Exam 3 Flashcards
What is shared for all depressive disorders?
Sad, irritable, empty mood
Impedes individual capacity to function
Why was disruptive mood dysregulation disorder added to DSM-5?
Concerns about overdiagnosis of bipolar in children who were experiencing extreme irritability
Children with severe irritability most fit which disorder?
And which disorder are they likely to be diagnosed with later on?
Disruptive Mood Dysregulation Disorder
likely depression/anxiety, or maybe bipolar
How many settings must disruptive mood dysregulation occur in
2 or more
How many times a week outbursts must occur for Disruptive Mood Dysregulation Disorder?
3 or more.
Which disorder is a leading cause of disability?
MDD
when does the first episode of depression typically occur?
adolescence or adulthood
Anhedonia
loss of pleasure in nearly all activities
What are the gender differences in MDD?
When do they emerge?
Much more female than male MDD prevalence.
Emerges in adolescence (around age 14)
How does puberty relate to MDD?
Likelihood of MDD onset increases with puberty.
What are the stats on improvement of symptoms for those with MDD since onset?
Within 3 months: 40% improve.
Within 1 year: 80% improve.
What’s heritability of MDD?
40%
What disorder often precedes persistent depressive disorder?
MDD
When was premenstrual dysphoric disorder added to DSM?
DSM-5
How is diagnosed usually confirmed for premenstrual dysphoric disorder?
Prospective ratings over 2 cycles (mood and symptoms each day for 2 cycles)
List the 4 depressive disorders covered
Disruptive Mood Dysregulation Disorder
Major Depressive Disorder
Persistent Depressive Disorder
Premenstrual Dysphoric Disorder
What big categories are mood disorders?
Bipolar and Depressive.
What constitutes bipolar disorders?
Mood disorders with mania. (often with depression)
What are bipolar disorders considered in between?
Between depression and schizophrenia spectrum disorders
What is mania? (or manic episode)
What’s hypomania?
Period of persistently elevated, expansive, irritable mood. 1+ week
Hypomania is 4 consecutive days
Rather than being elevated, manic episodes can be experiences of _____
irritability.
Bipolar disorders must importantly not be better explained by what?
Schizophrenia spectrum disorders.
is bipolar I or II more common?
I
60% of people with bipolar II disorder have what?
3 or more co-occuring disorders.
What’s common medicine treatment for bipolar?
Lithium - reduce mania.
medications are first-line
anti-depressants if depressive symptoms.
which bipolar disorders have depressive symptoms?
bipolar ii or cyclothymic
what disorders use psychoeducation? learn more about their disorder
bipolar disorders, schizophrenia
Most effective therapies for bipolar disorders (3)
1) CBT
2) Family-focused
3) Interpersonal and social rhythm therapy.
Cyclothymic Disorder comorbids with what disorders?
sleep disorders or substance-related.
Suicidal ideation (definition)
what are the 2 subtypes?
Thinking about, planning, or considering suicide.
passive ideation: thoughts of death
active ideation: thoughts of methods, plans, intent to die
Suicide attempt (definition)
intent to die, but ended up non-fatal.
NSSI
non-suicidal self-injury
self-harm without the intent to die.
are there more suicides or homicides?
2x more suicides
What are STBs?
what psychopathology?
Suicidal thoughts and behaviors.
all kinds of psychopathology, not just mood disorders.
What are treatments to STBs? (3)
Risk assessment
safety planning
reduction of other symptoms
What’s safety planning?
An intervention for suicide.
Talk with patient of what to do when triggers, places to go, hotline, etc.
bipolar disorders covered
bipolar i
bipolar ii
cyclothymic disorder
substance induced whatevs.
what’s a substance use disorder?
problematic pattern of use leading to clinical impairment.
2 or more symptoms within 12-month period
What’s the problem with substance use and activation of reward system?
Substances might eventually produce such intense activation of reward system that normal activities no longer feel rewarding.
how many possible symptoms for SUDs?
11 possible. 2 of 11 is criteria.
What is the impaired control symptom in SUDs?
Cravings; all daily activities revolve around substance.
What is the social impairment symptom in SUDs?
Failure to fulfill role obligations at work/school/home due to use.
SUD symptom: Failure to fulfill role obligations at work/school/home due to use.
social impairment
SUD symptom: Cravings; all daily activities revolve around substance.
impaired control
What is the risky use symptom in SUDs?
use of substance when physically hazardous and knowledge/experience of problems.
SUD symptom: use of substance when physically hazardous and knowledge/experience of problems.
risky use
What is the pharmacological criteria symptom in SUDs?
Tolerance and withdrawal
SUD symptom: Tolerance and withdrawal
pharmacological criteria
Substance use disorder severity
Mild: 2-3 symptoms
Moderate: 4-5
Severe: 6+
past-year prevalence of SUD
7.4%
What’s integrative model of substance-related disorders?
combines biological psychosocio influences on drug.
What are substance use disorders comborbid with?
With each other (eg. alochol, weed, tobacco). Bipolar/schizo/depression/anxiety
What’s aversive treatment for SUDs?
Drugs that make substances very unpleasant
How effective are biological treatments for SUD?
Generally ineffective when alone.
Helps withdrawal symptoms.
How do inpatient vs. outcpatient care treatment for SUDs compare?
Little diff.
Component treatment
Used for SUDs.
Uses elements like psychotherapy and contingency mangement
Motivational enhancement therapy
A type of psychosocio treatment for SUD
Contingency management.
what is it? what disorder?
For SUDs. create plan with therapist to change behaviors using goals/rewards
Gambling Disorder
what category? why?
what is it?
“Substance-use and addictive disorders”
Activate reward systems similar to psychoactive drugs.
behavioral symptoms are similar to SUDs
What is a personality disorder?
Disorders of interpersonal functioning. How we understand self and others.
How are PDs organized in DSM-5?
Section II (main part)
and Section III (emerging measures and models)
Section II of DSM - PDs
What categories?
10 types with 3 categories:
A: odd or eccentric
B: dramatic, emotional, erratic
C: anxious or fearful
What are problems with section II DSM on PDs
Lots of comorbidity, some low prevalence, some don’t meet criteria for one but have symptoms across.
Section III of DSM on PDs
name? acronym? what it is. how PDs are viewed as?
Alternative Model for Personality Disorders (AMPD)
Overall personality disorder with 6 subtypes.
PDs are on dimension of severity.
What are the 4 elements of personality functioning? where is this?
DSM-5 section III
Identity, self-direction, empathy, and initimacy
Some researchers think what captures the ‘core’ of PDs? most representative.
BPD
Define BPD
instability in interpersonal releationships. marked impusivity, instable self-image.
How mayn sympotoms to meet criteria for BPD?
5/9
How young can diagnose with BPD?
12-13 already validly can.
is BPD untreatable?
no. severity goes down in 30s and 40s
Suicide rate of BPD ppl
8%
Treatments for BPD
DBT (dialectical behavior therapy)
MBT (mentalization based)
TFP (transference-focused)
what is DBT?
Dialectical Behavior
aim to help accept and manage emotions.
what’s MBT?
Mentalization Based
understand how their thoughts, feelings, and behaviors affect themselves and others
TFP?
transference-focused psychotherapy
organize their sense of self and how they interact with others
What are schizo spectrum and other psychotic disorders?
abnormalities in the 5 domains
delusions
hallucinations
disorganized thinking (speech)
disorganized motor behavior
negative symptoms
What are delusions?
fixed beliefs that not changable in light of evidence.
Bizzare delusions
Clearly implausible and not derived from life experiences.
erotomanic delusions
belief that someone else is in love with them.
belief that someone else is in love with them.
erotomanic delusions
hallucinations
perception-like experiences without external stimulus.
most common hallucination sense
auditiory
Hallunications when are not considered a form of psychosis?
When asleep or waking up.
3 types of disorganized speech/thinking
loose associations
tangential speech
incoherence
Catatonic behavior
signifcant decrease in reactivity to nevironemnt.
negative symptoms
lack of normally experienced things.
avolition
decrease in motivated/purposeful activities
alogia
decreased speech output
How are schizo spectrum disorders ordered?
by increasing severity
List the schizo spectrum disorders in order
Schizotypal PD
Delusional disorder
Brief psychotic disorder
Schizophrenia
Schizoaffective disorder
Shizotypal PD is considered what type of disrder?
DSM-5: PD
ICD-11: schizo spectrum disorder
delusional disorder
1+ delusions for 1+ months
no other symptoms of a schizophrenia specturm dsiroder.
brief psychotic disorder
Less than 1 month. Any of the 5 main symptoms except negative bx.
Schizophreniform Disorder
at least 2 of the 5 symptoms.
1 to 6 months.
similar to schizo but less time.
Schizophrenia
6+ months
1 month of active phase.
2 or more symptoms.
Schizoaffective Disorder
Requires 2 weeks where what?
Mood episode (mania/depression) and active psychotic symptoms.
Period of 2 weeks where delulu/hallucin are without mood ep.
Gender diffs in schizophrenia
no
What happens before onset of active psychosis for some schizo ppl?
majority have some slow and gradual development of symptoms:
social withdrawal, emotional changes, cognitive changes.
Prodromal schizophrenia
what’s prodrome?
Period of decline leading up to the onset of psychotic episode.
prodrome is the time between behavioral/psych changes to onset of psychotic symptoms.
What’s neurology of schizophrenia?
Cognitive impairment; brain differences in white/grey matter, reduced volume of brain, eye tracking diffs.
Many neurological signs
Treatment for schizo
both pharma and behavioral treamtents recommended
antipsychotic medication
what do antipsychotic medication do in NS
dopamine receptors.
behavioral treatments for schizo
residental treamtent to stabalize, psychoeducation, social skills training, etc.
schizo prevalence
.3-.7% lifetime.
