exam 6 (last one thank EVERYTHING) Flashcards
(151 cards)
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.
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modern perspective on mental disorders
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based on the medical model––DSM
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disorder
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common set of signs and symptoms
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disease
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underlying pathological process affecting the body
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etiology
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pattern of causes for that illness
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diagnosis
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decision: present or not?
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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
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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
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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
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diathesis
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a predispositional vulnerability
14
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Anxiety disorders
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overarching DSM category. has: generalized anxiety disorder, phobic disorder, panic disorder, agoraphobia
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Q
everyday “normal” anxiety
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psychological and physiological response to stress. adaptive and evolutionary.
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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
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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
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social phobia
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fear of being publicly humiliated/embarrassed.
18
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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
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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
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etiology of generalized anxiety disorder
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modest level of heritability, neurotransmitter GABA, and stress of anxiety provoking situations
22
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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
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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
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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
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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
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DSM Category: Mood Disorders
includes: major depressive disorder, dysthymia/persistent depressive disorder, double depression, seasonal affective disorder
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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.
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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
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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).
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depersonalization
state of feeling disconnected from your body, feelings, and environment. like you're just watching everything happen instead of living it.
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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.
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etiology of bipolar disorders
highest rate of genetic heritability (polygenic, pleiotropic)
neurotransmitters: serotonin and dopamine
stressful life events
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polygenic
interaction of multiple genes to create the symptoms
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plieotropic
single gene susceptibility to develop disorder.
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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
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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?
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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.
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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
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anxious/inhibited cluster
-avoidant
-dependent
-obsessive-compulsive
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avoidant
easily hurt, few close friends, like routine, avoid new things, hypersensitive
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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
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etiology of personality disorders
least understood
biologically: family history
environmentally: unstable/chaotic childhood family life. physical, sexual, and emotional abuse/neglect.
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DSM Category: Dissociative Identity Disorders
typical symptoms: significant memory loss, depersonalization, derealization, depression, anxiety, suicidality, lack of self identity/identity confusion/alteration
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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
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dissociative amnesia
loss of memory, fugue state.
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fugue state
people become confused about identity, move away, assume new identity. can last mins/days/years
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depersonalization disorder
either or together: depersonalization and derealization
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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.
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etiology of Dissociative Identity Disorders
(childhood) trauma that is long term, repetitive, and overwhelming.
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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
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positive symptoms
adding more than normal. delusions, hallucinations, disorganized speech, grossly disorganized behavior, catatonic behavior.
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delusions
false beliefs about the nature of reality. no basis in reality.
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hallucinations
auditory, visual, smelling, tactile
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disorganized speech
no lack of fluency, but rhyming (clan association) and no sense.
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grossly disorganized behavior
inappropriate behavior for situation
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catatonic behavior
stupor, decrease in motor activity, hyperactivity
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negative symptoms
(more typically male, harder to treat)
normal things not present. emotional and social withdrawal. avolition, alogia
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avolition
extreme form of apathy, not engaging with anything
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alogia
reduced verbal fluency and output
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cognitive symptoms
(harder to diagnose)
disorganized/slow thinking, deficits in attention and working memory, difficulty understanding, poor concentration, poor memory
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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)
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barriers to treatment
attitudinal/belief barriers
structural barriers
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attitudinal/belief barriers
i should be able to deal with this on my own ... it's not severe ... treatment is ineffective ... perceived stigma
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structural barriers
expense ... lack of doctors ... inconvenience of attending ... lack of transportation
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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
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insight
personality structure, ego functioning
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transference
looking for evidence that client transfers issues from their life onto therapist
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counter transference
therapist putting their issues onto the client
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resistence
therapist analyses a client's resistance to confrontation and interpretation
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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
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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
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exposure response prevention
for OCD exposes you to anxiety (obsession) provoking stimulus and prevents compulsions
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systematic desensitization
treating a phobia. exposure technique.
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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
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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
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ABC model
A: activating event
B: beliefs about the event that happened
C: consequence–emotional response to belief
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3 forms of acceptance
-unconditional self acceptance
-unconditional other acceptance
-unconditional life acceptance
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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
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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
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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
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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
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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)
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Systems Perspective/Approaches to Treatment
understands psychotherapy in the context of dysfunctional social groups
key issue: homeostasis, social units
family systems approach
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family systems approach
focuses on:
-subsystems/hierarchies: marital, parental, sibling
-communication patterns
-boundaries (disengaged or enmeshed)
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Psychopharmacology
big unknown, intervention-causation fallacy
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antipsychotic medications
used for schizophrenia + related disorders
-traditional: thorazine, haldol
-new: clozapine, resperidone
side effects: Tardive dyskinesia
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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
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new/atypical antipsychotics
clopazine, resperidone
dopamine and serotonin
-effective on positive symptoms and fairly affective for negative as well
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Tardive dyskinesia
head/neck twitching, lip smacking. from long-term anti-psychotic use.
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Anxiety medications
benzodiazepines
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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
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psychopathology
sickness or disorder of the mind
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moral treatment
first benevolent treatment of those with mental illness. involved close contact with and careful observation of patients.
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maladaptive
a behavior is maladaptive when it interferes with the person's ability to respond to situations
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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.
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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.
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family systems model
proposes that a person's behavior must be considered within their social/familial context
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sociocultural model
views psychopathology as the result of the interaction between individuals and their cultures
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internalizing disorders
characterized by negative emotions
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externalizing disorders
characterized by impulsive or out of control behavior
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Antidepressant medications
MAOIs, tricyclics, SSRIs, SNRIs
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Monomine oxidase inhibitors (MAOIs)
MO is an enzyme that breaks down serotonin, norepinephrine, and dopamine. so this drug inhibits that.
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tricyclics
reuptake inhibitor of serotonin, norepinephrine
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tricyclics+MAOI side effects
strong side effects. high blood pressure, constipation and difficulty urinating, blurred vision, racing heart
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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
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serotonin and norepinephrine reuptake inhibitor (SNRIs)
reuptake inhibitor of serotonin and norepinephrine. effective for depression. fewer side effects than MAOI's and tricyclics.
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meds & bipolar disorder
antidepressants trigger manic episodes. mood stabilizers suppress the mood swings. lithium is traditional drug
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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.
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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
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treppany
ancient practice of drilling a hole in the skull (doesn't work to cure mental illness)
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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.
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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)
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anterior capsulotomy
modern version of lobotomy used for treating OCD. disrupts the pathway between the caudate nucleus and the putamen.
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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
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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
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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)
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common features for effective psychotherapy
insight (intellectual and emotional), quality of relationship with therapist, value of emotional expression, development of self-confidence
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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
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protective factors
prevent children from being affected by childhood stress, such as warm and nurturing parents, and other positive memories
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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
