Ch. 7: Psychological Disorders Flashcards
defn: psychological disorders
characteristic sets of thoughts, feelings, or actions that cause noticeable distress to the suffer, are considered deviant by the individual’s culture, or cause maladaptive functioning in society
defn: maladaptive
some aspect of the individual’s behavior negatively impacts others or leads to self-defeating outcomes
defn: biomedical approach to psychological disorders
therapy emphasizes interventions that rally around symptom reduction
assumes that any disorder has roots in biomedical disturbances
narrow
defn: biopsychosocial approach to pscyhological disorders
broader
assumes that there are biological, pscyhological, and social components to an individual’s disorder
biological: something in the body/genetics
psychological: stems from thoughts, emotions, or behaviors
social: results from the individual’s surroundings and can include issues of perceived class, discrimination, stigmaziation
defn: direct vs. indirect therapy
direct therapy = treatment acts directly on the individual (medication, periodic meetings with a psychologist)
indirect therapy = aims to increase social support by educating and empowering family and friends of the affected individual
defn: DSM-5
a manual of many known psychological disorders
based on descriptions of symptoms
20 diagnostic classes of mental disorders
what symptoms must an individual present with 1+ to have a PSYCHOTIC DISORDER?
- delusions
- hallucinations
- disorganized thought
- disorganized behavior
- catatonia
- negative symptoms
defn: positive symptoms
behaviors, thoughts, feelings added to normal behavior in psychotic individuals
delusions, hallucinations, disorganized thought, disorganized/catatonic behavior
defn: negative symptoms
the absence of normal or desired behavior (disturbance of affect and avolition) in psychotic individuals
defn: delusions
false beliefs discordant with reality & not shared by others in the same culture
defn: delusions of reference
the belief that common elements in the environment are directed at the individual
defn: delusions of persecution
the belief that the person is being deliberately interfered with, discriminated against, plotted against, or threatened
defn: delusions of grandeur
the belief that the person is remarkable in some significant way (inventor, historical figure, religious icon)
defn: thought broadcasting
the belief that one’s thoughts are broadcast directly from one’s head to the external world
defn: thought withdrawal
the belief that thoughts are being removed from one’s head
defn: thought insertion
the belief that thoughts are being placed in one’s head
defn: hallucinations
perceptions that are not due to external stimuli but which nevertheless seem real to the person perceiving them (auditory most common)
defn: disorganized thought + 3 manifestations
characterized by loosening of associations
- ideas shifting in speech
- word salad (words seem incomprehensibly thrown together)
- neologisms (invention of new words)
defn: disorganized behavior
an inability to carry out activities of daily living (bills, hygiene, appointments)
defn: catatonia + 3 manifestations
certain motor behaviors characteristic of some people with schizophrenia
- rigid posture, refuse to move OR useless, bizarre movements not caused by external stimuli
- echolalia (repeating other’s words)
- echopraxia (imitating other’s actions)
defn: affect
the experience and display of emotion
defn + description: 3 affective symptoms
- blunting (a severe reduction in the intensity of affect expression)
- emotional flattening (flat affect): virtually no signs of emotional expression
- inappropriate affect: affect is clearly discordant with the content of speech
defn: avolition
decreased engagement in purposeful, goal-directed actions
defn: schizophrenia
prototypical psychotic disorder
characterized by a break between an individual and reality
diagnosis: continuous signs of the disturbance for at least 6 months + this sixth month period must include at least one month of positive symptoms
defn: the three phases of schizophrenia. describe them.
- prodromal phase
- active phase
- residual phase
prodromal phase: before diagnosis; poor adjustment; clear evidence of deterioration, social withdrawal, role functioning impairment, peculiar behavior, inappropriate affect, unusual experiences
active phase: psychotic symptoms, diagnosis usually made here
residual phase / recovery phase: after an active episode, mental clarity resulting in concern, depression as individual becomes aware of previous behavior
what are 5 other psychotic disorders other than schizophrenia?
- schizotypal personality disorder
- delusion disorder
- brief psychotic disorder
- schizophreniform disorder
- schizoaffective disorder
defn: schizotypal personality disorder
personality disorder + psychotic symptoms with personality symptoms having been established before psychotic symptoms
defn: delusion disorder
psychotic symptoms limited to delusions and present for at least a month
defn: brief psychotic disorder
positive psychotic symptoms are present for at least a day, but less than a month
defn: schizophreniform disorder
same diagnosis as schizophrenia but required duration is only 1 month
defn: schizoaffective disorder
major mood episodes (depressive and manic) while also presenting psychotic symptoms
defn: depressive disorders
conditions characterized by feelings of sadness that are severe enough in magnitude and duration to meet specific diagnostic criteria
mnemonic + definitions: 9 depressive symptoms
sadness + SIG E. CAPS
SADNESS: depressed mood, feelings of sadness and emptiness
SLEEP: Insomnia or hypersomnia
INTEREST: Loss of interest and pleasure in activities that previously sparked joy (anhedonia)
GUILT: inappropriate guilt or worthlessness
ENERGY: Low energy throughout the day
CONCENTRATION: decreased concentration (self-described or observed)
APPETITE: pronounced change (increase or decrease) in appetite resulting in a significant change in weight
PSYCHOMOTOR SYMPTOMS: retardation (slowed thoughts and movement) AND agitation (restlessness resulting in undesired movement)
SUICIDAL THOUGHTS: recurrent
defn: major depressive disorder
the presence of major depressive episodes
defn: major depressive episode
a 2-week or longer period in which 5/9 depressive symptoms occur and must include either depressed mood or anhedonia (inability to feel and anticipate pleasure)
symptoms must be severe enough to impair daily social or work activities
defn + aka: persistent depressive disorder
aka: dysthymia
when an individual experiences a period of at least 2 years in which they experience a depressed mood on the majority of days
what are four other types of depressive disorders outside of MDD and PDD?
- disruptive mood dysregulation disorder
- premenstrual dysphoric disorder
- seasonal affective disorder
- postpartum depression
defn: disruptive mood dysregulation disorder
diagnosed ages 6 - 10
diagnostic feature: persistent and recurrent emotional irritability in multiple environments
defn: premenstrual dysphoric disorder
characterized by mood changes (often depressed mood), occurring a few days before menses and resolving after menses onset
defn + treatment: seasonal affective disorder
dark winter months are source of depressive symptoms (MDD with seasonal onset) –> may be related to abnormal melatonin metabolism
often treated with bright light therapy
defn: postpartum depression
rapid change in hormone levels after giving birth causes depressive symptoms
what are characteristics of bipolar disorders?
the presence of manic and depressive symptoms, which severe and persistent enough can be called episodes
defn: manic symptoms
an exaggerated elevation in mood + increase in goal-directed activity and energy
mnemonic + defn: 7 manic symptoms
DIG FAST
DISTRACTIBILITY: inability to remain focused on an activity
IRRESPONSIBILITY: engaging in risky activities without considering future consequences
GRANDIOSITY: exaggerated and unrealistic increase in self-esteem
FLIGHT OF THOUGHTS: racing thoughts (self-reported or shown through rapid speech)
ACTIVITY OR AGITATION: increase in goal-oriented work or social activities
SLEEP: decreased need for sleep
TALKATIVE: exaggerated desire to speak
defn: hypomanic episode
the presence of manic symptoms present for at least 4 days and include 3 + of the 7 defined symptoms, but not severe enough to impair social or work activities
defn: manic episode
3+ of 7 defined manic symptoms that are severe enough to impair social or work activities and persist for at least 7 days
defn: bipolar I disorder
key diagnostic feature: presence of manic episodes, depressive symptoms are not a requirement
defn: bipolar II disorder
the presence of both a major depressive episode an an accompanying hypomanic episode, but NOT a manic episode
defn: cyclothymic disoder
the presence of both manic and depressive symptoms that are not severe enough to be considered episodes (the patient has not experienced major depressive, manic, or hypomanic episodes)
a person must have experienced numerous periods of manic and depressive symptoms for the majority of time over a 2-year + period
defn: monoamine or catecholamine theory of depression
too much norepinephrine and serotonin in the synapse leads to mania, too little leads to depression
defn: fear vs. anxiety
fear: an emotional response to an immediate threat
anxiety: fear of an upcoming or future event
defn: anxiety disorder
irrational and excessive fear or anxiety affects an individual’s daily functioning
defn: phobia and specific phobia
a type of anxiety disorder
an irrational fear of something that results in a compelling desire to avoid it
a specific phobia is one in which fear and anxiety are produced by a specific object or situation
defn: separation anxiety disorder
excessive fear of being separated from one’s caregivers or home environment
persists beyond the age deemed developmentally appropriate
accompanied by the ideation that when separated, the caregiver or individual will be harmed
may result in avoidant behaviors
defn: social anxiety disorder
fear or anxiety towards social situations and encounters w/belief that they will be exposed, embarrassed, or negatively perceived by others
+ avoidant behavior to the point of social or occupational impairment
defn: selective mutism
consistent inability to speak in situations where speaking is expected
in more relaxed situations, speaking is unaffected
defn: panic disorder
recurrence of unexpected panic attacks + anxiety of having a panic attack that impairs daily functions and persists for at least a month
defn: panic attack
misfiring of sympathetic nervous system resulting in unwanted fight or flight response
includes associated emotions (intense fear, impending doom/danger)
the sudden surge of fear in which one feels they are losing control of their body and/or they are dying
defn: expected vs. unexpected panic attacks
expected: associated with specific triggers
unexpected: no clear trigger, seemingly random
defn: agoraphobia
fear of being in places or situations where it might be difficult to escape
assoc. with panic attacks and fear of negative evaluation by others
defn: generalized anxiety disorder
disproportionate and persistent worry about many different things for at least 6 months
worrying is hard to control, even when they know that it is irrational
often have physical symptoms (fatigue, muscle tension, sleep problems)
defn: obsessive-compulsive disorder
characterized by obsessions (persistent, intrusive thoughts and impulses) which produce tensions and compulsions (repetitive tasks) that relieve tension but cause significant impairment in life
defn: ego-dystonic (OCD)
describes the relationship between obsessions and compulsions
they know their behavior is irrational, but the anxiety that arises when compulsions are not performed cannot be ignored
defn: obsessions
perceived needs with accompanying ideation if a particular need is not met, disastrous events will follow
defn: compulsions
actions paired with obsessions
defn: body dysmorphic disoder
presence of unrealistic negative evaluation of personal appearance and attractiveness, usually directed toward a certain body part
defn: preoccupation
a type of worry that lacks the disastrous ideation that accompanies obsessions
defn: muscle dysmorphia
individuals believe their body is too small or unmuscular, responds by working out
persists with clear evidence against it
defn: hoarding disorder
a need to save or keep items, paired with excessive acquisition of objects
defn: trichotillomania
compulsion to pull out hair with previous attempt to stop, but failed
defn: excoriation disoder
compulsion to pick at skin with previous attempt to stop, but failed
characteristics of trauma and stressor-related disorders
traumatic event is source of symptoms + diagnostic requirement
typical responses: fear, helplessness, anxiety
present with maladaptive symptoms: anhedonia, dysphoria (generalized life dissatisfaction), aggression, dissociation
defn: PTSD
occurs after experiencing or witnessing a traumatic event and consists of
- intrusion symptoms
- arousal symptoms
- avoidance symptoms
- negative cognitive symptoms
a particular number of these symptoms must be present for at least one month
defn: intrusion symptoms (PTSD)
recurrent reliving of the event, flashbacks, nightmares, and prolonged distress
defn: arousal symptoms (PTSD)
an increased startle response, irritability, anxiety, self-destructive or reckless behavior, sleep disturbances
defn: avoidance symptoms (PTSD)
deliberate attempts to avoid the memories, people, place, activities, and objects assoc. with trauma
defn: negative cognitive symptoms (PTSD)
an inability to recall key features of the event, negative mood or emotions, feeling distanced from others, a persistent negative view of the world
defn: acute stress disorder
the same symptoms of PTSD last for less than one month, but more than three days
explain the four categories of PTSD symptoms from a behaviorist perspective
intrusion and arousal: classical conditioning (event has become assoc. with traumatic triggers, generalized to everyday stimuli)
avoidance: avoidance learning (learn behavior to avoid unpleasant stimuli)
negative cognitive: dissociation (defense mechanism to avoid unpleasant stimuli)
defn + 3 types: dissociative disorders
avoid stress by escaping from parts of their identity
- dissociative identity disorder
- dissociative amnesia
- depersonalization/derealization disorder
defn: dissociative amnesia
an inability to recall past experiences (not caused by neurological disorder)
defn: dissociative fugue
a symptom of dissociative amnesia
a sudden, unexpected move or purposeless wandering away from one’s home or daily location
confused about identity, may think they are someone else
defn: dissociative identity disorder
2+ personalities that recurrently take control of the patient’s behavior
results when components of identity fail to integrate
most have experienced severe physical or sexual abuse as young children
defn: depersonalization/derealization disorder
feel detached from their own minds and bodies (depersonalization) or from their surroundings (derealization)
defn: somatic symptom disorder
have at least one somatic symptom, which may or may not be linked to an underlying medical condition, and is accompanied by disproportionate concerns about its seriousness, devotion of an excessive amount of time or energy about it, or elevated anxiety
defn: illness anxiety disorder
being consumed about thoughts about having or developing a serious medical condition (no somatic symptoms)
defn + aka + examples: conversion disorder
aka: functional neurological symptom disorder
symptoms affecting voluntary motor or sensory functions that are incompatible with the patient’s neurophysiological condition
generally begin soon after stress or trauma, but may not develop until some time has passed
examples: paralysis or blindness
defn: la belle indifférence
part of conversion disorder
surprising lack of concern with the developed symptom
defn: (general) personality disorder
a pattern of behavior that is inflexible and maladaptive, causing distress or impaired functioning in at least two of: cognition, emotions, interpersonal functioning, or impulse control
defn. ego-syntonic vs. ego-dystonic
ego-syntonic: individuals perceive their behavior as correct, normal, or in harmony with their goals
ego-dystonic: individuals see the illness as something thrust about them, intrusive, and bothersome
what are the 10 personality disorders divided into their 3 clusters?
Cluster A: paranoid, schizotypal, and schizoid
Cluster B: antisocial, borderline, histrionic, and narcissistic
Cluster C: avoidant, dependent, and obsessive-compulsive
char and spec descrip: Cluster A personality disorders
- marked by behavior labeled as odd or eccentric by others
paranoid personality disorder: a pervasive distrust of others and suspicion regarding their motives
schizotypal personality disorder: a pattern of odd or eccentric thinking (may have ideas of reference and magical thinking (superstitions, clairvoyance))
schizoid personality disorder: a pervasive pattern of detachment from social relationships and a restricted emotional expression range
char and spec descrip: Cluster B personality disoders
- marked by behavior labeled as dramatic, emotional, or erratic by others
antisocial personality disorder: a pattern or disregard for and violations of the rights of others (repeated illegal acts, deceitfulness, aggressiveness, remorse for said actions)
borderline personality disorder: pervasive instability in interpersonal behavior, mood, and self-image (sexual identity, long-term goals, values); often an intense fear of abandonment; suicide attempt and self mutilation common
histrionic personality disorder: constant attention-seeking behavior (may include seduction)
narcissistic personality disorder: a grandiose sense of self-importance or uniqueness, preoccupation with success fantasies, need for constant admiration and attention, characteristic disturbances in interpersonal relationships (entitlement)
defn: splitting
a defense mechanism used by people with borderline personality disorder
they view others as either all good or all bad (angel vs. devil mentality)
char and spec descrip: Cluster C personality disorders
- marked by behavior labeled as anxious and fearful by others
avoidant personality disorder: extreme shyness and fear of rejection, see themselves as socially inept, socially isolated despite an intense desire for social affection and acceptance, tend to keep life the same even though they want to change
dependent personality disorder: a continuous need for reassurance, remain dependent on one specific person to take actions and make decisions
obsessive-compulsive personality disorder: perfectionistic, inflexible, like rules and order, lack of desire to change, stubbornness, lack of humor, keep worn-out objects, routines
what is difference between OCD and OCPD?
OCD: obsessions and compulsions are focal and acquired, ego-dystonic
OCPD: lifelong, ego-syntonic
what are the proposed biological bases and associations of schizophrenia?
- genetic (partially inherited)
- trauma at birth (hypoxemia, risk)
- excessive marijuana in adolescence (risk)
- structural brain changes
- excessive dopamine in brain
defn, func, aka: neuroleptic schizophrenia medications
block dopamine receptors
depress nerve function
aka: antipsychotics
biological markers of depression
- high glucose metabolism in amygdala
- hippocampal atrophy after long duration
- high levels of cortisol
- decreased production of norepinephrine, serotonin, dopamine
biological markers of bipolar disorder
- increased norepinephrine and serotonin
- parent with bipolar (risk)
- multiple sclerosis (risk)
biological factors of Alzheimer’s
- diffuse atrophy of brain on CT or MRI
- flattened sulci in cerebral cortex
- enlarged cerebral ventricles
- deficient blood flow in parietal lobes (cognitive decline)
- reduced ACh levels
- reduced choline acetyltransferase (enzyme that produces ACh)
- reduced temporal and parietal lobe metabolism
- senile B-amyloid plaques (misfolded protein in B-pleated sheet form)
- neurofibrillary tangles of hyperphosphorylated tau protein
what are 6 characteristic and 2 common symptoms of Parkinson’s disease? Describe them.
- bradykinesia (movement slowness)
- resting tremor (tremor appears when muscles not in use)
- pill-rolling tremor (flexing and extending the fingers while moving the thumb back and forth)
- masklike facies (static and expressionless facial features, staring eyes, partially open mouth)
- cogwheel rigidity (muscle tension that intermittently halts movement as an examiner attempts to manipulate a limb)
- shuffling gait with stooped posture
- depression
- dementia
biological basis of Parkinson’s disease
- decreased dopamine production in the substantia nigra (layer of cells in brain to produces dopamine to allow proper basal ganglia functioning) –> basal ganglia is deeply related to movement
defn: L-DOPA
helps manage Parkinson’s
a precursor that is converted into dopamine once in the brain, thus replacing dopamine lost by Parkinson’s
