Psyc 3607- Test I Flashcards
1
Q
personality
A
the enduring traits and characteristics that lead a person to behave in relatively predictable ways across a range of situations
2
Q
personality disorders
A
inflexible and maladaptive thoughts, feelings, and behaviours that arise across a range of situations and lead to distress or dysfunction
3
Q
characteristics of personality disorders
A
- heterogenous group of disorders
- long standing, pervasive and inflexible patterns of behaviour
- inner experience that deviates from cultural expectations, causes impairment in social and occupational functioning, and can cause emotional distress
4
Q
what are the ABCs of psychological functioning
A
affect, behaviour, and cognition
5
Q
affect
A
range, intensity, and changeability of emotions and emotional responsiveness
6
Q
behaviour
A
ability to control impulses and interactions with others
7
Q
cognition
A
perceptions and interpretations of events, other people, and onself
8
Q
neurological factors of personality disorders
A
- genetics are the most influential
- there is no evidence that genes underlie specific personality disorders, but they do influence temperament which plays a major role in personality disorders and create predisposition to develop personality disorders
9
Q
temperament
A
aspect of personality that reflects a person’s typical affective state and emotional reactivity via their effects on brain structure and function
10
Q
three elements of each personality disorder
A
automatic thoughts, interpersonal strategies, and cognitive distortions
11
Q
psychological factors of personality disorders
A
- personality traits involve sets of learned behaviours and emotional reactions to specific stimuli
- what is learned is in part shaped by the consequences of behaviour and how people respond to the behaviour
12
Q
diagnosing personality disorders
A
- to be diagnosed with a personality disorder, maladaptive traits:
- should date back at least to adolescence
- should not be related to a medical condition, substance use or abuse, or another psychological disorder
- are resistant to treatment but may improve over time
13
Q
other traits of individuals with personality disorders
A
- those with personality disorders tend to be less educated and more likely to have never married or be separated or divorced
- 30% of individuals who die by suicide and 40% who attempt suicide are thought to have a personality disorder
14
Q
what are personality disorder diagnoses based on
A
- what the patient says and patterns in the way it is said (pattern of complaints)
- personality inventories or questionnaires
- collateral information from family members
*clinicians should take into account the individual’s culture, ethnicity, and social background
15
Q
issues when diagnosing personality disorders
A
- culture- ensuring functioning is not merely a reflection of culture
- gender- diagnosis bias for certain disorders for certain genders
16
Q
criticisms of the DSM-V on the personality clusters
A
- treats personality disorders as categorical versus on a continua
- criteria creates an arbitrary cutoff between normal and abnormal
- clusters were organized by superficial commonalities (disorders are not distinct from one another)
- high comorbidity
17
Q
cluster A
A
- odd/eccentric
- includes paranoid, schizotypal, and schizoid
18
Q
cluster b
A
- dramatic/erratic
- includes antisocial, borderline, histrionic, and narcissistic
19
Q
cluster c
A
- anxious/fearful
- includes avoidant, dependent, and obsessive compulsive
20
Q
paranoid personality disorder characteristics
A
- persistent and pervasive mistrust and suspiciousness
- tendency to interpret other’s motives as hostile
- expect to be mistreated or exploited by others
- reluctant to confide in others
- better able to evaluate whether their suspicions are based on reality (perceived threats are of known individuals)
- cannot be easily persuaded that these beliefs do not reflect reality
- tend to be difficult to get along with
- secretive, argumentative, hold a grudge
21
Q
schizoid personality disorder characteristics
A
- no cognitive perceptual symptoms (differentiates from schizotypal)
- no desire for or enjoyment of relationships
- appear dull, bland, aloof and rarely report strong emotions
- have no interest in sex
- experience few pleasurable activities
- indifferent to praise and criticism
22
Q
schizotypal characteristics
A
- interpersonal difficulties, increased social anxiety
- eccentric symptoms identical to prodromal and residual phases of schizophrenia
- odd beliefs and magical thinking, recurrent illusions, odd speech, ideas of reference, suspiciousness, paranoid ideation
23
Q
understanding cluster A PD
A
- schizotypal is the most thoroughly researcher
- neurological factors that contribute to schizophrenia also contribute to schizotypal (genes, prenatal enviro, birth complications)
- first degree relatives of patients with cluster A are more likely to develop a schizophrenia related disorder
24
Q
treating odd/eccentric PD
A
- very little research into treatment
- most patients are uninterested in treatment and reluctant if urged or forced into it
- CBT may be beneficial for increasing social and other adaptive skills
- low doses of antipsychotics may be used to treat schizotypal
25
Q
avoidant characteristics
A
- fearful in social situations
- keenly sensitive to possibility of criticism, rejection, or disapproval
- reluctant to enter relationships unless sure will be liked
26
Q
dependent characteristics
A
- lack self reliance
- overly dependent on others
- intense need to be taken care of
- uncomfortable when alone
- subordinate own needs
27
Q
obsessive compulsive characteristics
A
- perfectionist approach to life
- preoccupied with details, rules, schedules
- serious, rigid, inflexible, formal
- unable to discard worn out and useless objects
- does not include the obsessions and compulsions that define OCD
28
Q
etiology of cluster C
A
- unknown (little data exists)
- speculation about cases have focused on parent- child relationships
29
Q
borderline personality disorder characteristics
A
- impulsivity and instability in relationships, mood, and self image
- attitudes and feelings toward other vary dramatically
- emotions are erratic and can shift abruptly
- argumentative, irritable, sarcastic, quick to take offence
30
Q
etiology of BPD
A
- Linehan’s diathesis stress theory
- biological
- runs in families, poor functioning in the frontal lobes
- environmental
- parental neglect and abuse are typically reported by BPD patients
31
Q
Linehan’s diathesis stress theory
A
Biological precursor coupled with an environmental stressor which creates/maintains the development/presentation of a disorder
32
Q
glutamate and BPD
A
- glutamate is the most abundant excitatory NT in the vertebrate NS and crucial in the functioning of rational cognitive functions (reward anticipation, decision making, etc.)
- glutamate is lower in individuals with BPD resulting in
33
Q
partner violence and BPD
A
- people with borderline PD are often aggressive in relationships
- BPD individuals set impossibly high standards for others and blame their partner when things go wrong and they can’t meet that standard
34
Q
histrionic personality disorder characteristics
A
- overly dramatic and attention seeking
- use physical appearance to draw attention
- display emotion extravagantly
- self centred
- over concerned with their attractiveness
- inappropriately sexually provocative and seductive
- speech may be impressionistic and lacking in detail
35
Q
narcissistic personality disorder characteristics
A
- grandiose view of own uniqueness and abilities
- preoccupied with fantasies of great success
- require almost constant attention and excessive admiration
- lack empathy, envious of others, arrogant, exploitative, entitled
36
Q
antisocial personality disorder characteristics
A
- conduct disorder present before 15 and pattern of antisocial behaviour continuing through adulthood are major components
- irresponsible and antisocial behaviour
- works only inconsistently, breaks laws
- irritable and physically aggressive
- impulsive and fail to plan ahead
37
Q
psychopathy characteristics
A
- poverty of emotions both positive and negative
- lack of remorse and no sense of shame or morality
- superficially charming
- manipulates others for personal gain
- grandiose sense of self worth
- pathological lying and failure to accept responsibility
- shallow affect
- normal to high on IQ test
38
Q
psychopathy etiology
A
- 2 pathways lead to the development of psychopathy
- fundamental psychopathy- caused by biological predisposition
- secondary psychopathy- relies on environmental exposure
39
Q
antisocial personality disorder and psychopathy
A
- related by not identical
- 20% of people with APD score high on the psychopathy checklist
- all psychopaths are diagnosed with APD but many individuals with APD do not meet the criteria for psychopathy
- up to 80% of convicted felons meet criteria for APD but only 25% meet criteria for psychopathy
40
Q
psychopathy and aggression
A
- psychopaths incarcerated in Canada perpetuate 2x as many violent crimes as non-psychopathic criminals
- psychopaths commit more violence and heinous acts of violence
41
Q
development of psychopathy
A
- begins in early childhood with callous and unemotional traits, delinquent behaviours, and impulsivity
- macdonald triad
42
Q
macdonald triad
A
- an extended period of bedwetting past the preschool years not due to any medical problem
- precocious sadism, often expressed as profound animal abuse
- fire starting
43
Q
role of the family and development of APD and psychopathy
A
- lack of affection, severe parental rejection, physical abuse, inconsistencies in disciplining, failure to teach child responsibility toward others
- limitations include:
- harsh or inconsistent disciplinary practices that are reactions to the child’s anti social behaviour
- many individuals who come from disturbed backgrounds do not become psychopaths
44
Q
genetic correlates of ADP and psychopathy
A
- criminality and APD have heritable components
- increase in concordance for MZ than DZ pairs
- supported by adoption studies
45
Q
psychopathy at the genetic level
A
- “warrior gene” is a high risk gene for psychopathy and leads to low MAOA
- gene is sex linked on the X chromosome, thus why most psychopaths are M
46
Q
fearlessness hypothesis
A
anxiety provoking events have little effect on those with APD
47
Q
emotion and psychopathy
A
- unresponsive to punishments- no conditioned fear responses
- have decreased levels of skin conductance in resting situations
48
Q
shock avoidance in psychopaths
A
- avoidance learning is assumed to be mediated by fear
- lykken found that psychopaths were more motivated with finding the correct lever to navigate the maze rather than on avoiding the shock
49
Q
antisocial personality disorder treatment
A
- treating depression and anxiety
- treatment must be responsive to the patient’s interpersonal needs
- important to form a therapeutic alliance to make them feel the treatment is voluntary and relevant
50
Q
psychopathy treatment
A
- treatment should focus on changing the behaviour rather than on changing the core personality characterisitcs
- generally there is neither cure nor effective treatment; there are no medications to instil empathy and psychopaths who undergo traditional talk therapy only become more adept at manipulating others
51
Q
anxiety
A
- an affective state whereby an individual feels threatened by the potential occurrence of a future negative event
- characterized by tension, apprehension, and worry
- future oriented
52
Q
fear
A
emotional response to a real or perceived current threat
53
Q
panic
A
extreme fear when there is nothing to be afraid of
54
Q
fight or flight response
A
- increase in HR, breathing, and palm sweating
- dilation of pupils
- underlies the fear and anxiety involved in almost all anxiety disorders
55
Q
anxiety and comorbidity
A
- 50% of individuals with an anxiety disorder are also depressed (three part model)
- 10-25% of individuals with anxiety disorders abuse or are dependent on alcohol
- with phobias, abuse develops after the anxiety symptoms
- with disorders, abuse may occur before or after the onset of symptoms
56
Q
tripartite model of anxiety and depression
A
- high level of negative emotions (both)
- low level of positive emotions (depression)
- physiological hyperarousal (anxiety)
57
Q
generalized anxiety disorder characteristics
A
- persistent and excessive anxiety often about minor items
- chronic, uncontrollable worry about everything
- primarily focused on family, finances, work, and illness
- often it is not the amount of stress in the patient’s life, but the anxiety and worry they experience
- difficulty concentrating, tiring easily, restlessness, irritability, high level of muscle tension
58
Q
GAD etiology
A
- decreased arousal due to highly responsive parasympathetic NS
- worry temporarily reduces arousal which suppresses negative emotions and produces muscle tension
- dopamine in frontal lobes do not function normally
- possibly dysfunction in GABA, serotonin, norepinehrine, and other NT
- 15-40% heritability
59
Q
neurobiological perspective of GAD
A
- benzodiazepines are often effective in treating anxiety
- receptor in the brain for benzodiazepines are linked to the inhibitory NT GABA
- benzodiazepines may decrease anxiety by the increase in realize of GABA
60
Q
psychological factors of GAD
A
- include three characteristic modes of thinking and behaving
- being particularly alert for possible threats (hypervigilence)
- feeling that the worrying is out of control
- sensing that the worrying prevents panic, giving an illusion of coping
61
Q
panic attack
A
- person suffers a sudden and often inexplicable attack of alarming symptoms: laboured breathing, heart palpitations, nausea and chest pain, feelings of choking or being smothered, dizziness, sweating, trembling, intense apprehension, terror, and feelings of impending doom
- may also experience depersonalization and derealization
62
Q
panic disorder characteristics
A
- panic attacks
- may be cued (associated with particular objects, situations, or sensations) or uncured (spontaneous, not associated with a particular object or situation)
- can occur anytime, even when sleeping
- diagnosed as with or without agoraphobia
63
Q
panic disorder prevalence
A
- typically begins in adolescence
- onset is associated with stressful life experience
- > 80% of individuals diagnosed with an anxiety disorder also experience panic attacks
64
Q
agoraphobia
A
- persistent avoidance of situations that might trigger panic
- avoidance of places in which it would be embarrassing or hard to obtain help in case of a panic attack
- extreme agoraphobics may become housebound
- usually develops within the first year of recurrent panic attacks
65
Q
panic disorder etiology
A
- biological
- heritable- 5x as likely to have PD if a parent has it
- neurological
- people who experience panic attacks have a lower threshold for detecting oxygen in the blood leading to hyperventilation and the strong sense of needing to escape
66
Q
learning theory
A
- first panic attack is a response to a stressful or dangerous life event (true alarm)
- initial bodily sensations of panic become false alarms associated with panic attacks
- individuals comes to fear interoceptive cues or the external environment in which they had the attack and normal sensations become associated with subsequent attacks
- sensations of arousal elicit panic attacks (learned alarms)
- fear of fear
- avoidance of behaviours or situations where sensations might occur begin
67
Q
cognitive theory
A
- focus on how a person interprets and then responds to alarm signals from the body
- misinterpretation of normal bodily sensations as indicating catastrophic effects
68
Q
fear of fear hypothesis
A
- suggests that agoraphobia is not a fear of public places but a fear of having a panic attack in public
- misinterpretation of physiological arousal symptoms
69
Q
social stressor on panic disorder
A
- tend to have had a higher than average number of stressful events during childhood and adolescence
- presence of a close relative/friend helps decrease catastrophic thinking and panicking in agoraphobia
- may perpetuate the disorder by making the person feel more alone when alone
70
Q
social phobia
A
- persistent, irrational fears linked generally to the presence of other people
- can be extremely debilitating
- tend to avoid situations in which they might be evaluated because they fear they will reveal signs of anxiousness or behave in an embarrassing way
71
Q
generalized social phobia
A
- involves many different interpersonal situations
- has an earlier age of onset and is more comorbid with other disorders
72
Q
specific social phobia
A
involves intense fear of one particular sensation
73
Q
social phobia characteristics
A
- very sensitive to criticism and rejection; worried about meeting expectations of others
- dread to be evaluated and may not perform to their potential
- diminished performance challenges self esteem increasing anxiety
- less likely to be in a romantic relationship
- may not complete school or advance at work due to avoidance of social interactions
74
Q
neurological factors of social phobia
A
- amygdala is strongly activated when afraid and when shown faces
- hippocampus and the cortical areas near the amygdala do not function normally
- dopamine, serotonin, and norepinephrine may function abnormally
75
Q
heritability of social phobia
A
heritability is 37% on average
76
Q
cognitive biases and distortions of social phobia
A
- see the world as a very dangerous place
- become chronically hyper vigilant for potential social threats and negative evaluations by others
- distorted emotional reasoning as proof that they will be judged negatively
77
Q
classical conditioning of social phobia
A
social situation paired with a negative social experience produces a conditioned emotional response
78
Q
operant conditioning of social phobia
A
- avoidance of social situations in order to decrease the probability of an uncomfortable experience
- negative reinforcement of avoidance behaviour because avoidance decreases anxiety
79
Q
social factors of social phobia
A
- parent child interactions
- extremely over protective parents may lead children to cope with their anxiety through avoidance
- different cultures emphasize different concerns about social interactions and these concerns influence the specific nature of social phobia
- fear of offending others in Asian cultures; fear of humiliation in western cultures
80
Q
phobia
A
- disrupting, fear mediated avoidance that is out of proportion to the danger actually posed and is recognized by the suffered as groundless
- broken down into 3 subtypes: agoraphobia, specific, and social
81
Q
specific phobia
A
- unwarranted fears caused by the presence or anticipation of a specific object or situation
- subdivided to 5 sources of fear
82
Q
5 sources of a specific phobia
A
- blood, injuries, and injections
- situations (planes, elevators, enclosed spaces)
- animals
- natural environment (heights, water)
- other
83
Q
neurological factors of phobias
A
- amygdala appears to have a hair trigger
- anxiety evoked by specific phobias is associated with too little of GABA
- different phobias appear to be influenced to different degrees by genetics and the environment
84
Q
psychological factors of phobias
A
- classical conditioning
- UCS results in UCR
- UCS is paired with CS to result in UCR
- eventually CS results in CR
- extinction occurs, so you need operant conditioning for the maintenance of the phobia
85
Q
behaviourism
A
- unrealistic fears of usually harmless things; believed these people myst have had a bad experience with the target of the phobia at some point
- recent research argues that conditioning cannot fully account for the onset of phobias
86
Q
behavioural theories of phobias
A
- focus on learning as the way in which phobias are acquired
- several types of learning may be involved: avoidance conditioning, modelling, prepared learning
87
Q
avoidance conditioning
A
- reactions are learned avoidance responses (negative reinforcement)
- avoidance conditioning formulation
- phobias develop from two related sets of learning:
- via classical conditioning
- person learns to reduce conditioned fear by escaping from or avoiding CS (operant)
88
Q
modeling
A
- person learns fear through imitating the reactions of others
- learning of fear by observing others is referred to as vicarious learning
89
Q
prepared learning
A
- people tend to fear only certain objects and events
- fear spiders, snakes, heights; but not lambs
- some fears reflect classical conditioning, but only to stimuli which an organisms is physiologically prepared to be sensitive
90
Q
cognitive diathesis
A
- the tendency to believe that similar traumatic experiences will occur in the future or not being able to control the environment
- important in developing a phobia
91
Q
cognitive theories of phobias
A
- focus on how people’s thought processes can serve as a diathesis and on how thoughts can maintain a phobia
- anxiety is related to being more likely to:
- attend to negative stimuli
- interpret ambiguous information as threatening
- believe that negative events are more likely than positive ones to reoccur
92
Q
obsessions
A
- intrusive and recurring thoughts, impulses, and images
- most frequent obsessions include: fear of contamination, fear of expressing some sexual or aggressive impulse, and hypochondriacal fears of bodily dysfunction
93
Q
compulsion
A
a repetitive behaviour or mental act that the person feels drive to preform to reduce the distress caused by obsessive thoughts or to prevent some calamity from occurring
94
Q
OCD in children
A
- childhood prevalence of 0.5-1%; gender ratio is equal
- most common obsessions are germs, fear of harm to self or others, need for symmetry
- most common compulsions are washing and cleaning, checking, counting, repeating, touching, and straightening
- children change obsessions/compulsions more than adults
95
Q
thought fusion action
A
- believing that having a certain though increases the likelihood that thought will come true
- belief that having a thought is equal to behaving in that way; seen more in religious people
96
Q
psychological factors of OCD
A
- obsession are caused by the person’s reactions to intrusive thoughts
- trying to suppress obsession can increase their frequency (rebound effect)
97
Q
rachman’s theory of obsessions in OCD
A
- unwanted intrusive thoughts are the roots of obsessions
- obsessions often involve catastrophic misinterpretations of negative intrusive thoughts
- person is compelled to engage in suppression, neutralization, and avoidance
98
Q
neurological factors of OCD
A
- may be caused by dysfunctional connections among the frontal lobes, thalamus, and basal ganglia
- both the frontal cortex and basal ganglia function abnormally in OCD patients
99
Q
impulse control disorders
A
- onset usually occurs between 7 and 15
- impulsivity can be thought of as seeking a small, short term gain at the expense of a large, long term loss
- those with the disorder repeatedly demonstrate failure to resist their behavioural impetuosity
- impulse control disorders are considered to be part of the OCD spectrum
100
Q
kleptomania
A
- occurs in fewer than 5% of shoplifters
- more common in F than M
- average age is 35; some report the onset as early as age 5
- evidence linking it with abnormalities in serotonin
- stressors, like a major loss, may precipitate kelptomaniac behaviour
101
Q
trichotillomania
A
- hair loss from repeated urges to pull or twist the hair until it breaks off
- symptoms usually begin before the age of 17
- other characteristics include: uneven appearance to the hair, bare patches or al around loss of hair, being unable to stop, etc.
- may affect up to 4% of the population; F are 4x more likely than M
- typically lasts <1yr
- SSRIs may reduce symptoms
102
Q
dermatillomania
A
- typically begins with the onset of acne in adolescence, compulsion continues even after acne has gone away
- linkage between dopamine and the urge to pick, stressful life events have been linked to the onset of the condition
103
Q
pyromania
A
- purposely set fires on more than one occasion
- before the act of lighting the fire, the person usually experiences tension and an emotional buildup
- when around fires, the person gains intense interest or fascination and may experience pleasure, gratification, or relief
- most cases occur in children/adolescents and 90% of cases are M
104
Q
trauma and stressor related disorders
A
- marked by four general types of persistent symptoms after exposure to the traumatic event
- intrusive re-experiencing of the traumatic event
- avoidance
- negative thoughts and mood and dissociation
- increased arousal and reactivity
105
Q
reaction to traumatic stressors
A
- traumatic events challenge the basic assumptions that most people have about the world
- the belief in a fair and just world
- the belief that it is possible to trust others and be safe
- the belief that it is possible to be effective in the world
- the sense that life has purpose and meaning
- people react differently to stressors and traumatic events based on previous experiences, appraisal of the stressors, and coping style
106
Q
criticisms of diagnosis PTSD
A
- distress and suffering experienced by people months after a traumatic event are not necessarily pathological
- many symptoms of PTSD overlap with those of depression and anxiety
- original criteria involved traumatic events far outside those normally experienced but now include more common traumatic events
- altered for second hand victimization
- has become a way to seek status as a victim for legal, financial, or psychological reasons
- only diagnosis for which people can sue for compensation, thus may be over diagnosed
107
Q
categories of PTSD symptoms
A
- re-experiencing a traumatic event
- avoidance of stimuli associated with the event or numbing of responsiveness
- symptoms of increased arousal
108
Q
PTSD vs acute stress disorder
A
if stressor causes significant impairment in social or occupation functioning less than one month acute stress disorder is diagnosed
109
Q
risk factors of PTSD
A
- exposure to trauma and severity of trauma
- gender (more F)
- preceived threat to life
- personality traits of neuroticism and extroversion
- early conduct problems
- family history of psychiatric disorders
- stressful ocucpations
110
Q
psychological theories of PTSD
A
- classical conditioning of fear
- anxiety sensitivity
111
Q
biological theories of PTSD
A
- genetics
- specific domains of noradrenergic system
- trauma may raise levels of norepinephrine
- evidence for increased sensitivity of noradreergic receptors in patients with PTSD
- associated with smaller hippocampus volume
- associated with decreased anterior cingulate and medial prefrontal performance
112
Q
biological treatments for panic disorder
A
- antidepressants
- both selective SSRIs and tricyclic antidepressants have been used successfully to treat PD
113
Q
psychological treatments for panic disorder
A
- exposure based treatments are often useful in reducing PD with agoraphobia
- CBT
114
Q
psychoanalytic approach for phobias
A
attempt to uncover the repressed conflicts believed to underlie the extreme fear and avoidance characteristic disorder
115
Q
behavioural approach for phobias
A
- systematic desensitization
- in vivo exposure
- virtual reality exposure
- flooding
116
Q
cognitive approach for phobias
A
- viewed with skepticism because of a central defining characteristic of phobias: phobia fear is recognized by the individual as excessive or unreasonable
- CBT
117
Q
Biological approach for phobias
A
- anxiolytics (drugs that reduce anxiety- sedatives/tranquillizers)
- barbiturates: first major category of drugs used to treat anxiety disorders
- propanediols
- benzodiazepines `
118
Q
therapies for GAD
A
- similar to that of phobias
- focus on restructuring cognitions
- patients taught to monitor their thoughts and beliefs, assess their validity, and develop more balanced appraisals
119
Q
therapies for OCD
A
- therapists attempt to normalize the occurrence of obsessional thinking by telling patients that approx 80% of population experience intrusive or unwanted obsessions
- exposure response prevention
- CBT
- drugs that increase serotonin
120
Q
therapies for PTSD
A
- combination of behavioural and cognitive methods (exposure, relaxation, breathing retraining to reduce arousal and anxiety)
- psychoeducation
- cognitive methods help patients understand the meaning of traumatic experiences and the misattributions they make about them
- ensuring that the traumatized person is as safe as possible (group therapy can provide support and a sense of safety)
- family and couples therapy can help educate family members in how they support their loved one
121
Q
depression
A
- emotional state marked by great sadness, worthlessness, and guilt
- often associated with other psychological problems (panic attacks, substance abuse, sexual dysfunction, personality disorders)
122
Q
prevalence and onset of major depressive disorder
A
- 10-25% of F; 5-12% of M
- different ethnicities, education levels, incomes, and marital statuses are affected equally
- can begin at any age, onset is typically mid 20s
123
Q
comorbidity of MDD
A
most people with MDD have an additional psychological disorder
124
Q
course of MDD
A
- more than half of those who have a single depressive episode have at least on additional episode (MDD, recurrent depression)
- periods of remission shorten with age
125
Q
anhedonia
A
- difficulty or inability to feel pleasure
- activities and intellectual pursuits that were once enjoyable no longer are
- can lead to social withdrawal
126
Q
cognitive symptoms of MDD
A
- feelings of worthlessness, grief, or guilt
- negative self evaluation with no objective reason
- tendency to ruminate over past events and feelings
- feelings of unwarranted responsibility for negative events (to the point of delusions)
- self deprecation (blaming self for depression)
- poor concentration, difficulty thinking, remembering, and making decisions
127
Q
self harm
A
- in the US, 1 in 200 girls between 13 and 19 cut, comprising 70% of teen girls who self harm
- number of cases is on the rise
- without treatment, the behaviour will continue
128
Q
suicidal ideation
A
thoughts and intentions of killing onself
129
Q
suicide attempts
A
self injury behaviours intended to cause death but that do not lead to death
130
Q
suicide gestures
A
self injury in which there is no intent to die
131
Q
suicide
A
behaviours intended to cause death and death occurs
132
Q
suicide statisitics
A
- ideators with a plan are more likely to make an attempt (31.9) than those without a plan (9.6); 43% of attempts are unplanned
- history of prior attempts is the strongest correlate of 12 month attempts
133
Q
what to look for in someone who is suicidal
A
- giving away possessions
- saying goodbye to family and friends
- talking about death
- making/threatening/rehearsing plans for death
134
Q
neurobiology and suicide
A
- MZ twins have a much higher concordance for suicidality than DZ twins
- decreased levels of 5-HIAA
- post mortem studies of brains of suicides and those with impulsivity revealed fewer serotonin receptors
135
Q
evolution of suicide
A
- the death of one carrier of genes preserves the life of many more carriers
- worker bee dies when stinging a predator, releasing alarm pheromones- protects the greater good of the hive
136
Q
psychomotor agitation
A
pacing, handwringing, difficulty sitting stillp
137
Q
psychomotor retardation
A
slowed bodily movements and speech, long pauses in speaking
138
Q
vegetative signs
A
- psychomotor symptoms
- changes in appetite or weight (increase/decrease)
- sleep disturbance (hypersomnia/insomnia)
139
Q
hypersomnia
A
sleeping more than normal
140
Q
insomnia
A
difficulty sleeping or staying asleep
141
Q
seasonal affective disorder
A
- a mood disorder in which people who have normal mental healthy throughout most of the year experience depressive symptoms in the winter, summer, spring, or autumn year after year
- it is a specifier of major depression
142
Q
neural communication in depression
A
not caused by too much or too little of one NT and instead raised from complex interactions among numerous NT substances
143
Q
monoamine oxidase inhibitors (MAOIs)
A
- decreases the breakdown of norepinephrine (NE)
- MAO is an enzyme that breaks down monoamines (e.g. NE) left in the synapse
- MAOIs inhibit MAO so it doesn’t breakdown the excess NT, leaving more to hit receptors and boost their effects
144
Q
tricyclic antidepressants
A
- decreases the reuptake of norepinephrine (NE)
- TCAs stop molecules from taking excess NE back into the firing neuron, leaving more in the synapse to keep hitting the receptors and boosting their effects
145
Q
selective serotonin/norepinephrine reuptake inhibitors (SSRIs/SNRIs)
A
medications that slow the reuptake of serotonin from the synapse
146
Q
stress related hormones
A
- excess cortisol in the blood makes the brain more prone to overreacting to stress (stress model)
147
Q
bipolar disorder
A
- mood is often persistently and abnormally upbeat or shifts inappropriately from upbeat to markedly down
- based of four building blocks:
- major depressive episode
- manic episode
- mixed episode
- hypomanic episode
148
Q
bipolar I
A
- must have a manic or mixed episode
- an MDE may also occur
149
Q
bipolar II
A
- must alternate between hypomanic episode and major depressive episodes
- less severe because of the absence of manic episodes
150
Q
manic episode
A
period of at least one week characterized by abnormal and persistent euphoria or expansive mood or irritability
151
Q
expansive mood
A
unceasing, indiscriminate enthusiasm for interpersonal, sexual, or occupation interactions
152
Q
what happens during a manic episode
A
- begin projects with no skills or special training
- believe they have special relationships with famous people or superior abilities
- have less need for sleep
- talk rapidly and loudly or have pressured speech
- rarely sit still
- flight of ideas
- be highly distractible
- have poor judgement resulting gin reckless gambling, spending, or sexual behaviours
- sometimes involves rapid cycling or mixed episodes
153
Q
mitochondria
A
- organelles that convert glucose to provide energy for the rest of the cell
- located in the cytoplasm of cells
- genes affect the number of these power plants
154
Q
psychoanalytic theory of depression
A
- according to freud, depression is created early in childhood
- during the oral period, child’s needs are insufficiently or over sufficiently gratified, causing fixation in this stage
155
Q
learned helplessness
A
- an acquired tendency to give up easily or not to try at all when faces with new or difficult tasks
- repeated failure
- belief that others are in control
- having others take care of ones needs
156
Q
merging psychology and biology
A
- twin studies have shown that identical twins who’s co twin has MDD has a 4x higher risk of MDD than non identical twins
- possibility that genes influence stress response- sensitivity to stress could contribute to depression
- the environment plays a key role in whether genes contribute to depression and how genes have their effects
157
Q
evolution of depression
A
- the symptoms of depression have been found in every culture
- rank theory hypothesis
158
Q
rank theory hypothesis
A
in dangerous situations, pessimism and lack of motivation may give a fitness advantage by inhibiting certain actions, especially futile or dangerous challenges to dominant figures, efforts that would damage the body
159
Q
behavioural method to treat depressive disorders
A
- focus on identifying and changing depressive behaviours
- behavioural activation- self monitoring, scheduling daily activities that lead to pleasure, identifying and decreasing avoidant behaviours
- superior cognitive techniques in treating both moderate and severe depression
160
Q
cognitive method to treat depressive disorders
A
- aim to diminish or change depressing thoughts (often distortions of reality)
- patients encouraged to collect data to assess the accuracy of their beliefs (can relieve and prevent depressive symptoms)
- CBT is often as successful as medication
- combination of CBT and medication is the most effective
161
Q
electroconvulsive therapy (ECT)
A
- may be used when a patient:
- has severe symptoms
- cannot take medications due to side effects or medical reasons
- has psychotic depression unresponsive to medication
- has sever depression that has not improved with medication or psychotherapy
- administered 2-3x/week for 6-12 weeks
- can cause memory loss
162
Q
transcranial magnetic stimulation
A
- sends high intensity magnetic pulses through the brain
- easier to administer and causes fewer side effects than ECT
