Abnormal psychology test 1

field devoted to the scientific study of abnormal behavior in an effort to describe, predict, explain, and change abnormal patterns of functions

• clinical scientists
• clinical practicioners

gather information systematically so that they may describe, predict and explain the phenomenon they are studying

use the knowledge acquired by the clinical scientist to detect assess and treat abnormal patterns of functioning

a society's stated and unstated rules for proper conduct

• many definitions have been proposed yet non has won total acceptance
• the four D's

• deviance
• distress
• dysfunction
• danger

• they have social constructs (depends on what society you live in)
• they change with time
• a behavior that deviates may not be a bad thing

different extreme unusual perhaps even bizarre

• different from behaviors thoughts and emotions that differ markedly from a society's ideas about proper functioning
• differ from society to society and also depend on specific circumstances

• unpleasant and upsetting the person
• according to many clinical theorists, behavior, ideas, or emotions usually have to cause distress before they can be labeled abnormal

ex: someone who feels honored to hear voices in their head

interfering with the persons ability to conduct daily activities in a construct way

culture plays a role in definition of abnormality

• posing risk of harm to oneself or others
• behavior may be consistently careless, hostile, or confused
• research suggess that it is actually the exception rather than the rule, most people struggling with anxiety, depression, and even bizarre thinking pose no immediate danger to themselves or anyone else

a people's common history, values, institutions, habits, skills, technology, and art

• places such emphasis on society's role that he finds the whole concept of mental illness to be invalid, a myth of sorts
• deviations called abnormal are only problems in living
• societies invent the concept of mental illness to better control or change people who threaten social order

• we may unable to apply our definition consistently
• alcohol use is considered normal in college even though it is defined as a psychological abnormality by the 4 d's
• a man who lives with 12 cats is considered eccentric rather than abnormal even though it can be defined with the 4 d's

• a procedure designed to change abnormal behavior into more normal behavior
• requires careful definition

• wrote book that all treatment contains three essential features
• a sufferer seeking relief from the healer
• trained socially accepted healer whose expertise is accepted by the sufferrer and his or her social group
• a series of contacts between the healer and the sufferrer through which the healer tries to produce certain changes in the sufferer's emotional state, attitudes, and behavior

• advice from friends
• new job
• vacation
• diet

• lack of agreement about goals or aims
• lack of agreement about successful outcome
• lack of agreement about failure
• are clinicians seeking to cure to to teach
• are sufferers patients (ill) or clients (having difficulty?

• 30% adults
• 19% children

although modern pressures may contribute they are hardly the primary cause, every society, past and present, has witnessed psychological abnormality

• historians have concluded that ancient societies probably regarded abnormal behavior as the work of evil spirits (as far back as stone age)
• treatment for severe abnormality was to force the demons from the body through trephination an exorcism

• drilled holes to get demons out
• used trephine to cut away a section of the skull to release evil spirits

• 500B.C to 500 A.D.
• Philosophers and physicians offered different explanations and treatments for abnormal behaviors
• Hippocrates believed and taught that illness had natural causes (humors)

• natural causes
• the 4 humors
• black bile
• yellow bile
• blood
• phlegm
• an excess in yellow bile caused frenzied activity and an excess of black bile caused saddness, treatment was to change lifestyle

plato and aristotle agreed with hippocrates

• 500-1350 AD
• the church rejected scientific forms of investigation and it controlled all education
• religious beliefs came to dominate all aspects of life, abnormality was seen as conflict between good and evil
• abnormal behavior apparently increased greatly during this period
• some of the earlier demonological treatments reemerged
• at close of middle ages demonology and its methods began to lose favor
• exorcisms and torture returned
• church rejected any scientific differences from aristotle

• eating
• locomotive
• thinking

• 1400-1700A.D
• demonological views of abnormality continued to decline
• german physician Johan Weyer believed that the mind was as susceptible to sickness as the body (first physician to specialize in mental illness)
• the care of people with mental disorders continued to improve in this atmosphere
• due to gallileo demonology was shattered
• saw a rise in asylums

• a community mental health program of sorts
• people would go to the community and the people would get them back on their feet by giving jobs and housing when they were back on their feet they would help someone else

institutions whose primary purpose was care of the mentally ill

intention was good care but because of overcrowding they became virtual prisons, not enough staff to treat them humanly

• hospital was given to Henry VIII and formed into an asylum where the prisoners would cry out in the middle of the night
• people could pay and see the patients

bedlam--> loud crazy sound, comes from this era, bedlam hospital in London, could hear patients screaming at night

• 1800s
• treatment of people with mental disorders began to improve once again
• Pinel (france) and Tuke (england) advocated moral treatment-- care that emphasized moral guidance and humane and respectful techniques
• in the US Benjamin Rush (father of American psychiatry) and Dorothea Dix (Boston School teachter) were the primary proponents of moral treatment
• by end of 19th century led to reversal of moral treatment movement
• by early 20th century the moral treatment movement had ground to a halt, long term hospitalization became the rule once again

was a medical custodian, director of the mental hospital who unchaned all of the patients in his hospital

Tuke came up with moral treatment and penitentries where you go to an estate that was comfortable and are treated with respect, everyone helped maintain the place but gave them a place to go to get better, gave lives meaning

• father of american psychology
• took Tukes ideas and applied them in America

Dix was a teacher in America who helped create state hospitals

• Money and staff shortages
• Declining recovery rates
• overcrowding
• emergence of prejudice--> traits were inherited and passed to children, dont allow them to reproduce (eugenics) and people stopped donating money, if someone in the family had a mental disorder then you were considered undesirable to marry

• as the moral movement was declining in the late 1800s, two opposing perspectives emerged
• the somatogenic perspective
• the psychogenic perspective

• abnormal functioning has physical causes
• began with Hippocrates belief that it was a brain disease and imbalance of humors
• was rebirthed in the 20th century
• despite optimism, biological approaches yielded mostly disappointing results throughout the first half of the twentieth century, when a number of effective medications were finally discovered
• treatments included sterilization and pulling out teeth and cutting nerves in the brain

• abnormal functioning has psychological causes
• rise in popularity of this perspective was based on work with hypnotism

philosophical problem where there is a physical world and the mental world

deals with disorders of CNS that have known causes and treatments for those disorders

deals with disorders of CNS that have not found neurological reasons or causes yet

• Emil Kraepelin's textbook argued that physical factors (such as fatigue) are responsible for mental dysfunction
• New biological discoveries were made such as the link between untreated syphilis and general paresis

• Friedrich Mesmer and hysterical disorders
• Sigmund Freud's theory of psychoanalysis

• Freud and his followers offered psychoanalytic treatment primarily to patients who did not require hospitalization-- not known as outpatient therapy
• by the early 20th century, psychoanalytic theory and treatment were widely accepted
• came up with psychoanalysis

either the theory or treatment of abnormal mental functioning that emphasizes unconscious psychological forces as the cause of psychopathology

• 43%
• 35%

the past 50 years have brought major changes in the ways clinicians understand and treat abnormal functioning

• in the 1950s researches discovered a number of new psychotropic medications
• antipsychotic drugs
• antidepressant drugs
• antianxiety drungs
• led to the deinstitutionalization and a rise in outpatient care

correct extremely confused and distorted thinking

drugs that primarily affect the brain and reduce many symptoms of mental dysfunctioning

lift the mood of depressed people

drugs that reduce tension and worry

releasing hundreds of thousands of patients from public mental hospitals

• when patients do need institutionalization they are usually given short-term hospitalization and then ideally, outpatient psychotherapy and medication in community settings and residences
• outpatient treatments are also becomming available for more and more kinds of problems
• yet another change in outpatient care has been the development of programs devoted exclusively to one kind of psychological problem

• the approach has been helpful for many patients, but too few community programs are available in the US only 40-60% of those with severe disturbances receive treatment of any kind
• majority of people with severe mental illness end up in prison for committing crimes

• since the 1950s outpatient care has continued to be the preferred mode of treatment for those with moderate disturbances
• although this type of care was once exclusively private psychotherapy now most health insurance plans cover it and it now includes various settings as well as specialty care

arrangement by which an individual directly pays a therapist for counseling services

1 in 6

the prevention movement

the prevention programs have been further energized by the growing interest in positive psychology

• correct the social conditions that underlie psychological problems
• help individuals at risk for developing disorders

the study and enhancement of positive feelings traits and abilities

interventions aimed at deterring mental disorders before they develop

• in response to growing diversity in the US this new area of study has emerged
• multicultural psychologists seek to understand how culture, race, ethnicity, and gender affect behavior and though and how people of different cultures, races, and genders, may differ psychologically

today the dominant form of insurance coverage is the managed care program

• program in which the insurance company determines key care issues
• at least 75% of all privately insured persons in the US are enrolled in managed care programs
• a key problem is that reimbursements for mental disorders tend to be lower than those for medical disorders
• therapists may choose the cost of sessions and the number of sessions for which a client may be reimbursed
• in 2011 a federal parity law went into effect

With this way is that it shortens therapy, unfairly favor treatments whose not always lasting, pose a special hardship for those with severe mental results in treatment determined by insurance companies

• psychoanalytic
• biological
• behavioral
• cognitive
• humanistic-existential
• sociocultural

none of these perspectives dominates the clinical field

physicians who complete three to four additional years of training after medical school in the treatment of abnormal mental functioning

MD, or DO

PhD psy D ed. D

MSQ, DSW

various degrees

clinical researchers have tried to determine which concepts best explain and predict abnormal behavior which treatments are most effective and what kinds of changes may be required

the systematic search for facts through the use of careful observations and investigations

• research
• it is the key to accuracy in all fields but it is particularly important in the field of abnormal psychology
• clinical researchers try to discover universal laws or principles of abnormal psychological functioning

• measuring unconscious motives
• assessing private thoughts
• monitoring mood changes
• calculating human potential

• must consider different cultural backgrounds, races, and genders, of the people they study
• must always ensure that the rights of their research participants, both human and animal, are not violated

• search of nomothetic understanding (understanding of nature, causes, and treatments for abnormality)
• do not typically assess, diagnose, or treat individual clients
• rely on the scientific method to pinpoint relationships between variables
• use three method of investigation to form and test hypotheses and to draw broad conclusions

• provides detailed, interpretative description of a person's life and psychological problems
• can be a source of new ideas about behavior
• (Freud's theories based mainly on case studies)
• may offer tentative support for a theory
• may challenge a theory's assumptions
• may inspire new therapeutic techniques
• may offer opportunities to study unusual problems that do not occur often enough

• has limitations
• reported by biased observers (therapist has personal stakes)
• rely of subjective evidence
• provide little basis for generalization
• these limitations are addresed by other two methods of investigation

• case study
• correlational method
• experimental method

• do not offer richness of detail
• do allow researchers to draw broad conclusions

• typically involve observing many individuals
• researchers apply procedures uniformly (studies can be replicated)
• researchers use statistical test to analyze results

a research procedure used to determine the "co-relationship" between variables

is the degree to which events or characteristics vary with each other

• are stress and onset of mental disorders related
• is culture generally linked to mental disorders
• are income and mental disorders related
• are social skills tied to mental disorders
• is social support tied to mental disorders
• are family conflict and mental disorders related
• is treatment responsiveness tied to culture

when variable change the same way their correlation is said to have a positive direction

the value of one variable increases as the value of the other variable decreases

variable also may be unrelated

variables which vary closely together

variables which do not vary as closely together

• the correlation coefficient can vary from +1.00 (perfect positive correlation) to -1.00 (perfect negative correlation)
• sign (+ or -) indicates direction
• number indicates magnitude
• 0.00= no consistent relationship
• most correlations found in psychological research fall far short of "perfect"

• correlations can be trusted based on a is statistical analysis of their data
• in essence they ask how likely it that the study's particular findings have occurred by chance

because researchers measure their variables, observe many participants, and apply statistical analyses, they can replicate findings

• result describe but do not explain a relationship
• results say nothing about causation

provides individual information

does not provide general information, does not provide causal information, no statistical analysis possible, not replicable

provides general information, statistical anaylysis is possible and is replicable

does not provide individual information or causal informathion

• provides general information, causal information, statistical analysis is possible, and is replicable
• does not provide individual information

• epidemiological studies
• longitudinal studies

• reveal the incidence and prevalence of a disorder in a particular population
• incidence
• prevalence

number of new cases that emerge in a given period

total number of cases in a given period

researchers observe the same individuals on many occasions over a long period

• use experiments to observe variables
• statistics and research design are very important
• researchers must try to eliminate all confounds (variables other than the independent variable that may also be affecting the dependent variables)

a research procedure in which a variable is manipulated and the manipulation's effect on another variable is observed

questions about causal relationships can only be answered by an experiment

independent variable

dependent variable

• does factor x cause a disorder
• is cause A more influential than cause b
• how does family communication and structure affect family members
• how does a disorder affect the quality of a person's life
• does treatment X alleviate a disorder
• is treatment x more helpful than treatment B
• why does treatment X work
• can an intervention prevent abnormal functioning

• A control group
• random assignment
• blind design

• a control group is a group of research participants who are not exposed to the independent variable but whose experience is similar to that of the experimental group
• by comparing the two groups, researchers can better determine the effect of the independent variable

• researchers must also watch out for differences in the makeup of the experimental and control group
• to do so researchers use random assignment- any selection procedure that ensures that every participant in the experiment is as likely to be placed in one group as another (flipping a coin, picking a name out of a hat)

• final confound problem is bias
• to avoid bias by the participant, experimenters emply a blind design in which participants are kept from knowing which assigned group (experimental or control) they are in

something that stimulates real therapy but has none of its key ingrediants

• experimenters and the participants are kept from knowing which condition of the study participants are in
• often used in medication trials

• quasi-experimental designs
• natural experiments
• analogue experiments
• single-subject experiments

• mixed designs
• investigators do not randomly assign participants to groups, but make use of groups that already exists (children with a history of  child abuse)
• to address the problem of confounds, researchers use matched control participants (these groups are matched to the experimental group based on demographic and other variables)

• nature itself manipulates the independent variable and the experimenter observes the effects
• ex: psychological impact of flooding

• allow investigators to freely manipulate independent variables while avoiding ethical and practical limitations
• they induce laboratory subjects to behave in ways that seem to resemble real life (ex: animal subjects)
• got depression-like symptoms in animals and humans by exposing them to negative events (loud sounds, shocks, and task failures)

• a single participant is observed both before an after manipulation of an independent variable
• an example is the ABAB or reversal design

• reversal design
• participant's reactions are measured during a baseline period (A) after the introduction of the independent variable (B) after the removal of the independent variable (A) and after reintroduction of the independent variable (B)

• roots in 19th century
• 1844 association of medical superintendents of America institutions for the insane
• in 1892 the name changed to american medico psychological
• created a standard classified nomenclature of disease
• US military during WWII expanded the standard in 1943
• APA made additional revisions and published the manual as the diagnostic and statistical manual of mental disorders in 1952
• (helped define what soldiers were going through)
• APA came under attack in 60s but behaviorial psychologists sociologists and skeptical psychiatrists

• 1968
• was the response from the APA
• relied less on psychodynamic theories and more on sociobiological evidence (more medical explanations)
• was still unreliable Spitzer and Fleiss (1974)--> published study that pointed out DSM was not reliable
• the goal of DSMII was to establish specific criteria (operational definitions) for disorders to improve clinical utility and inter-rater agreement
• structured clinical interview for DSMIII
• Spitzer did studies and showed how much better it was, used a different statistical methods for comparison and weighted it in favor of

• spritzer scammed people
• homosexuality was considered a disorder in DSM III
• so controversial issues were taken out in DSM III R

made and improved definition of what constituted mental disorder

• came out in 2000
• 5 part axial system to consider the patient as a whole person not just a disorder
• includes medical psychosocial and environmental functioning

• 2013
• attempts to include the latest findings in genetics and biomarker research
• got rid of the axial system
• reduced number of disorders and regrouped disorders according to proposed biological clusters rather than overt behavioral syndromes
• widely critisized (real APA, NIMH)
• lists approximately 400 disorders
• describes criteria for diagnosis key clinical features and related features that are often but not always present

• each model spells out the science basic assumptions, gives order to the field under study and sets guidelines for investigation
• models influence what investigators observe, the questions they ask, the information they seek and how they interpret this information

• biological model
• psychodynamic model
• behavioral model
• cognitive model
• humanistic- existential model
• sociocultural model
• family-social perspective
• mulitcultural perspective

• adopts a medical perspective
• main focus is that psychological abnormality is an illness brough about by malfunctioning parts of the organism
• typically point to problems in brain anatomy and brain chemistry

• brain is made up of about 100 billion nerve cells called neurons and thousands of billions of support cells called glia
• within the brain, large groups of neurons form distinct areas called brain regions
• information is communicated throughout the brain in the form of electrical impulses that travel from one neuron to one or more others
• an impulse is first received by a neuron's dendrites, travels down the axon, and is transmitted through the nerve ending to other neurons

• neurons do not actually touch each other, they are separated by a space (the synapse) across which a message moves
• when an electrical impulse reaches a nerve ending, the ending is stimulated to release a chemical called a neurotransmitter that travels across the synaptic space to receptors on the dendrites of neighboring neurons (some NTs tell receiving neurons to fire, other NTs tell receiving neurons to stop firing)

• researchers have identified dozens of NTs such as serotonin, dopamine, and GABA
• studies indicate that abnormal activity in certain NTs can lead to specific mental disorders (depression has been linked to low activity in serotonin and norepinephrine)
• mental disorders are sometimes related to abnormal chemical activity in the endocrine system
• endocrine glands release hormones which propel body organs into action
• abnormal secretions have been linked to psychological disorders (cortisol release is0 related to anxiety and mood disorders

• genetics
• evolution
• viral infection

genes that contribute to mental disorders are typically viewed as unfortunate occurrences

• may be mutation
• may be inherited after a mutation in the family line
• may be the result of  normal evolutionary principles

• human reactions and the genes responsible for them helped people to thrive and adapt
• in today's world, those genes and reactions may not be so adaptive

attempt to pinpoint the physical sources of dysfunction to determine the course of treatment

• drug therapy
• electroconvulsive therapy (ECT)
• psychosurgery

drugs that mainly affect emotions and through processes

• 1950s
• greatly changed outlook for a number of mental disorders

• antianxiety drugs (aka minor tranquilizers, anziolytics)
• antidepressent drugs
• antibipolar drugs
• antipsychotic drugs

• ECT
• used primarily for depression, particularly when drugs and other therapies have failed

attach two electrodes to the patients forehead, electric current is applied through the brain briefly causing seizures, after a few treatments the patients begin to feel less depressed

• neurosurgery
• historical roots in trephining
• 1930s= first lobotomy (cut between connections between the frontal lobes and the lower regions of brain)
• much more precise today than in the past
• considered experimental and used only in extreme cases

• enjoys considerable respect in the field
• constantly produces valuable new information
• biological treatments often bring great relief when other approaches have failed

• can limit, rather than enhance our understanding
• believes that all human behavior can be explained in biological terms
• both biological and nonbiological factors play a role in mental life
• treatments produce significant undesirable effects

• oldest and most famous psychological model
• based on belief that a person's behavior (whether normal or abnormal) is determined largely by underlying psychological forces-- that is dynamic- psychological forces that interact with each other (abnormal symptoms are the result of conflict among these forces)

Sigmund Freud (1856-1939)

• Id
• Ego
• Superego

• guided by the pleasure principle
• instinctual needs, drives, and impulses
• sexual, fueled by the libido (sexual energy)

• guided by the reality principle
• seeks gratification but guides us to know when we can and cannot express our wishes (environment does not always meet all our needs)
• ego defense mechanisms protect us from anxiety

• guided by the ideal principle
• conscience, unconsciously adopted from our parents

• Freud proposed that at each stage of development new events and pressures require adjustment in the id, ego, and superego
• if successful--> personal growth
• if unsuccessful--> fixation at an early developmental stage, leading to psychological abnormality
• because parents are the key figures in early life they are often seen as the cause of improper development

• oral (0 to 18 months of age)
• anal (18 months to 3 yrs of age)
• phallic (3-5 yrs)
• latency (5-12 yrs)
• genital (12 yrs to adulthood)

emphasize the role of the ego, consider it independent and powerful

emphasize the unified personality (role of self)

emphasize the human need for relationships especially between children and caregivers

• free association
• therapist interpretation
• catharsis
• working through

tpsychodynamic technique in which the patient describes any thoughts feelings or image that comes to mind

• resistance
• transference
• dream interpretation

an unconscious refusal to participate fully

they act and fell toward the therapist as they did not or do toward important persons in their lives

• can reveal unconscious instincts, need and wishes
• manifest content--> consciously remembered dream
• latent--> symbolic meaning
• interpretation of dreams means converting manifest content into latent content

reliving of past repressed feelings (settle internal conflicts)

must examine some issues over and over

• short term psychodynamic therapies
• relational psychoanalytic therapy

work through a single problem (dynamic focus) in only a few appoinments

therapist are key figures in lives of patients, therapists should also disclose things about themselves and their reactions to patients to establish a relationship with patient

• saw abnormal functioning as rooted in the same process as normal functioning
• first to apply theory and techniques systematically to treatment- monumental impact on the field
• first recognize importance of psychological theories and treatment

• unsupported ideas
• hard to research (non observable, inaccessible to human subject) (unconsious)

• like psychodynamic theorists, behavioral theorists believe that our actions are determined largely by our experiences in life
• concentrates wholly on behaviors and environmental factors
• bases explanations and treatments on principles of learning
• the model began in laboratories where conditioning studies were conducted

• classical conditioning
• operant conditioning
• modeling

• learning occurs when two events repeatedly occur close together in time
• become fused in a person's mind
• learning by temperal association
• when two events repeatedly occur close together in time become fused in person's mind before long the person responds in the same way to both events

may be used to change abnormal reactions to particular stimuli

humans and animals learn to behave in certain ways as a result of receiving rewards whenever they do so

individuals learn responses by observing other individuals and repeating behavior

• 1849-1936
• father of classical conditioning
• classic study using dogs and meat powder
• explains many familiar behaviors (both normal and abnormal)

• aim to identify the behaviors that are causing problems and replace them with more appropriate ones
• may use classical conditioning operant conditioning or modeling
• therapist is teacher rather than healer

• step by step procedure
• learn relaxation skills (learn to react calmly)
• construct a fear hierarchy (list of feared objects or situations in order from those that are less feared to most feared)
• confront feared situations (while in state of relaxation)

• powerful force in the field
• can be tested in the laboratory
• treatments have been successful

• no evidence that symptoms are ordinarily acquired through conditioning
• behavior therapy is limited
• too simplistic does not account for complexity of behavior (new focus on self-efficacy and cognitive-behavioral theories)

• this model proposes that we can best understand abnormal functioning by looking to cognition (the centers of behaviors, thoughts, and emotions)
• argues that clinicians must ask questions about assumptions, attitudes, and thoughts of a client

• abnormal functioning can result from several kinds of cognitive problems
• faulty assumptions and attitudes
• illogical thinking processes
• ex: some people consistently think in illogical ways and keep arriving at self defeating conclusions

• people can overcome their problems by developing new, more functional ways of thinking
• main model: Becks cognitive therapy

• the goal of therapy is to help clients recognize and change their thinking
• therapists also guide clients to challenge their dysfunctional thoughts, try out new interpretations and apply new ways of thinking in their daily lives
• widely used in treating depression

• very broad appeal
• focus exclusively on client interpretations attitudes, assumptions, and cognitive processes
• focuses on a uniquely human process
• theories lend themselves to research
• therapies effective in treating several disorders

• cognitive changes proposed by beck are not always possible to achieve
• therapies do not help everyone
• some changes may not be possible to achieve
• in response a new wave of therapies has emerged including Acceptance and commitment Therapy

combination model of the humanist view and existenialist view

emphasis on people as friendly, cooperative, and constructive, focus on drive to self actualize through honest recognition of strengths and weakness

emphasis on self-determination, choice, and individual responsibility, focus on authenticity

• believes in the basic human need for positive regard
• if recieved leads to unconditional self- regard
• if not, leads to "conditions of worth" (incapable of self-actualization because of distortion- do not know what they really need, etc.)

• therapist creates a supportive climate
• unconditional positive regard (full of warm acceptance for client)
• accurate empathy (skillfull listening and restatement)
• genuineness (sincere communication)
• little research support but positive impact on clinical practive

• developed by Fritz Perls
• goal is to guide clients toward self-recognition through challenge and frustration
• little research to support it

• skillfull frustration (therapist refuses to meet their clients expectations and demands)
• role playing (therapists instruct client to act out various roles)
• rules including "here and now" and "I" language

• for most of the twentieth century, clinical scientists viewed religion as a negative- or at best neutral-- factor in mental health
• this historical alienation between the clinical field and religion seems to be ending
• researchers have learned that spirituality does in fact often correlate with psychological health

• foundational belief that psychological dysfunction is caused by self deception
• people hide from life's responsibilities and fail to recognize that it is up to them to give meaning to their lives
• in therapy people are encouraged to accept personal responsibility for their problems
• goals more important than technique
• great emphasis place on client therapist relationship
• existential therapists do not believe that experimental methods can adequately test the effectiveness of their treatments
• as a result, very little controlled research has been conducted

• taps into domains missing from other models
• emphasizes the individual
• despite past and present events we make our own choices
• emphasizes health (view patients as people who havent fulfill potential)

• focuses on abstract issues of human fulfillment
• difficult to research
• weakened by rejected use of empirical research
• beginning to change

• argue that abnormal behavior is best understood in light of the social and cultural forces that influence an individual
• address norms and roles in society

• family-social perspective
• multicultural perspective

• argue that theorists should concentrate on forces that operate directly on an individual
• ex: social labels and roles
• diagnostic labels (rosenhan study)
• focus on family structure and communication
• family systems theory argues that abnormal functioning within a family leads to abnormal behavior (insane behavior becomes sane in an insane environment)
• social and financial resources could be how smart you are before a mental illness

• group therapy
• family therapy
• couple therapy
• community treatment (includes prevention work)

• aka culturally diverse perspective
• seek to understand how culture, race, ethnicity, gender, and similar factors affect behavior and thought as well as how people of different cultures, races, and genders, differ psychologically
• have noticed in studies that minorities do not have the same responses to psychotherapy
• holds that individual's behavior is best understood when examined in light of that individual's unique cultural context
• prejudice and discrimination faced by many minority groups may contribute to various forms of abnormal functioning

to the set of values, attitudes, beliefs, history, and behaviors shared by one group of people and communicated from one generation to the next

members of ethnic and racial minority groups tend to show less improvement in clinical treatment than members of majority groups

• greater sensitivity to cultural issues
• inclusion of cultural models in treatment, especially in therapies for children and adolescents

• added greatly to the clinical understanding and treatment of abnormality
• increased awareness of family, cultural, social, and societal issues
• clinically successful when other treatments have failed

• research is difficult to interpret
• correlation does not mean causation
• model unable to predict abnormality in specific individuals

THERAPY GOAL IS BIOLOGICAL REPAIR AND HAS STRONG RESEARCH SUPPORT

THEARPY GOAL IS BROAD PSYCHOLOGICAL CHANGE AND HAS MODEST RESEARCH SUPPORT

THERAPY GOAL IS FUNCTIONAL BEHAVIORS AND HAS STRONG RESEARCH SUPPORT

THERAPY GOAL IS ADAPTIVE THINKING AND HAS STRONG RESEARCH SUPPORT

THERAPY GOAL IS SELF ACTUALIZATION AND HAS WEAK RESEARCH SUPPORT

THERAPY GOAL IS AUTHENTIC LIFE AND HAS WEAK RESEARCH SUPPORT

THERAPY GOAL IS EFFECTIVE FAMILY OR SOCIAL SYSTEM AND HAS MODERATE RESEARCH SUPPORT

THERAPY GOAL I CULTURAL AWARENESS AND COMFORT AND HAS MODERATE RESEARCH SUPPORT

abnormality results from the interaction of genetic, biological, developmental, emotional, behavioral, cognitive, social, and societal influences

• takes in biology, social, and physiological factors
• some favor a diathesis-stress approach

you are predetermined to have a mental disorder but when a stresser is added it will push you into having the disorder

• integrative therapists
• takes  the strengths from each model and using them in combination

• creating your own model
• most common type above cognitive model

collecting relavant information in an effort to reach a conclusion

• used to determine how and why a person is behaving abnormally and how that person may be helped
• the focus is idiographic that is on an individual person
• also may be used to evaluate treatment progress

there are thousands of clinical assessment tools

• clinical interviews
• tests
• observations

• to be useful assessment tools must be standardized and have clear reliability and validity
• one must standardize administration, scoring, and interpretation

to set up common steps to be followed whenever it is administered

• refers to consistency of an assessment measure
• a good tool will always yield the same results in the same situation
• a characteristic of the test score
• test scores are the same every time test is given

• test-retest reliability
• interrater reliability

yields the same results every time the test is given to the same people

• different judges independently agree on how to score and interpret a particular tool (too subjective items like essays)
• take the test, two people grade it, they assign similar grades

• refers to the accuracy of a tool's results
• a good assesment tool must accurately measure what it is supposed to measure
• validity is a function of the interpretation not the test itself

• face validity
• predictive validity
• concurrent validity

a tool appears to measure what it is supposed to measureng, does not necessarily indicate true validity (looks valid on the surface but measures something completely different)

a tool accurately predicts future characteristics or behavior

a tool's results agree with independent measures assessing similar characteristics or behavior

• these face to face encounters often are the first contact  between a client and a clinician/assessor
• used to collect detailed information, especially personal history, about a client
• allow the interviewer to focus on whatever topics they consider most important
• focus depends on theoretical orientation

can be either unstructured or structured

clinicians ask open ended questions

• clinicians ask prepares questions often from a published interview schedule
• may include a mental status exam

• may lack validity or accuracy
• individuals may be intentionally misleading
• interviewers may be biased or may make mistakes in judgement
• interviews particularly unstructured ones, may lack reliability

• tests are standardized devices for gathering information about a few aspects of a person's psychological functioning from which broader information can be inferred
• more than 500 clinical test

• require the clients interpret vague or ambiguous stimuli or follow open-ended instruction
• mainly used by psychodynamic clinicians

• rorchach test (inkblot)
• thematic apperception test
• sentence completion test
• drawings (mostly with kids, draw a person and draw another person of opposite sex)

• TAT
• look at a picture and tell what is going on

• helpful for providing supplementary information
• have not consistently demonstrated much reliability or validity
• may be biased against minority ethnic groups

• designed to measure broad personality charactersitics
• focus on behaviors beliefs and feelings
• usually based on self reported responses
• most widely used test is Minnesota Multiphasic Personality Inventory

• for adults: MMPI (original) or MMPI-2 (1989 revision)
• for adolescents: MMPI-A
• Minnesota took questions and administered to normal and mentally ill people and then kept only the questions that were different between two groups
• consists of more than 500 self statements that can be answered "true", "false" or "cannot say"
• statements describe physical concerns, mood, sexual behaviors, and social activities

• hypochondriasis
• depression
• hysteria
• psychopathic deviate
• masculinity-femininity (how much you reject gender roles)
• paranoia
• psychasthenia
• schizophernia
• hypomania
• social introversion

• scores range from 0-120
• above 70=deviant
• graphed to create a profile

• normal is considered from rural minnesota residents
• however the test is the most researched test

• easier, cheaper, and faster to administer than projective tests
• objectively scored and standardized (no interpretation)
• display greater test-retest reliability than projective tests
• appear to have greater validity than projective tests
• however they cannot be considered highly valid; measured traits often cannot be directly examined- how can we really know the assessment is correct
• tests fail to allow for cultural differences in responses
• more than 10,000 scales

• usually based on self-reported responses
• focus on one specific area of functioning
• affective inventories (Beck depression inventory)
• social skills inventories
• cognitive inventories

• have strong face validity
• few have been subjected to careful standardization, reliability, and/or validity procedures (Beck Depression Inventory and a few others are exceptions)
• easy to scam

• measure physiological response as an indication of psychological problems
• includes heart rate, blood pressure, body temperature, galvanic skin response, and muscle contraction
• most popular is polygraph (lie detector)

• require expensive equipment that must be tuned and maintained
• can be inaccurate and unreliable
• not admissable in court
• do not work as well as they claim

• directly asses brain function by assessing brain structure and activity
• ex: EEG, PET scans, CAT scans, MRI, fMRI

• looking at pictures of the brain
• peoples brains are different from each other, just cause something looks different it does not mean that there is something wrong with that person

• indirectly assess brain function by assessing congnitive, perceptual, and motor functioning
• most widely used is the Bender Visual-Motor Gestalt test
• clinicians often use a battery of tests
• does not give only one test but they give many to make a diagnosis

• can be very accurate
• at best though these tests are general screening devices
• best when used in a battery of tests, each targeting a specific skill area
• these are highly specific and can diagnose and are not general screening only

• designed to indirectly measure intellectual ability
• typically comprised of a series of tests assessing both verbal and nonverbal skills
• general score is an intelligence quotient (IQ)

represents the ratio of a person's "mental" age to his or her "chronological" age

being reminded of the stereotype of a particular group will make that groups scores lower

• are among the most carefully produced of all clinical tests
• highly standardized on large groups of subjects
• have very high reliability and validity

• performance can be influenced by nonintelligence factors motivation, anxiety, test-taking experience)
• test may contain cultural in language or tasks
• members of minority groups may have less experience and be less comfortable with these types of tests, influencing their results

• naturalistic
• analog
• self-monitoring

• looking at someone in their natural environment
• can occur in homes, schools, institutions (hospitals and prisons) and community settings
• most focus on parent-child, sibling-child, or teacher-child
• observations are generally made by participant observers and reported to clinician

set up environment to study clients in

give them a form and they fill out their when they do their behavior

• much can be learned from witnessing behavior
• reliability is a concern
• different observers may focus on different aspects of behavior
• validity is also a concern
• risk of "overload", "observer drift' and observer bias (too much information, observer getting tired)
• reactivity may also limit validity (presence of observer may change reaction)
• observations may lack cross situational validity (may not act the same way everywhere)

people observe themselves and carefully record the frequency of certain behaviors, feelings, or cognitions as they occur over time

• useful in assessing infrequent behaviors
• useful for observing overly frequent behaviors
• provides a means of measuring private thoughts or perceptions
• validity is often a problem
• clients may no record information accurately
• when people monitor themselves they often change their behavior

• using all available information clinicians attempt to paint a clinical picture
• influenced by theoretical orientation
• using assessment data and clinical picture clinicians attempt to make a diagnosis based on existing disorders and observations

a determination that a person's psychological problems comprise a particular diorder

• list of categories, disorders and symptom descriptions with guidlines for assignment
• focus on clusters of symptoms

• DSM-5
• diagnostic and statistical manual of mental disorders (5th edition)

• categorical information
• dimensional information

• name of the category (disorder) indicated by the clients symptoms
• clinician must decide whether the person is displaying one of the hundreds of disorders listed in the manual
• anxiety disorders
• depressive disorders

• a rating of how severe a client's symptoms are and how dysfunctional the client is across various dimensions of personality
• diagnosticians also are required to assess the current severity of the clients disorder
• for each disorder, various rating scales are suggested
• ex: severity of illness rating scale
• if a client qualifies for a diagnosis of personality disorder, further assessment is required

clinicians also have the opportunity to provide other information including relavant medical conditions and special psychosocial problems

• judged by reliability and validity
• reliability means that different clinicians are likely to agree on a diagnosis using the system to diagnose the same client
• framers of DSM-5 followed certain procedures to help ensure greater reliability than any previous edition
• despite such efforts, critics still have concerns
• validity of a classification system is the accuracy of the information that its diagnostic categories provide
• predictive validity is of the most use clinically
• DSM-5 framers also tried to ensure the validity of this edition by conducting extensive literature reviews and running field studies (many still concerned with validity)

• took more than a decade
• a task force and numerous work groups were framed in 2006
• between 2010 and 2012 the task force released several drafts online and clinical researchers and practitioners were asked to offer suggestions
• the task force took the online feedback into consideration and DSM-5 was completed and published in 2013
• changes include additions to and removals of diagnostic categories, reorganizing of categories, and changes in terminology

• misdiagnosis is always a concern (major issue is the reliance on humans)
• sometimes unintended results may occur, diagnosis may be self fulfilling prophecy (they are treated as sick and therefore begin to act sick)
• because of these problems some clinicians would like to do away with the practice of diagnosis

• begin with assessment information and diagnostic decisions to determine treatment plan
• uses combination of individual information and broad information about nature and treatment
• a therapists theoretical orientation effects treatment
• today most treatment is based on evidence based research

• how do u define succes
• how do u measure improvement
• how do you compare treatments
• people differ in their problems, personal styles and motivations for therapy
• therapists differ in skill, knowledge, orientation and personality
• therapies differ in theory, format, and setting

• is therapy in general effective
• are particular therapies generally effective
• are particular therapies effective for particular problems

• research suggests that therapy is generally more helpful than no treatment or placebos
• in one major study using meta analysis the average person who recieved treatment was better off than 75% of untreated subjects
• some clinicians are concerned with a related question (can therapy can be harmful?)
• it does have this potential
• studies suggest that 5-10% of patients get worse with treatment

• lump all therapies together to consider their general effectiveness
• some critics call this a uniformity myth (false belief that all therapies are equivalent despite differences in the therapists training, experience, theoretical orientations, and personalities)

• alternative approach to the therapy outcome study
• looks at common stratagies among therapies
• regardless of clinician orientation

what specific treatment by whom is the most effective for this individual with that specific problem and under which set of circumstances

• recent studies focus on the effectiveness of combined approaches
• drug therapy combined with certain forms of psychotherapy- to treat certain disorders