PSYC-507 General Psychopathology

Question 1

ADHD

Answer 1

a neurodevelopmental brain based disorder marked by the inability to focus attention, overactive and impulsive behavior, or both. There are three types; inattentive, hyperactive-impulsive, and combined, with combined type being less common than the first two. Must be present by age 12 and usually is lifelong. ADHD causes physical abnormalities in the brain, which can manifest in decreased volume and functioning. Symptoms are typically maladaptive and age inappropriate, with features such as constant movement, poor decision making, susceptibility to distractions and clumsiness. Commonly comorbid with learning disorders and ODD/CD and greater risk for substance abuse. Occurs in males more than females. Etiology is more genetic in nature, and linked to maternal smoking during pregnancy. This can be treated with medication, SST, behavioral therapies, and routines.

Question 2

Anxiety Disorders

Answer 2

Occur when feelings of anxiety interferes with everyday life, includes multiple physical characteristics, and is irrational, uncontrollable, and disruptive. These include Generalized Anxiety Disorder, Phobias, Obsessive Compulsive Disorder, and Social Anxiety Disorder. They are the most common type of disorder experienced in general populations. The anxiety disorders deal with anxieties that are future focused, and tends to have cognitive, behavioral , and physiological components. Anxiety disorders can be displayed by someone at any age. Treatments include teaching coping strategies such as relaxation techniques or cognitive restructuring, along with exposure (if applicable) or anti anxiety medications.

ex/ someone who has a severe fear of dogs which includes avoiding places where dogs are and have a fight or flight reaction around dogs would be considered to have an anxiety disorder of phobias.

Question 3

Anxiety sensitivity

Answer 3

Can develop along side panic disorder, and relates to a fear of anxiety related senstations. this is when a person is sensitive to signs of a panic attack and are easily triggered to be anxious. Can misinterpret the signs of a panic attack to be dangerous and catastrophic and triggers the fight or flight response. Begins a vicious cycle of worrying about having another panic attack, causing a panic attack.

Question 4

Assessment interview

Answer 4

The process of collecting and interpreting relevant information about a client or research participant with intent to develop a treatment plan, typically during the initial session/meeting. May be structured, with specific questions in a specific order strictly adhered to in order to provide better reliability and validity. Or maybe unstructured where the interviewer follows their own line of questioning allowing them to pursue relevant topics as they arise. May be used in conjunction with other assessment techniques to formulate a better picture of individual, diagnosis, and treatment (e.g. psychological tests, behavioral observations)

Question 5

Bipolar I vs. Bipolar II

Answer 5

Bipolar I is a mood disorder that is equally common in men and women, and usually doesn’t present until between 15-30 years. It requires at least one manic/hypomanic episode and is usually accompanied by depressive episodes. Manic episodes typically last about a week or more, while depressive episodes can last two weeks to months. Bipolar I can have psychosis involved. No specific number of episodes is needed for diagnosis. Treatment usually includes medication and hospitalization if needed, along with psychoeducation.

Bipolar II is a mood disorder which is less severe than Bipolar I, but is capable of turning into Bipolar I. Bipolar II has a fluctuation between MDEs and Hypomania. Bipolar II tends to be harder to detect as people do not notice the hypomanic episodes, and rarely come into treatment. When they do it is for depression. Bipolar II does not present with full manic episodes. Onset tends to be a little later, starting in the 20’s rather than teens.

ex/ a client who has issues with depression, but exhibits elevated mood, flights of ideas, or other symptoms of mania but less severe, the client may have bipolar II.

Question 6

Borderline Personality Disorder

Answer 6

Borderline personality disorder is an illness marked by an ongoing pattern of varying moods, self-image, and behavior. These symptoms often result in impulsive actions and problems in relationships. People with borderline personality disorder may experience intense episodes of anger, depression, and anxiety that can last from a few hours to days.

ex. Ben, Olivia

Question 7

Case study

Answer 7

A case study is an in-depth study of one person, group, or event. In a case study, nearly every aspect of the subject’s life and history is analyzed to seek patterns and causes of behavior. tend to be highly subjective and it is sometimes difficult to generalize results to a larger population.

Question 8

Categorical vs. dimensional diagnosis

Answer 8

Categorical (medical) diagnosis are unique without overlapping features

Categorical Diagnosis:
A categorical approach to assessment relies on diagnostic criteria to determine the presence or absence of disruptive or other abnormal behaviors (DSM).

Dimensional Diagnosis:

Dimensional diagnosis assesses symptoms on a scale to discern a diagnosis from overlapping features

symptoms and features are rated on a scale rather than in categories, the profile determines a diagnosis. This is not a yes/no if they have a symptom, but instead focused on the severity of the symptom.
allows a clinician more latitude to assess the severity of a condition and does not imply a concrete threshold between “normality” and a disorder.

Question 9

Clinical significance

Answer 9

The practical importance of a treatment effect regarding impact on the client’s life

A type of significance for research experiments, and measured in the participants. Clinical significance looks at symptom levels, remissions, client functioning, and quality of life. A high clinical significance suggests the post treatment symptom scores are lower than the pre treatment symptom scores and the treatment works well in a clinical setting to lessen symptoms. it also looks at the benefits and costs to the patient. When looking for new treatments, it is important to pay attention to the clinical significance as well as the statistical significance.

Question 10

Comorbidity

Answer 10

a clinical description used to describe the coexistence of two or more clinical diagnoses in the same person at the same time.

Question 11

Competency to stand trial

Answer 11

The requirements must be met in order for someone to stand trial are that they must be able to understand the charges against them, and must be able to assist in their own defense (as in communicate, decide whether to go on the stand, etc). A thorough cognitive assessment is required. The burden is to prove incompetence, rather than competence. If found incompetent, they will be held in a mental health hospital until competent, time dependent on the charges. After the time elapses, they will either be set free or put under civil commitment.

Question 12

Conduct Disorder

Answer 12

A childhood disorder which generally follows oppositional defiant disorder, and is typically more severe. This can turn into antisocial personality disorder the earlier it can be diagnosed. Behaviors include lying, cheating, skipping school, criminal behaviors, and other more antisocial behaviors. Usually begins around the age of 10 and is exhibited by 6-16% of boys and 2-9% of girls. These are typically attributed to more genetic factors, drug abuse, or poverty rather than the surrounding environment. Treatment is more effective at younger ages, with Parent-Child Interaction Therapy and Parent-Child Relationship Training having the greatest effects.

Question 13

Diagnosis

Answer 13

the identification of the nature of an illness or other problem by examination of the symptoms. This can be an incomplete process, not including information about the client or how they may have developed the problem. Over the course of an evaluation an assessment of symptoms is conducted and compared with known criteria. There are two types of strategies; idiographic (individualized case conceptualization) and nomothetic (general class of problems based on shared features). There are three types of approaches; categorical (unique with non overlapping and essential features), Prototypical (combination of essential features and a minimum number of common features) and Dimensional (symptoms/features rated on a scale, profile determines diagnosis).

Question 14

Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Answer 14

Currently on the fifth edition. This is a nomothetic classification system for mental disorders developed by the american psychiatric association provides a prototypical diagnosis approach. This is the primary book used in diagnosing psychological problems. Can be considered as more of a “guide” for diagnosing psychological disorders used by clinical psychologists, counselors, and therapists. The DSM-IV has all the definitions of disorders, criteria for diagnosis, etc. This supplied a common language between therapists for describing client symptoms.

Question 15

Diathesis-stress

Answer 15

From the biopsychosocial model, this suggests the combination of a diathesis and stress create psychopathology in a person. Diathesis refers to a predisposition of some sort to an illness, and stress refers to some sort of life stressor. The greater the diathesis and the greater the stress, the more likely you will develop psychopathology.

Question 16

Dissociative disorders

Answer 16

A rare group of disorders where there is a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment with no clear physical causes such as a concussion or physical injury. Key features include depersonalization, derealization, and profound disturbance in memory. Traumatic events may make a person more susceptible to these disorders. These disorders include dissociative amnesia with or without fugue state, and dissociative identity disorder. These can last for various amounts of time, from a few hours to months or years at a time. Have increased risk of comorbidity and complications, such as self-harm and suicide, severe headaches, anxiety disorders, and depression, amongst others.

Question 17

Dopamine

Answer 17

a neurotransmitter that is involved in the reward/pleasure center of the brain affecting learning, rewards, and motivation. Critical in use/abuse/dependence roles of substances because it is stimulated by several such as ETOH, nicotine, cocaine, caffiene, etc. and the body can take up to a year to recover to normal production after heavy substance use. Abnormal levels also associated with symptoms of parkinson’s, schizophrenia and depression. Amounts present are linked to levels of serotonin, low levels of both equal less pleasure where as excess levels are associated with delusions, hallucinations, and bizarre behaviors of schizophrenia (positive symptoms).

Question 18

Eating disorders

Answer 18

A newer class of disorders related to weight and irregular eating patterns, seen as either minimal to no eating or excessive eating and purging. Anorexia, Bulimia, and Binge Eating Disorder fall in this category. Characterized by intense preoccupation with food, intense fear of weight gain, some obsessive thinking and compulsive behaviors, and lack of interoceptive awareness. These illnesses are often accompanied by a multitude of health issues and frequently comorbid with anxiety and mood disorders. Can be caused by social learning, family dynamics, or genetic components. Treatments include CBT, ERP, family counseling and medication.

Question 19

GABA

Answer 19

Gamma-Aminobutyric Acid, a neurotransmitter with a predominately inhibitory function. Action is important in anxiety and memory.
Because it blocks nerve stimulation and excitement, GABA can reduce stress and anxiety.
The anxiety reducing abilities of ethanol and benzodiazapines work by increasing GABA levels. Increasing GABA also vicariously increases dopamine levels in the pleasure pathway. Low levels of GABA is associated with generalized anxiety disorder. Low levels of GABA causes a failure to inhibit arousal in the inhibitory system. Depressants higher GABA and High dopamine leading to abuse.

Question 20

Heritability

Answer 20

the proportion of variation among individuals that we can attribute to genes. in contrast to environment factors used in the study of disorders when measuring whether symptoms are attributable to biology versus the environment, the nature versus nurture debate

Question 21

HPA Pathway

Answer 21

Hypothalamic-Pituitary-Adrenal Pathway is the long term stress response. Begins in the hypothalamus which triggers the pituitary gland to release the stress hormone ACTH. ACTH is carried in the blood to the adrenal gland, which releases the stress hormone Cortisol. The stress pathway functions differently than anxiety and panic. This pathway is turned off by the hippo-campus, and takes a while to turn off once begun. This pathway is most associated with PTSD and other trauma/stress disorders.

Question 22

Idiographic vs. nomothetic assessment/understanding

Answer 22

Idiographic Assessment/Understanding:
A strategy for diagnosis which describes the study of the individual, who is seen as a unique agent with a unique life history, with properties setting him/her apart from other individuals instead of what they have in common with others. It allows for the understanding of symptoms in the individual’s cultural context. Clinicians should be aware that many disorders manifest in these unique ways. This also allows the development of an individualized treatment plan for the individual.

Nomothetic Assessment/Understanding:
a strategy for diagnosis whereby a general understanding of the nature, causes, and treatments of abnormal psychological functioning are grouped into a general class of problems/disorders based on shared features. These classes of disorders are used to interpret the clients presenting behaviors into normal and abnormal categories. this helps clinician to have a starting point for diagnosis with each client, instead of always beginning anew. accomplished via large research investigations resulting in generalizable laws of behavior. the DSM is an example.

Question 23

Insanity

Answer 23

Not a clinical term, but rather a legal term pertaining to a defendant’s ability to determine right from wrong when a crime is committed. Developed as an attempt to protect people with mental illnesses from being punished for harmful behavior resulting from their disorder. A person may plead not guilty by reason of insanity, and the burden of proof lies on the defense to convince the judge, jury of this condition. if deemed to still be mentally unstable the person will be committed for treatment, otherwise if now stable, they are released as not guilty.To determine if someone meets the insanity definition, a cognitive assessment is required.

Question 24

Mania

Answer 24

a type of episode for mood disorders, mania is a main feature in Bipolar I and required for diagnosis (at least one episode). Characterized by an abnormal mood (irritable, expansive, or high) and at least three or more other criteria, including inflated self esteem, increased energy, decreased sleep, racing thoughts, pressured or increased speech, or impulsivity and poor judgement. Manic episodes typically last a week or more. Can include psychosis while in a manic state. These can be mood congruent (grandiosity,paranoia) or incongruent (aliens). Mood congruent most common. Typically mania is experienced as pleasurable by the client and preferable to depressive episodes. One episode makes following episodes more likely and easier to trigger in a process called kindling.

Question 25

Mood Disorders

Answer 25

Mood disorders are a class of disorders characterized by the elevation or lowering of a person’s mood. These typically include depression, bipolar, and variants of the two. Symptoms of these disorders may include depressive episodes or mania. depressive episodes may include symptoms such as sadness, lack of energy, and anhedonia. mania may include euphoria, frenzied activity or an inflated sense of self. Either can include psychosis if severe. Comes from a variety of causes, including genetics, social learning, and cognitive errors. Treatments can include medication, psychoeducation, behavioral activation, and CBT, amongst others.

Question 26

MRI

Answer 26

Magnetic resonance imaging (MRI) is a technique that uses a magnetic field and radio waves to create detailed images of the organs and tissues within your body. Used to study brain functioning, this has aided with diagnosis and research.

Question 27

Obsessive-Compulsive and Related Disorders

Answer 27

A newly separated class of disorders which includes obsessive compulsive disorder. hoarding disorder, and body dysmorphic disorder. These are characterized by obsessive thoughts and compulsive actions. The person feels driven to perform these behaviors due to thoughts. Thoughts cause anxiety, and behaviors lessen the anxiety felt by the thoughts. There are different classes of thoughts (contamination, pathological doubt, violent/sexual thoughts) and a wide variety of corresponding compulsions (washing, checking, counting, symmetry, hoarding). Generally the obsessions and compulsions are linked. Obsessions are in direct contrast to who they want to be/who they think they are as a person, which is why they are so disturbing to the person. Do not need both for a diagnosis. Tends to be a chronic lifelong illness, but can be controlled. Generally comes from genetic and neurological sources, though can come from social/behavioral/cognitive sources. Treatment comes in the form of cognitive therapy or exposure therapy with response prevention.

Question 28

Oppositional Defiant Disorder

Answer 28

A disorder seen during childhood, can turn into conduct disorder and antisocial personality disorder. Typically begins by 8 years of age and generally grow out of it by 1st grade naturally. More commonly seen in younger boys, but equals out by puberty. Characterized by tantrums, saying no, cursing, slamming doors, and doesn’t follow rules. Can come from relationship from parents/home life, inconsistent punishments, and attention seeking behaviors. Earlier the treatment begins the better. Parent Child relationships training and Parent child interaction training to be found most effective.

Question 29

Panic Attack

Answer 29

A sudden episode of anxiety that rapidly escalates in intensity. Onset can be sudden and time attacks last vary for each attach and person. Can include physical and psychological symptoms, including pounding heart, rapid breathing, sweating, choking sensation, dizziness, and feeling like “going to die” or “going crazy.”
Panic attacks can be seen in a variety of disorders, such as PTSD, phobias, and others, designated by a panic attack specifier. This usually indicates increased symptom severity, poor treatment response, and higher rates of comorbidity and suicide.

Question 30

Personality Disorder

Answer 30

A type of disorder characterized by a rigid and unhealthy pattern of thinking, functioning and behaving which repeatedly impairs a person’s sense of self, emotional experiences, goals, capacity for empathy, and/or capacity for intimacy. These personality traits are typically inflexible and maladaptive and causes significant functional impairment to the individual and usually distressing to the people around them. There are three clusters of personality disorder; cluster A (odd/eccentric), cluster B (dramatic/emotional), and cluster C (anxious/fearful). There are high comorbidity rates and treatment is refractory and often unhelpful or discontinued early. 9.1% of population has a personality disorder, and are most stigmatized group in psychology due to the difficulty in treating them. Can come from genetics or surroundings, as behaviors may have been previously adaptive and become maladaptive later. Disorder never really goes away, just manage the symptoms.

Question 31

PET scan

Answer 31

A positron emission tomography (PET) scan is a neuropsychological test that reveals the functioning of different areas of the brain with a computer produced image showing rates of metabolism, blood flow, and oxygen use throughout the brain. The patient consumes a radioactive glucose solution that is picked up by the scan as the brain engages in different areas based in the person performing certain tasks or feeling certain emotions. By identifying body changes at the cellular level, PET may detect the early onset of disease before it is evident on other imaging tests. Provides a map of brain functioning.

Question 32

Placebo effect

Answer 32

Occurs when there is a positive impact on patient’s symptoms from any treatment that is not known to have any effects or produce a meaningful change but is made to look like a creatable and active treatment. This is generally in the form of sugar pills in medication studies or general listening in therapeutic studies. The patient’s expectancies about the outcome of treatment can have a significant effect on what outcome they will see, so research studies compensate for this with noneffective stand in treatments to determine if symptoms improvement is from the actual active treatment being studied or this placebo effect.

Question 33

Positive vs. Negative symptoms

Answer 33

Labels for classifying symptoms of schizophrenia that refers to amounts of the behaviors being in excess or absence compared to normal experiences.
Positive symptoms include delusions, hallucinations, disorganized speech (tangentiality, derailment, neologisms, clang) and bizarre/disorganized behavior (appearance, affect, actions).
Negative symptoms include alogia (poverty of speech), affective flattening (no display of emotion), avolition (lack of motivation), and anhedonia (inability to experience pleasure). These are typically more common than positive symptoms. Symptoms can be seen in the prodromal and residual phases as well as the active phase.

Question 34

Psychosis

Answer 34

a general psychiatric term referring to a severe mental disorder in which thoughts and emotions are so impaired that contact is lost with external reality in key ways. A main feature is the inability to distinguish between internal and external stimuli. Most linked with schizophrenia, this can also be seen with severe cases of bipolar, depression and PTSD, among other disorders. Commonly linked with dopamine overactivity. Typically refers to features of delusions or hallucinations as a symptom using DSM diagnosis, but should not be considered a symptom of a psychiatric diagnosis until other relevant and known causes are excluded (CNS issue, disease, drugs) Adding this to the prognosis typically worsens it.

Question 35

Primary vs. Secondary gain

Answer 35

In psycho dynamic theory, describe the significant subconscious psychological motivators patients may have when presenting with symptoms. Mainly seen in somatic disorders, but can be present with others. Primary gain is the gain people achieve when their somatic symptoms keep their internal conflicts out of awareness. Secondary gain is the gain people achieve when their somatic symptoms elicit kindness from others or provide an excuse for avoiding unpleasant activities

Question 36

Remission

Answer 36

A period during which symptoms of disease are reduced (partial remission) or disappear (complete remission), and it usually means that the client is no longer experiencing clinical levels of symptoms related to the original issue.
In psychotherapy, the strength of a treatment is measured by rates of symptomatic decreases thereby identifying successful forms of treatment for specific disorders in meta studies as well as successful components of psychotherapy in dismantling studies.

Question 37

Schizophrenia

Answer 37

a long-term mental disorder involving a breakdown in the relation between thought, emotion, and behavior, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation. This generally impacts everyone in the client’s life, including the client. Symptoms are presented in two groups referred to as positive symptoms (excess of behaviors) or negative symptoms (absence of behaviors), with key symptoms of grossly disorganized behaviors, hallucinations and delusions. Can have three distinct phases; prodromal (before episode), active (psychotic episode), and residual (post episode). Age of onset is between 18-40 years of age. Typically comes from a genetic predisposition and altered neurochemistry. Treatment is generally anti-psychotic medication along with various forms of therapy, including family treatment and skills training in order to help prevent relapse.

Question 38

Serotonin

Answer 38

A neurotransmitter responsible for regulating mood, appetite, sleep, and other cognitive functions. Links to dopamine and norepinephrine. Low levels of serotonin can be seen in depression and OCD. SSRIs can aid in regulating serotonin levels. Can be considered the biological basis of some disorders.

Question 39

State vs. trait anxiety

Answer 39

This refers to the two recognizable ways which anxiety manifests itself. State anxiety refers to situational anxiety, where the anxiety is drawn from the situation at hand and is usually short lived. Can be seen in people who are anxious about specific instances such as public speaking, but aren’t anxious about tests. Trait anxiety refers to a personality trait, tend to regularly experience excessive worry and other anxiety symptoms in anticipation of future events. Trait anxiety can be defined as a long-lasting arousal in the face of potential threat. This expression can be high, moderate, or low.

Question 40

Substance-related disorders

Answer 40

characterized by a pattern of maladaptive behaviors and reactions brought about by repeated use of a substance, sometimes including tolerance for and withdrawal reactions from the substance, leading to significant impairment and or distress during a 12 month period including 2 or more listed symptoms in the DSM with the same criterion for all substances. This can be defined as failure to fullfil major role obligation, substance taken in larger amounts than expected, use despite persistent interpersonal problems caused by substance, amongst others. Encompasses both abuse and dependence. May have multiple listings within this disorder, with most problematic listed first. This type of disorder could be due to genetics (more prone to abuse, physical response enhanced), changes in brain and physiology which makes the substance necessary, or social, environmental or traumatic event. Treatments include Motivational interviewing, AA/NA, CBT, amongst others. There are medications available, but they are not best practice. There may also be legal problems.

Question 41

Tolerance vs. withdrawal symptoms

Answer 41

These are key symptoms to look for when determining a substance related disorder, and can be indicative of physical dependence. Tolerance refers to a physiological state where the effectiveness of a drug has decreased due to chronic administration. This means that more of the drug will be required to achieve the same effect in the future. Withdrawal is the onset of symptoms, both physical and mental, when a substance is reduced or not given to the body. Withdrawal symptoms vary depending on which drug was taken.

Question 42

Trauma and Stress or Related Disorders

Answer 42

A newly separated class of disorder, this includes PTSD, Acute stress disorder, and Adjustment disorders. A physical and emotional and cognitive patterns that arise in response to psychologically debilitating event in which a person is exposed to actual or threatened death, serious injury, or sexual violation directly or indirectly to an individual they are extremely close with. Exposure is a key diagnostic criterion for these disorders with other symptoms including arousal, anxiety, mood problems, or other stress symptoms following a traumatic event. Can include combat, child abuse, assault, or car accident amongst others. Symptoms generally include nightmares, intrusive thoughts, flashbacks, cognitive distortions, sleep disturbance, amongst others. Can be comorbid, often with depression and substance abuse. Most common treatment include medications, exposure therapies, cognitive and behavioral therapies, though other types have been used successfully.