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Psychological Disorders > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What are the Mood Disorders

A

Depression, Bipolar I and II

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2
Q

What are the two types of Depressive Disorders and their differences

A

Persistent depressive disorder (PDD) is a chronic long term but less acute form of depression with episodes ebbing and flowing over a long time say like 2 years
-Major Depressive Disorder (MDD): is discrete episodes lasting 2 weeks or more with substantial changes in affect, cognition and neurovegetative functions

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3
Q

Premenstrual dysphoric disorder

A

specific form of depression during a woman’s period

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4
Q

disruptive mood disorder

A

added to combat the overdiagnosis in children and is characterized by persistent irritability and behaviroal dyscontrol and develop unipolar, not bipolar depressive or anxiety disorders as they move into older years.

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5
Q

Mood Diagnostics for depressive disorders

A

mood disturbances and feelings of disinterest (anhedonia)

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6
Q

Behavior diagnostics for depressive disorders

A

decreased physical activity and productivity in daily life such as work, home and play life

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7
Q

Cognitive diagnostics for behavioral (mood) disorders

A

they hold a negative view of themselves and the world. A negative feedback loop reinforces their depressive states where they blame themselves when things go wrong and do not take credit for their accomplishments. Their mood also makes it hard for them to perform cognitive tasks and they may engage in self harm or suicide

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8
Q

Physical diagnostics for mood disorders

A

Hypersomnia and insomnia, changes in weight from undereating or overeating, psycho motor problems

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9
Q

Whats the difference between MDD and PDD

A

2 weeks of severe symptoms for MDD and two years of not so severe symptoms for PDD

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10
Q

Premenstral disorder symptoms

A

present during menses and disappear after menses such as anger/irritability, depressed mood, anxiety or tension. Also must have one of the following in accompaniment such as anhedonia, difficulty concentrating, lethargy, changes inn appetite, hypersomnia or insomnia, feelings of being overwhelmed or out of control and breast tenderness or swelling

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11
Q

Bipolar I and II distinction

A

If the person has experienced a manic episode with depression, its Bipolar I. if a person has only experienced a hypomanic episode with occasional depression , its Bipolar II.

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12
Q

Manic episode:

A

: A period of time when a person experiences an abnormal, persistent or expansive irritable mood nearly all day and every day for 1 weeks. A person can also experienced accessive happiness that may result into the person engaging in haphazardly sexual or interpersonal interactions. They also experience rapid shifts called Mood Liability going from happy to sad very quickly

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13
Q

Hypomanic episode

A

Same as Mania but not as severe for one week

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14
Q

Cyclothymic disorder:

A

Individuals experience symptoms similar cases as mania or hypomania but they are not nearly as severe and have mild depressive symptoms lasting no more than 2 months at a time and it can escalate to Bipolar I or II

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15
Q

Epidemiology of MDD

A

7% US

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16
Q

Epidemiology of Dysthymic disorder

A

0.5% US

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17
Q

Epidemiology of Bipolar I and Bipolar II

A

1.5% and is not gender specific and 0.8% in the US and 0.3 internationally more likely women respectively

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18
Q

Depression suicide rates

A

17 times the normal population

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19
Q

Bipolar suicide rates

A

20-30 times the normal population

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20
Q

MDD comorbidity

A

high comorbidity rate with ¾ of them suffering a comorbidity such as substance abuse, GAD, PTSD, OCD, anorexia, bulimia and BPD

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21
Q

PDD comorbidity

A

higher risk for comorbidity anxiety, substance abuse and personality disorders

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22
Q

Bipolar I comorbidity

A

have a history of three or more disorders including anxiety, alcohol/substance abuse, ADHD, BPD, ASD and Schizophrenia

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23
Q

Bipolar II comorbidity

A

often associated with other disorders such anxiety, phobia and excessive cannabis use

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24
Q

Cyclothymic disorder comorbidity

A

comorbid with substance abuse and sleep disorders

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25
Q

Twin studies with depression

A

if one has depression, there is a 46% chance the other twin will have it showing a strong genetic link

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26
Q

twin studies with Bipolar

A

if one twin has Bipolar, the other is 72% likely to have it however its only 5-15% likely with other close relatives. But considering Bipolar is at a 1% risk for the general population, that is still high

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27
Q

Neurotransmitters and hormones with Depression

A

Low amounts of Serotonin and norepinephrine are linked to depressive disorders also Cortisol and Melatonin are hormones involved with depression

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28
Q

Neurotransmitters and Bipolar

A

research is still being done however it is possible that manic episodes are caused by low serotonin and high norepinephrine, but it isn’t conclusive

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29
Q

Brain structures and depression

A

drastic changes in blood flow throughout the prefrontal cortex have been linked with depressive symptoms. Similarly, a smaller hippocampus, and consequently, fewer neurons, has also been linked to depressive symptoms. Finally, heightened activity and blood flow in the amygdala, the brain area responsible for our fight or flight response, is also consistently found in individuals with depressive symptoms

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30
Q

Brain structures and Bipolar

A

basal ganglia and cerebellum, which appear to be much smaller in individuals with bipolar disorder compared to the general public. Additionally, there appears to be a decrease in brain activity in regions associated with regulating emotions, as well as an increase in brain activity among structures related to emotional responsiveness

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31
Q

Learned Helplessness

A

Based on Martin Seligman’s asshole dog shocking experiment (Im going to find the fucker and kick him in the nuts!!!!!!!!!!!!) the term learned helplessness applies. That if an animal is placed in a situation that is painful and is displeasing but they have no way to escape they will continue the sense of helplessness even when no longer applicable

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32
Q

Attribution styles

A

modes of thinking, they can be positive or negative with internal, stable and global features. With depression it is a negative attribution style and that things are always their fault (internal) bad things always happen to them (stable) and it happen all day (global)

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33
Q

Maladaptive attitudes

A

negative attitudes about oneself and false beliefs such as I am stupid or worthless.

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34
Q

Cognitive triad

A

or how an individual interprets themselves, experiences and futures is often negative in people with depression

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35
Q

Cognitive Distortions or errors in thinking

A

misappraisal is often involved in depression with involves catastrophizing, jumping to conclusions and overgeneralization. Such as I will always fail

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36
Q

Automatic thoughts

A

negative thoughts occur constantly and without good appraisal

37
Q

Life stress theory

A

Women experience higher chronic stress which leads to higher rates of depression.

38
Q

gender roles theory

A

Women are not as inspired to seek personal autonomy thinking they are more dependent on the whims of another

39
Q

Artifact or hormone theory

A

thought that feminine mentalities (artifact theory) or hormonal influxes (hormone theory) for women make depression more likely but research hasn’t held well to these theories.

40
Q

Rumination theory

A

Women are more likely to ruminate on a problem than men

41
Q

SSRI’s

A

effective treatments with some minimal side effects but it still produces tolerance and doesn’t fix the inherent problem

42
Q

Tricyclic antidepressants

A

block the reuptake of Serotonin and norepinephrine and are pretty effective in treating depression however the side effects are worse such as constipation, sexual dysfunction and memory impairment and heart issues

43
Q

Four steps of CBT

A

Phase 1: increasingly pleasurable activities
Phase 2: Challenging Automatic thoughts
Phase 3: Identifying negative thoughts
Phase 4: Changing thoughts

44
Q

Who believed constructive behaviors occurred more infrequently until they stopped because the individual was not rewarded for those behaviors

A

Peter Lewisohn

45
Q

treating Bipolar

A

Meds are the best route however patients often forgo them for those euphoric highs so psychotherapy help with adherence and thus a combo may be the best option for both types of Bipolar disorder. Mood stabilizers are the main treatment

46
Q

Most common stressors

A

combat or physical/sexual assault

47
Q

PTSD Category 1

A

Recurrent experiences: The client suffers reoccurring experiences of distressing memories or dreams that can are triggered by environmental stimuli similar to the event and the symptoms can last seconds to days

48
Q

PTSD Category 2

A

Avoidance of Stimuli: They are avoiding environmental cues or stimuli that are related to the traumatic event to avoid the distressing thoughts or feelings

49
Q

PTSD Category 3:

A

Negative Alterations in cognition or mood: A generalized negative state of being along with an impaired memory of either something amnesia-like or false beliefs about themselves or the event

50
Q

PTSD Category 4

A

Alterations in Arousal or activity: PTSD patients often react violently or aggressively in a physical or verbal manner due to triggers related to the event and increased states of environmental sensitivity. They also are most likely suffering from sleep issues and are likely to be irritable from that.

51
Q

Acute Stress Disorder:

A

PTSD like symptoms but must have nine symptoms across five categories and the symptoms are present 3 days after the trauma to one month

52
Q

Adjustment Disorder

A

Problems adjusting up to 3 months after a stressor such as loss of a job or death of a loved one. There is not a list of symptoms that must be met like in PTSD however they are being impaired due to hurting from the event and show signs of depression, anxiety and mixed disturbance in someway

53
Q

Prolonged Grief disorder:

A

A longing or yearning for a loved one that has passed in the last 12 months. The person must experience 3 symptoms including numbness, disbelief in the death, hopelessness and meaninglessness, loneliness and social withdrawal and emotional pain also negative views of themselves and the world. It is not yet in the DSM 5

54
Q

PTSD Prevalence rate

A

prevalence rate is about 6.8 for US adults and 5.0-8.1% for US children

PTSD is most common among those who survive highly traumatic ordeals such as soldiers, rape victims, survivors of genocide and police/firefighters. In fact 30% of veterans are estimated to have PTSD

55
Q

Prevalence of Acute Stress disorder

A

Its estimated an average of 7-30% of those surviving a traumatic event will develop acute stress disorder and women are more likely than men to suffer from it. but Numbers are hard to identify for Acute Stress disorder because they must seek treatment in 30 days and they often do not.

56
Q

Prevalence of Adjustment disorder

A

Adjustment disorder is relatively common as life stressors are common. 5-20% of outpatient individuals from mental health treatment facilities suffer from this

50% of people who develop acute stress disorder go on the have PTSD

57
Q

Prevalence of Prolonged Grief Disorder

A

Prolonged Grief disorder is pretty new so there are no solid numbers yet, however a pooled prevalence of 9.8% has been shown

58
Q

PTSD comorbidity

A

depression, bipolar, anxiety and substance abuse symptoms along with major neurocognitive disorders

59
Q

Acute Stress Disorder Comorbidity

A

becomes PTSD after 30 days so its comorbidities have not been studied. 80% of accident survivors met the criteria for acute stress disorder.

60
Q

Prolonged Grief disorder comorbidity

A

MDD, PTSD, substance abuse and separation anxiety

61
Q

Biological factors of PTSD

A

HPA axis, PTSD patients show increased Amygdala activation

62
Q

Mental disorders that make PTSD more likely

A

Depression and anxiety

63
Q

Psychological Debriefing

A

is a way for therapists to feel out what happened to a client after a traumatic event. It’s a crisis intervention to help the client process the trauma and prevent the onset of PTSD. The rules are
1. Identifying the facts (what happened?)
2. Evaluating the individual’s thoughts and emotional reaction to the events leading up to the event, during the event, and then immediately following
3. Normalizing the individual’s reaction to the event
4. Discussing how to cope with these thoughts and feelings, as well as creating a designated social support system (Kinchin, 2007).
-Psychological debriefing is largely considered an ineffective tool as there is a alck of data supporting it and some data that says it may be worse because they could ruminate on the fact they may have PTSD instead of coping normally

64
Q

Ways of Exposure therapy

A

Imaginal, In-vivo, flooding

65
Q

TF-CBT

A
  • P: Psycho-education about the traumatic event. This includes discussion about the event itself, as well as typical emotional and/or behavioral responses to the event.
  • R: Relaxation Training. Teaching the patient how to engage in various types of relaxation techniques such as deep breathing and progressive muscle relaxation.
  • A: Affect. Discussing ways for the patient to effectively express their emotions/fearsrelated to the traumatic event.
  • C: Correcting negative or maladaptive thoughts.
  • T: Trauma Narrative. This involves having the patient relive the traumatic event (verbally or written), including as many specific details as possible.
  • I: In vivo exposure (see above).
  • C: Co-joint family session. This provides the patient with strong social support and a sense of security. It also allows family members to learn about the treatment so that they are able to assist the patient if necessary.
  • E: Enhancing Security. Patients are encouraged to practice the coping strategies they learn in TF-CBT to prepare for when they experience these triggers out in the real world, as well as any future challenges that may come their way
66
Q

EMDR

A

Eye movement desensitization and reprocessing)is used by using lateral eye movement in a saccade like fashion as part of exposure therapy. The steps are as follows.
1. Patient History and Treatment Planning – Identify trauma symptoms and potential barriers to treatment.
2. Preparation – Psychoeducation of trauma and treatment.
3. Assessment – Careful and detailed evaluation of the traumatic event. Patient identifies images, cognitions, and emotions related to the traumatic event, as well as trauma-related physiological symptoms.
4. Desensitization and Reprocessing – Holding the trauma image, cognition, and emotion in mind, while simultaneously assessing their physiological symptoms, the patient must track the clinician’s finger movement for approximately 20 seconds. At this time, the patient must “blank it out” and let go of the memory.
5. Installation of Positive Cognitions – Once the negative image, cognition, and emotions are reduced, the patient must hold onto a positive image or thought while again tracking the clinician’s finger movement for approximately 20 seconds.
6. Body Scan – Patient must identify any lingering bodily sensations while again tracking the clinician’s fingers for a third time to discard any remaining trauma symptoms.
7. Closure – Patient is provided with positive coping strategies and relaxation techniques to assist with any recurrent cognitions or emotions related to the traumatic experience.
8. Reevaluation – Clinician assesses if treatment goals were met. If not, schedules another treatment session and identifies remaining symptoms.

67
Q

Meds with stress disorders

A

While Meds are not the first line of treatment with Stress disorders. It can be a second line if therapy doesn’t work. There is some data that SSRI’s and MAOI’s do help but the data is limited.

68
Q

Dissociative Disorders

A

group of disorders characterized by symptoms of disruption and/or discontinuity in consciousness, memory, identity, emotion, body representation, perception, motor control and behavior which are likely to appear after a single significant stressor or years of ongoing stress

69
Q

Symptoms of Dissociative Disorders

A

similar symptoms that can be also PTSD and acute stress disorder related such as amnesia, numbing, flashbacks and depersonalization and derealization. But PTSD and other stress disorders have identifiable stressors whereas Dissociative Disorders do not.

70
Q

DID diagnosis

A

key diagnoses factors is the client is taken by two or more personalities in one body or a an experience of possession. How overt or covert these personalities are depend on several factors such as culture, motivation, stress, emotions and personal conflicts/dynamics

Another diagnostic is lapse in memory or attention from switching from personalities including well learned skills or recent events

The personalities must cause impairment in some way for a diagnosis and be involuntary

71
Q

DID average amount of personalities

A

Women average 15 and men 8 for those with DID

72
Q

Dissociative Amnesia

A

Diagnosed by inability to recall important autobiographical information following a significant stressor

73
Q

Localized Amnesia

A

the most common which is the inability to recall events during a specific period that can vary in time.

74
Q

Selective Amnesia

A

the client can recall some but not all information in the length of time in the amnesia.

75
Q

Systemized Amnesia

A

the individual fails to recall a specific category of information within the period of amnesia

76
Q

Generalized Dissociative Amnesia

A

a complete loss of semantic and procedural memory from sometimes acute traumas and individuals are often seen wondering around disoriented and are often hospitalized

Remember the John Doe assignment. Sometimes the total loss is just autobiographical and semantic memory remains

77
Q

Depersonalization/Derealization disorder

A

-Depersonalization can be experienced a detachment from ones own body, a sort of out-of-body experience. Sometimes the report feeling like a robot or enlarged or shrunk in their own skin. They also feel detached from their feelings despite knowing they can have them
-Derealization can be seen as a detachment or feelings of unreality about the world. Such as feeling surrounds that should be familiar are not. Disconnection from intimate family/peer members. Feeling burry, fuzzy or in a daze.

78
Q

Epidemiology of Dissociative Disorders

A

rare, but more common than once thought. 1.5% of the US population has DID with it mostly being women. Dissociative amnesia effects 1.8%.

79
Q

Epidemiology of Depersonalization or Derealization

A

half of US adults suffer a depersonalization/dissociative episode at least once in their lives but few go beyond these episodes.

80
Q

Comorbidities of Dissociative Disorders

A

PTSD and depression

81
Q

DID and dissociative amnesia comorbidities

A
  • dependent, obsessive-compulsive, avoidant, and borderline personality traits/disorders are comorbid and for dissociative identity disorder and dissociative amnesia there is evidence of comorbid substance-related and feeding and eating disorders
82
Q

Biological cause of Dissociative Disorders

A

Dissociation disorders show some studies of a 50-60% genetic rate. However this disorder does have some strong environmental roots.

83
Q

Cognitive Cause of Dissociative Disorders

A

: Psychological stressors and other factors may produce deficits in the prefrontal cortex in charge of memory retrieval but there is some contention to these findings. However there is differences in the hippocampus with dissociative disorders. Since memory retrieval is considered an issues, frontal lobe issues are believed to be part of the problem

84
Q

Sociocultural Cause of Dissociative Disorder

A

There is some evidence that mass media might have an impact particularly in its portrayal. After a publication of a woman named Sybil’s case who had 16 personalities, there was an uptick in cases of DID

remember quiz said this was strictly social

85
Q

Psychodynamic Cause of Dissociative Disorder

A

Caused by suppressed thoughts and feelings and using the personalities as a defense. Abuse can provoke the use of these personalities as a defense however there isn’t a ton of evidence for this claim

86
Q

Steps of integrating personalities

A

Step 1: Build a strong relationship with the prime personality. Then the therapist can gradually get the subpersonalities to engage with each other.
Step 2: Encourage fusion between the personalities
Step 3: Encourage a final fusion of all the personalities into the prime one.
It should be noted not all clients can or want to achieve the final fusion. For them, functionality is the prime directive

87
Q

Treatment of Dissociative Amnesia

A

Most dissociative amnesias recover on their own. But although not clinically well evidenced, hypnosis can help to reclaim memoires and sometimes even truth serums can help bring the memories back.

88
Q

Treatment for Depersonalization/Derealization

A

With depersonalization/derealization disorder, sometimes just a diagnosis helps them cope and snap them out of it. In more severe cases treating secondary comorbidities such and anxiety and depression symptoms can help heal and challenge the main trauma. SSRI’s along with psychological treatment is usually the most effective if this point is reached.

Psychological Disorders (10 decks)

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