Exam 2 Flashcards
Factors that increase a person’s risk of having a disorder
Etiology
What are the two broad types of mood disorders?
-Only depressive symptoms
-Includes manic symptoms
Examples of depressive symptoms
Extreme sadness and hopelessness
Examples of manic symptoms
-intense feelings of euphoria/high energy -reckless behavior
What is Substance-Induced Depressive Disorder?
Caused by use of substances
What is Depressive Disorder due to Medical?
Caused by some type of medical issue/illness
What is an Other Specified Depressive Disorder?
Results from an unlisted stimulus
When is a person diagnosed with an Unspecified Depressive Disorder?
When they definitely have some form of depression but the cause is unknown, sort of a buffer
What are the types of symptoms (3) shown in depressive disorders?
-With anxious distress (some anxiety symptoms)
-With mixed features (some symptoms of mania during a depressed episode)
-With psychotic features (some delusions and hallucinations)
What is the course of depressive symptoms (2)?
-In partial remission
-In full remission
What are the different levels of severity of symptoms (3)?
-Mild
-Moderate
-Severe
What are the physical symptoms of depressive disorders (3)?
-Psychomotor sluggishness/agitation
-Neglect in appearance/hygiene
-Suicidal ideation, plans, or events
What are the general symptoms of a depressive disorder (3)?
-Viewing things in a negative light/hopelessness
-Difficulty concentrating/memory problems
-Sleep, appetite, weight, and sexual functioning disturbances
What is the difference between a depressive disorder and “typical/everyday” depression?
Sadness is a normal emotion that makes up “typical” depression, while a depressive disorder is a clinically significant disturbance, distress/disability, not simply a predictable response.
What is the biggest criticism of the DSM?
That it pathologizes grief
What is the difference between chronic Major Depressive Disorder (MDD) and episodic MDD?
Chronic MDD occurs when a patient never reaches the remission stage while episodic is when the depressive symptoms dissipate over time.
What is a recurrent depressive disorder?
The idea that future depressive episodes are likely after onset.
What is the average number of depressive episodes?
Four
What is the controversy involved in diagnosing MDD (2)?
-There are over 200 ways to meet the diagnosis
-The cutoffs for symptoms are arbitrary
What is Persistent Depressive Disorder?
A less severe (less symptom presentation), more chronic (longer lasting) version of MDD
What is the controversy behind Premenstrual Dysphoric Disorder?
It attempts to legitimize the pain and suffering that people that menstruate may experience but could be viewed as stigmatizing towards those individuals.
Why are Bipolar Disorders called this?
Because most people will experience both depression and mania
What is mania?
State of intense elation or irritability
Give a few examples of symptoms of mania
-Loud, incessant remarks (jokes)
-Rapidly shifting topics (flight of ideas)
-Become more social/intuitive
-Overly confident/grandiose
-Decreased need for sleep (feeling rested after very few hours of sleep)
-Reckless behavior: speeding, overspending, sexual promiscuity
What are DSM requirements for symptoms to be classified as mania (2)?
-Comes on suddenly (over 1-2 days)
-Can’t result from substance use
What are the traits of a manic episode (2)?
-Symptoms last for at least 1 week or require hospitalization
-Symptoms cause significant distress or functional impairment
What are the traits of a hypomanic episode?
-Symptoms last at least 4 days
-Clear change in function that is observable to others but not completely impairing
What do most manic episodes purely consist of?
-Elevated mood
-Increase in confidence
-Reckless behaviors
What is the characteristic of Bipolar I?
At least one episode of mania
What is the characteristic of Bipolar II?
At least one major depressive episode with at least one episode of hypomania
What is Cyclothymic Disorder?
A milder, more chronic form of bipolar disorder
Which form of Bipolar Disorder is among one of the most severe forms of mental illness? Why (4)?
Bipolar I
-Hospitalization
-Suicidality
-Unemployment
-Housing insecurity
What does the term “heterogeneous” mean?
People with the same disorder can look very different
True or False: Mood disorders are the most likely psychological disorders to run in families
True
Which neurotransmitters are affected by mood disorders (3)?
-Norepinephrine
-Serotonin
-Dopamine
Which depression theory grew out of the success of antidepressants?
The monoamine theory
What is the difference between the original and newer models of mood study?
The originals wrongly focused on absolute levels while the newer models focus on sensitivity.
What must be considered before diagnosing an anxiety disorder?
-Developmental (not chronological) age
-Life circumstances
What is the key to abnormal levels of anxiety?
Functional impairment
What is the difference between anxiety and fear?
Anxiety is concern over a future threat while fear is a reaction to immediate danger.
What is the key behavior that characterizes anxiety?
Cautious or avoidant behaviors
When does “normal” anxiety become an anxiety disorder?
When it interferes with a person’s life
What does it mean if something is somatic?
It is bodily or biological
How do anxiety disorders differ from one another?
In terms of objects or situations that induce fear, anxiety, or avoidance behaviors, and the associated thoughts.
What are Specific Phobias?
Disruptive fear of a particular object or situation that is out of proportion to any danger posed
What must be determined after someone is diagnosed with a Specific Phobia?
A subtype
What are the subtypes of Specific Phobia (5)?
Animal - dogs, snakes, spiders
Natural environment - storms, heights, water
Blood, injection, injury - medical procedures
Situational - public transport, small spaces, tunnels
Other - loud sounds, clowns
What characterizes social anxiety disorder (4)?
-More intense and impairing than shyness
-Persistent, intense fear
-Avoidance of social situations
-Fear of negative evaluation or scrutiny
What are panic attacks?
Sudden attack of intense apprehension, terror, and feelings of impending doom
What is panic disorder?
Frequent panic attacks that are unrelated to specific situations (worry about future panic attacks)
What is Agoraphobia?
Anxiety about inability to flee anxiety-provoking situations like public spaces or crowds
What is generalized anxiety disorder?
Chronic, excessive, uncontrollable worry
What is worry?
Cognitive tendency to dwell on a problem
What biological factors cause an anxiety disorder?
-Amygdala overactive
-Medial prefrontal cortex overactive
-HPA Axis overactive
-Poor functioning of serotonin and GABA
-Over-activity of norepinephrine
What model states that pairing of stimulus with aversive unconditioned stimulus (UCS) leads to fear
Two-factor model
What are the extensions of the Two-factor model (3)?
-Modeling
-Verbal instruction
-Those with anxiety acquire fear more readily
Why is a SCID used when assessing someone for Agoraphobia?
Helps with differential diagnosis which reduces comorbidity
What methods are used to treat anxiety disorders (2)?
-Medication
-CBT
How is CBT used to treat an anxiety disorder?
-Must target specific source of anxiety or fear
-May lead to discomfort, typically short-lived
-Individual or group
-Psychoeducation and relaxation training
How does cognitive therapy help treat anxiety?
Identifying, challenging, neutralizing/replacing unhelpful thoughts
How does exposure therapy work to treat anxiety?
Confronting fears and stopping avoidance
What is the exposure process when treating anxiety (3)?
-Psychoeducation
-Relaxation
-Avoidance/Fear Hierarchy
According to Frances, what are the 6 things that have affected ADHD diagnoses (6)?
-Wording changes in the DSM-IV
-More drug ads
-Media coverage
-Pressure on parents to control their kids
-Accommodations for students
-Misuse of stimulants
What traits characterize Obsessive-Compulsive Disorder (OCD) (2)? Explain what these are
-Obsessions: Intrusive, repetitive thoughts and urges
-Compulsions: Impulse to repeat certain behaviors or mental acts to reduce distress
What are the DSM-5 criteria for OCD (3)?
-Obsessions, compulsions, or both
-Time-consuming (require at least 1 hour per day), or cause clinically significant distress or impairment
-Not attributable to a substance or another mental disorder
What are the treatment methods used for OCD?
-Medications (SSRIs)
-Exposure plus response prevention (EX/RP)
What does Exposure plus response prevention (EX/RP) involve (4)?
-Exposure hierarchy
-Refrain from ritualizing
-Therapist modeling
What is Body Dysmorphic Disorder characterized by (2)?
-Repetitive thoughts of imagined or exaggerated defects in appearance
-Engagement in compulsive behaviors like checking mirrors often or camouflaging appearance
How is Body Dysmorphic Disorder differentiated from Eating Disorders?
It is not better explained by concerns about weight
What is Hoarding Disorder characterized by?
Repetitive thoughts regarding parting with one’s possessions (specifically worthless objects)
What is Trichotillomania?
Repetitive pulling out of one’s hair, resulting in hair loss despite repeated attempts to stop
What is Excoriation?
Repetitive picking at one’s skin, resulting in skin lesions despite repeated attempts to stop
Which regions of the brain are hyperactive in patients with OCD (3)?
-Orbitofrontal cortex (decision-making)
-Caudate nucleus (motor processes, inhibitory control)
-Anterior cingulate
Is OCD also supported by the two-factor model?
Yes
What is PTSD?
Extreme and prolonged response to a severe stressor
What is Criterion A for PTSD?
Type of event, idea that you are exposed to the most traumatic type of event someone may be exposed to (ex. threat to life, sexual assault, etc.)
What are intrusion symptoms?
Sudden thoughts of the event
What is avoidance in PTSD?
Avoiding the place where the event took place or things that remind one of the event
What is PTSD characterized by (2)?
Alterations in mood and alterations in arousal which are present a month after the trauma occurs
What is Acute Stress Disorder?
A placeholder diagnosis for a person exhibiting PTSD symptoms which is put aside 1 month after the traumatic event
What is Adjustment Disorder?
Psychological response to a common stressor
How is PTSD treated (2)?
-Prolonged Exposure
-Cognitive Processing Therapy
How is prolonged exposure used to treat PTSD?
-Psychoeducation
-In vivo exposure/Fear Hierarchy
-Relaxation
-Imaginal exposure (in session and home)
How is Cognitive Processing Therapy used to treat PTSD?
-Psychoeducation
-Identify and challenge unhelpful thinking
-Trauma narrative
How are PTSD and OCD different?
PTSD involves thoughts of a specific trauma and other symptoms of PTSD. OCD involves intrusive thoughts that meet the criteria for obsession and present compulsions
What are the characteristics of Dissociative Disorder?
Dissociation, such as fragmentation of identity or inability to remember things about yourself - thought to be a protective avoidance response
What is Dissociative Amnesia?
Partial or total inability to recall important personal information
How is PTSD different from Dissociative Amnesia?
Is the memory loss restricted to details of the trauma (PTSD) or is it more global (DA)?
What is the Dissociative Fugue Subtype?
A far more extensive version of Dissociative Amnesia
What is Depersonalization/Derealization Disorder?
Person’s perceptions or experiences are altered
What is Depersonalization?
Experiences of unreality
What is Derealization?
The world has become unreal
What is Dissociative Identity Disorder (DID)?
Patient manifests two or more distinct identities or personality states that alternate in taking control of a person
What characterizes a somatic symptom disorder?
Excessive concerns about physical symptoms
What is Somatic Symptom Disorder?
Multiple, current somatic symptoms with authentic suffering but no evident medical cause
What is Illness Anxiety Disorder?
Preoccupation with having or acquiring a serious, undiagnosed medical illness
What is Conversion Disorder (Functional Neurological Disorder)?
Sensory or motor function impaired but no known neurological cause
What is psychosis?
Significant loss of contact with reality
What are delusions?
Belief held with strong conviction despite evidence to the contrary
What are hallucinations?
Sensory perception in the absence of stimulus
What could cause schizophrenia (4)
-Excess numbers of dopamine receptors and/or oversensitive dopamine receptors
-Localized mainly in mesolimbic pathway
-Issues during gestation or birth
-Viral damage to fetal brain
What treatments are used to help patients with schizophrenia?
-Antipsychotic medications
-Social skills training
-Family therapy
According to Allen, what are the ambitions of the creators of the DSM?
-Base diagnosis on new science
-Early detection/prevention
-Make diagnosis more precise with numbers/spectrum
According to Allen, what are the issues that the creators of the DSM do not address?
-Focus on reliability
-Avoided more practical questions
-Unrepresentative samples
-DSM is a moneymaker
What is Substance-Use Disorder?
Cognitive, behavioral, and physiological symptoms directly associated with ingesting a substance
Which classes of drugs does Substance-Use Disorder not apply?
9, all except for caffeine
What is the overarching criteria for Substance-Use Disorder?
Problematic pattern of use that leads to impairment
What are the two types of Substance-Induced Disorders?
-Substance Intoxication (applies to all except tobacco)
-Substance Withdrawal (applies to all except inhalants and hallucinogens)
What are the 10 types of drugs?
-Caffeine
-Alcohol
-Marijuana
-Tobacco
-Opioids
-Amphetamines
-Methamphetamine
-Cocaine
-Hallucinogens
-Inhalants
-Sedative/Hypnotics/Anxiolytics
-Other
What is the process of becoming a drug abuser?
-Positive attitude/Willingness to try
-Experimentation
-Regular use
-Heavy use
-Dependence or abuse
