Etiology

An active area of research that gives understanding of development and hopefully effective treatments

Brain

two hemispheres connected by corpus callosum

split-brain

awareness of both hemispheres as result of surgery to sever the corpus callosum for severe epilepsy

Forebrain

the largest part of the brain that conducts high-level processes such as consciousness, cognition, emotion, reasoning, language and memory. Contains: Cerebral cortex and Subcortical structures: • Thalamus; Hypothalamus; Pituitary gland; Limbic system

Cortex

outermost covering of the brain consisting of densely packed neurons; responsible for higher thought processes and interpretation of sensory input

Cerebral hemispheres

the two sections of the cortex on the left and right sides of the brain

corpus callosum

thick band of neurons that connects the right and left cerebral hemispheres

Central Nervous System (CNS)

brain and spine column (fight or flight or freeze)

Peripheral Nervous System (PNS)

nerves are messengers to CNS • Somatic: conscious or voluntary activities

autonomic

unconscious or involuntary activities (internal organs and glands)

Frontal Lobe

thinking, emotions, personality, judgment, self-control, muscle control/movements, memory storage, and controls your understanding of social norms

Parietal Lobe

information from the body’s senses. Damage impairs emotional processing and arousal.

Somatosensory cortex

sensory information from across the body, such as touch, temperature, and pain.

Occipital Lobe

primary visual cortex

Temporal Lobe

hearing, memory, emotion, and some aspects of language.

Prefrontal Cortex

higher level cognitive functioning

Thalamus

sensory relay for the brain (with exception of smell)

Limbic System

processes emotion, memory and smell

Hippocampus

learning and memory

Amygdala

emotional connection to memories

Hypothalamus

homeostatic process, body temperature, appetite, blood pressure, sexual motivation and behavior

Midbrain

structures deep within the brain

Reticular formation

regulates the sleep/wake cycle, arousal, alertness, and motor activity

Substantia nigra and ventral tegmental area (VTA)

critical for movement. Also responsible for mood, reward, and addiction through production of dopamine. (deficit linked to Parkinson’s Disease)

Hindbrain

located at the back of the head and looks like an extension of the spinal cord

Medulla

automatic processes of the autonomic nervous system (breathing, blood pressure, and heart rate) pons, and cerebellum

Pons (bridge)

serves to connect the hindbrain to the rest of the brain; assists with regulation of brain activity during sleep.

Cerebellum

coordinates voluntary muscle movements, balance and posture, and supports motor learning.

Thalamus

The “gateway to the cortex” as input from most of our sensory systems (vision, hearing, touch, and taste) travels first to the thalamus

Basal ganglia

Collection of large structures involved with voluntary movement

Amygdala

Appears to have a role in identifying, remembering, and responding to fear and aggression

Hypothalamus

Involved with motivation and homeostasis, or the regulation of body functions such as temperature, thirst, hunger, biological rhythms, and sexual activities

Hippocampus

Essential to the formation of long-term memories

Cingulate cortex

ACC - important in decision making, emotion, anticipation of reward, and empathy • PCC - participates in memory and visual processing

Nucleus accumbens

Important part of the brain’s reward and pleasure circuitry

Neurotransmitters

the chemical messengers of the nervous system connect to receptors

Agonists

chemicals that mimic a neurotransmitter at the receptor site.

Antagonist

blocks or impedes the normal activity of a neurotransmitter at the receptor.

Resting potential

state of the brain when not firing a neural impulse

Action potential

release of the neural impulse that is a reversal of the electrical charge in the axon that allows positive sodium ions to enter the cell.

Acetylcholine

Muscle action, memory Increased arousal, enhanced cognition

Beta-endorphin

Pain, pleasure Decreased anxiety, decreased tension

Dopamine

Mood, sleep, learning Increased pleasure, suppressed appetite

Gamma-aminobutyric acid (GABA)

Brain function, sleep Decreased anxiety, decreased tension

Glutamate

Memory, learning Increased learning, enhanced memory

Norepinephrine

Heart, intestines, alertness Increased arousal, suppressed appetite

Serotonin

Mood, sleep, Modulated mood, suppressed appetite

Classification

A system for describing the important categories, groups, or dimensions of disorder. Creates clinical utility, enhances communication among mental health professionals, and improves research efforts

Reliability

Determines whether clinicians, using the same set of criteria, classify children into the same clearly defined categories.

Inter-rater reliability

two or more clinicians gathering different pieces of information come to same diagnostic conclusion.

Cross-time reliability

same diagnosis is reached if child is evaluated (by same clinician) at two different time points.

Validity

the classification gives true-to-life, meaningful information

Internal validity

refers to the etiology of a disorder, or the core patterns of symptoms or difficulties experienced.

External Validity

refers to the implications of the disorder to treatment

Bottom-up process

(1) data collection from normal and abnormal adjustment (2) statistical grouping by distresses and disfunctions into dimensions.

Top-down process

(1) identification of types of disorder (2) specification of symptoms to disorder

Dimensions of Disorders

(1) externalizing: under controlled behaviors often directed at others (2) internalizing: over controlled behaviors often directed toward the self.

Developmental perspective

Disorders are conceptualized as delay, fixation, or deviance

Homotypic

two or more within a classification system (ex: different types of anxiety)

Heterotypic

two or more outside of same classification system (EX: depression (internalizing) and conduct disorder (externalizing)

Familial

two or more disorders are clinically related (EX: depression and substance use)

Concurrent

experienced at the same time

Successive

experienced after one another

Methodology

informant-completed forms and the the tendency to report any and all negative symptoms

Assessment

the systematic collection of relevant information to solve the issues of (1) differentiating everyday or transient difficulties from clinically significant psychopathology, and (2) classifying and caring for those who have been identified as having disorders.

Primary Prevention

reducing or eliminating risks, and reduce the incidence of disorder in children. (1) Universal: provided for entire population (2) Selective: groups in above-average risk (3) Indicated: specific risk factors

Secondary prevention

implemented when signs of distress/dysfunction are noted.

Tertiary prevention

implemented when disorder is present

Adaptive VS. Maladaptive

focus on effectiveness of actions; may not meet statistical deviance because of common occurrence; subjective perspective.

Distress vs. Disability

also subjective perspective; (EX: “strive on stress” vs. “buckle under pressure)

Dyscontrol vs. Dysregulation

emphasis on voluntary or involuntary

Harmful Dysfunction

emphasis on evolutionary theory to explain psychopathology development

Categories Model

use of DSM-5 and ICD-10 codes: categorical model with criterion; can be exclusionary (yes or no)

Dimensional Model

a continuum; effective in study of personality historically with more research being done on other psychopathologies

Social Constructionism

Psychopathology is not scientifically measured, but socially constructed. “Reality cannot be separated from the way that a culture makes sense of it” (Rosenblum & Travis, 1996)

electroencephalogram (EEG)

electrodes (to track electrical activity)

positron emission tomography (PET)

radioactively tagged glucose or oxygen (to track chemical activity)

functional magnetic resonance imaging (fMRI)

magnets (to track the flow of oxygen)

Evolutionary Genetics

focuses on how universal patterns of behavior and cognitive processes have evolved over time

Behavioral Genetics

focus on the expression of individual differences from the interaction of genes and the environment

phenotype

physical characteristics of the offspring with one half contributed from each parent

genotype

genetic makeup of that individual

Mutation

sudden, permanent change in a gene

range of reaction

a theory that genes set the boundaries (stimulation vs deprivation)

Reaction norms

a theory that genetic expression is determined by the environment

Genetic environmental correlation

a theory genes influence environment and environment influence gene expression

Age is a developmental marker influenced by:

cognitive and biological maturity, type and duration of environmental experiences

Equifinality

experience varying influences at differing points in development

Multifinality

interaction of experiences and biological factors

Erik Erikson

- 8 Psychosocial Stages and each involves a core conflict -successful resolving each stage leads to the development of a psychological strength or virtue -if it remains unsolved, it can negatively affect future stages and overall well-being

Jean Piaget

-pioneer of psychology - 4 cognitive development stages: sensorimotor, preoperational, concrete operational, and formal operational

Comorbidity

co-occurence of two or more psychological disorders. More typical than not

Transdiagnostic factors

risk and etiological factors that are common to multiple diagnoses

Diathesis- Stress Models

vulnerability combined with stressor creates maladaptation

Susceptibility Theory

factors increase sensitivity to environmental experiences in both adaptive and maladaptive ways

Resilience

dynamic, evolving ability (competence) to handle adverse conditions

Equity Diversity and Inclusion Framework

research must take into account the culture norms, socialization practices and values when determining maladaptive responses.

Culture

A unique meaning and information system shared by a group, transmitted across generations to meet basic needs, pursue happiness and derive meaning from life. Changing, interactive over static states.

Wilhelm Wundt

-German psychologist -father of psychology --> first lab on experimental psychology in Leipzig, Germany

G. Stanley Hall

-founded the first American psychological laboratory -became the president of the APA

Illness Ideology

mental disorders exist in individuals NOT in relationship with others or culture. Personal values that are congruent (same/aligned) with social environment/culture likely leads to positive sense of well-being.

Cross-cultural psychiatry

interdisciplinary research approach of anthropology and psychiatry investigates the subjective meaning and expression of distress through observation (Kraepelin)

Explanatory Model

the “5 W’s” (what happened; why this happened; why it happened to me; what effects on others; what should I do to change it

Theoretical perspective focus

(1) position individuals within dynamic social systems (2) integrate social systemic determinants of health (3) provide avenues for exploring interventions beyond the individual

A sociocultural process

identifying; describing; labeling and developing a treatment plan

Requires

(1) knowledge of patient’s culture (language, meaning of subjective experiences) (2) coping and support networks in culture

Outline for Cultural Formulation (OCF)and the Cultural Formulation Interview (CFI)

diagnostic tool in DSM to determine (1) cultural identity (2) cultural explanation of illness/distress (3) cultural elements of practitioner-client relationship

A.D.D.R.E.S.S.I.N.G

Age, Developmental, Disability, Religion (Spirituality), Ethic (racial identity), socioeconomic status (social class), sexual orientation, indigenous heritage, national origin, gender

Scoping view

used to map the literature on topic of research to identify key concepts, gaps in research and types of evidence to collect

Race

NOT a term to refer to biological variation among humans, a sociocultural concept to group people by shared physical traits such as skin color, facial features or ancestry.

Ethnicity

a shared cultural identity by common traditions, ancestry, language, history and religion.

Gender

the socially and culturally constructed roles, behaviors, expressions, and identities that a given society considers appropriate for men, women, and other gender identities. DOES NOT refer to biological sex at birth.

Class

a group that share common traits, features, or status. May include socioeconomic status from income, education, marriage status

Goal in Diagnosis

(1) identify the problem (2) treat the problem (3) enable patients to lead more functional, productive and rewarding lives.

Criticism

pertinent information gathered may be influenced by gender, ethnicity, race and class of both client and clinician

Gender Issues

-no gender differences in disorders among infants and toddlers -89% more boys than girls (childhood) -boys show more externalizing disorders (ASD, ADHD, disruptive) -girls show more internalizing disorders (SIB, eating disorders, anxiety and depression)

Sampling bias

barriers to obtaining community sample

Data analytic bias

analysis omit study of specific construct (EX: gender) impact

Rater bias

clinician bias from inaccurate information/vignettes not clinical setting in diagnosis over/under exaggeration of disorders by gender, ethnicity and race.

Referral bias

participants do not represent general population

Negative halo effects

Letting one positive trait/good action cloud judgment to rate everything else as excellent

Measurement variance

dispersion of values across the data set

Differential item functioning

error when test item has different properties for different groups

criterion bias

error when the standard used (the criterion) is flawed, incomplete, or influenced by outside factors

Missing symptom bias

diagnostic error when data on key symptoms is missed or not collected

Ascertainment bias

A flaw in the sampling or data-gathering phase that distorts findings before any statistical analysis begins

Mental Health Service Use and Quality of Care

-individuals in need of care do not recieve it (41%) -varies by race and ethnicity (white more than non-white education status = positive correlated to whites, negatively correlated for non-white

Treatment issues

-lack of financial resources/insurance led to low rates of treatment -more referral to MH treatment by law enforcement for non-whites in poverty areas -gender can affect treatment outcomes/success

Multiculutral/diversity is a significant area of ungoing research:

Frameworks suggest: (1) use of client’s preferred language (translator services) (2) therapist-client ethnic matching (3) remove barriers to access (4) including family input where appropriate (5) incorporation of cultural values (i.e. traditions, religion, etc…)

Pharmacotherapy

-use of MH medication (psychotropic/psychiatric) in combination with therapy as treatment in the past women and other minorities excluded from studies -women over men receive medications for depression and anxiety related disorders -African American received less pharmacotherapy, and less likely to recieve neweest medications than whites -gender and ethnicity may affect biological responses to medications in: (1) absorption (2) distribution (3) metabolism (4) elimination