Chapter 1
Lecture Notes

What is Abnormal Psychology?

Definition common features "the four D's": Deviance, distress, dysfunction, and danger.

-Deviant (different, extreme, unusual, perhaps even bizarre)

-Distressing (unpleasant and upsetting to the person)

-Dysfunctional (interfering with the person's ability to conduct daily activities in a constructive way); and possibly dangerous.

-Deviance- behaviors, thoughts, and emotions that are different from those that are considered normal in our place and time.

In short, behavior, thoughts, and emotions are those that differ markedly from a society's ideas about proper functioning.

Each society establishes norms- stated and unstated rules for proper conduct.

-Behavior that breaks legal norms is called criminal.

-Behavior, thoughts, and emotions that break norms of psychological functioning are called abnormal.

Alexandra were in fact occurring in the days following the deadly terrorist attack on the World Trade Center on September 11, 2001

Distress- behavior, ideas, or emotions usually have to cause distress before they can be labeled abnormal.
Brad does experience severe distress over the coming invasion and the life changes he feels forced to make. But what if, instead, he enjoyed listening to the voices, felt honored to be chosen, and looked forward to saving the world? Shouldn't we still consider his functioning abnormal?

Dysfunction- it interferes with daily functioning.

Brad, for example, has quit his job, left his family, and prepared to withdraw from the productive life he once led.

Danger- dysfunctioning is behavior that becomes dangerous to oneself or others

Brad, for example, seems to be endangering himself by his diet and to others by his buildup of arms and ammunition.
Most people struggling with anxiety, depression, and even bizarre thinking pose no immediate danger to themselves or to anyone else.

Marching to a Different Drummer: Eccentrics

Emily Dickinson: always wore white, never left her room, and hid her poems in tiny boxes.
Alexander Graham Bell: covered the windows of his house to keep out the rays of the full moon. He also tried to teach his dog how to talk.
The writer D.H. Lawrence enjoyed removing his clothes and climbing mulberry trees.

Societal invention of the concept of mental illness so that they can better control or change people whose unusual patterns of functioning upset or threaten the social order.
Eccentricity: an unusual pattern that others have no right to interfere with.

-These criteria are often vague.

The field devoted to the scientific study of abnormal behavior is call abnormal psychology.

-Its goals are to understand and treat abnormal patterns of functioning.

Abnormal functioning is generally considered to be deviant, distressful, dysfunctional, and dangerous.

Behavior must also be considered in the context in which it occurs, however, and the concept of abnormality depends on the norms and values of the society in question.

Treatment, or therapy, is a procedure to help change abnormal behavior into more normal behavior.

Therapy has three key features:

-Seek relief,
-Socially accepted healer,
-Series of contacts.

Abnormality may have begun in the Stone Age and shows evidence of an operation called trephination, which cuts away a circular section of the skull.

-The purpose of it is to let out the evil spirits that were supposedly causing the problem.

Later: Exorcism was to coax the evil spirits to leave or to make the person's body an uncomfortable place for them to live in.

Greeks and Romans: Illnesses had natural causes.

They saw abnormal behavior as a disease caused by internal physical problems.

From an imbalance of four fluids, or humors, that flowed through the body: yellow bile, black bile, blood, and phlegm.

Middle ages: People blamed the devil for these troubles and feared

Renaissance: Home care which the local parish supported financially

-Colonies of individuals: Community mental health programs

-Monasteries became asylums, which intended to do well but became overcrowded and turned into prisons.
(Bedlam)

19th century: moral reform
-Dorothea Dix: each state responsible for mental health hospitals.

20th century somatogenic and psychogenic perspectives

-Causes are psychological

-So you get different treatment: hypnosis, psychoanalysis (discussions)

Currently

-Psychotropic medications: drugs that affect the brain.

-Deinstitutionalization: let em out and treat from home.

Stats: 1 in 6 receive asst.
1 in 5 children

Very specific programs: Suicide, eating, sexual

Prevention approach. Physical and mental well-being.

Insurance now is involved to help.

Research

Variable: Characteristic than can vary

Case study: On person's life

Correlational method: Measure how much one thing varies with another.
-Participation in sports and academic retention
-Age that divorce occurs in a family and the effects on children.

Positive Correlation: Frequency goes up in both
-More frequent use of alcohol/drugs, more pregnancy.
Negative Correlation: One goes up, one goes down
-More education, less suicide

Correlation does not explain the relationship only that one exists either pos or neg.

Correlational coefficient: Strength of relationship.
-Closer to 1 the stronger, the closer to 0 weak.

Experimental method: Manipulate a variable and observe the effects on another variable.
-Try to eliminate other elements that may affect outcome.

-Independent: Manipulated
-Dependent: Not manipulated

EX. Children asked to complete a task. One group is given praise when they complete the task, the other is not. Scientists are looking into the effects of positive reinforcement on success rates for children. The praise is the independent variable and the performance is the dependent variable.

-Control group: Not exposed to the independent variable
-Experimental group: Exposed to the independent variable.

EX. The children who receive no praise are the control group and the children that are praised if the complete the task are the experimental group.

Random Assignment: Selection of groups randomly to avoid influence.
Blind design: People don't know what group they are in.

Placebo: Sugar pill

 

Psychology 2

Chapter 2 Lecture

 

Models of Abnormality:

-Models Handout supports this

 

Over the course of our lives each of us has developed a perspective that helps us make sense of things or explain others say and do: Those are our models.

 

-Why did the man who found his wife cheating on him kill her lover?  Humanistic? Biological? Behavioral?

 

-Why did the soldier freeze in battle? Sociocultural? Behavioral?

 

-Why did the child from a well to do family who had never been exposed to drugs go away to college and become a drug addict in his freshman year? 

 

How we explain these things begins to tell us, which model we favor.

 

Biological model

 

Theory: All of us are biological beings and our thoughts and feelings are a result of biochemical processes.

            Logically treatment needs to be a biological one. (most common today)

Show psychology

 

Brain is made up of neurons and has brain regions. Each region controls a function.

                        -Example: Hippocampus: emotions and memory

 

Research shows a connection between psychological problems and the loss of cells in the brain.

                        -Lack of emotional control: Loss of cells in the basal ganglia

 

Brain Chemistry

 

Synapse: The space between neurons

Neurotransmitter: Chemical that travels across the space

Receptors: Receive the transmission and pass the info along.

 

-Abnormal behavior has been traced to over firing (Schizophrenia) and under firing. (Depression)

 

Hormones: Release chemicals from glands into the bloodstream. Propel organs into action.

            -Improper levels of release can lead to stress and mood disorders.

 

Genetics: Genes passed down from parents and contain keys to many disorders, yet we can’t find the specific gene that contains the problem.  (25% chance of getting Alzheimer’s if either parent has it)

 

Evolution: Pass on fear genes that were useful before but not now. Incorrect perceptions of modern situations. Leads to disorders.

 

Viral Infections: Fetus exposure to infections prior to birth lead to abnormalities in the brain that may lay dormant until as late as puberty.  (Schizophrenia)

 

Treatments

 

Psychotropic medications (affect the brain):

-Anti anxiety, antidepressants, anti-polar (Stabilizers), and anti psychotic (reduce confusion.

 

Electro-convulsive therapy: Electrodes send current through the brain.

            -7 to 9 treatments,  2 to 3 days apart.

            -Effective for depression

 

Psychosurgery: Brain surgery that removes part of the brain or cuts connections within the brain.  Very rare.

 

 

Psychodynamic model

 

Theory: Behavior is connected to subconscious forces and are a result of past experiences.

            Logical treatment: bring to light events and understand them.

 

Abnormal behavior would be the result of conflicts that have seeded inside of you from traumatic experiences that have occurred earlier.

 

            Freud develops psychoanalysis to find these conflicts.

-Believed that 3 forces shape our personality: instinctual needs (id), rational thinking (ego), and moral standards (superego)

 

Id: impulses, pleasure principal, always seeks gratification

Ego: Uses reason to determine which needs can be satisfied and which can’t.

Superego: Conscience, developed from parents or whoever raises us.

Fixation: Stuck on one development.

Problems arise when one forces acts too strongly. A compromise must exist.

-When we behave without conscience or when we deny ourselves too often.

            We develop Defense Mechanisms to control unacceptable id impulses. page 39

 

Treatments

 

Psychotherapy: get to the trauma; make people realize their unconscious motives.

Use free association Therapy interpretation. Rorschach

Dream analysis: Less defense to what we really think here.

 

Catharsis: Relive the trauma to reduce its effect

-Take the person through the experience and show them the errors in their perceptions or inevitability of the outcome.

 

 

Behavioral model

 

Theory: Behaviorist also believe that experiences in life affect today’s actions

BUT the behavior has been learned. Or as the book says, “Conditioned”

 

            Logical Treatment: Unlearn or replace conditioned behavior.

 

            -Operant conditioning: Use of rewards to affect behavior.

                        -If I seek attention and I get it from acting out, I will act out.

                        -If I want approval, I will behave in a manner to get it.

            -Modeling: Observe others in similar situations

-You will find that you have developed both conscious and unconscious behaviors from your parents. (Stress handling, habits, and response types)

-Classical conditioning: associative learning

            -Pavlov’s dogs

                        -Unconditioned stimulus: meat

                        -Unconditioned response: salivation Natural

                        -Conditioned Stimulus: Bell

                        -Conditioned Response:  salivation Unnatural

                       

            -Response to a woman’s perfume: Conditioned response

            -Fear of clowns: comes from childhood experiences

 

Behavior Therapies

 

Try to identify behaviors that are causing problems and replace them with more appropriate ones.

Classical conditioning would be used in systematic desensitization: Dog bite example

 

Cognitive model

 

Theory: Cognitive therapists believe we create a world based on our perceptions and that can be accurate or inaccurate.

 

            Logical treatment: work to clarify perceptions.

 

            -Different from behaviorist in that this is about perceptions of events.

-Illogical thinking patterns such as generalizations lead to mis-perceptions. This leads to inappropriate behavior.

 

Cognitive therapies

           

            Need to develop new and more functional ways of thinking

                        -Recognize negative thinking patterns, errors in logic

                        -Example on pg 49 is good.

 

Humanistic model

 

Theory: Focus is on human issues such as self-awareness, values, meaning, and choice and how when we are denied these, conflict arises.

 

Logical treatment: Create an environment where person feels comfortable to discuss these private matters and resolve conflicts.

 

            We are all motivated to achieve. We want to be something or somebody.

                        -This does not necessarily mean fame and fortune: self-determined worth

 

            When we don’t achieve, abnormal behavior may result.

-         Conditions of worth: We are lovable only when they conform to certain guidelines and order to maintain positive self-regard.

-     First from parent figures

“The road to dysfunction begins in infancy.  Basic needs are to receive positive regard from the important people in our lives.”

-         Later from peers

-         Maybe society as a whole

 

Existential Theories: Sub group of humanists

 

Existentialists agree that human beings must have an accurate awareness of themselves and live meaningful.

 

Those who decide to “hide” from responsibility and choice will view themselves as helpless and weak and may live empty, inauthentic, and dysfunctional lives.

 

Dysfunctioning is caused by self-deception

 

Therapy: Encouraged to accept responsibility

 

Carl Rogers- the pioneer of the humanistic perspective, developed client-centered therapy, a warm and supportive approach that contrasted sharply with the psychodynamic technique.

 

Rogers would probably link Phillip’s problem to the critical ways he was treated by his mother throughout his childhood. 

 

Client-centered therapy tries to create a supportive climate in which clients feel able to look at themselves honestly.

-Client-centered therapy has not fared very well in research.

 

(Gestalt Theory) Frederick Perls

 

They often try to achieve this goal by challenging and even frustrating their clients.  Some of Perls’s favorite techniques were skillful frustration, role-playing, and numerous rules and exercises. 

 

Clients may be required to use “I” language rather than “it” language.

 

Spiritual Views and Therapy

 

Freud argues that religious beliefs were defense mechanisms, “born from man’s need to make his helplessness tolerable”

 

Researchers have learned that spirituality can, in fact, be of psychological benefit.  Repeatedly, these persons are found to be less lonely, pessimistic, depressed, of anxious than people without any religious beliefs or those who view God as cold.

 

Sociocultural Model

 

Theory: The sociocultural model looks outward to the social forces that affect members of a society.  Some sociocultural theorists focus on the family system, while others look at cultural background, social networks, societal conditions, or societal labels and roles.  Sociocultural principles are on display in culture-sensitive, group, family, and couple therapies.  Research indicates that these treatment approaches are useful for some problems and under some circumstances.  In community treatment, therapists try to work with people in settings close to home, school, and work.  Their goal is primary, secondary, or tertiary prevention.

 

Logical treatment: Understand the forces acting on the person and work to relieve them of the conflicts created.

 

Social forces are always affecting our behavior, thoughts, and emotions.

            -Pressures for teens

                        -

            -Pressures for adults

                        -

            -Pressure on women or men

                        -

            -Pressure because of position or role in society

                        -Judge must act a certain way and carry him/herself a certain way

 

Abnormal behavior is best understood in light of the social and cultural forces that influence an individual.

 

We must examine a person’s social and cultural surroundings if we are to understand abnormal behavior.

 

“Culture” refers to the set of values, attitudes, beliefs, history, and behaviors shared by a group of people and communicated from one generation to the next.

 

Some psychologist look at the family for the answers because it is the most important part of the “culture” they interact with.

            -Pressure because of birth order

            -Pressure because of family make-up  (No Father, older child)

 

Treatments

 

            Group Therapy

 

            Family Therapy

 

            Couple therapy

 

 

Comparing the models: Great review spot.

 

            Pg 63

 

 

 

Psychology 2
Chapter 3 notes

Assessment: the process of collecting and interpreting relevant information about a client or subject.

Clinical assessment is used to determine:

            How and why a person is behaving abnormally.
            How that person may be helped.
            To evaluate people's progress after they have been in treatment for a while.

Decide whether the treatment should be changed.

            -Psychodynamic clinicians use methods that assess a client's personality and probe for any unconscious conflicts.

            -Behavioral and cognitive clinicians use assessment methods that reveal specific dysfunctional behaviors and cognitions.

Clinical assessment techniques

 Three categories: clinical interviews, tests, and observations. To be useful, these tools must be standardized and have clear reliability and                         validity.

Characteristics of Assessment Tools

Standardize: If all the same, then they can be compared

            -Clinicians must standardize the way they interpret the results of an assessment tool

            -Standardize the scores of a test, first administering it to a group of subjects whose performance will then serve as a common standard, or             norm.

Reliability refers to the consistency of assessment measures. A good assessment tool will always yield the same results in the same situation.

            -High test-retest reliability: If your IQ score varies each time you take it, then the test is no reliable.

            -To measure test-retest reliability, subjects are tested on two occasions and the two scores are correlated.

            -School: True-false tests yield consistent scores because no judgment involved. Essay tests may not because of their subjective nature.

            -Psychology: Person draws a picture, or responds a certain way which a psychologist then evaluates.

Validity: Accurately measure what it is supposed to measure

            An assessment tool may appear to be valid simply because it makes sense and seems reasonable; this validity is called face validity.

            Depressed people would cry would have face validity but there are other reasons people cry.

Predictive validity: a tool used to predict future behavior.

            Identify elementary school children who are likely to take up cigarette smoking in junior high school.
                        -Based on the fact that they fit the "profile"

Concurrent validity: When measures gathered from other assessment techniques match another assessment.

            -Interview matches written assessment

Clinical Interviews

A clinical interview is a face-to-face encounter

            Psychodynamic interviewers try to learn about the person's needs and memories of past events and relationships.

            Behavioral interviewers try to pinpoint information about the stimuli that trigger abnormal responses.

            Cognitive interviewers try to discover assumptions and interpretations that influence the person.

            Humanistic clinicians ask about the person's self-evaluation, self-concept, and values.

            Biological clinicians look for signs of biochemical or brain dysfunction.

            Sociocultural interviewers ask about the family, social, and cultural environments.

Structured interview

            A standard set of questions

            Example: Mental status exam

            Ensures that clinicians will cover the same kinds of important issues and compare the responses of different individuals

What are the limitations of clinical interviews?

            Lack validity, or accuracy. Individuals may intentionally mislead, people may be unable to give an accurate report in their interview

            Interviewer biases: the psychologist may want the diagnosis to come out a specific way
                        -Gender, race, age
            People respond differently to different interviewers

Clinical tests

            Projective tests, personality inventories, psychophysiological tests, neurological and neuropsychological tests, and intelligence tests.

            Projective tests interpret vague stimuli, such as inkblots or vague pictures, and then are asked to "Draw a person"

            Rorschach test: Create a symmetrical but wholly accidental design

                        The images a viewer saw seemed to correspond in important ways with his or her psychological condition.

                        Most widely used projective tests of the twentieth century

                        Do the subjects view the design as a whole or see specific details? Do they focus on the blots or on the white spaces between                                     them? Do they use or do they ignore the shadings and colors in several of the cards?

            Thematic Apperception Test

                        A pictorial projective test

                        30 black-and-white pictures of individuals in vague situations and are asked to make up a dramatic story about each card.

                        People always identify with one of the characters on each card. The stories are thought to reflect the individuals' own circumstances,                         needs, and emotions.

            Sentence-Completion Test

                        Ask people to complete a series of unfinished sentences

                        Good springboard for discussion

                        Drawings

                                    Clinicians often ask clients to draw human figures and talk about them.

            Merits of Projective Tests

                        Assessing personality

                        Gain "supplementary" insights

                        Declined in use as the primary and are now the supplemental because they have rarely shown much reliability or validity
                                    -Not that they are not, but that they can't be proven

            Personality inventories assess themselves and have a wide range of questions about their behavior, beliefs, and feelings.

                        The original MMPI consists of 550 self-statements.

Response Inventories- asks people to provide detailed information about them, but these tests focus on only one specific area of functioning. Use them to determine the roles such factors play in a person's disorder.

            Measure the severity of such emotions as anxiety, depression, and anger.

            Beck Depression Inventory is an example on page 75

            Strong face validity.

Psychophysiological Tests- measure physiological responses as possible indicators of psychological problems.

            Polygraph, popularly known as a lie detector

            Psycho physiological measurements can be inaccurate and unreliable. Laboratory equipment may arouse a subject's nervous system and             thus change his or her physical responses.

Neurological and Neuropsychological Tests- Some problems in behavior are caused primarily by damage to the brain or changes in brain and other disorder can all cause such impairment.

            Important to know whether its primary cause is physical abnormality in the brain.

            Techniques may help pinpoint brain abnormalities.

            Brain surgery, biopsy, and X ray, have neurological tests, designed to measure brain structure and activity directly.

            Electroencephalogram, which records brain waves, the electrical activity taking place within the brain as a result of neurons firing.

            Neuropsychological tests that measure cognitive, perceptual, and motor performances on certain tasks and interpret abnormal                                     performances as indicators of underlying brain problems. Brain damage is especially likely to affect visual perception, memory, and                         visual-motor coordination, and so neuropsychological tests focus particularly on these areas.

            Bender Visual-Motor Gestalt Test: Redraw the designs from memory.

Intelligence Tests

            Series of tasks requiring people to use various verbal and nonverbal skills.

            Intelligence quotient or IQ

            Because they have been standardized on large groups of subjects, clinicians have a good idea how each individual's score compares with             the performance of the population at large.

            Very high reliability

            Children's IQ scores often correlate with their performance in school.

            Shortcoming, such as low motivation and high anxiety, can greatly influence a performance.

            Cultural biases: Who wrote the test?

Clinical Observations- Observe clients in their everyday environments, Analog observation, an artificial setting, Self-monitoring, Observe themselves.

            Problem is observer bias-the observer's judgments may be influenced by information and expectations he or she already has about the             person.

            Aware that someone special is watching them, for example, they may change their usual classroom behavior.

            Behavior is often specific to particular situations.

Diagnosis

            Clinicians use the information from interviews, tests, and observations to construct integrated picture of the factors that are causing and                         maintaining a client's disturbance, a construction sometimes known as a clinical picture.

            Diagnosis is a determination that a person's psychological problems constitute a particular disorder.

            Basically the same as one that has been displayed by many other people.

            Predict the future course of the person's problem and the treatments that are likely to be helpful.

            Classifications and diagnoses applied in one culture may not always be appropriate in another.

            Anorexia nervosa and bulimia nervosa are eating disorder found largely in Western countries.

            Diagnostic and Statistical Manual of Mental Disorders, a classification system developed by the American Psychiatric Association.

            DSM-IV lists approximately 400 mental disorders.

            Each entry describes the criteria for diagnosing the disorder and its key clinical features, which are often but not always present.

            Clinicians to evaluate a client's condition on five separate axes.

            Axis I, an extensive list of clinical syndromes that typically cause significant impairment.

            Some of the most frequently diagnosed disorders listed on this axis are the anxiety disorders and mood disorders.

            Syndrome- a cluster of symptoms that usually occur together

            Classification system- a list of disorders, along with descriptions of symptoms and guidelines for making appropriate diagnoses.

            Axis II, which includes long-standing problems.

            Two groups of Axis II disorders: mental retardation and personality disorders.

            Although people usually receive a diagnosis from either Axis I or Axis II, they may receive diagnoses from both axes.

            Axis III asks for information concerning relevant medical conditions from which the person is currently suffering. Axis IV asks about special             psychosocial or environmental problems the person is facing, such as school or housing problems. And Axis V requires the diagnostician to             make a global assessment of functioning that is to rate the person's psychological, social, and occupational functioning overall.

            Axis I: major depressive disorder
            Axis II: Dependent personality disorder
            Axis III: Diabetes
            Axis IV: Problem related to the social environment (termination of engagement)
            Axis V: GAF = 55 (current)

Can Diagnosis and Labeling Cause Harm?

            Overly influenced by information gathered early in the assessment process

            Too much attention to certain sources of information

            Personal biases

The very act of classifying people can lead to unintended results.

            Even with trustworthy assessment data and reliable and valid classification categories, clinicians will not always arrive at the correct                         conclusion. Moreover, the prejudices that labels arouse may be damaging to the person who is diagnosed.

Treatment

Therapists actually gather most of their information about the latest developments in the field from colleagues, professional newsletters, workshops, conferences, books, and the like.

            First problem is "How to define success"

            Second is "How to measure improvement"

            Complexity of treatment limits the conclusions that can be reached

Is Therapy Generally Effective?

            Therapy is often more helpful than no treatment or than placebos.

            5 percent of patients actually seem to get worse because of therapy.
                        -Attention to problems often heightens them

Are Particular Therapies Generally Effective?

            No one form of therapy generally stands out over all others

Researchers have investigated how effective particular therapies are treating particular disorders, and they have often found sizable differences among the various therapies.

            Behavioral therapies, for example, appear to be the most effective of all in treating phobias

            Drug therapy is the single most effective treatment for schizophrenia.

So then the diagnosis is critical because it leads to the decision of treatment method, which leads to increases or decreases in success percentages.

It is now common for clients to be seen by two therapists-one of them a psychopharmacologist, a psychiatrist who primarily prescribes medication, and the other a psychologist, social worker, or other therapist who conduct psychotherapy.

Psychology 2

Chapter 4 Notes

 

Fear- The central nervous system’s physiological and emotional response to a serious threat to one’s well being.

 

-The vague sense of being in danger is usually termed anxiety.

-It has the same features-the same increase in breathing, muscular tension, perspiration, and so forth- as fear.

 

-Prepares us for action when danger threatens. 

-Leads us to drive more cautiously in a storm, keep up with our reading assignments, treat our dates more sensitively, and work harder at our jobs.

 

Anxiety disorders are the most common mental disorders in the United States. 

-19 percent of the adult population.

 

Generalized anxiety disorder experience general and persistent feelings of anxiety. 

 

 Generalized Anxiety Disorder

 

1.      Excessive or ongoing anxiety and worry, for at least six months, about numerous events or activities.

2.      Difficulty controlling the worry.

3.      At least three of the following symptoms:  restlessness, easy fatigue, irritability, muscle tension, and sleep disturbance.

4.      Significant distress or impairment.

 

Generalized anxiety disorder is most likely to develop in people who are faced with societal conditions that are truly dangerous.

-Three Mile Island

 

One of the most powerful forms of societal stress is poverty.

-The rate is twice as high among people with low incomes.

-As salaries and wages decrease, the rate of generalized anxiety disorder steadily increases.

 

6 percent of all African Americans compared to 3.5 percent of white Americans.  African American women have the highest rate of all-6.6 percent.

 

Psychodynamic Perspective

 

Sigmund Freud believed that all children experience some degree of anxiety as part of growing up, and all use ego defense mechanisms to help control such anxiety.

 

-Their defense mechanisms are particularly inadequate, and these individuals may, in turn, develop generalized anxiety disorder.

 

-Early developmental experiences may produce an unusually high level of anxiety.

 

-May come to believe that his various id impulses are very dangerous, and he may experience overwhelming anxiety whenever he has such impulses.

            -Masturbation

 

Overprotected children, shielded by their parents from all frustrations and threats, have little opportunity to develop effective defense mechanisms.  When they face he pressures of adult life, their defense mechanisms may be too weak to cope with the resulting anxieties.

 

Psychodynamic Therapies

 

Help clients with generalized anxiety disorder become less afraid of their id impulses and more successful in controlling them.

 

Psychodynamic treatments only modest help to persons with generalized anxiety disorder.

 

The Humanistic Perspective

 

Repeated denials of their true thoughts, emotions, and behavior make theses people extremely anxious and unable to fulfill their potential as human beings.

 

Children who fail to receive unconditional positive regard from others may become overly critical of themselves and develop harsh self-standards. 

-They try to meet these standards by repeatedly distorting and denying their true thoughts and experiences.

 

Client-centered therapy tries to show unconditional positive regard for their clients

-An atmosphere of genuine acceptance and caring will help clients feel secure enough to recognize their true needs, thoughts, and emotions.

 

Controlled studies have failed to offer strong support for this approach.

 

The Cognitive Perspective

 

Generalized anxiety disorder is caused by maladaptive assumptions.  Many people are guided by irrational beliefs that lead them to act and react in inappropriate ways.

 

Basic irrational assumptions

 

People with generalized anxiety disorder constantly hold unrealistic silent assumptions.

Each person reported upsetting assumptions and images regarding such issues as physical injury, illness, or death; psychological dysfunctioning; and rejection.

 

Cognitive Therapies

 

Changing Maladaptive Assumptions:  Rational-emotive therapy

 

Individuals practice at challenging old assumptions and applying new ones.  This approach brings at least modest relief to persons suffering from anxiety.

 

Cognitive therapy

 

Self-instruction training

 

It teaches clients to rid themselves of the unpleasant thoughts that keep raising their anxiety during difficult situations and replaces them with coping self-statements instead.

 

The Biological Perspective

 

Generalized anxiety disorder is caused chiefly by biological factors.

 

Studies have in fact found that blood relatives of persons with generalized anxiety disorder are more likely than non-relatives to have the disorder.

 

Normal fear reactions, key neurons throughout the brain fire more rapidly, triggering the firing of still more neurons and creating a general state of excitability throughout the brain and body.

 

Feedback system

 

Some neurons throughout the brain release the neurotransmitter GABA, which then binds to GABA receptors on certain neurons and instructs those neurons to stop firing.  The state of excitability ends.

 

This finding suggests that people with generalized anxiety disorder may have ongoing problems in their anxiety feedback system.

 

The leading biological approach to treating generalized anxiety disorder is to prescribe anti-anxiety drugs, known popularly as tranquilizers. 

 

Barbiturates create serious problems. 

-Drowsy,

-Too high a dose could lead to death

-Physically dependent.

 

A non-chemical biological technique commonly used to treat generalized anxiety disorder is relaxation training.

-Physical relaxation will lead to a state of psychological relaxation.

 

The most widely applied method of biofeedback for the treatment of anxiety uses a device called an electromyograph

 

Electrodes are attached to the client’s muscles-usually the forehead muscles- where they detect the minute electrical activity that accompanies muscle tension

 

EMG biofeedback, like relaxation training, has only a modest effect on a person’s anxiety level

 

Phobias

 

A phobia is a persistent and unreasonable fear of a particular object, activity, or situation

-Most are well aware that their fears are excessive and unreasonable.

-It is normal for some things to upset us more than other things.

 

Surveys suggest that 10 to 11 percent of the adults in the United States suffer from one in any given year, and more than 14 percent develop a phobia at some point in their lives.

 

The disorder is more than twice as common in women as in men

 

Social phobia a fear of social or performance situations in which embarrassment may occur, and agoraphobia, a fear of venturing into public places, especially when one is alone.

 

Specific phobias (9%)

            Specific to one object and lasts over 6 months.

            Immediate anxiety

            Recognize that the fear is unreasonable

            Avoid situations

            Significant distress

 

Social phobias (8%)

 

What causes phobias?

 

            -Learned: can be as few as one event

                        -Experience trapped in the water

            -Modeling: observation and imitation

                        -Mom is afraid of hospitals

-Stimulus generalization: respond similarly to many stimuli with the same response.

            -Sound of water, pictures of water

            -Post T stress: firecrackers

 

Some phobias are more predisposed to occur: heights, dark  (preparedness)

 

Treatment

 

Systematic desensitization

            -Relaxation and slow introduction of the stimulus.

Flooding

            -Repeated and intense exposure to the fear.

            -Realize the foolishness of their fear

Modeling

            -Therapist deals with you fear.

 

Social Phobias treated

            Anti depressants

            Desensitization

            Social training

 

Panic Disorders

 

            Panic Attack: Sudden extreme bouts with panic

-People alter their behavior and then may increase attacks or develop other issues

                        -Agoraphobia: afraid to leave the house.

 

Biological perspective

 

            -Chemicals in the brain are stimulated, cause attack

            -Drugs to reduce attacks

 

Cognitive perspective

 

            -People prone to misinterpreting body message and they panic.

 

Cognitive therapies

 

            -Education

            -Produce panic and help them through it.

 

Obsessive compulsive

 

            Obsessions: a persistent thought or idea, impulse or image and causes anxiety

Compulsion: A repetitive and rigid behavior or mental act that a person feels driven to perform.

 

Classified as an anxiety disorder because the obsession causes anxiety and because they can’t resist the compulsion, it too causes anxiety.

 

Obsessions are thoughts that one can’t ignore.

            -Sexual, violent

 

Compulsions are technically voluntary, but people need to do them to avoid something terrible.

            -Cleaning, door locking, procedures

            -Touching, number of reps

 

These do not normally lead to any violent or immoral behavior.

 

Psychodynamic Perspective

 

Id impulse takes the form of obsessive thoughts and the ego defense mechanisms appears as a compulsive act.

 

-Fearful thoughts of her child’s injury/death; check to see if the phone is on and she is in range of hearing it.

-Thoughts of his world coming apart at any moment; straightens the house continuously, nothing out of place.

                       

Reaction formation: Have violent thoughts so overdo the kindness

                       

Treatment: uncover the conflict. Deal with it.

 

Behavioral perspective

 

            Compulsions occur randomly

                        -Dress a certain way and anxiety is reduced, or good things happen

                        -Repeat dress and now come to believe the two are tied.

                        -Now they feel uncomfortable if they don’t wear it and anxiety occurs

 

            Treatment

                        -Expose people to what they fear and have them avoid the compulsion.

                                    -Reduce times they clean and see if fears are realized.

                                    -55-85% successful in some types

Cognitive perspective

 

            1.Every one has these types of thoughts but most of us discount them.

            2.These people blame themselves for having these thoughts

            3. They develop neutralizing efforts: think good thoughts, clean hands

5.      This brings temporary reduction of anxiety

6.      This is reinforcement and leads to repetitiveness

7.      Frequency increases and we have compulsion

 

This population has been shown to be:

1.      More depressed

2.      Higher standards of conduct and morality

3.      Believe thought are equal to actions

4.      Believe they should be in control of their thoughts and behaviors

 

Treatment

            Habituation training: intense exposure to the thoughts

                        -Reduce fear and anxiety it causes

                        -Success has been seen in case studies but not in empirical documentation

 

Biological perspective

 

Low activity of the neurotransmitter serotonin

1.      Serotonin is the chemical that carries messages from neuron to neuron

2.      When given two specific antidepressants, increase in serotonin levels and symptoms reduced.

 

Abnormal brain functioning in specific regions of the brain

1.      Orbital region of the frontal cortex and the caudate nuclei convert sensory information to action.

2.      Also where your primitive impulses arise: sexual, violent

3.      If caudate nuclei sends message on to the thalamus the person will think further about the topic.

4.      If this transmission of info is too active, we have obsessive thinking.

-If this area of the brain is damaged, levels of obsession reduce.

-PET scans also reveal more activity in OCD patients

Therapies

 

            Antidepressants if they increase the serotonin activity

 

            Retraining

 

            Need both or relapse is high possibility

 

 

Beliefs in general are that some people are born with the predisposition for OCD and then coupled with being placed in an environment that creates anxiety; those people will develop the disorder.

 

 

 

 

 Psychology 2
Chapter 5 Notes

Stress Disorders

The state of stress has two components: a stressor, the event that creates the demands, and a stress response, the person's reactions to the demands

 

Emotional responses to extreme threats include horror, dread, and even panic, while in the cognitive realm fear can disturb our ability to concentrate and change our view of the world. We may exaggerate the harm that actually threatens us or later remember things incorrectly.

People who experience a large number of stressful events are particularly vulnerable to the onset of the anxiety disorders that we examined in Chapter 4. Similarly, increases in stress have been linked to the onset of depression, schizophrenia, sexual dysfunction, and yet other psychological problems.

The key psychological stress disorders are acute stress disorder and posttraumatic stress disorder.

Stress and Arousal

The features of arousal and fear are set in motion by the brain area called the hypothalamus. When our brain interprets a situation as dangerous, neurotransmitters in the hypothalamus are released, triggering the firing of neurons throughout the brain and the release of chemicals throughout the body.

Autonomic nervous system: nerve fibers

Endocrine system: glands and release hormones into the bloodstream

When the perceived danger is gone

Reactions are collectively referred to as the flight fight response

Psychologist have found that differences in trait anxiety appear soon after birth

The Psychological Stress Disorders:
Acute and Posttraumatic Stress Disorders

It is common for a person to feel anxious or depressed when involved in combat

Unlike anxiety

Both disorders:

What triggers the stress disorder?

Combat
29% who served in Viet Nam

Disaster
33% develop PTSD within a year

Hurricane Andrew: led to domestic violence increase

Victimization
33% affected

Sexual assault
94% diagnoses with acute stress disorder

Terrorism
On the rise
--Remember this is a perception disorder

Why people develop a disorder

Biological
--Abnormal activity of hormone cortisol and norepinephrine: Control stress reactions in brain

Identical twins both get it
--Genetic?
--Personality

Highly anxious before upped chances
--If you view life's problems as out of your control

Childhood experiences
Poverty more likely
Family history
Fewer than 10 at divorce of parents

Social Support
--Strong system fended off the disorder better
--Recovered quicker

Severity of trauma
--More severe most cases
--More involved more cases

How do we treat this disorder?

Combat
--Drug, therapy
--Exposure techniques
--Insight therapy, family therapy, group therapy

Sociocultural model
--Critical incident stress debriefing
--Meet the basic needs as quickly as possible

The Physical Stress disorders

--Psycho-physiological disorders

--Psychological disorders bring about physical damage

Traditional Psycho physiological disorders

Sociocultural Factors

Stress placed on people by demands of culture or social group sets the stage
--Crime in neighborhood
--Unsatisfied job

Psychological Factors

--Coping styles, emotions, and needs: lead to responses that may lead to disorders
--Type A personalities
-----Driven

Biological Factors
--Defects
--Damage organs
--Wear it down until it becomes both psych and physio disorder

Psychological Treatments for Physical Disorders

Cognitive Interventions
Training in coping methods for pain

Psychology 2
Chapter 6
Notes

Somatoform and Dissociative Disorders

Linked to anxiety and stress
Psychosocial
-Response and/or escape
Somatoform
A physical illness that can be explained largely by psychological
-Different from hypochondriacts because a physical change occurs
Conversion disorder
Physical ailment brought about by extreme stress
-Develop blindness or paralysis

These bring some reward to the patient

Body dysmorphic disorder
Excessive worry that some aspect of your body is defective
-Cosmetic surgery
Causes
Modeling
Classical conditioning
Over interpret body cues

Treatment
Rarely seek psychological help because they believe the problems are physical.
Antidepressants
Exposure response therapy

Dissociative Disorders
We recognize ourselves and have our own expectations, values and goals
Memory is our key: without it, we would be starting over.

Memory
People who experience memory disruption are classified this way. Their memory has been separated from the rest.

Dissociative Amnesia
Inability to recall events and people
-Triggered by an unsettling event
Selective amnesia: Remember some but not all

Retain memory of "common knowledge" but forget specifics

Dissociative Fugue

Forget who they are and assume new identity
-Last hours or days or years
-New personality as well

Dissociative Identity Disorder

Multiple personalities
Develops two or more distinct personalities (sub personalities)
-Each has unique set of memories and behaviors
-Dominate functioning at any time
-Transition or switching is sudden

Once considered rare, no becoming more common

Normally occurs for the first time in adolescence or early adulthood
97% are victims of abuse
Women 3X more likely

Sub personalities
-May or may not know each other exist
-One may know of others
-Most cases have two or three
-Own names, abilities, and vital signs
Explanation
Psychodynamic
Repression, ego defense mechanism
-Either massive or the storing of trauma over a period of time
Behavior
Learned from operant conditioning
Temporary relief, escape from reality

Self-hypnosis
Consciously or unconsciously hypnotize themselves for escape
Treatment
Psychodynamic: bring out the past event and deal with it.
Hypnotherapy: use hypnosis
Drug therapy: truth serums (sodium pentobarbital)
-Calming, free their inhibitions
1. Recognize the nature of the disorder
a. Bond with the primary personality and others and educate them
2. Recover memories
a. Must deal with the defense mechanisms, denial mostly
3. Integrate the sub personalities
a. Fusion

Psychology 2
Chapter 7
Mood Disorders

Terms:

Depression: Significantly low levels of sadness marked by lack of energy, low self-worth, guilt, or related symptoms.

Mania: A state or episode of euphoria in which people have an exaggerated belief that they can do anything.

Unipolar depression: Depression without a history of mania.

Bipolar disorder: Alternating periods of mania and depression.

Bipolar Disorders

 

 

  Psychology 2
Chapter 8 Notes

Suicide

"At least 60 Americans will have taken their own lives by this time tomorrow"

Ranked among the top 10 causes of death in the world.

600,000 make unsuccessful attempts

Not classified as a mental disorder

Defined: an intentional death

Parasuicide: attempt that does not end in death.

Studying suicide

Hard to do because the subject is deceased
----Retrospective analysis: Piece together info from friends and relatives
----Survival study: Talk to those who have survived.

Statistics

Country
--US in the middle

Religious affiliation
--Lower: Catholics, Jewish, Muslim

Gender
--Women 3x more attempt, but men are more successful
--more violent means for men

Marital status
--Married are less likely

Race
--More whites, and Native Americans

May be skewed because of deaths that are recorded as accidents
-car crashes, and overdoses are the most frequently assumed

Triggers

--Recent events: but not the cause
--Long-term depression and then bad day

--Illness: Initiators

--Environment: seeker, darer, ignorer

--Stress: seeker

--Mood changes

Suicide is usually preceded by a mood change and/or increased depression
--feelings of anxiety, anger, shame

Preoccupied with problems
--see the problem and solution as either/or

"ONLY" key perspective

Alcohol use

---60% used alcohol right before
---Lowers fears and inhibitors
---High levels of drug use as well

Mental Disorders

---50% have another disorders
---depression is #1

Modeling

---More frequent when someone reads about or is involved with suicide
---teenagers
---Celebrities

---Highly publicized cases

---Co-workers

Causes

---First: Lack of real understanding is acknowledged in this area.

---Psychodynamic: Redirected at oneself

--------Murder in the 180th degree

"No one who wanted to commit suicide didn't want to kill another."

Sociocultural: Involvement in groups decreases likelihood

Egotistic; Isolated people

Altruistic: Die to improve society: soldiers

Anomic: No meaning to life: result of their lack of involvement in society and groups

Biological: There is a genetic tie within families

---learned? Suffered a loss early in life? Or chemical?

Age

Adolescents: 2nd

Elderly: Most common 19% of all, 12% of population

Treatment

You can see how all these fit into the causes listed before

First suicide prevention program started in 1955

Procedure

Psychology 2
Chapter 13 Notes

Personality Disorders

Personality is long-term patterns of inner experience and behaviors.

Personality disorder: Behaviors that differs markedly from the expectations of the culture.

Paranoid Personality disorder: marked by distrust and suspicion.

Schizoid Personality Disorder: avoidance of social relationships and expressing emotion.

Schizotypal Personality disorder: extreme discomfort in relationships, odd perceptions, and behavioral eccentricities

Dramatic Personality Disorders

Antisocial Personality Disorder

Borderline personality disorder

Histrionic Personality Disorder

Dependent personality disorder