1
Q
psychotropic drugs
A
medications designed to alter psychological functioning
2
Q
In order to affect the brain in the desired way, psychotropic drugs must cross the blood-brain barrier, which is what?
A
a network of tightly packed cells that only allows specific types of substances to move from the bloodstream to the brain in order to protect delicate brain cells against harmful infections and other substances.
3
Q
Antidepressant drugs
A
medications designed to reduce symptoms of depression
4
Q
1st type of antidepressant: monoamine oxidase inhibitors (MAOIs) (down sides?)
A
work by deactivating monoamine oxidase (MAO), an enzyme that breaks down serotonin, dopamine, and norepinephrine at the synaptic clefts of nerve cells. (Down sides: dangerous side effects when interacting w/ other meds & certain foods e.g., aged cheese, smoked meats, alcohol)
5
Q
2nd type of antidepressant: tricyclic antidepressants (side effects?)
A
drugs that block the reuptake of serotonin and norepinephrine. (Side effects: nausea, weight gain, sexual dysfunction, & seizures)
6
Q
3rd type of antidepressant: selective serotonin reuptake inhibitor (SSRI) (side effects?)
A
a class of antidepressant drugs that block the reuptake of serotonin – means more serotonin will remain in synapse, thus allowing it to continue to affect the postsynaptic neurons. (Side effects: changes in sleep pattern & sex drive)
7
Q
what is the bystander effect
A
The presence of others decreases the likelihood of helping behaviour
8
Q
what decreases the likelihood of helping behaviour
A
- Notice the event: other people can cause a distraction
- Interpret that event as an emergency: pluralistic ignorance meaning that we look to the external behaviours of others as an indication of how they feel internally which can affect how we think
- Assume responsibility: the more people that are around the more responsibility gets diffuses
- Know the appropriate form of assistance: feelings of lack oh knowledge of competence in social situations
- Decide to implement help: danger to self embarrassment especially if others are not acting
9
Q
what is conformity
A
- Adjusting our behaviour or thinking to coincide with the group
○ “norm formation” (e.g., standing in an elevator, classroom behaviour)
10
Q
what are reasons for conformity: normative social influence
A
○ We follow social norms (unwritten rules for behaviour) to avoid rejection and gain approval
○ We don’t want to “stand out” or be punished
11
Q
what are reasons for conformity: informational social influence
A
○ Sometimes we assume the group knows something we don’t (look to others for information
○ Especially in new or ambiguous situations
12
Q
asch’s line judgement study
A
- Which lines matches the target line
- When 7 others (confederates of the researcher) give the clearly wrong answer
○ 1/3 people conform on any given test trial
○ 70% of people give at least one wrong answer overall
13
Q
what is obedience
A
- Complying with a direct request from an authority figure
14
Q
who is stanley milgram
A
wanted to understand the atrocities of world war II
○ Nuremberg trials - just following orders?
○ Would people violate moral beliefs when ordered
15
Q
milgram experiment
A
- Study of learning
○ Participant is the ‘teacher’, confederate is the ‘learner’
○ Electric shocks after each mistake, increase intensity
○ Learner protests, asks to leave study, screams, refuses to answer, falls silent - Experimenter says ‘the experiement requires that you continue’
- How many will continue to the highest voltage ~70% of people
- We’re more susceptible to social pressure & authority than we think
16
Q
why do people obey
A
- Lack of personal responsibility
- Not wanting to be rude or disobey rules
- Initially obey easy commands and then feel trapped and compelled to obey increasingly difficult commands; entrapment
17
Q
philip zimbardo
A
the Stanford prison experiment (1971)
- 24 young men randomly assigned to prisoner or guard
○ Guards: sleep deprivation, denied bathroom, stripped naked, solitary confinement, 1/3 sadistic by day 6
○ Prisoners: riots, passive acceptance, mental breakdown
- Criticisms
○ Unethical
○ Unscientific
§ No control group
§ Small, unrepresentative sample of 24
§ Selection bias
○ Participants behaved as they were expected to behave
§ No rules; told to create fear
§ Zimbardo was not a neutral observer; enabled bad behaviou
18
Q
person perception: thin slicing
A
- Thin-sliced judgements: we form quick impressions of others based on “thin-sliced of behaviour
○ These first impressions are surprisingly accurate
19
Q
explaining behaviours: attributions
A
- We describe others’ behaviours either in terms of their internal dispositions (stable) or their external situations (varying)
- When someone shows up late, is this because
○ They are irresponsible
○ Their bus was delayed
20
Q
fundamental attribution error
A
- We overestimate the influence of internal dispositions and underestimate the influence of situations
○ When judging others
§ A jerk or a nice guy
○ When judging ourselves
§ We blame sitch for bad and ourselves for good
21
Q
what is prejudice and what are its components
A
- An unjustifiable (usually negative) attitude toward a group and it’s members
○ Often cultural, ethnic, gender, or sexual orientation groups
○ A pre-judgement - Components of prejudice
○ Beliefs: stereotypes
○ Emotion: hostility, anger, fear, discomfort
○ Behaviour: discrimination
22
Q
is prejudice unconscious or conscious
A
- Prejudice works at both the conscious and (especially) the unconscious level
○ Implicit/automatic negative associations
○ Like a knee-jerk response more than a conscious decision - Eg. Unconscious racial prejudice
○ 9/10 respondents were slow at responding to words like peace or paradise when they saw a black persons photo compared to a white persons photo (hugenberg & bodenhausen, 2003)
23
Q
what are the social roots of prejudice
A
- Social inequalities
○ Influence of money, power, and prestige
○ Just world fallacy and system justification - Social divisions
○ In-groups: overestimate the diversity in our group
○ Out-group: underestimate the diversity within their group
○ In-group bias: tendency to favour one’s own group
24
Q
what is the stereotype threat
A
- Fear of confirming a negative stereotype about one’s group, leading to underperformance
○ Anxiety, depression, suppression
25
how do we reduce prejudice
- "colourblind" strategies are not effective
- Contact (especially friendships)
- Changing social norms: expectations, media, attitudes
26
St. John's wort (Hypericum performatum)
commonly used alternative to antidepressants. researchers found that it affects two neurotransmitters related to depression & anxiety: serotonin & epinephrine. However, it does interact w/ other meds, so users should consult physician before taking.
27
Mood stabilizers
drugs used to prevent or reduce the severity of mood swings experienced by ppl w/ bipolar disorder
28
Lithium (side effects?)
one of first mood stabilizers to be prescribed regularly in psychiatry, & from the 1950s to 1980s, was the standard drug treatment for depression & bipolar disorder; can be quite effective but also toxic to kidneys and endocrine system
29
Antianxiety drugs (examples?) (side effects?)
affect the activity of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that reduces neural activity; e.g., alprazolam (Xanax), diazepam (Valium), lorazepam (Ativan); side effects: drowsiness, tiredness, impaired attention
30
MDMA-assisted therapy
83% of patients in the MDMA group no longer met the criteria for PTSD, whereas only 25% of the placebo group showed improvement, and follow-up found recovery was long-lasting.
31
Antipsychotic drugs
generally used to treat symptoms of psychosis, including delusions, hallucinations, & severely disturbed or disorganized thought
32
1st gen. of antipsychotic drugs: Thorazine, Halodol (side effects?)
block dopamine receptors, b/c symptoms of schizophrenia are related to dopamine activity in the frontal lobes & basal ganglia; side effects: seizures, anxiety, nausea, impotence, & tardive dyskinesia
33
tardive dyskinesia
movement disorder involving involuntary movements & facial tics
34
2nd gen. of antipsychotic drugs: atypical antipsychotics or 2nd gen. antipsychotics (down sides?)
less likely to produce side effects, work by affecting dopamine & serotonin transmission; down sides: effects tend to weaken over time + risks -- Clozapine (drug), compromises the body's white blood cells.
35
Frontal lobotomy
surgically severing the connections between different regions of the brain
36
Who was Antonio Moniz and what did he do?
Portuguese surgeon who developed a technique to help ppl w/ severe psychoses & other disorders. The leucotomy - surgical destruction of brain tissues in the prefrontal cortex
37
Who were Dr. Walter Freeman & Dr. James Watts and what did they do?
Dr. Freeman was an American surgeon who w/ his collaborator Dr. Watts further refined the lobotomy, developing the trans-orbital lobotomy (icepick lobotomy) - insert a slender metal shaft in between the eyeball & the eyelid, then tap a hammer through the bony roof of the eye socket & into the brain, then move it around until frontal lobes were detached
38
Focal lesions
small areas of brain tissue which are surgically destroyed
39
Electroconvulsive therapy (ECT)
involves passing an electrical current through the brain in order to induce a temporary seizure; reserved for severe cases of disorders such as depression & bipolar disorder
40
Repetitive transcranial magnetic stimulation (rTMS)
a therapeutic technique in which a focal area of the brain is exposed to a powerful magnetic field across several treatment sessions
41
Deep brain stimulation (DBS)
a technique that involves electrically stimulating specific regions of the brain (inserting thin electrode-tipped wires into the brain & carefully routing them to targeted brain regions, then a small battery connected to the wires is inserted just beneath the skin surface)
42
Psychopathology
persistently harmful thoughts, feelings, & actions that are deviant, distressful, AND dysfunctional
43
Diagnostic and Statistical Manual of Mental Disorders
o Structured interview with patient about observable behaviours and symptoms
o Diagnosis based on consensus on clusters of symptoms
o DSM-5 (2013) is controversial
44
Generalized Anxiety Disorder
* Characterized by: WORRY
o Unrealistic / excessive / persistent anxiety
o Not linked to any specific situation / stressor
* Symptoms
o Emotional: Feeling tense, nervous, on edge
o Physical: Racing heart, motor tension/shaking
o Cognitive: Bias for negative information, less ability to focus
45
GAD: Who & why?
WHO?
* Lifetime prevalence: 5%
* 2x more frequent in women compared to men
* Tends to appear before the age of 30
WHY?
* Weakly related to genetics
* Often triggered by a convergence of stresses
* Fear a loss of control
o Worrying gives a false sense of control
46
Panic disorder
* Characterized by: PANIC
o Discrete instance of fear
o No predictable context/situation
* Mostly physical symptoms
o Heart palpitations, trembling, shortness of breath, tingling, dizziness, nausea
* Symptoms are misinterpreted cognitively
47
Panic disorder: Who & why?
WHO?
* Panic attacks are not necessarily panic disorder
* Lifetime prevalence: 1-2%
* 2x more frequent in women
* Onset at 18-34 years old
WHY?
* Physiological Response (the same as healthy people)
o Patients & healthy people given a sodium lactate infusion have similar physiological responses
* Interpretation of Response (different than healthy people)
o Those with panic disorder are more catastrophic in interpretation of response
48
Obsessive-Compulsive disorder
* Characterized by: Unwanted thoughts & dysfunctional actions
* Obsessions: persistent and unwanted thoughts, ideas, or images
o Not intentionally produced
* Compulsions: actions that people feel compelled to do to relieve anxiety
o Non-functional and ritualistic
o Most common: Checking, hand washing, hoarding
49
OCD: Who & why?
WHO?
* Lifetime prevalence: 2%
* Similar rates in men and women
* Onset at 18-34 years old
o Can appear in childhood
o Very uncommon to appear after age 35
WHY?
* Biological: Elevated glucose consumption in the brain
o Frontal regions
* Thoughts & behaviours reflect fixed action patterns
o When anxiety hits, these patterns get activated
50
The vicious cycle of anxiety
Anxiety -> increased scanning for danger, physical symptoms intensify, attention narrows & shifts to self -> escape or avoidance -> Short-term: relief -> Long-term: increase in physical symptoms of anxiety, more worry, loss of confidence about coping, increased use of safety behaviours -> REPEAT
51
anxiety treatments
* Break the associations between the emotion and the event
o Relaxation – does not work for GAD
o Systematic Desensitization / Exposure Therapies
* Drugs to treat the biological explanations for anxiety
o Xanax, Prozac, alcohol ... depress CNS activity
52
Cognitive-behaviour therapy
* Perceptions/thoughts are distorted and dysfunctional
o Focus is on identifying and changing maladaptive thoughts
* When this is achieved:
o Distress decreases
o Behaviour becomes functional
o Physiological arousal subsides
* Think in more adaptive ways which in turn will influence your reaction to events (behaviours)
o Effective for: anxiety, depression, substance abuse, bipolar disorder, schizophrenia (with medication), etc...
53
Seasonal Affective disorder
Down-in-the-dumps mood; every day; During Fall & Winter
54
Dysthymic disorder
Down-in-the-dumps mood; every day; 2 years +
55
Major Depression
* Depression is more than just feeling sad!
* DSM-5 criteria—for at least 2 weeks, you’ve shown:
o Depressed mood OR lost of interest or pleasure
o AND at least 4 of the following:
Significant weight or appetite change
Insomnia or hypersomnia nearly every day
Psychomotor retardation or agitation nearly every day
Fatigue or loss of energy nearly every day
Feelings of worthlessness or guilt nearly every day
Inability to concentrate/pay attention nearly every day
Thoughts of death or suicidal ideation nearly every day
56
Major depression: Who & why?
WHO?
* Canadian lifetime prevalence: 12% of adults
* 2x more frequent in women
o And more severe in women
* Found more often than before in young people
o Age of onset now 15-19
WHY?
* The brain: Neurotransmitters
o Norepinephrine, serotonin, dopamine dysregulation
* Cognition: stressful experiences -> negative thinking -> depressed mood -> cognitive/behavioural changes -> REPEAT
57
Bipolar disorder
* Mania: Physical, emotional, and cognitive changes
o Physical: High energy, activity, decreased eating, sleeping
o Mood: Elation and exhilaration
* Can become irritable/angry
o Cognitive: Racing thoughts (distractible), inflated self-esteem (special abilities)
o Leads to engagement in pleasurable behaviours that may lead to painful outcomes
58
Bipolar disorder: Who & why?
WHO?
* Relatively infrequent (1%)
* Equally seen in men and women
* More risk at higher socioeconomic status
o Could increased energy lead to higher status first?
o Could lower SES lead to different diagnosis?
WHY?
* Biological
* Genetic factors
o Family members seem to share diagnoses
* Neurotransmitters: dopamine regulation
o Areas involved in guiding active engagement with the environment
59
Mood disorder treatments
* Drug Therapies:
o Anti-depressants for major depression: Increase amount of serotonin or norepinephrine
* Agonist or antagonist?
* Prozac, Zoloft: selective serotonin reuptake inhibitors (SSRIs)
* Gradual effect; full effect often requires weeks
o Lithium carbonate for bipolar (mood stabilizing)
* Drug alternatives
o Aerobic exercise helps calm anxiety, uplift the depressed
o Cognitive-behavioural therapy
60
Brain stimulation
* Electro-Convulsive Shock Therapy
o First introduced in the 1930s
o Patient is shocked with 100V to the brain while awake
* Produced whole body convulsions and brief unconsciousness
* Now is used under general anesthetic with muscle relaxers
o Limited for severe cases where nothing else works
o Quite successful but no one knows HOW it works.
61
Schizophrenia
* Schizophrenia: A disorder involving disorganized and delusional thinking, disturbed perceptions, and inappropriate emotions and actions
* Originally named Dementia Praecox
o Described various kinds of progressive, irreversible mental deterioration (dementia)
* Term ’schizophrenia’ introduced in 1911
o Schizo: split & Phrenos: the mind
o This means a split from reality....NOT multiple personalities!
62
Features of schizophrenia: thought & language
* Idiosyncratic thoughts and associations that interfere with the ability to maintain a logical and consistent train of thought
- Psychologist: What have you been thinking about lately?
- Patient: I gotta get out of here, the people are talking. They’re talking about clocks, maps, and triangles within the neighbourhood. I can understand and I see the dangers. I know how people operate, and there isn’t any need to be upset.
* Word salad – real words but they don’t fit together
63
Features of schizophrenia: Delusional thinking
* Delusions: false beliefs that have no basis and that are not influenced by reality
o Delusions of grandeur – belief in special powers or characteristics ... “I am Joan of Arc, Jesus, Harry Potter...”
o Delusions of persecution – “people are plotting against me and mistreating me”
o Delusions of reference – “people are making secret reference to me” ... “The instructor keeps lecturing about me personally...”
* Thought insertion – “people are putting thoughts in my head & controlling my actions...”
64
Features of schizophrenia: Perceptual disturbance
* Hallucinations: reports of sensory stimulation when no such stimulation is present
o Auditory hallucinations – MOST COMMON
Voices that talk TO or ABOUT the schizophrenic person
Tells the person what to do, or criticises the person’s actions
Voices are unwanted and confusing
o Visual hallucinations
Visions of persons or objects perceived to be present
o Tactile, taste, and somatic hallucinations
E.g., Tiny bugs crawling all over the skin
65
Features of schizophrenia: Affect disturbance
* Flat affect
o Flat facial expression
o Speak in a monotone voice
o Flat affect strongly predicts a poor prognosis
* Difficulty controlling emotions/expresses inappropriate emotions
o Laugh in response to a sad situation
o Cry in response to a funny story
o Emotional expression can change rapidly without reason
66
Schizophrenia: positive vs. negative symptoms
* Positive Symptoms: added experiences that others don’t have
o Thought disturbances
o Delusional thinking
o Hallucinations
* Negative symptoms: absence of things that other people have
o Impaired relationships
o Flat affect
o Lack of pleasure/motivation
67
Schizophrenia: Who & why?
WHO?
* 1% of the population
* Every culture and every segment of population
o All races, both genders
o More severe symptoms in men
* Higher rates among low education, low SES
WHY?
* Two genetic markers:
1) Eye movement
2) Neurocognitive deficits
o Difficulties in memory and attention
* Prenatal environment important: viral infection during pregnancy (flu)
68
Schizophrenia: neurological changes
* Enlarged ventricles:
o Occurs before onset of disease
o Not all schizophrenic patients show enlarged ventricles
* Frontal Lobe Activity
o Reduced blood flow (BF) in the frontal regions of the brain
o More common when negative symptoms are present
* Ppl with schizophrenia are not fooled by the hollow mask illusion
* Dopamine Regulation in frontal lobes, limbic system
o Hypothesis: schizophrenia involves excess of dopamine
* Diathesis-Stress approach
o Interaction between genetics and the environment
o Diathesis: vulnerability – genetic
A necessary but not sufficient cause
o Stress: events / circumstances that shape the development of the organism
Overtaxes the ability to cope
69
Schizophrenia: treatments
* Antipsychotic drugs: Treat symptoms of psychosis, including delusions, hallucinations, and disorganized thinking
o chlorpromazine (positive symptoms)
o clozapine (negative symptoms)
* Common concern: Side effects
o E.g., tardive dyskinesia
70
Personality disorders
* Longstanding, pervasive and inflexible patterns of behaviour that deviate from cultural norms and impair social and occupational functioning.
* Often co-exist with disorders like schizophrenia, mood and/or anxiety disorders
* Affects ability to:
o Form stable relationships
o Function adaptively in society
71
Personality disorders: Cluster A (odd or eccentric behaviours)
Paranoid personality disorder; Schizoid personality disorder; Schizotypal personality disorder
72
Personality disorders: Cluster B (dramatic, emotional, or erratic behaviours)
Antisocial personality disorder; Borderline personality disorder; Histrionic personality disorder; Narcissistic personality disorder
73
Personality disorders: Cluster C (anxious or fearful behaviours)
Avoidant personality disorder; Dependent personality disorder; Obsessive-compulsive personality disorder
74
Histrionic personality disorder
* Attention-seeking
o Dramatic behaviour to get attention
o Manipulative, sexually provocative & seductive
o Inappropriate expression of emotion
* Focused on appearance; narcissistic
* Considered shallow & self-centered
* 2-3% prevalence rate, more common in women (especially if divorced or separated)
75
Borderline personality disorder
* Pervasive instability of mood, relationships, self-image
o Unstable sense of self, chronic feelings of emptiness
o Alternate between idealization and devaluation of loved ones
o Rapid, intense shifts into negative emotions
* Impulsivity
o Overspending, Excessive sexual activity, Self-mutilating
* 1-2% Prevalence; more common in women than men
Amongst criminals, Borderline P.D. traits are predictive of extreme levels of violence
76
Antisocial personality disorder
* Lack of conformity to social norms and legal standards
o Disregard for others’ rights; Repeated violation of the law
o Similar to psychopathy
* Deceitful, Impulsive, Lacks remorse
o Lies / cons others to get what they want
o Lack of empathy
* Males – 3%; Females – 1%
o More common in younger than older adults
o More common for low-socioeconomic status
o Often co-exists with substance abuse
77
clinical psychologists
have obtained phds and are able to formally diagnose and treat mental health issues ranging from the everyday and mild to the chronic and severe
78
counselling psychologists
mental health professionals who typically work with people who need help with more common problems such as stress and coping, issues concerning identity, sexuality, and relationships, anxiety and depression, and developmental issues such as childhood trauma
79
psychiatrists
medical doctors who specialize in mental health and who are allowed to diagnose and treat mental disorders through prescribing medications
80
deinstitutionalization
the movement of large numbers of psychiatric in-patients from their care facilities back into regular society
81
residential treatment centres
housing facilities in which residents receive psychological therapy and life skills training, with the explicit goal of helping residents become re-integrated into society
82
community psychology
which focuses on identifying how individuals' mental health is influenced by the community in which they live, and emphasizes community-level variables such as social programs, support networks, and community resource centres to help those with mental illness adjust to the challenges of everyday life
83
empirically supported treatments
treatments that have been tested and evaluated using scientific methods
84
therapeutic alliance
the relationship that emerges in therapy between the therapist and the patient
85
bibliotherapy
the use of self-help books and other reading materials as a form of therapy
- can be helpful and is low in cost, convenient, and can be accessed anonomously
- less likely to leap people to actually changing their lifestyles
86
insight therapies
general term referring to therapy that involves dialogue between patient and therapist for the purposes of gaining awareness and understanding of psychological problems and conflicts
87
psychodynamic therapies
forms of insight therapy that emphasizes the need to discover and resolve unconscious conflicts
88
free association
during which patients are encouraged to talk or write without censoring their thoughts in any way
89
dream analysis
a method of examining the details of a dream (the manifest content), in order to gain insight into the true meaning of the dream, the emotional, unconscious material that is being communicated symbolically (the latent content)
90
resistance
occurs in therapy when the patient engages in strategies that keep unconscious thoughts or motivations that they wish to avoid from fully entering entering conscious awareness
91
transference
whereby patients direct certain patterns or emotional experiences toward the analyst, rather than the original person involved in the experience
92
object relations therapy
a variation of psychodynamic therapy that focuses on how early childhood experiences and emotional attachments influence later psychological functioning
93
phenomenological approach
the therapist addresses the clients' feelings and thoughts as they unfold in the present moment, rather than looking for unconscious motives or dwelling in the past
94
client-centred therapy
focuses on individuals' abilities to solve their own problems and reach their full potential with the encouragement of the therapist
- emotion focused therapy (EFT) is a promising type of this therapy
95
behavioural therapies
attempt to directly address problem behaviours and the environmental factors that trigger them
96
systematic desensitization
gradual exposure to a feared stimulus or situation is coupled with relaxation training
97
aversive conditioning
a behavioural technique that involves replacing a positive response to a stimulus with a negative response typically by using punishment
98
cognitive-based therapy (CBT)
a form of therapy that consists of procedures such as cognitive restructuring, stress inoculation training, and exposing people to experiences they may have a tendency to avoid
99
mindfulness-based cognitive therapy (MBCT)
a technique that combines mindfulness meditation with standard cognitive-behavioural therapy tools
100
decentering
which occurs when a person is able to "step back" from their normal consciousness and examine themselves more objectively, as an observer
101
systems approach
an orientation that encourages therapists to see an individual's symptoms as being influenced by many interacting systems
102
pros and cons of insight therapies
pros:
- deep understanding to the self
- substantial personal growth
cons:
- long and expensive
- not really applicable for serious disorders
103
pros and cons of behavioural and cognitive therapies
pros:
- time and cost effeicent
-address immediate thoughts and problems
- for mild and severe problems
cons:
- not really deeper understanding
- may not be effective when used alone for some disorders (ie. schizophrenia)
104
pros and cons of group/family therapies
pros:
- empathize and relate to others
- gives family members insight into how each individual contributes to both positive and negative aspects of family life
-change larger social dynamics that reinforce and maintain the disorder
cons:
- do not fully address individual issues (bit often used in combo with individualized therapy)
psych101
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