PSY 342: Study Guide for Test #1

Abnormal Behavior in Historical Context (Chap. 1 and notes)

 psychological disorder: components of definition
o Psychological dysfunction associated with distress or impairment in functioning that is not a
typical or culturally expected response
 supernatural, biological, and psychological traditions
 Supernatural
 Causes: demonic possession, witchcraft, sorcery
 Treatments: exorcism, torture, religious rites
 Biological
 Ancient Greece
o Causes: physical disease (e.g. the humoral theory: ancient belief that psychological
disorders were caused by imbalances in bodily humors or fluids
o Treatments: bloodletting/vomiting, changing environmental conditions (reducing heat)
 19th Century developments
o Research into syphilis: showed physical illness could cause psychological symptoms
o Psychiatrists (e.g. John P. Grey) increasingly aligned with biology and medicine
 20th Century developments
o Electroconvulsive therapy: biological treatment for severe, chronic depression
involving the application of electrical impulses through the brain to produce seizures
o Psychosurgery: biological treatment involving neurosurgery (prefrontal lobotomy) for
a psychological disorder
o Psychiatric medications
 Neuroleptics: major antipsychotic medications, dopamine antagonists, that
diminish delusions, hallucinations, and aggressive behavior in psychotic patients
buy may also cause serious side effects (Clozaril, Haldol, Vesprin)
 Benzodiazepines: effective against anxiety, they show some side effects, such as
some cognitive and motor impairment, and may result in substance dependence.
Relapse rates are extremely high when the drug is discontinued. (Valium, Xanax)
 Psychological
 Goals: humane treatment, normal environment, social interaction
 Key Proponents: France (Philippe Pinel) and United States (Dorothea Dix)
 Early 20th Century schools of thought
o Psychoanalytic
 Key concepts: the unconscious (part of the psychic makeup that is outside the
awareness of the person) mind and intrapsychic conflict (struggles among the id,
ego, & superego due to personality structure)
 Goal: unearth hidden intrapsychic conflicts leading to catharsis and/or insight
 Techniques: free association, dream analysis, examination of defense mechanisms
and fixations
o Behavioral
 Classical Conditioning (Pavlov): learning through association of stimuli; led to
systematic desensitization
 Operant Conditioning (Thorndike; Skinner): learning through consequences; led to
behavior medication through reinforcement and shaping
o Humanistic
 Abraham Maslow: assumes we all strive for self-actualization but are hindered by
unfulfilled needs
  Carl Rogers: person-centered therapy, emphasizes therapist’s empathy and
unconditional positive regard
Clinical Assessment and Diagnosis (Chap. 3 and notes)
 Purpose: understand the individual, predict behavior, plan treatment, evaluate outcomes
 the clinical interview: core areas of the mental status exam
o Assesses multiple domains: presenting problem; current mental state; current and past
behavior; and detailed history
o 1. Appearance and Behavior: overt behavior; attire; appearance, posture, expressions
o 2. Thought processes: rate of speech; continuity of speech; content of speech
o 3. Mood and affect: predominant feeling state of the individual; feeling state accompanying
what individual says
o 4. Intellectual functioning: type of vocabulary; use of abstractions and metaphors
o 5. Sensorium: awareness of surrounding in terms of person (self and clinician), time and
place-“oriented times three”
 behavioral assessment: goals and methods
o Goals: identify and observe “target” (problematic behaviors); determine factors influencing
target behaviors
o Methods: may be done by clinician, other observer, or via self-monitoring; potential
problem: reactivity
 psychological tests: types (objective vs. projective) and examples
o Projective tests: rooted in psychoanalytic tradition; assumes projection of unconscious
processes onto ambiguous stimuli; require high degree of inference in scoring and
interpretation (Rorschach inkblot test and Thematic Apperception Test)
o Objective tests: rooted in empirical tradition; test stimuli are less ambiguous; require
minimal clinical inference in scoring and interpretation (personality tests [MMPI] and
intelligence tests [WAIS])
 testing physiological factors: physical examination, neurophysiological assessment, neuroimaging,
and psychophysiological testing (purposes and examples of each)
o Physical examination: can help to rule out physical causes such as general medication
conditions, medication side effects, allergic reactions, toxicities
o Neuropsychological testing: assess broad range of skills and abilities to understand brain-
behavior relations (Luria-Nebraska Battery and Halstead-Reitan Battery); problems: false
positives and false negatives
o Neuroimaging: imaging brain structure (CAT scan [utilizes X-rays] and MRI [utilizes
magnetic fields]) and imaging brain function (PET scan [injects radioactive isotopes] and
fMRI [images brief changes in brain activity])
o Psychophysiological Assessment: assesses brain/nervous system structure and function; key
assessment areas: brain wave activity (EEG), heart rate and respiration, electrodermal
(sweat) response
 the DSM: general evolution and unresolved issues
o Diagnostic and Statistical Manual of Mental Disorders: published by the American
Psychiatric Association
o Evolution: Number of diagnoses has increased over time; Diagnostic criteria have become
increasingly specific; Has moved towards an “atheoretical” descriptive approach; Reliance
on empirical research has increased
o Unresolved issues: the problem of comorbidity; categorical vs. dimensional classifications;
labeling issues and potential stigmatization
Anxiety, Trauma/Stressor-Related, and Obsessive/Compulsive Related Disorders (Chap. 5 and notes)
 anxiety, fear, and panic
o Anxiety: negative affect; somatic symptoms of tension; future-oriented; feelings that one
cannot predict or control upcoming events
o Fear: negative affect; strong sympathetic nervous system arousal; immediate alarm reaction
characterized by strong escapist tendencies in response to present danger or life-threatening
emergencies
o Panic: sudden, overwhelming fright or terror
 panic attacks (basic criteria/clinical description, expected vs. unexpected)
o Panic attack: abrupt experience of intense fear or discomfort accompanied by a number of
physical symptoms, such as dizziness, heart palpitations, nausea, sweating
 Expected: anticipated when one is subjected to specific cues or panic triggers
 Unexpected: occur suddenly without any obvious cause or indication
 panic disorders (basic criteria/clinical description for each)
o Generalized anxiety disorder: intense, uncontrollable, unfocused, chronic, and continuous
worry that is distressing and unproductive, accompanied by physical symptoms of tenseness,
irritability, and restlessness
o Panic disorder: recurrent unexpected panic attacks accompanied by concern about future
attacks and/or a lifestyle change to avoid future attacks
o Agoraphobia: anxiety about being in places or situations from which escape might be
difficult in the event of panic symptoms or other unpleasant physical symptoms
o Specific phobia: unreasonable fear of a specific object or situation that markedly interferes
with daily life functioning
o Social anxiety disorder: extreme, enduring, irrational fear and avoidance of social or
performance situations
 causes/contributing factors to anxiety
o Biological Factors
 Genetics: contributions are polygenic; anxiety as a set of heritable tendencies
 Neurotransmitters: GABA (depleted); serotonin (depleted)
 Brain structures: limbic system (especially the amygdala); frontal lobes (especially
the left)
 Brain circuits/systems: behavioral inhibition system (BIS), fight/flight system (FFS)
(especially related to the autonomic nervous system)
o Psychological Factors
 Learned associations of specific cues and fear
 Misinterpretation of bodily sensations
 Interpreting events catastrophically
 Belief of no control
 Observational learning from adult models
o Sociocultural Factors: stressful life events; interpersonal difficulties; cultural factors:
variable symptom expression and culturally-bound syndromes
 treatments for anxiety
o Psychosocial Therapies:
 Exposure therapies
 systematic desensitization and panic control therapy
 Cognitive-behavior therapy
 Social skills training
 o Biomedical treatments:
 Medications
 Benzodiazepines-stimulate GABA (Valium, Xanax, Ativan)
 SSRIs-stimulate serotonin (Prozac, Zoloft, Paxil)
 trauma/stressor-related disorders (basic criteria/clinical description for each)
o Post-traumatic stress disorder: enduring, distressing emotional disorder that follows
exposure to severe helplessness or a fear-inducing threat. The victim re-experiences the
trauma, avoids stimuli associated with it, and develops a numbing of responsiveness and an
increased vigilance and arousal
o Acute stress disorder: severe reaction immediately following a terrifying event, often
including amnesia about the event, emotional numbing, and derealization. If symptoms
persist beyond one month, victims are diagnosed with posttraumatic stress disorder
o Adjustment disorder: anxious or depressive reactions to life stressors
o Reactive attachment disorder: a child with disturbed behavior neither seeks out a caregiver
nor responds to offers of help from one; fearfulness and sadness are often evident
o Disinhibited social engagement disorder: a child shows now inhibitions whatsoever in
approaching adults
 obsessive/compulsive-related disorders (basic criteria/clinical description for each)
o Obsessive-compulsive disorder: involving unwanted, persistent, intrusive thoughts and
impulses, as well as repetitive actions intended to suppress them
o Body dysmorphic disorder: disorder featuring a disruptive preoccupation with some
imagined defect in appearance
o Hoarding disorder: excessively collecting/keeping items w/ minimal value
o Trichotillomania: people’s urge to pull out their own hair from anywhere on the body,
including the scalp, eyebrows, and arm
o Excoriation disorder: recurrent, difficult-to-control picking of one’s skin leading to
significant impairment or distress