Mental Disorder & Therapy Methods – Psychology

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


Bipolar Disorder

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

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