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The scientific study of abnormal behavior in order to describe, predict, explain, and change abnormal patterns of functioning |
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Criteria for determining abnormality |
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Behavior that is unusual/statistically deviant, behavior that is socially unacceptable and violates norms, distorted perception of reality, person is suffering or distressed, behavior is dysfunctional (maladaptive/self-defeating), behavior is dangerous |
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demon possession; Malleus Maleficarum = witch's hammer; Pope Innocent |
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Hippocrates; imbalance of bodily humors caused all illness |
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abnormality due to life experience and psychological processes in the mind |
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medical model/Psychiatry led to... |
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led to development of phenothiazenes; 1963 Kennedy's community mental health act |
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Freud; all behavior determined by dynamic processes and conflicts within the mind |
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cutting holes in the skull; exorcism (demonological model) |
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Freud's structure of personality - Id |
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from birth, pleasure principal |
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Freud's structure of personality - Ego |
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from age 1, reason/good sense, reality principle |
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Freud's structure of personality - Superego |
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from middle childhood, moral principle |
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Freud's defense mechanisms |
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repression, regression, rationalization, displacement, projection, reaction formation, denial, sublimation |
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Freud's stages of psychosexual development: Oral stage |
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Freud's stages of psychosexual development: Anal stage |
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Freud's stages of psychosexual development: Phallic stage |
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Freud's stages of psychosexual development: Latency stage |
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Freud's stages of psychosexual development: Genital stage |
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Freud's continuum of abnormality |
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normal <---> neurosis (anxiety, abnormality) <---> psychosis |
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all behavior is learned or conditional; environment creates learned behavior; abnormal behavior can be unlearned or replaced by healthy behaviors |
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Behaviorism (learning perspective) |
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classical conditioning + operant conditioning can explain any behavior (CC & OC); environment determines behavior |
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Pavlov; food = unconditional stimulus; bell = conditional stimulus; both eventually cause salivation (unconditional response); example of dog being classically conditioned to salivate by the sound of a bell |
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extinction (in conditioning) |
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over time, stops eliciting response |
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Human example of classical conditioning |
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car crash, adrenaline and tension response; may continue to exist in safe conditions |
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consequences of behavior affect later behavior |
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increases probability of behavior again |
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present positive consequence, increases behavior (reward) |
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remove something aversive, increases behavior (medication) |
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decreases probability of behavior again |
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present aversive (pain, limited movement) |
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remove something pleasant (time-out) |
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Reinforcement/Punishment: |
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can be classically conditioned, primary - biological and physical level; natural and immediate consequences are more powerful than delayed and imposed ones |
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strategies based in learning theory; CC & OC; help people change through self-monitoring, goal-setting, contingency management, stimulus control |
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Albert Bandura (founder); person & environment interact, bidirectional influence; person variables - self-efficacy, outcome expectancy |
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Bobo doll studies; can observe reinforcement and punishment; modeling; shaping and coaching; self-regulatory model; therapy - teach clients these skills |
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Power of Cognition - Automatic Thoughts & Beliefs |
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beliefs are our core: formed throughout life, usually adaptive (at first), automatic thoughts interface with our environment |
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Beck's Cognitive Distortions or Errors |
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Assumes negative emotions and problem behavior is controlled by cognition. Ex: - if I don't get an A, I'm a failure - everyone must like me - it doesn't matter what I do, nothing helps
Treatment: cognitive restructuring |
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Humanistic-Existential Model |
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emphasis on choice and meaning in life; Victor Frankl's logotherapy |
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hierarchy of needs physical needs safety needs belongingness esteem needs altruism self-actualization |
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Classification of Psychopathology |
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important for research, clinical practice, boulder model, scientist-practitioner model, scientists (research), practitioners (clinical practice), helps to merge them |
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diagnostic and statistical manual |
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match client's behavior to symptoms in criteria most disorders have essential symptoms some have rule-out symptoms some have associated but unnecessary symptoms abnormal behaviors are grouped into diagnostic categories |
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- abnormal behaviors are considered symptoms of psychological disorders - psychopathology requries both emotional distress/impaired daily functioning & not a culturally sanctioned response to a stressful event (e.g. bereavement) - assumes etiology has multiple causes or unknown causes - non-theoretical - somewhat empirical - descriptive, not explanatory |
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Multiaxial System: Axis I |
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clinical syndrome - other conditions which are focus of clinical attention |
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Multiaxial System: Axis II |
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Personality disorder - pervasive development disorders; permanent |
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Multiaxial System: Axis III |
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General medical conditions |
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Multiaxial System: Axis IV |
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Psychosocial/Environmental problems |
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Multiaxial System: Axis V |
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Global assessment of functioning (GAF) |
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100 - superior 80 - symptoms transient (temporary) 70 - mild symptoms 10 - danger to self and others |
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Tests - reliable vs. unreliable |
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Rorschach & MMPI tests unreliable Clinical interview most widely used |
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Primary Care Physicians (Stress, Illness, & Health Psychology) |
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gatekeepers, often follow medical model, 60% of office visits find nothing physically wrong - 80-90% due to stress/psychological consequences, yet stress is not treated - most psychological disorders go undiagnosed |
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APA 1978 Division 38 Merges psychology, medicine, and public health study etiology of disease scientifically promote health prevent and treat illness promote public health policy and improve health care system |
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pneumonia/influenza TB intestinal disease CHD stroke Nephritis accidents cancer senility diphtheria |
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Current leading causes of death |
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coronary heart disease (CHD) cancer stroke accidents COPD pneumonia/influenza suicide AIDS diabetes cirrhosis of liver homicide |
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Why the change in leading causes of death: |
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immunizations water purification sewage sanitation food preservation pasteurized milk preventative health care |
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Changing patterns in disease |
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relative decrease in infectious disease more chronic disease longer drain on health care system more lifestyle influence more disease revealed in elderly |
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events or situations; avoid or alter |
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filtered through automatic thoughts, beliefs, values - cognition altered thinking alters emotional response to stress |
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physiological and mental toll fight or flight - evolution exercise and formal relaxation help |
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Behavior to maximize physical & mental health: |
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don't smoke, exercise, diet, safe sex, alcohol in moderation, sleep |
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repetitive, purposeful, and intentional behaviors or mental acts that are performed in response to an obsession |
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- person recognizes that behavior is excessive/unreasonable - obsessions/compulsions cause marked distress; time-consuming, interfere with normal routine, occupational functioning, or social activities/relationships |
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- response to traumatic event - experiences, witnesses, confronted with events that involved actual or threatened death, serious injury, threat to physical or psychological integrity of self or others - response involved intense fear, helplessness, or horror - event persistently re-experienced: distressing recollections or dreams - nightmares, flashbacks, anniversaries, physiological reactivity to cues related to event - duration of over 1 month, otherwise acute stress disorder - significant distress or impairment in social, occupational, or other important area of functioning |
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PTSD: persistent avoidance of stimuli related to event & numbing of responsiveness |
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- avoid thoughts, feelings, activities, situations associated with trauma - inability to recall important aspect of trauma - diminished interest in significant activity (anhedonia) - feeling detached - restricted range of emotion/affect - sense of foreshortened future |
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PTSD: persistent symptoms of increased arousal/anxiety |
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- difficulty falling/staying asleep - irritability/anger outbursts - difficulty concentrating - hypervigilance - overawareness - exaggerated startle response |
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Gender Issues - specific to adult males victimized by males |
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2-31% male population sexually abused special population: runaways, prostitutes, institutionalized children, inpatient psychological population, perpetrators more underrepresented than women - fear homosexuality label - blaming - denial of adolescent to child abuse - recapitulation - lack of supervision - missing of sings - differential emotional response - males not supposed to be as affected as women |
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