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PSYC 3690
Benjamin Gottlieb

1 PSYC 3690: Study Notes (Readings) 1. Drug Abuse Prevention: What Works IOM continuum of care: prevention (universal, selected/subsets, indicated/serious warning signs), treatment, maintenance Universal Prevention: deter onset of substance abuse by providing info and skills for entire pop Selective Prevention: target specific subgroups at greater risk (e.g. kids of alcoholics) based on bio, psych, soc or env factors, require skilled staff and more $/person Indicated Prevention: for individuals who exhibit early signs of substance abuse and other problem behaviours, target multiple behaviours simultaneously, require precise assessment and staff with clinical training Treatment: identification and standard treatment, focus on decreasing vulnerability Risk: low esteem, high sensation seeking, conduct problems, shyness, alienation, academic failure, - peer groups, family history, lack of discipline, low SES, lack of school support, low morale, high norms, community high crime, high pop density, lack of active leadership, dysfunction etc. Protective: personality (optimism, empathy, insight, self esteem), skills emotional management, problem solving, planning, academic and job -Prevention programs need to incorporate peers, family, community and individual 2. Prevention of Behavioural and Social Problems Primary prevention programs for mildly impaired youth (~20% develop a clinical disorder up to 50% of them have more than one) -Most types of programs obtained significant positive outcomes; dual benefit of significantly reducing problems and significantly increasing competencies-Overall impression is that mental health programs seem able to both reduce risk (lessen problems) and increase protection (increase competencies) in target populations -Person Centered: Good Behaviour Game using group contingency to modify children’s classroom behaviour Strategy Mediator Outcome -Team competition to follow -Group contingency enhanced kids -Sig. decreased aggression (girls rules, rewarded for winning self control and prompts them to already low) help other control their behaviours 2 Mental Health Promotion: person-centered programs have chosen various strategies such as rational emotive therapy (RET) mental health principles to school children Strategy Mediator Outcome -Emphasizes the importance of -Teach children how to become - Helpful for middle school and controlling or correcting more aware of their own and high school students in reducing irrational cognitions that can others’ feelings and how to anxiety, irrational thinking, and produce negative feelings and understand the possible neuroticism behaviour intentions that guide behaviour -+ changes in personal -Personal causation training -Understand their strengths and responsibility and goal-setting weaknesses and set realistic behaviour, school absences and personal goals tardiness and improvement in boys language and arithmetic -Interpersonal problem solving -Recognize the existence of -Improving problem-solving skills training interpersonal problems, develop improves children’s adjustment multiple possible solutions to and reduces behavioural these problems, think through problems the consequences Transition Programs: 4 categories w/ + outcomes First-Time Parents: Strategy Mediator Outcome -Education and support for new -Promote secure -Sig. improvements in child moms attachments, more functioning -Home visits w/ child care responsive, stimulating and -More responsible and helpful, sig. specialists sensitive parenting more approp and fewer problem behaviours School Entry and Change: based on an ecological model that suggests that the adjustment process of transfer students depends on both individual and environmental factors and their interaction over time. Emphasizes individual factors as the child’s prior academic and emotional adjustment and their coping skills, and environmental factors in the presence of stressful life events and social support provided by peers, school staff, and parents Strategy Mediator Outcome -Contains an informational -School better able to respond to -Improved academic component for school staff to child’s needs achievement alert them to typical problems -No longer considered at high -Features include school and -Enables them to catch up to risk home based tutoring program new curriculum, increases confidence -Decreased social withdrawal -Peer leaders help new students -Increased peer acceptance, and inattentiveness among social skill transfer students Children of Divorce: school-based group interventions CODIP (Children of Divorce Intervention Program) Strategy Mediator Outcome -Provides peer support to -Facilitate expression of feelings - Improvements in competent educate kids about divorce and -Learn better coping skills classroom behaviours and clarify misconceptions, and corresponding reductions in 3 teach relevant coping skills internalizing and externalizing problems, less anxiety and more positive divorce-related attitudes and perceptions, parents report significantly fewer behavioural problems at home DAP (Divorce Adjustment Program) includes parental involvement in its intervention based on the belief that parental reactions to the child’s behaviour and emotions mediate children’s adjustment to divorce Strategy Mediator Outcome Social support, skill building, -Improved communication with -Significant improvements in parental involvement parents, sense of support and children’s school and home (workbooks) understanding, more realistic behaviours appraisals about the divorce, Dental and Medical (hospitalization/surgery): 90% show increased anxiety and behavioural distress Strategy Mediator Outcome -Modeling, desensitization, -Children become more -Reduce anxiety and behaviour coping skills, relaxation, self comfortable with the idea problems control strategies gradually, learn how regulate own emotions Environmental Centered-Programs: modify psychological characteristics of school or home environments (primary target is parent behaviour and indirectly child’s) School Transitions Environment Project (STEP) attempts to reduce stress levels and increase interpersonal support for high risk students transferring to junior high or high school Strategy Mediator Outcome -Assign kids to same home room -Increases sense of acceptance -Prevents decreasing grades, and enhance role of teacher to and belonging/decreases attendance and levels of self- inc. advisory and counseling anonymity concept functions for their students; -Increase clarity of school rules -Improvesstudents classroom monitor personal and social and sense of school as organized behaviour and adjustment, levels adjustment and cohesive of general stress, depression, -School is more stable, well anxiety, and delinquent organized and supportive behaviour Bullying: school-based early intervention Strategy Mediator Outcome -Adults at school and in home must ??? -Bullying rates have fallen by half, communicate warmth and acceptance of vandalism, fighting, stealing have been children and provide clear and prompt reduced, sanctions for any aggressive behaviour -Better outcomes the longer a program is in -Attempt to change social norms, rewards operation regarding interpersonal behaviours Vandalism: 4 Strategy Mediator Outcome -Make environment more + and -Increase attachment to school -Reduced vandalism reinforce students -Increased praise and self- -Fewer discipline problems, -Encourages + esteem grater cooperation teaching/management 3. Cumulative Adversity and PTSD... Most people experience trauma, 9-12% of young adults have PTSD, 25% by their 30s Predictors: bio/gen rape and sexual assault, sudden death of loved one = most common cause, parental divorce, failing, witnessing violence, personality and attitude vulnerability, stress can intensify Results: conclude the development of PTSD is a process that includes stress beyond a single event, events prior to stressor matter Limitations: highly subjective data, skewed memories (esp. for kids), young population 4. Hurricane-Related Exposure Experiences and Stressors, Other Life Events and Social Support Destructive hurricanes lead to PTS in kids, most symptoms decrease 3-7 months later Risk: life-threatening experiences, loss of possessions, ongoing loss and destruction, life events prior, girls, minorities, young age Protective: perceived social support Results: PTS levels stable over time suggesting no recovery, complex pathways b/w stressors and PTS, s most persistent, stressors had a direct effect and increased chance of experiencing another major life event Limitations: self report from kids, unrepresentative sample 5. Mental Health of Displace Refugee Children Resettled in Low/Mid Income Countries Displacement = double disruption – adjust to past adverse events and new soc, econ and intellectual settings Refugee camps riddles with own trauma (e.g. rape is common) Over 75% have PTSD Risk: depression more common in girls, age and sex need to be considered, little known about effect of family functioning, low SES, urban areas, type of conflict experienced Repatriation: being sent home –mental health similar to those who never left Limitations: small sample, not generalizable, more contextual info is needed 6. Youth Violence Perpetration: What Protects and Predicts Predictive/Risk: perpetrating/experiencing violence (strongest), carrying weapon, friend suicidal involvement, school problems, poor phys/mental health, booze and dope Protective: connectedness w/ adults (in and out of family) quality of family dynamics, consistent supervision, expression of norms, values and expectations, school and peers, social class, race, ethnicity, high GPA and religiosity Results: controlling for demographic covariates time 1 protective factors against time 2 violence inc. parental expectations, connectedness with parents, adults and school, higher grades and religiosity; significant predictive factors inc history of violence involvement and victimization, weapon carrying, school problems, substance use, health problems and friend suicide; probability profiles assessed ability of protective factors to offset risk factors; substantial reductions of violence in boys and girls in presents of protective factors, even with risk factors present Conclusion: supports utility of dual strategy of reducing risk and enhancing protective factors Limitations: not generalizable outside of school 5 7. Testing Mediators of Intervention Effects in Randomized Controlled Trials: An Evaluation of Two Eating Disorder Prevention Programs Risk: thin ideal internalization, dieting body dissatisfaction, negative affect 10% have eating disorder –prevalence Dissonance Program: most effective Strategy Mediator Outcome -Critiqued thin ideal via verbal, -Forced to publicly go against -Increased body satisfaction, written and behavioural EDs, decreased endorsement of decreased negative affect, exercises –counter attitudinal thin ideal bulimic symptoms and dieting exercises Healthy Weight: improvements over control groups Strategy Mediator Outcome -Encouraged to make healthy, -Healthy changes to lifestyle, -Increased body satisfaction, lasting changes, balance intake better health = less decreased negative affect, and energy use, increase phys dissatisfaction bulimic symptoms and dieting activity -Diary -Motivational interviewing Mediators tested by demonstrating relationship b/w mediator and intervention, then mediator and outcome 8. 2 Interventions Worse than None? Joint Primary and Secondary Prevention of Eating Disorders Goal: reduce eating disorders in college females (high risk group), attempt to prevent new cases, reduction of duration, early ID and treatment Primary: provides facts to deter behaviour (ineffective alone w/ drug use) Secondary: reduce stigma in hope people will come forward DIDN”T HELP, combined programs may be more hurtful 9. Early Intervention for Parents at Risk of Child Abuse and Neglect: A Preliminary Investigation Goals: dev + child-rearing habits (rewarding interactions), improve parent’s abilities to cope with stress (mental health support), promote children’s adaptive behaviours Target pop: young, at-risk parents under supervision of child protective agency Selected/ Primary Limitations: observational procedures may not have been effective, diversity and rapid change in target population, need to motivate participants, no control group Strategy Mediator Outcome -Parent training in child -Increased use of social rewards (child -Fewer behavioural problems management skills receives more praise –more confidence?), -Improved child management less verbal competition and more clear demands -Activities to promote -Opportunities for child to develop skills -Improvements in children’s children’s adaptive -Mothers learned how to promote the adaptive abilities behaviour behaviour -Informational program -Increased confidence in parental role, and
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