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Essay-questions-final
Abnormal Psychology (Psy 434)
Concordia University
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ABPSYCH EXAMPreview text
- Describe the human sexual response cycle and then describe one example of a male and female sexual dysfunction. Be sure to explain where the dysfunction occurs in the cycle.
(Draw the cycle)
The human sexual response cycle refers to the sequence of emotional and physical changes that occur as a person becomes sexually aroused and participates in sexually stimulating activities. It consists of the desire phase, arousal stage, plateau phase, orgasm phase an resolution phase. In the desire phase, sexual urges occur in response to sexual cues or fantasies. The arousal stage is a subjective sense of sexual pleasure and physiological signs of sexual arousal. For example, in males there is penile tumescence (increased flow of the blood into the penis) and in females, vasocongestion (blood pools in the pelvic area) leading to vaginal lubrication and breast tumescence (erect nipples). The plateau phase is a brief period that occurs before orgasm. The orgasm phase in males consists of feelings of the inevitability of ejaculation, which is followed by ejaculation. In the female orgasm, contractions of the walls of the lower third of the vagina are present. The resolution phase occurs particularly in men where a decrease in arousal occurs after orgasm.
The three stages of the sexual response cycle, desire, arousal and orgasm, are each associated with specific sexual dysfunctions. Additionally, pain can become associated with sexual functioning in women, which leads to an additional dysfunction.
An example of a male sexual dysfunction is erectile disorder. Erectile disorder is a specific disorder of arousal. The problem here is not desire, many males with erectile disorder have frequent sexual urges and fantasies and strong desire to have sex. Their problem is in becoming aroused displayed by a marked difficulty in obtaining an erection during sexual activity or maintaining and erection until the completion of sexual activity or a marked decrease in erectile rigidity. It is important to note that men are usually more impaired by arousal problems than women because the inability to achieve and maintain an erection makes intercourse difficult or impossible. Additionally, it is unusual for a man to be completely unable to achieve an erection; partial erection is usually the problem. Male erectile disorder is the most common problem for which men seek help (50%).
An example of a female sexual dysfunction is female orgasmic disorder. Female orgasmic disorder is present when there is a marked delay in orgasm, infrequency of orgasm, absence of orgasm or a reduced intensity of orgasmic sensations. An inability to achieve an orgasm despite adequate sexual desire and arousal is commonly seen in women and less commonly seen in men. Approximately 50% of women do not achieve orgasm with every sexual encounter, unlike most men, who tend to experience orgasm more consistently. Thus, an inability to reach orgasm is the most common complaint among women who seek therapy for sexual problems.
- Discuss the psychosocial causes of Paraphilias. How do these theories relate to/inform psychosocial treatments of Paraphilias?
(Draw the model of the paraphila development)
Psychosocial Causes:
Case histories help identify the psychosocial factors thought to contribute to the development of paraphilic disorders by providing hypotheses that can then be tested by controlled scientific observations.
In many cases, an inability to develop adequate social relations with the appropriate people for sexual relationships seems to be associated with developing inappropriate sexual outlets. However, it is difficult to determine cause and effect.
Secondly, the presence of disordered relationships in childhood and adolescence may result in deficits in healthy sexual development. However, many people with deficient sexual and social skills do not develop deviant patterns of arousal.
Additionally, forbidden or early sexual experiences (accidental or vicarious) in childhood or adolescence may play a role. For example a man who has his first sexual experience while “peeping”. However, many of us do not find our early experiences reflected in our sexual patterns.
Another factor may be the nature of the person’s early sexual fantasies. For example, in a famous study, the researchers demonstrated that sexual arousal could become associated with a natural object (e. a boot) if the object was repeatedly presented while the individual was sexually aroused. Thus, the development of unwanted sexual arousal may be simply due to an operant conditioning paradigm where early fantasies that are repeatedly reinforced through the very strong sexual pleasure associated with masturbation. Before an individual with a pedophilic or sadism disorder ever acts on his behavior, he may fantasize about it hundreds of times while masturbating. This may explain why paraphilic disorders are almost exclusively seen in males. Men masturbate and orgasm more frequently than women.
Finally, an incredibly high sex drive has been observed in individuals with paraphilic disorders. For example, it is not uncommon for these individuals to masturbate 3-4 times a day. The very act of trying to suppress unwanted emotionally charged thoughts and fantasies seem to have the paradoxical effect of increasing their frequency and intensity.
Psychosocial Treatment:
The theories previously stated help establish several psychosocial treatment procedures for decreasing unwanted arousal. Most treatments are behavior therapy procedures aimed at changing the associations and context from arousing and pleasurable to neutral. Covert
them. Biological treatments for substance abuse include agonist substitution, which involves providing the person with a safer drug that has a chemical makeup similar to the addictive drug, antagonist treatments, which block or counteract the effects of psychoactive drugs, and aversive treatments that make ingesting the abused substances extremely unpleasant. Specifically to individuals with alcohol use disorder, a relatively new serotonin antagonist drug called ondansetron is being studied. This drug may modulate some of the behavioral effects of alcohol, may decrease alcohol consumption, and may be particularly helpful for people who developed alcoholism at or before their early 20s. The most commonly known aversive treatment, disulfiram (Antabuse), is used with people who are alcohol dependent. People who drink alcohol after taking Antabuse experience nausea, vomiting, and elevated heart rate and respiration. Individuals are required to take Antabuse each morning, before the desire to drink wins out. However, unfortunately, noncompliance is a major concern and a person who skips the Antabuse for a few days is able to resume drinking. Thus, Antabuse has generally been less than successful as a treatment strategy on its own because it requires people to be extremely motivated to continue taking it outside the supervision of a mental health professional.
Other biological treatments such as medication (e. SSRIs) are now being tested for their potential therapeutic properties, especially for alcohol dependence.
Psychosocial treatments
For most abusers, none of the biological treatments alone are successful and the majority of research indicates a need for social support or therapeutic intervention. Because so many people need help to overcome their substance disorder, a number of models and programs have been developed.
Inpatient treatment facilities are designed to help substance dependent people get through the initial withdrawal period and to provide supportive therapy so they can go back to their communities. However, inpatient care is expensive and it may not be more effective than outpatient therapy.
The most popular treatment of substance abuse is the 12-step program developed by Alcoholics Anonymous (AA) in 1935, which takes an abstinence approach to drug abuse. AA is founded on the notion that alcoholism is a disease and alcoholics must acknowledge their addiction to alcohol and its destructive power over them. The addiction is seen as more powerful than any individual and therefore they must look to a higher power to help them over come their shortcoming. Central to AA is its independence from the established medical community and the freedom it offers from the stigmatization of alcoholism. An important component is the social support it provides through group meetings. Since participants attend meetings anonymously and only when they feel the need to, conducting systematic research on the effectiveness of AA has been especially difficult and studies have shown mixed results.
Researchers have questioned the total abstinence goal of AA and have offered an alternative approach, harm reduction. The harm reduction approach recognizes that substance use occurs in society and its primary goal is to minimize the harm associated with substance. Some believe that some substance abusers (notably alcohol) may be capable of becoming social users without resuming their abuse of these drugs. The notion of teaching people controlled drinking is extremely controversial. One study by Mark and Linda Sobell assigned alcohol dependent individuals to either a program that taught them how to drink in moderation or to a group that was abstinence oriented. At a 2 - year follow-up, participants in the controlled drinking group were functioning well 85% of the time, whereas those in the abstinence group were doing well only 42% of the time. However, some of the men in both groups had serious relapses and required rehospitalization and some were incarcerated. Thus, controlled drinking may be a viable alternative to abstinence for some alcohol abusers. In the United Kingdom and Canada controlled drinking is more widely accepted than in the United States. More recent research has shown controlled drinking to be at least as effective as abstinence, but that neither treatment is successful for 70-80% of patients over the long term.
Most comprehensive treatment programs aimed at helping people with substance abuse and dependence problems have several different component treatments thought to boost the effectiveness of the “treatment package”.
In aversion therapy, a conditioning model, substance use is paired with something extremely unpleasant such as a brief electric shock or feelings of nausea. For example, an alcoholic might be offered a drink of alcohol and receive a painful shock when the glass reaches his/her lips. The goal here is to counteract the positive associations of substance use with negative associations. The negative associations can also be made by imagining unpleasant scenes in a technique called covert sensitization.
In contingency management the clinician and patient together select the behaviors that the client needs to change and decide on the reinforcers that will reward reaching certain goals, for example money or small retail items.
An other package of treatments is the community reinforcement approach. Several different facets of the drug problem are assessed. First, a spouse, friend or relative who is not a substance user is recruited to participate in relationship therapy in order to help the abuser improve his/ her relationships with other important people. Second, clients are taught how to identify the antecedents and consequences that influence their drug taking. For example, if they are likely to drink alcohol with certain friends, patients are taught to recognize the relationship and encouraged to avoid the associations. Third, patients are given assistance with employment, education, finances, or other social service areas that may help reduce their stress. Fourth, new recreational options help the person replace substance use with new activities. There is currently strong empirical support for the effectiveness of this approach with alcohol users.
The relapse prevention treatment directly addresses the problem of relapse. The model developed by Alan Marlatt looks at the learned aspects of dependence and sees relapse as
Individuals with dependent personality disorder rely on others to make ordinary decisions as well as important ones, which results in an unreasonable fear of abandonment. This personality disorder belongs to the Cluster C, anxious/ fearful personality disorders because the interpersonally dependent behavior is motivated by anxiety (e. fear of abandonment). To not be rejected by others, these individuals may sometimes agree with other people when their own opinions differ. They have a strong desire to obtain and maintain supportive and nurturing relationships, which may lead to submissiveness, timidity, and passivity. Additionally, people with this disorder may have feelings of inadequacy, may be sensitive to criticism, and have a need for reassurance, in which they respond to by clinging to relationships. Having a sociotropic personality trait is relevant to the etiology of dependent personality disorders. Sociotropy refers to a personality orientation involving a strong investment in positive social interactions.
Very little research exists on the effectiveness of treatments for dependent personality disorder. Individuals with dependent personality disorder may seem like ideal patients because of their attentiveness and eagerness to give their responsibility to the therapist. However, that submissiveness negates one of the major goals of therapy, which is to make the person more independent and personally responsible. Therefore, therapy progresses gradually as the patient develops confidence in his/her ability to make decisions independently. There is a particular need for care that the patient does not become overly dependent on the therapist. 6. Describe the biological, psychological, and social causes of Schizophrenia. Be sure to use at least one well described example of each type of cause (biological, psychological, social), by reporting studies that support each claim.
Schizophrenia is an extremely complex disorder and there are many biological, psychological and social causes for this disorder.
Biological Causes
Research on the genetic influences of schizophrenia clearly illustrates the enormous complexity of genetic influences on behavior. By looking at family studies, twin studies and adoption studies, one can safely say that genes are responsible for making some individuals vulnerable to schizophrenia. Additionally neurobiological influences and abnormal brain structures have been noted in schizophrenia.
Family Studies:
A German researcher (Frenz Kallman), examined family members of more than 1000 persons diagnosed with schizophrenia in a Berlin psychiatric hospital. Kallman showed that the severity of the parent’s disorder influenced the likelihood of the children having schizophrenia. Thus, the more severe the parent’s schizophrenia, the more likely the children were to develop it also. Additionally, he showed that all forms of schizophrenia were seen within the families. Thus, you may inherit a general predisposition for schizophrenia that manifests in the same form or a different one from that of your parent. More recent research has suggested that families that have a member with schizophrenia
are not just at risk for schizophrenia or all psychological disorders but there seems to be an increase familial risk for a spectrum of psychotic disorders related to schizophrenia.
Twin Studies:
Twin studies have shown that both genes and environment play a role in the development of schizophrenia. Identical twins share 100% of genes and 100% of their environment while fraternal twins share 50% of genes and 100% of their environment. If the environment is solely responsible for schizophrenia we would expect little difference between identical and fraternal twins. In contrast, if only genetic factors are relevant, both identical twins would always have schizophrenia and the fraternal twins would both have it about 50% of the time. Research on twin studies indicates that the truth is somewhere in the middle, we see a difference between identical twins and fraternal (environment) twin and identical twins do not always both have the disorder (genes).
More interestingly, identical quadruplets all of whom have schizophrenia have been studied extensively. The “Genain” quadruplets represent the complex interaction between genetics and the environment. All four women shared the same genetic predisposition and were all brought up in the same particularly dysfunctional household. However, the time of onset for schizophrenia, the symptoms and diagnoses, the course of the disorder and their outcomes differed significantly from sister to sister. The case of the Genain quadruplets revels an important consideration in studying genetic influences on behavior, unshared environments. Even identical siblings can have very different prenatal and family experiences and can therefore be exposed to varying degrees of biological and environmental stress. This unusual case demonstrates that even sibling who are very close in every aspect of their lives can still have considerably different experiences physically and social as they grow up, which may result in vastly different outcomes.
Adoption Studies:
The largest adoption study was conducted in Finland. The data from this study support the idea that schizophrenia represents a spectrum of related disorders, all of which overlap genetically. If an adopted child had a biological mother with schizophrenia, he/she had about a 5% chance of having the disorder (compared with about only 1% chance in the general population). However, if the biological mother had schizophrenia or one of the related psychotic disorders (e. delusional disorder, schizophreniform disorder), the risk that the adopted child would have one of these disorders rose to about 22%. Thus, even when raised away from their parents, children of parents with schizophrenia have a much higher chance of having the disorder themselves. Moreover, there appears to be a protective factor if these children are brought up in healthy, supportive homes. A gene-environment interaction was observed in this study where a good home environment reduces the risk of schizophrenia.
Neurobiological influences:
- Linkage association studies
- Common traits: smooth-pursuit eye movement
- Schizo virus?
Psychological Causes:
The fact that one identical twin may develop schizophrenia and the other may not suggests that schizophrenia involves something in addition to genes. Additionally, not all individuals with schizophrenia have enlarged ventricles or hypofrontality. Thus, the causal picture may be further complicated by psychological and social factors.
Stress:
Stress can affect the development of schizophrenia. It is important to discover how much and what kind of stress makes a person with a predisposition for schizophrenia develop the disorder itself. Researchers have studied the effects of a variety of stressors on schizophrenia. Living in a large city is associated with an increased risk of developing schizophrenia, thus suggesting that the stress of urban living may precipitate its onset. Additionally stressful life events appear to precipitate the onset of the disorder. In one study, researchers observed that healthy people who engaged in combat during a war often display temporary symptoms that resemble those of schizophrenia. Moreover, in an other study, individuals diagnosed with schizophrenia experienced a high number of stressful life events in the three weeks just before they started showing sign of the disorder. However, it is important to note that the retrospective nature of such research creates problems. Each study relies on after-the-fact reports, collected after the person showed signs of schizophrenia. There may be bias in such reports and they may therefore be misleading.
One study used a prospective approach to examine the impact of stress on relapse. The researchers identified 30 people with recent-onset schizophrenia and followed them for a year. During the one-year assessment period, 11 of the 30 people had a significant relapse, their symptoms returned or worsened. The study found that relapses occurred when stressful life events increased during the previous month.
Social Causes:
Stress:
An other important area in the study of the impact of stress on schizophrenia is research showing a significant negative correlation between social class and schizophrenia. There is a significant tendency for individuals with schizophrenia to be found in the lowest social classes. This finding has been replicated in a variety of cultures. There are two possible explanations for this finding. First, the sociogenic hypothesis suggests that life in the lower social classes is stressful and thus predisposing those from the lower social classes to an increased likelihood of schizophrenia. Second, the social selection hypothesis pertains to the adverse effects of schizophrenia on a person’s ability to hold a
job. If the illness makes them less able to hold a job, individuals with schizophrenia may experience a downward social drift into lower social classes. Although results have been mixed, findings generally favor the social selection hypothesis.
Social support:
Social support appears to be a protective factor and improves the prognosis of schizophrenia. A longitudinal study at the University of Ottawa showed that higher levels of social support from non-family members in the social network predicted better outcomes five years later among patients experiencing their first episode of schizophrenia.
Families and Relapse:
Questions involving the role of family members has lead to a great deal of research on how interactions within the family affect people who have schizophrenia. Recent work has focused more on how family interactions contribute not to the onset of schizophrenia itself but to relapse after initial symptoms are observed. A particular communication styles called expressed emotion (EE) has been of focus. Brown and colleagues followed a sample of people who had been discharged from the hospital after an episode of schizophrenic symptoms. The researchers found that former patients who had limited contact with their relatives did better than patients who spent longer period with their families. Additionally, if the level of criticism (disapproval), hostility (animosity), and emotional over involvement (intrusiveness) expressed by the families was high, patients tended to relapse. Other studies have shown similar findings. If you have schizophrenia and live in a family with high expressed emotion, you are 3 times more likely to relapse than if you lived in a family with low expressed emotion.
Example of high expressed emotion: “I’ver tried to jolly him out of it and pestered him into doing things” Example of low expressed emotion: “I know its better for her to be on her own, to get away from me and try to do things on her own”, “whatever she does suits me”
It is important to note that high expressed emotion may be a contributing factor and not a cause of schizophrenia because EE levels differ worldwide and prevalence rates remain stable.
Essay-questions-final
Course: Abnormal Psychology (Psy 434)
University: Concordia University
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