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PSYC 500 > Mega Quiz 4 > Flashcards

Mega Quiz 4 Flashcards

1
Q

Elation and euphoria in bipolar can quickly change to…

A

…anger and hostility if behavior is impeded.

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2
Q

Mania is a distinct period of:

A
  • abnormally elevated or irritable mood
  • inflated self esteem/grandiosity
  • decreased need for sleep
  • pressured speech
  • racing thoughts
  • distractibility
  • increased goal directed activity
  • excessively risky but fun activity
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3
Q

A manic episode must last at least ______ days, unless psychiatrically hospitalized

A

7 days

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4
Q

Mania must NOT be:

A
  • not mixed
  • not substance induced
  • not due to general medical condition
  • causes marked significant impairment
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5
Q

Hypo mania (think “mania-lite”) involves distinct period of:

A

Elevated mood or irritability

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6
Q

Duration of hypo manic episode is atleast

A

4 days long

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7
Q

Difference between hypomania and mania

A

Not severe enough to cause MARKED impairment

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8
Q

Rates of bipolar increase after….

A

Puberty (when rates are as high as for adults)

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9
Q

Bipolar affects males and females…

A

Equally, but boys may show more manic mood and girls may show more depressed mood

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10
Q

Diseases that are comorbid with bipolar

A

ADHD, behavior disorders (ODD and CD), anxiety disorders, substance abuse

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11
Q

Medical problems that co-occur with bipolar

A

Cardiovascular and metabolic disorders, epilepsy, migraine headaches

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12
Q

What percentage of people have their first bipolar episode prior to age 19?

A

60%

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13
Q

What is the peak age of onset for bipolar?

A

15 and 19 years of age

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14
Q

Risk factors for bipolar

A
  • Major depressive episode
  • psychomotor retardation
  • psychotic features
  • family history of mood disorders
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15
Q

Early onset and course of bipolar

A

Chronic and resistant to treatment, with poor long term prognosis

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16
Q

How many youths were medicated for bipolar in 2001

A

93,000

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17
Q

Between 1994 and 2001, there was a ________ % increase in bipolar diagnoses

A

260%

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18
Q

In 2003, _______% of hospitalized youth under 12 diagnosed with bipolar

A

50%

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19
Q

Between 1994 to 2003, ______x increase in number of office visits for youth with BP

A

40x

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20
Q

Bipolar is the ______ leading disability in the world

A

6th

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21
Q

_____% of adults with bipolar end their own life

A

18

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22
Q

What percentage of people with bipolar are on 2+ meds?

A

85%

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23
Q

Lifetime medication exposure for bipolar

A

85% exposed to 4+ mesds

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24
Q

Causes of bipolar in children?

A

Few studies have looked at the causes of BP in kids and adolescents

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25
Q

Adult research regarding causes of bipolar disorder

A

Multiple genes (genetic predisposition does not necessarily mean a person will develop BP)

Brain imagining studies suggest mood fluctuations are related to abnormalities in areas of the brain related to emotion regulation

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26
Q

What happens if we don’t treat bipolar?

A
  • mood episodes recur
  • progressively more severe
  • progressively more treatment resistant
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27
Q

Untreated bipolar disorder at increased risk for:

A
  • substance abuse
  • juvenile offending/incarceration
  • suicide risk (25% show ideation)
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28
Q

Is bipolar curable?

A

No

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29
Q

Treatment goals for bipolar

A

Stabilize mood and allow for management and control of symptoms

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30
Q

Multimodal plan of bipolar treatment includes

:

A
  • close monitoring of symptoms
  • education of the patient and the family about the illness
  • medication, usually lithium or risperdal
  • psychotherapeutic interventions to address symptoms and related psychosocial impairments
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31
Q

Is pediatric bipolar disorder a USA phenomenon?

A
  • clinical presentation appears fairly similar

- associated features similar

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32
Q

Variable rates in pediatric bipolar internationally potentially due to:

A
  • differences in assessment and diagnostic criteria
  • differences in treatment seeking
  • differences in healthcare system
  • different training
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33
Q

Asian rates of bipolar vs. USA

A

Lower Asian rates potentially due to:

  • diet? (Fish, obesity)
  • genetic risk
  • differences in treatment seeking (stigma)
  • different training
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34
Q

Treated prevalence of bipolar increased _____x in Taiwan from 1996 to 2003

A

8x

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35
Q

Bipolar rates in Singapore

A
  • most adults with bipolar had adolescent on sent

- first episode depressed in 80%

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36
Q

Average rate of pediatric bipolar spectrum

A

2%

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37
Q

Is there a difference in the USA rate of bipolar disorder in kids than the world rates?

A

NOPE

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38
Q

Is USA driving the rate increase in pediatric bipolar

A

NO

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39
Q

Rank the bipolar spectrum in order of least common to most common

A 
Severe bipolar
Bipolar I
Bipolar II
Cyclothymia
BP NOS
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40
Q

Bipolar NOS

A

Manic symptoms don’t fit into any of the previous diagnostic categories

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41
Q

Some ways to earn a residual diagnosis of bipolar

A
  • manic or hypomania of insufficient duration (very rapid cycling)
  • repeated hypomania with a depressive episode
  • manic symptoms, but insufficient number co-occurring
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42
Q

What happens to bipolar NOS patients

A

About a 3rd recover, a 3rd remain NOS, and a third progress into more severe bipolar forms

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43
Q

BP NOS takes…… To remit?

A

LONGER

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44
Q

Which bipolar type has the most sick days per year?

A

BP NOS

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45
Q

BP NOS as difficult to treat

A
  • less responsive to mood stabilizers
  • no RCT for psychotherapy yet
  • high rate of progression
  • suicide ideation, attempts at same rate as bipolar I
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46
Q

Bipolar 1: 1 in ____ in Asian countries

A

1 in 200

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47
Q

BP: 2 in ___ in Europe

A

2 in 200

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48
Q

BP: 3 in ____ for New Zealand

A

200

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49
Q

BP: 3.4 in ____ for USA

A

200

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50
Q

Bipolar spectrum is ___x more likely

A

5x

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51
Q

Clear bipolar in one parent = ___x the risk

A

5x

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52
Q

Bipolar in one grandparent, aunt, uncle =

A

2.5x risk

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53
Q

“Fuzzy” bipolar or mood disorder in parents = ___ risk bipolar

A

2x

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54
Q

Using rating scales for bipolar assessment

A

CBCL most widely used, though similar performance on BASC, Conners, CASI

Parent report validity > teacher or youth

Can focus on externalizing score; no value added in looking at bipolar profile

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55
Q

Bipolar and externalizing scores

A
  • low parent externalizing rules bipolar out
  • powerful enough to reduce concerns due to family risk factors etc.
  • moderate elevations (60-70) don’t change clinical impressions
  • Because elevated externalizing could happen for a lot of reasons besides bipolar
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56
Q

GRAPES

A 
Grandiosity
Racing thoughts
Activity (goal directed activity episodes)
Pressured speech
Elated, expansive, euphoric mood
Sleep-decreased need
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57
Q

FIND criteria

A

Frequency: happening more than it should developmentally
Intensity: more severe than age appropriate
Number: excessive amount within episode
Duration: lasts much longer than developmentally appropriate

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58
Q

Looking for mood and energy changes in bipolar

A

Retro and prospective life charting

Mood and energy check ups

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59
Q

Process measures

A

Response to treatment

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60
Q

Outcome measures

A

Parent report is sensitive to treatment effects

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61
Q

What is the third most common illness among adolescent females

A

Eating disorders

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62
Q

Problematic eating habits and picky eating are common in…..

A

Early childhood (1/3 described as picky eaters)

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63
Q

At about age ___, girls are more anxious than boys about losing weight

A

9

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64
Q

What is the most important impact on fundamental biological processes?

A

Early parent child relationship

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65
Q

Second most significant impact on fundamental biological processes

A

Entering school; pressure to conform to perceptions of desirable body type

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66
Q

“Eating pathology”

A

A continuum that ranges from dieting to clinical syndromes across all ages

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67
Q

Drive for thinness

A

Believe that losing more weight is answer to overcoming problems

But increases negative side effects; weight preoccupation, concern with appearance, and restrained eating

Increases risk of eating disorder

68
Q

Western sociocultural values and preoccupation with weight and dieting may be internalized and expressed as young as….

A

Age 7-10

69
Q

Feeding disorder of infancy or early childhood

A

Sudden or marked deceleration of weight gain and a slowing or disruption of emotional and social development prior to age 6

70
Q

Prevalence and development of feeding disorder

A

Affects ~30% of young kids (both boys and girls), particularly those from disadvantaged environments

71
Q

Multi factorial, and variable outcome of feeding disorder

A
  • onset during first two years of life can lead to malnutrition and serious developmental consequences
  • may be related to medical problems or poor caregiving
72
Q

Many interacting risk factors influence child’s adaption to a certain level of caloric intake (feeding disorder)…..

A
  • associated with family disadvantage, poverty, unemployment, social isolation, parental mental illness
  • when there is no medical reason, it is often associated with poor caregiving, including maltreatment
  • failure to thrive is associated with mothers who have a history of disturbed eating habits/attitudes
73
Q

Treatment of feeding disorder

A

Detailed assessment of feeding behavior and parent child interactions plus allowing parents to play a role in the infant’s recovery

74
Q

Pica

A

Eating inedible, non nutritive substances for a period of at least one month

75
Q

Pica affects mainly….

A

Very young children and those with mental retardation

76
Q

Prevalence and development of pica

A
  • more prevalent among those with severe impairments and mental retardation
  • especially among institutionalized children and adults
77
Q

Causes of pica

A

Poor stimulation/supervision; vitamin/mineral deficiency; no evidence of genetic factors, except indirectly

78
Q

Risks of pica

A

Lead poisoning or intestinal obstruction

79
Q

Treatments for pica

A

Operant conditioning procedures and teaching caregivers to keep environment safe

80
Q

Failure to thrive

A

Weight is below the 5th percentile for age and/or deceleration of weight gain from birth to present of at least 2 SDs

81
Q

Causes of failure to thrive

A

Poor caregiver-child attachment, poverty, family disorganization, and limited social support as well as child’s temperament and acute physical illness
-outcome highly related to home environment: improved quality of care results in better adult adjustment

82
Q

Controversial theory of cause of failure to thrive

A

-deprivation of maternal stimulation and love –> emotional misery –> developmental delays –> physiological changes

83
Q

Average girl needs ____to ____ calories per day

A

1800-2400

84
Q

Average boy needs ____ to ____ calories per day

A

2200 to 3200

85
Q

At peak spurt, adolescents use _____x as much C, iron, Zinc, magnesium, and Nitrogen as other years of adolescence

A

2x

86
Q

Adolescents often have too little ____, _____, and _____ in their diet and too much ____, _____, and ______.

A

Too little vitamin A, thiamine, and iron; too much fat, sugar, and sodium

87
Q

By mid adolescence, __/___ girls report being on a diet during the previous year, and ___% of those girls, but only ____% of boys, are chronic dieters

A

2/3 girls; 10% of those girls; 2% of boys

88
Q

Metabolic rate

A

Balance of energy expenditure; based on individual genetic and physiological makeup, eating and exercise habits

89
Q

Body weight

A

An individual’s natural weight is regulated by his or her own set point-the biological and genetically determined range of body weight that the body tries to defend and maintain

90
Q

Growth

A

Major hormonal determinants of physical growth rate during child hood are growth hormone and thyroid hormone; additional gonadal steroids kicking in during adolescence to produce a further growth spurt and skeletal maturation

91
Q

Obesity

A

BMI > 95th percentile

92
Q

From the early 1980s to mid 1990s, the obesity rate nearly _____ for boys age 7-13 and more than ____ for girls

A

Tripled for boys, doubled for girls

93
Q

Is obesity stable from infancy to childhood?

A

No; more persistence from childhood to adolescence or adulthood

94
Q

Causes of overweight

A
  • heredity (metabolic set point)
  • modeling (overweight parents)
  • environment and role of TV (sedentary, food commercials)
95
Q

Between one in ___ and one in ____ kids and adolescents are overweight

A

One in six (16%); one in four (25%)

96
Q

Most overweight children become…

A

Overweight adults

97
Q

Overweight children are likely to be

A
  • rejected by peers
  • poor at sports
  • less likely to be seen as attractive
  • greater risk of health problems throughout life
98
Q

Bulimia is a culture bound syndrome, arising predominantly….

A

In western regions or those exposed to western culture

99
Q

Increasing SES associated with increased body image….

A

Dissatisfaction; until high SES achieved, then relationship weakens

100
Q

Risk factors of obesity

A
  • cardiovascular problems, elevated cholesterol, and triglycerides
  • later emergence of eating disorders
  • major factor in 10% of deaths in North America
101
Q

Of industrialized nations, US has the ______ percentage of overweight kids

A

Highest

102
Q

Problems for low SES kids

A
  • low cost of fast food and junk food

- limited physical activities due to living in unsafe neighborhoods

103
Q

Consequences of obesity

A
  • more heart disease
  • more of some cancers
  • more brain disease (bipolar, depression?)
  • greater health care costs
  • social stigma
104
Q

Heritability of obesity

A

Obesity gene that predisposes a resistance to leptin (hunger suppressor)

105
Q

Individual and family related risk factors for obesity

A
  • improper diet
  • unhealthy lifestyle
  • family disorganization
  • poor communication
  • lack of support
  • maltreatment
106
Q

Female to male ratio of anorexia is _____ to ____

A

10 to 1

107
Q

Sensitive periods in adolescence for eating disorders

A

Early passage into adolescence

Translation from later adolescence to young adulthood

108
Q

Which score higher on measures of eating disorders: non western or western participants?

A

Non western! South Korean and Chinese

109
Q

BMI of Korean women is the _____ compared to other countries, but percentage of women who want to lose weight is the _______

A

Lowest, highest (73-81%)

110
Q

Risk factors for eating disorder may be higher in Korea

A

Attachment styles may influence disordered eating indirectly through personality traits

Resistant attachment more likely to have ED if they have more neurotic personality traits

111
Q

Women with anorexia drop ____% of their body weight within a year

A

25%

112
Q

Consequences of extreme weight loss in anorexia

A
  • abnormalities in endocrine system that prevent ovulation
  • general health declines
  • every system in the body is affected
  • risk premature development of osteoporosis
113
Q

Mortality rate of anorexia

A

4 and 5%

114
Q

Major feature of anorexia

A

Distortion of body image

115
Q

Bulimia

A

Cyclical binge eating and purging; may include strict dieting, fasting, laxatives, and demanding exercise regime
-tends to afflict women during adolescence and young adulthood, connected with depression (all eating disorders are)

116
Q

Primary feature of bulimia

A

-recurrent binge eating (consuming a large amount of food and lack of control; attempt to conceal binge eating, and although not planned may involve rituals

117
Q

Binges followed by compensatory behaviors intended to prevent weight gain:

A
  • purging (vomiting or laxatives)
  • non purging compensation (fasting, excessive exercise)
  • about 2/3 purge
118
Q

Thinking in ED is rigid and absolutistic:

A
  • either feel completely in control or completely out of control
  • dissatisfaction with body proportions and distort true body size
119
Q

Medical consequences of bulimia

A
  • fatigue, headaches, puffy cheeks, loss of dental enamel, menstrual irregularity or amenorrhea, electrolyte imbalances
  • anorexia is even worse
120
Q

Mortality less common in bulimia or anorexia?

A

Bulimia

121
Q

Binge eating disorder

A

Similar to bulimia without the compensatory behaviors

DSM proposes to make it a separate category

122
Q

____% of females and ____% of males have binge eating disorder

A

3.5%, 2%

123
Q

Negative health correlates of binge eating disorder

A
  • low body satisfaction and self esteem
  • high depressive mood
  • weight and shape are very important to their overall feelings about themselves
  • 25% suicide attempts
124
Q

Prevalence of anorexia

A

0.9% females, 0.3% males

125
Q

Prevalence of bulimia

A

1.5% females, 0.5% males

126
Q

Persons with anorexia are ___% or more below normal weight and engage in binge eating only _______

A

15%; occasionally

127
Q

Those within bulimia are within ___% of normal weight and binge _____ then purge to control their weight

A

10%, frequently

128
Q

ED NOS

A

Diagnosis of eating disorders difficult for young people who are still maturing physically, cognitively, and emotionally

129
Q

Eating disorders among boys

A

-less preoccupied with food or a drive for thinness, place more emphasis on athletic appearance or attractiveness

130
Q

Sexual orientation and EDs

A

-gay men at greater risk; more susceptible to media images promoting thinness, more likely to experience poor body image and body dissatisfaction

131
Q

Onset of anorexia between ages

A

14 and 18

132
Q

Developmental course of anorexia

A

Highly variable course and outcome

133
Q

Outcome of anorexia

A
  • fewer than half show full recovery
  • third show fair improvement
  • fifth continue on chronic course
  • most common in fluctuation between recovery and relapse
134
Q

Onset of bulimia

A

Late adolescence to early adulthood; binging and purging and preoccupation with weight begin much earlier

135
Q

Binge eating often develops after…..

A

Period of restrictive dieting

136
Q

Course of bulimia

A

-may follow a chronic course or occur intermittently; between 50-75% show full recovery over several years

137
Q

Best predictors of favorable bulimia outcome

A
  • younger age at onset
  • higher social class
  • treatment that disrupts its cyclical course
138
Q

Single best predictor/risk for developing an eating disorder is ….

A

Being an adolescent female

139
Q

Neurobiological factors play a _____ role in precipitating anorexia and bulimia

A

Only a minor role

-likely contribute to their maintenance because of effects on appetite, mood, perception, and energy regulation

140
Q

Heritability of anorexia

A
  • 58-76%
  • negligible contribution by shared environment, although 38% may be attributable to unique environment (or error)
  • inherit a biological vulnerability that interacts with social and psychological factors
141
Q

Neurobiological factors in eating disorders

A
  • serotonin imbalances
  • similarities to other types of addictions raise question about whether anorexia and bulimia are food addictions
  • biochemical similarities found between people with eating disorders and those with OCD
142
Q

Features of western culture potentially contributing to EDs

A

-personal freedom, instant gratification, availability of food at any time, lack of supervision, cultural ideal of diet and exercise for weight loss

143
Q

Family influences on eating disorders

A

-dysfunction/conflict
-parent psychopathology
*child may be trying to direct attention away from basic family conflicts
-overemphasis on weight and dietary control
Physical abuse, child sexual abuse (esp. Bulimia)

144
Q

Psychological factors related to bulimia

A
  • struggle for autonomy, competence control, self respect

- phobic avoidance where phobic object is normal adult body weight and shape

145
Q

Personality characteristics associated with anorexia

A

-avoidance of harm, low novelty seeking, reward dependence

146
Q

Bulimia psychological dimensions

A 
-mood swings
Poor impulse control
OC behaviors
Depression
Anxiety disorders
Substance abuse
147
Q

Almost 90% of persons with eating disorders have other _____ disorders, usually ____, ______, and _____.

A

Axis I disorders: depression, anxiety, OCD

148
Q

Psychological interventions EDs

A
  • psychotherapy; sometimes accompanied by medical interventions
  • mostly outpatient
  • hospitalization (usually brief) for those with serious complications
149
Q

Pharmacological treatment for ED

A

SSRIs (not for initial treatment) may be helpful for bulimia, but not anorexia (should be used alongside CBT, not alone)

150
Q

Psychosocial interventions for ED

A

Comprehensive treatment plans with psychotherapist, nutritionist, psychopharmacologist, and internist are more affective than medications alone
-resolution of family and interpersonal problems are crucial

151
Q

Anorexia more or less responsive to treatment than bulimia?

A

Anorexia

152
Q

BFST for anorexia

A

-behavioral family systems therapy:

Emphasizes parental control over eating, cognitive restructuring, and problem solving communication training

153
Q

EOIT for anorexia

A

-ego oriented individual therapy: builds ego strength, adolescent autonomy, and insight

154
Q

Individual or family oriented CBT for bulimia

A
  • to change eating behaviors with rewards and modeling
  • help patients change distorted/rigid thinking patterns
  • cues that trigger the urge to binge or vomit
  • underlying interpersonal issues
155
Q

Interpersonal therapy for bulimia

A

Addresses situational personal issues contributing to the disorder

156
Q

Healthy parenting includes:

A
  • knowledge of child development and expectations
  • adequate coping skills
  • healthy parent child attachment and communication
  • home management skills, shared parental responsibilities, adn provision of social services
157
Q

Neglect accounts for ____% of all documented incidents

A

64%

158
Q

Sexual abuse is more prevalent for ______, while physical abuse is more prevalent for ________

A

Females, males

159
Q

Age as a characteristic of victimized kids

A

Younger more at risk
Sexual abuse more common among kids over 12
Victimization rate is inversely related to kids age (except for sexual abuse)

160
Q

Gender difference in victimized kids

A

80% of sexual abuse victims are females
Similar rates of overall maltreatment
Boys more likely to be sexual abused by male non family members; girls by male family members
Both more likely to be by someone they know

161
Q

Resilience to abuse factors include:

A

Good self esteem and sense of self

Good relationship with consistent person of support and protection

162
Q

Attachment and abuse

A

Insecure disorganized attachment characterized by a mixture of approach and avoidance, helplessness, apprehension, and general disorientation

163
Q

Emotion regulation and abuse

A

Difficulty understanding, labeling and regulation internal emotional states
Poor emotion regulation, which may lead to internalizing and externalizing problems

164
Q

Cognitive factors resulting from abuse

A
  • Negative representational models of self and others
  • feelings of betrayal and powerlessness, which may become central to identity
  • sometimes internal attributions of blame for the maltreatment
  • maltreated girls tend to show more internalizing signs of distress such as shame and self blame, while maltreated boys show heightened levels of verbal and physical aggression
165
Q

Neglected children

A

Most severe and wide ranging problems in school and interpersonal adjustment

166
Q

Sexually abused kids

A

Anxious, inattentive, and unpopular

Less autonomy and self guidance in completing school work

167
Q

Bipolar disorder

A

-a striking period of abnormally and persistently elevated, expansive, or irritable mood, alternating with or accompanied by one or more major depressive episodes

PSYC 500 (1 decks)

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