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mid 2 Flashcards

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1
Q

diagnosis

A

“from a categorical perspective is defined by rules that outline how many and what features of a mental disorder must be present.”

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2
Q

dimensional vs categorical approach

A

Dimensional
Psychological distress varies along a continuum from
none to extreme, “clinically severe”
All people lie somewhere along this continuum Mental illness is just a variation in degree of
symptoms

Categorical
Psychological disorders are “all or none”—either you
have one or you don’t
Derived from the medical model

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3
Q

How do we know when someone is in psychological distress and/or has a clinically
severe disorder?

A

Methods of Assessment (Psychological)
 Interview (Unstructured, Semi-structured, Structured)  Intelligence Tests/Neuropsychological Tests  Self-Report Questionnaires
 Measures of global personality  Measures of specific problems (and/or positive states)
 Self-Monitoring  Behavioral Observations  Projective Tests
 Methods of Assessment (Biological)
 Neuroimaging (Functional MRIs, PET Scans, etc.)  Neurochemical Assessment (Detect neurotransmitters from blood, urine, spinal fluid draws)  Psychophysiological Assessment (heart rate/EKG, muscle tension/EMG, sweating/GSR

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4
Q

self report

A

 Client’s retrospective reports of their own
functioning
 Indirect measures
Subject to memory bias Subject to social desirability
 Clinical Interviews
 Necessary starting point that suggests what other types of
measures might be appropriate
Unstructured Structured
 Self-Report Questionnaires  Self-Ratings

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5
Q

beck depression inventory

A 
 Measures  cognitive, affective, and
somatic symptoms of depression consistent with descriptions in the
psychiatric literature
 Items based on clinical observations
and patient symptom reports (atheoretical)
 High scores in college students could
mean overall adjustment problems vs.
clinical depression
Psychometric Properties
Internal Consistency
Ranged from .80 to .90
Test-Retest Reliability
Ranged from .48 to .86 in psychiatric populations Was .90 over  2 week among 200 college undergraduates
Construct Validity
Correlates….
.61 with MMPI Depression Scale .76 with SCLR90-R Scale .66 with Hamilton Depression Scale
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6
Q

self ratings

A

Subjective Units of Distress (SUDS)
Useful for Anxiety Disorders On a scale of 0-100, how anxious are you right
now?
Typically used in contrived situations
Imaginal, In Vivo, Virtual Reality Exposure

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7
Q

syndrome

A

“A group of emotional, cognitive, or behavioral symptoms, called a syndrome, that occur within a person.”

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8
Q

self monitoring

A

 The client records the frequency, duration,
intensity, description of events as they happen or as close to that time as possible (e.g. end of the day)
Antecedent, Behavior Consequences Antecedent Belief, Behavior, Consequences

 Advantages
 Does not suffer from
recall problems--not retrospective
 Can provide ongoing
data
 Convenient relative to
behavioral observations
 Provides more
complete information than outside observer
 Thoughts I’m going to fail!  Private Situations Sexual Dysfunctions
 Disadvantages
 More time-consuming
than questionnaires
 Reactivity effects
 Paying attention to behavior and recording it may alter the naturally occurring behavior
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9
Q

behavioral assesment

A

 The therapist records the frequency, duration,
intensity of overt behaviors as they happen or as close to that time as possible
Natural situation or controlled/contrived situation Videotape for later coding Time-consuming and expensive Behavioral reactivity (observation changes client
behavior)

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10
Q

Intelligence test

A

 Wechsler Adult (or Child) Intelligence
Scale
Full-Scale,Verbal& Performance
(Spatial Reasoning) IQ

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11
Q

Neuropsychological Tests

A 
 Halstead-Reitan BatteryIndirect
measure of brain functioning
Assesses many cognitive and
behavioral functions
Used to make differential diagnoses
between cognitive disorders and mood, anxiety, psychotic disorders
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12
Q

 Neuroimaging

A

CT Scan-structural abnormalities MRI-structural abnormalities fMRI-functional abnormalities PET scan-structural and functional

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13
Q

Neurochemical Assessment

A

Neurotrasmitter metabolites from urine,

blood, spinal fluid (low serotonin levels, high dopamine levels)

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14
Q

psycho-physiological measures

A

 Examining bodily changes associated with
various psychological states via electronic
devices
 Primarily used to detect stress, anxiety, and sexual
arousal

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15
Q

DSM-V Cultural Formulation

A

Cultural identity of the client
Cultural ideas of distress
Cultural factors related to the social environment
Cultural influences on the relationship between
the client and the mental health professional
Overall cultural assessment

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16
Q

Reliability

A

Is your measure consistent?

Across time Among items Between observers

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17
Q

Validity

A

Does your measure assess what it’s supposed to

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18
Q

Test-retest reliability

A

Consistency of test scores or diagnoses across some period of time

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19
Q

Interrater reliability

A

Agreement between two or more raters or judges about level of a trait or presence/absence of a feature or diagnosis

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20
Q

Internal consistency reliability

A

Relationship among test items that measure the same variabl

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21
Q

Content validity

A

How well test or interview items adequately measure various aspects of a variable, construct, or diagnosis

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22
Q

Predictive validity

A

How well test scores or diagnoses predict and correlate with behavior or test scores that are observed or obtained at some future point

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23
Q

Concurrent validity

A

How well test scores or diagnoses correlate with a related but independent set of test scores or behaviors

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24
Q

Construct validit

A

How well test scores or diagnoses correlate with other measures or behaviors in a logical and theoretically consistent way

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25
Q

“Objective personality measures”

A

“involve administering a standard set of questions or statements to which a person responds using set options.”

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26
Q

projective tests

A

“such as the Rorschach and TAT rely on the assumption that people project their needs, conflicts, and personality when responding to ambiguous stimuli.”

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27
Q

anxiety disorders

A

Panic Disorder
With or without Agoraphobia
 Social Phobia  Simple/Specific Phobia  Generalized Anxiety Disorder  Obsessive-Compulsive Disorder  Post-Traumatic Stress Disorder  Separation Anxiety Disorder

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28
Q

Changes to existing Anxiety Disorders

A

Obsessive-Compulsive Disorder
 Removed from Anxiety Disorders
 Obsessive-Compulsive & Related Disorders
 OCD  Hoarding  Body Dysmorphic Disorder
 Post-Traumatic Stress Disorder
 Removed from Anxiety Disorders  Trauma & Stress-Related Disorders
 PTSD  Adjustment Disorder  Reactive Attachment Disorder

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29
Q

panic attack

A

 Extreme fear
Intense physical symptoms
Elevated heart rate, chest pain, numbness and tingling in
extremities, dizziness, sweating, shortness of breath
Uncued
No specific stimulus (occurs “out of the blue”) Lasts about 10 minutes Defines Panic Disorder (with or without Agoraphobia)
Cued (Situationally Bound)
In response to a specific situation Characteristic of other Anxiety Disorders

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30
Q

panic disorder

A

Recurrent unexpected panic attacks and at least one of the attacks have
been followed by 1 month

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31
Q

agorophobia

A

Marked, Intense Fear: A pronounced and irrational fear of being unable
to get help or find escape if a panic attack should occur. In agoraphobia without history of panic disorder, the expected panic attack is generally
limited in symptoms.
 Avoidance or Extreme Distress: The feared situations are avoided if
possible. They can be endured, but only with extreme distress.

32
Q

social phobia

A

Marked and persistent fear of social or performance situations and fear of acting in a way that causes personal humiliation or embarrassment
Exposure to the feared social situation causes anxiety that may come in the form of a situationally bound or predisposed panic attack
Recognition that the fear is excessive or unreasonable
Feared social or performance situations are avoided or endured with intense anxiety
Significant interference with daily living or functioning or marked distress about having the disorder

33
Q

specific phobia

A

“Animal phobias involve fears of—you guessed it, animals—es- pecially dogs, rodents, insects, and snakes or other reptiles.
Natural environment phobias involve fears of surrounding phenomena such as heights, water, and weather events such as thunderstorms.
Blood-injection-injury phobias involve fears of needles, medical procedures, and harm to self.
Situational phobias involve fears of specific areas such as enclosed spaces in airplanes and elevators.
Other phobias involve any other intense fear of a specific ob- ject. Examples include more common ones such as iophobia (fear of poison) but also unusual ones such as levophobia (fear of things to one’s left), arachibutyrophobia (fear of peanut but- ter sticking to the roof of the mouth), and hippopotomonstro- sesquippedaliophobia (you guessed it—fear of long words).”

34
Q

gad

A

Restlessness Easily Fatigued Trouble Concentrating

Irritability Muscle tension seep disturbincw

35
Q

acute stress disorder

A

“refers to distressing memories and dreams, negative mood, dissociation (feelings of detachment from reality or dis- connectedness from others), avoidance, and arousal that last between 3 days and 1 month after the trauma.”

36
Q

anxiety treatments

A

 Biological Treatments
Subject to side-effects and/or dependence, addiction
 Psychological Treatments
Psychoeducation (explain causal model and rationale for
treatment)
Somatic Therapy (e.g. relaxation training) Cognitive Therapy (e.g. challenges, replaces cognitive
distortions)
Exposure-Based Therapies (plus Response Prevention)

37
Q

separation anxiety

A

“is marked by substantial distress when separation from a major attachment figure occurs or is expected to occur. This distress must last at least 4 weeks in children, so initial distress about going to school is excluded.”

38
Q

anxiety common…

A

19-31

women

39
Q

“Psychophysiological assessment of anxiety-related disorders”

A

“can consist of determining heart rate, muscle tension, sweat gland activity, and other symptoms to measure their severity.”

40
Q

“Effective treatment for anxiety-related disorders”

A

“addresses unpleasant physical feelings, negative thoughts, and avoid- ant behaviors.”

41
Q

“Psychological treatments for people with anxiety-related dis- orders”

A

“Psychological treatments for people with anxiety-related dis- orders”

42
Q

“Cognitive therapy”

A

“involve techniques such as examin- ing the evidence, hypothesis testing, and decatastrophizing.”

43
Q

somatic symptom disorder

A

 Medically unexplained
› Pain Symptoms › GI Symptoms › Fatigue › Dizziness › Heart Palpitations
 Symptoms not intentionally produced or faked  Persistent thoughts and anxiety about symptoms  Excessive time, energy devoted to symptoms  History of treatment seeking

44
Q

somatization

A

“a tendency to communicate distress through physical symptoms and to pursue medical help for these symptoms”

45
Q

Illness anxiety disorder

A

“preoccupied with having some serious disease that may explain general bodily changes.”
“last at least 6 months and cause substantial distress or impairment in daily functioning.”
autosuggestability

46
Q

presenting somatiziation

A

“refers to somatic symptoms usually presented as part of another mental disorder, especially anxiety or depression”

47
Q

conversion disorder

A

Presence of symptoms or deficits affecting
voluntary motor or sensory function that suggest a neurological or other general medical condition
“pseudoseizures, or seizure-like activity such as twitching or loss of consciousness without electrical disruptions in the brain.”
Patients seem relatively unconcerned about these severe symptoms(“la belle indifference,”)

48
Q

Factitious disorder

A

deliberately falsifying or producing physical feelings or psychological symptoms
may purposefully make self sick
no external incentives

49
Q

Munchhausen syndrome

and by proxy

A

“a factitious disorder in which a person causes symptoms and claims he has a physical or men- tal disorder.”

by proxy=adult onto child

50
Q

malingering

A

“refers to deliberate production of physical or psychological symptoms with some external motivation.”

51
Q

secondary and primary gain

A

“Secondary gain sometimes refers to receiving social reinforcement for so- matic complaints. Psychodynamic theo- rists view primary gain as unconscious use of physical symptoms to reduce psychological distress.”

52
Q

“illness beliefs or attributions,”

A

“perceived causes of physical symptoms.”

53
Q

Somatosensory awareness

A

amplifying physical sensations

54
Q

somatic treatments

A

Cognitive Therapy
›Reappraisal of physical symptoms ›Re-evaluate probability of disease
Contingency Management
 Involve others in the environment to refrain
from reinforcing sick role and other unhealthy behaviors
Response Prevention
›Prevent doctor shopping, surgeries, etc

55
Q

“Biological risk factors” somatic disorders

A

“genetic predispositions, as well as key brain changes in the amygdala, hypothalamus, limbic system, and cingulate, prefrontal, and somatosensory cortices.”

56
Q

Predictors of chronic somatic symptom disorders

A

Severity of symptoms
Female gender
Co-morbid mood problems
Unrealistic fears of illness

57
Q

Body dysmorphic disorder

A

Preoccupation with a “deficit” in
physical appearance
›Related to OCD ›Multiple cosmetic surgeries

58
Q

dissociative disorder

A 
"often involve disturbance in consciousness, memory, or identity"
Dissociative Amnesia ›Dissociative Fugue
Depersonalization/Dereali-
zation Disorder
Dissociative Identity
Disorder
› Previously Multiple Personality Disord
59
Q

dissociative amnesia

A

Forgetting highly personalized information
›Name ›Family members ›Childhood events
Precipitated by a traumatic event Not caused by neurological/medical
disorder or substance abuse

60
Q

dissociative fugue

A 
Sudden, unexpected travel
away from home with inability to recall one’s past
Confusion about personal
identity or assumption of a
new one
Precipitated by trauma
61
Q

Depersonalization/Derealization Disorder

A

The presence of persistent or recurrent experiences of depersonalization, derealization, or both:
1. Depersonalization: Experiences of unreality, detachment, or being an outside
observer with respect to one’s thoughts, feelings, sensations, body, or actions.
2. Derealization: Experiences of unreality or detachment with respect to
surroundings.
B. During the depersonalization or derealization experiences, reality testing remains intact.
C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
D. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, medication) or another medical condition (e.g., seizures).
DSM-5 Depersonalization/Derealization Disorder
E. The disturbance is not better explained by another mental disorde

62
Q

dissociative identity disorder

A

Presence of two or more
distinct identities of personalities each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self
one-third of patients complain of auditory or visual hallucinations

63
Q

dissocaitive prevention

A

eaching children to report maltreatment Educating children about unsafe situations
Teacher parents appropriate disciplinary practices Providing support groups for parents

64
Q

dissociative treatment

A

hypnosis
“The biological treatment of dissociative disorders usually includes medication for concurrent symptoms of anxiety, depression, and other problems. Psychotherapy for dissociation helps a person reintegrate consciousness, process traumatic events, and learn to cope with daily events without using dissociation.”

65
Q

major depressive episode

A

“involves a period of time, typically at least 2 weeks but usually longer, in which a person experi- ences sad or empty moods most of the day, nearly every day”

66
Q

major depressive disorder

A

“sometimes called major depression or unipolar depression, usually involves a longer period during which a person may experience multiple major depressive episodes”

With anxious distress
 With psychotic features
 With peripartum onset
Post partum depression

 With seasonal pattern
Seasonal Affective Disorder

67
Q

“Persistent Depressive Disorder (Dysthymia)”

A

Chronic feeling of depression for at least two years

“low grade” depression

68
Q

manic episode

A 
 Flight of ideas
 Grandiosity
 “I feel like I have the world by the
balls!”
 Impulsivity  Sexual promiscuousness, affairs  Shopping, spending sprees  Dangerous activities
69
Q

hypomanic episode

A

“comprises the same symptoms as a manic episode but may not cause severe impairment in daily functioning. Unlike “bursts of energy” that many of us occasionally have, hypomanic episodes last at least 4 days”

70
Q

bipolar 1 disorder

A

“disorder refers to one or more manic episodes in a per- son. The disorder is sometimes called manic-depression because a person may alternate between episodes of major depression and mania or hypomania.”

71
Q

bipolar 2

A

“comprises episodes of hypomania that al- ternate with episodes of major depression. Full-blown manic epi- sodes are not seen as they are in bipolar I disorder”

72
Q

cyclotymic disorder

A

“sometimes called cyclothymia, refers to symptoms of hypomania and depression that fluctuate over at least a 2-year period”

73
Q

mood disordeer risk fCTORS

A

Biological
Genetics (39-50% Depression; 80% Bipolar Disorder)
Family & Twin concordance rates
Brain Features Neurochemical Features
Depression Lower levels of serotonin Lower levels of norepinehprine
Bipolar Disorder Lower levels of serotonin Higher levels of norepinephrine
 Environmental
Stressful Life Events
Precipitate onset Severity and Meaning of the event Uncontrollability of the event
Job loss School failure Relationship break-up Major illness or injury Death of significant other
Cognitive Factors
Cognitive Distortions/Automatic Thoughts Cognitive Triad (Aaron Beck) Negative View of the Future = Hopelessness Learned Helplessness (Martin Seligman)
Nothing I do will make a difference
Interpersonal Factors
Social Skill Deficits Lack of Social Support Relationship Conflicts Social Reinforcement of “Sick Behavior” Depressed people are socially off-putting to
others

74
Q

prevent mood disorders

A

Declare existing strengths
Manage stress Modify negative and irrational thoughts Solve problems efficiently
Develop and use social support networks
Enhance social skill and recognize other perspectives

75
Q

mood disorder treatments

A

 Medications (See Tables 7.14 & 7.15)
 Lithium (mood stabilizer for Bipolar Disorders)
Highly toxic, requires regular blood tests
 Selective Serotonin Reuptake Inhibitors (SSRIs)
Celexa, Lexapro, Prozac, Zoloft, Paxil, Luvox
Fewest side-effects
 Tricyclics
Moderate side-effects
 Monoamine Oxidase Inhibitors
Severe side effects, dietary restrictions
 Electroconvulsive Therapy
 Repetitive Transcranial Magnetic Stimulation

 Cognitive Therapy/Cognitive Restructuring
 https://www.youtube.com/watch?v=m2zRA5zCA6M
 Behavioral Activation Therapy
Increasing daily activities and exercise
Set up reinforcement schedules (self and others)
for these
 Mindfulness
 Interpersonal Therapy
Social Skills Training
Support for relationship transitions

psych 381 2 (1 decks)

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