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
