Final Exam Flashcards
What is anxiety?
A mood state that follows from apprehension about (potential) negative future outcomes
How is some anxiety important for life?
Helpful by motivating action and increasing concentration, avoiding potential threats through problem-solving
Social/cultural forces have contributed to anxiety
Media, performance, norms, testing
Fight or flight system
panic response to perceived threat CRF stimulates the hypothalamic-pituitary-adrenocortical HPA axis
Behavioural inhibition system
freeze response which signals our bodies to stop and evaluate the situation to determine the threat
The triple vulnerability theory
The first vulnerability=diathesis which is your generalized biological vulnerability
The second vulnerability= generalized psychological vulnerability Eg. Believing the world is dangerous
The third vulnerability specific psychological vulnerability Eg. Learning about others experience to dangers makes you anxious thinking about those things
Most common health concern
Anxiety
Exposure therapy
Most anxiety disorders are categorized by avoidance, which worsens the anxiety. There are many types of ET.
Existential approaches to anxiety
Rather than focusing on specific strategies focus on meaning in life despite unfortunate truths
Benzodiazepines
Xanax, Valium, Ativan are fast acting CNS depressants that affect the GABA system
SSRI’s
antidepressants that are helpful at managing anxiety
4 notable features that people with GAD have
- intolerance of uncertainty: set of negative beliefs
- Positive beliefs about worry: the worry is what keeps me safe
- Poor problem orientation: difficulty seeing the problem
- cognitive avoidance
Panic disorder and agoraphobia relation
Panic comes with retreat then staying at home so nobody sees your panic
Difference between sudden or expected panic attack
Sudden happens out of the blue and expected have a clear trigger
Self-fulfilling prophecy
The fear of having panic attacks can cause one
Interoceptive exposure for panic disorder
up to 70% of people significantly improve. exposure to bodily sensations associated with panic
Psychosis
term for when we lose touch with reality
3 psychotic symptoms
Positive, negative and disorganized
Positive symptoms
Delusions and hallucinations
Delusion
A belief not grounded in reality
Delusions of grandeur
some sense as believing themselves to be a high religious figure
Delusion of reference
Associate an idea with another idea when they aren’t associated
Somatic Delusions
Someone is convinced something is wrong with them
Erotomanic delusions
Believe you have a loving relationship with a celebrity
Cotard’s syndrome
Believing some parts of your body is dead
Hypnagogic Hallucinations
Occur while falling asleep
Hypnopompic Hallucinations
Occur as you are waking up
Negative symptoms
The absence or insufficiency of normal behaviour such as avolition, anhedonia, asociality, affective flattening
Disorganized Symptoms
Disorganized speech, disorganized movement, inappropriate affect
Prodrome Phase of Schizophrenia
Disorganized thoughts, social withdrawal, sleep disturbance, suspiciousness, intense focus on ideas which may seem disturbing can take between 2 and 10 years before a full psychotic disorder emerges
Phase 2: Acute Psychotic Episode
The easiest phase to assess and diagnose. Positive symptoms emerge
Phase 3: recovery phase
Occurs after the symptoms of the acute psychotic episode have subsided
how do other schizophrenia spectrum differ?
Symptom type and severity, symptom duration, causes of symptoms, comorbidity with other disorders
Schizotypal Personality
Pattern of social and interpersonal deficits and a reduced capacity for close relationships, and eccentricities of behaviour
Brief psychotic disorder
Psychotic symptoms lasting at least one day but no longer than a month
Schizophreniform Disorder
Episode within the last month but less than 6 months
Delusional Disorder
Presence of delusions with a duration of one month or longer
Schizoaffective disorder
An uninterrupted period of illness during which there is a major mood episode
Causes of psychosis
cat poop (toxoplasma gondii), Fingerprint ridges, eye-tracking differences, living in cities
Dopamine’s role in psychosis
Most antipsychotic meds work by blocking dopamine, drugs that increase dopamine can cause psychosis
CBT for psychosis
Aaron Beck founding father of CBT focuses on getting people back into society, have reference points so they can connect with reality
What is trauma?
Any disturbing experience that results in significant fear, helplessness, dissociation, confusion, or other disruptive feelings intense enough to have a long-lasting negative effect on a person’s attitudes, behaviour, and other aspects of functioning
Window Of Tolerance
If you’re feeling hyper aroused you’re likely over your window of tolerance. Hypoarousal means the body is being understimulated (low mood, low energy, exhausted state)
Trauma happens when you are outside the normal window of tolerance
Challenges of assessing PTSD
Many different types of traumatic events.How do you gather information without asking too many detailed questions?
What if someone describes an event as traumatic but does not meet the criteria
OSI Clinics
Dedicated to people who experience traumatic events because of their employment
Moral Injury
Describes the psycho-spiritual consequences of events that seriously violate ones core moral beliefs and expectations
Treatment for PTSD
SSRI, Exposure therapy, eye movement desensitization
Acute stress disorder
Similar criteria to PTSD
Main distinction: can be diagnosed 3 days to 1 month after the traumatic event
Complex PTSD
May be diagnosed in adults or children who have repeatedly experienced traumatic events, such as violence, neglect or abuse
Very different from ptsd
ICD is a better guide
Dissociation
Disruption of and or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behaviour
Derealization
Experiences of unreality or detachment with respect to surroundings, individuals or objects are experienced as unreal, dreamlike, foggy, lifeless, or visually distorted
Depersonalization
Experiences of unreality, detachment, or being an outside observer with respect to ones thoughts, feelings, sensations, body, or actions
Disassociated personality disorder
Formerly multiple personality disorder. Distinct personalities known as alters
A memory may be fragmented. Highly stigmatized
Only one-third of American psychiatrists confidently believe that DID should be included in the DSM. What are some reasons why?
Highly likely to be agreeable
DID patients are highly suggestible and DID symptoms may be reinforced by therapists.
Could result in false report of childhood trauma.
Could lead to the idea of distinct personalities being reinforced.
Clinical characteristics of DID
The estimated average number of alters is 15. Almost everyone with DID has experienced significant childhood trauma(97%) and 68% reported incest.
Limited social support during or after traumatic events.
What disorders include cluster A
Odd and eccentric: Schizoid, Schizotypal, Paranoid
What disorders include cluster B
Borderline, Narcissistic, Histrionic, and Antisocial
Antisocial Personality disorder hypotheses
Underarousal hypothesis=evidence that people with ASPD are chronically understimulated
Fearlessness Hypothesis= people with ASPD do not experience fear to the same degree as others
DBT therapy
Distress tolerance
Interpersonal effectiveness
Emotion regulation
Mindfulness
Histrionic personality disorder
A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood
The big 5
Extroversion
agreeableness
Conscientiousness
Neuroticism
Openness to experience
Self monitoring
Personality trait that determines how much people regulate their behaviour based on the context
Categorial approach
clear categories with clear underlying cause
Dimensional approach
Trait exist on a continuum
Prototypical approach
Contains elements of both dimensional and categorical approach
What is a mental disorder?
Defined by thoughts, behaviours, and emotions that cause dysfunction, personal distress, and are atypical or not culturally expected
The 4 d’s of psychopathology
Dysfunction, distress, deviance, and danger
What time frame were mental health problems considered to be caused by supernatural forces
Middle ages
What are some medieval treatments align with evidence-based interventions
Hydrotherapy: DBT skills
What did Galen believe?
Humor theory: stated there are 4 bodily fluids that determine emotional balance: blood, black bile, yellow bile, and phlegm
What are the biological treatments from the 20th century?
Insulin shock therapy, lobotomies, and electro-convulsive therapy
Moral therapy
Creating spaces where people could rest, recover, and live normal lives developed by Phillipe Pinel
Mental Hygiene Movement
Pioneered by Dorthea Dix. The backlash against worsening conditions of asylums
Multidimensional model of causality
Social factors, psychological factors, and biological factors contribute to the development of a mental disorder also known as the bio-psycho-social model to understand mental disorders
What are emotions?
Short-lived, temporary states lasting from several minutes to several hours, occurring in response to an external event
Fight or flight response
Biological reaction to alarming stressors that musters the body’s resources to resist or flee the threat
How does gene expression depend on evironemt
A small portion of our genes are turned on or expressed. Depending on our environment it can determine whether our genes are expressed
Diathesis
Pre-existing genetic vulnerability
Epigenetics
biological factors other than DNA that influence gene expression and the traits passed on to future generations
Gene-environment correlation
People’s genetic predispositions often influence their environments
Passive gene-environment correlation
our environment is often created by our parents, who share 50% of their genes with us
Active gene-environment correlation
genes make us seek out our environments
Adverse childhood events
2/3s of people report at least one and more than 1/5 report 3 or more
Mental status exam
appearance and behaviour, thought processes, mood, cognitive and intellectual functioning, and sensorium
Categorial approach
Mental disorders are clear categories and have clear physiology and underlying cause
Dimensional Approach
mental disorders exist on a continuum
Prototypical approach
Contains elements of both dimensional and categorial
Major Depressive Disorder
Significant depressive symptoms, never been a manic or hypomanic episode
Persistent Depressive disorder (Dysthmia)
Depressed mood for most of the day, for more days than not for at least 2 years
How common is depression?
Approximately 16% of the global population will experience MDD at some point in their life and approximately 6% will experience it within any given year.
cognitive restructuring
Challenging negative thinking patterns
Manic Episode criteria
period of abnormally elevated, expansive or irritable mood and abnormally increased activity or energy lasting at least 1 week
Bipolar Disorder 1
criteria has been met for at least one manic episode
Hypomanic Episode
A manic episode lasting at least 4 days and is not severe enough to cause marked impairment in social functioning
Bipolar II disorder
Criteria met for at least 1 hypomanic episode and at least one major depressive disorder. No manic episode.
Bipolar specifiers
Rapid cycling: 20-50% of those with bipolar disorder experience rapid cycling
Ultra-rapid cycle lengths
Ultra-ultra rapid cycle lengths
Cyclothymic Disorder
Chronic alternation of. mood elevation and depression that does not meet the severity for manic or major depressive disorders
Average onset for bipolar disorder
late adolescence to early adulthood
Medications for bipolar disorder
Lithium Carbonate, valproate, anti-depressants, antipsychotics, anti-convulsants
Whats the world-wide prevalence of ED’s
7.8%
Mortality in anorexia nervosa
20% of people die from this disorder and 5% after 10 years. Females living with AN are 18x more likely to die by suicide
Bulimia Nervosa
Most common on university and college campuses
Eating large amounts of food in volumes higher than normal followed with compensatory behaviours
DSM-5-TR criteria for bulimia nervosa
recurrent episodes of binge eating, discrete period of time, sense of lack of control overeating, compensatory behaviours in order to prevent weight gain, at least once a week for 3 months
Anorexia Nervosa
characterized by a strong fear of gaining and losing control of overeating
DSM-5-TR criteria for Anorexia Nervosa
Restriction of food intake relative to requirements leading to low body weight, intense fear of gaining weight or becoming fat, disturbance in the way ones body weight or shape is
Comorbidity in Anorexia Nervosa
Anxiety and mood disorders. 13% prevalence of OCD
Insomnia
Complaint of dissatisfaction with sleep quantity or quality that causes significant distress, at least 3 nights per week and present for at least 3 months
24% of Canadians report symptoms
3P model of insomnia
Predisposing: complex bio-psycho-social factors
Precipitating: triggers in the environment
Perpetuating: thoughts/behaviours that continue to the cycle of insomnia
stimulus control
If the client cannot sleep in 10-15 minutes they are to get up and do something quiet then return to bed only when they are sleepy
Sleep Restriction
Limit the amount of sleep by setting a specific bedtime and wakeup time
Hypersomnolence
Excessive sleepiness despite enough hours of sleep
Narcolepsy
Irrepressible need to sleep or napping occurring within the same day. hypocretin deficiency
What percent of children have nighmares
10-50%
What percentage of adults experience nightmares
9-30%
Obsessive-compulsive disorder
presence of obsession, compulsions or both. These are time consuming
Four main subtypes of OCD
Symmetry
Forbidden thoughts/actions
Cleaning/contamination
Hoarding
Obsessive Compulsive Disorder Prevalence
Lifetime prevalence of 1.6-2.3%
Body Dysmorphic Disorder
Perceived defects or flaws in physical appearance that are not observable or appear slight to others, performing repetitive behaviours or mental acts, cause clinically significant distress
Prevalence of BDD
2-13% student samples
9-15% dermatology
7-8% of cosmetic surgery patients
Somatic Symptom Disorder
One or more somatic symptoms that are distressing or result in significant disruption of daily life
Illness anxiety disorder
Somatic symptoms are not present or present but very mild. Excessive health-related behaviours
Conversion Disorder
One or more symptoms of altered voluntary motor or sensory function
the symptom is not better explained by another disorder
Malingering
faking symptoms for personal gain
Factitious Disorder
Falsification of physical or psychological signs or symptoms of behaviour is evident even in the absence of obvious external rewards (faking symptoms for no obvious reason)
Sexual desire disorders
Male hypoactive sexual disorder and female interest/arousal disorder
- reduced desire must be present for at least 6 months and cause significant distress
Sexual arousal disorders
Erectile disorder: difficulty maintaining rigid erections for at least 6 months
What percentage of married men report occasional erectile dysfunction
40%
Orgasm Disorders
Premature ejaculation and delayed ejaculation
Female orgasmic disorder
Criteria for Genito-pelvic pain/penetration disorder
Recurrent difficulties with one or more: vulvovaginal or pelvic pain during sex, fear or anxiety, tensing or tightening of the pelvic floor, approximately 6 months
Paraphilias
Sexual disorders in which sexual arousal occurs almost exclusively in the context of inappropriate objects or individuals
Fetishistic Disorder
intense sexual arousal from using an inanimate object or non-genital body part
Voyeuristic and exhibitionistic disorders
The voyeuristic disorder is becoming intensely aroused by observing an unsuspecting person who is naked, undressing or engaging in sexual activity. Exhibitionistic disorders become intensely aroused through exposing genitals to unwilling audience.
Transvestic Disorder
cross-dressing. Intense sexual arousal from wearing clothes traditionally worn by a different gender
Sexual sadism and Sexual masochism
Masochism is when a person has sexual urges to have pain inflicted on them and sadism is sexual urges to inflict pain on others
Frotteuristic disorder
The act of touching or rubbing ones genitals against another non-consenting individual in sexual matter
Pedophilic disorder
Recurrent intense sexually arousing fantasies urges or behaviours involving sexual activity with a prepubescent child or children
Covert sensitization
Imagining consequences of certain behaviours repeatedly
Orgasmic reconditioning
re-pairing pleasurable orgasms with other stimuli
Relapse prevention programs
Similar to substance use programs
Drug interventions
Antiandrogens which are effectively chemical castration
Treatment for children for gender reassignment
Wait and see approach
What is aging?
Aging is the process of passing time
Delirium
4 key features
1. Disturbance of consciousness
2. Disturbance of cognition
3. Limited course
4. External causation
40-50% of people who experience delirium will die within one year
Major neurocognitive disorder (dementia)
Gradual deterioration of the brain functioning affects judgement, memory, language and many other cognitive processes/skills
Alzheimer’s disease
Increasing memory impairment, symptoms often worse at night, higher education = better outcomes, average survival 4-8 years
Vascular Neurocognitive disorder
blood vessels which can get blocked or damaged in the brain marked by a decline in processing speed and executive function
Lewy body disease
Small microscopic deposits of protein that damage brain cells. decline in alertness and attention, hallucinations and motor impairment
Huntingtons disease
A genetic disorder affecting motor movements caused by one specific gene
Substance/medication-induced neurocognitive disorder
50-70% of chronic alcohol users can show cognitive decline
