITMENT THERAPY - focus on acceptance rather than avoidance of distressing feelings...acknowledging that we are worried for say 10 minutes then put focus on something else...instead of totally just repressing it

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Panic disorder

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Must experience an unexpected (uncued) panic attack AND develop anxiety about future attacks May occur with or without AGORAPHOBIA May develop INTEROCEPTIVE AVOIDANCE - avoidance of situations or activities that produce internal sensations of anxiety or sensations reminiscent of a panic attack Some experience NOCTURNAL PANIC

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treatment of panic disorder

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This is the one disorder that treatment with medication is not very good, and should not be combined with psychotherapy Imipramine (antidepressant) acts on GABA and Serotonin SSRIs (Lexapro) Relapse rate high (90%) PSYCHOLOGICAL CBT 70% improve, few fully cured Low relapse rate COMBINING MEDS and PSYCH TX POORER outcomes CBT alone*** more effective than meds alone CBT alone*** is more effective than the combination

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specific phobias

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Persistent irrational fear of a specific object or situation that interferes with one's ability to function Situationally bound (cued) panic Concept of BIOLOGICAL PREPAREDNESS - Primed to be afraid of certain things as humans

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4 main categories of specific phobias

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1. BLOOD INJECTION / INJURY - vasovagal response - sensitized to pass out in situations that other people wouldn't ... runs in families 2. SITUATIONAL Eg. Public transportation, enclosed spaces Mean age of onset = early 20s 3. NATURAL-ENVIRONMENTAL Heights, storms, lightening, water, dark Mean age of onset = 7 4. ANIMAL Animals and insects Mean age of onset = 7

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Treatment of specific phobias

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systematic desensitization Exposure (gradual, either imagined or in vivo) + relaxation training

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phobias unique to children

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separation anxiety school phobia -If it's school phobia, the parents can leave at other times and its not a problem for the child.

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social phobia/social anxiety

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Extreme anxiety in social and performance related situations Public speaking is most common Can extend to any social event treatment for social phobia/anxiety: Systematic Desensitization combined with CBT

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obsessive compulsive and related disorders

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The thing a person is feeling anxious about is internal. There are these obsessions and thoughts that the person is having is what is making the person afraid. All of these disorders involve a person having an obsessive thought and the thought is what is causing them distress. Then, engage in a compulsive behavior to relieve it. Danger is INTERNAL not external Female in adults, male in children Age of onset in males = childhood and adolescence Age of onset in females = young adulthood Chronic and stable across cultures Obsessive Compulsive Disorder Body Dysmorphic Disorder Trichotillomania (Hair Pulling Disorder) Excoriation (Skin-Picking) Hoarding Disorder

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obsessive compulsive disorder

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OBSESSIONS - Intrusive, nonsensical thoughts, images, urges Individual tries to resist or eliminate them TYPICAL OBSESSIONS: contamination, aggression, sexual content, need for symmetry (keep things in order) 60% have multiple obsessions Aggression and sexual content obsesssions: incredibly rare that the person actually gives in to them; it is the thoughts that bother them, make these people uncomfortable. Praying: is more of a superstitious thing not an actual religious thing. Have to say something over and over, doesn't have a meditative component. All adults will typically acknowledge and know that her obsessions are irrational or odd, but this doesn't make them go away. COMPULSIONS Thoughts or actions designed to suppress the thoughts and provide some relief May be behavioral (hand washing, checking) or mental (counting, praying) TYPICAL compulsions = checking, order, arranging; washing and cleaning, hoarding

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causes of obsessive compulsive disorder

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Possibly stronger genetic component - OCD runs in families. Early childhood experiences with "dangerous" thoughts Kids who are raised in more fundamental religious families (regardless of religion) are more likely to have OCD. If you are raised to believe that having a THOUGHT is a sin, then that child believes having a THOUGHT is dangerous, which may cause anxiety for them.

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treatment of OCD

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Clomipramine, and SSRIs benefit up to 60%, common relapse MOST EFFECTIVE is EXPOSURE and RESPONSE PREVENTION - Exposure and response prevention....can be very painful to do... prevents the person to use their compulsions. FUTURE DIRECTIONS D-cycloserine (DCS), an antibiotic

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body dysmorphic disorder

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Imagined Ugliness Preoccupation with IMAGINED defect PLASTIC SURGERY AND MEDICAL TREATMENTS 18-25% seek plastic surgery MAKES IT WORSE following surgery -The person believes its worse than before...person gets more depression...will go somewhere else until they run out of options...when plastic surgeon has exhausted their license, the person must go to unlicensed, unethical surgeons (esp. in other countries) Comorbid with depression, SA, Suicide, and OCD CULTURAL CONCERNS -Cultural concerns: we need to understand as clinicians to understand what is considered beautiful/normal in that nation... same thing with piercings and tattoos when people get carried away from them; when you are doing it when you think your SKIN is ugly and youre doing it because of that then it is body dysmorphia disorder TWO TREATMENTS WITH ANY EFFECTIVENESS SSRIs CBT with exposure and response prevention

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Trichotillomania and excoriation

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Urge to pull one's own hair or pick at skin More common than once believed (1-5% of college students) Age of onset: typically 13 Genetic influence, but stress also involved Overlap with PTSD More women than men SSRIs and CBT show some promise as treatments Issue is a buildup of stress and anxiety, and the compulsion is pulling a hair or picking at the skin. The compulsion is mindless so it can be habitual even if the anxiety goes away.

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Hoarding disorder

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NEW to DSM 5 Previously recognized but as symptoms of other disorders Compulsion in OCD Complicated Grief Psychotic behavior If this disorder is in addition to one of the other broader disorders (grief, compulsion in OCD, etc.) then that is what it is considered and should be treated as such. Diagnosed when Hoarding behavior is not better accounted for by another disorder (i.e. Only diagnosed with hoarding disorder if it doesn't coincide with the other ones)

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trauma and stress related disorders

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acute stress disorder and post traumatic stress disorder Formerly classified with the anxiety disorders

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trauma and stress related disorder events

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A traumatic event: experiencing or witnessing an actual or threatened serious injury or danger to self or another That event would be traumatic to anyone Following the event 1. Rexperiencing a. a flashback - you are awake and something triggers a memory and you are seeing and living it again b. recurrent nightmares c. children may have repetitive play (ex: reenact a car accident and paying with cars and causing them to crash) 2. Avoidance - avoiding a place 3. Reduced responsiveness/ emotional numbing 4. Increased arousal, anxiety or guilt - Experiencing more irratibility, anxiety, guilt and reduced feelings of normal emotions like: joy, excitement or normative sadness always tense, always alert - Guilt: an overexperience of guilt that they survived and someone else didn't, that they didn't do enough, civilians killed, a friend was killed, etc.

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acute stress disorder time frame

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Symptoms occur within one month of event, and resolve by end of month

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post traumatic stress disorder time frame

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Symptoms still occurring one month after the event If within the first 3 months, often referred to as ACUTE PTSD If after 3 months, often referred to as CHRONIC PTSD *** DELAYED EXPRESSION Sometimes there are no or few symptoms IMMEDIATELY following event Symptoms emerge 6+ months later Delayed Expression: Also added in the most recent DSM Not common but we do see it happen Someone following a trauma has no symptoms of PTSD 6 months or more pass (in some people, this timeframe could be decades)... now it is called PTSD delayed expression .... A full month has passed (a full month of a traumatic event and the feelings are getting worse or staying the same) Before 3 months is the best time to treat...acute PTSD.... But most people are not able to seek out care this quickly... these individuals are made out to be indestructable, smart, strong, emotionally strong, so TO ADMIT something is wrong very difficult for them.... Will turn to suicide too... Also, if these individuals are diagnosed with a disorder, then this threatens their job and ability to go back

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trauma and stress related disorders statistics

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7% over lifetime Combat and sexual assault most common traumas 20% of New Yorkers living close to WTC after 9/11 33% victims of sexual/physical assault 50% of those exposed to terrorism or torture Vietnam About 20% of returning combat veterans 29% estimated if using current definitions and diagnoses 10% still have PTSD today Current wars in Iraq and Afghanistan expected to have much higher rates** multiple tours .... People have different resilience -now, we have some of the best trained equipment and medics who are able to save more lives; so more combat soldiers are surviving horrific traumas

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causes of trauma and stress related disorder

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-Close exposure to the trauma, intensity of the trauma, more severe trauma -Biological Vulnerabilities (same ones as other anxiety disorders) -Genetic predisoposition -Trauma may alter brain structures and function -Damage to hippocampus and amygdala Psychological Vulnerabilities: Negative worldview Sense of uncontrollability (such as with helicopter parents) Comorbid disorders like depression or anxiety Social Vulnerabilities: Impoverished childhood (malnutrition affects the am Adverse childhood events before the age of 10 Divorce/separation of parents before age 10 Experiencing earlier traumas: -Over time with more trauma, the BIS (?) becomes more sensitized....goes right to the amygdala (past the Cerebral cortex) and the reaction happens right away to a trigger with a person with PTSD (such as a car backfiring, immediate response...cannot think or process it first)

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treatment and outcomes of treatment for trauma and stress related disorders

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TREATMENT: CBT Gradual re-exposure within a supportive context With a SIMPLE trauma, CBT is actually a decent treatment. Develop effective coping skills Corrective emotional experience Early STRUCTURED interventions following trauma SSRIs helpful to tx symptoms of anxiety, panic, depression Supportive Group Therapy OUTCOMES ***Effective for 50%**** within 6 months Many will have improvement of symptoms but lingering effects For some, PTSD lingers for years with no effective tx -- The main reason we are not as effective at treating this disorder is because the focus of the trauma is HORRIFYING. So none of the methods we have will work as well. Other disorders that involve anxiety and fear, the thing that the person is focused on is NOT RATIONAL. (phobia, or cause of anxiety is not that bad)

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SSRIs and CBT with exposure and response prevention

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treatment for body dysmorphic disorder

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1950s

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date of first DSM

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Pavlov

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person who did the classical conditioning experiment with dogs salivating to bell

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Watson

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person who did the experiment with little albert ... afraid of white animals (generalized)

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panic disorder

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don't combine psychological treatment with medication for this disorder

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cohort effect

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a bad component of longitudinal studies because of influence from surroundings, peers, etc.

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describe, cause

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Correlational studies _____; they do not explain _______

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2013

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date of most recent updated DSM

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Dysfunction, distress, deviant

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Three D's that define abnormality

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supernatural (work of evil spirits and astrology)

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prehistoric society view of abnormal

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biological causes

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Greek and Roman historical view on abnormal =

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Greece

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Hypocrates

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Rome

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Galen

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four humors and hysteria

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Hypocrates and Galen believed in these two things

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blood, phlegm, yellow bile, and black bile

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four humours

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happy/euphoria

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blood indicated

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anger, anxious, stress

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phlegm

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depression

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bile

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bloodletting, sauna

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Out of balance four humours treatment

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supernatural

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Middle ages view of abnormal

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reform and "moral" treatment

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Nineteenth century view of abnormal

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reform and moral treatment

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Pinel, Tuke, Rush, Todd, Dix associated with what?

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Somatogenic (focus on the biological cause) and Psychogenic (focus on the psychological cause) perspective

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20th century view of abnormal combined these two as the causes

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Presenting Problem

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original complaint reported by the client to the therapist

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clinical description

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details of the combination of behaviors, thoughts nd feelings of an individual that make up a particular disorder

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prevalence

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number of people displaying a disorder in the total population at any given time

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incidence

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number of new cases of a disorder appearing during a specific period

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prognosis

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predicted development of a disorder over time

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etiology

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cause of a disorder

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developmental perspective

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age is at the center of this; how you are going to treat someone based on where they are developmentally

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psychopathology

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scientific study of psychological disorders

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Emil Kraeplin and John Grey

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2 people associated with somatogenic perspective/view of abnormal during the 20th century

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Sigmund Freud

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1 person associated with the psychogenic perspective of abnormal during the 20th century

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Biological Model Treatments

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Psychotropic Medications: - Antipsychotics (neuroleptics) - dopamine - Antidepressants - serotonin - Mood Stabilizers - lithium, others - Anxiolytics - such as valium ambien, benzo, adavan Electro-Convulsive Therapy (ECT) Psychosurgery

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biological, psychological, and sociocultural

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3 models of ABNORMALITY

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PTSD and schizophrenia

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psychodynamic treatments are NOT good for these two disorders

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Bobo doll study

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Bandura did WHAT study?

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Behavioral model

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Exposure Gradual vs. Flooding In Vivo vs. Imaginal Systematic Desensitization *** best treatment for phobias Counter-Conditioning: Relaxation Response Exposure and Response Prevention ***best treatment for OCD Contingency and Reward Systems Are treatments under WHAT MODEL?

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Carl Rogers; humanist model

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Unconditional Positive Regard Prizing CLIENT CENTERED THERAPY Reflection Under WHO? Under what Model?

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Ellis

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Person associated with Rational Emotive Therapy

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Beck

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Person associated with Cognitive Therapy

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Beck

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Person associated with the "automatic, dysfunctional" thoughts

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CBT

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type of therapy most effective for most disorders overall

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Sociocultural model

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Group therapy Family therapy Couple therapy Community treatment Prevention Are treatments associated with what model?

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classification

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assignment of objects or people to categories on the basis of shared characteristics

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taxonomy

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system of naming and classification in science

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nosology

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classification and naming system for medical and psychological phenomena... the DSM is an example

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nomenclature

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in a naming system, the actual labels or names that are applied (like the names of mood disorders or eating disorders)

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DIMENSIONAL APPROACH CATEGORICAL APPROACH PROTOTYPICAL CATEGORICAL APPROACH

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three approaches for diagnosis

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categorical approach

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approach for diagnosing where a patient completes a test and it comes back with result +/-

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dimensional approach

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approach for diagnosing where the patient reaches a certain "dimension" of dysfunction --> diagnosed

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prototypical categorical approach

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approach for diagnosing more symptom-based (having a certain number of symptoms checked off)

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DSM 5

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Asks Clinicians to provide both the Prototypical Categorical diagnosis AND a dimensional "impression"

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assessment

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THIS includes: interviews behavioral observations tests and measures (personality, response inventories, psychophysiological, cognitive)

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standardization

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process of establishing specific norms and requirements for a measurement technique to ensure it is used consistently across measurement occasions (instructions for administering, evaluating findings, etc.).... who have I measured this on before, the ages of people, education, etc...

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Concurrent Validity

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results from one test correspond to the results of other measures of the same phenomenon

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discriminant validity

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validity that does not correlate highly with another disorder

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content validity

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validity type - degree to which the characteristics of a disorder are a true sample of the phenomenon in question

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test-retest reliability

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getting the same results on one day as another

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split-half reliability

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randomly split the test and two and two halves should be highly correlated

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inter-rater reliability

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two or more observers make the same ratings or measurements

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predictive validity

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degree to which an assessment instrument accurately predicts a person's future behavior

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Behavioral observations

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Naturalistic Vs. Structured (Analogue) Self-Monitoring are two types of WHAT?

question

adults

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self monitoring is good for who?

question

clinical researchers

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WHO? Examine nature, causes, treatment of psychological disorders

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external validity (generalizability)

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extent to which research findings generalize or apply to people and settings not involved in the study

question

alternative

answer

These are WHAT type of designs? Quasi-Experimental Designs: No random assignments Matched Controls Natural Experiments Analogue Experiments Single Subject Designs ABAB

question

integrative model or triple vulnerability theory

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Three models coming together to explain the causes of anxiety (biological, psychological, and social)

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interoceptive avoidance

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avoidance of situations or activities that produce internal sensations of anxiety or sensations reminiscent of a panic attack

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early adulthood

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onset of panic disorder

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13

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age of onset for social phobia

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systematic desensitization

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behavioral therapy combining gradual exposure to feared stimulus and paired with positive coping skills (like relaxation)

question

BIS

answer

which mediates reactivity to threat and punishment and can predict an individual's response to anxiety-relevant cues in a given environment.

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physical stress disorders

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disorders where "Psychological Factors affecting medical conditions" Person has REAL, physical ailment that may be made worse by psychological factors

question

most common physical stress disorders

answer

Most common: GI issues (ulcers, colitis, etc) - aggravated by stress Asthma Chronic headaches High Blood Pressure - stress can contribute Diabetes - has a high comorbidity and correlation with depression; Cardiac issues - people who become depressed after an initial cardiac event/ bypass event, if that depression goes untreated, then person is much more at risk for a second CV event and for the second event being fatal ... very important for depression to be treated in individuals with cardiac events

question

somatic symptom disorders

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Preoccupation with health of body with no identifiable medical condition or cause -Used to be linked with dissociative disorders under one heading: Hysterical Neurosis

question

Somatic symptom disorders

answer

All are examples of what kind of disorders? ILLNESS ANXIETY DISORDER - hypochondriasis; MOST COMMON CONVERSION DISORDER FACTICIOUS DISORDER IMPOSED ON SELF FACTICIOUS DISORDER IMPOSED ON ANOTHER

question

illness anxiety disorder

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-physical complaints with severe anxiety focused on the possibility of having a serious illness -Medical reassurance does NOT help -essentially, the problem IS anxiety (over the physical symptoms) -Almost always presents first to medical doctors DISEASE CONVICTION = core diagnostic feature NOT ILLNESS PHOBIA (fear of actually catching or developing a disease)

question

somatization pattern and pain pattern

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two patterns of focus with somatic symptom disorders

question

somatization pattern

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-a somatic symptom disorder -Extended history of physical complaints BEFORE age 30 -Concerned about the symptoms themselves, not about future or progression of symptoms (no disease conviction then) -Symptoms = major part of the person's identity -it's the primary thing the person talks about (the bodily symptoms)

question

pain pattern

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-a somatic symptom disorder -often develops after injury/accident that caused genuine pain at one time - proof that the person has healed like on imaging; they still have the pain; these people will UNCONSCIOUSLY tense the area and it causes the pain .... CBT and relaxation techniques (hypnosis can be helpful for pain too)

question

conversion disorder

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-a somatic symptom disorder -person experiences physical malfunctioning with NO physical or organic pathology - the person is NOT faking their symptoms, however there is no REAL pathology (something wrong with them) -Prominent in sensory-motor areas Paralysis, blindness, mutism, seizures, and globus hystericus (sensation of lump in the throat) Symptoms typically precipitated by stress or trauma Can function normally on assessments, but have no insight (meaning they believe they cannot do something and then they have completely normal functioning)

question

women combat religious rituals

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Where is conversion disorder seen?

question

trauma or acute stressor

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main cause of conversion disorder

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factitious disorder imposed on self

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symptoms faked only gain is to assume sick role and get attention

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factitious disorder imposed on another (munchausen by proxy)

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A form of atypical child abuse Make child sick to get attention from role of parent of sick child

question

How to diagnose between real disorder/ somatic symptom disorder / etc.

answer

1. Determine if there is a pathology / acctual physical illness?... but you can never be 100% sure 2. Is there a PERSONAL gain (lawsuit, custody, etc.)? 3. Are they faking or not?

question

la belle indifference

answer

A naive, inappropriate lack of emotion or concern for the perceptions by others of one's disability (typically seen in conversion disorder)

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