Psych Final Review Flashcards
psychodynamic perspective
disorders arise from intrapsychic conflict produced by id, ego and superego that overwhelms ego’s defense mechanisms
cognitive behavioral perspective
disorders are learned patterns of maladaptive thinking and behaving
humanistic perspective
disorders arise from need to meet others’ demands to obtain their positive regard
sociocultural perspective
how cultural variables influecne the devleopment of disorders and people’s subjective reactions to them
biopsychosocial perspective
disorders are a result from the interaction of genetic, physiological, developmental and environmental factors
ADHD
primary symptoms: inattention, hyperactivity, impulsivity; must be present before age 7; displayed in 2 different settings; must interfere with age-appropriate functioning
possible etiology of ADHD
brain development: Maximum thickness of cerebral cortex doesn’t occur until age 10; earlier than usual maturation of motor cortex; Combination of developmental delay in areas of brain that exert inhibitory control over movements and premature development of areas that produce voluntary movements
other theory of disorder
result of insufficiency of dopamine as modulator in neural pathways involving glutamate and GABA reduced activity in dopaminergic branch of limbic system interferes with reinforcement and extinction
autistic disorder
symptom presentation by age 3; more likely in boys than girls; frequently accompanies by mental retardation; symptoms: abnormal forms of social interaction and communication, the disinclination to form friendships and a preference for solitary activities; marked aversion to disruption of activites
theory-of-mind theory
child with autistic disorder fails to understand that actions may be attributed to thoughts and feelings and that actions of others may be attributed similarly
substance related disorders
disorders that are characterized by addiction to drugs or alcohol or by abuse of them
alcoholism
likelihood of addiction is heritable; produces a larger release of dopamine in brains – stronger reinforcement effect
steady drinking
people who cannot abstain and drink consistently; antisocial, pleasure seeking personality; more influenced by heredity; undersensitive to punishment mechnism
binge drinking
repressed anxiety ridden personality; able to go without drinking for long periods but are unable to control themselves once they start; more influenced by environment; oversensitive to punishment mechanism
Schizophrenia
most common of psychotic disorders; distortions of thought, perception, memory and emotion; bizarre behavior, and social withdrawal; disorder with no borders; thought disorder most definitive symptom
positive symptoms
makes itself known by its presence; thought disorders (pattern of disorganized, irrational thinking) , delusions (belief contrary to fact) and hallucinations
most common type of hallucination for schizophrenics
auditory
negative symptoms
absence of normal behavior; flattened emotional response, poverty of speech, lack of initiative and persistence, inability to feel pleasure, and social withdrawal
etiology of positive symptoms
overactivity of dopamine neurons; may be treated with antipsychotic drugs
etiology of negative symptoms
brain damage: a virus that triggers autoimmune disease triggering disease later in life; virus that damages the brain early in life; birth trauma
five types of schizophrenia
paranoid, disorganized, catatonic, undifferentiated, residual
paranoid schizophrenia
delusions of persecution, grandeur or control
disorganized schizophrenia
characterized primarily by disturbance of thought; word salad; hallucination and delusions; emotions inappropriate to circumstances (flattened or silly affect)
catatonic schizophrenia
motor disturbances; extreme excitement and stupor; negative symptoms – catatonic postures – bizarre stationary poses and waxy flexibly maintained for long periods
undifferentiated schizophrenia
have delusions, hallucinations, and disorganized behavior but do not meet criteria for other types; some patients symptoms change
residual schizophrenia
at least one episode of one of the 4 types has occurred but no single prominent positive symptom is observable; however negative symptoms are observable and muted forms of positive symptoms; may mark transition from schizophrenic episode to remission
dopamine hypothesis
proposal that abnormal activity of dopamine containing neurons is a causal factor in schizophrenia; Positive symptoms result of overactivity of dopamine transmitting synapse; may need to be amended to become dopamine-serotonin-glutamate hypothesis
psychodynamic perspective
disorders arise from intrapsychic conflict produced by id, ego and superego that overwhelms ego’s defense mechanisms
cognitive behavioral perspective
disorders are learned patterns of maladaptive thinking and behaving
humanistic perspective
disorders arise from need to meet others’ demands to obtain their positive regard
sociocultural perspective
how cultural variables influecne the devleopment of disorders and people’s subjective reactions to them
biopsychosocial perspective
disorders are a result from the interaction of genetic, physiological, developmental and environmental factors
diathesis-stress model
the combination of a person’s genes and early learning experiences may predispose them for disorders; disorders are only expressed if person encounters stressors that overwhelm their capacity to cope; even though some people may be predisposed, coping skills they have acquire dthorugh experience may be enough to prevent development of disorder
DSM-IV-TR
the classification system of psychological disorders most widely used today; provides criteria along five axes
Axis I
major psychological disorders of clinical significance
Axis II
personality disorders and mental retardation
Axis III
presence of physical disorders
Axis IV
identifies level of stress
Axis V
assess overall level of psychological, social, or occupational functioning
comorbid
tendency of one type of disorder to occur together with one or more other disorders
Thomas Szaz
the concept of mental illness has done more harm than good because of negative effect it has on patients; o Labeling people with mental illness places responsibility of care on medical establishment instead of on patient of taking personal steps toward improvement for their problems of living
Clinical judgments
diagnosis of disorders or predictions of future behavior based on experts’ knowledge of symptoms and past clinical experience
Actuarial judgments
diagnoses of psychological disorders or predictions of future behavior based on statistical analyses of outcome data; more accurate but most clinicians do not use it
disorders usually diagnosed in childhood
ADHD and autism
ADHD
primary symptoms: inattention, hyperactivity, impulsivity; must be present before age 7; displayed in 2 different settings; must interfere with age-appropriate functioning
possible etiology of ADHD
brain development: Maximum thickness of cerebral cortex doesn’t occur until age 10; earlier than usual maturation of motor cortex; Combination of developmental delay in areas of brain that exert inhibitory control over movements and premature development of areas that produce voluntary movements
other theory of disorder
result of insufficiency of dopamine as modulator in neural pathways involving glutamate and GABA reduced activity in dopaminergic branch of limbic system interferes with reinforcement and extinction
autistic disorder
symptom presentation by age 3; more likely in boys than girls; frequently accompanies by mental retardation; symptoms: abnormal forms of social interaction and communication, the disinclination to form friendships and a preference for solitary activities; marked aversion to disruption of activites
theory-of-mind theory
child with autistic disorder fails to understand that actions may be attributed to thoughts and feelings and that actions of others may be attributed similarly
substance related disorders
disorders taht are characterized by addiction to drugs or alcohol or by abuse of them
alcoholism
likelihood of addiction is heritable; produces a larger release of dopamine in brains – stronger reinforcement effect
steady drinking
people who cannot abstain and drink consistently; antisocial, pleasure seeking personality; more influenced by heredity; undersensitive to punishment mechnism
binge drinking
repressed anxiety ridden personality; able to go without drinking for long periods but are unable to control themselves once they start; more influenced by environment; oversensitive to punishment mechanism
Schizophrenia
most common of psychotic disorders; distortions of thought, perception, memory and emotion; bizarre behavior, and social withdrawal; disorder with no borders; thought disorder most definitive symptom
positive symptoms
makes itself known by its presence; thought disorders (pattern of disorganized, irrational thinking) , delusions (belief contrary to fact) and hallucinations
most common type of hallucination for schizophrenics
auditory
negative symptoms
absence of normal behavior; flattened emotional response, poverty of speech, lack of initiative and persistence, inability to feel pleasure, and social withdrawal
etiology of positive symptoms
overactivity of dopamine neurons; may be treated with antipsychotic drugs
etiology of negative symptoms
brain damage: a virus that triggers autoimmune disease triggering disease later in life; virus that damages the brain early in life; birth trauma
five types of schizophrenia
paranoid, disorganized, catatonic, undifferentiated, residual
paranoid schizophrenia
delusions of persecution, grandeur or control
disorganized schizophrenia
characterized primarily by disturbance of thought; word salad; hallucination and delusions; emotions inappropriate to circumstances (flattened or silly affect)
catatonic schizophrenia
motor disturbances; extreme excitement and stupor; negative symptoms – catatonic postures – bizarre stationary poses and waxy flexibly maintained for long periods
undifferentiated schizophrenia
have delusions, hallucinations, and disorganized behavior but do not meet criteria for other types; some patients symptoms change
residual schizophrenia
at least one episode of one of the 4 types has occurred but no single prominent positive symptom is observable; however negative symptoms are observable and muted forms of positive symptoms; may mark transition from schizophrenic episode to remission
dopamine hypothesis
proposal that abnormal activity of dopamine containing neurons is a causal factor in schizophrenia; Positive symptoms result of overactivity of dopamine transmitting synapse; may need to be amended to become dopamine-serotonin-glutamate hypothesis
double bind
the conflict caused for a child when they are given inconsistent messages or cues from a parent
mood disorders
characterized by significant shifts or disturbances in mood that adversely affect normal perception, thought, and behavior; foreboding depression or combination of depression and mania
mania
“madness;” abnormal and persistent elevation of an expansive or irritable mood
bipolar I disorder
characterized by episodes of mania by itself or in a mix with anxiety, accompanied by episodes of major depression
major depressive disorder
persistent, severe feelings of sadness and worthlessness accompanied by changes in appetite, sleeping and other behavior
bipolar II disorder
major depressive episode accompanied by hypomania – less severe mania
5 major symptoms of depression
sad and apathetic mood; feelings of worthlessness and hopelessness; a desire to withdraw from other people; sleeplessness and loss of appetite and sexual desire; change in activity level, either to lethargy or to agitation
cognitive causes of depression
distortion of one’s view of reality and cognitive triad
cognitive triad
self blame; overemphasis on negative aspects of life; failure to anticipate positive change
which neurotransmitters are involved with expression of depression
lower levels of serotonin and norepinephrine
anxiety disorders
sense of apprehension or doom that is accompanied by physiological reactions like accelerated hear rate, sweaty palms, and tightness in the stomach
types of anxiety disorders
panic, phobia, OCD, PTSD, dissociative disorders
panic
episodic attacks of acute anxiety – periods of acute and unremitting terror that grip them for lengths of time from seconds to hours; feels like they are going to die -mistaken for a heart attack
symptoms of panic
SOB, clammy sweat, irregularities in heartbeat, dizziness, faintness, and feelings of unreality
phobia
persistent irrational fears of specific objects or situations
phobic disorder
unrealistic, excessive fear of a specific class of stimuli that interferes with normal activities
agoraphobia
fear of open spaces; anxiety disorder characterized by fear of and avoidance of being in places where escape may be difficult or embarrassing
social phobia
fear of situations in which person is exposed to possible scrutiny by others and fears that they may do something or act in a way that will be humiliating or embarrassing
specific phobia
any other phobias; caused by a specific traumatic experience
OCD
obsessive compulsive disorder; recurrent, unwanted thoughts or ideas and compelling urges to engage in repetitive ritual like behavior
4 categories most compulsions fall under
counting,checking,cleaning, avoidance
PTSD
post traumatic disorder; feelings of social withdrawal accompanied by atypically low levels of emotion; caused by prolonged exposure to a stressor ie war or natural catastrophe
Tourette’s syndrome
neurological disorder characterized by tics and involuntary utterances, some of which may involve obscenities and repetition of others’ utterances
symptoms of PTSD
recurrent dreams or recollections; feelings that traumatic event is recurring and intense psychological distress
double bind
the conflict caused for a child when they are given inconsistent messages or cues from a parent
mood disorders
characterized by significant shifts or disturbances in mood that adversely affect normal perception, thought, and behavior; foreboding depression or combination of depression and mania
mania
“madness;” abnormal and persistent elevation of an expansive or irritable mood
bipolar I disorder
characterized by episodes of mania by itself or in a mix with anxiety, accompanied by episodes of major depression
major depressive disorder
persistent, severe feelings of sadness and worthlessness accompanied by changes in appetite, sleeping and other behavior
bipolar II disorder
major depressive episode accompanied by hypomania – less severe mania
5 major symptoms of depression
sad and apathetic mood; feelings of worthlessness and hopelessness; a desire to withdraw from other people; sleeplessness and loss of appetite and sexual desire; change in activity level, either to lethargy or to agitation
cognitive causes of depression
distortion of one’s view of reality and cognitive triad
cognitive triad
self blame; overemphasis on negative aspects of life; failure to anticipate positive change
which neurotransmitters are involved with expression of depression
lower levels of serotonin and norepinephrine
anxiety disorders
sense of apprehension or doom that is accompanied by physiological reactions like accelerated hear rate, sweaty palms, and tightness in the stomach
types of anxiety disorders
panic, phobia, OCD, PTSD, dissociative disorders
panic
episodic attacks of acute anxiety – periods of acute and unremitting terror that grip them for lengths of time from seconds to hours; feels like they are going to die -mistaken for a heart attack
symptoms of panic
SOB, clammy sweat, irregularities in heartbeat, dizziness, faintness, and feelings of unreality
phobia
persistent irrational fears of specific objects or situations
phobic disorder
unrealistic, excessive fear of a specific class of stimuli that interferes with normal activities
agoraphobia
fear of open spaces; anxiety disorder characterized by fear of and avoidance of being in places where escape may be difficult or embarrassing
social phobia
fear of situations in which person is exposed to possible scrutiny by others and fears that they may do something or act in a way that will be humiliating or embarrassing
specific phobia
any other phobias; caused by a specific traumatic experience
OCD
obsessive compulsive disorder; recurrent, unwanted thoughts or ideas and compelling urges to engage in repetitive ritual like behavior
4 categories most compulsions fall under
counting,checking,cleaning, avoidance
PTSD
post traumatic disorder; feelings of social withdrawal accompanied by atypically low levels of emotion; caused by prolonged exposure to a stressor ie war or natural catastrophe
Tourette’s syndrome
neurological disorder characterized by tics and involuntary utterances, some of which may involve obscenities and repetition of others’ utterances
symptoms of PTSD
recurrent dreams or recollections; feelings that traumatic event is recurring and intense psychological distress
4 areas of psychopathology
mood, anxiety, thought, addiction
dysthymia
mild depression
unipolar depression
depression only
cyclothymia
dysthymia/hypomania
bipolar disorder I
depression/mania
bipolar disorder II
depression/hypomania
dysthymia
characterized by an overwhelming yet chronic state of depression, exhibited by a depressed mood for most of the days, for more days than not, for at least 2 years; must not have gone for more than 2 months without experiencing two or more of the following symptoms:
* poor appetite or overeating * insomnia or hypersomnia * low energy or fatigue * low self-esteem * poor concentration or difficulty making decisions * feelings of hopelessness
Rule of 7s
1/7 with recurrent depressive illness commits suicide
70% of suicides have depressive illness
70% of suicides see their primary physician within 6 weeks of suicide
Suicide is the 7th leading cause of death
Ways to Explain Depression
Anger turned toward the self
Defense: Sadness blocks Anger (and Guilt)
Attributional Style: Global, Permanent, Internal
Problems with Attachment: Depression=mourning
Biological Disorder
Cognitive Model of Emotion
event –> thought (interpretation) –> emotion
depressive attributional style
internal, permanent, global
classic model of inherited disease
gene –> gene product –> disease (100% will develop disease) classical autosomal dominant pattern
multi-hit model
risk factors 1-3 are inherited genetic hits; risk factor 4 and 5 are environmental hits expressed through abnormal genetic responses
3 kinds of people (with regards to dealing with depression)
Those who don’t suffer from depression or dysthymia, who have bad days, will grieve a loss, but don’t spiral down into a major depressive episode; Those who usually don’t suffer from depression but, when stressed beyond a certain point, develop depressive symptoms and benefit from a short-term use of medication and therapy to come out of it. When the stress or crisis resolves, they often taper off their meds without a relapse; Those who are chronically depressed without medication. Psychotherapy may be helpful in that it provides insight and ways to minimize stress, but these people only experience substantial relief with medication
how does brain structure tell us about depression?
smaller prefrontal cortex & hippocampus, larger amygdala
How do brain pathways tell us about depression
hypothalamic-pituitary axis, the stress circuit, is too often active, leading to damage in hippocampus
how does neuronal action tell us about depression
for many, increasing neurotransmitter levels relieves depression
antidepressant medication
selective seratonin reuptake inhibitors (SSRIs), such as Prozac or Zoloft, depend on molecules that target receptors more carefully than earlier drugs, so that side effects are reduced
side effects of SSRIs
loss of sexual drive and interference with sexual function
what many people suffering from suicidal ideation say
It seems as though the pain will never end…
My life will never change …
I can’t stand the guilt anymore …
Suicide is something I keep in my back pocket
3 kinds of suicide
Thoughtfully (and secretly) planned out, with notes to friends and family …
Done impulsively, with the hope of being stopped (driving recklessly, taking an overdose of medication …)
Committed because of psychotic thinking during a severe depressive episode (“I’m so evil I’ll cause torment to my family”)
what prevents suicide
Love and attachment to others
A sense that one can change one’s life
Restored hope in a wished for future self
An ability to take the “long view,” to appreciate life philosophically
Learning that loss is an inherent part of life, and that mourning is part of wisdom
escape theory
depressed person tries to escape from negative affect by rejecting and avoiding meaningful thought (cognitive deconstruction)
3 main signs of cognitive deconstruction
time perspective constricted to narrow focus on the present; concreteness is reflected in focus on immediate movements and sensations rather than broader ideas and emotions; proximal goals
healthy thinking
the ability to distinguish inner world experience from external world events
reality testing
The capacity to distinguish what is real from what is imagined
when reality fails…
healthy thinking is contaminated by: Delusions – false beliefs that are experienced as real
Hallucinations – false sensory events experiences as real
Disorganized Speech – spoken words that make no sense
Severely Idiosyncratic Associations
causes of psychotic states
Drugs – taken as treatment or recreationally Aging – dementia and Alzheimer’s Disease Depression Mania Bi-Polar Illness Schizoprenia Anxiety
acute onset
seems to happen suddenly … late teens/early twenties for men, a bit later for women
prodomal onset
the person has always had odd characteristics, often socially-isolated, and then “slides” into a schizophrenic episode
paranoid schizophrenia
Delusions of persecution, fear of mind control, obsessional thinking
disorganized schizophrenia
strange speech, “word salad,” inappropriate affect, strange interpersonal behavior, poor cognitive organization, low functioning
catatonic
predominantly “negative symptoms” including social isolation, paucity of thought, impoverished vocabulary, repetitive motions
positive symptoms
mental features which should not be present
examples of positive symptoms
Delusions
Hallucinations – auditory/visual/olfactory
Bizarre Speech – Neologisms
Inappropriate Affect
Perseverations/Clang Associations(uncontrollable repetition of a response)
Violent or threatening behavior
negative symptoms
loss or absence of mental functioning
examples of negative symptoms
Flattened Affect Paucity of thought Catatonia (restriction of movement) Lack of social awareness Poor hygiene
brain difference in schizophrenic patients
Enlarged ventricles (the housing of the brain)
Inconsistent density of neurons in the hippocampus – and they’re smaller.
The brain shrinks in size beginning in adolescence (neuronal loss)
Lower amounts of synaptophysin, a membrane protein involved in neurotransmission.
neurodevelopment of schizophrenia
Start with a genetic liability
Add intrauterine trauma, infection, stress
Add environmental, psychological stress
And you have a “schizotype” someone expressing some symptoms of neurological deficits, or …
prodromal or acute onset schizophrenia after puberty …
can you be a little bit schizophrenic?
Yes. The expression of schizophrenic liability is a spectrum … there are people prone to paranoid thinking, to social withdrawal and isolation, who do not have full blown schizophrenia. But they are likely to have first degree relatives who do.
defenses against anxiety in everyday life
magical thinking, obsessions, compulsions, rumination, perfectionism, drugs/alcohol, dissociation
examples of anxiety disorders
phobias, generalized anxiety disorder, eating disorders (anorexia, bulimia), panic attacks, panic disorder, post traumatic stress disorder, panic disorder with agoraphobia, social anxiety disorder, obsessive compulsive disorder, body dysmorphic disorder
DSM-IV-TR criteria for post-traumatic stress disorder
exposed to traumatic event in which involved actual/threatened injury/death; traumatic event persistently reexperienced; persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness; Persistent symptoms of increased arousal; duration of disturbance is more than one month; causes impairment in functioning
professor’s definition of psychotherapy
strategic use of the intimacy
psychotherapist guidelines
boundaries, therapist abstinence, fidelity to the process
universal psychotherapy components
forming the alliance, setting goals, creating an interpersonal space, interpreting what the patient does or doesn’t know
schools of psychotherapy
psychoanalysis, psychodynamic psychotherapy, behavior therapy, ratio-emotive therapy, cognitive-behavioral therapy, group psychotherapy, family psychotherapy, dialectical behavioral therapy
psychoanalysis
projection
psychodynamic psychotherapy
associations to the past
behavior therapy
behavior change
ratio-emotive therapy
rational solutions
cognitive behavioral therapy
homework
group psychotherapy
group identity
family psychotherapy
interpersonal process
dialectical behavior therapy
mindfulness
Freud’s categories
free association, transference, counter-transference, analysis of resistance and defenses, making what is unconscious conscious
free association
what comes to mind
transference
projections onto the analyst
counter-transference
analyst’s projections
analysis of resistance and defenses
interpreting ways of avoiding the analysis and anxiety
making the unconscious conscious
interpreting the underlying thoughts, emotions, wishes and fears
cognitive behavioral therapy
baseline measures of depression and anxiety; measuring the key “schemas” of the patient, using homework to increase awareness of automatic thoughts and distortions; avoid issues of transference or dwelling on early experience
limitations of CBT
very “American;” its surgical, focuses on one set of mental associations; it has not theory of development - focuses solely on the present, avoids looking at the relationship between patient and therapist, dreams, nonrational mental states; effective with only 30% of patients (others required broader mix)
Charles’ symptoms
irrational homicide of stranger, flat affect, dissociating from what happened, under drug induced hypnosis acknowledged hearing a voice saying kill
process of the work on Charles
Charles tells horrific story of childhood, Lindner catches him playing with chess pieces and decides to do play therapy on him, play therapy unleashes more anger, aggression, heroes and villains; the story of Charles’ rage and longing for his mother emerges with his psychotic belief that her ring is in the drug box Linder carries on his final rounds in hospital
When should you go into therapy?
real problems with love, work, play; symptoms of depression and anxiety; difficulty grieving a loss; fear at crossing a developmental hurdle; wanting to understand yourself better
