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Psych 371 EXAM #1
| Term | Definition |
|---|---|
| Psychopathology | Study of illness of the mind |
| Clinical Psych | concerned w/ the assessment / treatment of mental illness/ psychological problems |
| Counseling Psych | professional specialization that helps ppl improve their mental health/ quality of life + promote the positive growth, well-being of individuals, families, groups, community |
| Psychological disorder | abnormal behavior patterns that involves a disturbance of psychological functioning or behavior → dysfunction in psychological processes (very low low or very high high) |
| Abnormal Psych | branch of psychology that deals w/ the description, causes, treatment of abnormal behavior patterns |
| Educational paths allow diagnosis/ treatment of mental illness | Ph.D in Education Ph.D in Counseling Ph.D in Clinical Psy D in Clinical Master’s in MFT Master’s in Counseling Master’s in Clinical Social work |
| Historically- Counseling Psych | more emphasis on strengths, cultural factors influencing development/ adjustment, career development, multicultural class |
| Historically- Clinical Psych | more emphasis on treatment of severe diagnoses impacting individual (ex: schizophrenia) |
| Criteria for Determining Abnormality | 1. Unusualness 2. Social deviance 3. Faulty perceptions or interpretations of reality 4. Significant personal stress → most psychological disorders will create a lot of stress 5. Maladaptive or self-defeating behavior 6. Dangerousness |
| Determing Abnormality (4 D's) | 1. deviance 2. dsyfunction 3. distress 4. dangerousness |
| 1. Deviance | does it deviate from what is expected behavior in dominant culture |
| 2. Dsyfunction | not able to function well in the larger world |
| 3. Distress | causing distress the person experience the disorder |
| 4. Dangerousness | if its dangerous to others because its so socially deviant → acting against society/ breaking the rules |
| Cultural considerations | Behavior that is normal in one culture may be deemed abnormal in another/ in the same culture over time |
| Drapetomania | irrational urge to run away from slavery |
| Dysaethesia aethiopica | lashing out toward person who is enslaving them |
| Hysteria | traveling uterus that move throughout women’s body (faint, emotional, acting out) |
| Until 1973 | Homosexuality was considered a mental illness/ they removed it bc of a lot of backlash/ stigmatizing |
| Until 2013 (DSM-5) | Gender Identity Disorder- changed it to Gender Dysphoria (depression/ unhappiness) → the depressive symptoms are the problem/ basically asserting that there is something wrong w/ someone’s identity |
| Current | controversy (personality disorder, ADHD) → around half will be able to meet criteria for some disorder throughout our lives → w/ each addition there are more disorders |
| Major Categories of Psychological Disorders | 1. Mood disorders (bipolar/ depressive) 2. Anxiety disorders (panic disorder, phobias, PTSD) 3. Substance Use disorders (alcohol)= only need 2 criteria to meet it 4. Other= neurodevelopment (autism), schizophrenia, alzheimer's |
| Lifetime + Past-year Prevalence of Psychological Disorders | Mood disorders= 20% will meet criteria Anxiety disorder= 27% will meet criteria Substance Use= 14% will meet criteria Any disorder= 50% will meet criteria bc more disorders |
| Historical Perspectives- The Demonological Model | 1. Demonology 2. Treatments --> trephination |
| Demonology | supernatural causes of abnormal behavior or demonology was prominent in western society until age of enlightenment (1700s) - ppl sent to temple to heal if they had a mental illness |
| Trephination | drilling a hole in the skull to stop supernatural cause (a lot of ppl would die / personality would change) |
| Medieval Times | Belief in supernatural causes Roman Catholic Church's treatment of choice for possession: --> exorcism |
| Exorcism | to extract / exorcize evil spirits |
| Witchcraft | 15th-17th centuries were times of massive persections, particular for women accused of witchcraft - Diagnostic test= Water float test |
| Water float test | determine if someone was a witch or not (tie women w/ ropes- if she floated= witch, if sunk= not a witch, but still die anyway) |
| Asylums | Late 15th/ early 16th centuries= asylums or madhouses began to crop up throughout Europe - rich people would come / make fun of the mentally ill |
| Reform Movement & Moral Therapy (1700s-1800s) | People who behave abnormally suffer from diseases/ should be treated humanely - Jean Baptiste Pussin & Philippe Pinel |
| Regression | Later half in 19th= mental illness was seen as incurable and locked away back in asylums Mid-1900s= Big period Reform/ Change --> rise of phramaceuticals (antipsychotic drugs) |
| Deinstitutionalization | started shutting down mental hospitals to move toward community based services |
| Community Mental Health Movement (CMHC) | - County/ states in US had mental health outpatient places to get therapy/ prescribe medications (but not to stay there for long period of time) - Congress in 1963= established a nationwide system of community mental health centers |
| CMHCs Today | - still struggle w/ funding - Reduced # of people in those facilities/ large # of ppl on street has a mental illness and its keeps being a problem for lack of resources |
| Researching Mental Illness | 1. correlational 2. experimental designs 3. epidemiology 4. kinship studies 5. case studies 6. meta analysis |
| Correlational | relationship between 2 or more factors → NO CAUSATION → can’t be used to establish CAUSE AND EFFECT → correlation can PREDICT RELATIONSHIPS |
| 1. Correlational Method | Examining the relationship between factors and variables |
| Correlation coefficient | falls between -1.00 and +1.00 → closer get to 1 on either side, the stronger the relationship |
| Longitudinal study | correlation study in which individuals evaluated for long period of time (years, decades) |
| 2. Experimental Method | test for cause/ effect + manipulate IV’s - one group gets treatment/ one group does not / check/ measure both groups after treatment |
| Independent variable (IV) | factor that is manipulated (ex: CBT treatment) |
| Dependent variable (DV) | what is measured (the outcome) (ex: PTSD scores) |
| Experimentation- IV + DV= | → cause= manipulated (IV) → effect= measured (DV) |
| A true experimental includes 3 things: | 1. experimental group 2. control group 3. random assignment |
| 1. Experimental group | receives treatment |
| 2. Control group | NO treatment |
| 3. Random assignment | of people to the groups= equal chance of being in experimental or control group → EX: testing a new treatment for Bulimia nervosa |
| 3. Epidemiological Studies | track the rates of occurrence of a specific disorder → large, expensive, rely on survey method (try to generalize to a population → survey method |
| Incidence | # of new cases (in a year) of a disorder that occurs within a specific period of time |
| Prevalence | overall # of cases in an entire population (across a lifetime/ within a specific time) |
| Random sample | each person has equal chance of being chosen |
| 4. Kinship Studies | 1. twin studies 2. adoptee studies |
| Twin studies | Helpful when discussing psychological disorder/ genetic hereditability - monozygot twins/ dizygotic twins |
| Monozygot twin | become identitical twins |
| Dizygotic twin | fraternal twins |
| Adoptee studies | babies born/ abopted family, what’s the chances this child will develop something/ how does the birth mother tie into it → much higher rate of substance use disorder |
| 5. Case Studies | an in depth biography based on clinical interviews, observations, psychological tests, more qualitative (not using a lot of numbers), in-depth on various disorders |
| Single-case experiemntal design | case study in which the subject as his or her own control → (ABAB design)- A= intervention, B= withdrawal, A= intervention, B= withdrawal |
| 6. Meta-analysis | Combines data from several studies to develop a single conclusion that has greater statistical power → making a more convincing argument → strong body of different research for |
| Conclusion is stronger than one study- Why? | 1. Higher # of subjects 2. Greater diversity of subject → make sure subjects have wide range of social class, ages, gender, etc 3. Accumlation of effects/ results over time → want to see meta-analysis for any type of treatment |
| The Biological Perspective | Focus: Biological underpinnings of abnormal behavior |
| Medical Model | mental illnesses are just like physical issues, treat it like treating a physical injury → get prescribed medication → use of biological based apporaches (ex: meds) → rigid/ doesn’t take certain things into account |
| The Psychological Perspective | Sigmund Freud (1856-1939): developed the psychodynamic model/ looking at the unconscious/ principles (Id, ego, superego) - Focus: unconscious conflicts/ motives underlying abnormal behavior |
| Psychological perspective | says that personality/ personality traits influence development of abnormal behavior |
| The Sociocultural Perspective | Cause of psychological problems may be found in the failures or ills of society → not abt individual - External factors can influence us - Examine relationship between mental health & relationships to gender, SES, ethnicity, lifestyle |
| Mutlifactoral / Biopsychosocial Perspective (BEST METHOD) | Abnormal behavior is best understood by taking into account multiple causes (genes, individual personality culture) - biological, psychological, social all are right |
| Dendrite (neural communication) | receives messages from other cells |
| Axon (neural communication) | messages from cell body to other neurons, muscles, glands |
| Acetylcholine (ACH)- alzheimer's | muscle function/ memory formation |
| Dopamine | muscle function, learning, memory, emotions, rewards (pleasure) - Folks w/ schizophrenia have high dopamine levels - Parkison’s disease have low levels of dopamine |
| Norepinephrine | learning, memory, activation of fight or flight response Depression low levels |
| Serotonin | overall mood, satisfied, sleep Depression, anxiety, eating disorders have low levels |
| Occiptal lobe | visual processing |
| Temporal lobe | auditory processing (hearing, language, some memory) |
| Parietal lobe | sensory processing (touch, temp, pain, sensing where body is located) |
| Frontal lobe | decision making, inhibiting certain actions, executive function, planning, inhibiting emotions, personality may change if damaged |
| Cerebellum | coordination, balance, muscle tone |
| Epigenetics Influence Gene Expression | Have certain genes/ markers for things, but may not be expressed throughout life → enviro influences your genes - for most disorders= epigenetics play a role in influencing disorders |
| Diathesis stress Model | refers to how psychological disorders arise from an interaction of biological in nature/ stressful life experiences |
| Diathesis stress EX | 1. Person has genes related to schizophrenia (currently not expressed) 2. Person experiences a uniquely stressful event, childhood abuse (enviromental) 3. Result= person develops schizophrenia in adulthood |
| Psychoanalytic theory (Freud) | based on belief that the roots of psychological problems involve unconscious motives / conflicts that can be traced back to childhood |
| Freud's Mind's Structure | 1. conscious 2. preconscious 3. unconscious |
| Conscious | what we are aware of |
| Preconscious | info not in current awareness but can pull it up quickly (ex: phone number) (part conscious/ part unconscious) |
| Unconscious | instinctual urges, drives, motives, so hard to pull it into consciousness, contains unacceptable thoughts |
| Personality Structure (Freud) | 1. Id 2. Ego 3. Superego |
| Id | pleasure principle= no filter, drives for hunger, thirst, sex, wants what it wants, depends gratification, born w/ it |
| Ego | reality principle= delay gratification, helps navigate/ planning, personality sources, develop after birth If ego get overwhelmed, one is putting too much pressure on it |
| Superego | morality principle= develop sense of guilt when doing something wrong, keep behavior in check, sense of morals/ conscience (angel on one’s shoulder) Superego too much control: anxiety disorders, super rigid in behaviors |
| imbalance between ALL 3 will...(id, ego, superego) | CREATE MENTAL ILLNESS |
| Defense Machanisms | Reality-distorting stratgies used by the ego to shield the self from awareness of anxiety-provoking impulses EX: curling up into a ball → regression |
| Freud's Psychosexual Stages | 1. oral 2. anal 3. phallic 4. latency 5. gential |
| Oral (0-18 months) | pleasure centers on mouth- sucking, biting, chewing |
| Anal (18-36 months) | pleasure focuses on bowel/ bladder elimination; coping w/ demands for control (potty training) |
| Phallic (3-6 yrs) | pleasure zone in genitals; coping w/ incestuous sexual feelings |
| Opedipus complex | in the phallic stage --> boys attracted to mothers and feel competitive toward father visa versa |
| Latency (6-puberty) | a phase of dormant sexual feelings → learning things socially |
| Genital (puberty-on) | maturation of sexual interests → find a partner |
| Other Psychodynamic Theorists | Contemporary theorists focus more on conscious thought/ relationships w/ others (erikson, jung, adler, etc) |
| Psychodynamic Views on Abnormality | Underlying conflicts creating psychological disorders originate in childhood / are buried in unconscious Psychopathology: imbalance / conflict among the psychic structures (id, ego, superego) → have to explore the past in some senses |
| Behaviorism | study of observable behavior; focuses on the role of learning in explaining behavior, even maladaptive behaviors |
| Classical Conditioning (Pavlov) | US (loud sound) leads to --> UR (fear) NS (white rat) + US (loud sound) --> rat become CS that CS of the rat leads to CR (being scared from white rat) |
| Operant Conditioning | learning in which behavior is acquired / strengthened by consequences |
| Reinforcement | increase a behavior |
| positive reinforcement | increase behavior by adding something pleasant |
| negative reinforcement | increase behavior by removing something unpleasant EX: take out the trash and ill stop nagging you |
| Punishment | reduce/ stop a behavior |
| positive punishment | stop a behavior by adding a punishment → EX: yelling at someone or grounded |
| negative punishment | stop a behavior by removing something pleasant → EX: sneak out, the phone is taken away |
| Learning Views on Abnormality | Abnormal behavior itself is the problem Underlying “cause” is irrelevant; can unlearn abnormal behaviors → bc behaviors are learned Psychological disorders= abnormal behavior is learned → through observing ppl as well |
| Cognitive Models & Abnormality (Ellis & Beck) | Interpretations of events → expectations, beliefs, attitudes (what you took away from that experience internally, not the events themselves that cause the problems) - Psychological disorders= inaccurate processing of info abt the world/ ourselves |
| Sociocultural View of Abnormality | Abnormal behavior= failure of society, not person Psychological disorders= caused by society’s ills/ a way of stigmatizing those whole behave differently |
| Culture & Mental Health | Folks from marginalized: ethnicites/ races, genders, sexual orientation, physical ability/ disability status → effects mental health Lower socioeconomic status at greater risk for developing an illness/ struggle w/ mental health |
| Biopsychosocial Perspective | Diathesis-stress model: genetic predisposition + stressful environment/ events= ONLY EXPLAINS MENTAL ILLNESS - The stronger diathesis (genetic predisposition) → the stronger genes you’ll have that can lead to that psychological disorder |
| Psychological Methods of Treatment | - psychotherapy → treats psychological disorders / help clients change maladaptive behaviors or solve problems in living → helps people develop their unique potentials |
| Psychotherapy | structured form of treatment derived from a psychological framework that consists of verbal interactions between a client / therapist |
| Contemporary psychodynamic therapy | focus on clinet’s present relationships (not sex)/ thoughts + behaviors Encourage client to change behaviors → more direct face to face interactions |
| Behavioral therapy | use learning principle to treat psychological disorders (via behavior changes) → don’t care abt cause |
| Cognitive therapy | helps client identify / change faulty congitions |
| CBT | combo between changing behavior/ thoughts, beliefs, attitudes; well-researched/ very popular / tends to be effective |
| Humanisitc Therapies (person-centered, existential, etc) | Focus on subjective experiences Client’s experience in the present (HERE AND NOW) Rogers= developed person-centered therapy |
| Reflection (rogers) | restating / paraphrasing client’s expressed feelings/ thoughts without interpreting them |
| Integrative Therapist | Few psychologists are purists Folks more integrated and not just using superficial tools from all these theories |
| Group therapy | therapy in a group (saves a lot of money/ treat many ppl at one time) Don’t get the one on one attention/ problem w/ the group dynamics No confidentiality |
| Family therapy | Can’t give the individual attention Don’t want to align w/ one person in the family, you are colluding / don’t want to align w/ only one family member |
| Couples therapy | Smallest group (group of 2) Hard to navigate both needs are attended to |
| Biomedical therapies | drug therapy 20-25% of US citiizens take psychotropic drugs for mental illness → white folks more likely to take these drugs than other ehtnicities |
| Drug Therapy | main biomedical therapy/ anti-anxiety med (taken only has needed/ not daily) |
| Antianxiety | benzodiazepines (valium/ xanax) |
| Antidepressants | tricyclics, MAOIs, SSRIs (act on seretonin), SNRI (act on noepronephrine- prozac/ effexor) |
| Antipsychotics | neuroleptics (thorzine/ clozaril- schiophreniz) |
| Mood stabilizers | Lithium/ depakote- for bipolar disorder |
| Electroconvulsive therapy (ECT) | for severe medication resistant depression → only doctor can do it NOT therapist |
| Evaluating Psychotherapy | meta-analysis of outcomes EBTs/ EBP |
| Meta analysis of outcomes | the average client was better off then 75% of the clients who remained untreated → need strong relationship w/ therapist |
| EBTs/ EBP | specific treatments effective for specific problem behavior on the basis of studies (evidence-based treatments) |
| How to classify abnormal behavior patterns | Diagnostic and statistical manual of mental disorders (DSM 1952) - heavily based on psychodynamic theory |
| Latest edition DSM-5-TR | not a lot has changed since DSM-5 |
| International Statistical Classification of Diseases and related health problems (ICD) | internationally/ identify the prevalence and put out by the World Health Organization (WHO) |
| DSM & Models of Abnormal Behavior | Descriptive → describe psychological disorder, but NOT explain those mental illnesses Requires a strict Yes or No judgment (requires black/ white thinking) - Requires severity rating of disorder (mild, moderate, severe) |
| Culture-Bound Syndromes | Patterns of abnormal behavior that occur in some cultures but are rare/ unknown in others Each culture has own perspective of how to treat certain behaviors Western European/ US examples |
| DSM Controversy | 1. More disorder created w/ each revision (300+) 2. Change in classification of disorder 3. Changes in diagnostic criteria for particular disorders 4. Validity of disorders |
| Past/ Present DSM | - early DSM influenced by psychodynamic - TODAY based on research |
| Advantages of DSM | 1. Specific criteria to determine most appropriate diagnosis 2. Diagnosis can inform treatment |
| Disadvantages of DSM | 1. Oversimplification 2. Stigma of labels 3. Doesn't provide treatment recommendations |
| Methods of Assessment | 1. clinical interview/ intake 2. psychological tests 3. intelligence tests 4. personality assessment (MMPI/ MMPI-3/ MCMI) 5. neuropsychological assessment |
| 1. Clinical Interview (all therapists do this) | - identifying data - decription of presenting problems - psychosocial history - medical/ psychiatric history - medical problems/ medication |
| Identifying data | age, date of birth, where live, sexual orientation, religion, gender identity |
| Descriptions of presenting problems | (what are u experiences, how long has this been a problem, what does it look like for u, how severe is it) |
| Psychosocial history | (are u in a relationship, have you had relationships in the past, how many social supports/ friends) |
| Medical/ psychiatric history | (have u been hospitalized in the past, physical health issues) |
| Medical problems/ medication | (do you take medications in general, do u take medication for mental health) |
| Psychological Tests | Strucutred method of assessment used to evaluate reasonably stable traits - Usually standardized on large numbers of subjects - Compare clients’ scores w/ the average (“normed”) |
| Intelligence Tests | Assessment of abnormal behavior sometimes includes evaluation of intelligence (ex: ADHD) - scores expressed as "IQ" --> wechsler scales most common |
| Wechsler Adult Intelligence Test (WAIS) | subscales: Verbal comprehension Perceptual reasoning (visual skills) working memory processing speed (how quickly to do a task) |
| Personality Assessment | 1. projective test= Rorschach (ink blot) + TAT 2. objective tests= MMPI-3 + MCMI |
| Projective tests | personality tests that are usually scored subjectively - Rooted in psychodynamic - Subjectively scored by clinican |
| Rorschach (ink blot) test (subjective) | looking at ink blot picture and tell therapist what u see - need extensive training as a therapist for this |
| TAT (thermatic apperception test) (subjective) | people express their inner feelings/ interests via stories they make up abt ambiguous scenes (what are they thinking, saying, look for themes) |
| Objective tests | self-report measures scored objectively - Do it personally and get score from computer - May detect clinical levels of certain disorders |
| Minneosta Multiphasic Personality Inventory (MMPI- Objective) | 1. widely used test/ assist clinicians in diagnosis 2. 300+ true or false statements assessing interests, behaviors, physical complaints 3. consist of several individual scales |
| MMPI-3 | 52 scales → assess how well u do something → 10 validity scales, 10 internalizing scales, 7 externalizing scales, 5 interpersonal scales, 5 “Psy-5” scales - Often used in court cases for diagnostic clarity - could fake symptoms / false answers |
| Millon Clinical Multiaxil Inventory (MCMI) | made for clinicians use it to diagnose personality disorders/ psychological disorders - 4th edition (MCMI-IV) - Only useful for clinical populations → not used often |
| Neuropsychological Assessment | Measurement of behavior/ performance that may indicate underlying brain damage or defect - clinical neuropsychologits assess possible brain damage or cognitive decline via neuropsychological assessments EX: color strip test |
| Identifying ASD | 1. significant delays in social skills, communication, behavior (6-12 month) 2. American Academic of Pediatrics recommends screen infants at 18 months (lang delays, no eye contact) |
| ADIR | diagnostic tools to use from 18 months up to adulthood= focus on behavior in reciprocal social interaction, communication language, restricted/ repetitive stereotyped interests/ behaviors |
| ADOS G | diagnostic assessment of social interaction, communication play, imaginative use materials → intense observation |
| CARS | rating child's behavior/ abilities against expected developmental - child autism scale for childern over 2 yrs |
| 2 Essential Features of ASD | 1. Impairments in social communication/ interaction 2. Tendency to engage in repetitive behaviors, activities or interests |
| Impairment in Social Communication & Interaction ASD | Defining characteristic: failure to develop age-appropriate social relationships |
| Communication Impairments ASD | trouble maintaining relationships trouble nonverbal communication trouble w/ social reciprocity lack of appropriate expression/ tone |
| Restricted/ Repetitive Behaviors & Interests ASD | Preference for the status quo- maintance of sameness → like the same routine/ can be scary if things change |
| Severe forms ASD | stereotypes (motor behavior- spinning, flapping) or ritualistic behavior (rocking back and forth/ banging head against things) |
| Less severe forms ASD | intense, circumscribed interest in very specific subjects |
| Specifiers in DSM-5-TR ASD (1-2) | 1. With or without accompanying intellectual disability 2. With or without language impairment |
| Specifiers in DSM-5-TR (3-4) | 3. Associated w/ a medical or genetic or environmental condition 4. Associated with any other neurodevelopmental, mental, or behavior disorder |
| Autism | neurodevelopmental disorder- brain based, social skill/ social development are effected |
| Stimming | Doing continuous movements EX: facial cortortions, waving hands, flapping arms, fidgeting |
| Disorder Co-occuring in ASD | 1. Intellectual disability 2. Communication disorders 3. Behavior / emotional disorders |
| Co-occur | another disorder/ diagnosis associated with autism |
| Epidemiology | Overall prevalence= 1.5% in general pop/ its increasing - More prevalent w/ males, non-Latino white, in families of higher socioeconomic status (SES) - Prevalence= 31% diagnosed has intellectual disability (1 in 3) |
| boys vs. girls ASD (ratio) | 4 boys to every 1 girl diagnosed → girls could be missed bc they have better linguistic/ social functioning |
| Prognosis for Children w/ ASD (3 factors) | 1. intellectual ability 2. lang ability 3. level of social engagement |
| 1. Intellectual ability | non verbal= poor prognosis |
| 2. Language ability | low language ability or talk full sentence (poor language abilities= poor prognosis) |
| 3. Level of social engagement | no social interest= poor prognosis |
| DSM- 5 TR ASD (3 levels) | 1. least support 2. substantial support 3. extreme support |
| Level 1 ASD | needs the least amount of support → previously diagnosed for ppl who were high functioning (difficulty switching from one thing to another) |
| Level 2 ASD | substantial support → deficits in verbal/ non verbal communication/ distress changing focus |
| Level 3 ASD (poorest prognosis) | extreme difficult (tantrums when changing activites)/ severe deficits in verbal/ nonverbal communication / someone with them all the time meeting their needs (caregivers) |
| Causes of Autism | 1. genetic influences 2. neurbiological 3. early enviornmental factors 4. gut biome |
| 1. Genetic influences (autism is heritable) | twins who shared one egg that split that split- 60-90% other one will have the disorder if one twin has it (sharing genetics- more likely) - Dygotic twins = only 5-20% |
| 2. Neurobiological (brain abnormalities) ASD | Biological process happening in brain/ not sure what is occurring Pruning of connections- more research |
| 3. Early enviromental factors ASD | Pollutants in the environment |
| 4. Gut biome | Research = those ASD have different gut bacteria than those without the disorder Older parents are at higher risk of having a child w/ autism bc they have kids later in life/ older father cause the greater risk |
| Theory of mind | the ability to put our perspective in someone else shoes- understanding someone has a different perspective than what another person has |
| Empathizing-Systemizing Theory (Baron-Cohen) ASD | disadvnatge in empathizing advantage in systemizing |
| Disadvantage in empathizing | don’t understand their emotions very well → lack of emotional intelligence --> play a role in empathsizing |
| Alexithymia: | People w/ ASD don’t understand their emotions very well → lack of emotional intelligence / not understanding their own emotions or emotions of others |
| Advantage in systemizing | ability to analyze objects or events in terms of structure / future behavior |
| Baron-Cohen Model | that they struggle w/ emphasizing, but they think in a logical systematic way |
| Treatment of ASD | 1. psychosocial treatments 2. biological treatments |
| 1. Psychosocial treatments | Skill building in communication/ socalization → early intervention (around as early as 18 months) is critical/ help develop social skills - Reduce problem behaviors Naturalistic teaching strategies → hands on activities |
| 2. Biological treatments | Medications do not treat autism directly, but can treat comorbid disorder |
| Preferred Treatments of ASD | Preferred apporach intergrates early intervention, education, psychological support |
| Best Practices ASD (1-3) | 1. early intervention/ identiffy 2. intensive services 3. Planned, strcutred, repeated learning opportunties → routine is very important |
| Best Practices ASD (4-6) | 4. Low student to teacher ratio → more individual support 5. Active parental involvement 6. Monitoring student progress/ modifiying treatment when necessary |
| ADHD Features | Persistent patterns of inattention/ or hyperactivity impulsivity - Duration= 6+ months - Multiple settings= inconsistent w/ developmental level/ interferes w/ academic functioning |
| Epidemiology ADHD | Prevalence of ADHD in children/ adolescents is 5% globally (across the world)/ increased/ higher in US - ADHD is most commonly diagnosed in US |
| Boys vs Girls Ratio ADHD | ADHD is somewhat more common in boys than in girls (2:1 ratio) - use to be 3:1 ratio - Girls will be missed bc not as hyperactive |
| Inattention (6+ for children; OFTEN) | Fails to attend to details/ careless mistakes Difficulty sustaining attention in tasks Doesnt listen when spoken to directly Doesn’t follow through on schoolwork Easily distracted Forgetful in daily activities |
| Hyperactivity/ Impulsivity (6+ for children, OFTEN) | Fidgets / squirms in seat Leaves seat when sitting is expected Runs abt, climbs when it is inappropriate Unable to be quiet while doing play/ fun activities Difficulty waiting one’s turn Interrupts or intrudes on others |
| 3 Specifiers (Types of ADHD) | 1. combo presentation (both inattention/ hyperactivity) 2. Predominantly hyperactive/ impulsive 3. Predominetly inattentive |
| Assessment ADHD | Connors 3- children can take via computer ages 8-18 - CBCL (child behavioral check list) for adults/ teachers |
| Associated Problems ADHD | 1. conduct problems 2. substance use 3. academic 4. problematic parent/child interactions 5. peer rejection 6. sleep 7. sluggish congitive tempo |
| 1. Conduct problems | rule breaking/ lying/ aggressive comes along with ADHD, not all the time (antisocial problems) |
| 2. Substance use problems | higher risk of smoking (adolscent/ adulthood)/ impulsive |
| 3. Academic problems | hyperactive/ inattentive= not paying attention in class/ completing homework is hard / focusing on tests |
| 4. Problematic parent/child interactions | parents may respond negatively bc of hyperactive/ inattention/ punish kid alot and response angrily for having ADHD / create more problems |
| 5. Peer rejection/ neglect | ADHD people get bullied/ rejected from others |
| 6. Sleep problems | are common (insomnia) |
| 7. Sluggish cognitive tempo | slow downed thinking |
| ADHD Course | Fairly stable but declines in adulthood somewhat → 2.5% adults meet criteria - inattention= increase/ hyperactivity/impulsivity= decrease - 50-80% of children w/ ADHD meet diagnostic criteria as adolescents 50% continue to meet crtiera as adults |
| Causes of ADHD | 1. genetics 2. environment 3. brain abnormalities |
| 1. Genetics | Is heretiable → for monozygotic twins around 50-80%/ dyzgotic twins around 33% |
| 2. Environment | Prenatal (exposure to lead), perinatal (emotional stress), postnatal (poor parenting skills) Longer screen time/ digital media encourage certain behaviors |
| 3. Brain abnormalities | Control executive functioning, attention, impulse control, motion regulation - Thinner/less mature PFC in kids w/ ADHD - Breakdown in process of restriant (controlling ones behaviors)/ attention in PFC |
| Barkley’s Neurodevelopmental Model of ADHD | Genetic / early biological risks impair neural development → creates deficits in executive functioning (attention/ impulse control) - → interferes w/ subsequent brain development - Difficulty w/ working memory, internalized speech, problem solving |
| Behavioral Rating scales | Checklist in which you provide info abt the frequency, intensity, range problem behaviors seen in children EX: CBCL |
| CBCL (child behavior check list) | ask parents to rate on more than 100 specific problem behaviors (hits, refuse ot eat, destroys own things, uncooperative) / computer score (likely school psychologist) |
| Cognitive Assessment | Measurement of thoughts, beliefs, attitudes- specific to CBT EX: Thought record or though dairy (write down thoughts) EX: ATQ- 30 automatic thoughts questionnaire |
| Symptoms Checklist | Diagnostic tools- self-report symptoms Can track symptoms week by week Many checklist freely available online Cant diagnose just from the checklist still got back to DSM 5 TR criteria |
| Sociocultural & Ethnic Factors in Assessment | Researcher/ clinicans MUST keep sociaocultural/ ethnic factors in mind when asssessing psychological disorders Tests that are valid / reliable in one culture MAY NOT be valid in another culture Careful translations are essential |
| Sociocultural & Ethnic Factors in Assessment/ Treatment | Also you may need to incorporate clinents worldviews on mental illness EX: somali refugees in the US/ have own beliefs abt mental illness |
| Evidence-Based Treatments for ADHD- Meds | 1. psychostimulants 2. non-stimulants 3. alpha 2 receptor agonist |
| 1. Psychostimulants | increase dopamine/ norephrinein (flight or fight) to regulate attention/ activate frontal lobe of attention to inhibit behaviors / less hyperactive EX: amphetamines/ methylpjenidates |
| Amphetamines | (adderall, vyvanse) → wont get person high if taken as prescribed/ inhibit + block appetite |
| Methylpjenidates | ritalin, concerta |
| 2. Non-stimulants | selective nonrepinephrine reuptake inhibitors (SNRIs) EX: Strattera |
| 3. Alpha 2 Receptor agonist | Guanfacine (intuniv) → not as commonly prescribed |
| Efficacy of Medications | Medications improved ADHD better than placebo → stimulants most effective (non-stimulants are not) |
| Side effects of ADHD Meds | appetite suppression (fail to gain weight), insomina, stomach aches Stimulants can exasperate ticks |
| Improvements ADHD Meds | academic/ cognitive functioning at school, socially better/ conforming to the norms at school |
| Limitations of Medications ADHD | Not all children respond well to them Symptoms return quickly |
| Evidence-Based Treatments for ADHD | psychosocial interventions |
| Psychosocial interventions | behavioral, social, emotion regulation training - behavior therapy - behavior classroom management |
| Behavior therapy ADHD | reinforce good behaviors/ behaviors want to see at school Parent consultation/ school consultation |
| Behavior classroom management ADHD | move child w/ ADHD to front of room and for teacher to monitor child more closely Strucutre classroom enviroment as best they can Administer positive reinforcement |
| Potentially Effective Treatments | - special diets - sleep/ exercise - working memory training |
| Special diets | reduce sugars/ artificial dyes (candy), removing artificial sugars/ added sugar (juice) |
| Sleep + exercise | time outdoors/ exercise indoors |
| Working memory training | specific computer based program |
| Therapy vs Medication ADHD | medication is highly effective alone/ works better than therapy alone → but both combo results in fewer behavor issues, better social functioning, better academic performance, better parent-child interactions |
| Best Practices ADHD | Preschool age children: behavior therapy School age children/ adolescents: behaviors therapy plus medication Aduts: medication, usually → sometimes CBT |
| Cultural Issues ADHD | Folks of color are underrepresented in ADHD research White children more likely to be diagnosed w/ ADHD than Black children or Latino a/x children → lack of data/ representative samples |
| Controversy: Overdiagnosis | 1. Predominance of male children diagnosed vs. female 2. Prevalence increases 3. Big drug market for ADHD (recommend best practice for school age children) 4. Systemic/ structural issues in school days 5. Medicaton used less often in some countries |
| Stress (SRD- stress related disorders) | a demand made on an organism to adapt or adjust |
| Stressor | a source of stress (ex: exam, divorce, death of family member) |
| Health psychology | studies the relationships between pychological factors (stress)/ physical health |
| Stress + Health | With prolonged stress → immune system declines |
| Stress- Increased risk of | Digestive disorders Heart disease Diabetes Obesity Migraines Arthritis Increased inflammation |
| Minorities (stress related disorders) | Higher level of stress/ higher levels of health issues from discrimination |
| Expressing Emotions- SRD | Expressing emotions in writing can have beneficial psychological / physical effects |
| Bottled-up emotions may (not addressing them) | burden the autonomic nervous system (ANS) + weaken our immune system |
| General Adaptation Syndrome SRD (3 stages) | 1. alarm reaction 2. resistance stage 3. exhausted stage |
| Alarm reaction | mobilize to deal w/ the stressor / prepare body to deal w/ stressor - Fight or flight reaction only if its a huge stressor |
| Resistance stage | renew/ spend energy to repair the damage/ repair itself |
| Exhausted stage | body become depleted/ resource deplet/ the immune system crash - If its prolonged stress that continue → it will be hard to come back/ more prone to illness |
| Acculturative Stress | pressure from demands to adapt to a host or mainstream culture - immigrating to another country is stressful - Associated w/ poorer psychological functioning |
| Coping with Stress | 1. self efficacy expectancies 2. optimism 3. social support - ALL CORRELATED W/ BETTER HEALTH + WELL-BEING |
| Self efficacy expectancies | confidence/ your ability to be competent / learn something → do you believe you can cope w/ stress well |
| Optimism | positivity |
| Social support | do you have people around you/ rely on when ur struggling |
| Psychological hardiness | stress buffering traits |
| Traits | 1. commitment 2. challenge 3. control |
| 1. Commitment | are committed to challenging things bc think it is worth it or not seeking any challenges in life bc they want to be easy |
| 2. Challenge | open to facing change to grow / expect to be challenged |
| 3. Control | have control over things happening in your life NOT INNATE → can be learned |
| Ethnic Identity | Associated w/ psychological well-being among some groups Exposure to discrimination → poorer mental health/ physical health - Taking pride in ones ethnic identity may help individual withstand the stress imposed by racism |
| Adjustment Disorders | Maladative reaction to an identitied stressor characterized by significant impairment in functioning or emotional distress that exceeds what is expected (ex: leaving for college) - 5-20% of ppl seeking therapy present w/ an adjustment disorder |
| Traumatic Stress Disorders (TSD) (2 types) | - acute stress disorder - post traumatic stress disorder (PTSD) |
| Acute stress disorder | 3 days to 1 month after event happens / symptoms continue may develop PTSD later / not everyone will show symptoms for PTSD til later |
| Post traumatic stress disorder PTSD | symptoms are prolonged; last over 1 month after event/ continue on |
| Actual/ Threatened Death Routes (Trauma) | 1st route 2nd route 3rd route 4th route |
| 1st route | first hand experience |
| 2nd route | witness it in person |
| 3rd route | threatened death- learning abt it happening to close family or friend → rare/ has to be violent or accidental |
| 4th route | repeated exposure to adversive (graphic) details of the threatened death or violence |
| Assessing Trauma | - Informally (asking unstructured questions) - PCL-5 (questionnaire) - CAPS (intensive/ long diagnostic interview of PTSD symptoms) - IES impact events scale (look at current symptoms) |
| Acute Distress Disorder- Symptoms (1-4) | 1. intrusive memories 2. distrubing dreams 3. reexperience/ flashbacks 4. detachment/ dissociation from surroundings or self |
| Acute Distress Disorder- Symptoms (5-8) | 5. distrubance of sleep 6. irritable or agressive behaviors 7. exaggerated startle response 8. avoidance |
| Post-Traumatic Stress Disorder (PTSD) | May develop symptoms months or years after traumatic event → could be something from the environment that could delay the symptoms |
| PTSD Risk Factors (1-4) | 1. Gender (females) 2. Childhood sexual abuse 3. Genetic predisposition 4. Lack of social support |
| PTSD Risk Factors (5-8) | 5. Lack of active coping responses in dealing w/ the stressor 6. Feel shame 7. Detachment / dissociation shortly following the trauma or emotional numbness 8. Mental health issues prior to the traumatic event |
| Learning Perspective PTSD | US --> UR NS + US --> NS becomes CS CS --> turns into CR |
| Treatment PTSD | 1. CBT 2. Prolonged exposure |
| CBT- PTSD | GOAL= expose someone to the feared stimulus/ intrusive thought, but without danger or threat to life → that stimulus over time will no longer be a problem Challenge the beliefs that result from the trauma |
| Prolonged exposure PTSD | Client start telling trauma stories → expousre to stimulus of intrusive memories / the more they tell the story, the less power it has in the end → symptoms improve |
| Cognitive Processing Therapy (CPT) PTSD | write abt trauma - Focus on stuck points/ talk abt faulty beliefs |
| EMDR: eye movement desentization / reprogramming PTSD | Ask to think abt trauma while they move their eyes back and forth Only 5 or 6 sessions → very short - can't explain why its effective - distracted when thinking abt trauma making it easier to digest |
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lils33
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