Exam 1 Review Session Chapter 1 What is psychopathology? ❖ The scientific study of symptoms and causes of mental disorders Objectives: ❖ Describe ❖ Explain ❖ Predict ❖ Modify behaviors What is a mental illness? ❖ A condition that negatively affects a person's emotions, thinking, behavior, relationships, or overall functioning Psychodiagnosis ❖ Attempts to describe, assess, and understand the situation Other Key Terms Mental health professionals ❖ Psychologists, psychiatrists, social workers, therapists, etc Treatment plan ❖ Proposes a course of therapy that focuses on the most distressing symptoms Etiology ❖ The cause(s) of a condition Psychotherapy ❖ Designed to improve a person's behavioral, emotional, or cognitive state Psychiatric epidemiology ❖ The study of frequency with which mental illness occurs in a society. ❖ It can help guide us toward solutions that reduce the cost and distress associated with mental disorders. Prevalence Vs Lifetime Prevalence Prevalence The % of people in a targeted population who have a particular disorder during a specific period of time Lifetime prevalence The % of people in the population who have had a disorder at some point in their life Review Questions 1. Who is most at risk to exhibit violent behaviors? a. A 24 year old male b. A 24 year old female c. A 64 year old male d. A 64 year old female 2. Which of the following is not a risk factor for violence? a. Substance abuse history b. Takes medication c. Animal cruelty d. Lack of empathy/compassion 3.Which of the following is not an aspect of judging psychopathology a. Deviance b. Dangerousness c. Dysfunction d. Disinterest 4. Which of the following is the belief that lifestyles, cultural values, and worldviews affect the expression and determination of abnormal behavior? a. Culture b. Cultural universality c. Cultural relativism d. Cultural consistency Classifying Mental Disorders Must have the following components: 1. Disturbance in thoughts, feelings, or behavior, caused by a dysfunction in basic psychological, biological, or developmental processes 2. Causes significant distress/difficulty in day-to-day functioning 3. Is not an expected response to stress or loss and not related to political or religious beliefs Agreement that mental disorders include: ❖ Distress ❖ Dysfunction ❖ Deviance ❖ Dangerousness Impact Of Culture Culture: ❖ Learned behavior that members of a group transmit from one generation to another ❖ Includes shared beliefs, values, attitudes and views of the world Cultural Relativism: ❖ The belief that lifestyles, cultural values, and worldviews affect the expression and determination of abnormal behavior Cultural universality: ❖ The belief that the symptoms of mental health disorders are the same across cultures and societies Sociopolitical context: Thomas Szasz (1987) “problems in living” ❖ Laid the foundation for thinking about the sociopolitical context ➢ “Who has a diagnosis and why” “Are other groups more likely than others to have mental disorders” ❖ Szasz believes that: ➢ Diagnosing with a disorder is stigmatizing ➢ Giving children treatment drugs is poison ➢ Societal characterization of a behavior as abnormal does not necessarily mean that it is an illness; ➢ Unusual behavior or emotional distress is a reflection of something wrong with society rather than with the individual. Historical Perspectives Demonology: Attributed many forms of illness to demonic possession, sorcery, or retribution from an offended ancestral spirit. - Trephining: Part of the skull was chipped away to provide an opening through which evil spirits could escape, in hopes the person would return to normal - Exorcisms: Elaborate prayers, noises, emetics (drugs that induce vomiting) and other extreme measures (flogging, starvation) used to cast out evil spirits from the body Greco-Roman (500BC-500AD) - Hippocrates - Mania, melancholia (sadness), phrenitis (brain fever) - Melancholia treated with abstinence and bloodletting - Brain pathology: The root cause of dysfunction is disease - Galen - Major contributor to knowledge about the nervous system – including organic explanations for behavior and the role of the brain/CNS in mental illness - Argued that the sick should not blamed for their condition and should remain with families Historical Perspectives Middle Ages - Hysteria: referring to excessive or uncontrollable emotion, sometimes resulting in somatic symptoms (such as blindness or paralysis) that have no apparent physical cause - Tarantism: A form of mass hysteria characterized by wild raving, jumping, dancing, and convulsing - Became known as saint vitus’s dance - Believed they had been bitten by a spider 15th-17th centuries - Witchcraft and witch-hunts - 100k people (mostly women) were executed as witches The rise of humanism - Definition: a philosophical movement that emphasizes human welfare and the worth and uniqueness of the individual - 14th-16th century - Bedlam: “Human zoo” - Johann Weyer (1515–1588) Historical Perspectives (18th-19th Century) Philippe pinel: - instituted the moral treatment movement: a shift to more humane care for people who were mentally disturbed - He treated patients with kindness and reason, removed their chains and let them outside under the sunlight - This treatment improved behavior and foster recovery Benjamin Rush: acclaimed as the father of US psychiatry - Encouraged humane treatment of those residing in mental hospitals Dorothea Dix: new england school teacher - Dix was appalled to find jailed mental patients living under deplorable conditions - Campaigning for reform legislation and funds to establish suitable mental hospitals. Clifford beers - Wrote and published “A mind that found itself” in which he talks about the terrible treatment he and other patients experienced at mental institutions - Founded the national committee for mental hygiene (forerunner of the National Mental Health Association, now known as Mental Health America) Biological Viewpoint Biological viewpoint: Mental disorders have a physical or physiological basis Emil Kraepelin observed that certain symptoms tend to occur regularly in clusters, called syndromes - Believed that each cluster of symptoms represented a mental disorder with its own unique cause, course, and outcome Louis Pasteur’s germ theory of disease Discovery of general paresis Von kfrafft-Ebing Schaudinn Psychological Viewpoint Psychological viewpoint: belief that mental disorders are caused by psychological and emotional factors; - Supported by the observation that psychological treatments could provide relief and also induce symptoms of hysteria Friedrich Anton Mesmer - Practiced therapies that evolved into modern hypnotism - Believed suggestion could treat hysteria - Later discredited Cathartic method: therapeutic use of verbal expression used to release pent up emotional conflicts Behaviorism Behaviorism - Rooted in laboratory science - Stresses the importance of directly observable events and the conditions that evoke, reinforce, and extinguish the - Offered successful procedures for treating some psychological conditions Psychoanalytic traditions explained abnormal behavior as an intrapsychic phenomenon (occurring in the mind) Multicultural Psychology Multicultural psychology - Relevance of culture, face, ethnicity, gender, age, and socio-economic class to treatment Mental health professionals should - Be culturally sensitive and acquire knowledge of diversity - Develop culturally relevant therapy approaches Dimensions related to cultural diversity - Social conditioning - Cultural values and influences - Sociopolitical influences - Cultural and ethnic bias in diagnosis Positive Psychology & Recovery Movement Positive psychology - Objective: Study, develop, and achieve scientific understanding of positive human qualities that promote thriving - Concentrates on positive personal traits such as resilience, courage, compassion, spirituality, and wisdom Psychological resilience: The capacity to effectively adapt to and bounce back from stress, trauma, and other adversities Recovery movement - Perspective that people with mental illness can recover and live contributing and satisfying lives Drug Revolution & Managed Health Care Drug revolution - Led to medical advancements for treatments - Introduced - Psychotropic medications: Drugs used to treat or manage psychiatric symptoms by influencing brain activity associated with emotions and behavior Managed health care: the industrialization of healthcare, whereby large organizations in the private sector control the delivery of services Review Questions 1. 2. What is not a factor of positive psychology? 3. _______ are non-neuronal cells in supporting a. Seeks to add balance to our view of human roles in the central nervous system functioning a. Axons b. Study, develop, and achieve scientific b. Dendrites understanding of positive human qualities that c. Neurotransmitters promote thriving d. Glia c. Concentrates on positive personal traits such as resilience, courage, compassion, spirituality, and wisdom d. Concentrates on negative experiences and how 4. What word means the “genetic they influence traits makeup of an individual”? a. Phenotype What part of the brain plays a central role in b. Genotype emotions, decision-making, and memories? c. Gene a. Cerebellum d. Epigenes b. Limbic system c. Hindbrain d. Midbrain Chapter 2 - One Dimensional Models Model: An attempt to describe a phenomenon that cannot be directly observed Models of psychopathology - Biological - Psychological - Social - Socio-cultural Multi-Dimensional Models Biopsychosocial Model - Shows interactions between biological, psychological, & social factors - Doesn’t mention how the factors cause mental illness - No mention of culture - Doesn’t suggest any treatments Multi-Dimensional Models Multipath Model - Introduces a new dimension → sociocultural - Many disorders tend to be heterogeneous (diverse/dif) in nature (the symptoms can present very differently in different people) - Mentions how all of the factors interact with each other - Plays a part in the development of any mental disorder - Not all dimensions have an equal effect - Varies from person to person - Different combinations of dimensions Review Questions 1. 2. What is method involved chipping away part of the skull to provide an opening through which evil spirits could escape, in hopes the person would return to normal? a. Exorcisms b. Tarantism c. Trephining d. Tarantulas Who tried to treat hysteria with therapies that evolved into modern hypnotism? a. Freud b. Louis Pasteur c. Breuer d. Mesmer 3. Which component of personality represents the pleasure principle? a. Id b. SuperId c. Ego d. SuperEgo 4. What perspective represents the idea that humans are basically good and forward-moving - Maslow’s concept of self-actualization - The existential perspective - Humanistic perspective - Evolutionary perspective The Biological Dimension The Biological Dimension - Areas of the brain - Hindbrain → most primitive/survival - Midbrain → basic functions (movement, hearing, sleep, temperature regulation) - Forebrain → higher-order cognitive functions - Limbic system - Role in emotions, decision-making, and memories - Contains Amygdala and hippocampus - Directly affects the autonomic nervous system - Regulated “fight or flight” - Digestion/respiration when we are at rest The Biological Dimension Cont. The Biological Dimension - Lobes of the brain - Prefrontal cortex → attention, behavior, emotions - Occipital lobe → visual processing - Temporal lobe → processing sound & language, recognition - Parietal lobe → spatial awareness & visual processing - Frontal lobe → planning, impulse control, executive functions, decision making Biochemical Processes Biochemical Processes - The brain is made of: - Neurons → nerve cells - Dendrites → receive messages - Axon → sends messages - Glia act in supporting roles - Major neurotransmitters - Acetylcholine - Dopamine - Epinephrine - Glutamate - GABA - Serotonin Neuroplasticity Neuroplasticity - Neuroplasticity → ability of the brain to evolve and adapt - Neurogenesis → birth of new neurons Genetics & Heredity Genetics & Heredity - Heredity → genetic transmission of traits (individual) - Heritability → the proportion of variability in a trait of a population that can be connected to genetic variation (population) - Genotype → someone’s genetic makeup - Psych → genetic risk variants associated with symptoms and diagnosis Phenotype → someone’s observable traits - Psych → symptoms, diagnosis Genotype causes phenotype Gene expression → whether or not genes are “turned on” or “turned off” Epigenetics → how someone’s environment can change the way their genes are expressed - Gene x environment interaction Biology-Based Treatments - - Psychopharmacology → study of effects of psychotropic medications Medication categories - Anti-anxiety drugs - Anti-psychotics - Antidepressants - Mood stabilizers Antidepressant categories - Selective serotonin reuptake inhibitors (SSRIs) - Tricyclic antidepressants - Monoamine oxidase inhibitors (MAOIs) - Other (bupropion) - Electroconvulsive therapy → use electricity or magnet to induce small seizures - Treatment-resistant cases Psychosurgery → removing areas of the brain (not common anymore) Deep brain stimulation Criticisms of Biological Models & Therapies - Doesn’t mention individual circumstances/experiences - Medication doesn’t cure mental disorders (just helps with the symptoms) - Medications are highly sold and marketed - Could have drug-drug interactions - Drugs could not even work or cause detrimental effects from mixing drugs The Psychological Dimension The Psychological Dimension - Four major perspectives - Psychodynamic - Behavioral - Cognitive - Humanistic-existential Psychodynamic - Psychosexual stages → human personality is developed during first 5 years of life & emotional disturbance can stop it during one of the stages (Freud) - Components of personality - Id → pleasure principle - Ego → realistic and rational principle - Superego → moral considerations - Defense mechanisms protect us from anxiety Therapies Based On Psychodynamic Model Psycho-analysis - Uncover material blocked from consciousness - Free association - Dream analysis Interpersonal psychotherapy links childhood experiences with current relational patterns Behavioral Models - Concerned with the role of learning in development of mental disorders Three paradigms - Classical conditioning - Operant conditioning - Observational learning Therapies: - Exposure therapy Graduated exposure Flooding Systematic desensitization Cognitive Behavioral Models/Therapies - Focuses on observable behaviors and how thoughts influence emotions/behavior Ellis - ABC theory of emotional disturbance Cognitive-behavioral therapy (CBT) - Recognize patterns of irrational beliefs and replace them with rational/adaptive ones - Makes client aware of distorted schema (Framework for thinking) - Criticisms? Third-wave cognitive behavioral thoughts - Mindfulness: conscious attention to the present with an open, accepting and non-judgmental mental attitude – experience stressful emotional states without distress or physiological arousal - Dialectical behavior therapy (DBT) Humanistic & Existential Models Humanistic perspective (carl rogers): humans are basically good, forward-moving and trustworthy Maslow’s concept of self-actualization - Inherent tendency to strive for full potential (not just survive) Humanistic models.. - Emphasize the whole person - Acknowledge the role of free will The Existential Perspective - A set of attitudes on the context of the human condition (of or relating to human experience) - Meaning, purpose and value of the human existence - Focuses on challenges and suffering encountered by all humans - Responsibility to ourselves and others Problems arise when we do not meet life’s challenges (avoid challenge, difficulty, responsibility) The Social Dimension Socio-relational models: - Healthy relationships are important for human development and functioning - When relationships are dysfunctional/absent, individuals are more vulnerable to mental distress Family systems model - Behavior of one family member affects entire family system (especially how parents interact with us/other family members) Treatment approaches - Conjoint family therapeutic approach - Strategic family approaches - Structural family approaches - Couples therapy - Group therapy Criticisms - Studies have generally not been rigorous in design - Cultural diversity not adequately addressed - Family system models may have negative consequences Sociocultural Dimension Emphasizes importance of several factors explaining mental disorders - Race - Ethnicity - Gender - Socioeconomic status Acculturative stress - Associated with challenges of moving to a new country - Loss of social support - Hostile reception - Education and employment challenges Chapter 3 - Reliability Reliability: degree to which a test of procedure yields the same results repeatedly under the same circumstances (consistency) Test-retest reliability - Same results when given at two different points in time Internal consistency - Various parts of measure yield similar or consistent results Interrater reliability - Consistency of responses when scored by different test administrators Validity Validity: the extent to which a procedure actually performs its designed function (accuracy) Predictive validity - How well a test predicts a person’s behavior/response - Type of criterion validity and its important to mental health disorders Construct validity: - How well a test or measure accurately measures the underlying concept - How well a test or measure relates to the characteristic/symptom or disorder in question - Convergent validity: Correlation with measures of similar constructs - Divergent discriminant: Correlation with unrelated and dissimilar constructs Content validity - Assesses all areas/facets known to be associated with a particular disorder Standardization & Psychological Assessment Standardization: the use of identical procedures in the administration of tests - Standard administration - Professionals administering a test must follow common rules or procedures - “Do we have a well defined set of steps to carry out a particular assessment” - Standardization sample - Group of people who initially took the measure - Performance is used as standard or norm - Test-takers should be similar to the standardization sample for test to be valid Psychological assessment - Gathering information and drawing conclusions - Traits, abilities, emotional function, and more Four main assessment methods - Observations - Interviews - Psychological tests and inventories - Neurological test Observations & Interviews Observations: Controlled (analogue) observations - Made in laboratory, clinic, or other contrived setting Naturalistic observation - Informal observations made in natural setting - Usually in conjunction with interview Interviews - Allow a clinician to get to know a client, their history, relationships - May include sociocultural factors - Analyze - Verbal behavior - Nonverbal behavior - Communication process - Interviews may be structured or unstructured Structured interviews - Standard series of questions and procedures Review Questions 1. What type of reliability is concerned with the consistency of responses when scored by different test administrators? a. Test-retest reliability b. Internal consistency c. Interrater reliability d. Split-half reliability 3. What is the brain's ability to evolve and adapt called? a. Neurogenesis b. Neurotransmitter c. Neuroscience d. Neuroplasticity 2. What type of validity is concerned with how well a measure represents all elements/facets of a construct? a. Construct validity b. Predictive validity c. Concurrent validity d. Content validity 4. What is defined as the capacity to effectively adapt to and bounce back from stress, trauma, and other adversities a. Neuroplasticity b. Psychological resilience c. Positive psychology d. Overpathologize Questions?
