AP Psychology – Unit 5

Mental and Physical Health

Complete Study Guide – All Sections Covered

5.1 – Introduction to Health Psychology

Stress Perspectives
Perspective What Stress Is
Biological Activation of the sympathetic nervous system
Psychodynamic Turmoil in the unconscious that might show as something else
Evolutionary Result of having evolved for a different environment
Sociocultural Comes from not matching society's roles and expectations
Humanistic Arises when obstacles block us from growing and becoming
Cognitive The reaction of having disruptive and unpleasant thoughts
Behavioral The inability to obtain positive or negative reinforcement

Key Stress Definitions

• Stress = Distress – the psychological and physical response to perceived challenges
• Hedonic Adaptation – we become accustomed to a certain level of happiness and don't seem
to notice it

Distress vs. Eustress

Distress Eustress
Unpleasant, like punishment without Challenging, but not unpleasant
understanding
Unhealthy in the long run Possibility of long-term benefit
Avoidance-avoidance conflict Approach-avoidance conflict
Learned helplessness Optimum Arousal
Lack of control Consent and choice
External locus of control Internal locus of control
A teacher who yells, gives pop quizzes, grades Trying something new, going to college,
unfairly auditioning, interviewing
 ⚠️Important
Causes in psychology are nearly impossible to get — stay away from the word 'cause.'

Sources of Stress (Stressors)

Source Description
Daily Hassles More than additive — they are MULTIPLICATIVE. Constant noise,
physical discomfort, and financial uncertainty pile up.
Traumatic Events Anything can be traumatic. Often depends on cognitive appraisal,
personality traits, coping mechanisms, and resources.
Adverse Childhood Children are vulnerable and require care. When that care is denied, it can
Experiences affect development throughout life.

General Adaptation Syndrome (G.A.S.)

• Originated by Hans Selye
• Attempts to understand how stress affects our health
• Stress is a COMPLEX interaction between environment, appraisal, and the body's physical
reaction
• The body's ability to resist stress changes over time

Stage Description
Alarm Fight or flight. Sudden activation of the sympathetic nervous system. Anxiety,
Amygdala, Adrenaline.
Resistance 'Handling it.' With excess adrenaline, the body and brain rise to the challenge.
Exhaustion The body cannot fight the stressor, stress response, AND repair tissue/fight
infection simultaneously. Resources are limited.
Tend & Befriend Alternative stress response — tending to own needs and/or needs of others,
seeking social connection.

Fight, Flight, or Freeze

• There is evidence that acting aggressive OR withdrawing INCREASES feelings of fight or flight
• Tend & Befriend theory: some people react to stress by nurturing themselves/others and
seeking social connection

Coping Strategies
• A stressor causes stress — both good and bad
• Mediators = things that help us cope with stress
• The only real limit to coping strategies is our imagination
• Our imagination is limited when we are stressed: Yerkes-Dodson Theory
Problem-Focused Coping (Long Term / Outward)
• Seeing stress as a problem to be solved, working solutions until one is found
• Outward focused — a solution can eliminate the source
• Might be considered 'long term'
• Often a LATER strategy — used to affect or eliminate the stressor

Emotion-Focused Coping (Short Term / Inward)

• May include meditation, or medication aimed at reducing stressful emotional responses
• Inward focused — this is necessary and good!
• Might be considered 'short term'
• Often the FIRST strategy — used to stop emotional pain

Exam Tip
Emotion-Focused coping comes FIRST (manages pain). Problem-Focused coping comes
LATER (solves the problem).

PTSD Overview
• PTSD = a mental health condition that occurs after experiencing or witnessing a traumatic event
• See Section 5.4 for full PTSD symptom breakdown
5.2 – Positive Psychology
Definition & Focus
• The scientific study of human strengths and virtues focusing on human flourishing and optimal
functioning
• Focuses on what is RIGHT in a person, not what is wrong
• Martin Seligman developed the Authentic Happiness Inventory and the PERMA Profiler

Happiness
• Subjective: Based on or influenced by personal feelings, interpretations, or prejudices
• Objective: Impartial or uninfluenced by personal feelings, interpretations, or prejudices
• We use self-assessments to measure happiness

Three Core Areas of Positive Psychology

Area Description
Positive Emotion Psychologists look at how feelings like joy and love broaden a person's
thinking and foster personal growth
Character Strength Psychologists look at personality traits to better understand what qualities
contribute to a meaningful life
Resilience & Well-Being Psychologists examine how individuals recover from setbacks and
maintain positive psychological health in challenging circumstances

Key Vocabulary
Term Definition
Well-Being A state of happiness and contentment, with low levels of distress, overall
good physical and mental health and outlook, or good quality of life
Resilience The process of adapting well in the face of adversity, trauma, tragedy,
threats, or significant sources of stress
Gratitude (Action) Appreciating what an individual receives, whether tangible or intangible
Gratitude (State) A state of being thankful
Signature Strengths The characteristics that are most defining for an individual — operating
these is linked to higher happiness and well-being
Posttraumatic Growth A positive subjective experience that some people have after trauma —
positive psychological changes that result from struggling with challenging
life events

Remember!
Gratitude increases Well-Being (this is a commonly tested fact!)
Keys to Well-Being
Altruism, Awe, Bridging Differences, Compassion, Diversity, Empathy, Forgiveness, Gratitude, Social
Connection, Intellectual Humility, Mindfulness, Purpose

Six Virtues (Signature Strengths)

Virtue Consists of
1. Wisdom Creativity and curiosity
2. Courage Bravery and integrity
3. Humanity Interpersonal strengths such as kindness and love
4. Justice Fairness and leadership
5. Temperance Strengths that protect a person against excess, such as humility or self-
control
6. Transcendence Strengths that lead to better connections, such as gratitude and hope

Posttraumatic Growth — Five Areas

• Personal Strength
• Close Relationships
• Greater Appreciation for Life
• New Possibilities
• Spiritual Development

• Growth can take place AFTER a traumatic event and evolve into greater appreciation for life
and spiritual development
5.3 – Explaining and Classifying Psychological Disorders
The Three D's of Mental Disorders
D Meaning
Deviant Not typical of one's society's normal behavior
Distressful Worrisome, causing anxiety
Dysfunctional Impairment or disturbance in behavior

• Diagnosing psychological disorders requires specialized training

Diagnostic Tools
Tool Details
DSM-5-TR Diagnostic and Statistical Manual of Mental Disorders. Developed by the
American Psychiatric Association. Classifies and describes disorders. Does
NOT explain causes. Current edition is DSM-5-TR.
ICD-11 International Classification of Disease. Developed by the World Health
Organization. Used to standardize health information across the world. Most
current edition is the ICD-11.

Key Note
We need tools to standardize language and descriptions of disorders. Both DSM and ICD serve
this purpose.

DSM-5 Classification Categories

Category 1 Category 2 Category 3
Neurodevelopmental Disorders Depressive Disorders Anxiety Disorders
Schizophrenia Spectrum & Bipolar and Related Disorders Trauma and Stressor-Related
Other Psychotic Disorders Disorders
Dissociative Disorders Feeding and Eating Disorders Sleep-Wake Disorders

Diagnostic Labeling Consequences

Positive Effects Negative Effects
Individuals experience relief knowing their Negative attitude toward self, including shame
symptoms have a name (self-fulfilling prophecy)
Helps guide individuals toward appropriate Reduced hope and self-esteem
treatment
Simplifies communication with a common Self-limiting beliefs — may accept the role and
language outlook
Helps guide research Diagnosis made using self-reports; individuals
may not describe symptoms well
Helps predict future problems for an individual Stigma may keep people from seeking help

Cultural Differences in Diagnosis

Individualistic Cultures Collectivist Cultures
More likely to see mental health issues as a Mental illness seen as a sign of weakness
normal way of life
More likely to seek help Person may be seen as an outcast
Less likely to seek help

Reminder — Prejudice vs. Discrimination

Prejudice = Negative FEELING or BELIEF about a person or group (usually unjustified)
Discrimination = Negative TREATMENT of an individual or group of individuals

Summary
Diagnostic labeling can have both positive and negative effects. Individuals may respond
differently to a diagnosis. Different cultures perceive labeling differently, including family and
social systems.

Major Perspectives on Psychological Disorders

Perspective Focus / Cause of Disorder
Behavioral (Learning) Maladaptive learned associations between stimuli. Positive and
negative reinforcement. Example: Phobias — fear of spiders negatively
reinforced when running away.
Psychodynamic (Childhood Unconscious thoughts and experiences, often developed during
& Unconscious) childhood. Conflicts between id, ego, and superego. Anxiety stems
from socially unacceptable desires.
Humanistic (Personal Lack of social support and being unable to fulfill one's potential. Not
Growth) receiving unconditional positive regard creates self-doubt →
depression. Not fulfilling potential → anxiety.
Cognitive (Thinking) Maladaptive thoughts, beliefs, attitudes or emotions. Irrational fears →
irrational behaviors. Maladaptive thoughts and rumination → cycle of
depression.
Evolutionary (Survival) Behaviors and mental processes that reduce likelihood of survival.
Fears can be adaptive (dark, animals) OR reduce reproduction
chances (rejection, relationships).
Sociocultural (Group Maladaptive social and cultural relationships. Not meeting societal
 Relations) standards → depression and low self-esteem. Individualistic vs.
collectivist norms differ.
Biological (Genetics & Physiological or genetic issues. Oversupply or undersupply of specific
Chemicals) neurotransmitters.
Eclectic (Mental Health) Most psychologists do NOT ascribe to one approach. Use ideas from
many perspectives when diagnosing and treating.

Key Models of Psychological Disorders

Biopsychosocial Model
• Proposes that the development of any psychological issue is influenced by multiple
interconnected factors
Biological Psychological Sociocultural
Genetics/predispositions, brain Thoughts, emotional, coping Person relationships, cultural
chemistry, physical health skills, personality traits norms, environmental stressors

Diathesis-Stress Model
• Focuses on how psychological disorders come from the interaction between genetic/biological
vulnerabilities AND stressful life events
• Diathesis: Genetic predispositions or underlying biological factors that impact an individual
• Genetic Predisposition: An increased likelihood of developing a particular trait, condition, or
disorder due to inherited genetic factors
• How inherent vulnerabilities paired with environmental stressors may shape a person
5.4 – Categories of Psychological Disorders
Neurodevelopmental Disorders
Feature Description
Symptoms Focus on whether exhibited behaviors are appropriate for age or maturity
levels
Impact May affect emotions, learning ability, self-control, and memory
Onset Occurs during the developmental period
Duration Typically for life

ADHD – Attention Deficit/Hyperactivity Disorder

• DSM-5 has NINE indicators for EACH category
Inattention Hyperactivity / Impulsivity
Overlooking detail Fidgeting/Movement
Inability to focus on a single task Interrupting others
Frequently doesn't finish tasks Trouble waiting one's turn

• Requires Inattention AND/OR Hyperactivity-Impulsivity symptoms

• Heritability: about 74%
• No significant evidence to identify clear environmental causes, but cannot be ruled out

ASD – Autism Spectrum Disorder

• The range of symptoms can show DIFFERENTLY in different people
• Appears to be largely genetic but quite complex
• Pre-natal risk factors have been identified that increase likelihood of ASD

Symptom Category 1: Impaired Social and Communication Skills

◦ Social emotional reciprocity
◦ Deficits in nonverbal communication
◦ Difficulty making friends or lack of interest in peers
◦ Increased sensory sensitivity

Symptom Category 2: Restrictive and Repetitive Behavior

◦ Repetitive motor movements, use of objects, or speech
◦ Inflexibility with routines
◦ Fixated interests
◦ Hyporeactivity to sensory input
 • Children with ASD seek out less social and emotional contact than other children
• Less likely to seek parental support when distressed
• People with ASD tend to be hypersensitive to sensory stimulation

Alzheimer's Disease
• A form of dementia — a deterioration of cognitive abilities, often seen most dramatically in
memory

Causes of Neurodevelopmental Disorders — 3 Factors

Factor Type Description
1. Genetic Factors Include genetic mutations, inherited genes from parents, or genetic
makeup
2. Physiological Factors Inside a person's body (how the brain is developing)
3. Environmental Factors External factors — teratogens, infectious disease, social deprivation,
physical trauma

• Down Syndrome = example of a developmental disorder that is genetic

Schizophrenia Spectrum
Psychosis
A mental condition in which thoughts and emotions are so affected that contact is lost with reality.

Symptoms of Schizophrenia Spectrum Disorder

Symptom Description
Delusions Distorted or false beliefs about external reality
Hallucinations Perception of a stimulus that doesn't exist (often auditory)
Disorganized Speech 'Word Salad' or Nonsensical language; neologisms (making up
words)
Disorganized / Catatonic Aimless movement or lack of movement
Behavior

Positive vs. Negative Symptoms

Positive Symptoms (ADD behaviors) Negative Symptoms (REMOVE behaviors)
Delusions (false beliefs) Lack of movement (Stupor / Catatonic)
Hallucinations (false perceptions — often Flat Affect (low emotional response)
auditory)
Disorganized Speech Alogia — Reduction in speech
 Disorganized Movement / Catatonia

Types of Delusions:
• Delusions of Persecution: Belief that others are out to harm you
• Delusions of Grandeur: Belief that you have exceptional abilities, wealth, or power

Diagnosis Criteria
• The presence of TWO of the five main symptoms for MORE than one month
• At least ONE symptom must be delusions, hallucinations, OR disorganized speech
• Spectrum Disorder — combination of symptoms differs from person to person

Causes of Schizophrenia
• Individuals may genetically have higher or lower vulnerability for Schizophrenia Spectrum
Disorder
• Exposure to risk factors makes the disorder more likely
• Risk factors: prenatal virus exposure, childhood stress and trauma, social isolation, family
dysfunction

Dopamine Hypothesis
• Too much dopamine in the brain → positive symptoms (delusions, hallucinations, disorganized
thinking)
• Too much dopamine in limbic system → hallucinations
• Too low dopamine levels in prefrontal cortex → lack of motivation, flat affect
• Antipsychotic drugs lower dopamine levels → decrease disordered thought (but excessive use
→ tardive dyskinesia)
• Parkinson's disease treated with L-Dopa → increases dopamine → excessive use results in
schizophrenia-like symptoms
• Too much use of drugs like LSD → may lead to schizophrenia

⚠️Common Confusion
People often confuse Schizophrenia with DID. Schizophrenics do NOT have split personalities.
'Schism' means 'break' — but the break in schizophrenia is a break from REALITY, not a break
within a person's consciousness.

Depressive Disorders and Bipolar Disorders

• Formerly categorized together as 'Mood Disorders' — in DSM-5 they are NOW separate
categories

Depressive Disorders
• The presence of a sad, empty, or irritable mood along with physical and cognitive changes
affecting a person's ability to function
 • Linked to LOW levels of serotonin (a neurotransmitter)
• Depression has been found to correlate positively with feelings of LEARNED HELPLESSNESS

Type Description
Major Depressive Disorder Presence of symptoms EVERY DAY for at least TWO WEEKS
(MDD)
Persistent Depressive Disorder Presence of symptoms over TWO YEARS — often milder, but more
(PDD) persistent than episodic

Bipolar Disorder
• Characterized by cycling moods involving 'manic' episodes
• More receptors for acetylcholine
• Bipolar Cycling = experiencing depression and mania in alternating periods
Type Requirements
Bipolar I Requires the presence of a MANIC episode (3+ symptoms every day for most of
the day, at least one week). Manic episodes last at least 7 days. Depressive
episodes typically last at least 2 weeks.
Bipolar II Requires the presence of a HYPOMANIC episode (less severe than full mania)
AND a depressive episode. Does NOT have full-blown manic episodes.

Symptoms of Mania / Manic Episodes:

Symptom 1 Symptom 2 Symptom 3 Symptom 4
Inflated Self-Esteem or Decreased Need for Increase in Goal- Easily Distracted
Grandiosity Sleep Directed Activity or
Restlessness
Increased Racing Thoughts Reckless Behaviors High energy,
Talkativeness impulsivity, euphoria

Treatment for Bipolar:

• Medications: mood stabilizers (lithium), antipsychotics, antidepressants
• Therapy: CBT, psychoeducation, family therapy

Possible Causes of Depressive Disorders

Perspective Explanation
Cognitive Depressed people think differently — view themselves, environment, and
future in a negative pessimistic light. Misinterpret facts negatively, blame
themselves for misfortune.
Behavioral Depressive thinking can be learned observationally (watching parents fail to
cope). Or from lack of experiences that develop adaptive coping skills.
(Learned helplessness)
Biological Linked to over-activation of hypothalamus (coordinates stress response),
 over-activity of amygdala (signals threat, negative emotions), reduced activity
in prefrontal cortex (decision-making). Low serotonin and norepinephrine.
Behavior Genetics Risk is polygenetic — many genes each contribute a tiny risk. Having a first-
degree relative with depression doubles or triples one's risk (20–30% lifetime).
Socio-Cultural Stressors such as poverty, trauma, social isolation, and discrimination
contribute to the onset of depression.

Depression vs. Anxiety: Similarities and Differences

Depression Anxiety
Often a response to past or current LOSS Often a response to a THREAT of future loss
Reflective of experience for learning and moving Motivating and preparatory for future possibilities
forward
Symptoms SLOW us down to ponder Symptoms reflect sympathetic nervous system
AROUSAL
Quite normal unless excessive or in response to Quite normal unless excessive or in response to
everyday occurrences imagined or unrealistic threats

Anxiety Disorders
• Excessive fear or anxiety with related disturbances to behavior
• Anxiety is a NORMAL response to threat of a future loss
• Anxiety DISORDERS involve excessive responses, or responses to imagined or over-inflated
threats
• Distressing, persistent anxiety and perhaps anxiety-reducing behaviors

Disorder Description
Specific Phobia Fear of a specific object or situation: acrophobia (heights),
arachnophobia (spiders), claustrophobia (enclosed spaces)
Agoraphobia Intense fear of social situations — public transportation, open spaces,
enclosed spaces, standing in line, crowds, or being outside of home
alone
Panic Disorder Acute episodes of intense anxiety without any apparent provocation.
Panic attacks tend to INCREASE in frequency; people suffer additional
anxiety anticipating future attacks.
Social Anxiety Disorder Intense fear of being judged or watched by others. Formerly known as
'social phobia.' Fear of situations where one could embarrass oneself
in public.
Generalized Anxiety Experiences constant, low-level anxiety. Constantly feels nervous and
Disorder (GAD) out of sorts. Prolonged experiences of non-specific anxiety or fear.

• Sociocultural impacts: some disorders manifest only in certain cultures — e.g., Taijin Kyofusho
(Japan): social anxiety involving concern that one's body is displeasing to others
OCD – Obsessive-Compulsive and Related Disorders
• OCD is categorized SEPARATELY from Anxiety Disorders in DSM-5
• Presence of Obsessions (unwanted intrusive THOUGHTS)
• Compulsions (intrusive, often repetitive BEHAVIORS)

Obsessions (Thoughts) Lead Compulsions (Behaviors)

To
Dirt, germs → Handwashing, cleaning
Something bad is going to happen → Repeating rituals (checking locks)
Symmetry, order → Organizing/sorting

• The reduction of anxiety resulting from the behavior becomes NEGATIVE REINFORCEMENT
for the compulsion — reinforcing the cycle

Causes of Anxiety and OCD-Related Disorders

Factor Explanation
Genetic/Biological Fears of life-threatening animals, objects, or situations likely played a role
in natural selection. Reactivity to stimuli in certain brain pathways is
genetically predisposed.
Behavioral Learned associations through classical and operant conditioning
Cognitive Maladaptive interpretations of situations and irrational beliefs

Trauma and Stressor-Related Disorders

• Prior to DSM-5 these were classified as Anxiety Disorders — now their OWN category
• ALL require exposure to a traumatic or stressful event for diagnosis

PTSD – Post-Traumatic Stress Disorder

• Requires exposure to actual or threatened death, serious injury, or sexual violence either:
◦ Directly
◦ Witnessing in person
◦ Learning of a traumatic event happening to a close relative or friend
◦ Repeated or extreme exposure to details of traumatic events (police, first responders, etc.)

Category Symptoms
Intrusions Recurring memories, dreams, or flashbacks; distress with exposure
to cues that symbolize the traumatic event
Alterations of Cognition/Mood Negative beliefs, negative emotions; amnesia of parts of traumatic
event; detachment
 Avoidance Avoidance or efforts to avoid memories or external reminders of the
traumatic event
Alterations in Irritability, self-destructive behavior, hypervigilance, exaggerated
Arousal/Reactivity startle response, disturbed sleep

• Elements of PTSD show similarities to Anxiety Disorders, but the experience of trauma and
certain symptoms make it a different category
• PTSD CAN involve dissociative symptoms

Dissociative Disorders
• A dissociation = a separation of some mental functions from CONSCIOUS AWARENESS
• Dissociations from: consciousness, memory, identity, emotion, perception, body representation,
motor control, and behavior

Common everyday dissociative experiences:

• Getting to the bottom of a page and not knowing what you read
• Forgetting whether you've done something or just thought about it
• Being so involved in a show you're not aware of what others around you are doing
• Finding yourself somewhere and wondering how you got there

Type Description
Dissociative Identity Disorder Presence of two or more distinct personalities. Typically a reaction to
(DID) trauma as a way to avoid bad memories or experiences.
Dissociative Amnesia Response to a traumatic event. DIFFERENT from 'organic' amnesia
(which results from physical trauma). May be localized, selective,
continuous, systematized or generalized. Sometimes experience
'Fugue' — sudden, unexpected travel or relocation from home.

Feeding and Eating Disorders

• Altered consumption or absorption of food that impairs health or psychological functioning

Disorder Key Features

Anorexia Nervosa Restriction of energy intake (food) leading to significantly LOW body
weight. Intense fear of gaining weight. Self-worth influenced by body
weight or shape. Lack of recognition of severity of low body weight. May
engage in binge eating/purging.
Bulimia Nervosa Recurrent episodes of binge eating (eating more than most would eat in 2
hours; feeling out of control). Recurrent compensatory behaviors: vomiting,
laxatives, diuretics, fasting, or excessive exercise. Occurs at least
ONCE/WEEK for THREE MONTHS.

Multiple Possible Causes of Eating Disorders

 Factor Explanation
Biological & Genetic Influenced by hormones and chemicals in body and brain. Genetics can
increase susceptibility.
Social & Cultural Ideal body shape varies across time and culture. Western culture
promotes thinner ideal body shape.
Cognitive & Behavioral Self-image and perception play a role. Family environment and learned
behaviors have an influence.
Interaction of Factors Motivation for eating is a complex interaction between biopsychosocial
factors — this is true for disorders also.

Personality Disorders
• Enduring patterns of internal experience and behavior that:
◦ Are deviant from one's culture
◦ Are pervasive and inflexible
◦ Begin in adolescence or early childhood
◦ Are stable over time
◦ Lead to personal distress or impairment

Cluster Theme Types

Cluster A Odd or Eccentric Paranoid (distrust/suspicion) Schizoid (avoidance of
social interaction) Schizotypal (odd
thinking/perceiving/communicating)
Cluster B Dramatic, Emotional, Antisocial (disregard for others, no remorse)
Erratic Histrionic (excessive attention-seeking) Narcissistic
(inflated self-importance) Borderline (emotional
instability, impulsivity)
Cluster C Fearful or Anxious Avoidant (feeling inadequate/socially judged)
Dependent (helplessness, needs to be taken care
of) Obsessive-Compulsive (excessively focused on
order/perfection)

Causes of Personality Disorders

Factor Explanation
Biological & Genetic Genetic predispositions likely interact with environmental factors leading to
disorder
Social & Cultural Personality expression is influenced by family/social context & cultural
differences in what is dysfunctional
Cognitive & Behavioral Combination of maladaptive beliefs about self & others; environmental
factors that reinforce problematic behavior
Interaction of Factors A complex interaction of factors leads to personality development — also
true of personality disorders
5.5 – Treatment of Psychological Disorders
Trends in Treatment
Trend Description
1. Therapeutic Alliance Relationship between therapist and client. Includes: active participation,
trust and confidence with each other, genuine regard, mindful of cross-
cultural issues. Cultural humility is key.
2. Evidence-Based Reviewing the findings within the literature and incorporating it into a
Practice treatment plan. Psychologists are informed by evidence-based
interventions.
3. Meta-Analysis A statistical analytical review of MANY studies. Therapy is generally found
to be effective.

Timeline of Treatment (Historical Context)

Era/Date Approach
5,000+ BC Trephining — drilling holes in skull to release 'demonic spirits' (demonology)
800 BC Ancient Greece — Hippocrates suggested mental illness was result of
imbalance in the four humors (body fluids)
1300s Middle Ages — exorcism
1700s Bloodletting, shaking, restraining, castration
1913 Lobotomy — cutting main neurons leading to the frontal lobe of the brain
Present Eclectic approach — psychotherapy that uses techniques from various forms of
therapy

Ethical Guidelines
Researchers must follow:
Requirement Requirement
Institutional Review Board (IRB) approval Confidentiality/anonymity ensured
Informed consent/assent Asking if deception is necessary; are
confederates used?
Protection from harm Debriefing of all participants

APA Ethical Principles in treatment of psychological disorders:

• Non-malfeasance (do no harm)
• Fidelity (be faithful to commitments)
• Integrity
• Respect for rights and dignity
1. Cognitive Therapies
• Teaches adaptive thinking — because our thoughts affect our feelings
• May employ Cognitive Restructuring or Fear Hierarchies to combat maladaptive thinking

The Cognitive Triad (Beck)

• Negative thoughts about ONESELF
• Negative thoughts about the WORLD
• Negative thoughts about the FUTURE
• These three interact and reinforce each other in depression

2. Applied Behavior Analysis (Behavioral Therapies)

• Utilizes behavioral techniques to change unwanted behaviors
• ABA most used with developmental disorders like autism spectrum disorder — therapists set up
systems of reinforcement

Technique Description
Exposure Therapies Safely exposes the client to the source of their anxiety. A fear hierarchy
is created in systematic desensitization.
Systematic Desensitization Teaching the client to replace anxiety with relaxation. Techniques
include breathing exercises and meditation. Build an anxiety/fear
hierarchy (ranked from least to most frightening). In vivo
desensitization = confront actual feared object. Covert desensitization
= imagine the fear-inducing stimuli.
Flooding Immediate full exposure to feared stimulus (all three — systematic
desensitization, flooding, and modeling — are exposure therapies)
Counterconditioning A kind of classical conditioning where an unpleasant conditioned
response is replaced with a pleasant one
Aversion Therapy Conditions a negative/unwanted behavior with an unpleasant stimulus
until an aversion is created
Token Economies Positive target behavior is reinforced with small tokens; tokens can be
exchanged for a larger reward
Biofeedback Uses visual and/or auditory feedback to teach clients to control their
physical reactions. Uses conditioning principles to regulate
sympathetic/parasympathetic nervous systems. Helps with anxiety and
depression.

3. Cognitive-Behavioral Therapy (CBT)

• Combines techniques from cognitive AND behavioral perspectives
• Treats thoughts, feelings, and behaviors as an interconnected system

CBT Variant Creator / Key Concept

 DBT – Dialectical Behavior Therapy Identifies and changes negative thought patterns to bring a
positive change in behavior
REBT – Rational-Emotive Behavior Created by Albert Ellis. Challenges negative or irrational
Therapy thought processes and their consequences. The ABCs:
Adversity → Behavior → Consequences.

4. Humanistic Therapy
• Focus on helping people achieve their potential by taking control to overcome challenges
• Helps people become more self-aware and accepting of themselves
• Focus on CONSCIOUS rather than unconscious thoughts
• Emphasizes the patient's PRESENT and FUTURE (not the past)

Client-Centered Therapy (Carl Rogers)

• Active Listening: Therapist acknowledges, restates, and clarifies what the client expresses
('So, what I'm hearing you say is...')
• Unconditional Positive Regard: Not judging clients — accepting them for who they are,
regardless of what they say or do
• Genuineness: When people are genuine, they are open with their own feelings
• Empathy: When people are empathic, they share and mirror others' feelings and reflect their
meanings
• Self-Concept: All thoughts and feelings we have in response to 'Who am I?' — shapes how we
perceive the world
• Active therapy = controlled by therapist; Centered therapy = controlled by patient

Gestalt Therapy
• Another type of humanistic therapy — 'perception'; emphasizes the importance of the WHOLE
• Encourages clients to explore feelings they may not be aware of
• Emphasizes importance of body position and seemingly minute actions
• Clients integrate all of their actions, feelings, and thoughts into a harmonious whole

Humanistic Therapy Core Beliefs

• People have FREE WILL and can control their own destinies
• Determinism = the opposite belief (people have no influence over what happens; choices are
predetermined)
• Focus is on helping people understand and accept themselves and strive to SELF-ACTUALIZE
(reach highest potential)

5. Psychodynamic Therapy
• Unconscious mind stores repressed trauma, memories, and thoughts to avoid anxiety
• Anxiety gains consciousness → leads to mental distress and maladaptive behavior
Insight Therapy
• Gaining awareness into the underlying causes of the mental illness
• Tap into the unconscious mind
• Insight therapies highlight the importance of the patient/client gaining understanding of their
problems

Psychoanalysis (Sigmund Freud, 1890s)

• Create a trusting environment
• Neurosis = mental problems in conscious life, coming from long-repressed trauma and feelings
• 2-3 sessions per week = 7+ years; very expensive

Free Association Concept Meaning

Greater Trust Allows for the ego to lower its walls and reveal the true issue
Therapeutic Rapport Trusting relationship with therapist
Resistance Unwillingness of patient to reveal conflicts hidden in unconscious
Transference Natural — patient places their issue onto the therapist; positive or
negative feelings
Counter-Transference Therapist experiences an unconscious emotional response to the
patient

Dream Analysis Meaning

Manifest Content (patient) What is consciously remembered in a dream
Latent Content (therapist) Symbolic representations of the unconscious forces, urges, or
conflicts

• Why use dream analysis? Ego defenses are relaxed during sleep

Modern Psychodynamic Therapies

• Interpersonal Psychotherapy (IPT): Focus on improving existing relationships. Has been
shown to help with depression and anxiety. Works better when coupled with antidepressant or
antianxiety medication.
• Object Relations Therapy: Social relationships in early childhood lie at the heart of mental
problems in adulthood. 'Object' = important person in the client's life.

Psychoanalysis Psychodynamic
Not used as much today IPT has been shown to help with depression &
anxiety
Lacks empirical research Works better when coupled with medication
Expensive and lengthy

Therapist's interpretations are subjective

Modes of Therapy
Individual Therapy Group Therapy
One patient at a time Not alone — reduces isolation and hopelessness
More expensive Knowledge reduces isolation
May take longer depending on the problem Healthy interpersonal interactions supported by
therapist
Examples: CBT, psychoanalysis Healthier coping skills: problem-solving,
assertiveness, listening
Also includes: Self-Help, Couples/Marriage,
Family therapy

Hypnosis
Science of Hypnosis
• Induced state of consciousness — power of suggestion
• State of suggestibility
• Can aid in: reducing anxiety, depression, gastrointestinal disorders, and pain
• Post-hypnotic suggestion — encourage a client to respond to desired outcomes after the
session
• NOT for everyone — varies from person to person

Limitations of Hypnosis
• INEFFECTIVE with memory recovery — recovered memories are just falsely created memories
• Age-regression therapy — research shows is NOT feasible and lacks empirical support

Psychopharmacology (Drug Treatments)

• Psychopharmaceutical drugs interact with neurotransmitters, influencing how the mind and body
respond

Category Examples Neurotransmitter Target

Antianxiety Xanax (for OCD too) GABA
Antidepressants Prozac Serotonin, Norepinephrine
Antipsychotics Thorazine Dopamine (lowers it); side effect = Tardive
Dyskinesia with excessive use

Surgical and Invasive Interventions

• New technologies have advanced, allowing for more treatment options
Intervention Description
ECT – Electroconvulsive Electrical stimulation of the brain; used for severe depression
Therapy
TMS – Transcranial Magnetic Magnetic fields stimulate brain cells; less invasive than ECT
Stimulation

Summary: Types of Psychotherapy

Perspective Specific Example Key Concept/Techniques
Psychodynamic Psychodynamic therapy Free association, dream analysis
Humanistic Client-centered therapy Unconditional positive regard, active listening
Behaviorist Systematic desensitization Relaxation, anxiety hierarchy,
counterconditioning
Cognitive Cognitive therapy Challenging negative beliefs about the
cognitive triad
Cognitive-Behavioral Rational Emotive Behavior Challenging illogical ways of thinking and
Therapy assigning behavioral homework
Quick Reference: Stress vs. Anxiety
Stress Only Both Stress & Anxiety Anxiety Only
Goes away once the situation is Excessive worry Usually involves a persistent
resolved feeling of apprehension or dread
that doesn't go away
Can be positive or negative Uneasiness / Tension Interferes with how you live your
life
May inspire you to meet a Headaches or body pain / High Is constant, even if there is no
deadline or cause you to lose blood pressure / Loss of sleep immediate threat
sleep

Key Distinction
Stress and anxiety have similar physical and cognitive symptoms but represent DISTINCT
psychological experiences. Stress is typically tied to an external trigger; anxiety persists even
without one.

⚡ AP Exam — Must-Know Tips

Frequent Exam Traps
Common Mistake Correct Understanding
Schizophrenia = split personality Schizophrenia = break from REALITY. DID = split personality
(2+ distinct identities)
OCD is an Anxiety Disorder OCD has its OWN category in DSM-5 (no longer under Anxiety
Disorders)
PTSD is an Anxiety Disorder PTSD has its OWN category in DSM-5 (Trauma & Stressor-
Related)
Eustress is not stress Eustress IS stress — it is just beneficial/motivating stress
Emotion-focused coping is weak Emotion-focused is NECESSARY and good — it comes first
before problem-focused
DSM explains causes DSM only CLASSIFIES and DESCRIBES — it does NOT
explain causes
Bipolar I = worse than II because it Bipolar I only REQUIRES mania (depression may also occur
needs mania AND depression but is not required for diagnosis)
MDD = any sadness lasting 2 weeks MDD = symptoms EVERY DAY for at least 2 weeks
Antipsychotics increase dopamine Antipsychotics DECREASE dopamine levels

Key People to Know

Person Contribution
Hans Selye General Adaptation Syndrome (G.A.S.)
Martin Seligman Positive Psychology, PERMA Profiler, Authentic Happiness Inventory
Carl Rogers Client-Centered Therapy, Unconditional Positive Regard, Active Listening
Sigmund Freud Psychoanalysis, Free Association, Dream Analysis, Transference
Albert Ellis Rational-Emotive Behavior Therapy (REBT), ABCs model
Aaron Beck Cognitive Triad (negative thoughts about self, world, future)