ch 14: dissociative, DID, schizo,

Question 1

What are dissociative disorders characterized by?

Answer 1

Disruptions of identify/memory/conscious awareness

Splitting off of some parts of memory from conscious awareness

Related to extreme stress

Question 2

List and describe the different dissociative disorders.

Answer 2

Dissociative amnesia:
- Forgetting of events that happening or loss of awareness of substantial blocks of time
- May lose memory for personal facts, including identify and place of residence

Dissociative fugue
- Loss of memory accompanied by travel to another location
- Sometimes assume new identity

Question 3

What are the criteria for dissociative identity disorder (DID)?

Answer 3

• Formerly known as multiple personality disorder
• 2 or more distinct identities in same person memory gaps
• Adoption of several new identities (as many as 100, may just be a few, avg is 15)
• Identities display unique behaviors, voice and postures

High female to male ratio → 9:1
Onset is almost always in childhood/adolescence
More common than previously thought 3-6%

Question 4

describe the 3 terms for DID

Answer 4

ALTERS: different identities/personalities
HOST: the identity that keeps other identities together (core personality)
SWITCH: quick transition from one personality to another (from alter to alter)

Question 5

DID female to male ratio? when is onset? prevalence?

Answer 5

High female to male ratio → 9:1

Onset is almost always in childhood/adolescence

More common than previously thought 3-6%

Question 6

What are some causes of DID?

Answer 6

Typically linked to a history of severe, chronic trauma, often abuse in childhood

Closely related to PTSD, possibly an extreme subtype

Mechanism to escape from the impact of trauma

Question 7

What is the controversy surrounding DID?

Answer 7

Widespread reports of child abuse preceding DID came only after Sybil (movie abt DID) released in 1970

Relatively few clinicians diagnosed a large number of cases → 66% of diagnosed made by .09% of clinicians

The treatment for DID requires therapists to make concrete the distinct personalities

Question 8

What are the differences between hallucinations and delusions?

Answer 8

Both are psychosis → Gross departure from reality, which may include:

Hallucinations: Sensory experiences in the absence of sensory input (e.g. hearing voices)

Delusions: Strong, inaccurate beliefs that persist in the face of evidence to the contrary

Question 9

What characterizes schizophrenia?

Answer 9

Alterations in thought, in perceptions, or in consciousness

Among most devastating disorder for affected person and family

Associated with impaired social, personal, or vocational functioning

Question 10

What are the “positive symptoms” of schizophrenia?

Answer 10

Active manifestations of abnormal behavior / distortions or exaggerations of normal behavior

Delusions

Hallucinations

Disorganized speech

Question 11

What are the different types of delusions?

Answer 11

Persecutory: Others are persecuting, spying on, or trying to harm one

Referential: objects, events, or other people have particular significance to one

Grandiose: one has great knowledge, power, or talent

Identity: one is someone else, such as the president

Guilt: one has committed a terrible sin

Control: one’s thoughts and behaviors are being controlled by external forces

Question 12

What is the most common hallucination?

Answer 12

Experience of sensory events without environmental input

Can involve all senses (e.g., tasting something when not eating, having skin sensations when not being touched)

AUDITORY is most common→ hearing voices but dont exist, is within their own mind

Question 13

What is disorganized behavior?

Answer 13

A variety of unusual behaviors
- Wearing layers of clothes on hot day
- Muttering, pacing and wringing hands

Catatonia
- Decreased response to environment, may be immobile

Question 14

What is disorganized speech?

Answer 14

Can involve all senses (e.g., tasting something when not eating, having skin sensations when not being touched)
- Loose associations: conversation in unrelated directions (changing topics)
- Word salad: totally incomprehensible speech
- Clang associations: combo of words that rhyme but have no other link

Question 15

What are the negative symptoms of schizophrenia?

Answer 15

Avolition (apathy) → lack of initiation and persistence

Alogia → relative absence of speech

Anhedonia → lack of pleasure/indifference (also primary symptom of depression)

Affective flattening → little expressed emotion

Question 16

What are the twin concordance rates for schizophrenia?

Answer 16

If 1 twin has schizo → 50% chance identical twin will have it, 7-14% chance fraternal twin

Question 17

If 1 parent has schizophrenia there is a ___ percent chance a child will have it. If 2 parents have schizophrenia, there is a ___ chance a child will have it.

Answer 17

13%

40-50%

Question 18

What part of the brain when enlarged is a sign of deterioration?

Answer 18

VENTRICLES are enlarged as sign of deterioration → esp in frontal/temporal regions

Some researchers think schizo is problem of brian connectivity, not damage to any one area

Question 19

What role does dopamine have in schizophrenia?

Answer 19

Schizo is partially caused by overactive dopamine
- Drugs that increase dopamine (agonists) result in schizo-like behavior
- Drugs that decrease dopamine (antagonists) reduce schizo-like behavior

Question 20

What are the environmental influences associated with schizophrenia?

Answer 20

Stress increases risk

Schizo Virus → antibodies in blood of ppl w schizo not found in those w/o the disorder

Question 21

Do families play a role in triggering schizophrenia?

Answer 21

NO → is a myth
Fact → no evidence that families play a role in the onset

Question 22

What characterizes personality disorders?

Answer 22

Enduring, inflexible predispositions

Maladaptive, causing distress and/or impairment

Ego-syntonic → patients don’t feel that treatment is necessary

Question 23

What is Cluster a of personality disorders?

Answer 23

CLUSTER A: odd or eccentric disorders
- Paranoid: tense, guarded, holds grudges
- Schizoid: socially isolated, w restricted emotional expression
- Schizotypal: peculiarities of thought, appearance, and behavior that are disconcerting to others; emotionally detached/isolated

Question 24

What is cluster b?

Answer 24

CLUSTER B: dramatic, emotional, or erratic disorders (talk abt the most)

• Antisocial: manipulative, exploitative, dishonest, disloyal, lacking in guilt, habitually breaks social norms
• Borderline: can’t stand to be alone, intense, unstable moods/relationships, impulsive behavior
• Histrionic: seductive behavior, needs immediate gratification/constant reassurance, rapidly changing emotions, shallow
• Narcissistic: self-absorbed, expects special treatment and adulation, envious of attention to others

Question 25

what is Cluster C?

Answer 25

CLUSTER C: anxious/fearful disorders
- Avoidant: easily hurt/embarrassed, few close friends, sticks to routine to avoid potential stress
- Dependent: wants others to make decisions, needs constant advice/reassurance, fears being abandoned
- Obsessive-compulsive: perfectionistic, overconscientious, indecisive, preoccupied w details, unable to express emotion

Question 26

What is the difference between obsessive-compulsive disorder and obsessive-compulsive personality disorder? (OCD vs OPD)

Question 27

What is the controversy surrounding personality disorders?

Answer 27

May be extremes of normal personality
Overlap in criteria → high degree of comorbidity

Question 28

What percentage of people meet the criteria for borderline personality disorder? Do women or men meet the criteria more often?

Answer 28

1-2% of adults meet criteria

Women outnumber men 2:1

Question 29

What are the diagnostic criteria for borderline personality disorder?

Answer 29

Frantic efforts to avoid real/imagined abandonment

Pattern of unstable/intense interpersonal relationships

Identity disturbance: markedly/persistently unstable self image/sense of self

Impulsiveness in at least 2 areas that are potentially self damaging (spending, substance abuse, binge eating)

Recurent suicidal behavior/gestures/threats/self-mutilating

Affective instability due to marked reactivity of mood w periods of extreme depression, irritability, or anxiety usually lasting a few hours and only rarely more than a few days

Chronic feelings of emptiness

Inappropriate intense anger or difficulty controlling anger (e.g. displays of temper, constant anger, fights)

Transient, stress-related paranoid thoughts or severe dissociative symptoms

Question 30

What are the causes of borderline personality disorder?

Answer 30

High emotional reactivity

Runs in families (parents help label emotions, if parents disregard feelings → invalidates your emotion)

Early trauma/abuse play a causal role for some
70-80% experienced abuse or observed extreme violence

Invalidated emotions

Question 31

Who is Marsha Linehan? How has she contributed to the treatment of borderline personality disorder?

Question 32

What characterizes antisocial personality disorder?

Answer 32

Failure to comply with social norms

Violation of the rights of others

Irresponsible, impulsive, and deceitful

Lack of a conscience, empathy, and remorse

May be very charming, interpersonally manipulative

Question 33

What are the differences between antisocial personality disorder (ASPD) and psychopathy?

Answer 33

Often used interchangeably but not exactly same

Psychopathy based more on personality, ASPD based more on behavior

90% w psychopathy have ASPD, 30% w ASPD have psychopathy

Question 34

What characterizes psychopathy?

Answer 34

True psychopaths likely have an extreme version of ASPD, are pathological in degree of callousness, and are particularly dangerous

Psychopaths almost always kill intentionally; those without psychopathic tendencies are much more likely to murder impulsively

Question 35

Describe Gary Gilmore’s case.

Question 36

What percentage of the population meets the criteria for antisocial personality disorder?

Answer 36

1-4%

Question 37

Do women or men meet the criteria for psychopathy and ASPD more often? What age do these disorders tend to improve?

Answer 37

Both more common in MEN

Tends to improve around age 40

Question 38

What are the examples of early behavior for psychopathy?

Answer 38

Can’t be diagnosed before 18 – must have a history of conduct disorder before 15

Families with inconsistent parental discipline and support

Families often have histories of criminal and violent behavior

Question 39

When were the first symptoms of PTSD first observed?

Answer 39

Not world war 2

Symptoms have been there longer

Question 40

Arousal Theory:

Answer 40

People with APD are chronically under-aroused and seek stimulation from the types of activities that would be too fearful or aversive for most

Question 41

Psychological and social influences

Answer 41

In research studies, psychopaths are less likely to give up when goal becomes unattainable – may explain why they persist with behavior (e.g. crime) that is punished

Question 42

what is psychosis

Answer 42

Gross departure from reality, which may include:

Hallucinations: Sensory experiences in the absence of sensory input (e.g. hearing voices)

Delusions: Strong, inaccurate beliefs that persist in the face of evidence to the contrary