Midterm Flashcards
4 D’s of a Mental Disorder
deviance, dysfunction, distress, dangerousness
Dimensions underlying mental disorders
normal->mental disorder: more severe
History of Abnormal: Pre-common era
cause by supernatural phenomena, exorcism for treatments or trephination
Greek and Roman Thought
Hippocrates thought brain dysfunction was the reason for disorder
Renaissance
brought use of asylums, good intent, turned bad until eventually reformed
Dimensional Perspective
thought, behaviors, and emotions are a continuum of impairment
Primary Prevention
targeting groups who have not developed mental disorder: school curriculum, non discrimination, improve housing, educational resources
secondary prevention
addressing problems as they emerge while they are still manageable, before they become resistant to intervention
tertiary prevention
reducing the severity, duration, and negative effects of a mental disorder after its onset
consumer perspective
present relevant info in a way that will be easy to retain
biological model
focuses on genetics, nervous system and neurons, brain and brain changes, other factors like hormones
evaluating the biological model
pros: highly respected, findings have helped our understanding of many disorders
cons: not a full account of any disorder, denies crucial environmental/other factors that influence behavior
psychodynamic model
id(pleasure principle), ego(reality), and superego(internalized ideals). Psychosexual stages from birth to adolescence. Uses defense mechanisms to describe coping strategies.
Evaluating psychodynamic model
pros: focus on importance of early childhood, defense mechanisms make sense
cons: little empirical evidence supports, over emphasis of sexual and aggressive energy as engine of behavior
humanistic model
concepts include: self-actualization, conditional and unconditional positive regard, empathy, existential aspects of life, meaning of life
Maslow
(humanistic) well known for hierarchy of needs and self-actualization:
physiological->physical safety/security->social belonging->esteem and ego (accomplishments)->self actualization
Rogers
(humanist) client-centered therapy, importance of empathy and positivity in relationships
May
(humanist) best known for focus on existential aspects of psych including authenticity and meaning of life
evaluating the humanistic model
pros: focuses on human choice and growth, more optimistic, emphasizes responsibility, roger’s approach has been very important to helping clients
cons: more grounded in philosophy than science, many factors other than human perception influence behavior and disorders
cog-behavioral model
classic conditioning, schemas, working on cognition to modify cognitive set and thus change behavior
evaluating the cognitive behavioral model
pros: revolutionized treatment of many disorders, many of the treatments prove successful in therapy
cons: sometimes reductionistic, in that it reduces complex disorders to aberrant thinking, does not help understand etiology
sociocultural model
culture ethnicity race social upbringing and community have a large role in shaping cognition. different disorders more common in different genders and cultures and communities. family plays a big role
evaluating sociocultural model
pros: highlights importance of social influences on cognition, provides good info on stressors
cons: linking social, cultural, or envi factors to health can only be correlational, not everyone exposed to various adverse influences will go on to develop disorder
diathesis-stress model
diathesis: predisposition or vulnerability to developing disorder, can be genetic, biological, or developmental
stress: environmental stressors trigger onset of disorder, can be noxious physical stressors, relationships, jobs, trauma, abuse, neglect
treatment seeking
less than half of people with mental disorder seek treatment, treatment costs $57.5 billion annually
protective factors
individual-level: above average intelligence, positive demeanor, social competence, spirituality or religion
family: smaller family structure, supportive parents, good sibling relations, adequate rule-setting
community/social: commitment to schools, available healthcare, social cohesion
dimensional approach to diagnosis
4 Ds: behavior deviates from norm, dysfunctional to life, accompanied by personal distress or dangerousness. viewed on continuum from normal to severe disorder
categorical approach
large class of frequently observed syndromes composed of abnormal features, DSM
objective vs projective personality measures
objective: validity indicators, clinical scales, somatic/cog scales, internalizing, externalizing, interpersonal, PSY-5
projective: rorschach, thematic apperception
behavioral assessments
naturalistic observation, controlled observation, self-monitoring
anxiety disorders: prevalence, most common examples
most common mental disorders in the US, as many as 19% of Americans suffer from one anxiety disorders that include: separation anxiety disorder, specific phobias, generalized anxiety disorder, selective mutism, social anxiety disorder (social phobia- most common), agoraphobia, panic disorder, or substance/medication induced anxiety disorder
OC and related disorders
obsessive-compulsive disorder, body dysmorphic disorder, hoarding disorder, trichotillomania (hair pulling), excoriation disorder (skin picking), substance/med induced ocd
major trauma and stressor related disorders
reactive attachment disorder, disinhibited social engagement disorder, PTSD, acute stress disorder, adjustment disorders
comorbidity of anxiety disorders
most common: one caused by another, then two independent, then one by itself
worry vs anxiety vs fear
worry is a cognitive state in reaction to possible future threat, where anxiety is an emotional state in reaction to approaching threat. fear is emotional state when event is occurring or imminent
panic attack symptoms
need 4 of the following: pounding heart, sweating, trembling, shortness of breath, choking feeling, chest pain or discomfort, nausea/abdominal distress, dizzy or faint, chills or heat, parenthesis (pins and needles), derealization/depersonalization, fear of losing control, fear of dying
panic disorder
A. recurrent panic attacks
B.one of the attacks has to be followed by one+ months of the following:
1. concern about future attacks
2. significant maladaptive behavior change
agoraphobia
A. marked fear or anxiety about 2+ of the following 1. using public transport 2. being in open spaces 3. being in enclosed spaces 4. standing in line or being in a crowd 5. being outside of the home alone B. fears or avoid these situations C. provokes fear or anxiety D. actively avoids E. out of proportion to danger F. 6+ months G. significant distress
Social Anxiety Disorder or social phobia
A. fear of social situations where scrutiny is possible
B. fear of negative evaluation
C. the social situations almost always provoke fear or anxiety
D. social situations are avoided or anxiously endured
E. out of proportion fear
F. fear lasting 6+ months
G. significant distress
Specific Phobia
A. Marked fear or anxiety about a specific object or situation
B. provokes immediate fear or anxiety
C. actively avoided or endured w intense anxiety or
D. disproportionate fear
E. 6+ months
F. significant distress
Generalized Anxiety Disorder
A. Excessive anxiety + worrying occurring more days than not for 6+ months
B. difficulty controlling worry
C. 3+ of the following, some present more than not, for 6+ months
1. restlessness, on edge
2. easily fatigued
3. difficulty concentrating
4. irritability
5. muscle tension
6. sleep disturbance
D. significant distress
E. not attributable to substance or another condition. does not exclusively occur during mood disorder, psychotic disorder, or PDD
F. not better explained by another disorder
F.
OCD
A. presence of obsessions, compulsions, or both
B. time consuming or significant distress
Hoarding Disorder
A. difficulty discarding or parting with possessions
B. perceived need to save, distress discarding
C. significant distress
body dysmorphic disorder
A. preoccupation with one or more flaws in physical appearance
B. repetitive behaviors or mental acts in response to appearance concerns
C. preoccupation causes significant distress
acute stress disorder
A. exposure to threatened death, serious injury, or sexual violence in 1+ of the following ways: 1. directly experiencing trauma 2. witnessing trauma on others 3. learning trauma has happened to a loved one 4. experiencing repeated or extreme exposure to aversive details of trauma B. 9+ of the following: 1. distressing memories of trauma 2. distressing dreams 3. dissociative reactions 4. intense distress at cues 5. inability to experience positivity 6. altered sense of reality 7. inability to remember event 8. avoidance of distressing memory 9. avoidance of external reminders 10. sleep disturbance 11. irritable 12. hypervigilance 13. problems with concentration 14. exaggerated startle response -3 days to one month after traumatic experience
PTSD
A. exposure to threatened death, serious injury, or sexual violence in 1+ of the following ways:
1. directly experiencing trauma
2. witnessing trauma on others
3. learning trauma has happened to a loved one
4. experiencing repeated or extreme exposure to aversive details of trauma
B. presence of one or more of the following:
1. intrusive distressing memory of trauma
2. recurrent distressing dreams
3. dissociative reactions
4. psychological distress
5. psychological reactions
C. avoidance of stimuli associated w trauma, 1 or both of following
1. avoidance of distressing memories thoughts feelings about or related to trauma
2. avoidance or efforts to avoid external reminders
D. negative alterations in cognition or mood in assoc w trauma, evidenced by 2+:
1. inability to remember trauma
2. persistent negative beliefs
3. distorted cognitions about the cause of trauma
4. negative emotional state
5. diminished interest or participation in activity
6. detachment from others
7. inability to experience positivity
E. alterations in reactivity and arousal, marked by 2+:
1. irritable
2. reckless or self destructive
3. hypervigilance
4. exaggerated startle
5. problems w concentration
6. sleep disturbance
E. MORE THAN ONE MONTH
F. significant distress
Separation Anxiety Disorder
- developmentally inappropriate fear of separation
- at least 4 weeks in kids, 6+ months in adults
anxiety disorders
- almost 30% of adults at some point
- social anxiety and specific phobia are most common
- 23% seek treatment
- tend to begin at 19-31
- 13 for social phobia
- 7 for separation anxiety
- more common in women
- highly comorbid
- moderately genetic
- serotonin and norepinephrine
somatic symptom disorder
- physical symptom may or may not have discoverable cause
- excessive thoughts and anxiety related
- @ least 6 months
illness anxiety disorder
- preoccupation with having or acquiring serious illness
- @ least 6 months
- few or no somatic symptoms present
conversion disorder
-one or more symptoms of altered voluntary motor or sensory function
factitious disorder on self
-falsification of physical symptoms on self
factitious disorder on another
- falsification of symptoms on another with deceptive intent
- frequently parent on child
- perpetrator, not victim, received diagnoses
somatic symptom disorders
- difficult to collect data
- moderate genetic basis
- amygdala and limbic system
dissociative amnesia
- inability to recall info, usually of traumatic nature
- lost info often about one event
- not caused by substance use
- dissociative fugue disorder is classified under this, travel or wandering along with amnesia
dissociative identity disorder
- ‘split personality disorder’
- 2+ personality states
- not explained by broadly accepted cultural practice
- gaps in recall
- 2 way amnesic relation: none of the personalities are aware of each other
- 1 way: some are aware of others
- mutual: they’re all aware of each other
depersonalization/ derealization disorder
- reality testing remains intact
- personalization is detachment from self, realization from surroundings
dissociative disorders
- more common in black americans
- highly comorbid with others
- memory changes
- amygdala, locus coeruleus, thalamus, hippocampus, anterior cingulate cortex, frontal cortex
major depressive disorder
- depressed mood or loss of interest present during at least 2 week periods
- appetite changes
- insomnia or hypersomnia likely
- no manic episodes
persistent depressive disorder (dysthymia)
- depressed mood most of the time at least 2 years
- major but longer
disruptive mood dysregulation disorder
- temper outbursts and angry mood
- inconsistent w development level
- diagnosis shouldn’t be before 6 or after 18, age of onset must be before age 10
- don’t have hypermania
hypomanic episode v manic episode
hypomanic is not severe enough to cause impairment in normal functioning, manic is
bipolar I
- at least 1 manic
- depression or mania not better explained elsewhere
bipolar II
- at least 1 hypomanic
- at least 1 major depressive episode
- never been a manic episode
cyclothymic disorder
-at least two years of periods of hypomanic symptoms and depressive symptoms
depressive and bipolar disorders
- depression twice as common in women
- completion of suicide more common in men, attempts more common in women
- bipolar less common
- limbic system
- serotonin and norepinephrine, cortisol in depression
negative cognitive triad
- i will never amount to anything
- i am hopeless
- the world is against me
MAOIs
- increase serotonin and norepinephrine
- toxic food reactions
tricyclics
- norepinephrine and serotonin
- more negative side effects
SNRIs
- reuptake inhibitors for norepinephrine and serotonin
- cymbalta
SSRIs
- prevent serotonin reuptake
- associated with increased suicide attempts
lithium
- mood stabilizer
- increases serotonin, decreases others
divalproex
- anticonvulsant
- sedating
- increases GABA
electroconvulsive therapy
-severe depression or mania
anorexia nervosa
- restriction of intake-> significant weight loss
- intense fear of weight gain
- can involve purging or restricting
- low body weight
- lack of seriousness about low weight
binging/purging cycle
diet->break diet->binging triggered->purging->self hatred asnd shame
bulimia nervosa
- recurrent binge eating
- inappropriate compensatory behaviors
- 3+ months
- negative self evaluation
binge-eating disorder
- recurrent episodes, more rapid eating, until uncomfortably full, not hungry, eating alone, depressed or guilty
- at least once a week for 3 months
eating disorders
- peak age of onset is 15-19 for anorexia
- average death at 49-61
- 23% seek treatment
- bulimia mostly in western cultures
- nucleus accumbens, prefrontal, orbitofrontal, somatosensory, thalamus
- serotonin, dopamine, endogenous opioids
- perfectionism and impulsivity common
- SSRIs and antipsychotics used to treat
family factors of EDs
- insecure attachment
- reinforcement from family
- model mothers
- hyperemotional families
- neglect and maltreatment
