Exam 3 Material Flashcards
(133 cards)
1
Q
What is the defining feature of moods in mood disorders?
A
The extremes of emotion (affect)
2
Q
What is the mood depression?
A
A low, sad state in which life seems dark and its challenges overwhelming
low and slow
3
Q
What is the mood Mania?
A
State of intense and unrealistic feelings of excitement and euphoria
high and fast
4
Q
What is Unipolar depression?
A
people with depressive disorders suffer only from depression, no history of mania
5
Q
What is bipolar depression?
A
Other experience periods of mania that alternate with periods of depression
6
Q
What is the prevalence of Unipolar depression?
A
Adults in the US (pre-COVID)
-annual: 7%
-lifetime: 17%
The pandemic tripled these levels
7
Q
What are the gender differences of Unipolar depression?
A
Women > men, 2:1
gender differences emerge in adolescence
**No gender differences in children or adults ages 65+
8
Q
What are the demographic differences of unipolar depression?
A
Native American > European American & Hispanic > African Americans
Low SES > High SES
9
Q
What are the 5 mains areas of functioning for symptoms of depression?
A
Emotional Symptoms
Motivational symptoms
Behavioral Symptoms
Cognitive Symptoms
Physical Symptoms
10
Q
What is Major Depressive Disorder?
A
A depressive episode, lasting a min of 2 weeks (without mania)
5+/9 symptoms are present for 2+ weeks
11
Q
What must one of the symptoms of MDD be?
A
either depressed mood or loss of interest/pleasure
12
Q
What is the difference between relapse and recurrence?
A
Relapse = symptoms re-emerge quickly
-depressive episode had not yet run its course
Recurrence = onset of a new episode
-symptoms had previously ended and not been there for a while
13
Q
What are the two primary specifiers for MDD?
A
Trajectory:
-Single episode = initial depressive episode (no previous episodes)
-Recurrent = previous depressive episode(s)
Severity: mild, moderate, severe
14
Q
What is Persistent Depressive Disorder (PDD)?
A
Mild to moderate version of depression
Persistently depressed mood most of the day for at least 2 years
15
Q
What is the prevalence of PDD?
A
Lifetime prevalence of 2.5-6%
50% have onset before age 21
16
Q
What is the average duration of PDD?
A
4-5 years
17
Q
What is double depression?
A
moderate depression is chronic (PDD) but have periods of time in which depression is worse (MDD)
18
Q
What are two other forms of depression?
A
- Bereavement-triggered depression
- postpartum “baby blues”
19
Q
What are the 5 biological causes of unipolar depression?
A
*Genetic factors
*Neurotransmitters
–serotonin and norepinephrine (usually low)
–Dopamine (low)
*Endocrine system
–above-average levels of cortisol
–low thyroid
*brain anatomy and neural circuits
–hypoactive
*sleep disturbance
20
Q
What are the Environmental/Stress causes of unipolar depression?
A
Stress may trigger depression
Vulnerability factors:
-personality and cognitive diathesis
-early adversity
21
Q
What is the Behavioral Model causes of unipolar depression?
A
-Depression results from changes in rewards and punishments people receive in their lives
-Positive rewards in life decline, leading them to perform fewer and fewer constructive behaviors, and they spiral toward depression
22
Q
What is the negative thinking of Unipolar depression?
A
-Self-defeating attitudes developed during childhood
-Cognitive triad:
–Individuals repeatedly interpret (1) their experiences, (2) themselves, and (3) their futures in negative ways
*The Negative Cognitive Triad:
The self, the future, and the world
23
Q
What are Automatic negative throughts?
A
a steady train of unpleasant thoughts that suggest inadequacy and hopelessness
24
Q
What are Errors in thinking?
A
cognitive distortions
-includes things like catastrophizing, fortune telling
25
What is Beck's Cognitive Model of Depression?
Early experience --> formation of dysfunctional beliefs --> critical incident --> beliefs activated --> ANTs
26
What is the reformulated (learned) helplessness theory?
People become depressed when:
they no longer have control over the reinforcements in their lives
Dog on the shocking floor giving up when it cannot escape
27
What is the hopelessness theory?
Hopelessness has to be there first → then they experience a negative event
28
What is the rumination theory?
Excessive rumination – on their feelings, the causes & consequences of their depression - is a diathesis for depression
29
What are the 5 main areas of functioning that may be affected by bipolar disorders? and examples for each
1. Emotional symptoms
-excessive exuberance
2. Motivation Symptoms
-need for constant excitement
3. Behavioral symptoms
-excessive activity
4. Cognitive symptoms
-poor judgment
5. Physical symptoms
-high energy level
30
What are the 7 symptoms for diagnosing bipolar disorder?
1. Decreased need for sleep
2. pressured speech
3. grandiosity
4. flight of ideas
5. highly distractible
6. increases in goal-oriented activities
7. increases in engaging in risky behavior
31
What is a full manic episode?
for at least ONE WEEK, they display an abnormally high or irritable mood, increased activity or energy, and at least three other symptoms of mania
32
What is a hypomanic episode?
when the symptoms are less severe, lasting a minimum of 4 days
33
What is the difference between Bipolar I and Bipolar II?
Bipolar I: alternation of full manic and major depressive episodes
Bipolar II: alternation of hypomanic episodes with major depressive episodes
34
What is rapid cycling with bipolar?
If people experience 4+ episodes within a one -year period
-1 episode = a cycle from depression to mania
35
Does the manic episode or the depressive episode last longer?
depressive episodes occur three times as often as manic ones, and last longer
36
What is the prevalence and onset of bipolar disorder?
-Between 2-3% of adults suffer from a bipolar disorder at any given time
-Bipolar II is slightly more common than Bipolar I
-Women = men
-Onset usually occurs between the ages of 18- 22 years
37
What is cyclothymic disorder?
-numerous episodes of hypomania + mild depressive symptoms
-Mild symptoms for 2+ years, interrupted by periods of normal mood
38
What are the 5 biological causes of bipolar disorders?
**Genetics: 80-90% due to genes
*Neurotransmitters:
-overactivity of norepinephrine
-low serotonin
-Low serotonin + High norepinephrine = Mania
*Cortisol levels (high during depression)
*Shifting patterns of blood to prefrontal cortex
-Manic → blood flow is high in the prefrontal cortex
*Disturbances in biological rhythms
39
What are the Psychological causes of Bipolar disorder?
-stressful life events
-low social support
-personality variables
-pessimistic attributional style
40
What are the 3 pharmacotherapy options for treating unipolar depression?
MAOIs - prevent breakdown or norepinephrine and serotonin
Tricyclics - block reuptake
SSRIs
41
What are the 3 options for treatment of unipolar depression when meds don't work?
-Electroconvulsive therapy
-Brain stimulation
-Bright light therapy
42
What are some forms of psychological treatment for unipolar depression?
- cognitive-behavioral therapy
- behavioral activation treatment
- interpersonal therapy
- family and marital therapy
43
Why is Bipolar so difficult to treat?
Manic and depressive symptoms are almost the complete opposite
Distress may not be present during manic episodes
44
What are the biological treatments for bipolar disorder?
Mood stabilizers
-Lithium
-Anticonvulsants
-Antipsychotics
45
What is the psychological treatment for bipolar disorder?
Adjunctive psychotherapy
- focuses on medication management, social skills, and relationship issue
46
What are the two central themes for both eating disorders?
- intense and pathological fear of becoming overweight and fat
- pursuit of thinness that is relentless and sometimes deadly
47
What are the two elements of bulimia nervosa?
binges: bouts of uncontrolled overeating
purges: inappropriate compensatory behaviors
48
Why does the binge-purge cycle continue?
negative reinforcement
49
What are the two characteristics of anorexia nervosa?
- fear of gaining weight
- significantly underweight
50
What are the two types of Anorexia?
- restricting type
- binge-eating/purging type
51
What are psychological symptoms of anorexia?
- preoccupation with food
- distorted cognitions
--low opinion of body, overestimate their actual size
52
What is orthorexia nervosa?
Intense focus on "healthy eating"
53
What is binge-eating disorder (BED)?
individuals engage in repeated binges without performing compensatory behaviors
54
What are the typical body weights for those with the 3 different eating disorders?
Anorexia - underweight
bulimia - normal or overweight
BED - overweight
55
What is the age of onset for the 3 eating disorders?
Anorexia - 16-20 years
Bulimia - 21-24 years
BED - 30-50 years
56
What are the gender differences for eating disorders?
Female: Male – 10:1 --> 3:1
Gay & bisexual men > heterosexual men
57
What are the prevalences of eating disorders?
Bulimia - 1.5% in women, .05% in men
Anorexia - 0.9% in women, 0.3% in men
BED - 3.5% in women, 2% in men
BED in obese people 6.5-8%
58
What are the medical complications for anorexia and bulimia?
Anorexia:
Heart arrhythmias (can be fatal)
Kidney damage
Renal failure
Death: 3%
Bulimia:
Electrolyte imbalances
Hypokalemia (low potassium)
Damage to heart, hands, throat, and teeth
59
What are eating disorder commorbidities?
Depression
OCD
Substance abuse disorders
Various personality disorders
60
What is the psychodynamic theory of eating disorders
Parents respond to their children ineffectively --> broad cognitive distortions
Anorexia: effort to delay sexual maturation, response to conflicts to control
Bulimia: self-nurturing with food instead of parents
61
What are the biological factors of eating disorders?
Serotonin abnormalities
hypothalamus - responsible for weigh "set point"
mood disorders - set the stage
62
What are the sociocultural factors of eating disorders?
- societal pressures
- family pressures
63
What are some of the family influences on eating disorders?
- psychological tension
- emphasis on rule-mindedness
- parental over-direction
- poor skills in conflict resolution
64
What are the 9 individual risk factors of eating disorders?
- Gender (female) except for BED (male)
- Age (adolescence) except for BED (post-adolescence)
- Sexual orientation is a risk for males
- Internalization of thin ideal
- perfectionism
- negative body image
- dieting
- negative emotionality
- childhood sexual abuse (debatable)
65
What are the two main goals of eating disorder treatments?
- correct dangerous eating patterns
- address broader psychological and situational factors that led to and maintained the disorder
66
What are the main goal for treatment of each of the three eating disorders?
Anorexia: Promote normal eating behavior, regain lost weight, and recover from malnourishment
Bulimia: Eliminate binge-purge patterns, and promote normal eating behavior
BED: Eliminate binge patterns, promote normal eating behavior
67
What are the treatments for anorexia?
weight-restorative: supportive nursing care, nutritional counseling, high-calorie diets
meds: antipsychotics > antidepressants
Patients are encouraged to recognize their underlying feelings
68
What are the treatments for bulimia?
CBT
- exposure and response prevention
Teach individuals to identify and challenge ants
groups formats
antidepressant meds
69
What are the treatments of BED?
Medication: antidepressant, appetite suppression
Cognitive-behavioral and interpersonal therapy
70
What is personality?
set of unique traits and behaviors
71
What is the five-factor model of personality?
OCEAN
Openness
Conscientiousness
Extraversion
Agreeableness
Neuroticism
72
What is a "disordered" personality?
When someone's personality impairs their ability to effectively meet the demands of society
73
What are the two clinical features for personality disorders?
Chronic interpersonal difficulties
Problems with the identity of sense of self
74
What are the 4 DSM-5 criteria for behavior patterns for personality disorders?
Pervasive and inflexible
Stable and of long duration
Clinically significant distress or impairment in functioning
Manifested in at least two areas:
- Cognition; affectivity; interpersonal functioning; impulse control
75
What are the 3 cluster classifications of personality disorders and what disorders do those include?
Cluster A: odd/eccentric: Paranoid, Schizoid, Schizotypal
Cluster B: dramatic/emotional/erratic: Histrionic, Narcissistic, Antisocial, Borderline
Cluster C: anxious/fearful: avoidant, dependent, Obsessive-Compulsive
76
What is the prevalence for personality disorders?
Quite high
10-12% of people meet criteria for at least one disorder
Cluster C is greater than the other two
77
Why is it harder to diagnose personality disorders?
- criteria are not sharply defined
- personality is on a spectrum
- substantial overlap
- potential over pathologizing
- limited research
78
What are the 3 Psychological factors for personality disorders?
- psychodynamic theories: an infant’s getting excessive versus insufficient gratification of its impulses in the first few years of life
- Learning-based: habit patterns and maladaptive cognitive styles
- sociocultural styles
79
What are the common factors for Cluster A personality disorders?
display symptoms similar to schizophrenia
- suspicion, social withdrawal, and peculiar ways of thinking and perceiving
-people with these disorders rarely seek treatment
80
What is Paranoid personality disorder characterized by?
- deep distrust and suspicion of others
- often remain cold and distant
- sensitive to criticism
81
What is the prevalence of Paranoid personality disorder?
Low (1-2%)
females = males
82
What are the causes of Paranoid PD?
heritability: moderate
early adverse experiences
substance abuse
83
What are the treatments for Paranoid PD?
Attempt to help client control anxiety and improve interpersonal skills
try to restructure clients' maladaptive assumption
- most distrust and rebel against therapist
84
What are the characteristics of Schizoid PD?
- persistent avoidance of social relationships and limited emotional expression
- prefer to be alone
- large symptom overlap with ASD
85
What is the prevalence of Schizoid PD?
low (1%)
Males > Females
86
What are the causes of Schizoid PD?
Heritability: high (55%)
can precede psychotic illness
maladaptive schemas
87
What are the treatments for Schizoid PD?
CBT to experience more positive emotions and more satisfying social interactions
- group therapy
88
What are the characteristics of Schizotypal PD?
- extreme discomfort in close relationships
- odd ways of thinking
- behavioral eccentricities
- "magical thinking"
- often lead unproductive lives
89
What is the prevalence of Schizotypal PD?
low (1%)
males > females
90
What are the causes of Schizotypal PD?
Heritability: moderate
genetic abnormalities similar to schizophrenia
dopamine activity
91
What is the treatment for Schizotypal PD?
- CBT to teach clients to evaluate their thoughts and perceptions, provide social skills training
- antipsychotic meds
92
What characterizes Cluster B PDs?
dramatic/emotional/erratic
- so emotional and erratic
- hard for people to have satisfying relationships
93
What is Histrionic PD?
(think mean girls)
- extremely emotional, but shallow
- vain, self-centered
- attention-getting behaviors
- emotional and sexual manipulation
94
What is the prevalence of Histrionic PD?
(low) 1%
females > males
95
What are the causes of Histrionic PD?
unclear...
- legitimacy of disorder is in question
96
What are the treatments for Histrionic PD?
Cognitive therapists will help client develop healthier schemas for self and others, and better ways of thinking
97
What is Narcissistic PD?
grandiose, need much admiration, and feel no empathy with others
exaggerate achievements and appear arrogant
take advantage of others
98
What are the two subgroups of Narcissistic PD?
1. Grandiose - grandiosity, aggression, dominance
2. Vulnerable - fragile and unstable sense of self-esteem, hypersensitivity to rejection and criticism
99
What is the prevalence of Narcissistic PD?
very low (~1%)
males>females
100
What are the causes for the two types of Narcissistic PD?
Grandiose - parental overvaluation
Vulnerable - parental emotional, physical, and sexual abuse; intrusive, controlling, and cold parenting style
101
What are the treatments for Narcissistic PD?
No major approaches have been successful
- very unlikely to present for treatment
102
What is Antisocial Personality Disorder?
- the personality disorder most linked to adult criminal behavior
- persistent disregard for, and violation of, other persons' rights
- adolescent criminal behavior
103
When is ASPD diagnosed?
Over the age of 18
conduct problems must exist before 15
104
What is the prevalence of ASPD?
2-3% (low, but greater than other PD)
men 3-5x more likely than women
high in incarcerated populations
105
What are the causes of ASPD?
- Heritability: moderate
- low MAOA gene activity
- prefrontal cortex
- gene-environment interaction
106
What are 5 of the environmental factors of ASPD?
- low family income
- having a young mother
- conflict btw parents
- neglect
- harsh discipline from parents
107
What is Borderline PD?
- immense emotional and behavioral instability
- drastic mood shifts
- unstable self-image
- impulsive behaviors
- chronic feelings of emptiness
108
What is the prevalence of Borderline PD?
Gen Pop low (1-2%)
Females = Males
109
What are the comorbidities of Borderline PD?
high with depression/anxiety
high with substance use
other PDs
110
What are the causes of Borderline PD?
Heritability - high
Environment - high(er)
Gene-environment interaction
Stress leads to long-term dysfunction in the HPA axis, amygdala, and prefrontal cortex
111
What are the 4 treatments for Borderline PD?
- Antidepressants (SSRIs)
- Dialectical Behavioral Therapy
- Transference-focused psychotherapy
- mentalization
112
What are the characteristics of Cluster C PDs?
anxious/fearful
- symptoms are similar to those of anxiety and depressive disorders
113
What is Avoidant Personality Disorder?
- intensely uncomfortable in social situations
- overwhelmed by feelings of inadequacy
- extreme social inhibition
- desire interpersonal contact but avoid it out of fear of rejection
114
What is the prevalence of Avoidant PD?
low (2.5%)
Females > Males
115
What are the causes of Avoidant PD?
- heritability: moderate
- inhibited temperament in childhood
- genes (diathesis) +, rejection, humiliation
116
What are the treatments for Avoidant PD?
Therapy:
- therapist building trust with the individual
- group therapy provides practice in social interactions
Anxiolytic and antidepressant drugs are also sometimes useful
117
What is Dependent PD?
Persons have a pervasive, excessive need to be taken care of
- clingy
- obedient
- feel distressed and lonely
118
What is the prevalence of Dependent PD?
low (1%)
females > males
119
What are the causes of Dependent PD?
- heritability: moderate-high
- predisposition + authoritarian parenting
- cognitive schemas
120
What are the treatments for Dependent PD?
- CBT
- Group therapy
- Antidepressants
121
What is Obsessive-compulsive PD?
Preoccupation with order, perfection, and control that they lose all flexibility, openness, and efficiency
- set extremely high standards for themselves
122
What is the prevalence of OCPD?
low (2%)
Males > females
123
What are the causes of OCPD?
Heritability: moderate
high conscientiousness
Cloninger approach: dimensions of temperament are heritable
124
What are the treatments for OCPD?
CBT
ERP
SSRIs
125
What is the easiest and hardest cluster to treats?
Easiest: Cluster C
Hardest: Cluster B
126
What are 5 of Cleckey's Criteria for Psychopathy?
- superficial charm and good "intelligence"
- absence of delusions
- unreliability
- lack of remorse or shame
poor judgment and failure to learn from experience
127
What are the four factors of Psychopathy? and features of each
- interpersonal: superficial charm
- affective: lack of remorse
- lifestyle: impulsivity
- antisocial: criminality
128
What are the 5 causal factors of Psychopathy?
- genetics
- low levels of fear
- general emotional deficits
- early parental loss
- parental rejection
129
What are 3 risks for psychopathy?
- exhibit fearlessness
- poor conscience
- premeditated aggression
130
What is the treatment of psychopathy?
difficult/unsuccessful
CBT offers some promise
131
What is the interpersonal theory of depression?
depressed people often display social deficits that make other people uncomfortable and may cause then to avoid the depressed individual.
this leads to decreased social contact and a further deterioration of social skills
132
What is ECT and how does it work?
Electroconvulsive therapy
- targeted electrical stimulation cause a brain seizure which causes a restart to neurotransmitters
133
What are the 3 disorders where women = men?
- bipolar
- paranoid
- borderline
