PSY 436 Abnormal Psychology – Flashcards
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Criteria for determining abnormality
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deviance from the norm (statistical deviance); difficulties adapting to life demands (maladaptive behavior); experience of personal distress
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Mental disorder
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group of emotional, cognitive, or behavioral symptoms that cause distress or significant problems in functioning
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Abnormal psychology
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scientific study of troublesome feelings, thoughts, and behaviors associated with mental disorders
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Three general theories throughout history
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supernatural, biological, psychological
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Mental illness in ancient times
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- primarily supernatural explanations - what might happen to someone exhibiting bizarre behavior?
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Exorcism
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process intended to drive out demons or evil spirits
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Trephination
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drilling, cutting, or scraping a hole in the skull
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Hippocrates
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said abnormal behavior was due to diseases or dysfunctions in the brain; recommended treatments such as special diets, rest, avoiding alcohol, exercise, and celibacy
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Hippcrates' Humoral Theory
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disorders are caused by an imbalance of the our major bodily fluids: blood, black bile, yellow bile, and phlegm; too much black bile (melancholer) = depression; common treatments include bloodletting and vomitting
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Fall of the Roman Empire
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return to supernatural theories and exorcism; exorcism during this time: larger church influence
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Middle Ages
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interesting instances of "mass madness"
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St. Vitus's Dance
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dancing mania; large groups broke out in dance; hundreds, even thousands at a time
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Lycanthropy
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belief that you have been turned into a demonic animal like a werewolf
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Late Middle Ages
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starting in the 11th century, massive persecution of women declared to be witches; pope decreed that witches be executed
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Malleus Maleficarum (Witch's Hammer)
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manual written by two priests; outlined tests for witches (water-float test); sometimes tortured until they confessed; those found guilty of witchcraft were jailed, tortured, and executed
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Tools of witch torture
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burning at the stake, the breast ripper, burning iron chair
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The Renaissance
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cultural movement that led to rebirth in natural approaches to health and human behavior
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Paracelsus
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rejected humoral theory; theorized that disease came from sources outside the body (such as toxins); also proposed theory of influence of moon and stars as explanation of abnormal behavior; coined the term for people exhibiting bizarre behavior due to influence of the moon (lunatic)
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Asylums
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earliest version of psychiatric hospitals; mentally disturbed began to be seen as threatening to society; early laws regarding mentally ill were designed to protect the public, not the patient; first asylums appeared in Europe in 1500s
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Madhouses
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places where mentally disturbed people were housed; often tied/chained up; horrific conditions; little or no treatment for their problems; some were source of entertainment for the townspeople (St. Mary's of Bethlehem)
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Reform Movement and Dr. Philippe Pinel
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- French physician in charge of an asylum in Paris - argued that abnormal behavior was due to a disease - ordered a radical treatment of mental patients by removing shackles, allowed them fresh air and exercise, and treated them with dignity and respect
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Moral Therapy in the Asylums
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- moral = psychological or emotional - main premise: mental illness is due to separation from nature and stress of rapid social changes - led to interesting implications for what could cause "insanity
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Reform Movement in America and Dorothea Dix
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advocate for moral therapy in America, initiated legal reforms for jails, asylums; helped establish over 30 mental institutions
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Assumed causes of insanity in 1800s
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biological and moral causes thought to cause insanity; can look to asylum reports for examples (wide variety of biological, psychological, and moral causes)
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Modern Era, Clifford Beers and the Mental Hygiene Movement
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was a patient in a mental institution in 1900; published "A Mind that FOund Itself" describing neglect and abuse in the asylum; founded "National Committee for Mental Hygiene" which improved quality of care of mental patients, spurned research on prevention of mental illness, and provided information to public about mental illness
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Somatogenic
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emphasizes physical and bodily causes of mental disorders
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Psychogenic
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emphasizes psychological and mind-related causes of mental disorders
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Integrationist view
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cause of mental disorder is best understood as a complex interaction of biological, psychological, and sociocultural factos
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Primary prevention
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a type of prevention targeting large groups of people who HAVE NOT YET developed a disorder
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Secondary prevention
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a type of prevention that addresses EMERGING PROBLEMS while they are still manageable and before they become
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Tertiary prevention
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a type of prevention aimed to reduce the severity, duration, and negative effects of a mental disorder AFTER it has occurred
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Consumer perspective
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building your skills as consumer of scientific information; focus on empirically-supported treatments
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Structural theories of the biological model
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abnormalities in the structure of the brain
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Biochemical theories of the biological model
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imbalances in the levels of neurotransmitters or hormones, or poor functioning of receptors
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Genetic theories of the biological model
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abnormal genes
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Case of Phineas Gage
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illustrates just how important the brain is for personality and behavior; rod went through skull, changed personality, was nice now is vulgar
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Cerebellum
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coordination, posture, balance
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Brain stem
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involuntary life functions
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Medulla
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breathing and blood circulation
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Pons
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sleep and arousal
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Reticular activating system
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arousal and stress
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Cerebral cortex
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consciousness, memory, attention
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Frontal lobe
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planning and organization, decision making, behavioral inhibition, and expression of emotion and social behaviors
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Limbic system
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several structures deep in the brain; regulate basic emotions and impulses
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Amygdala
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emotion and aggression
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Hippocampus
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memory and learning
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Thalamus
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"relay station;" forebrain to other areas
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Basal ganglia
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posture and motor movement
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Hypothalamus
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basic instinctual behaviors (the four F's), fighting, fleeing, feeding, and f'ing
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Biochemical abnormalities
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neurotransmitters and neuron functioning; neuron receives stimulation from adjacent neurons, produces an action potential (chemically induced voltage transmission), stimulates release of neurotransmitters, termination of signal (degradation, re-uptake)
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Degradation
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enzymes break down neurotransmitters in synapse
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Re-uptake
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neurotransmitters "vacuumed" back up by the releasing neuron
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Ways neuron functioning may be abnormal
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neurotransmitter levels too high/low; not enough receptors/receptors too sensitive (or the opposite)
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Neurotransmitters involved in mood/behavior
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serotonin, dopamine, norepinephrine, GABA, and glutamate
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Serotonin
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regulation of emotions and impulsivity, including aggressive impulses
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Dopamine
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sociability, pleasure, and motivation; involved in areas of the brain regulating experience of reinforcement/rewards; voluntary motor functioning
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Norepinephrine
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mood regulation, attention and arousal, regulation of sleep, and also involved in the fight-flight response
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GABA
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mood regulation, especially anxiety, arousal, and behavioral activity level
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Glutamate
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involved in learning and memory
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Behavioral genetics
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study of the genetic and environmental influences on development of emotions, cognitions, and behavior, including mental disorders
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Types of abnormalities
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structure or number of chromosomes (Down's syndrome, extra copy of chromosome 21); abnormalities in the genes that make up chromosomes, most are polygenetic
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Genotype
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genetic composition of a person
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Phenotype
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observable characteristic of a person, influenced by genotype but can change
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Heritability
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amount of variation in a phenotype attributable to genetic factors
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Probands
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people who have the disorder
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Controls
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people who do NOT have the disorder
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Monozygotic vs Dizygotic
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MZ twins - 100% shared genes DZ twins - 50% shared genes
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Concordance rates
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degree of agreement in diagnosis between pairs of people; look at this for genetic influence (MZ vs DZ)
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Adoption studies
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asks to what extent does a disorder run in families, but without the shared environment as competing explanation; most common method is to identify people with the disorder who were adopted at birth, then compare incidence of disorder across first-degree biological relatives
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Psychodynamic model
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childhood experiences shape adult personality; causes and purposes of behavior partly due to unconscious motives; people use defense mechanisms to control anxiety; everything we do is done for a reason (Freud: "There are no accidents.")
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Freud's structure of mind theory
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the id and ego
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Three major components to personality
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id, ego, and superego
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Id
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present from birth and unconscious; drives you to meet immediate demands such as hunger, thirst, aggression, and sexual pleasure; pleasure principle
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Ego
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mediates between demands of the id and what society deems appropriate; rational, reality principle
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Superego
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represents rules of society, ideals, and values imparted by parents; what we would think of as a conscience
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Humanistic model
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developed as a reaction to a lack of free will inherent in the psychodynamic model; primary assumption is that people are naturally good and strive for personal growth and fulfillment; when striving is blocked, mental disorder results
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Founder of the Humanistic Model
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Abraham Maslow
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Developed a humanistic psychotherapy (client-centered therapy)
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Carl Rogers
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Maslow's Hierarchy of Needs
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basic premise is that everyone strives toward satisfying their basic and higher-order needs; hierarchy implies certain needs must be met before others can be pursued; most basic needs are physiological; basic survival includes food, water, and sleep
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Physiological needs
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breathing, food, water, sex, sleep, homeostasis, excretion
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Safety needs
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security of the body, of employment, of resources, of morality, of the family, of health, of property
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Love/Belonging needs
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friendship, family, sexual intimacy
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Esteem needs
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self-esteem, confidence, achievement, respect o others, respect by others
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Self-actualization needs
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morality, creativity, spontaneity, problem solving, lack of prejudice, acceptance of facts
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Client-centered therapy
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Carl Rogers; key ingredients included unconditional positive regard and accurate empathy
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Unconditional positive reward of client-centered therapy
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person is accepted completely and unconditionally
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Accurate empathy of client-centered therapy
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understanding of a persons feelings and experience; being able to "put yourself in their shoes"
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Humanistic model pros
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focus on potential for choice and personal growth, emphasizes personal responsibility, useful for establishing rapport, expressing emotions over issues such as grief
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Cons of humanistic model
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not empirically supported, not indicated for serious mental disorders such as schizophrenia or severely suicidal patients
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Cognitive-behavioral model
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focuses on both internal and external factors, cognitive focusing on thought processes and behavioral focusing on external events and consequences of behavior; relevant to a large number of mental disorders; excellent empirical support
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Main premise of cognitive model
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our thoughts have an influence on our behavior and emotions (vice versa); three general types of cognitions implied to disorders include causal attributions, control beliefs, and cognitive distortions
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Causal attributions
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focuses on our interpretations of "why" certain events happen (why did your boyfriend not call you back?); explanations can be categorized along dimensions such as temporary vs. stable or internal vs. external
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Control beliefs
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thoughts related to your ability to control important events/outcomes in your life; motivation to take action (hope); learned helplessness
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Cognitive distortions
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irrational, inaccurate thoughts about environmental events; usually occur as "automatic thoughts"; example include arbitrary inference, personalization, overgeneralization, should statements, emotional reasoning, and mental filter
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Arbitrary inference
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conclusions not based on evidence
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Personalization
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blaming yourself for events
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Overgeneralization
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general conclusion based upon one event
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Should statements
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"I should ______." "Other people should _____."
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Emotional reasoning
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if you feel it, it must be true
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Mental filter
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you pick one single negative detail and dwell on it
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Behavioral/learning models
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developed in reaction to psychodynamic theories of the unconscious; focuses on how behavior is learned through our experiences in the environment; two primary principles include classical conditioning and operant conditioning
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Classical conditioning
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Ivan Pavlov; research on dogs and the salivation reflex; a neutral stimulus acquires the capacity to evoke a response that is elicited automatically by some other stimulus; learning by association
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Unconditioned stimulus
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"food"
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Conditioned stimulus
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"bell"
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Conditioned response
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"salivation"
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Operant conditioning
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process by which behavior is shaped through its consequences; behavior followed by positive or pleasurable consequences is likely to be repeated but behavior followed by negative consequences is not likely to be repeated; Thorndike's Law of Effect
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Reinforcement
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consequences of behavior that increase the likelihood of the behavior occurring again; positive vs. negative
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Punishment
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consequences that decrease the likelihood of the behavior occurring again; positive vs. negative
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Positive reinforcement
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adding a pleasant event or consequence after a behavior to increase frequency of behavior
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Negative reinforcement
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removing an aversive event following a behavior to increase frequency of behavior
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Escape learning
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an organism acquires a response that decreases or ends some ongoing aversive stimulus
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Avoidance learning
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an organism acquires a response that prevents some aversive stimulus from occurring
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Sociocultural model
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perspective includes a primary emphasis on environmental factors, such as living environment and culture
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Culture
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values, beliefs, and preferences that are learned from others such as parents; not the same as race or ethnicity; difference between race and ethnicity
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Culture-bound syndromes
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specific mental disorders are only seen in certain cultures
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Koro
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extreme fear that your penis is shrinking and recessing into your abdomen (Asian men)
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Dhat
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extreme fear that one is "losing" semen through masturbation or in the urine, and will lead to illness (Indian men)
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Frigophobia
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extreme fear of getting cold (China and Taiwan)
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Voodoo death
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when someone dies after breaking some kind of cultural taboo or after being "cursed"; caused by intense fear; seen in areas with strong beliefs in witchcraft such as Africa, South America, Australian natives, and Pacific Islands
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Anthrophobia
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fear of being around people, driven by the fear of blushing, making eye contact with people, and fear that your body odor offends people; a form of social phobia seen primarily in Japan
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Anorexia nervosa
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eating disorder that causes most people to be underweight; prevalence varies by culture; mainly seen in American and European cultures; rarely seen in countries where food is not abundant or in cultures where being thin is not seen as the "ideal body"
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Neighborhoods and communities
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some characteristics of neighborhoods are correlated with psychological problems; high poverty and frequent turnover in residents results in higher rates of juvenile delinquent behavior/child maltreatment; crowding, pollution, noise, violence results in higher rates of depression, anxiety, and child behavior problems
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Why do neighborhood characteristics relate to mental health?
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social causation theory and social drift theory
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Social causation theory
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low SES causes mental disorder, overcrowding is stressful, violence leads to fear of safety, witnessing violence and being the victim of violence is very stressful and can lead to PTSD
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Social drift theory
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mental disorder leads to a decrease in social class
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Diathesis-stress model
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diathesis + stress = disorder
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Biological interaction of diatheses and stressors
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emphasis on biological processes such as genetics
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Psychological interaction of diatheses and stressors
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emphasis on psychological factors such as early childhood experience and self-concept
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Social interaction of diatheses and stressors
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emphasis on interpersonal relationships and social environment
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Dimensions vs categories
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symptoms are usually dimensions while disorders are considered categorical
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Dimensions
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range of severity of abnormality of thoughts, behaviors, and emotions
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Categories
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number of symptoms and severity of symptoms either enough to be considered a disorder or not
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DSM-5
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diagnostic and statistical manual of mental disorders; clear criteria for disorders including duration; prototype approach to classification; provides mental disorder classification, groups of related disorders are categorized under broad headings, such as bipolar disorders, depressive disorders, and anxiety disorders
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DSM-5 definiton of mental disorder
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syndrome; associated with emotional distress or impairment in functioning; syndrome not just an expected or culturally appropriate response to a specific event; symptoms considered to be caused by psychological, behavioral, or biological dysfunction
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Syndrome
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group of signs and symptoms
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Why is diagnosis important?
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communication among professionals, standardized definition of particular disorders when doing research on treatment or causes, and standard assessments for the conditions can be developed which allows for large scale epidemiological studies
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Purposes of clinical assessment
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to understand the individual, predict behavior, plan treatment, evaluate treatment outcome; usually trying to answer some kind of "referral question"
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Reliability
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consistency in measurement; are we measuring something?; test-retest, inter-rater, internal consistency
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Test-retest reliability
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extent to which a person provides similar answers to the same test items across time
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Interrater reliability
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agreement between two or more raters or judges about level of a trait or presence/absence of a feature or diagnosis
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Internal consistency
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extent to which test items appear to be measuring the same thing
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Validity
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degree to whether the test measures what it is supposed to measure
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Content validity
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degree to which test or interview items actually cover aspects of the variable or diagnosis under study
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Predictive validity
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whether test or interview results accurately predict some behavior or event in the future
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Concurrent validity
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whether current test or interview results relate to an important feature or characteristic at the present time
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Construct validity
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whether test or interview results relate to other measures or behaviors in a logical, theoretically expected fashion
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Standardization
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explicit instructions for how the procedure is administered, scores, and interpreted; ensures consistency in how the technique is used; ex: SAT
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Types of assessment methods
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clinical interview and psychological testing, including intelligence tests and personality assessments
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Formats for clinical interview
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structured and unstructured
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Structured clinical interview
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question are pre-set and laid out for the interviewer; most common use is for research; ex: SCID
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Unstructured clinical interview
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most common interview in treatment settings; no set questions
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Intake interview
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most common type of unstructured clinical interview; assess presenting problems such as chief complaint, related symptoms, development and progression of symptoms, and life events or stressors; screening for symptoms of other mental disorders, personal/social history, medical and family, and mental status exam in some settings
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Intelligence tests
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Sir Francis Galton first attempted an intelligence test, sensory discrimination tests
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Binet-simon scale
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1905; first successful intelligence test that was designed to determine which kids would do well in school
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Modern intelligence tests
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measure cognitive functioning and intellectual ability such as memory, language, logical reasoning, and speed of information processing; used in evaluations of learning disability, brain dysfunction, and as a supplement to diagnostic/personality assessments; usually a battery on many tests in one b/c it yields scores for multiple domains such as verbal IQ, performance IQ, and full scale IQ; average IQ score is 100
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Personality testing
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normal personality and abnormal personality
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Normal personality
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big five personality traits; extraversion, agreeableness, openness, conscientiousness and neuroticism
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Abnormal (clinical) personality traits
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anxiety, depression, narcissism, etc.
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Two types of personality tests
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objective and projective
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Projective personality tests
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began in the psychoanalytic tradition; we "project" aspects of personality onto our interpretation ambiguous test stimuli; most popular include Rorschach inkblot test and Thematic Apperception Test (tell story from pics)
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Objective personality tests
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usually are questionnaires with statements typically rated as true/false and sometimes using a Likert scale; Minnesota Multiphasic Personality Inventory (MMPI-2-RF) has 338 statements rated as T/F, yields scores for lots of traits, and has validity scales
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Validity scales of MMPI-2
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L, F, TRIN
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L scale
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uncommon virtues
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F scale
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infrequent responses
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TRIN scale
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true response inconsistency
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Personality scales
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demoralization, low positive emotions, antisocial behavior, anxiety, substance abuse, anger-proneness