Exam 3 Flashcards
somatic symptom disorder (diagnostic)
multiple somatic symptoms that impact daily functioning
- excessive thoughts, feelings, or behaviors surrounding somatic symptoms
- often diagnosed when another medical condition is present
Illness anxiety disorder (diagnostic)
excessive preoccupation with having or acquiring a serious medical illness
- does not typically present any somatic symptoms
- scanning and analyzing their body and/or searching the internet for related symptoms
functional neurological symptom (conversion) disorder (diagnostic)
individual presents with one or more symptoms of altered voluntary motor or sensory functions
- weakness, paralysis, abnormal movements, and gait abnormalities (limping)
- altered, reduced, or absent skin sensation, vision, or hearing
* incompatibility of the medical disorder and the symptoms
factitious disorder (diagnostic)
deliberate falsification of medical or psychological symptoms imposed on oneself or on another, with the overall intention of deception
- medical conditions may be present but the severity can be excessive
what is the common comorbidity in somatic symptoms disorders
the most common is anxiety and depressive disorders
- illness : OCD and personality
- functional : personality
- somatic : PTSD and OCD
* there is also high comorbidity with physical disorders
what is the impact of culture on somatic disorders
- western: psychological symptoms sometimes influence somatic symptoms
- eastern: psychological symptoms interact with somatic symptoms
- asian: report physical symptoms rather than cognitive or emotional problems
obsessive- compulsive disorder (OCD)
require obsessions, compulsions, or both
- obsessions: repetitive and persistent thoughts, urges, or images. Intrusive, time-consuming, and unwanted causing distress
- compulsions: time-consuming, repetitive behaviors or mental acts that an individual performs in response to an obsession. Repeatedly checking, counting, repeating words.
body dysmorphic disorder
obsessive disorder that focus on the perceived defects or flaws in one’s physical appearance
- can be obsessive over their own or another person
- considerable amount of time preoccupied with their appearance, impairment in social, occupational, or other areas of functioning
* burn victims do not fall under this
muscle dysmorphia
one’s body is too small or lack the appropriate amount of muscle definition
- higher use of substance abuse (steroids), poorer quality of life, and increased reports of suicide attempts
hoarding disorder
persistent over-accumulation of possessions
- indecisiveness, avoidance, procrastination, perfectionism, difficulty planning and organizing tasks, and are easily distractible
Neurological correlates of OCD
hereditary transmission: monozygotic twins have a concordance rate of 80-87% while dizygotic twins have 47-50%; first degree relatives
neurotransmitters: deficits of serotonin levels, maybe glutamate, GABA, and dopamine
brain structure: overactivity in the orbitofrontal cortex and a lack of filtering in the caudate nuclei thus causing to many impulses to transfer to the thalamus
most effective treatments in OCD
exposure and response prevention (ERP)
- relaxation technique is taught prior to therapy
- repeatedly exposed to their obsessions while simultaneously prevented from engaging in their compulsive behaviors
anorexia nervosa
restriction of energy intake which leads to significantly low body weight relative to the individual’s age, sex, and development
- emotional/behavioral: preoccupation with food, weight, calories, etc., feeling “fat”, avoid mealtimes and not eating in public
- physical: dizziness, difficulty concentrating, feeling cold, sleep problems, thinning hair/hair loss, and muscle weakness
bulimia nervosa
pattern of recurrent binge eating behaviors
- binge eating: discrete period of time where the amount of food consumed is significantly more than most people would eat during a similar time period
- compensatory behavior: vomiting, laxatives, fasting, excessive exercise, or other medications to rid the body of excessive calories
binge-eating disorder (BED)
recurrent binge eating episodes along with the feeling of lack of control during the binge-eating episode
- do not engage in compensatory behaviors
- occur at least one a week for 3 months
neurological correlations to eating disorders
twin studies: 70% concordance for maternal and 20% for fraternal (anorexia); 23% maternal and 9% fraternal (bulimia)
disruption in hypothalamus (hunger and thirst) can explain
- lateral: initiating hunger cues
- ventromedial: sending signals of satiation, stop eating
most effective treatment for feeding/eating disorders
anorexia:
- CBT
- family based therapy (FBT)
bulimia:
- CBT: exposure and response prevention
- interpersonal psychotherapy (IPT): psychoeducation and identifying interpersonal problems -> problem-solving interpersonal issues -> relapse prevention and long term results
BED:
- CBT + antidepressant medication
substance use disorder
cluster or cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems
- does not include caffeine
- lack of participation, impairment in relationships, recurrent substance abuse, cravings, difficulty reducing
substance intoxication
immediately following the ingestion of this substance, significant behavioral and/or psychological change is observed
- disturbances of perception, wakefulness, attention, thinking, psychomotor behavior, interpersonal behavior, and judgement
depressants
alcohol: 78% of teens drank at some point in their lives, 45% of colleged-aged student report in binge drinking
- impaired reaction time, disorientation, and slurred speech
sedative-hypnotic (anxiolytic) drugs: barbiturates, benzodiazepines (xanax); bind to GABA receptors and increase GABA activity
opioids: morphine and heroin; euphoria and drowsiness; withdrawal causes restlessness, muscle pain, fatigue, anxiety, and insomnia
stimulants
(substance abuse)
increase the activity in the central nervous system, increase blood pressure, heart rate, pressured thinking/speaking, and rapid behaviors
cocaine: feeling of energy and euphoria, increase in dopamine, norepinephrine, and serotonin; poor muscle coordination, grandiosity, compulsive behavior, aggression, and possible hallucinations and delusions
amphetamines: psychosis, violent behaviors, appetite suppressant, increase energy levels, dopamine, norepinephrine, and serotonin
methamphetamine: euphoria and confidence; heart and lung damage, significant teeth damage, and facial lesions
hallucinogens/cannabis
hallucinogens: hallucinations, changes in color perception, or distortion of objects; tingling/numbness of limbs, hot and cold sensations
cannabis: calm/peace, relaxation, increased hunger, and pain relief; increased anxiety/paranoia, dizziness, and increased heart rate
agonist vs antagonist
agonist: “safe” drug that has a similar chemical make-up to the addicted drug; not effective treatment (can be addicted) unless combined with education and psychotherapy
antagonist: block or change the effects of the addictive drug; disulfiram typically used for alcohol abuse; naloxone typically used for opioid abuse; dangerous has there is immediate, sever withdrawal symptoms
attention-deficit/hyperactivity disorder (ADHD)
+ treatment
persistent pattern of inattention and/or hyperactivity that interferes with functioning or development
- inattention: overlooks details, trouble listening when spoken to, fails to finish duties, problems organizing, forgetful
- hyperactivity: fidgets, runs around when inappropriate, excessive talking, often interrupts
* can be combination or predominant in one
treatment: stimulant drugs to increase dopamine levels, non stimulant drugs to affect the levels of norepinephrine, behavioral therapies (reinforcing attention, prosocial, and getting rid of impulsive behavior), stimulant therapy + psychosocial therapy (best)
autism spectrum disorder
+ treatment
impairment in two fundamental behavior domains
- social/communication: social emotional reciprocity, nonverbal communication, developing/maintaining/understanding relationships
- behavior, interest, and activities: repetitive movements ((self-stimulatory behaviors), adherence to routines, fixated interest, hypo/hyper reactivity to sensory input
+ drug therapy (SSRI’s, antipsychotic medications, stimulants), psychosocial therapies
intellectual disability
+ treatment
intellectual deficits and deficits in the ability to function in three broad domains of daily living
- conceptual, social, and practical domain
+ drug therapy (reduce seizures, etc), behavioral strategies (social and vocational skills), social programs
communication disorders
+ treatment
language disorder (spoken, written, other language); speech sound disorder (producing speech); stuttering/fluency disorder; social communication disorder (verbal and nonverbal communication for social purposes)
+ therapy to build missing skills, individualized education plan, changing skills can change brain function
major neurocognitive disorder
+ mild neurocognitive disorder
decline in cognitive functioning sever enough to interfere with daily living
- accompanied by changes in emotional functioning, personality, and insight may be poor
- deficits: memory, aphasia (language), echolalia (repeating what is heard), palilalia (repeating sounds), apraxia (can’t do common actions), agnosia (recognizing objects/people), loss of executive functions
mild: modest decline but has not resulted in significant impairment in functioning
what does treatment for neurocognitive disorders focus on?
neurocog disorders are degenerative so they only get worse, treatment focuses on secondary symptoms
