Exam 4 Review Psych 101 B Spring 2015

Today’s Review Psychological Disorders Mood disorders Schizophrenia Anxiety disorders Therapy Psychodynamic therapy Humanistic therapy Social Psychology Social influence Attraction & relationships

Psychological Disorders Syndromes marked by a significant disturbance in an individual’s cognition, emotion regulation, or behavior. Medical model: disorders are “sicknesses” with physical causes that can be cured through hospital treatment. Biopsychosocial model: disorders reflect both genetic predispositions and social influences.

DSM-5 Diagnostic and Statistical Manual of Mental Disorders, 5 th Edition: provides the diagnostic criteria used to classify psychological disorders. Pros: It provides a reliable way to guide medical diagnoses and treatment. Cons: Disorders are described by their symptoms instead of causes; labels can be subjective.

According to lecture, the Rosenhan study demonstrates that: A. Mental health diagnoses can be subjective and context dependent. B. The DSM is not an accurate tool for diagnosis. C. Symptoms of mental disorders vary significantly across people. D. Psychologists are more likely to have mental disorders.

Neurosis is characterized by: A. B. C. D. Anxiety and emotional disturbance. Loss of contact with reality. Distortion of perception & thought. Personality distortion.

Neurosis is characterized by: A. B. C. D. Anxiety and emotional disturbance. Loss of contact with reality. Distortion of perception & thought. Personality distortion. these describe psychosis instead

What’s the primary difference between clinical psychologists and psychiatrists? A. Only clinical psychologists can prescribe drugs. B. Only psychiatrists can prescribe drugs. C. Only clinical psychologists can help manage symptoms. D. Only psychiatrists can help manage symptoms.

Mood Disorders Disturbances in a person's mood and emotional state. The “common cold” of psychological disorders. Unipolar (e. g. major depressive disorder): experiencing extreme lows. Bipolar (e. g. manic-depressive disorder): fluctuating between extreme highs and extreme lows.

Major Depressive Disorder: Overview Diagnostic criteria: • Depressed mood; reduced interest or enjoyment. • Problems regulating appetite and sleep. • Feeling listless, worthless, hopeless, no energy. • Problems thinking, concentrating, making decisions. Duration: • Two or more weeks (DSM criteria). • Can last months or years.

What is NOT true of major depression? A. It can sometimes have no eliciting event. B. It is the primary cause of suicide. C. People can recover without professional help. D. Women’s rate of suicide fatality is almost double men’s.

Major Depressive Disorder: Biological Approach The presumed cause of depression is a chemical imbalance in the brain - underactive serotonin system. Implicated neurotransmitters: serotonin and norepinephrine. (NPR story says: not that much evidence. )

Tricyclics decrease depression by: A. Inhibiting the enzyme monoamine oxidase B. Partially blocking serotonin and norepinephrine reuptake C. Increasing endorphin production D. B & C

Major Depressive Disorder: Antidepressants MAO inhibitors (e. g. Nardil) - inhibit the enzyme monoamine oxidase from breaking down serotonin and norepinephrine. • Effective in 50% of patients • Side effects 1 st generation tricyclics (e. g. Elavil, Endep) – partially block the re-uptake of serotonin and norepinephrine. • Side effects

Major Depressive Disorder: Antidepressants 2 nd generation tricyclics (e. g. Prozac, Zoloft, Paxil) – more specifically block the re-uptake of serotonin. Serotonin-specific reuptake inhibitors (SSRIs). • Effective in 60 -80% of patients • Fewer side effects Some caveats: • Antidepressants usually take a month to start working • Don’t work for up to 40% of people

Schizophrenia Severe psychotic disorder of thought; thought and behavior are divorced. Diagnostic criteria: • Bizarre delusions • Paranoia • Hallucinations • Disorders of logical thought and speech • Catatonia or bizarre movements • Inappropriate emotional response/expression

Types of Schizophrenia Positive symptoms üHallucinations (false perceptions) üDelusions (false beliefs) üThought disorders (disorganized thinking and speech) Negative symptoms üFlat affect (emotionless) üImpaired attention üPoor social adjustment üReduction in speech this type has the worse prognosis

Schizophrenia: Dopamine hypothesis Schizophrenia is the result of a hyper-active dopamine system in the brain (excess of dopamine receptors). Antipsychotic drugs: reduce dopamine activity in the brain by blocking dopamine receptors. First generation: thorazine • Side effects – depression, bizarre muscle behavior (shuffle) New generation: “atypicals” (Zyprexa, Risperdal)

Schizophrenia is: A. Caused by extreme stress combined with poor coping skills B. Outcome of extremely exacerbated depressive and anxiety symptoms C. Caused by genetic predisposition combined with environmental stressors D. Primarily a genetic disorder

Schizophrenia: Genetic Component The incidence rate of schizophrenia in… • The general population: 1% • Siblings of schizophrenics: 10% • Fraternal twins of schizophrenics: 10 -15% • Identical twins of schizophrenics: 40 -50%

Schizophrenia: Genetic Component Polygenic model: schizophrenia is caused by a “toxic” combination of genetic variants. Multiple rare variants model: schizophrenia is caused by a single rare mutation

Anxiety Disorders Characterized by distressing, persistent anxiety or maladaptive behaviors to reduce anxiety. Excessive apprehension and anxiety (thoughts of future threat) or fear (present state of heightened physiological arousal).

Generalized Anxiety Disorder Characterized by chronic, excessive worry. Symptoms: • continuous worrying, fearfulness • autonomic nervous system arousal – tension, heart palpitations, trembling, perspiration • difficulties in concentration • avoidance of social situations The anxiety is “free-floating” rather than linked to a specific thing or event.

Phobic disorders Persistent, irrational fear and avoidance of an object, activity, or situation. Specific/simple phobia: fear of particular objects or situations. • Objects: spiders, snakes, clowns, peanut butter • Situations: flying, being buried alive, being in closed spaces

Phobic disorders Not all phobias have single, specific triggers; some are more complex with multiple components. Agoraphobia: fear of open spaces, where escape might be difficult in case of panic attacks. Social phobia/social anxiety disorder: fear being negatively judged and scrutinized by others.

In obsessive-compulsive disorder, an obsession is: A. A complex phobia B. The idea that everything must be “just right” C. Repetitive behavior according to rules and rituals D. A persistent thought, idea, image, or impulse

Obsessive-compulsive disorder Obsessive thought: persistent thought, idea, image, or impulse. • Dirt, germs, toxins; disaster, death; symmetry, order Compulsive behavior – repetitive behavior performed according to certain rules/rituals. • Excessive washing; checking doors & locks; repeated rituals Becomes a disorder when these thoughts and behaviors interfere with everyday living.

Post-traumatic Stress Disorder (PTSD) Occurs after being a victim or witness of a traumatic incident. Symptoms: • recurring/intrusive thoughts, memories, & nightmares • social withdrawal • “jumpy” anxiety – easily startled • sleep difficulties About 5 -10% of people develop PTSD after having a traumatic experience.

Prevalence Rates (Regier et al. , 1988) Disorder - % of people exhibiting disorder during their lifetimes • Any disorder – 32% • Substance abuse – 16% (most common) • Mood disorders – 8% (most deadly) • Anxiety disorders – 13% • Schizophrenia – 1% (most severe)

Therapy Psychotherapy: treatment involving psychological techniques, consisting of interactions between the patient and a trained therapist • Psychodynamic therapy – Freud • Humanistic therapy – Rogers (client-centered therapy), Perls (Gestalt therapy) Biomedical therapy: treatment involving medications or procedures that act directly on the patient’s physiology

Which therapy has the fundamental assumption that mental disorders reflect anxiety when forbidden impulses and desires threaten to arise? A. B. C. D. Humanistic Behavioral Cognitive behavioral Psychodynamic

What is a humanistic therapeutic technique? A. B. C. D. Unconditional positive regard Systematic desensitization Exposure therapy Dream analysis

What is a humanistic therapeutic technique? A. B. C. D. Unconditional positive regard Behavioral therapy Systematic desensitization Exposure therapy Dream analysis Psychoanalysis / psychodynamic therapy

Psychodynamic therapy – Freud Behavior and feelings are powerfully affected by unconscious motives and inner conflicts of the mind. Goal: improving patients’ self-insight, helping patients gain access to unconscious feelings. Tools: free association; transference; interpretation.

Humanistic therapy – Rogers For a person to "grow“ in self-awareness and acceptance, they need an environment of genuineness and empathy. Goal: helping patients grow and accept who they are. Tools: active listening; unconditional positive regard; non-directive counseling.

Humanistic therapy – Perls Self-awareness and personal responsibility is key to developing one’s full potential. Goal: helping clients gain awareness of what they are experiencing in the here and now. Tools: meaningful and authentic dialogue; role play; attention to body language.

Which statements are psychodynamic and which are humanistic? 1. Conscious thoughts are more important than unconscious ones. 2. It’s important to know the childhood roots of your current problems. 3. The therapist is the authority on the patient’s inner experiences.

Which statements are psychodynamic and which are humanistic? 1. Conscious thoughts are more important than unconscious ones. - Humanistic 2. It’s important to know the childhood roots of your current problems. - Psychodynamic 3. The therapist is the authority on the patient’s inner experiences. - Psychodynamic

Social Psychology The study of social influences, social relations between people, and the effect of the social situation on behavior.

What did Milgram conclude from his subway experiment? A. Subway commuters are unwilling to give up their seats. B. Social norms are difficult to break. C. People are likely to obey authority figures. D. People conform to the opinions of the group.

Social Influence Solomon Asch’s line study Normative social influence: influence resulting from the one’s desire to gain approval/avoid disapproval Informational social influence: influence resulting from one’s willingness to accept others’ opinions

Social psychology & World War II Tendency for humans to be influenced by their social roles (Zimbardo’s Stanford Prison Experiment) Tendency for humans to obey authority figures (Milgram study)

Stanford Prison Experiment Zimbardo set up a fake prison in a basement. College students were randomly assigned to be “prisoners” or “guards”. Study was intended to last for two weeks, but discontinued after 6 days.

The power of social roles Some guards became abusive. Some prisoners became obedient. Some were rebellious, before breaking down emotionally. Zimbardo himself conformed to his role as “warden. ” Our behavior is strongly influenced by the social roles that we find ourselves in.

Milgram’s “shock” experiments Participants were assigned to be a “teacher” to help a “learner” help learn word pairs. Each time the “learner” made a mistake, the “teacher” had to deliver an electrical shock, increasing the level of shock each time. The whole time, a researcher in a labcoat is in the room, giving the “teacher” orders to continue.

What percentage of participants went all the way and delivered the highest level of shock? A. B. C. D. 50% 33% 65% 80%

The power of social influence “Ordinary people, simply doing their jobs, and without any particular hostility on their part, can become agents in a terrible destructive process. ” – Milgram Other influencing factors: • Whether the authority figure was perceived as legitimate and supported by an institution • Whether “learners” were emotionally distanced • Whether “teachers” saw someone else rebel first

Other things to know Hofling hospital study - nurses were ordered by doctors to administer a dangerous dose of a (fake) drug to their patients. 21 out of the 22 nurses (95%) complied. Fundamental attribution error - tendency to emphasize internal characteristics to explain someone else's behavior, rather than considering external situational factors.

Attraction Proximity: the more you see something, the more you like it (mere exposure effect). Appearance: physically attractive people are perceived more favorably; and average, symmetrical faces are seen as more attractive. Similarity: people like others who share similar attitudes, beliefs, interests, demographics.

Love Romantic passionate love: an aroused state of intense positive absorption in another person (an overwhelming emotional state). Usually present at the beginning of a relationship. Companionate love: the affection we feel for those with whom our lives are deeply interrelated.

What is an example of a dyadic factor that causes relationship conflict? A. B. C. D. Differences in background Partner’s interest in someone else Conflicting sexual attitudes A&C

What is an example of a dyadic factor that causes relationship conflict? A. B. C. D. Differences in background Partner’s interest in someone else Conflicting sexual attitudes A&C Dyadic - involving both people in a pair Non-dyadic - just involving one

Hill, Rubin, & Peplau: dyadic & nondyadic reasons relationships end Dyadic: Boredom, differences in interests, differences in background, differences in intelligence, conflicting sexual attitudes, conflicting marriage attitudes. Non-dyadic: Woman’s desire to be independent, woman’s interest in someone else, living too far apart, pressure from woman’s parents, pressure from man’s parent

Which of the following is false: A. Most people in the U. S. have been married. B. The majority of marriages end in divorce. C. The average of people getting married has increased. D. The percentage of adults who are married in the U. S. has decreased.

Marriage: Stats 1986: 96% of people have been married. 2009: 81% of people have been married. Rate of marriage is decreasing over time. 1986: 27% of women were unmarried at age 30. 2009: 47% of women were unmarried at age 30. Median age @ first marriage is increasing over time.

Marriage: Sources of Conflict Reasons for divorce: Communication problems; Unrealistic expectations of marriage; Lack of demonstrations of affection; Lack of feelings of love (Osterhout: “only issue that can’t be fixed through therapy”) Risk factors associated with divorce: Marrying at a younger age; Marrying because of pregnancy; Having divorced parents; Marrying too quickly; Marrying someone very different; Having many premarital sexual relations; Having extramarital affairs

Final questions?

Good luck!!! • Exam is TOMORROW, June 10, at 2: 30 PM in Kane 120.