Psychological Disorders Flashcards
What is direct therapy?
Treatment that acts directly on the individual, such as medication or periodic meetings with a psychologist
What is indirect therapy?
Aims to increase social support by educating family and friends of the affected individual
What is the Diagnostic and Statistical Manual of Mental Disorders (DSM)?
A manual originally made to collect statistical data in the US but became a diagnostic tool for mental disorders
What information does the DSM 5 contain? How does it aid purpose?
Description of symptoms of mental symptoms which is used to help clinicians fit compiled lists of symptoms to diagnose patients
What type of disorder is schizophrenia?
A prototypical psychotic disorder
According to the DSM 5, psychotic individuals must suffer from at least one of the following:
- delusions
- hallucinations
- disorganized thought
- disorganized behavior
- catatonia
- negative symptoms
What must occur for a patient to be described as schizophrenic?
They must show continuous signs of the disturbance for at least 6 months and include 1 month of “active symptoms”(delusions, hallucinations, disorganized speech)
Symptoms of schizophrenia are split into
Positive and negative types
Define positive symptoms of schizophrenia
Behaviors, thoughts and feelings added to normal behavior such as hallucinations, disorganized thought
Name and give examples of the 2 dimensions of positive symptoms of schizophrenia
Psychotic dimension- delusions, hallucination
Disorganized dimension-disorganized thought and behavior
Define negative symptoms of schizophrenia
Involve the absence of normal or desired behavior, such as disturbance of affect and avolition
What are delusions?
False beliefs discordant with reality and not shared by others in the individual’s culture that are maintained despite contradictory evidence
What are the common delusions of schizophrenia?
Delusions of reference, grandeur and persecution
Also thought broadcasting, thought insertions
What are delusions of reference?
Involve the belief that elements in the environment are directed toward the individual (such as tv show characters talking to them)
What are delusions of persecution?
Involve the beliefs of the person being targeted against/threatened
What are delusions of grandeur?
Also a common bipolar 1 disorder, involves the person is remarkable I’m a significant way, such as historical figure or religious icon
What is thought broadcasting?
The belief that one’s thoughts are broadcast directly from ones head to the external world
What is thought insertion?
Belief that thoughts are being inserted into ones head
What are hallucinations?
Perceptions that are not due to external stimuli but have a compelling sense of reality
Give the types of hallucinations in order of most common first and least common last
- Auditory
- Visual and tactile hallucinations
- Olfactory and gustatory
What is disorganized thought?
Characterized by loosening associations such as speech which shifts ideas, words being used together incomprehensibly (word salad)
What are neologisms?
When a person may invent new words(common in schizophrenia)
What is disorganized behavior?
An inability to carry out activities of daily living such as paying bills and keeping appointments
What is catatonia?
Certain motor behaviors spontaneous which are characteristic of some people with schizophrenia.
Include spontaneous movement may be reduced, may maintain a rigid posture, refusing to be moved
Also include echolalia and echopraxia
What are echolalia and echopraxia?
Echolalia- repeating another’s words
Echopraxia- repeating another’s actions
What is blunting?
A negative schizophrenic symptom in which there is a great reduction in intensity of expression
What is the flat affect?
A negative schizophrenic symptom in which there are virtually no signs of emotional expression
What is the inappropriate affect?
A negative schizophrenic symptom in which the actions of the patient is discordant with the individuals speech
What is avolition?
A negative schizophrenic symptom in which patient no longer engages in purposeful goal-directed charity
What is t downward drift hypothesis?(common on MCAT with schizophrenia)
- It states that schizophrenia causes a decline in socioeconomic status, leading to worsening symptoms
- setting up a negative spiral for the patient towards psychosis and poverty
What hypothesis explains why schizophrenia rates are higher among the homeless and indigents?
The downward drift hypothesis
What is the prodromal phase?
Before schizophrenia is diagnosed, a patient goes through a phase deterioration, social withdrawal, role functioning impairment, peculiar behavior and unusual effects
State and explain the first line of treatment against depression
A class of medications called Selective Serotonin reuptake inhibitors ( SSRIs)
How do SSRIs work?
These block the reuptake of serotonin by the presynaptic neuron, resulting in higher levels of serotonin in the synapse and relief of symptoms
What is a major depressive disorder ?
a mood disorder characterized by at least one major depressive episode.
What is a major depressive episode?
A period of at least 2 weeks with at least 5 of the following:
- persistent depressive mood
- loss of all or most enjoyment in formerly enjoyable activities
- appetite disturbances and weight changes
- decreased energy
- feelings of worthlessness or guilt
- difficulty concentrating or thinking
- psychomotor symptoms(feeling slowed down)
- thoughts of suicide and attempts
Atleast one of the symptoms must be depressive mood or anhedonia
What is anhedonia?
Loss of all or most enjoyment of activities that were formerly enjoyable
How many individuals die by suicide of major depressive disorder?
As many as 15%
How is a diagnosis of persistent depressive disorder administered?
Given to those who suffer from dysthymia, a depressive mood that isn’t severe enough to meet the criteria of a major depressive episode usually of atleast 2 years
Or
Individuals with major depressive order for atleast 2 years
What is Seasonal Affective Disorder?
Depressive symptoms, present in winter months, often related to abnormal melatonin metabolism
How is Seasonal Affective Disorder treated?
With Bright Light therapy, where patient is exposed to a bright light for a specified amount of time each day
What are bipolar disorders?
Formerly known as manic depression, it’s a mood disorder characterized by depression and mania
What are manic episodes?
Abnormal and persistently elevated mood lasting at least one week with atleast 3 of the following:
- increased distractibility
- insomnia
- grandiosity
- racing thoughts
- increased goal directed activity of agitation
- pressured speech or increased talkativeness
- possibly psychosis
Describe Bipolar I disorder
Has manic episodes with or without major depressive episodes
Describe Bipolar II disorder
Has hypomania with atleast one major depressive episode
Contrast mania and hypomania
Hypomania does not significantly impair functioning, nor are there psychotic features, although the individual may be more energetic and optimistic
What is cyclothymic disorder?
Consists of a combination of hypomania episodes and periods of dysthymia that are not severe enough to qualify as major depressive episodes
What is the hormonal cause of depressive episodes?
Low norepinephrine and serotonin levels
What are the hormonal reasons for manic episodes?
High levels of norepinephrine and serotonin
Why must depressed patients who are treated with antidepressants be watched closely?
Antidepressants may unmask an underlying undiagnosed bipolar disorder and may be revealed via manic episodes
What monoamine/catecholamine theory of depression?
Theory states that too much norepinephrine and serotonin in the synapse leads to mania, while too little leads to depression
What are the most common psychiatric disorder in women of all ages?
Anxiety disorders
What is Generalized Anxiety Disorder?
A disproportionate and persistent worry about many different things
Individuals often have physical symptoms such as fatigue, muscle tension , sleep problems
The most commotion type of anxiety disorder is _______
Phobia
What is a phobia?
An irrational fear of something that results in a compelling desire to avoid it
What is a specific phobia?
A phobia caused by a specific object or situation
What is social anxiety disorder?
Characterized by anxiety that is due to social situations
What is Agoraphobia?
An anxiety disorder characterized by a fear of being in places or situations where it might be hard for an individual to escape (such as leaving homes for fear of a panic attack or exacerbation of another mental illness)
What is panic disorder?
Repeated panic attacks
What are the symptoms of panic disorder?
- fear and apprehension
- trembling and sweating
- hyperventilation and a sense of unreality
Why is treatment for panic disorder carried on for long periods of time?
Even after treatment, symptoms persist
What is obsessive compulsive disorder?
OCD is characterized by obsessions which produce tensions and compulsions that relieve tensions that cause significant impairment in a person’s life
Explain the relationship between obsessions and compulsions in OCD
Obsessions raise the individuals stress level and compulsions relieve the stress
What is body dysmorphic disorder?
When a person has an unrealistic negative evaluation of their appearance and attractiveness usually directed at a certain body part
What is post traumatic stress disorder?
Occurs after experiencing or witnessing a traumatic event and consists of several symptoms
What are ty 4 types of symptoms of PTSD?
- Intrusion symptoms
- Avoidance symptoms
- Negative cognitive symptoms
- Arousal symptoms
What are intrusion symptoms of PTSD?
Recurrent reliving if the event, flashbacks, nightmares
What are avoidance symptoms of PTSD?
Deliberate attempts to avoid anything associated with the trauma
What are negative cognitive symptoms?
Includes inability to recall key features of the event, negative mood or emotions feeling distanced from others and negative world view
What are arousal symptoms of PTSD?
Include increased startle response, irritability, anxiety, self-destructive of reckless behavior and sleep disturbances
What must happen before diagnosis of PTSD?
A certain number of symptoms must be presen5 for atleast for a month
If same symptoms last for less than one month but more than 3 days it is called acute stress disorder
What is dissociative amnesia?
Characterized by inability to recall past experiences
It is dissociative because amnesia is not due to neurological amnesia but often, trauma
What is dissociative identity disorder?
(Formerly multiple personality disorder) atleast 2 personalities that recurrently take control of a person
What are the psychological reasons for dissociative identity disorder?
Patients have suffered sexual abuse or physical abuse while young children
What is depersonalization/derealization disorder?
Individuals feel detached from their own body(depersonalization) mind and surroundings(derealization)
What is derealization?
Giving the world a dreamlike or insubstantial quality
What is depersonalization?
An out of body experience
What is somatic symptom disorder?
Individuals with at least one somatic symptom and disproportionate concern to its seriousness, devotion of an excessive amount of time and energy to it
What is illness anxiety disorder?
Characterized by being consumed with thoughts about having or developing a serious medical condition
What are symptoms of illness anxiety disorder ?
- Individuals with this disorder are quick to become alarmed about their health
- they either excessively check themselves for signs and avoid appointments altogether
What is conversion disorder?
Characterized by unexplained symptoms affecting voluntary motor or sensory functions
What are symptoms of conversion disorder?
Symptoms usually occur after high levels of stress or trauma
May not occur until sometime passes
Motor and sensory function impairment such as paralysis and blindness and no neurological damage
La belle indifference-person may be unconcerned by the symptom
What is a personality disorder?
A pattern of behavior that is inflexible and maladaptive, causing distress or impaired functioning in at least 2 of the following:
- cognition
- emotions
- interpersonal functioning
- impulse control
Personality disorders are considered ___________________ meaning…
Ego-syntonic
The individual perceives their behavior in harmony with their goals
What does ego-dystonic mean?
Individual sees the illness as thrust upon them as intrusive and bothersome
Describe each personality cluster and their examples with the 3 Ws
Cluster A- Weird(paranoid, schizoid and schizotypal)
Cluster B- Wild(antisocial, borderline, histrionic and narcissistic)
Cluster C- Worried(avoidant, dependent, and obsessive-compulsive)
Describe paranoid personality disorder
Shows pervasive distrust of others and suspicion regarding their motives
Describe schizotypal personality disorder
Refers to a pattern of of odd or eccentric thinking
May haves ideas of reference (not as extreme ideas of reference)
As well as magical thinking such as superstitious ness
Describe schizoid personality disorder
Pervasive pattern of detachment from social patterns from social relationships and a restricted range of emotional expression
Little desire of social interaction, few if any close friends and poor social skills
Describe antisocial personality disorder
A pattern of disregard for and violations of the rights of others. Evidenced by illegal acts, deceitful ness aggressiveness and lack of remorse
Describe Borderline personality disorder
Pervasive instability in interpersonal behavior, mood, and self-image.
There may be profound identity disturbance with uncertainty about self-image, sexual identity, long term goals or values
List some symptoms of borderline personality disorder
- sense of fear of abandonment
- may use splitting as a defense mechanism(angel vs demon mentality)
- suicude attempts and self mutilation
Describe histrionic personality disorder
Constant attention seeking behavior
They often wear colorful clothing, dramatic and exceptionally extroverted
Describe narcissistic personality disorder
One has a grandiose sense of self, pre-occupation with fantasies of success, a need for constant admiration and attention and feelings of entitlement
Describe avoidant personality disorder
Individual has extreme shyness and fear of rejection.
Individual will see herself as socially inept and is often socially isolated, despite an intense desire for social affection and acceptance
What is dependent personality disorder
Characterized by a continuous need for reassurance.
Patient tends to remain dependent on a specific person to take actions and make decisions
Describe Obsessive- Compulsive Personality Disorder(OCPD)
Individual is perfectionistic and inflexible, tending to like rules and order.
Inability to discard worn-out objects, lack of desire to change, excessive stubbornness, lack of sense of humor
Differentiate between obsessive compulsive disorder(OCD) and obsessive compulsive personality disorder(OCPD)
OCD is marked by obsessions (intrusive thought causing tension) and compulsions(repetitive tasks that relieve this tension but cause significant tension)
OCPD is a personality disorder in which individuals are perfectionists and inflexible
What is a chemical association of schizophrenia?
An excess of dopamine in the brain
What are some biological factors of schizophrenia ?
Genetics
Trauma at birth, especially hypoxia
Other exposure:
Excessive marijuana use in adolescence
What is a common pharmological function of many schizophrenia medication?
Blockage of dopamine receptors
What are 4 host markers of depression?
- Abnormally high glucose metabolism in the amygdala
- Hippocampal atrophy after a long duration of illness
- Abnormally high levels of glucocorticoids(cortisol)
- Decreased norepinephrine, serotonin and dopamine(monoamine theory of depression)
Chemically speaking, what causes depression?
Neurotransmitters-norepinephrine, serotonin and dopamine and their metabolites are produced in lower quantities
What are some biological factors of bipolar disorders?
- Increased norepinephrine and serotonin(monoamine theory)
- Higher risk if parent has bipolar disorder
- Higher risk for persons with multiple sclerosis
Describe Alzheimer’s disease
A type of dementia characterized by gradual memory loss, disorientation to time and place, problems with abstract thought and tendency to misplace things
Describe the later stages of Alzheimer’s disease
Associated with changes in mood or behavior, changes in personality, difficulty with procedural memory, poor judgement and loss of initiative
Who is Alzheimer’s most common in?
More common in women than men
Most common in people above 65 years old
Explain the genetic component of Ahlzeimers disease
Mutations in presensilin genes in Chromosomes 1 and 14 contribute to having the disease
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Mutations in the apolipoprotein E gene on chromosome 19 can also alter the likelihood of Alzheimer’s
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B-amyloid precursor protein gene on chromosome 2
List the biological factors of Alzheimer’s
- Diffuse atrophy of the brain on CT or MRI
- Flattened Sulci in the cerebral cortex
- Enlarged cerebral ventricles
- Deficient blood flow in parietal lobes, which is correlated with cognitive decline
- Reduction in levels of acetylcholine
- Reduction of choline acetyltransferase( ChAt)(produces Acetyl choline)
- Reduced metabolism in temporal and parietal lobes
- Senile plaques of B-amyloid
- Neurofibrillary tangles of hyperphosphorylated tau protein
What are the symptoms of Parkinson’s disease?
- bradykinesia( slow movement)
- resting tremor
- pill-rolling tremor(flexing and extending fingers while thumb moves back and forth)
- masklike fascies (facial expression consisting of static and expressionless facial features, staring eyes, and partly opened mouth)
- cogwheel rigidity (muscle tension that intermittently halts movement as an examiner manipulates a limb)
-shuffling gait with a stooped posture
What is the biological basis of Parkinson’s?
Decreased dopamine production in the substantia nigra
What is the substantia nigra?
A layer of cells in the brain that produce dopamine for proper functioning of the basal ganglia
What is the function of the basal ganglia?
Needed for initiating and terminating movements, sustaining repetitive motor tasks and smoothening motions,
