Exam 3 Flashcards
(139 cards)
1
Q
3 christs of Ypsilanti
A
Milton Rockeach
* worked at a psych hospital where in 3 different units at the same time 3 men had the same delusion that they were jesus christ
* the 3 got into conflicts all the time
* Clyde resolved that the other 2 christs were dead (corpses with machines inside them that did the talking)
* joseph concluded that the other 2 christs were crazy and that research assistants were his allies
* leon thought other men were faking, crazy, wanted recognition, or were lesser gods
- all 100% believed their delusions
2
Q
positive symptoms of schizophrenia
A
delusions
hallucinations
command auditory hallucinations
3
Q
delusions
A
false, fixed beliefs
disturbance in thought content
over 90% people with schizophrenia have delusions
4
Q
common types of delusions
A
granduer
persecution
thought broadcasting
insertion/withdrawl
reference
control
somatic
5
Q
delusions of grandeur
A
great power, knowledge, talent
*all 3 christs would have this
- less common
6
Q
delusions of persecution
A
paranoid
* police are in on it
* more common
7
Q
thought broadcasting
A
ones private thoughts are being broadcasted to others against your will
8
Q
thought insertion/withdrawl
A
thoughts are being taken out of your brain without knowledge
thought that your roommate is stealing information from your brain while you’re sleeping so you stay up all night
9
Q
delusions of reference
A
things in environment have a special meaning only intended for you
10
Q
delusions of control
A
thoughts being controlled by external agents such as robots
11
Q
somatic delusions
A
part of your body is diseased or altered or believing your intestines have been replaced by snakes
12
Q
symptoms of schizophrenia exist in
A
three dimensions:
positive
negative
disorganized
13
Q
positive symptoms aka
A
pathological excesses
14
Q
hallucinations
A
positive symptom of schizo
false sensory experiences
experienced as real
15
Q
most common hallucination
A
auditory
16
Q
types of hallucinations
A
visual
gustatory (taste)
olfactory (smell)
tactile (touch) ** red flag
17
Q
why is tactile (touch) symptom of hallucination a red flag for therapists
A
not very common and may be a red flag for malingering
18
Q
do hallucinatory symptoms occur one by one or together
A
can all occur together
19
Q
auditory hallucinations
A
often voices are known or of God/Devil
most people report hearing more than on voice
most of the time they utter rude, vulgar, critical comments
20
Q
command auditory hallucinations
A
command or not command
- command- voices tell person to do something - difficult to ignore and often telling the person to do something really bad to themselves or others
21
Q
negative symptoms of schizophrenia aka
A
pathological deficits
22
Q
negative symptoms of schizophrenia
A
alogia
avolition
restricted affect
anhedonia
social withdrawl
23
Q
what is a poor prognostic sign of schizophrenia
A
preponderance - excess superiority
24
Q
alogia
A
poverty of speech
* speak less often, use fewer words
(-) schizo
25
avolition
apathy, inability to initiate or persist in goal directed activities
* appears as lazy when really they truly do have significant challenges doing a particular task
*inability to start or complete paying bills even when urgent
(-) schizo
26
social withdrawl
when more psychotic, drawn deeper into social withdrawal which worsens dissociation from reality and makes delusions and hallucinations worse
(-) schizo
27
restricted affect
low emotional expression
(-) schizo
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anhedonia
inability to feel pleasure
(-) schizo
29
disorganized symptoms of schizo
disorganized speech or behavior
thought disorder
catatonia
posturing
stereotyped movements
inappropriate affect
30
disorganized speech
disorganized symptom of schizo
does not make sense
* could reflect an underlying thought disorder
loose associations (lack of connection between ideas)
clanging (words that sound the same but dont make sense together)
perseveration (stuck on idea)
neologisms (new word)
malapropisms (mistaken use of word in place of similar sounding one)
31
disorganized behavior
disorganized symptom of schizo
poor/unusual hygiene, dress
catatonic stupor (can't move or respond- stare into space)
posturing (hold specific position)
stereotyped movements (repetitive movements)
inappropriate affect (hysterically laughing in serious situation)
32
DSM Schizophrenia
two or more for one month:
- delusions
- hallucinations
-disorganized speech
-disorganized/catatonic behavior
- negative symptoms
continuous signs for 6 months to a degree that impairs social/occupational functioning
33
what % of population does schizophrenia affect
1%
34
are there differences in # of men vs women cases in schizophrenia
no
35
when is schizophrenia typically diagnosed
late adolescence or early adulthood
36
is schizophrenia progressive
no only debilitating
37
if a person has anosognosia, what is their diagnosis
anosognosia = lack of insight
* important for understanding schizophrenia
* a person with schizophrenia lacks insight into their mental health condition
* not knowing you have schizophrenia and lacking insight into fact you may be hallucinating
38
is genetics a factor in developing schizo
yes significant genetic component
as the degree of genetic similarity increases in people so does the risk of schizophrenia
60-80% heritability
* identical twins have a greater genetic similarity so they have a higher chance of developing schizo if other has it
39
environmental factors: schizo
really early - prenatal and perinatal
viral infection
maternal stress
birth complications
40
infants born to mothers who had the fly in their third trimester have significantly elevated risks of
schizophrenia
* this is because mothers antibodies for flu cross the placenta which may disrupt the development of the fetal brain
41
if a mother is stressed and has high cortisol, what is fetus at risk for developing
schizo because cortisol crosses placenta and has negative effects on devloping brain
42
if a baby is born in breach position or after prolonged labor or with umbilical cord wrapped around their neck what are they more at risk for developing
schizo due to lack of O2 to brain
43
neurodevelopmental perspective
the brain of someone with schizophrenia may be impacted early on in life
- maybe genetics or environmental factors
** but the symptoms do not reveal themselves until adolescence or early adulthood which coincides with a significant period of brain maturation in prefrontal cortex
44
dopamine hypothesis
schizophrenia results from excessive levels of dopamine activity
increased dopamine levels may be result of increase dopamine receptors on post-synaptic cell
45
how did the dopamine hypothesis come about
based on the action of thorazine which is a first generation antipscyhotic, which blocks dopamine receptors (D2 receptors)
blocking dopamine receptors = reduced hallucinations and delusions
46
first generation psychotics
thorazine
blocks dopamine receptor (D2 receptors) and reduces hallucinations and delusions (70%)
47
second generation antipsychotics
clorazil and risperdal
block D2 and other dopamine receptors and impact other NTs (Glutamate, GABA, serotonin)
70% much improved- mostly positive symptoms
48
what is the front line txt for schizo
second generation antipsychotics
49
side effects of second generation antipsychotics (clozaril and risperdal)
fewer extrapyramidal symptoms (EPS)
less tardive dyskinesia
weight gain and increased risk of diabetes, hypertension, and CHD
50
fewer extrapyramidal symptoms (EPS)
neurological disturbance: muscular rigidity, tremors, restless agitation, involuntary postures, Parkinsonism
51
Parkinsonism
difficult initiating motor movements, tremors (antipsychotic medications mimic antipsychotics)
52
less tardive dyskinesia (TD)
involuntary movements of :
the mouth (lip smaking, tongue thrusting)
eyes (rapid blinking)
fingers or limbs
53
what causes TD more: 1st or 2nd gen antipsychotics
1st generation
54
can TD be fixed
sometimes if caught early enough
55
when can a schizo stop taking meds
never
56
sociocultural perspective: schizo
clinical outcomes often better in non-western developing countries
Wusten and Lincoln
57
Wusten & Lincoln 2021
participants from high income countries and collective low and middle income countries were randomly assigned to label vs no label condition
HIC had more stigmatizing attitudes than LAMIC
label = increased stigma in both HIC and LAMIC
association between label and stigma stronger than association between HIC and LAMIC
58
deinstitutionalization
1963 community mental health act:
create community mental health centers
* had good intentions but poor funding for community mental health centers
problems for people with schizo and society
59
revolving door
1963 community mental health act
schizos always in and out of hospitals/jails
60
developmental psychopathology
understanding maladaptive behavior, emotion, and cognition in the context of normal development
* not a simple downward translation- can't take what we know about adult mental health and apply it to children
61
masked depression
children don't have the cognitive capacity to have depression so they misbehaved instead
62
symptoms of depression in children vs adults
children show same depression symptoms as adults EXCEPT children can either be showing symptoms as depressed mood OR irritability (more common)
63
disruptive mood dysregulation disorder
applying bipolar disorder to children/adolescents
new category for diagnosis of bipolar disorder
characterized by temper outbursts
64
internalization vs externalization
internalization = depression/anxiety - expressing distress INWARDS
externalization = oppositional defiant disorder, conduct disorder (behavior disorders, expressing distress OUTWARDS, ADHD)
65
ADHD : DSM
attention deficit/hyperactivity disorder
6 symptoms in either or both categories (inattention or hyperactivity/impulsivity) and must be present in more than one setting
inattention:
failure to attend to detail
doesnt follow instructions
difficulty organizing tasks
avoids tasks w attention/effort
difficulty sustaining attention
forgetful
hyperactivity/impulsivity :
fidgets of taps hands/feet
leaves seat
runs/climbs
talks excessively
blurts out answers/interrupting
difficult waiting turn
66
ratio of male to female ADHD
2:1 male to female
67
females are more likely to exhibit which category of ADHD symptoms
inattention
68
ADHD has comorbidity with
ODD and CD
69
treatment for ADHD
stimulants
ritalin or adderall
70
behavioral disorders in children include
oppositional defiant disorder
conduct disorder
71
oppositional defiant disorder (ODD)
more than one setting:
angry/irritable mood
argumentative
vindictive (seek revenge)
*likely to become CD if not treated
72
conduct disorder : DSM
more than one setting:
- aggression toward people and/or animals
- destruction of property
- deceitfulness or theft
- violation of rules
73
angry/irritable mood : ODD
loses temper
easily annoyed
often angry and resentful
74
argumentative/defiant behavior : ODD
argues with authority figures
defies requests
deliberately annoys others
blames others for mistakes/misbehavior
75
aggression to people or animals: conduct disorder
bullies, threatens, intimidates others
initiates physical fights
use of weapon
cruel to people
cruel to animals
forced sexual activity
76
destruction of property: CD
destroys others' property
fire setting
77
deceitfulness or theft; CD
lies
breaking into house, building, car
stealing
*in more than one setting
78
violation of rules : CD
breaks curfew
runs away
truancy
*in more than one setting
79
if CD is not treated what does it become
antisocial personality disorder
80
patterson's coercive model of antisocial behavior
parent with antisocial behavior leads to poor parental discipline and/or child conduct problems
81
parent management training
goal is to interrupt parenting strategies that sustain and escalate dysfunction
- set clear expectations
-follow through
- positive reinforcement
- time out (negative punishments)
82
problem solving skills training
goal is to generate alternatives to interpreting and managing interpersonal situations
- modeling
-role playing
- corrective feedback
- may occur in context of play (often structured)
83
play therapy
humanistic or psychodynamic
based on developmental idea that children lack capacity for abstract thought for using language as a primary means for expressing things such as thoughts and emotions
act out things they can't express though words
play reveals feelings through:
- choice
- how toys are used
- themes: how we understand what they are doing
84
Anorexia DSM
1) individual purposely takes in too little nourishment, resulting in body weight that is significantly low and below that of other people of similar age and gender
2) individual is very fearful of gaining weight, or repeatedly seeks to prevent weight gain despite low body weight
3) individual has distorted body perception; places inappropriate emphasis on weight or shape in judgements of self; fails to appreciate serious implications of her or his low weight
85
medical consequences of anorexia
amenorrhea
dry skin, brittle hair & nails, lowered body temp
reduced bone density
lanugo - downy hair on limbs and cheeks
CV problems
high mortality rate
86
typical behavior/dieting characteristics: anorexia
- inflexible food variety
- eat alone
- eating rituals
- consume low calorie foods/bevs to create false statiety
- restrict after certain times of day
- hide limited intake
- preoccupied with food
87
common thought distortions: anorexia
control/failure- "giving into hunger means im a failure"
minimizing ED- "having anorexia means im superior to others who cant show this degree of self restraint
eating habits - "chronic dieting is the only way to control my weight"
emotions- "being thin= being happy"
88
biological influences: anorexia
evolution
genes
brain structure or chemistry
89
psychological influences: anorexia
emotions
personality
learning
cognition
90
socio-cultural influences
roles
expectations
socioeconomic status
definitions of normality and disorder
91
bio influences anorexia: Keys Starvation Study
tested dietary restraint/starvation
objectors to the draft had to participate in studies
on avg each male lost 25% body weight
preoccupation with food
negative mood
food rituals
lack of dietary control (binged)
92
biological factors ED: genetics
MZ with AN = 70% (23% BN)
DZ with AN= 20% (9% BN)
93
bio factors ED: brain circuits
dysfunction in fear, OCD, and depressive circuits
94
treatment for BN
SSRI
prozac
95
Bulimia DSM
1) repeated binge eating episodes
2) repeated performance of compensatory behaviors (vomiting, exercise) to prevent weight gain
3) symptoms take place for at least 3 months
4) inappropriate influence of weight and shape on appraisal of oneself
96
medical consequences BN
salivary gland enlargement (chubby cheeks)
eroding of dental enamel
tear esophagus
electrolyte imbalance= cardiac arrhythmia, kidney failure, seizures
intestinal damage and colon damage
97
prevalence of ED
1-5%
98
when do ED begin
adolescence/young adulthood
99
comorbidity of ED
depression
anxiety
OCD
substance use disorders
100
ED more common in
women (?)
people involved in activities or jobs that emphasize weight and appearance
101
what % of women on college campuses suffer from an ED
40%
102
psychological influences of EDs
cluster of personality characteristics and cognitive factors predict the development of ED:
- body dissatisfaction
- low self esteem
- perfectionism
- struggle for control
- self evaluation based on others
103
diagnostic crossover in ED
mostly start with AN and end up with BN
104
what is the #1 predictor of ED
body dissatisfaction
105
sociocultural influences ED
family environment - focuses on thinness, dieting, perfection
enmeshed families
thin/muscular ideal
106
enmeshed families
sociocultural perspective ED
families too involved in each others lives - codependency- young girls
107
Sharma and Vidal
specific about social media and highly visible social media focusing on thin/muscular ideal
108
Fairburns Integrative Model of ED
most commonly done in groups
diet to feel better
restrict food intake
binge
purge
low self esteem/negative affect
(repeat cycle)
diet to feel better about self
restrict food intake
low self esteem/negative affect
109
txt: ED
CBT-E (enhanced)
110
CBT-E
txt for ED (BN)
3 stages
transdiagnostic- most preferred txt for EDs
111
stage 1 CBT-E
behavioral strategies to normalize and develop new eating patterns
- self monitoring
- three meals, 2 snack
- behavioral analysis and problem solving to generate alternatives to binges
112
stage 2- CBT-E
cognitive interventions to challenge overconcern with weight/shape
113
stage 3 CBT-E
relapse prevention
-abstinence violation effect
114
CBT-E effectiveness for BN
rates of binge/purge reduced by 75%
50% recover
30% relapse
20% chronically impaired (chronically ED'd for future)
115
txt for anorexia
inpatient
- controlled weight gain
- strict behavior therapy that makes rewards contingent on weight gain
- results in increased anxiety, depression, and distress
116
effectiveness of txt for AN
limited effectiveness
- 10% die
- 40% underweight and chronically impaired
- 50% normal weight but still have problems with food, weight, depression/BN
117
abstinence violation
tendency to continue to engage in prohibited behavior following violation of personal goal to abstain
118
personality disorders
enduring pattern of maladaptive experiences in cognition, emotion, interpersonal functioning, and/or impulse control
onset in early childhood
ego-syntonic vs dystonic
119
the number one factor that predicts outcome of therapy for EDs is
how long they have had ED before txt
120
egosyntonic
people with personality disorder are not distressed by their symptoms or they are comfy with their situation
everyone else has the problem but not me
121
borderline personality disorder DSM
pervasive patterns of instability or impulsivity, including 5 of the following:
- fear of abandonment
- unstable, intense relationships, alternating between idealization and devaluation
- unstable sense of self
- impulsive behavior in 2 areas
- recurrent suicidal gestures or self mutilation
- affective instability
- inappropriate, intense anger
transient paranoid ideation or dissociation
122
txt for borderline personality disorder
DBT (dialectical behavior therapy)
123
etiological theory : borderline personality disorder
strong emotional reactions (more active amygdala and trouble recruiting prefrontal cortex- impulse control)
lack of emotion regulation skills
invalidating early environment
lack stable sense of self
reliance on others (to supply them with sense of self and validate their existence)
resort to manipulation and impulsive actions
124
DBT
dialectic = a deep contradiction
therapist an client must both radically accept who you are
radical self acceptance vs need to change
3 stages
125
stage 1 : DBT
survival and basic functioning
behavioral skills in group context (mindfulness, distress tolerance, decrease suicidal behavior, call therapist prior to self injury, no calling within 24 hours after self injury , decrease behaviors that interfere with therapy)
126
stage 2: DBT
reduce distress with past trauamas through exposure therapy
- describe past abuse over and over until distress decreases
127
stage 3: DBT
address long term issues - achieve career and interpersonal goals
128
cluster B personality disorder DSM
antisocial
borderline
histrionic (attention seeking)
narcissistic
129
common misconceptions about psychopathy
1) psychopathy = ASPD (antisocial)
2) psychopathy = violence
3) people with psychopathic personalities are fundamentally different from the rest of humanity
4) psychopathy = psychosis
5) people with psychopathic personalities = no emotion
6) psychopaths are born, not made
7) psychopathy is inalterable
130
why is psychopathy NOT = ASPD
ASPD = observable behaviors
131
ASPD DSM
lifelong pattern of disregarding the rights of others and at least 3 of following :
Failure to conform to social norms and laws
Deceitfulness
Impulsivity
Irritability and aggressiveness
Disregard for safety of self or others
Irresponsibility
Lack of remorse
132
Hare (2003) characteristics of psychopathy
2 categories:
interpersonal-affective
- superficial charm/glib
-pathological lying
-manipulative/conning
- lack of guilt/respinsibilty
- shallow affect
-grandiose sense of self worth
- callousness/lack of empathy
antisocial
- need for stimulation
- parasitic lifestyle
-impulsivity/poor behavioral control
-irresponsibility
-juvenile deliquency/early behavioral problems
-criminal versatality
- promiscuous sexual behavior
133
"The mask of Sanity"
first identified psychopathy
mask - psychopaths initially presented just like Ted Bundy
actions and attitudes changed over time and revealed more severe underlying patholog
134
Duchenne smile
people high on psychopathy able to fake a real smile
135
Brinke et al 2007
criminals scoring high in the PCL-R showed marked behavioral incongruence: more Duchenne smiles while also more angry language
- duplicitous style of communicating
136
is psychopathy inherited
yes moderate (~50%)
137
biological factors: psychopathy
neuroscience: reduced amygdala activity- poor at identifying fearful faces
-reduced physiological arousal
138
environmental factors - psychopathy
history of abuse and parental jail time
139
effectiveness of txt : psychopathy
successful psychopaths wont make it to therapy and even if they do, they wont be motivated to change and will try to calm the therapist
effectivess may depend on dependent variable- unlikely to make an impact on the underlying symptom of a psychopath
parent management and parent solving skills training (from childrens unit)
