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Abnormal Psychology P-324 > Exam 4 > Flashcards

Exam 4 Flashcards

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1
Q

Bipolar I Disorder

A
  • 1 or more manic episodes; often have at least 1 major depressive episode
  • prevalence 1%
  • equal women and men
  • average age of onset 18 and getting younger
  • recurrent-90% have future episodes
  • related to creativity? Vincent Van Gogh and Ernest Hemmingway-no research link between mania and creativity. thought to be related because ideas come very fast
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2
Q

Cyclothymia Disorder

A

-at least 2 years: presence of numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that don’t meet criteria for MDE

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3
Q

Biological Theories of Bipolar

A
  • highly heritable: variance=90% (means that in any episode this is how much is probably genetic-chances much higher than person in population that doesn’t have the genetic component)
  • mania=overly sensitive to dopamine
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4
Q

Treatment of Mood Disorders-Biological for Bipolar

A
  • lithium: traditional, most common
  • helps up to 80%
  • treats: primarily mania (if you give antidepressant in depressive episode to some people it triggers a manic episode-25%)
  • stabilizes NTs: serotonin, dopamine, glutamate
  • prevents relapse
  • side effects: toxic if too high; dulls mania-doesn’t feel good
  • anticonvulsants
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5
Q

Treatment of Mood Disorders-Biological for Depression

A
  • medication: Tricyclic and MAO inhibitors
  • advantages of medications: two weeks for relief and not fatal if overdose
  • side effects: weight gain-difficult to feel satiated; restlessness; insomnia/fatigue; sexual dysfunction; anxiety; vivid dreams; difficult to wean off-flu-like symptoms
  • ECT: treat severe, recurrent depression (when drugs are ineffective); small electric current produces seizure in brain (shock
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6
Q

Treatment of Mood Disorders-Behavioral

A
  • change interactions with environment and with others (most effective treatment for depression and anxiety are a form of medication and CBT)
  • increase positive reinforcers=pleasant activities (realistic; no other people’s participation in case they don’t enjoy it)
  • increase social skills=decrease negative interactions
  • teach mood management skills for unpleasant situations-moods are transient (not permanent)
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7
Q

Treatment of Mood Disorders-Cognitive

A
  • change irrational or dysfunctional thoughts produced, maintain depression
  • help client discover negative automatic thoughts (homework: keep log)-identify thoughts
  • help challenge negative thoughts
  • hypothesis testing: gather data and test ex: stephanie has fight with husband and says no one can lover her-test this: nobody cares about you? friends? family?
  • what are alternative explanations?
  • change negative, core beliefs into more reality based ones-I’m an idiot changed to I’m not very good at math
  • therapist plays active role: teacher and coach
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8
Q

Evaluation of Methods for Treatment of Mood Disorders

A
  • CBT as effective as meds
  • 75% marked improvement or complete remission
  • fewer side effects
  • better at preventing relapse
  • best is combination of CBT and meds
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9
Q

Schizophrenia

A
  • not same as dissociative identity disorder (split from self)
  • split from reality
  • def: group of psychotic disorders characterized by major disturbances in thought, emotion, behavior
  • prevalence: 1% (higher in 1st degree relatives)
  • onset: males in early/mid 20s (earlier and more severe symptoms); females in late 20s early 30s; less and less likely when out of these years
  • equal in men and women
  • must include some disordered thinking
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10
Q

Brief Psychotic Episode

A
  • not considered schizophrenia
  • pilot runs out of cockpit screaming about Al Qaeda
  • super stressed and think this is what launched him into psychosis
  • symptoms subsided after about a week
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11
Q

Symptoms of Schizophrenia

A
  • no essential symptoms: very heterogenous
  • lack insight
  • positive symptoms (excess; something that’s there that shouldn’t be)
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12
Q

Types of Positive Symptoms

A
  • delusions: fixed, false beliefs (physical sensation of the world interpreted differently) cannot actually be occurring
  • hallucinations: sensory perceptions in the absence of adequate/any stimulation; having a sensory experience without physical sensation
  • loose associations: vague connections of thoughts-may make sense to the person but not to the rest of us (we don’t understand the reference) Eta: ask about relationship to Jesus-says he’s related to the money and gives it to widows and orphans (has moments of lucidity but aren’t maintained)
  • disorganized speech
  • derealization
  • inapproproiate affect
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13
Q

Types of Deluisons

A
  • persecution
  • grandeur
  • reference
  • control
  • truman show
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14
Q

Persecution

A
  • belief one is being punished/hurt/following you
  • Eta believes this to be true-the Eagle is trying to kill her if she doesn’t follow her fixed very convoluted rules
  • our culture often believes the government is doing the persecution
  • Eta’s eagle may be related to postal service symbol she gets on her husband’s GM penson checks
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15
Q

Grandeur

A
  • belief that one is someone special or has special abilities but in a way that you actually could not be
  • 3 Christs of Ypsilanti: can’t be talked out of delusions
  • all believe they’re Christ and think the others are wrong
  • erotomania: person believes that someone of higher status is in love with them (stalkers)
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16
Q

Reference

A
  • irrelevant stimuli have special meaning for self
  • i.e. seeing a billboard and thinking it’s saying something to you; hearing something on TV that you think relates to you
  • Eta: phone or doorbell rings-Jesus has a message; dog barks-writes down time to let Jesus know she heard the message
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17
Q

Control

A

-outside forces control self (Jesus, GM, the eagle)

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18
Q

Truman Show

A

-people believe they are being taped and watched by other people

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19
Q

Types of Hallucinations

A
  • Auditory-most common; often in form of hearing voices; usually unpleasant (almost always negative; very accusatory listening to own thoughts but not perceiving them in this way may affect auditory center near limbic system: auditory center lights up-just as real to the brain as your real voice
  • Visual-much less frequent; often related to drug/alcohol withdrawal
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20
Q

Neologisms

A
  • made up words, due to confusion

- type of disorganized speech

21
Q

Word Salad

A
  • string together a series of unrelated words
  • ex: the sun is blue dog tuesday
  • type of disorganized speech
22
Q

Perseveration

A
  • persistent repetition of sound, word

- type of disorganized speech

23
Q

Clanging

A
  • string together words that rhyme

- type of disorganized speech

24
Q

Derealization

A

-separation from sense of reality

25
Q

Inappropriate Affect

A
  • when you have the wrong response to a situation

- ex: Eta laughs when talking about her fear of death

26
Q

What causes positive symptoms?

A
  • impaired perception
  • Alterations of: external (noises from equipment) internal (body signals, thoughts) or overload (sensory stimuli floods into brain)
  • difficulty filtering sensory stimuli: perception
  • difficulty interpreting and responding to stimuli-brain attempts to derive meaning, misinterprets; inability to sort, interpret, respond like normal brains
27
Q

Negative Symptoms

A
  • avolition
  • alogia
  • anhedonia
  • flat affect
  • catatonia
  • psychotic episode may last much longer than a depressive episode-maybe even years; severity of episode also affects ability to ask about other symptoms; if thoughts are so disorganized that makes it difficult to talk about other symptoms. Can’t do CBT/traditional therapies if person is in midst of psychotic episode
  • *positive symptoms tend to happen at beginning of disorder and as you age with the disorder you tend to get more of the negative symptoms **
28
Q

Avolition

A
  • lack of will, motivation, purpose

- ex: Eta, lack of hygiene

29
Q

Alogia

A

-absence of speech

30
Q

Anhedonia

A

-lack of pleasure

31
Q

Flat Affect

A
  • lack of emotional responsiveness (may not be able to demonstrate it)
  • showed movie clips to schizophrenic “normal” to elicit emotions
  • people with schizophrenia did not display emotions
  • researchers needed to know what they felt so asked-self reported experiencing the same emotions as normal people
32
Q

Catatonia

A
  • motor freezing
  • don’t move for long periods of time
  • waxy flexibility-can move their body parts and they’ll stay in the position
  • like a mannequin
  • don’t see now because of meds
33
Q

DSM Criteria

A
  • very heterogenous

- could be diagnosed with only positive symptoms, only negative symptoms, or both

34
Q

Biological Etiology: Genetics

A
  • family studies: look at people who share your genes different degrees; risk increases with closeness of relatives
  • twin studies: MZ=48% DZ=17% tells us importance of diathesis stress model; strong genetic relationship but for MZ it’s not even half so without stress of environment you won’t express it. DZ twins higher incidence than regular siblings because they share same environment; must emphasize the role of the environment in development of the disorder
  • adoption studies: heston-had to have biological predisposition to develop schizophrenia (but this is not enough); tienari-familial maladjustment predicted expression of schizophrenia (if there are stressors going on in the home you are more likely to have the expression)
35
Q

Etiology: Biochemistry-Dopamine Hypothesis

A
  • excess dopamine: limbic system influence-responsible for emotion and memory consolidation; thalamus is where all sensory nerves travel through (sensory overload) (positive symptoms-too much of behaviors we shouldn’t see)
  • underactive dopamine: prefrontal cortex (negative symptoms)–>depression
36
Q

Etiology: Brain Structures

A
  • larger ventricles: seem to be related to mom having flu when she was pregnant-can be big risk factor
  • larger ventricles means less brain
  • cellular migration abnormalities: cell migration during fetal period doesn’t happen (2nd trimester)-neurons don’t get to where they need to go
  • fingerprint ridges: different ridge patterns among MZ twins when one is schizophreniac (indicates something happend in prenatal development that changed things up)
37
Q

Schizophrenia Reading

A
  • perceptual dysfunction is the most invariant feature of the early stage of schizophrenia
  • rarely can patients who are acutely or chronically psychotic describe these changes
  • alterations may either be enhancement (more common) or blunting; all sensory modalities may be affected
  • visual perceptual changes are more common than auditory changes-sharpness of colors as well as transformation of objects; some instances visual alterations improved appearance and sometimes made objects ugly or frightening
  • colors and textures may blend into each other
  • both hearing and visual sensations can be increased simultaneously
38
Q

Schizophrenia Reading II Sensory Overload

A
  • closely related to over acuteness of senses is flooding of senses with stimuli-not only senses become more sharply attuned, but they see and hear everything-normally brain screens out most incoming sights and sounds allowing us to concentrate; this screening mechanism appears to become impaired in many persons with schizophrenia, releasing veritable flood of sensory stimuli into brain simultaneously
  • hard to concentrate; impairments in attention and keeping track of time
  • difficult to socialize due to sensory overload
  • other sensory modalities may also be affected-some don’t like being touched (tried to bite nurse who tried to cut nails)
  • flooding of mind with thoughts; as if brain is being bombarded both with external stimuli (sounds, sights) and internal stimuli (thoughts, memories-can be from the past)
  • increased ability of some patients to recall childhood events that in the past mistakenly led psychoanalysists to assume that the recalled events were somehow causally related to the schizophrenia; no scientific evidence to support
  • sometime feel that someone is inserting the flood of thoughts into head; commonly referred to as thought insertion and when present is considered my many psychiatrists to be a symptom of schizophrenia
39
Q

Schizophrenia Reading III

A
  • alterations of senses can be terrifying-over acuteness leads to cacophony in brain–>scary
  • earliest stage of disease, before over acuteness too severe may be pleasent experience
  • peak experiences: initial days of development-heightened awareness; such experiences are also common in manic-depressive illness and in getting high on drugs
  • many patients interpret such experiences within a religious framework and believe they are being touched by god-excessive religious preoccupation listed as common early sign of schizophrenia
  • one sensation that may be blunted is pain (infrequent)
  • fundamental defect in schizophrenia is frequent inability to sort, interpret, and respond-more than just thoughts; visual and auditory stimuli, emotions, and some actions missarranged in exactly same way as thoughts; brain defect is probably similar for all
  • impairments in visual interpretation that that some persons with schizophrenia misidentify someone and say he or she looks like someone else
40
Q

Schizophrenia Reading IV

A
  • many persons with schizophrenia have difficulty putting visual and auditory stimuli together
  • difficulties in watching TV/movies very typical-some may sit in front and watch visual motion but few can tell you what’s going on (all levels of intelligence and education)
  • switchboard operation in brain includes hooking up stimuli with proper responses to be sent back outside
  • inability to interpret and respond appropriately is also at core of patients’ difficulties in relating to other people-many prefer to spend time by themselves, withdrawn, communicating with others as little as possible
  • may be relatively few underlying brain deficits leading to the broad range of symptoms the disease of schizophrenia comprises
  • schizophrenia thought patterns-disconnectedness, loosening of associations, concreteness, impairment of logic, thought blocking, and ambivalence
41
Q

Schizophrenia Reading-Concreteness and Blocking of Thoughts

A
  • meaning of proverbs which require an ability to abstract, to move from specific to the general
  • frequently loses ability to abstract
  • can also occur during everyday life
  • person is thinking or starting to respond to respond and then stops, often in mid-sentence and looks blank for a brief period
42
Q

Schizophrenia Reading V

A
  • an impairment of ability to think logically is another facet of thinking characteristic of schizophrenia-difficulty with daily activities (taking bus, following directions of planning meals); also explains fantastic ideas that some patients offer as facts
  • impairments may be vague in beginning of disorder but become distinct as it progresses
  • ability to make a decision has been impaired: brain initiates action but then countermands it with the opposite
  • always on alert for confirmatory evidence to support beliefs; always find it from among myriad visual and auditory stimuli perceived by all of us each day
  • common delusion: can control other people’s minds
  • common delusion: broadcasting-one’s thoughts are radiating out of one’s head and being broadcast over radio or TV
43
Q

Schizophrenia Reading-Thought Withdrawal and Ambivalence

A
  • 95% of all patients-thoughts being taken out of head
  • unable to resolve contradictory thoughts or feelings, holding opposites in minds simultaneously “yes they’re going to kill me and I love them”
44
Q

Schizophrenia Reading-hallucinations on a spectrum

A
  • one end over acuteness of vision-lights too bright, colors take on more brilliant hue
  • middle of spectrum gross distortions of visual stimuli (illusions)
  • far end seeing things that aren’t there-true hallucination
  • disease process selectivity affects auditory centers in the brain thereby producing auditory hallucinations
  • when only visual hallucinations appear it is unlikely schizophrenia is the cause (often appear in conjunction with auditory)
45
Q

Schizophrenia Reading-Alterations of Self

A
  • may range from somatic perceptual distortions to confusion in distinguishing oneself from another person
  • patients body parts may develop lives of their own, as if they become disassociated and detached
  • confusion regarding where her body stopped and rest of the world began
46
Q

Schizophrenia Reading-Changes in Emotions

A
  • early stages: depression, guilt, fear, rapidly fluctuating emotions
  • later stages: flattening of emotions; appear unable to feel emotions at all-makes it difficult to relate to them
  • retention of feelings and emotions is sharpest dividing line between schizophrenia and bipolar-if exaggerated feelings retained most likely bipolar
  • characteristic emotions are flattened or inappropriate
47
Q

Schizophrenia Reading-Changes in Behavior

A
  • usually secondary rather than primary symptoms of schizophrenia
  • withdrawing, remaining quietly in one place for long periods and immobility are common
  • mutism can also happen
  • slowing in movement may happen to slow down incoming sensory stimuli so the brain can sort them
  • movements may also be slowed so as to allow them to be integrated into a whole in exactly the same way that visual and auditory stimuli may need to be integrated
  • certain gestures may be repeated often for logical reasons to the person but bizarre ot onlooker
  • echolalia: repeat like a parrot whatever is said to them
  • many have dysregulation of body temp
48
Q

Self-Measuring-Ruler

A

-must use malfunctioning brain to assess the malfunction of your brain

Abnormal Psychology P-324 (5 decks)

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