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EPPP Clinical/Abnormal


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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
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
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
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
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
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
(effect size is a measure of SD - people who get treatment do .85 SD better)
Rational Emotive Therapy (RET)

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
speech that wanders but stays with original point
Treatments for Alcoholism
Effective: social skills training, stress management training

Promising: Antidepressants

Ineffective: anxiolytics

Roth & Fonagy, 1996
Big 5 Personality Traits
Costa & McCrae

Openness to Experience

originally identified by factor analysis of personality traits in the dictionary (lexical, atheoretical approach)
Interpersonal Therapy
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
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
Prochaska & DiClemente, 1992

5 stages:

optimal interventions match a client's stage of change
Existential Therapies
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
used in existential therapy

focus on a feared situation with humor
Gestalt Therapy
humanistic; Fritz Perls

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
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

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)
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
affects 15 - 20% in advanced stages

common early signs: concentration problems, forgetfulness, difficulty walking, social withdrawal
the analyst's total response to the client

can provide insight into the client's processes
Suicidal behavior in adolescents
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
to the nondominant hemisphere

less effective than bilateral

less anterograde & retrograde amnesia in the short-term (anterograde predominates)
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
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
cognitive distortion; Beck

attributing events to oneself without causal connection
Arbitrary Inference
cognitive distortion; Beck

drawing a conclusion without evidence
Selective Abstraction
cognitive distortion; Beck

interpreting a situation based on 1 detail
Dichotomous Thinking
cognitive distortion; Beck

extreme thinking
Freud's Structural Theory
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
model of white development with 6 statuses:
CONTACT - encounter or awareness
REINTEGRATION - racist views
IMMERSION-EMERSION - embracing white culture while rejecting racism
AUTONOMY - appreciation of cultural differences

therapists in autonomy stage are most effective
paradoxical technique used in Strategic Family Therapy

telling a client not to change
therapeutic technique used in Strategic Family Therapy

exaggerating the severity of a symptom
Communications/Interaction Family Therapy
Satir, Jackson, Bateson, Mental Research Institute (MRI)

focus on communication: double binds, symmetrical and complementary communication

uses direct & paradoxical techniques
Double Bind
conflicting negative injunctions, one may be verbal and the other nonverbal

in communcations family therapy
Strategic Family Therapy
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
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
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
designed to reduce the prevalence of mental disorders through early identification, intervention

examples - screening tests, crisis intervention
Treatment for PTSD
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

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
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
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
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
Masters & Johnson, 4 stages:

1. excitement
2. plateau
3. orgasm
4. resolution
observations of groups
closely observing 1 or a few individuals

(Piaget developed his theories based on relatively few children)
understanding a person within the context of cultural backgound
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
50% for children

70-80% for adults
Iatrogenically Produced Symptoms
symptoms caused by medical or psychological treatment

example = a rash due to a penicillin allergy
Self-Instructional Therapy

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
cognitive distortion

anticipating that events will turn out badly
cognitive distortion

refers to describing a person's entire character based on 1 incident
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
cognitive distortion

refers to seeing only the negative aspects of a situation
Schizotypal Personality Disorder
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
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.
misperception of stimuli that are actually present
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
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
identical twins: 55-60%
fraternal twins/siblings: 20%
patient improvement in the first few sessions of therapy is likely due to:
increased hope
a type of boundary disturbance in Gestalt therapy

turning back onto oneself what one wants to do to others
Transactional Analysis
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
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
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
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
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
female gender
late onset
paranoid symptoms
positive symptoms
Definition of Hypnosis
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
a person views the self or others as either all good or all bad

inability to integrate feelings
chanelling unacceptable impulses into socially desirable behaviors
Dissociative Identity Disorder (DID)
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
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."
making general conclusions based on 1 detail
Borderline Intellectual Functioning
IQ between 71 & 84, with no impairment in adaptive functioning

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