PSYC-507 General Psychopathology Flashcards
ADHD
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.
Anxiety Disorders
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.
Anxiety sensitivity
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.
Assessment interview
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)
Bipolar I vs. Bipolar II
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.
Borderline Personality Disorder
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
Case study
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.
Categorical vs. dimensional diagnosis
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.
Clinical significance
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.
Comorbidity
a clinical description used to describe the coexistence of two or more clinical diagnoses in the same person at the same time.
Competency to stand trial
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.
Conduct Disorder
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.
Diagnosis
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).
Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
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.
Diathesis-stress
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.
Dissociative disorders
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.
Dopamine
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).
Eating disorders
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.
GABA
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.
Heritability
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
HPA Pathway
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.
Idiographic vs. nomothetic assessment/understanding
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.
Insanity
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.
Mania
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.
