Abnormal Psychology

1. Abnormal Psychology Possible Essay Questions

2. Discuss the extent to which biological, cognitive, and sociocultural factors influence abnormal behavior. • Biological: People have a predisposition for certain behaviors. • Depression: Nurnberger & Gershon (1982) • PTSD: Hauff and Vaglum (1994); Geracioti (2001) • Bulimia: Kendler (1991), Strober (2000) • Cognitive: The way a person thinks and processes information influences the person towards abnormal behaviors. • Depression: Ellis (1962) • PTSD: Brewin (1996) & Rizzo “Virtual Iraq” • Bulimia: Slade & Brodie (1994); Polivy and Herman (1985) • Sociocultural: The environment, events, people, and situations influences behavior. • Depression: Brown & Harris (1978) • PTSD: Rousircar (2000); Silva (2000) • Bulimia: Sanders & Bazalgette (1993); Jaeger (2002)

3. Evaluate psychological research relevant to the study of abnormal behavior. • Explain the strengths and limitations of research. • Rosenhan (1973) Being Sane in Insane Places • Rosenhan and Seilgman Criteria (1984) • Jahoda (1958) • Szasz (1962)

4. Discuss the concepts of normality and abnormality. • Use PAGE 1 & 2 for this answer! • Abnormality defined by the APA as behavior that causes distress, loss of freedom, physical or emotional pain, increased risk of death or injury to self or causes a disability of some sort • 7 Criteria for Abnormal Behavior (Rosenhan & Seligman, 1984) • Suffering • Maladaptiveness • Irrationality • Unpredictability • Vividness and unconventionality • Observer discomfort • Violation of moral or ideal standards • 6 Characteristics of Mental Health (Jahoda, 1958) • Efficient self-perception • Realistic self-esteem and acceptance • Voluntary control of behavior • Accurate perception of the world • Sustaining relationships and providing affection • Self-direction and productivity • Evaluation • Actually applying these criteria means most people would be considered abnormal • Normalness is culturally determined • Revisions of DSM – In prior edition, homosexuality seen as mental illness, in new DSM rename substance abuse to addiction

5. Discuss validity and reliability of diagnosis. • Use page 3 & 4 for this answer! • Difficult to diagnose psychological disorders– no physical symptoms, have to go on word of patient • Reliability – Beck (1962), Cooper (1972), Dinardo (1993), Lipton and Simon (1985) • Validity – Rosenhan (1973)

6. Discuss cultural and ethical considerations in diagnosis. • Cultural • Reporting Bias (5) • Difference in symptoms – Body Memory (12) • Culture Blindness (5) • Culture-bound Syndrome (5) • Ethical • Self-fulfilling prophecy (5) • People who believe they are 'abnormal' may begin to act abnormal thus fulfilling the prophecy they have a psychological illness (Scheff, 1966) • Racial and ethnic (Jenkins-Hall & Sacco, 1991) (5) • African American women rated more negatively and less socially competent than European women by therapists watching them on videos of a clinical interview • Only women were used, possible gender difference • Confirmation bias(5) • Cognitive bias that leads practitioners to assume that patients seeking help are sick and thus look for signs/symptoms that can lead to a diagnosis even if patient is 'normal' (Rosenhan, 1973) • Powerlessness and depersonalization (5) • Makes assessing patients properly difficult • Effect of institutionalization where patient has little choice, few rights, not much privacy and a lack of constructive activities affects their 'normal' behavior

7. Discuss the interaction of biological, cognitive, and sociocultural factors in abnormal behavior. • This question is similar to the first one… Focus on how they interact with one another – • a person may have a predisposition for depression, but unless a certain social event occurs they may never have depression • A person my have bulimia in their family, but if they cognitively have a strong self image and high self esteem they may never experience it. • A person may expreience a traumatic event, but never suffer from PTSD. The severity of the trauma and it’s effect are determined by the person and their cognitive outlook.

8. Describe symptoms and prevalence of one disorder from two of the following groups: anxiety disorders, affective disorders, eating disorders. • Anxiety disorders – PTSD (10-11) • Affective disorders – Major Depression Disorder (6-7) • Eating disorders – Bulimia (12-13)

9. Anxiety disorders - PTSD • Affective - anhedonic (=inability to experience pleasure), callousness • Behavioral - flashbacks, paranoia and hypervigilance, nightmares • Cognitive - intrusive memories of traumatic event, problems concentrating, hyperarousal • Somatic - lower back pain, digestion issues, insomnia, losing ability to control bladder • US - 1-3% with lifetime prevalence of 5% in men and 10% in women • Affects 15-24% of people who experience a traumatic event (Davidson et al., 2007; Breslau et al., 1998) • Usually cooccurs with other disorders like depression and substance abuse • Affective disorders – Major Depression Disorder • Affective - sadness, inability to find joy in things once found enjoyable • Behavioral - lacking desire to do any activities, extremely passive and idle • Cognitive - negative thoughts, attribute failures to self, poor self-esteem, possible suicidal thoughts, hopelessness and lack of confidence in their condition improving • Somatic - low energy levels, insomnia or hypersomnia (=sleeping all the time), lack of sex drive • US - lifetime prevalence of 15% (Charney & Weismann, 1988) • 2-3x more likely to occur in women • 80% diagnosed will experience a subsequent episode • Eating disorders – Bulimia • Affective - feelings of inadequacy, guilt, shame • Behavioral - binge eating, vomiting after eating, laxative use, excessive exercising • Cognitive - distorted perception of body, perfectionism • Somatic - irregular menstrual cycle, tooth enamel erosion, gastrointestinal problems, risk of heart palpitations • Affects 2-3% of women • Roughly 5 million experience an eating disorder in US • Some symptoms reported in up to 40% of college women in US (Keel et al., 2006) • 5.79% for women aged 15-29 in Japan

10. Analyze etiologies (in terms of biological, cognitive, and sociocultural factors) of one disorder from two of the following groups: anxiety disorders, affective disorders, eating disorders. • Affective: Major Depressive Disorder (7-9) • Anxiety: PTSD (11-12) • Eating: Bulimia (13-14)

11. Anxiety disorders - PTSD • Biological • Twin research showed a potential genetic disposition (Hauff & Vaglum, 1994) • High levels of noradrenaline cause individuals more openly and PTSD patients had above average noradrenaline levels (Geracioti, 2001) • PTSD patients have Increased sensitivity in noradrenaline receptors (Bremner, 1998) • Cognitive • PTSD patients believe they have no control over their lives • Intrusive memories in the form of flashbacks occur because of cue-dependent memory • Cues in the real world are similar to the cues of the traumatic experience which cause the same level of panic as the cues in the traumatic event (Brewin et al., 1996) • Recovering from child abuse may be related to the patient's tendency to think the abuse was their fault - patients who did not think it was their fault were more likely to recover • Sociocultural • People exposed to racism and oppression are more likely to develop PTSD • Vietnam War veterans (Roysircar, 2000) • 20.6% black developed PTSD • 27.6% Hispanic developed PTSD • 13% white developed PTSD • Threat of death linked to PTSD so patients should avoid situations that cause anxiety and panic (Dyregrov) • Sarajevo, Bosnia 1998 • 35% boys had PTSD • 73% girls had PTSD • Higher rate linked to girls being threatened with rape (Kaminer et al., 2000)

12. Explain cultural and gender variations in disorders. • Cultural • Depression (9) • PTSD (12) • Bulimia (13 & 14) • Gender • Depression (10) • PTSD (12) • Bulimia (13 & 14)

13. Examine biomedical, individual, and group treatment approaches to treatment. • Biomedical • Drugs (15) • Individual • Cognitive Reconstructing & individual CBT (15 & 16) • Group • Couples Therapy & Group CBT (16)

14. Evaluate the use of biomedical, individual, and group approaches to the treatment of one disorder. • Depression • Biomedical – Kirsch & Sapirstein (1998/2008), Blumenthal (1999), Leuchter & Witte (2002), Elkin (19889) (15) • Individual – Beck Cognitive reconstructing (15), CBT Teasdale (1997), Riggs (2007) (15-16) • Group – Toseland and Siporin (1986), McDermut (2001), factors: group cohesion, exclusion, relationship w/ therapist (16) • PTSD • Biomedical – Marshall (1994), tranquilizers (16) • Individual – Foa (1986), Keane (1992)(16) • Group – Weine (1998), Mayou (2000) (17) • Bulimia • Biomedical – McGilley & Pryor (1998), Goldstein (1995) • Individual – CBT, Wilson (1996) (18) • Group – Group therapy, McKisack (1997), concerns for group therapy.

15. Discuss the use of eclectic approaches to treatment. • Eclectic approach to therapy – an approach that incorporates principles or techniques from various systems or therapy. • Eclectic therapy recognizes the strengths and limitations of the various therapies, and tailors sessions to the needs of the individual client or group. • USE CASE STUDIES FROM AREAS BELOW • Biological • Drug Therapy – antidepressants, tranquilizers • Cognitive (Psychological) • Individual Therapies – CBT • Social • Group Therapy

16. Discuss the relationship between etiology and therapeutic approach in relation to one disorder. • Etiology – the cause of the disorder. • Multifaceted Approach to Treatment is the most efficient. We do not know the exact causes of disorders, so using a biopsychosocial covers all aspects • Biopsychosocial (bio-psycho-social) perspective • Biological • Drug Therapy – antidepressants, tranquilizers • Cognitive (Psychological) • Individual Therapies – CBT • Social • Group Therapy