Psychological Disorders

Question 1

What two approaches are used in treating and evaluating psych disoders

Answer 1

• Biomedical approach- disease has biological distortions and can be treated by medical approaches
• Biopsychosocial approach- disease has biological, psychological and social schemes and involving all this improve outcomes.
  
  • Direct therapy and indirect therapy

Question 2

DSM-5

Answer 2

• classification of mental disorders in terms of symptoms. does not address cause or etiology

Question 3

Schizophrenia description/ diagnosis/ biological basis

Answer 3

• A psychotic disorder characterised by presence of delusions, hallucinations and disorganised speech.
• Symptoms must be present for at least 6months with 1 month of active symptoms
• Due to genetic, environmental associations, structural changes in the brain.
• caused by excess dopamine

Question 4

What are positive and negative symptoms of schizophrenia

Answer 4

• Positive symptoms involve additional symptoms to normal behaviour or thought
• Negative symptoms involve absence of normal behaviour

Question 5

Positive symptoms include

Answer 5

• Delusions- unreal, false beliefs
  
  • delusions of reference- belief that everything refers to him i.e TV announcement about him
  • delusions of persecution- belief that people are out to get him
  • delusions of grandeur- belief that they are very important/ star figure
  • thought broadcasting-belief that his thoughts are being aired to the outside world
  • thought insertion- belief that people are inserting thoughts into his head
• Disorganised thoughts
  
  • word salad- bunch of words with no clear meaning and association
  • neologisms- inventing new words
• Hallucinations- experiencing things that are not there auditory/visual/gustatory/olfactory
• Disorganised behaviour
  
  • Catatonia- remain in statue mode/ abnormal movement
  • Echolalia- imitate talk
  • Echopraxia- imitate movement

Question 6

Negative symptoms include

Answer 6

• Disturbance of affect
  
  • Blunted affect ( reduced)
  • Flat affect (no emotional expression)
  • Inappropriate affect- opposite of whats expected i.e laugh at a funeral
• Avolition- lack of purposeful and goal directed actions. lack of motivation
• Alogia- lack of speech

Question 7

What is the prodromal stage of schizophrenia

Answer 7

Phase before active symptoms are seen, patient shows deterioration of function

Question 8

Major depression description

Answer 8

• Mood disorder with at least 1 major depressive episode ( at least 2 wks) resulting in impaired function
• Symptoms include (Sadness + SIG E CAPS)
  
  • Sleep disturbances
  • Interest (anhedonia) lack of it
  • Guilt- excessive guilt,feel worthless
  • Energy- decreased
  • Concentration- poor
  • Appetite- poor, loss of weight
  • Psychomotor symptoms-feel slowed down
  • Suicidal ideation

Question 9

What is persistent depressive disorder

Answer 9

• Not bad enough to be MDD. Characterised by dysthymia i.e MDD that is low in intensity and lasts at least 2 years

Question 10

What is Seasonal affective disorder

Answer 10

MDD with seasonal onset ie during winter months d/t abnormal melatonin metabolism. Treated with light therapy

Question 11

Characterise bipolar disorders

Answer 11

• Mood disorder consisting of manic and depressive cycles
• Symptoms of manic episode include (DIG FAST)
  
  • Distractible
  • Insomnia
  • Grandiosity
  • Flight of ideas
  • Agitation
  • Speech (pressured)
  • Thoughtlessness( risky behaviour)

Question 12

What is Bipolar I/II/cyclothymic disorder

Answer 12

• Bipolar I- manic episodes with or without episodes of MDD
• Bipolar II-hypomania(euphoria and elevated mood)+ MDD
  
  • note hypomania does not cause significant impairment and no psychotic symptoms
• Cyclothymic disorder- hypomania + dysthymia for at least 2 years.

Question 13

What does the monoamine/catecholamine theory of depression state

Answer 13

Mood disorders arise from an imbalance of norepinephrine and serotonin ie too much= mania and too little= depression

• people with MDD have high cortisol, low norepi, serotonin and dopamine, high amygdala glucose metabolism
• People with BPD have high norepi and dopamine; higher risk of BPD if parent has it or if with MS

Question 14

What are some anxiety disorders

Answer 14

• Generalised anxiety disorder- excessive, persistent worry
• Specific phobias-irrational fear of specific thing, arachnophobia, xenophobia, agoraphobia( fear of being out in public)
• Social anxiety disorder- being anxious due to others
• Panic disorder- (autonomic sympathetic overactivation)severe sense of impending doom- lose their mind, associated with agoraphobia ie one feels they will have a panic attack in public
• §note thyroid disfunction has to be ruled out for anxiety disorder to be diagnosed

Question 15

Describe obsessive- compulsive disorders

Answer 15

• OCD- intrusive thoughts/obsessions= tension(stress) and compulsive acts to relieve the tension(decrease stress).
• Body dysmorphic disorder- constant obsession with a perceived body part that the individual sees as distorted.

Question 16

What are some Trauma related disorders

Answer 16

• PTSD-intrusion symptoms( reliving the event, flashbacks) avoidance symptoms (suppression of memories) negative cognitive symptoms ( holding negative view of the world, distancing from others at the event) arousal symptoms ( increased startle response, irritability or reckless behaviours)

Question 17

Describe some dissociative disorders

Answer 17

• person gets over stress by escaping from his identity
• Dissociative amnesia- inability to recall past experiences d/t trauma. dissociative fugue- person wanders away from place of living, can have a new identity.
• Dissociative identity disorder DID(multiple personality)- many different personalities present in a single person. can be way to escape sexual abuse trauma
• Depersonalization/ Derealization- feeling detached from own mind and body/ surroundings eg fail to recognise own reflection. No psychotic symptoms

Question 18

Describe somatic symptom disorders

Answer 18

marked by bodily disfunction

• Somatic symptom disorder-extreme focus on physical symptoms that may or may not be associated to a medical condition causing significant emotional stress
• Illness anxiety disorder- having an obsession about being sick with an ailment that has not been diagnosed- change MDs, go to ER too much
• Conversion disorder- having symptoms of voluntary motor or sensory functions that can not be attributed to an underlying disease eg blindness, paralysis, seizures

Question 19

Describe personality disorders

Answer 19

They’re either cluster

A(odd, eccentric)- paranoid, schizotypal, schizoid (avoids social relations, no pals etc)

B(dramatic, emotional, erratic)- histrionic(colourful, dramatic, seductive), antisocial( manipulative, no remorse), borderline(cutters, splitting- black and white thinking either all good or all bad defense mechanism), narcissistic

C(anxious and fearful) avoidant(shy, isolated), dependent( need reassurance), obsessive compulsive personality disorder(perfectionist and inflexible; rules and order, careful routines- lifelong- there are no obsessions or compulsions)

Question 20

Biological characteristics of Alz disease

Answer 20

• familh hx, decreased with higher level of education
• beta amyloid plaques, decreased ach, enlarged vetricles, presence of neurofibrillary tangles, flattened sulci atrophy of brain

Question 21

Biological characteristics of Parkinsons

Answer 21

• Due to decreased dopamine production by substantia nigra of the basal ganglia
• xtics= bradykinesia, resting tremor, pin-rolling, masklike facies, cogwheel rigidity, shuffling gait