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Abnormal > EXAM 3 > Flashcards

EXAM 3 Flashcards

1
Q

Normal depressed mood from a mood disorder (unipolar)

A
  • Persistence and intensity of the mood disturbance
  • Mal adaptive
  • Leads to problems in interpersonal functioning, social, and job functioning.
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2
Q

Major Depressive Disorder

A
    • 2 weeks - everyday
  • Periods of sadness, emptiness, hopelessness, worthlessness, anxiety
  • Diminished interest in most activities (used to have interest, not anymore)
  • 5% weight change within a month. (increase or decrease)
    Insomnia, sleep pattern changes, fatigue, irritable, can’t think clearly, suicidal thoughts
    • 1 episode of Mania - they will not have this diagnosis. (will be diagnosed with bipolar disorder).
  • The earlier the onset, more likely it’s genetic. (if mother diagnosed at 45, more likely you’ll have it too. Rather than later age. The earlier diagnosed, the increased likelihood of reaccurances
    • Women, twice as likelihood of getting MDD. (Reasons: women are more likely to report it,
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3
Q

Bereavement

A

*Previously in DSM 4 - (allowed 2 months of grieving)

  • DSM 5 - if major depressive disorder symptoms of 2 months do not apply. (after a month even if caused by loss of a loved one, you will still be diagnosed with MDD
    Mourning, grieving a loss of a loved one
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4
Q

Melancholic

A
  • Depression tends to be worse in the morning
  • Affects psychomotor functions (movement), moves a lot slower, loss of appetite, more likely to lose weight, excessive guilt
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5
Q

Psychotic Features

A
  • Delusions (false beliefs) and hallucination (visual, auditory misperceptions)
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6
Q

Atypical Features

A
  • Unusual, mood reactivity - they brightened with positive events. Mood will pick up and get better.
  • Weight gain.
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7
Q

Catatonic Features

A
  • Rigid, immobile, stuck in a position
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8
Q

With Seasonal Pattern

A
  • Lack of sunlight, causes depression
  • 2 or more depressive episodes in the past two years that vary according to the season.
  • Treatment: light therapy - 30-90 minutes a day.
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9
Q

Depressive Disorder with Peripartum Onset (Previously, Postpartum depression)

A
  • Major depressive disorder , but recent episode is during pregnancy or within 4 weeks of birth.
  • Minimal family support / loved ones
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10
Q

Persistent Depressive Disorder

A
  • New in DSM 5
  • *2 years - more days than not.
  • A mild form of depression
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11
Q

Premenstrual Dysphoric Disorder

A
  • New in DSM 5
    • A week before menstrual cycle, week after - there is a noticeable change.
  • Mood swings, increased irritability/ anger, increased conflicts, more tension, depressed mood.
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12
Q

Disruptive Mood Dysregulation

A
  • New in DSM 5
    • Ages 6-18
  • Severe recurrent temper tantrums, out of proportion to the situation.
  • More diagnosed now
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13
Q

Genetic Causes - Depression

A
  • Identical twins are twice as likely to suffer from depression compared to just siblings
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14
Q

Neurochemical Causes

Serotonin / Norepinephrine / Dopamine

A
  • Too little of either 3 can cause depression.
  • Hormonal factors
  • Low thyroid function
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15
Q

Neurophysiological causes

A
  • Damage in left lobe of prefrontal cortex of the brain - could cause depression.
  • Lower brain activity in the left side of the brain.
    Increased activation of the amygdala ( perceived though of threat )
  • High blood pressure
  • Early childhood trauma.
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16
Q

Psychoanalytic causes

A
  • Unresolved unconscious issues from childhood.
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17
Q

Attachment Therapist causes

A
  • Lack of attachment to a parent could cause depression.

- Learned helplessness - accepting the fact that your behavior will not change the outcome.

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18
Q

Cognitive causes

A
  • Perceptions, the way you interpret the events.
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19
Q

Humanistic Theory causes

A
  • Look at lack of meaning and purpose in your life.
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20
Q

Medication: MDD

A
  • Need moderate to severe depression - will not start out with meds if mild.
  • Improve energy level before improving the mood
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21
Q

SSRI (Antidepressants)

A
  • Antidepressants, fewer side effects
    Increased suicide risk
  • Prozac (only one approved 8yrs and above), zoloft, paxil
    2-4% increase, (Improve energy level before improving the mood - may now act on suicidal thoughts)
  • more agitated
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22
Q

Electroconvulsive Therapy (ECT)

A
    • still used in extreme cases, last resort, severely depressed
  • 70-80% effective
  • Chemical imbalances - tries to restore balance
    Side effects: confusion, temporary amnesia,
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23
Q

Transcranial Magnetic Stimulation

A
  • Magnetic foil over head, delivers electromagnetic pulse to the part of the brain that may be causing the depression
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24
Q

Deep Brain Stimulation

A
  • *used for parkinsons, ocd
  • Surgically implant electrodes into a specific part of the brain.
  • Attached to a pacemaker, electrodes are released
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25
Q

BiPolar

A
  • Fluctuation in mood. Up and down emotions
  • Depression, mania, depression - fluctuates.
  • Increase likelihood of substance abuse, diabetes, heart disease, anxiety disorder
  • Causes: chemical imbalances, different parts of the brain abnormal,
    • High Concordance Rate
  • Treatment: mood stabilizer - works on depression and mania (Lithium/ Depakote)
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26
Q

Concordance Rate

A
  • The chances you will develop the disorder given that someone in your family has the disorder. (Genetic)
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27
Q
  • Is there a diagnosis for mania in DSM 5?
A
  • No

- If you have mania -you have bipolar disorder

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28
Q

Mania

A
    • Symptoms must last for 7 days
  • Risky dangerous behavior, rapid speech, more irritable, impulsive, little need for sleep,
  • False sense of well being (risky behavior)
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29
Q

Hypomania

A
  • Lasts a minimum of 4 days (same symptoms as mania)
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30
Q

Rapid Cycler

A
  • 4 or more cycles a year (depressive episode followed by a manic episode)
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31
Q

Bipolar I

A
    • 7 days - full blown mania
    • more serious - can cause hospitalization
  • Alternates with symptoms of MDD
  • Affects social functions, interpersonal, job
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32
Q

Bipolar II

A
    • hypomanic episode 4 days
  • Alternates with symptoms of MDD
    • less severe - more common.
  • Not as impulsive, better judgement,
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33
Q

Cyclothymic

A
    • 2 years (3 or more cycles)
  • A more mild form of bipolar disorder - more mild than bipolar II.
  • Fluctuations of hypomania (mild) , depressive symptoms are mild.
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34
Q

Mood Stabilizers

A
  • Treatment: mood stabilizer - works on depression and mania (Lithium/ Depakote)
35
Q

Suicide

A
  • Females attempt suicide about 3x as often as men.

- Males commit suicide 3x often as men. Method - (pills vs. guns)

36
Q

Indicators of suicide

A
  • Giving away prized possessions, withdrawing from people, people who talk about suicide, isolation, divorced, hopelessness,
  • Impulsive (don’t think things thru) - more likely to commit suicide
  • Genetic gene for depression - family member who commits suicide.
37
Q

Suicide Treatment

A
  • Value, assess their support system.
38
Q

No suicide agreement

A
  • Signs with therapist
39
Q

Schizophrenia

A
  • Affects their personality, disorganized speech, disturbance in their effect.
  • Socially withdraw
  • Interfere with work or everyday life
  • Onset: late adolescence early adulthood 17-22 years old.
  • Symptoms: * 6 months - continuous signs. At least 1 month of delusions and a hallucinations.
40
Q

Positive Symptoms

A
  • *Respond well to medications
  • (excess too much)
  • Delusions
  • Hallucinations
  • Loose Association
  • Catatonia
41
Q

Delusions

A
  • false beliefs. Despite disconfirming evidence. * people can see into their mind, speaking to them. (if you can work with them and they can entertain the idea that they are wrong, that is a good sign?)
42
Q

Hallucinations

A
  • sensory misperceptions, seeing things that aren’t there. More common to hear voices. (delusions and hallucinations are common in schizo, but not only limited to it).
43
Q

Loose Association

A
  • they are constantly shifting from one topic to another. Not able to connect thoughts.
  • Not see common theme in different ideas. (ex. “John is a man, john is a father, all men are fathers - false. But schizo will have a hard time connecting theme).
44
Q

Catatonia

A
  • peculiar body movements, postures,stay in one position for long periods of time.
45
Q

Negative Symptoms

A
  • *lacking something
  • *More irreversible, deterioration in brain
  • Flattened affect
  • Avolition
  • Anhedonia
46
Q

Flattened Affect

A
  • not very many emotions, lack of meaningful speech.
47
Q

Avolition

A
  • inability to take goal oriented action. Don’t engage in purposeful behavior.
48
Q

Anhedonia

A
  • inability to feel pleasure.
  • Social withdrawing, little interest to connect with others, cognitive impairments (don’t process info quickly or efficiently, reasoning limited)
    • worse prognosis if more negative symptoms.
49
Q

Premorbid Functioning

A
  • (before the onset)
  • How were they functioning before the onset of schizophrenia
  • Before this, showing signal of abnormal behavior ( withdrawing, getting into their own world.
  • Poor grooming, poor communication
    • stress opens the door for more psychotic symptoms
50
Q

Prodromal

A
  • The onset of the psychotic symptoms (delusions, hallucinations)
  • Most common - paranoid delusions ( someone’s out to get them )
  • Good at reading people
  • Hospice setting -
  • They project onto others what’s really going on with them
    • Full recovery is rare, improvement in symptoms is not unusual.
    • Smoking weed - increase psychotic symptoms
51
Q

Brief Psychotic

A
  • Patient has sudden onset of psychotic symptoms but last less than a month
  • Caused by severe stressor
52
Q

Schizophreniform

A
  • Schizo symptoms between 1-6 months
53
Q

Schizoaffective

A
  • Schizo and depression symptoms
54
Q

Delusional Disorders

A
  • Have false beliefs - but not as bizarre as schizo delusions
  • No other psychotic symptoms.
  • Not as farfetched delusions
55
Q

Erotomania

A
  • Person has belief that someone is in love with them. (receptionist being nice - but they think they’re hitting on them)
56
Q

Grandiosity

A
  • A false belief that you have a special talent or a relationship with someone who is important. ( Michael Jordan same restaurant as you - and you say you ate dinner with him)
57
Q

Jealousy

A
  • A belief that you partner is being unfaithful.

- Projection example

58
Q

Persecution

A
  • Mistreated or conspired against
59
Q

Somatic

A
  • A belief you have a physical defect. (nose too big, ears too small)
60
Q

Causes of Schizo

A
  • Neurochemical theory ( chemical imbalance ) - too much dopamine.
  • Low levels of serotonin in specific synapses
  • Too little GABA
  • It’s genetic - if both parents - you have 50% chance.
  • Neuroanatomy - enlarged ventricles in the brain, causing reduced gray areas - cortex is not as large. ( can’t think at a deep level)
  • Prenatal - during pregnancy, infections, (bacterial, viral)
    • family dynamic: highly involved overly critical - this could increase adolescent becoming schizophrenic
61
Q

Treatment for Schizo

A
  • *medication

- Could use both

62
Q

Antipsychotics

A

Blocks dopamine receptors,

63
Q

Typical Antipsychotics

A
  • Older versions, 1960s - reduce the positive symptoms, but produce very serious side effects. (muscle stiffness, tremors, tardivedisconesia - can last week or months, involuntary movements of the mouth).
64
Q

Atypical

A
  • Blocks dopamine and increase serotonin
  • Much less likely to produce tardivedisconesia
  • Effects negative symptoms as well.
  • Work about 70% of the time.
  • *More prescribed now a days.
    • meds work best if started early on

Psychiatrist 10-15 minutes,

65
Q

Tardive Dyskinesia

A
  • A condition affecting the nervous system, often caused by long-term use of some psychiatric drugs.
  • Tardive dyskinesia causes repetitive, involuntary movements, such as grimacing and eye blinking.
  • Stopping or tapering drugs that may be contributing to involuntary repetitive movements can help. In rare cases, botulinum toxin, deep brain stimulation, or medications can help.
66
Q

Transcranial Magnetic Stimulation

A
  • Stimulate a targeted area in the cortex and create some brain activity,
  • Brain that could be responsible for delusions and hallucinations
  • Magnetic current - new form of treatment
  • Works better with hallucinations, not delusions
  • *major depression (more commonly used)
67
Q

Family Therapy

A
  • Not have them be so critical or overly involved
68
Q

Ego Syntonic

A
  • When people act consistent with typical behavior (mellow, compassionate, loving)
69
Q

Ego Dystonic

A
  • Acting inconsistent with their typical behavior
70
Q

Personality Trait

A
  • Agreeable, argumentative, calm

- Typical characteristics

71
Q

Personality Disorders

A
  • Chronic, inflexible, maladaptive characteristics that are stable over time,
  • Causes impairment for the person, work or personal functioning,
  • Causes more stress to others rather than themselves.
  • *Age - 18 years old - when officially diagnosed
  • *Personality disorders 6 months
  • *If younger than 18 - must have symptoms for a YEAR not just 6 months.
72
Q

Cluster A-Odd or Eccentric

A
  • Paranoid, Schizoid, Schizotypal
73
Q

Paranoid

A
  • This is your enduring ongoing personality
  • Unwarranted suspiciousness, hesitant to trust others, question other people’s motives, bare grudges,
  • Aloof from other people, don’t confide in others,
  • Interpret random events, having personal meaning

Psychoanalytic causes - projection

74
Q

Schizoid

A
  • Detached from social relationships, emotionally cold, distant, socially isolated,
  • No desire to have close relationships
  • Experience very little pleasure in their life.
  • Schizoid vs schizo - no hallucinations or delusions
75
Q

Schizotypal

A
  • Very peculiar, odd thoughts, behaviors,
  • Poor hygiene, poor interpersonal relationships, “magical thinking” - read other people’s minds.
  • Speech - odd, vague
    • no delusions, hallucinations
76
Q

Cluster B- Dramatic

A
  • Histrionic
  • Narcissistic
  • Anti-Social
  • Borderline
77
Q

Histrionic

A
  • Overly dramatic, hysterical, overly emotional.
  • “Drama queen/ king”
  • Seeking attention
  • Flirtations
  • (positive reinforcement - keeps it going)
78
Q

Narcissistic

A
  • Exaggerated sense of self importance
  • Arrogant, require the attention of others
  • Sense of entitlement
  • Difficult time accepting non complementary feedback
  • Fantasies of power and wealth.
  • Empathy
  • Deep understanding for other people
  • Need to devalue other people,
    perfectionist
  • Controlling, have underlying insecurity

Treatments: not often in the office, family history- no consistent bonding, get them to talk about their underlying insecurities, having them look at the value of relationship

79
Q

Anti-Social

A
  • Against societies norms or values,
  • Don’t conform to legal rules,
  • Aggressive, violent, impulsive, rarely learn from past experiences, charismatic.
  • Causes: childhood trauma, don’t learn right from wrong, lack of attachment growing up, abusive environment..
  • Overly active autonomic system - too much adrenaline - anxiety disorders.
  • *Under Active autonomic system - risky dangerous behavior, to get this adrenaline rush
80
Q

Borderline

A
  • Intense fluctuation in their mood that also have a history of unstable relationships, impulsivity, feels empty inside, fear of abandonment, originates from childhood, trauma, parent relationship
  • *Most commonly diagnosed personality disorder.
  • High risk of suicides.

Cognitive therapist - confront irrational thoughts

Dialectical Behavioral Therapy

81
Q

Cluster C- Anxious or Fearful

A
  • Avoidant
  • Dependent
  • Obsessive - Compulsive
82
Q

Obsessive- Compulsive

A
  • They are very perfectionist, orderly,
  • Right way and wrong way of thinking, need for order and perfection is very strong,
  • Everything has its place. (soup can, no preference- just seen as you’re doing it the wrong way - toilet paper example).

Causes:

  • Combination of genes - inhibited child (shy)
  • Traumatic events

Psychotherapy- bond and connect with the patient
- Show alternate ways of thinking, behaving, so they can compare their old behavior with new.

  • *Medications, not appropriate.
83
Q

Medications: Generic vs. Brand Name

A

Does a brand name or generic medication make a difference?
Generic medication has the same active ingredient as the brand name
Generic has different inactive ingredients (what hold the pill together, how the pill is delivered in your blood stream)
It’s possible you can have a allergic reaction to generic
New drug - 20 year patent - after that 20 is up other drug companies can apply to make a generic brand.
When compared it only has to be 80-125% similar
Generic- 25-36 healthy people when tested compared to hundreds of subjects
The cost is cheaper -
Brand name - FDA approval - show 2 studies that it is more effective than a placebo.

84
Q

Exam 3 Info

A

Exam 3
Know specifiers of major depressive disorder (atypical)
Depression - but not major DSM 5 - persistent depressive disorder)
Parts of the brain - low activity of left hemisphere - PET Scans, EEG,

Rogers- inconsistency between true self and ideal self (how you’d like to see yourself).

MAOI - Antidepressant- prevents enzymes from breaking down chemicals, can’t use it with a lot of things.

Medication to bipolar patients - Mood stabilizers

Abnormal (5 decks)

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