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Abnormal Psych.docx

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Mc Kenna

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CH. 1ABNORMALBEHAVIOR INAHISTORICALCONTEXT DSM 5-behavioral, psychological, or biological dysfunctions that are unexpected in their cultural context and associated with present distress and impairment in functioning, or increased risk of suffering, death, pain, or impairment Clinical terms • Presenting problem: original complaint reported by the client to the therapist. The actual treated problem may be a modification derived from the presenting problem o First step in clinical description • Clinical description: the unique combination of behaviors, thoughts, and feelings that make up a specific disorder. The description of the disorder. o “Clinical” refers to both the types of disorders you would find in a clinic or hospital and to the activities connected with assessment and treatment o Specify what makes the disorder different from normal behavior or from other disorders o Age is extremely important, especially for diagnosis • Prevalence rates: (prevalence=all disorders) statistics on how many new cases occur during a given period, such as a year, represent incidence of the disorder o Sex ratio: what percentage of males and females have the disorder • Incidence rates: number of new cases of a disorder appearing during a specific period (compare with prevalence) • Course: pattern of development and change of a disorder over time. The progression of it through time o Chronic: they tend to last a long time o Episodic: the individual is likely to recover within a few months only to suffer a recurrence of the disorder at a later time o Time-limited: improve without treatment in a relatively short period • Age of onset: when you first notice symptoms • Acute onset: disorders that begin suddenly • Insidious onset: disorders that develop gradually over an extended period of time • Prognosis: predicted development of a disorder over time. The expected end result. What will it look like in the future? • Etiology: the study of origin. The cause. o Why a disorder begins and includes biological, psychological, and social dimensions Supernatural model: supernatural influences were formerly believed to explain abnormal behavior. Extraordinary forces outside the body are causes of the weird behavior due to the devil or the moon o Treatments  Exorcism: religious ritual that attributes disordered behavior to possession by demons and seeks to treat the individual by driving the demons from the body • If that didn’t work, they tried to make the body “uninhabitable” for the evil spirits  Rest, sleep and healthy environment, baths, ointments, potions o Causes: astrology, evil spirits, mass hysteria Biological model: physicians started to recognize that there are diseases and that there are treatments. They also thought that mental illness was a disability of the brain o Greek—Hippocrates  Hippocratic corpus- psychological dysfunction should be treated like physical disease o Roman—Galen expanded on Hippocrates’s ideas  Humors: bodily fluids believed that normal brain functioning was related to these 4 and too much or too little of any of them caused problems • Blood from heart • Black bile from spleen • Phlegm from brain • Yellow bile/choler from liver  Hysteria: symptoms, such as paralysis and some kinds of blindness, appear to be the result of a problem for which no physical cause can be found  Syphilis: sexually transmitted disease caused by a bacterial microorganism entering the brain, include believing that everyone is plotting against you, or that you are God o American—John P. Grey; the causes of insanity were always of psychiatry.  Mentally ill patients should be treated as if they were physically ill, with treatment including rest, diet and proper room temperature and ventilation  Conditions in hospitals improved and became more humane institutions o Deinstitutionalization: patients were released into their communities when the hospitals became overly populated  Caused homeless mental patients out on the streets  Controversial o Insulin shock therapy-1930—found by accident.  At first used to stimulate appetite in the patients, but it also had seemed to calm them down and sometimes cure the patient  Abandoned because often caused coma and death o Electro convulsive shock therapy-1950—apply electric shock directly to the brain and destabilizes the current in the brain  Found by accident—applying seizures to schizophrenics cured them  Controversial, sometimes lose memory  Still used today, but the very last attempt to cure depression and the SSRI cannot work o Lobotomy—Dr. Walter Freeman: done in the 1930s and 1940s. They invented thorozine which is a chemical restraint, used for people who are very violent due to a lesion in the brain. It was quick, easy, and made the person docile  Two long ice picks shoved right above the eye balls through into the brain and manipulate them to separate/disconnects parts of the hypothalamus  However, they cannot think the same way after. They were alive, but not the same person anymore o Neuroleptic medication: medication that is specifically for mental illness and disorders o Benzodiazepines: minor tranquilizers reduce anxiety Psychological model: conflicts within the mind that cause neurosis and abnormal behaviors. Conflicts between the ID, ego and superego • Early philosophers- o Aristotle-social and cultural factors th • Moral therapy: psychosocial approach in the 19 century that involved treating patients as normally as possible in normal environments o Philippe Pinel-emotional or psychological o Decline-mid 19 century  Over crowding of institutions-immigrants  Dorothea Dix- reformer of institutions-mental hygiene movement • Benjamin rush-founder ofAmerican psychiatry • Anton Mesmer-father of hypnosis • Jean-Martin Charcot-developed mesmerism further • Sigmund Freud & joseph Breuer-hypnosis • Catharsis— Anna O o Rapid or sudden release of emotional tension thought to be an important factor in psychoanalytic therapy o It is therapeutic to recall emotional trauma that has been made unconscious and to release the accompanying tension Freud’s The Structure of the Mind- • The mind has 3 major components: must work together because too much of one is bad o ID: the source of out strong sexual and aggressive feelings or energies  Operates according to the “pleasure principle”—maximize pleasure o Ego: ensures that we act realistically  Operates according to the “reality principle”  The cognitive operations or thinking styles of the ego are characterized by logic and reason o Superego: our conscience. Counteracts the potentially dangerous aggressive and sexual drives of the id, the basis for conflict is apparent  “Moral principles”  Instilled in us by our parents and culture  The voice within us that nags at us when we know we’re doing something wrong • Intra-psychic conflicts: the conflicts between the 3 major components of the mind • Defense mechanisms—developed byAnna Freud after he died o Denial: refuses to acknowledge some aspect of objective reality or subjective experience that is apparent to others o Displacement: transfers a feeling about, or a response to, an object that causes discomfort onto another, usually less-threatening, object or person. Expression of unacceptable reactions onto a safe object/person. o Rationalization: falsely attributes own unacceptable feelings, impulses, or thoughts to another individual or object. Justification of your behavior to make it look more normal o Projection: conceals the true motivations for actions, thoughts, or feelings through elaborate reassuring or self-serving but incorrect explanations o Repression: substitutes behavior, thoughts, or feelings that are the direct opposite of unacceptable ones. Burying feelings and emotions that are very sever, that is too much to your psyche and might emerge eventually, but for now you cannot remember it at all o Sublimation: directs potentially maladaptive feelings or impulses into socially acceptable behavior. Taking inappropriate and socially unacceptable emotion and putting it towards a more healthy and acceptable place/thing/person o Regression: blocks disturbing wishes, thoughts, or experiences from conscious awareness. Defense to protect the psyche. Man is suicidal and lays down sucking his thumb to go back to a happy time in his life Free association: technique to get at the subconscious. • Client must state whatever comes into their head no matter what it is and go from there • You look for patterns in their thinking Transference: inappropriate emotions towards someone due to • Feel mad and then transfer it to your therapist Psychodynamic approach: contemporary version of psychoanalysis that still emphasizes unconscious processes and conflicts but is brief and more focused on specific problems. Focus on internal conflicts • Focus on affect and emotion • Emphasis on past experiences Humanistic theory- focuses on self actualization. About progress and looking at the positive. Based on the way you handle things will show if you will be able to get passed it eventually • Carl Jung • AlfredAdler: suffered a lot as a child and remembers feeling very out of control and inferior to everyone because he couldn’t do normal things. o States that everyone starts with an inferiority complex but that the drive in life is to overcome that state. It’s a need to move forward and sometimes it isn’t possible for some • Abraham Maslow: hierarchy of need. You need to conquer each level of needs to overcome it entirely 1. Shelter 2. Safety 3. Self-esteem 4. Self actualization-give back to society Carl Rogers • Person centered therapy. Must be empathetic to the client and non-judgmental. Must come across as genuine. This relationship between client and therapist will be therapeutic for the client. The fact that they are there to listen to anything the client has to say, which helps with their self-esteem Classical conditioning--Pavlov • The learning process through conditioning. Watson: littleAlbert experiment • Create fear response in neutral stimulus BF skinner • Reinforcement • Every behavior comes about by some sort of enforcement CH. 2 INTEGRATIVEAPPROACH TO PSYCHOPATHOLOGY 1 vs. 2: multi allows you to look at all aspects One-dimensional model: psychopathology is caused by a single cause Multi-dimensional integrative approach: approach to the study of psychopathology that holds psychological disorders are always the products of multiple interacting causal factors • Each component of the system inevitably affects the other components Diathesis stress model: a person having a pre-disposition, you still need a stressor to bring it out Cell body- nucleus in cell body • Vesicles • Neurotransmitters Neuron • Axon: vesicles travel on to the synapse (space between cells) • Nucleus: center of the cell. Where neurotransmitters are created • Vesicles: transporter units that neurotransmitters travel in • Myelin sheath: coating around axon that aids axon in dispersion, makes it very fast • Dendrites: receives neurotransmitters form other cells • Synaptic cleft Neurotransmitters • Serotonin- mood/hunger/sleep • Norepinephrine-excitatory. Fight/flight from the adrenal gland. Puts you in high alert • Dopamine-movement with memory and attention • GABA-calming system. Works with glutamate to balance behaviors and emotions SSRI: block the re-uptake in synapse so more neurotransmitters go to other cells • Typically used for: o Depression o Bi-Polar Disorder o Anxiety Sympathetic nervous system • Fight or Flight: response to real or perceived danger o Physical response heart rate increase, sweat, tunnel vision o Blood floods to extremities to fight/flight • Event hypothalamus CRH  anterior pituitary ACTH  adrenal cortex cortisol Structures of the brain • Reticular formation—fingerlike through pons and medulla o Sleep and alert states—signals (neural connections) to the cerebellum o Enables the eyes to track and fix on objects o Pain modulation, suppresses pain from the extremity, blocks some of the pain out o Habituation—process the brain learns to ignore while paying attention to other things (things you tune out and don’t notice) • Cerebellum: Posture, balance, movement that is already initiated (move with race) • Medulla—regulates autonomic responses and things you do with reflex (coughing, sneezing) o Parasympathetic and sympathetic autonomic system • Pons—controls sensory information o Analyzes some sensory info and sends it to the respective parts of the brain o Plays a part in consciousness o Linked to the cerebellum Lobes of brain (4) • Frontal lobe-behind the eyes o Decision making, judgment, sequential thinking, moral reasoning, impulse control center o Damage episodes of rage, cant hold a conversation o Motor cortex-initiates movement (getting up out of your chair) strip across frontal lobe in the back • Temporal lobe- over the ears o Processes auditory stimulus, language, memory • Parietal lobe- o Sensory cortex- strip across parietal lobe that is sensitive to sensations and facial recognition o Body space (gymnasts must know where they are) • Occipital lobe-processes visual stimulation o Damage hallucinations Limbic System Structures and Functions: Emotional brain • Thalamus—relay system. Sends info to proper structure in the brain o
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