exam 6 (last one thank EVERYTHING) Flashcards
1
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Mental Disorders
A
problematic patterns of thinking, feeling, and behaving that disrupt an individual’s sense of well being and social and occupational functioning.
2
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modern perspective on mental disorders
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based on the medical model––DSM
3
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disorder
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common set of signs and symptoms
4
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disease
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underlying pathological process affecting the body
5
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etiology
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pattern of causes for that illness
6
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diagnosis
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decision: present or not?
7
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prognosis
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typical course over time. how it will respond to treatment.
8
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comorbidity
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co-ocurrence of particular disorders
9
Q
DSM-V (diagnostic and statistical manual 5)
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guidelines for diagnosing the presence and severity of mental illnesses.
provides: symptomlogy, threshold and criteria to make a diagnosis, distinguishing characteristics, and the prognoses.
10
Q
intervention-causation fallacy
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the belief that because we intervene and symptoms recede we know the cause of the disease… but we actually do not. we don’t even cure the illness.
11
Q
biopsychosocial perspective
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integrates biological/genetic/neurological influences, psychological influences, and environmental influences
12
Q
diathesis-stress model
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a psychological theory that attempts to explain a disorder, or its trajectory, as the result of an interaction between a predispositional vulnerability, the diathesis, and stress caused by life experiences.
13
Q
diathesis
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a predispositional vulnerability
14
Q
Anxiety disorders
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overarching DSM category. has: generalized anxiety disorder, phobic disorder, panic disorder, agoraphobia
15
Q
everyday “normal” anxiety
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psychological and physiological response to stress. adaptive and evolutionary.
16
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anxiety is pathological when
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extreme duration and severity, disproportionate to real-life events, and occurs even in absence of precipitating event.
17
Q
phobic disorder
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persistent, excessive, irrational fear and avoidance of specific objects, activities, or situations. specific phobias include animals, environments, situations, and more.
18
Q
etiology of phobic disorders
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preparedness theory–evolutional
temperament based
conditioning–e.g. little albert
18
Q
social phobia
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fear of being publicly humiliated/embarrassed.
18
Q
Panic disorder
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sudden occurrence of multiple physiological and psychological symptoms producing a feeling of terror.
acute symptoms: shortness of breath, palpitations, sweating, dizziness, depersonalization, derealization, fear. symptoms are short lived.
DSM requires: recurrent, unexpected panic attacks, dread/anxiety about future attacks
19
Q
agoraphobia
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fear of public spaces. often a comorbidity of panic disorder.
20
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generalized anxiety disorder
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chronic excessive generalized anxiety without a precipitating cause.
need at least 3 of: restlessness, fatigue, concentration problems, irritability, sleep disturbance, muscle tension
21
Q
etiology of generalized anxiety disorder
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modest level of heritability, neurotransmitter GABA, and stress of anxiety provoking situations
22
Q
shared causal components of anxiety disorders
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psychological: personality, coping styles, intellectual functioning
situational: negative life events, social learning
biological: heritability, genetics, neurotransmitters, sensitivity to chemicals
23
Obsessive Compulsive Disorder (own DSM Category)
two components: obsessions, compulsions
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obsessions
frequent, repetitive intrusive thoughts. anxiety provoking.
examples: moral concerns, contamination
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compulsions
ritualistic behaviors/actions designed to fend off the obsessive thoughts and help the anxiety
examples: checking, ordering
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etiology of OCD
preparedness theory
genetic heritability
brain circuitry involved in habitual behavior
27
Post Traumatic Stress Disorder (own DSM category)
chronic physiological arousal, recurrent unwanted thoughts or images of the trauma, and avoidance of things that call the event to mind.
symptoms: flashbacks, exaggerated anxiety and reactions, medical conditions
28
etiology of PTSD
trauma, increased amygdala activity, reduced activity in medial prefrontal cortex, smaller hippocampus
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medial prefrontal cortex
involved in calming fear and trauma
30
DSM Category: Mood Disorders
includes: major depressive disorder, dysthymia/persistent depressive disorder, double depression, seasonal affective disorder
31
major depressive disorder
severely depressed mood and anhedonia with some combination of: feeling worthless, lethargy, appetite/weight changes, sleep disturbance, energy loss, concentration issues, guilt, thoughts of death/suicide.
need to be like this for 2 or more weeks.
32
dysthymia/persistent depressive disorder
same symptoms as MDD, but mild to moderate severity. present most of the day, most days, more often than not for two years or longer
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double depression
mixture of MDD and dysthymia: dysthymia with periods of major depression
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seasonal affective disorder (SAD)
seasonal depression
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etiology of depressive disorders
situational components: life stressors
cognitive/behavioral components: negative cognitions (internal, stable, global), interpersonal interactions
biological components: genetics, neurotransmitters (norepinephrine, serotonin), neural structures, biological rhythms
36
DSM Category: Bipolar Disorders
alternating episodes of depression and mania
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bipolar I
severe depression indistinguishable from MDD. periods of mania. ongoing for one or more weeks.
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mania
elevated, expansive, irritable mood with increased activity level, grandiose ideas, reckless behavior, lack of sleep. psychotic features could also occur (hallucination/delusion).
39
depersonalization
state of feeling disconnected from your body, feelings, and environment. like you're just watching everything happen instead of living it.
40
derealization
a state of feeling like the world is unreal or strange. It's a type of dissociation, which is a disconnection between your body, thoughts, and sense of self
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bipolar II
severe depression just like MDD but there's hypomania.
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hypomania
a lower level of mania, not as extreme as a full blown manic episode
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cyclothymia
dysthymia and hypomania
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rapid recycling bipolar disorder
four or more swings between depression and mania in one year.
45
etiology of bipolar disorders
highest rate of genetic heritability (polygenic, pleiotropic)
neurotransmitters: serotonin and dopamine
stressful life events
46
polygenic
interaction of multiple genes to create the symptoms
47
plieotropic
single gene susceptibility to develop disorder.
48
DSM Category: Personality Disorders
consistently inflexible and maladaptive pattens of thinking, feeling, and behaving or controlling impulses that:
-deviate from cultural norms
-cause distress
-impair social and occupational functioning
have four defining features:
-distorted thought patterns
-problematic emotional responses
-over/under regulated impulse control
-interpersonal difficulties
49
why personality disorders are controversial
-are they just unpleasant people, or are they actually people with mental illnesses?
-are these distinct types of disorders or just extremes of the big 5?
50
odd/eccentric cluster
dominated by distorted thinking
-paranoid
-schizoid
-schizotypal
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paranoid
guarded, suspicious, hold grudges
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schizoid
socially isolated, restricted emotional expression, cold + detached, no desire for social interaction
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schizotypal
strange thoughts, emotionally detached, uncomfortable in social situations
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dramatic/erratic cluster
impulse control and emotional regulation problems
-antisocial
-borderline
-histrionic
-narcissistic
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antisocial
manipulative, exploitative, dishonest, not guilty, break social rules, higher males than females. criminals. sometimes confused with psychopathy, which is a very extreme form of this
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borderline
labile, moods shift rapidly, impulse control issues, polarized world view. seem to lack a strong sense of self.
57
histrionic
attention seeking, seductive behavior, highly emotional, need to be center of attention, need approval of others
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narcissistic
envious, need to be the center of attention, entitled, problems with self worth, lack empathy, exploitative
59
anxious/inhibited cluster
-avoidant
-dependent
-obsessive-compulsive
60
avoidant
easily hurt, few close friends, like routine, avoid new things, hypersensitive
61
dependent
need others to make choices, clingy, needy, fears being abandoned
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obsessive-compulsive (personality)
perfectionistic, indecisive, preoccupied with details, can't express affection
63
etiology of personality disorders
least understood
biologically: family history
environmentally: unstable/chaotic childhood family life. physical, sexual, and emotional abuse/neglect.
64
DSM Category: Dissociative Identity Disorders
typical symptoms: significant memory loss, depersonalization, derealization, depression, anxiety, suicidality, lack of self identity/identity confusion/alteration
65
dissociation
change in memory and attention–loss of memory.
pathological when: an involuntary escape from reality characterized by a disconnection between thoughts, identity, consciousness, and memory
66
dissociative amnesia
loss of memory, fugue state.
67
fugue state
people become confused about identity, move away, assume new identity. can last mins/days/years
68
depersonalization disorder
either or together: depersonalization and derealization
69
dissociative identity disorder
(previously multiple personality disorder)
2 or more distinct personalities, each with changes in behavior, memory, thinking.
usually there's a dominant personality, and personalities don't know each other. ongoing memory gaps. very rare.
physiological evidence: diff parts of brain active with diff personalities. diff personality responses to allergens.
70
etiology of Dissociative Identity Disorders
(childhood) trauma that is long term, repetitive, and overwhelming.
71
Schizophrenia (own DSM category)
psychotic disorder, affects personality, thoughts, behavior. chronic and profound.
3 categories of symptoms: positive, negative, cognitive
for diagnosis: 2 or more symptoms, continuous period of at least 1 month, persistent signs for at least 6 months
age of onset: 16-25 overall, 18-25 males, 25-30, 40 women
72
positive symptoms
adding more than normal. delusions, hallucinations, disorganized speech, grossly disorganized behavior, catatonic behavior.
73
delusions
false beliefs about the nature of reality. no basis in reality.
74
hallucinations
auditory, visual, smelling, tactile
75
disorganized speech
no lack of fluency, but rhyming (clan association) and no sense.
76
grossly disorganized behavior
inappropriate behavior for situation
77
catatonic behavior
stupor, decrease in motor activity, hyperactivity
78
negative symptoms
(more typically male, harder to treat)
normal things not present. emotional and social withdrawal. avolition, alogia
79
avolition
extreme form of apathy, not engaging with anything
80
alogia
reduced verbal fluency and output
81
cognitive symptoms
(harder to diagnose)
disorganized/slow thinking, deficits in attention and working memory, difficulty understanding, poor concentration, poor memory
82
etiology of schizophrenia
genetic:
-closer relationship to someone diagnosed, higher genetic chance
neuroanatomy:
-structural differences in temporal and frontal lobes (25% less gray matter.
-brain activation levels are lower in medial frontal cortex and interior parietal cortex
neurochemicals:
-dopamine sensitivity (too much or too high sensitivity)
environmental:
-exposure to viruses, malnutrition in utero, birth problems, psychosocial factors (drug abuse)
83
barriers to treatment
attitudinal/belief barriers
structural barriers
84
attitudinal/belief barriers
i should be able to deal with this on my own ... it's not severe ... treatment is ineffective ... perceived stigma
85
structural barriers
expense ... lack of doctors ... inconvenience of attending ... lack of transportation
86
psychoanalysis treatments
not solving particular problems, but dealing with life as a whole. freudian foundation.
role of unconscious, childhood experiences, insight, object relations
client-therapist relationship is critical
87
insight
personality structure, ego functioning
88
transference
looking for evidence that client transfers issues from their life onto therapist
89
counter transference
therapist putting their issues onto the client
90
resistence
therapist analyses a client's resistance to confrontation and interpretation
91
interpersonal psychotherapy (IPT)
clients talk about their interpersonal behaviors and feelings. focus on improving current relationships to improve interpersonal functioning.
as compared to psychodynamic: fewer sessions, focus on present relationships, don't accept ALL of freud.
critical issue: developing insight; intellectual/emotional
92
Behavioral approaches to treatment
treatment based on learning theory: behavioral analysis (what triggers issues, conditions under which symptoms arise)
utilizes operant conditioning (reward/punishment).
reducing unwanted emotional responses using exposure techniques
93
exposure response prevention
for OCD exposes you to anxiety (obsession) provoking stimulus and prevents compulsions
94
systematic desensitization
treating a phobia. exposure technique.
95
cognitive approaches
psychopathology understood as a function of dysfunctional thinking
-low self efficacy, negative self virtues
utilizes cognitive restructuring, focusing on:
-irrational beliefs, maladaptive cognitive processes, automatic beliefs/assumptions
-replaces negative thinking with more positive/realistic thinking
-by considering the evidence for the negative irrational thoughts
96
rational emotive therapy (Ellis)
aka rational emotive behavioral therapy
-negative emotions are the result of interpretation of the event (cognitive restructuring)
-ABC model
-3 forms of acceptance
97
ABC model
A: activating event
B: beliefs about the event that happened
C: consequence–emotional response to belief
98
3 forms of acceptance
-unconditional self acceptance
-unconditional other acceptance
-unconditional life acceptance
99
cognitive distortion theory (Beck)
cognitive distortions:
-biased/exaggerated thought patterns+beliefs
-irrational and misrepresent reality
-promote negative thinking
examples:
-polarized thinking, overgeneralization, focusing solely on negative info, disqualifying positive info, catastrophizing
Focus: becoming aware/conscious of these, identifying them and challenging them with evidence
100
Cognitive-Behavioral Therapy
most common therapy in USA.
acknowledges:
-there are behaviors that clients cannot control with rational thought
-but there are also ways in which rational thought can be helpful
-combines behavioral and cognitive techniques
is:
-problem focused, action oriented, transparent
effective for:
-depression, GAD, panic disorder, social phobia, PTSD, childhood anxiety/depression
101
Humanistic + Existential Approaches to treatment
understanding of human nature: active agent subjects, fundamentally positive
root of psychological problems is: feelings of loneliness, meaninglessness, alienation due to failure to reach potential
102
Person-Centered Approach (Carl Rogers)
true self + tendency toward growth
conditions of worth (false self)
therapists role is to provide honesty (congruence), empathy, and unconditional positive regard
103
Gestalt Therapy (Fritz Perls)
focus on client's thoughts, behaviors, and experiences and the ownership/responsibility of those.
therapists role is yo be encouraging and warm
techniques are focusing, putting emotions into action (role playing) (empty chair technique)
104
Systems Perspective/Approaches to Treatment
understands psychotherapy in the context of dysfunctional social groups
key issue: homeostasis, social units
family systems approach
105
family systems approach
focuses on:
-subsystems/hierarchies: marital, parental, sibling
-communication patterns
-boundaries (disengaged or enmeshed)
106
Psychopharmacology
big unknown, intervention-causation fallacy
107
antipsychotic medications
used for schizophrenia + related disorders
-traditional: thorazine, haldol
-new: clozapine, resperidone
side effects: Tardive dyskinesia
108
traditional antipsychotic drugs (sedatives)
thorazine, haldol
they block dopamine receptors in meso-limbic pathways
-effective against positive symptoms
-ineffective against negative ones due to under-activity of dopamine or neuroanotomical deficits
109
new/atypical antipsychotics
clopazine, resperidone
dopamine and serotonin
-effective on positive symptoms and fairly affective for negative as well
110
Tardive dyskinesia
head/neck twitching, lip smacking. from long-term anti-psychotic use.
111
Anxiety medications
benzodiazepines
112
benzodiazepines
valium, xanax, ativan
-facilitate the action of GABA
potentially dangerous: highly addictive, tolerance builds up quickly, dangerous when mixed with alcohol
side effects: drowsiness, coordination loss, memory issues
113
psychopathology
sickness or disorder of the mind
114
moral treatment
first benevolent treatment of those with mental illness. involved close contact with and careful observation of patients.
115
maladaptive
a behavior is maladaptive when it interferes with the person's ability to respond to situations
116
Research Domain Criteria (RDoC)
defines basic domains of functioning (such as attention, social communication, anxiety) and considers them across multiple levels of analysis, from genes to brain systems to behavior.
meant to guide research rather than classify disorders for treatment.
117
assessment
examination of a person's cognitive, behavioral, or emotional functioning in order to diagnose possible psychological disorders. goal is to make a diagnosis so the person can be treated.
118
family systems model
proposes that a person's behavior must be considered within their social/familial context
119
sociocultural model
views psychopathology as the result of the interaction between individuals and their cultures
120
internalizing disorders
characterized by negative emotions
121
externalizing disorders
characterized by impulsive or out of control behavior
122
Antidepressant medications
MAOIs, tricyclics, SSRIs, SNRIs
123
Monomine oxidase inhibitors (MAOIs)
MO is an enzyme that breaks down serotonin, norepinephrine, and dopamine. so this drug inhibits that.
124
tricyclics
reuptake inhibitor of serotonin, norepinephrine
125
tricyclics+MAOI side effects
strong side effects. high blood pressure, constipation and difficulty urinating, blurred vision, racing heart
126
selective serotonin reuptake inhibitors (SSRIs)
reuptake inhibitor of serotonin. selective means it doesn't effect norepinephrine. effective for depression. fewer side effects than MAOI's and tricyclics
127
serotonin and norepinephrine reuptake inhibitor (SNRIs)
reuptake inhibitor of serotonin and norepinephrine. effective for depression. fewer side effects than MAOI's and tricyclics.
128
meds & bipolar disorder
antidepressants trigger manic episodes. mood stabilizers suppress the mood swings. lithium is traditional drug
129
lithium
metal used to treat bipolar disorder. potential long term kidney and thyroid problems. requires regular monitoring of blood levels because too much is poisonous.
130
Electrical convulsive therapy (ECT)
induce short seizures in the brain.
side effects: short term memory loss, headaches, muscle aches
highly effective temporarily for depression and bipolar disorder, more so than MAOIs or tricyclics.
131
Transcranial magnetic stimulation (TMS)
powerful pulsed magnet over left/right prefrontal cortex.
minimal side effects: mild headaches, small risk of seizures, NO impact on memory or concentration
as effective as ECTs
132
treppany
ancient practice of drilling a hole in the skull (doesn't work to cure mental illness)
133
prefrontal lobotomy
Moniz. sever connection between prefrontal lobes and inner brain structures. significant side effects: lethargy, child like behavior. there are effective modern versions, though.
134
cingulotomy
modern version of lobotomy used for treating OCD. is more targeted–brain tissue implicated in obsessions and compulsions is removed (part of corpus callosum and cingulate gyrus)
135
anterior capsulotomy
modern version of lobotomy used for treating OCD. disrupts the pathway between the caudate nucleus and the putamen.
136
deep brain stimulation
targeted electrical stimulation to specific brain areas implicated in disorders. effective for severe cases of OCD and depression, also the tremors associated with Parkinson's
137
placebo
substance/treatment with no known medical effect. a sugar pill, effectively.
138
placebo effect
improvement experienced when taking placebo. placebo effect increasing over time. effective in pain, nausea, asthma, phobias, depression, anxiety
139
causes of placebo effect
regression to the mean (mood disorders cyclical), confirmation bias/expectations (feeling better once diagnosed, for example), role of empathy and warmth (human connection)
140
common features for effective psychotherapy
insight (intellectual and emotional), quality of relationship with therapist, value of emotional expression, development of self-confidence
141
learned helplessness
A cognitive model of depression in which people feel unable to control events in their lives.
142
echolalia
schizophrenia symptom where, while in a catatonic state, a person mindlessly repeats words they hear
143
protective factors
prevent children from being affected by childhood stress, such as warm and nurturing parents, and other positive memories
144
interpersonal therapy
focuses on circumstances and relationships the client tries to avoid, kind of combines cognitive and psychodynamic
145
mindfulness-based cognitive therapy
based on mindfulness meditation, focuses on work with depression and preventing relapses
146
reflective listening
therapist repeats the clients concerns to ensure clarity
147
phototherapy
exposure to light to reduce symptoms of seasonal affective disorder (SAD/seasonal depression)
148
dialectical behavior therapy
combines elements of cognitive and behavioral therapy as well as mindfulness. treats personality disorders.
3 phases:
1. change extreme behaviors
2. explore past traumas
3. develop independence + self-respect
149
conduct disorder
a childhood disorder that can be a precursor for antisocial personality disorder
