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PSYC 331 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

The biological stress response

A

The effect stressors create within an organism; a by-product of poor or inadequate coping

Variety of coping strategies; Fight or Flight response activated by stress (activation of the Sympathetic Nervous System (SNS) and Hypothalamic-Pituatry-Adrenal Axis (HPA Axis)) which leads to increased heart rate and blood pressure, Release of adrenaline (epinephrine) and noradrenaline
(norepinephrine)

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2
Q

Characteristics of acute stress disorder and posttraumatic stress disorder

A

During and immediately after trauma, high levels of arousal and upset may be temporarily experienced (PTSD is long term)

PTSD Criteria: T - Trauma exposure R - Re-experiencing A - Avoidance of reminders U - Undermined cognition and mood M - Magnified arousal and reactivity A - Active symptoms for 1 month

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3
Q

Childhood experiences and later development of stress disorders

A

Growing up in poverty * Psychological disorders in the family * Assault, abuse, or catastrophe at an early age * Parental separation or divorce in early childhood

Combat exposure * Childhood physical abuse * Sexual violence * Physical assault * Being threatened with a weapon * An accident

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4
Q

Gender differences in stress disorders and traumatic events

A

Lifetime prevalence - 6.8%; Women show higher rates of PTSD and tend to have more severe symptoms.

Men tend to be more exposed to traumatic events
Male gender role stress refers to the experience of emotional distress as a result of violating or not adhering to traditional masculine gender role norms.
Traditional masculine gender roles play a part in the severity of PTSD in some men.

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5
Q

Complex PTSD

A

Frequent exposure to traumatic events can lead to more severe and chronic PTSD symptoms

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6
Q

Distinctions between dissociative amnesia and dissociative fugue

A

Dissociative amnesia: Loss of memory triggered by a specific upsetting event
Often recover without treatment * Leading treatments: psychodynamic therapy, hypnotic therapy, and drug therapy
* May have unpredictable consequences

Dissociative fugue: subtype of dissociative amnesia
person loses awareness of their identity
and engages in some form of unexpected travel
* Causes: severe stress
* Travels: * From a few hours to several months * Sudden “awakening” with confusion
* Amnesia for the fugue episode

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7
Q

Risk factors for dissociative identity disorder

A

Abuse in childhood a common factor:

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8
Q

Characteristics of dissociative identity disorder; subpersonalities

A

Dissociative identity disorder:
characterized by alternating between
multiple self states (subpersonalities
or alters)
The “host” has executive control most
of the time
“Switching” is usually sudden

Relationships among subpersonalities
* Mutually amnesic relationships
* Mutually cognizant patterns * One-way amnesic relationships

  • Often display dramatically different: * Identifying features
  • Abilities and preferences
  • Roles
  • Alters often display psychobiological differences
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9
Q

Theoretical explanations for dissociative identity disorder

A

Psychodynamic view: repression
Behavioral view: response learned through operant conditioning (dissociation is an escape behavior)
State-dependent learning: rigid state-to- memory links
* Self-hypnosis

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10
Q

Depersonalization and derealization

A

Derealization: “The world doesn’t feel real”
Depersonalization: “I don’t feel real”

  • Lifetime prevalence: 1-2% * Equal numbers of males and females * Mean age of onset: 16 years old
  • Comorbid conditions include mood or anxiety disorders.

Considered a disorder when:: * Depersonalization or derealization occurs on its own (that is, it
is not caused by drugs or another mental disorder), and it
persists or recurs. * The symptoms are very distressing to the person or make it
difficult for the person to function at home or at work.

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11
Q

Symptoms of depression

A

a low, sad state in which life seems dark and its
challenges overwhelming

  • Emotional * Motivational * Behavioral * Cognitive symptoms
  • Physical symptoms
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12
Q

Postpartum depression with psychosis (Andrea Yates case)

A
  • Postpartum psychosis constitutes a medical emergency. * Case example: Andrea Yates * Developed post-partum psychosis after her 4th child
  • Took Effexor and the antipsychotic Haldol off and on * Told of risk if she had more children * After the birth of her 5th child in 2001 she developed
    postpartum psychosis again and drowned her 5 children
  • Diagnosed with peripartum-onset depression with psychotic
    features
    Charged with capital murder. Found not guilty by reason of
    insanity in 2006. Committed to a high-security mental health
    facility for an indefinite stay
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13
Q

The cognitive-behavioral perspective and the family-social perspective regarding the causes of depression

A
  • Behavioral dimension
  • Learned helplessness
  • Negative thinking

Treatment includes
Interpersonal Therapy (IPT) * Focuses on changing
maladaptive interaction
patterns in relationships
* IPT as effective as
medications or CBT for
unipolar depression

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14
Q

Efficacy of the different classes of antidepressants

A

SSRI’s: * SSRIs inhibit the reuptake of serotonin following its release
into the synapse
* Fewer side effects
* Not fatal in overdose
* No more effective than other types of antidepressants

SNRI’s: * Serotonin and norepinephrine reuptake inhibitors (SNRIs)
(e.g., Effexor and Cymbalta) * Similar side effects to SSRIs
* Relatively safe in overdose
* Slightly more effective than SSRIs

Bupropion: Dopamine and norepinephrine reuptake inhibitor * Lacks side effects associated with SSRIs
* Side effects can include anxiety, restlessness, tremor,
insomnia, seizures
* Also marketed as a smoking cessation (Zyban)

Fail to help at least 40% of clients with depression
* Actual failure rate is likely higher (publication bias); study
designs * Most effective for severe depression

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15
Q

Issues with Study 329 (paroxetine)

A

Article used to promote paroxetine for
off-label use in teenagers
* Ghost-written by PR firm * Misrepresented negative effects
* Misrepresented efficacy

Article was never retracted

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16
Q

Ketamine and depression

A
  • Ketamine: 80% efficacy for treatmentresistant depression * Esketamine: approved by FDA in 2019
    (article on Sakai) * Dangerous without medical supervision
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17
Q

Brain stimulation treatments for depression

A

Electroconvulsive therapy
* Vagus nerve stimulation
* Transcranial magnetic stimulation * Deep brain stimulation

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18
Q

Cognitive explanations for unipolar depression (consider Beck and Seligman)

A

Unipolar depression caused by a combination of the factors
* These factors intersect in a developmental sequence

(Cognitive Distortions and Learned Helplessness)

19
Q

Symptoms of a manic episode

A

A. For at least 1 week - continually abnormal, inflated, or irritable
mood with heightened energy or activity, for most of every day. * B. Plus, at least 3 of the following: * Grandiosity or overblown self-esteem * Reduced sleep need * Increased talkativeness, or drive to continue talking * Flight of ideas
* Attention pulled in many directions * Heightened activity or agitated movements * Excessive pursuit of risky/problematic activities. * C. Significant distress or impairment

20
Q

Theoretical perspectives of bipolar disorder

A
  • Heredity
  • Neurotransmitters * Low serotonin + Low norepinephrine = Depression
  • Low serotonin + High norepinephrine = Mania
  • Brain structure abnormalities
21
Q

Bipolar depression and biochemical factors

A

Women may experience more depressive and fewer manic
episodes than men do, and rapid cycling is more common in women

22
Q

Lithium treatment

A
  • Mood-stabilizing drugs: Lithium
  • Effective but has side effects
  • Dosing issues
  • Too low = no effect * Too high = lithium intoxication (poisoning)
23
Q

“Mary” case study of psychotic symptoms in bipolar disorder

A

Video in Sakai

24
Q

Undercounting of suicides due to misclassifications of cause of death

A

Something

25
Q

Shneidman’s typology

A

Death seekers
* Death initiators
* Death darers
* Death ignorers

26
Q

Gender and suicide

A
  • Men die of suicide at four times the rate of women. * Women make significantly more nonlethal attempts
  • Firearms most commonly used method among males (62%). * Poisoning most common method for females (34.8%).
27
Q

Psychological disorders and suicide

A
  • Majority who die by suicide have a history of at least one
    psychological disorder. * 50-90% of suicides occur during a depressive episode or
    while in the recovery phase
  • Individuals with 2 or more mental disorders are at even
    greater risk.
28
Q

The social contagion effect

A
  • Exposure to other suicides increases risk and can lead to a
    suicide cluster * Suicides by family members and friends
  • Suicides by celebrities
29
Q

Joiner’s interpersonal theory of suicide

A

Thwarted belongingness fits with the known risk/protective
factors for suicide
* Belongingness is a fundamental need. * Being married, having children, and having more friends
associated with a lower risk. * “Pulling together” has a preventive effect

30
Q

Risk factors and warning signs of suicide

A
  • Immediate stressors (e.g., job loss) * Long-term stressors * Social isolation * Serious illness * Abusive environments * Occupational stress
  • Talking about death or suicide
  • Seeking methods for self harm
  • Talking about feeling hopeless * Talking about being a burden
  • Increased bouts of anger; talking about revenge
  • Increased alcohol or drug use. * Giving away prized possessions. * Sudden happiness after a prolonged depression. * Withdrawal from friends or family or saying goodbye to them
31
Q

The public health approach to suicide prevention

A
  • Limit access to common means of suicide including: * Firearm regulations
  • Safer medications
  • Better bridge barriers
  • Car emissions controls
32
Q

Malingering

A

Motivated by external
incentives, such as escaping consequences (never goes well), can be tried for a felony

33
Q

Factitious disorders/Munchausen syndromes

A

Munchausen: Deceives others by appearing
sick or by self-injury
* Prevalence: about 1% of
patients in hospital setting
Causes
* More common in certain groups of people
* Possible causes are depression, unsupportive parental
relationships, and extreme need for social support

Munchausen by proxy: * People with this disorder
produce or fabricate
symptoms of illness in
another under their care
* Ends in death 6%- 30%
* Viewed as crime by law
enforcement

34
Q

Conversion disorder

A

Displays neurological symptoms in the absence of neurological
diagnosis
* Not consciously wanted or purposely produced * Difficult to distinguish from genuine medical problems

Categories of symptoms: * Sensory * Motor * Seizures
* Mixed presentation

35
Q

Somatic symptom disorder

A
  • Extreme anxiety about physical symptoms. * Intense thoughts, feelings, and behaviors related to the
    symptoms that interfere with daily life.
  • Somatization pattern: Numerous physical symptoms that
    have little or no organic basis
  • Predominant pain pattern: the primary feature is pain
36
Q

Mass Hysteria

A

Mass psychogenic illness: similar
physical symptoms with no
known physical cause in a group
of people

  • Increase of outbreaks due to social media
  • Considered a form of conversion disorder.
37
Q

Somatic complaints in non-Western medical settings

A

Physical and psychological reactions to stressors are often
influenced by one’s culture
* High rates of stress-induced somatic symptoms seen
throughout the non-Western world

38
Q

Illness anxiety disorder

A
  • Chronic anxiety about their health
  • Believe that minor complaints (usually normal bodily changes,
    such as occasional increased heart rate, coughing, or sores)
    are signs of very serious medical problems
  • Most often begins in early adulthood
  • No gender differences

Drug and cognitive-behavioral approaches
* Antidepressants. * CBT (specifically exposure and response prevention)

39
Q

Traditional psychophysiological disorders

A
  • Ulcers
  • Asthma
  • Insomnia
  • Chronic headaches
  • High blood pressure
  • Coronary heart disease

physical
illnesses that result from an interaction of biological,
psychological, and sociocultural factors

40
Q

Personality styles and illness

A
  • TYPE A
  • Ambitious
  • Time conscious
  • Hardworking
  • Often hostile
  • TYPE B
  • Relaxed
  • Less competitive than Type A
  • Slow to anger
  • Free floating hostility
  • Time urgency and impatience
  • Competitive drive
41
Q

“Hispanic Health Paradox”

A

The Hispanic paradox is an epidemiological finding that Hispanic Americans tend to have health outcomes that “paradoxically” are comparable to, or in some cases better than, those of their U.S. non-Hispanic White counterparts, even though Hispanics have lower average income and education, higher rates of disability,

42
Q

Perceived discrimination and cortisol dysfunction - understand the difference between normal
diurnal cortisol slope and the dysfunctional flattened cortisol pattern described in lecture

A
  • Perceived racial
    discrimination during
    adolescence linked to
    cortisol dysfunction
  • Dysfunctional cortisol levels
    linked to fatigue, impaired
    memory, cardiovascular
    disease
43
Q

Definition of psychoneuroimmunology

A

psycho-‘ means thoughts and emotions
* ‘-neuro-‘ means that the physical brain is involved
* ‘-immunology’ explains how your immune system protects
you from illness

  • Stress leads to: * Increased activity by the SNS
  • Slowdown in functioning of the immune system

Prolonged stress also triggers increased cytokines leading to
chronic inflammation

44
Q

Behavioral medicine techniques

A

To deal with surgeries or treatments, some patients are put hypnosis. Or kids playing games before a major surgery

PSYC 331 (4 decks)

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