PSYC 507 Flashcards
ADHD
What: A behavioral syndrome (neurodevelopmental based disorder) characterized by the persistent presence of six or more symptoms involving (a) inattention or (b) impulsivity or hyperactivity that impair social, academic, or occupational functioning. Tx: stimulants (most common) or CBT
Where: observed in many setting
Who: commonly diagnosed in children, symptoms appear before the age of 7. 4x more likely in males; big genetic component
When: commonly comorbid with other learning disorders and ODD/CD; greater risk for substance abuse
Why: extremely important in the conceptualization of a child’s behavior as it can manifest as issues in school, with social relationships and behavioral problems
EX: Freddy has difficulty concentrating, fidgets, and blurts out answers a lot in the classroom. It seems to be affecting his success in school and his parents take him to a therapist and they determine that Freddy has ADHD.
Anxiety Disorders
What: most common of mental disorders. Anxiety is an unpleasant emotional state characterized by physical arousal and feelings of tension, apprehension, and worry. Anxiety becomes abnormal when it is irrational, uncontrollable, and disruptive. Cognitive overlay of anticipating a threat, not actual fear. Associated with cautious or avoidant behaviors. GAD, SAD, Agoraphobia, Panic Disorder, Phobias. Tx = CBT, mindfulness, relaxation techniques (exposure) and anti-anxiety meds
Where: psychopathology
Who: 29% of adults experience an anxiety disorder in their lifetime, females more likely to have one
When:
Why: relevant because it’s the most common mental disorder, so a lot of clients will come in with one. We need to know how to approach treatment and understand how it’s affecting the patient’s life
EX: Mark is afraid he will be judged or rejected in social settings. Even imagining a meal out with coworkers can elicit a physiological anxiety response in him. He avoids such situations as a way to manage his anxiety. He mentions this to his therapist and the therapist mentions he could be suffering from social anxiety.
Anxiety Sensitivity
What: misinterpretation of the physical signs of anxiety. Fear of sensations associated with anxiety because of the belief that they will have harmful consequences. Can anticipate onset of panic disorder
Where: anxiety disorders, psychopathology
Who: the majority of those seeking therapy
When: clinically relevant in those with anxiety disorders
Why: This is important because it can be a maintaining factor in a client’s anxiety disorder, and teaching a client to habituate to these sensations can improve overall well-being and decrease anxiety and psychological distress
EX: Dana has high anxiety sensitivity so every time her heart starts racing and she gets sweaty, she goes to the ER because she thinks she is having a heart attack. This maintains her anxiety.
Bipolar 1 vs Bipolar 2
What: Bipolar I is categorized as having at least one manic episode in a lifetime, with most of the time spent in MDE than mania but is not required to fully meet criteria for Bipolar I. Bipolar II is categorized as having MDE and hypomanic episodes with no history of mania. Bipolar 2 can turn into Bipolar 1 because hypomania can turn into a manic episode. Tx = meds (antipsychotics, mood stabilizers, lithium) and psychotherapy (med management and social skills) Therapy reduces hospitalization
Who: equally common between men and women; onset 15-30
When: very heritable disorder
Why: Need to understand the parameters of this disorder so we are not misdiagnosing patients with the wrong disorder (maybe schizophrenia) and then supplementing Tx with the correct medications.
EX: Helen has been depressed the last few weeks and missed work, hasn’t talked to her friends and isn’t showering. Her husband noticed a couple days later she was missing work but going on these crazy adventures and staying up all night and this lasted about a week. He was worried about her and told her she needed to go in for treatment
Borderline Personality Disorder
What: a personality disorder characterized by a long-standing pattern of instability in mood, interpersonal relationships, and self-image that is severe enough to cause extreme distress or interfere with social and occupational functioning. Cluster B - fear of abandonment, emotional volatility, manipulative, black/white thinking, feelings of emptiness, poor sense of self, psychosocial fallout. Inability to self sooth, cutting, dissociative experiences. Most common personality disorder SEEN in clinical settings. Comorbid with MDD very high
Where:
Who: Marsha M. Linehan, DBT (tx along with SSRIs and mood stabilizers)
When: A heritable disorder can come about from trauma and abuse in childhood and is more commonly diagnosed in women (75% of diagnoses are women)
Why: knowing about a personality disorder can help better understand comorbid disorders and how they interact within the patient. You may miss a personality diagnosis but they have anxiety, depression, etc
EX: Laura has been getting into fights with everyone around her and threatening to cut them off from her life and is blaming everything on them but a couple days later forgets about it and tells them she loves them a lot. She cuts herself almost every night and has tried to commit suicide a couple times. She has been diagnosed BPD and starts DBT
Case Study
What: a type of research that includes a detailed description of a specific individual and the tx of that individual. Cannot generalize results or determine causality from a case study
Who: specific individuals, can lead to further research on bigger populations
When: It’s used to document success of specific treatment, describe new tx, or demonstrate novel application of existing tx. Used to assess a person’s treatment journey and the success of that treatment
Why: a great tool to examine patients, look at research, and understand why a certain tx has worked for that specific person. Can lead to further research with larger sample sizes.
EX: A client comes in with a rare psychological disorder, I look at the case study research on this disorder to find out more information regarding treatment considering there aren’t any manualized treatments/large-scale research studies done on it.
Categorical vs Dimensional Diagnosis
What: categorical: organized, evidence-based, assumes disorders have specific etiologies, pathologies, and treatments, and assumes disorders are qualitatively distinct. Dimensional: individualized, symptoms reflect quantitative deviations from normal, also takes comorbidities into account. The DSM-5 is currently categorical but shifting to a dimensional outlook
Who: Affects the treatment of individuals
When: relevant when diagnosing and determining treatment; use of the DSM5, which is categorical distinction
Why: It is helpful to be aware of the weakness of the categorical system in order to use it as effectively as possible
EX: A client comes in with feelings of hopelessness, suicidal ideation, anhedonia and loss of interest in activities. Without taking into account possible comorbidity, the client can be diagnosed with depression based on the categorical diagnosis.
Comorbidity
What: It is the clinical term to describe the co-occurrence of distinct disorders, apparently interacting with one another at the same time. Very common in mood disorders and SUDs
Who: Individuals with more than one diagnosis, those who have one diagnosis and are susceptible to getting another one
When: certain disorders are frequently present together and it’s important to be aware of this. Important when determining which diagnosis to treat first.
Why: knowing different disorders are comorbid can help better assess a patient, conceptualize their sx and move forward with treatment planning. The presence of comorbidity may affect the type of therapeutic and pharmacological interventions available to the client.
EX: The comorbidity between anxiety and depression is high, a clinician should keep that in mind when assessing and diagnosing
Competency to Stand Trial
What: a person’s ability, at the time of trial, to understand and appreciate the criminal proceedings against them, to consult with an attorney with a reasonable degree of understanding, and to make and express choices among available options. It requires a cognitive assessment and the burden is placed on the defense to prove incompetence
Where: psychopathology
When: this is relevant in trial/court room settings. This has nothing to do with the insanity plea – competency to stand trial is about the person’s mental state at the time of the trial, not at the time of the crime
Why: understand the large effect a mental disorder can have on someone - it permeates their life in ways that can cause damage/harm not only to themselves, but others as well
EX: Boris has been diagnosed with schizophrenia. He is arrested on murder charges. Because of his delusions and other mental instabilities, he is held in custody but declared incompetent to stand trial, but he will go under treatment to be reevaluated to be deemed competent to stand trial.
Diagnosis
What: a determination that a person’s problems reflect a particular disorder or syndrome in a particular classification system (usually DSM5). OR the classification of individuals on the basis of a disease, disorder, abnormality, or set of characteristics. Labels make it easier for clinicians to communicate, but can carry a negative connotation. Not all are accurate or fit perfectly.
Where: DSM, 507, psychopathology.
Who: generally those seeking treatment, and is given to those individuals by the clinician
When: This is relevant when the evidence of sx reflect a certain disorder found in a manual with clear distinctions made out of what requirements must be met for said disorder.
Why: knowing that diagnoses may have a negative social stigma can help us empathize with patients and the idea that it may be hard to accept some diagnoses. We can help clients work through this and improve their lives/functioning.
EX: After an assessment interview, Claire’s symptoms of a weight below a healthy BMI for her age, starvation behavior, and fixation on thoughts of food and weight qualify her for an anorexia diagnosis
Diagnostic and Statistic Manual of Mental Disorders (DSM)
What: the handbook used by psychologists and health care professionals as the authoritative guide to the diagnosis of mental disorders. It contains descriptions, symptoms and other criteria for diagnosing mental disorders. Advantage - allows for easy communication b/w clinicians. Disadvantage - diagnoses are stigmatizing and co-morbidity isn’t accounted for
Where: used when diagnosing clients, psychopathology
Who: those seeking treatment for how symptoms of a diagnosis are affecting their lives
When: it’s relevant when determining diagnoses, checking client sx, and becoming knowledgeable on different mental disorders (clinicians)
Why: it is an essential tool for clinicians when diagnosing patients, understanding the different sx of disorders, and how to use this information when treating clients
EX: Shelley, a therapist, uses the DSM-5 to evaluate whether her clients’ symptoms indicate an official diagnosis. She uses the DSM codes when reporting to insurance companies for reimbursement
Diathesis-Stress Model
What: the theory that mental and physical disorders develop from a genetic or biological predisposition for that illness (diathesis) combined with stressful conditions that play a precipitating or facilitating role. Diathesis are the pre-existing factors and stress is the stressor or life event that occurs.
Where: the biopsychosocial model
When: this is relevant because the greater the diathesis and the greater the stress - more likely you will develop psychopathology.
Why: This hypothesis is important because it considers a multitude of etiological factors relating to the development of a disease. Can help explain client sx, diagnoses, by examining the stress in their environment.
EX: Dale had his first episode of psychosis after losing his job and girlfriend. He was eventually diagnosed with schizophrenia. Later brain scans showed increased ventricles common in people with schizophrenia. Dale’s relatively psychologically normal life up until the point of intense stress is an example of the diathesis-stress model at work.
Differential Diagnosis
What: the process of determining which of two or more diseases or disorders with overlapping symptoms a particular patient has.
Where:
When: The goal is to figure out which specific disorder best explains the presenting complaints. The DSM-V has been updated to help counselors differentiate between diagnoses easier.
Why: Important to identify and differentiate between disorders as to be able to treat the client appropriately and to the best of your ability.
EX: A client comes in with symptoms of depression and a few sessions in also tells you that she has a trauma history. I will look to the DSM to see if these depression symptoms are PTSD or true depression.
Dissociative Disorders
What: Rare group of disorders characterized by a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment known as dissociation. Characterized by one’s conscious awareness separating (dissociating) from certain memories, caused almost entirely by psychosocial factors rather than physical ones.
Where: Dissociative symptoms can potentially disrupt every area of psychological functioning.
Who: Includes dissociative amnesia, dissociative fugue, and dissociative identity disorder
Why: This is the most controversial diagnosis in the DSM-V, people who have this diagnosis are at an increased risk for suicide and self-harm. These disorders are also frequently found in the aftermath of trauma.
EX: Emilia goes missing. Days later, she is found in another state, applying for a job under the name Stephanie. She is suffering from dissociative fugue
Dopamine
What: key neurotransmitter that is involved in the pleasure center of the brain affecting learning, reward, and motivation. Use/abuse/dependence roles of substances because almost every substance directly or indirectly affects the DA system. Natural dopamine declines when it is routinely artificially introduced.
When: This is a key part of the etiology of addiction, and low dopamine activity is a key biological factor is depression and negative symptoms of schizophrenia while high dopamine activity contributes to positive symptoms of schizophrenia
Why: knowing the biological aspect of certain mental disorders can help us in treatment and the use of medications. Can teach a client so that they can learn more about their disorder and how affects their body/brain
EX: Sarah comes into treatment with schizophrenia is currently in the active phase, this can be attributed to high dopamine levels, the therapist will get her mood stabilizers and antipsychotics to stabilize her dopamine levels.
