Psych quiz 2 Flashcards

1
Q

Characteristics of anxiety

A

Fear - is a more primitive emotion and occurs in response to a real or perceived threat happening in the here and now.
- a response to danger and elicits fight or flight response.

Anxiety/ worry - an affective state where the individual feels threatened by the potential occurrence of a future negative event.

Panic- can be described as a false alarm that is triggered in the absence or a concrete identifiable death. (panic attacks are uncommon in children)

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2
Q

Separation Anxiety Disorder - DSM criteria

A

Children have a lot of fears and can have separation anxiety but this is normal - what matters is the duration and the intensity of it.
after 3-5 this behavior becomes a typical.
(criteria - you need to have baseline for what is typical for a kid that age)

Distress when separated from the attachment
* Full-blown panic
* Diagnosis before puberty -(rare to be diagnosed as teenager or adult but possible)
* 1/3 develop other anxiety disorders or
depressive disorders
* SAD (separation anxiety) : specific worry VS GAD: worry in multiple domains (generalized)

you have to observe 3 or the following symptoms.

  1. Recurrent excessive distress when anticipating or experiencing separation
  2. Persistent and excessive worry about losing MAF or about possible harm to them
  3. Persistent and excessive worry about losing major attachment figures or about possible harm to them experiencing an untoward event that causes separation from a MAF
  4. Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere because of fear of separation
  5. Persistent and excessive fear of or reluctance about being alone or without MAF at home/else
  6. Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a MAF
  7. Repeated nightmares involving the theme of separation
  8. Repeated complaints of physical symptoms when separation from MAF occurs or is anticipated 5

1/3 with develop GAD if that happens they are more prone to having depression and or substance abuse problems.

MAF = Major attachment Figures.

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3
Q

Comorbidity of SAD

A

they are more predisposed to having more than one anxiety disorder or some sort of depressive disorder - generalized anxiety disorder, specific phobia, social anxiety etc…

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4
Q

Etiology of SAD

A

there is a link with temperament, which is based on your genes.

brain is highly reactive to stress

(behavioral inhibition) - usually shy, and super reactive to their environment.

BI may be due to abnormal functioning in the amygdala

uncomfortable in new situations - shut down and want to avoid a lot of those situations

Elevated levels of cortisol in the mother during pregnancy

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5
Q

SAD etiology part 2

A

See that other people in the family are anxious. They might suffer from different anxiety disorders, but it really is something not specific that they inherited.
(environment is also shaping you)

Learn to fear by observing fear reactions in their parents

an anxiety disorder is just increasing your risk. So this predisposition will be expressed more strongly when it’s combined with

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6
Q

SAD treatment

A

CBT - common in children because they have a harder time elaborating on their symptoms - help them to feel that they have more control, and they can do it and make them proud that they manage to be alone.

they were able to use relaxation techniques during that time to make them feel better.

expose them to those situations that makes them feel uncomfortable, so that the fear response extinguishes

For TEENAGERS - a form of medication on top of therapy - Tricyclic antidepressants and benzodiazepines (common, but efficacy
is questionable - because you didnt stop the feelings yourself the meds did)

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7
Q

NEUROSIS

A

it was used for anxiety disorders for a long time. - used for people who are not psychotic don’t have this break reality, but that are they’re dealing with emotional problems (depression or anxiety)

implied that the cause of of the neurosis is due to a disturbance in your central nervous system.

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8
Q

ETIOLOGY - BIOLOGICAL FACTORS

A

Heritability is lower than other disorders

High neuroticism. Is also connected to depression. - means you’re more likely to feel anxious, worried, and easily upset. People with high neuroticism often think about things that went wrong and focus on the negative side of life, like seeing the glass half empty instead of half full

neural fear circuit begins with just
processing information, registering what’s going on in your environment? In your life. And this is with the thalamus and then the information is sent to the amygdala And then view areas of your hypothalamus
through the midbrain and the brain stem, and finally to your spinal course. So the later areas are really connected to automatic and behavioral outputs. That will be your fear response.

GABA, norepinephrine, and serotonin play a role in this.

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9
Q

PSYCHOLOGICAL FACTORS

A

Anxiety and fear are acquired through learning

Fears are sometimes acquired in the absence of classical conditioning

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10
Q

PANIC DISORDER

A

Panic attacks are very sudden, out of the blue. -

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11
Q

Interpersonal etiology SAD

A

Helicopter parents - excessive control, fostering beliefs of helplessness, & failing to promote self-efficacy and
independence

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12
Q

DSM -5 PANIC DISORDER

A

Palpitations, pounding hear, or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or smothering
5. Feelings of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, light-headed, or faint
9. Chills or heat sensations
10. Paresthesias (numbness or tingling sensations)
11. Derealization (feelings of unreality) or depersonalization
(being detached from oneself)
12. Fear of losing control or ‘going crazy’
13. Fear of dying

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13
Q

Agoraphobia

A

Not only experiences experiencing those continuous panic attacks
and like feeling all distress, but also, you’re avoiding situations because you’re afraid to have a panic attack in those situations, and some people will not go out anymore. They will stay in their house. They will, you know. Not drive under bridges or tunnel etc..

avoiding places or situations that might cause panic

panic disorder and agoraphobia - can be comorbid or exist on their own

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14
Q

Etiology: A Problematic Cycle
A Cognitive Perspective (panic disorder)

A

panic attacks arise
from catastrophic misinterpretation, like cognitive distortions. That are gonna be activated when you have those bodily sensations.
arousal related bodily sensation. So your heartbeat is a bit faster. You start to have a little problem breathing, etc. And then, if you start to have catastrophic misinterpretation at that time that could lead you to a panic attac

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15
Q

Panic Disorder
Diagnosis and assessment

A

Panic Disorder vs other anxiety disorder
* Uncued/unexpected panic attacks VS in response to a specific situation
* A multi-method assessment includes:
* Interviews
* Behavioural assessment called a behavioural avoidance test
* Symptom induction test: Observing the individual’s reactions to uncomfortable bodily sensations
(Ex. Spin in a chair to induce dizzy feeling)

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16
Q

Specific Phobia

A

Marked and persistent fear and avoidance of a
specific object or situation
* Ex. animals, heights
* Excessive and disproportionate fear
* Must interfere significantly with the person’s life.

Five subtypes: (1) animal phobia, (2) natural environmental phobia, (3) blood- injection-injury phobia, and (4) situational phobia, and (5) an “other” category

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17
Q

Specific Phobia
Etiology

A

Associative model
* Criticism: Equipotentiality premise
* Non-associative model
* Biological predisposition for acquiring certain phobias
* Failure to habituate + genetic vulnerability to anxiety = specific phobias
* Disgust sensitivity (ex. spiders, rodents)

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18
Q

Generalized Anxiety Disorder

A

Chronic, excessive and
uncontrollable worry and anxiety
* 3 out of 6 symptoms:
1. Restlessness, feeling on the
edge
2. Being easily fatigued
3. Difficulty concentrating, mind
going blank
4. Irritability
5. Muscle tension
6. Sleep disturbances

GAD tends to be more like depression than the other anxiety
disorders

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19
Q

Obsessive-Compulsive Disorder

A

Obsessions are thoughts, images, or urges that are persistent, unwanted and markedly distressing.

Compulsions are repetitive behaviours (e.g., checking) or mental acts (e.g., counting) that a person performs
to reduce anxiety/distress or to prevent a
feared outcome.

Neutralizations are brief behavioural or mental acts that individuals employ in response to an intrusion, to prevent or “undo” the feared situations that appear in their intrusive thought.

The obsessions or compulsions
are time-consuming (ex. take
more than 1 hour per day) or cause
clinically significant distress or
impairment in social, occupational,
or other important areas of
functioning
30

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20
Q

Obsessive-Compulsive Disorder
Etiology

A

So there are structural and functional abnormalities in the brain’s brain system that may be responsible for the compulsions and obsession. So patients with Ocd. Have less brain volume in parts of the frontal cortex and more in the basal ganglia

Obsessions are caused by the person’s reaction to
their own intrusive thoughts
Catastrophic misinterpretations of these thoughts Unhelpful efforts to control the intrusions (ex.thought suppression)

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21
Q

Posttraumatic Stress Disorder

A

A) Exposure to actual or threatened death, serious injury, or sexual violence in
one (or more) ways
B) Presence of one (or more) of intrusion symptoms associated with the
traumatic event(s), beginning after the traumatic event(s) occured
C) Persistent avoidance of stimuli associated with the traumatic event(s),
beginning after the the traumatic event(s) occured
D) Negative alternations in cognitions and mood associated with the traumatic
event(s)
E) Marked alterations in arousal and reactivity associated with the traumatic
event(s), beginning or worsening after the traumatic event(s) occured
35

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22
Q

Major Depressive Disorder (MDD)

A

Prevalence: 5% of Canadians suffer from depression
* Typical age of MDD onset: mid-twenties
* 50% of patients with MDD also have an anxiety disorder
* More severe and chronic depression
* Slower and less complete response to treatment
* Relapse following a first episode is high; greater risk with each episode

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23
Q

DSM-5 Diagnostic Criteria for
Major Depressive Disorder

A

Depressed mood most of the day as indicated by either subjective
(e.g., feels sad, empty, hopeless) or observation made by others
(e.g. appears tearful).
2. Markedly dimished interest or pleasure in all, or almost all, activities
3. Significant weight loss when not dieting or weight gain, or decrease
or increase in appetite
4. Insomnia or hypersomnia *nearly every day

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24
Q
  1. Psychomotor agitation or retardation
A

you’re having a hard time just articulating. It’s just like talking is like an effort. So you’re like, tone of voice. Your articulation

  • Speech
  • Facial expression
  • Eye movements
  • Speed and degree of movements
  • Posture
  • Self-touching
    18
    5. Psychomotor agitation or retardation
    6. Fatigue or loss of energy
    7. Feelings of worthlessness or excessive or inappropriate guilt
    19
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25
Q

Hypomania

A

less severe form of mania that involves a similar number
of symptoms to mania, but need only be present for four days.

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26
Q

DSM-5 Diagnostic Criteria for Manic Episode

A

A distinct period of abnormally and persistently elevated,
expansive, or irritable mood and abnormally and persistently
increased goal-directed activity or energy, lasting at least 1 week
and present most of the day, nearly every day (or any duration if
hospitalization is necessary

. During the period of mood disturbance and increased energy or activity, three (or more)
of the following symptoms (four if the mood is only irritable) are present to a significant
degree and represent a noticeable change from usual behavior:
1. Inflated self-esteem or grandiosity.
2. More talkative than usual or pressure to keep talking.
3. Decreased need for sleep (e.g., feels rested after only three hours of sleep)
4. Flight of ideas or subjective experience that thoughts are racing
5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external
stimuli), as reported or observed.
6. Increase in goal-directed activity (either socially, at work or school, or sexually) or
psychomotor agitation (i.e., purposeless non-goal-directed activity).
7. Excessive involvement in activities that have a high potential for painful consequences
(e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business
investments).

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27
Q

Bipolar 1

A

Had at least 1 manic episode

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28
Q

Bipolar 2

A

Never had manic episode
1 hypomanic episode
1 major depressive disorder episode

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29
Q

Etiology of Mood Disorders

A

Can be genetic, or because of life events - pre existing vulnerabilities. (not part or genes more so our experiences.)

there needs to be a trigger in the environment or their life for the first episode.

inherit some genes. That kind of predispose you to a mood disorder.
genes that make people less resilient to stress.

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30
Q

DSM-5 Diagnostic Criteria for Schizophrenia

A

Criteria A: Two or more of the following symptoms, each present for a significant portion of time during a 1-month period. At least one must be (1), (2), or (3):

1.	Delusions: False beliefs that are not based in reality.
2.	Hallucinations: Seeing or hearing things that don’t exist.
3.	Disorganized Speech: Incoherent or illogical speech.
4.	Grossly Disorganized or Catatonic Behavior: Strange movements or lack of movement.
5.	Negative Symptoms: Reduced ability to function normally, such as lack of emotion or motivation.

Other Criteria: Symptoms must affect the person’s ability to function in daily life and persist for at least 6 months.

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31
Q

What is Schizophrenia?

A

Schizophrenia is a chronic brain disorder that affects less than 1% of the U.S. population. It is characterized by delusions, hallucinations, disorganized speech, and other symptoms that cause social or occupational dysfunction

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32
Q

Symptoms (positive) (Schizophrenia)

A

Positive Symptoms: Symptoms that add abnormal experiences.

*	Delusions: Beliefs that are not true and are resistant to change.
*	Hallucinations: Sensing things that aren’t there, especially hearing voices.
*	Disorganized Speech: Jumbled or nonsensical speech.
*	Disorganized Behavior: Erratic or abnormal behavior.
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33
Q

Negative Symptoms (Schizophrenia)

A

Symptoms that take away normal abilities.

*	Avolition: Lack of motivation or interest in daily activities.
*	Anhedonia: Inability to feel pleasure.
*	Flat Affect: Reduced expression of emotions.
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34
Q

Etiology (Schizophrenia)

A

Biological Factors:

*	Genetics: Schizophrenia runs in families, suggesting a genetic link.
*	Brain Structure: Differences in brain structure, such as larger ventricles and reduced gray matter.
*	Neurotransmitters: Imbalances in brain chemicals like dopamine.
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35
Q

Environmental Factors: (Schizophrenia)

A

Prenatal Factors: Complications during pregnancy, such as exposure to the flu virus.
* Stress: High-stress situations may trigger symptoms in those at risk.
* Urban Upbringing: Growing up in a city environment is linked to a higher risk.

Diathesis-Stress Model: This model suggests that schizophrenia develops due to a combination of genetic vulnerability (diathesis) and environmental stressors.

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36
Q

Differential Diagnosis (Schizophrenia)

Schizoaffective Disorder:

A

Similarities: Includes symptoms of schizophrenia and a major mood disorder (depression or bipolar).
* Differences: Psychotic symptoms (hallucinations and delusions) occur without mood symptoms for at least two weeks.

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37
Q

Major Depressive Disorder (MDD) with Psychotic Features: Schizophrenia

A

Similarities: Includes depressive episodes with psychotic symptoms.
* Differences: Psychotic symptoms only occur during mood episodes.

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38
Q

Bipolar Disorder with Psychotic Features: Schizophrenia

A
  • Similarities: Includes manic or depressive episodes with psychotic symptoms.
    • Differences: Psychotic symptoms only occur during mood episodes
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39
Q

Comorbidity (Schizophrenia)

A

Substance Abuse: Many individuals with schizophrenia also struggle with alcohol or drug addiction.
* Anxiety Disorders: High prevalence of anxiety disorders in individuals with schizophrenia.
* Depressive Disorders: Co-occurrence with depression is common.

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40
Q

Schizophrenia - Treatment

A

Medications:

*	Antipsychotics: Primary treatment to reduce symptoms.
*	First-Generation: Chlorpromazine.
*	Second-Generation: Risperidone, Olanzapine.
*	Side Effects: Weight gain, drowsiness, and more.
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41
Q

Schizophrenia - Psychotherapy

A

Cognitive Behavioral Therapy (CBT): Helps patients manage symptoms and improve functioning.
* Social Skills Training: Enhances social interactions and reduces isolation.
* Family Therapy: Provides support and education to family members.

42
Q

Schizophrenia - Risk of Suicide:

A

Statistics: 5-6% die by suicide; 20% attempt it.
* Risk Factors: Young age, male gender, substance abuse.

43
Q

What are Dissociative and Somatic Disorders?

A

Dissociative Disorders: Severe, maladaptive disruptions or alterations of identity, memory, and consciousness that feel beyond one’s control.
* Somatic Disorders: Disorders with a predominant focus on bodily concerns, often without a medical explanation.

44
Q

Dissociative Amnesia

A

Definition: Inability to recall important personal information, usually of a traumatic or stressful nature.

45
Q

DSM-5 Criteria: amnesia

A

A: Inability to recall important autobiographical information.
* B: Symptoms cause significant distress or impairment.
* C: Not due to substance or medical condition.
* D: Not better explained by other disorders.

Specifier: With fugue (sudden, unexpected travel away from home with amnesia for past events).

46
Q

Depersonalization/Derealization Disorder

A

Definition: Persistent or recurrent experiences of depersonalization (feeling detached from oneself) or derealization (feeling detached from surroundings).

47
Q

DSM-5 Criteria: Depersonalization/Derealization Disorder

A

A: Persistent or recurrent experiences of depersonalization, derealization, or both.
* B: Reality testing remains intact during experiences.
* C: Symptoms cause significant distress or impairment.
* D: Not due to substance or medical condition.
* E: Not better explained by other mental disorders.

48
Q

Dissociative Identity Disorder (DID)

A

Definition: Formerly known as Multiple Personality Disorder, characterized by the presence of two or more distinct personality states.

49
Q

Dissociative Identity Disorder (DID)
DSM-5 Criteria:

A

A: Disruption of identity with two or more distinct personality states.
* B: Recurrent gaps in recall of everyday events, important personal information, and/or traumatic events.
* C: Symptoms cause significant distress or impairment.
* D: Not a normal part of cultural or religious practice.

50
Q

Etiology of Dissociative Disorders

A

Diathesis-Stress: Combination of genetic vulnerability and environmental stressors.
* Personality Traits: High hypnotizability, fantasy proneness, and openness to altered states.
* Attachment Theory: Early attachment disruptions can lead to dissociative symptoms.

Socio-Cognitive Model: Role-playing: Symptoms might be influenced by therapist suggestions and societal factors.
* Iatrogenic: Symptoms could be inadvertently created during therapy.

51
Q

Comorbidity of Dissociative Disorders

A

Common Comorbidities: Anxiety, depression, bipolar disorder, personality disorders.
* Self-destructive behavior: Common among those with DID, with high rates of suicidal thoughts and attempts.

52
Q

Differential Diagnosis (Depersionalization/Derealization

A

Depersonalization/Derealization Disorder vs…
* Illness anxiety disorder
* Major depressive disorder
* Obsessive-compulsive disorder
* Other dissociative disorders
* Anxiety disorders
* Psychotic disorders
* Substance abuse

53
Q

Somatic Disorders - Somatic Symptom Disorder (SSD)

A

Definition: Multiple, recurrent somatic symptoms that cause significant distress and disruption.

54
Q

Somatic Symptom Disorder (SSD) DSM-5 Criteria:

A
  • A: One or more somatic symptoms causing distress.
    • B: Excessive thoughts, feelings, or behaviors related to somatic symptoms.
    • C: Symptoms persist for more than 6 months.

Specifier: With predominant pain.

55
Q

Illness Anxiety Disorder - DSM Criteria

A

Preoccupation with having or acquiring a serious illness,

A: Preoccupation with having or acquiring a serious illness.
* B: Somatic symptoms are not present or mild.
* C: High level of anxiety about health.
* D: Excessive health-related behaviors or avoidance.
* E: Preoccupation persists for at least 6 months.

56
Q

Conversion Disorder + DSM 5

A

characterized by symptoms affecting voluntary motor or sensory function.

A: One or more symptoms of altered voluntary motor or sensory function.
*	B: Incompatibility between symptoms and medical conditions.
*	C: Not better explained by another disorder.
*	D: Causes significant distress or impairment.
57
Q

Factitious Disorder + DSM 5

A

Deliberate falsification of physical or psychological symptoms, or induction of injury or disease, for the purpose of receiving medical attention.

A: Falsification of symptoms or induction of injury.
* B: Presents self as ill, impaired, or injured.
* C: Deceptive behavior evident in the absence of external rewards.
* D: Not better explained by another mental disorder.

58
Q

Etiology of Somatic Disorders

A

Conversion of Anxiety: Anxiety from unconscious conflicts converted into physical symptoms.

HPA Axis Dysfunction: Stress response system involvement.

Dysfunctional Beliefs: Incorrect beliefs about illness.

Personality Traits and Early Life Experiences:

*	Social Learning: Adoption of the “sick role” for attention or escape
59
Q

Comorbidity of Somatic Disorders

A

High Comorbidity: With anxiety disorders, depressive disorders, and other personality disorders.

60
Q

What are Personality Disorders?

A

Personality disorders are enduring patterns of behavior, cognition, and inner experience that deviate markedly from the expectations of the individual’s culture. These patterns are inflexible and pervasive across many situations, leading to distress or impairment.

61
Q

Clusters of Personality Disorders

A

Personality disorders are categorized into three clusters:

1.	Cluster A (Odd and Eccentric):
*	Paranoid
*	Schizoid
*	Schizotypal
2.	Cluster B (Dramatic, Emotional, or Erratic):
*	Antisocial
*	Borderline
*	Histrionic
*	Narcissistic
3.	Cluster C (Anxious and Fearful):
*	Avoidant
*	Dependent
*	Obsessive-Compulsive
62
Q

Paranoid Personality Disorder
DSM-5 Criteria:

A

Cluster A: Odd and Eccentric Disorders

Pervasive distrust and suspicion of others, interpreting their motives as malevolent.

A: At least four of the following:
1.	Suspects others are exploiting, harming, or deceiving them without sufficient basis.
2.	Preoccupied with unjustified doubts about loyalty or trustworthiness.
3.	Reluctant to confide in others due to unwarranted fear.
4.	Reads hidden meanings into benign remarks or events.
5.	Persistently bears grudges.
6.	Perceives attacks on their character and reacts angrily.
7.	Recurrent suspicions about fidelity of partner.
63
Q

Schizotypal Personality Disorder
+DSM

A

Cluster A: Odd and Eccentric Disorders

a person has difficulty forming and maintaining relationships, experiences significant discomfort in social situations, and has odd thoughts and behaviors.

A: At least five of the following:
1.	Ideas of reference.
2.	Odd beliefs or magical thinking.
3.	Unusual perceptual experiences.
4.	Odd thinking and speech.
5.	Suspiciousness or paranoid ideation.
6.	Inappropriate or constricted affect.
7.	Odd behavior or appearance.
8.	Lack of close friends.
9.	Excessive social anxiety associated with paranoid fears.
64
Q

Schizoid Personality Disorder + DSM

A

Cluster A: Odd and Eccentric Disorders

Pattern of detachment from social relationships and restricted range of emotional expression.

A: At least four of the following:
1.	Neither desires nor enjoys close relationships.
2.	Almost always chooses solitary activities.
3.	Has little interest in sexual experiences with others.
4.	Takes pleasure in few activities.
5.	Lacks close friends.
6.	Appears indifferent to praise or criticism.
7.	Shows emotional coldness or detachment.
65
Q

Antisocial Personality Disorder
+DSM

A

Cluster B: Dramatic, Emotional, or Erratic Disorders

A: At least three of the following:
1.	Failure to conform to social norms.
2.	Deceitfulness.
3.	Impulsivity.
4.	Irritability and aggressiveness.
5.	Reckless disregard for safety.
6.	Consistent irresponsibility.
7.	Lack of remorse.

Other Criteria:

*	B: At least 18 years old.
*	C: Evidence of conduct disorder before age 15.
*	D: Antisocial behavior not during schizophrenia or bipolar disorder.
66
Q

DSM+ Borderline Personality Disorder

A

Cluster B: Dramatic, Emotional, or Erratic Disorders

Definition: Instability in relationships, self-image, and affects, marked by impulsivity.

DSM-5 Criteria:

*	A: At least five of the following:
1.	Frantic efforts to avoid abandonment.
2.	Unstable and intense relationships.
3.	Identity disturbance.
4.	Impulsivity in self-damaging areas.
5.	Recurrent suicidal behavior or self-mutilation.
6.	Affective instability.
7.	Chronic feelings of emptiness.
8.	Inappropriate, intense anger.
9.	Transient stress-related paranoia or dissociation.
67
Q

DSM + Histrionic Personality Disorder

A

Cluster B: Dramatic, Emotional, or Erratic Disorders Definition: Excessive emotionality and attention-seeking behavior.

DSM-5 Criteria:

*	A: At least five of the following:
1.	Uncomfortable when not the center of attention.
2.	Inappropriate seductive behavior.
3.	Rapidly shifting and shallow emotions.
4.	Uses physical appearance to draw attention.
5.	Impressionistic speech.
6.	Self-dramatization.
7.	Suggestible.
8.	Considers relationships more intimate than they are.
68
Q

DSM+ Narcissistic Personality Disorder

A

Cluster B: Dramatic, Emotional, or Erratic Disorders

Definition: Grandiosity, need for admiration, and lack of empathy.

DSM-5 Criteria:

*	A: At least five of the following:
1.	Grandiose sense of self-importance.
2.	Preoccupation with fantasies of success and power.
3.	Belief of being special and unique.
4.	Requires excessive admiration.
5.	Sense of entitlement.
6.	Interpersonally exploitative.
7.	Lacks empathy.
8.	Envious of others.
9.	Arrogant behaviors or attitudes.
69
Q

DSM+ Avoidant Personality Disorder

A

Cluster C: Anxious and Fearful Disorders

Social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.

DSM-5 Criteria:

*	A: At least four of the following:
1.	Avoids occupational activities involving significant interpersonal contact.
2.	Unwilling to get involved with people unless certain of being liked.
3.	Shows restraint in intimate relationships.
4.	Preoccupied with being criticized or rejected.
5.	Inhibited in new interpersonal situations.
6.	Views self as socially inept or inferior.
7.	Reluctant to take personal risks or engage in new activities.
70
Q

DSM+Dependent Personality Disorder

A

Cluster C: Anxious and Fearful Disorders
Excessive need to be taken care of, leading to submissive and clinging behavior.

DSM-5 Criteria:

*	A: At least five of the following:
1.	Difficulty making decisions without excessive advice.
2.	Needs others to assume responsibility for most areas of life.
3.	Difficulty expressing disagreement.
4.	Difficulty initiating projects on their own.
5.	Goes to excessive lengths for nurturance.
6.	Feels uncomfortable or helpless when alone.
7.	Urgently seeks another relationship for support.
8.	Unrealistically preoccupied with fears of being left to care for themselves.
71
Q

DSM+Obsessive-Compulsive Personality Disorder (OCPD)

A

Cluster C: Anxious and Fearful Disorders
Preoccupation with orderliness, perfectionism, and control at the expense of flexibility.

DSM-5 Criteria:

*	A: At least four of the following:
1.	Preoccupied with details, rules, lists, order, or schedules.
2.	Shows perfectionism that interferes with task completion.
3.	Excessively devoted to work and productivity.
4.	Overconscientious and inflexible about morality and ethics.
5.	Unable to discard worn-out or worthless items.
6.	Reluctant to delegate tasks.
7.	Adopts a miserly spending style.
8.	Shows rigidity and stubbornness.
72
Q

Etiology Personality disorders

A

Cluster A: Primarily biological explanations.
* Cluster B: Both biological and attachment theories.
* Cluster C: Limited investigation, but some focus on attachment styles and early experiences.

73
Q

Comorbidity Personality disorders

A

High rates of comorbidity with other mental disorders, such as anxiety, depression, and substance use disorders.

74
Q

What is an Addiction?

A

Compulsive drug seeking and drug taking despite severe harms, with an inability to control strong urges to consume the drug.

75
Q

Substance Use Disorder

A

Addiction, clinically referred to as Substance Use Disorder, involves the problematic use of one or more substances leading to significant impairment or distress.

76
Q
  • Polysubstance Abuse Disorder
A

Simultaneous misuse of two or more substances.
* Examples: Drinking and smoking, cocaine and alcohol, amphetamines and benzodiazepines, opioids, alcohol, cocaine, benzodiazepines, heroin, and prescription drugs.

77
Q

DSM-5 Diagnostic Criteria for Alcohol Use Disorder

A

A problematic pattern of alcohol use leading to significant impairment or distress, manifested by at least two of the following within a 12-month period:

1.	Alcohol is often taken in larger amounts or over a longer period than intended.
2.	Persistent desire or unsuccessful efforts to cut down or control alcohol use.
3.	A great deal of time is spent in activities necessary to obtain, use, or recover from alcohol.
4.	Craving or strong desire to use alcohol.
5.	Recurrent alcohol use resulting in failure to fulfill major role obligations.
6.	Continued alcohol use despite social or interpersonal problems.
7.	Important activities are given up or reduced due to alcohol use.
8.	Recurrent alcohol use in physically hazardous situations.
9.	Continued use despite knowledge of physical or psychological problems.
10.	Tolerance: Need for increased amounts or diminished effect with continued use.
11.	Withdrawal: Symptoms or using alcohol to avoid withdrawal symptoms.

Severity:

*	Mild: 2-3 symptoms
*	Moderate: 4-5 symptoms
*	Severe: 6 or more symptoms
78
Q

Effects of Alcohol - Short-term Effects:

A

Stimulating: Reduced anxiety, euphoria, sense of well-being, reduced inhibition.
* Depressant: Eye-hand coordination deficits, drowsiness, decreased sensitivity to taste, smell, and pain, slow reaction time.

79
Q

Long-term Effects:

A

Damage to organs
* Risk of cancer
* Wernicke-Korsakoff syndrome (thiamine deficiency leading to memory impairment and loss of contact with reality).

80
Q

Etiology - Substance use

A

Genetics: Higher rates of substance use disorders in individuals with family history (26-77% in men, 25-32% in women).
* Neurobiological Influences: EEG differences, low serotonin levels, increased heart rate response to alcohol.

Psychological Factors:

*	Personality: Traits like behavioral disinhibition, negative emotionality (depression and anxiety).
*	Tension-reduction Hypothesis: Using alcohol to reduce unpleasant emotions.
*	Alcohol Expectancy Theory: Effects are influenced by what individuals expect alcohol to do.

Sociocultural Factors:

*	Family values and attitudes towards alcohol
*	Cultural expectations and environmental influences

Treatment

81
Q

Psychological Treatment:
substance abuse

A

Contingency Management: Behavioral approach to identify high-risk situations.
* Community Reinforcement Approach: Focuses on enhancing coping strategies.
* Relapse Prevention Treatment: Addresses coping failures and self-defeating thoughts.
* Marital and Family Therapy: Support for affected relationships.
* Brief Interventions and Motivational Interviewing: Encourages change in drinking behavior.

82
Q

Pharmacotherapy:

A

Benzodiazepines: For withdrawal management.
* Naltrexone: Reduces gratification and craving.
* Acamprosate: Facilitates GABA action, reduces craving.
* Antabuse: Makes drinking aversive.

83
Q

Residential Treatment & Mutual Support Groups:
Substance abuse

A

Residential Treatment: Alcohol use disorder treated as a disease.
* Minnesota Model: Combines education, group, and individual therapy.
* Alcoholics Anonymous (AA): Self-help group based on the disease model.

84
Q

Other Substances
Depressants (Barbiturates and Benzodiazepines)

A

Definition: Drugs that inhibit neurotransmitter activity in the CNS, causing sedation and relaxation.
* Effects: Mild euphoria, slurred speech, poor motor coordination, impaired judgment, chronic fatigue, mood swings, and paranoia.
* Treatment for Dependency: Gradual reduction in dosage, psychological support, and educational programs.

85
Q

Hallucinogens

A

Definition: Drugs that induce perceptual and sensory distortions or hallucinations.
* Examples: LSD, psilocybin mushrooms.
* Effects: Excitatory effects on the CNS, mimicking serotonin.
* Dependency: Primarily psychological.
* Potential Benefits: Anxiolytic and antidepressive effects, enhanced social cognition, and openness to experience.

86
Q

Types of Interventions:

A

1 .Medications & Biological Approaches
2. Psychotherapies
3. Review of Treatments for Specific Disorders

87
Q

Biological Approach
interventions

A

Electroconvulsive Therapy (ECT):

*	History: Used in the 1930s for schizophrenia.
*	Current Use: Treats severe, non-responsive major depressive disorder (MDD).
*	Side Effects: Greatly reduced over time.

Psychopharmacology:

*	Challenge: Finding an agent to modify the disorder’s process.
*	Types of Psychotropic Agents:
*	Antipsychotics: Developed in the 1950s, allowed for deinstitutionalization, but have side effects like extrapyramidal effects.
*	Anxiolytics: Alleviate anxiety and muscle tension; issues with tolerance and addiction.
*	Antidepressants: Four major categories (MAOIs, TCAs, SSRIs, SNRIs); not effective immediately and can increase suicidal thoughts in youths.
*	Mood Stabilizers: Treat bipolar disorder; narrow window of effectiveness (low = ineffective, high = toxic).
*	Stimulants: Treat ADHD; side effects include appetite suppression, sleep and mood disturbances, headaches, abdominal discomfort, and fatigue.
88
Q

Psychotherapies

A

A professionally trained therapist uses techniques derived from psychological principles to relieve psychological distress or facilitate growth.

89
Q

Types of Psychotherapy

A
  • Techniques: Free association, dream interpretation, analysis of resistance and transference.
    • Brief Psychodynamic Psychotherapy: Active, flexible, short-term, and focuses on conversation and empathy.
    • Ego Analysis: Focus on the ego rather than the id.
    • Adler’s Individual Psychology: Overcoming personal weakness and maladaptive beliefs.
    • Interpersonal Psychodynamic Therapy: Emphasizes client’s interactions with their social environment.
90
Q

Humanistic-Experiential Approaches:

A

Client-Centered Therapy: Developed by Carl Rogers.
* Existential Therapy: Inspired by Sartre and Kierkegaard.
* Gestalt Therapy: Created by Fritz Perls.
* Emotion-Focused Therapy: Developed by Les Greenberg.

91
Q

Behavioral Approaches:

A

Techniques: Contingency management, response shaping, behavioral activation, relaxation training, exposure, assertiveness training, and dialectical behavior therapy.
* General Approach: Use of reinforcements and extinction.

92
Q

Integrative Approaches

A

Effective Therapy Factors (Frank, 1961):

1.	Hope
2.	Alternative explanation for the problem
3.	Expectations of change
93
Q

Cognitive Approaches:

A

Techniques: Identifying automatic thoughts, cognitive restructuring, mindfulness practices.
* Focus: Modify maladaptive thoughts and behaviors.

Cognitive-Behavioral Therapy (CBT):

*	Principle: Thoughts and feelings influence behavior.
*	Techniques: Journaling, cognitive restructuring, examining evidence, mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), acceptance and commitment therapy (ACT).
94
Q

Evidence-Based Therapy Relationships:

A
  • Therapeutic alliance
    • Therapist empathy
    • Monitoring progress
    • Consensus and collaboration
95
Q

Individual Therapy:

A

Most common modality, practiced with adults, adolescents, and children.
* Significant others may be involved.

96
Q

Couples Therapy:

A
  • Goal is to enhance relationship satisfaction.
97
Q

Family Therapy:

A
  • Focuses on family interactions that contribute to problems.
98
Q

Group Therapy:

A
  • Cost-effective and provides feedback and a sense of universality.
99
Q

Review of Treatments for Specific Disorders

Anxiety Disorders

A

Specific Phobias:

*	Treatment: Cognitive restructuring and exposure.

Obsessive-Compulsive Disorder (OCD):

*	Treatment: Exposure and response prevention, cognitive restructuring.
100
Q

Review of Treatments for Specific Disorders Mood Disorders

A

Depression:

*	Effective Therapies: CBT and Interpersonal Therapy (IPT).
*	Key Techniques from CBT: Behavioral activation, cognitive restructuring.
*	Medications: Helpful for severe depression; higher relapse risk with medication alone.

Unipolar Depression:

*	CBT Focus: Modify maladaptive thoughts to alleviate distress.
*	IPT Focus: Address interpersonal disruptions due to depression\

Schizophrenia

Treatment Components:

*	Early Interventions: During the prodromal phase.
*	Medication: Antipsychotics.
*	CBT: Psychoeducation, belief modification, fostering adaptive coping strategies.
101
Q

Review of Treatments for Specific Disorders Personality Disorders

A

General Approaches:

1.	Object-Relations Therapy: Focuses on interpersonal relationships.
2.	Cognitive-Behavioral Therapy: Addresses maladaptive coping strategies.
3.	Psychopharmacological Therapy: Uses antidepressants, antipsychotics, and anticonvulsants.

Dialectical Behavior Therapy (DBT):

*	Effective for Borderline Personality Disorder:
*	Skills: Mindfulness, emotion regulation, distress tolerance, interpersonal effectiveness.