Exam 2 Flashcards
one of a group of disorders involving severe and enduring disturbances in emotionality ranging from elation to severe depression
mood disorders
most common and severe experience of depression, including feelings of worthlessness, disturbances in bodily activities such as sleep, loss of interest, and inability to experience pleasure, persisting at least 2 weeks
major depressive episodes
what is mania?
period of abnormally excessive elation or euphoria associated with some mood disorders
what is a hypomanic episode?
less severe and less disruptive version of a manic episode that is one of the criteria for several mood disorders
condition in which the individual experiences both elation and depression or anxiety at the same time. also known as dysphoric manic episode or mixed manic episode
mixed features
a mood disorder involving one (single episode) or more (separated by at least 2 months without depression, recurrent)
major depressive disorder
what does recurrent mean?
repeatedly occurring
a mood disorder involving persistently depressed mood, with low self-esteem, withdrawal, pessimism, or despair, present for at least 2 years, with no absence of symptoms for more than 2 months
persistent depressive disorder (dysthymia)
what is double depression?
severe mood disorder typified by major depressive episodes superimposed over a background of dysthymic disorder
what is integrated grief?
grief that evolves from acute grief into a conditions in which the individual accepts the finality of a death and adjusts to the loss
grief characterized by debilitating feelings of loss and emotions so painful that a person has trouble resuming a normal life; designated for further study as a disorder by DSM-5
complicated grief
clinically significant emotional problems that can occur during the premenstrual phase of the reproductive cycle of a woman
premenstrual dysphoric disorder
a condition in which a child has chronic negative moods such as anger and irritability without any accompanying mania
disruptive mood dysregulation disorder
what is bipolar II disorder?
alternation of major depressive episodes with hypomanic episodes (not full manic episodes)
what is bipolar I disorder?
alternation of major depressive episodes with full manic episodes
chronic (at least 2 years) mood disorder characterized by alternating mood elevation and depressive levels that are not as severe as manic or major depressive episodes
cyclothymic disorder
what are neurohormones?
a hormone that affects the brain and is increasingly the focus of study in psychopathology
Martin Seligman’s theory that people become anxious and depressed when they make an attribution that they have no control over the stress in their lives (whether or not they actually have control)
learned helplessness theory of depression
thinking errors by depressed people negatively focused in 3 areas; themselves, their immediate world, and their future
depressive cognitive triad
a medication used in the treatment of mood disorders, particularly bipolar disorder, that is effective in preventing and treating pathological shifts in mood
mood-stabilizing drug
biological treatment for severe, chronic depression involving the application of electrical impulses through the brain to produce seizures. the reasons for its effectiveness are unknown.
electroconvulsive therapy (ECT)
treatment approach that involves identifying and altering negative thinking styles related to psychological disorders such as depression and anxiety and replacing them with more positive beliefs and attitudes - and, ultimately, more adaptive behavior and coping styles
cognitive therapy
brief treatment approach that emphasizes resolution of interpersonal problems and stressors, such as role disputes in marital conflict, forming relationships in marriage, or a new job. it has demonstrated effectiveness for such problems as depression.
interpersonal psychotherapy (IPT)
combination of continued psychosocial treatment, medication, or both designed to prevent relapse following therapy
maintenance treatment
what is suicidal ideation?
serious thoughts about committing suicide
what is suicidal plans?
the formulation of a specific method of killing oneself
what is a suicidal attempt?
effort made to kill oneself
postmortem psychological profile of a suicide victim constructed from interviews with people who knew the person before death
psychological autopsy
a devastating disorder that may involve characteristic disturbances in thinking (delusions), perception (hallucinations), speech, emotions, and behavior
schizophrenia
what is catatonia?
a disorder of movement involving immobility or excited agitation
what is hebephrenia?
a silly and immature emotionality, a characteristic of some types of schizophrenia
what is paranoia?
people’s irrational beliefs that they are especially important (delusions of grandeur) or that other people are seeking to do them harm
the Latin term meaning premature loss of mind; an early label for what is now called schizophrenia, emphasizing the disorder’s frequent appearance during adolescence
dementia praecox
a separation among basic functions of human personality (for example, cognition, emotion, and perception) seen by some as the defining characteristic of schizophrenia
associative splitting
what is psychotic behavior?
a severe psychological disorder category characterized by hallucinations and loss of contact with reality
what are positive symptoms?
a more overt symptom, such as a delusion or hallucination, displayed by some people with schizophrenia
what is a delusion?
a psychotic symptom involving disorder of thought content and presence of strong beliefs that are misrepresentations of reality
a psychotic symptom of perceptual disturbance in which something is seen, heard, or otherwise sensed although it is not actually present
hallucination
what are negative symptoms?
a less outgoing symptom, such as flat affect or poverty of speech, displayed by some people with schizophrenia
what is avolition?
an inability to initiate or persist in important activities. also known as apathy
what is alogia?
a deficiency in the amount or content of speech, a disturbance often seen in people with schizophrenia
what is anhedonia?
an inability to experience pleasure, associated with some mood and schizophrenic disorders
what is the flat affect?
an apparently emotionless demeanor (including toneless speech and vacant gaze) when a reaction would be expected
a style of talking often seen in people with schizophrenia, involving incoherence and a lack of typical logic patterns
disorganized speech
what is an inappropriate affect?
an emotional display that is improper for the situation
what is catatonic immobility?
a disturbance of motor behavior in which the person remains motionless, sometimes in an awkward posture, for extended periods
what is schizophreniform disorder?
a psychotic disorder involving the symptoms of schizophrenia but lasting less than 6 months
what is schizoaffective disorder?
a psychotic disorder featuring symptoms of both schizophrenia and major mood disorder
a psychotic disturbance in which individuals develop a delusion similar to that of a person with whom they share a close relationship. also known as folie a deux.
shared psychotic disorder
what is substance-induced psychotic disorder?
psychosis caused by the ingestion of medications, psychoactive drugs, or toxins
condition that is characterized by hallucinations or delusions that is the direct result of another physiological disorder, such as stroke or brain tumor
psychotic disorder associated with another medical condition
a psychotic disturbance involving delusions, hallucination, or disorganized speech or behavior but lasting less than 1 month; often occurs in reaction to a stressor
brief psychotic disorder
disorder involving the onset of psychotic symptoms such as hallucinations and delusions, which puts a person at high risk for schizophrenia; designated for further study by DSM-5
attenuated psychosis syndrome
period of 1-2 years before serious symptoms of schizophrenia occur but when less severe yet unusual behaviors start to appear
prodromal stage
according to an obsolete, unsupported theory, a cold, dominating, and rejecting parent who was thought to cause schizophrenia in her offspring
schizophrenogenic mother
according to an obsolete, unsupported theory, the practice of transmitting conflicting messages that was thought ti cause schizophrenia
double blind communication
hostility, criticism, and over-involvement demonstrated by some families toward a family member with a psychological disorder. this can often contribute to the person’s relapse
expressed emotion (EE)
a social learning behavior modification system in which individuals earn items they can exchange for desired rewards by displaying appropriate behaviors
token economy
an enduring maladaptive pattern for relating to the environment and self, exhibited in a range of contexts that cause significant functional impairment or subjective distress
personality disorder
a cluster A (odd or eccentric) personality disorder involving pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent
paranoid personality disorder
a cluster A (odd or eccentric) personality disorder featuring a pervasive pattern of detachment from social relationships with a restricted range of expression of emotions
schizoid personality disorder
a cluster A (odd or eccentric) personality disorder involving a pervasive pattern of interpersonal deficits featuring acute discomfort with, and reduced capacity for, close relationships, as well as cognitive or perceptual distortions and eccentricities of behavior
schizotypal personality disorder
a cluster B (dramatic, emotional, or erratic) personality disorder involving a pervasive pattern of disregard for and violation of the rights of others. similar to the non-DSM-5 label psychopathy but with greater emphasis on overt behavior than on personality traits
antisocial personality disorder
a non-DSM-5 category similar to antisocial personality disorder but with less emphasis on overt behavior. indicators include superficial charm, lack of remorse, and other personality characteristics
psychopathy
a cluster B (dramatic, emotional, or erratic) personality disorder involving a pervasive pattern of instability of interpersonal relationships, self-image, affect, and control over impulses
borderline personality disorder
a promising treatment for borderline personality disorder that involves exposing the client to stressors in a controlled situation, as well as helping the client regulate emotions and cope with stressors that might trigger suicidal behavior
dialectical behavior therapy
a cluster B (dramatic, emotional, or erratic) personality disorder involving a pervasive pattern of excessive emotionality and attention seeking
histrionic personality disorder
a cluster B (dramatic, emotional, or erratic) personality disorder involving a pervasive pattern of grandiosity in fantasy or behavior, need for admiration, and lack of empathy
narcissistic personality disorder
a cluster C (anxious or fearful) personality disorder featuring a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to criticism
avoidant personality disorder
a cluster C (anxious or fearful) personality disorder characterized by a person’s pervasive and excessive need to be taken care of, a condition that leads to the submissive and clinging behavior and fears of separation
dependent personality disorder
a cluster C (anxious or fearful) personality disorder featuring a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency
obsessive-compulsive personality disorder
eating disorder involving recurrent episodes of uncontrolled excessive (binge) eating followed by compensatory actions to remove the food
bulimia nervosa
what is a binge?
relatively brief episode of uncontrolled, excessive consumptions of food or alcohol
what is anorexia nervosa?
eating disorder characterized by recurrent food refusal, leading to dangerously low body weight
pattern of eating involving distress-inducing binges not followed by purging behaviors; being considered as a new DSM diagnostic category
binge-eating disorder
what is the definition of obesity?
excess of body fat resulting in a body mass index of 30 or more
in the eating disorder bulimia nervosa, the self-induced vomitting or laxative abuse used to compensate for excessive food ingestion
purging techniques
surgical approach to extreme obesity, usually accomplished by stapling the stomach to create a small stomach pouch or bypassing the stomach through gastric bypass surgery
bariatric surgery
periodic intervals of sleep during which the eyes move rapidly from side to side, and dreams occur, but the body is inactive
rapid eye movement (REM) sleep
what are dyssomnias?
problems in getting to sleep or in obtaining sufficient quality sleep
what are parasomnias?
abnormal behaviors such as nightmares or sleep walking that occur during sleep
an assessment of sleep disorders in which a client sleeping in the lab is monitored for heart, muscle, respiration, brain wave, and other functions
polysomnographic (PSG) evaluation
small electronic device that is worn on the wrist like a watch and records body movements. this device can be used to record sleep-wake cycles
actigraph
what is sleep efficiency?
percentage of time actually spent sleeping of the total time spent in bed
what are microsleeps?
short, seconds-long periods of sleep that occur in people who have been deprived of sleep
what is insomnia disorder?
condition in which insufficient sleep interferes with normal functioning
what is primary insomnia?
difficulty in initiating, maintaining, or gaining from sleep; not related to other medical or psychological problems
in a person with insomnia, the worsened sleep problems that can occur when medications are used to treat insomnia and then withdrawn
rebound insomnia
what are hypersomnolence disorders
sleep dysfunction involving an excessive amount of sleep that disrupts normal routines
what is sleep apnea?
disorder involving brief periods when breathing ceases during sleep
what is narcolepsy?
sleep disorder involving sudden and irresistible sleep attacks
sleep disruption leading to excessive sleepiness or insomnia, caused by a breathing problem such as interrupted (sleep apnea) or labored (hypoventilation) breathing
breathing-related sleep disorders
sleep disturbances resulting in sleepiness or insomnia, caused by the body’s inability to synchronize its sleep patterns with the current pattern of day and night
circadian rhythm sleep disorder
frightening and anxiety-provoking dreams occurring during rapid eye movement. the individual recalls the bad dreams and recovers alertness and orientation quickly
nightmares
what is disorder of arousal?
category of sleep disorder during NREM sleep that includes sleepwalking and sleep terrors
episodes of apparent awakening from sleep, accompanied by signs of panic, followed by disorientation and amnesia for the incident. these occur during non rapid eye movement sleep and so do not involve frightening dreams
sleep terrors
what is sleepwalking?
parasomnia that involves leaving the bed during non rapid eye movement sleep
legal proceedings that determines a person is mentally disordered and may be hospitalized, even involuntary
civil commitment laws
term formerly used to mean psychological disorder but less preferred because it implies that the causes of the disorder can be found in a medical disease process
mental illness
tendency to violence that, contrary to popular opinion, is not more likely among mental patients
dangerousness
systematic removal of people with severe mental illness or intellectual disability from institutions like psychiatric hospitals
deinstitutionalization
movement of people with severe mental illness from large psychiatric hospitals to smaller group residencies
transinstitutionalization
legal procedure by which a person found not guilty of a crime by reason of insanity must be confined in a psychiatric hospital
criminal commitment
evidence of an abnormal mental condition in people that causes criminal charges against them requiring intent or knowledge to be reduced to lesser offenses requiring only reckless or criminal neglect
diminished capacity
ability of legal defendants to participate in their own defense and understand charges and the roles of the trial participants
competence
mental health professional’s responsibility to break confidentiality and notify the potential victim whom a client has specifically threatened
duty to warn
person who because of special training and experience is allowed to offer opinion testimony in legal trials
expert witnesses
one of a proposed set of guidance for evaluating clinical interventions on the evidence of their effectiveness
clinical efficacy axis
one of the proposed set of guidelines for evaluating clinical interventions by whether they can be applied effectively and cost effectively in real clinical settings
clinical utility axis
what is anhedonia?
loss of pleasure
symptoms of major depressive episode
indecisiveness
feelings of worthlessness
fatigue
appetite change
restlessness or slowing down
sleep disturbance
symptoms of a manic episode
inflated self-esteem
decreased need to sleep
excessive talking
flight of ideas or sense that thoughts are racing
easy distractibility
increase in goal-directed activity or psychomotor agitation
excessive involvement in pleasurable but risky behaviors
average onset of bipolar 1 disorder
15-18
average onset of bipolar 2 disorder
19-22
what percentage of cases of bipolar 2 disorder progress to full bipolar 1 disorder?
10-25%
what gender is more likely to have major depression?
women 2x
what gender is more likely to have bipolar disorder?
equal
what gender is more likely to experience rapid cycling?
women
what gender is more likely to be in depressive period?
women
mood disorders are related to low levels of _____
serotonin
concordance rates for mood disorders are highest in…
identical twins
heritability rates for mood disorders are higher in what gender?
women
what is arbitrary interference?
overemphasize the negative aspects of a mixed situation
what is depressive attributional style?
negative outcomes are one’s own fault
believing future negative outcomes will be one’s fault
believing negative events will disrupt many life activities
what is cognitive triad?
thinking negatively about oneself, the world, and the future
marital dissatisfaction is strongly related to depression, more so in what gender?
males
what percent of females have major depression or have had major depression?
70%
which gender is more likely to have an anxiety disorder?
females
what are some possible explanations for the gender disparity for mood disorders?
- women socialized to have stronger perception of uncontrollability
- parenting style/culture makes girls less independent
- women more sensitive to relationship disruptions
- women ruminate more than men
- women more likely to be discriminated against or abused
how many patients see benefits in taking medication/treatment?
50%
how many patients achieve normal functioning taking medication/treatment?
25%
what so SSRIs do?
block reuptake of serotonin so more serotonin is available to the brain
what do SNRIs do?
block reuptake of serotonin and norepinephrine
- have fewer side effects than SSRIs
what do tricyclic antidepressants do?
block reuptake of epinephrine and other neurotransmitters
- many negative side effects
what do MAO inhibitors do?
block monoamine oxidase, an enzyme that breaks down serotonin/norepinephrine
- too many dietary restrictions
what does the term schizophrenia mean?
splitting of the mind
what portion of the brain is most active during auditory hallucinations?
broca’s area
what is Broca’s area responsible for?
speech production
1
broca’s area
2
wernicke’s area (hearing)
3
visual cortex
4
sylvian or lateral fissure
what is avolition?
lack of initiation and persistence
what is alogia?
relative absence of speech
what is the prevalence of schizophrenia world wide?
1%
when is the usual onset for schizophrenia?
early adulthood
what gender is more likely to have schizophrenia
equal
women usually have better prognosis
onset earlier than males
what is the dopamine hypothesis?
schizophrenia caused by overactive dopamine
drugs that increase the targeted effect
agonists
drugs that decrease the targeted effect
antagonists
what are some historical medical treatments for schizophrenia?
insulin induced coma
ECT
psychosurgery
what are some psychological treatments for schizophrenia?
behavioral interventions on inpatient: reward adaptive behavior
community care programs
social and living skills training
behavioral family therapy
vocational rehabilitation
what is the 5 factor model of personality?
(OCEAN)
openness to new experience
conscientiousness
extraversion
agreeableness
neuroticism
what are cluster A personality disorders?
odd or eccentric
- paranoid
- schizoid
- schizotypical
what are cluster B personality disorders?
dramatic, emotional, erratic
- antisocial
- borderline
- histrionic
- narcissistic
what are cluster C personality disorders?
fearful or anxious
- avoidant
- dependent
- obsessive compulsive
prevalence of personality disorders in general population?
1%
what gender is more likely to have antisocial personality disorder?
males
what gender is more likely to have histrionic personality disorder?
females
what 3 things must an individual demonstrate to be diagnosed with antisocial personality disorder?
inadequately motivated behavior
lack of conscience or responsibility to others
emotional poverty
what is the triple vulnerability model of borderline personality disorder?
generalized biological vulnerability (reactivity)
generalized psychological vulnerability (lash out)
specific psychological vulnerability (stressors elicit)
treatment options for borderline personality disorder?
antidepressant medications - short term
dialectic behavior therapy most promising
treatment options for histrionic personality disorder?
focus on attention seeking and long-term negative consequences
targets may also include problematic interpersonal behaviors
little evidence that treatment is effective
treatment options for narcissistic personality disorder?
focus on grandiosity, lack of empathy, unrealistic thinking
what percent of 9 year old girls have dieted?
40%
what percent of bulimia cases are female?
90%
when is the typical onset for bulimia?
adolescence
what health problems can arise from bulimia?
electrolyte imbalance
erosion of dental enamel
intestinal problems, permanent colon damage
treatments for bulimia?
- CBT
- interpersonal therapy
- antidepressants
treatments for anorexia?
- general goals and strategies
- intensive residential treatments
- prevention
is the long term prognosis worse in bulimia or anorexia?
anorexia
managing care for people with serious mental illness requires a balance between 3 things:
- patients right as an individual
- patient’s individual safety
- society’s right to safety and security
what are the laws determining when one can be committed involuntarily to a mental hospital?
vary by state
previously, before the government made laws in the 1800s, who was usually responsible for the mentally ill?
family or abandoned
what was the liberal era?
1960-1980
emphasize rights of individual
what was the neoconservative era?
1980-present
emphasize rights of majority
what are the possible commitment criteria?
- person has “mental illness” and needs tx
- dangerous to self or others
- “gravely disabled” - inability to care for self
legal proceedings to assess status:
- personal fails to seek help
- others feel that help is needed
- petition is made to a judge on the behalf of the person
- individual must be notified on the comittment process
- judge makes decision - informed by exert opinion
what is the criteria for having a “mental illness”?
severe thought/emotional disturbance affecting health/safety
- often excludes drug abuse, personality disorders, and intellectual disabilities
what is the criteria for dangerousness?
predicting general tends, but not specific acts
vats majority of people with mental illness are not dangerous
what is rouse v cameron?
right to treatment and not just therapeutic environment
- must use proven treatments
- supposed to treat individual, not punish
what is wyatt v stickney?
constitutional right to treatment
- right to privacy and dignity
- right to least restrictive regimen necessary
- freedom of unnecessary/excessive meds
- right to send sealed mail and use telephone
- individual tx plan that is periodically reviewed
what is the mental health systems act (1980)?
advisory law-not mandated
- appropriate tx and services
- no tx w/o informed consent
- not restrained unless extreme circumstances
- confidentiality of records
- inform about tx/condition in timely manner
- participate in/be informed about tx course
