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bipolar exam > Bipolar II > Flashcards

Bipolar II Flashcards

1
Q

Why is there a lack of support for bipolar psychological explanations?

A

it is a biologically driven disorder, mania usually leads to hospitalization, multiple endpoints of bipolar make it extremely complex to control in experiments

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2
Q

Gray’s Reinforcement Sensitivity Theory

A

2 motivational systems that work inversely of each other and are responsible for coordinating behavior

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3
Q

What are the two systems in Grays reinforcement sensitivity theory?

A

Behavioral activation system, behavioral inhibition system

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4
Q

behavioral activation system:

A

behavior to attain rewards and goals

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5
Q

behavioral inhibition system:

A

avoidance behavior to avoid threats/punishment

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6
Q

BIS/BAS scale:

A

24 item self-report questionnaire

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7
Q

What do higher scores in BAS associate with?

A

higher probability of bipolar diagnosis as well as an indicator of an upcoming episode

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8
Q

Idea of BAS:

A

in people with bipolar, their BAS system is weakly regulated and highly sensitive as well as prone to extreme fluctuations

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9
Q

Is BAS active or inactive during mania/ depression?

A

active during mania, deactive during depression

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10
Q

Response styles theory idea:

A

how people respond to their mood state is indicative of the duration and severity of these mood episodes

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11
Q

Response styles theory-4 response or coping styles

A
  1. ruminative style
  2. distraction style
  3. risk-taking style
  4. problem solving style
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12
Q

ruminative style:

A

thoughts/behaviors that focus persons attention on their symptoms and the causes/consequences of those

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13
Q

distraction style:

A

thoughts/behaviors that take the individuals mind off their symptoms

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14
Q

risk-taking style

A

maladaptive distractions (usually dangerous activities)

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15
Q

problem-solving style

A

plan of action to alleviate symptoms

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16
Q

what does depression score high in?

A

rumination

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17
Q

what does mania score high in?

A

rumination, distraction and risk-taking

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18
Q

Manic-defense model:

A

mania is viewed as an unconscious defense mechanism to evade the depressive state/cognitions

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19
Q

what kind of approach is the manic-defense model?

A

psychodynamic

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20
Q

What is mania and depression seen as in the depression avoidance theory?

A

seen as one entity, a counteraction to depressive tendencies

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21
Q

Extensions of the cognitive styles for mdd:

A

individuals with mania have positive cognitive distortions/schemas about themselves

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22
Q

what is the diathesis of bipolar regarding cognition?

A

positive cognitive schemas

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23
Q

Barcelona approach:

A

21 session, group format

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24
Q

What are the 5 things Barcelona approach focus on?

A
  1. awareness of disorder
  2. medication non-adherence (patients dont take medications as described)
  3. importance of avoiding substance abuse
  4. early detection of new episodes
  5. lifestyle regularity (sleeping habits, circadian rhythms, diet)
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25
Q

prodromes:

A

early symptoms indicating onset of disease/illness

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26
Q

prodrome period:

A

early signs/mild symptoms that an episode is coming on

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27
Q

Prodromes for mania:

A

poor quality of sleep/start to decrease need for sleep, elevated mood, increased activity, extreme goal setting

28
Q

prodromes for depression:

A

sleep disturbance, anxiety, tension, G.I problems, fatigue, emotional distancing

29
Q

Goal of targeting prodromes:

A

identify prodromes and address accordingly to prevent/lessen impact of episode

30
Q

Family focused therapy number of sessions and duration:

A

21 sessions over 9 months

31
Q

Variations of family focused therapy:

A

multi family (MF~PEP); Individual family (IF~PEP)`

32
Q

Goal of family focused therapy:

A

address family dynamics and relationships and how they contribute to factors that help or hurt the illness

33
Q

The 4 points to address in family focused therapy:

A
  1. assessment
  2. psychoeducation component
  3. communication enhancement component
  4. problem solving skills training component
34
Q

assessment in family focused therapy:

A

identify communication patterns of family, identify If high expressed emotion is present

35
Q

psychoeducation component in family focused therapy:

A

discuss etiology of illness, identify prodromes, improve medication adherence

36
Q

communication enhancement component in fft:

A

enhancing quality of family’s communication, active listening and delivering correct feedback

37
Q

Problem solving skills training component in fft:

A

brainstorm solutions to problems, weigh pros and cons of proposed solutions, identifying what to do during aftermath of episodes.

38
Q

CBT basic tenet:

A

change conceptualization of how individual structures and interprets their moods, experiences, and behavior

39
Q

Is cbt more difficult while someone has manic symptoms?

A

yes

40
Q

what should you target and teach in cbt?

A

the cognitive thinking patterns and teaching clients to restrain oneself during the prodromal period

41
Q

4 strategies of cbt in bipolar:

A
  1. daily mood monitoring
  2. activity scheduling
  3. identify early warning signs/limit impulsivity
  4. treatment contracting
42
Q

daily mood monitoring for bipolar:

A

connections between mood and sleep/stressors

43
Q

activity scheduling for bipolar:

A

minimize stimulation during mood elevation

44
Q

identify early warning signs/limit impulsivity in bipolar:

A

48 hours before acting rule: wait two full days before acting on any major decision/purchase

45
Q

treatment contracting in bipolar:

A

formulate written plan for support team: what are early warning signs, directives in an event of an episode

46
Q

Dialectal behavior therapy goal:

A

how thoughts and emotions affect behavior. does not focus on changing cognitive schemas, but rather accept the intense emotions can happen and figure out a way to move on from this. provides you with skills needed to cope

47
Q

dialectal=

A

integration of opposites, how acceptance and change can coexist

48
Q

hierarchy of behavioral targets (4):

A
  1. decrease life-threatening behaviors
  2. decrease therapy-interfering behaviors (alleviating physical/emotional discomfort)
  3. change quality of life-interfering behaviors (cues to mania, burning bridges)
  4. increase skills development
49
Q

DBT 5 components:

A
  1. mindfulness
  2. distress tolerance
  3. emotional regulation
  4. interpersonal effectiveness
  5. walking the middle path
50
Q

what is mindfulness?

A

awareness of ones own thinking and irrational beliefs and prevent self-invalidation thoughts

51
Q

distress tolerance:

A

recognize breakdown of emotions and recognize what’s happening sooner so you can prevent going 0 to 100 on an emotional scale

52
Q

DBT 4 structural components:

A
  1. weekly individual therapy session
  2. skills group training
  3. in the moment telephone consultations
  4. therapy team consultation
53
Q

what 2 things are involved with weekly individual therapy session?

A
  1. diary cards which track intensity of emotions, urges, did you use skills to cope, did you give in.
  2. behavioral chain analysis: if you acted on an urge, understand the precursors that led up to that and figure out what skills you could have used to cope with urge
54
Q

in the moment telephone consultations:

A

on call services with therapist and has 24 hour rule: clients can call before urge but if they acted on urge, cannot call for 24 hours. figure out coping strategies on their own

55
Q

therapy team consultation

A

therapy for therapists to prevent burnout

56
Q

circadian/social rhythm disruption theory:

A

disruption in circadian rhythm trigger and lead to potential development of mood episodes

57
Q

disrupted sleep is associated with:

A

worse course of illness and can present early warning sign for triggering the episodes

58
Q

in circadian disruption theory, bipolar is a result of:

A

dysrehulated circadian rhythm and dysregulated social rhythm

59
Q

Interpersonal and social rhythm therapy goal:

A

to regularize daily routines to stabilize moods and prevent episodes

60
Q

Interpersonal interventions in IPSRT goal:

A

focus on resolution of current interpersonal problems and prevention of future problems

61
Q

what is “grieving for the lost health self”

A

facilitate mourning for the life that patients might have had without BD. this increases recovery and lengthens time between episodes

62
Q

chronotherapy:

A

shifting sleep-wake cycle using sleep phase advance/delays

63
Q

chronotherapy goal:

A

to regularize daily routines, still controverial

64
Q

Bright light therapy in chronotherapy:

A

for mania: bright light in middle of the day 12-2 pm. for depression: first thing in the morning for 30 minutes.

65
Q

Dark light therapy:

A

constant darkness 8pm-6am

bipolar exam (4 decks)

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