Final Exam Flashcards
Phillippe Pinel
reformed how the mentally ill were treated
emphasized improving environment, treating patents with dignity
environmental factors are a cause of disorders!
psychopathology
illness of the mind
disorders need to be diagnosed so people can be treated
psychological disorder
clinically significant disturbance in an individual’s cognition, emotional regulation, or behavior
dysfunctional and/or maladaptive
pattern
a colleciton of symptoms that tend to go together
distress and dysfunction
interference by a disorder with daily life and well-being
deviant
differing from the norm, developmentally or culturally
Why classify disorders?
- predict future course of disorder
- suggest appropriate treatment
- prompt research into causes
ADHD
6 or more symptoms of inattention/hyperactivity for children up to 16
5 or more symptoms for adults
symptoms present for >6 months and inappropriate for developmental level
3 presentations of ADHD
combined: both inattention and hyperactivity-impulsivity
predominantly inattentive
predominantly hyperactive-impulsive
DSM
diagnostic and statistical manual
DSM-V is current, used to diagnose disorders
used to justify payment for treatment
criticisms of DSM diagnosis
calls many people “disordered”
classification can be arbitrary
labels direct how we view and interpret the world (self-fulfilling prophecies) and how we are treated by others
anxiety disorder
distressing, persistent anxiety and the dysfunctional behaviors that reduce anxiety
what makes anxiety a disorder?
distressing: constant anxiety
maladaptive coping responses
impairing: social, academic, occupational
generalized anxiety disorder (GAD)
continually tense, apprehensive, and in a state of autonomic nervous system arousal
difficult to control worry, across a range of activities
emotional/cognitive symptoms: worrying, anxious anticipation interfering with concentration
physical symptoms: autonomic arousal, trembling, sweating, bad sleep
panic disorder
repeated, unexpected, and recurrent panic attacks as well as fear of the next attack
change in behavior to avoid attacks
panic attack
minutes of extreme dread or terror
chest pains, choking, numbness
need to escape
phobias
persistent, irrational fear and avoidance of a specific object, activity, or situation
out of proportion to actual danger, avoidance of triggers
6 months or more
obsessive compulsive disorder
unwanted repetitive thoughts (obsessions), actions (compulsions) or both
often “rechecking”
obsessions
thoughts, urges, or images that are experienced as intrusive and unwanted
compulsions
repetitive behaviors or mental acts that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly
posttraumatic stress disorder
experience of a traumatic event, followed by:
intrusive symptoms, avoidance behaviors, negative changes in thoughts and mood, hyperarousal
at least 1 month
trauma
exposure to actual or threatened death, serious injury, or sexual violence
direct experience, witnessing, knowledge of it happening to family or friend, repeated/extreme exposure to details of trauma
form powerful associations in amygdala
anxiety and genetics
identical twins develop similar phobias
genes regulate levels of neurotransmitters (serotonin, glutamate)
evolutionary?
ACC
anterior cingulate gyrus
monitors actions and checks for errors
high activity in OCD brains
disorder explanatations
classical conditioning: overgeneralizing a conditioned response
operant conditioning: rewarding avoidance
observational learning: worrying like mom
observational learning
fears get passed down in families
when fear/avoidance is observed, it can be learned
reconsolidation
memory is “reactivated” then must be resolidified in long-term memory
following reactivation, memory is vulnerable to disruption
possible treatment for phobias
treatment for anxiety
anxiolytics like benzodiazepines
enhance effect of GABA at GABA-A receptor
effective during short term
depression
the "common cold" of mental disorders #1 reason people seek mental health services must be distressing or dysfunctional
major depressive disorder
MDD
depressed mood most of day, less interest/pleasure in activities
fatigue, sleep issues, worthlessness, thoughts of suicide
must last over 2 weeks
treatment not always needed
seasonal affective disorder
seasonal pattern of depression brought on by dark, cold days of winter
crying survey b/t august and december
bipolar disorder
“manic-depressive”
bouts of depression offset by periods of mania, energetic, euphoric, and hyperactive mood
disruptive mood dysregulation disorder
similar to bipolar disorder but more commonly diagnosed in children
cycles of depression and rage instead of mania
Who is more susceptible to depression?
Women
evolutionary perspective on depression
mild, non-disordered depression may have survival value
“social-emotional hibernation” under stress that allows us to conserve energy, avoid conflicts, take time to think
brain biology in depression
brain activity diminished
frontal lobes smaller
less norepinephrine and reduced serotonin
drugs try to restore NT levels, exercise, diet
antidepressants
SSRIs or SNRIs (serotonin norepinephrine reuptake inhibitors
block reuptake, increase NT levels at synapse
depressive explanatory style
mood predicted by how we analyze bad news
stable, internal, global problems instead of temp, external, specific
suicide
at greatest risk when rebounding from depression
women more likely to attempt, men more likely to complete
public suicides increase rates
NSSI
non-suicidal self injury used to deal with distress, cry for help usually does not lead to suicide peaks at 14-19 and for females relieves guilt, distraction
schizophrenia
“split from reality”
negative, cognitive, then positive symptoms appear over 3-5 years
both genetic and environmental factors
schizophrenia symptoms
+ symptoms: hallucinations, delusions, thought disorders
- symptoms: flattened emotions, speechlessness, lack of initiative, social withdrawal
cognitive symptoms: poor attention span, motor speed, learning, memory, abstract thinking, problem solving
courses of schizophrenia
acute/reactive: some people develop + symptoms like hallucinations in response to stress, recovery is likely
chronic/progressive: develops slowly, more - symptoms like flat affect, treatment can improve but recovery is doubtful
susceptibility hypothesis
there is a gene for schizophrenia but it must be activated by the environment
identical vs. fraternal twins and their children
dopamine hypothesis
positive symptoms caused by overactivity of dopaminergic synapses
mesolimbic dopaminergic pathway involved in reward system is affected, hard to follow orderly thought sequences
increased activity to amygdala
hypofrontality
decrease in dopaminergic activity in prefrontal cortex leads to - and cognitive symptoms
dissociation
a separation of conscious awareness from thoughts, memory, bodily sensations, feelings, or even from identity
psychological escape from stress
dissociative disorder
dysfunction and distress caused by chronic and severe dissociation
dissociative identity disorder
multiple personality disorder
personalities are distinct, not conscious at same time, may or may not be aware of each other
debate over biological vs. cultural/societal explanations
personality disorders
eccentric/odd: schizophrenic - symptoms
dramatic: attention-seeking, narcissistic, amoral, antisocial
anxious: avoidant personality, ruled by fear of social rejection
antisocial personality disorder
borderline/histrionic
total lack of empathy or conscience
may be aggressive and ruthless or intelligent
irresponsible, does not conform to social norms, deceitful
biosocial roots of crime
murderers seem to have: less tissue/activity in brain area that suppresses impulses
less amygdala response to violence
overactive dopamine
eating disorders
extremely prevalent even among kids
unrealistic body image, desire to control food when other things can’t be controlled, depression cycles, health issues
anorexia nervosa
when someone maintains starvation diet despite being extremely underweight
results in many health issues, high mortality rate
bulimia nervosa
vicious cycle of strict diet, craving and binge eating, then purging and shame
psychotherapy
interaction with a trained professional, working on understanding and changing behavior, thinking, relationships, and emotions
eclectic
treatment from various forms of therapy
eating disorder contributors
cultural ideals of body appearance mother focused on her and child's weight negative self-evaluation in the family competitiveness/protectiveness for anorexia childhood obesity for bulemia
humanistic therapy
Carl Rogers, person-centered therapy
is non-directive, genuine, accepting, unconditional positive regard, empathetic, active listening
help people gain self-awareness and acceptance, support personal growth
behavioral therapies
uses learning and classical/operant conditioning to reduce unwanted responses
exposure therapy
exposure therapy
reverses reinforcement of conditioned fear avoidance behaviors by waiting for anxiety to subside during exposure
systematic desensitization: continuously increasing exposure intensity as patient tolerates lower levels
virtual reality therapy: simulating fears
aversion therapy
exposure to stimulus that typically elicits problematic positive response, while simultaneously introducing discomfort
adding nausea drug to booze to associate alcohol with nausea
operant conditioning therapy
behavior modification: shaping a chosen behavior to look more like a desired behavior
desired behaviors rewarded
problematic behaviors unrewarded or punished
cognitive therapy
helps alter negative thinking that worsens symptoms
seeks to improve explanatory style for depressive causes (internal vs. external attribution)
changes irrational, self-defeating thinking
cognitive therapy for depression
Aaron Beck
correcting cognitive distortions, self blame, overgeneralizing
cognitive behavioral therapy
combines cognitive and behavioral therapy, most commonly used type of therapy
family therapy
allows therapist to work on family system
related to couples/marital therapy
client outcomes of therapy
people often enter in crisis, need to believe it worked
generally speak kindly of their therapists
most feel better when leaving than when they enter
therapist outcomes of therapy
therapists hear praise from successes but little from those whose problems return
one client may be a success in multiple therapists’ files
evidence-based practice
using outcome research and clinical expertise to select therapeutic interventions
based on clinical expertise, research, patient’s values/preferences/circumstances
EMDR
eye movement desensitization and reprocessing
client recalls trauma while therapist waves finger or light in front of their eyes
effectiveness does not depend on eye movement technique
light exposure therapy
daily exposure to bright light (esp. blue) as treatment for SAD
What might make psychotherapy effective?
Hope for demoralized people, a new perspective, an empathetic, trusting, caring relationship
psychologists
PhD, PsyD
therapy, intelligence and personality testing
psychiatrists
MD, DO
psychotherapy and medicine
social workers
MSW
counselors, nurses, and other professionals that can diagnose and treat mental disorders
biomedical therapies
change the brain’s electrochemical state with psychotropic drugs, magnetic impulses, electrical currents, or surgery
psychopharmacology
study of the effects of drugs on mind and behavior
antipsychotic
competitive dopamine antagonist
reduce positive symptoms like hallucinations, delusions
obesity, diabetes, movement problems
antianxiety drugs
GABA agonist
temporarily reduces worried thinking and physical agitation, can permanently erase trauma associations
slows nervous system activity in body and brain
slowed thinking, reduced learning, dependence
antidepressant
improves mood/control over depressing and anxious thoughts
SSRI/SNRI (serotonin, norepinephrine), possible neurogenesis
dry mouth, constipation, reduced libido
mood stabilizers
reduce the highs of mania and the depressive lows
must measure blood levels
mechanism unknown
lithium
ADHD stimulants
control impulses, reduce distractability and need for stimulation
block dopamine reuptake
decreased appetite
electroconvulsive therapy
gentle anesthetic, muscle relaxant
30-60 secs of mild current resulting in mild seizure
some memory loss, no brain damage
can be very effective but relapse not uncommon
RTMS
repeated transcranial magnetic stimulation
magnetic coil stimulates targeted brain regions via magnetic pulses
may lead to formation of new neural connections
increase activity in left frontal lobe?
deep brain stimulation
implanted electrode delivers periodic stimulation like pacemaker
targets bridge between frontal lobes and limbic system
