comorbidity: occurrence of two or more identified disorders in the same
psychologically disordered individual
etiology: causal pattern or factors underlying abnormal behavior
Multiaxial Assessment (Axis I, II, III, IV, V): first three axes or foci assess an
individual’s present clinical status or condition (I = clinical syndromes or other
conditions that may be a focus of clinical attention; II = personality disorders or
mental retardation; III = general medical conditions potentially relevant to
understanding or management of case); IV = psychosocial and environmental
problems and V = GAF
GAF = Global Assessment of Functioning (0-100 with lower scores more
maladaptive and threatening to individual; summarizes the patient’s overall
functionability)
diathesis-stress model: views of abnormal behavior as the result of stress operating
on an individual with a biological, psychosocial or socio-cultural predisposition
(vulnerability or diathesis) toward developing a specific disorder
acute: term used to describe a disorder of sudden onset, usually with intense
symptoms
chronic: a long-standing or frequently recurring disorder, often of progressing
seriousness
clinical assessment: procedure in which a clinician uses psychological tests,
observation, and interviews to develop a summary of a client’s symptoms and
problems in order to understand their nature and extent
dynamic formulation: integrated evaluation of an individual’s personality traits,
behavior patterns, environmental demands, and the like intended to describe the
person’s current situation and to hypothesize about what is driving the person to
behave in maladaptive ways
eclectic approach: using a blend of therapies or integrating a variety of perspectives
to understand and treat mental illnesses
unstructured and structured interviews: assessment interviews in which the
clinician follows no preexisting plan (unstructured) with respect to content and
sequence of questioning vs. a highly controlled and sequential manner (structured;
e.g., Structured Clinical Interview for DSM Diagnosis)
ECT = Electroconvulsive Shock Therapy (used for MDD and manic episodes)
neurosurgery: brain surgery used in the treatment of functional or CNS disorders
prefrontal lobotomy: surgical procedure used before the advent of antipsychotic
drugs in which the frontal lobes of the brain are severed from the deeper centers
underlying them, resulting in permanent structural changes in the brain; access is
through a hole drilled in the scalp (near the temples); Egas Moniz was inventor
transorbital lobotomy: similar surgical procedure as prefrontal; major difference is
in how surgeon accesses the brain – here with an “icepick” (orbitoclast) through the
orbital cavities; Walter Freeman was inventor
cingulotomy: surgical procedure targeting the anterior cingulated cortex, part of the
limbic system, which integrates feelings and emotion in the cortex; a last resort for
OCD and chronic pain sufferers
psychopharmacology: science of determining which drugs alleviate which mental
disorders and why they do so
psychoactive/psychotropic medications: drugs that act on the brain to affect mental
processes
antipsychotic drugs: group of drugs that produce a calming effect in many patients
as well as alleviating or reducing the intensity of psychotic symptoms, such as
delusions and hallucinations; also called neuroleptics (e.g., Thorazine, Haldol,
Clozaril – generally inhibit dopamine)
tardive dyskinesia: a movement disorder characterized by involuntary twitching,
typically involving the tongue, face, and neck; the most serious side effect of
antipsychotic medications
antidepressant drugs: drugs used to elevate mood and relieve depression; increase
the amount of norepinephrine, serotonin, or both in synapses (e.g., SSRI’s - Prozac,
Zoloft and Paxil; Wellbutrin)
antianxiety drugs: drugs used to alleviate a wide range of conditions involving
tension and anxiety; typically GABA enhancers (e.g., benzodiazepines like Valium or
Xanax)
lithium: drug used to treat bipolar symptoms, especially effective in resolving manic
episodes
psychotherapy: professional treatment of mental disorders by psychological methods
psychodynamic therapy: any psychological treatment that focuses on individual
personality dynamics (intra-psychic conflict), usually from a psychodynamic
perspective
classical psychoanalysis: intensive, long-term procedure for uncovering repressed
memories, thoughts, fears, and conflicts presumably stemming from problems in early
psychosexual development (i.e., client in a relaxed position on a couch free
associating)
free association: psychoanalytic method for probing the preconscious (that part of
the mind thought to contain derivatives of repressed unconscious material, which if
properly interpreted can lead to its uncovering) by having a client say whatever comes
into his or her mind
manifest content: the meaning of a dream as it appears to the dreamer, which serves
to mask the latent content
latent content: actual motives of a dream that are seeking expression but are so
painful or unacceptable that they are disguised by the manifest content of the dream
resistance: in psychoanalysis, the person’s unwillingness or inability to talk about
certain thoughts, motives, or experiences; a sort of defense mechanism that prevents
painful and threatening material from entering awareness
transference: in psychoanalysis, the process whereby clients project onto the
therapist attitudes and feelings they had in a past relationship with a parent or other
person close to them; the resolution of the transference is the key element in effecting
a psychoanalytic “cure”
countertransference: in psychoanalysis, the process in which the therapist reacts in
accord with the client’s transferred attributions rather than objectively; this increases
the likelihood that the client will merely repeat in the therapeutic relationship the
typical relationship difficulties characterizing his or her adult life
interpretation: involves a therapist’s tying together a clients’ often disconnected
ideas, beliefs, and actions into a meaningful explanation to help the client gain insight
into the relationship between his or her maladaptive behavior and the repressed
(unconscious) events and fantasies that drive it
behavior therapy: the use of therapeutic procedures based originally on the
principles of classical and operant conditioning; came into its own in the 1960’s;
therapists attempt to modify problem behaviors directly by extinguishing or
counterconditioning maladaptive reactions, such as anxiety, or by manipulating
environmental contingencies (i.e., by the use of reward, suspension of reward, or,
occasionally, punishment to shape overt actions)
counterconditioning: any behavioral therapy that applies classical conditioning
principles to unlearn certain maladaptive reactions (e.g., systematic densensitization
or aversion therapy)
systematic desensitization: behavior therapy technique developed by Joseph Wolpe
in 1958 that is aimed at teaching a person to relax or behave in some other way that is
inconsistent with anxiety while in the presence (real or imagined) of the anxietyproducing stimulus; a form of guided exposure
flooding: an anxiety-induction therapy in which the client is exposed to highly
anxiety-provoking stimuli all at once. The exposure may take place in a real world
setting (in vivo) or through the use of imagery (in vitro)
guided exposure: technique developed to ensure the unlearning of certain
maladaptive reactions by gradually exposing (graded exposure) them feared stimuli
in vivo exposure: real exposure to threatening stimuli; seems to be more effective in
treating anxiety whenever it is possible to identify in concrete terms those situations
evoking anxiety and to induce the client to confront them directly (e.g., agoraphobia)
in vitro exposure: imagined exposure to threatening stimuli; takes place in a
therapeutic or laboratory setting
response prevention: a key component of all exposure techniques; preventing the
patient from producing responses that allow avoidance of the feared stimulus
aversion therapy/conditioning: form of behavior therapy aimed at modifying
undesirable behavior by using punishment (may involve either the removal of highly
desired reinforcers (negative) or the use of aversive stimuli (positive)); basic idea is to
reduce the “temptation value” of stimuli that elicit undesirable behavior; effective in
treating smoking, drinking, overeating, drug dependence, gambling, and sexual
deviance
covert (vicarious) sensitization: a variant of aversion therapy in which an attempt is
made to induce unpleasant feelings such as disgust or fear in association with
tempting stimuli (e.g., showing videotape of rape in prison as plausible consequence
to deviant behavior)
modeling: involves the learning of skills through observation and imitation
contingency management: systematic programs involving the management of
reinforcement to suppress (extinguish) unwanted behavior or to elicit and maintain
effective behavior
response shaping: behavior therapy technique using positive reinforcement to
establish by successive approximations a response that is actively resisted or is not
initially in a person’s behavioral repertoire (i.e., 3-year-old autistic child trained to
wear his glasses)
token economies: behavior modification programs often used in hospital or
institutional settings, in which patients are rewarded for appropriate behavior with
reinforcers in the form of tokens that can later be exchanged for desired objects or
privileges
behavioral contracting: positive reinforcement technique that uses a contract, or
formal agreement, often between members of a couple or family, to identify the
behaviors to be changed and to specify the rewards or privileges that will follow
biofeedback: behavioral treatment technique in which a person is taught to influence
his or her own physiological processes
cognitive or cognitive-behavioral therapy: any therapy based on altering
dysfunctional thoughts and cognitive distortions
REBT (Rational Emotive Behavior Therapy): type of cognitive-behavioral therapy
focusing on changing a client’s irrational beliefs, on which maladaptive emotional
responses and thus behavior are presumed to depend; introduced by Albert Ellis in
1970; proposed that one or more core irrational beliefs are specific to and at the root
of most psychological maladjustment (i.e., one should be loved by everyone, certain
acts are awful and people should be severely punished for performing them, one must
have perfect and certain self-control, we have no control over our emotions, it is
better to avoid problems, etc.); coined terms “musturbation” and “awfulizing”
stress-inoculation therapy (SIT): a cognitive-behavioral treatment approach that
focuses on altering the self-statements an individual makes in stressful situations in
order to improve functioning under stressful conditions; involves three stages
(cognitive preparation, skill acquisition and rehearsal, and application and practice)
Aaron Beck’s cognitive therapy: assumes that maladaptive behaviors result from the
clients’ illogical and catastrophizing beliefs about themselves, the world in which
they live, and the future (depressive “triad”); client and therapist first identify the
clients’ beliefs and expectations and formulate them as hypotheses to be tested;
disconfirmation experiments are key to success, frequently accompanied by activity
scheduling
encounter group: a small group which focuses on intensive interpersonal interactions
(encounters); goals are to remove psychological barriers and defenses, achieve
openness and honesty, and to deal with the difficulties of emotional expression
group therapy: multiple people meet to work toward therapeutic goals
client-centered or person-centered therapy: nondirective type of humanisticexistential therapy developed chiefly by Carl Rogers, which focuses on the natural
power of the organism to heal itself – to help clients accept and be themselves;
assumes that people experience psychological difficulties when their concept of self is
incongruent with their actual experience
unconditional positive regard: synonymous with an attitude of fundamental
acceptance toward the client (no requirements or conditions)
conditions of worth
nondirective techniques: involves empathic reflecting or restatement of the client’s
descriptions of life difficulties
existential therapy: like the humanists, emphasize the importance of the human
situation as perceived by an individual; deeply concerned about the “human
predicament,” the alienation and depersonalization of individuals in contemporary
society and the lack of meaning in peoples’ lives; differs from most other therapies in
that there is a strict avoidance of intellectual explanation and interpretation; the focus
is on the immediate reality shared by client and therapist which sets stage for the
individual to clarify and choose between alternative ways of being
gestalt therapy (Fritz Perls): places considerable importance of the need to integrate
thought, feeling, and action into one’s self-awareness; combines the psychoanalytic
emphasis on bringing unconscious feelings to awareness and the humanistic emphasis
on getting in touch with oneself; aims to help people become more aware of and able
to express their feelings, and to take responsibility for their feelings and actions;
commonly used technique is the empty-chair technique (therapist places an empty
chair near the client and asks him to imagine that the person to whom he would like to
express his feelings is in the chair