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Abnormal Psych Midterm Essay Q’s

1. Outline the definitions of abnormal behavior discussed in the text and in class. Compare and contrast the definitions of abnormal behavior in terms of their strengths and weaknesses. What definition of “abnormal behavior” do you think is best? Defend your answer. Using your preferred definition, how would you have labeled the activities portrayed in the “monkey brains” or the brain trephination video segments? Use other video clips shown in class to characterize each of the other definitions of “abnormal” presented in class and in the text.

Abnormal Behavior definition Strengths WeaknessesTextbook Definition: found on page 2 of book: a psychological dysfunction within an individual that is associated with distress or impairment in functioning and a response that is not typical or culturally expected

Gives a broad definition that can be used in different cultures

From page 4 of book: “difficult to define normal and abnormal”Vague because you need to know what psychological dysfunction is, what personal distress is, and what atypical/culturally different expectations are

DSM-IV-TR definition found on page 4 of book: behavioral, psychological, or biological dysfunctions that are unexpected in their cultural context and associated with persistent distress and impairment in functioning, or increased risk of suffering, death, pain, or impairment

From page 4 of book: talks about how it can be used as a definition across different cultures and subcultures as long as you focus on what is functional and dysfunctional in a given culture

From page 4 of book: there is no way to truly define the words “disease” and “disorder” for every culture and subculture.

Definition from lecture #1: Jamner gives the direct definition that I have already put from page 2 of the book but expands on it with definitions of the main parts: Abnormal behavior has one or more of the following features. . . Dysfunction: the behavior or feelings cause the person or others significant stressDistress: the behavior or feelings cause the person or others significant distressDeviance: The behavior or feelings are highly unusual.

The meaning of the maladaptive behaviors are clearly defined as to what they are

What is seen as “normal” in one culture and comfortable to people can be seen as “abnormal” and “distressing” in another culture.

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*One or all of these features mean that the behavior is maladaptive or seen as abnormal*

In my opinion, the best definition is the one provided by the DSM-IV-TR for a couple of different reasons. First, it is the most commonly used definition of abnormal behavior that psychologists and clinicians can reference regardless of the culture or subculture they are apart of. Also, the definition is the clearest and least vague of the three.

With my favorite definition in mind, I would label the “monkey brains” video as abnormal behavior because the people participating in the eating of the monkey brains were tourists who were behaving in a manner that in the culture they were apart of would be normal but since they were not apart of that culture and know in their own society they would be seen as deviants their behavior to me is abnormal. But, the “trephination” video in my opinion is not abnormal behavior because the society that they are in views this trephination by a witch doctor to be normal and cleansing for the person having the holes put into their skulls. If someone not from that culture participated in the act, I would say they would be abnormal but since it is a societal accepted behavior, it is not abnormal. Another example of a video clip is the woman who pulls her hair out and eats the root in order to temporarily feel better and calm her anxiety. This behavior can be seen as abnormal because the action of pulling out her hair by the root is slowly ridding herself of her hair which causes her social embarrassment when she goes out in public. Also, it can be seen as abnormal because the behavior leaves her distressed when she goes in public and people can see her partially bald scalp. Finally, the behavior can be seen as deviant because the action of pulling out your hair and consuming the root is not considered “normal” in society.

2. Compare the Freudian psychodynamic perspective the cognitive perspective and the behavioral perspective in terms of their view of the world, basic drives and motives, and how they contribute to the development of psychopathology. Discuss their basic differences. Describe how these different perspectives produced the disparate treatment approaches used by each perspective. Psychoanalytic perspective: practice and treatment of psychoanalysisPsychodynamic perspective: the actual theory that psychoanalytic psychologists useFreudian perspective: pathology due to poor psychological development, social context, conflict of basic drives

Perspective Freudian Psychodynamic: pg 21 of book. It has 7 parts to it.a focus on affect and the

expression of patients’ emotionsan exploration of patients’

Cognitive:cognitive

processes are at the center of

behavior, thought,

Behavioral:The Behavioral Model: also known as the

cognitive-behavioral or social learning model. . . from page 23: explanation of human behavior, including dysfunction, based on principles of

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attempts to avoid topics or engage in activities that hinder

the progress of therapythe identification of patterns in

patients’ actions, thoughts, feelings, experiences, and

relationshipsan emphasis on past experiences

a focus on patients’ interpersonal experiences

an emphasis on the therapeutic relationship

an exploration of patients’ wishes, dreams or fantasies

and emotions learning and adaptation derived from experimental psychology.

Our actions are determined largely by our experiences in life

View of the World

A constant struggle of our subconscious drives, anxiety

from those conflicts, and usage of defense mechanisms

What happens in the mind is at the center of how to

fix things.

It is only about our responses to our environment

Basic Drives and

Motives

Id: source of strong sexual and aggressive desires (pleasure

principle)Ego: makes sure we act

realistically (reality principle)Super Ego: represents our

conscience that we learn from family and society (moral

principles)

Thoughts Behavior

How they contribute to the develop-

ment of psycho-

pathology

The ego must be able to mediate between the id and superego so that everything stays balanced.If the ego loses control and the ego and superego take control,

psychological disorders can develop (Page 18).

Defense mechanisms: used by the ego when anxiety develops.

These are unconscious mechanisms to help the ego get

everything back in check. Examples: reaction formation,

repression, displacement, sublimation, and rationalization

(page 18).

Cognitive Therapy: help

clients recognize the negative

thoughts, biased interpretations,

and errors in logic that dominate their thinking and cause

them to be depressed.

illogical thought processes

overgeneralizationmake

assumptions/mal-adaptive attitudes

Conditioning: simple forms of learningModeling: learn responses by watching and

imitating others (Bobo clown study)Therapy is short term

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Discuss their basic differences

page 21: “psychodynamic therapists deemphasize the goal of personality reconstruction, focusing instead on relieving the suffering associated with

psychological disordersTherapy is long term

Allows for thought which is different from behavioral

modelUsed a lot with

behavioral therapies

Not worried about our thoughts or underlying drives.

Therapy is short term

How these different

perspectives produced

the disparate treatment

approaches used by

each perspective

Reduction of symptoms only happens if the conflict is dealt

with. Free association: technique intended to explore threatening material repressed

into the unconscious. The patient is instructed to say whatever comes to mind

without censoring. Dream analysis: dream contents are examined as symbolic of id impulses and intrapsychic

conflicts. Transference: concept suggesting that clients may seek to relate to the therapist as they

do to important authority figures, particularly their

parents. Counter transference: involving personal issues the

therapist brings to professional relationships with clients

Cognitive Therapy: help

clients recognize the negative

thoughts, biased interpretations,

and errors in logic that dominate their thinking and cause

them to be depressed.

illogical thought processes

overgeneralizationmake

assumptions/mal-adaptive attitudes

Bobo the clown study: the kids saw the adult hit the Bobo clown toy then they did it as well. If the adult

did not hit the clown the child did not either.Used in treating anxiety and phobias a lot due to its

exposure effect

3. What purposes does a defense mechanism serve? Identify 4 different defense mechanisms postulated by Freud. Describe 3 situations in which you or someone you know used specific defense mechanisms in the past month. Include the name of the defense mechanism you are describing. Describe at least one modern piece of scientific evidence that is consistent with the processes and constructs proposed by Freud.

Page 18 of the book as well as lecture #1 notes.Defense mechanisms have a very important purpose. They are there to help protect us from consciously thinking about either things that have happened to us physically or psychologically that if thought about consciously will upset us or traumatize us.

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4 different defense mechanisms postulated by Freud: from lecture #1 notesSublimation: Transformation of negative emotions or instincts into positive actions, behavior, or emotion. Regression: Temporary reversion of the ego to an earlier stage of development rather than handling unacceptable impulses in a more adult way. Rationalization: you come up with various explanations to justify the situation (while denying your feelings). Reaction Formation: You turn the feelings you have into the opposite of them. 3 situations in which you or someone you know used a specific defense mechanismMy friend John was very angry at his mother for taking his car away for coming home too late. Instead of yelling at her he went for a run. This is sublimation.My friend James recently got dumped by his girlfriend. Instead of wallowing in sadness, he tried to rationalize that it was better that he was single because it would give him more time to focus on his studies and job. This is rationalization.My friend Sarah was mad at her parents for deciding not to help her with her apartment rent. Instead of lingering in anger at her parents, she instead told herself that her parents were great for giving her this challenge of paying for her own apartment because it would build character for her. This is reaction formation.One modern piece of scientific evidence that is consistent with the processes and constructs proposed by Freud is a study done by Pollack & Andrews in 1989 that found that different psychological disorders do indeed seem to be associated with certain defense mechanisms (page 19 of book).

4. Choose two approaches to abnormal psychology (psychodynamic, behavioral, cognitive, biological, and sociocultural). Compare and contrast their approaches to clinical assessment. What types of assessment tools (e.g. projective tests, self-monitoring diaries, observation) reflect each of the following paradigms: psychodynamic, cognitive, biological, and behavioral.

Clinical Assessment Approach Comparisons ContrastsCognitive: Focus is on how a person’s

thoughts affect their behavior, thoughts, and emotions. This is similar to behavioral perspective because the thoughts in turn affect the behavior just like how experiences affect how people think about different things.

Allows for thoughts

Behavioral: our actions are determined largely by our experiences in life

Focus is on how experiences in life affect

Does not allow for thought

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*I am not really sure about the assessment tools if anyone has some thoughts here it would be much appreciated*The assessment tools that reflect. . . Psychodynamic: Self-monitoring, Analogue measures, Behavioral rating scales, Generalized or assimilative projection, Thematic apperception test, Rorschach test, sentence completion test. Projective Drawings: Projective drawings are expressive techniques in that they suggest aspects of the person while he or she is performing some activity.To obtain an accurate view of a person’s inner world, one must somehow circumvent unconscious defenses and conscious resistances.

Cognitive: Self-monitoring diaries, Self-monitoring, Beck depression inventory, Hamilton rating scale of anxiety, Daily mood rating scale.

Biological: Mental Status exam, Self-monitoring, Behavioral, Analogue measures, Behavioral rating scales, Mental Status Exam

5. Define the importance of reliability and validity of the methods used for clinical assessment. Give an example of how a test can be highly reliable but not valid; very valid but unreliable. How do these constructs related to the major problems in assessment?-Clinical assessment: the systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder (Page 69 of book)-Reliability: the degree to which a measurement is consistent.-Validity: whether something measures what it is designed to measure.Reliability is important for the methods used in clinical assessment because if the results are not consistent with one another, the assessment is useless. An example would be someone going to four different doctors and all of them giving the same diagnosis. Validity is important for the methods used in clinical assessment because if the technique does not measure what it is supposed to, the study was done for no reason since the results will be worthless.An example of how a test can be highly reliable but not valid is using a ruler to measure length but when you try and use it to measure volume, it is not valid.An example of how a test can be very valid but unreliable is a qualitative study where you were able to find out disorders for people you spoke with that could discuss their issues to you but you were not able to figure out the disorders of people who did not speak with you clearly in the qualitative study.In other words, if someone was doing a study that found 4 conflicting reasons for why a certain behavior occurred, there would be little reliability in the findings.These constructs are related to the major problems in assessment in a couple of ways. Some examples that can lead to problems are a person's motivation, anger, personality, intelligence, love, attachment, or fear.For example asking high school students to report how many times they missed class last year is a valid measure of academic dedication, however due to problems of recollection and misrepresentation, it is not a particularly reliable measure.

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6. Characterize the symptoms associated with panic disorder using examples from the text or video segments shown in class. How does each of the psychological approaches explain panic and agoraphobic anxiety disorders? How are their respective explanations reflected in their preferred treatments?

Panic attack is defines as an abrupt experience of intense fear or acute discomfort, accompanied by physical symptoms that usually include heart palpitations, chest pain, shortness of breath, and dizziness. This symptoms are exemplified by the story in our text about the woman who was bound to her home for fear of panic attacks. She could not even look out the front door of her house into the hallway for fear of a panic attack. 3 basic types of panic attacks:situationally bound- known fearful situations where panic attacks occur only in those situations. This is someone who is afraid of heights or small spaces. unexpected- no clue when the next attack will occursituationally predisposed- more likely to experience attacks where they’ve happened before.Agoraphobia is a fear of being in places where escape might be difficult, or where help might not be available. To avoid being in situations that may induce panic.Psychoanalytic explanation: controlling parents or being shy as children influenced their stages of development and resulted in them developing panic disorder. The preferred treatment would to a long series of psychoanalytic sessions to discover the underlying reasons why they have panic attacks.Cognitive explanation: people interpret certain bodily sensations as dangerous, like a person running would interpret the fast beating of their heart as a sign that they are about to have a panic attack. The preferred treatment would be to Behavioral explanation: people learn that certain things or situations cause them to panic, so they learn to avoid those situations to avoid the panic associated with them. The preferred treatment would involve gradually exposing these people to the situations Meds are effective while people are taking them, but once they are stopped the symptoms often quickly returnGreatest effects may be in combination with therapyPsych interventions-situation-exposure tasksGradual group exposures with relaxation or breathing trainingPanic control treatment- therapist induces panic-like symptoms, and then teaches coping strategies to reduce anxiety caused by somatic disorders

7. Discuss the evidence for a biological basis of anxiety disorders (Be sure to provide at least 3 separate pieces of evidence). Does Generalized Anxiety Disorder differ from any of the other anxiety disorders in terms of its biological features? Pg 123

1. GAD tends to run in families, 2. GAD is more likely in twins if one has it strengthened on twin studies- inherited anxious traits and neuroticism; similar to GAD. 129-1302. Individuals with GAD are less responsive on most physiological measures (heart rate, Bp, skin conductance, and respiration rate) (unlike panic disorders)

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3. GAD individuals are chronically tense because they are highly sensitive to threats in general and particularly personal threats.This high sensitivity may come from early stressful experiences where they learned that the world is dangerous and they can’t handle it. Also this acute awareness of a personal threat is unconscious and seems automatic.People with GAD do not respond as strongly as individuals with anxiety disorders in which panic is more prominent. In terms of its biological features people GAD differ from other anxiety disorders because they generally have a lot of muscle tension, mental agitation and becoming fatigued easily.

8. What are the chief characteristics associated with obsessive-compulsive disorder? Provide several examples. Provide a brief description of the psychoanalytic, behavioral, cognitive, and biological views of the etiology of OCD. Evaluate the relative effectiveness of the various psychological and biological therapies that have been used to treat this disorder.

1. Obsession: Recurrent and persistent thoughts, impulses or images that are experienced at some time during the disturbance, as intrusive and inappropriate marked by anxiety or distress2. Compulsion: Repetitive behaviors (hand washing, ordering, checking) or mental acts (praying, counting, repeating words silently) that the person feels driven to perform in response to obsession

Psychoanalytic etiology: obsessions and compulsions reflect maladaptive responses to unresolved conflicts from early stages of psychological development. The symptoms of OCD symbolize the patient’s unconscious struggle for control over drives that are unacceptable at a conscious level. Thought –action-fusion caused by attitudes of excessive responsibility and guilt developed during childhood when a bad thought is associated with evil intentBiological etiology: people can inherit a general biological vulnerability to anxiety disorders.Behavioral etiology: people can learn that certain rituals calm their obsessions for a time.Cognitive etiology: People can have a general psychological vulnerability where they may believe that thoughts are equal to actions, so if they have an unacceptable thought they feel it is just as bad as the action

Psychoanalytic therapy: The goals of these forms of therapy are uncovering hidden motivations and gaining insight, it takes a very long time. Biological: Meds: SSRIs are effective, but relapse is common once meds are ceasedPsychological:. Exposure and ritual prevention- active prevention of rituals, and they are gradually exposed to what they fear, Flooding, restrictions, exposure e.g., can’t shower every day, have to use a gross toilet, these work better than medicationPsychosurgery- last resort, surgical lesion to the cingulate bundle, can be effective (30%)

9. Describe the similarities and differences between the somatoform disorders. Is it possible to distinguish conversion disorder from malingering? Provide an example of how this might be accomplished. On what basis would you classify fictitious disorder by proxy (Munchausen Syndrome) as child abuse rather than as a somatoform disorder? Defend your response.

Somatoform disorder – is marked by numerous recurring physical ailments w/o organic basis.

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Lasts longer than conversion disorder, psychological trauma translated into a physical experienceThey usually seek treatmentMust have 8 symptoms- 4 pain, 2 gastro, 1 sexual- sex becomes painful, no erection, 1 pseudo neurological- stroke like, muscle movements, vision problems Nothing wrong with body parts but report they doConversion disorder- generally has to do with a physical malfunction. That has no organic cause

Usually triggered by a stressful eventThey are generally not terribly upset about them, and they are genuinely unaware that

they are actually functional. No concern to go see a doctor, woke up one day and can’t walk… experience of a trauma = conversionGenuinely unaware of the source of these symptomsMalingering- Faking a malfunction, they are fully aware of their faking and are clearly attempting to manipulate others. There are clear gains to their playing sick (e.g. get out of work, win a settlement, etc.)To distinguish between conversion disorder and malingering you could administer a test to a person claiming to be blind. A conversion disorder person would perform at chance level, but a malingering person would perform well below chance due to the fact that they are trying to seem blinder than they are. Factitious disorder- symptoms are under voluntary control, but there is no obvious gain to playing sick, done just to get attention. Inflicting harm to self in order to get symptomsFactitious disorder by proxy- symptoms are induced by someone close to get attention, inflicting harm to others, usually its mom, who is hyper- involved in the treatment/ care, and loves the praise of taking care of the sick person. Usually the person knows a lot about the medical system. I would classify fictitious disorder by proxy as child abuse rather than as a somatoform disorder on the basis that the person is not pathologically concerted with the functioning of their bodies, which is the main classifying feature of somatoform disorders. The person is more concerned with getting attention or being praised as being a good mother than being concerned with their body and how it is operating.

10. For which somatoform disorders has exposure and response prevention treatment been used? Briefly, describe how it would be applied. Distinguish between Hypochondriasis Disorder, Illness Phobia, and Somatization Disorder –describe both their commonalities and the features that make each disorder a unique condition.

Hypochondriasis- severe anxiety is focused of having a serious disease; everything gets blown out of proportion. It shares many features with anxiety and mood disorders, particularly panic disorder. Treatment: explanatory therapy (175) where the doctor explains in detail, the source and origins of their symptoms.Illness phobia- a specific fear that one will become sickSeparate from the fear that you HAVE a disease Early age of onsetExposure and response prevention has been used with BDD due to the patients OCD like obsession with their appearance and compulsion like behavior of checking their appearance. Somatoform disorder – is marked by numerous recurring physical ailments w/o organic basis.Lasts longer than conversion disorder, psychological trauma translated into a physical experienceThey usually seek treatment

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Somatization Must have 8 symptoms- 4 pain, 2 gastro, 1 sexual- sex becomes painful, no erection, 1 pseudo neurological- stroke like, muscle movements, vision problems Nothing wrong with body parts but report they do

11. 11. It is said that almost individuals with mood disorders are also anxious, but not those with anxiety disorders are depressed. What features do the Mood Disorders share with Anxiety Disorders? Describe the characteristics that distinguish these two classes of disorders. How do these two groups differ in their etiology? Their treatment?

Mood disorders are similar to anxiety disorders in many ways. Both anxiety and depression share a sleep disturbance pattern. Distress is a common characteristic in the mood disorders as well as the anxiety disorders. Patients in both disorders may feel fatigue and irritable. The characteristics that distinguish these two classes of disorders are that people who are experiencing depression often have a lack of pleasure, a slowing of their motor and speech, depressed mood, loss of interest, lack of pleasure, suicidal ideation, diminished libido while people with anxiety apprehension, tension, edginess, trembling, excessive worry and nightmares.

The difference in the etiology of these two disorders could be due to many different factors. One could be general biological predisposition. Another could be environmental. People’s depression is sometimes triggered by a very tragic experience, such as the loss of a loved one, while anxiety is sometimes triggered by a very anxiety producing situation. The best treatment for those with depression is cognitive behavior therapy works well for individuals dealing with depression. CBT involves reframing the person’s state of mind. Instead of having a negative outlook a person can reverse it to a more positive, healthy one. In an anxiety disorder the therapist may assist the patient with rumination. The consist thought of something that cannot be changed is detrimentally to their health.

12. Identify 4 dissociative disorders. Describe the characteristics associated with the dissociative identity disorder (DID). What objective biological evidence is there supportive of the existence of DID? Why has the existence of DID been disputed by some clinicians.

The four dissociative disorders are dissociative identity disorder, dissociative amnesia, dissociative fugue, depersonalization disorder. Dissociative identity disorder is two or more distinct identities within a person. Each identity has particular traits and characteristics and can take control over the person’s behavior. When the person changes personalities it is called a switch. It is established that there is a biological vulnerability to this disorder. Biological evidence that supports DID ranges from people changing their blood pressure during a switch, changing handedness and changing brain functioning. Early childhood trauma can cause a person to develop dissociative identity disorder. Physical transformation occurs when a person changes into another identity. A characteristic of this disorder is changing genders. For example one identity may be a tall, young slim male while another may be an obese middle aged woman. The average number of identity a person with this disorder has is fifteen. Clinicians are in dispute whether people can fake having dissociative identity disorder. Individuals that have this disorder are suggestible. Therefore these identities could be created through hypnosis. People could be faking this disorder to escape from life stressors or to avoid responsibility for their actions. Therapist could also play a role in dissociative identity disorder.

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Therapist could be discussing early childhood trauma with the patient and this could trigger the patient into faking this disorder.

13. Describe the similarities and differences between a state of hypnosis and a dissociative state. In your opinion did the individual who you viewed in the video inserting a fishing needle through his arm while not apparently experiencing any discomfort demonstrate a dissociated state or self-hypnosis? Defend your answer.

The similarities between a state of hypnosis and a dissociative state are the state of mind the person is not in tune with reality. If suggestibility is possible in a person then someone could be convinced that they have different identities. People could also be persuaded into believing they are possessed by a demon or such which would be similar to the dissociative trance. In hypnosis people believe under the hypnotist control that they have no memory as seen in dissociative amnesia. The differences between hypnosis and a dissociative state is hypnosis is a product of suggestibility. While everything that happens in the dissociative state is purely involuntary and uncontrollable. People in the dissociative state are dependent on the environment and people could have a genetic disposition for the disorder. I think the man in the video shown in class demonstrated he was in a dissociative state. The reason being he was able to dissociate his arm from the rest of his body. He was prevented the usual sympathetic reaction from occurring. He was able to control the blood flow to the injury site. He controlled the pain gateways in his brain. 14. Identify the major components of the central nervous system (CNS) and the autonomic nervous system (ANS). Describe the functions that these components serve. Name 3 of the major neurotransmitters found in the CNS and/or the ANS. What neurotransmitters have been thought to be involved in the development of anxiety disorders, the mood disorders? How do the pharmacological therapies work to treat these disorders?

The two major components central nervous system is the brain and spinal cord. The components of the autonomic nervous system are the sympathetic division and the parasympathetic division. The sympathetic response prepares you in a fight or flight situation. Basically when you are hit with a major stressor this system kicks in. The parasympathetic calms the body down. The spinal cords major function is to send and receive messages from the brain to the body. The brain then processes this information and decides what is relevant. The brain then sends back out these important messages to the body through the spinal cord. The three major neurotransmitters involved in the development of anxiety or mood disorders are norepinephrine, dopamine, and serotonin. A lack of serotonin is involved with depression. Anxiety disorders include too little serotonin and an increased amount of noradrenalin (norepinephrine). Mania is associated with excess dopamine. The medication used for depression is SSRI’s. This drug blocks the reuptake of serotonin in the synaptic cleft and in the presynaptic cell. This increases serotonin’s effect on the postsynaptic cell and in turn reduces depression. Lithium is prescribed for a bipolar disorder. Lithium limits the availability of dopamine and norepinephrine. The dosage of Lithium given to a patient needs to be monitored. If a patients takes too much of this drug it can cause liver damage. Anxiety disorders are treated with SSRI’s as well and they work in the same way as in depression.

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Anxiety is sometimes treated with benzodiazepines which increase GABA, the main inhibitory neurotransmitter in the brain, and reduce people’s anxiety.

15. Based on the material covered in the readings to date, which of the perspectives (e.g., biological, behavioral, cognitive, psychodynamic, socio-cultural) seems to provide the best model for identifying the causes of the psychological disorders covered so far this quarter? Which perspective offers the best model for treating psychological disorders? Defend your answer with evidence (e.g., examples from studies).

(The biological perspective is the best model for identifying the cause of psychological disorders. In the biological perspective it is thought that disorders are genetic and have hereditability. For example someone with a phobia that is exposed to the stimuli may show signs of increased blood pressure and elevated heart rate. The person also feels light headed. If this person has these physiological responses most likely a family member will feel the same to the stimuli. Treatment with the biological perspective is being prescribed the proper drug. I think that a therapist should not only look at one perceptive to treat the individual but rather a combination. The patient should also go to therapy regularly.)

I feel that the best model that gives us the most insight into the causes of psychological disorders is the biological model. I feel that this is so because people who have relatives who have psychological disorders, on average, are far more likely than the general population at large to develop psychological disorders themselves. Gershon 1990 found that people with depression had relatives who developed depression 2 to 3 times more than the population at large. In addition, Klein et. al. (2002) found that people who had worse depression more often had more relatives with depression than people with lower grade depression less often. I think that the best model for treating psychological disorders is also the biological method. Many psychological disorders have a biological underpinning and can be treated, controlled and even prevented by using medication. For example, for people with mania, Prien and Potter in 1993 demonstrated lithium’s effectiveness in 30-60% of cases. In addition, Lapierre in 1994 showed that SSRI's to be effective in treating dysthymia with only minor negative side effects.

16. Define negative reinforcement. Describe how negative reinforcement processes are believed to contribute to the maintenance of some of the anxiety disorders. If negative reinforcement processes contribute to the maintenance of the maladaptive responses, what learning process contributed to their initiation? What model attempts to integrate the roles of both learning processes in the development of anxiety disorders? How did Prof. Jamner attempt to target the negative reinforcement contributing to the maintenance of fear in the class exercise involving the presentation of snakes and spiders?

Negative Reinforcement- the process by which a detrimental stimulus is removed in order to increase behavior. Negative reinforcement contributes to the maintenance of some anxiety disorders by the individual removing themselves from the detrimental stimulus that was causing them anxiety. This removal of the stimulus that was causing anxiety causes the person to have less anxiety and there for reinforce their removal behavior. This does not solve the issue of the anxiety; it simply causes people to avoid situations or items that cause them anxiety which in turn causes them anxiety about coming in contact with that dreaded situation, in turn maintaining

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the anxiety disorder. The learning process that contributed to their initiation would be classical conditioning learning. This is because people learned that their anxiety was associated with their dreaded stimulus and that the removal of that stimulus removed the anxiety, thus they learned to associate a panic response with the dreaded object and a calming response with the removal of that object. Jamner attempted to target the negative reinforcement contributing to the maintenance of fear in the class by showing people that their level of anxiety would be reduced if they allowed themselves to be exposed to the feared item for an extended period of time and not just avoiding it.

17. Imagine that a person just had moderately damaged the rear of their car, caused when the person backed into a light pole. Using concepts of attribution in learned helplessness, provide an example of what an individual at risk for depression and one not at risk for depression would say. Be sure to include all three attributional dimensions. In what other ways have individuals with MDD or at risk for MDD been shown to employ distorted cognitive schemas (world views).

A person who is at risk for depression would say that they are a complete failure at driving ( internal), that driving is just another example that they cannot do anything right (global) and they are always going to suck at driving (stable). A person who is not at risk for depression would say that it was the fact that they were driving a new car, that is why they crashed (external), even though they might not be the best driver they are really good at riding a motorcycle and doing lots of other things (specific), and they will get better at driving with more practice (unstable). People with MDD or at risk for MDD have also shown negative cognitive distortions in their view about themselves, the world and the future.

18. Carefully distinguish between bipolar disorder, unipolar disorder, dysthymic disorder and cyclothymic disorder. Going beyond describing each disorder, highlight the characteristics that they share in common and those that make each distinct. How did the videos shown in class depict the features you describe? What types of medications would you prescribe (if any) for each of these disorders? Explain how each of the medications you prescribed act on the nervous system to improve functioning.

Bipolar disorder is where people cycle through manic phases and major depressive phases, this is similar to depressive disorder but it also has manic phases where people show high levels of elation, grandiosity, beliefs of invulnerability and at times paranoia. The video of the lady switching from a depressive state to a manic one showed this range of emotions quite well; she went from having psychomotor retardation, negative thoughts about the world and a general negative view of the world to feeling on top of the world, able to control the wind and get drunk from drinking anything. Unipolar disorder is where people only experience major depressive phases, this includes the feeling that they are worthless human beings, they generally lack energy and everyday tasks are very difficult to do. The video of the lady who had depression her whole life showed good symptoms of this: she had, when she was depressed, a negative view of herself and the world, felt black at the edges of her vision and trouble sleeping. Dysthymic disorder is where people experience a low grade depression for longer bouts of time than a major depressive episode; people would kind of be sad for most of the time and seem sort of blue. Again the lady who started feeling lower bouts of depression when she was a child suffered from this. He general down feelings throughout her childhood and into her teens and early adulthood before

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her depression even started is a good depiction of dysthymic disorder. Cyclothymic disorder is where people alternate between hypo-manic episodes, where people are more productive, feel pretty good, require little sleep and eat little, and low grade depressive episodes but neither reach the level of Bipolar disorder, these would be more along the lines of those seen in dysthymic disorder. The female artist who followed the truck to Florida from the upper east coast showed us a good depiction of this disorder: when down she felt not as bad as a major depressive episode and she was able to still function but she had no energy and did not feel to motivated to do anything, she always was hungry and gained weight. However when she felt good she was able to accomplish many tasks, became renowned for her art and did not sleep or eat much. For bipolar disorder, the type of medication that I would prescribe would be lithium. This natural salt is thought to limit the availability of dopamine and norepinephrine available in the brain and it may also have an affect on neurohormones in the endocrine system that influences the production of sodium and potassium in the body. For unipolar disorder I would prescribe a SSRI (selective serotonin re-uptake inhibitor), this medication reduces the ability of serotonin to be absorbed into the presynaptic cell that released it. This results in the serotonin stimulating the next cell that it is connected to more, allowing people to pull themselves out of their depression. For the Dysthymic disorder I would not prescribe any medication. Because this disorder is less severe than major depressive disorder I would suggest using cognitive behavior therapy (CBT). CBT would be used to alter the person’s negative view of themselves, the world and the future by having them recognize their negative errors in thinking and replacing them with more realistic ones. For cyclothymic disorder, although it is not as severe as bipolar I, I would recommend using lithium. Lithium is known for its ability to regulate the swings in mood associated with bipolar I and cyclothymic disorder quite well if dosage is monitored correctly. In cyclothymic patients lithium acts in the same way as with bipolar patients; by limiting the availability of dopamine and norepinephrine available in the brain and affecting neurohormones in the endocrine system that influences sodium and potassium in the body lithium can help control the swings associated with cyclothymic disorder and help the patient live a more normal life.

19. The position that many psychological disorders can be viewed as more extreme manifestations of common human tendencies, that is, a human characteristic taken to a more intense level. Based on the readings and material presented in class, provide 3 clear examples of a disorders that appear to be more exaggerated forms of usual behaviors or traits. Defend your selection.

Anxiety disorder is one example of extreme manifestations of common human tendencies. A normal human reaction to a dangerous situation would be to produce a sympathetic reaction which would prepare the body to fight or flight the situation. In phobic anxiety disorders this reaction is linked around a specific type of thing, such as spiders. This fear is normal for most people where they are uncomfortable and may even start to panic a little at the sight of a spider, but in phobic anxiety disorders the person is thrown into a huge panic attack at even the thought of a spider, let alone the sight. This reaction is beyond the normal range of most people, and I would consider it an extreme manifestation. A second example would be bipolar I. Normal people cycle in their moods, they have good days where they feel on top of the world for no real reason and can accomplish many things, may not feel as hungry and have some trouble getting to sleep. Normal people also have down days were they feel a little depressed, have trouble getting out of bed, feel less or more hungry than usual and see the world in a negative light. These range

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of emotions are normal, but for bipolar I these alterations in mood get out of control. Their depressed days can last for weeks or months on end. During this time they can do hardly anything. Their negative view of themselves, the world and the future cloud their vision so much that they cannot see the world clearly and have trouble getting out of bed or getting to work. In addition to their depression they have manic phases. During these phases, which can also last weeks or months, they feel on top of the world, they can accomplish anything. They have grandiose plans of doing almost anything, unlimited energy, they sleep very little, eat very little and can overwhelm a normal person with their pressing speech which seems to bowl you over with force. You can see how these normal reactions in mentally healthy people are pushed to extremes with people suffering from bipolar I. The final normal human reaction pushed to extremes in psychological disorders would be dissociative identity disorder. In normal people who all have different “faces” we put on in different situations. At work we put on our professional face where we act very pleasant and proper to the customers, at a family function we might relax a little more than at work but we still know where to draw the line on what to say and do around our family members, we may also act very differently while playing sports (putting on an aggressive face and hurting people in ways we would never do outside of the arena), and around friends we might act like a crazy person that no other situation would bring out of us. This variation in our behavior in different situations is very normal for almost all people but in dissociative identity disorder this is taken to the extreme. In DID people literally switch between different identities in different situations. This different identities can have different eye sight, different handedness and different brain functioning. Usually these people have several different identities for specific types of situations; they might have a protector identity for situations in which they are being threatened, a child identity for times they are fearful or playful, a professional identity for times they have to do work, and even a shy or confident identity for different situations. This normal variation of “faces” people put on in different situations is pushed to extremes in DID.

Psychological disorders present differently for different cultures. Depression, for example, is described as being “heart broken” for the Hopi Native American tribe. In Hispanic Americans, from the Caribbean, panic attacks fall more along the lines of ataques de nervios, where people display many of the same symptoms of panic attacks but may also shout or cry uncontrollably, which is not displayed in panic attacks in our culture. (And I could not find a disorder that is the same for all cultures, so if you guys can think of one let me know.)

19. The position that many psychological disorders can be viewed as more extreme manifestations of common human tendencies, that is, a human characteristic taken to a more intense level. Based on the readings and material presented in class, provide 3 clear examples of disorders that appear to be more exaggerated forms of usual behaviors or traits. Defend your selection. (161, and slides from Lecture 4 on Somatoform and Dissociative Disorders (slides 27,32)

Obsessive Compulsive Disorder- Intrusive and distressing thoughts are common in nonclinical (normal) individuals. Many people engage in checking behavior substantial enough to score within the range of patients with OCD. It would e unusual to not have an occasional strange or intrusive thought. Many people have bizarre, sexual or aggressive thoughts without actually having Obsessive Compulsive Disorder. Many normal people engage in ritualistic behavior

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especially when under a great amount of stress. Also, Dissociation is a common human characteristic, many people have moments of daydreaming, not knowing where they are, or getting somewhere without remembering how they got there. For example, most people have driven a care and didn’t remember how they got to their destination. Lastly, Body Dysmorphic Disorder is an exaggerated form of a natural human characteristic. Many people experience common human concerns such as, wanting to change something about their appearance. In these disorders, it is natural for people to have similar experiences, but not to the extent to which they have them.

20. Cultural factors are recognized to contribute to particular aspects of how psychological disorders present themselves. Using examples from class and the textbook provide 3 examples of disorders that present with culturally specific symptoms (symptoms typically not shown by individuals in other cultures with the same disorder). Identify a disorder with a symptom set that is similar across almost all cultures (prevalence, gender breakdown, diagnostic criteria, etc.) (pg. 135,173, I can’t seem to find the universal one, but I will keep looking and get back to you guys.)

Their cultural concepts and thinking seem to account for these symptoms. Secondly, a form of hypochondriacs in Chinese males (mostly), known as Koro, that the genitals are retracting into the abdomen accompanied by severe anxiety and sometimes panic. Couvade- Found in Europe b/w Spain and France, results in cravings, suffered nausea, breast augmentation, insomnia, development of a belly similar to a 7 month pregnancy, gain of 25-30 lbs. Also, Kwa-Byung- Korea which results in anger illness or fire illness, sighing, heavy feeling in chest, perceived abdominal mass, hot flashes, insomnia, palpitations, panic.

21. Anxiety and Mood Disorders share a number of clinical features (e.g mixed symptoms) and possibly a common genetic vulnerability. What evidence (biological, psychological, social) supports the DSM IV-TR differentiation of anxiety and mood disorders as distinct conditions? (pg.227-237)

Psychopathologists are identifying biological, psychological, and social factors that seem strongly implicated in the etiology of mood disorders, whatever the precipitating factors. Biological factors have been determined and studied among twins and family studies in mood disorders. Data from family studies indicate that more signs and symptoms of anxiety and depression there are in a given patient, the greater rate of anxiety, depression or both in first degree relatives, which shows that the same genetic factors account for both anxiety and depression. Recent studies have found that social and psychological explanations seemed to account for the factors that differentiate anxiety form depression rather than genes. Most of the experiences of people with depression have contributed their depression to psychological experiences. Stress and trauma are unique contributions to depression. The stress among people with depression is very subjective, and the context to which it is in shows depression among the individual. Thus, stressful events are strongly related to mood disorders such as depression. Twin studies have showed that depression is not necessarily genetic, as twins with different life

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experiences will have a mood disorder such as depression, while the other one doesn’t. Data strongly supports that the interaction of a life event with some kind of vulnerability (genetic, psychological, or a combination of the two), will bring about the disorder. Social situations such as, marital dissatisfaction are strongly related to mood disorders (depression). In summary, due to the fact that depression and anxiety may often share a common, genetic vulnerability, it is more so their unique, psychological and social factors that make them distinct conditions.

Psychologically, anxiety produces an inappropriate fear response to some event or object that should not be triggering a fear response. While depression is associated with a more lack of pleasure, energy and a general lack of interest in life. Socially, anxiety can be a product of observing other people react negatively to an event or object or being told about someone’s negative reaction to an event or object. While depression, has been known to be triggered by the loss of a loved one, a job or the ending of something very enjoyable. Biologically, depression is thought to be associated with low levels of serotonin with allows other neurotransmitters to vary more widely. While anxiety is also associated with low levels of serotonin it is also known to be associated with low levels of GABA.

22. Provide 3 clear examples of where a diathesis-stress model (integrative) best describes the processes involved in the development and maintenance of any of the psychological disorders covered in class or in the assigned readings. (hint: examples provided in the casebook). (case #7, case #8,)

The lady in the video who had had a low level mood since her childhood is a clear example of the diathesis-stress model. This lady had been suffering from dysthymia since she was a child. This would be the genetic portion, the diathesis. It was later in her life, when she was in college, where the craziness and stress may have triggered her first bout of depression.

In the case of physical aggression and violence, it was important to look at his past and understand the history and genetic factors that played a role in his later physical aggression, borderline personality disorder, and bipolar 2 disorders. In his case, his family had a history of addiction such as alcoholism, and drug addiction. Due to the fact that he is genetically vulnerable to these behaviors, they are brought on more so, by stressors such as heavy work schedules, and nagging wives. In order to maintain a safer environment for himself, girlfriend and children, he learned cognitive restructuring, and learned to channel his aggression and cope with certain stressors in his life in a more positive manner.

In the case with Judy from our book she suffered from blood-injection injury phobia. This disorder has a very strong genetic component that involved a vasovagule response to an increase in blood pressure associated with sight of blood. This is her diathesis aspect of the disorder. Her viewing of the video involving dissecting a frog that caused her to become nauseas and eventually develop blood-injection-injury phobia would be her stress portion.

23. Provide a brief integrative theory that involves genetic, biological, psychological, and social dimensions (at least two) that best explains the greater prevalence of anxiety, somatoform and mood disorders among women compared to men. (pg. 229-236, 169)

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In cases of anxiety, somatoform, and mood disorders there are common variables. It is known that in these cases, there is a generalized biological vulnerability, as well as a generalized psychological vulnerability. Twin studies have been conducted among both genders to determine the biological aspect of having a disorder. Estimates of heritability showed that women were twice as likely than men to have a mood disorder by genetic dimensions. Inherited vulnerability to experience these disorders, as well as activation of certain brain circuits, neurotransmitters, and neurohormonal systems account for them. There is a similar ratio for most anxiety disorders, particularly panic and generalized anxiety disorder. It may be gender differences in the development of emotional disorders are strongly influenced by perceptions of uncontrollability. It is often contributed to cultural reasons and expectations, meaning that the roles are different among women and men in society. In this case, women feel a sense of uncontrollability and helplessness which contributes as a psychological dimension. Thus, the onset of psychological factors brings upon the genetic vulnerability, which highly contributes to all three disorders, more so, in women.

24. Using the information provided in the following vignette, provide the most appropriate DSM-IV-TR Axis 1 diagnosis (diagnoses). Make certain that you specify the bases of your diagnosis (e.g. criteria met). A complete response would also include the reasons you decided to exclude possible alternative diagnoses.

Criteria She has of social phobia:never felt comfortable sociallyfelt overwhelmed at parties and would avoid themself conscious when meeting new people and won’t make eye contact with themanxiety gradually builds to a constant high level in anticipation of social situationsCriteria She is missing for social phobia:never experienced sudden anxiety or a panic attack never experienced psychotic symptomsCriteria she has of dysthymic disorder:claims to have felt constantly depressed since the 1st grade only periods of “normal” a few days at a timedepression accompanied by lethargy, little or no pleasure or interest in anything, trouble concentrating, feelings of inadequacy, pessimism, and resentfulness.Only normal mood at home alone: listening to music or watching TVlow self-esteemno history of a manic or hypomanic episodeaverage age of first onset: 1st gradeCriteria she is missing for dysthymic disorder:poor appetite or overeatingfeelings of hopelessness