Neuron: individual
cells in the nervous system that receive,
integrate, and transmit
information (neural impulses).
BASIC STRUCTURES OF A NEURON:
A. Cell Body (soma): contains
the cell nucleus & much of the
chemical machinery common
to most cells
B. Dendrites: are branch like
parts of a neuron that are
specialized to receive
information
C. Axon: is a long, thin fiber
that transmits signals away from
the soma to other neurons
(or muscles & glands)
D. Myelin Sheath: is an insulating
material (fatty protection)
E. Axon Terminals: end point
of an axon where one neuron
communicates with the
another neuron.
II. FUNCTION OF NEURONS:
A. Neural Impulse: a sudden
change in the electrical charges
within and outside the
membrane of a neuron.
B. Ions: electrically charged
atoms & molecules
C. Resting Potential: When the
cell is INACTIVE
D. Action Potential: a brief
change in a neuron's electrical
charge (+40 mV)
+40
-60
-70 -
_____________________________
Time ->
E. All-Or-None Principle: A
neuron stimulated will either
produce an action potential
or it will not.
Neural Threshold:
the minimum amount of stimulation that a
neuron requires in order
to fire.
III. FROM ONE CELL TO ANOTHER: THE SYNAPSE
A. Synapse: The junction
between the axon terminal and the
dendrite
of the next neuron.
B. Vesicles: sacs in
the axon terminal that hold
neurotransmitters.
C. Synaptic Cleft: a
microscopic gap between the terminal
button of
the sending neuron and the cell membrane of
another neuron
D. Receptor Sites: where
NT is received
E. Neurotransmitters:
are chemicals that transmit information
from one
neuron to another
1) Acetylcholine
(ACh): found throughout the brain &
spinal cord
- Most common EXCITATORY Transmitter
2) Norepinephrine
(NE): Involved in MOOD Regulation
- Implicated in bipolar mood disorders
3) Dopamine:
control of voluntary movements
4) Endorphins
(endogenous morphines):
- Family of internally produced chemicals that resemble
opiates in structure and effect
* % * THE HUMAN NERVOUS SYSTEMS * % *
I. NERVOUS SYSTEM = CNS + PNS
A. Central Nervous System
(CNS): consists of the brain and
the spinal
cord
B. Peripheral Nervous System
(PNS): relay system connecting
all parts
of the body with the CNS
PNS
________________|_______________
|
|
Somatic Nervous
System Autonomic Nervous
System
_________|______
|
|
Sympathetic Parasympathetic
1. Somatic Nervous
System: "outer" functions
- Critical for generation of motor movement
2. Autonomic
Nervous System (ANS): "inner" function
*-> TWO COMPLEMENTARY
PARTS: Together, they regulate
responses such
as heart rate, blood pressure, digestion,
and adrenal gland
activity.
a. Sympathetic
Division: Fight or Flight response
prepares
body for stressful and/or vigorous action
b. Parasympathetic
Division: Sustains non-stress
functioning,
lower heart rate & blood flow to skeletal
muscles,
enhances digestion
C. Endocrine System:
consists of glands that secrete
chemicals
into the blood stream that help control bodily
functioning
* Partner
to the nervous system
Hormones: Released
into blood system
II. THE CENTRAL NERVOUS SYSTEM
CNS
Brain
Spinal Cord
Forebrain
Midbrain
Hindbrain
Limbic Hypothalamus
Reticular Cerebellum Medulla
Thalamus
Formation
Pons
A. Spinal Cord:
Spinal Cord: connects the brain
to the rest of the body
through the PNS.
B. LOWER BRAIN CENTERS
1) HINDBRAIN: consists
of Medulla, Pons, & Cerebellum
(* Gerow classifies Medulla
& Pons as brain stem Structures)
(Brain Stem: lowest part of
the brain, comprised of medulla
and the pons.)
a) Medulla:
in charge of unconscious but essential
functions (breathing, maintaining muscle tone ...)
Cross
Laterality: nerve fibers crossing from one side of
the body to the opposite side of the brain.
b) Pons (literally
"bridge"): bridge of fibers that
connects the brain stem with the cerebellum (concerned
with sleep and arousal)
c) Cerebellum
(literally "little brain"): Involved in the
coordination of movement and is also critical to our
sense of balance
2) MIDBRAIN
Reticular
Activating System (RAS): complex network of
nerve fibers
involved in maintaining levels of arousal.
3) FOREBRAIN
a) Limbic
System: involved in control of emotion,
motivation, and memory
- Collection of structures
b) Thalamus:
all sensory information (except smell) must
pass through to get to the cerebral cortex
c) Hypothalamus:
Involved in the regulation of basic
biological needs.
- Lies beneath the thalamus, Hypo means under
- Controls the AUTONOMIC NERVOUS SYSTEM
- Serves as a vital link between brain & the endocrine
system
Basal Ganglia: control motor responding - controls slow
movements
C. CEREBRAL CORTEX
1) Cerebral Cortex:
convoluted outer covering of the brain
2) Cerebral Hemispheres:
right and left halves of the
cerebrum
D. LOBES
1) Frontal Lobes:
- Largest
lobe
- Control
the movements of muscle groups (primary motor
cortex)
2) Temporal Lobes (means
"near the temples"):
- Has an
area devoted to auditory processing
3) Occipital Lobes: where
most visual signals are sent
4) Parietal Lobes: where
we register the sense of touch
E. TWO CEREBRAL HEMISPHERES:
1) Corpus Callosum:
structure of nerves that connect the two
cerebral
hemispheres
2) Split-Brain Procedure:
the corpus callosum is cut
- Hemispheres
operate independent of one another
CHAPTER 12: DEFINING
AND CLASSIFYING
PSYCHOLOGICAL DISORDERS
A. Maladaptive Behavior: interfere with a person's
normal
social or occupational functioning
B. Deviance: abnormal ABCs
C. Personal Distress: person reports great
personal
distress
II. NORMALITY & ABNORMALITY
III. MEDICAL MODEL
A. MEDICAL CONCEPTS:
1) Diagnosis: Involves
distinguishing one illness from
another based on a constellation
of symptoms.
2) Etiology: Refers to the
apparent causation and
developmental history of an illness.
3) Prognosis: predicted
course of the illness
B. DSM-IV: Diagnostic & Statistical
Manual of Mental
Disorders (version 4).
C. CRITICISM OF THE MEDICAL MODEL:
1) Labeling:
2) Pseudoexplanation:
3) Patient Role:
D. Diagnosis involves a value judgment
E. Insanity: not a psychological term but a
legal term
IV. COMMON STEREOTYPES ASSOCIATED WITH VARIOUS
PSYCHOLOGICAL
DISORDERS:
1) Psychological disorders are a SIGN OF PERSONAL WEAKNESS
2) Psychological disorders are incurable
3) People with psychological disorders
are often violent
and dangerous
4) People with psychological disorders
behave in bizarre
ways and are
very different from normal people
* * * A SAMPLING OF PSYCHOLOGICAL DISORDERS * * *
Neurotic: refer to behavior marked by subjective
distress (usually chronic anxiety) and reliance on avoidance coping
Psychotic: refers to behavior marked by impaired
reality contact and profound deterioration of adaptive functioning.
A. ANXIETY DISORDERS: are a class of disorders
marked by
feelings of excessive apprehension and
anxiety
1) Generalized Anxiety Disorder: is
marked by a chronic, high
level of anxiety that is
not tied to any specific threat,
often called "free-floating
anxiety"
2) Panic Disorder: involves recurrent
attacks of
overwhelming anxiety that
usually occur suddenly and
unexpectedly.
3) Phobic Disorder: is marked by a persistent
and irrational
fear of an object or situation
that presents no realistic
danger
Agoraphobia: is a fear of
going out to public places.
4) Obsessive-Compulsive Disorder (OCD):
is marked by
persistent, uncontrollable
intrusions of unwanted thoughts
(obsession) and urges to
engage in senseless rituals
(compulsion).
Obsessions (cognitions):
intrude on one's consciousness
in a distressing way.
Compulsions (behaviors):
usually involves stereotyped
rituals that temporarily
relieve anxiety
5) Posttraumatic Stress Disorder (PTSD):
a condition
characterized by periodic
outbursts of anxiety, panic, or
depression provoked by reminders
of a traumatic
experiences.
B. SOMATOFORM DISORDER: a class of disorders
involving physical
ailments with no authentic organic basis
that are due to
psychological factors
1) Hypochondriasis: involves excessive
preoccupation with
health concerns and incessant
worry about developing
physical illnesses.
2) Conversion Disorder: involves a significant
loss of
physical function (with
no apparent organic basis).
C. DISSOCIATIVE DISORDERS: a class of disorders
in which people
lose contact with portions of their
consciousness or memory,
resulting in disruption in their sense
of identity
1) Dissociative Amnesia: is a sudden
loss of memory for
important personal information
that is too extensive to be
due to normal forgetting
2) Dissociative Fugue: condition of
amnesia that involves
an unexplained change of
location.
3) Dissociative Identity Disorder (Multiple
Personality):
A condition in which a person
alternates among two or more
distinct personalities.
D. PERSONALITY DISORDERS: a maladaptive, inflexible
way of
dealing with the environment and other
people.
Cluster 1: Disorders of "Odd" or Eccentric"
Paranoid Personality Disorder
Schizoid Personality Disorder
Cluster 2: Disorders of Dramatic, Emotional,
or Erratic
Reactions
Histrionic Personality Disorder:
Narcissistic Personality Disorder:
Antisocial Personality Disorder
Cluster 3: Disorders Involving Anxiety
and Fearfulness.
Maladaptive efforts to control
anxiety in addition to
fearfulness about social rejection
Avoidant Personality Disorder
Dependent Personality Disorder
Passive-Aggressive Personality Disorder
E. ALZHEIMER’S DEMENTIA (ORGANIC MENTAL DISORDERS):
1) DEMENTIA: a deterioration in mental
abilities that
adversely affects the person’s
memory and judgment.
2) Alzheimer's Disease: cognitive deterioration:
can develop
illusions, hallucinations,
and delusions
- Cholinergic neurons possibly
degenerate
Acetylcholine
(ACh) plays role in encoding memories.
F. MOOD DISORDERS: are a class of disorders
marked by EMOTIONAL
DISTURBANCES that may spill over to
disrupt physical,
perceptual, social, and thought processes.
1) Major Depression: a condition in
which a person takes
little pleasure in life
and experiences feelings of
worthlessness, powerlessness,
and guilt.
2) Dysthymia: essentially a mild case
of depression
3) Bipolar Disorder (manic-depressive):
alternate between
depression and mania
Mania: a condition
marked by constant, driven activity and
a lack of inhibitions.
Seasonal Affective Disorder:
a condition in which the
person becomes depressed
every winter
Causes of Depression:
Theories suggest that LOW LEVELS of serotonin,
dopamine, and
norepinephrine cause depression
Biological Factors:
BIPOLAR:
UNIPOLAR (Depression Only):
Psychological Factors:
G. SCHIZOPHRENIA: Are a CLASS (GROUP) of disorders
marked by
disturbances in thought that spill over
to affect perceptual,
social, and emotional processes.
1) DELUSIONS: are false beliefs that
are maintained even
thought they are clearly
out of touch with reality
2) HALLUCINATIONS: sensory perception
that occur in the
absence of a real, external
stimulus or gross distortions
of perceptual input
Process Schizophrenia:
Symptoms developed gradually
over time.
Reactive Schizophrenia:
sudden onset of schizophrenic
symptoms
Positive Symptoms:
Major symptoms are hallucinations,
delusions, muscular rigidity,
and/or bizarre behavior
a) Positive Disorganized Symptoms of Schizophrenia:
b) Positive Psychotic
Symptoms of Schizophrenia:
Negative Symptoms:
Major symptoms are social withdrawal,
reduced energy & motivation
DSM-IV Types:
Paranoid Type:
Catatonic Type:
Disorganized Type:
Undifferentiated Type:
Residual Type:
OBSERVATIONS ON THE CAUSES OF SCHIZOPHRENIA
Hereditary Factors:
* One may inherit a PREDISPOSITION
to develop
schizophrenia
Biochemical Factors: The
Dopamine Hypothesis
- Possibly caused by excessive
amount of DA
Psychological and Social Factors:
Lobotomy: For DEPRESSION & VIOLENT
BEHAVIOR
II. Electroconvulsive Therapy (ECT): is used
to produce a
cortical seizure
III. DRUG THERAPY:
PSYCHOACTIVE DRUGS: chemicals that effect
cognitions, affect or behavior
Psychoactive drugs differ in their ability to regulate
neurotransmitters(NT):
1) change sensitivity
2) change number of receptors
3) block re-absorption of NT
4) block receptor sites
5) block conversion into inactive molecules
A) ANTIPSYCHOTIC DRUGS: Typically given
to treat schizophrenia
although can be given to
people with severe mood disorders
who become delusional
Lithium: (antipsychotic drug
used to treat bipolar mood
disorders) may stabilize
synapses
Clozaril (Clozapine) reduces
negative & positive symptoms.
Neuroleptic Drugs: drugs that relieve schizophrenia
- All block dopamine receptors in the brain.
SIDE EFFECTS: drowsiness, constipation,
cotton mouth,
tremors, impairment
of coordination, sexual impotence
SERIOUS EFFECTS: seizures, cardiovascular
damage
Tardive Dyskineisa: a NEUROLOGICAL
DISORDER marked by
chronic tremors and involuntary
spastic movements
B) ANTIDEPRESSANT DRUGS: these drugs
help to bring a person out
of depression by GRADUALLY
elevating their mood
1) Tricyclics: Good
for MAJOR DEPRESSION
2) MAO Inhibitors:
GOOD FOR DEPRESSION ACCOMPANIED BY
ANXIETY
OR PANIC SYMPTOMS
3) SSRI:
MAO EFFECTS: elevated blood pressure,
liver damage
Lithium: used to control mood swings
in patients with
bipolar mood disorders ->
prevents future episodes
SIDE EFFECTS has to be monitored kidney
damage and
cardiac complications
C) ANTIANXIETY DRUGS (or tranquilizers):
Relieve tension, apprehension,
& nervousness
Benzodiazepines (Valium,
Librium, Xanax):
PROBLEMS: Dependency
& abuse with antianxiety drugs
SIDE EFFECTS: Principle
side effect of drowsiness and
Lethargy
TWO REASONS WHY DRUG THERAPIES ARE CONTROVERSIAL
1) Drug Therapies often produce superficial
curative
effects
2) Drugs are OVER PRESCRIBED and many patients
are over
medicated
DEINSTITUTIONALIZATION: A MIXED BLESSING
Deinstitutionalization: Releasing patients from mental
institutions
* * THE PSYCHOTHERAPIES
* *
Psychiatrist:
Psychoanalyst:
Licensed Professional Counselor:
Clinical Social Workers:
I. INSIGHT THERAPIES: Involve verbal interactions
intended to
enhance clients' self-knowledge
A. PSYCHOANALYTIC TECHNIQUES a method
of psychotherapy that
attempts to bring UNCONSCIOUS
THOUGHTS and MOTIVATIONS to
the conscious level so that
they can be dealt with
rationally
1) Free Association:
a procedure in which someone reports
everything
that comes to mind, without omission or
censorship
2) Resistance: in
psychoanalysis, continued REPRESSION that
interferes
with the therapy.
3) Dream Interpretation:
MANIFEST CONTENT:
LATENT CONTENT:
4) Transference: reacting
toward a therapist as if s/he were
a parent
or some other important figure in one's life
B. HUMANISTIC TECHNIQUES: Therapist
provides
UNCONDITIONAL POSITIVE REGARD
and supports the client's
efforts to grow and change
from within.
Client-Centered Therapy
(Rogers):
C. COGNITIVE TECHNIQUES: emphasizes
recognizing and changing
negative thoughts and maladaptive
beliefs.
1) Rational-Emotive Therapy
(RET): a form of therapy that
focuses
on the thoughts and beliefs that lead to people's
emotions
and attempt to REPLACE IRRATIONAL BELIEF with
rational
ones.
2) Cognitive Restructuring
Therapy: less confrontational &
direct
than RET.
II. BEHAVIORAL TECHNIQUES: a form of therapy
in which the
therapist and client agree on
specific BEHAVIORAL GOALS and
set up LEARNING EXPERIENCES to
achieve those goals
A. Behavior Therapy: a collection of
SPECIFIC TECHNIQUES BASED
ON CLASSICAL CONDITIONING aimed
at changing specific
behaviors.
1) Systematic Desensitization:
patient relaxes first, then
thinks or is
exposed to a hierarchy of stimuli that are
anxiety producing.
2) Aversion Therapy: aversive
stimulus paired with undesired
behavior.
3) Flooding: subject confronted
with object of his/her phobic
fear while with
therapist.
4) Implosive Therapy: images
one's worst fear in therapist
office.
B. BASED ON OPERANT CONDITIONING:
1) Contingency Management:
Rewards & punishments are
controlled to
change a behavior
2) Contingency Contracting:
III. GROUP APPROACHES
Family Therapy: therapy provided to
a family, generally
focusing on COMMUNICATIONS within
the family
IV. EVALUATING PSYCHOTHERAPY
Direction: focus of one's behavior and
maintenance of that
behavior.
I. THEORIES OF MOTIVATION:
A) INSTINCTS: all behavioral patterns
that are
1) unlearned
2) uniform in express, and
3) universal in the species.
Imprinting: occurs when an
animal makes a strong social
attachment during a critical
period shortly after birth
B) THEORIES BASED ON DRIVE OR NEEDS:
[PUSH; motivation within person - motivated
to reduce tension
1) Hull's Theory:
Need: arises from deprivation
Drive: is an internal state
of tension that motivates an
organism to engage in activities
that should reduce this
tension.
a) Strength of need & strength
of drive.
b) to restricting
Primary Drives: based on
physiological needs
Secondary Drives: drives
based on learned experience
2) Maslow's Hierarchy: Placed
needs and drives in a hierarchy
* Self-Actualization
Need
* Esteem Needs
* Love & Belongingness Need
* Safety Needs
* Physiological Needs
Self Actualization: take full advantage of
own potential
C) INCENTIVES: [PULL; motivation outside
the body]
Incentive: an external goal
that has the capacity to
motivate behavior
D) THEORIES OF MOTIVATION BASED ON EQUILIBRIUM
(BALANCE):
driven to maintain a state
of balance
1) Homeostasis: a
state of physiological equilibrium or
stability.
- Each physiological process has
a SET POINT of operation
that is considered
normal (optimum)
2) Arousal Theory of Motivation:
AROUSAL:
overall level of activation
3) Cognitive Dissonance:
a state of tension when we hold
inconsistent
cognitions
-> motivated
to bring about a change in our cognitions
II. PHYSIOLOGICAL BASED DRIVES
A) Temperature Regulation:
Hypothalamus:
B) THIRST AND DRINKING BEHAVIOR:
Internal, Physiological
Cues
External, Psychological Cues
C) HUNGER AND EATING BEHAVIOR: INTERNAL,
PHYSIOLOGICAL CUES:
Experience of hunger controlled
by hypothalamus
INTERNAL, Physiological
Cues:
(DUAL-CENTER THEORY)
1) Lateral Hypothalamus:
“feeding center”
STARTS
experience of hunger
2) Ventromedial Hypothalamus
(Ventromedial Nucleus of
Hypothalamus):
STOPS experience of hunger
Blood Sugar Levels:
Fat Cells:
EXTERNAL, PSYCHOLOGICAL CUES:
1) Learned preferences & Habits can influence
WHAT we eat
and HOW MUCH we eat.
2) Food-Related Cues
3) Stress
Homeostasis:
D) EATING DISORDERS:
1. Anorexia Nervosa: (literally:
loss of appetite - for
nervous reasons)
2. Bulimia: a condition
in which people have periods of
excessive eating
and then purge to remove the just eaten
food.
3. PROGNOSIS:
* % * THE SEX DRIVE AND HUMAN SEXUAL BEHAVIORS
* % *
I. SEX DRIVES AND SEXUAL BEHAVIOR:
Internal, Physiological Cues:
Sexual behaviors tied closely to physiology
to hormonal
levels. These are important in lower
animals but as
complexity increases role of internal cues
become less
certain.
External, Psychological Cues:
- Besides hormones, sex desires can be stimulated
by a
number of environmental cues (pictures,
reading material)
II. BIOLOGICAL BASES OF HUMAN SEXUALITY
A. GENETIC BASES:
Zygote: a one-celled organism
formed by the union of a
sperm & egg. All other
cells develop from this single
cell.
- 23 pairs of chromosomes; 23rd
will determined the sex of
the person-to-be.
X and Y Chromosomes: neither do
much by itself - work in
pairs
Being Female:
Being Male:
B. HORMONAL BASES: sexuality maybe determined
by chromosomes
inherited at conception, BUT expression of
sexuality requires
action of sex hormones
Gonads: sex glands
Testes: when Y chromosome
is present, gonads will be testes
in males.
Androgens: Hormone
produced by testes.
- Helps direct the
development of male reproductive
organs
(penis, testes, & scrotum)
Testosterone: most
important of the male androgens
Ovaries: when Y chromosome
is absent, gonads will become
ovaries in females.
Hormones Produced by the Ovaries:
Estrogen & Progesterone:
hormones produced by the
ovaries.
Estrogen directs the
development of female reproductive
organs vagina, uterus,
& ovaries
*** BOTH male & female sex hormones are produced
by both male & female sex glands
NORMAL SEXUAL DIFFERENTIATION
Genetic Gonads
Testes
Male --> become --> Secrete
-->
Fetus XY Testes
Androgens
Genetic Gonads
No
Female --> become --> Androgens ->
Fetus XX Ovaries
EXPERIMENTAL SITUATION
/-Testes Removed
Genetic Gonads |
No
Male --> become -|-> Androgens-->
Fetus XY Testes
Genetic Gonads
Androgens
Female --> become -|-> Present -->
Fetus XX Ovaries |
\_Given Androgens (except for its gonads
which remain ovaries)
ORGANIZATIONAL EFFECTS: of hormones produce
permanent changes in the organization of sexual characteristics.
For O.E. to occur these hormones must be present during a CRITICAL PERIOD
in prenatal development.
ACTIVATIONAL EFFECTS: sex hormones activate
latent sex characteristics or behaviors
III. PSYCHOLOGICALLY BASED MOTIVES
A. NEED TO ACHIEVE: striving for competitive
success and
excellence.
B. NEED FOR POWER: need to be in control
of situations or of
others
C. NEED FOR AFFILIATION: a need to be
with others typically
to work towards a common
goal
* % * THE
PSYCHOLOGY OF EMOTION * % *
I. FOUR COMPONENTS TO AN EMOTIONAL REACTION:
1) Subjective feeling
2) Cognitive Reaction
3) Physiological Reaction - Visceral
involving your
glands, hormones,
and internal organs.
4) Behavioral Reaction
Emotion: the subjective feeling, cognitive
interpretation,
physical reaction, and behavioral reaction.
II. Facial Feedback Hypothesis:
III. Cognitive Interpretation (Schacter & Singer,
1962)
A. Stress: a response made to a perceived threat to one's well being.
B. Stressors: sources of stress, typically due to a perceived threat
C. THREE TYPES OF STRESSORS:
1) Frustration: occurs in any situation
in which the pursuit of
some goal is thwarted.
Environmental: blocking
of goal by something or someone in
the environment
Personal: personal or internal reasons for not obtaining a goal
2) CONFLICT:
a) Approach-Approach Conflicts:
a conflict that requires that
a choice be
made between two attractive goals.
b) Avoidance-Avoidance Conflicts:
a conflict that requires that
a choice be
made between two unattractive goals.
c) Approach-Avoidance Conflicts:
a conflict that requires that
a choice be
made about whether to pursue a SINGLE GOAL that
has both ATTRACTIVE
and UNATTRACTIVE aspects.
d) Multiple Approach-Avoidance
Conflicts: number of alternatives
each of which
have positive and negative aspects at the
same time.
3) LIFE-CHANGE-INDUCED STRESS
- Any noticeable alterations in one's living
circumstances that
requires readjustment
Social Readjustment Rating Scale (SRRS):
D. HARDY PERSONALITIES:
1) Challenge
2) Control
3) Commitment
E. General Adaptation Syndrome (GAS):
F. EFFECTIVE STRATEGIES FOR COPING WITH STRESSORS
1) Identify the Stressor
2) Remove or negate the stressor
3) Reappraise the situation
Cognitive Reappraisal: rethinking
a stressful situation in a
more positive way
4) Inoculate against future stressors
5) Learn techniques of relaxation
Biofeedback:
6) Engage in physical exercise
7) Seek social Support
INEFFECTIVE STRATEGIES FOR COPING WITH STRESSORS
Fixate
Frustration-aggression hypothesis:
* * HEALTH PSYCHOLOGY * *
Health Psychology:
TYPE A behavior Pattern (TABP):
1) Time Urgency
2) Chronic Activation
3) Multiphasia
TYPE B behavior Pattern:
HELPING PATIENTS “FOLLOW DOCTOR’S ORDERS”