Mental Disorder & Therapy Methods – Psychology
This chapter covers mental disorder and psychology therapy methods.
Positive aspects to Freud’s thinking
Discussion of sex led to scientific study of sexuality
Positive aspects to Freud’s thinking
Scope of theoretical contribution: unconscious, symptoms of various disorders, personality, family, development, memory, dreams, language (Freudian slips)
Humanistic Theories
Relate to pyramid of human needs
Emphasis on fundamental goodness of people and their striving toward high levels of functioning and fulfillment (adapt, learn, grow, excel)
Concern with person’s perception if him/herself in the present (no emphasis on childhood)
Do not like idea of personality being pushed around by internal instincts
Which personality theory emphasizes the fundamental goodness of people and their striving toward high levels of functioning and fulfillment?
Humanistic theories
How do Freud’s theories and Humanistic theories differ?
Emphasis on childhood (Freud does, Humanistic doesn’t)
Personality shaped by instincts (Freud does, Humanistic doesn’t)
Self-actualization
Humanistic theories
Innate push toward growth with all parts of personality working in harmony
Criticisms of Humanistic Theory
Concepts are “fuzzy”, unclear about nature of concepts
Criticisms of Humanistic Theory
Neglect of environmental variables
Criticisms of Humanistic Theory
Neglect of person’s past
Criticisms of Humanistic Theory
Inability to predict behaviour
Criticisms of Humanistic Theory
Little to say about individual differences
Personality Assessment Techniques
Objective personality tests
Behaviour observation
Interviews
Projective (unstructured) measures
MMPI
Minnesota Multiphasic Personality Inventory
Assesses a number of psychiatric patterns simultaneously
567 questions
Certain distinct patterns of responding for different types of mental disorders
Yes/No questions
Social Psychology
The scientific study of how we influence one another’s behaviour and thinking
Conformity
A change in behaviour, belief, or both to conform to a group norm as a result of real or imagined group pressure
Informational Social Influence
Influence stemming from the need for information in situations which the correct action or judgment is uncertain
Normative Social Influence
Influence stemming from our desire to gain the approval and to avoid the disapproval of others
Compliance
Acting in accordance with a direct request from another person or group.
Foot-in-the-door Technique
Compliance to a large request is gained by preceding it with a very small request.
Door-in-the-face Technique
Compliance is gained by starting with a large, unreasonable request that is turned down and following it with a more reasonable, smaller request
Low-ball Technique
Compliance to a costly request is gained by first getting compliance to an attractive, less costly request but then reneging on it
That’s-not-all Technique
Compliance to a planned second request with additional benefits is gained by presenting this request before a response can be made to a first request.
Obedience
Following the commands of a person in authority
Social Facilitation
Facilitation of a dominant response on a task due to social arousal, leading to improvements on simple, well-learned tasks and worse performance on complex or unlearned tasks when other people are present.
Social Loafing
The tendency to exert less effort when working in a group toward a common goal than when individually working toward the goal.
Diffusion of Responsibility
The lessening of individual responsibility for a task when responsibility for the task is spread across the members of a group.
Bystander Effect
The probability of a person’s helping in an emergency is greater when there are no other bystanders than when there are other bystanders
Deindividuation
The loss of self-awareness and self-restraint in a group situation that fosters arousal and anonymity
Group Polarization
The strengthening of a group’s prevailing opinion about a topic following group discussion about the topic
Group think
A mode of group thinking that impairs decision making because the desire for group harmony over-rides a realistic appraisal of the possible decision alternatives
Attribution
The process by which we explain our own behaviour and that of others
Fundamental Attribution Error
The tendency as an observer to overestimate dispositional influences and underestimate situational influences on others’ behaviour
Just-world Hypothesis
The assumption that the world is just and that people get what they deserve
Primacy Effect
Information gathered early is weighted more heavily than information gathered later in forming an impression of another person
Self-fulfilling Prophecy
Our behaviour leads a person to act in accordance with our expectations for that person
Actor-observer Bias
The tendency to overestimate situational influences on our own behaviour, but to overestimate dispositional influences on the behaviour of others
Self-serving Bias
The tendency to make attributions so that one can perceive oneself favourably
False Consensus Effect
The tendency to overestimate the commonality of one’s opinions and unsuccessful behaviours
False Uniqueness Effect
The tendency to underestimate the commonality of one’s abilities and successful behaviours
Attitudes
Evaluative reactions (positive or negative) toward objects, events, and other people
Cognitive Dissonance Theory
A theory developed by Leon Festinger that assumes people have a tendency to change their attitudes to reduce the cognitive discomfort created by inconsistencies between their attitudes and their behaviour
Self-perception Theory
A theory developed by Daryl Bem that assumes that when we are unsure of our attitudes, we infer them by examining our behaviour and the context in which it occurs
Behaviour Observation
Personality assessment technique
Problems with MMPI
Person can misrepresent themselves
To check for misrepresentation, questions are asked that would require a subject probably to lie
Interview
Personality assessment technique
Conversation with a purpose
Conversation with a purpose
Interview
Projective (unstructured) measures
Personality assessment technique
Person describes ambiguous picture or pattern
TAT
Thematic Aperception Test
Thematic Aperception Test
Ambiguous picture, no right or wrong answer
Story you tell will describe your personality
Does the person identify with the hero or victim of the story?
Look for certain themes (eg failure)
Rorschach Test
Inkblots
Location, contents, determinants (eg colour, shading)
Using whole inkblot indicates integrative thinking
Using colour indicates a emotionality and impulsiveness
Describing movement indicates imagination or a rich inner life
Criticism of personality assessment tests
Low predictive values (don’t predict people’s personality)
Why are people fascinated with abnormal psychology?
See something of ourselves in the abnormal
Have felt pain and bewilderment of a psychological disorder through ourselves, family, or friends
Norm violation
A difference in the degree to which behaviour or thinking resembles an agreed upon criteria (varies with culture and times, often based on statistics)
Abnormality (related to psychological disorders)
Involves behaviour and thinking
Must meet a certain set of criteria: MUDA
MUDA
Abnormal Psychology:
Maladaptive
Unjustifiable
Disturbing (to others)
Atypical
DSM IV (1994)
Helps in describing, treating and researching disorders
Assumes Medical Model
203 disorders and conditions
Classifies, but does not attribute cause
In any given year, how many American adults have suffered from a diagnosable mental disorder?
26.2%
57.7 million adults
What is the number one disorder ever experienced?
Phobias
What is the number two disorder ever experienced?
Alcohol (substance) abuse
What is the number three disorder ever experienced?
Mood disorders (including depression)
Who is more likely to suffer with alcohol abuse?
Men
Who is more likely to suffer with phobias?
Women
Who is more likely to suffer with mood disorders?
Women
Who is more likely to suffer with antisocial personality disorder?
Men
Types of mental disorder
Personality Disorder
Anxiety Disorder
Somatoform Disorders
Dissociative Disorders
Affective (Mood) Disorders
Psychotic Disorders
Eating Disorders
Personality disorder
Longstanding, inflexible, maladaptive patterns of perceiving, thinking, or behaving
Subtypes of Personality Disorder
Narcissistic Personality Disorder
Antisocial Personality Disorder
Narcissistic Personality Disorder
Need for constant attention
Respond inappropriately to criticism
Grandiose sense of self importance
What causes people to suffer from Narcissistic Personality Disorder?
Person does not grow out of view that he/she is the center of the world (centrism)
Antisocial Personality Disorder
Formally called sociopath or psychopath
Typically male
Violate rights of others – violent, criminal, unethical, exploitative
(Hannibal Lecter)
Hannical Lecter
Antisocial Personality Disorder
Gaston
Narcissistic Personality Disorder
What causes people to suffer from Antisocial Personality Disorder?
Emotional deprivation in early childhood (attachment issues)
Learned from parents
Arrested moral development
Brain abnormalities
Heredity
Anxiety Disorders
Originally grouped under “neurosis”
Anxiety inappropriate to circumstance or defenses that ward off anxiety
Subtypes of Anxiety Disorder
Phobias
Generalized Anxiety Disorders
Obsessive-Compulsive Disorder
Panic Disorder
Post Traumatic Stress Disorder
Phobia
Intense and irrational fear (no real danger or exaggerated danger) of some object or situation
Generalized Anxiety Disorders
Not focused like a phobia (free-floating)
Continually tense and uneasy
Obsessive-Compulsive Disorder
Lasts a long time
Trying to deal with consistent thoughts
Panic Disorder
Short term-each attack lasts a short time
Sudden, unpredictable feeling of intense fear or terror
Post Traumatic Stress Disorder
Anxiety long after an event occurs
War, rape
Why do people suffer with anxiety disorders?
Psychoanalytic – unconscious conflicts, behaviour that once helped to control anxiety becomes a problem
Behavioural – associate anxiety and harmful situation
Biological – inherited
Observational Learning – observe someone who is anxious in a particular situation then you become anxious too
Somatoform Disorders
Physical complaint suggests physical disorder but no organic problem is found
* Hypochondria
* Conversion Disorder
Soma
Means “body”
Hypochondria
Somatoform disorder
Preoccupied with bodily sensations, despite assurance that there is no problem
Interpret small symptom as sign of serious illness
Conversion Disorder
Somatoform disorder
Loss of specific sensory or motor function (hysterical blindness)
Why Somatoform Disorders?
Psychoanalytic: conversion of emotional problems to physical problem
Behavioural: Learn that sickness can avoid unpleasant situation
Biological: Unusual sensitivity to internal process
Dissociative Disorders
Some part of memory or personality fragmented from the rest
* Dissociative amnesia
* Dissociative fugue
* Dissociative Identity Disorder (Multiple Personality Disorder)
Dissociative Amnesia
Dissociative disorder
Selective memory loss brought on by extreme stress
Dissociative Fugue
Dissociative disorder
Loss of identity
Dissociative Personality Disorder
Dissociative disorder
Sybil
Why Dissociative Disorder?
Psychoanalytic: block out thoughts (typically from childhood) that cause anxiety
Behavioural: Blocking out unwanted thoughts is rewarding
Affective (Mood) Disorders
Disturbances in mood in which the person is either excessively depressed (loss of interest or pleasure) or elated (manic) or both (bipolar)
* Depression
* Manic Disorder
*Bipolar Disorder
Depression
Think of oneself as a failure
“Paralysis of will” – lack of motivation
Loss of appetite for food and sex
Don’t sleep
General state of weakness and fatigue
2 or more weeks of feeling sad
Suicide
Depression implicated in 40-60% of suicides
Manic Disorder
Elated and very active emotional state
Impulsive
Unrealistic optimism
High energy
Severe agitation
Swings between low and manic states
Why Affective Disorders?
Psychoanalytic: real or imagined loss of a loved one turns anger against oneself (depression)
Behavioural: lack of reinforcement (depression)
Cognitive: negative and self-blaming thoughts (depression)
Biological: heredity, neurotransmitters (low levels of seratonin)
Psychotic Disorders
Schizophrenia
Schizophrenia
Out of touch with reality
Prevalent (2% will have episode)
1/2 countries mental health beds occupied by schizophrenics
Schizophrenia Symptoms
Pervasive thought disturbance
Fluid thinking
Difficulty with selective attention
Withdrawal from social contact
Delusions (misinterpret real events)
Paranoid (perceive personal threat where there is none)
Hallucinations (no actual stimulus)
Bizarre behavioiur (catatonic, odd gestures)
More sensitive to sensory stimuli
Why Schizophrenia?
Cognitive: inability to keep things in proper focus
Biological: viral infection during pregnancy, heredity, neurotransmitter (too much dopamine)
Eating Disorders
Deprive oneself of food or prevent food from being digested
Anorexia nervosa
Bulimia nervosa
Anorexia nervosa
1% of all adolescents, 95% are female
Fanatical dieting (self-starvation)
Intense interest in food but view eating with disgust
Not aware that dieting behaviour is abnormal
Menstruation cycle often affected
Bulimia Nervosa
Binge on high calorie foods in a short period of time, then purge
Secretive behaviour
Aware that behaviour is abnormal
Why Eating Disorders?
At a time when young women are coming to grips with their changing bodies and sexuality, society bombards them with ads for rich foods and ads espousing a slim body.
(Anorexia) Overdependence on parents may lead to fear of becoming sexually mature and independent. By not eating you delay sexual maturity.
Problems of Drug Therapy
Side effects: blurred vision, dry mouth
Regulating dosage
Drug dependence
Interaction of drugs
Not necessarily a cure, just dampening symptoms
Psychosurgery
Pre-frontal lobotomy: cut connection between thalamus and frontal lobes
Thought to disconnect person from emotions and past trauma
Brain damage, including loss of memory, emotion, personality
Only used in extreme cases (intractable psychosis)
Electroconvulsive Therapy (ECT)
Electrical current put through brain at each side of forehead
Loss of consciousness followed by convulsive seizure
Originally used with schizophrenia, now used for severe depression
Used only if drugs are ineffective or person is suicidal
May increase norepinephrine which elevates arousal and mood
Treatment of Psychpathology
4 stages
Diagnosis, Etiology, Prognosis, Treatment
Biomedical Treatment
Deal with body by changing brain’s functioning
Typically done by psychiatrists
Past Biomedical Treatment
Bloodletting
Dunking in water
Trephining (drilling holes in skull)
Current Biomedical Treatment
Drug Therapy
Drug Therapy
Anti-psychotics: chlorpromazine (block dopamine which has been implicated as possible cause of schizophrenia)
Tranquilizers: calm and relax (valium and librium)
Antidepressants: increase norepinephrine and seratonin (prozac)
Lithium: bipolar disorder
Psychotherapy
Use of psychological methods to help people modify their behaviour so they can more satisfactorily adjust to their environment
What does psychotherapy involve?
Emotional reeducation
Interpersonal learning
Having person achieve greater self-knowledge
Types of Psychotherapy
Psychoanalytic/Psychodynamic
Behaviour Therapy (Behaviour Modification)
Aversion Therapy
Cognitive Therapy
Psychoanalytic/Psychodynamic Therapy
Problems stem from unconscious defenses pitted against unacceptable urges dating back to childhood
Person must gain access to his buried thoughts and wishes, gain insight and resolve them (intrapsychic harmony)
Victory of reason over passion
Psychoanalytic/Psychodynamic Techniques
Therapist sits behind patient, remaining neutral and mostly silent
Free association
Interpreting Dreams
Transference
Free Association
Bring unconscious (repressed) thoughts into consciousness, and these thoughts are interpreted by analyst (manifest vs latent content)
Manifest vs Latent Content
Manifest: what the client says
Latent: how the therapist interprets it, what it really means
Interpreting Dreams
Person must not just remember things from the unconscious, but must regain access to the feelings that went with them
This will allow for catharsis
Catharsis
Emotional release
Transference
Patient responds to analyst in person terms – transfer their feelings to the therapist
Analyst identified with a person who has been at the center of an emotional conflict in the patient’s past
Behaviour Therapy (Behaviour Modification)
Importance of unlearning stimulus-response association and learning new stimulus-response association
Classical Conditioning Techniques
Systematic Desensitisation
Used with phobias
Learn relaxation techniques
Fear hierarchy
Desensitisation: imagine each situation while relaxed, fear replaced by relaxation
Implosion (Flooding)
No fear hierarchy
Continuous, intense exposure to anxiety provoking situation
BUT implosion may cause more anxiety
Aversion Therapy
Learn negative association
Eg: certain drugs create nausea when drinking/smelling alcohol
Friends: Rachel & Ross (Phoebe hits Rachel)
Operant Conditioning
Reinforcement
– Token economy (reward behaviour with token)
Punishment
– Time out
Humanistic Therapy
Goal is self-awareness and self-acceptance, not cure
Help CLIENT fulfil potential, recognize freedoms, enhance self-esteem
Treats person at global level
Stress what’s going on in the present
Client-Centered Therapy
Client-Centered Therapy
Created by Carl Rogers
Type of Humanistic Therapy
Have client arrive at insights, make own interpretations and take responsibility for thoughts and actions
Reflection of feeling
Non-direct
Unconditional positive regard
Reflection of Feeling
Client-centered therapy
Therapist paraphrases what client said to help client understand their emotions
Non-direct
Client-centered therapy
Therapist does not direct client to a specific topic
Unconditional positive regard
Client-centered therapy
Therapist shows unconditional positive regard to create atmosphere of acceptance and feedback
Cognitive Therapy
Modeling (observe models)
Social skill learning
Cognitive restructuring
Rational-Emotive Therapy
Modeling
Cognitive therapy
Observation of models
Social Skill Learning
Cognitive therapy
Learn when, where, why, how to say something to someone else
Importance of generalization (generalize learning to other situations)
Cognitive Restructuring
Cognitive therapy
Change the way a person thinks about themselves and the world
Used with depression
Rational-Emotive Therapy
Cognitive Therapy
Change false (irrational) beliefs
Eg: “everyone hates me”
What is the best therapy?
No definite answer
Some therapies seem to be better for some disorders than others
Leads to many therapists using an eclectic approach
Eclectic approach to therapy
Therapists may combine different methods