Mania, Psychosis and 'Personality Disorders' Flashcards
What is Mania?
Periods of severe over-active and high-energy behaviour that can have a significant impact on your day-to-day life
What is hypomania?
A milder version of mania that typically lasts for a shorter period
Severe mania is the opposite of…?
Severe depression
Manic episodes are characterised by a cluster of experiences. What are the 4 changes one might experience during manic episodes?
1) Affect/Emotional changes
2) Bodily/Physiological changes
3) Behavioural changes
4) Cognitive changes
What emotional changes occur during manic episodes? List 2
- Intense elated mood
- Irritable/agitated mood
What bodily/physiological changes occur during manic episodes? List 3
- Decreased need for sleep
- Increased sense of energy
- Psychomotor agitation
What behavioural changes occur during manic episodes? List 3
- Excessive involvement in pleasurable risk-taking activities
- The pressure of speech
- Increased goal-directed activity
What cognitive changes occur during manic episodes? List 3
- Inflated self-esteem/grandiosity
- Flight of ideas/ racing thoughts
- Distractibility
- Intense elated mood
- Irritable/agitated mood
These are examples of what type of changes during manic episodes?
a. Affect/Emotional changes
b. Bodily/Physiological changes
c. Behavioural changes
d. Cognitive changes
a. Affect/Emotional changes
- Decreased need for sleep
- Increased sense of energy
- Psychomotor agitation
These are examples of what type of changes during manic episodes?
a. Affect/Emotional changes
b. Bodily/Physiological changes
c. Behavioural changes
d. Cognitive changes
b. Bodily/Physiological changes
- Excessive involvement in pleasurable risk-taking activities
- The pressure of speech
- Increased goal-directed activity
These are examples of what type of changes during manic episodes?
a. Affect/Emotional changes
b. Bodily/Physiological changes
c. Behavioural changes
d. Cognitive changes
c. Behavioural changes
- Inflated self-esteem/grandiosity
- Flight of ideas/ racing thoughts
- Distractibility
These are examples of what type of changes during manic episodes?
a. Affect/Emotional changes
b. Bodily/Physiological changes
c. Behavioural changes
d. Cognitive changes
d. Cognitive changes
How common is the lifetime prevalence of mania in the general population? List a %
4% - 9%
……% - …..% of the population presents experiences sufficiently severe to receive a diagnosis of bipolar disorder
0.5% - 1.5%
How many people with bipolar take their own lives?
20%
How many people with diagnoses of bipolar have less than 1 episode?
< 1%
True or False?
Episodes of mania and hypomania always co-occur with depression/low mood
False
Episodes of mania and hypomania often (but not always) co-occur with depression/low mood
What is a distinct mania and depression?
A manic episode followed by a period of depression
A manic episode followed by a period of depression
This is known as…?
Distinct mania and depression
What is concurrent mania and depression?
Mixed manic-depressive episodes
Mixed manic-depressive episodes
This is known as…?
Concurrent mania and depression
What are the 2 types of manic and depressive episodes?
- Distinct
- Concurrent
What are the 2 types of bipolar?
- Bipolar 1
- Bipolar 2
What is bipolar 1?
Patients have at least one manic episode
Major depressive episodes are typical but not necessary for diagnosis
True or False?
Major depressive episodes are necessary for a diagnosis of Bipolar 1
False
Major depressive episodes are typical but not necessary for a diagnosis of Bipolar 1
What type of bipolar is this?
Has at least one manic episode but major depressive episodes are not necessary for a diagnosis
Bipolar 1
What is Bipolar 2?
At least one hypomanic episode and one major depressive episode
True or False?
Major depressive episodes are typical but not necessary for a diagnosis of Bipolar 2
False
There must be at least one hypomanic episode and one major depressive episode for someone to be diagnosed with Bipolar 2
What type of bipolar is this?
At least one hypomanic episode and one major depressive episode
Bipolar 2
What are the psychological factors of bipolar? List 2
1) Highly unstable and fluctuating self-esteem
2) Conflictual appraisals about mood and internal states
How do people with extreme mood swings increase their swings in mood?
They hold conflictual beliefs about their mood states (e.g. “feeling energetic helps my creativity” and “if I get too energetic I will not be able to focus and I’ll mess up my work”)
What is psychosis?
A number of unusual experiences involving “loss of contact with reality”
Psychosis involves significant changes in 3 actions. What are they?
- The person’s ability to think clearly
- Telling the difference between “reality” and inner experiences
- Changes in the way people behave
Psychosis is regarded as a characteristic feature of specific psychiatric disorders, in particular ….?
Schizophrenia
How are psychotic experiences observed?
In the context of many other mental health difficulties
e.g. bipolar, depression, trauma, etc
What are the 2 types of symptoms of psychosis?
- Positive
- Negative
What are positive psychosis symptoms?
The presence of states and experiences that most individuals do not normally experience
The presence of states and experiences that most individuals do not normally experience
Which psychosis symptom is this?
Positive
What are negative psychosis symptoms?
The absence of emotional responses, thought processes and behaviours that are usual in most individuals (deficits)
The absence of emotional responses thought processes and behaviours that are usual in most individuals (deficits)
Which psychosis symptom is this?
Negative
What are the 3 main experiences which fall under positive psychosis symptoms?
1) Hallucinations
2) Delusions
3) Thought disorder
What are the 5 main experiences which fall under negative psychosis symptoms?
1) Alogia
2) Avolition
3) Blunted, flat or reduced affect
4) Anhedonia
5) Asociality
What are hallucinations?
Sensory perceptions unrelated to outside events
They are often auditory but can be in any other/multiple sensory modality including visual, auditory, gustatory, olfactory, tactile, somatic
Sensory perceptions unrelated to outside events
This is known as…?
Hallucinations
What are delusions?
A false belief
Often held with great conviction and a wide range of possible themes
e.g. grandiose beliefs, persecutory/ paranoid beliefs
A false belief
Often held with great conviction and a wide range of possible themes
This is known as…?
Delusions
What is a thought disorder?
Incomprehensive thought patterns as evidenced by disorganised speech
e.g. flight of ideas, “loose” associations based on phonetics rather than semantics
Incomprehensive thought patterns as evidenced by disorganised speech
This is known as…?
Thought disorder
What is Alogia?
Poverty of speech (lack of conversation)
The poverty of speech (lack of conversation)
This is known as…?
Alogia
What is Avolition?
The lack of motivation
The lack of motivation
This is known as …?
Avolition
What is the blunted, flat or reduced affect?
The inability to express ‘appropriate’ emotions
The inability to express ‘appropriate’ emotions
This is known as…?
The blunted, flat or reduced affect
What is Anhedonia?
The inability to experience pleasure
The inability to experience pleasure
This is known as…?
Anhedonia
What is Asociality?
Social withdrawal and/or lack of desire to engage in social interactions/form relationships
Social withdrawal and/or lack of desire to engage in social interactions/form relationships
This is known as…?
Asociality
What are the 2 extreme ends of the psychosis spectrum?
- Low vulnerability
- High vulnerability
True or False?
Psychotic symptoms exist on a continuum with normal functioning
True
True or False?
Paranoia experiences build upon unusual worries
False
Paranoia experiences build upon normal worries
Approximately …% of the general population experiences paranoid ideation
30%
What is paranoia?
When thinking is dominated by suspicious, persecutory, or grandiose content such as being spied on, followed, secretly tested or plotted against
When thinking is dominated by suspicious, persecutory, or grandiose content such as being spied on, followed, secretly tested or plotted against
This is known as…?
Paranoia
In Beavan et al.’s systematic review, they included 17 studies investigating auditory hallucinations in the adult general population
They found that the prevalence of hearing voices in the general population ranged from ….% to …..%
0.6% to 84%.
Estimated only …..% - ……% of people have a diagnosis of hearing voices
0.5% - 1%
True or False?
Hearing voices is always negative and threatening
False
In many cases, psychotic experiences are not perceived as inherently distressing as some people hear positive voices rather than negative ones
What are the 3 extremely negative effects of Psychosis?
Psychosis can cause severe:
- Distress
- Disability
- Mortality
The content of psychotic experiences can be extremely distressing.
How does this affect an individual in their everyday life?
Psychosis symptoms can interfere with a person’s functioning, life goals, etc.
True or False?
A quarter of people who receive diagnoses of schizophrenia improve socially and occupationally after diagnosis over time
False
A quarter of people who receive diagnoses of schizophrenia remain socially and occupationally impaired many years after diagnosis
True or False?
Hearing commands from voices does not mean people will act on them
True
The lifetime risk of suicide in Schizophrenia is …% - ….%
5% - 10%
Which psychological theories propose that psychosis is associated with the emergence of psychotic experiences? List 3
1) Hallucinations = Source monitoring bias
2) Delusions/Paranoia = Theory of Mind difficulties
3) Psychosocial factors
Which psychological theories propose that psychosis is associated with distress? List 2
1) Negative beliefs about the self and the world
2) Negative, threatening appraisals of psychotic experiences
Which psychological theory explains why hallucinations occur?
Source monitoring biases
Having the ability to distinguish between internal and external cognitive events; stress can disrupt the ability to distinguish
What are source monitoring biases?
Having the ability to distinguish between internal and external cognitive events; stress can disrupt the ability to distinguish
Source monitoring biases is a psychological theory which explains which symptom of psychosis?
Hallucinations
Which psychological theory explains why delusions/paranoia occur?
Theory of Mind difficulties
- Not understanding other’s mental states
- Jumping to conclusion biases (making overconfident conclusions based on little evidence)
- Attributional style (external, personalised attributions for negative events)
What are the 3 theory of mind difficulties present in delusions/paranoia?
- Not understanding other’s mental states
- Making overconfident conclusions based on little evidence
- External, personalised attributions for negative events
Theory of mind difficulties is a psychological theory which explains which symptom of psychosis?
Delusions/Paranoia
What psychosocial factors contribute to psychosis? List 3
- Stressful life events
- Trauma
- Social inequality
Negative beliefs about the self and the world often arise from…?
A background of victimisation and powerlessness
A background of victimisation and powerlessness influences…?
Negative beliefs about the self and the world
Negative, threatening appraisals of psychotic experiences lead to…
e.g. “Hearing voices means that I am going nuts!”
Distress
Negative beliefs about the self and the world lead to …?
Distress
What is a personality?
The collection of enduring behavioural and psychological traits that distinguish human beings.
The collection of enduring behavioural and psychological traits that distinguish human beings.
This is known as…?
Personality
Personality difficulties are seen as …?
Maladaptive
Personality difficulties are seen as enduring patterns of behaviour, thought, and inner experiences exhibited across many contexts, that differ markedly from those accepted by the individual’s culture and society
True or False?
True
Personality disorders are particularly evident in 2 areas. What are they?
1) Expression and self-regulation of
distressing emotions
2) Interpersonal relationships
True or False?
Each personality disorder follows the same, cohesive diagnostic criteria
False
Each personality disorder has its own set of diagnostic criteria
How can an individual get a specific diagnosis of a certain personality disorder?
Each personality disorder has its own set of diagnostic criteria and a person must meet some of these criteria
What are the 10 types of personality disorder?
1) Paranoid personality disorder
2) Schizoid personality disorder
3) Schizotypal personality disorder
4) Antisocial personality disorder (ASPD)
5) Borderline personality disorder (BPD)
6) Histrionic personality disorder
7) Narcissistic personality disorder
8) Avoidant personality disorder
9) Dependent personality disorder
10) Obsessive-compulsive personality disorder (OCPD)
People diagnosed with personality disorders often experience …? List 3 experiences
1) Intense and overwhelming negative feelings
(such as depression, anxiety, worthlessness or anger)
2) Difficulties in managing overwhelming feelings
(often using self-harming or abusing drugs and alcohol or other potentially damaging strategies to cope with overwhelming feelings)
3) Difficulties in maintaining stable and close relationships
(especially with partners, children and professional carers)
What are the stigmas related to personality disorders? List 3
1) Negative reaction from mental health professionals , not seen as ‘real’ mental illness
2) Professionals expect negative interactions
3) People with a diagnosis are seen as untreatable, manipulative, attention-seeking
How do you overcome personality disorder stigmas? List 4 ways
1) Empathy
2) #TraumaNotPD
3) ‘What happened to you?’ rather than ‘What’s wrong with you?’
4) Meta-analysis inc. 97 studies found people with a diagnosis of Borderline Personality Disorder (BPD) over 13 times more likely to report childhood adversity than non-clinical controls
Meta-analysis inc. 97 studies found people with a diagnosis of Borderline Personality Disorder (BPD) over …… times more likely to report ……….. than non-clinical controls
a. 13
b. Childhood adversity
What is the main psychological theory attempting to explain personality difficulties/disorders?
Attachment
Why will attachment help with personality disorders?
Attachment is an important determinant of effective emotional self-regulation (we learn to self-soothe from being soothed)
True or False?
Secure attachment styles have been extensively linked to personality difficulties
False
Insecure attachment styles have been extensively linked to personality difficulties
Emotional neglect, dismissing family environments and adverse early life experiences have been linked to the development of…..?
Personality difficulties
