ch 8-11 exam Flashcards
obesity (not psychiatric diagnosis)
rates increasing
BMI
causes - genetics 30% of cause
modernization (inactive lifestyle, high-fat foods) biological factors (initiation and maintenance of eating) psychosocial factors (impulse control, attitude, affect reg)
treatment - weight loss programs, behavior mod programs, bariatric surgery
bulimia nervosa
DSM criteria
-recurrent episodes of binge eating
-recurrent compensatory behaviors to prevent weight gain
-cycle at least once/week for 3 months
-self in unduly influenced by body shape/weight
most diagnoses within 10% of normal body weight
medical consequences - erosion of dental enamel, electrolyte imbalance, kidney failure, seizures, intestinal problems
causes - ideal body size, culture, social/gender standard, dieting trends, fam history of dieting/EDs, perfectionism, low sense of control, low self confidence, distorted body image
treatment - antidepressants, logic-based therapy (best) interpersonal psychotherapy, prevention
90-95% female
anorexia nervosa
DSM criteria
-restricted energy intake leading to significant low body weight
-intense fear of weight gain or persistent behavior to prevent weight gain
-disturbance in way body weight or shape is experienced
medical consequence - no period, dry skin, brittle hair/nail, cardiovascular problems, electrolyte imbalance
comorbidity - anxiety/mood disorders, substance use
stats - 90-95% female and 1% gen pop
causes - ideal body size, culture, social/gender standard, dieting trends, fam history of dieting/EDs, perfectionism, low sense of control, low self confidence, distorted body image
treatment - weight restoration, CBT, psychoeducation, prevention
sleep disorder assessment
polysomnographic evaluation
-detailed history
-sleep hygiene
-EEG
-EOG
-EMG
actigraph
sleep logs
insomnia
DSM criteria
-predominant complaint of dissatisfaction with sleep quality/quantity
-cause significant impairment/distress
-difficulty at least 3 nights/week for 3 weeks
-not due to something else
stats - female:male 2:1, frequently associated with anxiety, depression, substance
causes - diathesis/stress, predisposing factors (genetics, personality, hyperarousal), precipitating factors (situational stress, injury, illness), perpetuating factors(time in bed, napping, alc, caffeine intake, conditioned arousal)
treatment - benzos, sleep restrictions, CBT (sleep hygiene, stimulus control, relaxation)
sleep apnea
restricted air flow, brief cessations of breathing
stats - male>female
associated with obesity and age
treatment - tricyclics, weight loss, surgery, CPAP machine
50% of leading causes of death linked to what
behavioral/lifestyle patterns
ex. genital herpes - sexual behaviors and stress
psychological factors influence what
biological processes
behavioral patterns influence what
increases disease risk
biopsychosocial model
biological, social, and psychological factors are interrelated to influence health and well-being
benefits of social support
reduce stress, promote psych adjustment to chronic disease, protect against cognitive decline, faster recovery from surgery, fewer complications in pregnancy and childbirth
psychosocial pathway
beneficial when attempting behavior change (help with accountability)
social-biological pathway
alters the perception of stress (buffers in inflammatory process in response to stress)
stress response
nature of stress - stressor, stress, individual variability
general adaptation syndrome - phase 1 (alarm response), phase 2 (resistance), phase 3 (exhaustion)
two endocrine systems
hypothalamic-pituitary-adrenocortical (HPA) axis = corticotropin releasing factor
sympathetic-adrenaline-medullary (SAM) system
clinical psych in treatment of HIV/AIDS
high stress is exacerbation of AIDs progression
stress reduction increased t helper cells
clinical psych in treatment of cancer
factors in adapting to cancer diagnosis
-intrapersonal (personality, coping ability)
-interpersonal (social support)
-socioeconomic (low SES is a barrier to healthcare access)
clinical psych in treatment of cardiovascular disease
denial as a means of coping, coronary bypass surgery, and optimists have quicker recovery,
types of pain
acute vs chronic
true or false: severity of pain predicts reaction to it
FALSE: it DOES NOT
factors that predict reaction to pain
perceived control, negative emotion, poor coping skills, social support, compensation
comprehensive treatment program for pain
monitor and ID stressful events, monitor somatic symptoms, muscle relaxation, cognitive therapy, increase coping strategies (more effective than individual components)
gender differences in sex
women - emphasis on context of committed relationship and satisfaction is from demonstration of love
men - focus on arousal and self concept includes power, independence, and aggression
sex
biological indicators
assigned at birth
gender
denotes public identity
gender identity
gender dysphoria
DSM criteria
-marked incongruence with one’s experienced gender and assigned sex for at least 6 months
-clinically significant distress or impairment in school, social, or other important areas
-must of 6 of 8 (strong desire to be other gender, strong preference to cross-dress, a strong dislike for one’s anatomy, etc)
stats - prevalence = rare
causes - biological is unclear but likely genetic,, hormones, gender identity (parental reinforcement
treatment - hormones to suspend puberty, hormones to promote opposite sex characteristics, sex reassignment surgery (>18)
sexual disorders
dysfunction in desire, arousal, and/or orgasm; pain with sex
specifiers - lifelong vs acquired, generalized vs situational, severity
assessment - interviews, medical (medication side effects, physical conditions), psychophysiological (exposure to erotic material, sexual arousal response
causes - biological (disease, meds, alc and drugs), psych (performance anxiety), social (negative scripts, trauma, poor interpersonal relationships)
treatment - education, psychosocial intervention (eliminate performance anxiety, non-demand pleasuring), med intervention
frotteuristic disorder
the act of touching or rubbing one’s genitals up against another person in a sexual manner without their consent to derive sexual pleasure or reach orgasm
voyeuristic disorder
observing an unsuspecting individual
risk is necessary
exhibitionistic disorder
exposure or be observed by others; compulsivity
fetishistic disorder
sexual attraction to non living objects (inanimate, tactile, partialism)
transvestic disorder
sexual arousal via cross-dressing
sexual sadism disorder
inflicting pain/humiliation
sexual masochism disorder
suffering pain/humiliation
pedophilic disorder
sexual attraction to young children (90% male)
rationalized behavior as “loving”
causes of paraphilia
low level of arousal to normal stimuli, sexual problems, conditioning, high sex drive, low suppression of urges/drives, social deficits
treatment for paraphilias
psychosocial interventions - behavioral, target inappropriate sexual associations, orgasmic reconditioning, coping, relapse prevention
70-98% imrpove
medications (for pedophilia) - chemical castration or meds that reduce testosterone but have a high relapse rate
depressants
alcohol, benzos
stimulants
cocaine, meth, caffeine, nic
most widely consumed drug in U.S.
increases alertness and energy
opiates
herion
hallucinogens
LSD, cannabis
alter sensory perception
can produce hallucinations, delusions, paranoia
substance use disorder
DSM 5 criteria
problematic pattern of substance use leading to clinical impairment with at least 2 (loss of control, craving, high tolerance, withdrawal, failure to fulfill responsibilities
male>female for alc, cannabis, opiate, and gambling
causes: diathesis-stress model, fam/genetic influence, pleasure/reward centers, GABA (inhibition yields more), dopaminergic systems (midbrain/frontal cortex), opponent process theory (positive reinforcement - high and later negative reinforcement - withdrawal so want more), cognitive factors (belief about drugs, cravings), social dimensions (exposure to drugs, societal views)
treatment: medication (agonist sub - safer version of same drug ex: nic gum, antagonist treatment - help manage cravings, aversive treatment - make use of substance unpleasant), psychosocial (residential/inpatient, outpatient, self-help - AA, controlled use, CBT, contingency management - positive reinforcement, relapse prevention)
fetal alcohol syndrome
growth retardation, cognitive deficits, behavior problems, facial abnormalities
progression of alc related disorders
spontaneous remission, course of mild use disorder - variable, course of severe use disorder - progressive
effects of amphetamines
“up” - elation and reduced fatigue
“crash” - fatigue and depression
link with hallucinations and delusions
significant agonist and reuptake block effects (norepinephrine and dopamine)
cocaine use disorder
blocks dopamine reuptake (euphoria and short-term powerful/confidence)
increased bp/pulse
insomnia
paranoia
decreased appetite
nic use disorder
sensations of relaxation, wellness, pleasure
stimulates nicotinic acetylcholine receptors
“dosing” - maintain a steady level of nic in the bloodstream
withdrawal: physiological - restlessness/weight gain, psychological - depressed mood, irritability, anxiety, concentration difficulty
