Exam 2 Flashcards
Somatic Symptoms Disorder
When patient has physical symptoms that are not fully explained by a medical condition.
Physical symptoms caused by psychological disorders.
6 months (default in order to have disorder)
Conversion Disorder
Person has a loss of functioning due to a psychological condition.
Not intentionally produced.
Altered motor/ sensory dysfunction. Sudden paralysis, blindness,
I.e. fighter pilot, kill wrong group of people, months later can develop temporary blindness - traumatic so that it closes down vision.
Undisturbed about their symptoms -
Illness Anxiety Disorder
DSM 4 hypochondriac -
Not making up symptoms, they have them, they just exaggerate the severity of the symptoms.
Difficult to reassure these patients.
*treatment - family history, get reassurance from Dr.
Comorbidity
Factitious Disorder
- When patient has physical or psychological symptoms that are intentionally produced for the purpose of being in the sick role.
- Go to extensive travel and energy
- Munchausen’s syndrome - is now called factitious disorder - not in DSM 5
- This is about attention. 2 different types, yourself or towards another person.
- Malingering- produces symptoms for obvious gain (get drugs, get out of something)
Dissociative Disorders
- identity, memory, consciousness is disrupted.
* triggered by stress
Dissociative Amnesia
- When person has inability to recall important information
Sometimes this person wanders around.
*Fugue - travel and wander away,
Dissociative Identity
DSM 3 - called Multiple personality disorder - DSM now called
- Two or more distinct personalities within the same person.
Almost always caused by severe childhood trauma (physical, sexual) - Look back, find out history, and talk about trauma. *rare disorder
Depersonalization / Derealization
- When person has feeling that they are detached from their body or surroundings
Underlying anxiety. - Causes : Vascular impairment, dementia, drugs, chronic stress
Anorexia Nervosa (restrictive or purging)
- Refusal to maintain a body weight that’s 85% generally recognized normal weight for an age or height. Intense fear of gaining weight, distort body image.
- Mainly adolescent, young females 14-25yrs old. 3 month period
Can lead to death, irregular heartbeat, electrolyte imbalance. *highest mortality rate. - DSM 4 requirement miss 3 menstrual cycles.
Restrictive - control amount of calorie intake. (not taking in food, calories) - Purging - take in a lot of food, then make themselves vomit, lax, exercise.
- dispute cognitive distortions
Causes : perfectionism, attempt to get control, controlling family system, chemical imbalance
Psycho - unexpressed conflicts, tensions, feelings, unconscious fear of intimacy or sexuality.
Low self esteem - more critical.
Sexual abuse, genetic, low levels of serotonin
When they eat, it causes anxiety, food leads to unpleasant feeling,
*prozac is used to treat eating disorders
Treatment: family history, psychotherapy, pediatrician,
70-75% impatient program - medical treatment?
Bulimia Nervosa
Recurring episodes of binge eating more than the average person.
Lack of control over eating.
once a week, 3 months *more common than anorexia, and occurs later in life.
After eating, take action to prevent weight gain (vomiting, excessive exercise)
See other problems GI, heart abnormalities,
Impulsive and sensation seeking: risky behaviors.
Causes: distressing thoughts, anxiety,
Treatment: what are these unresolved conflicts, break this cycle - as a therapist. Write down when it happens and what you’re thinking about.
Relapse trigger: what’s going on that causes you to eat hella much, and when it comes up, find alternate ways of handling this.
Cognitive Behavioral: the way you think about things, causes you to eat a lot.
Antipsychotic can be given?
Binge Eating Disorder
DSM 5 - new category
Most common than anorexia or bulimia
Eat rapidly, lack of control, eat until uncomfortable, eat a lot when not hungry, eating a lot when alone,
once a week for 3 months
Causes: reinforcing effects of food, food produces more dope,
Listed in DSM 5
Pica
Persistent eating of nonfood substances
Usually has developmental disorder, lack of iron, living in impoverished environment
Rumination
Eat recently discarded food, consistent way of eating.
Avoidant- Restrictive Food Intake
- Very narrow range of foods, usually done to regulate emotions, avoid anxiety.
- Lead to nutritional deficiency and weight loss.
Anxiety Disorders / Neurocognitive Disorders
To be classified with an anxiety disorder - feeling of apprehension / tension / fear - over arousal. Debilitating to the person. - (must have those three).
Debilitating
disrupts their social functioning or could disrupt their personal function in or job functioning.
Sometimes people are aware of their fears - but doesn’t help.
When people have mild or moderate levels of arousal - increases learning and memory - often beneficial. But when it is too much - negative effects happen.
Comorbiduty
- diagnoses that go along with another one. 57% of people that have anxiety disorder have another diagnosable disorder.
Panic Attacks
- accelerated heart rate, sweating, trembling, shortness of breath, choking, chest pain, nausea, depersonalization - detached, dizziness, fear of losing control.
Panic Disorder
- Severe episodes of apprehension and feelings of doom. (without any trigger, particular cause).
- Needs to be recurrent unexpected panic attacks. 1 month of worry over another panic attack. ( needs to have two or more, plus another worry of another panic attack).
- Fear of losing control - trigger (10 minutes come on quickly subside within an hour).
Agoraphobia
When patient has increased fear of anxiety and has to be in two of the following situations:
- Anxiety about using public transportation /anxiety in being in open public places / can also be in enclosed places / being in a crowd / or even outside of the home.
- Fear that they will be in places where help can not get to them.
- 6 months
Generalized Anxiety Disorder
- Chronic high levels of anxiety that is not tied to any specific situation.
- Have more days than not having it, *6 months.
- More irritable, sleep disturbances, fatigue, muscle tension, restlessness, impaired concentration, more nervous. - can’t tolerate ambiguity
- Negative life events, trauma can cause this *
- children have more physio symptoms -stomach aches, headaches
- Goes hand in hand with depression, substance abuse.
- High need for structure and clarity.
Social Anxiety Disorder ( 3rd most commonly diagnosed psych disorder)
- When the person has an increased fear of social situations: be evaluated or judged by others, rejected, or viewed in a negative light.
(is it limited to public speaking? Or performing?)
- Average age - 12 years old.
- Treatment: be supportive, teach them social skills
Specifier - DSM 5
Specifier DSM 5 - level or degree of impairment
Selective Mutism
- Consistent failure to speak in specific social situations outside of the home * have to last for at least one month.
(excludes the first month of school).
Specific Phobia
When a person has an increased fear of a specific situation or object.
( 1st category -if your phobia is around animals or insects, 2nd category - a natural enviroment - heights, thunder, 3rd - blood or injections, 4th- situational phobia - tunnel bridges, 5th - other.)
Seperation Anxiety Disorder
Most common in kids 5-12 years of age. Has to last at least 1 month*
- Being separated from a loved one or that something horrible is going to happen to them if they are separated from a loved one or you.
OCD
- Thoughts, repeatedly enter your mind against your will, uncontrollable, produce anxiety
- Actions and behaviors that someone engages in to reduce the anxiety from the obsession.
- Compulsions are negatively reinforced - the only way of taking away the anxiety is washing their hands.
- Causes: abnormalities, increased activity in certain parts of the brain, low levels of serotonin, - medication SSRI* , psychosurgery - go in and destroy specific areas in the brain that are connected to worry.
- in DSM 5, no longer listed as anxiety disorder.
Body Dysmorphic Disorder
Person is preoccupied with body defect, spends a lot of time thinking “ears are too big, nose is big” seeks reassurance from others. Plastic surgeons.
Hoarding Disorder
Difficulty discarding possessions, hella shit
Trichotillomania
Repetitive hair pulling - leading to hair loss, done when person is alone.
Feeling tension or anxiety - yank hair
Excoriation Disorder
Picking at your skin - creating lessions.
PTSD
- Exposure or witness to traumatic event
- Intrusive memories of the event, distressing dreams, flashbacks, avoid stimuli that is similar to original trauma, inability to feel job, struggle to feel sadness
- Adrenaline, hypervigilance, sleep disturbances
- 1 month symptoms.
Specifier- combat related, civilian related.
18 vets suicide per day 80% vets PTSD, 10% civilian rate.
Help them by talking about it.
Depression, anxiety, substance abuse.
Ptsd -amygdala, hippocampus - overly sensitive and over active.
Acute Stress Disorder
All ptsd symptoms- but you have it less than 3 days.
Benzodiazepines
Increased Gaba - makes more calm. - sedative
Addictive
Valium - long acting
Xanax - short acting
Flooding/ Exposure Therapy
Gradually expose the person to the fear stimuli and you prevent their escape.
Systematic Desensitization
Make a list of what is least anxiety provoking to the most.
- gain trust, find out problem
- relaxation treatment
- hierarchy of fear producing stimuli
- expose them to that shit
Covert Sensitization
you have them imagine the worst case scenario
Modeling
client learns by imitation
Neurocognitive Disorder
Depressive disorder due to another medical conditin
Cerebrovascular Disease
disease of arteries, affects blood supply going to the brain.
The earlier the onset
Elderly
problems with attentin, speed of processing information, difficulty plannin out activities.
Benzo- yes, SSRI’s - More often
Antabuse
Makes you sick when you drink alcohol
Naltrexone
Removes rewarding consequences of drinking
Delrium
Disturbances in persons attention, memory, and orientation.
infection could cause this / chemical imbalances
onset is quick
Major Neurological Disorder
Person has extreme deficits in cognitibe ability.
thinking things through, executive functions (gradual onset)
Alzheimers Disease
Can go on for years
- no affect in language, initially.
- affects short term memory
Cause: decreased blood flow to the brain.
