FACULTAD DE PSICOLOGÍA

GRADO EN PSICOLOGÍA

SCIENTIFIC ENGLISH
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 TABLA DE CONTENIDO

▪ UNIT 1: CLASSYFYING PSYCHOLOGY ………………………………………………………………………. Pg. 4

▪ UNIT 2: ADDICTIONS ………………………………………………..……………………………………………. Pg. 14

▪ UNIT 3: OBSESSIVE COMPULSIVE DISORDER ……………………….…………………………..……. Pg. 24

▪ UNIT 4: EATING DISORDERS ……………………………………………………………….…………………. Pg. 34

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 UNIT 1. CLASSIFYING PSYCHOLOGY

1. WHAT IS PSYCHOLOGY?
- Psychology is the scientific study of human mind and behaviour: how we think, feel, act and
interact individually and in groups.

1.1 Subfields of Psychology

o HEALTH PSYCHOLOGY:
- Uses knowledge of psychology and health to promote general well-being and
understanding of physical illnesses.
- Promote general well-being and understanding of a physical illness.
- Trained to help people deal with the emotional and psychological aspects of chronical
illnesses.
- Promote healthier lifestyles (ex. help people stop smoking).
- Try to improve healthcare systems (advise doctors better ways to communicate with their
patients).

- Employed in a number of settings: Hospitals, Community health settings, Local authorities,

University departments, Consultancy companies (training, intervention skills), NHS (Nacional
Health System).

o CLINICAL PSYCHOLOGY:
- Aims to reduce psychological distress and promote psychological well-being.
- Clinical psychologists deal with a wide range of mental and physical health problems
including: anxiety, depression…
- They might undertake clinical assessments to investigate their clients situation, including:
psychometric tests, interviews and direct observation of behaviours. Which may lead to
advice, counselling or therapy.

- Employed in a number of settings: Hospitals, Health centres, Child and Adolescent Mental
Health Services (CAMHS), Social services… Most clinical psychologists are employed by the
National Health Service (NHS), but some work in private practice.

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o EDUCATIONAL PSYCHOLOGY:
- Concerned with helping children and young people experiencing problems that can hinder
their chance of learning.
- Educational psychologists tackle challenges such as: learning difficulties, social and
emotional problems, issues around disability, complex developmental disorders.

- They work in a variety of ways including: observations, interviews, assessments, offer

consultation, advice, support to teachers (train) / parents.
- They work in: schools, colleges, nurseries, special units, primarily with teachers and
parents.
- The work of an educational psychologist can either be directly with a child (assessing
progress, giving counselling) or indirectly (through their work with parents, teachers and
other professionals).

o RESEARCH PSYCHOLOGY:
- Requires the application of skills and knowledge to scientifically hypothesize about an
aspect of human behaviour, then to test it, analyse it and communicate the results.

- Teaching and research in psychology usually go hand in hand.

- All university lecturers are expected to help extend their subject by gathering psychological
evidence on key research questions and telling others what they have found by publishing
articles.
- Lecturers and researchers work in: universities, colleges and Schools.
- Research scientists may also work in research units.

o OCCUPATIONAL PSYCHOLOGY:
- Concerned with the performance of people at work and with how individuals, small groups
and organisations behave and function. Its aim is to increase the effectiveness of the
organisation and improve the job satisfaction of individuals.

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o COUNSELLING PSYCHOLOGY:
- Focuses on working with a tailored psychological formulation to improve psychological
functioning and well-being, working collaboratively with people across a diverse range of
disciplines.
- Counselling psychologists deal with a wide range of mental health problems concerning life
issues including: bereavement, domestic violence, sexual abuse, traumas, relationship
issues.

- They understand diagnosis and the medical context to mental health problems and work
with the individual’s unique subjective psychological experience to empower their recovery
and alleviate distress.

- Counselling psychologists are concerned with the integration of psychological theory and
research with therapeutic practice. The practice of counselling psychology requires a high
level of self-awareness and competence in relating the skills and knowledge of personal and
interpersonal dynamics to the therapeutic context.

o NEUROPSYCHOLOGY:
- Concerned with the assessment and rehabilitation of people with brain injury or other
neurological disease.

- Neuropsychologists work with people of all ages dealing with patients who have had:
traumatic brain injury, strokes, toxic and metabolic disorders, tumours and
neurodegenerative diseases.
- Neuropsychologists require not only general clinical skills and knowledge of the broad
range of mental health problems, but also a substantial degree of specialist knowledge in
the neurosciences.

o SPORTS PSYCHOLOGY
- Predominant aim is to help athletes prepare psychologically for the demands of
competition and training.
- Exercise psychology is primarily concerned with the application of psychology to increase
exercise participation and motivational levels in the general public.

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o FORENSIC PSYCHOLOGY
- Concerned with the psychological aspects of legal processes in courts. The term is also
often used to refer to investigative and criminological psychology: applying psychological
theory to criminal investigation, understanding psychological problems associated with
criminal behaviour and the treatment of those who have committed offences.

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2. SCHOOLS OF THOUGHT
- Since time immemorial, men and women have pondered over questions that are psychological in
nature. From the early Egyptians to the ancient Greek philosophers, there has been no letup in
efforts to understand human thought and behavior. Yet, in spite of its long past, the formal history
of psychology dates back only 133 years to 1879 – the year when Wilhelm Wundt opened the doors
of the first psychology laboratory in Leipzig, Germany. As a result of this significant move, Wundt is
widely regarded as the founder of psychology. Yet, this was just the beginning of Wundt’s
contributions to the field. He went on to become the first of several spirited speakers to engage in
an ongoing debate over what should be the focus of psychology. The history of psychology is
indeed short, but it has never been short of drama. With that said, let the drama unfold…

o STRUCTURALISM
- Wundt’s ideas formed the basis of the first school of thought (or perspective) in
psychology, known as structuralism.
- Structuralism, was based on investigating the structure of the mind. Wundt believed that
psychology should focus on breaking down consciousness into its basic elements.

- Wundt advanced the technique of introspection as the “scientific” tool that would enable
researchers to unveil the structure of the mind. Introspection involves looking inwards;
reflecting on, analysing and trying to make sense of our own internal experiences as they
occur.

- Wundt and his followers helped to establish psychology as an independent experimental

science.
- Subjects’ reports therefore tended to be subjective and conflicting.

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o FUNCTIONALISM
- “The mind is fluid, not stable; consciousness is ongoing, not static.”
- They attempted to study the function of the mind as opposed to the structure.

- Function in this sense can mean one of two things:

a) First, how the mind operates that is, how the elements of the mind work together.
b) second, how mental processes promote adaptation.

- They relied heavily on the technique of introspection.

o PSYCHOANALYSIS
- Freud was not content with examining only conscious thought, he dived head-first into the
unconscious.
- Freud compared the human psyche to an iceberg → Only a small portion is visible to others
with most of it lying below the surface. Freud also believed that many of the factors that
influence our thoughts and actions lie outside of conscious awareness and operate entirely
in our unconscious.
- Psychology therefore needed to study these unconscious drives, motives and impulses to
arrive at a more complete understanding of the individual.

- Freud’s work led to the development of the first form of psychotherapy.

- Biggest criticisms is that his theory falls short of being scientific as many of his concepts are
not testable.

- Freud also failed to recognize how experiences after childhood contribute to personality
development and focused mainly on psychological disorders rather than more positive,
adaptive behaviours.

o BEHAVIOURISM
- Behaviourists believed that human behaviour can be understood by examining the
relationship between stimuli (events in the environment) and responses (observable
behaviour).
- B.F. Skinner, advanced the idea that human behaviour can be explained by reinforcement
and punishment.

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o GESTALT PSYCHOLOGY
- The word “gestalt” means “form, pattern or whole.”

- Gestalt psychologists believed that psychology should study human experience as a

“whole,” not in terms of separate elements as the structuralists would contend. Their
slogan, “the whole is greater than the sum of its parts”.
- Conveyed the idea that meaning is often lost when psychological events are broken down;
only when these pieces are analysed together and the whole pattern is visible do we find
true meaning in our experiences.
- Their work also led to the emergence of a form of psychotherapy widely practiced by
modern psychologists.

o HUMANISTIC PSYCHOLOGY
- Humanistic psychologists, however, viewed humans as free agents capable of controlling
their own lives (as opposed to being controlled), making their own choices, setting goals and
working to achieve them.
- Determinism is the idea that our actions are controlled by forces beyond our control. For
the psychoanalysts, these forces are unconscious; for the behaviourists, they exist in our
environment.

o COGNITIVE PSYCHOLOGY
- Studies mental processes including how people think, perceive, remember and learn. As
part of the larger field of cognitive science, this branch of psychology is related to other
disciplines including neuroscience, philosophy, and linguistics.
- One of the most influential theories of this school of thought was the stages of cognitive
development theory proposed by Jean Piaget.

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o PERSONALISM
- Personalism is a philosophical and ethical perspective that emphasizes the significance of
the individual person. It developed as a reaction to depersonalizing elements in various
fields, including psychology. Key features of personalism include:
1) Centrality of the Person: Personalism focuses on the person as the primary subject
of philosophical and theological inquiry, considering the person the ultimate
explanatory principle for all of reality.
2) Uniqueness and Inviolability: It underscores the uniqueness and inherent dignity of
each person, deserving unconditional respect.
3) Interpersonal Relations: Personalism highlights the importance of social and
relational aspects of the person's nature, emphasizing the role of community and
relationships.
4) Dignity of the Person: Every person, regardless of individual characteristics, is of
inestimable worth, setting them apart from non-personal entities.
5) Interiority and Subjectivity: Personal subjectivity, including moral and religious
dimensions, is a central focus, influencing ethical responsibilities toward individuals.
6) Self-Determination: Human beings have free will, enabling moral choices and
actions that shape their identity and moral character.
7) Relationship and Communion: Personalists recognize the social nature of humans,
emphasizing the importance of interpersonal relationships for personal fulfillment.
8) The "Law of the Gift": Personalists assert that true self-realization and fulfillment
come through self-giving and love, allowing individuals to discover their true selves
based on their inherent dignity.

- In essence, personalism highlights the individual's uniqueness, dignity, and the significance
of their relationships, placing the person at the center of various philosophical and ethical
considerations.

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 UNIT 2. ADDICTIONS

1. WHAT IS AN ADDICTION?
- An addiction is a habitual psychological or physiologic dependence on a substance or practice that
is beyond voluntary control (unlike a habit).

1.1 Types of Addiction

o CHEMICAL ADDICTION: Refers to addiction that involves the use of substances.
o BEHAVIOURAL ADDICTION: Involves compulsive behaviours that are carried out
despite not having any benefit.

1.2 How does a Habit turn into an Addiction?

- A habit is generally non- destructive. A bad habit is one that is annoying, and tends to have a
negative effect, but the negative effect is somewhat negligible. When the habit becomes damaging,
destructive, or out of control, then it becomes an addiction.

1.3 What is the Difference between Habit-forming and Addiction?

- Probably the most important distinction between habit vs. addiction is how choice, to an extent, is
still possible with habit-forming behaviors. When it comes to addiction, people generally have a
harder time making decisions because of their dependence on a substance or behavior.

➢ Addiction: There is a psychological/physical component; the person is unable to control

the aspects of the addiction without help because of the mental or physical conditions
involved.

➢ Habit: It is done by choice. The person with the habit can choose to stop and will
subsequently stop successfully if they want to. The psychological/physical component is not
an issue as it is with an addiction.

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1.4 Addiction Cycle
- The brain experiences pleasure because of the repeated times the person has consume the
substance, what ends in a substance dependence (when someone abuses high doses of an
addictive substance, they feel like they cannot function without the drug, can have many negative
consequences in someone’s life). So:

➢ Dependence: When someone abuses high doses of an addictive substance, they may
develop a dependence. Drug dependence refers to someone feeling like they cannot
function normally without the use of the substance. A drug dependence can be either
physical or psychological and can have many negative effects on someone’s life.

➢ Tolerance: Drug tolerance occurs when someone abuses a substance over a long period.
When someone continuously abuses a substance, their body becomes used to it, meaning
the drug will stop having as much of an effect. When someone develops a tolerance to an
addictive substance, they will begin taking a higher dose to get the same effects as before.
Taking high doses of a substance may lead to many negative consequences.

➢ Withdrawal: Psychological and/or physical syndrome caused by the abrupt cessation or

abstinance of the use of a drug in a habituated person.

1.5 Signs and Symptoms of Substance Addiction

➢ Symptom: Is something the patient senses and describes, while a sign is something other
people, such as the doctor notice. For example, sleepiness may be a symptom while dilated
pupils may be a sign. The signs and symptoms of substance dependence vary according to
the individual, the substance they are addicted to, their family history (genetics), and
personal circumstances.

1. The person takes the substance and cannot stop; in many cases, such as nicotine, alcohol
or drug dependence, at least one serious attempt was made to give up, but unsuccessfully.

2. Withdrawal symptoms; when body levels of that substance go below a certain level the
patient has physical and mood -related symptoms. There are cravings, bouts of moodiness,
bad temper, poor focus, a feeling of being depressed and empty, frustration, anger,
bitterness, and resentment. There may suddenly be increased appetite. Insomnia is a
common symptom of withdrawal. In some cases, the individual may have constipation or
diarrhoea. With some substances, withdrawal can trigger violence, trembling, seizures,
hallucinations, and sweats.

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3. Addiction continues despite health problem awareness; the individual continues taking the
substance regularly, even though they have developed illnesses linked to it. For example, a
smoker may continue smoking even after a lung or heart condition develops.

4. Social and recreational sacrifice; some activities are given up because of an addiction to
something. For example, an alcoholic may turn down an invitation to go camping or spend a
day out on a boat if no alcohol is available, a smoker may decide not to meet up with friends
in a smoke-free pub or restaurant.

5. Maintaining a good supply; people who are addicted to a substance will always make sure
they have a good supply of it, even if they do not have much money. Sacrifices may be made
in the house budget to make sure the substance is as plentiful as possible.

6. Taking risks; in some cases, the addicted individual makes take risks to make sure he/she
can obtain his/her substance, such as stealing or trading sex for money/drugs. While under
the influence of some substances the addict may engage in risky activities, such as driving
fast.

7. Dealing with problems; an addicted person commonly feels they need their drug to deal
with their problems.

8. Obsession; an addicted person may spend more and more time and energy focusing on
ways of getting hold of their substance, and in some cases how to use it.

9. Secrecy and solitude; in many cases the addict may take their substance alone, and even in
secret.

10. Denial; a significant number of people who are addicted to a substance are in denial. They
are not aware (or refuse to acknowledge) that they have a problem.

11. Excess consumption; in some addictions, such as alcohol, some drugs and even nicotine, the
individual consumes it to excess. The consequence can be blackouts (cannot remember
chunks of time) or physical symptoms, such as a sore throat and bad persistent cough
(heavy smokers).

12. Dropping hobbies and activities; as the addiction progresses the individual may stop doing
things, he/she used to enjoy a lot. This may even be the case with smokers who find they
cannot physically cope with taking part in their favourite sport.

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 13. Having stashes; the addicted individual may have small stocks of their substance hidden
away in different parts of the house or car, often in unlikely places.

14. Taking an initial large dose; this is common with alcoholism. The individual may gulp drinks
down in order to get drunk and then feel good.

15. Having problems with the law; this is more a characteristic of some drug and alcohol
addictions (not nicotine, for example). This may be either because the substance impairs
judgment and the individual takes risks they would not take if they were sober, or in order
to get hold of the substance they break the law.

16. Financial difficulties; if the substance is expensive the addicted individual may sacrifice a lot
to make sure its supply is secured.

17. Relationship problems; these are more common in drug/alcohol addiction.

1.6 What is a Risk Factor?

➢ Risk Factor: Something which increases the likelihood of developing a condition or
disease.

1) Genetics: Anybody who has a close relative with an addiction problem has a higher risk of
eventually having one themselves. It may be argued that environmental and circumstantial
factors that close family members share are the prominent causes.

2) Having a mental illness/condition: People with depression, ADHD (attention deficit

hyperactivity disorder) and several other mental conditions/illnesses have a higher risk of
eventually becoming addicted to drugs, alcohol or nicotine.

3) Peer pressure: Trying to conform with other members of a group and gain acceptance can
encourage people to take up the use of potentially addictive substances, and eventually
become addicted to them. Peer pressure is an especially strong factor for young people.

4) Family behavior: Young people who do not have a strong attachment to their parents and
siblings have a higher risk of becoming addicted to something one day, compared to people
with deep family attachments.

5) Loneliness: Being alone and feeling lonely can lead to the consumption of substances as a
way of copying; resulting in a higher risk of addiction.

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 6) The nature of the substance: Some substances, such as crack, heroin or cocaine can bring
about addiction more rapidly than others. For example, if a group of people were to take
crack every day for six months, and another identical group of people were to drink alcohol
every day for the same period, the number of crack addicts at the end of the six months
would be a lot higher than the number of alcoholics. For some people trying a substance
even once can be enough to spark an addiction. Crack, also known as crack cocaine or rock,
is a freebase form of cocaine that can be smoked.

7) Age when substance was first consumed: Studies of alcoholism have shown that people
who start consuming a drug earlier in life have a higher risk of eventually becoming
addicted, than those who started later. Many experts say this also applies to nicotine and
drugs.

8) Stress: If a person’s stress levels are high there is a greater chance a substance, such as
alcohol may be used in an attempt to blank out the upheaval. Some stress hormones are
linked to alcoholism.

9) Metabolization (How the body metabolizes -processes- the substance): In cases of alcohol,
for example, individuals who need a higher dose to achieve an effect have a higher risk of
eventually becoming addicted.

1.7 Consequences for the Brain

- It causes physical changes in some nerve cells in the brains (neurons).
- Neurotransmitters don’t work well.

➢ Neurotransmiters: A neurotransmitter is a chemical that a nerve cell releases, which

thereby transmits an (electric) impulse from one nerve cell to another nerve cell, organ,
muscle, or other tissue.
Brain chemicals that communicate information throughout our brain and body. They relay
signals between nerve cells, called “neurons.” The brain uses neurotransmitters to tell your
heart to beat, your lungs to breathe, and your stomach to digest. They can also affect mood,
sleep, concentration, weight, and can cause adverse symptoms when they are out of
balance.
Put simply, a neurotransmitter is a messenger of neurologic data from one cell to another
cell.

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- Tolerance increases: After a while, the user of the potentially addictive substance does not get
the same pleasure and has to increase the dose - his/her body’s tolerance to it increases.
Eventually, the user no longer experiences pleasure from the substance and takes it simply to
prevent withdrawal symptoms - taking the substance just makes them feel normal. Experts say that
when tolerance increases, the risk of addiction is much greater.

- Other common complications might be: Mental/emotional/physical problems, Accidental

injuries/death, Suicide, Relationship problems, Child neglect/abuse, Unemployment, poverty and
homelessness, Problems with the law…

1.8 Diagnosing an Addiction

- In many cases, it is a family member or very good friend who raises concern about the patient’s
behavior.
- The first port of call is usually a GP (general practitioner, primary care physician, family doctor). A
general practitioner (GP) is frequently the first person turned to help with mental health. They can
prescribe you medicine, have a brief conversation or refer you to the proper specialist. A GP
psychotherapist is a general practitioner (GP) or primary care physician (PCP) with psychotherapy-
focused practice
- The doctor will ask several questions, including how often the substance is consumed, whether
the substance use has been criticized by other people, and whether the patient feels he/she may
have a problem. If the doctor suspects there is an addiction problem, the patient will be referred to
a specialist.

I. BLOOD TEST: This may be ordered to determine whether the substance is still in the
blood (whether the substance has been taken recently). It is not used to diagnose addiction.

II. DSM CRITERIA FOR SUBSTANCE DEPENDENCE: A patient diagnosed with substance
dependence (an addiction) must meet criteria laid out in the DSM (Diagnostic and Statistical
Manual of Mental Disorders), a manual published by the American Psychiatric Association.
The criteria for drug dependence that causes significant problems must include three of the
following:

a. Tolerance: The substance has less effect on the patient because their body has
developed tolerance. They need more and more of it to get the same pleasure.

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 b. There are physical/psychological withdrawal symptoms, or the patient takes the
substance to avoid experiencing withdrawal, or the patient takes a similar substance
to avoid experiencing withdrawal.

c. The patient frequently takes higher-than-intended doses of the substance.

d. The patient often tries to quit or cut down.

e. More and more time is spent getting hold of the substance, using it, or recovering
from its effects.

f. The patient’s drug use causes him/her to give up social, occupational or recreational
activities.

g. Even though patients know it causes psychological/physical problems, they continue

taking it.

1.9 Steps for the Addicted Person

1º Acknowledge that there is a substance dependency problem (addiction problem).

2º Get help. In most of the world there are several support groups and professional services
available. Treatment options for addiction depend on several factors, including what type
of substance it is and how it affects the patients. Typically, treatment includes a
combination of inpatient and outpatient programs, counselling (psychotherapy), self -help
groups, pairing with individual sponsors, and medication.

ADDICTION TREATMENT PROGRAMS

− Addiction treatment programs typically focus on getting sober and preventing relapses.
Individual, group and/or family sessions may form part of the program. Depending on the
level of addiction, patient behaviors, and type of substance this may be in outpatient or
residential settings.

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 I. PSYCHOTHERAPY: There may be one -to -one (one -on -one) or family sessions
with a specialist. Help with coping with cravings, avoiding the substance, and dealing
with possible relapses are key to effective addiction programs. If the patient’s family
can become involved there is a better probability of positive outcomes.

II. SELF -HELP GROUPS: Self -help groups may help the patient meet other people
with the same problem, which often boosts motivation. Self -help groups can be a
useful source of education and information too.

III. HELP WITH WITHDRAWAL SYMPTOMS: The main aim is usually to get the
addictive substance out of the patient’s body as quickly as possible. Sometimes the
addict is given gradually reduced dosages (tapering).
In some cases, a substitute substance is given. Depending on what the person is
addicted to, as well as some other factors, the doctor may recommend treatment
either as an outpatient or inpatient. The doctor or addiction expert may recommend
either an outpatient or inpatient residential treatment centre.
Withdrawal treatment options vary and depend mainly on what substance the
individual is addicted to:

➢ Addiction to depressants. During withdrawal the patient may experience

anxiety, insomnia, sweating and restlessness. In rare cases there may be whole -
body tremors, seizures, hallucinations, hypertension (high blood pressure),
accelerated heart rate and fever. In severe cases there may be delirium.

➢ Addiction to stimulants. During withdrawal the patient may experience

tiredness, depression, anxiety, moodiness, low enthusiasm, sleep disturbances,
and low concentration. Treatment focuses on providing support, unless the
depression is severe, in which case a medication may be prescribed.

➢ Addiction to opioids. During withdrawal there may be sweating, anxiety and

stuffy nose symptoms tend to be mild. In rare cases there may be serious sleeping
problems, tachycardia, hypertension and diarrhoea. The doctor may prescribe
methadone, or buprenorphine for cravings (alternative substances).

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1.10 An Addiction may affect person’s life in the following years
➢ Health: Addiction to a substance, be it a drug, narcotic or nicotine usually has health
consequences. In the case of drug/alcohol addiction there may be mental/emotional as well
as physical health problems. In the case of nicotine addiction, the problems tend to be just
with physical health. Coma, unconsciousness, or death -some drugs, taken in high doses or
together with other substances may be extremely dangerous.

➢ Some diseases: People who inject drugs have a risk of developing HIV/AIDS or hepatitis if
they share needles. Some substances, including specific drugs or alcohol can lead towards
riskier sexual behaviour.

o SURPRISING ADDICTIONS: Smartphones/ social media, Caffeine, Chocolate and Other

Sweets, Shopping, Gambling, Plastic Surgery, Tanning, Exercise…

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 UNIT 3. OBSESSIVE COMPULSIVE DISORDER (OCD)

1. WHAT IS OCD?
- Obsessive Compulsive Disorder (OCD) is a disorder of the brain and behavior. OCD causes severe
anxiety in those affected. OCD involves both obsessions and compulsions that take a lot of time
and get in the way of important activities the person values.

1.1 How is OCD diagnosed?

- Only trained therapists can diagnose OCD. Therapists will look for three things:
a) The person has obsessions.
b) He or she does compulsive behaviors.
c) The obsessions and compulsions take a lot of time and get in the way of important activities
the person values, such as working, going to school, or spending time with friends.

1.1.1 What is an Obsession?

- Thoughts, images, or impulses that occur over and over again and feel out of the person's control.
- The person does not want to have these ideas.

- He or she finds them disturbing and unwanted, and usually know that they don't make sense.
- They come with uncomfortable feelings, such as fear, disgust, doubt, or a feeling that things have
to be done in a way that is "just right."
- They take a lot of time and get in the way of important activities the person values.

1.1.2 What is a Compulsion?

- Repetitive behaviors or thoughts that a person engages in to neutralize, counteract, or make
their obsessions go away.

- People with OCD realize this is only a temporary solution, but without a better way to cope, they
rely on the compulsion as a temporary escape.
- Compulsions can also include avoiding situations that trigger obsessions.
- Compulsions are time consuming and get in the way of important activities the person values.

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1.2 Who gets OCD?
- OCD can start at any time from preschool to adulthood. Although OCD can occur at any age, there
are generally two age ranges when OCD tends to first appears:

➢ Between the ages 8 and 12.

➢ Between the late teen years and early adulthood.

o Adults: Our best estimates are that about 1 in 100.

o Children: There are also at least 1 in 200.
- That means four or five kids with OCD are likely to be enrolled in any average size elementary
school. In a medium to large high school, there could be 20 students struggling with the challenges
caused by OCD.

1.3 What Causes OCD?

- Unfortunately, we still do not know the exact cause or causes of OCD. However, research suggests
that differences in the brain and genes of those affected may play a role.

- Research suggests that OCD involves problems in communication between the front part of the
brain and deeper structures. These brain structures use a chemical messenger called serotonin.

1.3.1 Is OCD a Brain Disorder?

- Research suggests that OCD involves problems in communication between the front part of the
brain and deeper structures of the brain. These brain structures use a neurotransmitter (basically, a
chemical messenger) called serotonin. Pictures of the brain at work also show that, in some people,
the brain circuits involved in OCD become more normal with either medications that affect
serotonin levels (serotonin reuptake inhibitors, or SRIs) or cognitive behavior therapy (CBT).

1.3.2 Is OCD Inherited?

- Research shows that OCD does run in families, and that genes likely play a role in the development
of the disorder. Genes appear to be only partly responsible for causing the disorder, though. No
one really knows what other factors might be involved, perhaps an illness or even ordinary life
stresses that may induce the activity of genes associated with the symptoms of OCD.

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- Some experts think that OCD that begins in childhood may be different from the OCD that begins
in adults. For example, a recent review of twin studies has shown that genes play a larger role when
OCD starts in childhood (45-65%) compared to when it starts in adulthood (27-47%).

1.4 What are the Most Effective Treatments for OCD?

- The most effective treatments for OCD are Cognitive Behavior Therapy (CBT) and/or medication.
More specifically, the most effective treatments are a type of CBT called Exposure and Response
Prevention (ERP), which has the strongest evidence supporting its use in the treatment of OCD,
and/or a class of medications called serotonin reuptake inhibitors, or SRIs.
- Exposure and Response Prevention is typically done by a licensed mental health professional (such
as a psychologist, social worker, or mental health counsellor) in an outpatient setting. This means
you visit your therapist’s office at a set appointment time once or a few times a week, and it
consists in:

➢ The “Exposure” in ERP refers to confronting the thoughts, images, objects and situations
that make a person with OCD anxious.

➢ The “Response Prevention” in ERP refers to making a choice not to do a compulsive

behavior after coming into contact with the things that make a person with OCD anxious.

➢ This strategy may not sound right to most people. Those with OCD have probably
confronted their obsessions many times and tried to stop themselves from doing their
compulsive behavior, only to see their anxiety skyrocket. With ERP, a person has to make
the commitment to not give in and do the compulsive behavior until they notice a drop in
their anxiety. In fact, it is best if the person stays committed to not doing the compulsive
behavior at all. The natural drop in anxiety that happens when you stay "exposed" and
"prevent" the "response" is called habituation.

- Medications can only be prescribed by a licensed medical professional (such as your physician or a
psychiatrist), who would ideally work together with your therapist to develop a treatment plan.

- Taken together, ERP and medication are considered the “first-line” treatments for OCD.

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1.3 Common Obsessions

CONTAMINATION FEAR

− The fear of: Becoming personally contaminated through one’s own actions, being
contaminated by others or contaminating others, or different combinations of any of
these.

− The fear of coming into contact with either real or magical things viewed as harmful.

− Some typical symptoms of contamination fears are:

i. Getting an illness, either serious or fatal, or spreading an illness to others through
contact with viruses, bacteria, animals, or people who appear to be ill or simply
unclean.
ii. Becoming ill through contact with such things as blood, urine, feces, semen, sweat,
saliva, etc.
iii. Being poisoned by dangerous or common household chemicals, or poisoning others
accidentally.
iv. Becoming ill in a magical way through contact with the names of illnesses, disabled
people, or pictures or names of people known to have had serious or fatal illnesses.

v. Having bad luck attaching itself to oneself in a magical way through contact with bad
numbers, or objects associated with bad events (clothing worn to a funeral, for
example.)

− These obsessive fears are usually dealt with through compulsions:

a) Repetitive hand washing, showering, or disinfecting of one’s body or possessions.

b) Throwing away or avoiding things thought to be contaminated and that can’t be
cleaned.
c) Repeated questioning of others as to whether they, or certain things may be
contaminated.
d) Avoiding certain people, objects, or places seen as being contaminated.

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 e) Constant researching to find out whether certain things may be contaminated or
dangerous.
f) Magical rituals (prayers, undoing rituals, etc.) to neutralize magical contamination.
g) Maintaining clean areas within homes or workplaces that others cannot enter or
touch.
h) Repeatedly asking others for reassurance that they, or certain things are safe or not.

− The effects that these fears have on sufferer’s lives are:

➢ Their social contact with other people may become limited, and close relationships
may suffer.

➢ Their ability to function at work may suffer.

➢ Their freedom to go out and function normally in public places may be seriously
hampered.
➢ They may protect their living spaces to the point where others may not be allowed
to visit them.
➢ They may suffer physical effects, such as cracking skin or other types of skin
damage.

LOSING CONTROL

− Fear of acting on an impulse to harm oneself.

− Fear of acting on an impulse to harm others.

− Fear of violent or horrific images in one’s mind.

− Fear of blurting out obscenities or insults.

− Fear of stealing things.

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 HARM

− Fear of being responsible for something terrible happening (examples: fire, burglary).

− Fear of harming others because of not being careful enough (example: dropping something
on the ground that might cause someone to slip and hurt him/herself).

PERFECTIONISM

− If you ask perfectionists about the intentions of their perfectionism (“What do you want to
happen?”), what you commonly hear is a need to be seen as competent, wanting to feel
satisfied with something they’ve accomplished, or wanting to stand out.

− It is important to highlight that you agree with them that the problem is not with their
intentions, it is with their strategies:
a) Rigidly Following the Rule: “It has to be done this way” or “Do things right or don’t
do them at all”.
b) Everything is Equally Important: They have a difficult time prioritizing tasks.

c) Mistakes are Catastrophic: Phobia of mistake making.

d) Repetition Until it Feels/Looks/Sounds “Right”.
e) Missing Deadlines and Procrastination: “Do it right or don’t do it at all”.

UNWANTED SEXUAL THOUGHTS

− Forbidden or perverse sexual impulses about others.

− Obsessions about sexual identity.

− Sexual obsessions that involve children or incest.

− Obsessions about aggressive sexual behavior towards others.

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− Some typical cognitive errors made by sufferers include:
1) I must always have certainty and control in life (intolerance of uncertainty).

2) I must be in control of all my thoughts and emotions at all times.

3) If I lose control of my thoughts, I must do something to regain that control.
4) Thinking the thought means it is important and it is important because I think about
it.
5) It is abnormal to have intrusive thoughts, and if I do have them, it means I’m crazy,
weird, etc.
6) Having an intrusive thought and doing what it suggests are the same, morally.
7) Thinking about doing harm, and not preventing it is just as bad as committing harm
(also known as Thought-Action Fusion).
8) Having intrusive thoughts means I am likely to act on them.
9) I cannot take the risk that my thoughts will come true.

RELIGIOUS OBSESSIONS (SCRUPULOSITY)

− Concern with offending God, or concern about blasphemy.

− Excessive concern with right/wrong or morality.

− How can scrupulosity be distinguished from normal religious practice?

➢ Unlike normal religious practice, scrupulous behavior usually exceeds or disregards

religious law and may focus excessively on one trivial area of religious practice while
other, more important areas may be completely ignored. The behavior of scrupulous
individuals is typically inconsistent with that of the rest of the faith community.

OTHER OBSESSIONS

− Concern with getting a physical illness or disease (not by contamination e.g., cancer).

− Superstitious ideas about lucky/unlucky numbers, certain colours.

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1.4 Common Compulsions

WASHING AND CLEANING

− Excessive showering, bathing, tooth brushing, grooming or toilet routines.

− Cleaning household items or other objects excessively.

− Doing other things to prevent or remove contact with contaminants.

CHECKING

− Checking that you did not/will not harm others.

− Checking that you did not/will not harm yourself.

− Checking that nothing terrible happened.

− Checking that you did not make a mistake.

− Checking some parts of your physical condition or body.

REPEATING

− Rereading or rewriting.

− Repeating routine activities (examples: going in or out doors, getting up or down from
chairs).

− Repeating body movements (example: tapping, touching, blinking).

− Repeating activities in "multiples" (examples: doing a task three times because three is a
"good", "right", "safe" number).

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 MENTAL COMPULSIONS

− Mental review of events to prevent harm (to oneself, others, to prevent terrible
consequences).

− Praying to prevent harm (to oneself, others, to prevent terrible consequences).

− Counting while performing a task to end on a "good", "right", or "safe" number.

− "Cancelling" or "Undoing" (example: replacing a "bad" word with a "good" word to cancel it
out).

OTHER COMPULSIONS

− Collecting items which results insignificant clutter in the home (also called hoarding).

− Putting things in order or arranging things until it "feels right".

− Telling, asking, or confessing to get reassurance.

− Avoiding situations that might trigger your obsessions.

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33
 UNIT 4. EATING DISORDERS

1. WHAT ARE EATING DISORDERS?

- Eating disorders are abnormal eating habits that can threaten your health or even your life. They
include:

I. ANOREXIA NERVOSA: Individuals believe they’re fat even when they’re dangerously thin
and restrict their eating to the point of starvation.

II. BULIMIA NERVOSA: Individuals eat excessive amounts of food, then purge by making
themselves vomit or using laxatives.

III. BINGE EATING: Individuals have out-of-control eating patterns, but don’t purge.

- In a society that continues to prize thinness even as Americans become heavier than ever before,
almost everyone worries about their weight at least occasionally. People with eating disorders take
such concerns to extremes, developing abnormal eating habits that threaten their well-being and
even their lives. This question-and-answer fact sheet explains how psychotherapy can help people
recover from these dangerous disorders.

1.1 Major kind of eating disorders

- There are three major types of eating disorders:

➢ People with anorexia nervosa have a distorted body image that causes them to see
themselves as overweight even when they're dangerously thin. Often refusing to eat,
exercising compulsively, and developing unusual habits such as refusing to eat in front of
others, they lose large amounts of weight and may even starve to death.

➢ Individuals with bulimia nervosa eat excessive quantities, then purge their bodies of the
food and calories they fear by using laxatives, enemas, or diuretics; vomiting; or exercising.
Often acting in secrecy, they feel disgusted and ashamed as they binge, yet relieved of
tension and negative emotions once their stomachs are empty again.

➢ Like people with bulimia, those with binge eating disorder experience frequent episodes of
out-of-control eating. The difference is that binge eaters don't purge their bodies of excess
calories.

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- Another category of eating disorders is "eating disorders not otherwise specified," in which
individuals have eating-related problems but don't meet the official criteria for anorexia, bulimia or
binge eating.

- It's important to prevent problematic behaviors from evolving into full-fledged eating disorders.
Anorexia and bulimia, for example, usually are preceded by very strict dieting and weight loss.
Binge eating disorder can begin with occasional bingeing. Whenever eating behaviors start having a
destructive impact on someone's functioning or self-image, it's time to see a highly trained mental
health professional, such as a licensed psychologist experienced in treating people with eating
disorders.

1.2 Who suffers from eating disorders?

- According to the National Institute of Mental Health, eating disorders primarily affect girls and
women. But eating disorders aren't just a problem for the teenage women so often depicted in the
media.
- Men and boys can also be vulnerable. About a quarter of preadolescent cases of anorexia occur in
boys, for example. And binge eating disorder strikes males and females about equally. People
sometimes have eating disorders without their families or friends ever suspecting that they have a
problem.
- Aware that their behavior is abnormal, people with eating disorders may withdraw from social
contact, hide their behavior, and deny that their eating patterns are problematic. Making an
accurate diagnosis requires the involvement of a licensed psychologist or other appropriate mental
health expert.

1.3 What causes eating disorders?

- Certain psychological factors and personality traits may predispose people to developing eating
disorders. Many people with eating disorders suffer from low self-esteem, feelings of helplessness,
and intense dissatisfaction with the way they look.

- Specific traits are linked to each of the disorders. People with anorexia tend to be perfectionistic,
for instance, while people with bulimia are often impulsive. Physical factors such as genetics also
may play a role in putting people at risk.

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- A wide range of situations can precipitate eating disorders in susceptible individuals. Family
members or friends may repeatedly tease people about their bodies. Individuals may be
participating in gymnastics or other sports that emphasize low weight or a certain body image.

- Negative emotions or traumas such as rape, abuse, or the death of a loved one can also trigger
disorders. Even a happy event, such as giving birth, can lead to disorders because of the stressful
impact of the event on an individual's new role and body image.
- Once people start engaging in abnormal eating behaviors, the problem can perpetuate itself.
Bingeing can set a vicious cycle in motion, for instance, as individuals purge to rid themselves of
excess calories and psychic pain, then binge again to escape problems in their day-to-day lives.

1.4 Why is it important to seek treatment for these disorders?

- Research indicates that eating disorders very often go untreated. In one study, for example, less
than 13 percent of adolescents with eating disorders received treatment.

- But leaving eating disorders untreated can have serious consequences. Research has found that
individuals with anorexia have a mortality rate 18 times higher than peers who don't have eating
disorders, for example.

- Eating disorders can devastate the body. Physical problems associated with anorexia, for instance,
include anemia, constipation, osteoporosis, even damage to the heart and brain. Bulimia can result
in a sore throat, worn-away tooth enamel, acid reflux, and heart attacks... People with binge eating
disorder may develop high blood pressure, cardiovascular disease, diabetes, and other problems
associated with obesity.

- Eating disorders are also associated with other mental disorders like depression. Researchers
don't yet know whether eating disorders are symptoms of such problems or whether the problems
develop because of the isolation, stigma, and physiological changes wrought by the eating disorders
themselves. What is clear from the research is that people with eating disorders suffer higher rates
of other mental disorders - including depression, anxiety disorders, and substance abuse - than
other people.
- Psychologists are finding effective ways to treat these dangerous disorders. Family therapy,
cognitive-behavioral therapy and interpersonal psychotherapy can help individuals overcome two
common eating disorders.

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 ANOREXIA TREATMENT

− Families can play a key role in treating anorexia, according to clinicians using a treatment known
as the Maudsley approach.

− The treatment is a form of family therapy that enlists parents’ aid in getting their daughters to
eat again.

− Early in the treatment, clinicians invite the family to share a picnic meal. That gives them a sense
of family meal patterns. It also allows them to suggest ways parents can get the child to eat
more.

− In weekly sessions, the parents then describe what they’ve fed their daughter and what’s
working well.

− The approach also helps to strengthen the daughters’ feelings of independence by gradually
letting them take control of their eating. Clinicians also help the family learn how to help the
child cope with the challenges of adolescence.

− In contrast to current treatment, this approach is relative short-term. It relies mostly on

outpatient treatment. And it’s successful over the long-term, say researchers.

− One study found that two-thirds of patients regained normal weight without hospitalization.
Most showed big improvements in psychological functioning. And parents became less critical of
each other and their daughters.

BULIMIA TREATMENT

− The largest controlled study on bulimia so far shows that two types of psychotherapy can help
individuals stop bingeing and purging:

a. Cognitive-behavioral therapy helps individuals change the unrealistically negative

thoughts they have about their appearance and change their eating behaviors.

b. Interpersonal psychotherapy helps individuals improve the quality of their

relationships, learn how to address conflicts head-on and expand their social networks.

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 BINGE EATING TREATMENT

− Experts agree that binge eating treatment must tackle obesity and psychological problems.
However, they’re still debating which aspect to treat first.

− People with binge eating disorder have distorted attitudes about eating, weight and shape. They
also have mood-related symptoms, such as depression and personality disorders.

− Not surprisingly, experts on eating disorders say the best treatment focuses on the eating
disorder. Their goal is to help patients reduce or eliminate bingeing, improve their self-esteem and
acceptance of their bodies and treat underlying problems such as depression and anxiety.

− Advocates of this approach say addressing the psychological problems that cause the condition
will eliminate binge eating and help patients feel better about themselves.

− They call for treatments like cognitive-behavioral therapy, which addresses a person’s eating-
related thoughts and behaviors, and interpersonal psychotherapy, which helps a person develop
healthier relationships.

− Weight loss, these experts say, will follow.

− In contrast, obesity experts say it’s best to tackle the weight problem first. Treatment that targets
obesity directly is typically less expensive and shorter in duration than psychological treatment,
they say.

− The best treatment approaches combine both psychological and weight-loss components, say
other researchers.

1.5 How can a psychologist help someone recover?

- Psychologists play a vital role in the successful treatment of eating disorders and are integral
members of the multidisciplinary team that may be required to provide patient care. As part of this
treatment, a physician may be called on to rule out medical illnesses and determine that the
patient is not in immediate physical danger. A nutritionist may be asked to help assess and improve
nutritional intake.

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- Once the psychologist has identified important issues that need attention and developed a
treatment plan, he or she helps the patient replace destructive thoughts and behaviors with more
positive ones. A psychologist and patient might work together to focus on health rather than
weight, for example. Or a patient might keep a food diary as a way of becoming more aware of the
types of situations that trigger bingeing.
- Simply changing patients' thoughts and behaviors is not enough, however. To ensure lasting
improvement, patients and psychologists must work together to explore the psychological issues
underlying the eating disorder. Psychotherapy may need to focus on improving patients' personal
relationships. And it may involve helping patients get beyond an event or situation that triggered
the disorder in the first place. Group therapy also may be helpful.
- Some patients, especially those with bulimia, may benefit from medication. It's important to
remember, however, that medication should be used in combination with psycho-therapy, not as a
replacement for it. Patients who are advised to take medication should be aware of possible side
effects and the need for close supervision by a physician.

1.6 Does treatment really work?

- Yes. Most cases of eating disorder can be treated successfully by appropriately trained health and
mental health care professionals. But treatments do not work instantly. For many patients,
treatment may need to be long-term.

- Incorporating family or marital therapy into patient care may help prevent relapses by resolving
interpersonal issues related to the eating disorder. Therapists can guide family members in
understanding the patient's disorder and learning new techniques for coping with problems.
Support groups can also help.

- Remember: The sooner treatment starts, the better. The longer abnormal eating patterns
continue, the more deeply ingrained they become and the more difficult they are to treat.
Eating disorders can severely impair people's functioning and health. But the prospects for long-
term recovery are good for most people who seek help from appropriate professionals. Qualified
therapists, such as licensed psychologists with experience in this area, can help those who suffer
from eating disorders regain control of their eating behaviors and their lives.

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CITATIONS

Narrative
PARAPHRASING

Parathentical
IN-TEXT
CITATIONS
Short
QUOTATIONS Narrative
Long
Parathentical

Paraphrasing = Rewrite with your own words

When Paraphrasing is not obligatory to put the page

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authors.

Parathentical It is been proved that is very important ____. (author, year, p.35)

Short 1-39 words; YES quotation marks.

Long > 40 words; NO quotation marks.

Narrative According to Perez (year): _______________. (p.35)

Parathentical Some researchers have identified: _____________. (author, year, pages)

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