PSY 275 1st EditionExam # 4 Study Guide Lectures: 17-19&3/1-16Chapter 17 Commonly divided in two broad categories- Internalizingo Problems like depression and anxietyo More common among girls- Externalizingo Problems like ADHD, conduct disorder, and oppositional defiant disordero More common among boysPsychological Disorders and DSM - DSM-IV-TR included a separate category- “Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence”- Included:o Attention-Deficit Hyperactivity Disordero Conduct Disordero Oppositional Defiant Disordero Separation Anxiety DisorderDSM-5- DSM-5 does not single out disorders of childhood- “Life span” mentalhealth approacho Developmental considerations discussed for each disorderDevelopmental Psychopathology- The view that typical and atypical development can inform each other- More than just the timing of the disorderAssessment Techniques- Many of the same assessment tools developed for use with adults have been adapted for childreno Self-report questionnaireso Diagnostic interviewso Projective personality testso Objective personality testso Intelligence testso Achievement testsMultisource, Multimethod, Multisetting- Multisourceo Child, Parent, Teacher- Multimethodo Interviews, questionnaires, behavioral observation- Multisettingo Clinic, School, HomeBehavioral Observation- Used more frequently with children than with adolescents or adultso Naturalistic or analogueo Standardizedo behavior rating scales- The same concerns apply- Reactivityo the Hawthorne effectGeneral Considerations - More likely to involve others in therapyo Parents, teachers, siblings- Children and adolescents are less likely to bring themselves to therapyo Children and parents may have different or competing goals for therapy- Depending on developmental stageo May have difficulty expressing feelings in wordso May not be able to sit still for extended periods of timeTypes of Psychotherapy- The major theoretical orientations are representedo Psychodynamico Humanistico Cognitive-behavioralPlay Therapy- Play therapy is most common with younger children (under age 11)- Instead of sitting and talking with the therapist, children communicate through play- Typically are offered a range of toys Psychodynamic Play Therapy- Developed by Melanie Klein- Play is thought to be a window into the unconscious- Therapists interpreto Which toys are selectedo How the child uses themo Themes that emerge- Has received the same criticisms as other psychodynamic therapieso Subjectiveo Difficult to test empiricallyHumanistic Play Therapy- Different goal than psychodynamic therapy- Goal is to conveyo Empathyo Unconditional Positive Regardo Genuineness- Play is thought to be an easier way for children to communicate their feelingsCognitive Behavioral Therapy- Similar to CBT for adultso Simplified languageo Learn to challenge thoughts through games and storieso More explicit reinforcement for homework completion- Self-Instructional Training- Specific form of CBT- Developed by Donald Meichenbaum- Teach children to “talk through” situations in which they might act out using positive “self-statementso First therapist models talking through the situation o Then child does it with therapist talking him through ito Then child talks himself through the situationParent Training- CBT- Behaviorally based - Parents have a very active roleo Specific problem behavior is identifiedo Functional analysis – what is reinforcing the behavior?o Parent is taught to develop contingencies and communicate them to the child- Example: - Parent Management Training Developed by Alan Kazdin- for treatment of conduct disorder- Parents are taught to ignore problem behaviors and positively reinforce adaptive behaviorsDoes it work?- Different levels of empirical support for different types of child and adolescent therapyo CBT has largest research baseo Play therapy has less research supportChatper 18Behavioral Medicine- Integration of social sciences with medical science- Become increasingly important over past centuryo Rise in the prevalence of chronic illnesses with strong behavioral componentHealth Psychology- Subdiscipline of Behavioral Medicine- Focuses on how psychological processes influence health and illnessSmoking- Smoking is the single greatest cause of preventable death in the United States- Increases risk foro Heart Diseaseo Cancero Vascular Diseaseo Stroke- Education is not sufficiento Most people are aware that smoking is bad for them- Treatmento Nicotine replacemento Cognitive behavioral treatments for tobacco cessationWeight Management- Obesity is another leading cause of preventable death- To maintain a healthy weighto Dieto Exercise- Again, education is not enough- Treatmento Cognitive Behavioral Treatment Activity Increase, Behavior change, Cognitive change, Dietary change, and Social support- Average weight loss is 10% of total body weight- Maintenance is challenging- Preventiono Policy changes to promote healthy eatingo Counteract our “toxic food environmentCompliance- Some health problems occur because patients are not compliant with medical recommendations o Taking medications as recommendedo Following dietary restrictions o Activity restrictions- Noncompliance is common wheno Treatment is complicatedo There are many side effects- Particularly common in certain medical disorderso HIVo Gastrointestional disordero Diabeteso Cancer- Interventiono Collaborate with medical providerso Identify barriers to complianceo Generate solutionso Involve family and friendsStress and Health- Acute versus Chronic Stress- General Adaptation Syndrome (Hans Selye)o Our bodies evolved responses to deal with to acute stressors, which become harmful when stress is chronic Fight-or-flight response Cortisol (the stress hormone)- Psychoneuroimmunologyo Chronic stress weakens the immune systemo Makes us more vulnerable to disease- Makes us more vulnerable to diseaseMindfulness-Based Stress Reduction- Intervention to reduce stress developed byJon Kabat Zinno Been shown to have many physical and mental health benefits- Core component is mindfulness practiceo “Moment-to-moment, nonjudgmental awareness”o Commonly achieved through meditationCoping with Chronic Pain- Chronic Paino Pain that lasts 6 months or longero Often leads to depression or anxiety- Treatment includes o Medication (Antidepressants)o Psychotherapy (Behavioral Pain Management)Behavioral Pain Management- Based on Gate Control Theoryo