Nicohwilliam - Paper Answers

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Youtube videos:

Anxiety-What Is the Generalized Anxiety Disorder:

https://www.youtube.com/watch?v=3WJYmgXcoEI

Howie Mandel talks about living with OCD:

Assignment 1: please write at least 250 words APA format and relevant sources (textbook, and 2 other sources)

1. Define a “psychodiagnosis” and it’s role in the treatment of mental disorders.

The DSM 5 and the ICD 10 codes provide healthcare workers with a common way of talking with each other about illness. As professional counselors we work with other practitioners such as psychiatrists, primary care physicians, social workers, psychologists, physical/occupational therapists etc.

While the importance of an actual diagnosis cannot be overlooked, we must always keep in mind what can be done to help the client to live optimally.

2. It is helpful when conceptualizing a case that the intensity, duration and frequency of the symptoms in the daily life of the client be considered. This information can help you to realize how “disabling” (mild, moderate, severe) the symptoms are for the client. How does this information relate to the DSM 5 and the ICD 10?

3. Compare and contrast (be very specific) the following assessment techniques, and their role/impact on diagnosis: Interviews/MSE, Psychological Tests and Inventories, Tests of Cognitive and Neurological Functioning, Self Report Inventories.

It is not necessary to mention every video in your responses, but you must be specific in your responses. Refer to what you have viewed in the videos and read in your text.

Assignment 2: please write at least 250 words APA format and relevant sources

View the video above on DSM 5 and Mental Illness. Please post your impressions of the video, as well as implications for you as a future counselor, of the information presented in the video.

What DSM-5 Means for Diagnosing Mental Health Patients:

Assignment 3: please see powerpoint slide titled DSM-5 Disorder categories and features

Choose one disorder from Ch. 3. Describe it (be specific) in the context of the multipath model of understanding it, and the implications of viewing the disorder this way for the client, client’s family, and society as a whole.

This paper must be in APA style, with a title page and a reference page. You must use your textbook and at least one other professional resource for this assignment. It must be at 2 full double spaced, typed pages (not including Title page and Reference page).

Clinical Research, Assessment, and Classification of Abnormal Behavior

The Scientific Method in Clinical Research
Scientific method
Systematic data collection, controlled observation, and testing hypotheses
Hypothesis
Tentative explanation for certain facts or observations
Theory
Group of principles and hypotheses that together explain some aspect of a particular area of inquiry

Importance of Replication
Replication
Repeating results under similar test conditions
Replicating research has resulted in changes to previous findings described as “conclusive” in mass media
Examples:
Childhood vaccines may cause autism (not supported)
Antidepressants raise suicide risk in children and adolescents (needs further research)

Characteristics of Clinical Research
Development of hypotheses about relationships
Potential for self-correction
Consideration for reliability and validity
Use of operational definitions
Acknowledgement of base rates
Evaluation based on statistical significance

Case Study
Intensive study of one individual
Relies on clinical data
Observations
Medical and psychological tests
Historical and bibliographic information
Can determine characteristics, course, and outcome of a rare disorder
Used to study therapeutic or diagnostic techniques

Correlational Studies
Statistical analysis to determine correlation between variables
Allow analysis of variables that cannot or should not be controlled
Types of correlation
Positive correlation
Negative correlation
No correlation

Experiments
Best tool for testing cause-and-effect relationships
Components of a simple experiment
Experimental hypothesis
Independent variable
Manipulated by the experimenter
Dependent variable
Expected to change as a result of manipulating the independent variable

Types of Groups in an Experiment
Experimental group
Group exposed to an independent variable
Control group
Similar in every way to experimental group but not exposed to independent variable
Placebo group
Participants receive an inactive substance

©2017 Cengage Learning. All rights reserved.
Additional Controls in Experimental Research
Design of the experiment
Single-blind design
Participants unaware of purpose of research
Double-blind design
Participant and individual working directly with the participant unaware of the experimental conditions
Some variables cannot be manipulated
Example: child abuse
Correlational studies are appropriate

Analogue Studies
Investigation that attempts to simulate real-life situation under controlled conditions
Used when not possible to control all variables in real-life situations or when ethical, legal, or moral issues preclude other types of studies
e.g., to test effects of lack of control on depression, exposing rats to uncontrollable negative events

Field Studies
Behaviors and events are observed and recorded in their natural environment (e.g., after floods, earthquakes, and war)
The main technique is observation
Also uses interviews, questionnaires, and review of existing data
Observers must be highly trained
Avoid disrupting the natural environment

Biological Research Strategies
Methods for studying biological processes involved in mental illness
Endophenotypes
Twin comparisons
Genetic studies
Study of the epigenetic processes

The Endophenotype Concept
Endophenotypes: measurable characteristics
Characteristic must be heritable
Occur more frequently in affected families than in the general population
Examples: anatomical or chemical differences in the brain, eye-tracking irregularities
Guide prevention and early treatment efforts

©2017 Cengage Learning. All rights reserved.
Twin Studies
Monozygotic (identical) twins
Share the same DNA
Have different fingerprints
Develop more differences from one another as they age
Fraternal twins
Share same childhood environments
Often used to evaluate hereditary versus environmental influences on development

©2017 Cengage Learning. All rights reserved.
Genetic Linkage Studies
Goal: determine whether a disorder follows a genetic pattern
If disorder is genetically linked:
Individuals closely related to person with disorder (proband) more likely to display disorder
Penetrance
Proportion of individuals with a particular genotype who manifest the phenotype

©2017 Cengage Learning. All rights reserved.
Epigenetic Research
Study of environmental factors that influence whether or not a gene is expressed
Builds on idea that certain environmental factors have greatest impact during sensitive periods in development
Epigenetic changes can leave an imprint on eggs or sperm
Affects traits inherited by future generations

Epidemiological Survey Research
Examines rate and distribution of mental disorders in the population
Prevalence
Percentage of individuals in targeted population with a particular disorder during a specific period of time
Incidence
Number of new cases of a disorder that appear in an identified population within a specific period of time

Reliability
Degree to which a test or procedure yields the same results repeatedly under the same circumstances
Test-retest reliability
Same results when given at two different points in time
Internal consistency
Various parts of measure yield similar or consistent results

Reliability (cont’d.)
Interrater reliability
Consistency of responses when scored by different test administrators

Validity
Extent to which a procedure actually performs its designed function
Predictive validity
How well a test predicts a person’s behavior or response
Construct validity
How well a test or measure relates to the characteristics or disorder in question

Validity (cont’d.)
Content validity
How well a test measures what it is intended to measure
Assesses all areas known to be associated with a particular disorder

Standardization
Standard administration
Professionals administering a test must follow common rules or procedures
Standardization sample
Group of people who initially took the measure
Performance is used as standard or norm
Test-takers should be similar to the standardization sample for test to be valid

Assessment Techniques
Psychological assessment
Gathering information and drawing conclusions
Traits, abilities, emotional function, and more
Four main assessment methods
Observations
Interviews
Psychological tests and inventories
Neurological tests

Interviews
Observe client and collect data about the person’s life history, current situation, and personality
Analyze
Verbal behavior
Nonverbal behavior
Content
Process of communication

Types of Interviews
Interviews vary in degree of structure and formality
Structured interviews
Common rules and procedures
Standard series of questions
Disadvantage: limit conversation
Advantage: collect consistent and comprehensive information

Observations
Controlled (analogue) observations
e.g., laboratory, clinic
Naturalistic observations
Natural setting (e.g., classroom, home)
Usually in conjunction with an interview

©2017 Cengage Learning. All rights reserved.
Children’s social behavior can be observed in a controlled setting like a clinic office or in a naturalistic setting like the playground.
26

Mental Status Examination
Objective: evaluate client’s cognitive, psychological, and behavioral functioning
Uses questions, observations, and tasks
Clinician considers the appropriateness and quality of the client’s responses
Forms tentative opinion of diagnosis and treatment needs

Psychological Tests and Inventories
Standardized tools
Measure characteristics such as personality, social skills, and more
Projective personality tests
Test taker presented with ambiguous stimuli and asked to respond in some way
Rorschach Technique
Thematic Apperception Test (TAT)
Sentence-completion test
Draw-a-person test

Self-Report Inventories
Used to assess depression, anxiety, or emotional reactivity
May involve completion of open-ended sentences
Minnesota Multiphasic Personality Inventory (MMPI and MMPI-2)
Interpretation is complicated

The Ten MMPI-2 Clinical Scales and Sample MMPI-2 Tests (Partial)

©2017 Cengage Learning. All rights reserved.
Figure 3.1 The 10 MMPI- 2 Clinical Scales and Sample MMPI- 2 Tests
Shown here are the MMPI- 2 clinical scales and a few of the items that appear on them. As an example, answering “no” or “false” (rather than “yes” or “true”) to the item “I have a good appetite” would result in a higher scale score for hypochondriasis, depression, and hysteria. These sample questions do not pertain to some of the MMPI categories such as paranoia, hypomania, and social introversion.
30

Intelligence Tests
Primary functions
Obtain intelligence quotient (IQ), or estimate of current level of cognitive functioning
Provide clinical data
Wechsler scales
Assess verbal and perceptual reasoning, working memory, processing speed
Stanford-Binet scales
More complicated; uses basal and ceiling

Criticisms of Intelligence Tests
Fail to consider the effects of culture, poverty, discrimination, and oppression
Do not consider multidimensional attributes of intelligence
Have a poor level of predictive validity
Do not accurately predict future behaviors or achievement
Motivation and work ethic may matter more

Tests for Cognitive Impairment
Bender-Gestalt Visual-Motor Test
Involves copying geometric designs
Halstead-Reitan Neuropsychological Test Battery
Differentiates patients with brain damage
Can provide valuable information about the type and location of the damage

The Nine Bender Designs

©2017 Cengage Learning. All rights reserved.
Figure 3.3 The nine Bender designs The figures presented to participants are shown on the left. The distorted figures drawn by participants that are possibly indicative of brain damage are shown on the right.
34

Neurological Tests
Allows noninvasive visualizations of brain structures
Electroencephalograph (EEG)
Computerized axial tomography (CT)
Magnetic resonance imaging (MRI)
Functional MRI (fMRI)
Magnetoencephalography (MEG)
Positron emission tomography (PET)

Diagnosing and Classifying Abnormal Behavior
Psychiatric classification system
Similar to a catalogue, with detailed descriptions of each disorder
Patterns of behavior are distinctly different
Each category accommodates symptom variations

Diagnostic and Statistical Manual of Mental Disorders (DSM)
Widely used classification system
DSM-I (1952): Identified 106 mental disorders
DSM-II (1968): Identified 182 disorders
DSM-III (1980): 265
DSM-III-R: 292
DSM-IV (1994): 297
DSM-V (2013): no significant increase in disorders, but many changes
Revisions (DSM-II, DSM-III, DSM-III-R, DSM-IV, DSM-5) attempt to increase reliability and validity

DSM-5 Disorders – Categories and Features

DSM-5 Disorders – Categories and Features (cont’d.)

Evaluation of the DSM-5
More people meet criteria for diagnosis
e.g., alcohol use disorder criteria less strict
Influence of outside forces
e.g., 70% of professionals who developed DSM-5 had direct ties to drug companies
Medicalization of some issues
e.g., gambling disorder; premenstrual dysphoric disorder
Cross-cultural applicability concerns

©2017 Cengage Learning. All rights reserved.
Review
What kinds of studies are used in the field of abnormal psychology?
What kind of tools do clinicians use to evaluate a client’s mental health?
How are mental health problems categorized or classified?

4-4aEtiology of Generalized Anxiety Disorder

GAD is the result of biological factors combined with psychosocial stressors, as shown in

Figure 4.8

. Let’s take a look at each of the factors that may contribute to the etiology of GAD.

Figure 4.8Multipath Model of Generalized Anxiety Disorder (GAD)

The dimensions interact with one another and combine in different ways to result in generalized anxiety disorder (GAD).

Biological Dimension

Heritability appears to play a small but significant role in the development of GAD (Kendler & Prescott, 2006). Genes associated with anxiety are often expressed in terms of neurotransmitter abnormalities or overactivity of brain regions associated with anxiety.

As mentioned earlier, our prefrontal cortex modulates our responses to threatening situations. GAD may involve a disruption in this system. In an MRI investigation, 18 adolescents with GAD and 15 without GAD were exposed to angry faces (Monk et al., 2006). Those with GAD showed greater activation of the prefrontal cortex in response to the faces, suggesting that the prefrontal cortex was attempting to regulate the anxiety aroused by the faces.

Did You Know?

A 2-year study of adolescents with GAD or social phobia revealed the following:

· GAD (but not social phobia) was associated with increased frequency of underage drinking.

· GAD symptoms preceded alcohol and cannabis use.

· Adolescents with social phobia used less alcohol and cannabis than those with GAD or no anxiety disorder.

Source: Frojd, Ranta, Kaltiala-Heino, & Marttunen, 2011

Psychological Dimension

Cognitive theories emphasize the role of dysfunctional thinking and beliefs in the development of GAD. Individuals with this disorder have a lower threshold for uncertainty, which leads to worrying. They also have erroneous beliefs regarding worry and assume that worry is an effective way to deal with problems or that it prevents negative outcomes from occurring (Ladouceur et al., 2000). A. T. Beck (1985) believes that negative

schemas

(mental frameworks for organizing and interpreting information) play a key role in anxiety disorders. Schemas may involve beliefs such as “I am incompetent” or “The world is dangerous.” When someone interprets everyday occurrences through the filter of a negative schema, ambiguous or even positive situations may be viewed with concern and apprehension.

Some researchers believe that the roots of GAD lie in beliefs regarding the function of worrying (A. Wells, 2005, 2009). In this model, there are two types of worry. The first involves the frequent use of worry to cope with stressful events or situations that might occur. However, the stress of constantly generating solutions to “what if” scenarios eventually results in a belief that worry is uncontrollable, harmful, and dangerous. GAD develops when the second type of worry (“worrying about worry”) occurs (D. M. Ellis & Hudson, 2010).

Social and Sociocultural Dimensions

A variety of social factors may influence the development of GAD. Mothers who themselves have anxiety symptoms may be less responsive and engaged with their infants than mothers who are not anxious. These behaviors appear to increase the likelihood that the child will develop GAD (A. Stein et al., 2012). Conflict in peer relationships, including being a victim of bullying, can increase the chances of developing GAD (Copeland, Wolpe, Angold & Costello, 2013). Stressful conditions such as poverty, poor housing, prejudice, and discrimination also contribute to GAD and may be responsible for the high prevalence of GAD in African Americans (Sibrava et al., 2013) and Latino/Hispanic Americans (Bjornsson et al., 2014).

4-4bTreatment of Generalized Anxiety Disorder

Benzodiazepines have been successful in treating GAD; however, because GAD is a chronic condition, drug dependence is a concern. Antidepressants are usually preferred because they do not have the potential for the physiological dependence seen with the benzodiazepines (NIMH, 2013a).

Cognitive-behavioral therapy (CBT) is an effective psychological treatment for GAD. A meta-analysis of CBT for GAD found it to be successful in reducing pathological worry; nearly 60 percent of those treated with CBT showed significant symptom reduction that continued 12 months after treatment (Hanrahan, Field, Jones, & Davey, 2013). This treatment generally involves teaching clients to (Stanley et al., 2003):

· identify worrisome thoughts;

· discriminate between worries that are helpful to problem solving and those that are not;

· evaluate beliefs concerning worry, including evidence for and against any distorted beliefs;

· develop self-control skills to monitor and challenge irrational thoughts and substitute more positive, coping thoughts; and

· use muscle relaxation to deal with somatic symptoms.

We now discuss another set of disorders characterized by persistent troublesome thoughts and underlying anxiety: obsessive-compulsive and related disorders.

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