Chapter 7: Psychological Disorders Flashcards
In the biopsychosocial model, the goal is often to provide not only direct therapy, but also ________ therapy, which aims to increase social support by educating and empowering family and friends.
indriect
According to the DSM-5, individuals with a ____________ disorder present with 1+ of the following symptoms: delusions, hallucinations, disorganized thought, disorganized behavior, catatonia, and negative symptoms.
psychotic
____________ symptoms are behaviors, thoughts, or feelings that are added to normal behavior.
Positive
e.g. delusions, hallucinations
____________ symptoms are those that involved the absence of normal/desired behavior.
Negative
e.g. avolition, disturbance of affect
____________ are false beliefs discordant with reality and not shared by others in the individual’s culture.
Delusions
often maintained in spite of evidence to the contrary
Delusions of ____________ involve the belief that common elements in the environment are directed toward the individual.
reference
e.g. might think someone in the TV is talking directly to you
Delusions of ________________ involve the belief that the person is being deliberately interfered with, discriminated against, plotted against, or threatened.
persecution
Delusions of ____________ involve the belief that the person is remarkable in some significant way, e.g. thinks they are an inventor, historical figure, or religious icon.
grandeur
________ ________________: the belief that one’s thoughts are broadcast directly from one’s head to the external world.
Thought broadcasting
________ ________________: the belief that thoughts are being removed from one’s head
Thought withdrawal
________ ____________: the belief that thoughts are being placed in one’s head.
Thought insertion
________________ are perceptions that are not due to external stimuli but which nevertheless seem real to the person perceiving them.
Hallucinations
________________ thought is characterized by loosening of associations, e.g. ideas shifting in a way that you cannot follow train of thought. Also known as word salad. People with schizophrenia may even invent new words, called ____________.
Disorganized; neologisms
________________ behavior refers to an inability to carry out activities of daily living.
Disorganized
____________ refers to certain motor behaviors characteristic of some people with schizophrenia. Spontaneous movement and activity may be greatly reduced and the patient may be rigid. May include other behaviors like ____________ (repeating others words) or ____________ (imitating another’s actions)
Catatonia; echolalia, echopraxia
The 2 most common examples of negative symptoms are:
affect and avolition
________ is the experience and display of emoiton.
affect
Affective symptoms may include ____________ (severe reduction in intensity of affect expression), ________________ ________________ (aka flat affect, no signs of emotional expression), or ________________ affect, in which affect is discordant with speech.
blunting; emotional flattening; inappropriate affect
____________ is marked by decreased engagement in purposeful, goal-directed actions.
Avolition
________________ is characterized by a break between an individual and reality.
Schizophrenia
What are the 3 stages of schizophrenia?
- Prodromal
- Active
- Residual
The ____________ phase of schizophrenia is associated with clear evidence of deterioration, social withdrawal, role functioning impairment, peculiar behavior, inappropraite affect, and unusual expreiences.
prodromal
The ________ phase of schizophrenia is associated with a pronounced display of psychotic symptoms.
active
The ________ phase, also called the recovery phase, occurs after an active episode and is characterized by mental clarity. Often concerned about previous behavior.
residual
What are some other psychotic disorders?
- Schizotypal Personality Disorder (mix of personality disorder and psychotic symptoms, which come later)
- Delusion Disorder (only delusions for at least a month)
- Brief Psychotic Disorder (positive psychotic symptoms for at least a day, less than a month)
- Schizophreniform Disorder (schizophrenia criteria displayed for only 1 month)
- Schizoaffective Disorder (Major mood episodes + psychotic symptoms)
____________ disorders are characterized by feelings of sadness that are severe enough to meet diagnostic criteria. What are the 9 symptoms?
S + SIG E. CAPS
Depressive
1. Sadness
2. Sleep: insomnia
3. Interest: loss; anhedonia
4. Guilt
5. Energy: low
6. Concentration: difficult
7. Appetite: may over or under eat; 5% change in weight
8. Psychomotor symptoms: retardation or agitation
9. Suicidal thoughts
The key feature of ________ ________________ disorder (MDD) is the presence of major depressive episodes.
major depressive
How many?
A major depressive episode is defined as a ____-week (or longer) period in which ____ of the 9 defined depressive symptoms are encountered.
2; 5
To be classified as a major depressive episode, one of the experienced symptoms must be ________________ or ________________. How severe should the symptoms be?
- sadness/depressed mood
- anhedonia
Severe enough to impair daily activities
A diagnosis of ____________ depressive disorder (PDD), also known as ____________, is given when an individual experiences a period, lasting at least 2 years, in which they experience a depressed mood on the majority of days.
persistent; dysthymia
________________ ________ ________________ disorder is typically diagnosed between the ages of 6 and 10 and has the key diagnostic feature of persistent and recurrent emotional irritability in multiple environemnts.
disruptive mood dysregulation
done because kids often exhibit more dramatic emotional responses than adults – keeps them from being overdiagnosed with bipolar disorders
________________ ____________ disorder is characterized by mood changes, often depressed mood, occurring a few days before menses onset.
Premenstrual dysphoric disorder
____________ ____________ disorder (SAD): the dark winter months are believed to be the source of depressive symptoms.
seasonal affective
____________ depression is the rapid change in hormone levels after giving birth.
postpartum depression
____________ ____________ disorder could be treated with bright light therapy, where the patient is exposed to bright light for a specified amount of time each day.
Seasonal affective
________ symptoms are associated with an exaggerated elevation in mood, accompanied by an increase in goal-direct activity and energy.
Manic
What are the 7 manic symptoms according to the DSM-5?
DIG FAST
- Distractability
- Irresponsibility
- Grandiosity
- Flight of thoughts
- Activity or agitation
- Sleep: decreased
- Talkative
The presence of manic symptoms are considered a ____________ episode if the symptoms are present for at least 4 days and include at least 3+ out of 7 symptoms, yet are not severe enough to impair activities.
hypomanic
An episode could be consider ________ if the manic symptoms (3+) are severe enough to impair daily activities.
manic
When manic episodes are present, a diagnosis of ____________ ____ disorder is likely to be made, as they key diagnostic feature of this disorder is the presence of manic episodes. They usually include depressive symptoms/episodes, but they are not a requirement.
bipolar I
The key feature of a ____________ ____ disorder is the presence of both a major depressive episode and an accompanying ________________ episode, not a manic episode.
bipolar II; hypomanic
If a patient has experienced both major depressive and manic, bipolar ____ diagnosis will be made. But if a person only experiences major depressive symptoms, then a ________ ____________ disagnosis will be made.
Bipolar I, Bipolar II
The diagnositc features of ____________ disorder are the presence of both manic and depressive symptoms that are not severe enough to be considered episodes.
cyclothymic
For a diagnosis of cyclothymic disorder to be made, a person must have experienced ____________ periods of manic and depressive symptoms for the majority of time over a ____-year or longer period.
numerous; 2
THe most common explanation for mood disorders revolves around which 2 neurotransmitters?
norepinephrine and serotonin
Norepinephrine and serotonin are linked togehter into that is called the ____________ or ________________ theory of depression.
monoamine; catecholamine
Too much norepinephrine and serotoninin the synapse leads to ________, whereas too little leads to ________.
mania; depression
Fear is often defined as the emotional response to an immediate threat, whereas ____________ is viewed as fear for an upcoming/future event.
anxiety
Something is only considered an anxiety disorder if what?
Interferes with daily functioning
A key diagnostic feature of ________ ________ disorder is the fear or anxiety towards social situations with the belief that the individual will be exposed, embarrassed, or simply negatively perceived by others.
social anxiety
____________ ____________ is heavily associated with social anxiety disorder and is characterized by the consistent in ability to speak in situations where speaking is expected.
selective mutism
The key diagnostic feature of ________ disorder is the recurrence of unexpected panic attacks.
Panic
A panic attack is the misfiring of the ____________ nervous system, resulting in an unwanted fight or flight response.
sympathetic
A ________ ________ is the sudden surge of fear in which individuals feel they are losing control of their body and/or that they are dying.
panic attack
Panic attacks that are associated with specific triggers are termed ____________.
expected
If there is no clear trigger and panic attacks are seemingly random, they are ________________ panic attacks.
unexepcted
____________ is an anxiety disorder caharcterized by a fear of being in places or situations where it might be difficult to escape.
agoraphobia
________________ ____________ disorder is defined as a disproportionate and persistent worry about many different things for at least 6 months.
generalized anxiety
____________-____________ disorder is characterized by obsessions (persistent, intrusive thoughts and impulses), which produce tension, and compulsions (repetitive tasks) that relieve tension but cause significant impairment in a person’s life.
obsessive-compulsive
What is the key relationship between obsessions and compulsions?
Obsessions raise individual’s stress level and compulsions relieve this stress.
Obsessions and their compulsions are ________________, meaning that the indiviudal knows that their behavior is irrational, but the anxiety that arises when compulsions are not performed cannot be ignored.
egodystonic
A ________________ is a type of worry that lacks the disastrous ideation that accompanies obsessions.
preocupation
________________ is an OCD-related disorder in which individuals are compared to pull out their hair.
Trichotillomania
____________ disorder is an OCD-related disorder associated in which individuals are compelled to pick at their skin.
Excoriation
________________ ________ disorder occurs after experiencing or witnessing a traumatic event.
posttraumatic stress
________ symptoms of PTSD include recurrent reliving of the event, flashbacks, nightmares, and prolonged distress. What explains this?
intrusion; associative learning - classical conditioning, the event is associated with traumatic triggers and now includes everyday stimuli
________ symptoms of PTSD include an increased startle response, irritability, anxiety, self-destructive or reckless behavior, and sleep disturbances. What explains this?
Arousal; associative learning - classical conditioning, the event is associated with traumatic triggers and now includes everyday stimuli
____________ symptoms of PTSD include deliberate attempts to avoid the memories, people, places, activities, and objects associated with the trauma. What explains this?
Avoidance; operant conditioning - learn behavior to avoid unpleasant stimuli
____________ ____________ symptoms of PTSD include an inability to recall key features of the event, negative mood or emotions, feeling distanced from others, and a persistent negative view of the world. What explains this?
Negative cognitive; defense mechanism (dissociation) to avoid unpleasant stimuli
To meet PTSD criteria, some symptoms must be present for at least how long?
one month
If symptoms of PTSD are present for less than a month but more than 3 days, it is called what?
acute stress disorder
Patients with ____________ disorders avoid stress by escapint from parts of their identity.
dissociative
Dissociative ____________ is characterized by an inability to recall past experiences. Often linked to trauma. May also experience dissociative ________, a sudden, unexpected move or purposeless wandering away from one’s home or location of usual daily activtiies (may assume new identity or be confused about one’s identity).
amnesia; fugue
In dissociative ____________ disorder, there are 2+ personalities that recurrently take control of the patient’s behavior. Typically happens when components of identity fail to integrate. Commonly experience abuse as a child.
identity
In ________________ disorder, individuals feel detached from their own minds and bodies.
Depersonalization
In ____________________ disorder, individuals feel detached from their surroundings.
derealization
____________ anxiety disorder is characterized by being consumed with thoughts about having or developing a serious medical condition.
Illness
Individuals with ____________ symptom disorder have 1+ somatic symptom, which may or may not be linked to an underlying medical condition, and that is accompanied by disproportionate concerns about its seriousness, devoting time/energy to it, and elevated anxiety.
somatic
____________ disorder is characterized by symptoms affecting voluntary motor or sensory functions that are generally incompatible with the patient’s neuropsychological condition. It is also known as?
Example: going blind after child dies
Conversion; functional neurological symptom disorder
typically begins soon after high level of stress/trauma
may not develop until some time has passed
In conversion disorder, a patient may be surprisingly unconcerned by the symptom, this is termed:
la belle indifference
A ____________ disorder is a pattern of behavior that is inflexible and maladaptive, causing distress or impaired functioning in 2+ of the following: cognition, emotions, interpersonal functioning, or impulse control. There are 3 clusters of disorders.
Personality
Personality disorders are considered ________________, meaning that the individuals perceive their behavior as correct, normal, or in harmony with their goals.
ego-syntonic
Cluster ____ personality disorders are marked by behavior that is labeled as odd or eccentric by others. Examples: paranoid, schizotypal, and schizoid.
A
________________ personality disorder is marked by pervasive distrust of others and suspicion regarding their motives. It is in Cluster ____.
Paranoid; A
________________ personality disorder refers to a pattern of odd or eccentric thinking. These individuals may have ideas of reference as well as magical thinking, e.g. superstitiousness or belief in clairvoyance. It is in Cluster ____.
Schizotypal; A
____________ personality disorder is a pervasive pattern of detachment from social relationships and a restricted range of emotional expression. Little desire for social interactions, few friends, poor social skills. It is in Cluster ____.
Schizoid; A
Cluster ____ personality disorders are marked by behavior that is labeled as dramatic, emotional, or erratic. Examples: antisocial, borderline, histrionic, narcissistic.
B
____________ personality disorder is 3x more common in males than females. Associated with pattern of disregard for and violations of the rights of others. It is in Cluster ____.
Antisocial; B
________________ personality disorder is 2x more common in females than males. There is pervasive instability in interpersonal behavior, mood, and self-image. Often intense and unstable relationships. Uncertainty about self-image, sexual identity, goals, values. Intense fear of abandonment. May use ____________ as a defense mechanism; view others as either all good or all bad. Often suicidal and self-mutilate. It is in Cluster ____.
Borderline; splitting; B
________________ personality disorder is characterized by constant attention-seeking behavior. Wear colorful clothes, dramatic, exceptionally extroverted. May use seductive behavior to gain attention. It is in Cluster ____.
Histrionic; B
________________ personality disorder involves a grandiose sense of self-importance or uniqueness, preoccupation with fantasies of success, a need for constant admiration and attention, and charcateristic disturbances in interpersonal relationships, like feelings of entitlement. It is in Cluster ____.
Narcissistic; B
Cluster ____ personality disorders are marked by behavior that is labeled as anxious/fearful by others. Examples: avoidant, dependent, and obsessive-compulsive personality disorders.
C
In ____________ personality disorder, the individual has extreme shyness and fear of rejection. See themselves as socially inept and often socially isolated despite desire for affection and acceptance. It is in Cluster ____.
avoidant; C
________________ personality disorder is characterized by continuous need for reassurance. Dependent on one specific person to take actions and make decisions. It is in Cluster ____.
dependent; C
________________-________________ personality disorder: individual is perfectionistic and inflexible, tending to like rules and order. It is in Cluster ____.
obsessive-compulsive; C
How does OCD differ from OCPD?
OCD is ego-dystonic, OCPD is ego-systonic.
Schizophrenia is associated with an excess of ____________ in the brain.
Dopamine
________________, which are used to treat schizophrenia, work by blocking dopamine receptors. They work by “depressing nerve function.”
Neuroleptics
Neuroleptics are also known as ________________.
Antipsychotics
Depression is associated with (high/low?) glucose metabolism in the amygdala
high
Depression is associated with ____________ atrophy after long illness.
hippocampal
Depression is associated with abnormally (high/low?) levels of glucocorticoids (cortisol).
high
Depression is associated with (increased/decreased?) norepinephrine, serotonin, and dopamine. Which theory?
decreased; monoamine
It has been found that both these monoamine neurotransmitters and their metabolites are decreased in depressed patients, what does this mean?
actual production is decreased
rather than production staying the same and degradation increasing
For bipolar disorders, they are associated with (decreased/increased?) norepinephrine and serotonin. What theory?
increased; monoamine
________________ disease is a type of dementia characterized by gradual memory loss, disorientation to time and place, problems with abstract thought, and a tendency to misplace things.
Alzheimer’s
Is Alzheimer’s more common in women or men?
Women
Alzheimer’s associated with ____________ atrophy of the brain on CT or MRI. There are also flattened ____________ in the cerebral cortex and enlarged cerebral ____________.
diffuse; sulci; ventricles
Alzheimer’s is also associated with deficient blood flow in ____________ lobes and a reduction in the levels of which neurotransmitter and the corresponding enzyme that produces it (which is?)?
parietal lobes; acetylcholine; choline acetyltransferase
Alzheimer’s is associated with reduced metabolism in which 2 lobes?
temporal and parietal
Alzheimer’s is associated with plaques of ____-________, a misfolded protein in beta-pleated sheet form. It is also associated with neurofibrillary tangles of hyperphosphorylated ____ protein.
beta-amyloid; tau
Parkinson’s disease is characterized by ________________ (slowness in movement), ________________ ____________ (a tremor that appears when muscles are not being used, and________________ tremor (flexin/extending fingers while moving thumb back and forth, like rolling something).
bradykinesia; resting; pill-resting tremor
Parkinson’s is also associated with ____________ ________ (static and expressionless facial features, staring eyes, and partially open mouth), ________________ ____________ (muscle tension that intermittently halts movement as an examiner attempts to manipulate a limb, and a ________________ ________ with stooped posture.
masklike facies; cogwheel rigidity, shuffling gait
The biological basis for Parkinson’s is decreased ________________ production in the ____________________ ________, a layer of cells in the brain that functions to produce the aforementioned neurotransmitter to permit proper functioning of the ________ ____________.
dopamine; substantia nigra; basal ganglia
The basal ganglia are critical for what type of action?
Initiating and terminanting movements. Especially smoothening motions.
Parkinson’s can be partially managed using ____-________, the precursor that is converted to dopamine once in the brain, which replaces that which is lost due to Parkinson’s.
L-DOPA
