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Cultural Perspectives on Abnormal Psychology, Cheat Sheet of Psychology

Pamantasan ng Lungsod ng Maynila (PLM)Psychology

This document delves into the historical evolution of understanding abnormal behavior, highlighting cultural influences on its definition and treatment. It explores key figures like hippocrates and galen, examines the rise of asylums and humanitarian reforms, and traces the development of biological and psychological perspectives. The document also discusses the impact of cognitive-behavioral theories and the importance of psychosocial assessment in understanding mental disorders.

Typology: Cheat Sheet

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ABNORMAL PSYCHOLOGY (NOTES) BUTCHER
CHAPTER 1: An Overview
Abnormal psychology is concerned with understanding the
nature, causes, and treatment of mental disorders.
Family aggregation --- whether a disorder runs in the family.
ELEMENTS OF ABNORMALITY
1. Suffering
2. Maladaptiveness
3.Statistical deviancy
4. Violation of the Standard of Society
5. Social Discomfort
6. Irrationality and Unpredictabilty
7. Dangerousness
Classifying mental disorders/classification systems provide
us with a NOMENCLATURE (naming system) and enable us
to structure information in a more helpful manner.
Advantages and Disadvantages of classifying mental
disorders: DSM as classification tool
Descriptive and concrete
Provides a common language
Allows us to structure information in an efficient
manner
Defines the domain of what is considered as
pathological
Disadvantages
Lose detailed personal information about the person
with the disorder
Can facilitate stigma, stereotyping and labeling
Fear of being discriminated against may lead some
people to avoid treatment.
CULTURAL DIFFERENCES in what is abnormal
Societal norms and expectations in reference to
which abnormality is defined
Ways individual presented the disorders
Variation in the way different cultures describes
distress (now word for depress in native American
culture)
Certain form of culture – specific psychopathology
PREVALENCE in mental disorders – mental health
epidemiology
EPIDEMIOLOGY – study of distribution of
diseases, disorders, or health related behavior in a
given population
PREVALENCE – number of active cases in a
population during any given period of time
(typically expressed in percentage)
POINT PREVALENCE – estimated proportion of
actual, active cases of a disorder in a given
population
1 YEAR PREVALENCE – total number of cases of
a health-related state or a condition in a population
for a given year
LIFEIME PREVALENCE – proportion of living
persons in a population who have ever had a disorder
up to the time of epidemiologic assessment
INCIDENCE – occurrence (onset) rate of a given
disorder in a given population
COMORBIDITY – occurrence of two or more
identified disorders in the same psychologically
disordered individual
COMMON forms of treatment
1. Psychotherapy
2. Medication
APPROACHES USED TO GATHER INFORMATION
ABOUT MENTAL DISORDER
Case study : an in-depth examination of an
individual or family that draws from number of data
sources including interviews and psychological
assessment/testing
---- can be subject to BIAS because the writer selects
what information to include and what information to
omit/exclude
---- means that the conclusion have low
generalizability – they cannot be used to draw
conclusions about other cases
Self-report data : data collected directly from
participants, typically by means of interviews /
questionnaires
Direct observation (observational approached) :
method of collecting research data that involves
directly observing behavior in a given situation.
FORMING AND TESTING HYPOTHESIS
Hypotheses : an effort to explain, predict, or explore
something
Sampling and Generalization
Sampling : representative sample of people or an
organization
Samples of Convenience : they study groups of
people who are easily accessible to them and who
are readily available.
INTERNAL AND EXTERNAL VALIDITY
External Validity : The extent to which we can
generalize our findings beyond the study itself
Internal Validity : reflects how confident we can be
in the results of a particular given study
(Note)
Research in abnormal can be correlational or
experimental
Correlational : examines factors as they currently
are
Experimental : involves manipulating variables
(independent variable) and observing the effect this
manipulation produces with regard to another
variables (dependent variable)
Research Designs Studying the World as It Is: Correlational
Research Designs
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ABNORMAL PSYCHOLOGY (NOTES) BUTCHER

CHAPTER 1: An Overview

Abnormal psychology is concerned with understanding the nature, causes, and treatment of mental disorders. Family aggregation --- whether a disorder runs in the family. ELEMENTS OF ABNORMALITY

  1. Suffering
  2. Maladaptiveness 3.Statistical deviancy
  3. Violation of the Standard of Society
  4. Social Discomfort
  5. Irrationality and Unpredictabilty
  6. Dangerousness Classifying mental disorders/classification systems provide us with a NOMENCLATURE (naming system) and enable us to structure information in a more helpful manner. Advantages and Disadvantages of classifying mental disorders: DSM as classification tool  Descriptive and concrete  Provides a common language  Allows us to structure information in an efficient manner  Defines the domain of what is considered as pathological Disadvantages  Lose detailed personal information about the person with the disorder  Can facilitate stigma, stereotyping and labeling  Fear of being discriminated against may lead some people to avoid treatment. CULTURAL DIFFERENCES in what is abnormal  Societal norms and expectations in reference to which abnormality is defined  Ways individual presented the disorders  Variation in the way different cultures describes distress (now word for depress in native American culture)  Certain form of culture – specific psychopathology PREVALENCE in mental disorders – mental health epidemiology  EPIDEMIOLOGY – study of distribution of diseases, disorders, or health related behavior in a given population  PREVALENCE – number of active cases in a population during any given period of time (typically expressed in percentage)  POINT PREVALENCE – estimated proportion of actual, active cases of a disorder in a given population  1 YEAR PREVALENCE – total number of cases of a health-related state or a condition in a population for a given year  LIFEIME PREVALENCE – proportion of living persons in a population who have ever had a disorder up to the time of epidemiologic assessment  INCIDENCE – occurrence (onset) rate of a given disorder in a given population  COMORBIDITY – occurrence of two or more identified disorders in the same psychologically disordered individual COMMON forms of treatment 1. Psychotherapy 2. Medication APPROACHES USED TO GATHER INFORMATION ABOUT MENTAL DISORDER  Case study : an in-depth examination of an individual or family that draws from number of data sources including interviews and psychological assessment/testing ---- can be subject to BIAS because the writer selects what information to include and what information to omit/exclude ---- means that the conclusion have low generalizability – they cannot be used to draw conclusions about other cases  Self-report data : data collected directly from participants, typically by means of interviews / questionnaires  Direct observation (observational approached) : method of collecting research data that involves directly observing behavior in a given situation. FORMING AND TESTING HYPOTHESIS  Hypotheses : an effort to explain, predict, or explore something Sampling and Generalization  Sampling : representative sample of people or an organization  Samples of Convenience : they study groups of people who are easily accessible to them and who are readily available. INTERNAL AND EXTERNAL VALIDITY  External Validity : The extent to which we can generalize our findings beyond the study itself  Internal Validity : reflects how confident we can be in the results of a particular given study (Note)  Research in abnormal can be correlational or experimental  Correlational : examines factors as they currently are  Experimental : involves manipulating variables (independent variable) and observing the effect this manipulation produces with regard to another variables (dependent variable) Research Designs Studying the World as It Is: Correlational Research Designs

CRITERION AND COMPARISON GROUPS

 To test their hypotheses, researchers use a comparison group (sometimes called a control group). This may be defined as a group of people who do not exhibit the disorder being studied but who are comparable in all other major respects to the criterion group. MEASURING CORRELATION  Positive correlation : measures vary together in a direct, corresponding manner  Negative correlation : conversely, is there an inverse correlation  The strength of a correlation is measured by a correlation coefficient  Just because two variables are correlated does not mean that there is a causal relationship between them. Always remember that correlation does not equal causation.  Analogue studies (e.g., animal research) are studies that provide an approximation to the human disorders of interest. CHAPTER 2: HISTOICAL & CONTEMPORARY VIEWS OF ABNORMAL BEHAVIORS  How abnormal behavior has been viewed through out history : include both humor and tragedy  A progression of beliefs from what we now consider superstition to those based on scientific awareness— from a focus on supernatural explanations to knowledge of natural causes. The Edwin Smith papyrus (named after its nineteenth-century discoverer) – the brain is described as the site of mental functions  The behavioral problem were not dealt through medicine but through religious rites/incantations that were made by people who sought exorcism from antisocial traits and behaviors by REPEATING explicit phrases. KEY PEOPLE, DEFINITIONS, CLASSIFICATIONS, GREEK AND ROMANS Physical amount (temperament is determined by 4 bodily fluids)

  1. Blood (sanguis)
  2. Phlegm
  3. Bile
  4. Blackbile (melancholic)  HIPPOCRATES : Father of modern medicine  Denied that deities and demons intervened in the development of illnesses  Insisted that mental disorders, like other diseases had natural causes and appropriate treatment  Classified mental disorders into 3 categories
  5. Mania
  6. Melancholia
  7. Phrenitis (brain fever) PLATO : studied individuals with mental disturbances who had committed criminal acts and how to deal with them  Emphasized the importance of individual differences in intellectual and other abilities and took into account sociocultural influences in shaping, thinking, and behavior ARISTOTLE : Held the view that “thinking” as directed would eliminate pain and help attain pleasure.  Rejected that mental disorders could be caused by psychological factors (such as frustrations & conflict) GALEN : original findings concerning the anatomy of the nervous system  Most influential Greek physician EARLY CHINA : earliest developed civilization  Chinese medicine was based on a belief in natural rather that supernatural causes of illnesses  The body is like YIN & YANG, if two forces are balanced, the result is physical & mental health  This, treatments focused on restoring balance EUROPEAN MIDDLE AGES : Influenced by medieval Christianity  2 causes of human nature
  8. God-given soul

2. Devil-given soul

ISLAMIC MIDDLE AGES : Greek medicine  1 st^ mental hospital in Baghdad – human treatment  Followed by DAMASCUS & ALEPPO  AVICENNA “prince of physicians” DURING MIDDLE AGES IN EUROPE  Scientific inquiry into abnormal psychology was limited  Treatments of individuals who where psychologically disturbed was characterized more by RITUAL/ SUPERSTITION than by attempts to understand an individual conditions  MASS MADNESS : the widespread occurrence of group behavior disorders that were apparently cases of hysteria  DANCING MANIAS : epidemic of raving, jumping, dancing & convulsions : 1st^ episode that occurred on Italy, early 13th^ century – TARANTISM  LYCANTHROPY : condition which people believed themselves to be possessed by wolves and imitate their behaviors TOWARD HUMANITARIAN APPROACHES Resurgence of scientific questioning in Europe ‘  PARACELSUS : early critic of superstitious beliefs about possessions  JOHAN MEYER : writer of “Latin nome of Joannus Wierus”

 Mesmerism: about the influence of the planets on the human body. Mesmer believed that the planets affected a universal magnetic fluid in the body, the distribution of which determined health or disease. Ambrose August Liébeault (1823–1904), a French physician  The NANCY SCHOOL  1940). Their hypothesis was based on two lines of evidence: (1) The phenomena observed in hysteria—such as paralysis of an arm, inability to hear, and anesthetic areas in which an individual could be stuck with a pin without feeling pain (all of which occurred when there was apparently nothing organically wrong)— could be produced in normal subjects by means of hypnosis. (2) The same symptoms also could be removed by means of hypnosis. THE BEGINNING OF PSYCHOANALYSIS The first systematic attempt to answer this question was made by Sigmund Freud (1856–1939).  CATHARSIS : a powerful emotional release that, when successful, is accompanied by cognitive insight and positive change. According to psychoanalytic theory, this emotional release is linked to a need to relieve unconscious conflicts  this approach that thus led to the discovery of the unconscious—the portion of the mind that contains experiences of which a person is unaware—and with it the belief that processes outside of a person’s awareness can play an important role in determining behavior. Two related methods enabled him to understand patients’ conscious and unconscious thought processes. (1) FREE ASSSOCIATION : association, involved having patients talk freely about themselves, thereby providing information about their feelings, motives, and so forth. (2) DREAM ANALYSIS : involved having patients record and describe their dreams. The Evolution of the Psychological Research Tradition: Experimental Psychology  The origins of much of the scientific thinking in contemporary psychology lie in early rigorous efforts to study psychological processes objectively, as demonstrated by Wilhelm Wundt (1832–1920) and William James (1842–1910). THE EARLY PSCYHOLOGICAL LABORATORIES In 1879 Wilhelm Wundt established the first experimental psychology laboratory at the University of Leipzig. THE BEHAVIORAL PERSPECTIVE  perspective is organized around a central theme: the role of learning in human behavior. Classical Conditioning (Ivan Pavlov)  a form of learning in which a neutral stimulus is paired repeatedly with an unconditioned stimulus that naturally elicits an unconditioned behavior. Behaviorism  Watson thus changed the focus of psychology to the study of overt behavior rather than the study of theoretical mentalistic constructs Operant Conditioning  E. L. Thorndike (1874–1949) and subsequently B. F. Skinner (1904–1990)  In Skinner’s view, behavior is “shaped” when something reinforces a particular activity of an organism—which makes it possible “to shape an animal’s behavior almost as a sculptor shapes a lump of clay” CHAPTER 3: CAUSAL FACTORS AND VIEWPOINTS Etiology – causal pattern of abnormal behavior TYPES OF CAUSES Necessary, Sufficient, and Contributory Cause  NECESSARY CAUSE : condition that must exist for the disorder to occur  One thing is a necessary cause of another, then that means that the outcome can never happen without the source (If disorder Y occurs then X must have preceded it)  SUFFICIENT CAUSE : if a disorder is a condition that guarantees the occurrence of the disorder (If cause X occurs, then the probability of disorder Y increases)  CONTRIBUTORY CAUSE : one that increases the probability of a disorder (if X occurs, then the probability of disorder Y increases) TIMEFRAMES of Causal Factor  DISTAL (far away) causal factor : DISTAL RISK FACTOR  Some causal factors occurring relatively early in life may not show their effects for many years but may contribute to a predisposition to develop a disorder  PROXIMAL (immediate) causal factor : PROXIMAL RISK FACTOR  shortly before the occurrence of the symptoms of a disorder  REINFORCING causal factor  Tends to maintain maladaptive behavior that is already occurring. FEEDBACK and BIDIRECTIONALITY in Abnormal behavior  CAUSE & EFFECT RELATIONSHIP : has focused on isolating the condition X (cause) that can be demonstrated to lead to condition Y (effect)  CAUSAL PATTERN : when more than 1 causal factor is involved  the effects of feedback and the existence of mutual, two- way (bidirectional) influences must be taken into account. DIATHESIS-STRESS MODELS

 Many mental disorders are believed to develop when some kind of stressor operates on a person who has a diathesis or vulnerability for that disorder.  DIATHESIS (vulnerability) : a predisposition toward developing a disorder that can derive from biological, psychological, or sociocultural causal factors.  STRESS : the response or experience of an individual to demands that he or she perceives as taxing or exceeding his or her personal resources  Often occurs when an individual experiences CHRONIC & EPISODIC EVENT (Note) Important to note that factors contributing to the development of a diathesis are themselves sometimes highly potent stressors, as when a child experiences the death of a parent and may thereby acquire a predisposition or diathesis for becoming depressed later in life. A DIATHESIS & STRESS may combine to produce a disorder  ADDITIVE MODEL : the diathesis and the stress sum together, and when one is high the other can be low, and vice versa  INTERACTOVE MODEL : some amount of diathesis must be present before stress will have any effect.  PROTECTIVE FACTORS (late 1980s) : factors, which are influences that modify a person’s response to environmental stressors, making it less likely that the person will experience the adverse consequences of the stressors  One important protective factor in childhood is having a family environment in which at least one parent is warm and supportive, allowing the development of a good attachment relationship between the child and parent that can protect against the harmful effects of an abusive parent  Some stressors paradoxically promote coping. This “steeling” or “inoculation” effect is more likely to occur with moderate stressors than with mild or extreme stressor  RESELIENCE : the ability to adapt successfully to even very difficult circumstances.  MULTICAUSAL DEVELOPMENTAL MODELS : These risk factors also interact, however, with a variety of protective processes, and sometimes with stressors, to determine whether the child develops in a normal and adaptive way—as opposed to showing signs of maladaptive behavior and psychopathology—in childhood, adolescence, or adulthood  DEVELOPMENTAL PSYCHOPATHOLOGY : focuses on determining what is abnormal at any point in development by comparing and contrasting it with the normal and expected changes that occur in the course of development VIEWPOINTS for Understanding the Causes of Abnormal Behavior  BIOLOGICAL PERSPECTIVE/ VIEWPOINT : acknowledges that biological, psychological, and sociocultural factors all interact and play a role in psychopathology and treatment. (1) Genetics (2) Neurobiology (3) Hormonal responses (4) Can influence psychopathology  SOCIOCULTURAL PERSPECTIVE : how social and cultural factors can influence the way what we think about abnormal behavior The BIOLOGICAL VIEWPONT and BIOLOGICAL CAUSAL FACTOR  Mental disorders are thus viewed as disorders of the central nervous system, the autonomic nervous system, and/or the endocrine system that are either inherited or caused by some pathological process. BIOLOGICAL CAUSAL FACTOR (1) • Neurotransmitter and hormonal abnormalities (2) • Genetic vulnerabilities (3) • Temperament (4) • Brain dysfunction and neural plasticity IMBALANCES OF NEUROTRANSMITTERS AND HORMONES Hormones  Axon endings : branches at the end of the axons  Synapse : tiny-fluid filled space between the axon endings of 1 neuron ( presynaptic neuron) and the dendrites or cell body of another neuron (postsynaptic neuron). neuron). The synapse is the site of communication between the axon of one neuron and the dendrites or cell body of another (interneural transmission)  Neurotransmitter: chemical substances that are released into the synapse by the presynaptic  Can stimulate the postsynaptic neurons to either initiate / inhibit impulse transmission  Sometimes, the neurotransmitters are quickly destroyed by an ENZYME such as monoamine oxidase & sometimes they are returned to storage vesicles in the axon ending by REUPTAKE MECHANISM – process of reabsorption A.IMBALANCES OF NEUROTRANSMITTER  Stress can cause / bring on neurotransmitter imbalances (1) Noripinephrine : monoamines (2) Dopamine : monoamine (3) Serotonin : monoamine (4) Glutamate (5) Gamma aminobutyric acid (GABA)  Monoamines mean one amine  Agonists: medications that facilitates the effects of a neurotransmitter on the post synaptic neuron

THE IMPACT OF THE BIOLOGICAL VIEWPOINT

Biological discoveries have profoundly affected the way we think about human behavior. THE PSYCHOLOGICAL VIEWPOINTS

  • Psychosocial perspectives attempt to understand humans not just as biological organisms but also as people with motives, desires, and perceptions.
  • There are three major psychosocial perspectives on human nature and behavior:
    1. Psychodynamic
    2. Behavioral
    3. Cognitive-behavioral
  • Also includes two other perspectives:
  1. the humanistic perspective
  2. the existential perspective THE PSYCHODYNAMIC PERSPECTIVE Fundamentals of FREUD’S PSYCHOANALYTIC THEORY The structure of personality: ID, EGO, SUPEREGO  The id is the source of instinctual drives and is the first structure to appear in infancy. These drives are inherited and are considered to be of two opposing types: (1) life instincts, which are constructive drives primarily of a sexual nature and which constitute the libido, the basic emotional and psychic energy of life; (2) death instincts, which are destructive drives that tend toward aggression, destruction, and eventual death.  Pleasure principle, primary process thinking  The ego mediates between the demands of the id and the realities of the external world.  Secondary process thinking, reality principle  The superego is the outgrowth of internalizing the taboos and moral values of society concerning what is right and wrong.  Conscience, executive branch of personality Freud believed that the interplay of id, ego, and superego is of crucial significance in determining behavior. Often inner mental conflicts arise because the three subsystems are striving for different goals. If unresolved, these intrapsychic conflict leads to mental disorder.  ANXIETY, DEFENSE MECHANISM AND THE UNCONCIOUS  Anxiety: a warning of impending real or imagined dangers as well as a painful experience, and it forces an individual to take corrective action.  Defense mechanism: where the ego resort PSYCHOSEXUAL Stages of development
    1. Oral stage: During the first 2 years of life, the mouth is the principal erogenous zone: An infant’s greatest source of gratification is sucking, a process that is necessary for feeding.
    2. Anal stage: From ages 2 to 3, the anus provides the major source of pleasurable stimulation during the time when toilet training is often going on and there are urges both for retention and for elimination.
    3. Phallic stage: From ages 3 to 5 or 6, self-manipulation of the genitals provides the major source of pleasurable sensation.
    4. Latency period: From ages 6 to 12, sexual motivations recede in importance as a child becomes preoccupied with developing skills and other activities.
    5. Genital stage: After puberty, the deepest feelings of pleasure come from sexual relations. THE OEDIPUS COMPLEX and the ELECTRA COMPLEX One of the most important conflicts occurs during the phallic stage, when the pleasures of self-stimulation and accompanying fantasies pave the way for the Oedipus complex. These castration anxiety forces the boy to repress his sexual desire for his mother and his hostility toward his father. mother. Freud also believed that each girl at this stage experiences penis envy, wishing she could be more like her father and brothers. She emerges from the complex when she comes to identify with her mother and settles for a promissory note; One day she will have a man of her own who can give her a baby—which unconsciously serves as a type of penis substitute. NEWER PSYCHODYNAMIC PERSPECTIVE Freud was chiefly concerned with the workings of the id, its nature as a source of energy, and the manner in which this id energy could be channeled or transformed. He also focused on the superego and the role of conscience but paid relatively little attention to the importance of the ego. EGO PSYCHOLOGY OBJECT-RELATION THEORY A second new psychodynamic perspective was object- relations theory. they share a focus on individuals’ interactions with real and imagined other people (external and internal objects) and on the relationships that people experience between their external and internal objects  ATTACHMENT THEORY emphasizes the importance of early experience, especially early experience with attachment relationships, as laying the foundation for later

functioning throughout childhood, adolescence, and adulthood. THE BEHAVIORAL PERSPECTIVE  Learning—the modification of behavior as a consequence of experience—is the central theme of the behavioral approach. THE COGNITIVE-BEHAVIORAL PERSPECTIVE  Albert Bandura (b. 1925), a learning theorist who developed an early cognitive-behavioral perspective, placed considerable emphasis on  the cognitive aspects of learning.  Bandura stressed that human beings regulate behavior by internal symbolic processes—thoughts. That is, we learn by internal reinforcement  Today the cognitive or cognitive-behavioral perspective on abnormal behavior generally focuses on how thoughts and information processing can become distorted and lead to maladaptive emotions and behavior.  SCHEMA: Underlying representation of knowledge that guides the current processing of information and often leads to distortions. SCHEMAS AND COGNITIVE DISTORTIONS  Our schemas about the world around us and about ourselves (self-schemas) are our guides, one might say, through the complexities of living in the world as we understand it.  Accommodation: Accommodation—changing our existing frameworks to make  it possible to incorporate new information that doesn’t fit  Assimilation: Important feature of information processing (1) a great deal of information is processed non- consciously, or outside of our awareness. (2) Implicit memory demonstrated when a person’s behavior reveals that she or he remembers a previously learned word or activity even though she or he cannot consciously remember it. ATTRIBUTION, ATTRIBUTIONAL STYLE AND PSYCHOPATHOLOGY  ATTRIBUTION: simply the process of assigning causes to things that happen.  ATTRIBUTION STYLE: characteristic way in which an individual tends to assign causes to bad events or good events.  nondepressed people tend to have what is called a self-serving bias in which they are more likely to make internal, stable, and global attributions for positive rather than negative events

COGNITIVE THERAPY

IMPACT OF COGNITIVE-BEHAVIORAL

PERSPECTIVE

WHAT THE ADOPTION OF A PERSPECTIVE DOES

AND DOES NOT DO?

 Because different causal perspectives influence which components of maladaptive behavior the observer focuses on, each perspective depends on generalizations from limited observations and research.  Thus, which perspective we adopt has important consequences: It influences our perception of maladaptive behavior, the types of evidence we look for, and the way in which we are likely to interpret data. PSYCHOLOGICAL CAUSAL FACTORS  whether they are predictable or controllable  disorder. Psychological factors are those developmental influences—often unpredictable and uncontrollable negative events—that may handicap a person psychologically, making him or her less resourceful in coping with events. 4 CATEGORIES of psychological causal factors (1) early deprivation or trauma (2) inadequate parenting style – parental psychopathology  parenting styles: warm and control (3) marital discord and divorce (4) maladaptive peer relationships INSTITUTIONALIZATION NEGLECT AND ABUSE IN THE HOME SEPARATION SOCIOCULTURAL FACTORS

  • Low socioeconomic status and unemployment
  • Prejudice and discrimination in race, gender, and ethnicity
  • Social change and uncertainty
  • Urban stressors: Violence and homelessness CHAPTER 4: CLINICAL ASSESSMENT AND DIAGNOSIS Psychological assessment refers to a procedure by which clinicians, using psychological tests, observation, and interviews, develop a summary of the client’s symptoms and problems. Clinical diagnosis is the process through which a clinician arrives at a general “summary classification” of the patient’s symptoms by following a clearly defined system such as DSM-5 or ICD-10 (International Classification of Diseases) BASIC ELEMENTS IN ASSESSMENT  presenting problem, or major symptoms and behavior the client is experiencing, must be identified.

STRESS AND THE DSM

The relationship between stress and psychopathology is considered so important that the role of stress is recognized in diagnostic formulations. FACTORS PREDISPOSING A PERSON TO STRESS  Stress tolerance: person’s ability to withstand stress without becoming seriously impaired. Characteristics of stressors Key factors involve (1) the severity of the stressor (2) its chronicity (i.e., how long it lasts) (3) its timing (4) how closely it affects our own lives (5) how expected it is (6) how controllable it is  Stressors that involve the more important aspects of a person’s life—such as the death of a loved one, a divorce, a job loss, a serious illness, or negative social exchanges—tend to be highly stressful for most people  The experience of crisis / crisis: is used to refer to times when a stressful situation threatens to exceed or exceeds the adaptive capacities of a person or a group. RESILIENCE: A kind of healthy psychological and physical functioning after a potentially traumatic event STRESS AND THE STRESS RESPONSE  The sympathetic-adrenomedullary (SAM) system - is designed to mobilize resources and prepare for a fight-or-flight response.  The second system involved in the stress response is called the hypothalamus-pituitary-adrenal (HPA) system  Cortisol is a good hormone to have around in an emergency.  It prepares the body for fight or flight. It also inhibits the innate immune response. This means that if an injury does occur, the body’s inflammatory response to it is delayed. BIOLOGICAL COSTS OF STRESS  The biological cost of adapting to stress is called the allostatic load  When we are stressed and feeling pressured, our allostatic load will be higher. THE MIND-BODY CONNECTION  Psychoneuroimmunology: the study of the interaction between the nervous system and the immune system.  Immunosuppression UNDERSTANDING THE IMMUNE SYSTEM  The immune system protects the body from such things as viruses and bacteria.  The front line of defense in the immune system is the  white blood cells. These leukocytes (or lymphocytes) are produced in the bone marrow and then stored in various places throughout the body, such as the spleen and the lymph nodes.  2 IMPORTANT TYPES OF LEUKOCYTES (1) B-cell – matures in the bone marrow (produces specific antibodies that are designed to respond to specific antigens (2) T-cell – matures in the thymus which an important endocrine gland ( Each T-cell has receptors on its surface that recognize one specific type of antigen)  Important Components of the IMMUNE SYSTM response (1) CYTOKINESIS: small protein molecules that serve as chemical messengers and allow immune cells to communicate with each other. Cytokines are chemical messengers that allow the brain and the immune system to communicate with each other. Some cytokines respond to a challenge to the immune system by causing an inflammatory response. Other cytokines, called anti-inflammatory cytokines, dampen the response that the immune system makes when it is challenged. How does the body respond to stress?

  • When we are stressed, the autonomic nervous system responds in a variety of ways. One consequence of stress is increased production of cortisol. High levels of this stress What role does our emotional state play in our physical health?
  • Negative emotional states, such as being under a lot of stress or having low social support, can impair the functioning of the immune system and the cardiovascular system, leaving a person more vulnerable to disease, infection, and problems such as hypertension and cardiovascular disease.
  • Many physical illnesses seem to be linked to chronic negative emotions such as anger, anxiety, and depression. Hostility is well-established as an independent risk factor for CHD. The same is true of depression. What mental disorders are explicitly recognized as being triggered by stress?
  • The DSM- 5 classifies people’s psychological problems in response to stressful situations under two general categories: adjustment disorders and posttraumatic stress disorder.
  • Several relatively common stressors (prolonged unemployment, loss of a loved one through death, and marital separation or divorce) may produce a great deal of stress and psychological maladjustment, resulting in adjustment disorder.
  • More intense psychological disorders in response to trauma or excessively stressful situations (such as military combat, being held hostage, or torture) may be categorized as posttraumatic stress disorder.
  • A new diagnostic category called “Trauma- and stressor- related disorders has been added to DSM-5. Several disorders (including PTSD) that were formally in the Anxiety

Disorders section of the DSM have been moved into this new category. What are the clinical features of posttraumatic stress disorder?

  • PTSD can involve a variety of symptoms including intrusive memories or recurrent and distressing dreams about the event, avoidance of stimuli associated with the trauma, negative cognitions or impaired memory about aspects of the traumatic event, and increased arousal or reactivity.
  • Many factors influence a person’s response to stressful situations. The impact of stress depends not only on its severity but also on the person’s preexisting vulnerabilities. Resilience is the most common long-term trajectory.
  • Although it is very common to experience psychological symptoms after a traumatic event, these often fade with time. Most people exposed to traumatic events do not develop PTSD. The prevalence of PTSD in the general population is 6.8 percent.
  • If symptoms begin 6 months or more after the traumatic event, the diagnosis is delayed posttraumatic stress disorder. What are the risk factors for PTSD?
  • Factors that increase a person’s risk of experiencing traumatic events include certain occupations (e.g., firefighter), being male, not having a college education, conduct problems in childhood, high levels of extraversion and neuroticism, as well as a family history of psychiatric problems.
  • Factors that increase the risk of developing PTSD are being female and having low levels of social support; higher levels of neuroticism; a family history of depression, anxiety, and substance abuse; as well as preexisting problems with anxiety and depression.
  • Women with PTSD have higher baseline cortisol levels than women who do not have PTSD. This is not the case for men with PTSD. Under conditions of stress, people with PTSD show an exaggerated cortisol response.
  • Having the s/s genotype of the serotonin-transporter gene may increase vulnerability to PTSD in the face of trauma exposure. Smaller hippocampal volume is also a biological vulnerability factor. What treatment approaches are used for PTSD?
  • Medications are sometimes used in the treatment of PTSD. Psychological treatments include prolonged exposure therapy and cognitive therapy. A new approach that appears promising is the use of virtual reality exposure therapy. Note: READ THE WHOLE CHAPTER

DEMONS AND WITCHES

STRESS AND MELANCHOLY

: Mental depression and anxiety were recognized as illnesses : although symptoms such as despair and lethargy were often identified by the church with the sin of acedia, or sloth. : Common treatments were rest, sleep, and a healthy and happy environment. Other treatments included baths, ointments, and various potions. : During the Middle Ages, individuals with psychological disorders were sometimes thought to be possessed by evil spirits and exorcisms were attempted through rituals.  NICHOLAS CRESME (14th century) one of the chief advisers to the king of France, a bishop and philosopher

  • suggested that the disease of melancholy (depression) was the source of some bizarre behavior, rather than demons. TREATMENTS FOR POSSESSIONS  Snake pits (hanging people over a pit full of poisonous snakes)  Dunking in ice-cold water MASS HYSTERIA  Saint Vitu’s dance  Tarantism MODERN MASS HYSTERIA  may simply demonstrate the phenomenon of emotion contagion, in which the experience of an emotion seems to spread to those around us.  if one person identifies a “cause” of the problem, others will probably assume that their own reactions have the same source.  shared response is sometimes referred to as mob psychology THE MOON AND THE STARS  Paracelsus (1943-1541): rejected notions of possession by the devil, suggesting instead that the movements of the moon and stars had profound effects on people’s psychological functioning. THE BIOLOGICAL TRADITION  Important to the biological tradition are a man, Hippocrates; a disease, syphilis; and the early consequences of believing that psychological disorders are biologically caused. HIPPOCRATES AND GALEN  Greek physician Hippocrates (460– 377 b.c.): considered to be the father of modern Western medicine.  Hippocratic Corpus: believed that psychological disorders might also be caused by brain pathology or head trauma and could be influenced by heredity (genetics).  Hippocrates considered the brain to be the seat of wisdom, consciousness, intelligence, and emotion.  Hippocrates also recognized the importance of psychological and interpersonal contributions to psychopathology, such as the sometimes-negative effects of family stress; on some occasions, he removed patients from their families.  Roman physician Galen (approximately a.d. 129– 198): adopted the ideas of Hippocrates and his associates and developed them further.  Hippocratic-Galenic approach is the humoral theory of disorders. 4 BODILY FLUIDS OR HUMORS: Blood, black bile, yellow bile, phlegm  In addition to rest, good nutrition, and exercise, two treatments were developed. --- bleeding or bloodletting (a carefully measured amount of blood was removed from the body, often with leeches) --- induced vomiting THE 19TH^ CENTURY SYPHILIS  syphilis, a sexually transmitted disease caused by a bacterial microorganism entering the brain, include believing that everyone is plotting against you (delusion of persecution) or that you are God (delusion of grandeur), as well as other bizarre behaviors. THE DEVELOPMENT OF BIOLOGICAL TREATMENTS  CONSEQUENCES OF THE BIOLOGICAL TRADITIONS  THE PSYCHOLOGICAL TRADITION  a precursor to modern psychosocial treatment approaches to the causation of psychopathology, which focus not only on psychological factors but also on social and cultural ones. THE MORAL THERAPY  a strong psychosocial approach to mental disorders ASYLUM REFORM AND THE DECLINE OF MORAL THERAPY  after the mid-19th century, humane treatment declined because of a convergence of factors.
  • DOROTHEA DIX (Mental hygiene movement) LATER DEVELOPMENTS IN PSYCHOANALYTIC THOUGHT  ANNA FREUD (1895-1982) Ego Psychology: the defensive reactions of the ego determine our behavior.
  • the individual slowly accumulates adaptational capacities, skill in reality testing, and defenses.
  • Abnormal behavior develops when the ego is deficient in regulating such functions as delaying and controlling impulses or in marshaling appropriate normal defenses to strong internal conflicts.  HEINZ KOHUT (1913–1981) Self-psychology: focused on a theory of the formation of self-concept

and the crucial attributes of the self that allow an individual to progress toward health, or conversely, to develop neurosis.  Object relations: Object relations is the study of how children incorporate the images, the memories, and sometimes the values of a person who was important to them and to whom they were (or are) emotionally attached.

  • attached. Object in this sense refers to these important people, and the process of incorporation is called introjection.
  • Introjected objects can become an integrated part of the ego or may assume conflicting roles in determining the identity, or self.  CARL JUNG (1875–1961) ALFRED ADLER (1870–1937) Collective unconscious:
  • a wisdom accumulated by society and culture that is stored deep in individual memories and passed down from generation to generation.
  • Jung also suggested that spiritual and religious drives are as much a part of human nature as are sexual drives;
  • emphasized the importance of enduring personality traits such as introversion (the tendency to be shy and withdrawn) and extroversion (the tendency to be friendly and outgoing).  ADLER Feelings of inferiority and striving for superiority: he created the term inferiority complex.
  • Adler also believed that the basic quality of human nature is positive and that there is a strong drive toward self-actualization (realizing one’s full potential).
  • Jung and Adle believed that by removing barriers to both internal and external growth the individual would improve and nourish.  KAREN HORNEY (1855-1952) ERICH FROMM (1900-1980) BEST KNOWN THEORIST ERIK ERIKSON (1902-1994)
  • emphasizing development over the life span and the influence of culture and society on personality. HUMANISTIC THEORY / HUMANISTIC PSYCHOLOGY Self-Actualizing: was the watchword for this movement. The underlying assumption is that all of us could reach our highest potential, in all areas of functioning, if only we had the freedom to grow.  ABRAHAM MASLOW (1908-1970) He postulated a hierarchy of needs:
  • Maslow hypothesized that we cannot progress up the hierarchy until we have satisfied the needs at lower levels.  CARL ROGERS (1902-1987) Person-Centered Therapy:
  • the therapist takes a passive role, making as few interpretations as possible.
  • The point is to give the individual a chance to develop during the course of therapy, unfettered by threats to the self.
  • UNCONDITIONAL positive regard: the complete and almost unqualified acceptance of most of the client’s feelings and actions, is critical to the humanistic approach.
  • Empathy: the sympathetic understanding of the individual’s particular view of the world. BEHAVIORAL MODEL known as the cognitive-behavioral model or social learning model PAVLOV AND CLASICAL CONDITIONING  Ivan Petrovich Pavlov (1849–1936) Classical Conditioning:
  • a type of learning in which a neutral stimulus is paired with a response until it elicits that response.
  • Stimulus generalization: response generalizes to similar stimuli.
  • Ivan Pavlov (1849–1936) identified the process of classical conditioning, which is important to many emotional disorders.
  • EXTINCTION:
  • INTROSPECTION: Subjects sim-
  • ply reported on their inner thoughts and feelings after experiencing certain stimuli, but the results of this “armchair” psychology were inconsistent and discouraging to many experimental psychologists. WATSON AND THE RISE OF BEHAVIORISM  Mary Cover Jones (1896–1987) was one of the first psychologists to use behavioral techniques to free a patient from phobia. THE BEGINNINGS OF BEHAVIOR THERAPY  Joseph Wolpe (1915–1997) Systematic desensitization:
  • Individuals were gradually introduced to the objects or situations they feared so that their fear could extinguish
  • BEHAVIOR THERAPY BF SKINNER AND OPERANT CONDITIONING THE PRESENT: SCIENTIFIC METHOD AND AN INTEGRATIVE APPROACH  With the increasing sophistication of our scientific tools, and new knowledge from cognitive science, behavioral science, and neuroscience, we now realize that no contribution to psychological disorders ever occurs in isolation. Our behavior, both normal and abnormal, is a product of a continual interaction of psychological, biological, and social influences. CHAPTER 2: AN INTEGRATIVE APPROACH TO PSCYHOPATHOLOGY ONE-DIMENSIONAL VS MULTIDIMENSIONAL MODELS  A system, or feedback loop, may have independent inputs at many different points, but as each input

 Neurotransmitter currents called brain circuits. Of the neurotransmitters that may play a key role, we investigated five: serotonin, gamma-aminobutyric acid (GABA), glutamate, norepinephrine, and dopamine. BEHAVIORAL COGNITIVE SCIENCE  The relatively new field of cognitive science provides a valuable perspective on how behavioral and cognitive influences affect the learning and adaptation each of us experience throughout life. Clearly, such influences not only contribute to psychological disorders but also may directly modify brain functioning, brain structure, and even genetic expression.  helplessness, modeling, prepared learning, and implicit memory.