- an individual's characteristic pattern of thinking, feeling, and interacting with the world. 

- stable properties that make your behavior predictable to others. 

Competitive, driven to succeed, make more money, publish more, but less happy than Type B People.

- Need varied and novel experiences. 

- Willing to take physical and social risks for these experiences. 

High: buy sports cars or exotic cars, large sailboats, etc. 

Low: buy comfort items, more careful with their money.

- Provides both an approach to therapy and a theory of personality. 

- Emphasizes unconscious motivation - the main causes of behavior lie buried in the unconscious mind. 

Freud's Theory of the Mind

The mind is like an iceberg and most of it is hidden from view. 

Contains:

- Conscious

- Ego

- Superego

- Id

- Unconscious

- In awareness now

- Rational

- Goal-directed thoughts. 

- A reservoir of unacceptable thoughts, wishes, feelings and memories

- The ugly contents of the unconscious are kept this way by repression. 

- strives to satisfy basic sexual and aggressive drives

- operates according to the pleasure principle 

- find pleasure and avoid pain at whatever cost

- think of a screaming, spoiled child that never shuts up. 

- internalization of society's moral standards for what we should be doing.

- responsible for guilt

- purpose is to oppose the Id.

- mediator between id and superego

- operates on the reality principle, satisfying the id's desires in ways that will realistically bring pleasure rather than pain.

- think of a skilled baby-sitter doing his/her best to keep the screaming child (i.e., the Id) happy. 

Freud's Theory of the Mind:

What happens to the id, ego, and superego?

The id, ego, and superego are forever in conflict. 

The individual is always torn between desire and conscience. 

Conflict produces anxiety. 

What are defense mechanisms? 

What are they?

Unconscious mental processes employed by the ego to reduce anxiety. 

In other words, we strive to reduce anxiety by defending ourselves from certain kinds of knowledge. 

They are: Repression, Displacement, Sublimation, Projection, Rationalization

Project your own acceptable urges onto others

(a person who insists everyone else is selfish)

Describe basic personality characteristics that are relatively stable

Internal dispositions that are relatively stable over time and across situations...

think of extrovert/introvert, it's not good to be at the extremes (such as bipolar)

Just 5 traits can explain much of the personality differences from person to person. 

OCEAN

Openness - related to creative/intellectual profession.

Conscientious - related to health-protective behavior

Extroversion - related to physical health

Agreeableness - related to longevity, community involvement and negatively related to criminality

Neuroticism - related to criminality and morbidity.

Tests of Personality:

Minnesota Multiphasic Personality Inventory (MMPI)

- the most widely researched and clinically used of all personality tests

- developed to identify emotional disorders (still considered its most appropriate use)

Your personality becomes stable especially after age 30. 

Then there is high stability throughout adulthood. 

People become less neurotic, less extroverted, less open to new experiences, more conscientious and more agreeable. 

Social-Cognitive Perspective. 

Focus on differences in learned beliefs or thoughts that predispose people to react in particular ways.

Personality is formed by interaction of cognitions and environments. 

Social-Cognitive Perspective

External Locus & Internal Locus of Control (explain these!)

External Locus of Control - the perception that chance or outside forces beyond one's personal control determine one's fate.

Internal Locus of Control - the perception that one controls one's own fate. 

Expected & Culturally sanctioned response.

Deviant Behavior. 

According to the DSM-IV: a mental disorder is one that fulfills the following critera: 

Distress and impairment of functioning.

Involuntary.

Internal Source. 

Perspectives on Mental Disorders:

What are mental disorders also known as? What are the causes of the mental disorders?

Mental Disorders are known as PHYSICAL DISEASES.

Multiple causes can be brain abnormalities, birth difficulties, and heredity. 

Biopsychosocial Perspective

What are they caused by? 

Anxiety Disorders:

Anxiety and Fear are normal...

WHEN ARE THEY DYSFUNCTIONAL?

Anxiety and Fear are dysfunctional when:

- pervasive, persisitent

- significant distress

- irrational & uncontrollable

4 Types of Anxiety Disorders

- Generalized Anxiety Disorder (GAD)

- Panic Disorder

- Phobias

- Obsessive-Compulsive Disorder (OCD)

Generalized Anxiety Disorder (GAD)

Explain the defining features. 

- Excessive uncontrollable worry about life events

- Strong, persistent anxiety

- Persists for 6 months or more

- Interferes with normal functioning

- 4% of general population; Females outnumber males approximately 2:1

Panic Disorder

explain the defining features

- abrupt experience of intense fear or discomfort

- accompanying physical reactions to the fear

- worry about another attack

- symptoms persist for at least 1 month

- 3.5% of general population, 2/3 with panic disorder are female

Specific Phobias

(explain defining features)

Extreme and irrational fear of specific object/situation that is out of proportion to the danger posed by the object....

phobic object can cause a full-blown panic attack, it interferes with one's ability to function. 

Phobias...

explain causes and associated features

subtypes of specific phobias

animals...natural environment (events occuring in nature, etc.)

causes of specific phobias: biological vulnerability (hereditary preparedness), past experience, (e.g., conditioning)

5-8% of population

Social Phobia

explain defining features

- Fear/shyness in social situations

- interferes with functioning

- avoids social situations

- 13% of population

Obsessive-Compulsive Disorder (OCD)

explain defining features, such as obsessions and compulsions

- Obsessions - recurrent, persistent, and disturbing thoughts and images or urges that intrude into consciousness. the person recognizes that these ideas are irrational.

- Compulsions - repetitive actions performed to suppress thoughts and provide relief. 

Major Depressive Disorder

explain mood, symptoms, and duration

- extremely depressed mood state lasting at least 2 weeks

- symptoms:

 - sad, depressed mood

 - loss of interest or pleasure in all activities

 - loss of energy, difficulties sleeping, appetite and weight change, difficulties concentrating, etc. 

the depressive disorder dissipates over time. person often returns to normal within 6 to 8 months. 

Bipolar Disorder

explain mood, what manics experience, and average age of onset. 

- mood alternates from severe depression to extreme euphoria (mania)

- manics experience: elevated mood, increased activity, diminished need for sleep, grandiose ideas, extreme distractibility

- average age of onset is 18. between 0.6% and 1.1% of the population will have a bipolar disorder

Biological (e.g., heritability) - bipolar disorder has a strong genetic component, depression suggests less of a genetic basis but still has biological influence

Situational (e.g., stress)

Cognitive (e.g., thought patterns)

There is a positive correlation between stressful life events and onset of depression. 

Most depressogenic life events are losses of: spouse or companion

long-term job

health

income

Aaron Beck said that depressed people hold pessimistic views of themselves, the world, and the future. 

Beck's Cognitive theory...a tendency to interpret life events negatively, and overgeneralization

Beck argues that depression is a thought disorder instead of a mood disorder.

Depressed people distort their experiences in negative ways. they will exaggerate bad experiences and minimize good experiences. 

Psychological Disorders

Explain Anxiety & Mood disorders - what it is and what happens to the person

distressing and debilitating but the person has not lost touch with reality

Psychological Disorders

Psychotic Disorder - explain what happens to the person.

The person loses contact with reality.

The person will experience irrational ideas and distorted perceptions. 

Dissociative Disorders

What is dissociation?

literally a disassociation from yourself or your memory. 

an example is when people are driving a car and not realizing or being able to remember what happened during a part of the trip.

Dissociative Disorders

How are dissociative disorders caused?

They're marked by a complete repression of anxiety-provoking materials from consciousness. 

The repression can cause a sudden unawareness of some aspect of the individual's identity or history.

Dissociative Amneisa

what's the only symptom??

Memory loss is the only symptom. 

Often selective memory loss surrounding traumatic events. 

(think about the girl whose brother was killed during a robbery and she was there to witness the entire thing! she didn't recall the event for over 4 days because she was so shocked.)

- Originally known as "multiple personality disorder"

- 2 or more distinct personalities manifested by the same person at different times. 

- VERY RARE. 

Facts & Causes of Dissociative Identity Disorder

- Facts and Statistics

 - Average number of identities ~ 15

 - Ratio of females to males is high (9:1)

- Causes

- Frequent histories of horrible child abuse

- Highly suggestible

- Mechanism to escape from impact of    trauma

Schizophrenia vs. Psychosis

- Psychosis - Broad term referring to hallucinations and/or delusions.

- Schizophrenia - A type of psychosis with disturbed thought, language, and behavior. 

Three clusters of Symptoms of Schizophrenia

Positive - delusions and hallucinations

Negative - withdrawal, apathy, a lack or absence of normal behavior. 

Disorganized thoughts/speech. 

"Positive" Symptom Cluster

name what happens...

- Active manifestations of abnormal behavior.

- Delusions (false beliefs)

- 'they're out to get me' paranoia (e.g., Avoid the Noid from the pizza hut commercial)

- Hallucinations (false perceptions)

- hearing things that aren't there. 

"Negative" Symptom Cluster

what occurs in the negative symptom cluster?

- Absence or insufficiency of normal behavior

- Spectrum of Negative Symptoms

Avoliton (or apathy) - inability to initiate and persist in activities

Relative absence of speech

Anhedonia - lack of pleasure

Affective flattening - show little expressed emotion. 

"Disorganized" Symptom Cluster

Explain what happens...(Schizophrenia)

- Disorganized Speech

overinclusion - jumping from idea to idea without the benefit of logical association 

tangentiality - responding in a tangential or irrelevant manner

- Disorganized behavior - behavior that is inappropriate for the situation 

e.g. wearing sweaters and overcoats on hot days

affect is inappropriately expressed

laughing at serious things, crying at funny things. 

During a 1-month period, 2 (or more) of the following symptoms.

- delusions

- hallucinations

- disorganized speech

- grossly disorganized/catatonic behavior

- negative symptoms

- Onset and prevalence worldwide

- about 1% of the population

- Affects males and females about equally

-onset for men is between 18 and 25

-onset for women is between 26 and 45

Yes! There data suggests that there is a biological cause. 

For example, if your identical twin has schizophrenia, then you are 45% more likely to get schizophrenia. that is versus 1% chance when you're not related to anyone who has schizophrenia.

Also...drug therapy often works the best. NOT TALK THERAPY.

Similar prevalence of schizophrenia across different cultures. 

YES. THE ENVIRONMENT IS CRUCIAL AS WELL. 

The Diathesis - Stress Model

Diathesis and Stress...

Diathesis: pre-disposition to a particular disorder.

Stress: environmental factors that increase the likelihood of a disorder appearing.

You can have a pre-disposition to a disorder without it ever manifesting it when there is no stress. 

- Malfunctioning neurotransmitter system

- neurotransmitter excesses or deficits

- dopamine theory. 

- Drugs that reduce dopamine reduce symptoms. 

- Drugs that increase dopamine produce symptoms   even in people without the disorder

Theory: Schizophrenia is caused by excess dopamine. 

Are there any predictors in Schizophrenic?

Also...what are the rates of mental disorders? 

- Early warning signs.

nothing very reliable has been found yet.

certain attention deficits common to Sz can be found in children who are at risk for the disorder (e.g., children whose parents have Sz)

- 50% of people between 15-54 have had at least 1   episode of some kind of disorder.

- Highest frequency between the ages of 25-34

- Most common disorders in US population:

- Major Depressive Disorder ~ 17%

- Social Phobia ~ 13%

Summarize Schizophrenia (Sz)

- Many biological factors seem involved

- heredity

- dopamine neurotransmitter

- brain structure abnormalities

Environmental factors are also important. 

Combined Diathesis-Stress model of Sz.

- biological predisposition combined with   psychosocial stressors leads to the   disorder. 

Historical Views of Mental Illness

Middle Ages to 18th Century

Explanation of Mental Illness - symptom of demonic possession. 

Treatment: witch hunts, torture, hanging, burning

The dunking test: if the woman did not drown, then she was in league with the devil. if she did drown then she was not in league with the devil. 

Psychotherapy and Bio-medical therapy

- Psychodynamic

- Humanistic

- Cognitive

- Behavior

Psychodynamic Therapy

What is it? 

Mental disorders result from inner mental conflicts, typically from some childhood experience.

Basic assumption: understanding and gaining insight about the conflict will resolve the mental disorder. 

The goal:

Analyst's job is to make inferences about patient's unconscious conflicts.

Once patient experiences them consciously, then he or she can modify and resolve them. 

Methods...

Free Association

- patient relaxes and reports everything                 that comes to mind. 

Dream Analysis

- latent content

Mistakes

- slips of the tongue. 

Assumes that mental disorders are best treated by increasing awareness of motivations and needs.

Differences from psychodynamic approach. 

- Does not focus on unconscious motivations. 

- nonjudgmental because inner feelings &   desires are seen as positive & life-   promoting. 

Humanistic Therapy

What is the goal of humanistic therapy?

Carl Rogers's Client-Centered Therapy -- Therapist provides "Unconditional Positive Regard"

Goal: resolve mental disorders by helping the client grow in self-awareness and self-acceptance.

- make & take responsibility for life choices. 

Cognitive Therapy

What is it? What's the goal of it?

Assume that our thinking influences our feelings. 

Goal: to identify problematic styles of thinking (e.g., self-defeating thoughts) and to replace them with beneficial styles. 

- attribution retraining (self-serving bias)

Overgeneralization: a negative event is viewed as a never-ending pattern of defeat. 

Discount the positives: accomplishments and successes "don't count."

Labeling and identifying with shortcomings: Instead of saying, "I made a mistake," you tell yourself, "You're a loser."

1. Identify the maladaptive thought or anxiety.

2. Examine the evidence. 

3. E.g., when treating anxiety disorders: challenge irrational thoughts about danger, personal vulnerability & ability to tolerate anxiety. 

Re-examine irrational appraisals of danger & coping skills. 

Specific phobias - examine likelihood/probability of outcome.

GAD - what is the utility of assuming the worst? 

Social phobia - test thoughts re. negative evaluation from others.

Panic & Agoraphobia - look at past attacks to consider probability. 

- Uninterested in self-awareness. 

- Relatively uninterested in possible underlying causes.

- Focus on and change observable behaviors via conditioning and other behaviorist methods. 

Behavior Therapy...

What methods are used?

Flooding: force patient to confront their feared object.

Systematic Desensitization (SD): treat an anxiety by pairing a relaxed state with a gradually increasing anxiety-provoking stimulus. 

People report feeling better after therapy...however they MIGHT'VE gotten better anyway with the passage of time. 

Studies show that people in therapy do better than no-treatment control groups.

Conclusion: Different psychotherapies are effective for different problems. There is not a single "super-therapy" that is great for everything. 

Psychotherapy: General Conclusions....

What is Cognitive-behavioral best for?

Humanistic?

Psychodynamic?

Cognitive-behavioral - best for fear or anxiety...

Humanistic - best for self-esteem problems. 

Psychodynamic - best for achievement problems...

What is biological therapy?

what do we use today?

- Attempts to solve the mental disorder by altering bodily processes...

History - DRILLING HOLES IN HEAD. BLOOD LETTING. 

Today we use Electric Convulsive Therapy (ECT)

 and drug therapy. 

What is Electroconvulsive Shock Therapy (ECT)?

What is the goal?

Originated from observing that epileptics and people who suffer fever-induced convulsions are often NOT depressed.

The goal of ECT is to induce a seizure similar to that experienced by epileptics; without the seizure the ECT is ineffective. 

This is used primarily in cases of severe, unrelenting depression. 

Causal mechanism is unclear, except that it involves the frontal lobes.

60% people who don't respond to other treatments get relief from ECT.

Drug Therapy...

what is it? 

is it safe?

Psychopharmacology

- generally safe & effective

- most popular bio treatment

- has side effects. 

Many work to increase the availability in the brain of certain neurotransmitters.

Prozac makes the neurotransmitter, Serotonin, more available by inhibiting its reuptake by the presynaptic neuron. 

Currently:

Beta-blockers, such as Inderal, are very effective.

Originally, a high-blood pressure medicine with the side-effect of causing serenity in stressful situations. 

Medication Treatment for Schizophrenic Disorders

What is it? 

What problems occur?

Typical Antipsychotic medication (e.g., Thorazine)

-Reduces relapse rates

- motor side effects (shaking, problems controlling movements)

Problems:

- drugs tend to relieve positive but not   negative symptoms

- compliance: many patients fail to take     drug

- high rates of relapse.