Exam 5 Flashcards
1
Q
Schizophrenia Treatment: Lobotomy
A
- connection severed between frontal lobes, rest brain: primary side effect decrease in functioning, IQ
- popular until development of antipsychotic meds (50s)
2
Q
Schizophrenia Treatment: Antipsychotic Meds
A
- thorazine
- blocks dopamine: decreases levels of available dopamine
- reduce severity of positive symptoms (typically cause the most grief) not negative symptoms
- decrease violent behavior, calming effect
- 30% do not benefit; 40% poor compliance (don’t take meds)–>works for 70% (insight should return if meds start working
- why wouldn’t they take their meds? delusions (persecution); no insight when theyre actively psychotic-don’t think they have a problem, why would they need them; sometimes you forget; you think you’re better; unstable lives-chaos in environment
3
Q
Side Effects of Antipsychotic Meds
A
- extrapyramidal (dysfunctions=nerves descending from brain to spinal motor neurons)
- resemble parkinson’s disease; affects motor movement
- tremors; shuffling gait; drooling; dyskinesia (abnormal motion of voluntary, involuntary muscles)
4
Q
Schizophrenia Treatment: Atypical Antipsychotics
A
- treat both positive and negative symptoms in addition to dopamine affect
- Haldol
- serotonin receptors: frontal lobes
- those resistant to traditional meds, increase cognitive functioning
- fewer motor side effects
- compliance still poor
- side effects: weight gain
5
Q
Somatic Delusion/Hallucination
A
- he keeps touching his hair, maybe thinks something is there
- woman believes sisters and nurses are sucking her dry; literally sucking her insides out: if she actually feels it (and she does) that’s a hallucination
6
Q
Personality Disorders: Extreme Versions of Personality Traits
A
- stable enduring patterns of behavior, thinking and perception
- occur across situations and lifelong
- when it comes to personality disorders we do not give children (under 18) these diagnoses (problems that are normal developmental occurrences for kids can be problematic for adults)
7
Q
Diagnosis of Personality Disorders
A
- diagnostic interviews: talking to therapist directly and therapist is asking questions
- personality inventories: pen and paper tests where you’re answering questionnaires
- may depend on which personality disorder you have that determines which may be better suited-they’re equal in terms of effectiveness/methodology
8
Q
General Criteria for Personality Disorders
A
- inflexible and maladaptive-think you’re doing something good for yourself but you’re really screwing yourself over-cutting off your nose to spite your face; difficult for person to change
- causes significant functional impairment (all areas of life-school, work, relationships with other people)
- causes significant subjective distress (exception ASPD)
9
Q
Features of Personality Disorders
A
- over half diagnosed have 2 PDs; share characteristics
- individuals rarely seek treatment
- no effective treatment for most PDs
- 10-13% of population; 20% of college students (were overrepresented in one personality disorder)
10
Q
DSM 3 Clusters
A
- Odd or Eccentric
- Dramatic, Emotional, Erratic
- Anxious or Fearful
11
Q
Schizoid
A
- detachment from social relationships
- asocial=avoid interactions, activities that involve others (don’t like being with other people)
- appears cold/aloof; restricted range of emotions
12
Q
Paranoid
A
- a lot like persecution but no delusions or hallucinations
- excessively mistrustful and suspicious of others without justification
- belief that others are lying, cheating
- emotional detachment and hostility (think you’re trying to rip them off)
13
Q
Schizotypal
A
- closest to schizophrenia
- socially isolated, excessive social anxiety-want to be with others but have high social anxiety
- odd behaviors=speech and affect
- unusual beliefs, magical thinking (not to the point of delusions)
- genetically related to schizophrenia, episodes not as frequent, intense
14
Q
Antisocial Personality Disorder
A
could make you a good criminal or CEO-most common treatment is jail-no good treatment for this; sometimes age out of it while in jail
- pervasive (ongoing) disregard for the law and rights of others
- tendency to lie, steal, not fulfill responsibilities
- lack of empathy (feel others pain-share with narcissism), remorse (don’t feel sorry)
- impulsive and entitled (feel like you deserve it because you’re awesome-shares with narcissism)
- primarily male: aggressive
15
Q
Genetic Causes ASPD
A
- impulsivity: doesn’t think before acting
- cortical under-arousal: seeks stimulation (not necessarily a bad thing-depends how it’s channeled)
- weak behavioral inhibition system (BIS-tells you to stop doing something when you’re going to get in trouble): don’t stop when facing punishment
16
Q
Environmental Causes ASPD
A
- antisocial parents: inattentive, coercive and inconsistent discipline
- deviant peers, violent community
17
Q
Borderline Personality Disorder
A
- not psychotic
- unstable, distorted sense of self
- difficulty regulating emotions-feels things very intensely and can’t seem to regulate things how she needs to (Becky got in physical fight with mom-scratching, clawing, breaking dishes, throws a chocolate cake, threatens to slit wrists all because her mom said no to going out with her friend)
- feel damaged, worthless (overlap with depression)
- love-hate relationship, idealize–>wants to be with others (don’t want to hurt you/work against you); anger, impulsivity, frequent mood swings=push others away (not in an asocial manner); may start to panic that they’re being left or neglected which may result in more intense reaction that drives people away (analogous to a lifeguard being drowned by the person they’re trying to save)
- idealize you and then when you disappoint them they react very negatively-often “live” at these extremes; fear of abandonment
- impulsive, risky behavior: often engage in suicidal or self-injurious behavior-other possible reasons than trying to end your life
- primarily female
18
Q
Reasons For Self-Injurious Behavior
A
- cathartic-a way to feel your emotions if you were not previously
- control-a way to get back into control
- makes them feel alive
- punishment
- communication-way to nonverbally let people know you’re not okay
19
Q
Treatment for Borderline Personality Disorder
A
- DBT: form of CBD
- first focus on feelings currently; lot of focus on emotional dysregulation
- coping strategies to deal with emotions
- emotions aren’t reality–>emotional stability
- very intensive therapy; lots of homework and regular sessions and therapist is often available 24 hours
20
Q
Causes of BPD
A
- biological=genetic link to mood disorders (depression)
- environmental=abuse, trauma during childhood
21
Q
Histrionic Personality Disorder
A
- pattern of excessive emotional expression and attention-seeking
- excessive need for approval
- inappropriately seductive (want people to fall in love with them)
- rapidly shifting emotions, very dramatic, theatrical (everything they feel they feel so strongly)
- primarily female
22
Q
Narcissistic Personality Disorder
A
- grandiose, extremely exaggerated sense of self-importance
- lacks empathy for others, but needs constant admiration from them (but won’t give any back)
- entitled, arrogant, jealous
- causes: did parents spoil and not teach empathy-if you spoil your kids, the rest of the world won’t and they’ll just end up being assholes to you
23
Q
Obsessive-Compulsive Personality Disorder
A
- to a moderate degree can be helpful
- no obsessions or compulsive behaviors
- fixated on things being done “the right way” (rigid)
- perfectionist, controlling
- can be useful as a college student: always get assignments done, always want to do the best
24
Q
George-ASPD
A
- disregard for law because he’s a drug dealer
- said he put a gun to his father’s head and hit his mother-seemed like he was bragging=no remorse
- said he didn’t care about his family
- people lie so have to take some of what he says with a grain of salt
- said he didn’t have any feelings for anybody-lacks empathy
- said he lied all the time and stoel all the time-disregard for other people’s rights and property (steals dad’s knives and his mom’s valuable comic books for money)
- loves animals, would never do anything to animals but would to humans
- beat a guy up because he talked to george
- says he would never sexually assault a woman (he has sisters, says he respects women); yet he went to jail for assaulting a woman-she got in his face
- compared himself to a bomb and when he blows up he will probably hurt a lot of people-said he’s not going out without taking anyone with him
25
Conduct Disorder
- diagnosis for kids under age of 17/18
| - basically baby ASPD
26
Becky
- wants to be close to people but when she loses track of them in a store or something she attacks them when she finds them again
- presents herself differently in public vs. private and perceives it in a way that she doesn't know who she is; thinks other people may idealize her like she does them and that she will let them down=unstable sense of self
27
Historical Classification of Dissociative and Somatoform Disorders
- hysterical neurosis (Freud)
- hysterical: dramatic behavior characteristic of women, including physical symptoms without a discernible physical cause
- neurosis: anxiety that results from underlying unconscious conflicts
28
Common Feature of Both Disorders
- underlying (not actively aware of it) anxiety
- differs from anxiety disorders=person directly and consciously experiences the anxiety
- anxiety is inferred
- symptoms=escaping anxiety without being (consciously) aware of it=anxiety changed into symptom-->somatoform disorders: through physical symptoms (no organic physical cause); dissociative disorders: more extreme escape=split off memory of anxiety-provoking stimulus from consciousness (idea that some sort of trauma has occurred)
29
Dissociative Experience
-slight detachment in consciousness or identity
30
Dissociative Disorders
- disturbances in-identity, memory, consciousness (awareness), perception of environment
- don't just forget anxiety=forget self, life, personality
- assumed: precipitated by extremely traumatic conflict/event
31
Depersonalization Disorder
-persistent or recurring feeling of being detached from one's body or mental processes and by a feeling of being an outside observer of one's life
32
Dissociative Amnesia
- a pervasive (ongoing) loss of memory of significant personal information (name, birthday, family)-no physical cause
- organic amnesia is different and usually happens from physical injury
33
Dissociative Fugue:
- one or more episodes of sudden, unexpected, purposeful travel from home, during which a person can't remember some or all of their past life
- "amnesia with feet"
34
Dissociative Identity Disorder
- anxiety comes out in the form of different personalities
- split is more severe; splitting from yourself
- must have at least two separate personalities (one being the core personality and one that is easily distinguished from yourself by people around you)
- other personalities may: be different genders, ages, have different abilities or characteristics, and they may or may not know each other
- three things in common (almost always women diagnosed) in most people who are diagnosed: early abuse (no control over your environment so you do you survive-escape mentally to get away; become someone else-in DID this may be what is still happening; creating a new person when under stress as an adult is not an adaptive response); being highly suggestive; most also have borderline PD-unstable sense of self makes you more likely that when you experience different parts of yourself to see it as a different personality
35
Therapy For DID
- made it worse first: new personalities created under hypnosis-therapist got excited and reinforced her by giving her attention
- made it better: second therapids ignored the other personalities and only reinforced her for being Chris
36
Two Other Disorders in Which Derealization Happens
- schizophrenia
| - panic attacks
37
Parents Forgetting Children
- often because they're doing other things or it's something new in their routine (normally takes child to daycare, but this morning she stopped to get donuts for the office and then went straight to the office without the baby), out of routine (highly educated individuals) more likely to make mistake-->on autopiloit
- happening more often than it used to because of backward facing car seats being used until age of 2 (used to be younger) you can't see their face and they're often sleeping so when you look back you don't see the child
- out of routine as well which leads to increased infant Death
38
Chris
- 22 different personalities that she experienced over a period of 40 years
- attacks could be painful without hypnosis (headache, red face, dark period before the next would come out-said personalities were scared of this dark period because they thought they might get stuck there forever
- some would only emerge for hours and some would stay for weeks or months; she would wake up and not remember what happened (core Chris returned and didn’t remember what happened when she was someone else)
- some personalities didn’t know the others existed or what they did
- each personality had very strong traits (purple lady only wore purple; strawberry girl only ate strawberries and was kind of wild)
- alters were in competition with each other-each wanted to be the survivor and live as the main personality
- alters had different physical traits: purple lady had arthritis but none of the others had it and she doesn’t have it today (somatoform symptoms-no physical causes for physical symptoms)
- switching seems to happen when Chris is in stressful situations
- “Personalities you seem to encounter are rather two dimensional”
- seems that there must be some level of awareness-eve black stepped in when eve white tried to slit her wrists.
39
Lucy
- NP that delivers babies and has never switched at work
- how is she able to contain it at work when work is so stressful?
- also doesn't do it in front of her children
- higher level of control
