Abnormal Psychology – Final Exam – Cumulative – Flashcards
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PTSD
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Consequence of experienceing extreme stressor (trauma)
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Trauma
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Actual or threatened death, serious injury, or sexual violation
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What are several ways of obtaining Trauma?
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1. Direct experience/witness 2. Learned event happened to someone they are close to 3. Repeted/extreme exposure to details of trauma
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What are the symptoms of PTSD?
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1. Re-experienced 2. Avoidance 3. Negative thoughts/moods 4. Chronic arousal
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What are the intrusive symptoms needed (one or more) of re-experiencing for PTSD?
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a. Recurrent, involuntary, intrusive memories of event b. Recurrent distressing dreams w/ content related to trauma c. Dissociative reactions d. Intense/prolonged distress at exposure to internal or external cues of trauma e. Marked physiological reactions to internal or external cues of trauma
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Avoidance
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Persistent avoidance of stimuli associated with traumatic event (begins after event occurs)
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What are the Symptoms of Avoidance for PTSD?
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1. Avoidance of distressing memories thoughts or feelings of things associated with trauma 2. Avoidance of external reminders that arouse distressing thoughts, feelings, or memories of trauma
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Negative thoughts/moods
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Negative alternation in cognitions & mood associated with trauma
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What are the sympotoms needed (two or more) of negative thoughts/moods for PTSD?
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a. Inability to remember imporant aspects of trauma (dissociative amnesia) b. Persistent, exaggerated, negative beliefs ot ecpevtations about oneself, others, or the world ("I'm bad," "No one can be trusted") c. Persistent distorted cognitions about causes.consequences of trauma - lead person to blame themselves or others d. Persistent negative emotional state (e.g. fear, horror, anger, guilt, shame, etc....) e. Markedly diminished interest/participation in significant activities f. Feelings of detachment or estrangement from others g. Persistent inability to experience positive emotions
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Chronic Arousal
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Marked changes in arousal and reactivirt associated with trauma
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What are the symptoms needed (two or more) of chronic arousal for PTSD?
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a. Irritable behavior or angry outbursts b. Reckless or self-destructive behavior c. Hypervigilance d. Exaggerated startle response e. Difficulty concentrating f. Sleep disturbances
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Other criteria for PTSD
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a. Symptom duration > 1 month b. Significant impairment c. Not due to substance or other medical condition
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Specific Phobia
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Marked fear/anxiety of specific object/situation
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What are the specific phobia specifiers?
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a. Animal b. Natural Event c. Blood-injection-injury d. Situational e. Other
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Criteria for Specific Phobia
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a. Phobic object/situation almost always provokes immediate fear/anxiety b. Phobic object/situation actively avoided or endured w/intense fear/anxiety c. Fear/anxiety out of proportion to actual danger d. Fear/anxiety/avoidance lasts > 6 months e. Significant distress or impairment f. Symptoms not better explained by another disorder
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Agoraphobia
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Fear of not being able to escape/get help (if they have a panic attack)
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Social Anxiety Disorder (SAD)
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Marked fear of social situations a. Social interactions (e.g. meeting new people) b. Being observed (e.g. restaurant) c. Performance (e.g. speech)
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Criteria for Social Anxiety Disorder
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a. Fear/anxiety out of proportion to actual threat b. Fear/anxiety/avoidance > 6 months c. Fear of acting in way or showing anxiety that will be negatively evaluated
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What are the Social Anxiety Disorder specifiers?
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Performance only
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Panic Disorder
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Recurrent unexpected panic attacks
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What are the symptoms needed (4 or more) to be diagnosed with Panic Disorder?
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a. Palpitations/accelerated heart rate b. Sweating c. Trembling/shaking d. Shortness of breath/smothering e. Feelings of choking f. Chest pain/discomfort g. Nausea/abdominal distress h. Dizzy/faint i. Chills/heat j. Numbness/tingling k. Derealization/depersonalization l. Fear of losing control/"going crazy" m. Fear of dying
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At least 1 attack followed by > 1 month of:
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a. Persistent concern/worry about another panic attack b. Significant maladaptive change in behavior related to attacks
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OCD
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Presence of obsessions, compulsions, or both
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Obsessions:
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a. Recurrent, persistent thoughts, urges, or images - cuase marked distress or anxiety b. Try to ignore or suppress or neutralize thoughts, urges, or images (may use compulsions)
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Compulsions:
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a. Repetitive behaviors (e.g. checking, ordering) or mental acts (e.g. counting praying) done in response to obsession - rigid b. Behaviors or mental acts aimed at preventing or reducing anxiety/distress (Not realistically connected with dreaded event or situation or are clearly excessive)
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Criteria of OCD
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a. Obsessions/compulsions are time consuming or cause significant impairment b. Not result of substance abuse c. Not caused by another mental disorder
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Generalized Anxiety Disorder (GAD)
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Excessive anxiety/worry more days than not for at least 6 months about a number of different events/activities (work, school, future, unlikely events)
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Criteria of GAD
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a. Worry difficult to control b. Anxiety/worry has more than three of six symptoms c. Significant distress/impairment d. Not result of substance abuse e. Not caused by another medical condition
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What are the symptoms needed (3 or more) of anxiety/worry for a diagnosis of Generalized Anxiety Disorder (GAD)?
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a. Reslessness/feeling keyed up or on edge b. Easily fatigued c. Difficulty concentrating d. Irritability e. Muscle tension f. Sleep disturbance
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Depressive Disorders
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Core - depressed mood out of proportion to any causes
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What are the symptoms of Depressive Disorders?
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a. Either depressed mood or anhedonia b. Four other symptoms c. Significant impairment d. Can be caused by substance abuse or other medical condition *** e. Comorbids f. Lack of manic and/or hypomanic episode g. Longer than two weeks - more often than not, change from previous functioning
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Depressed Mood
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Most of the day, nearly every day as indicated by either subjective report (feels sad, empty, hopless) or observer report (appears tearful)
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Anhedonia
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Diminished interest or pleasure in activities
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What are the Comorbids of Depressive Disorders?
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Other mental disorders (Schizoaffective Disorder, Anxiety Disorders, etc. . .)
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What are the other symptoms (at least 4 needed) for a Depressive Disorder?
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a. Weight - Change (5% body weight), or decrease/increase in appetite b. Sleep - insomnia or hypersomnia nearly everyday c. Behavioral tempo - psychomotor agitation or retardation (observable by others, not just your own impression) d. Fatigue - loss of engery e. Worthlessness/inappropriate guilt f. Concentration - diminished ability to think/concentrate, indecisiveness g. Suicidal ideation - recurrent ideation w/o specific plan, or suicide attempt or a specific plan to commit suicide
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What are the 8 subtypes of Depressive Disorders?
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1. Anxious disress - Prominent anxiety symptoms 2. Mixed features - Presence of at least 3 manic/hypomanic symptoms, but does not meet criteria for manic episode 3. Melancholic features - Inability to experience pleasure, distinct depressed mood, depression regurlarly worse in the morning, early morning awakening, marked psychomotor retardation or agitation, significant anorexia or weight loss, excessive guilt 4. Psychotic features - Presence of mood-congruent or mood-incongruent delusions or hallucinations 5. Catatonic features - Catatonic behaviors: not actively relating to environment, mutism, posturing, agitation, mimicking another's speech or movements 6. Atypical features - Positive mood reactions to some events, significant weight gain or increase in appetite, hypersomnia, heavy or leaden feelings in arms or legs, long-standing pattern of sensitivity to interpersonal rejection 7. Seasonal pattern - History of at least 2 years in which major depressive episodes occur during one season of the year (usually the winter) and remit when the season is over 8. Peripartum onset - Onset of major depressive episode during pregnancy or in the 4 weeks following delivery
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Emotion context insensitivity - Jonathan Rottenberg
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a. Attenuated reaction to positive and negative cues in environment b. Flattened behavioral responses acress a variety of contexts
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Suicide
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Self-inflicted death (90/day is US)
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What are the methods of Suicide?
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Various - poisoning, drowning, gunshot, cutting, etc...
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What are the categories of Suicide?
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a. Completed - death b. Attempted - tried to complete suicide c. Ideation - thoughts (may include plans) - most people fall into this category
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Non Suicidal Self Injury (NSSI)
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Seperate to Suicide, but related - raises tolerance/threshold for injurious behaviors (mostly found in Adolescence)
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What are the Suicide Outbreaks?
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1. Suicide Cluster 2. Suicide Contagion
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Suicide Cluster
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a. Primarily among adolescents b. Mass suicides - single time/place
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Suicide Contagion
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a. Attempts to model behavior of friend or celebrity b. Idea of suicide more acceptable c. Lower inhibitions against suicide
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Egoistic Suicide
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Committed by people who feel alienated from others, empty of social contacts, and alone in an unsupportive world
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Anomic Suicide
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Committed by people who experience severe disorientation because of a major change in their relationship to society
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Altruistic Suicide
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Committed by people who believe that taking their life will benefit society
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Somatic Disorders
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Core: significant physical symptoms w/o physical cause
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What are three Somatic Disorders?
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1. Somatic Symptom Disorder 2. Illness Anxiety Disorder 3. Factitious Disorder
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What is the criteria of Somantic Symptom Disorder?
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a. Distressing or result in significant disruption of daily life b. Excessive thoughts, feelings, or behaviors related to somatic symptoms c. Symptomatic > 6 months
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Illness Anxiety Disorder
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Somatic symptom disorder w/o somatic symptoms
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Factitious Disorder
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a. Faking - deliberately playing "sick role" to gain medical attention b. Factitious Disorder imposed on another - individual fakes disorder on another (usually under their care) to gain attention for themselves
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Dissociative Identity Disorder (DID)
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Two or more distinct personalities (alters) - marked discontinuity in sense of self (Related alterations in thoughts, feelings, & behaviors)
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What is the criteria of Dissociative Identity Disorder (DID)?
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a. 2 or more distinct personalities (alters) b. Recurrent gaps in recall of important information c. Significant impairment of daily life d. Symptoms not part of accepted cultural practice e. Not due to other medical/psychological condition or substances
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Dissociative Amnesia
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Impaired recall - Inability to recall important autobiographical information
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What is the criteria of Dissociative Amnesia?
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a. Usual trauma/stressful event related information b. Inconsisent with ordinary forgetting c. Significant impairment d. Not due to other medical condition e. Not better accounted for by other psychological disorder
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Psychogenic Amnesia
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- Caused by psychological factor - Sledom involves anterograde amnesia (inability to learn new information acquired since onset of amnesia) - Can involve retrograde amnesia (inabillity to remember events from the past) - Retrograde amnesia often only for personal information, not for gerneral information
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Organic Amnesia
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- Caused by biological factors (such as disease, drugs, and blows to head) - Often involves anterograde amnesia - Can involve retrograde amnesia - Retrograde amnesia usually for both personal and general information
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(T/F) An individual can be diagnosed with PTSD if their symptoms are caused by drinking too much alcohol.
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False
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Panic disorder requires a panic attack to be followed by at least one month of _____________.
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Persistent concern about having another panic attack
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The obsessions and compulsions of Obsessive Compulsive Disorder (OCD) _____________.
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- May not be realistically connected witht he dreaded situation - Are time consuming - Cause significant impairment
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(T/F) The following are symptoms of depression: - Anhedonia - Hypersomnia - Psychomotor retardation
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True
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Continuum Model of Abnormality
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The continuum model of normality suggests that all behavior falls along a continuum from normal to abnormal and that we make subjective judgments of where to draw the line between normality and abnormality
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Categorical Model of Abnormality
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Diagnostic criteria defined where normality ends and psychopathology begins
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Latent Measurement Models
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Symptoms of a mental disorder are present but not visible, apparent, or actualized; existing as potential - "Mental illness" implies biological origins or disease process - No biological test available to diagnose - No common biological origin identified yet
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Emergent Measurement Models
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Psychopathology as collections of problems in cognition, emotional dysregulation, and social behavior - Other influences on labeling of behavior as "abnormal" a. Quality b. Quantity c. Culture
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Culture Relativism
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The view that there are no universal standards or rules for labeling a behavior abnormal; instead, behaviors can be labeled abnormal only relative to cultural norms - No objective truth - "Normality" and "Abnormality" defined by culture
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Szasz
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Societies throughout history use label of "abnormality" to control - Hitler labeled Jewish individuals as abnormal - Cartwright (1851) - drapetomania
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Drapetomania
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A supposed mental illness described by physician Samuel A. Cartwright in 1851 that caused black slaves to flee captivity.
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Critical Realism
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Absence of absolute truth, there are better options
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4 D's of Abnormality
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Dysfunctional Distress Deviant Dangerous (Framing)
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Dysfunctional
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In defining abnormality, there is functional impairment/interference with everyday life
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Distress
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In defining abnormality, symptoms cause emotional or physical pain to themselves or others
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Deviant
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In defining abnormality, depart markedly from expected social behavior
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Dangerous
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In defining abnormality, there is a potential for harm
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Framing
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In defining abnormality, all symptoms can be framed by quality, quantity, and culture
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Testing
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Some assessment tools (tests) are based on the assumption that behaviors or feelings lie along a continuum--the task is to determine where an individual's experiences fall along that continuum
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Assessment
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Systematic methods of gathering/incorporating information about a person to arrive at a diagnosis a. Background (previous medical and psychiatric history) b. Current life situation i. Living situation ii. Stressors iii. What makes them seek assessment now? c. Nature/course of current symptoms i. Onset/duration ii. Impairment/severity iii. Quantity/frequency iv. Cognitions/affect OR thoughts/feelings
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Diagnosis
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- A label for a set of symptoms that often occur together - Meaningful descriptor that conveys information about a person's mental disorder/illness
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Symptom Inventories
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Checklists of symptoms associated with disorders - BDI-II, BAI - ASEBA
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BDI-II
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Beck Depression Inventory
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BAI
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Beck Anxiety Inventory
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ASEBA
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Achenbach System of Empirically Based Assessment
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Personality Inventories
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Assess people's typical ways of thinking, feeling, and behaving (personality)
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Intelligence Tests
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Measure intellectual strengths and weaknesses
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Neuropsychological Tests
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Detect specific cognitive deficits (i.e. visual-spatial ability)
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Imaging Techniques (fMRI, CT, PET, SPECT)
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Identify specific organic abnormality - Caveat is that there is no singular identified organic abnormality associated with most traditionally identified mental disorders
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Projective Tests
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Present ambiguous stimuli and have person interpret according to their own current concerns, feelings, and underlying desires - Example is the Rorschach Inkblot Test
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Validity
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Accuracy of measure
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Construct Validity
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Does the test measure what it is supposed to measure
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Content Validity
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Test assess all important aspects of a phenomenon
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Predictive Validity
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Test predicts the behavior it was suppose to measure
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Concurrent Validity
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Test yields the same results as other measures of the same behaviors, thoughts, or feelings
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Discriminant Validity
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Test yields different results as other measures of different behaviors, thoughts, or feelings
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Reliability
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Precision; does measure provide consistent information about a person
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Test-Retest Reliability
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Test produces similar results when given at two points in time - More information for trait-like measurement models
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Alternate Form Reliability
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Two versions of same test produce similar results
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Internal Reliability
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Different parts of same test produce similar results
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Inter-Rater Reliability
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Two or more raters or judges who administer and score a test come to similar conclusions
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Clinical Interviews
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Gather information about individual a. Mental Status i. Dress ii. Behavior iii. Orientation (inforGathermally: 3 spheres - person, place, time, formally - Mini-Mental Status Exam) iv. Thought content/organization
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Three Types of Clinical Interviews
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1. Unstructured 2. Semi-Structured 3. Structured - Standardized format (SCID - Structured Clinical Interview for DSM)
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Incorporating Multiple Informants in Assessments
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1. Traditional use - populations with impaired ability to self-report i. Children ii. Psychosis iii. Dementia 2. See chart on slide 6 i. Validity/Insight - question accuracy of self-report ii. Generalizability/Context - question reliability of self-report across time/situations
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What is the goal of incorporating multiple informants in assessments?
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To improve assessments regardless of DSM criteria
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Scientific Method
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Series of steps designed to obtain and evaluate information relevant to a problem in a systematic way
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Hypothesis
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Testable statement of what we predict will happen in the study i. Null (H0) ii. Alternate (H1)
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Experiment/Methods
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Makes implications about the phenomena under study Ex. Using self-report vs. fMRI to study depression therapy efficacy
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What is the difference between a cross- sectional study and a longitudinal study?
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Cross-sectional studies assess a sample at one point in time, while longitudinal studies assess a sample at multiple points in time. A longitudinal study assesses a sample that is expected to have some future key event both before and after the event, then examines changes that occurred in the sample
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What is linear change in longitudinal research?
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Stable trajectory over time (looks like line), change is same across whole study period
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What is nonlinear change in longitudinal research?
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Non-stable trajectory over time (all over the place), change differs across whole study period
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Discontinuous
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Change is 0 before and after event
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Case Studies
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In-depth histories of the experiences of individuals
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Benefits of case studies
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1. Capture uniqueness of individual 2. Study rare disorders
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Limitations of case studies
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1. Generalizability - uniqueness may not apply to others 2. Lack of objectivity - both person with disorder & clinician may selectively attend to information
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Correlational Study
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Examines the relationship between two variables without manipulating either variable - Correlation DOES NOT equal causation
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Magnitude/Strength
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Degree to which variables move in tandem with one another
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Correlation Coefficient
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Statistic used to indicate the degree of relationship between two variables (-1.00 to +1.00)
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Epidemiological Studies
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Study frequency and distribution of disorder in populations
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What 3 types of data epidemiological studies focus on?
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1. Prevalence - Proportion of population with disorder 2. Incidence - Number of new cases of disorder during specific time 3. Risk Factors - Conditions/variables that are associated with a higher risk of having a disorder
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Meta-Analysis
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Statistical technique for summarizing results across several studies
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Effect Size
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How big the differences are between two groups (Cohen's d)
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Psychosis
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Unable to tell difference between real & unreal
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What is the prevalence of psychotic disorder?
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1-2% of the population
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What is the stigma/popular portrayal of people with psychotic disorder?
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That they are much more likely to be victims rather than perpetrators of crime
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Schizophrenia Spectrum
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DSM-5 recognized continuum of psychotic disorders by listing of disorders
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Schizophrenia Spectrum 5 domains of symptoms
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i. Quality (severity) & quantity (frequency) of symptoms distinguish these disorders ii. Positive symptoms (4 types) - represent overt expressions of unusual perceptions, thought, & behaviors 1. Delusions 2. Hallucinations 3. Disorganized thoughts/speech 4. Disorganized/abnormal behavior (catatonia) iii. Negative symptoms (1 type) 1. Restricted emotional expression/affect
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What is the core definition of delusions?
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Beliefs or ideas an individual believes are true, but they are highly unlikely or impossible - Continuum (self-deceptions --> delusions)
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Self-deceptions
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- Unlikely, but possible (e.g. winning lottery) - Think about them occasionally - Can acknowledge you are wrong
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Delusions
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- Impossible (e.g. died 7 years ago) - Preoccupied with delusional thoughts - Look for evidence to support their beliefs - Try to convince others of beliefs - Take actions based on beliefs - Highly resistant to acknowledging beliefs are wrong
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Hallucinations
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Unreal perceptual experiences a. 15% healthy college students b. Psychotic disorders - hallucinations more frequent, bizarre, complex, persistent
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Auditory Hallucinations
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Hearing things that aren't really there - Most common - Origin is either outside or inside a person's head
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Visual Hallucinations
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Seeing things that aren't really there - Usual accompanies by auditory hallucinations
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Tactile Hallucinations
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Feeling things that aren't there - Origin is either outside or inside body (bugs on skin, worms in stomach)
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Smell/Taste Hallucinations
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Less common - usually associated with content of other sensations (e.g. bugs on skin crawling into mouth & having bad taste)
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Formal Thought Disorder
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Official name of disorganized thoughts/speech
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Word Salad
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Speech so disorganized it is incoherent to the listener
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Neologisms
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Make up words that mean something only to the person
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Clangs
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Associate words based on sound of words rather than content
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Catatonia
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Disorganized behavior that reflects unresponsiveness to environment a. Negativism - not responding to instructions b. Posture - rigid, inappropriate, bizarre c. Mutism - not making verbal or motor responses
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Negativism
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- Restricted affect and avolition/asociality - "Negative symptoms" - loss of certain qualities of person
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Restricted affect
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Severe reduction/absence of emotional expression i. Fewer facial expressions ii. Poor eye contact iii. Fewer gestures to communicate iv. Flat tone of voice
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Avolition
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Inability to initiate or persist at common, goal-directed activities i. Physical slowness ii. Compromised personal hygiene iii. Asociality - lack of desire to interact with other people
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Criteria for Schizophrenia
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1. Two or more of the following present for a significant portion of time during a 1-month period (at least 1 must be a, b, or c) a. Delusions b. Hallucination c. Disorganized thought/speech d. Disorganized/abnormal behavior (catatonia) e. Negative symptoms 2. Significant impairment (representing change from previous functioning) 3. Symptoms last at least 6 months a. At least 1 month active phase (symptoms) b. Possible prodromal & residual symptoms - negative symptoms + milder/fewer positive symptoms i. Prodromal (before acute phase) ii. Residual (after acute phase) 4. Symptoms not better explained by other disorder 5. Not due to substance or other medical condition
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Schizoaffective Disorder
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Schizophrenia + major mood episode (major depressive or manic episode)
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Schizophreniform Disorder
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Schizophrenia symptoms for 1-6 months
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Brief Psychotic Disorder
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Schizophrenia symptoms for at least 1 day to 1 month, eventually full return to premorbid functioning levels
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Personality
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Relatively stable, enduring patterns of thoughts, feelings, and behavior
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Personality traits/dispositions are:
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a. latent - can only be inferred from behaviors b. relatively stable, highly consistent (consistency coefficients) c. exert widely generalized causal effects on behavior 1. lead to consistency in person's behavior across situations d. variability of behavior across situations = error 1. error addressed using aggregation of large # of observations 2. finding a person's "true" personality requires you to take out "error" of situation e. used people's rank-order in situation vs. absolute levels of a trait to counter situational influences
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Situationalists
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Situation is a fundamental unit of personality science ("personalityless" view of man)
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Traits
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Descriptive summary of observed behavior a. Extension of "trait" term to other situations based purely on actuarial/statistical probabilities 1. "trait" is causally neutral 2. NOT underlying psychic property of person
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Attribution Bias
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Research shows people believe traits are responsible for behavior when they are not (tripping example)
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Confirmation Bias
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People persist with initial impression, even when it's wrong
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Self-fulfilling Prophecy
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People elicit expected behaviors in individuals
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If...Then Contingencies
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Conditional frequency of behavior is a fundamental unit of personality
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Cluster A
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Odd-Eccentric PDs
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Cluster B
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Dramatic-Emotional PDs
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Cluster C
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Anxious-Fearful PDs
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Five-Factor Model
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A dimensional perspective that posits that everyone's personality is organized along five broad personality traits, or factors.
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PDs of Cluster A
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- Paranoid PD - Schizoid PD - Schizotypal PD
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Paranoid PD
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Pattern of pervasive distrust and suspiciousness in others
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Schizoid PD
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Pervasive detachment from social relationships & restricted range of emotional expression when interacting with others
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Schizotypal PD
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Personality disorder with symptoms similar to schizophrenia
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PDs of Cluster B
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- Antisocial PD - Borderline PD - Histrionic PD - Narcissistic PD
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Antisocial PD
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Pervasive pattern - disregard for & violation of rights of others (since age 15)
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Borderline PD
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Pervasive pattern - instability in interpersonal relationships, self-image, affect, & marked impulsivity
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Histrionic PD
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Pervasive pattern - excessive emotionality and attention seeking
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Narcissistic PD
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Pervasive pattern - grandiosity, need for admiration, & lack of empathy
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PDs of Cluster C
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- Avoidant PD - Dependent PD - Obsessive Compulsive PD
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Avoidant PD
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Pervasive pattern - social inhibition, feelings or inadequacy, & hypersensitivity to negative emotion
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Dependent PD
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Pervasive pattern - need to be taken care of; leads to submissive/clingy behavior & fears of seperation
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Obsessive Compulsive PD
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Pervasive pattern - preoccupation with orderliness, perfectionism, & mental/interpersonal control at expense of flexibility, openness, & efficiency
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Autism Spectrum Disorder
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- No more Asperger's Syndrome - Symptoms must be present in early developmental period (may not be present until social demands increase later in life or may be masked by learned strategies later in life) - Persistent social deficits - deficits in social communication and social interactions between/within multiple contexts (all symptoms must be present) a. Social-emotional reciprocity b. Nonverbal behaviors used for social interactions c. Developing, maintaining, & understanding relationships