Unit XII (Abnormal Behavior) & Unit XIII (Treatment) Test

ReviewIncludes practice questions!

Other resources

• The textbook website has tutorials, outlines, and practice questions

• See the Unit notes on the course website

• Try the practice questions in the book at the end of each module and unit.

Format

• Approximately 50 m.c. questions

• One essay is on schizophrenia (the symptoms, the causes, the treatments)

• The second is a review of research methods (Unit II) and the influence of media on aggression (Unit XIV).

Attention-Deficit Hyperactivity Disorder (ADHD)

= a psychological disorder marked by the appearance by age 7 of one or more of three key symptoms;

extreme inattention,

hyperactivity,

and impulsivity.

Medical Model, 653

When physicians discovered that syphilis led to mental disorders, medical model started

looking at physical causes of these disorders.

1. Etiology: Causation and developmental of the disorder.

2. Diagnosis: Identifying (symptoms) and distinguishing one disease from another.

3. Treatment: Treating a disorder in a psychiatric hospital.

4. Prognosis: Forecast about the disorder.

Figure 16.1 The biopsychosocial approach to psychological disordersMyers: Psychology, Eighth EditionCopyright © 2007 by Worth Publishers

3. PAGES 653-4: the Biopsychosocial model

Goals of DSM 5, 654

1. Describe (400) disorders.2. How prevalent is the disorder?

Disorders outlined by DSM-5 are reliable thus diagnosis by different professional are similar.Others criticize DSM-5 for “putting any kind of behavior within the compass of psychiatry.”

Labeling Psychological Disorders

1. Critics of the DSM-IV manual for identifying disorders argue that labels can stigmatize individuals.

2. On the Psychopathology Zimbardo video, psychologist David Rosenhans talked about his study where he faked a mental illness.

3. When he informed the hospital of his normal mental state he was released as mentally ill but in remission. He had been diagostically labeled as mentally ill, even though he was quite normal.

Generalized Anxiety Disorder

1. Persistent and uncontrollable tenseness and apprehension.

2. Autonomic nervous system arousal.

3. Unable to identify or avoid the cause of their feelings.

Practice

• An integrated understanding of psychological disorders in terms of stressful memories, evolutionary processes, and gender roles is most clearly provided by:  a. linkage analysis. b. a biopsychosocial approach. c. the medical model. d. the learning perspective.

Practice

• A current authoritative scheme for classifying psychological disorders is known as the:  a. DID. b. medical model. c. DSM-V. d. biopsychosocial approach.

Practice• Brian often interrupts his teacher while she is

speaking and frequently forgets to complete his homework assignments. He also has difficulty taking turns in playground games with classmates. Brian most clearly exhibits symptoms of:  a. DID. b. OCD. c. PTSD. d. ADHD

Practice

•  After participants in one study were informed that a videotaped interviewee was a psychiatric patient, they characterized the person with phrases such as “a passive type” and “frightened of his own impulses.” This study best illustrated the:  a. dangers of dissociative identity disorder. b. unreliability of the DSM-IV. c. biasing power of diagnostic labels. d. shortcomings of the social-cognitive perspective.

Panic Attack

• The woman featured on a Today Show segment, Sandy Smith, suffered from panic attacks.

• She suffered from short, intense periods of dread along with dizziness and trembling.

Anxiety Disorder: Phobia, 662

persistent, irrational fear of a specific object or situation

Today show video segment on phobias shown in class:

Diane Rivero has a fear of driving on a certain kind of bridge.

Obsessive-Compulsive Disorder, 663

Persistence of unwanted thoughts (obsessions) and urge to engage in senseless rituals (compulsions) that cause distress.

Dissociative Disorder

Conscious awareness becomes separated (dissociated) from previous

memories, thoughts, and feelings.

Symptoms

1. Having a sense of being unreal.2. Being separated from the body.3. Watching yourself as if in a movie.

Practice

•  Lenore is unexplainably and continually tense and is plagued by muscle tension, sleeplessness, and an inability to concentrate. Lenore most likely suffers from a(n):  a. phobia. b. dysthymic disorder. c. obsessive-compulsive disorder. d. generalized anxiety disorder.

Post-Traumatic Stress Disorder, 664

Four or more weeks of the following symptoms constitute post-traumatic stress disorder (PTSD).

1. Haunting memories.2.Nightmares.

3. Social withdrawal.4. Jumpy anxiety.5. Sleep problems.

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Major Depressive Disorder

Major depressive disorder occurs when signs of depression last two weeks or more and are

not caused by drugs or medical conditions.

1. Lethargy and tiredness2. Feelings of worthlessness3. Loss of interest in family &

friends4. Loss of interest in activities

Signs include:

Bipolar Disorder

Formerly called manic-depressive disorder, alteration between depression and mania, or manic episodes, signals bipolar disorder.

Multiple ideas

Hyperactive

Desire for action

Euphoria

Elation

Manic Symptoms

Slowness of thought

Tired

Inability to make decisions

Withdrawn

Gloomy

Depressive Symptoms

Practice

• Years after he barely survived a terrorist attack that killed his wife and two children, Mr. Puskari suffers recurring flashbacks and frequent nightmares of the event that render him incapable of holding a steady job. Mr. Puskari is most clearly showing signs of:  a. obsessive-compulsive disorder. b. generalized anxiety disorder. c. post-traumatic stress disorder. d. dissociative identity disorder.

Neurotransmitters & Depression, 678

Post-synapticNeuron

Pre-synapticNeuron

Norepinephrine Serotonin

Reduction of

norepinephrine and

serotonin has been

implicated in

depression.

Drugs that alleviate

mania reduce

norepinephrine.

Learned Helplessness, 679

When unable to avoid repeated adverse events an animal or human learns helplessness.

DEPRESSION IS COMMON DUE TO OUR INDIVIDUALISTIC CULTURE (SELIGMAN)

1.      Linked with drug/alcohol abuse

2.      Few who talk of, attempt it; but most who commit it, have talked of it

3.      whites more than blacks (2x)

4.      women more likely to attempt; men more likely to kill self

5. teens rate doubled since 1950

David Myers’ key points on suicide from your text, 676-77

Symptoms of Schizophrenia, 684-5

Literal translation “split mind”. A group of severe disorders characterized by:

1. Disorganized and delusional thinking.

2. Disturbed perceptions (hallucinations)

3. Inappropriate emotions and actions.

Practice• Although Mark realizes that his behavior is

unreasonable, he is so alarmed by high bridges or expressway overpasses that he avoids them by taking an unnecessarily lengthy route to and from work each day. Mark appears to suffer from a(n):  a. obsessive-compulsive disorder. b. mood disorder. c. phobia. d. generalized anxiety disorder.

Practice

• Elaine feels that her life is empty, has lost all interest in her career and hobbies, and wonders if she would be better off dead. She is most likely suffering from:  a. a dissociative disorder. b. antisocial personality disorder. c. a mood disorder. d. agoraphobia.

Other forms of delusions include, delusions of persecution (“someone is following me”) or grandeur (“I am a

king”).

1. Disorganized & Delusional Thinking, 684

“This morning when I was at Hillside [Hospital], I was making a movie. I was surrounded by movie stars … I’m Mary Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday.”

(Sheehan, 1982)

This monologue illustrates fragmented, bizarre thinking with distorted beliefs, called delusions

(“I’m Mary Poppins”).

2. Hallucinations: Disturbed Perceptions (selective attention break down), 685

Schizophrenic person may perceive things not there (hallucinations). Frequently such hallucinations are

auditory, and lesser visual, somatosensory, olfactory or gustatory.

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Positive and Negative symptoms, 686

+ Delusions

+ Hallucinations

+ Disorganized speech

+ Disordered behavior

- Lack of expression

- Lack of speech

- Lack of direction

Brain Abnormalities, 686

Dopamine Over-activity: Researchers have found that schizophrenic patients express higher levels of dopamine D4 receptors in the brain.

Somatoform Disorders,693

• Add another box to your chart! • Somatic symptom disorder : Physical ailments

that cannot be explained by organic causes• Psychosomatic diseases• Have a psychological origin• Symptoms are more imaginary than real

Practice

• Mrs. Higgins believes that aliens from another planet have removed her stomach and are watching her to see how long it takes her to grow another one. Mrs. Higgins is most likely suffering from:  a. agoraphobia. b. bipolar disorder. c. schizophrenia. d. a dissociative identity disorder.

Practice

• Which of the following best illustrates a negative symptom of schizophrenia?:  a. hallucinations b. delusions. c. social withdrawal d. inappropriate rage

Practice

•  Mr. James believes that people are constantly laughing at him and that FBI agents are trying to steal his life savings. Mr. James is most clearly suffering from:  a. compulsions. b. catatonia. c. delusions. d. hallucinations.

Eating Disorders, 478

Anorexia Nervosa: A condition in which a normal-weight person (usually an adolescent woman) continuously loses weight but still feels overweight.

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Bulimia Nervosa

A disorder characterized by: * episodes of overeating, usually high-calorie foods*followed by: vomiting, using laxatives, fasting, or excessive exercise.

http://www.youthnoise.com/site/images/fitc/bulimia.jpg

Personality Disorders, 698

Characterized by inflexible and enduring behavior patterns that impair social functioning.

Usually without anxiety, depression, or delusions.

Narcissistic personality disorderSee page 677

narcissistic:

preoccupied with self-importance

Antisocial Personality Disorder, 699

The person (usually men) exhibits a lack of conscience for wrongdoing, even toward friends and family members.

(Formerly called sociopath or psychopath.)

http://www.beliefnet.com/healthandhealing/images/prefrontal_cortex.jpg

Interpretation in Psychoanalysis, 710

• “I thought we were all done fighting, Antwone.”

• The analyst notes childhood issues, resistance to therapy and significant patient behaviors to promote insight in the patient.

Resistance, 710

• The patient blocks from their conscious mind the events from the past that are causing them anxiety.

• Dr. Davenport has to get Antwone to open up so they can explore the source of his rage.

Transference, 710• The patient transfers emotions linked with other relationships to

the therapist.

• Ex. If the patient hates their father, they might hate the therapist.

• (This can prevent the therapist from helping the patient.)

Practice

• Kyle is extremely manipulative and can look anyone in the eye and lie convincingly. His deceit often endangers the safety and well-being of those around him, but he is indifferent to any suffering they might experience as a result of his actions. His behavior best illustrates:  a. schizophrenia. b. bipolar disorder. c. obsessive-compulsive disorder. d. an antisocial personality disorder.

2. Empathy: Identifying and understanding

the client’s feelings, situation and

motives

3. The client discovers treatment methods on their own through counseling

4. Goal: emphasizing the fulfilling of the client’s potential

Client centered/insight therapy, 712

Humanistic Therapy, 711-713

• Aka “Client-Centered” Therapy– developed by Carl Rogers– uses techniques such as active listening within a

genuine, accepting, empathic environment to facilitate clients’ growth

– (unconditional positive regard)

• 1. Active Listening– empathic listening in which the listener echoes,

restates, and clarifies

http://www.isbn3-540-21358-9.de/myers/zeitleiste/images/vRogers.jpg

Practice

• Client-centered therapists emphasize the importance of:  a. interpreting the meaning of clients’ nonverbal behaviors. b. enabling clients to feel unconditionally accepted. c. helping clients identify a hierarchy of anxiety-arousing experiences. d. discouraging clients from using antianxiety or antidepressant drugs.

Exposure Therapy, 717

Expose patients to things they fear and avoid.

Through repeated exposures, anxiety lessens because they habituate to the things feared.

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Behavior Therapy: systematic desensitization, 717

Associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli.

*A step by step procedure for becoming relaxed in a situation that would normally cause you extreme discomfort.

*At each step in the process the person must learn to associate calm feelings with the stimulus.

(Commonly used to treat phobias.)

Behavior therapy: Aversive Conditioning, 718

– Type of counter-conditioning that associates an unpleasant state with an unwanted behavior

– Unlike the previous examples, In this case you want to eliminate a behavior

– For example: With an alcoholic you want to teach the following association

– nausea ---> alcohol

Practice

•  In order to help Janet overcome her nearly irresistible craving for chocolate, a therapist provides her with a supply of chocolate candies that contain solidified droplets of a harmless but very bitter-tasting substance. This approach to treatment best illustrates:  a. systematic desensitization. b. light exposure therapy. c. aversive conditioning. d. stress inoculation training.

Behavior Therapy: Token Economy, 719

– An operant conditioning procedure that rewards desired behavior

– Person exchanges a token of some sort--- earned for exhibiting the desired behavior--- for various privileges or treats

– EXAMPLE: First, you set a goal: I want to lose ten pounds.

– Reward yourself 1 “point” for every pound lost. When you get to ten, you get to go to a movie.

Cognitive Therapy

– teaches people new, more adaptive ways of thinking and acting

– based on the assumption that negative thoughts intervene between events and our emotional reactions

Albert Ellis and RET, 721• This was on the

Zimbardo video

• Ellis challenged his clients unreasonable attitudes and false beliefs

• He called it Rational Emotive Therapy (RET)

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Cognitive-Behavior Therapy

Cognitive therapists often combine the reversal of self-defeated thinking with

efforts to modify behavior.

Cognitive-behavior therapy aims to alter the way people act (behavior therapy) and alter the way they think (cognitive therapy).

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Family Therapy

Family therapy treats the family as a system. Therapy guides family members toward positive relationships and improved communication.

Focuses on tensions in the family that may causes individuals to experience mental disorders or problems

Practice

• Several years after his wife’s death, Mr. Sanchez remains incapacitated by feelings of guilt and sadness. In order to reduce Mr. Sanchez’s depression, a therapist is actively encouraging him to stop blaming himself for not being able to prevent his wife’s death. The therapist’s approach is most representative of:  a. systematic desensitization. b. psychoanalysis. c. cognitive therapy. d. client-centered therapy.

Does Therapy Work?• Meta-analysis 731

– procedure for statistically combining the results of many different research studies

Poor outcome Good outcome

Averageuntreated

person

Averagepsychotherapy

client

Number ofpersons

80% of untreated people have pooreroutcomes than average treated person

a.       meta-analysis: statistically combines results of many studies (meta=many)

b.      regression toward the mean

the more something is done the closer it gets to average

Ex: the Milwaukee Brewers had a big lead early in the year, but the more games they played the closer they achieved to their ability: an average team

c.       double blind studies neither researcher nor subjects know who gets treatment

Research concepts, 730

Practice

• When people’s symptoms of psychological distress are at their worst, whatever they do to try to alleviate the condition is likely to be followed by improvement rather than further deterioration. This is best explained in terms of:  a. systematic desensitization. b. the therapeutic alliance. c. counter-conditoning. d. regression toward the mean.

Placebo effect. 730

• the phenomenon that a patient's symptoms can be alleviated by an otherwise ineffective treatment

• the individual expects or believes that it will work.

Resilience, 737Personal strengths people possess in fighting off mental illness.

Example: Many accident victims, war veterans, and Holocaust survivors have shown remarkable resilience against traumatic situations.

(And so has Harry Potter as in his battle against the Dark Lord.)

Antipsychotic drugs for schizophrenia

Clozapine (Clozaril) blocks receptors for dopamine and serotonin to remove the negative symptoms of schizophrenia.

Antidepressant Drugs and serotonin, 741-42

Antidepressant drugs like Prozac, Zoloft, and Paxil are Selective Serotonin Reuptake Inhibitors (SSRIs) that improve the mood by elevating levels of serotonin by inhibiting reuptake

Can lead to neurogenesis: new brain cells.

A. ECT

• Electroconvulsive Therapy, 743

• Treats depression

Alternative to ECT, 745

Repetitive Transcranial Magnetic Stimulation (rTMS)Magnetic energy apparently activates neural connections.In TMS, a pulsating magnetic coil is placed over prefrontal regions of the brain to treat depression with fewer side effects than ECT.

C. Psychosurgery, 746

Surgery that removes or destroys brain tissue in an effort to change behavior.

Lobotomy: Procedure once used to calm uncontrollably emotional or violent patients.

http://www.museumofdisability.org/siteimages/medicine/Lobotomy.jpg