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· completes a residency in psychiatry after obtaining their medical degree
· adult, child, adolescent, health, pediatric, forensic, severe psychopathology, according to age group or type of disorder etc.
Biologically driven via maturation, influenced by those around us.
First 18 months of life, nursing, getting nourishment, being cared for
18 months-3 years. Toilet training
3-5 years, discover, genitals
oedipal & electra complex
successful resolution-identify with same sex parent
oedipal-boys desire mom
electra-girls desire dad
5 years to adolescence
not much happening
adolescence through adulthood
being successful in life's activities
criticized because of too little focus on post-adolescent development, controversial, hard to verify scientifically
Unconscious is the main motivator of our behavior; below the water line, 90% of the ice
Conscious:that which we are aware of about 10%
Preconscious: that which can be made conscious. At the water line
· insight oriented therapy. Goal is to make the unconscious, conscious.
If insight is gained for the reasons for behavior the person should be able to change it.
· person talks about whatever comes up w/out the usual censoring that occurs in conversations.
Therapist tries to make connections about themes the person talks about
· the person tries to avoid important but unpleasant topics,events.
· when the client acts toward the therapist as if the therapist was some important person in the client's past...mom, dad.
· (not good, not a technique): therapists must guard against it.
Therapist acts toward the client as if the client was some important person in therapists past.....therapist themselves undergo long therapy to uncover the issues
· having gathered info and formed hypothesis, the therapists shares his/her insights w /the client
· the treatment makes the situation worse. Term applied in medicine and in general healthcare. We must consider this with any treatment.
The assumption is that if people are given unconditional love, they will develop into healthy people.
Not much theory!
Where do the other therapies come from?
Two main branches:
includes both promise and peril. You can come out of them better or worse off than before you entered them. If it is indeed a crisis, you will invariably be changed.
Not a therapy, but has implications for healthy adjustment
1st year, parents should provide predictable, secure nurturing
1-3 years. Autonomy is making and implementing decisions. Give child choices within safe parameters.Don’t be overly critical or restrictive.
young adulthood. Entering into relationships that are, of necessity, going to demand of you
Stages have “prepotency” in that successful resolution of conflict or crises at earlier stages presupposes successful resolution of conflicts/crises at later stages.
Begin with the end in sight
Successful resolution of prior crises helps
there is moving into and out of stages at different points in time for different people
Ex: divorce or death of a spouse, career change, life changing experiences. ..crises
· Cognitive Behavior Therapy (CBT)
Behavior psychology grew in its opposition to Psychoanalytic psychology
It was a paradigm clash®and such clashes can be very fruitful
Other stimuli, to the extent that they resemble the CS, will elicit some degree of the CR
This is not due to additional training, but it is considered to be a given in classical conditioning
Burris Fredrick Skinner
worked with rats or pigeons
a decrease in behavior because of something been added (shocking the rat after it pushes the button)
behavior results in something being taken away which leads to a decreased in behavior (taking away a kid’s toy when he’s bad)
an increase in behavior because something is added (laughing at someone’s jokes) following the behavior; (positive does not equal good!)
give a dog a treat
an increase in behavior because something is taken away (buckling your seatbelt to make the beeping noise go away): two key words to cue you in that it isNR- escape or avoidance from or of something aversive
turning off alarm clock
When you suppress a negative behavior, another may come to take its place
Give them something desirable as well/ use reinforcement
Task Analysis-break a complex task into its component parts
Success Approximations of the desired behavior-You do this by teaching each of the component parts in order.(1) teaching a rat to press a bar. (2) Teaching dog to sit. (3) Teaching a person with MR to put on their pants
Requires 2 people:
reinforcement of other behavior than the problem behavior
works more on the antecedent than anything (intervening when you see the signs)
you lose something when you do this behavior
Automatic Thoughts-thoughts the client thinks automatically which cause them stress
Cognitive Triad-Bad me, bad world, bad future
Collaborative Empiricism-therapist and client work together to examine the data of the client’s life
Make sure stimuli are present in non-training environment that were present in training environment
Person receives reinforcers for undesirable behavior
Two or more diagnoses
Ie, someone has depression, anxiety
indirect or vicarious experience
Seligman’s preparedness theory of phobias-
Barlow’s triple vulnerability theory
natural environment type
biological vulnerability (predisposition)-inherited contribution to negative affect or anxious responding
generalized psychological vulnerability- the sense that things are uncontrollable, unpredictable & dangerous. Childhood experiences of unresponsive overprotective & over-restrictive parenting as possible risk factors
specific psychological vulnerability-
exposing someone to the feared object in the real world
Construct a fear of hierarchy
Gradually progress up the fear of hierarchy, moving from least to most fearful stimuli
Children’s excessive, unrealistic and persistent fear that something will happen to:
recurrent thoughts, images or impulses that are experienced as intrusive & that cause marked anxiety & distress. More than just excessive worries about real life problems
Cleanliness, checking things,germs,hoarding, contamination, repeated doubts (did I hit that person in traffic? Left iron on? Door locked?), having to have or do things in order
the repetitive behaviors or mental acts, the goal of which is to reduce or neutralize anxiety
hand washing, ordering, checking; counting, repeating words silently
Avoidance and re-experiencing are key features
tend to be chronically over-aroused, anxious, and depressed
PTSD occurring within the first month post-trauma
ASD moves beyond 4 weeks, then PTSD
Major Depressive Disorder (MDD) also called unipolar depression
Bipolar Disorder (manic depressive)
Dysthymic Disorder (DD) – longer lasting but less intense depressive symptoms
Cyclothymic – up and down, longer lasting but less intense than bipolar disorder
Bipolar 1 is particular, one or more manic episodes or mixed episodes. Often the person also has one or more major depressive episodes (not necessary though)
5 or more of the following symptoms present for the same 2 week period. At least 1 symptom is either a) depressed mood or b) loss of interest or pleasure
Presence, while depressed, of at least 2:
Cluster A-Odd or eccentric:
Cluster B-Dramatic,Emotional,or Erratic
Cluster C- Anxious or fearful
Delusions – beliefs people hold that aren’t founded in reality
Hallucinations – experiences of sensory events in the absence of sensory stimuli
Eating is perceived as uncontrollable
Self-induced vomiting, diuretics, laxatives
Some exercise excessively, whereas others fast
Medical & Psychological Treatment of Bulimia
Some developed binge eating
Some developed symptoms of anorexia and fear of food
Some developed rigid thinking patterns similar to OCD
Moderate success with adults
Greater success with children and adolescents
Gross deviations in eating behavior
Fear or concern about weight, body size, appearance
Heavily influenced by social, cultural, and psychological factors
Study of the frequency and distribution of an illness in a population
Data on an illness & correlated conditions are gathered:
Skills, knowledge, behaviors, diet
have potential to inform the design of treament interventions
Watching animals/people in their natural environment and observing what happens
Goal is to determine rules for the animal's behavior
Positive and Negative correlations. Signs tell the direction
Magnitude goes from 0 to 1.0 [1.0=perfect correlation
Manipulation of an independent variable (treatment) and examining the results on a dependent variable (outcome)
Simplest case: 2 X 2 design. CBT v no treatment control for depression
Does one produce better results than the other? Treatment: independent variable -- depression dependent, outcome
3 phases necessary
ABA ABAB responds to baseline treatment, baseline
Withdrawal** means you are withdrawing treatment
When treatment is taken away, behavior returns a little bit
In figure, you control by taking away treatment and then giving treatment again (adding and removing) shows cause & effect
Height, weight, anxiety, depression/sadness (there are degrees of sadness & joy
Others react negatively toward the person because of the label
Person may misbehave consistent with the label
label becomes somewhat of a self-fulfilling prophecy
Each of the mental disorders is classified as a clinically significant behavioral or psychological syndrome or pattern that occurs in the individual that is associated with:
environment is not the cause of your disorder, but it did bring about some change
Clinical disorders and other conditions that may be a focus of treatment
Almost everything will fit on axis I
Global Assessment of Functioning
Pick some period of time (often within last year) and decide if the person was functioning well or poorly
Personality Disorders and Mental Retardation (long standing conditions)
May have 1, 2, + or no diagnoses
General Medical Conditions
Cutoff may be you need 10 symptoms to be diagnosed… you have 8 or 9? Gray range
is a defense mechanism that allows us to act out unacceptable impulses by converting these behaviors into a more acceptable form. person experiencing extreme anger-kick-boxing to vent. a sign of maturity-allows people to function in acceptable ways.
taking out our frustrations, feelings and impulses on people or objects that are less threatening.
educe anxiety by thinking about events in a cold, clinical way. This defense mechanism allows us to avoid thinking about the stressful, emotional aspect of the situation and instead focus only on the intellectual component. Cancer patient
outright refusal to admit or recognize that something has occurred or is currently occurring,
acts to keep information out of conscious awareness
taking up the opposite feeling, impulse or behavior. An example of reaction formation would be treating someone you strongly dislike in an excessively friendly manner in order to hide your true feelings.
taking our own unacceptable qualities or feelings and ascribing them to other people
-No one behavior making something a disorder
-social judgements, era, other factors
-Structure and naming system
Dysfunction - prevent function
-Gives people comfort
Cons of Classification
-labeled for life
-could be innacurate
-stereotypes and stigmas
Clinical, Counseling, and School Psychologist- PhD, PsyD, EdS - no prescribe
Psychiatrist (MD), Psychiatric (NP) - prescribe med
Clinical Social Worker, Mental Health Counselor (MA) - counseling
Neurotransmitter and Hormonal Abnormalities
Brain Dysfunction and Neural plasticity
Psychodynamic, Behavioral, Behavioral-Cognitive aproaches
Maladaptive Peer relationships
Low status and unemployment
Change, urban stressors
Monoamine, emergency situations of the body
Gamma Aminobutyric Acid
Used in reducing anxiety and emotional disorders
Treat schizophrenia / mood disorders
block dopamine receptors to eliminate delusions
SE Tardive Dyskinesia
SSRI - safe and pretty effective but take a long time to be effective
SNRI - safe and effective help people that don't respond to others
Tricyclics - less safe, overdose
MAOI- early, couldn't eat lots of foods
Benzodiazepines- work quick but are addicting- work on GABA
Busiprone- Serotenergic, but not sure
-unconscious motives and thoughts
-Problems occur when unconscious things aren't brought to the surface
Schizoid and paranoid
The single best word for the person with paranoid personality disorder is
Concern about childhood sexual abuse has increased in the past decade due to
c. the recognition that such abuse may lead to other problems later in life.
There is a new trend to focus on dopamine receptor sensitivity rather than on dopamine itself because
b. there is no strong evidence that people with schizophrenia have too much dopamine.
Patricia, age 10, refuses to wear dresses and insists on being called Pat. She knows she is a girl, but she says boys have it better. She prefers playing with boys and only plays the games they play. She says she wants to be a football player and a mother when she grows up. Pat has
d. no disorder.
Virginia exhibits a variety of schizophrenic symptoms including delusions, auditory hallucinations, and formal thought disorder. She has been symptomatic for a little more than a month. Virginia qualifies for a diagnosis of
d. schizophreniform disorder.
One of the most controversial issues in psychology today concerns
c. the validity of recovered (formerly repressed) memories of abuse.
The newest classification system for types of rapists (McCabe & Wauchope) varies in terms of
b. amount of sexual and aggressive motives.
a. may be an environmental risk factor for the development of schizophrenia.
"Semen is responsible for masculine characteristics such as beard growth and for general physical and sexual vigor. Therefore, wasting semen through masturbation and patronizing prostitutes is damaging to the nervous system" This statement best illustrates the __ theory of sexual behavior.
d. disturbances in the content of thought.
Which of the following is an example of a negative symptom of schizophrenia?
b. Karen no longer socialized with her friends.
What is unique about some of the disorders described as sexual variants?
c. They do not cause harm.
Among psychoanalysts in the 1930s and 1940s, homosexuality was first seen as ________ but later was seen as ________.
d. a variation of sexual function; a pathological escape from heterosexuality
One-on-one psychotherapy for people with schizophrenia
b. seems to be very effective when combined with medication.
Glutamate is an excitatory neurotransmitter that researchers suspect might be involved in schizophrenia because
d. it can produce schizophrenic-like symptoms in normal subjects.
What is the major difference between a diagnosis of undifferentiated schizophrenia and schizophreniform disorder?
d. The duration of symptoms
What type of hallucinations are the most common?
Which of the following sex offenders is most likely to reoffend?
a. A twenty-five-year-old pedophile
Harold and Tanya both have a wide range of schizophrenic symptoms that came on rather suddenly. Harold's symptoms have lasted for eight months; Tanya's have lasted only eight weeks. According to the DSM-IV their diagnoses should be
a. undifferentiated schizophrenia for Harold; schizophreniform disorder for Tanya.
Studies on neurocognition have found that people with schizophrenia
a. are unable to pay attention on demand and don't habituate to stimuli.
One aspect of family environment that has been found to be important in schizophrenia is
a. the level of expressed emotion.
The first-generation antipsychotics seem to work because they block dopamine. This is supported by the new research findings that
a. the level of expressed emotion.
Which of the following statements about sexual abuse is TRUE?
a. About one-third of children show no symptoms.
Adoption studies are typically used
b. to separate the effects of nature and nurture.
Research about sexuality is
c. surprisingly limited due to taboos and political controversies surrounding sexual topics.
Both surgical and chemical castration
a. lower testosterone levels.
Extrapyramidal side effects
a. are involuntary movements that result mainly from taking first-generation antipsychotic drugs.
Which of the following is most likely to be a victim of incest?
b. A stepdaughter
Which of the following is NOT a possible cause of female sexual arousal disorder?
Which of the following people has the highest risk of developing schizophrenia?
c. A person whose father was over 50 when he/she was born
What do rape and incest have in common?
b. The accuracy of prevalence estimates is questioned.
Joe has a delusional belief. When people argue with him
d. he doesn't admit he could be wrong, no matter what proof he is shown.
Lori just found out that she is pregnant. Her husband has schizophrenia. What is her unborn child's risk of developing schizophrenia?
b. 10 percent
Gary finds himself sexually aroused by dressing in women's clothing. He sometimes steals the clothes from women and from stores. He has a wife and is happy in his marriage. Gary's most likely diagnosis is
d. transvestic fetishism.
Which of the following best describes the person with undifferentiated schizophrenia?
a. Jake, who shows bizarre behavior, delusions, and disordered speech but has normal emotions.
Which of the following is a true statement about attitudes in the United States about masturbation?
b. Masturbation is no longer viewed as a disordered behavior, but public discussion of it may be actively discouraged.
Sexual variants illustrate a theme in abnormal psychology better than any other category of disorder. Which theme?
c. The difficulty in defining the boundaries of normal and abnormal
In genetic studies, a "proband" or "index case" is someone who
d. has the disorder of interest.
Aversion therapy may involve
a. exposure to a foul odor when becoming sexually aroused to a deviant stimulus.
According to DSM-IV-TR, the two components of gender identity disorder are cross-gender identification and ________.
d. gender dysphoria
Which of the following could be described as "short-term" schizophrenia?
d. Schizophreniform disorder
Rape shield laws
limit the amount of information about a victim's past sexual history that can be used in court.
Which of the following disorders is associated with engaging in autoerotic asphyxia?
People with transvestic fetishism
are usually heterosexual.
Which of the following suggests a diagnosis of disorganized schizophrenia?
Peter appears to feel no emotion and tends to make odd facial expressions and movements.
The term "demence precoce" was used by Benedict Morel to describe schizophrenia and to also explain the
difference between schizophrenia and dementias of old age.
Cognitive-behavioral treatment for people with schizophrenia
tries to help people question their delusions to help reduce their intensity.
Post-traumatic stress disorder, when caused by a rape,
is often associated with severe sexual symptoms.
The most common form of incest is between
brother and sister.
The recidivism rate for rapists
decreases steadily with age.
Pedophilia frequently involves
Secondary prevention for schizophrenia
involves trying to intervene early with people who are at high risk of developing schizophrenia.
It is quite rare for pedophilia to
involve a female pedophile.
One problem with Kraepelin's use of the term "dementia praecox" is that
it assumed that progressive deterioration of the brain is a universal feature of the disorder.
Patients in a catatonic stupor
resist efforts to change their position.
is sexual activity with a person who is legally defined to be under the age of consent.
Which schizophrenic subtype usually has the earliest onset, the greatest indifference to reality, and the worst prognosis?
Which of the following is an example of the most common type of hallucination seen in schizophrenia?
Sondra tried to ignore the voices in her head.
sensory experiences with no basis in reality.
work by blocking dopamine receptors.
Which of the following statements is true?
Sexual practices and standards are constantly evolving.
The central feature of catatonic schizophrenia is
excited or stuporous motor symptoms.
There is some debate as to whether ________ is a variant of schizophrenia or a form of mood disorder.
Aberrant salience means that
dysregulated dopamine can cause people with schizophrenia to pay too much attention to stimuli that are not actually important.
Ted is a rapist. If he is typical of most convicted rapists, he
is under 25 and has a prior criminal record.
Which of the following is an example of a negative symptom?
Social-skills training for people with schizophrenia
tries to help people gain the skills they need for daily living outside the hospital.
A mother constantly demands that her son show her how much she is loved, but when he tries to hug her she yells at him to be more discreet. No matter what the child does, he is wrong. Further, the mother prohibits him from commenting on this paradox. What does this best illustrate?
What is the value of research that monitors children at high risk for schizophrenia for a long time?
It can identify factors that precede breakdown and aid in intervention efforts.
What is the most common sexual offense reported to the police?
Over the course of the disorder, most individuals with schizophrenia
d. display a mix of positive and negative symptoms.
The only treatment that has been shown to be effective in treating gender dysphoria is
c. surgical sex reassignment.
The finding that prenatal viral exposure, rhesus incompatibility, and early nutritional deficiency are associated with an increased risk of developing schizophrenia indicates that
b. anything that interferes with normal brain development might lead to a greater risk of schizophrenia.
Why might Kraepelin's idea that schizophrenia was similar to dementia not be as far from the truth as previously thought?
a. Evidence suggests that there sometimes are progressive changes in brain volume over time in people with schizophrenia.
The fact that a significant number of monozygotic twins share the same placenta, while no dizygotic twins do, suggests that
a. we may have overestimated the influence of genetics in schizophrenia.
One's sense of maleness or femaleness is called
a. gender identity.
The McMartin Preschool case demonstrates how
a. interviewing style can alter the nature of a child's testimony.
Sam was a child with gender identity disorder. Now he is 26 and he wants to become a woman, feeling trapped in a man's body. Adults with gender identity disorder are often referred to as a
Newer research suggests that desire leading to sexual activity ending in orgasm
b. often doesn't apply to women.
Autogynephilic transsexuals differ from homosexual transsexuals in that
b. they are not especially feminine.
It was once believed that masturbation caused
Which of the following accounts for the belief that schizophrenia is becoming more common in males than females?
c. Females with schizophrenia have less severe symptoms so may be misdiagnosed.
When it comes to cross-cultural similarities and differences concerning sexual behavior, which of the following statements is accurate?
a. Taboos on sex between close relatives are found in all known cultures.
Which of the following is an argument against the use of surgical sex reassignment surgery for gender identity disorder?
c. Surgery should not be used to treat a psychological disorder.
d. is a disorder involving genital pain associated with intercourse.
The decision by APA to remove homosexuality from the DSM
c. was based on a vote by mental health professionals.
To be diagnosed with a paraphilia, a person
a. must have acted on the sexual fantasies.
Males who have been raped
a. show similar long-term psychological distress as women do.
Adopted children who were high risk for schizophrenia, who were raised in healthy families,
c. showed lower risk for schizophrenia than those adopted into dysfunctional families - a good environment may protect people with genetic vulnerabilities from developing schizophrenia.
"My father and I swiggered to the beach yesterday." This is an example of a
Which type of training has an emphasis on helping patients deal with their neurocognitive deficits?
a. Cognitive remediation training
After her last episode of schizophrenia, Jill continued to behave a bit eccentrically and she showed little emotion. Which of the following diagnoses should she be given?
a. Residual schizophrenia
Based on current research, which statement is most justified?
b. Genetics increase a person's vulnerability to develop schizophrenia.
All of the following have been found to lead to an increased risk of developing schizophrenia EXCEPT
a. prenatal alcohol exposure.
Which of the following people with schizophrenia is likely to have the best prognosis?
b. The woman who believes she is being persecuted because she is Helen of Troy
The most common theory about voyeurs is
b. they have difficulty relating to women and find peeping satisfies needs in a way that feels safe and powerful.
What is a stressor that has been found to increase the risk of developing schizophrenia?
c. Being a recent migrant
What is a paraphilia?
d. Persistent sexual behavior patterns in which unusual objects or situations are required for sexual satisfaction.
Sterling believes that the TV special that was on last night was shown to tell her that she should break up with her boyfriend. She is absolutely certain this is true and plans to do it. This type of belief is an example of a
b. delusion of reference.
b. was much more accepting of homosexuality than his contemporaries.
If schizophrenia were exclusively a genetic disorder,
b. the concordance rate for monozygotic twins would be 100 percent.
It has been suggested that the catatonic patient's immobility
a. is a consequence of the patient's inability to ignore irrelevant stimuli.
Studies of family concordance patterns for schizophrenia have found
d. that the more genetically related you are to someone with schizophrenia, the greater your risk of the disorder.
Schizophrenia is best described as a
b. genetically influenced polygenic disorder.
d. was once used to protect the royal blood in Egypt.
Julia clearly had psychotic symptoms. As she also showed symptoms of bipolar disorder, she was ultimately diagnosed with
b. schizoaffective disorder.
The individual diagnosed with schizophreniform disorder
b. usually exhibits symptoms of schizophrenia that would fit only undifferentiated type.
Anosognosia is an inability to
Which of the following is not listed in the DSM-IV-TR under disorders of infancy, childhood, and adolescence?
The cohesive family model is a treatment strategy for the child with conduct disorder that
proposes that dysfunctional interactions have served to maintain the child's problematic behavior.
As children with ADHD become adolescents and adults,
many continue to experience symptoms.
Which of the following is a risk factor for developing Alzheimer's disease?
Being a woman
Historically, why has little attention been paid to childhood psychopathology?
Childhood disorders were viewed as childhood versions of adult disorders.
What type of behavioral therapy is most likely to be used in the treatment of child with an anxiety disorder?
Behavior therapy that includes assertiveness training and desensitization using graded real-life situations.
Cross-cultural studies of tics find that
the average age of tic onset appears to be universal.