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PS346 - Abnormal Psychology > Exam 3 > Flashcards

Exam 3 Flashcards

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1
Q

OCD

A

Obsessive Compulsive Disorder

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2
Q

What is OCD?

A

Anxiety disorder characterized by obsessions and compulsions

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3
Q

Obsessions

A

Recurrent and persistent thoughts, urges, images, cause unwanted anxiety and stress
(contamination, order, losing control, doubt)

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4
Q

Compulsions

A

Repetitive behaviors/covert mental acts intended to reduce anxiety
(washing hands, ordering, counting, checking)

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5
Q

Negative reinforcement

A

Removing distress due to an action

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6
Q

DSM-V Criteria for OCD

A

Presence of obsessions, compulsion, or both
Obsessions and compulsions are extremely time-consuming

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7
Q

Hair Pulling Disorder

A

Trichotillomania : compulsion to pull hair - there are also skin-picking disorders causing lesion, hoarding disorder, difficulty with parting from things, and body dysmorphic disorder . . .

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8
Q

Body Dysmorphic Disorder

A

DSM-V : Preoccupation with 1 or more perceived defects, repetitive mirror checking (behavior(s) develop), clinically significant distress

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9
Q

OCD - Neuro Factors

A

Overregulation in brain systems (dysfunctional connections in frontal lobe, thalamus, and basal ganglia)
Abnormalities in neural communication (too little serotonin SSRIs can work)
Genetics (identical twins 65%, fraternal twins 15%)

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10
Q

OCD - Psych Factors

A

Operant conditioning: comp: short-term relief: reinforced
Obsessional thinking: OCD: mental or behavioral rituals

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11
Q

OCD - Social Factors

A

Stress: OCD follows stressor: severity proportional
Culture + Religion: may determine context of obsessions and compulsions

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12
Q

OCD - Treatment - Neuro

A

Medication (SSRI - Zoloft, Celexa, and Paxil)
TCA Anafranil
Meds + behavioral treatment recommended

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13
Q

OCD - Treatment - Psych

A

Cognitive methods: reduce irrationality and frequency of intrusive thoughts / accuracy of thoughts
Exposure + response prevention therapy

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14
Q

Exposure and Response Prevention Therapy (ERPT)

A

face or confront fear until subsiding
refrain from compulsions, avoidance, escape behaviors
graduated exposure based on fear hierarchy
if you challenge with anxiety-provoking tasks, body will habituate anxiety

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15
Q

Trauma

A

actual or threatened death, serious injury, sex violence

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16
Q

Stress

A

overwhelmed, worried, run down

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17
Q

General Adaptation Syndrome (GAS)

A

3 Stages: alarm: fight or flight response to stressor
resistance: way an organism adapts to physical and psychological stressor
exhaustion: effects of long-term stress on emotional and physical well-being

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18
Q

PTSD

A

Go through traumatic event - can lead to developing PTSD as a stress disorder

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19
Q

Characteristics of PTSD

A

intrusive re-experiencing event
avoidance
negative thoughts and mood
increased arousal and activity
symptoms can last longer than 1 month

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20
Q

Acute Stress Disorder (ASD)

A

symptoms within 4 weeks of traumatic event, last less than 1 month

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21
Q

Factors in “What is traumatic?”

A

Kind of trauma (disaster, accident, injury)
severity of trauma
duration and proximity of trauma

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22
Q

What basic assumptions does PTSD challenge?

A

1) belief in a fair and just world
2) belief that it’s possible to trust others/safety
3) belief that it’s possible to be effective in this world
4) the sense that life has purpose + meaning

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23
Q

Adjustment Disorder

A

emotional reactions to milder life circumstances: new job, married, new home, retiring, breakup

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24
Q

PTSD - Historical Perspective

A

US Civil War: Palpitations, exhaustion, “irritable heart”
Traumatic neurosis: 1880s - central nervous system railway spine
Hysterical neurosis: Variety
War neurasthenia: weak nervous system - can’t handle combat
Shell shock: artillery and exposure to shells (Abram Kardier wrote on shell shock

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25
Q

Emergence of PTSD diagnosis

A

PTSD debut in 1980s, DSM-III, rape trauma syndrome: sexual assault reaction
Recent!

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26
Q

PTSD - Neuro Factors

A

Brain structure and function: smaller hippocampi
high amygdala activity
the under-responsive medial prefrontal cortex
dysregulated HPA-axis
- hyperactive at first
- inhibited in later stages of PTSD
neural communication: serotonin: help treat disorder, moderate stress
genetics: small role, 20-30%, heritability 30-40% variance

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27
Q

PTSD - Biological Treatment

A

Drugs prescribed: anti-depressants (SSRIs) most effective

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28
Q

PTSD - Psych Factors

A

History of depression and other disorders
lower IQ - severe symptoms
negative emotionality - tendency to mood swings

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29
Q

PTSD - Psych Factors - Cognitive

A

Cognitive: unable to control stressors, the conviction of the world is a dangerous place

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30
Q

PTSD - Psych Factors - Behavioral

A

Behavioral: classical + operant conditioning - may explain avoidance. Avoidant symptoms + self-medicate - negatively reinforced

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31
Q

PTSD - Psych Factors - Psychodynamic Concepts

A

Freud + Breuer - 1800s: trauma primary cause of the difficulty. Recall can be helpful

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32
Q

PTSD - Psychodynamic Treatment

A

Short-term dynamic therapy of stress syndrome
12 session therapy
1-4: trust building, safely recounting trauma
5-8: work through conflicts, problematic beliefs
9-12: Integrate strides patients have made - process end of therapy

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33
Q

PTSD - Humanistic

A

Post-traumatic growth (PTG) - positive changes following crises/trauma/loss
various inventories (PTG, SRGS, BFS)
PTG associated with tendency to think about traumatic event (rumination may be beneficial)
Meaning reconstruction: trauma + loss
constructivist perspective: people invent ways to understand self
trauma + loss often invalidate construct self-narratives
complicated grief - unable to construct meaningful story
too theoretical?

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34
Q

PTSD - Social Factors

A

1) Socioeconomic stress - less access to treatment resources
2) social support - immediately after trauma - lower risk for PTSD
3) cultural patterns - teach one coping style over another

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35
Q

PTSD - Treatment - Social

A

1) Psychodynamic PTSD Group - make trauma memories conscious
2) Interpersonal PTSD Group - gain awareness of feelings and patterns that relate to others
3) Supportive PTSD Group - members provide emotional support for each other (cope)
4) Trauma-focused cog./behavioral Group - structural groups educate about trauma, anxiety addressed via exposure

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36
Q

PTSD - Treatment - Psych Factors

A

1) Psychoeducation - first step is to educate about condition
2) Relaxation, exposure, breathing, retraining (avoidance unhelpful)
3) Cognitive methods - help patients understand the meaning of their traumatic experiences and the misattributions they make about there experiences and the aftermath
4) Eye movement desensitization and reprocessing (EMDR) treatment
5) Cognitive Processing Therapy (CPT)

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37
Q

EMDR

A

Widely used but debated treatment
similar to exposure therapy - think about a troubling image then move the eyes left and right for 15 seconds
symptoms of trauma from the inability to process images and cognitions

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38
Q

CPT

A

Psychoeducation about PTSD
rules/beliefs log
impact statement - safety, trust, power/control, esteem, intimacy
ABC sheets
Writing trauma accounts (read to self each day)

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39
Q

Dissociation

A

Symptom of PTSD with four primary symptoms

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40
Q

Amnesia

A

memory loss, generally temporary

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41
Q

Identity problem

A

not sure who he/she is (assume new identity)

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42
Q

Derealization

A

external world perceived and experienced as strange and unusual

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43
Q

Depersonalization

A

feeling like observer/outsider, normal v abnormal dissociation

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44
Q

Dissociative Amnesia

A

Impaired memory - not explained by forgetfulness, takes several forms

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45
Q

Generalized Amnesia

A

can’t remember life - RARE

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46
Q

Selective Amnesia

A

only remember parts of forgotten time period

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47
Q

Localized Amnesia

A

memory gap for specific period of time, often before traumatic events

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48
Q

Dissociation - Neuro Factors

A

after brain injury - not dissociative amnesia
damage to hippocampus after prolonged stress (recovered memories)

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49
Q

Dissociation - Psych Factors

A

Dissociation Theory (1907) strong emotions impair cognitive processes

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50
Q

Dissociation - Social Factors

A

Combat + Abuse

51
Q

Depersonalization - Derealization Disorder

A

Persistent feeling of being detached from one’s mental processes, body, surroundings

52
Q

DDD - Neuro Factors

A

disrupted emotional processing - emotional detachment
frontal lobe activity unusually high
low norepinephrine production

53
Q

DDD - Psych Factors

A

Cognitive deficits
short term memory impairment
difficult sustaining attention

54
Q

DDD - Social Factors

A

Childhood emotional abuse

55
Q

Dissociative Identity Disorder

A

Used to be MPD
2 or more distinct alters (own histories)
most people have 10 or fewer alters
significant diagnostic plague DSM-V

56
Q

DID - Neuro Factors

A

PET scan reveal brain respond differently for each alter
one alter - trauma activated / other alter - trauma not activated

57
Q

DID - Psych Factors

A

Hypnotizability

58
Q

DID - Social Factors

A

Early childhood abuse
rarely diagnosed prior to 1976 (Sybil movie)
may be induced in some cultures

59
Q

Dissociative Disorders - Treatment

A

DD improve simultaneously w/o treatment
- especially dissociative amnesia, d fugue (travel)
medication not used

60
Q

DD - Treatment - Psych Factors

A

1) Coping strategies
2) address the presence of alters
3) reinterpret symptoms (limit stress)

61
Q

Somatic Symptom Disorder

A

Physical well-being NOT medically explained

62
Q

SSD - Patients Report…

A

muscle, joint, back pain
palpitations
IBS
tension headaches
chronic fatigue
insomnia
chest pain
relatively rare - common psych disorder in medical setting
250 BILLION dollars in medical costs/year

63
Q

SSD - Two common features

A

Bodily preoccupation
symptom amplification

64
Q

SSD - three main disorders

A

somatic symptom disorder
conversion disorder
illness anxiety disorder

65
Q

SSD - DSM-V

A

one or more somatic symptoms distressing or disrupting daily life
excessive thoughts, feelings, behaviors, health concerns
- disproportionate persistent thoughts about the seriousness
- persistently high level of anxiety about health symptoms
- excessive time and energy devoted to health symptoms
typically more than 6 months (being symptomatic) even if any one somatic symptom may not be continuously present

66
Q

SSD - Neuro

A

genetics - account for half of variability

67
Q

SSD - Psych

A

catastrophic thinking, misinterpretation of bodily signals

68
Q

SSD - Social

A

observational learning (ill parent)
operant conditioning (reinforced illness behavior - extreme attention or buying treats when ill)
culture - acceptable way to express helplessness (?)

69
Q

Conversion Disorder

A

Sensory or motor symptoms incompatible or inconsistent with medical or neurological condition
patients with CD do not consciously produce the symptoms they experience
diagnosis made after all possible medical causes ruled out

70
Q

CD - three types of symptoms

A

1) motor - tremors, tics, jerks, spasms, staggering
2) sensory - blindness, deafness, auditory hallucinations
3) seizures - twitch or jerk part of body, uncontrollable spasms, lose consciousness (non-epileptic)

71
Q

CD - Neuro

A

muscle weakness from CD not the same as conscious muscle weakness
fMRI suggest some patients with CD develop sensory deficits limb paralysis

72
Q

CD - Psych

A

self-hypnosis

73
Q

CD - Social

A

life stressors (combat, abuse)

74
Q

Illness Anxiety Disorder

A

Preoccupation with fear or belief of having serious disease, misinterpreting symptoms
patients cling to conviction they have serious disease despite evidence against it
symptoms for at least 6 months
causes significant distress or impairment in functioning

75
Q

IAD - Neuro

A

Serotonin not functioning properly

76
Q

IAD - Psych

A

biases in reasoning (catastrophic thinking, unpleasant sensation focus

77
Q

IAD - Social

A

traumatic sexual experience, physical violence, family upheavel

78
Q

Treatment - Somatic Disorders

A

clinicians target all areas
SSRIs or St. John’s Wort
CBT - identify irrational thoughts
support from therapist
psychoeducation

79
Q

Eating Disorders

A

Abnormal eating - preoccupied with body image
3 types

80
Q

Anorexia Nervosa

A

key feature: low body weight (prevent weight gain)
pursue extreme thinness
high risk of death

81
Q

Anorexia Nervosa - DSM-V

A

Must meet 3 criteria:
1) low body weight for age and sex
2) intense fear of becoming fat/gain weight
3) distortions of body image
some symptoms overlap with OCD
obsession over symmetry, hoard, order precisely

82
Q

AN - Restricting Type

A

severe undereating or excessive exercise

83
Q

AN - Binge Eating/Purging

A

Eat more at once than most, reduce calories already consumed - vomiting, laxatives, diuretics, enemas

84
Q

AN - Medical Effects

A

Loss of bone density, low heart rate, heart muscle thins, slow metabolism

85
Q

AN - Psych + Social Effect

A

Key Starvation Study: develop depression and anxiety, hoard food and other items, lost sense of humor

86
Q

Bulimia Nervosa

A

2x as prevalent than Anorexia Nervosa
Key feature: binge-eating and inappropriate efforts to prevent weight gain (can have a normal weight range)

87
Q

BN - Purging

A

Eating so much then vomiting, laxatives, enemas

88
Q

BN - Non-purging

A

fasting or excessive exercise

89
Q

Bulimia Nervosa - DSM-V

A

recurrent binge eating episodes
-eat discrete period of time (within any 2-hour period) more food than typical
-sense of lack of control over eating during the episode
recurrent inappropriate compensatory behaviors to prevent weight gain
compensatory behaviors and binge once a week for 3 months
self evaluation unduly influenced by body shape and weight
disturbances not exclusively during anorexia nervosa episdoes

90
Q

BN - Medical Effects

A

Heart and muscle problems
eroded tooth enamel from chronic vomiting
loss of intestinal function from laxative use
dehydration and electrolytic imbalance

91
Q

Binge Eating Disorder

A

Binge eating without subsequent purging
DIFFERENT from Bulimia
1) do not persistently try to compensate for binges
2) most people with binge eating disorder are obese

92
Q

Binge Eating Disorder - DSM-V

A

Binge eating once a month/week? for 3 months
lack of control over eating during episode
eating in discrete period of time (within 2-hour period) amounts of food greater than what people would normally eat in same time

93
Q

Binge Eating Disorder - Biological

A

Neurotransmitters: important in weight and feeding
monoamines (dopamine, norepinephrine, serotonin)
GABA - inhibitory NT
glutamate - excitatory NT
Anorexia: lower dopamine and serotonin
Bulimia: lower serotonin, though dopamine important in binge eating

94
Q

Binge Eating Disorder - Biological - Treatment

A

eating improvement first
maybe antidepressants and antipsychotics at the same time?
SSRI effective-ish
not enough evidence on this

95
Q

Binge Eating Disorder - Biological - HPA-Axis

A

Produces cortisol
hyperactivity in anorexia (elevated cortisol)
hyperactivity in bulimia (elevated cortisol, but less than anorexia)
Less active in binge eating?
response to chronic stress?
STS - greater HPA - greater cortisol
Chronic - less HPA - less cortisol
causal links unknown

96
Q

Binge Eating Disorder - Biological - Reward

A

Reward pathway disturbances
eating problem akin to addiction? - same brain systems affected
Anorexic - unresponsive to rewards
Bulimia - binge eating, obesity, too responsive to rewards
Mesolimbic pathway - reward pathway
dysfunction in dopamine transmission
Genetics more likely to have a BED if family member does

97
Q

Binge Eating Disorder - Psych Perspective

A

Risk Factors
negative self-evaluation
sexual abuse
comorbidity with anxiety and depression
using avoidant strategies to cope with problems
excessive concerns - overvalue weight
consistent predictors: dieting and bodily dissatisfaction

98
Q

Abstinence Violation Effect

A

condition arises when violation of self imposed rule about food restriction, can make one feel out of control w/food

99
Q

Binge Eating Disorder - Psych Perspective

A

Learning Theory
Operant Conditioning
- positive reinforcement: restrict behaviors positively reinforced by the person’s sense of power and mastery over appearance
positive reinforcement for “losing control” of appetite and binges
bingeing - endorphin rush
- negative reinforcement: preoccupied with food - distract from problems
binge turns off unpleasant thoughts (- reinforce)
purging - (- reinforced) relieving anxiety and fullness (overeat)

100
Q

Binge Eating Disorder - Psych Perspective

A

Personality
Perfectionism
harm avoidance (avoid harmful situations)
neuroticism (anxiety, emotional reactivity)
low self-esteem (food = self-worth)

101
Q

Binge Eating Disorder - Social Perspective

A

Culture contributes - promote ideal shape (media propagates it)
1) cultural idea of thin
2) media exposure
3) assimilation of thinness ideal
found in westernized and industrialized western countries

102
Q

Binge Eating Disorder - Gender Differences

A

Male less likely to have eating disorder (physical ideals unrealistic however)
They may have another disorder - excessive exercise or steroid use

103
Q

Objectification Theory

A

Girls learn to consider their bodies as object and commodities
happens before adulthood
ED encouraged to fit an ideal standard
Men - observers and agents to do tasks and be strong, power issues
Women - be looked at, looks, thinness, body image issues

104
Q

Treating Eating Disorders - Medical

A

Reach safe weight medically
in-patient hospitalization
CBT

105
Q

Treating Eating Disorders - Psych

A

CBT - effective, change your thoughts
Acceptance and Commitment Therapy (ACT)
mindfulness techniques - commit to change (psych flexibility)

106
Q

Treating Eating Disorders - Social

A

Interpersonal Therapy (4-6 months of weekly therapy)
improve relationships with others and the problems within relationships
reduce longstanding IP problems
become hopeful and empowered

107
Q

Treating Eating Disorders - Social

A

Family Therapy
Maudsley Approach - parents integrated in the process of their daughters eating habits, making them appropriate

psychiatric hospitalization
- get weight up, normal eating pattern, change irrational thoughts
24-hour community: less intensive treatments failed - do this!

108
Q

Eating Disorders - Reasons for Relapse

A

Reluctance for treatment
unwillingness to continue change once discharged
patients don’t receive adequate outpatient care after discharge
treatments can cost too much - leave the program(s) early :(

109
Q

Gender

A

Attitude, feelings, behaviors that given culture associates with a person’s biological sex

110
Q

Cisgender

A

Person’s gender identity and expression align w/social expectations of ones sex

111
Q

Transgender

A

Umbrella term or identity that encompasses many different genders and expressions that challenge traditional categories

112
Q

Gender Dysphoria - DSM-V

A

incongruence gender one is assigned to at birth/experienced gender
one diagnosis/separate criteria
Dysphoria in children and dysphoria in adolescents and adults
only diagnosed in those who experience conflict
Very rare

113
Q

Should it be removed? - Yes

A

incongruent feeling not disordered
reflect questionable beliefs about gender as biological

114
Q

Should it be removed? - No

A

Diagnosis - lead to extensive interventions
name changed - remove disorder

115
Q

Paraphilic Disorder

A

Unusual sexual interests (Paraphilia)
distress, impair functioning, harm self or others
symptoms for at least 6 months
recurrent fantasies related to nonhuman objects, nonconsent, suffering or humiliation

116
Q

Pedophilic Disorder

A

Must be at least 16 years or older, 5 years older than a child
View themselves as less responsible, child responsible
often begins in adolescence (chronic)

117
Q

Understanding Pedophilic Disorder

A

Overlap w/OCD (involve obsessions and compulsions)
frontal lobe deficits
SSRIs decrease sexual fantasies and behaviors
most are male
Classical and operant conditioning
Zeignark Effect: recall interrupted activties - try to finish

118
Q

Paraphilic Disorders - Treatment

A

Chemical castration (temporary - decrease testosterone levels)
CBT - decrease cognitive distortions
relapse prevention training - assess triggers then avoid
train to empathize w/victims - less likely to reoffend

119
Q

Sexual Functioning - Dysfunctions

A

Problem in sexual response cycle
Men: Up and down, fairly standard
Women: could be all over the place

120
Q

Sexual Dysfunctions - 3 Categories

A

Sexual desire + arousal disorders
- F: get aroused / M: hypoactive sexual desire
Orgasmic disorders
- delayed ejaculation, premature ejaculation, female orgasm disorder
Sexual pain disorders
- Genito pelvic pain/penetration disorder

121
Q

Understanding Sexual Dysfunctions - Factors

A

interruption, disease, medication, stress, sexual trauma, image concerns, conflict in relationship

122
Q

Sexual Dysfunction - Treatment

A

Positive trend toward medicalization of sex therapy
educate patients about sexuality - human sex response
counter negative thoughts, beliefs, attitudes that interfere
sensate focus exercises (touch, smell, etc)
sex therapy

123
Q

Experiential Sex Therapy

A

Focus on experiential meaning of sex
deemphasize fix broken parts
encourages exploring feelings
awareness of feelings (allow for discovery and growth)

124
Q

Bibliotherapy

A

therapy by reading particular books and texts

PS346 - Abnormal Psychology (2 decks)

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