Abnormal Psych. Exam 3 Flashcards
Bulimia Nervosa
Characterized by recurrent episodes of uncontrolled excessive eating followed by compensatory actions to remove the food
ecurrent episodes of uncontrolled excessive (binge) eating followed by compensatory actions to remove the food (Ex: vomiting, laxative abuse, and escessive exercises)
Anorexia nervosa
Characterized by recurrfent food refusal, leading to dangerously low body weight
recurrent food refusal, leading to dangerously low body weight
Binge Eating disorder
Pattern of eating involving very rapid, distress-inducing consumption of large amounts of food that are not followed by purging behaviors
pattern of eating involving distress-inducing binges not followed by purging behaviors
Criteria for Bulimia Nervosa
-Recurrent episodes of eating, in a discrete period of time an amount of food that is definetly larger than most people would eat during a similar period of time under similar circumstances AND a sense of lack of control over eating during the episode
-Recurrent inappropriate compensatory behaviors in order to prevent weight gain (ex: self-induced vomiting, misuse of laxatives, diuretics, other medications, fasting, or excessive exercise)
-Binge eating and inappropriate compensatory behaviors both occur on average once a week for 3 months
-Self-evaluation is unduly influenced by body shape and weight
-The disturbance does not occur exclusively during episodes of anorexia nervosa
Criteria for Anorexia Nervosa
-Restriction of energy intake relative to requirements, leading to a significantly low body weight (by age, sex, developmental trajectory, physical health)
-Intense fear of gaininig weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight
-Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape of self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight
Significantly low weight
weight that is less than minimally normal or, for children and adolescents, less than that minimally expected
Two subtypes of Anorexia
Restricting and Binge-eating/purge type
Restricting type of Anorexia Nervose Criteria
-During the past 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)
-Weightloss is accomplished primarily through dieting, fasting, and/or excessive exercise
Binge-eating/purging type of Anorexia Nervosa Criteria
-During the past 3 months, the individual has engaged in recurrent episodes of binge eating or purging behavior (i.e. self-induced vomiting or the misuse of laxatives, diuretics, or enemas)
Binge-Eating Criteria
-Recurrent episodes of eating, in a discrete period of time, an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances AND a sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating)
-Episodes are associated with at least 3 of the following: eating much more rapidly than normal, eating until feeling uncomfortably full, eating large amounts of food when not feeling physically hungry, eating alone because of feeling embarrassed by how much one is eating, feeling disgusted with oneself, depressed, or very guilty afterward
-Marked distres regarding binge eating being present
-The binge eating occurs, on average, at least once a week for 3 months
-The binge eating is not associated with the recurrent use of inappropriate compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa
Bingeing
-hallmark of bulimia nervosa and binge eating disorder
-Eating excess amounts of food in a discrete period of time
-Eating is perceived as uncontrollable
-May be associated with guilt, shame, or regret or particularly stressful times
-May hide behavior from family members
-Foods consumed are often high in sugar, fat, or carbohydrates
Examples of Purging
vomiting, laxatives, diuretics
Causes of Eating Disorders: Social Dimensions
-Societal emphasis on thinness -> Prioritization of being perceived as thin over being healthy -> Dieting
-Glorificatiton of slenderness
-Close Friendships group sharing similar attitudes concerining body image, dietary restraint, and extreme weight-loss behaviors
-Settings where social pressures are exceptionally intense for being thin, such as ballet schools or among athletes or gymnasts
-Failure to thrive syndrome
-Dieting in an early age is linked to an increased risk of future dietary attempts and developing eating disorders (dietary attempts in adolescent girls result in weight gain, stress, and heightened preoccupation with food & eating during the dieting
Glorification of slenderness
the extent to which women internalize media messages glorifying thinness increseases the risk of developing eating disorders
-Gender differences in body image perceptions
Failure to thrive syndrome
Toddlers does not gain weight at the expected rate
Parents put their toddlers on diets in the hope of preventing obesity
Causes of Eating Disorders
Family interaction before eating disorders
-Success orientation, ambition, perfectionism, concern for external appearances, desire to maintain harmony
-Not the primary causes of eating disorders
Family dynamics after eating disorder can quickly deteriorate
-Physical punishment from parents is linked with poorer outcomes for the eating disorder
Reverse Anorexia Nervosa
men reported concern about looking small, even though they were muscular
-prone to steroids
Causes of Eating disorders: Biological Dimension
Inherited vulnerability
-unstable or excessive neurobiological response to stress associated with impulsive eating
Genetic influence
-Response emotionally to stressful events, impulsive eating, perfectionism, negative affect
Hypothalmus -> regulating eating
Reduced Serotonin activity-> impulsivity & binge eating
Ovarian hormones-> Hormone-responsive genes
-Speculate onset of puberty & hormonal changes may “turn on” certain risk genes
-Emotional or binge eating peaked in postovulatory phase (menstrual)
Causes of Eating Disorders: Psychological Dimension
-Anxiety focused on appearance
-Distorted body image
-Diminished self-confidence
-Low self-esteem
-High perfectionism
-Imposter Syndrome
-Distortions in the perception of body image
-Mood intolerance
Imposter syndrome
-Perceive self as a fraud
-False any impressions made of being adequate self-sufficient, or worthwhile
-Heightened levels of social anxiety
Mood intolerance
extreme regulation tactics for mood
Treatment of Bulimia Nervosa
-Psychoeducation about the physical effects of binge eating and purging, the inefficacy of vomiting and laxative abuse for weight control
-Discussing the adverse effects of dieting
Behavioral component
-Adopting a structured eating schedule, consuming small, manageable portions five or six times daily with no more than a 3-hour interval between any planned meals and snacks
-introducing forbidden foods into diet
-organizing activities to avoid solitary time
Cognitive Component
-coping strategies
-Monitoring and confronting the cognitions that accompany the binge episodes and purging episodes. Then the therapist helps the client confront these cognitions and develop more adaptive attitudes toward weight and body shape. Afvter meals in the initial stagees of treatment is also an important aspect of the treatment
-Cognitive-behavioral therapy-enhances (CBT-E) -> Interpersonal therapy & Psychoanalytic psychotherapy
-Family therapy has also proven effective
Cognitive-behavioral therapy-enhances (CBT-E)
-Treatment of choice
-Principal focus is on the distorted evaluation of body shape and weight and on maladaptive attempts to control weight in the form of strict dieting and compensatory activities
Treatment of Binge Eating Disorder
-Previously used medications for obesity are now not recommended
Psychological treatment
-CBT (effective)
-Interpersonal psychotherapy (equally effective as CBT)
-Self-help techniques (effective)
Treatment of Anorexia
-Initial treatment goal is attaining a weight in the healthy range
Psychoeducation
-Behavioral and cognitive interventions
-target food, weight, body image, thought, and emotion
-Treatment often involves the family
-Has the most support from clinical trials for treating adolescents with anorexia
Night eating disorder
-Consume 1/3+ of daily calories after dinner
-Get out of bed at least once during the night for a high-calorie snack
-Often not hungry the next morning and skip breakfast
Bariatric surgery
stapling the stomach to create a small pouch or bypassing the stomach through gastric bypass surgey
-popular approach for BMI > equal to 40
-health risk due to permanent
Social Jetlag
repeated switching of a daily scedule because of social factors, similar to changing time zones when traveling
Stages of sleep
Non-Rapid Eye Movement (NREM) sleep: 3 stages
1- brain waves slowing down
2-shallow
3-deep sleep
Rapid Eye Movement (REM) sleep: muscles become atonic but nitense mental activity can be observed
Chronotype
the tendency for the body to prefer the morning or eveninig, regulated by body’s circadian clock, genetic variations in the clock genes, and the environment
Polysomnographic (PSG) evaluation of sleep
-clear & comprehensive of sleep habits
-overnight patient moniored on a number of measures
-detailed history, assessment of sleep hygiene and sleep efficacy
Polysomnographic (PSG) evaluation of sleep: Electroencephalograph (EEG)
brain waves
Polysomnographic (PSG) evaluation of sleep: Electrooculograph (EOG)
eye movements
Polysomnographic (PSG) evaluation of sleep: Electromyography (EMG)
muscle movements
Actigraph
wearable device sensitive to movement
-can detect different stages of wakefulness/sleep
-length & quality of sleep
Dyssomnias
Difficulties in amount, quality, or timing of sleep
Ex: still feeling tired
Parasomnias
Abnoraml behavioral and physiological events during sleep
Ex: nightmares & sleepwalking
Parasomnia Criteria
-Recurrent episodes of incomplete awakening from sleep usually occurring during the first third of the major sleep episode, accompanied by either one of the following: sleepwalking or sleep terrors
-No or little dream imagery is recalled
-Amnesia for the episodes is present
-The episodes cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
-The disturbance is not atttributable to the physiological effects of a substance (e.g., a drug abuse, a medication)
-Coexisting mental and medical disorders do not explain the episodes of sleepwalking or sleep terrors
Sleepwalking
-Repeated episodes of rising from bed during sleep and walking about
-While sleepwalking, the person has a blank, staring face; is relatively unresponsive to the efforts of others to communicate with him or her; and can be awakened only with great difficulty
Sleep terrors
-Recurrent episodes of abrupt terror arousals from sleep, usually beginning with panicky scream
-Intense fear and signs of autonomic arousal, such as mydriasis, tachycardia, rapid breathing, and sweating, during each episode
-Relative responsiveness to efforts of others to comfort the individual during the episodes
Insomnia
-Characterized by difficulty initiating or maintaining sleep
-one of the most common sleep disorders
-problems initiating/maintaining sleep (e.g. trouble falling asleep, waking during the night, waking too early in the morning)
-Only diagnosed as a sleep diroder if it is not better explained by a different condition like anxiety (primary insomnia)
Microsleeps
short, seconds-long periods of sleep that occur in people who have been deprived of sleep
Rebound insomnia
sleep problems reappear; worsened sleep problems can occur when medications are used to treat insomnia and then withdrawn
Hypersomnolence disorder
-a disorder involving excessive amount of sleep that disrupts normal routines
-characterized by sleeping too much
-experience excessive sleepiness as a problem
-often associated with other medical and/or psychological conditions such as depression
Sleep apnea
brief periods when breathing ceases during sleep
-snore loudly, pause between breathes, dry mouth & headache
Narcolepsy
-A disorder characterized by sudden and irresistible sleep attack
-Recurrent intense need for sleep, lapses into sleep, or napping
-Accompanied by one of the following: Cataplexy, Hypocretin deficiency, Going into Rem sleep abonormally fast
-Rare condition
—-Suggested to be associated with cluster of genes on Chromosome 6 and may be an autosomal recessive trait
—Appears a significant loss of a certain nerve cell (hypocretin neurons) in those with narcolepsy
Sleep paralysis
brief period after awakening when they can’t move or speak that is often frightening
Hypnagogic Hallucinations
vivid & often terrifying experiences that begin at start of sleep and seem realistic due to multiple sensations
Hyperventilation
constricted and labored breathing
Breathing related disorders:
-Obstructuve sleep apnea hypopnea
-Central sleep apnea (CSA)
-Sleep-related hypoventilation
Obstructuve sleep apnea hypopnea
-Airflow stops, but respiratory system works
-Associated with age and obesity
-Occurs in 10 to 20% of population
-More common in males
Central sleep apnea (CSA)
-repiratory systems stops for brief periods
-often associated with certain CNS disorders
-no daytime sleepiness reports, unaware
Sleep-related hypoventilation
Decreased breathing during sleep not better explained by another sleep disorder with a complete pause in breathing
-Cause increase in CO2 levels, insufficient air exchange
Circadian Rhythm
Disturbed sleep leading to distress and/or functional impairment
-Affects supriachiasmatic nucleus, which stimulates melatonin and regulates sense of night and day
Types:
-shfit work type
-familial type
-delayed or advanced sleep phase type
-irregular slep-wake type
-Non-24 hour sleep-wake type
Circadian Rhythm: Shift work type
job leads to irregular hours
Circadian Rhythm: Familial type
associated with family history of dysregulated rhythms
Circadian Rhythm: Delayed or advanced sleep phase type
person’s biological clock is naturally “set” earlier or later than a normal bedtime
Circadian Rhythm: Irregular sleep-wake type
people who experience highly varied sleep cycles
Circadian Rhythm: Non-24 hour sleep-wake type
sleeping on a 25-26 hour cycle with later and later bedtimes, ultimately going throughout the day
Parasomnias: Non-REM Sleep Arousal Disorders
=characterized by abnormal events that transpire eitherduring sleep or the transitional phase between sleeping and waking
Non-rapid eye movement sleep arousal disorders
incomplete awakening and either sleepwalking or sleep terrors and recurrent episodes of screaming or other signs of great fear
Nightmare disorder
frequent awakening by terrifying dreams
Rapid eye movement sleep behavior disorder
involves arousal during sleep associated with vocalization or complex motor behaviors
Restless legs syndrome
involves an urge to move the legs that disturbs sleep
Substance/medication-induced sleep disorder
involves severe sleep disturbances apparently caused by intoxication or medication
Circadian rhythm sleep-wake disorder
a disorder that occurs as a result of a mismatch between the resting schedule a person requires to function at their best and the schedule imposed by the environment
Obstructive sleep apnea
a disorder associated with snoring, snorting/gasping or breathing pauses during sleep and daytime sleepiness that occurs as a result of blockages in the upper respiratory system
Parasomnia Treatment
-Research on treatment of nightmares suggests that both psychological intervention (such as cognitive-behavioral therapy) and pharmacological treatment (such as prazosin) can help reduce these unpleasant sleep events
-One approach to reducing chronic sleep terrors is the use of scheduled awakenings
Paraphilic disorders
sexual arousal occurs primarily in the context of inappropriate objects or individuals
Gender dysphoria
incongruence and psychological distress and dissatisfaction with the gender one has been assigned at birth
Non-binary
Spectrum of gender identities that are neither male or female
When defining “Normal” Sexual Behavior one needs to consider
Normative (i.e. common, average) facts and statistics
-current views tolerant of variety unless associated with substantial impairment in functioning or involves nonconsenting individuals
Cultural considerations
-social, generational, cultural, regional, religious, and economic factors
Gender differences in sexual behavior and attitudes
-most pronounced in less industrialized countries
-Older women tend to lack suitable partner (earlier male mortality), some married to older men
-Many older women said sex was “not all that important”
-Higher % of men masturbate
-greater # of partners associated with greater worry & vulnerability for women (oppo. for men
Peplau (2003) Gender diff. Themes
1-Men show more sexual desire and arousal than women
2- Women emphasize committed relationships as a context for sex more than men
3-Men’s sexual self-concept is characterized partly by power, independence, and aggression
4- Women’s sexual beliefs are more “plastic” in that they are more easily shaped by cultural, social, and situational factors
Categories of Sexual Dysfunction for Men & Women include
Desire, Arousal, Orgasm, and Pain
Categories of Sexual Dysfunction: Male hypoactive sexual desire disorder
= persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire for sexual activity
-little or no interest in any type of sexual activity, including masturbation and fantasies
-often leads to infertility
-type of disorder: Desire
Categories of Sexual Dysfunction: Female sexual interest/arousal disorder
= reduced sexual interest, reduced sexual activity, fewer sexual thoughts, reduced arousal to sexual cues, reduced pleasure or sensations during almost all sexual encounters
-low sexual desire is more frequent in women
-type of disorder: Desire
Categories of Sexual Dysfunction: Erectile disorder
=difficulty achieving or maintaining an erection
-sexual desire is usually intact
-most common problem for which men seek treatment
-prevalence increases with age (rapidly after 60)
-type of disorder: Arousal
Categories of Sexual Dysfunction: Female sexual interest/arousal disorder
=prevalence difficult to estimate because many still don’t consider absence of arousal to be a problem
-type of disorder: Arousal
Categories of Sexual Dysfunction: Delayed ejaculation
-treatment rarely sought
-some men cannot ejaculate during intercourse but can ejaculate with manual or oral stimulation
-great difficulty to or not at all
-type of disorder: Orgasm
Categories of Sexual Dysfunction: Female orgasmic disorder
=marked delay in, marked infrequency of, or absence of climax or markedly reduced intensity of sensations during climax
-Anorgasmia
-marked by delay, absence, or decreased intensity of orgasm in almost all sexual encounters
-not explained by relationship distress or other significant stressors
-most common complaint of female sexual disorders in sexuality clinics
-prevalence is assumed to be around 25%
-type of disorder: Orgasm
Categories of Sexual Dysfunction: Premature (early) ejaculation disorder
= a persistent or recurrent pattern of climax occurring during partnered sexual activity within approximately 1 minute following vaginal penetration and before the person wishes it
-ejaculation occurring within about 1 minute of penetration and before it is desired
Most prevalent sexual dysfunction in adult males
-affects 21% of all adult males
-most common in younger, inexperienced males
-type of disorder: Orgasm
Retrograde ejaculation
ejaculatory fluids travel backward into the bladder rather than forward
Categories of Sexual Dysfunction: Genito-pelvic/penetration disorder
=persistent or recurrent difficulties with vaginal penetration during intercourse or tensing or tightening of the pelvic floor muscles during attempted vaginal penetration
-Only in females, difficulty with vaginal penetration during intercourse, associated with one or more of the following:
-Pain during intercourse or penetration attempts
-Fear/anxiety about pain during sexual activity
-Tensing of pelvic floor muscles in anticipation of sexual activity
-type of disorder: Pain
Vulvodynia
Vaginismus
Vulvodynia
=chronic pain in the area outside of a women’s genitals (the vulva)
-burning, rawness, stinging
-often associated with tenseness & tightening of pelvic floor muscle during intercourse
-often report child maltreatment and show anxiety around intercourse -> depressed
-No clear cause and often chronic
Vaginismus
=pelvic muscles in the outer third of the vagina undergo involuntary spasms when intercourse is attempted
-may occur during any attempted penetration
-ripping, burning, or tearing
Classification of Sexual dysfunctions include 2 vs
Lifelong vs. Acquired
Generalized vs. Situational
When a sexual dysfunction is classified as Lifelong
chronic condition present during a person’s entire sexual life
When a sexual dysfunction is classified as Acquired
disorder that begins after sexual activity has been relatively normal
When a sexual dysfunction is classified as Generalized
occurring everytime the individual attempts sex
When a sexual dysfunction is classified as Situational
occurring with same partners or at certain times
Assessing Sexual Behavior includes
Detailed interviews, Medical evaluation, Psychophysiological assessment
Assessing Sexual Behavior: Detailed interviews
-Clinicians should be comfortable in talking sexual matters & use language that patients can understand
-The interview should cover other related life areas
-Questionnaires should be used as patients may feel more comfortable providing information in written form
-If applicable, the partner is interviewed simultaneously
-Patients may volunteer to write down some information they are not ready to talk about
Assessing Sexual Behavior: Medical evaluation
Medication side effects
-including some commonly for hypertension, anxiety, and depression
Physical conditions
Assessing sexual hormones or vascular functioning
-Urologist and gynecologist
Urologist
a physician specializing in disorders of genitals, bladder, and associated structures
Assessing Sexual Behavior: Psychophysiological assessment
=Sexual arousal in response to erotic material
Males- Penile strain gauge (measures erection)
-As the peis expands, the strain gauge picks up changes and records them on polygraph
-Self-report how arousal level differs from the objective measure and it increases/decreases as a function of the type of sexual problem
Females- Vaginal photoplethysmograph (measures blood flow to vagina)
-Device in vagina, photorecepters on the side of the instrument measure the amount of light reflected back from walls (i. blood flows to walls during arousal, amount of light passing through decreases)
Medical treatment of Sexual Dysfunction: Erectile dysfunction
Viagra (Sildenafil) and similar medications
-only if sexually aroused
Injection of vasodilating drugs into the penis
-dilate blood vessels, allowing blood flow to penis and producing erectionwithin 15 minutes, lastin 1-4 hours
Testosterone
Penile prosthesis or implants
Vascular surgey
Vaccum device therapy
-Creating a vaccum in a cylinder placed over the penis (draws blood from penis and then trapped by a specifically designed ring placed around the base of the penis)
Medical Treatment of Sexual Dysfunction in regards to women
Few medical procedures exist
-Flabariserin: for hypoactive sexual desire
Treatment of Sexual Dysfunction: Education
Alone can be effective
Masters and Johnson’s psychosocial intervention
-Education about sexual response, foreplay, etc.
-Sensate focus and nondemand pleasuring
—Sexual activity with the goal of focusing on sensations without trying to achieve orgasm
—Decreases performance anxiety
Treatment of Sexual Dysfunction Premature ejaculation: Psychosocial
Squeeze technique
-Penis stimulated by partner to nearly full erection
-Then partner squeezes the penis near the top (head joins shaft), quickly reducing arousal
-Repeated until (heterosexual) eventually penis is briefly inserted into vagina without thrusting
-If arousal occurs to quickly, penis withdrawn and squeeze technique again
Treatment of Sexual Dysfunction Female orgasm disorder: Psychosocial
Masturbatory training
-Vibrator and speaking out loud how they feel (everything)
-practice and good communication
Treatment of Sexual Dysfunction Vaginismus: Psychosocial
Use of dilators
-gradually insert larger dialators at women’s pace
-genital and nongenital arousal
Treatment of Sexual Dysfunction Low sexual desire problems: Psychosocial
Exposure to erotic material
Causes of Sexual Dysfunctions: Biological
Physical disease
-Neurological diseases and others affecting nervous system (reducing sensitivity to genital area & common cause of erectile dysfunction)
-Vascular disease major cause (men: erections, women: vaginal engorgement)
Chronic illness
-Indirect
-Individuals risk for heart attacks
-Coronary heart disease
Prescription medications (e.g. antihypertensive medication)
-Antidepressants, anti-anxiety drugs
-Alter levels of certain subtypes
Alcohol and drugs
-suppresses sexual arousal (CNS) and produce widespread sexual dysfunction
How does alcohol impact sexual dysfunction
-At low/moderate it reduces social inhibitions so feel more like having sex
Chronic use:
-permanent neurological damage -> eliminating sexual response cycle
-liver & testicular damage -> decreased testosterone to sexual desire/arousal
-fertility problems for both
Causes of Sexual Dysfunction: Psychological
People with sexual dysfunction are more likely to experience anxiety and negative thoughts about sexual encounters (performance anxiety)
-tend to expect the worse and find the situation relatively negative and unpleasant
-avoid awareness of sexual cues and distract self with negative thoughts -> underreport arousal
-Anxiety doesn’t necessarily decrease arousal and performance, distraction does
Causes of sexual dysfunction: Sociocultural
Learning
-early childhood by families, religious authorities, etc.
Erotophobia
Unpleasant or traumatic experiences
-sudden failure to become aroused or actual sexual trauma like rape/sexual abuse
-women sexually victimized before puberty or forced sexual contact, 2x likely to have orgasmic dysfunction
-Male victims of adult-child contact, 3x likely erectile dysnfunction
Poor interpersonal relationships
—-partner or self no longer seen as attractive
-Lack of communication
–what sexual activities increase arousal (discomforting sharing)
—–poor sexual skills
John Gagnon’s Script Theory of Sexual functioning
Erotophobia
=associate sexuality with negative feelings, anxiety, or threat
John Gagnon’s Script Theory of Sexual functioning
beliefs that portray sexuality as dangerous or forbidden can make individuals more susceptible to developing sexual dysfunction
-cultural script may contribute to the type of dysfunction
Paraphillic disorders
=misplaced sexual attraction and arousal
-focused on inappropriate people or objects
-often multiple paraphilic patterns of arousal
-high comorbidity with anxiety, mood, and substance use disorders
-not a disorder unless it is associated with distress and impairment or harm or the threat of harm to others
Frotteuristic disorder
type of paraphilic disorder in which a person gains sexual gratification by rubbing against unwilling victims in crowds from which they cannot escape
Fetishistic disorder
=sexually attraction to nonhuman objects (lingerie, shoes, etc.) or nongenital body parts (feet, hair, etc.)
-The desire and fantasies revolve around the object itself, not the individual wearing them
-Almost reported only by males
-The prevalence of the behavior is high, the prevalence of the disoder is quiet low
Voyeuristic disorder
observing an unsuspecting individual undressing, naked, or engaged in sexual activity
Exhibitionistic disorder
exposure of genitals to unsuspecting strangers for sexual gratificationF
Frotteuristic disorder
persistent pattern of seeking sexual gratification from rubbing up against unwilling others
Transvestic disorder
sexual arousal associated with the act of wearing clothing of the opposite sex
Autogynephilia
when sexual arousal is associated with thoughts or images of oneself as the opposite gender
Sexual masochism disorder
suffering pain or humiliation to attain sexual gratification
Sexual Sadism
inflicting pain or humiliation to attain sexual gratification
Hypoxyphilia
involves sexual arousal by means of oxygen deprivation
Pedophilia
sexual attraction to prepubescent children
-vast majority males
Associated features:
-incestuous males may be aroused by adult women (more to do with availability and interpersonal issues ongoing in the family)
-male pedophiles are usually not aroused by adult women
-some rationalize the behavior
Moral cleansing
when individuals with paraphillic disorders rationalize their behavior by engaging in some other practices they consider to be morally correct or uplifting at the same time
Covert sensitization
imagining aversive consequneces to form negative associations with the unacceptable behavior
Orgasmic reconditioning
masturbation to appropriate stimuli
-substitute before ejaculation
Treatment for paraphilic disorders includes
-target problematic sexual associations
-covert sensitization
-orgasmic reconditioning
-Medications that reduce testosterone may be used in some populations like convicted sex offenders
Cyproterone acetate
“chemical castration” drug that eliminates sexual desire and fantasy by reducing testosterone levels dramatically, but return as soon as drug is removed
Autogynephilia
gender dysphoria begins with a strong and specific sexual attraction to a fantasy of oneself (auto) as a female (gyne), the progressing into a more comprehensive all-encompassing experienced gender as a female
Gender identity
essence of feelings toward being a man, a woman, gender fluid, or nonbinary or toward having other experiences
-desire to live life openly in a manner with that of the person’s gender
-usually formed between `8-36 months of age
Gender dysphoria
-there is a marked incongruence between one’s experienced/expressed gender and assigned gender AND there is clnically significant distress or impairment as a result
Intersexuality/hermaphroditism
individuals born with ambiguous genitalia associated with documented hormonal or other physical abnormalities
Gender confortmity
a phenomenon in which pre-pubescent children do not identify with their biological sex, but instead identify with the gender of the opposite sex and display varying degrees of behavior more characteristics of the opposite sex
Gender affirming surgery
-must be psychologically/socially stable and live as desired gender first
-most report satisfaction with surgical results
Substance
any natural or synthesized product that has psychoactive effects
-it changes perceptions, thoughts, emotions, behaviors
Substance use
=the ingestion of psychoactive substances in moderate amounts that does not significantly interefere with social, educational, or occupational functioning
taking moderate amounts of a substance in a way that doesn’t interfere with functioning
Substance intoxication
=the psychological reaction to ingested substance
physical reaction to a substance
ex: drunkeness or getting high
(Impaired control-)Psychological dependence
-the substance is taken in increasingly larger amounts or over a longer period of time than originally intended
-the substance user craves the substance
-the substance user feels an ongoing desire to cut down or control substance abuse, or has made unsuccessful attempts to do so
-much time is spent in obtaining, using, or recovering from the substance
(Pharmacological-) Physical Dependence includes what two things
Tolerance and Withdrawal
Tolerance
the need for increased amounts of the substance to achieve the desired ffect or by a diminished experience of intoxication over time with the same amount of the substance
Withdrawal
the substance user experiences the characteristic withdrawal syndrome of the substance and/or takes the same or similar substance to relieve withdrawal symptoms
Substance use disorder
=ingestion of psychoactive substances in a way that significantly intereferes with the user’s education, job, or relationships with others or puts the user in physically dangerous situations
-pattern of substance use leading to significant impairment and distress
-how significantly the use interferes with the user’s life
Depressants
=behavioral sedation; relaxation
-Alcohol (ethyl alcohol), sedative & hypnotic drugs in the families of barbiturates (ex: seconal), and benzodiazepines (ex: valium and xanax)
-slow the central nerbous system activity, reducing the body’s level of physiological arousal
-among most prone to inducing physical dependence, tolerance, and withdrawal symptoms
Stimulants
=increase alertness and elevate mood
-amphetamines, cocaine, nicotine, and caffeine
-most widely consumed drugs in the United States due to both caffeine and nicotine
Opiates
=produce temporary analgesia and euphoria
-pain reduction
-Heroin, Kratum, Opium, Codeine, and Morphine
Hallucinogens
=alter sensory perception
-can produce delusions, paranoia, and hallucinations
-Cannabis and LSD
Other drugs of abuse include
Inhalants (ex: airplane glue), Anabolic steroids, over the counter and prescription medications (ex: nitrous oxide)
Gambling disorders
unable to resist the urge to gamble, results in negative personal consequneces (ex: divorce, loss of employment, etc.)
Substance dependence
=maladaptive pattern of ingestion of psychoactive substances characterized by the need for increased amounts to achieve the desired effect, negative physical effects when the substance is withdrawn, unsuccessful efforts to control its use, and substantial effort expended to seek it or recover from its effects
Psychological and physiological effects of alcohol
Central nervous system depressant
-increased sociability, impaired functioning, diminshed motor coordination, impaired judgment
Several body parts
-heart, lungs, liver
Influences several neurotransmitter systems
-glutamate system: excitatory , helping neurons fire; learning & memory-> alcohol affecting cognitive abilities (ex: Blackouts)
-neurotransmitter system: affects mood, sleep, and eating behaviors-> alcohol cravings
Specific target is GABA
=inhibitory neurotransmitter interfere with firing of neuron it attaches to; affect anxiety
-alcohol’s anti-anxiety from interaction
Chronic use of Alchol-related disorders
Effects:
-intoxication
withdrawal including delirium temens
-fetal alcohol syndrome
Longterm heavy use may lead to:
-dementia
-Wernicke-Korsakoff syndrome
Delirium tremens
condition that can produce frightening hallucinations & body tremors
Fetal alchol syndrome
problems in the fetus from alchol use during pregnancy
-fetal retardation, cognitive deficits, behavior problems, and learning difficulties
Wernicke-Korsakoff syndrome
confusion, loss of muscle coordination, and unintelligable speech
-caused by deficiency of thiamine (vitamin metabolized poorly by drinks)
Barbituates
family of sedative drugs first synthesized in Germany, prescribed to help people sleep
-at low doses, relax muscles and mild feeling of well-being
Benzodeiazepines
originally miracle cure for anxiety, safer than barbiturates because less risk of excessive use and dependence
-calm and induce sleep
-muscle relaxants & anticonvulsants
Effects of Amphetamines
=can induce feelings of elation & vigor and reduce fatigue, then later “crash” (depressed and tired)
-Syntheticaly produced in laboratories
-include prescribed drugs for the treatment of attention problems (e.g. Ritalin, Adderall, narcolepsy, and chronic fatigue, antihistamines and diet drugs (-reduces appetite)
-swallowed as pills and injected intravenously
-Methamphetamine can be snorted (“crank”) or smoked (“crystal meth” or “ice”)
-Stimulate CNS by enhancing release and blocking reuptake of norepinephrine and dopamine
-Euphoria or blunted effect (reduced emotional expression), changes in sociability, interpersonal sensitivity, anxiety, tension, anger, stereotype behaviors (repeated motor movements), impaired judgment, and impaired social or occupational functioning alterations in heart rate or blood pressure perspiration or chills, nausea or vomiting, weight loss, muscular weakness, respiratory depression, chest pain, seizures, or coma, hallucinations, panic, agitation, and paranoid delusions
-Tolerance develops rapidly
Withdrawal: apathy, extended periods of sleep, irritability, and depression
Effects of Cocaine
-short-lived snesations of elation, vigor, reduced fatigue
-effects result from blocking the reuptake of dopamine
-Alertness, euphoria, increase blood pressure and pulse, and causes insomnia and loss of appetite
-Prolonged usage disrupts sleep, increases tolerance, induces paranoia, and leads to social isolation, accelerate brain aging
—Prenatal cocaine exposure: crack babies (irritability, long-birsts of high-pitched crying, decreased birth weight & head circumference
With drawal: Apathy and boredom
Effects of nicotime
-stimulates nicotinic acetylcholine receptors in CNS resulting in sensations of relaxation, wellness, pleasure
Smoking has complex relationship to negative affect
-appears to help improve mood in short-term
-depression occurs more in those with nicotine dependence (bidirectional relationship)
Withdrawal: depressed mood, insomnia, irritability, anxiety, difficulty concentrating, restlessness, increased appetite, weight gain
Effects of Caffeine
-used by over 85% of Americans
-found in tea, coffee,cola drinks, and cocoa products
-small doses elevate mood and reduce fatigue
-regular use can result in tolerance and dependence
-caffeine blocks the reuptake of the neurotransmitter adenosine
—-important role on release of dopamine and glutamate in the striatum, which may explain the elation and increased energy that comes with caffeine use
Withdrawal: headaches, drowsiness, generally unpleasant mood
The nature of Opiods
Opiate- natural chemical in the opium poppy with narcotic effects
Opiods- natural and synthetic substances with narcotic effects (“analgesics”- relieve pain)
Effects:
-activate body’s enkephalins and endorphins
-low doses induce euphoria, drowsiness, and slowed breathing
-high doses can lead to death if respiration is completely depressed
Withdrawal: excessive yawning, nausea & vomiting, chills, muscle aches, diarrhea, and insomnia; lasting and severe (disrupting work, school, and social relationships)
-Brain similarily-acting substances called enjephalins, beta-endorphins, and dynorphins (body’s natural opiod system)C
Cannabis
-reactions include altered perceptions and mood swings
-frequent, long-term users may experience impairments of memory, concentration, relationships with others, and employment
-Evidence regarding tolerance is contradictory (usable to reach same high vs. “reverse tolerance”)
-Can be used in the treatment of some diseases (Chemotherapy-induced nausea & vomiting, HIV associated anorexia, neuropathic pain in multiple sclerosis, and cancer pain)
-Active ingredients are the tetrahydrocannabinols (THC)
—-brain makes its own version of THC called anadamide
Hallucinogen-related disorders
-altered perceptions (e.g. seeing or hearing things not present) and physical- pupilar dialation, rapid heart beat, sweating, blurred vision
-can also produce delusions, paranoia
-LSD (“acid”; grani fungus ergot; most common), psilocybin, mescaline, PCP (snorted or injected for impulsivity & aggressiveness
-tolerance builds quickly, but resets after brief periods of abstinence
-NO Withdrawals, but effects place individual under great risk
-NO short or long term toxicity
Inhalants
-highest use during early adolescence
-found in volatile solvents
-breathed into the lungs directly (rapid absorption)
-Ex: spray paint, hair spray, paint thinner, gasoline, nitrous oxide
-Effects similar to alcohol intoxication (dizziness, slurred speech, lack of coordination, euphoria, and lethargy
-produce tolerance and prolonged withdrawal symptoms (sleep disturbance, tremors, irritability, and nausea; 2-5 days)
-multiple negative physiological effects
Steroids
derived or synthesied from testosterone
-used medicinally or to increase body mass
-asthma , anemia, breast cancer, and males with inadequate sexual development
-No associated high (enhance performance & body size; taken orally or injected)
-rather, dependence involves wanting to maintain the effects of the substance (i.e. increasedmuscle mass
-may cause long-term mood disturbances
Designer drug
“dissociative anesthetics”
-drowsiness, pain relief, being out of one’s body
MDMA (Exctasy) both has the stimulant and hallucinogenic effects
Ketamin
-“drug club”
-dissociative anesthetic -> detachment & reduced sense of pain
Gamma-hydroxybutyrate (GHB, or liquid ectasy)
-low doses induce relaxation and increased verbalization
-higher doses or combined with alcohol or other drugs can lead to seizures, severe respiratory depression, and coma
-Can result in Tolerance & Dependence
Functional genomics
how the genes (influencing substance use disorders) function when it comes to addiction
Opponent-process theory
increase in positive feelings will be followed shortly by an increase in negative feelings
-motivation for drug use shifts from desiring the euphoric high to alleviating the increasingly unpleasant crash
Expectancy effect
what people expect to experience when they use drugs influences how they react to them
Cycling
drug schedule of several weeks/months by a break from its use
Stacking
combine several types of steroids
Cravings
powerful urges one people stop taking drugs after prolonged or repeated use
-triggered by availability if drug, contact with things associated with drug taking, specific moods, or having
Agonist substitution
safer drug with a similar chemical composition as the abused drug
Antagonist drugs
drugs that block or counteract the positive effects of substances
-most prescribed-> naltroxene - produces immediate withdrawal symptoms to these dependent on opiates
Compelled drinking
severe users taught to drink in moderation (extremely controversial)
