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PSY240 > lecture 11 + ch6+11(some) > Flashcards

lecture 11 + ch6+11(some) Flashcards

1
Q

what % of ppl aged 65+ in Canada have a psychological disorder? also, who specifically in this age group has higher rates?

A

20%

people living in health care and social institutions

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2
Q

__% of older adults report mental health problems get treatment

A

50%

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3
Q

cognitive declines and other changes occuring with age

A

cognitive declines:
- perceptual speed
- episodic memory
- spatial visualization
- reasoning

changes in structure and functioning in areas associated w executive control (hippocampus, PFC)

older adults recruit more brain regions than do younger adults, so may need additional executive resources to perform the same task

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4
Q

delirium

A

acute state of confusion

disoriented and impaired attentional skills and consciousness

onset is abrupt with a short duration, and symptoms may fluctuate throughout the day

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5
Q

what % of those in urgent care facilities (esp intensive care) experience delirium?

A

10-30%

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6
Q

delirium causes

A
  • fever, malnutrition, severe dehydration, acute infection
  • meds and subtances
  • brain trauma/injury
  • brain changes due to neurocognitive disorder
  • environmental stressors
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7
Q

delirium treatment

A

first step is identifying underlying cause

rapid treatment= better longterm outcome

acute delirium (triggered by substance withdrawal) treated with antipsychotics

psychosocial treatment is used to help ppl cope with anxiety and hallucinations

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8
Q

major neurocognitive disorder

A

previously called dementia

gradual deterioration of brain functioning that impacts judgement, memory, language and other processes that interfere w independence

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9
Q

mild neurocognitive disorder

A

new to dsm5

focus on early stages of cognitive decline

modest decline that does not interfere with independence yet

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10
Q

causes of major/mild neurocognitive disorders

A

alzheimers
vascular disease
traumatic brain injury
parkinsons
substance abuse
huntingtons disease
prion disease

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11
Q

neurocognitive disorder due to alzheimers disease symptoms

A

initial memory + learning issues that develop gradually and slowly get worse

irritable and social withdrawal

aphasia (cant think of words they wanna say), apraxia (loss of fine motor skills, ex; gestures) , and anomia (cant recognize and name objects u used to known/name)

difficulty planning, organizing, sequencing or abstracting info

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12
Q

what is the most prevalent neurodegenerative disorder

A

neurocognitive disorder due to alzheimers disease

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13
Q

causes of neurocognitive disorder due to alzheimers disease symptoms

A

there is widespread synaptic and neuronal loss

specifically, there are 2 specific structural abnormalities that affect this:

  1. neurofibrillary tangles: Tau fibres twist
  2. neuritic (beta amyloid) plaques: plaque made of beta amyloid that aggregates in spaces between neurons

these 2 things can be caused by gene mutations in genes that code for proteins that typically clear beta amyloids from the brain. obvi when this gene is mutated, it won’t do this action properly (resulting in the plaque). can also be caused by environmental factors like smoking!

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14
Q

can gene mutations be inherited?

A

yes

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15
Q

what are Tau fibres?

A

proteins that help transport nutrients in the nerve cell

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16
Q

neurocognitive disorder due to vascular disease

A

cognitive decline due to reduced blood flow to brain

this can be a one time event (stroke) or ongoing

cognitive issues have abrupt onset, like sudden numbness in face/arm/leg, confusion or trouble speaking, trouble seeing, etc

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17
Q

what is the 2nd most frequent cause of neurocognitive disorders after alzheimers disease?

A

vascular disease

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18
Q

causes of neurocog. disorder due to vascular disease

A

atherosclerosis, which is thickening or arteries due to plaque build up. the arteries narrow and blood flow is reduced.

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19
Q

neurocognitive disorder due to traumatic brain injury cause+ symptom

A

results from hit to the head

ranges from mild to severe

symptoms + duration range depending on what brain area affected
(concussion= not too serious, cerebral contusion= bruised brain, cerebral laceration= brain is pierced, chronic traumatic encephalopathy= repeated concussions over time)

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20
Q

neurocognitive disorder due to parkinsons disease symptoms + cause

A

4 main symptoms
1. tremor of hands/arms/legs/jaw/face
2. rigidity of limbs and trunk
3. slowness in initiating movement
4. drooping posture or impaired balance and coordination

occurs due to damage to neurons in substantia nigra
- dopamine loss
- dopamine neurons are dying due to accumulation of Lewy bodies (plaque build up INSIDE of neuron)

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21
Q

substance induced neurocognitive disorder

A

delirium associated w substance intoxication, withdrawal, use of multiple substances, or inhalants

symptoms of this are common in those w history of heavy substance use

exposure to environment toxins can also cause this

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22
Q

neurocognitive disorder due to huntingtons disease (causes, symptoms, treatment)

A

rare, genetically transmitted, degenerative disorder
(kids have 50% chance of getting this from a parent who has it)

symptoms: cognitive, emotional, and physical disturbances

no treatment + death usually happens 15-20 years after it starts.

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23
Q

neurocognitive disorder due to prion disease (cause)

A

Prions make spongy holes in the brain, which give it a sponge-like texture and causes neurocognitive symptoms

ex; mad cow disease

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24
Q

what are prions?

A

infectious pathogens structurally different from other pathogens

25
Q

list + give examples of neurocognitive disorder treatments

A

FIRST any underlying medical issues are treated.

THEN other treatments can be used:
- rehab services (physical/speech therapy)
- biological treatment (medications for symptoms)
- psychological treatment (address emotion changes)
- lifestyle changes (exercise)
- environmental support

26
Q

define personality disorders

A

enduring pattern of inner experience and behaviour that deviates markedly from expectations of the individuals culture

the pattern is stable and does not change

starts in adolescence

pattern leads to distress or impaired functioning

27
Q

state the names of the 2 approaches to personality disorders

A

dimensional approach
DSM-5 approach (categorical)

28
Q

dimensional approach to personality disorders (state the criteria and then explain each one) .. long card sorry :(

A

says that personality disorders involve 2 things:
1. a disturbance in continuum of healthy self

disturbance in continuum of healthy self can be…:
- disturbance in self direction (normal self direction: goals consistent with ur identity/societys norms, appropriate self reflection)
- disturbance in their identity (normal identity: seeing yourself as a unique identity from others, accurate self perceptions)
- disturbance in positive interpersonal relationships
(normal relationship: having empathy and intimacy)

AND

  1. presence of 1 or more pathological personality traits

ex:
- negative affectivity (instead of emotional stability) , like depressed/anxious, emotional
- detachment (instead of extraversion) , like withdrawal
- antagonism (instead of agreeableness), which is like being manipulative and hostile
- disinhibition (instead of conscientiousness), like being irresponsible/impulsive
- psychoticism (instead of lucidity) , like having unusual beliefs and experiences

29
Q

categorical approach to personality (dsm-5)

A

the dsm5 identifies 10 personality disorders that are organized in clusters:

cluster A: odd or eccentric disorders
cluster B: dramatic, emotional or erratic disorders
cluster C: anxious or fearful disroders

30
Q

causes of personality disorders (generally)

A

genetic: heritability ranges from 40-60%

environmental: early emotional/physical/sexual abuse

31
Q

general treatments for personality disorders

A

structure

treatment alliance

consistency

validation

motivation

metacognition

32
Q

paranoid personality disorder + treatment

A

cluster A disorder

excessive mistrust and suspicion of others without justification

they are also reluctant to trust bc they expect to be exploited

psychotherapy (like cognitive therapy) that focuses on reducing paranoia

33
Q

2 perspectives on causes of paranoid personality disorder

A

psychodynamic perspective:
- disorder results from projection (the id is making hostile/aggressive thoughts abt others, so ego uses projection as defense mech.), so the person believes that the other ppl want to be aggressive to them even though its actually the opposite

cognitive behavioural perspective:
- person has adapted maladaptive schemas/thinking patterns, so they assume that others have negative intentions always + thus mistrust them

34
Q

schizoid personality disorder

A

cluster A disorder

pervasive pattern of detachment from social relationships + restricted range of expression of emotion

have a history of social isolation, emotional coldness, and seeking solitary activities

show social deficiencies similar to other cluster A disorders, but not the unusual thought process

35
Q

causes + treatment of schizoid personality disorder

A

not much known abt causes besides childhood shyness, abuse or neglect

treatments: psychotherapy that focuses on teaching value of relationships and social skills (ex; role playing)

36
Q

schizoTYPAL personality disorder

A

odd, eccentric, paranoid or weird thoughts and behaviours combined with discomfort and less capacity for relationships

does NOT involve breaks with reality, despite it being more common among those related to someone w schizophrenia

37
Q

causes + treatment of schizoTYPAL personality disorder

A

genetic/biological causes: may be linked to schizophrenia

treatment: 1.psychotherapy focused on developing social skills
2.sometimes meds, but the side effects reduce compliance to meds

38
Q

antisocial personality disorder (ACCORDING TO THE DSM-5)

A

cluster B disorder

criteria (according to dsm5):
pattern of disregard for and violation of rights of others, occurring since age 15 (ex: failure to conform to social norms/laws)

evidence of conduct disorder before age 15

however it is only diagnosed at 18+

39
Q

is antisocial personality disorder the same as psychopathy?

A

NO!

40
Q

psychopathy + criteria

A

NOT INCLUDED IN DSM-5

internal functioning issues like emotional detachment, impulsiveness, etc

Hervey Cleckley published the diagnostic criteria for psychopathy, which includes 16 criteria organized in 3 categories:

  1. positive adjustment (ex; suicide threats)
  2. chronic behavioural deviance (ex: recklessness)
  3. emotional interpersonal deficits (ex: lack of remorse)
41
Q

dimensional approach to personality disorders (ASPD example)

A

disturbances:
1. disturbance in self direction: personal gratification, failure to confirm to legal/ethical standards

  1. disturbance in identity: egocentric (they r the main star of their life lol)
  2. disturbance in positive relationships: lack of concern for others feelings, exploitative
42
Q

causes of antisocial personality disorder + different perspectives of causes

A

gene-environment interactions

underarousal hypothesis:
- abnormal brain structure/function
- low lvls of cortical arousal lead to sensation and stimulation seeking

fearlessness hypothesis:
-higher threshold for experiencing fear

43
Q

treatment for antisocial personality disorder

A

intervening in childhood

cognitive therapy (guide client away from self focus)

CBT (target inappropriate behaviors + teach them consequences of norm violates)

44
Q

borderline personality disorder

A

Cluster B

pattern of volatile unstable emotional reactions, instability in relationships, poor self image / unstable self image and impulsive responding

hypersensitive to social cues

fearful preoccupation ( always suspicious of partners n cues that they dont love them)

45
Q

what % of borderline personality ppl engage in self injurious behaviours? what % die by suicide?

A

75% do the self harming behaviours

10% die by suicide

46
Q

what is the most commonly diagnosed personality disorder

A

borderline

47
Q

borderline personality disorder causes

A

biological:
- genetic (impulsive trait)
- brain struc/func (less brain volume + acitivity differences in areas for emotional regulation)

psychological
- negative cognitions ( I’m worthless)

social
- early childhood abuse/neglect

48
Q

GENERALLY, what are 2 treatment options for borderline (will go into more specific on another card cuz hard 2 remember)

A

medications and psychotherapy

49
Q

medication treatment for borderline

A

antidepressants, lithium, antipsychotics

50
Q

psychotherapy treatment for borderline

A

dialectical behaviour therapy
- for those with suicide ideation/behaviour
- stage1: develop a stable life
- stage2: address trauma
-stage 3: self respect

dynamic deconstructive psychotherapy
- for those who find therapy difficult or have comorbid conditions
- focus on forming a coherent sense of self

transference focused psychotherapy
- good for reducing self destructive behaviours
- focus on forming a coherent sense of self

51
Q

histrionic personality disorder (what is it, causes, treatment)

A

Cluster B

pattern of excessive emotionality and attention seeking

engage in self dramatization, exaggerate emotions, flirtatious behaviours

causes:
- autonomic or emotional excitability
- parental reinforcement

treatment:
- psychodynamic therapies that focus on finding out why they want attention (ex; CBT)

52
Q

narcissistic personality disorder (what is it, cause, treatment)

A

Cluster B

pattern of grandiosity, need for admiration, lack of empathy

require constant attention/approval, not good w criticism, entitled

starts in early adulthood

cause:
- possibly psychological factors like parental model

treatment:
- little success, but may focus on building empathy and reducing self involvement

53
Q

avoidant personality disorder

A

Cluster C

pattern of social inhibition, feeling inadequate, hypersensitive to -ve evaluations

intense fear of humilitation/rejection and low self esteem

cause:
-maybe interaction bw childhood environment and temperament

treatment:
- behavioural therapies that teach social skills in groups

54
Q

what is the debate around avoidant personality disorder?

A

ppl wonder if its a continuum of social anxiety disorder

55
Q

dependent personality disorder (what it is, cause , treat)

A

Cluster C

excessive need to be taken care of that leads to submissive and clinging behaviour and fear of separation

lack self confidence, cant take responsibility

causes:
-psychodynamic perspective: maternal deprivation leading to fixation at oral stage
-behavioural perspective: family environment rewarded dependent behaviours
- cognitive perspective: development of distorted beliefs that encourage dependency

treatments: no clue! but possibly to develop self confidence

56
Q

obsessive compulsive personality disorder (wht is it, cause, treat)

A

cluster C

preoccupation w orderliness, perfectionism, at the expense of efficiency

very preoccupied with details

cause:
- not sure! but occurs in families so maybe genetic

treatment:
- possibly cbt

57
Q

list the names of all the disorders under each cluster

A

cluster A:
- schizotypal personality disorder
- schizoid personality disorder
- paranoid personality disorder

cluster b:
- antisocial pers. dis.
- borderline
- histrionic
- narcissistic

cluster C:
- avoidant pers. dis.
- dependent pers. dis.
- obsessive compulsive pers. dis.

58
Q

what disorder is considered a psychotic disorder AND a cluster A personality disorder?

A

schizotypal personality disorder

PSY240 (6 decks)

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