Final Flashcards
Hippocrates
Imbalance of 4 body fluids (black bile, yellow bile, phlegm, and blood)
Byzantine physicians rationalize etiologies of mental illness
4th-15th century
Demon possession timeframe
16th century onward
Vincenzo Chiarugi
Reformer from Italy
Phillippe Pinel
Reformer from France- moral therapy (cure them)
William Turke
Reformer from England- Philanthropist who donated to moral therapy
Benjamin Rush
Reformer from USA, Father of American Psych, Seal of APA, used blood letting
Dorothea Dix
Reformer from USA- brought moral therapy to England, lobbied Congress
Most recent Diagnostic & Statistical Manual of Mental Disorders
DSM-5
How many disorders are mentioned in DSM-5
over 300
What is a mental disorder?
A syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning
Aspect of Abnormality: Distress/Disability
Egodystonia, disabled functioning, decreased autonomy
Aspect of Abnormality: Maladaptiveness
Actions hinder goal attainment, well-being
Aspect of Abnormality: Irrationality
Acts/talks in ways incomprehensible to others
Aspect of Abnormality: Unpredictability
Uncontrollable, erratic behavior
Aspect of Abnormality: Unconventionality/Statistical rarity
Behaviors violate standards of acceptability/desirability
Aspect of Abnormality: Observer discomfort
Others feel threatened/distressed because of behavior
Aspect of Abnormality: Violation of ideal/moral standards
Ex. Person is an atheist
Thomas Szasz
Book: The Myth of Mental Illness (1961)
Mental illness= a stigmatizing social construct
Once labelled “abnormal” the patient will conform to that label
David Rosenhan (1973)
8 pseudo patients faked being delusional to get into a psych hospital.
None were detected by staff as being “normal”
Range of stay 7-52 days. Avg=19 days
Advantages of experimental designs
Cause-effect established, control of extraneous variables
Disadvantages of experimental designs
Artificial, may not be practical
Symbol for correlation method
r
When is correlation method used
When experimental method is not ethical/practical
Disadvantage of correlation method
Cannot establish cause-effect, strength of relationship (high= 0.7 - 1.0)
Name the 4 psychometrics
Reliability, Validity, Content, Construct
MMPI, BDI, EDI, RSES, STA
Standard Testing
Types of Structure
unstructured, semi-structured, structured
Case Study
1 person, stereotyping, in depth
Disadvantage of Case Study
Generalizing to others in population is ill-advised
Mental Status Exam
Appearance/behavior Orientation Thought content/language Affect/mood Perceptual experiences Sense of self Motivation Cognitive Functioning Insight/judgment
Reliability
Does the test yield consistent scores
Validity
Does the test measure what it says it measures
CAT scan
X-rays measure density of brain structures
MRI
Radio waves cause H atoms in the brain to release energy -> computer image of brain
fMRI (functional)
Measures blood and O2 flow
Both structural and functional info
PET (Positron Emission)
Radioactive glucose injected into bloodstream
Glucose metabolism measured -> indicates level of neural activity
Differential Diagnosis #1
Rule out a substance-related etiology (drug abuse, meds, toxins)
Differential Diagnosis #2
Rule out etiology related to general medical condition
Differential Diagnosis #3
Determine specific primary disorder (If comorbidity -> establish principal diagnosis
Differential Diagnosis #4
Determine if adjustment disorder present
Differential Diagnosis #5
Establish boundary between mental disorder and no mental disorder (gray area)
Differential Diagnosis #6
Rule out factitious disorder or malingering (faking it)
Egodystonia
Symptoms are distressing/troubling to patient
Comorbidity
2+ diagnoses simultaneously present in a patient
Insight
Patient’s knowledge/understanding of the problem
Prognosis
Projected course of an illness
Etiology
Apparent course of an illness
Insanity
A legal term; describes a person determined to have a mental illness and/or is not “mentally competent” to stand trial
John Hinckley
Attempted assassination of Reagan
Dan Sickles
Congressmen who Shot and killed his wife’s lover in 1859. Acquitted because he claimed insanity. Rose to Major General, lost right leg, received medal of honor
Biopsychosocial Theory
Physical/mental wellness is a function of three interconnected factors:
Biological factors
Genetics, NS, diseases, viruses, tumors
Psychological factors
Coping styles, locus of control, cognitive appraisal
Social factors Support networks (e.g., family, friends), occupational settings, church
Psychoanalytic Theory
Sigmund Freud.
“The Unconscious”- Reservoir of instinctual drives,
storehouse of thoughts & wishes that are concealed from conscious awareness
Id
The Pleasure Principle- immediate gratification of needs; wish fulfillment. Biological drives
Ego
The Reality Principle- Mediates between Id’s demands and reality’s constraints. Conscious, rational, decision-making aspect.
Superego
The Conscience- Represents ideals, moral standards of society as conveyed to the child by his/her parents
Behavioral Theory
Operant Conditoning: Learning by way of reinforcement and punishment
Classical Cond: Forming associations between reflexive response and unrelated stiumuls
Modeling
Imitating the behavior of another
Cognitive-Behavioral Approach
Maladaptive behavior/illness stems from faulty belief sets/automatic thoughts -> poor decision-making -> dysfunctional behavior
Humanistic Approach
Abraham Maslow and Carl Rogers.
People are basically good, disorders arise from environmental stimulus that interfere w/ personal growth and fulfillment, conditions of worth, and unconditional positive regard
What is anxiety?
Increased arousal associated w/ generalized feelings of apprehension or fear
How many people experience symptoms of anxiety?
1 in 4
Generalized Anxiety Disorder
6+ months of persistent anxiety
More common in women (60%)
Panic Disorder
Moderate anxiety and recurrent unexpected panic attacks
More common in women (2:1 ratio)
ABC Reporter Dan Harris
Meds for panic disorder
benzodiazepines and antidepressants
Agoraphobia
Fear/anxiety in public transportation, being in open spaces, enclosed spaces, standing in line or being in a crowd, being outside the home alone; escape may be difficult/embarrassing. Females 2x more likely
Monophobia
Being outside the home alone
Specific Phobia
Fear persists for 6+ months.
TX: cognitive, behavioral
women 2x more likely
Obsessive-Compulsive Disorder
Characterized by seemingly unpreventable repetitious behaviors and/or recurrent modes of thought
Characteristics of Obsessions
Recurrent/persistent thoughts, urges, and/or images that are intrusive & unwanted
Other thoughts/actions adopted to suppress, ignore, or neutralize the thoughts
Person recognizes thoughts as coming from his/her mind
Characteristics of Compulsion
Repetitive behaviors/mental acts performed as a result of obsession or according to rigidly-applied rules
Aimed at reducing/preventing distress or some dreaded situation/event
Behaviors are clearly excessive and may not realistically be connected to what they’re designed to prevent
Treatment of OCD
Meds, cognitive, behavioral
Greg Valentino
Muscle Dysmorphia
PTSD is diagnosable after how many months of symptoms
For 1+ month
mTBI
mild Traumatic Brain Injury
Anhedonia
Can’t experience pleasure
Treatment of PTSD
meds, behavioral, CBT-type approach (exposure therapy)
Dissociative Disorders
Disruption in consiousness, identity, memory, emotion, or sensory/motor behavior. Recurrent gaps in recall of everyday events, important personal info, or traumatic events
SYX onset usually trauma
Dissociative fugues
Leaving normal locations
Treatment of Dissociative Disorder
Hypnosis and long-term supportive treatment
William Milligan
Arrested in 1977 for rape, two suicidal attempts
Found 10 personalities, pleaded insanity (not guilty)
Percentage of M&F Eating Disorders
90% women for anorexia and bulimia nervosa
2:1 female to male ratio for Binge-eating disorder
Highest mortality rate in DSM
Anorexia nervosa
Anorexia Nervosa
Restricting and binge/purge
Health consequences of anorexia
slow heart rate and low BP Osteoporosis Muscle loss Dehydration Lanugo (peach fuzz hair growth over the body) Dry hair and skin
Health consequences of bulimia
Frequent weight change Lethargy Sore throat, tooth decay Poor skin Abdominal pain from laxative use
Dysphoria
Gloominess, sadness, despair
Major Depressive Disorder criteria needs
Criteria must be present for 2+ week period
MDD must contain 1 of these 2
Depressed mode more often than not OR Anhedonia
Persistent Depressive Disorder
Dysthymia- Depressed mood for minimum of 2 years. Criteria haven’t left in 2+ month period
Biological Etiology of Depressive Dis
Low levels of 5-HT, NE
Decreased volume of PFC, hippocampus
Strong genetic link (67%)
Psychodynamic Etiology of Depressive Dis
Depression stems from unresolved unconscious conflicts/hostilities held over from childhood
Behavioral Etiology of Depressive Dis
Insufficient positive reinforcers, and too many punishers
Cognitive Etiology of Depressive Dis
Cognitive Triad (Aaron Beck) Negative views of self, ongoing experiences, and future.
Explanatory Style (Martin Seligman)- learned helplessness
Tx of Depressive Disorders
CBT, antidepressants (Tricyclics, MAOIs, SSRIs), ketamine, ECT (last resort for severe depression/mania
Side effects of ECT
Short-term confusion, temporary memory loss
Bipolar Disorder I- Manic episode criteria
Abnormally elevated/expansive/irritable mood OR increased goal-directed activity atleast 1+ week
Bipolar I
Manic episodes are pleasurable, may believe they have super powers, may become hostile
Age onset 18-25
Bipolar II
Either currently having, or have had, either a Major Dep Episode or a Hypomanic Episode
Cyclothymic Disorder
Numerous periods over 2 years of hypomanic symptoms with depressive symptoms
Word for Cycling in Bipolar Dis
Lability
Biological Etiology of Bipolar Dis
Manic state = increased levels of 5-HT, NE Genetic Link (twin studies = 74%)
Psychodynamic Etiology of Bipolar Dis
Mania= Buffers person from depression/gloom that would arise from perceived inadequacy/helplessness
Behavioral Etiology of Bipolar Dis
No comprehensive theories
Bipolar disorder may be exacerbated by negative life events
Cognitive Etiology of Bipolar Dis
Inability to effectively regulate emotions, solve daily problems
Pharmacological Tx of Bipolar
Mood stabilizers (lithium, depakote, topamax)
Neurocognitive Disorder
Refers to Delirium and a host of illnesses that cause mild or major cognitive deficits
6 Cognitive Domains (mild or major) of NCDs
Complex attention (sustained/divided attention)
Executive Function (Planning/decision-making)
Learning and memory (Recent memory, very LTM)
Language (Expressive/receptive language)
Perceptual-motor (praxis, gnosis)
Social Cognition (Recognizing emotions)
Praxis
Gestures
Gnosis
Inability to recognize things
Aphasia
ability to recall words
Major NCD and Minor NCD
Major- does interfere with capacity for independence. Minor does not interfere
Alzheimer’s Disease markers
cortical atrophy/ enlarged ventricles
Beta-amyloid plaques and Neurofibrillary tangles
Autism Spectrum Dis
Persistent deficits in:
- social-emotional reciprocity
- nonverbal communicative behaviors used for social interaction
- developing, maintaining, and/or understanding relationships
General characteristics of Autism
Comorbid intellectual/language impairment Motor deficits common Self-injurious behavior Odd responses to sensory Stimulus Abnormalities in eating, sleeping, mood
Autism
Prevalence- 4x more likely in males
SYX evident by age 2
37-90% genetic
Treatment for Autism
Behavior Therapy, start before age 4. long-term needs
Cluster A
Odd or eccentric behavior
Paranoid, schizoid, schizotypal PD
Cluster B
Dramatic, emotional, or erratic behavior
Antisocial, borderline, histrionic, narcissistic PD
Cluster C
Anxious or fearfulness
Avoidant, dependent, OCPD
Paranoid PD
Unwarranted feelings of persecution
Mistrust almost everyone
Hypersensitive to criticism
Strong fear of being exploited, losing control or autonomy
Borderline PD
Unstabable personal relationships, mood swings, often impulsive, sometimes suicidal, frantic efforts to avoid abandonment
Narcissistic PD
Grandiosity, sense of being entitled, special, need for power/status/success/admiration
Exploitation of others for personal benefit
Humiliated/hurt/ashamed/enraged when exposed to small slights
Antisocial
Deceitfulness, repeated law-breaking, basic disregard for rights of others
Impulsive, aggressive, lack of remorse for mistreatment of others
Superficially charming
Schizoid
Detachment from social relationships; loner
Restricted range of emotional expression
No desire for close friendships, relationships
Prefer solitary activities
No interest in sexual relationships
