abnormal psych psychological disorders -...

Abnormal Psych

Chapter 16

Psychological Disorders


1. Define abnormal vs. normal

2. Distinguish b/w methods of deciding normality

3. Recognize and use the bell-shaped curve showing normal

4. Develop and analyze surveys to determine normal personality qualities and behaviors


1. Normal/ Abnormal: Who decides?

2. Group Survey Creation

3. Individual survey Completion

4. Results tabulation and presentation of results


1. Quiz 16-1/ Developmental Review Sheets on Desk/ EC on Desk

2. Calendar Review

3. Developmental Test Review

4. Abnormal Project

HW: 16-2, Review U1 (Prologue & Ch 1)

EC Due


16-1 619-626

Perspectives on Psychological Disorders: Medical Model, Pinel, Bio-Psycho-Social Perspective, DSM-IV, Diagnostic Labeling, Rosenhan

z 1. Identify the criteria for judging whether behavior is psychologically disordered.

z 2. Describe the medical model of psychological disorders, and discuss the bio-psycho-social perspective offered by critics of this model.

z 3. Describe the aims of DSM-IV and discuss the potential dangers associated with the use of diagnostic labels.


! Psychological Disorder

! a “harmful dysfunction” in which behavior is judged to be:

! atypical--not enough in itself

! disturbing--varies with time and culture

! maladaptive--harmful

! unjustifiable--sometimes there’s a good reason


! 5 Axes of the DSM-IV

! Axis I- addresses clinical syndromes & major disorders: schizo, anxiety dis, dis diag in infancy, childhood, adolesc, somatoform dis, sexual dis, delirium, amnesia, dementia

<<all disorders other than Personality & MR>>

! Axis II- personality disorders; MR

! Axis III – Gen Med Conditions relevant to understanding/ managing the disorder (Hypothyrodism-Depression)

! Axis IV-Psychosocial & Environmental Problems that may affect diagnosis, treatment, prognosis of mental disorders (housing, economic, family)

! Axis V-rep global assessment of person’s level of functioning. (90 indicates minimal symptoms & 1 maximal –ie. viol subj likely to harm others)

Historical Perspective

! Perceived Causes

! movements of sun or moon

! lunacy--full moon

! evil spirits

! Ancient Treatments

! exorcism, caged like animals, beaten, burned, castrated, mutilated, blood replaced with animal’s blood, bloodletting


! Phillipe Pinel –France early 1800s – said madness was sickness of mind, not demon posession, unchained patients and talked to them

! Led to Medical Model in 1800s (hospitals replaced asylums)

! Medical Model

! concept that diseases have physical causes

! can be diagnosed, treated, and in most cases, cured

! assumes that these “mental” illnesses can be diagnosed on the basis of their symptoms and cured through therapy, which may include treatment in a psychiatric hospital


Cross-Cultural Analysis

! Environmental effects evident from cross-cultural analysis:

! Dep and Schizo present worldwide

! Anorexia & Bulimia – Western

! Susto- Latin America; severe anxiety, restlessness, fear of black magic

! Taijin-kyofusho-Japan; social anxiety of appearance, blushing & fear of eye contact


! Today, mental health workers agree that disorders influenced by:

! genes

! physiological states

! inner psychological dynamics

! social-cultural

! circumstances

! Bio-Psycho-Social Perspective

! assumes that biological, sociocultural, and psychological factors combine and interact to produce psychological disorders

Psychological

Disorders--Etiology

! DSM-IV! American Psychiatric Association’s Diagnostic and

Statistical Manual of Mental Disorders (Fourth Edition)

! a widely used system for classifying psychological disorders

! presently distributed as DSM-IV-TR (text revision)

! 17 categories of mental disorders & neurotic disorders & psychotic disorders

! Most Health insurance companies require diagnosis w DSM-IV to pay for therapy

Anxiety Disorders

! Anxiety Disorders

! distressing, persistent anxiety or maladaptive behaviors that reduce anxiety

! Generalized Anxiety Disorder

! person is tense, apprehensive, and in a state of autonomic nervous system arousal

Anxiety Disorders

! Panic Disorder

! marked by a minutes-long episode of

intense dread in which a person

experiences terror and accompanying

chest pain, choking, or other frightening

sensation

Anxiety Disorders

! Phobia

! persistent, irrational fear of a specific object

or situation

! Obsessive-Compulsive Disorder

! unwanted repetitive thoughts (obsessions)

and/or actions (compulsions)

Anxiety Disorders

! Common and uncommon fears

Anxiety Disorders

Anxiety Disorders

! PET Scan of brain of

person with Obsessive/

Compulsive disorder

! High metabolic activity

(red) in frontal lobe

areas involved with

directing attention

16-2 Mood Disorders

20

Mood Disorders

! Mood Disorders

! characterized by emotional extremes

! Major Depressive Disorder

! a mood disorder in which a person, for no apparent reason, experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities

! Dysthymic Disorder- less extreme than MJD, but longer lasting (“the blues”)

41

Major Depressive Disorder

Depression is the “common cold” of psychological disorders. In a year, 5.8% of men and 9.5% of women

report depression worldwide (WHO, 2002).

Chronic shortness of breath

Gasping for air after a hard run

Major Depressive Disorder

Blue mood

Mood Disorders-Depression

! Major Depressive Disorder

! a mood disorder in which a person, for no apparent reason, experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities

! Dysthymic Disorder- less extreme than MJD, but longer lasting (“the blues”)

2343

Dysthymic Disorder

Dysthymic disorder lies between a blue mood and major depressive disorder. It is a disorder characterized by daily depression

lasting two years or more.

Major Depressive

Disorder

Blue

Mood

Dysthymic

Disorder

Mood Disorders-Depression Mood Disorders-Depression

! Canadian depression rates

Mood Disorders

! Manic Episode! a mood disorder marked by a

hyperactive, wildly optimistic state

! Bipolar Disorder! a mood disorder in which the person

alternates between the hopelessness and lethargy of depression and the overexcited state of mania

! formerly called manic-depressive disorder

44

Bipolar Disorder

Formerly called manic-depressive disorder. An alternation between depression and

mania signals bipolar disorder.

Multiple ideas

Hyperactive

Desire for action

Euphoria

Elation

Manic Symptoms

Slowness of thought

Tired

Inability to make decisions

Withdrawn

Gloomy

Depressive Symptoms

45

Bipolar Disorder

Many great writers, poets, and composers su!ered from bipolar disorder. During their

manic phase creativity surged, but not during their depressed phase.

Whitman Wolfe Clemens Hemingway

Bettm

ann/ C

orb

is

Georg

e C

. Bere

sfo

rd/ H

ulto

n G

etty

Pic

ture

s L

ibra

ry

The G

ranger C

olle

ctio

n

Earl T

heis

sen/ H

ulto

n G

etty

Pic

ture

s L

ibra

ry

Mood Disorders-Bipolar

! PET scans show that brain energy consumption

rises and falls with emotional switches

Depressed state Manic state Depressed state

46

Theory of Depression

Since depression is so prevalent worldwide, investigators want to develop a theory of

depression that will suggest ways to treat it.

Lewinsohn et al., (1985, 1995) note that a theory of depression should explain the

following:

1. Behavioral and cognitive changes

2. Common causes of depression

47

Theory of Depression

3. Gender di!erences

Mood Disorders- Suicide

50

Biological Perspective

Genetic Influences: Mood disorders run in families. The rate of depression is higher in identical (50%) than fraternal twins (20%).

Linkage analysis and

association studies

link possible genes

and dispositions for

depression.Je

rry Irw

in P

hoto

gra

phy

51

Neurotransmitters &

Depression

Post-synapticNeuron

Pre-synapticNeuron

NorepinephrineSerotonin

A reduction of

norepinephrine and

serotonin has been

found in

depression.

Drugs that alleviate

mania reduce

norepinephrine.53

Social-Cognitive

PerspectiveThe social-cognitive perspective suggests

that depression arises partly from self-defeating beliefs and negative explanatory

styles.

Mood Disorders-Depression

! The vicious

cycle of

depression

can be

broken at

any point

55

Example

Explanatory style plays a major role in

becoming depressed.

Schizophrenia &

Personality Disorders

16-3 646-657

Schizophrenia: Symptoms, Subtypes, Biological and Psychological Factors; Personality Disorders; Prevalence of Psych Disorders

1. Explain the development of mood disorders, paying special attention to the biological and social-cognitive perspectives.

2. Describe the various symptoms and types of schizophrenia, and discuss research on its causes.

3. Describe the nature of personality disorders, focusing on the characteristics of the antisocial personality disorder.

4. Describe the characteristics and possible causes of dissociative identity disorder.

5. Describe the prevalence of various disorders and the timing of their onset.

Dissociative Disorders

! Dissociative Disorders

! conscious awareness becomes separated

(dissociated) from previous memories,

thoughts, and feelings

! Dissociative Identity Disorder

! rare dissociative disorder in which a person

exhibits two or more distinct and alternating

personalities

! formerly called multiple personality disorder

Schizophrenia

! Schizophrenia

! literal translation “split mind”

! a group of severe disorders

characterized by:

! disorganized and delusional thinking

! disturbed perceptions

! inappropriate emotions and actions

Schizophrenia

! Delusions

! false beliefs, often of persecution or

grandeur, that may accompany

psychotic disorders

! Hallucinations

! sensory experiences without sensory

stimulation

Schizophrenia

56

Schizophrenia

If depression is the common cold of psychological disorders, schizophrenia is

the cancer.

Nearly 1 in a 100 su!er from schizophrenia, and throughout the world over 24 million people su!er from this

disease (WHO, 2002).Schizophrenia strikes young people as they

mature into adults. It a!ects men and women equally, but men su!er from it

more severely than women. 57

Symptoms of Schizophrenia

The literal translation is “split mind.” A group of severe disorders characterized by

the following:

1. Disorganized and delusional thinking.

2. Disturbed perceptions.

3. Inappropriate emotions and actions.

58

Other forms of delusions include, delusions of persecution (“someone is following me”) or

grandeur (“I am a king”).

Disorganized &

Delusional ThinkingThis morning when I was at Hillside [Hospital], I

was making a movie. I was surrounded by movie stars … I’m Marry Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday.”

This monologue illustrates fragmented, bizarre thinking with distorted beliefs called delusions (“I’m Mary Poppins”).

59

Disorganized & Delusional

Thinking

Many psychologists believe disorganized thoughts occur because of selective

attention failure (fragmented and bizarre thoughts).

60

Disturbed Perceptions

A schizophrenic person may perceive things that are not there (hallucinations).

Frequently such hallucinations are auditory and lesser visual, somatosensory, olfactory,

or gustatory.

L. B

erth

old

, Untitle

d. T

he P

rinzhorn

Colle

ctio

n, U

niv

ers

ity o

f Heid

elb

erg

August N

atte

r, Witc

hes H

ead. T

he P

rinzhorn

Colle

ctio

n, U

niv

ers

ity o

f Heid

elb

erg

Photo

s o

f pain

tings b

y K

rannert M

useum

, Univ

ers

ity o

f Illinois

at U

rbana-C

ham

paig

n

61

Inappropriate Emotions &

Actions

A schizophrenic person may laugh at the news of someone dying or show no

emotion at all (apathy).

Patients with schizophrenia may continually rub an arm, rock a chair, or remain motionless for hours (catatonia).

62

Subtypes of Schizophrenia

Schizophrenia is a cluster of disorders. These subtypes share some features, but

there are other symptoms that di!erentiate these subtypes.

63

Positive and Negative

Symptoms

Schizophrenics have inappropriate symptoms (hallucinations, disorganized

thinking, deluded ways) that are not present in normal individuals (positive

symptoms).

Schizophrenics also have an absence of appropriate symptoms (apathy,

expressionless faces, rigid bodies) that are present in normal individuals (negative

symptoms).

64

Chronic and Acute

Schizophrenia

When schizophrenia is slow to develop (chronic/process) recovery is doubtful.

Such schizophrenics usually display negative symptoms.

When schizophrenia rapidly develops (acute/reactive) recovery is better. Such

schizophrenics usually show positive symptoms.

65

Subtypes

66

Understanding

Schizophrenia

Schizophrenia is a disease of the brain exhibited by the symptoms of the mind.

Dopamine Overactivity: Researchers found that schizophrenic patients express higher

levels of dopamine D4 receptors in the brain.

Brain Abnormalities

67

Abnormal Brain ActivityBrain scans show abnormal activity in the frontal cortex, thalamus, and amygdala of

schizophrenic patients. Adolescent schizophrenic patients also have brain

lesions. Paul T

hom

pson a

nd A

rthur W

. Toga, U

CLA

Labora

tory

of N

euro

Imagin

g a

nd Ju

dith

L. R

apport, N

atio

nal In

stitu

te o

f Menta

l Health 68

Abnormal Brain

Morphology

Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles.

Both

Photo

s: C

ourte

sy o

f Danie

l R. W

ein

berg

er, M

.D., N

IH-N

IMH

/ N

SC

69

Viral Infection

Schizophrenia has also been observed in individuals who contracted a viral infection

(flu) during the middle of their fetal development.

70

Genetic Factors

The likelihood of an individual su!ering from schizophrenia is 50% if their identical twin has the disease (Gottesman, 1991).

0 10 20 30 40 50

Identical

Both parents

Fraternal

One parent

Sibling

Nephew or niece

Unrelated 71

Genetic Factors

The following shows the prevalence of schizophrenia in identical twins as seen in

di!erent countries.

72

Psychological Factors

Psychological and environmental factors can trigger schizophrenia if the individual

is genetically predisposed (Nicols & Gottesman, 1983).

Genain Sisters

The genetically identical Genain

sisters su!er from schizophrenia. Two

more than others, thus there are contributing environmental factors.

Courte

sy o

f Genain

Fam

ily

73

Warning SignsEarly warning signs of schizophrenia

include:

Birth complications, oxygen deprivation

and low-birth weight. 2.

Short attention span and poor muscle coordination.

3.

Poor peer relations and solo play.6.

Emotional unpredictability.5.

Disruptive and withdrawn behavior.4.

A mother’s long lasting schizophrenia.1.

Somatoform Disorders

• Somatoform disorders are

problems that appear to be

physical or medical but are due

to psychosocial factors– Not faking (Factitious Disorder-Munchausen

[by proxy])

62


• Hypochondriasis

– People with hypochondriasis unrealistically

interpret bodily symptoms as signs of serious

illness

– Often their symptoms are merely normal bodily

changes, such as occasional coughing, sores, or

sweating

• Although some patients recognize that their

concerns are excessive, many do not63


• Conversion disorder

– In this disorder, a psychosocial conflict or need is converted into dramatic physical symptoms that affect voluntary or sensory functioning

– Symptoms often seem neurological, such as paralysis, blindness, or loss of feeling

– Most conversion disorders begin between late childhood and young adulthood

– They are diagnosed in women twice as often as in men

– They usually appear suddenly and are thought to be rare

64


• Body dysmorphic disorder (BDD)

– This disorder, also known as dysmorphophobia, is

characterized by deep and extreme concern over

an imagined or minor defect in one’s appearance

– Foci are most often wrinkles, spots, facial hair, or

misshapen facial features (nose, jaw, or eyebrows)

– Most cases of the disorder begin in adolescence

but are often not revealed until adulthood

– Up to 2% of people in the U.S. experience BDD,

and it appears to be equally common among

women and men65

16-4 Personality Disorders

66

74


Personality disorders are characterized by

inflexible and enduring behavior

patterns that impair social functioning. They are usually without anxiety, depression, or

delusions.

Cluster A

(odd or eccentric disorders)

• Paranoid personality disorder:

characterized by irrational suspicions and

mistrust of others.

• Schizoid personality disorder: lack of

interest in social relationships, seeing no

point in sharing time with others.

• Schizotypal personality disorder:

characterized by odd behavior or thinking.

68

Cluster B

(dramatic, emotional or erratic disorders)

• Antisocial personality disorder: a pervasive disregard for the law and the rights of others.

• Borderline personality disorder: extreme "black and white" thinking, instability in relationships, self-image, identity and behavior often leading to self-harm and impulsivity. Borderline personality disorder occurs in 3 times as many females as males.

• Histrionic personality disorder: pervasive attention-seeking behavior including inappropriate sexual seductiveness and shallow or exaggerated emotions.

• Narcissistic personality disorder: a pervasive pattern of grandiosity, need for admiration, and a lack of empathy.69

Cluster C

(anxious or fearful disorders)

• Avoidant personality disorder: social

inhibition, feelings of inadequacy, extreme

sensitivity to negative evaluation and

avoidance of social interaction.

• Dependent personality disorder: pervasive

psychological dependence on other people.

• Obsessive-compulsive personality disorder

(not the same as obsessive-compulsive

disorder): characterized by rigid conformity to

rules, moral codes and excessive orderliness.70 75

Antisocial Personality Disorder

A disorder in which the person (usually men) exhibits a lack of conscience for wrongdoing,

even toward friends and family members. Formerly, this person was called a sociopath

or psychopath.

Sociopath vs. Psychopath

• Sociopath- Erratic, tend to leave several clues and evidence. Unable to maintain normal relationships– Jeffrey Dahmer, Ted Kaczynski, Klebold/Harris, Timothy

McVeigh

• Psychopath- Controlled, tend to have well planned crimes, try not to leave any clues behind. Appear normal in their social relationships– Ted Bundy, Charles Manson, Richard Ramirez, David

Berkowitz, BTK72

76

Understanding Antisocial Personality Disorder

Like mood disorders and schizophrenia,

antisocial personality disorder has

biological and psychological reasons.

Youngsters, before committing a crime, respond with lower

levels of stress hormones than others

do at their age.77


PET scans of 41 murderers revealed reduced activity in the frontal lobes. In a follow-up study repeat o!enders had 11% less frontal lobe activity compared to normals (Raine et

al., 1999; 2000).

Normal Murderer

Courte

sy o

f Adria

n R

ain

e,

Univ

ers

ity o

f South

ern

Califo

rnia

78


The likelihood that one will commit a crime doubles when childhood poverty is

compounded with obstetrical complications (Raine et al., 1999; 2000).

80

Rates of Psychological Disorders

The prevalence of psychological disorders during the previous year is shown below

(WHO, 2004).

79

Rates of Psychological Disorders

81

Risk and Protective Factors

Risk and protective factors for mental disorders (WHO, 2004).

82

Risk and Protective FactorsLow Socioeconomic Class

•Why?

80


! Personality Disorders

! disorders characterized by inflexible and

enduring behavior patterns that impair

social functioning

! usually without anxiety, depression, or

delusions


! Antisocial Personality Disorder

! disorder in which the person (usually

man) exhibits a lack of conscience for

wrongdoing, even toward friends and

family members

! may be aggressive and ruthless or a

clever con artist


! PET scans illustrate reduced activation in a

murderer’s frontal cortexNormal Murderer


Rates of Psychological

Disorders

Chapter 17

Therapy

17-1 659-664

Psychological Therapies: Dix, Psychoanalysis - Methods, Psychodynamic Therapy; Freud, Humanistic-Client Centered Therapy, Active Listening, UPR, Maslow, Rogers

1. Discuss the aims and methods of psychoanalysis, and explain the critics’ concerns with this form of therapy, noting how psychodynamic therapists have tried to answer the criticisms.

2. Identify basic characteristics of the humanistic therapies and the specific goals and techniques of client-centered therapy.

z 17-2 664-673

z Behavior Therapies: Classical Conditioning Therapies-Counterconditioning (Exposure Therapies--Systematic Desensitization, Vrtual Reality Exposure Therapy; Aversive Conditioning), Operant Conditioning Therapy-Token Economy, Cognitive Therapy, CBT, Group & Family Therapy

z

z 3. Identify the basic assumptions of behavior therapy, and discuss the classical conditioning techniques of systematic desensitization and aversive conditioning.

z 4. Describe therapeutic applications of operant conditioning principles, and explain the critics’ concerns with this behavior modification process.

z 5. Describe the assumptions and goals of the cognitive therapies and their application to the treatment of depression.

z 6. Describe the rationale and benefits of group therapy, including family therapy.

1. States of Consciousness Q/A

2. States of Consciousness Review Quiz

3. Review Test Essay

4. Project Presentations

5. HW: 17-4, Practice Essays – Bring on Disk or Flash Drive

1. States of Consciousness Q/A

2. States of Consciousness Review Quiz

3. IB Exam Prep

4. Review Test Essay

5. HW: 17-4, Practice Essays – Bring on Disk or Flash Drive

z 17-3 674-684

z Evaluating Psychotherapy: Effectiveness of Psychotherapy, Meta-

Analysis, Alternative Therapies: Therapeutic Touch, EMDR, Light

Exposure Therapy, Commonalities of Therapies, Types of Therapists

z 7. Discuss the findings regarding the effectiveness of the psychotherapies,

and explain why

ineffective therapies are often mistakenly perceived to be of value.

z 8. Describe the commonalities among the psychotherapies, and discuss

the role of values and

cultural differences in the psychotherapeutic process.

1. 17-4 Quiz


3. Essay Review

4. Review Confusing Pairs/ Fond Remb/ People Packet

5. HW: Disorders & Therapies- Take Home Tests on Web

2 Sheets of Paper

Take Both, Check Answers, then create test review sheet and create notes for missed questions (if you missed 10 items, you should have 10 annotations for notes)

1. 17-4 Quiz


3. Review M.C.

4. Review Confusing Pairs/ Fond Remb/ People Packet

5. HW: Online

Disorders & Therapies- Take Home Tests on Web, can work w/ partner

Review Essay Rubrics

**FRI Review Session in S-7, 2:15-3:15 (Con’t be Late)….EC???

Deinstitutionalization – 50s, sparked by Thorazine

Dissociative Disorders

z Dissociative Amnesia – forget after trauma

z Dissociative Fugue- flee and forget after trauma

z Dissociative Identity Disorder-multiple personality disorder

Conversion Disorder-convert psychological distress into medical problem

Somatoform Disorders-

z Hypochondriasis – misinterpret normal bodily changes/ functions as abnormal

z Conversion Disorder-convert psychological distress into medical problem

Extra Items Notes:

Hans Selye

z 17-4 685-693

z Biomedical Therapies: Drug Therapies-Anitpsychotics, Antianxietys,

Antidepressants, Mood Stabilizers-lithium, ECT, Psychosurgery-lobotomy

z 9. Identify the common forms of drug therapy.

z 10. Describe the use of electroconvulsive therapy and psychosurgery in the

treatment of psychological disorders.

History of Treatment

Therapy

! Psychotherapy

! an emotionally charged, confiding interaction

between a trained therapist and someone

who suffers from psychological difficulties

! Eclectic Approach

! an approach to psychotherapy that,

depending on the client’s problems, uses

techniques from various forms of therapy

Therapy-

Psychoanalysis

! Psychoanalysis

! Freud believed the patient’s free associations,

resistances, dreams, and transferences – and

the therapist’s interpretations of them –

released previously repressed feelings,

allowing the patient to gain self-insight

! use has rapidly decreased in recent years

! Resistance

! blocking from consciousness of anxiety-laden

material

Therapy-

Psychoanalysis

! Interpretation

! the analyst’s noting supposed dream

meanings, resistances, and other significant

behaviors in order to promote insight

! Transference

! the patient’s transfer to the analyst of

emotions linked with other relationships! e.g. love or hatred for a parent

Humanistic Therapy

! Client-Centered Therapy

! humanistic therapy developed by Carl

Rogers

! therapist uses techniques such as active

listening within a genuine, accepting,

empathic environment to facilitate

clients’ growth

Humanistic Therapy

! Active Listening-empathic listening in which the

listener echoes, restates, and clarifies

Behavior Therapy

! Behavior Therapy

! therapy that applies learning principles to the

elimination of unwanted behaviors

! Counterconditioning

! procedure that conditions new responses to

stimuli that trigger unwanted behaviors

! based on classical conditioning

! includes systematic desensitization and

aversive conditioning

Behavior Therapy

! Exposure Therapy

! treat anxieties by exposing people (in imagination

or reality) to the things they fear and avoid

Behavior Therapy

! Systematic Desensitization

! type of counterconditioning

! associates a pleasant, relaxed state with

gradually increasing anxiety-triggering stimuli

! commonly used to treat phobias

! Aversive Conditioning

! type of counterconditioning that associates an

unpleasant state with an unwanted behavior

! nausea ---> alcohol (eg. Antabuse)

Behavior Therapy

! Systematic Desensitization

Behavior Therapy

! Aversion

therapy

for

alcoholics

(eg.

Antabuse)

Behavior Therapy

! Token Economy! an operant conditioning procedure that rewards desired behavior

! patient exchanges a token of some sort, earned for exhibiting the desired behavior, for various privileges or treats

Cognitive Therapy

! Cognitive Therapy ! teaches people new, more adaptive ways of thinking and acting

! based on the assumption that thoughts intervene between events and our emotional reactions

Cognitive Therapy

! The

Cognitive

Revolution

Cognitive Therapy

! A cognitive

perspective

on

psychological

disorders

Cognitive Therapy

! Cognitive

therapy for

depression

Cognitive Therapy

! Cognitive-Behavioral Therapy

! a popular integrated therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior)

Group and Family

! Family Therapy

! treats the family as a system

! views an individual’s unwanted

behaviors as influenced by or directed

at other family members

! attempts to guide family members

toward positive relationships and

improved communication

Evaluating

! To whom do

people turn

for help for

psychological

difficulties?

Evaluating

! Regression toward the mean! tendency for extremes of unusual

scores to fall back (regress) toward their average

! Meta-analysis! procedure for statistically combining the

results of many different research studies

Evaluating

Poor outcome Good outcome

Averageuntreated

person

Averagepsychotherapy

client

Number ofpersons

80% of untreated people have pooreroutcomes than average treated person

Evaluating

Therapists and their

Training

! Clinical psychologists

! Most are psychologists with a Ph.D. and

expertise in research, assessment, and

therapy, supplemented by a supervised

internship

! About half work in agencies and

institutions, half in private practice


Training

! Clinical or Psychiatric Social Worker! A two-year Master of Social Work

graduate program plus postgraduate supervision prepares some social workers to offer psychotherapy, mostly to people with everyday personal and family problems

! About half have earned the National Association of Social Workers’ designation of clinical social worker


Training

! Counselors! Marriage and family counselors

specialize in problems arising from family relations

! Pastoral counselors provide counseling to countless people

! Abuse counselors work with substance abusers and with spouse and child abusers and their victims


Training

! Psychiatrists

! Physicians who specialize in the

treatment of psychological disorders

! Not all psychiatrists have had extensive

training in psychotherapy, but as M.D.s

they can prescribe medications. Thus,

they tend to see those with the most

serious problems

! Many have a private practice

Biomedical Therapies

! Psychopharmacology

! study of the effects of drugs on mind

and behavior

! Lithium

! chemical that provides an effective drug

therapy for the mood swings of bipolar

(manic-depressive) disorders

Biomedical Therapies

! The emptying of U.S. mental hospitals

Biomedical Therapies Biomedical Therapies Biomedical Therapies

! Electroconvulsive Therapy (ECT)

! therapy for severely depressed patients in

which a brief electric current is sent through

the brain of an anesthetized patient

! Psychosurgery

! surgery that removes or destroys brain tissue

in an effort to change behavior

! lobotomy

! now-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients

Electroconvulsive Mind-Body Interaction

abnormal psych psychological disorders -...

Documents