Exam 2 Flashcards
Posttraumatic Stress Disorder: exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
- directly
- witnessing
- learning it occurred to close family/friend
- experiencing repeated or extreme exposure of the traumatic events
PTSD: Intrusion symptoms (one or more)
a. Distressing (recurring, involuntary, and intrusive) memories
b. Recurrent dreams
c. Dissociative reactions - often misdiagnosed as psychosis
d. Psychological or physiological distress with the exposure of stimuli that resembles trauma
PTSD: Avoidance symptoms
a. Efforts to avoid memories, thoughts, or feelings about event
b. Avoidance of external reminders
PTSD: Negative alterations in cognition and mood
a. Inability to remember an important aspect of trauma
b. persistent/exaggerated negative beliefs or expectations of oneself, others, or the world
c. Distorted thoughts about cause or consequences of trauma
d. Persistent negative emotional state
e. Diminished interest in activities
f. Detachment or estrangement from others
g. Inability to experience positive emotions
PTSD: Arousal and reactivity
a. Irritable behavior and angry outbursts
b. Reckless or self-destructive behavior
c. Hypervigilance
d. Exaggerated startle response
e. Problems with concentration
f. Sleep disturbances
Comorbidity w/ PTSD
Substance use, depressive disorder, anxiety disorders
Acute Stress Disorder
captures the before it develops into PTSD
Adjustment Disorder
development of emotional or behavioral symptoms in response to an identifiable stressor occurring within 3 months of the onset of the stressor
- distress doesn’t meet criteria for another disorder
adjustment vs. PTSD/Acute
exposure to a stressor vs. trauma
Complex Trauma
childhood abuse, repeated instances of harmful situations from caregivers or teachers
Treatment for PTSD
Cognitive behavioral therapy and cognitive therapy: targets unhelpful thoughts, top down approach vs bottom up approach. role of unhelpful thoughts: client decides stuck points. role of therapist: assessment of stuck points from client report.
role of client in PTSD CPT
active
examine their own beliefs and their impact
impact statement
Goal: learn strategies to examine and challenge unhelpful thoughts and beliefs outside of the therapeutic setting
Historical trauma
cumulative emotional and psychological wounding across generations, including the lifespan, which emanates from massive group trauma
Historical trauma is…
- trauma that is complex and collective
- experienced over time and across generations
- experienced by a group of people who share an identity, affiliation, or circumstance
Historical trauma response
historical unresolved grief, ptsd, depression, substance abuse
difference in historical trauma and ptsd
single event that occurs to individual vs. cumulative effects of individual and generations before
ethnic-racial trauma
individual and/or collective psychological distress and fear of danger that results from experiencing or witnessing discrimination, threats of harm, violence, and intimidation directed at ethno-racial minority groups
subtle discrimination related outcomes
mental health:
decreased well-being
decreased self-worth
decreased quality of life
physical well-being:
increased alcohol and illicit drug use
cardiovascular problems
explicit discrimination and related outcomes
mental health:
decreased positive affect, self-esteem
decreased well-being
increased depression
physical well-being:
cardiovascular problems
sources of ethno-racial trauma
othering, laws (immigration), sociopolitical climate
PICA comorbidity
anxiety disorders and iron-deficiency
-more likely to be caught by primary care physicians (PCP)
PICA
persistent eating of nonnutritive, nonfood substances over a period of at least 1 month
associated features of anorexia nervosa
low bone density, amenorrhea, hypothermia, bradycardia
subtypes for anorexia nervosa
restricting and binge-eating/purging
anorexia nervosa
restriction of energy intake relative to requirements, intense fear of gaining weight, distress around body image
bulimia nervosa
recurrent episodes of binge eating, inappropriate compensatory behaviors to prevent weight gain (both occur at least once a week for 4 mo), self-evaluation influenced by body
antecedent of binge eating
antecedent (trigger) –> behavior –> consequences
-loss of control
conceptualizing eating disorders and disordered eating
-BMI
-difficulties w/ current diagnostic criteria:
Missing individuals who may not be considered underweight
Stigma against fat bodies
Use of bmi misses a subset of people
Social context of eating disorders
Ideals of a “healthy body”
Social media
Popular culture
Stereotypes
Accessibility
disordered eating vs. eating disorder
similar behavior but lower severity
Somatic symptoms
are not present, or if present are only mild in intensity. if another medical condition is present or there is a high risk for developing a medical condition (pain real but not rly an answer for it)
illness anxiety disorder
excessive health related behaviors (eg repeatedly checks his or her body for signs of illness or exhibits maladaptive avoidance
illness preoccupation has been present for at least 6 months
preoccupation is not better explained by another mental disorder such as somatic symptoms disorder, panic disorder, generalized anxiety disorder, body dysmorphic disorder, or ocd
dissociation and trauma/stress
Prevalence of childhood abuse and neglect
clinically significant dissociation may also be due to other disorders:
schizophrenia spectrum
mood disorders
personality disorders
PTSD
personality disorders
enduring pattern of behaviors that deviates markedly from the individuals culture
a. pervasive and inflexible, stable over time
onset: adolescence or early adulthood
cluster A
paranoid
schizoid
schizotypal
described as people who feel odd or eccentric
paranoid personality disorder
pervasive distrust and suspiciousness of others regarding their motives
Schizoid personality disorder
pervasive pattern of detachment from social relationships and a restricted range of emotions in interpersonal settings
cluster B
antisocial
borderline
histrionic
narcissistic
externalized behaviors that affect how they relate to others; role of affect
antisocial personality disorder
disregard for and violation of the rights of others since the age of 15 as evidence by 3 or more:
failure to conform to social norms with respect to lawful behaviors
deceitfulness
impulsivity or failure to plan ahead
irritabillity and aggressivness
reckless disregard for safety of self or other
consistent irresponsibility
lack of remorse
factors related to antisocial personality disorder
SES
sociocultural factors
gender
borderline personality disorder and DBT
Learn about borderline personality disorder symptoms
explore some of the traditional difficulties in treatment of BPD
examine the approach marsha linehan took to treatment development
explore the principles
Borderline personality disorder
pervasive pattern of instability of interpersonal relationships, self image, and affects, and market impulsivity in a variety of contexts
borderline personality disorder stigma
Providers disclose negative reactions towards clients who may have borderline personality disorder
Termination of treatment
lower therapeutic alliance
lack of empathy
lack of belief in treatment
treatment for BPD: DBT structure
DBT modules: mindfulness, emotion regulation, interpersonal effectiveness, distress tolerance (can help with suicidal behavior, impulsivity → manage when those emotions feel overwhelming)
spectrum of psychoactive substance use
beneficial use –> casual/non-problematic use –> problematic use –> chronic dependence
impaired control
Larger amounts or over a longer peiod of time
Desire to cut down or regulate, but has been unsuccessful
Spending a great deal of time obtaining substance, using, or recovering from effects
Craving - desire or urge for substance (classical conditioning, reward structure)
social impairment
Difficulty in fulfilling major role obligations (school, work, home)
Continued use despite having social or interpersonal problems caused or exacerbated by effects of substance
Important social, occupational, or recreational activities may be given up or reduced because of substance use
risky use
Use of substances where it is physically hazardous
Continued use of substances despite knowledge of having a persistent physical or psychological problems that may have been caused or exacerbated by the substance
Pharmacological criteria
tolerance and withdrawal
Harm reduction for treating substance use
does not promote abstinence from, or even necessarily reduction of, substance use. focuses on helping people use the substance in ways that are minimally destructive
Schizophrenia
delusions, hallucinations, disorganized thinking (speech), grossly disorganized or abnormal motor behavior, negative symptoms
negative symptoms
diminished emotional expression, avolition (decreased in purposeful activities ex. not eating), anhedonia, alogia (diminished speech output), asociality
rule out for schizophrenia
substance use, hypomanic and manic disorders, depression or psychosis
over diagnosis for schizophrenia
Higher rates of diagnosis among black and latine people, and immigrant populations
Black people are about 2.4 times more likely than white people to be diagnosed with schizophrenia
Use of structured interviews slightly reduces the rates
neurodevelopmental disorders
intellectual disability, communication disorders, ASD, attention-deficit/hyperactivity disorder, specific learning disorder, motor disorders, other neurodevelopmental disorders
often seen in childhood and found in grade school
intellectual disability
Deficits in general mental abilities
Problem solving skills, critical thinking
Focus on impact on functioning vs. IQ measures
Practical, social, conceptual domain
Ability to get dresses, make relationships, connect with others, are they where they should theoretically be developmentally
Observable
ASD: restrictive, repetitive patterns
Restricted, repetitive patterns of behavior; interests, or activities as manifested by at least 2 of the following:
Stereotyped or repetitive motor movements, use of objects, or speech
Insistence of sameness, inflexibility, or ritualized patterns
Highly restricted, fixated interests
Hyper- or hypo reactivity to sensory input or unusual interest in sensory aspects of environment
Overstimulated or absolute lack of stimulation
ASD: social communication and social interaction
Persistent deficits in social communication and social interaction across multiple contexts (same in diff environments w/ diff people) as manifested by all of the following
Deficits in social-emotional reciprocity
nonverbal communication behaviors for social interaction
Lack eye contact, facial expressions
Difficulty in developing, maintaining, and understanding relationships
comorbidity among neurodevelopmental disorders
lots of comorbidity, often people may have one and another one
