Exam 2-Bipolar, Schizophrenia, Mania, etc. Flashcards
Describe features of panic disorder
- Panic attack comes out of nowhere
- Become frequent
- Person becomes afraid of having them in the future
- Start to avoid public places or places where they might have one
- Can lead to agoraphobia (fear of open places)
- Fear is that they can’t get to some sort of safe place
- Fear is of their own physiological arousal (the panic attack) it’s a fear of experiencing a physical reaction
- notice physiological arousal more than others (fear of fear)
- anxiety sensitivity, focus on internal arousal
- create catastrophic attribution (they think the worst)
suffers of panic disorder are essentially afraid of
they are afraid of their own fear response.
Describe Social Phobia
- Experience persistent, intense social fears
- Either specific social phobia, or more generalized phobia
- status differential, dating, speeches, friends
- negative interpretation of social interactions
- looks for all the mistakes they made and magnify them, and think about them over and over again
- ruminate about situations that they have been in (post event processing)
Describe Generalized Anxiety Disorder
GAD described in one word: “Worried.”
Persistent and chronic worry
Worry about everything
Excessive and uncontrollable. They can’t shut it off.
-Contemplating some future negative outcome. “What if”
-Chronically stressed, elevated cortisol levels
Headaches, higher blood pressure, weight fluctuations, concentration. stomach aches, GI problems, insomnia
-Minimum of 6 months, must be excessive, about a number of different things
How high is comorbidity for GAD?
Very high comorbidity-up to 50%.
What are specific phobias?
A particular stimuli that’s not accounted for by another disorder (claustrophobia, animal phobia, clown phobia, etc).
Most common specific phobias are:
Spiders
Snakes
Heights
what two things can lead to specific trauma?
social learning
traumatic experience
What is the only phobia where one is prone to fainting?
Blood/Injury/Injection Phobia
Treatment suggestions for blood/injury/injection phobias are:
Teach muscle tension to increase muscle tension to prevent fainting.
Describe Separation anxiety Disorder
S.A.D-outside of the window of what is considered developmentally appropriate (9 or 10 years old, not a 2 year old)
- parents may play a significant role in this - may reinforce this - good news: many kids outgrow it - bad news: can take awhile, kids are at risk for other disorders - panic disorder seems to be linked to S.A.D
Describe selective mutism
Selective mutism
- refuse to speak in certain situations - typically out of social fear
Where is PTSD now in the DSM Five?
Trauma chapter (used to be in anxiety chapter)
Prevalance of Anxiety Disorders
One year: 18.1%
Lifetime: 28.8%
As a family of disorders, this is probably the most common psychiatric problem (single most common disorder would be depression).
75% lifetime comorbidity rate for 2nd anxiety disorder
50% lifetime comorbidity rate for depression
With comorbidity of anxiety and depression, usually people report the anxiety before the depression.
What is the most common psychiatric problem as a family of disorders?
Anxiety disorder
PTSD-is in part an anxiety disorder that needs a _______ of ______ days to be diagnosed
-MINIMUM of 30 days
symptoms of PTSD include:
- Symptoms: Anger, depression, mood disturbance, nightmares, flashbacks and intrusive imagery, avoidance, depersonalization(feeling you’re not yourself), derealization (Feeling like the world is not real)
- thought suppression-the more you try to push them out, the more they pop up
- instead, allow yourself to experience it. Then, it will have less of an impact on you
What PTSD treatment works very well?
-exposure. Works extremely well.
What is Acute Stress Disorder
- People who experience trauma between day 2 and day 30.
- Same symptoms as PTSD but they haven’t reached the month criteria
- Sometimes, the symptoms subside, and sometimes they persist
- person may recover with minimal intervention
What is adjustment disorder?
- Are stressed and showing some kind of disruptions but don’t meet criteria for other disorders.
- Many people recover over time, it is usually stress driven
- in direct response to a stressor
- showing depressed move, anxiety, conduct, bereavement (death of a loved one)
- bereavement (can set off a depressive episode)
-muscle dysmporphia focuses on what
(usually males) obsessed about muscularity
Describe Bipolar I Disorder
Presence of a manic or mixed episode
Presence of a depressive episode (not necessary for diagnosis)
what is a mixed episode?
People who simultaneously meet depressive and manic disorder
describe manic episode
Distinct period of an abnormally elevated, expansive, or irritable mood
Duration-one week minimum
One manic episode____________________
One manic episode takes you out of depression and puts you in bipolar disorder
Symptoms of Mania:
- inflated self esteem
- decreased need for sleep
- rapid/pressured speech
- distractibility/poor concentration
- increased in goal directed activity or psychomotor agitation
- excessive involvement in pleasurable activities that have a high risk for painful consequences
- fidgety (psychomotor agitation)
- racing thoughts/flight of ideas-jump from one topic to the next
Bipolar I Prevalence
- Lifetime prevalence .5 to 1%
- No gender differences in prevalence
- Less cross cultural differences
- probably more of a genetic component
- onset is usually late adolescence or early adulthoo
course of bipolar episode
- often chronic
- about 75% exhibit poor functioning following a manic episode
- Deficits in social & occupational functioning
Bipolar II Disorder: Required for diagnosis:
History of one documented hypomanic episode AND one major depressive episode
Symptoms of Bipolar II
- No full manic episode
- Hypomanic episode (4 days of symptoms)
- Major depressive episode necessary for diagnosis
Which of the following disorders require a major depressive episode:
a. bipolar II
b. Bipolar II
c. Both
Answer: Bipolar II
Cyclothymic Disorder
2 years of Symptoms
- hypomanic episodes
- depressive symptoms
- No longer than 2 months without experiencing symptoms
- probably fits more of the stereotype disorders
- almost like a low-grade chronic bipolar disorder
Name one extra credit word
hippo
Primary feature of schizophrenia is
psychosis-
what is psychosis-
a significant loss of contact with reality
Core symptoms of schizophrenia include:
2 or more of the following are present for at least one month:
delusions hallucinations disorganized speech grossly disorganized or catatonic behavior negative symptoms
Hallucinations are _____________ delusions are _________
hallucinations are sensory based-delusions are belief based
positive symptoms of schizophrenia
positive symptoms-above and beyond what other people experience-additional symptoms
negative symptoms of schizophrenia
negative symptoms-things that are missing
Positive symptoms of schizophrenia-excess or distortion in typical behavior and/or experiences:
- Delusions
- Hallucinations
- Disorganized speech
- Disorganized behavior
Negative symptoms-absence or deficit of typical behaviors:
Flat or blunted affect
- Absence of speech (alogia) - Limited goal-directed activity (avolition) - Anhedonia
phases of a schizophrenic episode are
Prodromal Phase-symptoms are coming
Acute phase-worst part
Residual Phase-after the acute phase, symptoms don’t usually leave
Brief psychotic disorder
rapid onset
lasts less than a month
stress related
recovery prognosis=may recover fully and never have one again
Delusional disorder subtype includes
subtype: Erotomania-believe they have a special connection/relationship with someone they have never met
Schizophrenia-
Age and Gender factors:
onset- typically late teens to early 20’s, females mid up to late 20’s
Women who develop schizophrenia have a more favorable course
Men often exhibit more negative symptoms
Second extra credit word:
saber tooth kangaroo
Treatment and Outcome for schizophrenia
Novel antipsychotics
less extrapyramidal side effects (motor abnormality)
activity at dopamine and serotonin receptor sites
examples: Risperdal, Zyprexa, Seroquel, Abilify
Psychosocial approaches include: Case Management Social-skills training Cognitive-behavioral therapy Family Therapy
diathesis stress model views disorders as…
they believe certain individuals have a biological vulnerability toward developing the disorder- a vulnerability that is brought to the surface by psychological and sociocultural factors.
stress hormones are known as
corticosteroids
What events might make Acute and PTSD occur?
Disasters Victimization Sexual Assault Terrorism Torture
most common treatments for combat veterans with PTSD or Acute stress
drug therapy behavioral exposure techniques insight therapy family therapy group therapy typically are combined
one form of exposure therapy for PTSD is
EMDR (eye movement desensitization and reprocessing)
what is unipolar depression?
Depression without a history of mania
two chemicals linked to unipolar depression are
norepinephrine and serotonin
biological treatments for unipolar depression include
ECT (electroconvulsive therapy)
which medications work for anxiety disorders?
- Psychotherapy and medication work about equally well
- Tricyclic antidepressants
- SSRI’s seem to work (in higher doses). Not all antidepressants work for all anxiety disorders.
- Benzodiazepine (xanax, valium)-increase gaba activity
- Good news is that they work!
- negatives are that they can be habit forming
- withdrawal can be dangerous
- rebound effect-very anxious, at risk for seizures
- can become extremely reinforcing
- Benzos and alcohol-can kill you.
- SNRIs
- increasing gaba-slows down nervous system
- Beta Blockers
- social phobia is the only one it seems to really work
difference between bipolar I and bipolar II
Bipolar I has a presence of a manic episode or a history of mania
Bipolar II has a presence or history of major depressive disorder, presence of hypomanic episodes but NO history of mania and significant distress or impairment
what is cyclothymic disorder
milder form of bipolar continue for two or more years, interrupted occasionally by normal moods that may last for only days or weeks
