Exam 2 ohhhhh nooo... Flashcards
Individuals with __ find it difficult to function adequately while having sex
Sexual dysfunction
i.e. they may not become aroused or achieve orgasm
In __ disorders, sexual arousal occurs primarily in the context of inappropriate objects or individuals
Paraphilic
__ means a strong attraction or liking, and __ indicates that the attraction is abnormal or atypical
Philia;
Para
What is gender dysphoria?
There is incongruence and psychological distress and dissatisfaction with the gender one has been assigned at birth
In a scientifically sound survey done by Mosher et. al (2005) where they collected data from 12,561 men and women as a part of the National Survey of Family Growth…, what was revealed?`
Virtually all men and women studied by Mosher and colleagues were sexually experienced, with vaginal intercourse a nearly universal experience, even for those who had never been married. Furthermore, by the age of 15, 1/4 of males and females have engaged in vaginal intercourse, and the prevalence rate increases steadily with the age of individuals
Which pattern has been used to explain the increases in adolescent STI rates at a time when teen pregnancy rates have been on the decline in Canada and elsewhere?
A national survey of Canadian students in Grades 7, 9, and 11 showed that among those who were sexually active, oral contraceptive use was more common (84% to 90%) than condom use (64% to 80%)
Cindy Meston and colleagues surveyed 702 students at the University of Colombia where their findings supported __ percent of men versus only __ percent of women reported masturbating alone
80; 48
- Frequency of masturbation was greater for men than for women
Studies of “hooking up” demonstrate similar findings to older studies of casual sex, in that it is often precipitated by __, and women are less likely to consider it a positive experience than men
Alchol
Owen and Fincham (2011) found that greater alcohol use leads to greater engagement in __ relationships
“Friends with benefits”
Examining trends from 1943 to 1999, we find that almost all existing gender differences became __ over time, especially in regard to attitudes toward marital sex
Smaller
- 12 percent of young women approved of premarital sex in 1943, compared with 73 percent in 1999
- 40 percent in 1943 and 79 percent in 1999 for men
In the late 1990s and after 2000, investigators have noted a __ in number of sexual partners and a tendency to __ sexual intercourse among adolescents
Decrease;
Delay
What are the three stages of the sexual response cycle? They are each associated with specific sexual dysfunctions. In addition, pain can become associated with sexual functioning in women
1) Desire
2) Arousal
3) Orgasm
Disorders can either be generalized meaning __, or they can be situational meaning __
It occurs every time the individual attempts sex;
It occurs only with some partners or at certain times, but not with other partners or at other times
__ percent of all Canadian women and __ percent of all Canadian men experience sexual dysfunction, making this class of disorder one of the most prevalent of all psychological or physical disorders
28; 18
Two of these disorders are characterized by little or no interest in sex that is causing significant distress in the individual. In males this disorder is called __.
In females low sexual interest is almost always accompanied by a diminished ability to become excited or aroused by erotic cues or sexual activity, this is combined in a disorder called __.
For males, there is a specific disorder of arousal called __.
Male Hypoactive Sexual Desire Disorder;
Female Sexual Interest/Arousal Disorder;
Erectile Dysfunction
__ is a specific disorder of arousal; the problem here is not desire; their problem is in becoming aroused
Erectile Disorder
Should a sexual problem be identified as a diagnosis when dysfunction is clearly present but the person is not distressed about it?
In the DSM-5, the symptoms must clearly cause clinically significant distress in the individual
Males who achieve orgasm only with great difficulty or not at all meet criteria for a condition called __. In women, this is called __
Delayed ejaculation;
Female orgasmic disorder
The work of Grenier and Byers (2001) suggests that self-identifying with premature ejaculation had three components:
1) Behavioral component (i.e. the regularity of their rapid ejaculation experiences)
2) An emotional component (i.e. worry or concern about ejaculating too early)
3) An efficiency component (i.e. perceiving that they have little control over the timing of their ejaculation)
__ is a sexual dysfunction specific to women that refers to difficulties with penetration during attempted intercourse or significant pain during intercourse
Genito-pelvic pain/penetration disorder
- For some women sexual desire is present, and arousal and orgasm are easily attained, but the pain during attempted intercourse is so severe that sexual behavior is disrupted
What are the three major aspects to the assessment of sexual behavior:
1) Interviews, usually supported by numerous questionnaires because patients may provide more information on paper than in a verbal interview
2) A thorough medical evaluation, to rule out the variety of medical conditions that can contribute to sexual problems
3) Psychophysiological assessment, to measure directly the physiological aspects of sexual arousal
A variety of drugs, including some commonly prescribed for __, __, and __, often disrupt sexual arousal and functioning
Hypertension; anxiety; depression
Because erections most often occur during REM sleep in physically healthy men, psychophysiological measurement of __ was in the past used frequently to determine a man’s ability to obtain normal erectile response
Nocturnal penile tumescence
28 percent of men with __ experienced complete erectile failure. Vascular disease is a major cause of erectile difficulties
Diabetes
The two relevant vascular problems are __, which makes it difficult for blood to reach the penis, and __, where blood flows out too quickly for an erection to be maintained
Arterial insufficiency (constricted arteries); Venous leakage
__ can also indirectly affect sexual functioning
Chronic illness
__ medications, in the class known as beta-blockers, including propranolol, may contribute to sexual dysfunction. __ antidepressant medications and other antidepressant and antianxiety drugs may also interfere with sexual desire and arousal in both men and women
Antihypertensive;
Selective-Serotonin reuptake inhibitor (SSRI)
Physically, alcohol is a central nervous system __, and for men to achieve erection and women to achieve lubrication is much more difficult when the central nervous system is __
Suppressant;
suppressed
This negative cognitive set has been termed __, which is presumably learned early in childhood from families, religious authorities, or others. It seems to predict sexual difficulties later in life
Erotophobia
If women experienced sexual victimization through adult sexual contact before puberty or were forced to have sexual contact of some kind, they were approximately __ as likely to have orgasmic dysfunction as women who did not experience that.
For male victims of adult-child contact, the probability of experiencing erectile disorder is more than __ times greater than if they had not had the contact
Twice;
Three
__ is when the pelvic muscles in the outer third of the vagina undergo involuntary spasms when intercourse is attempted
Vaginismus
One surprising simple treatment is effective for a large number of individuals who experience sexual dysfunction: __
Education
- Ignorance of the most basic aspects of the sexual response cycle and intercourse often leads to long-lasting dysfunctions
What are the clinicians’ primary goal in a therapeutic program for sexual dysfunctions?
To eliminate psychologically based performance anxiety
- Also providing basic education about sexual functioning, altering deep-seated myths, and increasing communication
p. 357
To treat premature ejaculation, most sex therapists use a procedure sometimes called the __, in which the penis is stimulated, usually by the partner, to nearly full erection. At this point the partner firmly squeezes the penis near the top where the head of the penis joins the shaft, which quickly reduces arousal
Squeeze technique
- Success rate: 60-90% but drop to 25% after three years or more follow-up
To treat vaginismus, and pain related to penetration in genitopelvic pain/penetration disorder, what is recommended?
For the woman and eventually the partner, to gradually insert larger and larger dilators at the woman’s own pace
- Success rate: 80-100%
Researchers argue that additional relevant outcomes that should be (but rarely are) assessed for penile-vaginal intercourse as the indicator of therapy “success”:
1) Whether the vaginal muscle spasm has in fact been resolved
2) Whether interference with intercourse has been decreased
3) Whether intercourse is less painful or more pleasurable
4) Whether the couple is experiencing greater sexual satisfaction
What may be the two different types of treatment involving vaginismus?
1) Subtype involving a phobia of penetration for which cognitive-behavioral techniques developed for fear reduction would be most appropriate
2) Separate subtype involving genital pain for which psychosocial techniques developed for the treatment of chronic pain would be most appropriate
For some time, __ and __ have been used to treat erectile disorder. But although they are safe and have relatively few side effects, they have only negligible effects on erectile disorder.
Yohimbine; also when combined with 1-arginine glutamate, it is superior to placebo in increasing vaginal responses to erotic stimuli among women with sexual arousal disorder
Testosterone
Some urologists teach patients to inject vasodilating drugs such as __ and __ directly into the penis when they want to have sexual intercourse
Papaverine; Prostaglandin
- These drugs dilate the blood vessels, allowing blood to flow to the penis and thereby producing an erection within 15 minutes that can last from one to four hours
p. 360
Insertion of __ or implants has been a surgical option for almost 100 years; one procedure involves implanting a semirigid silicone rod that can be bent by the male into correct position for intercourse and maneuvered out of the way at other times. In a more popular procedure, the male squeezes a small pump that is surgically implanted into the scrotum, forcing fluid into an inflatable cylinder
Penile prostheses
Another approach is __, which works by creating a vacuum in a cylinder placed over the penis. The vacuum draws blood into the penis, which is then trapped by a specifically designed ring placed around the base of the penis
Vacuum device therapy
Why are treatment programs for sexual dysfunctions readily available in many locations?
Because few health and mental health professionals are trained to apply them, although the availability of Viagra for male erectile disorder is widespread
These disorders of sexual arousal and attraction - if they cause distress or impairment to the individual, or cause personal harm, or cause the risk of harm to others - are called __
Paraphilic disorders
The DSM-5 does not consider a(n) __ a disorder unless it is associated with distress and impairment or harm or the threat of harm to others
Paraphilia
It is not uncommon for individuals with paraphilic disorder to also have comorbid __, ___, and __
Mood, anxiety, and substance abuse disorders
What is frotteuristic disorder?
Takes place in a public setting, in which a person takes advantage of forced physical contact with strangers to become aroused
- Frotteuristic act is usually successful because victims cannot escape easily
What is fetishistic disorder?
A person is sexually attracted to nonliving objects
Fetishistic arousal is associated with two different classes of objects or activities:
1) An inanimate object
2) A source of specific tactile stimulation, such as rubber, etc.
(In terms of fetishistic arousal) A third source of attraction, sometimes called partialism is:
A part of the body, such as the foot, DAT ASS, or hair
What is voyeuristic disorder?
The practice of observing an unsuspecting individual undressing or naked in order to become aroused
What is Exhibitionistic disorder?
Achieving sexual arousal and gratification by exposing one’s genitals to unsuspecting strangers
Anxiety actually increases __ under some circumstances
Arousal
To meet diagniss for exhibitionistic disorder, the behavior:
Must occur repeatedly and be compulsive or out of control
Another specifier for transvestism describes a pattern of sexual arousal associated not with clothing itself but rather with thoughts or images of oneself as a female. This specifier is called __
“Autogynephilia”
Both __ and __ are associated with either inflicting pain or humiliation (sadism) or suffering pain or humiliation (masochism)
Sexual sadism disorder; sexual masochism disorder
In many such cases something goes wrong and the individual accidentally hangs himself or herself, an event that should be distinguished from the closely related condition called __, which involves self-strangulation to reduce the flow of oxygen to the brain and enhance sensation of orgasm
Hypoxiphilia
Sexual attraction to children (or very young adolescents generally aged 13 years or younger), called __
Pedophilic disorder
__ disorders are seldom seen in women and were thought to be totally absent in women for many years, with the possible exception of sadomasochistic practices. But in recent years, several reports have appeared describing individual cases or small series of cases
Paraphilic
Therapists and sex researchers who work with individuals with paraphilic disorders have observed what seems to be a(n) __
Incredibly strong sex drive
- It is not uncommon for some individuals to masturbate three or four times a day
Several treatment procedures are available for decreasing unwanted arousal. Most are behavior therapy procedures directed at changing:
The associations and context from arousing and pleasurable to neutral
What is covert desensitization?
Sexually arousing images are associated with the very consequences of the behavior that bring the patient to treatment in the first place
__ is present if a person’s physical sex (male or female anatomy, also called “natal” sex) is not consistent with the person’s sense of who he or she really is or with his or her experienced gender
Gender dysphoria
What is the primary purpose of cross-dressing and the primary goal of gender dysphoria?
Cross-dressing: Sexual gratification
Gender dysphoria: The desire to live life openly in a manner consistent with that of the other gender
__, in which gender dysphoria begins with a strong and specific sexual attraction to a fantasy of oneself (auto) as a female (gyne)
Autogynephilia
Slightly higher levels of __ or __ at certain critical periods of development might masculinize a female fetus or feminize a male fetus
Testosterone; estrogen
At least some evidence suggests that gender identity firms up between __ months and __ years of age and is relatively fixed after that
18; three
One study found that exposure to higher levels of __ was associated with more masculine play behavior in both boys and girls
Fetal testosterone
What are the qualifications for sex reassignment surgery at a reputable clinic?
Individuals must live in the desired gender for one to two years so that they can be sure they want to change sex. They also must be stable psychologically, financially, and socially
__ represent a number of related problems that involve the inability to resist acting on a drive or temptation
Impulse-control disorders
__ refers to using multiple substances
Polysubstance use
__ substances alter mood, behavior, or both.
Psychoactive
List some symptoms of intoxication?
Impaired judgment, mood changes, and lowered motor ability (e.g., problems walking or talking)
How does the DSM-5 define substance abuse?
How significantly it interferes with the user’s life
i.e. if substances disrupt your education, job, or relationships with others, and put you in physically dangerous situations (while driving), you would be considered a drug abuser
What is alcohol withdrawal delirium?
In which a person can experience frightening hallucinations and body tremors. Withdrawal from many substances can bring on chills, fever, diarrhea, nausea and vomiting, and aches and pains
Which drug is this most likely? Withdrawal that has a pattern that includes anxiety, lack of motivation, and boredom
Cocaine
Which drug is this most likely? Withdrawal which includes symptoms such as nervousness, appetite change, and sleep disturbance
420 blaze it ~~
The repeated use of a drug, a desperate need to ingest more of the substance (stealing money to buy drugs, standing outside in the cold to smoke), and the likelihood that use will resume after a period of abstinence are behaviors that define the extent of drug dependence; this is referred to __
Psychological dependence (different from physiological)
Substance-related disorders are now described by levels of severity, including:
- Mild (i.e. the person exhibits only two or three of the eleven criteria met)
- Moderate (i.e. four or five criteria met)
- Severe (i.e. six or more criteria met)
Some researchers have estimated that more than half the people with alcohol disorders have an additional psychiatric disorder, such as:
Major depression, antisocial personality disorder, or bipolar disorder
__ disorders were found to be highly comorbid with __ and __ disorders
Mood; anxiety
Research suggests that alcohol’s effects in increasing risk-taking may contribute to the high co-occurrence of alcohol and __ disorders
Gambling
What are the six general categories of substances?
1) Depressants
2) Stimulants
3) Opiates
4) Hallucinogens
5) Other drugs of abuse
6) Gambling disorder
__ are substances that result in behavioral sedation and can induce relaxation. They include alcohol and the sedative and hypnotic drugs in the families of barbiturates i.e. Seconal and benzodiazepines (Valium, Xanax, etc).
Depressants
__ are substances that cause us to be more active and alert and can elevate mood. Included in this group are amphetamines, cocaine, nicotine, and caffeine
Stimulants
__ are substances with the major effect to produce analgesia temporarily (reduce pain) and euphoria. Heroin, opium, codeine, morphine, and oxycodone are included
Opiates
__ are substances that alter sensory perception and can produce delusions, paranoia, hallucinations. Cannabis and LSD are included
Hallucinogens
__ are substances that are abused but do not fit neatly into one of the categories here include inhalants (i.e. airplane glue), anabolic steroids, over-the-counter medication. They produce a variety of psychoactive effects
Other drugs of abuse
__ is associated with the ingestion of substances, and they are individuals who are unable to resist the urge to gamble, which in turn results in negative personal consequences (e.g., divorce, loss of employment)
Gambling disorder
__ primarily decrease central nervous system activity. Their principal effect is to reduce our levels of physiological arousal and help us relax
Depressants
__ influences a number of different neuroreceptor systems, which makes it difficult to study; for example: GABA system
Alcohol
Blackouts, the loss of memory for what happens during intoxication, may result from the interaction of alcohol with the __. The __ also appears to be sensitive to alcohol as it affects mood, sleep, and eating behavior and is thought to be responsible for alcoholic cravings
Glutamate system; Serotonin system
Alcohol also exerts effects on the dopamine reward system, and these effects may be responsible for:
The pleasurable feelings people experience when drinking alcohol
Alcohol also results in release of __, our bodies’ naturally occurring analgesics
Endogenous opioids
- Which may explain why alcohol has pain numbing effects
What is withdrawal delirium?
A condition that can produce frightening hallucinations and body tremors
Consequences of long-term excessive drinking include:
Liver disease, pancreatitis, cardiovascular disorders, and brain damge
Two types of organic brain syndromes may result from long-term heavy alcohol use:
Dementia and Wernicke-Korsakoff syndrome
What does Wernicke-Korsakoff syndrome result in?
Confusion, loss of muscle coordination, and unintelligible speech
- It is believed to be caused by a deficiency of thiamine, a vitamin metabolized poorly by heavy drinkers
Mild to moderate intake of alcohol (especially wine) may actually serve a protective role in:
Cognitive decline as we age
__ is now generally recognized as a combination of problems that can occur in a child whose mother drank while she was pregnant. These problems include fetal growth retardation, cognitive deficits, behavior problems, and learning difficulties
Fetal alcohol syndrome (FAS)
Men are __ likely than women to drink alcohol and are __ likely to drink heavily
More; more
__ percent of Canadian drinkers experience some level of problem with alcohol, however, with about __ percent of Canadian adults thought to be alcohol dependent in any given year
9; 3
Among the general population, __ are most likely to be heavy drinkers and to have alcohol use problems
Young (18-29) single males
About 20 percent of people with __ alcohol dependence have a spontaneous remission and do not re-experience problems with drinking
Severe
Centre for Addiction and Mental Health found that drinking at an early age, from __ to __, was predictive of later alcohol-related disorders
11; 14
Does alcohol cause aggression?
No, but it may reduce the fear associated with being punished, and it may impair the ability to consider the consequences of acting impulsively
The general group of depressants also includes:
- Sedatives (calming)
- Hypnotic (sleep-inducing)
- Anxiolytic (anxiety-reducing)
These drugs include the barbiturates and the benzodiazepines
In general, __ are considered much safer than barbiturates, with less risk of abuse and dependence
Benzodiazepines
At low doses, barbiturates:
At larger doses, barbiturates:
At extremely high doses, barbiturates:
Low: Relax the muscles and can produce a mild feeling of well-being
Larger: Results similar to those of heavy drinking; slurred speech and problems walking, concentrating, and working
Extreme: Diaphragm muscles can relax so much as to cause death by suffocation
Sedative, hypnotic, and anxiolytic drugs affect the brain by acting on the __
GABA neurotransmitter system
At low doses, amphetamines can:
Induce feelings of elation and vigour, and can reduce fatigue. You feel “up” and then you “crash” feeling depressed or tired
Some research also shows that repeated use of __ can cause lasting memory problems
MDMA
Amphetamines stimulate the central nervous system by enhancing the activity of __ and __
Norepinephrine; dopamine
In small amounts, cocaine:
Increases alertness, produces euphoria, increases blood pressure and pulse, and causes insomnia and loss of appetite
Cocaine enters the bloodstream and is carried to the brain. There, the cocaine molecules:
Block the reuptake of dopamine
What are the negative effects of continued cocaine use?
Sleep is disrupted, increased tolerance causes a need for higher doses, paranoia and other negative symptoms set in, and cocaine user gradually becomes socially isolated
Cocaine withdrawal isn’t like that of alcohol, instead of rapid heartbreat, tremors, or nausea, withdrawal from cocaine:
Produces pronounced feelings of apathy and boredom
The DSM-5 does not describe an intoxication pattern for tobacco-related disorders. Rather:
It lists withdrawal symptoms, which include depressed mood, insomnia, irritability, anxiety, difficulty concentrating, restlessness, and increased appetite and weight gain
Nicotine appears to stimulate specific receptors:
Nicotinic acetylcholine receptors - in the midbrain reticular formation and the limbic system
One potential explanation for the finding that nicotine increases alcohol responding is that:
Simultaneous smoking may make drinking alcohol more rewarding in terms of effects on the dopamine reward system
__ is the most common of the psychoactive substances, used regularly by 90 percent of all North Americans
Caffeine
Caffeine in small doses can:
Caffeine in larger doses can:
Elevate your mood and decrease fatigue;
Make you feel jittery and can cause insomnia
The DSM-5 includes caffeine use disorder, defined as:
Problematic caffeine use that causes significant impairment and distress
What is caffeine’s effect on the brain?
It involves the neuro-modulator adenosine, and to a lesser extent the neurotransmitter dopamine; it seems to block adenosine reuptake
__ refers to the family of substances that includes natural opiates, synthetic variations (methadone, pethidine), and the comparable substances that occur naturally in the brain (enkephalins, beta-endorphins, dynorphins)
Opioid-related disorders
__ induce euphoria, drowsiness, and slowed breathing
Opiates
- They are also analgesics (substances that help relieve pain)
People who cease or reduce their opioid intake begin to experience symptoms within 6 to 12 hours; these include:
Excessive yawning, nausea and vomiting, chills, muscle aches, diarrhea, and insomnia
- These symptoms can persist for one to three days, and the process is completed in about a week
The high or “rush” experienced by users come from activation of the body’s:
Natural opioid system (called enkephalins and endorphins) that provide narcotic effects
Marijuana contains more than 80 varieties of the chemicals called __, which are believed to alter mood and behavior. The most common of these chemicals includes the __
Cannabinoids;
Tetrahydrocannabinols (THC)
__ is the most common hallucinogenic drug. It is produced synthetically in laboratories
LSD (sometimes called acid)
The DSM-5 diagnostic criteria for hallucinogen intoxication are similar to those for cannabis. These criteria include:
Perceptual changes such as the subjective intensification of perceptions, depersonalization, and hallucinations. Physical symptoms include pupillary dilation, rapid heartbeat, sweating, and blurred vision
__ develops quickly to many of the hallucinogens including LSD. Sensitivity returns after about a week of abstinence, however. For most hallucinogens, no withdrawal symptoms are reported
Tolerance
Inhalant use is most commonly observed among __
Young males (aged 13 to 15) who are economically disadvantaged
The high associated with the use of inhalants resembles that of alcohol intoxication and usually includes:
Dizziness, slurred speech, poor coordination, euphoria, lethargy
Long-term use of inhalants can:
Damage bone marrow, the kidneys, the liver, and the brain
What is “cycling” and “stacking”?
Cycling: When users administer the drug on a schedule of several weeks or months followed by a break from its use
Stacking: Combining several types of steroids
Long-term effects of steroid use suggests:
Mood disturbances are common (depression, anxiety, panic attacks), and there is concern that more serious physical consequences may result from its regular use
The term __ is applied to a growing group of drugs developed by pharmaceutical companies to target specific diseases and disorders
Designer drugs
i.e. MDMA or Ecstasy
__ is a dissociative anesthetic that produces a sense of detachment along with a reduced awareness of pain
Ketamine (K, Special K, and Cat Valium)
Several studies suggest that genetics has __ influence on alcoholism in women
Relatively little
__ helps people stop drinking by chemically preventing the breakdown of acetaldehyde so that people feel sick when they drink
Antabuse
- In some people of Asian descent, ADH seems to be absent naturally, so many Asians have difficulty metabolizing alcohol (dat flush doeeee)
The liver produces an enzyme called __, that breaks down acetaldehyde, a by-product of alcohol
Alcohol dehydrogenase (ADH)
Alcohol may be related to a particular gene, __, and it appears to regulate the sensitivity of receptors to dopamine
DRD2
The role of dopamine in drug rewards is the phenomenon of sensitization. This refers to:
Repeated exposure to stimulant drugs like amphetamines leads to an increased dopamine release when taking the drug
Individuals at __ risk for alcoholism may experience more of a pleasurable response to alcohol ingestion than do others
High familial genetic
In addition to initial euphoria, many drugs provide escape from __, from __, or from __
Physical pain (opiates); stress (alcohol); panic and anxiety (benzodiazepines) --> Tension reduction, negative affect, and self-medication
What is the opponent-process theory?
An increase in positive feelings will be followed by an increase in negative feelings a short time later; similarly, an increase in negative feelings will be followed by a period of positive feelings
__ explains why people are more likely to take health risks (e.g. engaging in unprotected sex)
Alcohol myopia
According to the __, drug use is seen as a failure of self-control in the face of temptation (psychosocial perspective)
Moral weakness view
The __, assumes that drug dependence is caused by an underlying physiological disorder (biological perspective)
Disease model
__ involves providing the person with a safer drug that has a chemical makeup similar to the addictive drug
Agonist substitution
Trading a more harmful behavioral pattern for a much less harmful alternative, is a notion referred to as __
Harm reduction
A newer substitution treatment for heroin dependence is with the drug __
Buprenorphine
The most often prescribed opiate-antagonist drug, __, has had only limited success with individuals who are not simultaneously participating in a structured treatment program
Naltrexone
The most commonly known averse treatment uses __, with people who are alcohol dependent
Disulfiram (Antabuse)
What is covert sensitization in terms of alcoholism?
The negative associations can also be made by imagining unpleasant scenes, or for example, a person might be offered a drink of alcohol and receive a painful shock with the glass reaches their lips
What is contingency management?
The clinician and client together select the behaviors that the client needs to change and decide on the reinforcers that will reward reaching certain goals
What is community reinforcement approach?
Several different facets of the drug problem are addressed, to help identify and correct aspects of the person’s life that might contribute to substance use, or interfere with efforts to abstain
People with __ have episodes in which they act on aggressive impulses that result in serious assaults or destruction of property
Intermittent explosive disorder
People with __ score high on assessments of impulsivity, reflecting their inability to judge the immediate gratification of stealing compared with the long-term negative consequences i.e. arrest, embarrassment
Kleptomania
Patients with kleptomania often report having no memory (amnesia) about the act of shoplifting, True or False?
TRUUU
- Brain imaging research supports these observations
What is pyromania? What is the treatment?
An impulse-control disorder that involves having an irresistible urge to set fires
Treatment: Cognitive-behavioral and involves helping the person identify the signals that initiate the urges and teaching coping strategies to resist the temptation to start fires
__ are one of the most common reasons children are referred for mental health services
ADHD
For ADHD, the DSM-5 differentiates two categories of symptoms:
1) Inattention - People may appear not to listen to others, lose things, make careless mistakes
2) Hyperactivity - includes figeting, having trouble sitting for any length of time and impulsivity - blurting out answers before questions have been completed and having trouble waiting turns
In terms of ADHD and with respect to gender distribution, boys outnumber girls roughly __ to __
Four; one
What happens to children and adolescents with ADHD as they become adults?
According to a study, when compared with a group without ADHD, the majority of these men (84 percent) were employed but in jobs with significantly lower positions than the comparison group, had 2.5 fewer years of education and were much less likely to hold higher degrees
ADHD is frequently comorbid with other __ disorders, including oppositional defiant disorder
Disruptive behavior
ADHD is considered to be highly influenced by __
Genetics; environmental influences play a relatively small role in the cause of the disorder when compared to many other disorders
There is strong evidence that ADHD is associated with the dopamine __
D4 receptor gene, dopamine transporter gene (DAT1), and the dopamine D5 receptor gene
What did the general finding from brain-imaging studies of those with and without ADHD?
Although no major damage is found in the brains of those with ADHD, there are subtitle differences: One of the more reliable findings is that the volume (or overall size) of the brain is smaller than is typical - the frontal cortex, basal ganglia, and the cerebellar vermis
__ is characterized by performance that is substantially below what would be expected given the person’s age, IQ, and education
Specific learning disorder
Three major characteristics of ASD are expressed in the DSM-5:
1) Impairments in social communication and social interaction
2) Restricted, repetitive patterns of behavior, interests, or activities
Individuals with the less severe form of ASD may also lack appropriate facial expressions or tone of voice, known as __
Prosody
The DSM-5 identifies difficulties of intellectual disability (ID) in three domains:
- Conceptual (language, reasoning, knowledge, memory)
- Social (social judgment and ability to make and retain friendships)
- Practical (difficulties managing personal care or job)
What are the three categories to identify the abilities of students with ID?
1) Educable intellectual disability (IQ of 50 to approximately 70-75)
2) Trainable intellectual disability (IQ of 30 to 50)
3) Severe intellectual disability (IQ below 30)
To be diagnosed with ID, a person must have:
Significantly subaverage intellectual functioning
What are the known causes of ID?
- Environmental (i.e. deprivation, abuse, and neglect)
- Prenatal (exposure to disease or drugs while still in the womb)
- Perinatal (difficulties during labour and delivery)
- Postnatal (Infections, head injury)
__ is a second common chromosomally related cause of ID. It is caused by an abnormality on the X chromosome, a mutation that makes the tip of the chromosome look as though it were hanging from a thread, giving it the appearance of fragility
Fragile X syndrome
Cultural influences that may contribute to ID can include abuse, neglect, and social deprivation. Sometimes referred to as __
Cultural-familial intellectual disability
__ is a type of intellectual disability caused by the presence of an extra 21st chromosome
Down syndrome
Each province and territory has __ under the provincial or territorial Mental Health Acts that detail when a person can be legally detained in a psychiatric institution - even against his or her will
Civil commitment laws
What is the criteria for civil commitment?
1) The person has a “mental disorder”
2) The person is dangerous to himself or herself or others
3) The person is in need of treatment
Two types of authority permit the government to take actions that are against a citizen’s will:
1) Police power
2) Parens patriae “state as the parent”
Under __, the government takes responsibility for protecting the public health, safety, and welfare and can create laws and regulations to ensure this protection
Police power
The provinces and territories apply the second rationale for civil commitment - __ power - in circumstances in which citizens are not likely to act in their own best interest
Parens patriae
i.e. It is used to commit individuals with severe mental illness to mental health facilities when it is believed that they might be harmed because they are unable to secure the basic necessities of life, such as food and shelter, or because they do not recognize their need for treatment
In Canada, people deemed suitable for commitment are not necessarily committed to a hospital. Instead, there are also options for __, for the mentally ill
Compulsory Community Treatments (CCT)
What are CCT’s main goals?
To prevent relapse and to provide care in a less restrictive environment
In Canadian jurisdictions, the patient must satisfy one of two necessary criteria for CCT:
The patient must have some risk of increased mental deterioration or possibly pose harm to themselves
__ is a legal concept, typically meaning severe emotional or thought disturbances that negatively affect an individual’s health and safety
Mental health
Among incarcerated individuals, inmates with serious mental illnesses like schizophrenia are less likely to commit a new violent offence upon release than inmates without serious mental illnesses. True or False?
True
Many advances in assessing dangerousness have been made by Canadian research teams. A series of studies showed that a rating scale based on important predictors of violence and can reliably predict violence among individuals who have already been violent, are:
- Psychopathy score
- Never have been married
- Failure on prior conditional release
Two trends have influenced the number of people in Canada who are involuntary committed each year:
(1) The increase in the number of people who were homeless
2) Deinstitutionalization (the movement of people were severe mental illness out of institutions
Which groups of people are overrepresented among the Canadian homeless?
- First Nations people
- Refugees
- Ethnic minorities
Deinstitutionalization had two goals:
1) To downsize or even close the large provincial and territorial mental hospitals
2) To create a network of community mental health services in which the released individuals could be treated
__ or the movement of people with severe mental illness from large psychiatric hospitals to nursing homes or other group residences, including jails and prisons, many of which provide only marginal services
Transinstitutionalization
The Supreme Court of Canada has acknowledged that in certain extreme cases involving battered woman syndrome, an accused may well be under a reasonable apprehension of death even though she is not in danger of __
Imminent or immediate harm at the moment that fore is used to protect herself
__ is the process by which people are held because 1) they have been accused of committing a crime and are detained in a mental health facility until they can be assessed as fit or unfit to participate in legal proceedings against them or 2) they have been found not criminally responsible on account of a mental disorder
Criminal commitment
Almost __ percent agreed that “insanity plea is a loophole that allows too many guilty people to go free”
90
According to the Canadian Criminal Code, what does “unfit to stand trial” mean on account of mental disorder?
A) To understand the nature or object of the proceedings
B) Understand the possible consequences of the proceedings
C) Communicate with counsel
What are expert witnesses?
Individuals who have specialized knowledge, to assist them in making decisions
What is malingering?
To malinger is to fake or grossly exaggerate symptoms, usually to be absolved from blame
- Malingering is detectable using MMPI
__, or formal agreement by the subject to participate after being fully apprised of all important aspects of the study, including any possibility of harm
Informed consent
The __ axis is a thorough consideration of the scientific evidence to determine whether the intervention in question is effective
Clinical efficacy (internal validity) - Measure of whether a treatment works
The __ axis is concerned with the effectiveness of the intervention in the practice setting in which it is to be applied
Clinical utility (external validity) - Measure of whether treatment is effective
What is duty to warn?
An American legal standard and Canadian professional ethical standard that sets forth the responsibility of the therapist to warn potential victims that a client may attempt to hurt or kill them
In __, people become acutely aware of any tension in their bodies and counteract it by relaxing specific muscle groups
Progressive muscle relaxation
In __, attention is focused solely on a repeated syllable, or the mantra
Transcendental meditation (TM)
What is the relaxation response?
A person silently repeats a mantra to minimize distraction by closing the mind to intruding thoughts
Why are appraisals and attitudes an important part of stress?
Clients learn how they exaggerate the negative impact of events in their daily lives
Individuals undergoing coronary artery bypass surgery who were optimistic recovered __ quickly, returned to normal activities __ rapidly, and reported a __ quality of life six months after surgery than those who were not optimistic
More; more; stronger
Studies discovered that optimistic people are less likely to use __ as a means of coping with a severe stressor such as surgery
Denial
Psychological and social factors influencing health and physical problems in two distinct ways:
Directly affecting biological processes and through unhealthy lifestyle
What are the three most common behaviors that put us at risk in the long term for many physical disorders?
- Unhealthy eating habits
- Lack of exercise
- Smoking
__ are the fourth leading cause of death in Canada across all age ranges and the top cause of death for people aged 1 to 45
Injuries
What were the five interventions of HIV prevention in a classroom-based intervention?
1) Factual information about HIV transmission and prevention and dispelling myths
2) Changing students’ attitudes and social norms about HIV risk and prevention
3) Enhancing students’ motivation to engage in HIV prevention
4) Training in behavioral skills for abstinence from sex and for acquiring and using condoms
5) Training in effectively communicating about safer sex
What are the myths that characterize Chinese smokers?
1) The identification of smoking as a symbol of personal freedom
2) A perception that tobacco is important in social and cultural interactions
3) The perception that the health effects of smoking can be controlled through reasonable and measured use
4) The importance of tobacco to the economy
__ is a relatively new disorder attributed at least in part to stress but may also have an as yet undiscovered viral or immune system dysfunction component
Chronic fatigue syndrome
Approximately __ people in China are habitual smokers, __ percent of them male
250; 90
What are the biological means of prevention for AIDS?
There is none, the disease is always fatal. However, drug therapy may control the virus and delay it
__ typically involves joints, muscles, and tendons; may result from enlarged blood vessels, tissue degeneration, or cancerous tumours
Chronic pain
The heart and blood vessels can be damaged by:
- Stroke: blockage or rupture of blood vessels in the brain
- Coronary heart disease: blockage of arteries supplying blood to the heart
- Biological, psychological, and social factors also contribute
More women are infected with AIDS through intravenous drug use than through heterosexual interactions. True or False?
False, more women are infected through heterosexual interactions
Regarding injury control, children’s injury prevention focuses on:
- Escaping fires
- Crossing streets
- Using car seats, seat belts, helmets
- First aid
