EPPP Clinical/Abnormal
Terms
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- Prescribing the symptom
- paradoxical technique in which the therapist instructs the client to engage in the target behavior, usually in an exaggerated manner
- MMPI: F Scale
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infrequently endorsed items
high scores could indicate malingering or random responding
random responding (or alternating true and false responses) produces high scores on most of the clinical scales along with a very high score on the F-scale. - MMPI: K Scale
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measures guardedness/ defensiveness
points may be added to clinical scales to correct for degree of guardness - Schizoaffective Disorder
- uninterrupted period of illness during which at some time, there has been a mood episode; during the same period of illness, there have been psychotic symptoms for at least 2 weeks without mood symptoms
- Howard at al (1986) meta-analysis of psychotherapy outcome
- 50% of patients measurably improved by 8th session; 75% measurably improved by 6 mos
- Kubler-Ross's Stages
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Denial
Anger
Bargaining
Depression
Acceptance - Confabulation
- fabrication of events in response to questions about information that is not recalled because of memory impairment
- Primary Prevention
- intervention designed to prevent the development of mental disorders
- Erotomanic Delusion
- false belief that someone, usually of higher status, is in love with you
- Kohut
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best known for work on narcissism
believed narcissism developed due to consistently unempathic responses from one's mother
used empathy as a treatment tool - % of MR cases due to...
- heredity = 5%
- Tertiary Prevention
- intervention designed to reduce the prevalence of mental disorders by preventing their recurrence & reducing their duration
- inner and outer externalizations
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inner: adapting to and coexisting with a problem (consistent with a Mexican world view)
outer: a problem can be defeated - average effect size of recent therapy research
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.85
(effect size is a measure of SD - people who get treatment do .85 SD better) - Rational Emotive Therapy (RET)
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Ellis
depression due to experiencing distressing events, negative interpretations of those events, & maladaptive responses
proposed that irrational thoughts are attributable to natural tendencies toward, for example, moodiness, negativity, or excitement-seeking - circumstantiality
- speech that wanders but stays with original point
- Treatments for Alcoholism
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Effective: social skills training, stress management training
Promising: Antidepressants
Ineffective: anxiolytics
Roth & Fonagy, 1996 - Big 5 Personality Traits
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Costa & McCrae
Openness to Experience
Conscientiousness
Extroversion/Introversion
Agreeableness
Neuroticism
originally identified by factor analysis of personality traits in the dictionary (lexical, atheoretical approach) - Interpersonal Therapy
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a brief therapy; Klerman & Weissman (1984)
depressed patients present with 4 key problems: grief, interpersonal role disputes, role transition, & interpersonal deficits
depression is related to problems with social roles & relationships and is traceable to a lack of strong attachments early in life
goals = symptom reduction, improved interpersonal functioning - Motivational Interviewing
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Miller & Rollinick (1991)
designed to help clients build commitment & readiness to change
based on assumption that interventions are most effective when matched to a client's readiness to change
derived from client-centered treatment & Bandura's notion of self-efficacy
consistent with trans- theoretical model of change - Transtheoretical Model of Change
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Prochaska & DiClemente, 1992
5 stages:
Precontemplation
Contemplation
Preparation
Action
Maintenance
optimal interventions match a client's stage of change - Existential Therapies
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humanistic; people are in a constant state of becoming
maladaptive behavior = part of human nature (anxiety = response to constant threat of death)
goal = help clients overcome feeling meaningless - Paradoxical Intention
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used in existential therapy
focus on a feared situation with humor - Gestalt Therapy
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humanistic; Fritz Perls
targets:
Contact (being in touch with the here & now)
Awareness (of one's whole personality through understanding one's thoughts & feelings)
Experimentation (trying something new to increase understanding)
Goal = help client achieve integration of the various apsects of self to become a unified whole; enhancing individuals' capacity to communicate with themselves & others
neurotic behavior comes from disturbance in the boundaries between self & environment
questions are discouraged because they promote intellectualization & interfere with experiencing feelings
use of empty chair technique & other dialogue games - Person-Centered Therapy
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humanistic; Carl Rogers
a self-actualizing tendency guides people's growth
3 facilitative conditions: unconditional positive regard, genuineness (congruence, accurate empathic understanding
maladaptive behavior results from incongruence between self & experience - Archetype
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Jung
a universal thought form of an experience that has been repeated for many generations
part of the collective unconscious (example = birth)
also defined as a primordial image that causes people to experience a phenomenon in a universal way (self, persona, shadow) - Transference
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in psychoanalysis
a form of resistance, distortion that is interpreted to help the client see its origins & irrational nature & to become aware of the effects of one's unconscious on behavior
Freud - sexual in nature
Jung - elements of the unconscious are projected onto the therapist
New Freudians - patient's response to the therapist's behavior, attempt to give it personal meaning - AIDS/HIV Dementia
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affects 15 - 20% in advanced stages
common early signs: concentration problems, forgetfulness, difficulty walking, social withdrawal - Countertransference
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the analyst's total response to the client
can provide insight into the client's processes - Suicidal behavior in adolescents
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increases with age in adolescence
females are at greater risk for attempts
associated factors for attempts: poor social skills, poor school achievement, parental separation/divorce - Unilateral ECT
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to the nondominant hemisphere
less effective than bilateral
less anterograde & retrograde amnesia in the short-term (anterograde predominates) - Delirium
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usually due to a general medical condition or substance use
reduced attention, disturbances of consciousness, cognition, perception
symptoms are random, onset is rapid
risk factors: elderly, elderly with illness or surgery, cardiotomy, burns, rapid withdrawal from alcohol, sedative, hypnotic, anxiolytic - Adler's Individual Psychology
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behavior is purposeful, motivated by future goals
Key concepts: inferiority, striving for superiority, style of life, social interest
maladaptive behavior stems from attempts to compensate for inferiority - Personalization
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cognitive distortion; Beck
attributing events to oneself without causal connection - Arbitrary Inference
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cognitive distortion; Beck
drawing a conclusion without evidence - Selective Abstraction
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cognitive distortion; Beck
interpreting a situation based on 1 detail - Dichotomous Thinking
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cognitive distortion; Beck
extreme thinking - Freud's Structural Theory
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psyche has 3 parts:
ID (unconscious drives & needs, birth)
EGO(reality, defers gratification of impulses, 6 mos)
SUPEREGO (internalization of society's values, 4-5 yrs)
a healthy ego resolves conflicts between id, superego, and reality - Helm's Model
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model of white development with 6 statuses:
CONTACT - encounter or awareness
DISINTEGRATION - confusion
REINTEGRATION - racist views
PSEUDO-INDEPENDENCE - questioning
IMMERSION-EMERSION - embracing white culture while rejecting racism
AUTONOMY - appreciation of cultural differences
therapists in autonomy stage are most effective - Restraining
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paradoxical technique used in Strategic Family Therapy
telling a client not to change - Positioning
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therapeutic technique used in Strategic Family Therapy
exaggerating the severity of a symptom - Communications/Interaction Family Therapy
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Satir, Jackson, Bateson, Mental Research Institute (MRI)
focus on communication: double binds, symmetrical and complementary communication
uses direct & paradoxical techniques - Double Bind
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conflicting negative injunctions, one may be verbal and the other nonverbal
in communcations family therapy - Strategic Family Therapy
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Cloe Madanes, Jay Haley
derived from Milton Erickson, Interaction Tx, structural tx
emphasizes the PRESENT, uses specific strategies to change behavior by changing communication
reliance on directives, may be straighforward or paradoxical (ordeals, restraining, positioning, reframing, prescribing the sx) - Structural Family Therapy
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Minuchin - 3 steps: joining, evaluating/diagnosing, restructuring
restructures a family's transactional patterns by marking boundaries, escalating stress, utilizing sx, manipulating mood, enactment, reframing
3 types of rigid triads: detouring, stable coalition, unstable coalition (triangulation)
before a family's structure can be altered, must first joing with them & then unbalance - Bowenian Family Therapy
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Extended Family Systems Therapy
source of dysfunction = high degree of fusion
goal = differentiation/individuation (separation of intellect & emotion)
typically not all family members are seen
emotional triangles - 3rd person brought in to increase stability or decrease tension
problems result from multigenerational transmission of low differentiation
use of genograms - Secondary Prevention
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designed to reduce the prevalence of mental disorders through early identification, intervention
examples - screening tests, crisis intervention - Treatment for PTSD
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prolonged exposure & stress inoculation, & combination of the 2 are all effective
prolonged exposure has the best long term effects - Freud's Fundamental Rule
- free association, a treatment technique
- Milan Systemic Family Therapy
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Selvini-Palazzoli
problems result when a family's patterns are fixed in circular patterns
goal = help members see their choices
techniques = hypothesizing, neutrality, paradox, circular questions - Socrative questioning
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inductive questioning (from detailed to general)
used by Beck to guide clients through identifying the impact of their cognitions on their emotions & behaviors & identifying alternative ways of thinking - Schizoid Personality Disorder
- pattern of detachment from social relationships & restricted range of emotional expression
- Yalom's Stages of Group Therapy
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Initial: members talk to therapists, hesitance
Second: conflict, rebellion, attempts at dominance
Third: closeness, cohesion, talking freely with each other
group members should be heterogeneous in conflict, homogeneous in ego strength
ideal group size = 7 or 8 - Object Relations Theory
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approach to personality development & therapy
emphasizes impact of early relationships with others (objects) on personality development
problems result from abnormalities in early object relations
early social relations impact future social situations
a psychodynamic therapy, object relations therapy utilizes many traditional psychodynamic strategies. It focuses on the impact of unconscious processes that impact the client’s current relationships and involves identifying and interpreting the client’s defenses and transferences. Object relations therapy is associated with several individuals including Melanie Klein. - Sensate Focus
- based on counterconditioning, replace sexual performance anxiety with pleasure
- Sexual Response Cycle
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Masters & Johnson, 4 stages:
1. excitement
2. plateau
3. orgasm
4. resolution - Nomothetic
- observations of groups
- Idiographic
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closely observing 1 or a few individuals
(Piaget developed his theories based on relatively few children) - Emic
- understanding a person within the context of cultural backgound
- Etic
- non-culture specific, universal
- Essential feature of Bipolar II
- occurence of 1 or more Major Depressive episodes, accompanied by at least 1 Hypomanic episode
- Essential feature of Bipolar I
- occurrence of 1 or more Manic or Mixed Episodes
- percentage of intelligence test scores attributable to genetics
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50% for children
70-80% for adults - Iatrogenically Produced Symptoms
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symptoms caused by medical or psychological treatment
example = a rash due to a penicillin allergy - Self-Instructional Therapy
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Meichenbaum
combines graduated practice with RET, repeated practice of a targeted task to change cognitions
5 steps, from therapist modeling to client performing the task - Fortune Telling
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cognitive distortion
anticipating that events will turn out badly - Labeling
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cognitive distortion
refers to describing a person's entire character based on 1 incident - Magnification/Minimization
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cognitive distortion
often abbreviated to one word or the other
refers to:
1. perceiving something as more important than it is
2. minimizing one's positive qualities or seeing something as less important than it is - Tunnel Vision
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cognitive distortion
refers to seeing only the negative aspects of a situation - Schizotypal Personality Disorder
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pervasive social & interpersonal deficits, eccentricities in cognition, perception, & behavior
few friends, seem to prefer being alone - most common comorbid symptoms with Tourette's
- obsessions & compulsions
- Ellen Berscheid's Relationship Research
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problems associated with relationship satisfaction & stability; emotional experiences within relationships; people underestimate effect of external factors on relationship satisfaction
partner is most likely to experience a high degree of emotion in an intimate relationship when his/her partner's behavior disrupts an organized sequence of behavior.
Disruptions in organized sequences of behavior (established behavior patterns) – and the resulting emotional response – are more likely in the early stages of a relationship than in its later stages. - Illusion
- misperception of stimuli that are actually present
- Derealization
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alteration in the perception of the external world so that it seems strange or unreal
example = perceiving alteration in the size or shape of objects; people seem unfamiliar or mechanical - Delusion
- fixed false belief that is rigidly held despite evidence to the contrary
- Rehm's Self Control Theory of Depression
- depression results from low rates of self-reinforcement & high rates of self-punishment
- Advocacy Consultant
- focuses on social & legal reform to improve well being of a particular disenfranchised group
- Mental health Advocate
- represents patient in hearings that are conducted in order to determine whether the patient should continue to be held on an involuntary basis in an inpatient facility
- Beck's Depressive Triad
- negative views of the future, the self, & the world
- Concordance rate for depression
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identical twins: 55-60%
fraternal twins/siblings: 20% - patient improvement in the first few sessions of therapy is likely due to:
- increased hope
- Retroflection
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a type of boundary disturbance in Gestalt therapy
turning back onto oneself what one wants to do to others - Transactional Analysis
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examination of scripts & roles: the rules by which a person has lived & the roles taken on
focus on helping the person become aware of new options, enhancing the ability to live a "scriptless" life - Reality Therapy
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clarifying values
evaluating current behavior & plans in relation to values - Melanie Klein
- object relations theorist; focus of treatment on recognizing & modifying the impact of problematic early relationships
- NeoFreudians
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e.g., Sullivan, Horney
focus on both social & cultural factors
view psychological disturbance as the result of faulty learning & as consisting of a maladaptive style of interacting with the environment - Ego Psychology
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e.g., Anna Freud, Heinz Hartmann
focus on capacities for integration & adaptation - Jung's view of neurosis
- struggle of people to free themselves from the interference of the archetypes, interference that otherwise impedes progress toward personality integration & fulfillment of potential
- Stereotypic Movement Disorder
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characterized by motor behavior that is repetitive & nonfunctional
movement tends to be driven or to seem intentional
only diagnosed when movements don't meet criteria for another disorder such as Tourette's or Tic Disorder - Factors associated with better prognosis for schizophrenia
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female gender
late onset
paranoid symptoms
positive symptoms - Definition of Hypnosis
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alteration in consciousness, dissociated state, or a subjective experiential change
there are tests that indicate the extent to which someone can be hypnotized
degree to which someone can be hypnotized is not related to level of emotional disturbance - Reaction Formation
- dealing with conflict by engaging in behaviors or expressing feelings that are the opposite of the unacceptable feelings that one is having
- Splitting
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a person views the self or others as either all good or all bad
inability to integrate feelings - Sublimation
- chanelling unacceptable impulses into socially desirable behaviors
- Dissociative Identity Disorder (DID)
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2 or more distinct personalities or identities with a failure to integrate aspects of identity, memory, & consciousness
severe, chronic abuse during childhood is thought to contribute - Dementia
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impairment in STM or LTM, plus 1 of the following:
* aphasia
* apraxia
* agnosia
* disturbance in executive functioning
involves a decline from previous functioning, symptoms are generally permanent & progressive - Anterograde amnesia
- inability to recall information learned after a particular event or trauma
- Retrograde amnesia
- inability to recall information learned before an event or trauma
- Emotional Reasoning
- "I feel, therefore I am."
- Overgeneralization
- making general conclusions based on 1 detail
- Borderline Intellectual Functioning
- IQ between 71 & 84, with no impairment in adaptive functioning