w What is abnormal behavior? What is a psychological disorder? ABNORMAL PSYCHOLOGY.
Abnormal Psych Psychological Disorders -...
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Abnormal Psych
Chapter 16
Psychological Disorders
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
Psychological Disorders
1. Normal/ Abnormal: Who decides?
2. Group Survey Creation
3. Individual survey Completion
4. Results tabulation and presentation of results
Psychological Disorders
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
Psychological Disorders
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 Disorders
! 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
Psychological Disorders
! 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
Psychological Disorders
! 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
Psychological Disorders
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
Psychological Disorders
! 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
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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.
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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
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Imagin
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L. R
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atio
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Abnormal Brain
Morphology
Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles.
Both
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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
Somatoform Disorders
• 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
Somatoform Disorders
• 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
Somatoform Disorders
• 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
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
Understanding Antisocial Personality Disorder
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
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f Adria
n R
ain
e,
Univ
ers
ity o
f South
ern
Califo
rnia
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Understanding Antisocial Personality Disorder
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
! Personality Disorders
! disorders characterized by inflexible and
enduring behavior patterns that impair
social functioning
! usually without anxiety, depression, or
delusions
Personality Disorders
! 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
Personality Disorders
! PET scans illustrate reduced activation in a
murderer’s frontal cortexNormal Murderer
Personality Disorders
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
2. Project Presentations
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
2. Project Presentations
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
Therapists and their
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
Therapists and their
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
Therapists and their
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