Chapter 1 Understanding Abnormal Behavior Case Report 18 year old Rebecca college freshmen o Depressed lonely hopeless o Insomnia o Difficulty concentrating on schoolwork o Adjustment disorder w depressed mood Concordance agreement ratios between people diagnosed as having a particular disorder and their relatives schizophrenia in twins 6 out of 10 twins have a disorder concordance rate is 6 Biopsychosocial model the interaction of biological sociocultural and psychological factors is seen as influencing the development of the individual Prevalence the number of people who have ever had a disorder at a given time or over a specified period Incidence frequency of new cases within a given time period DSM 5 Mental disorder psychological biological and developmental processes disorder must have clinical utility help guide clinicians in making decisions about treatment descriptive categorical five criteria 1 Clinical significance in disturbance in cognition emotion behavior 2 Causes significant stress or disability 3 Exhibiting behavior is not expectable cultural 4 Not representative of a conflict between individual and society Class 1 Andrew paranoid schizophrenic o Thinks 3 martians are following him grandfather has hx of schizophrenia Tardive dyskinesia loss of control of facial muscles irreversible neurological symptom almost occurred when his Thorazine dose was raised to 2000mg Protective factors experiences social circles preventing development of psychosis o Concordance rate of schizophrenia in twins one twin has protective factors and is less likely to develop the disorder biological and environmental components Chapter 2 Diagnosis and Treatment Case Report 28 year old Peter law attorney o Change in behavior following his parents divorce more of a worrier o Anxious irritable tense fidgety short tempered wired o Generalized Anxiety Disorder Reliability degree to which clinicians provide diagnoses consistently across individuals who have a particular set of symptoms Validity the extent to which a test diagnosis or rating accurately and distinctly characterizes a person s psychological status International Classification of Diseases the diagnostic system of the World Health Organization Culture bound syndromes recurrent patterns of abnormal behavior or experience that are limited to specific societies or cultural areas Comorbid the situation that occurs when multiple diagnostic conditions occur simultaneously within the same individual Case formulation a clinician s analysis of the factors that might have influenced the client s current psychological status Cultural formulation includes the clinician s assessment of the client s degree of identification with the culture of origin the culture s beliefs about psychological disorders the ways in which the culture interprets particular events and the cultural supports available to the client Halfway house a community treatment facility designed for deinstitutionalized clients leaving a hospital who are not yet ready for independent living Andrew Mileu therapy a treatment approach used in an inpatient psychiatric facility in which all facets of the mileu environment are components of the treatment Evidence based practice in psychology clinical decision making that integrates the best available research evidence and clinical expertise in the context of the cultural background preferences and characteristics of clients Class 2 Derrick brief psychotic disorder with marked stressors transiently psychotic o Disheveled no jacket in the snow trembling hasn t slept in days can t stop washing going crazy since Dec 10th went to gay teacher s house o Thinks a stalker is trying to kill him and police are in on it o Thanksgiving dad had a heart attack after a huge argument o Factors contributing to nervous breakdown dad s heart attack fight with girlfriend stress from changing schools o Relevant history has a thyroid condition and had a concussion Criteria for brief psychotic disorder o Delusions deeply entrenched false belief not consistent with the client s intelligence or cultural background o Hallucinations a false perception not corresponding to the objective stimuli present in the environment o Disorganized speech o Disorganized or catatonic behavior o One day to one month not due to another disorder Precipitant the spark or psychotic break that brought an individual into therapy Clinical psychologists are rescuers and wounded healers Class 3 Steve exhibitionist sex problem o Motivational interview focus on positives of situation then less positive o Caught masturbating to a woman in a window 14 excited him o Sexually abused by uncle on a camping trip as a child o Treat told him to think of his daughter every time he goes to masturbate Holding environment context of psychotherapy therapist will hold client emotional outpour like an infant patient feels safe to engage Catharsis a cleansing after sharing something so personal Frame of therapy rules to therapy like the perimeter of a frame o Boundaries do not violate each other or cross a boundary therapist is not your friend lover pay your bill respect show up on time frame Transference important people are related to your past experiences unconscious redirection of feelings from one person to another Countertransference redirection of therapist s feelings towards a client unconscious reactions towards a patient Microcosm miniature interaction before session Steve accused Halgin of being consistently negative Formulation hypotheses as to what caused a person s current psychological status Steve victimized as a child nothing wrong with violating others Three part model of therapy o Present concerns o Past experiences o Therapeutic relationship Class 4 Ben descending into psychosis o Wool hat gloves on a hot day asked for psychological testing o Paranoid delusions hallucinations o Believes police on horses are out to get him buildings are going to cave in o IQ test WAIS MMPI HTP Thematic Apprehension test Inkblots o Utilitarian approach to women struggling w sexual energy o Falling apart borderline suicidal crying out for help Projective technique project your personality used w TAT House Tree Person o House on stilts top room w window is his because it is sunniest o Person girl no pupils marks on cheeks arms behind back heavyset freshman ignored future is destined for institutionalization battering o Person Yankee baseball player no pupils heavyset 69 o Tree Lombardi poplar blocks the wind