Abnormal Psych & Therapies

Chapters 16 & 17

Abnormal Psych & Therapies

Part 1: Psychological Disorders

Mental health workers view psychological disorders as ______harmful thoughts, feelings, and actions.When behavior is ______(not rational), ______(hinders lifestyle), ______(violates the norm), and ______ psychiatrists and psychologists label it as disordered. (______)

- The American Psychiatric Association rendered a ______

______(DSM) to describe psychological disorders.The most recent edition,

______, describes around 400 psychological disorders compared to the 60 identified in the 1950s.

- Disorders outlined by DSM-V are reliable. Therefore, diagnoses by different professionals are similar. Also, insurance companies usually require a firm diagnosis & code to cover health care costs.

- Others criticize DSM-V for classifying almost anything as a disorder/syndrome.

Anxiety Disorders

Feelings of ______

and______that cause distress or cause maladaptive behaviors to reduce the levels of stress.

______(G.A.D) - disorder characterized by persistent and uncontrollable tenseness and apprehension (worrying).

______- minute-long episodes of intense dread which may include feelings of terror, chest pains, choking, or other frightening sensations.

______are marked by a persistent and irrational

fearof an object or situation that disrupts behavior.

______(O.C.D) - persistence of unwanted thoughts (______) and urges/behaviors (______) to engage in senseless rituals that cause distress. *

______(P.T.S.D) is often caused by severely threatening uncontrollable events. Four or more weeks of the following symptoms: haunting memories (flashbacks), nightmares, social withdrawal, anxiety & insomnia.*

• Psychoanalytic Perspective – Freud suggested that we ______our painful and intolerable ideas, feelings, and thoughts, resulting in anxiety.

• Behavioral Perspective – Learning theorists suggest that (classical) ______leads to anxiety. This anxiety then becomes associated with other objects or events (stimulus generalization) and is reinforced (operant). Investigators believe that fear responses can be passed along to others through ______learning (modeling).

• Biological Perspective – A PET scan of the brain of a person with OCD shows high metabolic activity (red) in the ______areas are involved with directing attention.Too little of the neurotransmitter ______can also contribute to anxiety disorders

• Evolutionary Perspective – ______has led our ancestors to learn to fear snakes, spiders, and other animals. Therefore, fear preserves the species. Perhaps it’s part of Jung’s collective unconscious?Twin studies suggest that our ______may be partly responsible for developing fears and anxiety. Twins are more likely to share phobias.

• Biopsychosocial Perspective - assumes that biological, socio-cultural, and psychological

factors combine and interact to produce

psychological disorders.

Dissociative Disorders

Usually ______where conscious awarenessbecomes ______(dissociated) from previous memories, thoughts, and feelings. A break from the self.

______- consists of having a sense of being unreal, separated from the body, as if watching one’s self in a movie.

______–amnesia caused by some kind of trauma (not by injury). For example, soldiers in combat.*

______(flight) – when a person totally forgets who they areand may develop a completely new identity, personality, etc. in a new place (involves ______).

Like “witnessprotection” from yourself! *

______(D.I.D) - formerly called Multiple Personality Disorder (MPD), it is a disorder in which a person exhibits______and ______personalities(each with its own name, voice, mannerisms, occupations, etc).

Mood Disorders

Characterized by ______(variations in mood).

______occurs when signs of depression last two

weeks or more and are not caused by drugs or medical conditions.

______lies between a blue mood and major depressive

disorder. It is a disorder characterized by ______ lasting two years or more.

______, formerly called Manic-Depressive Disorder, it is an alternation between mood - depression and mania (highs & lows). *

Since depression is so prevalent worldwide, investigators want to develop a theory of depression that will suggest ways to treat it.

1. Behavioral and cognitive changes
2. Common causes of depression(stressful life events)

3. Gender differences

1. Depressive episodes usually self-terminate.
2. Depression is increasing, especially in the teens.

The most severe form of behavioral response to depression is ______. Each year some 1 million people commit suicide worldwide.

• Biological Perspective – A reduction of the neurotransmitters ______and ______has been found in depression. Drugs that alleviate mania reduce norepinephrine. Mood disorders tend run in families. The rate of depression is higher in ______(50%) than fraternal twins (20%). In addition, PET scans show that brain energy consumption rises and falls with manic and depressive episodes.

• Social-Cognitive Perspective – Suggests that

depression arises partly from ______beliefs and ______styles.

Psychotic Disorders - Schizophrenia

Schizophrenia strikes young people as they ______into adults. It affects men and women equally, but men suffer from it more severely than women.

The literal translation is “______” (a break from reality), but is not the same as DID (a break from the self). Schizophrenia is a group of severe ______disorders characterized by the following:

1. ______(word salad) & ______(distorted) thinking
2. Disturbed ______(hallucinations – auditory, visual, olfactory…)
3. ______emotions & actions (or show no emotion/______)

Schizophrenia is a cluster of disorders. These subtypes share some features, but there are other symptoms that differentiate these subtypes. *

Schizophrenics______inappropriate symptoms (hallucinations, disorganized thinking, deluded ways) that are not present in normal individuals (______symptoms - inward). Schizophrenics also have an______of appropriate symptoms (apathy, expressionless faces, rigid bodies) that are present in normal individuals

(______symptoms - outward).

When schizophrenia is ______to develop (chronic/process) “recovery” is doubtful. Such schizophrenics usually display negative (outward) symptoms.When schizophrenia

______develops (acute/reactive) “recovery” is better.Such schizophrenics usually show positive (inward) symptoms.

• Biological Perspective – Schizophrenia is a disease of the brain exhibited by the symptoms of the mind.Researchers found that schizophrenic patients express higher levels of ______receptors in the brain. Brain scans show abnormal activity in the ______cortex, ______, and ______of schizophrenic patients. Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles. The likelihood of an individual suffering from schizophrenia is 50% if their ______twin has the disease. Poor fetal nutrition and viral infection during fetal development, along with oxygen deprivation have been linked to schizophrenia.Malnutrition, methamphetamine and cocaine abuse, and social conditions (urban life, racial discrimination, adversity and family dysfunction) have also been contributed to the development of the disorder.

Personality Disorders

Personality disorders are characterized by inflexible and enduringbehavior patterns that ______

______. They are usually ______anxiety, depression, or delusions.

Avoidant Personality Disorder– the person commonly withdraws due to fear of rejection

Narcissistic Personality Disorder – the person is very self-absorbed and have delusions of grandeur

Borderline Personality Disorder – the person has unstable emotions and relationships and ultimately an unstable identity

* Antisocial Personality Disorder – the person (usually male) exhibits a ______

______for wrongdoing, even toward friends and family members. Formerly, this person was called a sociopath or psychopath.

Dependent Personality Disorder– the person is abnormally dependent on other people

• Biological Perspective - Like mood disorders and schizophrenia, antisocial personality disorder has biological and psychological reasons. Youngsters with personality disorders, before committing a crime, respond with ______of stress hormones than others do at their age. They also show reduced activity in the ____________. In addition, the likelihood that one will commit a crime doubles when childhood ______is compounded with ______.

Somatoform Disorders

Disorders that usually involve abnormal ______or ______.

______– fear of or believing that you have illnesses that you don’t really have*

______– developing physical symptoms without an actual biological cause

(usually caused by trauma, stress/anxiety…)

______– belief that one or more of the features/parts of your body are abnormal/grotesque and needs to be fixed

Childhood Disorders

______(ADHD) – Controversial disorder with 3 key symptoms: ______, ______, and ______.

______* - marked by ______or development, ______

______(decreased eye contact; inability to carry on a conversation), ______(understanding of others’ point of view),

______(stick to routine; distress when it changes). Tends to occur more in males than in females and may be accompanied by a savant syndrome.

______– facial tics, blurted out words or sounds such as Tourette’s Syndrome (motor or vocal tics)

______– disorders in which the person fakes symptoms or inflicts symptoms on self or others to gain attention/sympathy (malingering = sickness for personal or monetary gain) such as Munchausen Syndrome where a person claims to have symptoms and undergoes many treatments/surgeries to receive attention or Munchausen Syndrome by Proxy where a person induces illnesses in others (usually parents do this to kids) to receive indirect attention

Part II: Therapy

Maltreatment of the insane throughout the ages was the result of irrational views. Many patients were subjected to strange, debilitating, and downright dangerous treatments.Philippe Pinel in France and ______in America founded humane movements to care for the mentally ill.

______involves an emotionally charged, confiding ______ between a trained therapist and a mental patient.

1. Psychoanalytical 3. Behavioral
2. Humanistic 4. Cognitive

______uses ______ or other procedures that act on the patient’s nervous system, curing him or her of psychological disorders.

An______uses ______ of healing techniques depending upon the client’s unique problems.

Psychoanalytic Therapy

The first formal psychotherapy to emerge was psychoanalysis, developed by Sigmund Freud. Since psychological problems originate from childhood repressed impulses and conflicts, the aim of psychoanalysis is to bring repressed feelings into ______ where the patient can deal with them.When energy devoted to id-ego-superego conflicts is released, the patient’s anxiety lessens.

Freud developed the method of ______

to unravel the unconscious mind and its conflicts. The patient lies on a

couch and speaks aboutwhatever comes to his or her mind.Comes under criticism because is cannot be proven or disproven and takes a long time and is very expensive.

Humanistic Therapy

Humanistic therapists aim to boost ______by helping people grow in self-awareness and self-acceptance.

Unlike psychodynamic therapies,humanistic therapies focus on:

• The present and future, not past conflicts
• Conscious issues, not unconscious conflicts
• Taking responsibility for one’s feelings and behaviors, not finding what is “hidden”

• Promoting individual growth, not curing illnesses

- Person in therapy called client (not patient)

Developed by Carl Rogers, ______ therapy is a form of humanistic therapy.

The therapist listens to the needs of the patient in an accepting and non-judgmental way (______) ,addressing problems in a productive way and building

his or her self-esteem. Therapist also demonstrates empathy and genuineness.

- The therapist engages in ______and echoes, restates, and clarifies the patient’s thinking, acknowledging expressed feelings.

Behavioral Therapy

Therapy that applies ______principles to the elimination of unwanted behaviors.To treat phobias or sexual disorders, behavior therapists do not delve deeply below the surface looking for inner causes. ______procedures enable therapists to use behavior modification, in which desired behaviors are rewarded and undesired behaviors are either unrewarded or punished.

______involves exposing people to fear-driving objects in real or virtual

environments. ______(Counter-conditioning) is a type of exposure

therapy that associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli (commonly

used to treat ______).

- ______is a type of counterconditioning that associates an unpleasant state with an unwanted behavior. With this technique, temporary conditioned aversion to alcohol has been reported (but doesn’t seem to work long-term).

Therapists may create a ______in which patients exchange a token of some sort

(usually a ______reinforcer), earned for exhibiting the desired behavior, for various privileges or treats (perhaps a ______reinforcer). It’s often used by parents and teachers.

Will the desired behaviors continue and/or undesirable

behaviors come back when the training/reinforcement stops?

Is it really ethical for one human being to “train” another?

Cognitive Therapy

Teaches people adaptive ways of ______and acting based on the assumption that thoughts intervene between events and our emotional reactions.Cognitive therapists often combine the ______of self-defeated thinking with efforts to modify behavior. ______therapy aims to alter the way people act (behavior therapy) and alter the way they think (cognitive therapy).

Albert Ellis developed the ______that irrational thoughts led to self-defeating emotions. Therapists present common irrational beliefs to clients and help to train them to cognitively restructure/reappraise their thinking.

Ellis developed the ABCD model to explain this:

•A = Activating event that triggers the emotion

(e.g. failing a test)

•B = Belief System: how person appraises the event

(e.g. “I’m stupid and no good at this subject”)

•C = emotional/behavioral Consequences of the appraisal in step B

(e.g. feeling worthless and dumb)

•D = Disputing their erroneous beliefs in step B

(e.g. “I’m not dumb. I just did not study hard enough and go in for the extra help that I needed”)

Alternative Therapies

Many different types exist (color, musical, touch, etc.). ______(SAD), a form of depression, has been effectively treated by light exposure therapy.

Biomedical Therapy

These include physical, medicinal, and other forms of biological therapies (including ______treatment, ______, or ______therapy).

______is the study of drug effects on mind and behavior.With the advent of drugs, ______in mental institutions has rapidly declined.However, many patients are left homeless on the streets due to their ill-preparedness to cope independently outside in society.

-______antipsychotics remove a number of ______symptoms (inward)

associated with schizophrenia such as agitation, delusions, and hallucinations(Thorazine). ______antipsychoticsremove ______symptoms (outward) associated with

schizophrenia such as apathy, jumbled thoughts, concentration difficulties,

and difficulties in interacting with others(Clozapine & Risperdal).

●Clozapine blocks receptors for ______

and serotonin to remove the negative symptoms.

- ______drugs depress the central nervous system and reduce anxiety and tension by elevating the levels of the ______neurotransmitter(Xanax and Ativan).

- ______drugs like Prozac, Zoloft, and Paxil are Selective Serotonin Reuptake Inhibitors (SSRIs) that improve the mood by elevating levels of ______by inhibiting reuptake.

- ______drugs like Lithium Carbonate, a common salt, has been used to

stabilize manic episodes in bipolar disorders. It moderates the levels of

______and glutamate neurotransmitters.

______(ECT) is used for severely______patients who do not respond to drugs. The patient is anesthetized and given a muscle relaxant. Patients usually get a 100 volt shock that relieves them of depression.

Psychosurgery was popular even in Neolithic times. ______(trephination/lobotomy) is used as a last resort in alleviating psychological disturbances. Removal of brain tissue changes the mind and psychosurgery is irreversible

Types of Therapy & Therapists

______normally consists of 6-9 people attending a 90-minute session that can help more people and costs less. Clients benefit from knowing others have similar problems.______treats the family as a system. Therapy guides family members toward ______relationships and ______communication. Marriage counseling is a form of this.

______usually have PhDs. They are experts in research,

assessment, and therapy, all of which is verified through a supervised internship.Clinical or Psychiatric ______usually have a Masters of Social Work. Postgraduate supervision prepares some social workers to offer psychotherapy, mostly to people with everyday personal and family problems.______are physicians who specialize in the treatment of psychological disorders. Not all psychiatrists have extensive training in psychotherapy, but as MDs they can prescribe medications.

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