psych Flashcards
What is mental disorders?
Any behavior/emotional state that causes distress is maladaptive and disturbs relationships and greater community
Legal standards are?
Level of subjective distress and whether it interferes with the ability to successfully function in everyday life
BIOPSYCHSOCIAL
Biological, psychological, sociological
DSM IS?
Diagnostic and Statistical Manual of Mental disorders
DSM problems?
Danger of overdiagnosis, the power of diagnostic labels, many of symptoms are subjective not objective, many overlapping causes, stressful experiences can trigger disorder like death of loved one
What is ADHD
Attention deficit/hyperactivity disorder
how many must adhd hit?
must frequently show at least 6 symptoms
What is inattention
fails to attend to details, difficulty organizing tasks, loses things, forgetfuls
What is impulsivity and or hyperactivity
fidgets, “on the go”, interrupts, runs and climbs inapproporiately for a childs particular developmental age
what has the either or style caused
this diagnosis has allowed people to qualify for same diagnosis in many ways
what is personality disorder
Paranoid Personality Disorder
Suspicious
Argumentative
Reluctant to confide in others because of fears information will be “used against” him/her
Looking out for trickery
Blame others and bears grudges
Schizoid Personality Disorder
Have very few if any friends or family relationships
Loner, choosing solitary activities
Indifferent to praise or criticism
Shows no warm or tender feelings to other people
Schizotypal
Bizarre or odd patterns in behavior
Odd beliefs or magical thinking that influences behavior
Uses unusual words (vague, metaphorical)
Inappropriate or constricted affect
**
rigid, maladaptive traits that cause great distress or lead to an inability to get along with others, or to function well in the world
Pattern is inflexible, pervasive and of long duration
what are personality clusters
Clusters include:
Odd/Eccentric: paranoid, schizoid, schizotypal
Dramatic/Erratic: antisocial, borderline, histrionic, narcissistic
Anxious/Inhibited: ocpd, dependent, avoidant
Odd/Eccentric:
1.Paranoid Personality Disorder
Suspicious
Argumentative
Reluctant to confide in others because of fears information will be “used against” him/her
Looking out for trickery
Blame others and bears grudges
2. schizoid personality disorder
-have few friends family and loner and dl praise and no feelings to ppl
3.schizotypal
-odd behaviour and beliefs and unusual words and inappropriate affect
Dramatic/Erratic: antisocial, borderline, histrionic, narcissistic
1.Antisocial Personality Disorder
Likes to break rules/laws
Deceitful
Gladly take advantage of people
Lacks remorse
Can appear charming/friendly
Often intelligent
History of conduct disorder
2.Borderline Personality Disorder
Manipulative
Stable pattern of unstable relationships
Frantic efforts to avoid “abandonment”
Splitting: all good or bad
Self-mutilating behaviors
Impulsivity
Sexual promiscuity
Quick to anger
3.Histrionic Personality Disorder
4.Narcissistic Personality Disorder
Anxious/Inhibited: ocpd, dependent, avoidant
Obsessive-Compulsive Personality Disorder
Perfectionist to the point that task completion can be difficult
Preoccupied with details so that major point of activity is lost
Rules are essential
Particular
Serious and formal
Work gives pleasure
Reluctant to work with others unless they submit to doing things “exactly” his/her way)
2.Avoidant Personality Disorder
Excessively sensitive to rejection
Fearful of humiliation or shame
Socially withdrawn
Wishes to be accepted by others but avoids opportunities based on anxiety and fear of rejection or ridicule
Views self as socially inept, personally unappealing, or inferior to others
3.Dependent personality disorder
Submissive and clinging behavior
Excessive need to be taken care of.
Difficulty making decisions without an excessive amount of advice and reassurance from others.
Has difficulty expressing disagreement with others because of fear of loss of support or approval
Feels helpless when alone and goes to great lengths to get nurturance from others
4.
what is psychotic disorder
Schizophrenia: psychosis or condition involving distorted perceptions of reality and an inability to function in most aspects of life
Typical age of onset: 17-25
Strong genetic component
what is positive psychotic disorder?
Positive Symptoms: (Presence of a distortion or bizarre behavioral symptom)
Bizarre delusions
Hallucinations
Heightened Sensory Awareness
Disorganized incoherent speech and behavior
what is negative psychotic disorder?
Negative Symptoms (loss of functioning or ability; behavioral deficits)
Poverty of speech
Emotional flatness
Loss of motivation
Social withdrawal
Apathy
Impaired attention
what is Dissociative Disorders:
consciousness, behavior and identity are split off
May develop in response to traumatic events
Amnesia: inability to remember important personal information; cannot be explained by ordinary forgetfulness
Fugue state: no concept of self/ can take on a whole new identity/life
(DID)???
Dissociative Identity Disorder (DID): Formerly called multiple personality disorder. Described by the appearance of 2 or more distinct identities within one person
Psychoanalysis: based on Freudian principles that emphasize the impact of early childhood
Goal is to increase insight and uncover repressed conflicts to decrease their unwanted influence (stress, anxiety, relationship challenges)
Traditionally very intensive (4-5 x a week)
Uses free association: saying whatever comes to mind
Dream Interpretation
Transference: develop relationship with therapist and reactions are based on earlier relationships and uncovered repressed fantasies.
Psychodynamic Therapies: looks at unconscious conflicts, defense mechanisms and symptom resolution in a broader manner than Freud. Usually less intensive.
Interpersonal psychotherapy (IPT): one form of psychotherapy focuses on helping clients improve current relationships. Works on improving relational functioning (adaptive role transitions, social and emotional skills…)
Still a form of “talk therapy”. Goal to reduce/relieve symptoms, promote insight, offer advice and support.
Humanistic or Client-Centered Therapies:
belief that people need to be supported and set the pace of their own therapy. (Rogers)
Basic principles include:
Unconditional positive regard
Help build self esteem and feelings of acceptance with genuineness and empathy
Behavioral and Cognitive Therapies
Systematic Desensitization: step by step process of eliminating a fear.
Based on principles of counterconditioning from classical conditioning.
Pairs relaxation techniques with increasing levels of contact with the feared situation/object to reduce physical response of anxiety
Aversion Therapy:
substitutes punishment for the reinforcement of a bad habit. Antabuse to treat alcohol dependency, bad tasting nail polish to stop biting your nails.
Exposure Therapy:
confronting an emotionally arousing stimulus directly and repeatedly leading to a decrease in emotional response
flooding
a form of exposure that involves immersion into the feared situation/ circumstance as an intervention to decrease the phobic/feared response.
OCD TREATMENT IS?
OCD treatment known as Exposure-and-Response-Prevention (ERP) therapy was developed through research applying behavioral principles. It is still the primary psychological treatment for OCD today.
Graduated exposure: practicing in situationsthat involve higher “doses” of trigger; challenging “what if’s” and “I cant’s”
Often paired with coping responses that are incompatible with anxiety (e.g. relaxation)
ERP/ applied CBT: successful in 70%-80% of cases
Cognitive Therapies:
help identify beliefs and expectations that maintain problems and conflicts. Challenges distortions in thinking.
Identify faulty thinking and encourage realistic reappraisal with therapist support
Cognitive restructuring: replace negative thinking with more realistic and positive beliefs
Cognitive Behavioral Therapies:
Includes a variety of behavioral elements incorporating modeling and rehearsal coupled with cognitive restructuring
Family/Couples Therapy
focus on the dynamics in the family as a system with different rules, roles and motivations
Treat each person as integral to the bigger system; “identified patient” is symptom bearer in the family—and not the cause of the challenges.
Change one part of the system and the whole system needs to adapt
Group Therapy:
people with similar or different problems come together to provide support, strategies
Normalization a key component
Can aid in social skills, modeling of adaptive strategies and encourages empathy
Efficient use of resources
Biological Therapies
Psychotropic Medication:
alter the biochemistry of the brain.
ADHD Medications:
Ritalin, Concerta, Adderall ( stimulants/dopamine)
Straterra (norepinephrine)
SSRI’s/SNRI’s: Antidepressants
Prozac, Zoloft
Lithium for Bi-polar disorder; newer classes of mood stabilizers
Anti-anxiety Drugs:
Xanax, Ativan (increase GABA), addictive potential
Psychosurgery?
Psychosurgery: Lesion/destroy problematic areas of the brain to eliminate disruptive behaviors (lobotomy; ocd surgery)
Electroconvulsive Therapy (ECT):
Electroconvulsive Therapy (ECT): shock therapy; beneficial to those with severe depressions which are not responsive to medication/therapy. Can lead to memory impairment. Unclear on why/how it works.
Transcranial Magnetic Stimulation:
Transcranial Magnetic Stimulation: using a powerful pulsing magnet alters neuronal activity in the brain; less invasive than ECT. Some studies show similar benefits with less negative side effects.
WHAT IS USED FOR SAD?
Phototherapy: exposure to bright lights, often used to treat SAD (seasonal affective disorder)
Psychotherapy Outcome Research:
Treatments for psychological disorders are generally more effective than no treatment at all.
2. Research supports that some therapies may be more effective for some disorders (ocd, anxiety, phobias…) but overall there is not one “best approach”.
3. Many therapists said they are “eclectic” using techniques from different kinds of therapies, based on client/patient needs.
4. A positive therapeutic relationship with the therapist can be vital. The key is to seek support when needed!
Autism Spectrum Disorders
A. Deficits in social communication and social interactions
1. No back and forth conversation
2. Lack of eye contact, gestures
3. Deficit in social relationships
B. Restricted repetitive patterns of behaviors or activities
1. Repetitive speech or use of objects
2. Excessive need for routines/rituals including verbal
3. Restricted interests and preoccupations
4. Sensory sensitivity (hypo or hyper reactivity)
All 3 required in criterion A and 2 of 4 in B for the diagnosis.
Conduct Disorder: a repetitive and persistent pattern of behavior in which the basic rights of others or major age appropriate societal norms or rules are violated.
Aggression to people and animals
Destruction of property
Deceitfulness or Theft
Serious violation of rules
Specify if with limited prosocial emotions: lacks remorse, callous (no empathy), unconcerned about performance, shallow or deficient affect
May be a precursor to antisocial personality
Tourette’s Disorder
Both multiple motor and one or more vocal tics
Occur many times a day nearly every day or intermittently over a period of more than 1 year
Onset before age 18
Does NOT need to interfere with functioning for diagnosis
Generalized Anxiety Disorder (GAD):
Continuous feelings of worry, anxiety
dread/foreboding
Restlessness
Difficulty concentrating
Irritability
Muscle tension
Sleep disturbance
Panic Disorder: the spontaneous and unexpected occurrence of panic attacks
Recurring attack of intense fear or panic accompanied by feelings of impending doom or death
Symptoms include: trembling, shaking, dizziness, chest pain, sweating, heart palpitations, hot/cold flashes, sense of losing control
Panic attacks must be associated with longer than 1 month of subsequent persistent worry about having another attack or consequences of the attack, or significant maladaptive behavioral changes related to the attack.
Anxiety and Phobias: exaggerated fear of a specific situation, activity or thing
Social Anxiety Disorder (Social Phobia): fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others
Agoraphobia: fear of being alone in public places from which escape might be difficult or help will be unavailable; at its worst one doesn’t leave his/her home
Specific Phobias: e.g., spiders, squirrels, dogs
Obsessive-Compulsive Disorder (OCD
Obsessive-Compulsive Disorder (OCD)
Obsession: a recurrent, persistent and unwished for thought
Compulsion: repetitive ritualized behavior in which people feel a lack of control over it.
Examples: contamination; need for orderliness, aggressive impulses or thoughts, obsessive worry about an accident happening
Hoarding Disorder:
Hoarding Disorder:
Persistent difficulty discarding items—even those with no or little value
Due to a perceived need to save the items and associated distress with discarding
Difficulty discarding the items results in clutter and inability to use living space
Severity is related to levels of insight
Multiple factors associated with individuals who develop Hoarding Disorder (e.g., Steketee, et al 2015 )
Being raised in a chaotic home
Challenges with decision making and problem solving;
ADHD (overwhelmed with organization/task)
Anxiety and/or depression;
Guilt about waste
Effort to “protect” and comfort with objects/items
Need to be sensitive to the intensity of the symptoms and respect where they are in the process.
Treatment often involves CBT
Post Traumatic Stress Disorder (PTSD):
Post Traumatic Stress Disorder (PTSD): trauma or stress related disorder following exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence. Reflects change from previous functioning
Reexperiencing symptoms: spontaneous intrusions of traumatic memory in the form of images or nightmares
Avoidance symptoms: avoiding places and reminders of the traumatic event
Hyperarousal symptoms: insomnia, irritability, impaired concentration, hypervigilance, and increased startle responses.
Mood Disorders: Depression (Major Depressive Disorder, Persistent Depressive Disorder, Premenstrual Dysphoric Disorder)
Mood Disorders: Depression (Major Depressive Disorder, Persistent Depressive Disorder, Premenstrual Dysphoric Disorder)
Sadness, lethargy, inactivity and feelings of helplessness and hopelessness
Behavioral changes: e.g., slower motor reactions
Cognitive changes: e.g., cognitive distortions
Physical changes: e.g. alters immune functioning
Bi-polar Disorder (historically called Manic-Depression)
Bipolar I disorder, characterized by a least 1 manic episode or mixed episode (manic and depressive features in the same episode)
Bipolar II disorder: 1 or more major depressive episodes, together with at least 1 hypomanic episode
Cyclical nature of the disorder
Responsive to lithium and other mood stabilizers
Challenges with treatment compliance
Can be adaptive, healthy, and contributing members of society
Mania/Hypomania as part of the Bi-Polar Diagnosis
Inflated self-esteem or grandiosity.
Decreased need for sleep
Pressured speech
Flight of ideas or subjective experience that thoughts are racing.
Distractibility
Increase in goal-directed activity
Excessive involvement in activities that have a high potential for painful consequences (e.g., buying sprees, sexual indiscretions, or poor business investments)
Somatic Symptom and Related Disorders
Somatic Symptom Disorder: history of diverse physical complaints which are psychological in origin and result in disruption in daily life
Illness Anxiety Disorder: excessive preoccupation with health concerns/worry about developing illnesses. Used to be called hypochondriasis.
Conversion disorder: loss of motor or sensory function with no organic basis, usually a specific area or system affected
Personality Disorders: rigid, maladaptive traits that cause great distress or lead to an inability to get along with others, or to function well in the world
Pattern is inflexible, pervasive and of long duration
Some question the validity of the category.
Clusters include:
Odd/Eccentric: paranoid, schizoid, schizotypal
Dramatic/Erratic: antisocial, borderline, histrionic,
narcissistic
Anxious/Inhibited: ocpd, dependent, avoidant
