Abnormal Psychology #2

Question 1

DIGFAST

Answer 1

Bipolar I Symptoms

Grandiosity not grounded in reality (G)
Sleep (S)
More talkative (T)
Flight of ideas, racing thoughts (F)
Distractibility (D)
Increase in goal-directed activity or psychomotor agitation (A=activity/agitation)
Excessive involvement in risky behaviors (I=irresponsibility)

Question 2

SIGECAPS

Answer 2

Unipolar Depression Symptoms

The SIGECAPS mnemonic (sleep, interest, guilt, energy, concentration, appetite changes, psychomotor agitation or retardation, suicidality)

Question 3

Emotions and Moods

Answer 3

Emotions: short-lived
Moods: persistent, background state

Question 4

Depression: POC

Answer 4

Prevalence: 16.6% lifetime, highest of all disorders, 2 to 1 female to male
Onset: any age
Course: usually late adolescence to middle adulthood

Question 5

Cumulative probability of recurrence

Answer 5

~40‐50% of people who have one depressive episode will have another
Probability of recurrence increases with # of prior episodes, punishing

Question 6

Stress and depression

Answer 6

Depression is often preceded by a very stressful life event (~20‐50% of cases)

Question 7

Kindling

Answer 7

Takes more stress to start the first episode, easier for later ones

Question 8

Depression: biopsychosocial

Answer 8

Bio: Genetics (30‐40% of population variance due to genetic factors). Neurotransmitters (serotonin, norepinephrine)
Psycho: Rumination in excess, dysfunctional beliefs/brooding
Social: social support or lack thereof

Question 9

Rumination

Answer 9

Reflection and rumination in excess is harmful
Repetitive, relatively passive thought about how you feel, why you feel that way, and the consequences of feeling that way rather than solutions
Women tend to ruminate more than men
When you control for differences in rumination, gender gap in depression is reduced

Question 10

Dysfunctional beliefs

Answer 10

Brooding
Self-blaming
Self-critical
Pessimism
Rigid, extreme schemas about self, world, or future
“If everyone doesn’t love me, then my life is worthless.”

Question 11

Biological treatments of depression

Answer 11

SSRI: most effective for severe depression but not for mild and moderate depression
TMS: non-invasive, stimulating
DBS: deep-brain, down-regulation

Question 12

Therapy for depression

Answer 12

Behavioral activation
CBT/mindfulness-based
Exercise
Interpersonal therapy
In general, therapy is more helpful in preventing relapse than medication

Question 13

Diagnosis of Bipolar

Answer 13

At least 1 manic episode, afterwards cannot be diagnosed with depression

Question 14

Manic episode

Answer 14

Abnormally and persistently elevated, expansive OR irritable mood AND abnormally and persistently increased activity or energy
1 week or longer!

Question 15

Bipolar: POC

Answer 15

Prevalence: 1% lifetime, equal gender ratio
Onset: late adolescent to early adulthood
Course: chronic and episodic

Question 16

Bipolar I

Answer 16

Rapid cycling: 4 or more episodes in a given year

Question 17

Bipolar II

Answer 17

Major depressive episodes with periods of hypomania (less severe, lasting 4+ days)
Hypomania and manic episode is distinguished by severity and duration

Question 18

Cyclothymic disorder

Answer 18

Milder, chronic form of bipolar disorder for 2+ years

Numerous hypomanic and depressed mood episodes (not major depression)

Question 19

Bipolar Spectrum

Answer 19

Normal: 0,0
Cyclothymic: m,d
Bipolar II: m,D
Unipolar Mania: M,d
Bipolar I: M,D

Question 20

Bipolar: bio

Answer 20

Genes account of 80‐90% of variance in population, It is the strongest genetic heritably mental disorder we know
Neurotransmitter: Norepinephrine, Dopamine, Serotonin
Circadian rhythms: Decreased need for sleep often heralds the onset of mania

Question 21

Bipolar: psychosocial

Answer 21

Under-studied
• Stress
	• Disruption of sleep? 
• Low social support
Social support is important in buffering against stress

Question 22

Bipolar medication

Answer 22

Lithium (mood stabilizer)
Anticonvulsants (GABA, Glutamate)
Antipsychotics (dopamine)

Question 23

Suicide/attempt/self-injury

Answer 23

Intend to die
Non-fatal
Non-suicidal self-directed

Question 24

Deaths by suicide

Answer 24

1.4% of global deaths

More deaths every year by suicide, than by all wars, genocide, and interpersonal violence combined

Question 25

Predictors of suicide

Answer 25

Prior attempts: best predictor Mental disorder Gender: women more likely to attempt, men more likely to die Age: Highest rate of completed suicide occurs in people > 65 years of age Hopelessness: feeling things may not get better

Question 26

Interpersonal‐Psychological Theory of Suicide

Answer 26

Thwarted belongingness Perceived burdensomeness Acquired capability for suicide

Question 27

Prevention of suicude

Answer 27

Treat mental disorder Limit access to lethal means Crisis support: help them see that situation is not endless Treat individuals at high risk

Question 28

Psychosis defining feature

Answer 28

Disruption in connection to reality Disruption in basic sense of self (SZ) Positive symptoms

Question 29

Psychosis positive symptoms

Answer 29

Delusions: beliefs Hallucinations: perceptions Disorganized speech Catatonia

Question 30

Delusions

Answer 30

Delusion of reference: personal significance into events/activities/communications Persecutory delusion: being attacked and conspired against Delusion of being controlled: feelings/thoughts/actions under external control Mind reading: by or of others

Question 31

Hallucinations types

Answer 31

``` Auditory: most common Visual: next most common Tactile Somatic Gustatory Olfactory ```

Question 32

Catatonia

Answer 32

Unpredictable agitation (shouting, wearing) Markedly disheveled Unusually dressed (multiple coats on hot day) Inappropriate sexual behavior (e.g., public masturbation) Catatonia: stupor, grimacing, echolalia...

Question 33

Negative symptoms

Answer 33

``` Negative symptoms: absence of things we expect to be there Motivation Energy Pleasure Expressiveness Socialization ```

Question 34

Schizophrenia predictive factors

Answer 34

``` – Genetic risk with recent deterioration – Higher unusual thought content – Higher suspicion/paranoia – Greater social impairment – History of substance abuse North American Prodrome Longitudinal Study (NAPLS) ```

Question 35

Finnish Adoption Study

Answer 35

HGR and LGR mothers | High OPAS interacted with HGR to produce more schizophrenia

Question 36

Attenuated psychotic symptoms

Answer 36

``` Psychotic-like Unusual ideas/beliefs Suspiciousness/paranoia Grandiosity/inflated Perceptual abnormalities Disorganized communication ```

Question 37

Psychosocial treatments

Answer 37

* Cognitive Behavioral Therapy * Family Focused Therapy & Multifamily Group Psychoeducation * Cognitive Remediation/Enhancement: rebuilding basic cognitive abilities * Social Skills Training * Case Management * Crisis Management: meet an individual’s and family’s comprehensive health needs through communication

Question 38

Stages of intervention for psychosis

Answer 38

Nonspecific: psychosocial intervention Attenuated: psychosocial intervention, benign or low-dose medication Psychosis: medication, psychosocial interventions

Question 39

Family as protective

Answer 39

``` Improve: – constructive communication – active listening – calm communication Deteriorate: – conflictual behaviors, – Irritability, anger, – criticism, and – off-task comments ```

Question 40

Psychotic spectrum

Answer 40

Brief: 1 day to 1 month, remit on its own Delusional D: longer than 1 month, false beliefs, global functioning not markedly impaired Schizophreniform: SZ-like, 1-6 months Schizoaffective: mood as base, psychotic as addition Nia: psychotic as base

Question 41

Schizophrenia diagnosis threshold

Answer 41

Delusions* 2. Hallucinations* 3. Disorganized Speech* 4. Grossly disorganized or catatonic behavior 5. Negative symptoms (e.g., flat affect or avolition) * One of two symptoms must be # 1, 2, or 3

Question 42

Auditory hallucinations

Answer 42

Can occur in any sensory modality • auditory, visual, olfactory, tactile, gustatory • Auditory hallucinations are most common • Occur in ~75% of patients with SCZ at some point in illness • Often at normal conversational volume • Often voices of people known to patient though can be unfamiliar or supernatural (God, devil) • Most people hear more than one voice • Usually critical, abusive though sometimes pleasant or supportive

Question 43

Avolition

Answer 43

Inability to initiate and persist in activities, basically immobile

Question 44

Alogia

Answer 44

Minimal speech

Question 45

Schizophrenia: POC

Answer 45

Prevalence: less than 1% lifetime prevalence, 1.4 to 1 male to female Onset: late adolescence to early adulthood Course: chronic

Question 46

Causes of Schizophrenia

Answer 46

Genetics Prenatal and perinatal events: maternal infections, birth complications, maternal nutritional deficiency, maternal stress Neurochemistry: dopamine hypothesis: agonists can result in schizophrenic-like, antagonist can reduce schizophrenic-like The hypothesis is still oversimplified conclusion

Question 47

Dopamine and SZ

Answer 47

Schizophrenics make more dopamine than those without Dopamine helps us tag things as salient, the hypersensitivity might result in lots of inappropriate things being identified as important Kapur, 2003

Question 48

Problems with dopamine hypothesis

Answer 48

Many people do not respond to agonists, indicating heterogeneity Dopaminergic drugs are generally not helpful in reducing negative symptoms Other drugs, like PCP and ketamine, can produce SCZ‐like symptoms • Decreased glutamate? Dopaminergic and glutamatergic systems work together.

Question 49

Environmental factors in schizophrenia

Answer 49

Family environment Urban living Immigration Drug use

Question 50

Cannabis use and schizophrenia

Answer 50

Cannabis use is associated with an increased risk for schizophrenia Especially true with higher concentration of THC rather than CBD

Question 51

Schizophrenia-biopsychosocial treatments

Answer 51

Bio: antipsychotics, dopamine antagonists, estrogen, glutamate agonists (glutamate is a neurotransmitter for major excitatory function) Psychosocial: psychoeducation, family therapy, case management, social-skills training, cognitive remediation, CBT

Question 52

Anhedonia

Answer 52

Inability to experience pleasure

Question 53

Network analysis of depression

Answer 53

Symptoms of depression interact with each other

Question 54

ECT

Answer 54

Electro-compulsive Therapy | One of the most effective treatment for severe depression

Question 55

Matt Nock's talk about preventing suicide

Answer 55

Objective measure: self-report is not objective, IAT scores is a good prediction for suicide Real time data collection: notification on the phone Intervention: classic conditioning of self-harm with undesirable images

Question 56

Night falls fast

Answer 56

People can be extremely bright and talented but still fall to suicide Interpersonal-psychological theory in practice

Question 57

Brooke's account of schizophrenia

Answer 57

One of the take aways: nobody asked her if she was hearing voices She was not disorganized, she was high-functioning

Question 58

Excessive synaptic pruning

Answer 58

Possible cause of schizophrenia

Question 59

“Mental illnesses are the chronic diseases of the young”

Answer 59

50% of adult mental disorders begin before age 14. 75% before age 24. (Insel & Fenton, 2005)

Question 60

How dose cognitive functioning decline?

Answer 60

Deteriorates: gets worse over time Deficit: rate the same, but always behind normal Lag: rise at slower rate The answer is lag, I think

Question 61

Experience of hallucination

Answer 61

People staring at you Delusion, schizophrenic symptoms People disappear, people talk to you from the TV Bees, buzzing, voices speaking gibberish People can not know which voice to listen to, persistent, impossible to ignore or filter A range of voices with different emotions Cannot tell whether somethings is real or not Voices are worse when they are alone

Question 62

Flat affect

Answer 62

Negative effect of schizophrenia | Lack expression instead of experience