Ch. 14 and Ch. 15 Quiz – Flashcards
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Regarding the difference between normal and abnormal behavior, which of the following statements is TRUE?
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The difference between normal and abnormal is often a matter of degree.
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Which of the following examples reflects a symptom of an anxiety disorder rather than normal anxiety?
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For the past several weeks, Mavis has been unable to concentrate at work because she keeps thinking that something terrible might happen to her son at school, even though she knows that he's safe.
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The most common symptoms of a _____ are a pounding heart, rapid breathing, breathlessness, and a choking sensation. The person may also sweat, tremble, and experience light-headedness, chills, or hot flashes. Accompanying the intense, escalating surge of physical arousal are feelings of terror and the belief that one is about to die, go crazy, or completely lose control.
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panic attack
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Most cases of specific phobia involve particular categories of objects or situations. Which of the following are people least likely to have a phobia of?
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household cleaners, such as dishwashing liquid, soap, toilet cleaners, mops, and brooms
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Before leaving her home, Margaret makes sure that every electrical appliance is unplugged and checks that every window and door is securely locked. She checks everything seventeen times according to a strict ritual that she has worked out. If she misses one window, door, or appliance, she must begin all over again. If she tries to skip any step of the ritual, she experiences unbearable anxiety. Margaret is probably suffering from:
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obsessive-compulsive disorder.
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Over the last three months, Ivana's feelings of despondency have intensified for no apparent reason. Although her friends have tried to be encouraging and supportive, Ivana says that she feels completely detached from people, worthless, and has even thought about killing herself. Ivana's symptoms would suggest that she is probably suffering from:
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Over the last three months, Ivana's feelings of despondency have intensified for no apparent reason. Although her friends have tried to be encouraging and supportive, Ivana says that she feels completely detached from people, worthless, and has even thought about killing herself. Ivana's symptoms would suggest that she is probably suffering from:
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In the last three days, Doug has become progressively more energetic and euphoric. He has been sleeping no more than an hour or two a night, but he seems to have unlimited energy. Doug is inappropriately self-confident as he veers from one grandiose idea to another in his plans to become rich and famous. Doug appears to be experiencing:
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a manic episode
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Deceiving and manipulating others for one's own personal gain is a hallmark of which personality disorder?
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antisocial
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When Spencer first started dating Melissa, their relationship quickly became very intense. But after a couple of weeks, Spencer became increasingly uneasy because Melissa seemed to constantly need his attention and reassurances of his commitment to her. When Melissa showed up unexpectedly at Spencer's office to have lunch with him, she became enraged when Spencer told her that he was taking two important clients to lunch. Shortly after this incident, Spencer tried to break off the relationship with Melissa, which turned into an ugly scene with her screaming profanities at him in the middle of the street. Several days later, Spencer learned that Melissa had been hospitalized for overdosing on tranquilizers. Melissa's pattern of behavior seems to fit which of the following disorders?
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borderline personality disorder
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Which of the following is an example of a dissociative experience that is pathological or abnormal?
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being unable to remember your own name or other important details about your life
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Philip has been hospitalized for an episode of schizophrenia. He believes that secret agents are bombarding his brain with gamma rays, and he sometimes sees grotesque creatures climbing on the wall of his hospital room. Philip's symptoms are referred to as:
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positive symptoms of schizophrenia
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Despite attempts by his friends who have tried to reason with him, Simon is convinced that a news announcer on TV is talking in a special code about him and his thoughts. Simon appears to be experiencing delusions of:
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reference
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False or distorted perceptions that seem vividly real are called
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hallucinations
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Susan was treated for an episode of schizophrenia before she was married. In recent weeks, her husband has noticed that Susan's speech and facial expressions have become flat and expressionless and that she seems to have little motivation. Assuming that Susan is on the verge of another episode of schizophrenia, these symptoms are referred to as _____ symptoms of schizophrenia.
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negative
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One potential problem with insight-oriented therapies, such as psychoanalysis and client-centered therapy, is that:
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gaining an understanding of the cause of maladaptive behaviors does not necessarily result in more adaptive and healthier behaviors
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In contrast to insight-oriented therapies, behavior therapy focuses on:
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unlearning maladaptive behaviors and acquiring more adaptive behaviors in their place
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According to Beck's cognitive therapy, psychological problems are caused by:
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negative cognitive biases, distorted thinking, and unrealistic beliefs
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Which of the following is a key advantage of group therapy?
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The therapist can observe how a client actually interacts with others.
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Bipolar disorder, which is also often referred to as manic depression, is most commonly treated with a medication called:
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lithium
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Prozac, Zoloft, and Paxil are all examples of:
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a category of antidepressants called selective serotonin reuptake inhibitors, abbreviated SSRIs
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three criteria for labeling a pattern of behavior as a psychological disorder
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1. Cause significant distress 2. Impair the ability to function in one or more important areas of life 3. Represents a serious departure from prevailing social or cultural norms
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What is the DSM 5?
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Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Guideline for labeling and diagnosing disorders Describes more than 260 psychological disorders Symptoms Criteria that must be met for diagnosis Frequency, typical course, risk factors
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examples of the different psychological disorders
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dissociative fugue phobias obsessive compulsive disorders major depression seasonal affective disorder bipolar disorder anti-social personality disorder borderline personality disorder jerusalem syndrome delusions of reference
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normal v. pathological anxiety
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Irrational, uncontrollable,disruptive Normal anxiety can be adaptive, but pathological anxiety is not: it interrupts everyday activities for no good reason
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Generalized Anxiety Disorder
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worry about everything
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Panic Attacks/Disorder
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attack: sudden episode of extreme anxiety that rapidly escalates in intensity disorder: An anxiety disorder in which the person experiences frequent and unexpected panic attacks
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agoraphobia
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Fear of a panic attack in a place they can't escape May result in avoiding crowded places, elevators, public transit, etc. or even unwillingness to leave their home
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phobia
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Persistent and irrational fear of a specific object, situation, or activity
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Post-Traumatic Stress Disorder symptoms?
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Frequent recollection of traumatic event, often intrusive and interfering with normal thoughts Avoidance of stimuli or situations that trigger recall of the event Negative alterations in thinking, moods, and emotions Increased physical arousal
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Obsessive-Compulsive Disorder
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A disorder characterized by obsessions and compulsions.
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OCD obsession most common?
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Repeated, intrusive, and uncontrollable irrational thoughts or mental images that cause extreme anxiety and distress Common obsessions: Fear of dirt, germs, or other forms of contamination Doubt about having accomplished a simple task such as shutting off appliances or locking the door
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OCD compulsion most common?
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Repetitive behavior a person feels driven to perform. Usually a ritual that must be carried out in a particular pattern or sequence Often related to an obsession Common compulsions: Repeatedly washing hands Repeatedly checking to see if a task has been accomplished, e.g. door has been locked.
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main symptoms of major depression
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feels sad or empty diminished interest or pleasure in activities significant weight loss insomnia agitation or retardation fatigue feelings of worthlessness inability to concentrate suicidal thoughts
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characteristics of major depression: demographics
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6 percent to 7 percent of Americans are affected by major depression in any given year About 15 percent of Americans at some point in their lives Women are about twice as likely as men to be affected by major depression
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Seasonal Affective Disorder
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Mood disorder in which episodes of depression typically occur during the fall and winter and subside during the spring and summer
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Persistent Depressive Disorder (Dysthymia) and how does it differ from major depression?
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Mood disorder in which episodes of depression typically occur during the fall and winter and subside during the spring and summer Symptoms less severe than an major depressive episode, but overall impact can be just as great because it does not remit.
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Bipolar Disorder symptoms and course
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Mood disorder involving abnormal moods at both ends of the spectrum
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mania symptoms of a manic episode
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Manic episodes: Little sleep but boundless energy Highly inflated self-esteem and grandiose plans Rapid speech and thoughts Manic episodes seriously impact ability to function Tends to increase impulsive or high-risk behaviors Excessive spending Hypersexuality Illegal acts Substance abuse Severe mania may involve delusions or hallucinations
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Personality disorders
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Personality disorders are characterized by inflexible and enduring behavior patterns that differ markedly from cultural expectations and impair social functioning.
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three major categories of personality disorder
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1.Anxious/fearful Avoid problems, dependent on others, OCD-like traits 2.Odd/eccentric Social deficits, odd ways of thinking 3.Dramatic/impulsive Egocentric, attention-seeking, difficulty empathizing with others
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Paranoid Personality Disorder and what are the common symptoms?
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distrust and suspicion assumes other people intend to deceive, exploit or harm them
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Antisocial Personality Disorder and what are the common symptoms?
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blatantly disregards or violates rights of others impulsive, irresponsible, deceitful, manipulative, lacks guilt or remorse
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Borderline Personality Disorder and what are the common symptoms?
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Characterized by instability of interpersonal relationships, self-image, and emotions, and marked impulsivity
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Dissociative disorders
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Category of psychological disorders in which extreme and frequent disruptions of awareness, memory, and personal identity impair the ability to function
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dissociative experience example
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Dissociative experience: A person's awareness, memory, or personal identity become separated or divided
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dissociative fugue
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Dissociate fugue - a rare, generally reversible amnesia for personal identity
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dissociative identity disorder symptoms controversial diagnosis?
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Involves extensive memory disruptions along with the presence of two or more distinct identities, or "personalities" (often called alters). Mechanism is that there is another mental illness coming on, not that one traumatic event caused the formation of multiple personalities
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culture-bound syndrome
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The idea that mental illnesses can present with symptoms that are specific to culture Koro in parts of China and southeast Asia: Belief that one's genitals are retracting into the body and will disappear
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schizophrenia
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A psychological disorder that involves severely distorted beliefs, perceptions, and thought processes
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difference between positive and negative symptoms
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Positive symptoms - Presence of abnormal thoughts and behaviors Negative symptoms -Absence of normal thoughts and behaviors
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positive symptoms of schizophrenia
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Presence of abnormal thoughts and behaviors Delusions-False beliefs Hallucinations- False perceptions Severely disorganized thought processes or speech Severely disorganized behavior
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delusion and the four major categories of delusions examples for each
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1. Delusions of reference- all about you 2. Delusions of Grandeur- believe that are powerful, famous, etc. Real person is imposter 3. Delusions of persecution- most common; belief that they are out to get you 4. Delusions of being controlled- belief that outside sources are directly trying to control you Government, aliens
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hallucinations most common
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Hallucinations: False or distorted perceptions that seem vividly real and located in external space
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negative symptoms of schizophrenia
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Absence of normal thoughts and behaviors Flat affect Lack of normal emotional expression: Reduction in facial expression Speaking in monotone Alogia Greatly reduced speech production Avolition Inability to initiate or persist in goal-directed behavior
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explanations for schizophrenia
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50 percent of people with schizophrenia show some type of brain structure abnormality Most consistent finding: enlargement of the ventricles Loss of gray matter Loss in temporal lobes correlated with hallucinations and delusions Loss in frontal lobes correlated with negative symptoms
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psychotherapies examples
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Psychoanalytic therapies Humanistic therapies Behavior therapies Cognitive therapies Mindfulness-based therapies Group, family, and couples therapies
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insight-oriented therapies vs. cognitive or behavioral therapies
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know problem v. change problem
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Psychoanalysis basic idea that underlies it how is it done?
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Repressed conflicts continue to influence a person's thoughts and behaviors Helps unearth unconscious conflicts so the patient attains insight Free association: Patient sits on couch saying whatever comes to mind
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Humanistic therapies: What are they? What is the basic idea that underlies it? How is it done?
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Emphasis on human potential and self-awareness Client-centered therapy Developed by Carl Rogers Emphasizes client's perception of his or her self and environment Therapy is nondirective: therapist does not make diagnoses or suggestions, point out contradictions, or agree or disagree with the client Therapist's role is to create conditions that allow client to direct focus of therapy
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What is client-centered therapy? What is the basic principle behind it?
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Therapeutic conditions that promote self-directed change:
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What are the three therapeutic conditions held to be necessary by client-centered therapy?
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Genuineness: Therapist honestly and openly shares thoughts and feelings with client Unconditional positive regard Therapist must value, accept, and care for client Empathic understanding Therapist must communicate and listen actively: be a mirror that reflects a patient's thoughts and feelings back to the patient.
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Behavior therapy: What is it? What is the basic idea that underlies it?
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Behavior therapy seeks to directly change problem behaviors. Maladaptive behaviors are learned and can be unlearned; adaptive behaviors can be learned in their place.
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How is behavior therapy used to treat phobias?
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Systematic desensitization or graduated exposure therapy Teach the patient relaxation techniques Expose the patient to a less-threatening form of the feared stimulus while they practice relaxation techniques E.g a picture of a snake, a rubber snake, etc. Gradually work up to more threatening stimuli E.g. holding a live snake
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What is the role of operant conditioning and shaping in behavior therapy?
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Use positive reinforcement and extinction to unlearn maladaptive behaviors and learn adaptive ones. Start with simple tasks and work up to more complex ones.
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Cognitive therapy: What is it? What is the basic idea that underlies it?
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Assumes that psychological problems are caused by faulty or illogical patterns of thinking Therapists actively disputes these irrational beliefs.
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rational-emotive therapy
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Therapists actively disputes these irrational beliefs.
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components of the ABC model
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Activating event triggers Beliefs which cause Emotional Consequences
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cognitive therapy
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Suggested that depressed patients have a negative cognitive bias: psychological problems caused by distorted thinking and unrealistic beliefs.
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cognitive therapy differ from RET
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Rather than challenging "irrational" beliefs as in RET, asks patient to empirically test accuracy of assumptions.
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two stages of cognitive therapy
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Step one: monitor positive and negative thoughts that are occurring automatically without conscious control Step two: empirically test negative thoughts
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Cognitive-Behavioral Therapy
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Combines both behavioral and cognitive therapy techniques. Cognition, behavior, and mood are interrelated.
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Acceptance and Commitment Therapy
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Acceptance and Commitment Therapy (ACT) Core principles Cognitive diffusion: diffuse the effects of negative thoughts (rather than challenge them as in CBT) Acceptance: allow negative thoughts, emotions, etc. to come and go without struggling with them Mindfulness: contact with the present moment Observing self: access a transcendent sense of self Values: discovering what is important to you Committed action: set and carry out goals according to your values.
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Acceptance and Commitment Therapy What is diffusion and acceptance and what role do they play in ACT?
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Cognitive diffusing- rather than challenging negative beliefs, you do not test them. Rather you are acknowledging or diffusing. Separating yourself from idea.
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How do ACT and other mindfulness therapies differ from cognitive therapies?
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in that rather than trying to teach people to better control their thoughts, feelings, sensations, memories and other private events, ACT teaches them to "just notice," accept, and embrace their private events, especially previously unwanted ones.
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What are some benefits of group, family, and couples therapies?
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Less expensive The client can see that they're not alone in having their particular problems. Clients can give each other advice Clients can try out new behaviors in supportive settings Therapist can actually see client interact with others instead of relying on clients' own perceptions and reports
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antipsychotic medications what are they used for?
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Used to treat hallucinations, delusions, and disordered thoughts associated with schizophrenia.
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What were some of the problems with typical antipsychotics that lead to the use of atypical antipsychotics?
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More effective than typical antipsychotics in treating negative symptoms of schizophrenia Less likely to have motor-related side effects or cause tardive dyskinesia (although both can still occur) However, have some of the same side effects: weight gain, dry mouth, constipation, sleepiness, poor concentration Increased risk of hyperglycemia and diabetes
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Antianxiety medications: What is benzodiazepines? What are some advantages and disadvantages?
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benzodiazepines (Valium, Xanax). Increases level of GABA, an inhibitory neurotransmitter Take effect rapidly Reduce coordination, reaction time, alertness Interacts with some other drugs, including alcohol and antihistamines Can produce severe intoxication or death Potentially addictive Good for fast, short-term relief
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Antianxiety medications: What are some of the advantages and disadvantages of buspirone relative to the benzodiazepines?
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Primary antianxiety drug that is not a benzodiazepine is buspirone (Buspar) Not really clear how it works, may effect dopamine and serotonin. Doesn't mess with coordination or cause sedation Not addictive However, it takes weeks to begin to work. Sometimes used off-label to augment SSRIs in treating depression.
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Bipolar medications: Lithium: What is it used for? What are some of the problems and side effects associated with lithium?
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Used to treat bipolar disorder Lithium counteracts both manic and depressive symptoms in bipolar patients (but more effective than mania) The difference between the therapeutic and toxic dose is small: Too low = manic symptoms persist Too high = lithium poisoning, which causes vomiting, muscle weakness, and reduced muscle coordination Lithium blood levels must be carefully monitored Common side effects include weight gain, tremor, thirst, dry mouth, digestive symptoms, acne.
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Bipolar medications: Depakote: What is it used for?
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Anticonvulsant used to treat bipolar disorder Especially effective for rapidly-cycling bipolar disorder However, the side effects can suck: Digestive problems Weight gain Hair loss Vision problems Memory problems Drowsiness Headache Low platelet count...
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Antidepressants First generation antidepressants: MAOIs: Characteristics and problems/side effects.
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First-generation antidepressants: MAOIs (monoamine oxidase inhibitors) First discovered to have antidepressant properties in 1952 Works on serotonin, norepinephrine, and dopamine Quite effective but (like many antidepressants) can take 6+ weeks for symptoms to lift Has food interactions: eating food with high levels of tyramine (mostly aged or fermented foods) can cause a hypertensive crisis, nasty headaches, and (rarely) death. Has scads of potentially fatal drug interactions, especially pretty much any other antidepressant. Also cough syrup, decongestants, some anesthetics and pain killers, etc. etc.
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Antidepressants First generation antidepressants: Tricyclics: Characteristics and problems/side effects.
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First-generation antidepressants: Tricyclics Also discovered in mid-1950s Works on serotonin and norepinephrine Quite effective but (like many antidepressants) can take 6+ weeks for symptoms to lift Main problem is the side effects: Weight gain Dry mouth Sedation Constipation
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Antidepressants Second generation antidepressants: Bupropion (Wellbutrin): What are some of the advantages relative first-generation antidepressants and SSRIs? Often used in combination with SSRIs.
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Second-generation antidepressants: Bupropion (Wellbutrin) Works on norepinephrine and (maybe) dopamine Comparatively fast acting (as fast as 2-3 weeks) Does not cause weight gain or sexual side effects Can cause agitation, insomnia, weight loss Increased risk of seizures Still used today either alone or in combination with SSRIs
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Antidepressants Second generation antidepressants: Trazodone: What is its major side effect? How is it most commonly used today?
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Second-generation antidepressants: Trazodone Works on serotonin Less prone to causing dry mouth, weight gain, etc. than the tricyclics, but is very sedating. Commonly used off-label as a sleep aid
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SSRIs How do they work? What are some of the benefits relative to the prior generations of antidepressants? What are some of the major side effects?
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Selective Serotonin Reuptake Inhibitors (SSRIs) First was fluoxetine (Prozac) approved in 1987. Target serotonin Not more effective than first-generation antidepressants, but have fewer and milder side effects. Sexual side effects Weight gain (but not as much as tricylics) Insomnia and/or drowsiness
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SNRIs How do they work? What are some of the advantages/disadvantages relative to SSRIs?
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Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) E.g. Effexor, Cymbalta Work on serotonin and norepinephrine May be more effective than SSRIs but also have more side effects, so not usually used as a first-line medication Headache, insomnia and/or drowsiness, digestive symptoms, dry mouth... Discontinuation syndrome, esp. Effexor: mood disturbances, sleep disturbances, flu-like symptoms, dizziness, tremors...
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Electroconvulsive therapy How quickly does it work and for how long? What are some major side effects? When is it usually used?
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ECT involves using a short burst of current to induce a seizure in the brain. Most commonly used to treat major depression. Works very quickly - usually within days -- but half of patients relapse within 6 months Mechanism by which it works is still unclear Side effects can include temporary confusion and disorientation, temporary or permanent memory loss. Usually used only when other treatments have failed or in people who are extremely high risk for suicide
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Transcranial Magnetic Stimulation
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Strong magnetic pulses are applied through the scalp to the surface of the brain The magnetic pulses cause electrical activity in the brain. Used to do brain research because it has the effect of creating a temporary "lesion"
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Transcranial Magnetic Stimulation What are some advantages and disadvantages?
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Seems to relieve treatment-resistant depression in some cases (approved in 2008) Few side effects Treatment received 5 days a week for 4-6 weeks Expensive and often not covered by insurance.
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categories of disorders
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Anxiety disorders Mood disorders Personality disorders Dissociative disorders Schizophrenia
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characteristics of major depression: usual course
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Left untreated, symptoms of major depression can last six months or longer Left untreated, depression may recur and become progressively more severe More than half of all people who have been through one episode of major depression can expect a relapse, usually within two years Symptoms tend to increase in severity and time between episodes decreases About 10% of people with major depression attempt suicide at some point