Chapter 7: Psychological Disorders Flashcards

Question

How are depressive and manic episodes essentially two side sides of the same coin

Answer 1

The most common explanation of proposed neurological etiologies of mood disorders revolves around the neurotransmitters norepinephrine and serotonin Norepinephrine and serotonin are often linked together into what is called the monoamine or catecholamine theory of depression This theory holds too much norepinephrine and serotonin in the synapse leads to mania Too little norepinephrine and serotonin in the synapse leads to depression

Answer 2

In the case of anxiety, fear is the associated emotion. As we have seen in bipolar and depressive disorders, when the regulation of emotions, such as happiness or sadness, are insufficient then symptoms arise. Anxiety can be viewed as fear of an upcoming or future event Whereas anxiety is healthy and important in one’s life, it is only considered an anxiety disorder when irrational and excessive fear or anxiety affects an individuals daily functioning

Answer 3

Specific phobias: most common. Phobia is an irrational fear of something that results in a compelling desire to avoid it. Specific phobia is one in which fear and anxiety are produced by a specific object or situation. (claustrophobia, acrophobia, arachnophobia) Separation anxiety disorder: excessive fear of being separated from one’s caregiver or home environment. Social anxiety disorder: similar to phobia, however, social anxiety disorder has an accompanying ideation in which individuals think that they will be perceived negatively by others Selective mutism: heavily associated with social anxiety disorder, and characterized by the consistent inability to speak in situations were speaking is expected Panic disorder: recurrence of unexpected panic attack attacks. A panic attack is a sudden surge of fear in which individuals feel that they are losing control of their body and or that they are dying. Agoraphobia: characterized by fear of being in places or situations where it might be difficult for an individual to escape. Tend to be uncomfortable, leaving their homes, using public transportation, being an open spaces, waiting in lines, or simply being in crowds. Generalized anxiety disorder: disproportionate and persistent worry about many different things

Answer 4

Panic disorder is the recurrence of unexpected panic attack attacks. From a physiological perspective, a panic attack is the misfiring of the sympathetic nervous system, resulting in an unwanted fighter flight response From a psychological perspective of a panic attack includes the associated emotions that accompany, the sympathetic response, such as intense fear, and a sense of impending doom or danger A panic attack is the sudden surge of fear in which individuals feel that they are losing control their body and that they are dying Expected panic attack attacks is the occurrence of an individuals attack associated with specific triggers Unexpected panic attack attacks happen if there is no clear trigger, and the panic attacks are seemingly random The diagnosis of panic disorder requires the recurrence of unexpected panic attacks

Answer 5

Panic attack themselves are not considered a psychological disorder They may occur in the absence of physiological disorders or may be associated with anxiety disorders in which there is a clear trigger For instance, individual with arachnophobia may experience expected panic attacks when encountering a spider

Answer 6

The DSM5 categorize his anxiety disorder based on the stimulus that induces fear or anxiety However, some individuals have more anxious temperament, making them susceptible to anxiety, triggered by a multitude of stimuli It is for this reason that specific anxiety disorders are often comorbid with one another, resulting in patients having multiple diagnoses Generalized anxiety disorder is defined as a disproportionate and persistent worry about many different things for at least six months. The worrying is difficult to control, even in cases where the individual knows that they’re worrying and fear is irrational.

Answer 7

Obsessive, compulsive and related to disorders were formally classified under anxiety and somatic symptom disorders, but have been relayed as obsessive, compulsive and related disorders in the DSM5 Defining feature of obsessive, compulsive, and related disorders is the individual perceives a particular need and respond to the need by completing a particular action

Answer 8

Obsessive compulsive disorder is characterized by obsessions which produced tension and compulsions that relieve tension, but cause significant impairment in a person’s life Obsessions are perceived needs with the accompanying ideation that if a particular knee is not met, then disastrous events will follow Actions paired with obsessions are termed compulsions

Answer 9

A person has an unrealistic negative evaluation of personal appearance and attractiveness, usually directed towards a certain body part This is known as preoccupation: a type of worry, which lacks the disastrous ideation that accompanies obsession

Answer 10

Presents as a need to save or keep items and is often impaired with excessive acquisition of objects

Answer 11

Trichotillomania: individuals are compelled to pull out their hair Excoriation: individuals are compelled to pick at their skin

Answer 12

A traumatic event is the source of the symptoms, and thus is a diagnostic requirement in these disorders Typical response to traumatic events include fear, helplessness, and anxiety Individuals present with maladaptive symptoms like anhedonia (lack of pleasure), dysphoria (generalized dissatisfaction with life), aggression, or dissociation

Answer 13

Post traumatic stress disorder occurs after experiencing or witnessing a traumatic event, such as war, home invasion, rape, or a natural disaster, and consist of intrusion symptoms, arousal symptoms, avoidant symptoms, and negative cognitive symptoms Intrusion symptoms: recurrent reliving of the event, flashback, nightmares, and prolonged distress Arousal symptoms: increased startle response, irritability, anxiety, self-destructive or reckless behavior, and sleep disturbances Avoidant symptoms: deliberate attempts to avoid the memories, people, places, activities, and objects associated with the trauma Negative cognitive symptoms: inability to recall key features of the event, negative mood or emotions, feeling distance from others, and persistent negative view of the world To meet the criteria of PTSD, a particular number of these symptoms must be present for at least one month. If the same symptoms last for less than one month, it may be called acute stress disorder

Answer 14

Patients with dissociative disorders, avoid stress by escaping from parts of their identity Patients otherwise still have an intact sense of reality Dissociative amnesia: inability to recall past experiences (dissociative simply means that the amnesia is not due to a neurological disorder) Dissociative identity disorder: formally multiple personality disorder, there are two or more personalities that were currently taking control of a patient’s behavior Depersonalization/derealization disorder: individuals feel detached from their own minds and bodies (depersonalization and derealization, respectively)

Answer 15

Characterized by inability to recall past experience Dissociative simply means that the amnesia is not due to a neurological disorder, the disorder is often linked to trauma Dissociative fugue is a sudden unexpected move or purposeless wandering away from one’s home or location of usual daily activities.

Answer 16

Dissociative identity disorder was formally known as multiple personality disorder and his characterized by two or more personalities that we currently take control of the patient’s behavior

Answer 17

Individual feels detached from their own mind and bodies (depersonalization and derealization, respectively)

Answer 18

Somatic symptom disorder: at least one somatic symptom, may or may not be linked to underlying medical condition, accompanied by disproportionate concerns about its seriousness. Illness anxiety disorder: consumed with thoughts about having or developing an underlying medical condition Conversion disorder: functional neurological symptom disorder, symptoms affecting voluntary motor or sensory functions that are incompatible with patients neurophysiological conditions. Example: paralysis or blindness without evidence of neurological damage.

Answer 19

Personality disorder is a pattern of behavior that is inflexible and maladaptive, causing distress or impaired functioning, and at least two of the following: cognition, emotions, interpersonal functioning, or impulse control Ego syntonic: individual perceives their behavior as correct, normal Ego-dystonic: see the illness is something thrust upon them that is intrusive and bothersome

Answer 20

ego syntonic means that the individual perceived their behavior as correct Ego-dystonic means that the individual will see the illness is something for us upon them that is intrusive and bothersome

Answer 21

Cluster A: marked by behavior that is considered odd and eccentric Paranoid personality disorder: marked by pervasive distrust of others and suspicion regarding their motives. Many time patients are in prefrontal phase of schizophrenia and are termed premorbid. Schizotypical personality disorder: odd or eccentric thinking. Ideas of reference (Ideas of reference (IRs) are the false belief that neutral events or coincidences have a special, personal meaning; similar to delusions of reference, but not as intense) Schizoid personality disorder: pervasive pattern of detachment from social relationships, restricted range of emotional expression. Little desire for social interaction, few or no close friends, poor social skills. Note: neither schizoid nor schizoid typical are the same as schizophrenia.

Answer 22

Schizoid personality disorder and schizophrenia are distinct mental health conditions, though they share some overlapping features. Schizophrenia is a psychotic disorder characterized by hallucinations, delusions, and disorganized thinking, leading to significant impairment in daily functioning. Schizoid personality disorder, on the other hand, is a personality disorder that involves a pattern of social detachment and limited emotional expression, without the psychotic symptoms seen in schizophrenia.

Answer 23

Cluster B is defined by dramatic, emotional, and erratic behavior. Antisocial: 3x more common in males than females. Disregard for and violation of rights of others. Repeated illegal acts, deceitfulness, aggressiveness, lack of remorse. Think serial killers and career criminals, comprising 20-40% of prison population. Borderline: 2x more common in females than males. Instability in interpersonal behavior, mood, self image. Interpersonal intense and unstable. Identify disturbance, uncertainty about self image, sexual identity, long term goals and values. Histrionic: constant attention seeking. Wear colorful clothing, dramatic, exceptionally extroverted. Seductive behavior to gain attention. Narcissistic: grandiose sense of self importance or uniqueness, preoccupation with fantasies of success, need for constant admiration, feeling of entitlement. “Like themselves too much”. However fragile self esteem, concerned with how other think of them. Marked with rage, inferiority, shame, humiliation, emptiness when not viewed favorably.

Answer 24

Borderline Personality Disorder (BPD) was named that way because, in the early 20th century, it was believed to fall between the two main diagnostic categories of psychosis and neurosis. Psychosis: cannot distinguish reality and non reality. Neurosis: susceptibility toward stress, anxiety, worry, fear, anger.

Answer 25

Cluster C marked by behavior that is labeled as anxious and fearful of others. Avoidant: extreme shyness, fear of rejection. See themselves as socially inept, socially isolated, despite intense desire for acceptance. Same job, life situation, relationships despite wanting to change Dependent: continuous need for reassurance. Remain dependent on a specific person to take action and make decisions OCPD: perfectionist and inflexible, like rule and order. Lack of desire to change, stubborn, lack of humor, maintain careful routines.

Answer 26

Not the same. OCD has obsessions and compulsions that are focal and acquired, OCPD is lifelong. OCD is also ego dystonic (I can’t stop washing my hand because of the germs) and OCPD is ego systonic (I just like rules and order).

Answer 27

Schizophrenia is associated with excess dopamine in the brain, many medications known as neuroleptics block dopamine receptors. Neuroleptics are medications that spread nerve function (aka antipsychotics)

Answer 28

Depression: High glucose metabolism in amygdala Hippocampal atrophy after illness High levels of glucocorticoids (cortisol) Decreased norepinephrine, serotonin, and dopamine (monoamine theory of depression) Bipolar disorders: Increased norepinephrine and serotonin (monoamine theory) Higher risk of parent has bipolar disorder Higher risk for people with multiple sclerosis

Answer 29

Type of dimensia characterized by gradual memory loss, disorientation of time and place, problems with abstract thought, tendency to misplace things. Women greater risk than men, 65 and older is higher risk. Genetic component. Mutations in presenting gene on chromosome 1 and 14. Beta amyloid precursor protein gene on 21 is known to contribute to Alzheimer’s disease. Explain higher risk of Alzheimer’s in individuals with Down syndrome.

Answer 30

Characterized by: Bradykinesia: slowness in movement Resting tremor: tremors when muscles aren’t being used Pull rolling tremor: flexing and extending fingers while moving thumb back and forth, as if rolling something in fingers Masklike facies: static and expressionless facial features, starting eyes, partially open mouth Cogwheel rigidity: muscle tension that intermittently halts movement as a examiner attempts to manipulate limbs Shuffling gait with stopped posture Dimensia is common in Parkinson’s disease

Answer 31

Decreased dopamine production in substantia nigra Improper functioning of the basal ganglia (critical for initiating and terminating movement, sustaining repetitive motor tasks, smoothening motions) Partially managed with L-DOPA, a precursor that is converted to dopamine once in the brain.

Answer 32

Too much dopamine is associated with schizophrenia and psychosis. Deficit of dopamine is associated with Parkinson’s disease. Antipsychotic medications leads to parkinsonian side effects like muscle rigidity and flattened effect. Medication for Parkinson’s often lead to psychotic side effects such as hallucination and delusion.