A meLhod of funcLlonal behavloral assessmenL ls called Lhe A8C approach

where observaLlons are made on AnLecedenLs WhaL comes dlrecLly before Lhe
behavlor? 8ehavlor WhaL does Lhe behavlor look llke? and Consequences
WhaL comes dlrecLly afLer Lhe behavlor?
Ax|s I Menta| d|sorders Dement|a pervaslve dlsLurbance of
cognlLlve funcLlon wlLh normal consclousness ln several areas
uellrlum ulsLurbance ln cognlLlve funcLlon wlLh cloudlng of
consclousness and decreased envlronmenLal awareness AcuLe
onseL rapldly alLernaLlng ln severlLy PalluclnaLlons common
SubsLance lnduced AcuLe lnLoxlcaLlon alcohol ampheLamlnes
WlLhdrawal alcohol
Ax|s II ersona||ty]Deve|opmenta| d|sorders lfelong paLLern of
behavlor causlng lmpalrmenL ln soclal or occupaLlonal funcLlonlng or
causlng conslderable dlsLress unrelaLed Lo perlods of lllness MosL
are unaware of Lhelr behavlor and lf become aware are unllkely Lo
change
Ax|s III Med|ca| d|sorders
Ax|s IV sychosoc|a| and env|ronmenta| d|sorders deaLh of
famlly member healLh problems ln famlly dlsrupLlon of famlly by
separaLlon dlvorce
Ax|s V G|oba| funct|on|ng Mlnlmal sympLoms (eg mlld anxleLy
abouL complex school asslgnmenLs) Some mlld sympLoms some
dlfflculLy ln home school or peer funcLlonlng (eg occaslonal
Lruancy or small LhefLs from famlly members or peers) ModeraLe
sympLoms (eg flaL affecL mlnlmal speech occaslonal anxleLy
reacLlons) Serlous sympLoms (eg sulcldal ldeaLlon severe
obsesslve rlLuals frequenL sLeallng

Cluster A-Patients often seem odd or eccentric (such as paranoid
or schizoid). Schizotypal disorder is often included in this cluster

Cluster B-Patients may seem dramatic, emotional, or erratic
(such as dissocial, histrionic, or borderline type of emotionally
unstable personality)

Cluster C-Patients present as anxious or fearful (such as
dependent, anxious, anankastic).
$ = Not Otherwise Specified.
Anxiety Disorder-diffuse, vague feelings of fear and
apprehension, every one has it, becomes a problem when it is
irrational, uncontrollable and disruptive.
Generalized Anxiety Disorder (GAD)- Constant general
worry(6mo) decreased functioning, cant control it. Has 3+ of the
following.
Restlessness
Being easily tiered
Difficulty concentrating
Irritability
Muscle tension
Sleep disturbance
Phobias- An intense and persistent irrational fear. Person
recognizes that the fear is out of control. Person may focus on
category of objects, event or situation, social setting.
bsessive Compulsive disorder (CD) - Obsession- irrational,
disturbing thoughts that intruded into consciousness.
Compulsions- repetitive actions performed to alleviate
obsessions. Checking and washing are most common
compulsions. (Usually 1+ hrs per day)
Posttraumatic $tress Disorder (PT$D) - Follows traumatic
event or events such as war, rape, or assault. Intrusion,
avoidance of thoughts and feelings (1+mo) less than (1 mo) if
called acute stress disorder. Symptoms include: nightmares,
flashbacks, sleeplessness, easily startled, depression, irritability.
Bipolar Disorder- cycling between depression and mania

Symptoms of mania or a manic
episode incIude:
Symptoms of depression or a
depressive episode incIude:
Mood Changes
A long period of feeling "high," or an
overly happy or outgoing mood
Extremely irritable mood, agitation,
feeling "jumpy" or "wired."
ehavioraI Changes
Talking very fast, jumping from one idea
to another, having racing thoughts
Being easily distracted
ncreasing goal-directed activities, such
as taking on new projects
Being restless
Sleeping little
Having an unrealistic belief in one's
abilities
Behaving impulsively and taking part in a
lot of pleasurable,
high-risk behaviors, such as spending
sprees, impulsive sex, and impulsive
business investments.
Mood Changes
A long period of feeling worried
or empty
Loss of interest in activities once
enjoyed, including sex.
ehavioraI Changes
Feeling tired or "slowed down"
Having problems concentrating,
remembering, and making
decisions
Being restless or irritable
Changing eating, sleeping, or
other habits
Thinking of death or suicide, or
attempting suicide.

CycIothymic Disorder, or CycIothymia, is a mild form of bipolar disorder.
People who have cyclothymia have episodes of hypomania that shift back
and forth with mild depression for at least two years. However, the
symptoms do not meet the diagnostic requirements for any other type of
bipolar disorder
A dissociative disorder is the breakdown of one's perception of his/her
surroundings, memory, identity, or consciousness.
Dissociative identity disorder: Dissociative identity disorder was formerly
called "multiple personality disorder." When a person intermittently
experiences two or more identities, he/she may have a dissociative identity
disorder. While experiencing a new identity, a separate personality takes
control, and the person is unable to remember important and personal
information about him/her. Each personality has its own personal history
and identity and takes on a totally separate name.

$chizophrenia Disorder- "Split Mind schizophrenia may
experience hallucinations (most commonly hearing voices),
delusions (often bizarre or persecutory in nature), and
disorganized thinking and speech. The latter may range from loss
of train of thought, to sentences only loosely connected in
meaning, to incoherence known as word salad in severe cases.
There is often an observable pattern of emotional difficulty, for
example lack of responsiveness or motivation. Impairment in
social cognition is associated with schizophrenia, as are
symptoms of paranoia, and social isolation commonly occurs.
Delusions: These are beliefs that are not true, such as feeling
people are following or trying to hurt them, believing other people
can read their minds, or beliefs that they have special powers or
abilities.
Hallucinations: This usually takes the form of hearing voices
that are not there, but people with schizophrenia may also see,
smell, taste, and feel things that are not there.
Types of therapy
Unconditioned Stimulus (UCS)
stimulus that unconditionally--automatically and
naturally--triggers a response
Unconditioned Response (UCR)
unlearned, naturally occurring response to the
unconditioned stimulus
salivation when food is in the mouth
Conditioned Stimulus (CS)
originally irrelevant stimulus that, after association with
an unconditioned stimulus, comes to trigger a
conditioned response
Conditioned Response (CR)
learned response to a previously neutral conditioned
stimulus
Operant Conditioning
type of learning in which behavior is strengthened if
followed by reinforcement or diminished if followed by
punishment
Reinforcer
any event that strengthens the behavior it follows
Fixed Ratio (FR)
reinforces a response only after a specified number of
responses
faster you respond the more rewards you get
different ratios
very high rate of responding
like piecework pay
'ariable Ratio ('R)
reinforces a response after an unpredictable number of
responses
average ratios
like gambling, fishing
very hard to extinguish because of unpredictability
Fixed Interval (FI)
reinforces a response only after a specified time has
elapsed
response occurs more frequently as the anticipated
time for reward draws near
'ariable Interval ('I)
reinforces a response at unpredictable time intervals
produces slow steady responding
like pop quiz

Psychodynamic Perspective
Sigmund Freud
Unconscious conflicts and drives
arly childhood trauma
therapy helps person become aware of underlying
conflicts
Anxiety - diffuse, vague feelings of fear and
apprehension
everyone experiences it
becomes a problem when it is irrational, uncontrollable,
and disruptive
eneralized Anxiety Disorder (AD)
Constant general worry (6 mo)
Decreases functioning, cant control it
Has 3+ of following: (FFR)
Restlessness
Being easily tired
Difficulty concentrating
Irritability
Muscle tension
Sleep disturbance
Phobias
Intense and persistent irrational fear that may focus on: (in
under 18, at least 6 mo)
Person recognizes that the fear is out of control
category of objects
event or situation
social setting
Intense and persistent irrational fear that may focus on: (in
under 18, at least 6 mo)
Person recognizes that the fear is out of control
category of objects
event or situation
social setting Obsessions - irrational, disturbing thoughts
that intrude into consciousness Compulsions - repetitive
actions performed to alleviate obsessions
Checking and washing most common compulsions
1+ hrs per day usually
Panic DisorderPanic attacks - helpless terror, high
physiological arousal
'ery frightening - sufferers live in fear of having them
Agoraphobia often develops as a result
Posttraumatic Stress Disorder (PTSD)
Follows traumatic event or events such as war, rape, or
assault
Intrusion, Avoidance, Increased Arousal (1 mo)
If less than 1 mo, its called Acute Stress Disorder
Symptoms include:
nightmares
flashbacks
sleeplessness
easily startled
depression
irritability
Depression
Symptoms include:
Depressed mood
feelings of worthlessness
changes in sleep
eight change (more than 5% in a month)
Insomnia
Psychomotor agitation or retardation
Fatigue
Cant concentrate
anhedonia
Recurrent focus on death
5+ symptoms over 2 weeks= depression
2+ symptoms over 2 weeks= dysthymia
Bipolar disorders
cycling between depression and mania (extreme
euphoria

Schizophrenia
literal translation "split mind
a group of severe disorders characterized by:
disorganized and delusional thinking
disturbed perceptions
inappropriate emotions and actions
Delusions
false beliefs, often of persecution or grandeur, that may
accompany psychotic disorders
Hallucinations
sensory experiences without sensory stimulation


Psychoanalysis
Freud believed the patients free associations,
resistances, dreams, and transferences - and the
therapists interpretations of them - released
previously repressed feelings, allowing the patient to
gain self-insight
use has rapidly decreased in recent years
Resistance
blocking from consciousness of anxiety-laden material
Interpretation
the analysts noting supposed dream meanings,
resistances, and other significant behaviors in order to
promote insight
Transference
the patients transfer to the analyst of emotions linked
with other relationships
e.g. love or hatred for a parent
Client-Centered Therapy
humanistic therapy developed by Carl Rogers
therapist uses techniques such as active listening within
a genuine, accepting, empathic environment to
facilitate clients growth
Behavior Therapy
therapy that applies learning principles to the
elimination of unwanted behaviors
Counterconditioning
procedure that conditions new responses to stimuli that
trigger unwanted behaviors
based on classical conditioning
includes systematic desensitization and aversive
conditioning
xposure Therapy
treat anxieties by exposing people (in imagination or
reality) to the things they fear and avoid
Systematic Desensitization
type of counterconditioning
associates a pleasant, relaxed state with gradually
increasing anxiety-triggering stimuli
commonly used to treat phobias
Aversive Conditioning
type of counterconditioning that associates an
unpleasant state with an unwanted behavior
nausea ---> alcohol
Token conomy
an operant conditioning procedure that rewards desired
behavior
patient exchanges a token of some sort, earned for
exhibiting the desired behavior, for various privileges or
treats
Cognitive Therapy
teaches people new, more adaptive ways of thinking
and acting
based on the assumption that thoughts intervene
between events and our emotional reactions
Cognitive-Behavioral Therapy
a popular integrated therapy that combines cognitive
therapy (changing self-defeating thinking) with
behavior therapy (changing behavior)
Clinical psychologists
Most are psychologists with a Ph.D. and expertise in
research, assessment, and therapy, supplemented by a
supervised internship
About half work in agencies and institutions, half in
private practice
Clinical or Psychiatric Social orker
A two-year Master of Social ork graduate program
plus postgraduate supervision prepares some social
workers to offer psychotherapy, mostly to people with
everyday personal and family problems
About half have earned the National Association of
Social orkers designation of clinical social worker
Counselors
Marriage and family counselors specialize in problems
arising from family relations
Pastoral counselors provide counseling to countless
people
Abuse counselors work with substance abusers and
with spouse and child abusers and their victims
Psychiatrists
Physicians who specialize in the treatment of
psychological disorders
Not all psychiatrists have had extensive training in
psychotherapy, but as M.D.s they can prescribe
medications. Thus, they tend to see those with the
most serious problems
Many have a private practice
Social Facilitation
improved performance of tasks in the presence of
others
occurs with simple or well-learned tasks but not with
tasks that are difficult or not yet mastered
Social Loafing
tendency for people in a group to exert less effort when
pooling their efforts toward attaining a common goal
than when individually accountable
Bystander ffect
hen many are present, we feel less responsible for a
bad situation and thus less likely to help
roup Polarization
enhancement of a groups prevailing attitudes through
discussion within the group
roupthink
mode of thinking that occurs when the desire for
harmony in a decision-making group overrides realistic
appraisal of alternatives
Prejudice
eneral term for an unjustifiable (and usually negative)
attitude toward a group and its members
Stereotype
a generalized (sometimes accurate, but often
overgeneralized) belief about a group of people
Discrimination
unjustifiable negative behavior toward a group or its
members