Exam 4 Study Objectives : Abnormal Psychology Chapter 4 – Flashcards

The scientific study of mental disorders and their treatment.

A Mental Disorder Is.... Atypical: not always a reflective disorder Example: Having hallucinations, is an atypical behavior that likely does reflect a disorder. Maladaptive: doing this that are not good for you Example: Being afraid to leave one's home is a atypical and maladaptive behavior that would interfere with daily functions. Disturbing:Insight on your disorder or not knowing about your disorder Example:drinking blood Irrational:Inability to use any critical thinking Example:A fear of birds might be so strong that even thinking about them causes great anxiety.

DSM Describes symptoms-common language for practitioners Information about prognosis and appropriate treatment Stimulates research into causes insurance

The downside to classifying a mental disorder, regardless of the system used, is that labels are attached to people, and this biases our perception of these people in terms of the labels. Our perception is no longer objective. Their is a famous study that demonstrates the perceptual biassing effect of labeling. David L. Rosenhan, then a psychology professor at Swarthmore College, and seven others went to several different hospitals in five states and tried to gain admission. They each faked a major symptom of schizophrenic disorders, auditory hallucinations (hearing voices). The voice in this case was saying the words "empty," "hollow," and "thud." Other than this sole symptoms, the researchers acted normal and only lied about their true identities. First, they wanted to see whether they would be admitted given this singular symptom. All of the pseudopatients (fake patients) were admitted with a diagnosis of schizophrenia and were stuck in psychiatric wards for between 8 and 52 days. Their subsequent normal behavior was misinterpreted in terms of their diagnoses.

Definition: Explaining abnormality as the result of the interaction among biological, psychological (behavioral and cognitive), and sociocultural factors. It appears best to formulate an explanation in terms of more than one kind of cause

Disorders that share features of excessive fear and anxiety and related behavioral disturbances, such as avoidance behaviors.

An anxiety disorder indicated by a marked and persistent fear of specific objects or situations that is excessive and unreasonable Example: A woman had a specific phobia of birds. She became housebound because of her fear of encountering a bird. Any noises that she heard within the house she thought were birds that had somehow gotten in. Even without encountering an actual bird, the dreaded anticipation of doing so completely controlled her behavior. When she did leave her house, she would carefully back out of her driveway so that she did not hit the bird, she feared that the birds would retaliate if she did. She realized that such cognitive activity was beyond the capabilities of birds, but she could not control her fear. Her behavior and thinking were clearly abnormal.

An anxiety disorder indicated by a marked and persistent fear of one or more social performance situations in which embarrassment may occur and in which there is exposure to unfamiliar people or scrutiny by others. Example: The person may fear eating in public and will have great difficulty managing lunch at work; she will reject all lunch and dinner invitations, greatly limiting her social opportunities.

An anxiety disorder indicated by a marked and persistent fear of being in places or situations from which escape may be difficult or embarrassing. Example: being in a crowd, standing in a line, and traveling in a crowded bus or train or in a car in heavy traffic

An anxiety disorder in which a person experiences recurrent panic attacks. A panic attack includes symptoms such as trembling, sweating, heart palpitations, chest pains, shortness of breath, and feeling of choking and dizziness Example: Some panic attacks occur when a person is faced with a dreaded situation such as going to the dentist

An anxiety disorder in which a person has excessive, global anxiety and worries that he cannot control, occurring more days than not for at least a period of 6 months. The person cannot stop worrying, and the anxiety is general-- it is not tied to specific objects or situations as it is in a phobic disorder.

A disorder in which the person experiences recurrent obsessions or compulsions that are perceived by the person as excessive or unreasonable, but cause significant distress and disruption in the person's daily life.

Obsession: Is a persistent intrusive thought, idea, impulse, or image that causes anxiety Compulsion: Is a repetitive and rigid behavior that a person feels compelled to perform in order to reduce anxiety

Hoarding disorder reflects a persistent difficulty in discarding or parting with possessions due to a perceived need to save the items and the distress associated with discarding them Such clutter may not only impair personal and social functioning but also result in fire hazards and unhealthy sanitary conditions. Individuals with hoarding disorders seldom seek consultation for hoarding symptoms Excoriation (skin-picking) disorder People with this disorder keep picking at their skin, leading to sores and other skin problems, as well as, in some cases, lesions. Most people with this disorder pick their fingers and center their focus on one area of the body, most often the face The skin-picking is usually triggered and accompanied by anxiety and stress Trichotillomania (hair-pulling disorder) Continually pull out hair from the scalp or other areas of the body The hair-pulling typically is only focused on one body part, most often the scalp, eyebrows, or eyelids, and done one hair at a time, sometimes in a ritualistic manner This disorder is triggered and accompanied by anxiety and stress

Disorders that involve the presence of sad, empty, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual's capacity to function

A major depressive episode is characterized by symptoms such as feelings of intense hopelessness, low self-esteem, and worthlessness; extreme fatigue; dramatic changes in eating and sleeping behavior; inability to concentrate; and greatly diminished interest in family, friends, and activities for a period of two weeks or more.

An episode characterized by abnormally elevated mood in which the person experiences symptoms such as inflated self-esteem with grandiose delusions, a decreased need for sleep, constant talking, distractibility, restlessness, and poor judgment for a period of at least a week. Example: A postal worker stayed up all night and then went off normally to work in the morning, however, having quit his job, withdrawn all of his family savings, and spent it on fish and aquariums. He told his wife that, the night before, he had discovered a way to keep fish alive forever. He then ran off to canvass the neighborhood for possible sales.

A disorder in which recurrent cycles of depressive and manic episodes occur

Bipolar I disorder: the person has both major manic and depressive episodes Bipolar II disorder: the person has full-blown depressive episodes, but the manic episodes are milder Bipolar I disorder is more common than Bipolar II disorder.

Schizophrenia is referred to as a psychotic disorder, because it is characterized by a loss of contact with reality.

No, in schizophrenia, the split is between the mental functions and their contact with reality; in multiple personality disorder, one's personality is split into two or more distinct personalities.

Positive Something has been added Symptoms are the more active symptoms that reflect an excess or distortion of normal thinking or behavior; including hallucinations (false sensory perceptions) and delusions (false beliefs). Example: hallucinations and delusions Negative Something has been removed These are deficits or losses in emotion, speech, energy level, social activity, and even basic drives such as hunger and thirst. Example: Many people with Schizophrenia suffer a flat affect in which there is a marked lack of emotional expressiveness. Disorganized symptoms Nonsensical speech and behavior and inappropriate emotion One thought does not follow the other. Those who show inappropriate emotion may smile when given terrible news. Their emotional reactions seem unsuited to the situation. Example: Disorganized speech sounds like a "word salad" with unconnected words incoherently spoken together and shifting from one topic to another without any apparent connections.

Physical actions that do not appear to be goal directed, such as assuming and maintaining postured and remaining motionless for a long period of time Takes extreme forms ranging from immobility to hyperactivity (such as rocking constantly).

A psychotic disorder in which at least two of the following symptoms are present most of the time during a 1-month period---hallucinations, delusions, disorganized speech, disorganized or catatonic behavior, or negative symptoms such as loss of emotion.

In chronic schizophrenia, their is a long period of development, over years, and the decline in the person's behavior and thinking occurs gradually. In acute schizophrenia, their is a sudden onset of symptoms that usually can be attributed to a crisis in the person's life, and the person functioned normally before the crisis with no clinical signs of the disorder. Acute schizophrenia is more of a reactive disorder, and recovery is more likely. Type I is characterized by positive symptoms, and Type II by negative symptoms. Type I is similar to acute schizophrenia. People with Type I schizophrenia respond better to drug therapy than do those with Type II. This difference may because the positive symptoms of Type I result from neurotransmitter inbalances, which are affected by drugs, whereas the most permanent structural abnormalities in the brain that produce the negative symptoms of Type II are not affected by drugs.

Positive

A disorder characterized by inflexible, long standing personality traits that lead to behavior that impairs social functioning and deviates from cultural norms

The avoidant, dependent, and obsessive-compulsive personality disorders

Shows total disregard for the rights of others and the moral rules of the culture.

Psychopath or sociopath

Biomedical therapy: involves the use of biological interventions, such as drugs, to treat disorders Psychotherapy:involves the use of psychological interventions to treat disorders

Clinical psychologist: Doctoral degree in clinical psychology; provides therapy for people with mental disorders Counseling psychologist: Doctoral degree in psychological or educational counseling; counsels people with milder problems such as academic, job, and relationship problems Psychiatrist: Medical degree with residency in mental health; provides therapy for people with mental disorders and is the only type of therapist who can prescribe drugs or other biomedical treatment Psychoanalyst: Any of the above types of credential, but with training in psychoanalysis from a psychoanalytic institute; provides psychoanalytic therapy for psychological disorders Clinical social worker:Master's doctoral degree in social work with specialized training in counseling; provides help with social problems, such as family problems

The earliest biological treatment was trephining, which was done in the Middle Ages. In this primitive treatment, a trephine (stone tool) was used to cut away a section of the person's skull, supposedly to let evil spirits exit the body, thus freeing the person from the disorder. The "tranquilizing chair" was designed by Benjamin Rush, the "father of American psychiatry," who actually instituted many humane reforms in the treatment of mental patients. The treatment called for patients to be strapped into a tranquilizing chair, with the head enclosed inside a box, for long periods of time. The restriction of activity and stimulation was supposed to have a calming effect by restricting the flow of blood to the patient's brain.

Drug therapy

Advantages Monoamine oxidase (MAO) inhibitors increase the availability of the neurotransmitters norepinephrine, serotonin, and dopamine (which affect our mood) by preventing their breakdown Tricyclics make the neurotransmitters norepinephrine and serotonin more available by blocking their reuptake during synaptic gap activity Research indicates that Monoamine oxidase (MAO) inhibitors are fairly succesful in combating depressive symptoms Antidepressent medicine is significant for patients with very severe depression Benzodiazepines reduces anxiety by increasing the activity of the major inhibitory neurotransmitter GABA. When GABA's activity is increased, it reduced anxiety by slowing down and inhibiting neural activity, getting it back to normal levels. Some antidepressant drugs, especially the SSRIs, has been very successful in treating anxiety disorders. Antipsychotic drugs are drugs that reduce psychotic symptoms. This drug works antagonistically by globally blocking receptor sites for dopamine, thereby reducing its activity. These drugs greatly reduced the positive symptoms of schizophrenia but had little impact on the negative symptoms. Abilify (third generation antipsychotic drug) achieves its effects by stabilizing the levels of both dopamine and serotonin activity in certain areas of the brain. It blocks receptor sites for these two neurotransmitters when their activity levels are too high and stimulates these receptor sites when their activity levels are too high. Disadvantages Monoamine oxidase (MAO) are not used often because of a potentially very dangerous side effect. Their interaction with several different foods and drinks may result in fatally high blood pressure. Recent evidence has shown that benzodiazepines has potentially dangerous side effects, such as physical dependence or fatal interactions with alcohol. The traditional drugs (for example, Thorazine and Stelazine) produce side effects in motor movement that are similar to the movement problems of Parkinson's disease. There is a long-term use side effect of traditional antipsychotic drugs called tardive dyskinesia in which the patient has uncontrollable facial tics, grimaces, and other involuntary movements of the lips, jaw, and tongue. Long-term antipsychotic treatment was associated with smaller volumes of both brain tissues and gray matter. Other studies have found similar decreases in gray matter in the short term memory. Antipsychotic drugs may lead to loss of brain tissue or exacerbate declines in brain volume caused by schizophrenia.

A biomedical treatment for severe depression that involves electrically inducing a brief brain seizure

yes

Transcranial magnetic stimulation (TMS)

A biomedical treatment in which specific areas of the brain are destroyed

No, because it is involves irreversible brain injury, psychosurgery is done very infrequently today. These procedures are used only in cases of serious disorders when all other treatments have failed, and only with the patient's permission.

A type of psychosurgery in which the neuronal connections of the frontal lobes to lower brain areas are severed.

Freeman developed the transorbital lobotomy technique--gaining access to the frontal lobes through the eye socket behind the eyeball with an ice-pick-like instrument, and then swinging the instrument from side to side, cutting the fiber connections to the lower brain Because it renders the patient unconscious, ECT was often used as the anesthetic Unfortunately, these primitive procedures had already left thousands of victims in a zombelike, deteriorated state

Psychoanalysis and humanistic therapies are usually referred to as insight and therapies-- they focus on the person achieving insight into (conscious awareness and understanding of) the causes of his behavior and thinking. In contrast, behavioral and cognitive therapies are usually referred to as action therapies-- they focus on the actions of the person in changing his behavior or ways of thinking.

Such problems are repressed in the unconscious but continue to influence the person's behavior and thinking. The task for the psychoanalyst is to discover these underlying unconscious problems and then help the patient gain insight. The therapist has to identify conscious reflections of the underlying problems and interpret them. The major task of the psychoanalyst, then is to interpret many sources of input--including free associations, resistances, dreams, and transferences-in order to find the unconscious roots of the person's problems.

A style of chotherapy, developed by Carl Rogers, in which the therapist uses unconditional positive regard, genuineness, and empathy to help the person to gain insight into his or her self-concept.

A style of psychotherapy in which the therapist uses the principles of classical and operant conditioning to change the person's behavior from maladaptive to adaptive.

Behavioral therapies are based in either classical or operant conditioning.

Counterconditioning therapies, such as systematic desensitization, virtual reality therapy, and flooding, have been especially successful in the treatment of anxiety disorders. Systematic desensitization is when the patient first develops a hierarchy of situations that evoke a fear response, from those that evoke slight fear up to those that evoke tremendous fear. Once the hierarchy is set, the patient is then taught how to use various techniques to relax. Once this relaxation training is over, the therapy begins. The patient starts working through the hierarchy and attempts to relax at each step. First the patient relaxes in imagined situations in the hierarchy and latter in the actual situations. With both imagined and actual situations, the anxiety level of the situation is increased slowly. In Virtual reality therapy the person wears a motion-sensitive display helmet that projects a three-dimensional virtual world, the patient experiences seemingly real computer-generated images rather than imagined and actual situations as in systematic desensitization. When the patient achieves relaxation, the simulated scene becomes more fearful until the patient can relax in the stimulated presence of the feared object or situation.

Behavioral therapies using operant conditioning principles reinforce desired behaviors and extinguish undesired behaviors.

Yes, it has been fairly successful in managing autistic and schizophrenic institutionalized populations.

A style of psychotherapy in which the therapist attempts to change the person's thinking from maladaptive to adaptive

In Ellis's rational-emotive therapy, the therapist directly confronts and challenges the patient's unrealistic thoughts and beliefs to show that they are irrational. Rational-emotive therapists are usually very direct and confrontational in getting their clients to see the errors of their thinking. Aaron Beck's form of cognitive therapy is not confrontational. A therapist using Beck's cognitive therapy works to develop a warm relationship with the person and has a person carefully consider the objective evidence for his beliefs in order to see the errors in his thinking. The therapist is like a good teacher, helping the person to discover the problems with his thinking.

Depressive disorders

None of the psychotherapies are very successful in treating schizophrenia.

No one particular type of psychotherapy, is superior to all the others.

Some types of psychotherapy seem to be more effective in treating particular disorders. Behavioral therapies have been very successful in treating phobias and other anxiety disorders. Cognitive therapies tend to be very effective in treating depressive disorders.