Final Exam Flashcards
Munchausen’s syndrome by proxy is a variant of which disorder?
Factitious disorder
The inability to learn new information is known as _______.
anterograde amnesia
Gerard became amnesic, wandered away from home and assumed a completely new identity as a shoe salesman. He suffers from _______.
dissociative fugue
A person with two or more well-developed identities has the disorder called ______.
dissociative identity disorder
Felicia has been diagnosed with bulimia nervosa with purging. We should expect that she _______.
experiences electrolyte imbalances & mineral deficiencies
Henry used to become intoxicated after six drinks. Now he needs ten or twelve to get the same effect. This is an example of ______.
tolerance
Brendan has been using marijuana daily for more than six years. If he stops using the drug, he might experience _______.
withdrawal-like symptoms such as nervousness & changes in sleeping & eating
_______ are opium-like substances that the body produces.
endorphins
Gary finds himself sexually aroused by dressing in women’s clothing. He sometimes steals the clothes from women and from stores. He has a wife and is happy in his marriage. Gary’s most likely diagnosis is _______.
transvestic disorder
The ______ enjoys inflicting pain, while the ____ desires pain & degradation.
sadist;masochist
The type of rape legally defines as sexual activity with a person who is under the age of consent is called _______ rape.
statutory
Extensive bilateral damage to the temporal lobes of the brain is most likely to result in ______.
the inability to store new memories
The first sign of neurocognitive disorder in older adults is typically _______.
memory problems
Consistent with its established role in memory, neurons in the ______ suffer much damage in Alzheimer’s disease.
hippocampus
When a closed-head injury occurs, ______.
damage results from the brain colliding with the skull
After the car accident, Sherry was unable to remember what happened from the time of the crash until the following morning. Sherry appears to have experienced _______.
anterograde amnesia
Which of the following is a key element of the therapeutic relationship?
agreement between the client & therapist about the goals of treatment
The ruling that came to be known as “duty to warn” was also called the _______ decision.
Tarasoff
______ demonstrate deficiencies in fear, anxiety, lack empathy, are deceitful, irresponsible, impulsive, manipulate, & exploit others. They have abnormalities in the limbic and prefrontal areas of the brain.
Psychopath/Antisocial Personality Disorder
What does soma mean?
body
What is somatic symptom disorder?
when concern about physical/physiologically symptoms is severe & leads to clinically significant distress & impairment
What are the causes of somatic symptom disorder?
Freud, Breuer, and Janet long thought that sx dev.’d as defense mechanism against unresolved/unacceptable unconscious conflicts. psychic energy channeled into more acceptable phys. probs.
What are the current views of somatic symptom disorders?
cognitive-behavioral approach
What are the core features of models of somatic symptom disorders?
1) focus on attention on the body; hyper vigilant & increased awareness of bodily changes
2) person tends to see bodily sensations as somatic symptoms – physical sensations attributed to illness
3) person worries excessively about what symptoms mean & has catastrophizing cognitions
4) b.c. of the worry,
somatic symptom disorder can be viewed as a disorder of both __________ (noticing being sensations such as one’s heart skipping a beat) & _____________ (does this mean I have a serious problem?)
perception; cognition
Top down vs. bottom-up processes
cognitive processes vs. differences in bodily sensations seem to account for problems that these individuals have
People with somatic symptom tend to do the following:
- focus excessive attn. on their phys. experiences, labelling physical sensations as symptoms; perceive them as more dangerous than they really are & judge particular disease to be more likely or dangerous than it really is.
- see themselves as physically weak; unable to tolerate physical effort/exercise
- once misinterpreting a symptom, they look for confirming evidence and discount evidence that shows they are in good health.
- equate being healthy to being symptom-free
- creates vicious cycle: anxiety about illness & sx –> physiological symptoms of anxiety –> further fuels convictions that they’re ill
- past experiences w/ illnesses (themselvs, others, media) contribute to set of dysf. assumptions about sx & diseases that may predispose some1 to developing somatic sx disorder
negative affect
risk factor for developing somatic symptom disorder; not sufficient
What are absorption & alexythima?
other important characteristics in somatic sx disorder; absorption- tendency to become absorbed in 1’s experiences & often associated w/ being highly hypnotizable; alexythima- difficulties identifying 1’s feelings
When people are absorbed in their own experiences…
they are prone to having certain attentional (top-down) processes activated when exp. neg. events. alterations in attentional system trigger memories/past representations of sxs (cog. schemas) formed as a result of prior exp. w/ illness; person becomes aware of minor phys. sesnations / trigger exp. of sxs that are as “real” as they would be if they resulted from known medical cause
Somatic disorders often maintained by ____________ reinforcements; such as _ __________________.
comfort, attention, excused from school/other resp./obligations
What is illness anxiety disorder?
when ppl have high anxiety about having or developing serious illness
What is conversion disorder?
presence of neurological sx in absence of neurological diagnosis; pt. has sx /deficits affecting senses or motor behv. that strongly suggest med/neuro cond.
pattern inconsistent w/ other neuro diseases/med probs.
– partial paralysis, blindness, deafness, episodes of limb shaking + impairment/loss of conscisouness resembling seizures
*diag can only be made after full med & nearo workup
*person not intentionally faking/producing sx.
-sx usually start/ are exacerbated by preceding emotional/interpers conflicts/stressors
4 categories of Conversion Disorder Symptoms
1) Sensory
2) Motor
3) Seizures
4) Mixed presentation of 1st 3
Sensory Symptoms/Deficits
-sx in affected area inconsistent w/ how known anatomical sensory pathways operate; can involve any sensory modality
most often in visual system (esp. blindness & tunnel vision); auditory system (esp. deafness) or in sensitivity to feeling (especially anesthesias)
*sensory input registered, but somehow screened from explicit conscious
What is anesthesias?
someone loses sense of feeling in part of the body
What is glove anesthesia?
person can’t feel anything in area where gloves are worn. this doesn’t usually make anatomical sense
It is crucial for person w/ suspected conversion symptoms to receive a thorough _ _ _ _ _ and _ _ _ _ _ _ examination.
medical and neurological examination
Criteria used to distinguish conversion disorders & true neurological disturbances:
- freq. failure of dysfunction to conform clearly to Sx of particular disease/disorder simulated. ex] little/no wasting away/atrophy of “paralyzed” limb occurs in conversion paralyses except in rare/long-standing cases.
- nature of dysfunction is highly selective; in conv. blindness, affected individual doesn’t usually bump into ppl/objects & “paralyzed” muscles can be used for some activities & not others
- under hypnosis/narcosis (sleeplike state induced by drugs), Sx. can usually be removed, shifted, or reindexed @ suggestion of therapist; some1 abruptly awakens from sound sleep may be suddenly able 2 use “paralyzed” climb.
A conversion disorder loses defensive function if it can be _ _ __ _ _.
readily shown to lack a medical basis
What is a primary gain of conversion disorders?
reduction in anxiety & intrapsychic conflict
What is a secondary gain of conversion disorder?
receiving sympathy and attention from loved ones
What is factitious disorder?
person intentionally produces psychological or physical symptoms (or both). Goal is to obtain and maintain the benefits of playing the “sick role”
Dissociation becomes pathological when _ _ _ _ _ .
dissociative symptoms are perceived as disruptive, invoking a loss of needed info, as producing discontinuity of experience or as recurrent, jarring involuntary intrusions into executive functioning and sense of self
What is implicit memory?
remembering things one cannot consciously recall
What is retrograde amnesia?
partial/total inability to recall/identify previously acquired info or past experiences
What is anterograde amnesia?
partial/total inability to retain new info.
What is dissociative amnesia?
failure to recall previously stored personal information (retrograde amnesia) when that failure cannot be accounted for by ordinary forgetting.
*gaps in mem. most often occur following intolerably stressful circumstances - combat, catastrophic events, trauma.
sometimes becomes apparent in hypnosis/narcosis-induced interviews or in cases where amnesia spontaneously clears up
episodes usually last between few days –> few yrs
basic habit patterns (abilities to read, talk, perform skilled work, etc.) remain intact
What is episodic memory?
pertaining to events experienced (only type of memory affected by dissociative amnesia)
What is autobiographical memory?
pertaining to personal events experienced (only type of memory affected by dissociative amnesia)
What is dissociative fugue?
a person is not only amnesic for some or all aspects of the past but also departs from home surroundings and even a new identity.
-confusion abt. personal identiy/assumption of new identity (*identities don’t alternate as they do in DID)
-unaware of memory loss 4 prior stages of their lives, but memory for what happens during future is intact
-behavior usually normal, unlikely to draw attention
some time later, they may suddenly emerge from fugue state & find themselves in strange place, working in a new occupation w/ no idea how they got there.
recovery from fugue state often occurs only after repeated questioning & reminders s of who thy are.
as fugue state remits, initial amnesia remits - but new, apparently complete amnesia for fugue period occurs
In the DSM-5, dissociative fugue is considered to be a _ _ _ _ _ of dissociative amnesia rather than a separate disorder
subtype
Dissociative identity disorder (DID)
formerly known as multiple personality disorder. Disruption of identity characterized by two or more personality states as well as recurrent episodes of amnesia. can be self-reported or observed by others.
condition in which normally integrated aspects of memory, identity & conscisouness no longer integrated
Why did the DSM abandon the term multiple personality disorder in favor of DID?
Mainly due to the growing recognition that it had misleading connotations, suggesting multiple occupancy of space, time & ppl’s bodies by differing but fully organized & coherent “personalities”; when in fact, alters aren’t in any meaningful sense personalities but rather reflect failure to integrate various aspects of person’s identity, consciousness, & memory.
What is amenorrhea?
no more periods- no longer req. for someone to be given diagnosis
studies show that women who continue having periods but meet all other diag. crib. for anorexia nervosa are v. similar psychologically 2 women who have amenorrhea & have ceased menstruating.
What are the 2 types of anorexia nervosa?
1) restricting type
2) binge-eating type
What role does the hypothalamus play in eating?
part of brain that plays an important role in eating
- no good evidence that obvious abnormalities in hypothalamus play central role in EDs
- damage to frontal & temporal cortex linked to dev. of AN & sometimes BN. (temp cortex involved in body image perception); parts of frontal cortex play role in monitoring pleasantness of smell & taste
- reasonable 2 suggest that hypothalamus “senses” weight in some way & keeps things in balance w/ ventromedial hypothalamus acting as “satiety center” & lateral hypothalamus serving as an “appetite center”
- lateral hypothalamus receives info from frontal cortex & amygdala (involved in fear learning) –> suppressing eating in response to fear & overeating in resp. 2 env. cues
What role does serotonin play in eating?
neurotransmitter that has been implicated in obsessionality, mood disorders, and impulsivity. It also modulates appetite and feeding behavior. Made from tryptophan and can only be obtained by food
many patients w/ EDs respond well to Tx w/ antidepressants (which target serotonin)– it’s thought that EDs involve disruption in serotonergic system.
-resuming normal eating makes it possible to detect abnormalities in serotonin system; ppl w/ serotonin overactivity use dieting to regulate this by dec. amt. of tryptophan available to make serotonin
What is the best studied model for anorexia nervosa: family therapy?
approach blames neither parents or child - Maudsley model
10-20 sessions over 6-12 mos.
What is the Maudsley model?
- referring phase - TH works w/ patients & supports efforts to help child to eat healthily 1x more; family meals observed; efforts made to guide parents as functioning support team for recovery.
- relationship phase - negotiations for new pattern of family dynamics/issues
- termination phase - develop more healthy rel. btwn patient & parents
What is a personality disorder?
when people have certain inflexible and maladaptive personality traits to the extent that they are unable to function effectively or meet the demands of society
What are the general features of personality disorders?
interpersonal difficulties, problems with identity or sense of self, inability to function adequately in society
To be diagnosed with a personality disorder… person’s enduring pattern of behavior must be:
pervasive & inflexible
- stable & of long duration
- must cause either clinically sig. distress/impairment in functioning & be manifested in 2+ of the following areas: cognition, affectivity, interpersonal functioning, impulse control.
PDs do not stem from _ _ _ _ _ _, but rather from _ _ _ _ _ _
debilitating reactions to past stressors (i.e. PTSD), but rather from gradual dev. of inflexible & distorted pers. & behv. patterns resulting in persistently maladaptive ways of perceiving, thinking about & relating to the world
Cluster A
eccentric, odd; includes Paranoid, Schizoid, Schizotypal
Cluster B
dramatic, extreme; Histrionic, Narcissistic, Antisocial, Borderline
Cluster C
fearful, anxious; Avoidant, Dependent, Obsessive-Compulsive
What cluster of PDs are the most common?
Cluster C [Avoidant, Dependent, OCPD]
Why is it challenging to do research on personality disorders?
- more misdiagnoses occur here than any other category of disorder.
- problems w/ reliability & validity
- a lot of money doesn’t go into the research - not highly prioritized, might deny existence of disorder; vague & subjective
- criteria not sharply defined
Histrionic Personality Disorder:
- self-dramatization
- over concern w/ attractiveness
- irritability & temper outbursts
- unappreciated if not center and attention
-appearance & behv. often theatrical & sexually provocative; attempt to control partners thru seductive behv. & emotional manip.; show dependence
-vague & impressionistic speech
-self-centered; excessively concerned about others’ approval (who might find them reactive, shallow, & insincere)
-more commonly seen in women b/c of stereotypical “female” traits - over dramatization, vanity, seductiveness & over concern w/ phys. appearance
other traits more common in men such as high excitement seeking & low-self consciousness
Two Subtypes of Narcissistic PD:
grandiose and vulnerable narcissism
- both associated w/ high interpersonal antagonism/low agreeableness (traits of low modesty, arrogance, grandiosity, and superiority), low altruism (expecting favorable treatment, exploiting others) & tough-mindedness (lack of empathy)
- spouses describe them as bossy, intolerant, cruel, argumentative, dishonest, opportunistic, conceited, arrogant, & demanding
- some may fluctuate btwn. the 2
Is ASPD the same as Psychopathy? If no, why?
ASPD - heavy emphasis on observable behaviors (lying, getting into fights, or failing to honor financial obligations); vs. psychopathy - more attn. to personality characteristics (superficial charm, lack of empathy, manipulation)
*these are often confused
BPD:
- impulsiveness
- inappropriate anger
- affective instability - intense emotional responses to env. triggers & slow return to baseline emotional state
- drastic mood shifts
- chronic feelings of boredom
- attempts at self-mutilation or suicide
- highly unstable self-image/sense of self
- chronic feelings of emptiness, can’t tolerate being alone
- often over idealize friends/lovers/therapists –> bitter disillusionment, disappointment & anger
- often test close relationships. misperceive anger when presented w/ neutral faces
- causal link btwn perception of rejection & intense, uncontrollable rage
- risky sexual behv. & driving
- 75% have cog. sx: transient episodes where they’re out of contact w/ reality & exp. psychotic-like Sx (hallucinations, paranoid ideas, severe dissociative sx) – mostly during times of stress
- most well-researched form of personality pathology
Borderline Personality Disorder: Causal Factors
-runs in families
-linked to traits such as neuroticism/ impulsivity
-candidate genes related to serotonin (mood + impulsivity) & dopamine (impulse control + cognition + sensitivity to award) systems
-very complex & heterogeneous
-**env. factors account for largest proportion of variance of borderline traits: child maltreatment, early life experiences (adversity) linked; many w/ BPD have traumatic childhood
emotional abuse
stressful early events –> long-term dysreg. of HPA axis and shape brain dev., compromising circuits involved in emotion reg.
increased amygdala activation in emotion-inducing situations, reduced prefrontal reg.
Avoidant Personality Disorder
o hypersensitivity to rejection or social derogation
o self-conscious and self-critical
o shyness
o insecurity in social interaction & initiating relationships
o extreme social inhibition and introversion
o desire affection but often lonely & bored
o *unlike schizoid, don’t enjoy aloneness
o often associated w/ depression
o feeling inept & inadequate = 2 most prevalent & stable features
o more generalized
o more common in women
-avoidant personality and generalized social phobia share features– some feel APD may be somewhat more severe manifestation of social phobia that doesn’t warrant separate diagnosis – very rarely cases of APD w/o Social phobia
–compared to social phobia – more consistent feelings of low-self-esteem, higher dysfunction & distress
OCPD - Causal Factors
- excessive high levels of conscientiousness
- leads to extreme devotion to work, perfectionism, and excessive controlling behavior
- high level on assertiveness (a facet of extraversion)
- low level on compliance (a facet of agreeableness
- 3 primary dimensions of personality: novelty seeking, rewards dependance, and harm avoidance (i.e., the respond strongly to aversive stimuli and try to avoid them)
- traits show a modest genetic influence
Psychopathy
initially sociopathic personality; condition involving features of antisocial personality disorder and such traits as lack of empathy, inflated & arrogant self-appraisal & glib + superficial charm.
no epidem. studies have assessed this
features of ASPD don’t fully map onto construct of psychopathology as originally described (to increase reliability of ASPD diagnosis) – but many key features of psychopathy not included in criteria.
although there is a lot of overlap – ASPD diag more inclusive & reflects a lot of criminality; psycopathy diag more narrow & much more focused on pers. structure.
What is tolerance?
the need for an increased amount of a substance to achieve desired effects. – results from biochem changes in body affecting rate of metabolism & elimination of substance from body
What do psychoactive substances do?
affect mental functioning in the central nervous system: alcohol, nicotine, barbiturates, tranquilizers, amphetamines, heroin, ecstasy, and marijuana.
What is substance abuse?
excessive use resulting in 1) potentially hazardous behavior (DWI) or 2) continued use despite a persistent social, psychological, occupational, or health problem
What is substance dependence?
more severe forms of substance use disorders and involves a marked physiological need for increasing amounts of a substance to achieve a desired effect. Will show tolerance and experience withdrawal.
Alcohol in ancient cultures
Egyptians, Greeks, Romans, & Israelites made extensive & excessive use of alcohol and other substances
problems w/ excessive use observed almost as early as its use began
True/False: alcohol is a stimulant
FALSE: it’s both nervous system stimulant & depressant
What are the detrimental effects of alcohol?
associated w/ vulnerability to injury
-marital discord
-partner violence
-life span of some1 w/ alc. dep. 12 yrs shorter than some1 w/o
-sig. lowers perf. on cog tasks (problem solving)- more complex task –> more impairment
-organic impairment (brain shrinkage) in high proportion of ppl w/ alc dep.
all abuse – inc. risk of diabetes, stroke, cardiovasc. disease
abuse -40% of deaths suffered in automobile accidents, 40-50% of all murders/assaults/rapes/violent police encounters
more freq. associated w/ violent+n.violent crime than other drugs; more likely to have positive breathalyzer test
-strong presence in workplace
Problem drinkers:
- ppl exp. life probs as a result of alc abuse
- men 5x women
- can develop at any point in time
- over 37% have 1+ coexisting mental disorder ** depression especially, substance abuse disorders & eating disorders; personality disorder
Alcohol’s effects on the brain:
- lower levels - activates pleasure areas (release endogenous opioids stored in body)
- higher levels - decreases brain functioning, inhibiting 1 of brain’s excitatory neurotrsmtrs (glutamate) – > slows down activity in parts of the brain
- impairs learning ability & judgment/rational processes & lowers self-control
- lowers inhibition, behavioral restraints decline; engage in impulsive behvs. normally left in control
- lack of motor coordination apparent
- drinker’s discrimination & perception of cold, pain, & other discomforts dulled
- typically, experience sense of warmth, expansiveness, and well-being. unpleasant realities screened out & feelings of self-esteem & adequacy rise; leaves worries behind; casual acquaintances become best friends
What is fetal alcohol syndrome (FAS)?
condition caused by excessive alcohol consumption during pregnancy & results in birth defects such as MR
What happens during alcohol withdrawal delirium?
AKA delirium tremens - : usually follows prolonged drinking spree + during withdrawal. disorientation, vivid hallucinations, acute fear, extreme suggestibility, marked tremors, and other symptoms including perspiration, fever, rapid and weak heartbeat, a coated tongue, and foul breath.
-3-6 days, followed by deep sleep. after waking up - no sx, but usually scared and abstains from drinking for a while
~5-25% of ppl w/ AWD die as result from convulsions, heart failure, other complications
drugs like chlordiazepoxide (librium) decrease withdrawal sx.
Alcohol amnestic disorder:
AKA korsakoff’s syndrome; 1 of most severe alcohol-related disorders
severe alcohol related disorder with primary symptom being memory defect which could be accompanied by falsification of events (confabulation) + unconnected/distorted associations.
May appear delirious, delusional, and disoriented.
-may not recognize pics, faces, rooms & other objects they’ve just seen, but seem familiar. inability to form new associations in way to make them retrievable
planning deficits, int. decline, emotional & judgment deficits
-sx result from malnutrition/lack of vitamin B1 (thiamine)
tx of thiamine reverses condition if caught in 48-72 hrs. can restore memory function w/ prolonged abstinence
if undiagnosed and long progression, brain damage irreversible
Alcohol abuse: genetic vulnerability
- heredity plays important role – ~1/3 of alcoholics had 1+ parent w/ alc. problem
- pre alcoholic personalities - ppl @ high risk for substance abuse but not yet affected by alcohol; described as individual who has inherited predisposition toward alc cause & who is impulsive, risk taking & emotionally unstable
- physiological patterns differ if gen. predisp.
- Asians & Native Amers have abnormal physiological rxns 2 alc– “alcohol flush reaction” - hypersensitive – flushing of skin, drop in BP, heart palpitations, nausea – results from mutant enzyme that fails to break down alc. molecules in liver
What is the excitement (arousal) phase?
subjective sense of sexual pleasure and by physiological changes that accompany this subjective pleasure.
What are the 4 human sexual responses?
- desire phase
- excitement phase
- orgasm
- resolution
What does the left brain do?
serial processing of familiar info.
language & mathematic equations
What does the right brain do?
- specializing in grasping the overall meanings in novel situations
- reasoning on a nonverbal intuitive level
- appreciating spacial relations
What does damage to the frontal area produce?
- unmotivated & with limited thoughts
OR - impulsivity & distractibility
What does damage to the right parietal lobe produce?
impairment of visual-motor coordination
What does damage to the left area produce?
impairments in reading, writing, & math
What is effected when there is damage to the temporal lobe structures?
disturbances in sex, eating, & emotions
Occipital damage:
visual impairments
Was the word “consciousness” removed from the DSM-5?
Yes
What has dementia been named to in the DSM-5?
major neurocognitive disorder
Who was Alfred Kinsey?
launched the contemporary era of sex research
What is the degeneracy theory?
Swiss physician - Simon Tissot- held central belief that semen is necessary 4 phys. & sexual vigor in men & 4 mass chars. such as beard growth; based on obs. about castrated men & animals.
-2 practices particularly harmful: masturbation & patronizing prostitutes (wasted the vital fluid, semen, & overstimulated & exhausted nervous system).
Old view of masturbation & insanity…
masturbation was believed to cause insanity - present in pscychiatric txtbks as late as 19440s; arose from patients in mental asylums masturbating openly & age which maturbation starts to begin (puberty/adolecences) precedes age when 1st signs of insanity appear
masturbation not seen as normal & healthy until 1972; but “sinful” views of masturbation still perpetuated in today’s society
What is ritualized homosexuality in Melanesia?
ritualized homosexuality among young Sambian men was seen as exchange of sexual pleasure for vital semen. thought to provide physical growth, strength & spirituality. after puberty, they transitioned to heterosexuality & female body was thought to be less dangerous because they had ingested protected semen over their formative years. homosexual behavior stopped upon birth of first child. in their culture, adolescent males who refused to partake in homosexual activity were deemed “normal”; whereas in the US they would be stigmatized as homosexual pedophilia.
Beer was first made in what ancient culture?
Egyptians first made it around 3000 B.C.E.
Up until the 1970’s homosexuals were considered to be….?
a disease (paraphilic)
Paraphilic disorders:
recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors that involve abnormal targets of sexual attraction, unusual courtship behaviors, or the desire for pain and suffering of oneself or others.
DSM-5 recognizes these 8 specific paraphilias:
- fetishism
- transvestic fetishism
- voyeurism
- exhibitionism
- pedophilia
- frotteurism
- sexual sadism
- sexual masochism
What is fetishism?
recurrent, intense sexually arousing fantasies, urges, and behaviors involving the use of some inanimate object or part of the body not typically found erotic to obtain sexual gratification
What is autogynephilia?
paraphilic sexual arousal by thought/fantasy of being a woman
What is voyeuristic disorder?
recurrent, intense sexually arousing fantasies, urges, or behaviors involving the observations of unsuspecting females who are undressing or of couples engaging in sexual activity. Typically involves masturbation. “peeping toms” - committed often as young men
What is Frotteuristic Disorder?
sexual excitement at rubbing one’s genitals against, or touching, the body of a nonconsenting person. Commonly co-occurs with voyeurism and exhibitionism.
(often occurs in crowded buses/trains)
Sexual Sadism Disorder:
- recurrent, intense sexually arousing fantasies, urges, or behaviors that involve inflicting psychological or physical pain on another individual.
- fantasies include themes of dominance, control & humiliation
- most acts occur in consensual sexual relationship w/o evidence of harm
What is masochism?
sexual stimulation and gratification from the experience of pain and degradation in relating to a lover.
Recurrent, intense sexually arousing fantasies, urges, or behaviors involving the act of being humiliated, beaten, bound, or otherwise made to suffer.
What is gender dysphoria?
-discomfort with one’s sex relevant physical characteristics or with one’s assigned gender. -Diagnosed during early childhood or adolescence/adults
-previously Gender Identity Disorder (DID)
the degree of the dysphoria can vary & is fluid
When the brain is damaged….
cognitive changes result; changes in cognitive functioning are the most obvious signs of a damaged brain
What is delirium?
- confusion, disturbed concentration, & cognitive dysfunction
- a disturbance in awareness
How to distinguish between major & mild neurocognitive disorders?
SEVERITY
What are the clinical signs of brain damage?
- loss in established functioning; often painfully aware of abilities+ lack thereof; adds psychological burden to existing physical burden
- impairment may extend to loss of capacity 4 realistic self-apprhsal (anosognosia)- - leaving them relatively unaware losses & poorly motivated 4 rehab
- degree of mental impairment related to degree of damage of brain; depends on nature & location of damage & pre disorder competence & personality
What is diffuse damage?
widespread damage
What is focal damage?
circumscribed areas of abnormal change in brain structure; might occur w/ sharply defined traumatic injury/interruption of blood supply
Most of what we do is in our….
unconscious
Who was Aquinas?
first to postulate unconscious
Who was Herbart?
first proposed a boundary between conscious & unconscious
Weber:
psychophysics: quantify what people can detect, how fast they think & perceive
What is our perception?
projects all the activity in your nervous system (aka: CEO; long-term planner; sets goals)
What is psychotherapy?
- AKA psychological treatment; treatment of mental disorder by psychological methods
- people with psychological problems can change & learn more adaptive ways of perceiving, thinking, evaluating, & behaving
Why do people typically seek therapy?
- b/c of high stress situations, such as divorce or unemployment
- client feels overwhelmed
What are the main three psychotherapeutic services?
- Clinical psychologists - trying to change clients behavior and thought patterns; some states allow them to prescribe medications if they have additional training
- Psychiatrists - able to prescribe drugs and administer other therapies like Electroconvulsive therapy.
- Psychiatric social workers
What is the client’s major contribution?
their motivation
Therapeutic Alliance:
- sense of working collaboratively on the problem
- agreement between therapist & client about treatment goals/tasks
- affective bond between patient & therapist
How can we estimate a clients gains?
- client’s self-report
- clinicians rating of changes
- reports from client’s family/friends
- compare post & pre treatment
- measures of change in selected behaviors
What is neurogenesis?
new neurons in the brain
*counseling supports building of new neurons
What is neuroplasticity?
how flexible/adaptable the brain is with changes
CNS:
brain & spinal cord
PNS:
automatic & somatic nervous system
What is integration?
harmonious, creative, & meaningful life
Limbic system:
attention, emotions, “fight or flight”, memory
What is retrograde amnesia?
inability to recall events immediately preceding the injury
What is anterograde amnesia?
- (aka: posttraumatic amnesia)
- inability to store effectively in memory events that happen during variable periods of time AFTER the trauma
- (hint: anterograde & after both between with the letter “a”)
Prevention efforts are classified into 3 subcategories:
- universal interventions
- selective interventions
- indicated interventions
What are universal interventions?
aimed at influencing general population school-based efforts at preventing, rerating, & responding to suicide-related behavior
What are selective interventions?
specific subgroup of populations at risk
What are indicated interventions?
directed toward high-risk individuals having minimal, but detectable mental disorder, but don’t meet the criteria for diagnosis (ex: someone who went through a natural disaster)
What are the 2 key tasks of universal interventions?
- ) alter conditions that can cause/contribute to mental disorders
- ) establish conditions that foster positive mental health (protective factors)
Alcohol use in adolescents:
- most commonly used drug; related to social, emotional, & behvavioral probs
- strong predictor of lifetime alc. abuse & dependence
What is milieu therapy?
all ongoing activities of hospital brought into total treatment program & env., or milieu, is crucial aspect in therapy.
structuring env. to provide clear communication of expectations & gets patient involved in tx. major goal: encourage participation thru group process
*significant improvement improvement in overall functioning & resulted in more successful hospital releases than traditional hospital care not ass successful as social-learning treatment
Social learning programs:
patients take increased responsibility for their own behavior
What is deinstitutionalization?
reducing population of inpatients by closing hospitals & treating patients w/ mental disorders as outpatients
initiated to prevent neg. effects of being confined to mental hospital 4 long periods of time & to lower health care costs
hospital staffs establish close ties w/ pt’s family & comm, providing the w/ pos. expectations about patient’s recovery
What is forensic psychiatry/psychology?
center on rights of members of society to be protected from individuals for mental disturbances
U.S. govt approached drug abuse problem with these 3 broad strategies for dealing w/ teen substance use (all of which have proved inefficient):
1- intercepting and/or reducing supply of drugs available [hard b/c availability is widespread in gas stations and home, unavoidable due to media/peer influence; they don’t caution about damaged health potential
2-providing treatment services for those who develop drug problems - probably least effective way to reduce problem b/c addictive disorders difficult to overcome- treatment failure/relapse common.
therapeutic programs for addicts aren’t the answer to eliminating or sig. reducing problems in society
3- encouraging prevention – most desirable + potentially most effective means of reducing drug problem – teaching young people ways to avoid using them, warning about associated problems.
many prevention efforts fail to bring about desired reduction in substance use; hasn’t been conducted long enough to show desired effect, not powerful enough to make sufficient impact; strategy not well implemented
