Abnormal Psychology Notes.docx

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Department
Psychology
Course
PSY100H1
Professor
Dan Dolderman
Semester
Fall

Description
Abnormal Psychology Chapter 1 – Introduction  Psychopathology: the field concerned with the nature and development of abnormal behaviour, thoughts and feelings What is Abnormal Behaivour?  Determined by presence of several characteristics at one time:  1) Statistical Infrequency o One that does not deviate from the average o Normal distribution curve o Ex. having a low IQ (as discovered from the normal, or bell curve) can diagnose mental retardation o However, stat infrequency by itself cannot diagnose a disorder o What happens when someone has a high IQ? Are they abnormal? Or one with high athletic abilities? We do not say these people are abnormal o Case study ex – J.Brett Barkley’s alternating episodes of depression and mania  2) Violation of Norms o The behaviour violates social norms or threatens o Case study ex – Barkley’s verbal and physical attacks on wife o Cultural diversity can affect how people view social norms – what is the norm in one culture may be abnormal in another  3) Personal Distress o The behaviour causes great distress and torment in the person experiencing it o Case study ex – Barkley’s self-consciousness and distress about being evaluated o However, again this does not fit all criteria – those with depression experience this, but psychopaths do not  4) Disability or Dysfunction o The behaviour impairs an important area of life (i.e. work or personal relationships) o Case study ex – Barkley’s disrupted marital relationship o Applies to some, not all  5) Unexpectedness o Distress that is an unexpected response to environmental stressor o I.e. one who is well off but constantly worries about their financial situation Mental Health Professions  Clinical psychologist o Phd o Focus on assessment and diagnosis, and learn how to practice psychotherapy (helping to change individuals thoughts, feelings and behaviours to reduce distress and achieve greater life satisfaction)  Psychiatrist o MD degree o Prescribe psychoactive drugs  Psychoanalyst o Receive specialized training at a psychoanalytic institute o No one becomes this anymore……..  Social worker o Master of social work degree o Counseling psychologists o Don’t learn as intense stuff as the others  Psychological services are underused and are more available in urban rather than rural settings History of Psychopathology  People first thought the deviancy of behaviour reflected the displeasure of gods or possession by demons Early Demonology  Demonology: the doctrine that an evil being, such as the devil, may dwell witin a person and control his or her mind and body  Treatment often involved exorcism: the casting out of evil spirits by ritualistic chanting or torture  Trepanning was also used – where they made a surgical opening in a living skull by some instrument to “let the bad spirits out” Somatogenesis  Somatogensis: the notion that something wrong with the soma, or physical body, disturbs thought and action  Psychogenesis: in contrast, is the belief that a disturbance has psychological origins  Discovered by Hippocrates, the father of modern medicine. He separated medicine from religion, magic and superstition  He classified mental disorders into 3 categories: mania, melancholia and phrenitis (brain fever)  Treatments he described were different (for mania: certain foods and drinks, abstinence from sex  Believed abnormal behaviour produced by some kind of physical imbalance or even damage The Dark Ages and Demonology  The church came into play – monks would nurse the sick by praying for them, making special potions for them to drink  Those who were accused of witchcraft were tortured if they did not confess  Then it was thought that those who were mentally ill WERE witches th  Lunacy trials were developed to determine a persons sanity in the 13 century Development of Asylyms  Leprosariums were converted to asylums (as leprocy started fading away) th th  15 and 16 century  Asylum: refuges established for the confinement and care of mentally ill  Bethleham had some of the earliest asylums  Bedlam was an early name for hospital – a place of wild uproar and confusion  It became a tourist attraction  Medical treatments were crude and painful o Some dumbass thought mental disorders were caused by an excess of blood to the brain so his treatment was taking out great quantities of blood, and also thought he could treat them by scaring them…dumbass.  Phillippe Pinel was the smart guy who said they should be treated as human beings with dignity and respect, treated with compassion and understanding. In response, hospitals became more controlled, sick ppl were walking around more calm and easier to handle. BUT he’s still an a hole bc he only treated upper class like this – lower class was put to torturous treatment  Finally in the states at some point they approached this with moral treatment: patients had close contact with the attendants who talked and read to them and encouraged them to engage in purposeful activity – residents led as normal lives as possible and in general took responsibility for themselves within the contraints of their disorders  La di da…then they started using meds Asylums in Canada  This section is really boring and nothing sounds that important  I just remember from class saying how the names of the buildings were really nice  The Center for Addiction and Mental Health (CAMH) downtown was Toronto’s asylum The Beginning of Contemporary Thought  Started looking at the body and anatomy of it…but realized we are different from apes that was studied at the time  Kraepelin discerned among mental disorders a tendency for a certain group of symptoms (called a syndrome) to appear together regularly and attributed to a biological dysfunction o Proposed 2 major groups of severe mental diseases: demntia praecox (schizo) and manic-depressive psychosis (bipolar) o Said chemical imbalance cause of schizo and irregulairy in metabolism reason for bipolar  General paresis, deterioration in mental and physical health, was designated as a disease in 1825 o Ppl thought this was caused by seawater (b/c of high rate of sailors who had it) or alcohol/tobacco/coffee (b/c majority were men)  1860’s/70’s the germ theory of disease was established -> disease is caused by infection of the body by minute organisms  in 1905 the microorganism that causes syphilis was discovered -> link established b/w infection, destruction of certain areas of the brain and form of pschopathology  Mesmer and Charcot were the first to kind of start hypnosis. They thought hysterical disorders (i.e. paralysis, blindness) were caused by a particular distribution of a universal magnetic fluid in the body. So they had patients sit around a tub that had chemicals and rods in it and they would touch the rod on a part of the persons body. The rods were believed to send animal magnetism and adjust the distribution of the fluid, removing the disorder  Bruer created cathartic method ->the experience of reliving an earlier emotional catastrophe and releasing the emotional tension caused by suppressed thoughts about the event. He did this through hypnosis. The Lesson of History: a View from the 21 Century  Periods in which ppl were persecuted and treated cruel alternated with periods of humanitarianism and care for suffering people  Cycles of persecution, neglect and humanitarianism in treatement occurred irrespective of the helping agency, whether religious, medical, psychological  We look back and think some of these treatments are crazy! But future generations might look back at today and think the same (ex. lobotomy – surgical procedure which the tracts connecting the frontal lobes to lower centres of the brain are destroyed)  Recent reforms may easily be reversed during adverse economic, political and social conditions Current Attitudes Toward People with Psychological Disorders  A lot of stereotyping and stigmatization is faced by those with psychological disorders  Often, people think that ppl w/ mental illness are dangerous (i.e. they will hurt us), however, this is uncommon and there is a small relationship b/w schizo and violent acts  Ppl also think that they are incurable and cannot contribute to society ever again  Today, there are many anti-stigma campaigns that aim to get rid of the stigmatization against mental illness o The media can play a big role in this  The term mental health literacy has been created to refer to the accurate knowledge that a person develops about mental illness and its causes and treatments  Clarence Hincks played a large role in all this mental health business (he went to UofT and cofounded the Canadian National Committee for Mental Hygiene). 5 purposes of this: o Psychiatric exam for soldiers returning from war o Post-war psychiatric exam for immigrants o Good facilities to diagnosis and treat o Care for mentally ill o Prevention Canada’s Mental Health Care System  In Canada, we are pretty lucky – we consider mental health under the general health category, have it covered for us and is readily available  What makes us different in comparison to the States is that we have medicare which basically we pay through taxes to support universal health care  Most relevant factors associated with mental health in Canada are: o Current stress, social support, life events, education and childhood trauma strongly and independently associated with positive and negative mental health status o Amount of current stress is strongest correlate for all pos and neg measures o Social support is second strongest correlate o Number of childhood traumas strongly associated w/ many neg including depression o Amount of formal education strongly related to pos indicators  20% of Canadians are mentally ill  2% severally mentally ill  72% age 25-44  No major regional differences in mental health population – aboriginals is another topic, and PEI and Newfoundland people are apparently pretty happy and stress free – they don’t have much mental illness there  We have really long wait times….  This section is stupid  We need to increase service use, especially for men and young adults/teens  Need to develop outreach programs that target low-income, working individuals who have not completed high school  We want to move from the “waiting mode” where help is located in schools, business and wait for ppl to come to them to community psychology where they seek out problems and focus on prevention  The estimated economic burden of serious mental illness in Canada is substantial  The report from the Commission on the Future of Health Care in Canada (the Romanow Report) recommended that mental health be made a priority within the system. Specific recommendations included broadening medicare to include a limited number of home care services and some drug treatments  The Senate Committee Final Report (the Kirby Report) relating to mental health, mental illness, and addiction made 118 recommendations, including establishing a Canadian mental health commission to focus national attention on mental illness, and a proposal to fund the development of a community- based system of mental health service delivery Chapter 2: Current Paradigms and the Role of Cultural Factors The Role of Paradigms:  paradigm - the conceptual framework or approach within which the scientist works; a set of basic assumptions that outline the particular universe of scientific inquiry  each paradigm has their own biases and affects the interpretation of facts  four major types include: biological, cognitive-behavioural, psychoanalytic, and humanistic existential  modern views of abnormal behaviour and its treatment tend to integrate several paradigms (diathesis-stress and biopsychosocial paradigms) The Biological Paradigm:  biological paradigm - a continuation of the somatogenic (body) hypothesis, believing that mental disorders are caused by biological processes (known as the medical model or disease model)  medical illnesses can differ widely from one another in their causes, however, they all share one characteristic: in all of them, some biological process is disrupted or not functioning normally  dominant paradigm in Canada from the late 1800s until the 1950s  EXAMPLE → Hall's (1900) used of gynecological procedures to treat insanity in women from British Columbia: Mrs.D reported delusions that her husband was trying to poison her. Her behaviour was attributed to a cyst on both of her ovaries, and they were removed as the form of treatment  contemporary approaches used today are more sophisticated: heredity probably predisposes a person to have an increased risk of developing schizophrenia, depression may result from chemical imbalances in the brain, anxiety disorders may stem from a defect within the autonomic nervous system, and dementia can be traced to impairments in structures of the brain  the three areas of research within this paradigm in which the data are interesting are: behaviour genetics, molecular genetics, and biochemistry  behaviour genetics - the study of individual differences in behaviour that are attributable in part to differences in genetic makeup  genotype is the unobservable genetic constitution and phenotype is the observable characteristics (such as level of anxiety)  phenotype is very dynamic and is viewed as the product of genotype and environment  the study of behaviour genetics relies on four basic methods to uncover whether a predisposition for psychopathology is inherited: o family method → comparison among family members as first-degree relatives share 50% of the same genes (parents, siblings). If a predisposition for a mental disorder can inherited, a study of the family should reveal a relationship between the number of shared genes and the prevalence of the disorder in relatives. Index cases or probands, are the people being diagnosed. o twin method → twin studies (both monozygotic and dizygotic) begin with diagnosed cases and then search for the presence of the disorder in the other twin. When the twins are similar diagnostically, they are concordant. When monozygotic twins have a higher concordance than dizygotic twins then the disorder is said to be heritable. Having equal environments between the sets of twins during the studies is also very important while determining what is heritable and what is not. o adoptees method → study children with abnormal disorders who were adopted and separated apart from their parents o linkage analysis → in the study of molecular genetics, researchers use this method to study families in which a disorder is heavily concentrated. They compare blood samples and study the inheritance pattern of genetics, or genetic markers (such as eye colour as it is always constant). If the occurrence of a form of psychopathology among relatives goes along with the genetic markers, it is concluded that they are linked  neuroscience is the study of the brain and nervous system  reuptake is the process by which the presynaptic neuron returns to normal state by pumping the left over neurotransmitter back into the cell. This is because the diffusion process from presynaptic neuron to postsynaptic neuron does not always releases all of its neurotransmitter → failure of reuptake would leave excess transmitter molecules in the synapse and cause a situation of too much neurotransmitter being released, creating a potential imbalance and error  norepinephrine is a neurotransmitter in the sympathetic nervous system, involved in producing states of high arousal and may be involved in anxiety disorders (as well as too littler of the neurotransmitter GABA). Serotonin may be involved in depression and dopamine in schizophrenia  too many postsynaptic receptors could be a potential cause of too much neurotransmitter being released (the delusions and hallucinations of schizophrenia may result from an abundance of dopamine receptors)  biological approaches to treatment include an intervention involving psychoactive drugs o valium can be used for anxiety disorders by stimulating GABA neurons to inhibit other neural systems that create the physical systems of anxiety o antidepressants such as prozac, increase neural transmission in neurons that use serotonin as a neurotransmitter by inhibiting the reuptake of serotonin o antipsychotic drugs such as Clozaril (used in treatment of schizophrenia) reduce the activity of neurons that use dopamine as neurotransmitter by blocking their receptors  MRI has become very beneficial for diagnosing and studying different disorders  even though this is a biological paradigm, contemporary workers also prescribe non-biological interventions as they can be beneficial (Linden found that cognitive behaviour therapy could be useful for some disorders such as OCD)  this paradigm is often viewed as reductionism → the view that whatever is being studied can and should be reduced to its most basic elements (this is not ideal as the whole is often greater than the sum of its parts) The Cognitive-Behavioural Paradigm: Behaviour Perspective  the behavioural perspective views abnormal behaviour as responses learned in the same ways other human behaviour is learned  behaviourism - an approach that focuses on observable behaviour rather than on consciousness  John B. Watson promoted a focus on behaviourism by extrapolating from the work of psychologists who were investigating learning in animals  classical conditioning was discovered by Russian physiologist, Ivan Pavlov (1849-1936) o the experiment where the dog automatically started to salivate from the stimulus of a bell, as it was trained that when it heard the bell, it would get food o before learning, the unconditioned stimulus would be the food, and the unconditioned response would be the salivating. After training the dog with the neutral stimulus of the ringing of the bell, the sound of the bell is the conditioned stimulus and the salivary response is the conditioned response o John Watson and Rosalie Rayner conducted a similar experiment but instilling pathological fear into a little boy of a white rat o this may explain possible association between classical conditioning and the development of certain emotional disorders, including phobias  operant conditioning was introduced by B.F Skinner (1904-1990) o reformulated the law of effect by shifting the focus from the linking of stimulus and responses to the relationships between responses and their consequences or contingencies o discriminative effect - where you tell an organism that if it performs a certain behaviour, a certain consequence will follow o positive and negative reinforcers o operant conditioning can produce abnormal behaviour such as a conduct disorder (high frequency of aggressive behaviour) where aggression is often rewarded, as when one child hits another to get a toy  Albert Bandura did experimental work involving modeling, where we learn by watching and imitating others  did a study using modelling treatment to reduce fear of dogs in children. After watching a fearless model engage in various activities with the dogs, the fearful children became more willingly to approach and handle a dog  modelling may explain abnormal behaviour because children of parents with phobias or substance-abuse problems may acquire similar behaviour patterns  behaviour therapy , started in the 1950s, uses classical and operant (behaviour modification) conditioning to alter clinical problems  the theoretical approaches to behaviour therapy include modelling, counterconditioning and the application of operant conditioning o counterconditioning is relearning achieved by eliciting a new response in the presence of a particular stimulus  For instance, Mary Cover Jones treated a young boy's fear of rabbits by feeding him in the presence of a rabbit. After training, the fear produced by the rabbit was replaced by the strong positive feelings evoked by eating  systemic desensitization, discovered by Joseph Wolpe (1958), is a technique used behind counterconditioning where a person who suffers from anxiety works with the therapist to compile a list of feared situations, starting with those that arouse minimal anxiety and progressing to the most frightening  aversive conditioning is when a stimulus attractive to the client is paired with an unpleasant event, such as a drug that produces nausea, in the hope of endowing it with negative properties o using operant conditioning as an intervention can be used for children with learning disabilities, tantrums, aggression, mental retardation, and hyperactivity (the objective of this method is to basically unlearn the behaviour through reinforcement) Cognitive Perspective  cognition - a term that groups together the mental processes of perceiving, recognizing, conceiving, judging, and reasoning  cognitive paradigm - focuses on how people structure their experiences, how they make sense of them, and how they relate their current experiences to past ones that have been stored in memory  schema - organized network of already accumulated knowledge  Beck's Cognitive Therapy → Aaron Beck created a cognitive therapy for depression based on the idea that a depressed mood is caused by distortions in the way that people perceive life experiences o Karen Kain, a ballerina had severe bouts of depression and the goal of this theory was to provide experiences both inside and outside of the consulting room, that will alter their negative schemas and dysfunctional beliefs and attitudes  rational-emotive behaviour therapy - discovered by Albert Ellis, the aim of this technique is to eliminate self-defeating beliefs through a rational examination of them (therapist will talk out the problem with the client and used techniques such as argueing with the client and creating dialogue)  cognitive behaviour therapy (CBT) incorporates theory and research on cognitive and behavioural processes (such as thoughts, perceptions, judgements, self-statements, and unconscious assumptions) and represents a blend of cognitive and learning principles  cognitive restructuring - general term for changing a pattern of thought that is presumed to be causing a disturbed emotion or behaviour  Donald Meichenbaum created the cognitive-behaviour modification where he integrates the two theories  the cognitive-behaviour integrated approach concluded that the client is influenced more by their perception of events versus the objective features of the events  criticisms of the cognitive approach include the concepts on which it is based on (schemas) and how they are abstract and not always well defined, as well as too much focus on current determinants of a disorder and less on its historical antecedents The Psychoanalytic Paradigm:  psychoanalytic paradigm - developed by Sigmund Freud, psychopathology results from unconscious conflicts in the individual  id - present at birth, and it the part of the mind that accounts for all the energy needed to run the psyche (unconscious and comprises of basic urges). Operates according to the pleasure principle and primary process thinking  ego - develops during the second six months of life, it is primarily conscious and deals with reality. Realizes that operating on pleasure principle all the time is not ideal and operates on secondary process thinking (also is involved in defence mechanisms)  superego - operates roughly as the conscience and develops throughout childhood  the interplay between these forces are referred to as the psychodynamics of the personality  objective (realistic) anxiety - when one's life is in jeopardy  neurotic anxiety - a feeling of fear that is not connected to reality or to any real threat  handled by means of a defence mechanism → a strategy, unconsciously used, to protect the ego from anxiety: repression, denial, projection, displacement, reaction formation, regression, rationalization, and sublimation  moral anxiety - "the perfection principle" where impulses of the superego punish an individual for not meeting expectations Psychoanalytic Therapy  based on Freud's second theory of neurotic anxiety, that neurotic anxiety is the reaction of the ego when a previously punished and repressed id impulse presses for expression  this insight therapy attempts to remove the earlier regression and help the client face the childhood conflict, gain insight into it, and resolve it in the light of adult reality  free association - client reclines on a couch, facing away from therapist, and just talks about anything they want o resistances - when client becomes suddenly silent or changes the subject to topics that are ego-threatening and these topics are what the therapist want to further elaborate on  dream analysis - when ego defences are relaxed, it may allow normally repressed material to enter the sleeper's consciousness (symbolic content is called latent content  transference - when the client's responses reflect relationships with important people in their past  countertransference - refers to the analyst's feelings toward the client  modifications in this type of therapy include a focus on group analyzing, ego analysis, brief psychodynamic therapy, and interpersonal psychodynamic therapy o ego analysis - places a greater emphasis on a person's ability to control the environment, saying that the individual is as much ego as id. There is a focus on the person's living conditions as well o brief therapy - developed to meet expectations of many clients who prefer therapy to be fairly short and targeted to specific problems in their everyday lives. It evolved from the need to respond to psychological emergencies such as post-traumatic stress disorder o contemporary psychoanalytic thought includes: (1) modern structural thought, (2) self-psychology, (3) object relations theory, (4) interpersonal-relational, and (5) attachment theory o interpersonal therapy (IPT) emphasizes the interactions between a client and their social environment, and was pioneered by Harry Stack Sullivan. The techniques used include empathetic listening with suggestions for behavioural changes, and how to implement them, sometimes through the act of role-playing (has been used on people with various forms of depression)  the problems with the psychoanalytic paradigm are that is was originally too focused on sexual drives, not scientific enough as it is just based off of therapy sessions, and the id, ego, and superego were described as sometimes having their own existence  the contributions that Freud made to the field of abnormal psychology include: childhood experiences help shape adult personality, there are unconscious influences on behaviour, and people use defence mechanisms to control anxiety or stress The Humanistic-Existential Paradigms:  humanistic and existential therapies - insight-focused, based on the assumption that disordered behaviour results from a lack of insight, and can be treated by increasing the individual's awareness of motivational needs  this paradigm places a greater emphasis on the person's freedom of choice, regarding free will as the person's most important characteristic, and its main influence is on intervention  Carl Rogers, came up with the client-centred therapy, which is based on several assumptions about human nature and the way we can try to understand it: o people can only be understand from their vantage point, healthy people are aware of their behaviour, healthy people are innately good and effective, healthy people are purposive and goal-directed, and therapists should not attempt to manipulate events for the individual (self actualization → when people are not concerned with the evaluations, demands, and preferences of others) o Roger's therapeutic intervention includes providing the client with unconditional positive regard → the therapeutic atmosphere is warm, attentive, and receptive, accepting the person for whomthey are o empathy was also very important, including two main types: primary empathy is when the therapist basically restates the client's thoughts and feelings, where advanced empathy is when the therapist involves an interpretation of the meaning of what the client is thinking and feeling Existential Therapy  existentialism stresses the anxiety that is inevitable in making important choices, such as staying or not staying with a spouse, with a job, or even with this world, therefore making it more gloomier than the humanistic approach  avoiding choices may protect people from anxiety, but it also deprives them from living a life with meaning and is at the core of psychopathology  in this view, people create their own existence anew at each moment, and must know that they can redefine themselves at any moment  the problem with the humanistic and existential paradigms is that it focuses on the client's phenomenology (but how can the therapist know how the client views the world?)  this theory however, has taught to emphasize empathy as it makes it easier for clients to reveal highly personal and sometimes unpleasant facts about themselves Consequences of Adopting a Paradigm: Different Perspectives on a Clinical Problem: J. Brett Barkley (the guy who abused his wife)  a biological perspective would suggest that the depressed states and mood swings are a genetic factor (disregarding environmental factors)  a behavioural or cognitive behaviour perspective would suggest that his self- consciousness in university, and undermining confidence led to his current state. In this situation, a technique of behavioural rehearsal may be beneficial  a psychoanalytic point of view emphasizes that events in early childhood play a major role, therefore his behaviour is accounted for his mother's early death and he blamed his father Eclecticism in Psychotherapy: Practice Makes Imperfect  eclecticism - employing ideas and therapeutic techniques from a variety of schools  a survey of clinicians in Calgary found that prescriptive eclectic therapy was the main approach used, followed by cognitive behavioural therapy  eclectic therapy is also otherwise known as "integrated" therapy Diatheses-Stress and Biopsychosocial: Integrative Paradigms  diathesis-stress paradigm - an approach that links biological, psychological, and environmental factors o biological would be genetic predispositions of certain genes, and possible diathesis as birth such as oxygen deprivation, or maternal smoking during pregnancy that may have lead changes to the brain that predispose toward psychopathology o this paradigm accounts for environmental stressors such as losing one's job and daily hassles such as being stuck in traffic, and these stressors may trigger a psychopathology  biopsychosocial paradigm - similar to and overlaps with the diathesis-stress perspective; biological, psychological, and social factors are conceptualized as different levels  resilience - protection from risk factors, or the ability to bounce back in the face of adversity  some people show a remarkable resilience and overcome a history of maltreatment, while others do not  gene-environment interaction would be an example of the theory that extreme poverty and low socioeconomic status puts you at a greater risk of mental illness; however according to recent studies, there is a steady decline in mental health as a function of lower levels of household income  being rich does not mean you have a chance of developing a mental health disorder  examples of risk factors that may develop mental health problems: o individual factors → birth injury, prenatal brain damage, low intelligence, low self-esteem o family/social factors → single parent, marital discord in parents, neglect in childhood, parental mental disorder o school context → bullying, peer rejection, deviant peer group o life events and situations → physical/sexual/emotional abuse, job insecurity, natural disasters, death of a family member o community and culture factors → isolation, socio-economical disadvantage, housing condition  protective factors (resilience levels) influencing risk of metal health problems: o individual factors → adequate nutrition, attachment to family, social skills, good coping style, moral beliefs, values o family/social factors → supporting or caring parents, strong family norms and morality o school context → sense of belonging, positive school climate, good peer group o life events and situations → involvement with a significant other, good physical health, economic security o community and cultural factors → sense of connectedness Cultural Considerations:  judgements about what is acceptable or normal vary considerably from culture to culture (client-therapist cultural differences)  Canada is a cultural mosaic, welcoming all cultures  it is hard to determine if minorities are more susceptible to develop a mental health but it also depends on which groups are being compared  origins of mental health problems among Canadian Aboriginal People: o drug abuse, child/sexual abuse, and family conflict are common among Aboriginal people o they experience a lot of discrimination and no clear sense of identity as they are torn between their traditional culture and norms of the majority  Asian immigrants have the lowest rates of depression and African immigrants have the lowest rates of alcohol dependence (contributes to healthy immigrant effect)  behavioural problems in youths of Filipino and Caribbean decent are more connected to discrimination than family separation (mother or father may not immigrant to Canada until they've been sponsored)  minority groups are less likely to use mental health services because of the language barrier, the issue of culturally determined interpretation of psychological disorders, lack of knowledge of these services, and racial discrimination  similarity between client and therapist may strengthen the therapeutic alliance (gender, background, etc.). However the greatest factor may be the similarities in values or cognitive match  multicultural therapy and cognitive behavioural therapy are two methods of intervention that are compatible in bridging the gap between the client (which is a minority) and therapist OTHER: Canadian Contributions 2.1 - Albert Bandura: The World's Greatest Living Psychologist?  fourth psychologist in the 20th century in terms of impact behind Skinner, Piaget, and Freud  his work is based on the premise that it is important to be able to study clinical phenomena in experimental situations  his initial work was focused on social learning and on the idea that much of what we learn is through the process of imitation  the Bobo doll study: children who witnessed an adult being aggressive with a plastic Bobo doll were observed imitating this aggression while playing with other children  found that there were four key processes in observational learning: (1) attention, (2) retention, (3) reproduction, and (4) motivation  his recent work focuses on self-efficacy, an individual's perceived sense of being capable Canadian Contributions 2.2 - Albert Meichenbaum: Evolution of a Lifespan Cognitive Behavioural Ecological Approach  self-instructional training - therapist helps to make specific coping statements when confronted with difficult situations  stress-inoculation training - systematic acquisition of coping skills through learning to cope with small but manageable amounts of stress, incorporating self-instructional training  help clients understand the narratives they create and learn ways to alter how they appraise events and their abilities to handle stressful events Focus on Discovery 2.1: Structure and Function of the Human Brain  brain is enveloped in three non-neural layers of tissues called the meninges  cerebrum is the thinking centre of the brain  the corpus callosum connects the two cerebral hemispheres  the outside layer of the brain is covered in grey matter; the ridges are called gyri and the depressions are called sulci  vision in the occipital lobe, discrimination of sounds in the temporal lobe, higher mental processing and regulation of fine voluntary movement in the frontal lobe  white matter constitutes the inside of the brain  diencephalon, containing the thalamus (relay station for sensory pathways to the cerebrum) and hypothalamus (highest centre of integration for many visceral processes, regulating metabolism, temperature, perspiration, blood pressure, sleeping, and appetite)  midbrain connects the cerebral cortex with the pons, the medulla oblongata, the cerebellum, and the spinal cord  the midbrain is the neural relay station containing the pons and medulla oblongata (regulates involuntary processes such as heart rate and breathing). In the core of the brain stem is the reticular formation, playing an important role in arousal and alertness  the cerebellum (the little brain) regulates balance, posture, equilibrium, and coordination when the body is in motion  the limbic system controls the visceral and physical expressions of emotion and primary drives such as hunger, thirst, mating, defence, attack, and flight. The hippocampus and amygdala are a part of this system Focus on Discovery 2.2: The Neuroscience of ADHD  ADHD clients experience up to five years of delay in cortical maturation  the delay was most evident in the lateral prefrontal cortex, which is the region responsible for working memory and attention  may be due to dopamine deficit, believed to be genetic in origin Focus on Discovery 2.3: What is Psychotherapy?  psychotherapy - a social interaction in which a trained professional tries to help another person, the client or patient, behave and feel differently  categorized psychotherapies are insight therapies or action therapies → assumes that behaviour, emotions, and thoughts become disordered because people do not understand what motivate them. These therapies try to help people discover why they behave, feel, and think as they do Chapter 3: Classification and Diagnosis  The official diagnostic system is widely employed by mental health professionals (Diagnostic and Statistical Manual of Mental Disorders, DSM or DSM-IV) A Brief History of Classification:  Due to advances in medical treatment and diagnostics investigators of abnormal behaviour also sought to develop classification schemes. Early Efforts at Classification  During 19 -20 centuries, inconsistency in classifications of abnormal psychology  Became serious problem that impeded communication among people in the field Development of the WHO and DSM systems  In 1952, the American Psychiatric Association published its own Diagnostic and Statistical manual which was turned down  In 1969, WHO published a variation of the DSM called DSM-II  Problem was, only a list of definitions and classifications were just a listing of diagnostic categories  Did not specify some symptoms for given disorder  Finally reached a consensus that DSM-IV is acceptable and widely used  Still brings up controversy cuz no two disorders are the same The Current Diagnostic System of the American Psychiatric Association (DSM-IV & DSM-IV-TR):  DSM-IV-TR states that a mental disorder is a clinically significant behaviour or psychological syndrome or pattern that occurs in an individual and is associated with distress or disability or increased risk of suffering, death or pain  in order to exclude controversy, must cause manifestations of a behavioural, psychological or biological dysfunction in the person Five Dimensions of Classifications rd  Most significance between 3 edition and other versions of DSM is the use of multiaxial classifications (individual is rated on 5 separate axes: 1. Axes 1: All diagnostic categories except personality disorders and mental retardation
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