Abnormal Psychology Flashcards
Infrequency
Statical infrequency
Depends on type of mental disorder
Deviance
Contextual eg gender roles
Symptoms abnormal from society norms
Distress
Suffering and desire to discontinue the behaviour Insight needed (need to know they are suffering)
Disability
Impairment
Danger
Harm to self and others
Not all dangerous
Psychological disorder =
Psychological dysfunction
Distress/impairment
Atypical response
Defining mental illness
Increase risk taking
Not an expected response to situation
Dysfunction across many areas
Biological treatment
As a disease
Changing physical functioning
Medication
Psychodynamic
Focus: past
Behaviour stem from unsolved tension from early childhood traumas
In-sight oriented
Behavioural
Focus: present
Modify problem behaviour via conditioning
Reinforce positive behaviour
Cognitive
Focus: how and what we think
Interpreting situation influence how we feel
Adaptive thoughts
Humanistic
Seek fulfillment and reach potential
Eclectic
Techniques from various types that meets individual’s needs
Forms of therapy
Individual, couple, family,…
Use evidence-based interventions
What is anxiety
Apprehension about anticipated issue
Fear/panic
Apprehesive response to immediate threat
3 components to anxiety
Cognitive
Physiological
Behavioural
Fight/flight response sympathetic
Sweat
Shake
Heart racing
Shallow breathing
Fight/flight response automic
Physical
Social
Thoughts
Yerkes-Dodson Law
Performance and anxiety level
Optional arousal
Generalised anxiety disorder
generalised and persistent
“free floating”
Difficult to control worry
Panic disorder
Period of intense fear in absence of real danger
Sudden
Not predictable
Free of anxiety b/w attacks
Agoraphobia
Fear from being in public, open or enclosed spaces and being outside home alone
Social anxiety disorder
Be negatively evaluated by others
Specific phobias
Specific situations
Fear disproportion to situation
Avoidance of situation
Obsessive - compulsive - related disorders
Repetitve thoughts = distress, feel uncontrollable and time intensive
Obsessive-compulsive disorder obsession
Intrusive thoughts
Persistent
Obsessive-compulsive disorder compulsions
Repeative excessive behaviour that reduce anxiety or prevent expected consequences
PTSD
Exposure to traumatic experiences
Intrusive symptoms and avoidance of stimuli
negative affects to cognition and mood
> 1 month
Psychological treatment
Limited but effective
Eg relaxation, cognitive restructuring
Exposure therapy
Relonged and consistent
In vivo vs imaginal
Desensitisation
70-90% successful
Major depressive episode
5+ symptoms
2 week period
Change from previous functioning
Major depressive episode symptoms
Depressed mood most of day Diminished interest or pleasure Weight loss or gain Sleep problems Fatigue Worthlessness Indecisiveness Suicidal
Etiology depression
Combination of biological, social, psychological
BIological factors
Behaviour genetics
Biochemical
Brain abnomalities
Biochemical
Neurotransmitters
Hormones
Neurotransmitters
Communicate b/w neurons (absent = depression)
Norepinephrine - energy, motor activity
Serotonin - memory, concentration
Dopamine - rewarding stimuli
Hormones
HPA axis
Cortisol
Brain abnormalities
Profronal cortex
Emotion regulation system
Left frontal hemisphere asymmetry - right more activated = more depressed
Emotion regulation system
Amygdala - emotional importance Emotion regulation Subgenual anterior cingulate Dorsolateral prefrontal cortex Hippocampus
Social/ environmental factors
Life stress
Biological vulnerability and stress reactivity
Diathesis-stress model
Mental health disorders due to predisposition and stress
Cognitive theories
Negative thoughts & beliefs = depression
Cognitive distortiosn
Should-ing Over-generalisation Discount positives Black and white thinking Unfair comparisons
Beck’s cognitive therapy
4 phases (~20 sessions) 1 elevate mood 2 challenge antomatic thoughts 3 identity negative thinking 4 change primary attitude
Cognitive restructuring
Effective and reduced relapse
Online and face to face
Antidepressant drugs
MAO inhibitors
Tricyclics
Selective serotonin reuptake inhibitors
Electroconvulsive therapy
For severe depression
Side effect - damaging
relapse common
Psychosis
Difficulty determining whether what is real or not
Schizophrenia
Mental illness in which people interpet reality abnormally
Positive symptoms
Things that occur in excess
Negative symptoms
Absent or lack of things
Criteria for schizophrenia
2+ symptoms
Social dysfunction and decline
Continuous for 6 months
Symptoms for schizophrenia
Delusion Hallucination Disorganized speech Grossly disorganized behaviour Negative symptoms
Persecution
Someone is out to harm them
Grandeur
Fixed belief that they are higher status
Reference
Objects directing speaking to them
Erotomania
Fixed belief someone is in love with you
Somatic
Fixed belief that something medically wrong
Nihilistic
The world is about to end
Bizzarre vs non-bizarre
Non - bizzare
Not the truth but can be rational
Bizzare
Not real
Positive symptoms hallucinations
All senses
Auditory, visual, olfactory, gustatory, tacile
Loose association
Makes sense to the person, not to others
Neologisms
Making new words that make no sense
Clang associations
Speak in rhyme
Echolalia
Repeating what has been said to them
Echopraxia
Mimicking non-verbal behaviour
Word salad
Jumble speech
Negative symptoms
Affective flattening Alogia Thought blocking Avolition Anhedonia
Affective flattening
Shallow emotions
Alogia
Poverty of speech (loss)
Avolition
Lack of motivation
Anhedonia
Inability to experience pleasure
Course of schizophrenia
1 prodromal
2 active
3 residual
% of pop suffer from schizophrenia
0.7 - 1.5%
3/4 cases schizophrenia occurs b/w
15 - 45 years
Male’s first psychotic break
18 - 25
Schizophreniform Disorder
Short duration of symptoms
Good prognosis
Schizoaffective disorder
Independent symptoms of SZ and mood disorder
Prognosis similar to SZ
Delusional disorder
1+ months
Delusions, few negative symptoms
Less observable impairment
Rare Subtypes
% of pop suffer from schizophrenia
0.7 - 1.5%
Etiology
Brain disorder
Schizophrenia environmental causes
Birth month (winter & spring)
Schizophrenia predisposing causes
Pregnancy and birth complications
Schizophrenia neuropsychological deficits
Maternal drug use
Schizophrenia genetic influences
50-60% heritability index
Schizophrenia molecular genetics
DTNBP1, NGR1
Neurotransmitters, white matter development
COMT, DDNF
Prefrontal functioning
Schizophrenia brain abnormalities
Enlarged ventricles
Prefrontal hypometabolism
Neurodegenerative hypothesis
Schizophrenia is a disorder caused due to the degeneration of the brain
Enlarged ventricles Schizophrenia
Reduced bloodflow
Lower brain volume
12/15 twins can be identified
Prefrontal hypometabolism Schizophrenia
Less activity, esp left side
Schizophrenia biological treatment 1st generation
Anti-psychotics
Reduce positive symptoms
Side effects: Tardive Dykinesia, neuroleptic malignat syndrome
Schizophrenia biological treatment 2nd generation
Anti-psychotics
Reduce positive and negative symptoms
Schizophrenia cognitive treatment
Rehabilitation Modify over- & under-attention Restructuring Challenge delusional beliefs Psychoeducation
Manic episode
1 week
3 symptoms
Impairment
Not attributed to substance/medical condition
Manic episode (ME) symptoms
Lower need of sleep Grandios self-esteem Overly talkative Racing thoughts Easily distracted Engagement in high risk activities
Hypomanic episode (HME)
4 days
Mood disturbance doesn’t crtitcally impair work/ social responsibilities
Not stable mental state
Bipolar I disorder
MDE + ME
Bipolar II disorder
MDE + HME
Cyclothymic disorder
PDD + HME
MDE
Major depressive episodes
PDD
Persistent Depressive Disorder
Bipolar epidemiology U.S
12 months: 1.6% (men); 1.5% (women)
Lifetime: 2.2% (men); 2.0% (women)
Bipolar epidemiology NZ
3.8%
Maori x2 more likely
Bipolar genetic factors
80% heritable
Bipolar twin studies
FInland: 93%
Bipolar adoption studies
Doesn’t explain timing of mania
Bipolar and unipolar
Vulnerability for unipolar or bipolar mood disorder inherited separately
Bipolar biochemical factors
Low 5HT + Hi NE -> mania
Low 5HT + low NE -> depression
Dopamine involvement
Ion activity in brain
Bipolar brain abnormalities
Deficits in membranes
Basal ganglia & cerebellum
Bipolar treatment
Medication and in conjuction psychotherapy
Bipolar medication
Mood stabilizers - lithium
Anticonvulsants
Atypical antipsychotics
Bipolar psychotherapy
Focuses: medication management, self-care, social skills, interpersonal relationships
Bipolar psychotherapy benefits
Reduced hospitalization
Improves social and occupational functioning
Anorexia Nervosa
Restriction of energy intake = less 15% of normal weight; arbitrary
Fear for gaining weight
Anorexia Nervosa types
Restriciting type - no bingeing/purging
Binge-eating/purging type - regular
Bulimia Nervosa
Binge eating with no control
Inappropriate compensatory behaviour
From 1 week to 3 months
Influnced by body image
Bulimia Nervosa associated features
Normal weight/over weight
B/w binge, restrict caloric intake
Low self-esteem, mood
High smoking, substance abuse
Binge eating disorder
Recurrent binge (2x week, at least 6 months) DOESN'T involve use of compensatory behaviour
Binge eating disorder symptoms
Eating more rapidly Eating until uncomfortably full Binging when not hungry Eating alone (embarrassment) Feeling negative after overeating
Epidemiology AN U.S
- 42% women
0. 12% men
Epidemiology BN U.S
- 46% women
0. 08% men
Epidemiology BED U.S
- 25% women
0. 42% men
Epidemiology Anorexia NZ
- 0% w
0. 1% m
Epidemiology Bulimia NZ
2 w
0.5 m
Epidemiology any ED
- 9 w
0. 5 m
Maori x…. ED
x2 (primarily BN)
Risk of ED
Multidimensional
More = greater risk
Biological factors ED
Genetic influence
x6 more likely to have ED with relatives with ED
Neurotransmitters
Hormones (AN - hypothalamus functioning - weight set point)
Sociocultural factors ED
Societal pressure
Treatment AN
Restoration of proper weight
REsidential programs
Cognitive Behvioural Therapy
Treatment BN/BED
Cognitive Behvioural Therapy
Medication
Defining disorder of childhood
Difficult
Likely to act out vs seek help
Some deviance normal
Some psychological disorder = little conscious distress
Intellectual disability
Onset before 18
Persists throughout life
Deficits - communication, social, practical
Range from mild to profound
Intellectual disability etiology
Genetic abnormalities
Metabolic abnormalities
Prenatal & postnatal complication
Genetic abnormalities intellectual disability
Down syndrome
Fragile X Syndrome
Metabolic abnormalities intellectual disability
PKU
Tay-Sachs Disease
Prenatal & postnatal complication intellectual disability
Drug exposure
Anoxia at birth
Autism Spectrum Disorder
Deficits in social communication
Restricted, reptitve behaviour patterns
Onset in early childhood
Autism Spectrum Disorder epidemiology
<1% pop
Recognized during 2nd year of life
4x more common in boys
No period of normal development, just gained in later childhood
Autism Spectrum Disorder etiology
Genetics - highly heritability
Brain abnormalities
Prenatal and birthing factors
Autism Spectrum Disorder brain abnormalities
Cerebellum, white matter
Neurotransmitter
Autism Spectrum Disorder treatment
Modeling conditioning
Communication training
Parent training
community intergration
ADHD
Inattention, hyperactivity, inpulsivity
ADHD 3 types
Predominantly inattentive type
Predominantly hyper-impulsive typee
Combined type
ADHD etiology
50 - 75% heritability rates
Structural abnormalities - dorsolateral regions
Neurotransmitter abnormalities - dopamine
ADHD treatment biological
Stimulant or non-stimulant medications
ADHD treatment psychological
Behaviour therapy
Oppositional defiant disorder (ODD)
Early onset Argumenative Temper tantrums Authority problems Anger
Conduct disorder
More severe than ODD
Limited prosocial emotions
2+ for at least 12 months, in more than 1 relationship or setting
Conduct disorder symptoms
Lack of remorse or guilt
Callous-lack of empathy
Unconcerned about performance
Shallow or deficient affect
Etiology of ODD and CD
Genetic factors
Familial risk factors (child abuse, family conflict)
Sociocultural risk (poverty, past antisocial behaviours)
Treatment of ODD and CD
Family focused
Child focused
Prevention focused
Best predictor for ODD and CD
Peer groups + past antisocial behaviour
NZ alcohol facts
Hazardous drinking
Higher in Maori, men and age group from 18 - 24 years
Economically deprived areas 1.7x more likely to be hazardous drinkers
NZ Illicit drugs
x2 rate in Maori
x0.25 in asian ethnicities
Substance Use disorder
Problematic pattern of use, 2+ symptoms, within one year period
Substance use symptoms
Failure to meet obligations Continue use despite problems substance taken for longer time or in greater amounts than intended Impairment to functioning Cravings
Substance use diagnosis
Substance specific
Addiction
Severe substance use
6+ symptoms
Tolerance
Larger doses required
Effect of drug less
Withdrawal effects
Dependence increses
Physical
Psychological
Drug classes
Depressants
Stimulants
Hallucinogens
Cannabis
Polysubstance use
Using 3 drugs, interchangably
Gender difference substance use men
Men more likely to use alcohol and psychoactive drug
Gender difference substance use women
More likely to misuse in respoonse to stress or self-medicate
Lower tolerance to alcohol
Etilogy of substance abuse
Genetics
Biochemical factors
Behavioral
Sociocultural
Treatment substance abuse
Biological treatments - detoxification, antagonist therapy
Aversion therapy
Motivational interviewing
12-step program
Alcholics/Narcotics Anonymous
Self-help program
Alcoholic = disease without cure, abstinance
Alcoholics/Narcotics Anonymous
Self-help program
Alcoholic = disease without cure, abstinance
Personality disorder
Persisent maladaptive/culturally infreguent, thought, feeling, behaviour
Infelexible
Significant distress
Traced back to adolescence
PD categorical
Psychiatric classification
PD dimensional
From normality to severe
PD normal vs abnormal traits
Extreme variants of normal traits
Abnormal traits in only disordered individuals
Cluster A
Odd
Eccentric
Cluster B
Dramatic
Emotional
Erratic
Cluster C
Anxious
Fearful
A PD
Paranoid PD
Schizoid PD
Schizotypal PD
Paranoid PD
Deep mistrust of others
Hypersensitivity, caution
Pathological jealousy
Control, anger
Schizoid PD
Persistent avoidance
Limited emotional expression
Withfrawn
<1% of pop (more likely to occur in men)
Schizotypal PD
Odd beliefs/ magical thinking
Unusual perceptual experiences
Suspiciousness
Excessive social anxiety
Etiology A
Genetic link - family members of schizophrenic at higher risk for schizotypal
Schizotypal - linked to positive symptoms of schizophreniz
Schizoid - linked to negative symptoms
B PD
Antisocial PD
Borderline PD
Histrionic PD
Narcissistic PD
Antisocial PD
Disregard social norms Reckless behaviour Prone to anger Lack of guilt or remorse Evidence of CD before 15
Antisocial PD diagnosis
Low cut-off criteria (3/7)
Mostly behavioral
50-80% of correctional inmates
Alternative “diagnosis” for ASPD
Psychopathy
15-25%
what is psychopathy?
Use charm, manipulation, violence to cotrol other an satisfy own selfish needs.
Lack conscience and feelings for others
Violate social norms
No sense of guilt
Psychopathy
Interpersonal deficits
Grandiosity
Social potency
Low anxiety
Psychopathy
Affecive deficits
Shallow emotions
Inability to form deep relationships
Fearlessness
Etiology
Factor 1
Affective/interpersonal
Amygdala
Poor fear conditioning, inability to read distress cues
Etiology
Factor 2
Antisocial behaviour
Orbitofrontal cortex
Disinhibition, poor emotional decision making
Borderline personality disorder instability of self-image and relationships
Intense interpersonal attachments
Idolization vs devaluation
Borderline personality disorder affective instability
Dysphoria, feelings of emptiness
Emotional outbursts
Extreme emotional response to abandonment
Borderline personality disorder impulsive, unpredictable, destructive behaviour
Suicidal gestures
Substance abuse
Reckless behaviour
Borderline personality disorder
Etiology Psychodynamic
Early parent relationships
Borderline personality disorder
Etiology Object-relations
Lack of early acceptance of parents
Borderline personality disorder
Etiology Biopsychosocial Theory
Invalidating childhood environments
Borderline personality disorder
Treatment
Dialectical behavior therapy
Histrionic PD symptoms
Extremely dramatic
Shallow emotion
Center of attention
Histrionic PD
Etiology and treatment
No research
Narcissistic PD symptoms
Need constant admiration
Lack of empathy
Superiority
Narcissistic PD Etiology
Psychodynamic therorists
Cold, rejecting parents
Narcissistic PD Etiology
Behaviour and congitive theorists
Too much positive reinforcement
Narcissistic PD Treatment
None
Seeking treatment very rare
Cluster C
Avoidant PD
Dependent PD
Obsessive-compulsive PD
Avoidant PD symptoms
Inhibited in social situations
Dependent PD symptoms
Difficultly with separation
Relys on others
Clingy
Dislike themselves
Obsessive-compulsive PD symptoms
Preoccupied with order, control (no flexibility, openness)
High standards for themselves and others
RIgid, stubborn, trouble expressing affection
Borderline personality disorder
Etiology Biopsychosocial Theory
Invalidating childhood environments
Borderline personality disorder
Treatment
Dialectical behavior therapy
Histrionic PD symptoms
Extremely dramatic
Shallow emotion
Center of attention
Histrionic PD
Etiology and treatment
No research
Narcissistic PD symptoms
Need constant admiration
Lack of empathy
Superiority
Narcissistic PD Etiology
Psychodynamic therorists
Cold, rejecting parents
Narcissistic PD Etiology
Behaviour and congitive theorists
Too much positive reinforcement
Narcissistic PD Treatment
None
Seeking treatment very rare
Cluster C
Avoidant PD
Dependent PD
Obsessive-compulsive PD
Avoidant PD symptoms
Inhibited in social situations
Dependent PD symptoms
Central feature
Clingy, obedient
Rely on others for decisions
Distressed, lonely, hate themselves
Obsessive-compulsive PD symptoms
Preoccupied with order: no flexibility, openness
High standards
Rigid, trouble expressing affection
Limitation with DSM-5 system
Excessive comorbidity
Inadequate coverage
No boundary b/w normal and pathological personality
Inadequate scientific base
Solutions to DSM-5 system
Dimensional personality traits define disorders
Analogous to intellectual disability
Dimensional personality traits define disorders
Vary in degree vs in kind
Extreme manifestation of personality traits = disorder
Analogous to intellectual disability
Extreme standing on a dimension (intelligence) + impairment in functioning = disorder
DSM-5 Section 3 model
Criterion A
Impairment in self (identity/self - direction) and interpersonal (empathy/intimacy) functioning
DSM-5 Section 3 model
Criterion B
Personality profile
5 personality trait domains
5 personality trait domains
Negative affectivity Detachment Antagonism Disinhibition & compulsivity Psychoticism
Personality types
Defined by trait profile
Personality disorder trait specific (PDTS)