PSY280 - Exam 2

Question 1

Dissociative Disorders

Answer 1

Disruption of and/or discontinuity in the normal integration of consciousness/memory/identity/emotion/perception/body representation/motor control/behavior.

• -Unbidden intrusions into awareness and behavior accompanied by a loss of continuity in subjective experience (depersonalization/derealization).
• -Inability to access information or to control mental functions that are normally accessed/controlled easily (amnesia).
• -Commonly follow traumatic events.

Question 2

Depersonalization/Derealization Disorder

Answer 2

• Persistent/recurrent depersonalization and/or derealization.
• –50% adult population experiences brief depersonalization episodes; equal rates across gender.

Question 3

Dissociative Amnesia

Answer 3

-Inability to recall important autobiographical information, usually of a traumatic/stressful event.
—Localized amnesia: loss of memory for a specific period of time (most common)
—Selective Amnesia: some events/pieces of an event during a period of time.
—Generalized amnesia: complete memory loss (rare)
-Women twice as likely as men
+–With Dissociative Fugue: travel associated w/ amnesia for identity/other important autobiographical info. Inability to recall past during travel. Sometimes will assume new identity. Course of Fugue often abrupt, typically remits, often one-time event.

Question 4

Dissociative Identity Disorder

Answer 4

2+ personality states, discontinuity in sense of self and sense of personal ownership/control, accompanied by related alterations in affect/behavior/consciousness/memory/perception/cognition/sensory-motor functioning.
Gaps in recall of everyday events/personal information/traumatic events.
90%+ maltreatment in childhood, many (70%) attempt suicide.
Different from PTSD because focuses on dissociation rather than anxiety.
Begins in childhood, not diagnosed until adulthood.
Mean alters is 15.
Twice is high for women, much more severe.
Treatment: identify/neutralize triggers//confront and relive early trauma/gain psychological control over traumatic events.

Question 5

Somatic Symptom

Answer 5

Body-related.
Prominence of somatic symptoms associated with significant distress or impairment.
Shares features with anxiety disorders.
Often co-morbid with medical concerns/anxiety/mood/personality disorders.

Question 6

Somatic Symptom Disorder

Answer 6

1+ somatic symptoms that are distressing or result in significant disruption of daily life.
Excessive thoughts/feelings/behaviors related to somatic symptoms or associated health concerns as manifested by at least one:
-disproportionate/persistent thoughts about seriousness of one’s symptoms.
-persistently high level of anxiety about health or symptoms.
-excessive time/energy devoted to symptoms or health concerns.
Although somatic symptom may not be constant, being symptomatic is persistent (often for 6+ months).
Suffering authentic, even if no medical explanation for the somatic symptom or severity of suffering.
Sometimes normal bodily sensations/discomfort misinterpreted as signs of illness/appraised as threatening/harmful.
Can lead to invalidism. High levels of anxiety about illness.
New disorder includes those formerly with somatization disorder/pain disorder/hypochondriasis.
Depressive disorders/increased risk of suicide.
No info about gender.

Question 7

Illness Anxiety Disorder

Answer 7

Preoccupation w/ having/acquiring a serious disease.
No somatic symptoms or are very mild.
High level of anxiety about health, easily alarmed about personal health status.
Excessive health-related behaviors/exhibits maladaptive avoidance.
>6 months.
Care-seeking vs. Care-avoidant type
3-8% in medical populations - but doesn’t show anything because of care-avoidant type.
Equal across men and women.
Chronic w/ frequent relapses, begins early to middle adulthood, worsens with age, rare among children.
Comorbidity - 2/3 have another major psychological diagnosis.

Question 8

Conversion Disorder

Answer 8

1+ symptoms of motor or sensory deficits: suggests neurological or other medical condition.
Medical evidence –> incompatible with neurological disease (hand tremor stops if concentrating on other thing).
Psychological factors implicated.
Not intentionally faked:
-La belle indifférence - lack of concern
-Secondary Gain - unconscious ulterior motives
-Malingering - deliberate exaggerations for personal gain.
More affecting disease.
2-3x more common in women.
Common in adolescence.
Short duration with re-occurrences.
Blindness/paralysis more likely to recover than tremors and seizures.

Question 9

Facticious Disorder

Answer 9

Munchausen’s
Imposed on self or on another
Falsification of physical/psychological signs or symptoms, causing injury or disease with deliberate deception.
Present self/other as ill/impaired/injured.
Deception even w/o obvious reward.

Question 10

Mood Disorders

Answer 10

Major depressive episode, manic episode, hypomanic episode.

Question 11

Major Depressive Episode

Answer 11

At least 2 weeks, most of day, nearly every day.
Depressed mood (sad/hopeless/lethargic) or Anhedonia (loss of interest/pleasure).
4+ of the following:
-significant weight loss/gain.
-Insomnia/hypersomnia
-psychomotor agitation/retardation
-feelings of worthlessness or excessive/inappropriate guilt
-diminished ability to think/concentrate or indecisiveness
-suicidal ideation or attempts
Children/adolescents: irritable mood, somatization, social withdrawal.
Gradual onset over days or weeks.
Initial episodes cued by stressors.
Untreated worsens condition overall.
Antidepressants can cue mania in Bipolar.

Question 12

Major Depressive Disorder

Answer 12

1+ major depressive episode.
No manic/hypomanic episodes.
3x higher in younger than older.
Late life onset common.
Variable/episodic (2 weeks to several years)
90% remission after 5 years.
Most have multiple episodes, median = 4
Women 1.5-3x more likely.
Risk factors:
-introspective, ruminative cognitive style, disadvantage/negative life events, hormones.

Question 13

Persistent Depressive Disorder

Answer 13

Depressed mood most of day every day for 2+ years.
2+ of following:
-poor appetite/overeating, insomnia/hypersomnia, low energy/fatigue, low self-esteem, poor concentration/difficulty making decisions, feelings of hopelessness.
Recovery cannot last longer than 2 months at a time.
Episode may be continuously present for the entire 2 years.
No manic or cyclothymic disorder.
Includes MDE for 2+ years, and dysthymia (chronic/mild depression).

Question 14

Manic Episode

Answer 14

Period of abnormally/persistently elevated/expansive/irritable mood.
At least 1 week, present most of day nearly every day.
If hospitalization necessary, duration is waived.
At least 3 of 7:
-inflated self-esteem/gradiosity, decreases need for sleep, pressured speech/talkative, flights of idea/racing thoughts, distractibility, increase in goal-directed activity or psychomotor agitation, excessive involvement in pleasurable activities w/ potential for painful consequences.
Symptoms cause:
-marked impairment, necessitate hospitalization to prevent harm to self or others, involve psychotic features, personal distress not required.
Not due to substance.

Question 15

Hypomanic Episode

Answer 15

Elevated/expansive/irritable mood and abnormally and persistently increased activity or energy and lasts 4 days.
3+ sxs of mania.
Not severe enough to cause marked impairment of hospitalization.
No psychotic symptoms.

Question 16

Bipolar I

Answer 16

History of 1+ manic episodes
Most common to have mania and depressive symptoms (Manic-depressive)
Psychotic symptoms are common.
90% will have recurrent episodes, mode = 4 in 10 years.
70-80% have full recovery between episodes.
Rapid cycling - 4 episodes in 1 year.
Suicide risk 15x general population, 25% of all suicides.

Question 17

Bipolar II

Answer 17

1+ hypomanic episodes, 1+ full major depressive episodes, never met full criteria for a Manic episode.

Question 18

Bipolar Disorders Stats

Answer 18

Slightly more women in BPD II, men get mania first, women get depression.
Rare in children and after 40, bi I @ 18, bi II @ 22.
Acute onset (chronic but episodic).

Question 19

Cyclothymic Disorder

Answer 19

2+ years hypomanic symptoms and depressive symptoms that do not meet duration/severity/pervasiveness for Manic/Major depressive episodes.
Never Symptom-free for 2+months at a time.
No MDE/manic/hypomanic episodes during 2 years.
15-50% eventually develop Bipolar I or II.

Question 20

Suicide

Answer 20

Women 3x as likely to attempt, men 4x as likely to succeed.
50+% associated with mood disorders.
Often occur after improvement.
Adults >65, physical illness/depressed/divorced/widowed, chronically ill, males, teens, native american teen boys.

Question 21

Suicide Risk Factors

Answer 21

Previous attempts, mental illness and physical illness, impulsivity/aggressiveness, cultural/religious beliefs, child abuse/neglect, hopelessness, significant loss, alienation/isolation, knowing another who has succeeded, natural disaster.

Question 22

Suicide Assessment (PALS)

Answer 22

Plan
Accessibility
Lethality
Suicidality - thoughts of death, wanting to be dead.
(Hopelessness)

Question 23

Personality Disorders

Answer 23

Enduring pattern of inner experience and behavior that deviates markedly from expectations of the individual’s culture. 2+ of following:
-cognition, affectivity, interpersonal functioning, impulse control.
Enduring pattern, clinically significant/distress/impairment
Ego syntonic
Enduring pattern is stable and long-lasting and onset can be traced back at least to adolescence or early adulthood.