Midterm Two Flashcards

1
Q

What is obsessive compulsive disorder (OCD)?

A

Obsessions, with/without compulsions
Often associated with mental rituals, fluctuating insight, family involvement (often reinforcing the behaviour), avoidance, and reassurance seeking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are obsessions?

A

Intrusive, unwanted, reoccurring, and foreign ideas that come in the forms of thoughts, images, impulses, and feelings
Often theme of contamination, aggression, violence, sexuality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are compulsions?

A

Repetitive behaviour or mental act that you are driven to perform to neutralize the obsession, prevent feared event, and/or provide relief
Not always functionally related to the obsession

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the comorbidity of OCD?

A

Mood and anxiety disorders are very common with OCD
80% of people with OCD also have depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Biopsychosocial model of OCD: Etiology: Bio

A

Very biological
Moderately heritable
5-HT (SSRIs decrease emotional force)
Slight structural abnormalities in basal ganglia (motor control, learning, rewards)
Heightened thalamus (cleaning and checking)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Biopsychosocial model of OCD: Etiology: Psycho

A

Attention driven toward disturbing material related to obsession
Thought fusion: bad thought is same as doing the thing
Behavioural theory: conditioning
Initial fear is classically conditioned (something happened and now they must go together)
Compulsions negatively reinforced is operant conditioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Biopsychosocial model of OCD: Etiology: Social

A

Behavioural theory: conditioning
Social reinforcement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Biopsychosocial model of OCD: Presentation: Bio

A

Compulsions correlated with increased brain activity
Basal ganglia
OFC
function: emotion in reward/punishment anticipation
increased activity preoccupation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Biopsychosocial model of OCD: Presentation: Psycho

A

Over importance of thoughts
Over estimation of threat
Intolerance of uncertainty
Cognitive distortions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Biopsychosocial model of OCD: Presentation: Social

A

Content of obsessions seems to be different from culture to culture
Cultures where OCD is not a problem and does not need to be treated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Biopsychosocial model of OCD: Treatment: Bio

A

Decreased activity in basal ganglia
Anti depressants (SSRIs)
Cingulotomy (disconnect part of the limbic system communication)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Biopsychosocial model of OCD: Treatment: Psycho

A

Behavioural: exposure and response prevention
Cognitive: challenge maladaptive thinking patterns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Biopsychosocial model of OCD: Treatment: Social

A

Family behavioural change
Increase social support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are mood disorders?

A

Defining feature: extremes of emotion that cause a disruption in mood
Depression
Mania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the types of mood disorders (2)?

A

Unipolar: just one type of mood disorder (depressive episodes)
Bipolar: two types (depressive episodes and manic episodes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the features of major depressive disorder (MDD)?

A

Sad, depressed mood
Anhedonia: loss of pleasure in things you used to enjoy (must have one of the first two)
Sleep difficulties
Agitation
Worthlessness
Recurrent thoughts of death or suicide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is persistent depressive disorder (PDD)?

A

Chronic, lowgrade depression (>2 years)
Average duration 4-5 years
intermittent normal moods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Explain Beck’s cognitive theory

A

Main idea: negative interpretation of situation/events lead to feelings of depression which lead to more negative interpretations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Explain negative cognitive triad

A

negative views of individual from levels of the self (I am unloveable), world (no one loves me) and future (no one will ever love me)
All continually feed into each other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Explain helplessness theory

A

Learned helplessness from lack of perceived control over life events and pessimistic attribution style
Uncontrollable event → attributions → sense of helplessness → emerging depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Explain hopelessness theory

A

Uncontrollable event → attribution or other cognitive factors → sense of
hopelessness → emerging depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Helplessness vs hopelessness

A

Helplessness theory
Pessimistic attributional styles (diathesis)
+
Stressful life events (stressor)

Hopelessness theory
Pessimistic attribution styles (diathesis 1)
+
State of hopelessness (diathesis 2)
+
Stressful life event (stressor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are internal vs external attributions?

A

Internal (me): negative outcomes are one’s own fault
External (other): negative outcomes are the result of some uncontrollable factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are stable vs unstable attributions?

A

Stable (always): future negative outcomes will be one’s own fault
Unstable: can be changed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are global vs specific attributions?
Global (everything): negative events disrupt many life activities Specific: negative events are related to one particular activity
26
Biopsychosocial model of MDD: Etiology: Bio
Heritability ~35% Lower 5-HT Higher NE and DA leads to mania Lower NE and DA leads to depression
27
Biopsychosocial model of MDD: Etiology: Psycho
Beck's cognitive theory
28
Biopsychosocial model of MDD: Etiology: Social
29
Biopsychosocial model of MDD: Presentation: Bio
Lower left PFC Higher Right PFC Heightened amygdala
30
Biopsychosocial model of MDD: Presentation: Psycho
Beck's cognitive theory Negative cognitive triad Helplessness and hopelessness theory Rumination
31
Biopsychosocial model of MDD: Presentation: Social
Interpersonal theories Genuine negative effect on others, alienation from social support Insecure in relationships
32
Biopsychosocial model of MDD: Treatment: Bio
Pharmacology (help people see clearly) SSRIs, MAOIs, SNRIs Light therapy (seasonal depression) Treatment resistance: ECT (induce seizure using electric current) TMA (magnetic stimulation in parts of brain) Ketamine (NMDA receptors, may reduce inflammation)
33
Biopsychosocial model of MDD: Treatment: Psycho
Psychodynamic (importance of early loss, attachment styles) CBT: Cognitive (primary control: I can do something about it, secondary control: I can something about my attitude) Behaviour (gold standard, get out of bed, increase mastery and experiences of pleasure)
34
Biopsychosocial model of MDD: Treatment: Social
Interpersonal therapy with relationships Family and marital therapy
35
What is bipolar disorder?
Bipolar 1: Manic episodes + depression Problems High risk of suicide, DV, divorce, truancy, substance abuse, episodic antisocial behaviour Bipolar 2: Hypomania (shorter period of time)
36
What are manic episodes?
Marked increase in activity level in a short period of time Unusual talkativeness, rapid speech Less that the needed amount of sleep Inflated self esteem, believed have special talents, powers, and abilities Excessive involvement in pleasurable activities there are likely to have undesirable consequences
37
Biopsychosocial model of Bipolar: Etiology: Bio
Super genetic (1st degree relatives at risk) Identical twin 85% Lower NE and DA lead to depression Higher NE and DA lead to mani
38
Biopsychosocial model of Bipolar: Etiology: Psycho
Pessimistic attributional style Personality: high neuroticism and high levels of achievement striving
39
Biopsychosocial model of Bipolar: Etiology: Social
Stressful life events often the stressor for an episode Dependent (it was my fault) More likely to get into an episode Independent (that was not on me) Less likely to be thrown into a mood episode Low social support
40
Biopsychosocial model of Bipolar: Presentation: Bio
41
Biopsychosocial model of Bipolar: Presentation: Psycho
42
Biopsychosocial model of Bipolar: Presentation: Social
43
Biopsychosocial model of Bipolar: Treatment: Bio
Pharmacotherapy Mood stabilizers: Lithium, not very effective in the long haul Antipsychotics TMS ECT
44
Biopsychosocial model of Bipolar: Treatment: Psycho
CBT Cognitive restructuring of what went down during the episode, restricting attributions Mindfulness based cognitive therapy Acceptance of thoughts, emotions `
45
Biopsychosocial model of Bipolar: Treatment: Social
Interpersonal and social rhythm therapy Biological system has different rhythms, goal is to be as consistent as possible Family and marital therapy
46
What are the statistics for suicide?
>10 per day Base rate 11.9/100 000 2x higher in old age For every completed, 20 attempt
47
How do sex differences relate to suicide?
Men 4x as likely to complete usually by gun or hanging Women 3x as likely to attempt and survive by overdose
48
What is the comorbidity of suicide completions?
Bipolar Conduct disorder (youth) PTSD Substance abuse Panic disorder
49
What are some challenges when predicting suicide?
Low base rates Hard to apply risk factors to individuals Short vs long term risk Interactions between risk factors
50
What are some protective factors for suicide?
Cognitive flexibility Strong social support Hope Receiving treatment for psychiatric disorder
51
What are some myths about suicide?
People who talk about it won't do it People who are suicidal always want to die Improved mood = less risk Suicide ideation is rare Asking about suicide might give them the idea
52
Why suicide?
A solution to problem of intense suffering Goal is to stop the pain by ceasing consciousness Solutions: Reduce suffering Help identify other options Pull back from suicidal act
53
Explain Joiner's theory
Desire for suicide: Perception of self as burden Perception of not belonging Suicide attempt: Desire for suicide + acquired capacity for suicide
54
Biopsychosocial model of Suicide: Etiology: Psycho
Impulsivity Aggression Pessimism Family psychopathology or instability
55
Biopsychosocial model of Suicide: Etiology: Social
Divorce Suicide of friend/family member Substance use Unemployment Access to gun
56
Biopsychosocial model of Suicide: Treatment: Bio
Pharmacology Antidepressants Mood stabilizers
57
Biopsychosocial model of Suicide: Treatment: Psycho
CBT DBT, acceptance
58
Biopsychosocial model of Suicide: Treatment: Social
Crisis intervention Cope with immediate stress Validate emotional pain Clarify problems Social support
59
What is non suicidal self injury (NSSI)?
Self inflicted damage to own tissue without the intent to die Differs with suicide attempt based off of intent, not type of injury
60
What is the contagion effect?
When one person talks about it, it can implant the idea into someone else More prevalent in the past 20 years Reason why the media tries not to talk about it
61
What is the relationship of NSSI and suicide?
Approximately 1/2 of individuals who die by suicide have a history of NSSI Less pain you feel the more likely to die by suicide Can result in unintentional death
62
What is the 4 factor model (FFM)?
Reinforcement (positive or negative) Target (automatic - intrapersonal or social)
63
Biopsychosocial model of NSSI: Treatment
Treat the function of the behaviour Acceptance and commitment therapy CBT DBT: Emotional regulation Distress tolerance Moment by moment analysis
64
What are the 3 most common eating disorders?
Binge eating disorder (BED) Anorexia nervosa (AN) Bulimia nervosa (BN)
65
What are the primary characteristics of binge eating disorder?
Frequent episodes of binge eating Sense of a lack of control No behaviours to prevent weight gain
66
What are associated behaviours of BED?
Eating for emotional comfort Agitation during binge Disassociation Self disgust, guilt or depression after binge Intense cravings for certain foods
67
What are the primary characteristics of anorexia nervosa?
Fear of gaining weight Refusal to maintain a healthy weight Distorted view of self/role of body in self worth
68
What are the two types of AN?
Restricting Binge eating/purging
69
What are some associated behaviours with AN?
Dietary restrictions Very rule based Eating rituals Hoarding, concealing, discarding food Preoccupation with food Efforts to conceal weight loss
70
What are medical complications related to AN?
Death, suicide, kidney damage, heart arrhythmia
71
What are the primary characteristics of bulimia nervosa?
Frequent episodes of binge eating Lack of control over eating Recurrent compensatory behaviour to prevent weight gain Average weight (slightly overweight) Distorted view of self/role of body in self worth
72
What are the two types of bulimia?
Purging Non purging
73
What is the path of BN?
Restricted eating (goal to be thin) Binging or eating restricted foods Compensatory behaviour
74
What are associated behaviours with BN?
Preoccupation with food and/or weight Severe self-criticism Dietary restriction in public Frequent washroom visits after meals Impulsivity
75
What are the labels used to describe weight?
Severely underweight Underweight Normal weight Overweight Obese
76
Diagnostic crossover with eating disorders?
Anorexia (R) ↔ Anorexia (B-P) Tends to stick with anorexia Anorexia (B-P) → Bulimia Less often going to see bulimia going to anorexia Infrequently Bulimia → Anorexia (B-P) Bulimia ↔ Binge Eating Disorder Most often Binge Eating Disorder → Bulimia
77
What is comorbidity with eating disorders?
Depression OCD Substance abuse disorders Personality disorders
78
Biopsychosocial model of Anorexia and Bulimia: Etiology: Bio
Hereditary Brain abnormalities: frontal and temporal cortex 5-HT
79
Biopsychosocial model of Anorexia and Bulimia: Etiology: Psycho
Perfectionism Excess self focus Cognitive rigidity Just self worth by body shape
80
Biopsychosocial model of Anorexia and Bulimia: Etiology: Social
Child sexual abuse (way of disassociating) Family characteristics Family systems theory Sociocultural
81
Biopsychosocial model of Anorexia and Bulimia: Presentation: Psycho
Weight preoccupation Mood dependent Small weight gain leads to depression and irritability Self image dependent Slippery slope
82
Biopsychosocial model of Anorexia and Bulimia: Treatment: Bio
SSRIs Appetite suppressants (BED) Hospitalization to restore weight (AN)
83
Biopsychosocial model of Anorexia and Bulimia: Treatment: Psycho
CBT IPT, mistakes are not catastrophes, desensitization Shift need to control to other areas
84
Biopsychosocial model of Anorexia and Bulimia: Treatment: Social
Family lunch sessions to eat casually and redefining the eating problem as an interpersonal problem