Chapter 7- Psychological Disorders Flashcards
Biomedical approach vs Biopsychosocial approach
Symptom reduction of psychological disorders. Focuses on medical solution
Considers biological psychological and social components to an individuals disorder
Direct therapy vs indirect therapy
Treatment acts directly on the individual (meds and periodic meetings with a psychologist)
Aims to increase social support by educating and empowering family and friends of the affected individual
DSM
Diagnostic and Statistical Manual of Mental Disorders
20 diagnostic classes of mental disorders. Used to diagnose pts.
Schizophrenia
Prototypical disorder c psychosis as a feature. Positive and negative symptoms.
Positive and Negative symptoms of schizophrenia
+ adds something to behavior cognition affect. Ex: delusions, hallucinations, disorganized speech and disorganized behavior
- loss of something from behavior cognition or affect. Ex: Disturbance of affect, avolition
(Avolition: total lack of motivation that makes it hard to get anything done
Disturbance of affect: paranoid type.
disorganized type, catatonic type, undifferentiated type, residual type.
Types of depressive disorder
Major depressive disorder: at least one major depressive episode
Persistent depressive disorder considered (dysthymia) for at least two years that does not meet criteria for major depressive disorder
Seasonal depressive disorder: major depressive disorder with seasonal onset during the winter months
Major depressive disorder
Contains at least one major depressive episode
A period of at least two weeks with at least five of the SIG E CAPS symptoms
Persistent depressive disorder
Depression for at least two years it does not make criteria for major depressive disorder.
Depressed mood that isn’t severe enough to meet the criteria for a major depressive episode
Seasonal affective disorder (SAD)
Colloquial name for major depressive disorder with seasonal onset depression occurs during winter months
Types of bipolar disorders
Bipolar I – contains at least one manic episode.
Bipolar II – contains at least one hypomanic episode and at least one major depressive episode
Cyclothymic disorder – contains hypomanic episodes with dysthymia
Manic versus hypomanic episode
Characterized by abnormal and persistently elevated mood with at least three of the following: DIG FAST
Duration: In mania, an elevated or irritable mood lasts at least one week. In hypomania, symptoms last for at least 4 days. Intensity: In mania, symptoms are severe, and in hypomania, they are mild to moderate
Symptoms of a major depressive episode
SIG E CAPS
Sleep, interest, guilt, energy, concentration, appetite, cycle motor symptoms, suicidal thoughts
Positive versus negative symptoms associated with schizophrenia
Positive symptoms include behaviors thoughts or feelings added to normal behavior including delusions, hallucinations, disorganized thoughts, disorganized behavior, echolalia echo proxy.
Negative symptoms include disturbance of a fact, blunting, flat affect, inappropriate affect, avolition
Delusions
Different types of delusions
False beliefs discordant with reality and not shared by others in the individuals culture maintained in spite of strong evidence to the contrary.
Delusions of reference – belief that common elements in the environment are directed toward the individual (Thinking someone on the TV is talking to you)
Delusions of persecution – belief of the persons being deliberately interfered with discriminated against, plotted against or threatened.
Delusions of Grandor – involve a belief that the person is remarkable in some significant way such as being an inventor historical figure a religious icon. 
Hallucinations
Perceptions that are not due to external stimuli but have a compelling sense of reality.
Auditory hallucinations, visual, olfactory
Neologisms
When a person with schizophrenia invents new words. Associated with disorganized thoughts/loosening of associations.
Catatonia
Characteristic of an individual with schizophrenia spontaneous movement may be greatly reduced or increased and bizarre.
Echolalia versus echopraxia
Repeating another’s words
Imitating another’s actions
Disturbance of affect
The expression of emotion as observed by others
Blunting
Severe reduction in the intensity of affect. Less severe than flat affect or emotional flattening
Inappropriate affect
The affect is clearly discordant with the context of the individual speech.
Example of patients with inappropriate affect may begin to laugh hysterically when describing a parents death.
Avolition
Decreased engagement in purposeful goal directed actions
Anhedonia
Loss of interest and all or almost all formally enjoyable activities
Symptoms of manic episode
DIG FAST
distractible, insomnia, grandiosity, flight of ideas (racing thoughts), agitation, pressured speech, risky behavior or thoughtlessness
Bipolar disorder
Bipolar 1– manic episodes without major depressive episodes
Bipolar 2- hypomania with at least one major depressive episode
Cyclothymic disorder
Combination of hypomanic episodes and periods of dysthymia that are not to be an app to qualify as major depressive episodes
Types of anxiety disorders
Generalized anxiety disorder, specific phobias, social anxiety disorder, agoraphobia, panic disorder
Generalized anxiety disorder
Disproportionate and persistent worry about many different things for at least six months
Specific phobias
Anxiety brought on by irrational fears of specific objects or situations
Social anxiety disorder
Anxiety due to social performance situations
Agoraphobia
Fear of places or situations where it is hard for an individual to escape
Panic disorder
Marked by recurrent panic attacks, intense overwhelming fear and sympathetic nervous system activity with no clear stimulus.
May lead to agoraphobia.
Obsessive compulsive disorder
Characterized by obsessions which are persistent intrusive thoughts or impulses and…
Compulsions which are repetitive tasks that relieve tension but cause significant impairment in a persons life
Body dysphormic disorder
Characterized by an unrealistic negative evaluation of one’s appearance or a specific body part.
May take extreme measures to correct the perceived in perfection.
Post traumatic stress disorder PTSD
A trauma or stress related disorder

Characterized by…
intrusion symptoms- reliving the event flashbacks nightmares
avoidance symptoms- avoidance of people, places, objects associated with the trauma
negative cognitive symptoms- amnesia, negative mood and emotions
arousal symptoms-increase startle response, irritability and anxiety
Dissociative disorders
When a person avoid stress by escaping from their identity
Ex: Dissociative amnesia, dissociative fugue, dissociative identity disorder, depersonalization/derealization disorder
Dissociative amnesia
Inability to recall past experience without an underlying neurological disorder in severe forms that may involve dissociative fugue
Dissociative fugue
Sudden change in location that may involve the assumption of a new identity
Dissociative identity disorder
The occurrence of two or more personalities that take control of a persons behavior
Depersonalization/Derealization disorder
Involve feelings of detachment from the mind and body or from the environment
Somatic related disorders
Somatic symptom disorder, illness anxiety disorder, conversion disorder
Somatic symptom disorder
Involves at least one somatic symptom which may or may not be linked to an underlying medical condition that causes disproportionate concern
Illness anxiety disorder
Preoccupation with thoughts about having her coming down with a serious medical condition
Conversion disorder 
Unexplained symptoms affecting moderate sensory function is associated with prior trauma
Personality disorders
Clusters
Patterns of inflexible maladaptive behavior that causes distress or impaired functioning in at least two of the following: cognition, emotions, interpersonal functioning or impulse control.
Cluster A: odd and eccentric
Cluster B: dramatic emotional erratic
Cluster C anxious fearful
Cluster A
Odd and eccentric- Includes paranoid schizo typo schizoid personality disorders
Cluster B
Dramatic emotional erratic
Includes antisocial, borderline, histrionic, narcissistic personality disorder
Cluster C
Includes avoidant dependent and obsessive compulsive personality disorder
Paranoid personality disorder
Pervasive distrust and suspicion of others
Schizotypal personality disorder
Pattern of odd or eccentric thinking.
Ideas of reference (similar to delusions of reference but not as extreme in intensity)
Magical thinking superstitiousness or a belief in clairvoyance (supposed faculty of perceiving things or events in the future or beyond normal sensory contact)
Schizoid personality disorder
Detachment from social relationships and limited emotion
Antisocial personality disorder
Disregard for the rights of others. Serial killers often fall under this category
Borderline personality disorder
Instability in relationships mood and self image. Splitting is characteristic as are suicide attempts
Splitting
Characteristic of borderline personality disorder uses a defense mechanism in which an individual views others as either all good or all bad angel versus devil mentality.
Histrionic personality disorder
Involves constant attention seeking behavior
Narcissistic personality disorder
Grandiose sense of self importance in need for admiration
Avoidant personality disorder
Involves extreme shyness and fear of rejection
Dependent personality disorder
Involves a continuous need for reassurance
Obsessive compulsive personality disorder
Involves perfectionism and flexibility and preoccupation with rules
What things may be associated with schizophrenia
Genetic factors, birth trauma, adolescent marijuana use, family history
Highly associated with an excess of dopamine
Treated with medication such as neuroleptics which block dopamine receptors
What are some markers associated with depression
Abnormally high glucose metabolism in the amygdala, hippocampal atrophy after a long duration of illness, abnormally high levels of cortisol (glucocorticoids) decrease norepinephrine and serotonin and dopamine
For bipolar disorders What biological and genetic factors contribute to the disease
Increased norepinephrine and serotonin, higher risk if a parent has bipolar disorder, higher risk for persons with multiple sclerosis
Alzheimer’s disease is associated with what?
Genetic factors, brain atrophy, decreases in acetylcholine, senile plaques of b amyloid (miss folded proteins and beta pleated sheet form) neurofibrillary tangles of hyperphosphorylated tau protein
Parkinson’s disease is associated with what?
Bradykinesia- Slowness in movement
resting tremor- tremor that appears when muscles are not being used
pill rolling tremor- Flexing and extending the fingers were moving the thumb back-and-forth as a rolling something in the fingers
masklike fasciitis- Facial expression consisting of static an expression less facial features staring eyes and partially open mouth
cogwheel rigidity- Muscle tension that intermittently halt movement as an examiner attempts to manipulate a limb
shuffling gait with stooped posture
Decreased production of dopamine by cells in the substantial nigra.
