Midterm 2 Flashcards
Types Dissociative disorders
- dissociative amnesia
- dissociate fugue
- depersonalization/ derealization disorder
- dissociative identity disorder or multiple personality disorder
Dissociative disorders
Characterized by severe maladaptive disruptions or alterations of identity, memory, and consciousness that are experienced as being beyond ones control
Dissociation
- The lack of normal integration of thoughts, feelings, and experiences in consciousness and memory;
- Persistent maladaptive disruptions in the integration of memory, consciousness, and identity
- symptom in many mental disorders
Repressed
Referring to memories that a person cannot call into awareness, but which remain in the person’s subconscious and can be retrieved under certain conditions or with the help of psychotherapists
False memory syndrome
A proposed condition in which people are induced by therapists to remember events that never occurred
Dissociative amnesia
The inability to recall significant personal information in the absence of organic impairment
Localized amnesia
Individual can’t recall info from a specific time period
Selective amnesia
Parts of events (trauma) are remembered, others forgotten
Generalized amnesia
Individual forgets all past personal information from his or her past
Continuous amnesia
Individual forgets information from a specific date (trauma?) to present
Systematized amnesia
The person forgets certain categories of information such as people or places
Which two categories of dissociative amnesia are the most common?
-localized & selective
The five patterns of memory loss characteristic of dissociative amnesia described in DSM-5
1) localized amnesia
2) selective amnesia
3) generalized amnesia
4) continuous amnesia
5) systematized amnesia
Dissociative fugue
An extremely rare and unusual type of amnesia in which individuals not only have a loss of memory for their past and personal identity, but they also travel suddenly and unexpectedly away from home
Depersonalization/ derealization disorder
- A dissociative disorder in which the individual has persistent or recurring experiences of depersonalizations and/ or derealization
- likely related to emotional trauma
- reduced emotional reactivity to stressful or emotionally intense stimuli, & cognitive disruptions in perceptual and attentional processes
Depersonalization
A condition in which individuals have a distinct sense of unreality and detachment from their own thoughts, feelings, sensations, actions, or body (sense of unreality, detachment from self)
Derealization
Involves feelings of unreality and detachment with respect with respect to one’s surroundings rather than the self(feelings of unreality, detachment from surroundings)
Depersonalization is the _______ most commonly reported symptom
Third
Dissociative identity disorder (DID)
- (multiple personality disorder)
- diagnosed when the patient presents with two or more distinct personality states that regularly take control of the patient’s behaviour and emotions
- disruption identity & marked discontinuity in sense of self and agency
- diagnosis age 29-35
- high rate self-injury & suicide attempts
- controversial disorder
Alters
The subsequent (not host) personalities found in dissociative identity disorder (DID)
Social factors- etiology of dissociative disorders
- speculations about hat happens when parents are both loving and abusive
- Iatrogenic effects
Switching
- The process of changing from one personality to another
- often occurs in response to a stressful situation
Trauma model
According to his model, dissociative disorders are a result of severe childhood trauma, including sexual, physical, and emotional abuse, accompanied by personality traits that predispose the individual to employ dissociation as a defence mechanism or coping strategy (diathesis- stress formulation)
Abreaction
Re- experiencing of emotions that were felt at that time
Psychological factors- etiology of dissociative disorders
- trauma
- state dependent learning
- attachment theory
Treatment of dissociative disorders
- uncovering and expressing past traumas
- hypnosis (abreaction)
- DID: re-integrate all the personalities into a whole
- medication to reduce stress
Socio-cognitive model
- According to this perspective,multiple personality is a form of role playing in which individuals come to construe themselves as possessing multiple selves and then begin to act in ways consistent with their own or their therapist’s conception of the disorder
- taken by many mental health professionals who do not accept DID as a legitimate disorder
Types of somatic symptoms and related disorders
- Somatic symptom disorder with predominant pain
- illness anxiety disorder
- factitious disorder (Münchausen syndrome)
- body dysmorphic disorder
Somatic symptom disorder
- New diagnosis in DSM-5 which subsumes the former somatization disorder as well as hypochondriasis
- a disorder characterized by one or more bodily symptoms that are distressing to the individual, result in significant disruption of daily life, and are accompanied by excessive worry and preoccupation, extreme anxiety, or disproportionate time and energy
To be diagnosed with a somatic symptom disorder, a person must:
- have a history of multiple symptoms
- changing somatic complaints involving multiple organ systems
- history must have started before age 30 and include:
- pain at least 4 different sites or pain during bodily functions
- at least 2 gastrointestinal complaints
- at least one sexual or reproductive complaint
- at least one symptom other than pain suggests a neurological condition
Somatic symptom disorder with predominant pain
A subtype of somatic symptom disorder in which the presenting bodily symptom involves pain (called pain disorder in previous editions of DSM)
- pain must be sufficient to warrant professional attention and cause distress, work interruptions
- people must have excessive, unrealistic thoughts, feelings, or behaviour related to the symptom, exaggerated concerns about its seriousness, high levels anxiety, and/ or devote excessive time to dealing with it
- ‘doctor shopping’
Hysteria
An outdated psychiatric term once used to describe a a symptom pattern characterized by emotional excitability and physical symptoms (e.g. Convulsions, paralyses,numbness, loss of vision) without any organic cause
Conversion disorder (functional neurological symptom disorder)
Individuals with this disorder have a loss of functioning in apart of their body that appears to be due to neurological or other medical cause, but without any underlying medical abnormality to explain it
Somatic symptom and related disorders
A group of disorders in which individuals present with physical symptoms suggestive of medical illnesses, along with significant psychological distress and functional impairment at cannot be explained by organic impairment
Symptoms: impairment somatic system, multiple symptoms, preoccupation about the body, fear of physical illness
Glove anaesthesia
Involves a loss of all sensation throughout the hand, with the loss sharply demarcated at the wrist, rather than following a pattern consistent with the sensory innervation of the hand and forearm
La belle indifference
A nonchalant lack of concern about the nature and implications of ones symptoms
Illness anxiety disorder
A disorder characterized by preoccupation with having or acquaint a serious illness, even though the individual does not have any serious bodily symptoms. Individuals with this disorder are very preoccupied and anxious about their health, become easily alarmed by even mild symptoms,and perform excessive health-related behaviours such as repeatedly checking their body for signs of disease (hypochondriasis)
- fear life threatening condition
- Doctor shopping
Difference between panic disorder and illness anxiety disorder
- people with illness anxiety disorder do not have the symptoms of a panic attack
Difference between somatic symptom disorder and illness anxiety disorder
People with somatic symptom disorder do have symptoms, which are unexplained by standard medical science
Factitious disorder (Munchausen syndrome)
Individuals deliberately fake or generate the symptoms of illness or injury to gain medical attention
- can be physical or psychiatric
- there must not be any evidence of external rewards. Must be “sick role”
Factitious disordered imposed on another (Münchausen by proxy)
An individual falsifies illness in another person, most commonly one’s own child
Body dysmorphic disorder (BDD)
- Excessive preoccupation with an imagined or exaggerated body disfigurement, sometimes to the point of delusion
- distressing & difficult to control & interfering with social relations
- classified as an anxiety disorder under OCD
Are somatoform disorders more common in men or women
Except for,illness anxiety disorder, much more common in women in North America & Europe
More common in men in Puerto Rico and Greece
Somatoform disorders are more common in:
- low SES groups
- people less than high school education
- some cultures
- people lost a spouse
- Comorbidity with mood and anxiety disorders
Two-factor psychobiological theory: somatoform disorders
- Increased bodily signals due to biological factors related to prolonged distress, lack of physical condition, chronologically stimulated HPA axis
- A deficient ‘filter system’ that amplified body signals rather than inhibitiong them or effectively selecting them
Psychological factors: somatoform disorders
- unconscious expression of conflict, negative affect
- secondary gain
- positive and negative reinforcement
- learned sick role
- Tendency to pay excessive attention & amplify somatic symptoms
- misattribution of normal somatic symptoms
- alexithymia: deficit in the capacity to recognize and verbalized emotions
Alexithymia
Deficit in the capacity to recognize and verbalized emotions
Illness
Defined by symptoms, which are subjective reports of internal states
Disease
Defined by signs, which are objective indications of disease process observable directly or by the use of tests
Stress
An event that creates physiological and/or psychological strain, thus creating a need for adaptation by the individual; influences all physical disorders
Coping
The thoughts and behaviours a person uses to regulate distress (emotion-focused coping), manage the problem causing distress (problem-focused coping), and manta ion positive well-being (meaning-based coping)
Dualistic
A view of mind and body as separate entities, subject to different laws. Nowadays avoided in DSM terminology, hence the substitution of the term psychophysiological for psychosomatic
4 ways in which psychological or behavioural factors can affect a medical condition:
- The factors affect the course of the medical condition
- Psychological factors interfere with the treatment of the condition
- Psychological factors present an abnormal risk to the health of the individual
- Psychological factors influence the pathophysiology of the disorder
Behavioural medicine
Application of the methods of behaviour modification to the treatment or prevention of disease- for example, the use of psychological techniques to control pain in patients undergoing medical procedures, or interventions to improve the diabetics’ ability to control blood glucose
Health psychology
Any application of psychological methods and theories to understand the origins of disease, individual response to disease, and the determinants of good health
Mechanism
An activity of a living system that mediates the influence the influence of an antecedent factor on disease
Lesions
Disruptions of bodily tissue or of the normal function of a bodily system
Nonspecific immune responses
One of the three general categories of immune response, in which circulating white cells called granulocytes and monocytes identify invading agents and destroy them by phagocytosis engulfing and digesting them
Cellular immunity
One of the three general categories of immune response, based on the action of a class of blood cells called T-lymphocytes. The “T” designation refers to the locus of their production, the thymus gland. Cellular immunity results from a cascade of actions of various types of T-lymphocytes
Humoral immunity
One of the three general categories of immune response, in which invading agents are presented by macrophages to B-lymphocytes…
Psychoneuroimmunology
The study of mind-brain-immune system interaction
Three pathways through which psychosocial variables can influence immune activity:
1) by the direct action of CNS on organs and structures of the immune system
2) as a secondary consequence of the hormonal changes
3) by changes in behaviour (ie poor diet) that reflect personal characteristics of adaptations to changing life conditions
General adaptation syndrome (GAS)
A stereotyped pattern of bodily changes that occurs in response to diverse challengers to the organism, first described by Hans Selye. The syndrome comprises three stages: alarm, resistance, and exhaustion. The GAS was the first formal description and definition of stress
Alarm
The first phase of the general adaptation syndrome (GAS), a concept that was the first formal description and definition of stress as a consequence of adaptation to demands on the body. In the alarm phase, the body, faced with an adaptive challenge, mobilizes its defences
Resistance
The second phase of the general adaptation syndrome (GAS. In the resistance phase, if the challenge of the alarm phase persists, the body actively fights or copes with the challenge through immune and neuroendocrine changes. These adaptive responses enhance the body’s ability to ward off threats in short term
Transactional model
A model of stress that conceives of stress as a property neither of stimulus nor of response, but rather as an ongoing series of transactions between an individual and his or her environment. Central to this formulation is the idea that people constantly evaluate what is happening to them and its implications for themselves (appraisals)
People that can appraise an event as a ….
Challenge rather than a harm or threat cope with stress better
Appraisal
In the transactional model of stress, evaluations that people constantly make about what is happening to them and its implications for themselves
Primary appraisals
In the transactional model, Cognitive evaluation of the challenge, threat, or harm presented by an event
Secondary appraisals
In the transactional model of stress, a set of appraisals that occur after a primary appraisal if the individual concludes there is an element of threat, equivalent to the question: “is there anything I can do about this?”; the assessment of ones abilities and resources for coping with a difficult event
Internal locus of control
See themselves as the masters of their own destiny
Physiological responses to stress
- endocrine system (HPA axis)
- autonomic nervous system & sympathetic-Arsenal medullary system (SAM)
- immune system (paychneuroimmunogy)
External locus of control
See themselves as being buffeted by the random events of the world
Who is less likely to develop stress related illness?
- those who can recognize and express emotion within reasonable ranges, and those who are prepared to discuss emotional and traumatic experiences
Longitudinal study
A large group of people are evaluated for psychological or behavioural features and then are followed up, years or decades later, to determine whether they have developed the disease
Ischemic heart disease
Blood supply to the heart becomes compromised
Myocardial infarction
Heart attack
Stroke
Blood supply to the brain is interrupted, leading to death of neural tissue
Potential years of life lost (PYLL)
A measure calculated by subtracting age of death from an individual’s life expectancy
Vasculature
The system of arteries, arterioles, capillaries, venues, and veins responsible for circulation of the blood to all parts of the body and its return to the heart
Systolic blood pressure/ diastolic blood pressure
A measure of the pressure of the blood flowing through the Vasculature. It is obtained by finding the number of millimetres of mercury displaced by a sphygmomanometer (blood pressure cuff)
Cardiac output
The amount of blood pumped by the heart
Total peripheral resistance
The diameter of the blood vessels
Arrhythmias
Disturbances in the normal pumping rhythm of the heart
Atherosclerosis (Atherogenesis)
A buildup of deposits, known as plaques, on the walls of the blood vessels
Controllable risk factors
Factors increasing the likelihood of a disease, such as poor diet or smoking, that are under the control on the individual
Protective factors
Events or circumstances that help to offset, or buffer, risk factors, anything that lessens the likelihood of disease. For example, exercise is thought to be a protective factor for cardiovascular disease
Hypertension
A characteristically high level of resting blood pressure (more than 140/80)
Stress reactivity paradigm
A viewpoint that sees the reaction to stress as important to an understanding of cardiovascular disease
Cardiovascular reactivity
How much an individual’s cardiovascular function changes in response to a psychologically significant stimulus
Type A
A syndrome of behaviours that includes hyper alertness and arousabilty, a chronic sense of time-urgency, competitiveness, hostility, and job-involvement
Psychophysiological reactivity model’s theory of how hostility lead to health risk?
- hostile people are at higher risk because they experience exaggerated autonomic and neuroendocrine responses during stress
Psychosocial vulnerability model for how hostility lead to health risk?
Hostile people experience a more demanding interpersonal life than do others
Transactional model for how hostility lead to health risk?
A hybrid of the psychophysiological reactivity model and psychosocial model
- posits that the behaviour of hostile individuals constructs, by its natural consequences, a social world that is antagonistic and unsupportive. Consequent interpersonal stress and lack of social support increase the vulnerability of these people
Health behaviour model for how hostility lead to health risk?
- hostile people may be more likely to engage in unhealthy behaviours and less likely to engage in healthy practices, such as exercise
Constitutional vulnerability-how hostility lead to health risk?
Suggests that he link between hostility and poor health outcomes is the result of a third variable, constitutional vulnerability, with which they are both associates
Exhaustion
The third phase of the general adaptation syndrome (GAS). If the challenge persists beyond the resistance phase, the body can no longer maintain resistance, and characteristic tissue changes occur. As this point, the organism may succumb to a disease of adaptation, such as an ulcer
Anorexia nervosa
Sufferers develop a morbid fear of fatness, perceive themselves as fat, and reduce their food intake to the point of emaciation
- refusal to maintain normal weight
- highest morbidity
Bulimia nervosa
Periods of food restriction alternate with periods of binge eating, wherein excessive amounts of food are consumed
Binge-eating disorder (BED)
Recurrent episodes of binge eating occur, however without the regular, inappropriate compensatory behaviours to try to rid the body of calories
Purging behaviours
Self-induced vomiting, laxative abuse, or abuse of enemas or diuretics
Objective binge
Consists of eating a large amount of food in a specific period of time
Body mass index (BMI)
Weight in kilograms divided by height in meters squared
Restricting type
Individuals that attain their extremely low body weights through strict dieting, and sometimes, excessive exercise
Binge-eating/ purging type
Individuals not only engage in strict dieting (and possibly excessive exercise) but also regularly engage in binge eating and/ or purging behaviours
Eating disorder examination (EDE)
A structured clinical meter view die diagnosing eating disorders
Lanugo
The fine white hair that grows on individual with anorexia when they have no body fat left to keep themselves warm
Amenorrhea
The absence of at least three consecutive menstrual periods, often occurs in women with anorexia nervosa as well
Russel’s sign
An indication of bulimia in which scrapes or calluses occur on the back of the hands as a result of manual,y induced vomiting
Precipitating factors
Events or situations that trigger the eating disorder (e.g. Death of a loved one, transition into puberty, dieting)
Perpetuating factors
The physical and psychological symptoms that serve to maintain the disorder, such as reduced basal metabolic rate, delayed gastric emptying, social isolation, and depression
Substance use disorder
Recurrent substance use that results in significant adverse consequences in social or occupational functioning, or us of a substance that impairs one’s performance in hazardous situations for example drinking and driving
Impairment of control
Includes taking the substance in greater amount or for longer than intended
Social impairment
A failure to fulfill major role obligations at work, home, or school; continued use despite clear negative consequences on relationships; and the reduction of other involvements to give priority to using the substance
Pharmacological dependence
The indicators are tolerance and withdrawal
Tolerance
The person needs increased amounts of substance to achieve the same effect
Withdrawal
Unpleasant and sometimes dangerous symptoms, such as nausea, headache, or tremors when the addictive substance is removed from the body
Substance-induced disorders
Includes intoxication, withdrawal, and other substance- or medication-induced mental disorders
Poly substance abuse
The simultaneous misuse or dependence upon two or more substances
Risky use
Continued substance use in situations that might be hazardous, such as driving or operating machinery
Low-risk drinking guidelines
A research-based definition of the upper limits on drinking that is not likely to lead to physical impairment in people in general
Ethyl alcohol
The effective chemical compound in alcoholic beverages, which reduces anxiety and inhibitions, produces euphoria, and creates a sense of well-being
Blood alcohol level (BAL)
Alcohol level expressed as a percentage of blood volume
Alcohol dehydrogenase
An enzyme that helps break down alcohol in the stomach. Women have significantly less of this enzyme than men
Blackouts
Memory deficit caused by alcohol intoxicatingly in which an interval of time passes for which a person cannot recall key details or entire events
Korsakoff’s psychosis
A chronic disease characterized by impaired memory and a loss of contact with reality
Fetal alcohol syndrome (FAS)
Prenatal and postnatal growth retardation and central nervous system dysfunction due to alcohol consumption during pregnancy
Behavioural disinhibition
A personality trait describing an inability to inhibit behavioural impulses,rebelliousness, aggressiveness, and risk-taking that are associated with the development of alcohol problems
Negative emotionality
The tendency to experience psychological distress, anxiety, and depression that is associated with the development of alcohol problems
Tension-reduction hypothesis
Suggests that drinking is reinforced by its ability to reduce tension, anxiety, anger, depression, and other unpleasant emotions
Alcohol expectancy theory
Proposes that drinking behaviour is largely determined by the reinforcement that an individual expects to receive from its
Behavioural tolerance effect
Through the principles of classical conditioning, cues in the environment can become conditioned stimuli to the effects of drug use. These cues cause the individual to anticipate the drugs effects so that when the drug is actually administered the effects are diminished. Tolerance, or the need for a greater amount of drug for the same effect, is greatest when the conditioned environmental cues are present
Minnesota model
A residential treatment for alcohol dependence advocating a 12-step alcohol olives anonymous philosophy and viewing alcoholism as a disease
Antagonist drug
A neurotransmitter that inhibits the production of acetylcholine, a bodily substance that mediates the transmission of nerve impulses within the brain. Used as a pharmacological agent
Agonist drug
A neurotransmitter that facilitates the inhibitory action of the neurotransmitter GABA at its receptors. Used as a pharmacological agent for the treatment of alcohol dependance
Antabuse
Disulfiaram, a drug that is used to make the experience of drinking extremely aversive. It blocks the action of metabolizing enzyme acetaldehyde dehydrogenase, resulting in build-up of acetaldehyde in the body, like people who naturally lack this enzyme, people who drink alcohol after taking Antabuse experience increased heart rate, nausea, vomiting, and other unpleasant effects
Relapse
The return of an illness or disorder after a recovery
Brief intervention
One-to three session treatments, offering time-limited and specific advice regarding the need to reduce or eliminate alcohol and other drug consumption or gambling behaviour
Motivational interviewing
A therapeutic approach that is client- centred and helps to engage intrinsic motivation for changing behaviour by creating discrete and exploring and resolving ambivalence within the client
Depressants
Drugs that inhibit neurotransmitter activity in the central nervous system. Examples are alcohol, barbiturates (downers) and benzodiazepines
Abstinence syndrome
A reaction that many individuals experience during treatment for barbiturate abuse. It occurs at the stage at which the user is no longer dependant, and is characterized by insomnia, headaches, aching all over the body, anxiety, depression, and can last for months
Stimulants
A class of drugs that have a stimulating or arousing effect on the CNS and create their effects by influencing the rate of uptake of the neurotransmitters dopamine, norepinephrine, and serotonin at receptor sites in the brain. They include tobacco, amphetamines, cocaine, and caffeine
Tobacco nicotine
An extremely potent CNS stimulant related to amphetamines. The very small amount present in a cigarette is not lethal, and can increase alertness and improve mood. The pleasure centres of the brain seem to have receptors specific to it
Amphetamines
Drugs that have effects in the body similar to those of naturally occurring hormone adrenaline. Originally developed as a nasal decongestant and asthma treatment. In addition to shrinking mucous membranes and constricting blood vessels, they increase alertness and concentration. Chronic amphetamine use is associated with feelings of fatigue and sadness, as well as periods of social withdrawal and intense anger
Toxic psychosis
Hallucinations, delirium, and paranoia caused by repeated high doses of amphetamines
Opioids
A class of nervous system depressants whose main effects are the reduction of pain and sleep inducement
Endogenous opiates
The body’s natural painkillers
Exogenous opiates
Narcotics, which bind to receptor sites throughout the body, including the brain, spinal cord, and bloodstream, and reduce the body’s production of endogenous opiates
Harm reduction approaches
Approaches to treatment for alcohol and other drug abuse that focus on reducing the consequences of the use versus reducing or eliminating use
Methadone
A heroin replacement used to treat heroin addicts, often to reduce the craving after initial withdrawal symptoms have abated. Methadone therapy appears to work best in conjunction with good individual and group psychological intervention programs, as well as ongoing peer support
Cannabis
Hashish, which comes from the hemp plant cannabis sativa, indigenous to Asia but not grown in many parts of the world. Has psychoactive effects caused primarily by the chemical THC
Amotivational syndrome
A continuing pattern of apathy, profound self- absorption, detachment from friends and family, and abandonment of career and educational goals evident in some long term users of cannabis
Hallucinogens
Drugs that change a person’s mental state by inducing perceptual and sensory distortions of hallucinations
Flash-backs
Unpredictable reoccurrences of some of the physical or perceptual distortions experienced during a previous trip
Hallucinogen persisting perception disorder
Applied if flashbacks cause significant distress or interfere with social or curation all functioning
Trait
A personal quality that is characteristic of someone; that is, it is persistently displayed over time and in various situations. Every person manifests several traits, the combination of which makes up his or her personality
Personality disorders
Personality styles that are characterized by inflexible and pervasive behavioural patterns, often cause serious personal and social difficulties, and impair general functioning
6 criterion in defining personality disorders in the DSM-5
- Pattern of behaviour must be manifested in at least two of the following areas: cognition, emotions, interpersonal functioning, or impulse control
- Enduring pattern of behaviour must be rigid and consistent across a broad range of personal and social situations
- The behaviour should lead to clinically significant distress in social, occupational, or other important areas of functioning
- Stability and long duration of symptoms, with onset in adolescence or earlier
- Behaviour cannot be accounted for by another mental disorder
- Behavioural problems cannot be he result of substance abuse or of another medical condition
Clusters
Groups of personality disorders. DSM-5 lists 10 personality disorders in three clusters
Cluster B
Dramatic, emotional, or erratic disorders
Antisocial, borderline, histrionic, and narcissistic
Paranoid personality disorder
Pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent
Suspiciousness
A generalized distrustful view of others and their motivations, but not sufficiently pathological to warrant a clinical diagnosis of paranoia
Delusion
False beliefs that are strongly held, even in the face of solid contradictory evidence. Such beliefs usually involve a misinterpretation of one’s experiences
Cluster C
Anxious and fearful disorders
Avoidant, dependent, and obsessive-compulsive
Cluster A
Odd and eccentric disorders
Paranoid, schizoid, and schizotypal
Emotional responsiveness
Reflecting a range of appropriate and contextual emotions do different situations and individuals
Eccentricity
Generally describes behaviour that deviates from the norm and would be considered odd or whimsical
Schizoid personality disorder
A pattern of detachment from social relationships and a restricted range of emotional expression
Psychopaths
People who are considered to be predisposed via temperament to antisocial behaviour and whose primary characteristics include callousness and grandiosity combined with a history of poor self-regulation
Sociopaths
People who are considered to have normal temperament but who are weakly socialized because of environmental failures, including poor parenting, antisocial peers, and disorganized home and school experiences
Fearlessness hypothesis
A theory that suggests that psychopaths have a higher threshold for feeling fear than other people. Events that make most people anxious (such as the expectation of being punished) seem to have little or no effect on psychopaths
Oppositional behaviour
Refers to a tendency to do the opposite of what is being asked of the person
Instability
In the context of personality disorders, describes an individual who has maladaptive interpersonal relationships and decisions and is generally unable to effectively regulate emotions or behaviour
Anxious ambivalent attachment
The interpersonal style of a person who strongly desires intimacy with others and persistently seek out romantic relationships, but who, once they begin to get close to their partner, become anxious and back away; while they desire closeness, the appear to be afraid of it. People are considered to have developed these difficulties as a result of poor parent-child attachments that fail to I still the self-confidence and skills required for intimacy. (BPD)
Schizotypal personality disorder
A pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behaviour
Antisocial personality disorder
A pattern of disregard for, and violation of, the rights of others
Borderline personality disorder
Pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity
Histrionic personality disorder
A pattern of excessive emotionality and attention seeking
Narcissistic personality disorder
A pattern of grandiosity, need for admiration, and lack of empathy
Avoidant personality disorder
A pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation
Dependent personality disorder
A pattern of submissive and clinging behaviour related to excessive need to be taken care of
Obsessive-compulsive personality disorder
Pattern of preoccupation with orderliness, perfectionism, and control
Cognitive restructuring
A technique used by cognitive- behavioural therapists to encourage clients to become aware of, and to question, their assumptions, expectations, attributions, and automatic thoughts
Dialectical behaviour therapy
One of the cognitive-behavioural approaches to treatment of borderline personality disorder (BPD) ,one of whose main features is the acceptance by the therapist of the patients demanding and manipulative behaviours. In addition, several standard behavioural procedures are used, such as exposure treatment for the external and internal cues that evoke distress, skills training, contingency management, and cognitive restructuring
Personality change due to another medical condition
Is a persistent personality disturbance that is judged to be due to the direct physiological effects of a medical condition
Responsivity factor
The circumstance that treatment must be responsive (or matched) to a particular client’s needs and interpersonal style- that is, it must be of sufficient intensity and relevance, and see by the patient as voluntary. Apparently, th efficacy of the treatment programs tend to be determined more by the orientations for the therapist of director
Other specified personality disorder adu specified personality disorder
1) the individuals personality meets the general criteria for a personality disorder, and traits id several different personality disorders are present, but the criteria for any specific personality disorder are not met or
2) the individual’s personality meets the general criteria for a personality disorder, but the individual is considered to have a personality disorder testing included in the DSM-5 classification
Polythetic approach
Only a subset of symptoms or behaviours is required for a diagnosis
Prevalence
The frequency of a disorder in a population at a given point or period of time
Egosyntonic
They do not view their functioning as problematic
Egodystonic
They cause distress and are viewed as problematic by the individual sufferer
Comorbidity
The co-occurrence in the same person of two or more disorders
Overlap
The similarity of symptoms in two or more disorders (ie same criteria apply to different diagnoses)
Attachment theory
Asserts that children learn how to relate to others, particularly in affectionate ways, by the ways in which their parents relate to them
Parasympathetic
Rest or digest
Sympathetic
Fight or flight
HPA axis
Hypothalamus–> CRH–> pituitary gland–> ACTH–> adrenal gland–> cortisol/ adrenaline and noradrenalin
Psychosocial factors that influence the disease process
- social status: people higher social hierarchies better resistance to stress and live longer
- controllability: people who believe they are in control & overestimate ability bring about positive outcomes cope better
- social support: people who are highly connected with others live longer; low social support contributes to making existing disease worse
Psychosocial oncology or psychoncology
The study of psychosocial factors associated with the development and course of cancer, and the factors associated with the support, treatment, and quality of life of cancer patients throughout the disease trajectory
Cancer & psychological factors
- helplessness, repression and negative emotions
- depression
- smoking, weight problems, poor diet etc.
Risk factors of cardiovascular disease
- Gender, low SES, family history
- Type A behaviour
- hostility
- continual or intense stress
- depression
Eating disorders
Severe disturbances in eating behaviours that negatively affect the persons physical or mental health
3 major subtypes of eating disorder in the DSM
- anorexia nervosa
- bulimia nervosa
- binge eating disorder (BED)
Two subtype of anorexia nervosa:
- Restricting type: individual restricts amount of food they eat to the extreme
- binge eating/ purging type
Comorbid psychological disorders of anorexia
OCD, obsessive- compulsive personality disorder, depression
Comoros psychological disorders with bulimia
Depression, anxiety, borderline personality disorder, substance abuse
Other specified/ unspecified eating disorder
- disorders do not meet full criteria for a diagnosis of eating disorder
- atypical anorexia, sub threshold bulimia, purging disorder, night eating syndrome
Epidemiology of eating disorders
- highest mortality rate
- more common in women
- affects mostly industrialized developed words
- age of onset: late adolescence/ early adulthood
Social factors eating disorders:
- more common in fields that emphasize weight and appearance
- more commune in females report greater exposure to media
- more common middle to upper class white females
- higher prevalence in Arab and Asian females living in America than in native countries
Psychological factors eating disorders:
-struggle for control
- depression, low self-esteem
- negative body image
- dietary restraint leading to binges
Personality factors: perfectionism, obsessiveness, compliance, lack of awareness of inner feelings, negative self-concept
Weight set point theory
Idea body is set for a specific weigh
Substance abuser
Pattern of substantive use associated with personal, healthy, or social problems
Substance dependence
Repeated use of a drug resulting in tolerance
Craving
Compelling need for a drug
Drug of abuse
A chemical that alters mood, perception, and/ or brain functioning
What is withdrawal most severe for?
Most severe for alcohol, opiods, and sedatives/ hypnotics
4 groupings of indicators of substance use disorders:
- impairment of control
- social impairment
- risky use
- pharmacological criteria
Which drug is the most harmful?
Alcohol
Where are rates of substance use typically higher?
Males, younger people with lower formal education, blue- collar workers, and aboriginal Canadians
Older people tend to
Drink less but use more prescription drugs
3 stages of etiology of alcohol use:
- initiation and continuation
- escalation and transition to abuse
- development of tolerance and withdrawal
PD diagnosis and reliability
Inter-rater reliability good, but test-retest reliability poor
Important characteristics of PDs
- long standing
- pervasive, usually with a central personality characteristic that dominates whole personality
- social distress
- ego- syntonic
Cognitive behavioural aspects of PDs
- schemas early in life become rigid & become comfortable
- invalidation child’s emotional experienced & simplistic problem solving
- parents model
- bad child discipline
Biological perspectives PDs
Frontal temporal dysfunctions
Fronto-limbic dysfunction
Heritable
Highest prevalence rates PDs
Antisocial, schizotypal, hystroionic most
Narcissistic least
What cluster of patients is most likely to get help?
Cluster B
Cluster A more common in
Men who have never married
Cluster B more pre leant in
Young, portly educated men
Cluster C more common in
People who finished H.S. But never married
Men C’a women
Antisocial personality more common in men (avoidant, dependent, paranoid, and borderline PDs more commonly diagnosed women)
