Name: _______________________________
What is Psychology?
The purpose of this is to help you to understand what psychology is and how it differs
from the popular ideas that most people have. You probably had some of the same
misconceptions as you began this course. In your paper, address all of the following:
Look for the scientific definition of psychology in your textbook/notes. Write down this
definition and explain the definition in your own words.
Ask 3 people who are not currently enrolled in a general psychology course to define
psychology and to describe what psychologists study. You can ask your family, friends,
or students NOT enrolled in general psychology. Record each of their responses
verbatim (word for word). After each person’s response, include their age, sex, and
educational level.
In a few paragraphs, compare the responses of your respondents to the scientific
definition given in the text. Be sure to address the following:
a) What were some of the common elements or ideas in the answers given by your
respondents?
b) How do the popular notions about psychology given by your respondents differ from
the scientific definition given in the text?
c) What were the major misconceptions that your respondents had about psychology?
Formatting and submission expectations for this assignment:
•
•
•
•
Your paper must be typed and double-spaced.
Carefully and thoroughly address the information asked for in areas 1-3 above.
Number your responses.
Use complete sentences whenever possible and put quotation marks around direct
quotes. Overall length of the paper does not matter as much as completely
addressing and explaining the required information.
Chapter 12: Health,
Stress, and Positive
Psychology
Pastorino, What Is Psychology?, 5th Edition.
©2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a
Pastorino, What Is Psychology?, 5th Edition. ©2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to
publicly accessible website, in whole or in part.
a publicly accessible website, in whole or in part.
1
What Is Stress? Stress and
Stressors
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2
Life events: Change is stressful
Stress: Any stimulus we respond to, perceived as
challenging or threatening.
• Reaction to stress includes physiological and
behavioral changes.
• Cope by perceiving and then reacting.
Life events: Good or bad events that require
adjustment.
• Voluntarily or involuntary
• Desirable or undesirable
• Scheduled or unscheduled
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publicly accessible website, in whole or in part.
3
Catastrophes and trauma
Catastrophes (or catastrophic events)
• Very sudden and occur without warning
• Require enormous levels of adaptation
• Unpredictable
Types of Trauma
• Posttraumatic stress disorder (PTSD)
• Rape trauma syndrome
• COVID stress syndrome
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4
Daily hassles: Little things add up
Daily hassles: Plays a
role in health and life
satisfaction.
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5
Variations in stress
Gender: Women are more likely to perceive
stress from money, having too much to do,
health concerns, trouble relaxing.
Age: younger people report more daily hassles
and perceive them as more stressful than older
adults.
Socioeconomic status: welthier people feel
they have more control over their lives and
report having more fun.
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6
Variations in stress
Racial and ethnic differences:
• African American are more likely to report
economic hassles, exposure to noise,
feeling lonely, and invasion of personal
privacy.
• Hispanic Americans are more likely to report
problems with aging parents as a hassle.
• Acculturative stress: The difficulties
associated with adapting to a new culture.
Prejudice, stigma, and discrimination:
• Members of racial and sexual minorities and
lower-income groups
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7
Resilience
Resilience: Adapting well to significant
stressors, bouncing back from adversity.
• People who are resilient, perceive stressors
more as opportunities for learning and
growth than as threats, and they have a
high sense of personal control over their
actions and outcomes.
• As a result, resilient people cope effectively
with stressful situations.
• The implications extend to physical health
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8
Conflict: Approach and avoidance
Four common conflict situations:
• Approach-approach conflicts: Choose between
two positive events
• Avoidance-avoidance: Choose between two
negative events.
• Approach-avoidance conflict: Each choice has
positive and negative qualities.
• Multiple approach-avoidance conflicts: Several
potential options, each of which has positive
and negative qualities.
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9
The Stress Response
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10
Cognitive appraisal: Assessing stress
Primary appraisal
• Initial interpretation of an event.
• Can lead to positive or negative
emotions.
• Threatening events perceived to
cause some harm in the future.
• Challenge appraisal typically elicits
positive emotions, perceived as less
stressful.
Secondary appraisal
• Evaluation of event after first
appraisal.
• People consider resources available
to cope with the stress.
• Includes coping strategy
assessments.
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11
The body’s response to stress
• Alarm
• Resistance
• Exhaustion
Levels of resistance to stress
Three phases of biological stress
response:
Fight-or-flight activation
More
Homeostasis
Normal
Less
Alarm
Resistance
Exhaustion
Time
General Adaptation Syndrome
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12
Alarm reaction and the HPA axis
Alarm reaction: Bodily responses immediately
triggered after primary appraisal.
• Distress signal sent to hypothalamus activates
the sympathetic nervous system.
• Adrenal gland secretes stress hormones
adrenaline and corticosteroids.
• Pituitary secretes endorphins preparing the
body cope with stress.
• HPA axis is the interaction between the
hypothalamus, pituitary gland, and adrenal
gland.
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13
Resistance and exhaustion stages
Resistance Stage: Body tries to repair itself
and store energy to cope with stressor.
Exhaustion stage
• Wear and tear on the body begins.
• High levels of adrenaline and
corticosteroids damage the heart and
lessens effectiveness of immune system.
Exhaustion increases
vulnerability to disease.
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14
Gender and the stress response
Males
Females
• Higher corticosteroid levels produced
compared to adult females, possibly
due to higher levels of testosterone.
• Estrogen enhances the level of
oxytocin producing a more calming
effect under stress.
• More likely to confront a threat under
stress.
• More likely to come together in
groups and seek social support.
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15
Stress and the immune system: Resistance to disease
Psychoneuroimmunology: Study of how stress
affects physical health.
Immunosuppression: Reduction in activity of the
immune system.
Immune system:
• Body’s basic defense against illness-causing agents.
• Fights and destroys bacteria, viruses, and other
foreign substances.
• Immunosuppression occurs when system is
compromised.
• Leaves us vulnerable to developing illness.
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16
Coping with Stress
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17
Problem-focused coping: Change the situation
Problem-focused coping: efforts to address
the stressor to the best of our ability.
• Go to the source to solve the problem.
• Reducing the source of the stress, makes
the situation more manageable.
• Focus on our own reactions when solving
the problem is not possible.
“ I wont be taking any more calls today. I
threw my phone out the window”
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18
Emotion-focused coping: Change your reaction
Emotion-focused coping
• Concentrate on adjusting our own reactions to
stressors.
• Often necessary when the source of a stressor is
outside of our control.
• Cognitive reappraisal: Altering our interpretation of
an event to reduce the stress potential and make it
easier to cope with.
• Defense mechanisms: Unconscious, emotional
strategies to reduce anxiety and maintain a positive
self-image.
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19
Managing stress: Applying the research
Strategies to help reduce stress:
• Exercise and meditation
• Relaxation, including progressive
relaxation and laughter
• Developing social support relationships
• Spirituality and/or religion
• Guided imagery focused on a calm
environment
• Optimism
• Effective time management
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publicly accessible website, in whole or in part.
20
Personality, Health, and WellBeing
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publicly accessible website, in whole or in part.
21
Types of personality
Personality types are associated with different risk of
physical illnesses.
• Type A—aggressive, competitive, and driven.
• Type B—relaxed, easygoing, and flexible.
• Type C—cautious and careful and does not express
negative emotions, stuffing them inside.
• Type D—highly pessimistic and avoids social contacts.
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22
Learned helplessness: I can’t do it
Learned helplessness: passive response to
stressors.
• One feels incapable of impacting a given
situation.
• Seligman demonstrated that learned helplessness
can be induced in dogs.
• Why people choose to stop trying to change or
improve their circumstances.
• May appear to be “giving up,” but the
psychological foundation of this pattern is much
more problematic.
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23
The Hardy personality: Control, commitment, and challenge
A personality high in the traits of commitment,
control, and challenges.
• Hardiness is a general style that enables a
person to turn stressors into opportunities
for personal growth and change.
• More positive worldview.
• Problem-focused coping and better ability to
handle conflict.
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24
Lifestyle, Health, and Well-Being
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25
Health-defeating behaviors
Suicide
• Health-defeating
behaviors increase
illness, disease, or
death.
• Most leading causes of
death have been linked
to personal habits.
Influenza and
pneumonia
Diabetes
Cause of death
• Risky behaviors related
to higher risk of injury.
Kidney disease
Alzheimer’s
disease
Accidents
Stroke
Lung disease
(not cancer)
Cancer
Heart disease
30
50
70
90
110
130
150 550
Deaths per year (thousands)
570
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590
26
Health-defeating behaviors
Alcohol
Smoking and vaping
• Leads to social
problems.
• Vaping perceived as
less harmful than
smoking by teens.
• Causes major health
problems.
• Nicotine use related
to biological and
environmental
factors.
Unsafe sex and
sexually transmitted
infections (STIs)
• Can be passed from
mother to fetus.
• Often have no
symptoms.
• People aged 15 to 24
most at-risk.
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27
Health-defeating behaviors
Risk factors for STIs: Engaging in high-risk sexual
behaviors such as having multiple partners and
unprotected sexual intercourse.
Types of STIs:
• Bacterial infections: Include chlamydia, gonorrhea,
syphilis; usually treated with antibiotics.
• Viral infections: Include genital herpes human
papillomavirus (HPV) and HIV/AIDS; remains in the
body for life.
• Parasitic infections: Includes pubic lice; treated with
solution that kills eggs.
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28
Health-promoting behaviors
Behaviors that decrease the chance of illness,
disease, or death.
• Physical activity: Combats stress, helps us live
longer, improves mental health, and positively
affects memory and cognition.
• Eating right: Being overweight is associated with
higher risk of several types of health problems.
• Getting enough sleep: At least 8 hours per night.
Helps to enhance immune system.
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29
Happiness and well-being
Healthy living promotes happiness and
subjective well-being.
Factors contributing to happiness are:
• Social relationships
• Cognitive patterns
• Steady temperament
• Wealth
• Culture and shared values
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30
Chapter 13: Mental
Health Disorders
Pastorino, What Is Psychology?, 5th Edition.
©2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a
Pastorino, What Is Psychology?, 5th Edition. ©2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to
publicly accessible website, in whole or in part.
a publicly accessible website, in whole or in part.
1
History of psychopathology
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2
Early demonology and biological explanations
• Early Demonology (500 B.C.E.)
− Possession by evil beings or spirits
§ Exorcism or torture
§ This idea was widely accepted up until the sixteenth
and seventeenth centuries
• Early Biological Explanations
− Hippocrates (450 B.C.E.)
§ Rejected the notion of evil spirits and argued instead
that mental illness was a disease of the brain relating
to imbalances of bodily humors, or chemicals in the
body
§ Normal brain functioning depended on balance of four
humors: blood, black bile, yellow bile, & phlegm
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3
Dark ages and demonology
• Dark ages (2nd century A.D.)
− Christian monasteries replaced physicians as healers
and as authorities on mental disorders.
− Monks cared and prayed for mentally ill
• Witches (13th century A.D.)
− Witchcraft was seen as a heresy and a denial of God.
− Torture sometimes led to bizarre delusional
sounding confessions, e.g., concourse with demons
− Burning was the usual method of driving out the
supposed demon.
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4
Lunacy trials
• Lunacy trials
− Trials held to determine sanity
§ Began in 13th century England
− Hospitals began to come under secular
jurisdiction
− Municipal authorities assumed responsibility
for care of mentally ill
− Lunacy attributes insanity to misalignment of
moon “luna” and stars
− The defendant’s orientation, memory,
intellect, daily life, and habits were at issue in
the trial.
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5
Development of asylums
• Asylums (15th century AD)
− Establishments for the confinement and care of mentally ill
− Priory of St. Mary of Bethlehem (founded in 1243)
§ One of the first mental institutions
§ The wealthy paid to grape at the insane
§ Origin of the term bedlam (wild uproar or confusion)
− Confining people with mental illness in hospitals and placing
their care in the domain of medicine did not necessarily
lead to more humane and effective treatment.
§ Benjamin Rush recommended drawing copious
amounts of blood, to relieve brain pressure
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6
Pinel’s reforms and moral treatment
• Philippe Pinel (1745-1826)
− Pioneered humanitarian treatment at LaBicetre
− Has often been considered a primary figure in the
movement for humanitarian treatment of people with
mental illness.
• Moral treatment
− Small, privately funded, humanitarian mental
hospitals
§ Friends’ asylum (1817)
§ Patients engaged in purposeful, calming
activities (e.g., gardening)
§ Talked with attendants
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7
Dorothea Dix
• Dorothea Dix (1802-1887)
− Crusader for prisoners and mentally ill
− Urged improvement of institutions
− Worked to establish 32 new, public hospitals
§ Unfortunately, small staffs at these new public
hospitals could not provide necessary individual
attention
§ Hospitals administered by physicians, who were
more interested in biological rather than
psychological aspects of mental illness
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8
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9
What Is a Mental Health
Disorder?
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10
Defining mental health disorders
A dysfunction in thinking (cognition), emotions,
and/or social behavior that impairs functioning
and is not culturally expected.
• Not typical or culturally expected
• Causes personal distress to the individual or
those around them.
• Creates dysfunction and interferes with a
person’s ability to function in everyday life.
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11
Prevalence of mental health disorders
A leading cause of disability worldwide.
• Females more likely to have both any
mental health disorder and a serious
mental health disorder.
• Data shows 22% of U.S. teens are
likely to experience a mental health
disorder with severe impairment or
distress.
Prevalence of Depression, Anxiety, Substance Abuse,
and Antisocial Personality Disorder in Women and Men
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12
Biological theories: The medical model
• The medical model:
− Biological theories include
imbalance in hormones or
neurotransmitters, or some
brain or bodily dysfunction.
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13
Psychological theories: Internal and external influences
• Psychoanalytic perspective: Attributes mental health
disorders to unresolved unconscious conflict.
• Social learning perspective: Attributes difficulty in
functioning to learning processes such as classical
conditioning, operant conditioning, and observational
learning.
• Cognitive perspective: Thoughts, expectations,
assumptions, and other mental processes in mental health
disorders.
• Humanistic perspective: Considers mental health disorders
as resulting from a distorted perception of the self and reality.
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14
Sociocultural theories and biopsychosocial model
• Sociocultural models: Focus on the
contextual situations and conditions that
can lead people to unhealthy
psychological functioning.
• Biopsychosocial model: Integrates all
and considers the simultaneous effect of
many influences.
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15
The DSM Model for Classifying
Abnormal Behavior
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16
The structure of the DSM
Diagnostic and Statistical Manual of Mental
Disorders (DSM):
• Lists the diagnostic criteria for almost 300
mental health disorders.
• Lists 20 major categories of mental health
disorders.
• Excludes how to treat disorders and their
causes.
− This atheoretical position underscores the
complex biopsychosocial nature of the
causes of mental illness.
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17
How good is the DSM model?
The reliability and validity for many of the
diagnostic categories have improved.
• DSM does not guarantee accurate diagnosis.
− No biomarkers yet (e.g., blood test)
• Diagnosis usually involves subjectivity and
personal bias.
Worst edition ever
• Symptoms may be listed as part of several
disorders.
• Negative effects of labeling may serve as a selffulfilling prophecy and create a social stigma.
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18
Anxiety, Obsessive-Compulsive,
and Trauma-Related Disorders:
It’s Not Just “Nerves”
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19
Components of excessive anxiety
• Chronic disruptive worry, fear, or apprehension culturally unexpected, involving
four different areas of symptoms:
Physical
Cognitive
Emotional
• Dizziness
• Worry
• Dread
• Elevated heart
rate/blood
pressure
• Fear of losing
control
• Terror
• Irritability
• Sweating palms
• Exaggerating
danger of a
situation
• Dry mouth
• Paranoia
• Muscle tension
• Panic
• Restlessness
Behavioral
• Escaping or
fleeing
• Behaving
aggressively
• Freezing or
avoiding
situations in the
future
• Wary and
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watchful
publicly accessible website, in whole or in part.
th
20
Prevalence of Anxiety, Obsessive-Compulsive, and TraumaRelated Disorders in a Given Year
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21
Generalized anxiety disorder
• Excessive anxiety/worry more days than
not for at least 6 months
− Anxiety non-specific and out of
proportion
− Worry about everything
− Affects about 5% of the U.S. population
− Lifetime disorder beginning in childhood
or adolescence in half the cases
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22
Panic disorder
• Sudden onset of intense fear
• Feeling overwhelmed like having a heart
attack or seizure
• Unexpected and persistent
• No specific environmental triggers
• Begin in late adolescence to mid-30’s
• Can be treated with medication
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23
Phobias
• Marked, persistent, unreasonable fear
− Animals, insects, snakes
− Environments (storms, heights,
water)
− Blood
− Situations (buses, bridges,
elevators, driving, enclosed places)
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24
Obsessive-compulsive disorder (OCD)
• Recurrent obsessions or compulsions (rituals)
− Cleaning, checking, counting, arranging and
straightening things
• Time consuming or causing distress
• Excessive or unreasonable
• Person cannot stop
• Not to be confused with obsessive compulsive
personality
− No compulsions
− Preoccupied with orderliness, perfection, control
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25
Hoarding
• Characterized by persistent difficulty in
throwing away possessions
• Impairs ability to function yet discarding
these possessions causes significant
distress and anxiety
• Person’s living environment becomes
cluttered, unusable, and hazardous.
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26
Trauma-related disorders
• Post traumatic stress disorder
− Development of severe symptoms following
exposure to an extreme traumatic exposure
− Must last one month and cause significant
distress
− Symptoms include
§ Persistent re-experiencing of event
§ Avoidance of stimuli associated with the event
§ Numbing of general responsiveness
§ Increased arousal
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publicly accessible website, in whole or in part.
27
Trauma-related disorders
• Post traumatic stress disorder
− Typical traumas:
§ Military combat
§ violent personal assault
§ torture
§ kidnapped/hostage
§ natural disasters
§ severe auto accident
§ diagnosis of a life threating illness
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28
Research Explaining Anxiety, Obsessive-Compulsive, and
Trauma-Related Disorders
Biological factors
Psychological factors
Sociocultural factors
• Neurotransmitters
and genetic factors
have been identified.
• Cognitive processes
and learning (notably
classical and operant
conditioning and
modeling).
• The influence of
poverty, sex and
gender, race and
ethnicity, and other
cultural factors on
anxiety.
• Specific brain areas
have been identified
as showing abnormal
structure or activity.
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29
Dissociative and Somatic
Symptom and Related Disorders:
Other Forms of Anxiety?
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30
Dissociative disorders: Loss of self-awareness
Involve a loss of awareness of some part of our self, our
surroundings, or what is going on around us. Mild
dissociative experiences are common.
Dissociative identity disorder (DID): Involves the
existence of two or more separate identities in the same
individual.
• Each “alter” appears to have a specific function.
• Frequent blackouts or episodes of amnesia are
common in people with dissociative identity disorder.
• Most people diagnosed with DID are women.
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31
Somatic symptom and related disorders “Dr., I’m sure I’m sick”
• Conversion disorder: feature nervous system
(neurological) symptoms that can’t be explained by a
neurological disease or other medical condition.
• Somatic symptom disorders (and their related
diagnoses): Occur when physical symptoms appear
that have no identifiable physical cause.
• Illness anxiety disorder: Ongoing worry and fear
about having or developing a physical illness.
Previously referred to as hypochondriasis.
− Some people with illness anxiety disorder
constantly visit physicians, while others believe
they are ill but refuse to do so.
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32
Depressive and Bipolar
Disorders: A Change in Mood
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33
Major depressive disorder
Extended periods of intense sadness,
hopelessness, and a lack of ability to take
pleasure in previously enjoyed activities
(anhedonia) +
• Physical symptoms: sleep patterns, appetite,
and motor functioning changes, fatigue or loss of
energy.
• Cognitive symptoms: inability to concentrate,
worthlessness or guilt, thoughts of suicide.
• Persistent depressive disorder (formerly
called dysthymic disorder): less severe but longlasting.
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34
Individual variations in depressions
Depressive disorders:
• A commonly diagnosed psychological condition.
• Often severe enough to warrant significant
therapeutic intervention.
• Related to age, gender, and ethnicity.
• People aged 15 to 24 at high risk for major
depressive episode.
• Adults aged 60 or older have the lowest rates of
major depressive episodes.
• Women 2x as likely to experience both mild and
more severe depression.
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35
Bipolar-related disorders: The presence of mania
Bipolar disorder: shift in mood between two
states, or poles.
• One shifts is to a depressed state, with symptoms
similar to those of major depressive disorder.
• One shifts to a “high” or euphoric state, called
mania, which involves a persistently elevated
mood and increased activity or energy.
Cyclothymic disorder is a less severe but more
chronic form of bipolar disorder, where a person
alternates between milder periods of mania and
more moderate depression for at least 2 years.
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36
Biological factors: Genes, neurotransmitters, and stress hormones
Genes
• Depression and
bipolar disorders
runs in families.
• Specific genes are
likely related to these
conditions.
Neurotransmitters
Malfunctioning
neurotransmitters,
serotonin and
norepinephrine.
Stress hormones
• Hormones regulate
sleep, appetite,
sexual desire, and
pleasure.
• Symptoms of
depression relate to
these bodily
functions.
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37
Biological factors: Brain structure
Brain structures abnormalities linked to
depression, according to research:
• Depression linked to abnormal functioning of the
prefrontal cortex and limbic system.
• Connections between the cortex and the limbic
system may be associated with depressive
symptoms.
• Dysfunction in subgenual cingulate, also
known as Brodmann’s area 25, is related to
depression, according to research
Boddaert, et al., 2017
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38
Psychological Factors: Early Adverse Life Events,
Learned Helplessness, and Negative Thinking
Early adverse life
events
• Theory suggests that
depression is linked to
unresolved childhood
issues.
• Results in self-blame,
self-hatred, and other
symptoms of depression.
Learned
helplessness
• Involves the belief that
you cannot control the
outcome of events or
what is going to happen.
Negative thinking
• Ruminative coping
style: focusing on how
one feels without
attempting to do anything
about one’s feelings.
• Cognitive distortions:
Thoughts that tend to be
pessimistic and negative.
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39
Gender and depression
Biopsychosocial forces that are unique to women may
explain their higher vulnerability to depressive disorders.
• Genetic risk appears stronger in women than in men.
• Estrogen and progesterone levels may influence the
neurotransmitters serotonin and dopamine, which play
a central role in mood.
• Females are more likely than males to engage in a
ruminative coping style.
• Women are more likely to have an interpersonal
orientation that puts them at risk for depression.
• Women are at a disadvantage in society.
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40
Schizophrenia: Disintegration
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41
Individual variations
Schizophrenia: A severe mental health disorder
characterized by disturbances in thought, perceptions,
emotions, and behavior.
• Typically appears in the late teens or early adult years.
• The onset is typically somewhat later in women than in
men.
• Diagnosed more in African American and Asian
American individuals.
• Most people with this condition can receive effective
treatments that significantly reduce symptoms and
improve overall functioning.
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42
Course of schizophrenia
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43
Symptoms of schizophrenia
• Delusions
• Hallucinations
• Disorder behavior
• Blunted affect
• Alogia
• Avolition
Subtypes:
• Catatonia (waxy flexibility)
• Disorganized (even delusions
lack a theme)
• Paranoid (delusional but well
controlled, works in society)
• Undifferentiated (we don’t
know where they fit)
video
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44
A strong genetic factor
General population
• Those genetically similar to
Spouse of patient
someone with schizophrenia are
First cousin
more likely to develop the disorder.
Uncle/aunt
• Unlikely a single gene is
responsible for the disorder; if it
were, the heritability rates would
be higher.
Nephew/niece
Grandchild
Half sibling
Child
Sibling
Fraternal twin
One parent
Identical twin
Two parents
0
10
20
30
40
Lifetime Risk of Developing Schizophrenia (Percentage)
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50
45
The brain: neurotransmitters and structural abnormalities
• Dopamine and
glutamate: key
neurobiology underlying
schizophrenia, according
to theories.
• Enlarged ventricles: most
consistent abnormality in
people with schizophrenia.
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46
Personality Disorders:
Maladaptive Patterns of Behavior
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47
Antisocial personality disorder
Diagnostic clusters:
• Cluster A: Odd or Eccentric Disorders – paranoid,
schizoid, and schizotypal personality disorders.
• Cluster B: Dramatic, Emotional, or Erratic
Disorders – borderline, narcissistic, antisocial, and
histrionic personality disorders.
• Cluster C: Anxious or Fearful Disorders dependent, obsessive-compulsive, and avoidant
personality disorders.
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48
Antisocial personality disorder: Impulsive and dangerous
Impulsive behaviors that violate the basic rights of
others and the norms and rules of society.
• “Antisocial” does not equate with wanting to be
separated from others.
• Manipulation and using others for their own benefit.
• Lacks empathy for the harm that they cause others.
• Focuses almost entirely on their own needs and
desires.
• History of harmful or aggressive behaviors going
back to childhood.
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49
Borderline personality disorder: Living on your fault line
Unstable moods, interpersonal relationships,
self-image, and behavior.
• Moods disrupt a person’s relationships,
career, and identity.
• Intense anger, depression, or anxiety may
occur for hours or for days.
• Extreme insecurity and exaggerated
feelings of importance at other times.
• Borderline personalities lack a clear
definition of themselves, prompting changes
in goals, jobs, friendships, and values.
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50
Crisis Hotlines
• Suicide Prevention Lifeline – (800) 273-8255
• Crisis Line – (205) 323-7777 crisiscenterbham.org
• Rape Response Line – (205) 323-7273
• Teen Link – (205) 328-5465
• Kid’s Help Line – (205) 328-5437
Mental Health and Counseling Resources
• Chilton Shelby Mental Health Center
− Clanton Office – (205) 755-5933
− Pelham Office – (205) 663-1252
• Gateway Family Counseling Services – (205) 510-2780 Sliding Scale Fees, gway.org/family-counseling
• Eastside Mental Health Center – eastsidemhc.org
− Birmingham Office – (205) 836-7283
− Blount County Office – (205) 625-3882
− Clair County – (205) 338-7525
• Jefferson Blount County Mental Health – Birmingham Office (205) 595-4555
• JBS Mental Health Authority – (205) 595-4555 jbsmha.com
• Oasis Counseling for Women and Children – (205) 933-0338 Sliding Scale Fees – oasiscounseling.org
• Trinity Counseling – (205) 822-2730, Sliding Scale Fees – trinitycounselingbham.org
• UAB Counseling Clinic – (205) 996-2414, Counseling by graduate students/supervised licensed counselors, $5.00 per session – limited to
residents of Jefferson County, UAB counseling clinic services More information is available at 211connectsalabama.org
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51
Chapter 14: Mental
Health Therapies
Pastorino, What Is Psychology?, 5th Edition.
©2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a
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publicly accessible website, in whole or in part.
a publicly accessible website, in whole or in part.
1
Early Treatment of Mental
Disorders
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2
Early treatment of mental disorders
• Crude
• Largely ineffective
• Unintentionally cruel
• video
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3
Providing Psychological
Assistance
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publicly accessible website, in whole or in part.
4
Psychotherapy vs. biomedical therapy
Psychotherapy
• Uses psychological principles and techniques.
• For mental health disorders, such as major
depressive disorder.
• Used for problems other than mental health
disorders.
• Includes many forms of therapy.
Biomedical therapy
• Uses medications or other medical intervention.
• Treats the symptoms of mental health problems.
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5
Who is qualified to give therapy?
• Clinical psychologist: PhD or PsyD.
Supervised research/training in psychotherapy
techniques, psychological testing, diagnosis of
mental health disorders.
• Counseling psychologist: PhD, PsyD, or
EdD. Supervised training in assessment,
counseling, and therapy techniques.
• Psychiatrists: MD with training in the
diagnosis and prevention of mental health
disorders, pharmaceutical treatment, may
include training in psychotherapy methods.
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6
Who is qualified to give therapy?
• Licensed Professional Counselor: BA or
MA. Supervised training in assessment,
counseling, and therapy techniques.
• Licensed Social Worker: MSW.
Supervised training in a social service
agency or a mental health center, may or
may not include training in psychotherapy.
• Couple or Family Therapist: MA or PhD.
Supervised training in family and couple
therapy, may also include training in
individual psychotherapy methods.
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7
Ethical standards for psychotherapists
Ethical standards are established by the
American Psychological Association, the
violations of which are reported to professional
review boards.
Essential ethical principles:
1. Culturally sensitive, competent
treatments, and informed consent
2. Confidentiality
3. Appropriate interactions
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8
Psychoanalytic Therapies:
Uncovering Unconscious
Conflicts
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9
Traditional psychoanalysis
• Free association: Expression of thoughts and
feelings as they occur, with minimal censorship.
• Dream analysis: Therapist interprets the symbolic
meaning of client’s dreams.
• Interpretation: Psychoanalyst’s views on issues that
may influence behavior.
• Resistance: Defensive maneuvers client uses to
hinder the progress of therapy.
• Transference: Client relates to therapist in ways
similar to critical relationships in their lives.
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10
Modern psychoanalysis
Psychodynamic therapy or short-term
dynamic therapy.
• Consistent with Freud’s views and
psychoanalytic approach.
• Relies on therapist’s interpretations of
client’s feelings and behavior.
• Less focus on the client’s past.
• Current problems and interpersonal
relationships considered more important in
improving the client’s behavior.
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11
Humanistic Therapy:
Facilitating Self-Actualization
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12
Client-centered therapy: Three key ingredients
Client-centered therapy (or person-centered
therapy): Focus comes from client.
Requires empathy, genuineness, and
unconditional positive regard.
Empathy
• Understanding without judgment.
• Active listening, eye contact, and
assuming an interested and attentive
pose.
The humanists believed that
people are inherently good.
• Reflecting.
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13
Client-centered therapy: Three key ingredients
Genuineness
• Openly sharing thoughts and feelings.
• Allowing clients to see therapist as a
real, living person.
Unconditional positive regard
• Accepting and valuing a person for who
they are regardless of faults.
• Reflecting on thoughts, not agreement.
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14
Behavior Therapies: Learning
Healthier Behaviors
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15
Applying classical conditioning: Exposure and aversion
Behavior therapy (or behavior modification):
Focuses directly on changing current problem
behaviors.
Behavior therapy techniques replying on
classical conditioning principles:
1. Systematic desensitization
2. Flooding
3. Aversion therapy
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16
Systematic desensitization: Relax and have no fear
Fear or anxiety responses replaced with
relaxation and positive emotion responses.
Three steps in systematic desensitization:
1. Train client in progressive muscle relaxation.
2. Develop an anxiety hierarchy.
3. Combine muscle relaxation and anxiety
hierarchy techniques.
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17
Flooding: Facing our fears
Flooding (or exposure therapy)
• Client exposed to feared object,
situation, or image for extended time.
• Starts with most feared item or
situation. video
• Anxiety subsides quickly, but relapses
are common.
Virtual reality exposure therapy allows clients
to experience their fears in a simulated,
nonthreatening environment.
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18
Aversion therapy: We won’t do something if we dislike it
Pairing unpleasant stimulus with a specific
undesirable behavior. video
Occurs frequently in everyday life (e.g.,
food poisoning).
Covert sensitization therapy:
• Graphic imagery used to create
unpleasant associations with specific
stimuli.
• Smoking and tooth decay, blackened
lungs, amputation.
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19
Applying operant condition techniques in therapy
• Positive reinforcement: Encourages or maintains a
behavior.
• Nonreinforcement and Extinction: Discourages
unwanted behavior by removing reinforcers.
• Punishment: Sometimes used to decrease
undesirable behaviors.
• Shaping: Positive reinforcement of successive
attempts at behavior.
• Token economy: Reinforcing desired behavior with
symbolic rewards that are then exchanged for desired
prizes.
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20
Cognitive Therapies: Changing
Thoughts
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21
Ellis’ rational-emotive therapy: Reinterpret one’s viewpoint
• Mental health problems stem from
how people think about and
interpret events.
• Common irrational beliefs often
impede functioning.
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22
Examples of irrational assumptions
• I must be loved by or approved of by everyone.
• I must be competent and achieving in all things I do,
or I am worthless.
• Some people are bad and should be severely
blamed and punished for it.
• I should be extremely upset over the wrongdoings of
others.
• It is awful and upsetting when things are not the way
I would like them to be.
• External events cause unhappiness, and I cannot
control my bad feelings and emotional reactions.
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23
Examples of irrational assumptions
• If something unpleasant happens, I should dwell
on it.
• Avoiding difficulties, rather than facing them, will
make you happy.
• Always rely on someone who is stronger than you.
• Your past will always affect your present life.
• There is a perfect solution for every problem, and
it is awful and upsetting if this solution is not found.
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24
Beck’s cognitive therapy: Replace negative thoughts
Cognitive therapy: Uncovering negative
automatic thought patterns that impede
mental health.
Cognitive distortions: Distorted thinking
patterns lead to depression, anxiety, low selfesteem.
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25
Examples of cognitive distortions
• All-or-nothing thinking: See each event as completely
good or bad, right or wrong, a success or failure.
• Arbitrary interference: Concluding something negative
will happen or is happening even with no evidence to
support it.
• Disqualifying the positive: Rejecting positive
experiences.
• Emotional reasoning: Assuming negative emotions are
accurate without questioning them.
• Labeling: Placing a negative, global label on a person or
situation.
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26
Examples of cognitive distortions
• Magnification and minimization: Overestimating
importance of negative events or underestimating
impact of positive events.
• Overgeneralization: Apply a negative conclusion
from one event to an unrelated event.
• Personalization: Attributing negative events to
oneself.
• Selective abstraction: Focus on a single aspect
while ignoring more relevant aspects.
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27
Group Therapy: Strength in
Numbers
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28
The benefits of group therapy
Group therapy: Therapy administered to
more than one person at a time.
Advantages:
• Less expensive than individual therapy
• Therapist sees client’s social interactions
with others.
• Safe mini-environment to explore new
social behaviors.
• Clients see they are not the only ones with
difficulties.
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29
The nature and types of group therapy
Family therapy
Couple therapy
Self-help groups
• Family unit is the
group.
• Focuses on
improving
communication and
intimacy.
People share same
problems and meet to
help one another.
• Aims to balance and
restore harmony by
improving family
functioning.
• Emotionally focused
therapy.
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30
Effective Psychotherapy: Do
Treatments Work?
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31
Conducting research on therapy’s effectiveness
Psychotherapy has positive effects and is better
than a placebo treatment or no treatment.
• Different approaches produce relatively
equivalent results in terms of client improvement.
• Certain forms of therapy work better for certain
mental health disorders.
• Conducting research on therapy is complex
because of difficulty in finding people with the
same issues, comorbidity issues, and
independent variables.
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32
Eclectic therapy: CBT, MBCT, and EMDR
Cognitive behavior
therapy (CBT)
• Eclectic therapy:
Integrated and
diverse use of
therapeutic methods.
• CBT is combined
with technique of
behavior therapy.
Mindfulness-based
cognitive therapy
(MBCT)
Eye movement
desensitization and
reprocessing (EMDR)
• Prevent relapse in
people with recurrent
depression.
• Recommended as an
effective treatment
for trauma.
• Mindfulness
meditation and
breathing exercise
with cognitivebehavioral therapy.
• Client is directed to
notice thoughts
feelings, or images
that come to mind.
video
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33
Factors that contribute to effective psychotherapy
Therapeutic alliance requires therapist to:
• Create interactive and collaborative relationship
with client.
• Establish positive relationship based on mutual
respect and trust.
• Be empathetic and warm, evidencing a caring
attitude and ability to listen.
• Offer an explanation or interpretation of why
client is having a problem.
• Provide culturally sensitive treatment by
adapting to client’s cultural background.
Pastorino, What Is Psychology?, 5th Edition. ©2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a
publicly accessible website, in whole or in part.
34
The effectiveness and ethics of technology in the delivery of
psychotherapy
Behavioral intervention technologies
• Computer-based programs to administer
assessments.
• Smartphones to collect data on thoughts,
behaviors, and mood.
• Text therapy apps (Talkspace, BetterHelp).
• Cybertherapy and e-health interventions.
Pastorino, What Is Psychology?, 5th Edition. ©2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a
publicly accessible website, in whole or in part.
35
Biomedical Therapies: Applying
Neuroscience
Pastorino, What Is Psychology?, 5th Edition. ©2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a
publicly accessible website, in whole or in part.
36
Drug therapies: Chemically altering the brain
Medications generally prescribed by
physicians or psychiatrist who have
extensive training in
psychopharmacology.
Antianxiety medications: Includes
sedatives and benzodiazepines.
• Highly addictive if taken over long
periods.
• Effects cognitive and motor
functioning.
• High relapse rates.
Pastorino, What Is Psychology?, 5th Edition. ©2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a
publicly accessible website, in whole or in part.
37
Antipsychotic drugs: Reduce symptoms of psychosis
Antipsychotic medication
Tardive dyskinesia
• Tranquilizer to relieve psychotic
symptoms.
• Caused by long-term use of drugs.
• Effective for only 60% of those who
try them.
• Newer drugs might cause less
serious side effects and lower
incidence of tardive dyskinesia.
• Irreversible.
Pastorino, What Is Psychology?, 5th Edition. ©2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a
publicly accessible website, in whole or in part.
38
Antidepressant drugs: Mood, compulsion, and cravings
• Antidepressants: Alter mood and alleviate
symptoms.
• Tricyclics: Influence norepinephrine and serotonin.
• MAO inhibitors: Blocks monoamine oxidase,
which breaks down serotonin, norepinephrine, and
dopamine.
• Selective serotonin reuptake inhibitors (SSRI):
Side effects less severe and not fatal in overdoses.
• Serotonin and norepinephrine reuptake
inhibitors (SNRI): Elevate mood by leaving both
serotonin and norepinephrine in the synapse
longer.
Pastorino, What Is Psychology?, 5th Edition. ©2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a
publicly accessible website, in whole or in part.
39
Antimanic drugs: Mood stabilizers
• Prescribed to alleviate manic symptoms of
bipolar disorder.
• Lithium controls both manic and depressive
symptoms in people with bipolar disorder.
• Side effects: nausea, vomiting, diarrhea,
blurred vision, reduced concentration, wight
gain, increased risk of diabetes and kidney
problems.
• Almost 50% of patients with bipolar disorder
do not take medications as prescribed, and
manic symptoms often return.
Pastorino, What Is Psychology?, 5th Edition. ©2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a
publicly accessible website, in whole or in part.
40
Electroconvulsive therapy (ECT): Inducing a brief seizure
• Highly controversial.
• Electrical current is passed through
the brain; causes a seizure.
• Used when other psychotherapy or
drug therapy does not work.
• video
Pastorino, What Is Psychology?, 5th Edition. ©2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a
publicly accessible website, in whole or in part.
41
Other biomedical treatments
• Deep brain simulation. video
• Vagus nerve stimulation. video
• Gamma knife surgery. video
• Cingulotomy.
• Anterior capsulotomy.
Pastorino, What Is Psychology?, 5th Edition. ©2022 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a
publicly accessible website, in whole or in part.
42
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