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| physical or psychological reastions to demanding situations |
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| The demanding or threatening situations that produce stress |
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Alarm - "fight or flight" response, body energized Resistance- body adjusts to cope with the threat Exhaustian - energy depleted; body "gives up" |
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Sequence Issues: is stress highest before, during, or after an event? Measurement Issues: should we look at self-report, behavior, or physiological response? |
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| Physical Consequences of Prolonged Stress |
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Immune Response is lowered - measured by white blood cells (lymphocytes) - affects likelyhood of getting flu/cold - may effect cancer liklyhood (controversal) Cardiovascular System affected - increased blood pressure - increased cholesterol levels in blood |
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Personality and links to Hear Disease
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Type A - determined to achieve, time urgency, irritable, respond to threat very quickly, impatient with obstacles. Type B - calmer and less intense Type B experience fewer stress- related ailments Type A is less predictive of of health problems then hostility Hostility - proneness to anger Hostility is a major risk factor for heart disease |
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| Psychological Consequences of Prolonged Stress |
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Post traumatic stress disorder: flashbacks, avoidance of stimuli associated with the traumatic event, and chronic arousal - relatively rare Burnout: physical, emotional, and mental exhaustion created by long-term involvement in an emotionally demanding situation -more common in people who approach stressful jobs with a strong sense of idealism |
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| The Life Events Model of Stress |
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-changes that disrupt everyday life -daily hassles: traffic, long lines (Hassles Scale messures irritating, daily demands, predicts illness better then the SRRS) - Chronic exposure to noise increases stress - crowding increases stress and aggression Social Readjustment Rating Scale: Holmes and Rahe, ranked the stressfullness of different life events Limitations: problems with SRRS, life experiance survey is better. life events model ignores mediating variable and cognitive apraisal. |
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| The Folkman and Lazarus model |
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Definition
Primary Appraisal: "is it a stressor?" Secondary Appraisal: "will i be able to handle it? how?" Problem focused coping: attempts to modify, reduce, or eliminate the source of stress. Emotion-focused coping: attempts to alter the emotional response to the stressor Other Coping: reappraising the situation, learning from the experience, making social comparison. cultivating a sense of humor. religious beliefs. |
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ability to adapt to stress in unusually positive ways - commitment - challenge - control results in difficult events being viewed less negatively, reducing stress |
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| Psychological Characteristics that Reduce Stress and Illness |
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Optomism Social Support Positive Emotions -nuns lived longer
Explanatory style sense of control |
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| Psychological Disorder and its Historical Views |
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Any behavior or emotional state that causes an individual great suffering or worry, is self-defeating or self-destructive, or is maladaptive and disrupts the person's relationships or the larger community. Historical Views: - "Evil Spirits": witch hunts - Imbalance of bodily fluids |
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| Medical Model of Psychological Disorders |
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Definition
view that abnormal behavior is symptomatic of underlying "disease" that can be "cured" with appropriate therapy - draws an analogy between mental and physical illness -a widely held view, but some question it - causes of mental illness often unclear - social, cultural context of symptoms is important, more so than for physical illness |
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| Diathesis-Stress model for Psychological Disorders |
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Diatheses + Stressors = psychological disorders Diatheses: Genetic factors, biological characteristics, psychological tests Stressors: traumatic life events, negative family life, economic disadvantage |
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1) Negative emotional and functional consequences for the person - unhappiness, inability to fufill roles, harmful to self or others 2) Statistical frequency 3) Nonconformity to societal tolerance limits 4) Expert Judgement (Rosenhan- participants faked disorders to enter psych ward, patients say through deception, but not staff) 5) Absolute Standard - DSM: provides specific criteria for diagnosis; provides language for clinicians to communicate with |
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Diagnostic and Statistical Manual of Mental Disorders, 4th Edition -used for diagnosis and classification of psychological disorders -intended to give objective, measurable criteria for diagnosing disorders -does not suggest therapies or treatment - does not discuss possible causes |
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| The Five Axis of the DSM-IV-TR |
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Axis = rating dimension 1) Common psychological disorders - schizo, bipolar 2) Personality disorders - paranoid pers. dis. 3) Medical conditions relevant to diagnosis or treatment - diseases of the circulatory system 4) Psychosocial and environmental problems that may affect diagnosis, treatment, or prognosis - homelessness 5) Global assessment of functioning scale |
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Advantages: - when used correctly and diagnosis made with valid objective tests, the DSM improves reliability of and agreement among clinicians -DSM IV included for the first time a list of culture-bound syndromes, disorders specific to a particular culture |
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-the danger of overdiagnosis - confusion of serious mental disorders with normal problems - the power of diagnostic labels - reliance on the medical model |
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| Problems associated with diagnostic labeling |
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diagnostic labeling effects: -labels for psychological problems can become self-fufilling prophecies - make it difficult to recognize normal behavior when it occurs - may increase likelihood of abnormal behavior |
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| Major Categories for Disorders |
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1) Anxiety Disorder 2) Mood Disorder 3) Somatoform Disorder 4) Dissociative Disorder 5) Personality Disorder 6) Schizophrenia |
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- a class of disorders marked by excessive apprehension and worry that in turn impairs normal functioning - coping with the anxiety typically involves either avoidance or ritualized behavior Types: 1)Generalized anxiety disorder 2) Phobic disorder 3) Panic Disorder 4) Obsessive Compulsive Disorder 5) Agoraphobia Gender and Culture: -Women more likely then men (men less likely to report symptoms or seek treatment) - hispanic more then white americans |
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| Generalized Anxiety Disorder |
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Definition
- anxiety disorder -"free floating" anxiety - chronic worrying lasting over 6 months - usually accompanied by many minor physical symptoms |
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-anxiety disorder - highly focused fear of a specific object or situation - example: irrational fear of snake |
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-anxiety disorder - person experiances reoccuring panic attacks, feelings of impending doom or death, accompanied by physiological symptoms such as rapid breathing and dizziness |
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-anxiety disorder - fear of public places - a set of phobias, often set off by a panic attack, involving the basic fear of being away from a safe place or person |
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| Obsessive-Compulsive Disorder (OCD) |
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Definition
-anxiety disorder - persistent, uncontrollable thoughts (obsessions) and compelling need to perform repetitive acts (compulsions) - ex: excessive cleaning, checking -person understands that the ritual behavior is senseless but guilt mounts if not performed. |
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prolonged, disabling disruptions in emotional state 2 types: Major Depression Bipolar Disorder Gender and Culture: -suicide: women more then men (men more often successful) - depression: women more then men - bipolar: no trend Suicide: - possible consequence of mood disorders - 3rd leading cause of death in adolescents - 8th leading cause of death among all ages - another major predictor is prior suicide attempts and thoughts |
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-mood disorder - involves disturbances in emotion (excessive sadness), behavior (loss of interest in one's usual activities), cognition (thoughts of hoplessness), and body function (fatigue and loss of appetite) Episode Diagnosis (5+, for at least 2 weeks): -depressed mood most of the day -change in activity level -reduced interest in almost all activities -significant weight gain or loss, without dieting -sleep disturbance (insomnia or too much sleep) -fatigue or loss of energy -feelings of worthlessness or guilt -negative self-concept -reduced ability to think or concentrate -recurrent thoughts of death |
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-mood disorder -disordered mood shifts in two directions, from depression to manic state -manic state: person becomes hyperactive, talkative, decreased need for sleep -manic state must last at least a week to be classified as such, but may last for months -note that functioning is often severly impaired -bipolar disorder can have rapid mood swings |
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-psychological disorders that focus on the physical body 2 types: 1) Hypochondriasis 2) Conversion Disorder Gender and Culture: -conversion: women more then men -hypochondriasis: no trend -Asia and India have similar conditions common fear for men |
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-somatoform disorder -long-lasting preoccupation with idea that one has a serious disease, based on misinterpretation of normal body reactions |
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-somatoform disorder -real physical problems that seem to have no physical cause |
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-characterized by seperation, or dissociation, of conscious awareness from previous thoughts or memories 3 types: 1) Dissociative Amnesia 2)Dissociative Identity Disorder 3) Dissociative Fugue |
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-dissociative disorder -inability to remember important personal information -generally psychological in origin |
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-dissociative disorder -loss of personal identity, often accompanied by a flight from home
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| Dissociative Identity Disorder |
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-dissociative disorder -individual alternates between what appear to be two or more distinct identities or personalities (also known as multiple personality disorder) -not all clinicians believe in it -some symptoms can be faked -an extreme form of our ability to present many aspects of our personalities to others. -some therapists may reward patients with attention and praise for revealing more and more personalities |
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-chronic, enduring patterns of behavior leading to significant impairment in social functioning -cause personal distress or an inability to get along with others -some clinicians view these as extremes of personality rather than disorders per se 3 types 1)Narcissistic Personality Disorder 2) Paranoid Personality Disorder 3) Anti-Social Personality Disorder Gender and Culture: -Anti-social there are more men then women |
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| Narcissitic Personality Disorder |
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-personality disorder -characterized by an exaggerated sense of self-importance and self-absorption |
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| Paranoid Personality Disorder |
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-personality disorder -characterized by habitually unreasonable and excessive suspiciousness and jealousy. |
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| Anti-Social Personality Disorder |
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-personality disorder -characterized by antisocial behavior such as lying, stealing, manipulating others, and sometimes violence; and a lack of guilt, shame and empathy -sometimes called psychopathy or sociopathy DSM criteria for Antisocial (must have 3): -repeatedly break the law -deceitful, uses aliases and lies to con others -impulsive and unable to plan ahead -repeatedly get into physical fights or assaults -reckless disregard for own and others safety -irresponsible, failing to meet obligations -lack remorse for actions that harm others |
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-involves fundamental disturbances in thought processes, emotion, and/or behavior -complex disorder that may be expressed in a variety of ways 4 types 1) Paranoid 2) Disorganized 3) Catatonic 4) Undifferentiated Gender and Culture: -men at slightly greater risk and tend to develop earlier in life -more african americans then whites |
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| Symptoms of Schizophrenia |
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1)Hallucinations (mostly auditory) 2) Delusions (of gradeur and persecution are most common) 3)Speech Disturbances (including word salad) 4)Disorganized behavior (silliness, wierd motor behaviors) 5) Inappropriate affect (emotional responses that are inappropriate for the circumstances, such as crying at comedy shows) |
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| Diagnosis of Schizophrenia |
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Positive Symptoms: observable expressions of abnormal behavior -Hallucinations -Delusions -Disorganized speech Negative Syptoms: Elimination or reduction of normal behavior -Flat affect little or no emotional reaction to events. - Refusing to take care of self |
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-schizo -delusions of grandeur and persecition -usually harmless but may become violent if threatened |
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-schizo -periods of frenzied activity alternating with periods of immobility -may stay in odd positions for hours |
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-schizo -innappropriate affect and actions -incoherent verbal behavior and silliness -delusions and hallucinations |
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-schizo -used to describe schizos with mixed or unusual symptoms |
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| Causes of Psychological Disorders |
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1) Biological 2) Genetic 3) Cognitive 4) Environmental |
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| Causes: Biological Factors |
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-include physical problems of the brain -neurotransmiter imbalances: dopamine excess in schizo serotonin in mood disorders OCD low serotonin -schizo associated with enlarged ventricles (structural problems in the brain) |
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| Causes: Genetic Contributions |
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-do some people inherit predispostions toward developing disorders? -schizo increase with closeness of relative who has it -highest likelihood for identical twin -similar pattern for depression, bipolar disorder |
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| Causes: Cognitive Factors |
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-maladaptive thought patterns may contribute to depression -internal, stable, global attributions for negative experiances may play role in depression -learned helplessness: acquired when people repeatedly fail in attempts to control environment -may also contribute to depression -internal: "Its totally my fault" -stable: "I was born stupid" -global: "ill prob fail all my courses" |
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| Causes: Environmental Factors |
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-do people learn to act abnormally? -culture that emphasizes thinness may predispose you to anorexia nervosa -cultural background may influence the kinds of delusions seen in schizo -conditioning may ply a role as well -specific phobias may be acquired through classical conditioning or observational learning |
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| Life Experiances and Circumstances |
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Dissociative Disorders: emotional trauma in early life Conversion Disorder: early life or current stress Depression: loss of or problems with important relationships throughout life Women are less satisfied with work and family and more likely to live in poverty women are more likely to be victims of sexual violence |
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| Major Approachs to the Treatment of Psychological Disorders |
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Biomedical Therapies Psychotherapy |
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Drug Therapies Electroconvulsive Therapies (ECT) Psychosurgery |
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-antipsycotic drugs reduce positive symptoms of schizo -chloropromazine first used in 50s to treat delusions and hallucinations -most act on dopamine -highly successfull in reducing in-patient pop. -side effects include involuntary movements of tongue, jaw, face -Antidepressant drugs modulate availability or effectiveness of neurotransmitters implicated in mood disorders -tricyclics modulate norepinephrine -flouxetine (prozac) modulates serotonin -Lithium carbonate used for bipolar -Antianxiety drugs reduce tension, anxiety -short term success high but mant patients (50-66%) stop taking meds cuz side effects -ind. taking antidep. w/out learning to cope w/ problems are more likely to relapse -problems with getting right dosage -drugs are metabolized in everyone differently |
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| Electroconvulsive Therapy |
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-brief electric shock to the brain -used mainly for depression (success 50-70%) -often last resort treatment -needs anesthesia, muscle relaxants reduce physical trauma -controversial because unclear how or why it works, causes confusion an memory loss, relapse rate is high |
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-surgery that destroys or alters tissues in the brain in an effort to affect behavior -very rare treatment -prefrontal lobotomy is most famous example -produced calming effects, but also serious cognitive deficits, sometimes death Approachs: 1) Psychoanalysis(Psychodynamic) 2) Behavioral 3) Cognitive 4) Humanistic |
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-derived from freuds work -Goal: bring hidden impulses, memories to surface of awareness - make the uncounscious conscious -long intense and expensive -works best with verbal educated patients -Techniques: free association-patient relaxes and freely expresses whatever comes to mind dream analysis-determine latent content of dreams Resistance: blocking that indicates areas that should be explored Transference: in psycodynamic therapies, a critical step in which the client transfers unconscious emotions or reactions, such as conflicts about his or her parents, onto the therapist Countertransference: problem to be avoided in therapy. therapis projects feelings about importnat people in therapists life onto the patient. should not happen. example:therapist might project feelings for a parent onto an older patient contemporary psychodynamic therapists speed up the lengthy process |
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- a form of therapy that applies principles and techniques of classical and operant conditioning and overscational learning to help people change self defeating or problematic behaviors. Systematic Desensitization: use counterconditioning, extinction to reduce fear. works through an anxiety hierarchy of situations that lead to fearful reactions. -imagine fearful situations while remaining relaxed Aversion Therapy: Replace a positive reaction to a harmful stimulus with something negative -ex: give a drug that causes severe nausea when alcohol is ingested Social Skills Training: use modeling and reinforcement to shape appropriate adjustment skills |
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-Goal: remove irrational beliefs, negative thoughts presumed to be responsible for psychological disorders -ex. depression -Techniques: -identify irrational beliefs, maladaptive interpretations of events -challenge beliefs directly -encourage more rational beliefs and interpretations -Ellis:Rational Emotive Therapy- therapist verbally assualts irrational thought processes almost like a cross-examiner ex. i must be perfect -can be harsh -Becks cognitive therapy: less harsh and confrontational. encourages clients to identify irrational thouht processes themselves. |
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-Goal: Help clients gain insight into their fundamental self-worth and value as human beings; facilitate clients growth toward self-actualization -Rogers Client Centered Therapy: client, not therapist, holds key to psychological health, happiness. problems stem from incongruence in self-concept -Genuineness: therapist is not "phony", expresses feelings openly and honestly -Unconditional positive regard: therapist does not place conditions of worth on client. accepts all clients Empathy: therapist tries to see things from the clients perspective |
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-cognitive therapy best for depression -behavioral best for some kinds of anxiety disorders -therapy produced improvement (up to 26 sessions then levels off) success = (qualities of client + qualitites of therapist) + effective method for given problem |
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