Exam 3 Flashcards
Eating Disorders
Anorexia: Refusal to maintain 85% of normal body weight, intense fear of becoming overweight, 75% women, can be restricting or binge-eat/purging subtypes
Bulimia: Characterized by binges and inappropriate compensatory behaviors (forced vomiting, laxatives, fasting, or excessive exercise), 75% women,
Differences from anorexia: more concerned about pleasing others or being attractive, more sexually experienced, more likely to have mood swings, low frustration tolerance, poor coping, more likely to display signs of a personality disorder, less likely for women to experience amenorrhea, bulimia experience damage like tooth loss or intestinal disorders
Binge-Eating Disorder: repeated eating binges without control, no compensatory behaviors, 2/3 become obese, 64% are female, not driven to thinness, smaller gender differences,
Sexual Disorders
Female sexual interest/arousal disorder is both desire and excitement
Disorders of Desire: Male hypoactive sexual disorder, female sexual interest/arousal disorder,
Disorders of Excitement: Erectile Disorder
Disorders of Orgasm: premature ejaculation (within one minute), delayed ejaculation, female orgasmic disorder
Disorders of Sexual Pain: Genito-pelvic pain/penetration disorder
Paraphilic disorders have to include distress or impairment or cause others harm or distress. There are fetishistic disorders (far more common in men), transvestic disorder (dress up as opposite gender), exhibitionistic disorder (expose genitals in public), voyeuristic disorder (observe others’ sexual activites), frotteuristic disorder (touching and rubbing a nonconsenting person), pedophilic disorder, sexual masochism disorder (wants to be beat), and sexual sadism disorder (wants to beat others).
Substance Abuse Disorders
A pattern of maladaptive behaviors and reactions brought about by repeated use of substances.
Checklist: 1. Individual displays a maladaptive pattern of substance abuse that leads to distress or impairment 2. Presence of 2 of the following within a year: substance often taken in larger amounts, unsuccessful efforts to reduce or control substance use, much time spent trying to obtain, use, or recover from the effects of the substance use, failure to fulfill major role obligations 3. Presence of 2 of the following within a year: continued use despite persistent interpersonal problems, reduction of important activities, continuing use in dangerous situations, continued use despite worsening of physical or psychological problems, craving for substance, tolerance effects, withdrawal reactions
Schizophrenia
Personal, social, and occupation functioning deteriorate as a result of unusual perceptions, odd thoughts, disturbed emotions, and motor abnormalities
Checklist: 1. For 1 month, individual displays two: delusions, hallucinations, disorganized speech, very abnormal motor activity, including catatonia, negative symptoms, 2. at least one of the individuals symptoms must be delusions, hallucinations, or disorganized speech, 3. individual functions much more poorly in various life spheres than was the case prior to the symptoms, 4. Beyond this 1 month of intense symptomology, individual continues to display some degree of impaired functioning for at least 5 additional months
Treatment of Eating Disorders
Treatment has two goals: correct dangerous eating patterns, address broader psychological and situational factors that are responsible for the disease.
Anorexia Nervosa: 1/3 seek treatment, goals: regain lost weight, recover from malnourishment, eat normally again, forms: behavioral weight-restoration provides rewards for proper eating and weight gain, feeding tubes, supportive nursing care, nutritional counseling, motivational interviewing, CBT (shown to be more effective than other approaches alone), family therapy, combined treatment is the best
Bulimia Nervosa: 43% seek treatment, goals: eliminate binge-purge patterns, establish good eating habits, eliminate the underlying cause of bulimic patterns, forms: diaries (B), exposure and response prevention (B), change maladaptive attitudes (C), challenge negative thoughts (C), interpersonal psychotherapy which is often supplemented by family therapy, antidepressant medication
Binge-Eating Disorder: 45% seek treatment, CBT psychotherapy and antidepressant medications reduce or eliminate binge patterns, psychotherapy is generally more effective than medications
Treatments of Substance Abuse Disorders
Psychodynamic therapies are used to uncover and work through underlying needs to help the patient change their styles of living, this is best when combined with other approaches.
CBT helps identify and change behavior patterns and dysfunctional cognitions, ex. Aversion therapy, contingency management, relapse prevention training, and acceptance and commitment therapy.
Biological treatments have had limited success over the long term when used alone but can be effective when used conjunctively, ex. Detoxification, antagonist drugs, drug maintenance therapy.
Sociocultural therapies like AA, NA, community prevention programs, culture and gender sensitive programs are popular but are not always effective.
Treatment of Sexual Disorders
Sexual dysfunctions is usually handled through assessment, mutual responsibility, education, emotion identification, attitude change, mindfulness, elimination of performance anxiety, increase of communication skills, addressing physical and medical factors. Disorders of desires can use affectual awareness, self-instruction training, behavioral techniques, insight-oriented exercises, and biological interventions. Erectile disorders can try to increase stimulation, decrease performance anxiety, use drugs (sildenafil; Viagra), or use other biological things (gels, suppositories, penile injections, VED). Premature ejaculation can use start-stop procedure and SSRIs. Delayed Ejaculation tries to reduce performance anxiety. Female orgasmic disorder uses CB techniques, self-exploration, enhancement of body awareness, and directed masturbation training. Genito-pelvic pain disorder usually tries to practice tightening and releasing muscles of vagina and use gradual behavioral exposure training.
Treatment of Schizophrenia
Institutional care was used in the past, but that is less common now. There is milieu therapy, which is a humanistic approach to institutional treatment based on the premise that institutions can help patients recover by creating a climate that promotes self-respect, responsible behavior, and meaningful activity. The token economy programs emphasized a person’s desirable behavior by awarding tokens that can be exchanged for goods. Antipsychotic drugs are the most common and most effective forms of treatments. Cognitive remediation, hallucination reinterpretation and acceptance are a couple examples of CBT. Family therapy, coordinated specialty care, and community care are other forms of treatment.
Foods Consumed During Binge
Sweet, soft, high-calorie foods like ice cream, cookies, doughnuts, and sandwiches.
Hilde Bruch’s View on EDs
He believed that disturbed mother-child interactions or ineffective parenting led to eating disorder because it caused serious ego deficiencies in the child. He also says that improper labeling of internal sensations and needs may cause eating disorders.
Tolerance, Withdrawal, and Dependence
Tolerance – Needing increasing doses to get an effect
Withdrawal – Unpleasant and dangerous symptoms when substance use is stopped or cut down
Dependence – The presence of both tolerance and withdrawal
Depressants
Depressants – Alcohol, sedative-hypnotic drugs, and opioids
Alcohol – consuming five or more drinks in a single occasion is binge-drinking episode, Alcohol use disorder – one of the most dangerous recreational drugs, men outnumber women 2 to 1,
Sedative-Hypnotic Drugs – aka anxiolytics, used to be barbiturates but they have been replaced by benzodiazepines, most common kinds are Xanax, Ativan, Valium, increases GABA activity, don’t cause drowsiness and less likely to overdose
Opioids – Both natural (opium, heroin, morphine, and codeine) and synthetic (methadone), known collectively as narcotics, can be injected or consumed, depress CNS and attach to endorphin receptors, mortality rate for individuals with untreated opioid use disorder is 63 times higher than the general population
Stimulants
Stimulants – increase CNS activity, includes cocaine, amphetamines, caffeine, and nicotine
Cocaine – most powerful natural stimulant known, linked to dopamine, norepinephrine, and serotonin, can have intoxication and psychosis, most dangerous risk is overdose
Amphetamines – manufactured in labs, they increase energy, alertness, and reduce appetite, includes methamphetamine
Caffeine – most widely used stimulant, 90% of people worldwide consume caffeine daily, releases dopamine, norepinephrine, and serotonin, and can cause withdrawal symptoms
Hallucinogens
Hallucinogens – aka psychedelics, causes “trips,” includes mescaline, psilocybin, LSD, MDMA (Ecstasy)
LSD is one of the most powerful hallucinogens, causes hallucinosis, can cause synesthesia, tolerance and withdrawal are rare, but bad trips and flashbacks can occur
MDMA is a popular club drug, it acts as a stimulant and hallucinogen, causes serotonin and dopamine to be released, unlikely to cause a substance abuse disorder
Cannabis is produced from hashish or marijuana, produces hallucinogenic, depressant, and stimulant effects, THC is the main active ingredient, can develop tolerance and withdrawal
Alcohol Withdrawal vs. Delirium Tremens
Delirium tremens are a very severe symptom from alcohol withdrawal. Delirium tremens happen around 3 days after withdrawal, and they are severe hallucinations.
