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Psychopathology > PSYCHOPATHOLOGY Midterm 2 content > Flashcards

PSYCHOPATHOLOGY Midterm 2 content Flashcards

1
Q

What is fear?

A

Immediate emotional alarm reaction to
present danger or life-threatening emergencies

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2
Q

What is anxiety?

A

a mood state that follows from
apprehension about (potential) negative future
outcomes
○ Anxiety is future-oriented: anticipating a future negative event

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3
Q

What is panic?

A

sudden overwhelming fear or terror

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4
Q

What is a panic attack?

A

fast onset of panic that includes intense physical
symptoms
○ Can be expected or unexpected

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5
Q

Why is anxiety important?

A
  • A moderate level of anxiety is helpful
    by motivating action and increasing
    concentration
    ● Anxiety can help us avoid potential
    threats through problem solving
    ● Too much anxiety can be harmful
    ● Many of life’s most important
    moments (e.g. weddings, first dates,
    starting school) involve some degree
    of anxiety/excitement
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6
Q

what are the 2 major neural circuits control anxiety?

A
  • Fight or flight
  • Behavioural inhibition system
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7
Q

what is fight or flight?

A

Panic response to a perceived threat

Corticotropin-releasing factor (CRF) stimulates the hypothalamic pituitary–adrenocortical (HPA) axis

Leads to specific physiological change (e.g. increased heart rate

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8
Q

What is behavioural inhibition system?

A

Freeze response

Another physiological response to threat

Signals our bodies to stop and evaluate the situation to determine
the threat

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9
Q

What are development factors?

A
  • Predictable childhood environment
  • Parental strategies
    ○ Social learning (from parents)
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10
Q

What is the triple vulnerability theory?

A

An integrated model of three key factors that contribute to anxiety

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11
Q

What is the first vulnerability (diathesis)

A

generalized biological vulnerability

E.g., the tendency of being “uptight” can be heritable

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12
Q

What is the second vulnerability?

A

generalized psychological vulnerability

E.g., believing the world is dangerous = harder to cope with = more anxiety

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13
Q

What is the third vulnerability?

A

specific psychological vulnerability

E.g., learning from others and experience about dangerous things makes you
more anxious about those things (like the neighbours scary dog… eeep)
The triple vulnerability theory

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14
Q

______ aged 12 and over have a diagnosed anxiety disorder (Canadian Community Health
Survey, 2016

A

8.6% of canadians

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15
Q

Many large population-based surveys, report that around _____of the population are affected by an
anxiety disorder during their lifetime(

A

31%

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16
Q

Approximately _______Canadians diagnosed with a mood disorder have been diagnosed with an
anxiety disorder

A

1/3

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17
Q

Up to ________ comorbidity between anxiety and depressive disorders over a lifetime

A

50%

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18
Q

What are common techniques used across anxiety disorders:

A

● Exposure therapy
● Relaxation techniques
● Existential techniques
● Cognitive-behavioural strategies

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19
Q

What are types of exposure therapy?

A
  • Imaginal exposure
  • In-vivo (real-life) exposure
  • Interoceptive (physical sensations) exposure
  • Virtual reality exposure
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20
Q

what is flooding?

A

Exposing someone
immediately to extremely distressing stimuli

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21
Q

How does exposure work?

A
  • Habituation
  • Inhibitory learning
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22
Q

What do existential approaches focus on?

A

Finding meaning in life despite bad events

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23
Q

What is stoicism?

A

Achieving happiness through cultivating virtues (not
material success) and accepting the present moment as it is,
regardless of the pleasure or pain it brings

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24
Q

What is benzodiazepines

A

○ E.g. Xanax, Valium, Ativan

○ Fast-acting central nervous depressant that affects the GABA
system

○ Provide effective relief from anxiety, but can be addictive

○ Can be prescribed for managing short-term crises (with caution)

○ Not recommended for managing anxiety in the long-term
■ Can lead to dependence and many negative health
effects

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25
Q

What are SSRIs?

A
  • Often referred to as “anti-depressants” although are also helpful at
    managing anxiety
  • The recommended first line medication treatment for anxiety
  • Takes several weeks to notice a different (prozac)
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26
Q

What is generalized anxiety disorder?

A

Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).

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27
Q

How do you know you have it from the symptoms?

A
  • 3 or more of the 6 symptoms
  • 6 months
  • only 1 item is required in children
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28
Q

What are the 6 symptoms ?

A
  1. Restlessness or feeling keyed up or on edge.
  2. Being easily fatigued.
  3. Difficulty concentrating or mind going blank.
  4. Irritability.
  5. Muscle tension.
  6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep
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29
Q

What is the prevalence of GAD in Canada?

A

3% of the Canadian population at a given time

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30
Q

What about the life time population?

A

9%

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31
Q

There are 4 notable features that distinguish people with GAD:

A
  1. Intolerance of uncertainty
  2. Positive beliefs about worry
  3. Poor problem orientation
  4. Cognitive avoidance
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32
Q

Exposure to situations that lead to
uncertainty:

A

○ Can lead to habituation (lower anxiety
after each practice exercise)

○ Can lead to the ability to tolerate feeling anxious (“I can do this even if it makes me feel anxious)

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33
Q

Clients with GAD often believe that worrying is _______ and ________

A

necessary and beneficial

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34
Q

Are people with GAD good at problem solving strategies?

A

No

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35
Q

What is a component of CBT for people with GAD?

A

Problem-solving skills

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36
Q

What are invisible strategies?

A

Suppressing thoughts

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37
Q

What are overt strategies?

A

avoiding certain strategies

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38
Q

What is the white bear experiment?

A

Check textbook

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39
Q

Imaginal exposure

A

imagine making a mistake at work
and sit with the anxiety (without doing avoidance strategies)

  • Write out a “worry script” that describes the
    worst case scenario
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40
Q

Are panic disorder and agorophobia highly related?

A

Yes

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41
Q

What is an example of an expected panic attack?

A

Giving a speech for someone with social anxiety

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42
Q

What is an example of an unexpected panic attack?

A

They do NOT have clear triggers and happen out of the blue (nocturnal panic attacks)

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43
Q

A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur:

A

A. Palpitations, pounding heart, or accelerated heart rate.
B. Sweating.
C. Trembling or shaking.
D. Sensations of shortness of breath or smothering.
E. Feelings of choking.
F. Chest pain or discomfort.
G. Nausea or abdominal distress.
H. Feeling dizzy, unsteady, light-headed, or faint.
I. Chills or heat sensations.
J. Paresthesias (numbness or tingling sensations).
K. Derealization (feelings of unreality) or depersonalization (being detached from oneself).
L. Fear of losing control or “going crazy.”
M. Fear of dying.
● Culture-specific symptoms (e.g., tinnitus, neck soreness, headache, uncontrollable screaming or crying) may be
seen. Such symptoms should not count as one of the four required symptoms.

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44
Q

What is ataque de nervios?

A

a subtype of panic attacks that present in many South American countries; characterized by screaming and crying

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45
Q

What is Kayak angst

A

a phenomenon described in
Inuit and Western Greenland hunters where
panic symptoms emerge while hunting at
sea; can lead to avoidance

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46
Q

what is the lifetime prevalance rate for panic disorder for Canadians?

A

3.7%

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47
Q

What is the lifetime prevalance rate for agoraphobia?

A

5.3%

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48
Q

What is the DSM-5 criteria for agoraphobia?

A

Marked fear or anxiety about TWO (or more) of the following five situations:

  1. Using public transportation (e.g., automobiles, buses, trains, ships, planes).
  2. Being in open spaces (e.g., parking lots, marketplaces, bridges).
  3. Being in enclosed places (e.g., shops, theaters, cinemas).
  4. Standing in line or being in a crowd.
  5. Being outside of the home alone
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49
Q

Are panic disorders highly treatable?

A

Yes (one of the most responsive to treatment)

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50
Q

Does unexpected mean random and completely unpredictable?

A

No

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51
Q

Do people with panic disorder badly misattribute normal bodily sensations?

A

Yes

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52
Q

What do people with panic disorder engage in?

A

Safety behaviours

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53
Q

What are safety behaviours?

A

Overt actions or thoughts that people do to cope with anxiety in the short term, but perpetuate anxiety in the long-term

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54
Q

What are common safety behaviours?

A

avoiding physical activities

relaxing activities, checking one’s body and of medical info

seeking reassurance from family and friends

carrying safety aids such as cellphone, water bottle and medications

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55
Q

What is self-fulfilling prophecy?

A

the fear of having a panic attack can cause a panic attack

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56
Q

What is a good coping mechanism/therapy method for panic disorder?

A

Interoceptive exposure

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57
Q

What is interoceptive exposure?

A

Interoceptive exposure for panic disorder is a therapy that involves purposely triggering the physical symptoms of panic in a safe setting to teach the person that these sensations are not dangerous and reduce their fear of them

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58
Q

How much (%) do people get better using this method?

A

70%

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59
Q

What are some exercises for the interoceptive exposure assessment?

A
  • shake head side to side
  • place head between legs
  • run in place
  • hold breath
  • swallow quickly
  • spin
  • pushups
  • breathe through straw
  • hyperventilate
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60
Q

What is a specific phobia?

A

Marked fear or anxiety about a specific object or situation

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61
Q

Does the phobic object almost always provoke immediate fear or anxiety?

A

Yes

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62
Q

Is the fear proportionate to the actual danger?

A

No

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63
Q

How long does the fear and anxiety last?

A

6 months or longer

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64
Q

What are the top things people are SCARED of?

A
  1. snakes
  2. heights
  3. flying
  4. enclosures
  5. illness
  6. death
  7. injury
  8. storms
  9. dentists
  10. journeys alone
  11. being alone
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65
Q

What are the top PHOBIAS?

A
  1. illness
  2. storms
  3. animals
  4. agoraphobia
  5. death
  6. crowds
  7. heights
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66
Q

What % of people are scared of needles?

A

10%

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67
Q

Do most people get treated for their phobias?

A

No

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68
Q

What is the best treatment?

A

Gradual exposure

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69
Q

What is separation anxiety?

A

Developmentally inappropriate and
excessive fear or anxiety concerning
separation from those to whom the
individual is attached

More common in children (4% of children) than adults (0.9-1.9%)

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70
Q

What is social anxiety disorder?

A

Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others.

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71
Q

What is performance only social anxiety disorder?

A

if the fear is restricted to speaking or performing in public

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72
Q

What is the lifetime prevalence of social anxiety disorder?

A

13.3%

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73
Q

What is Taijin Kyofusho?

A

A subtype of social anxiety in Japan in which people worry about embarrassing other people

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74
Q

What other diagnoses are social difficulties common in?

A

Autism

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75
Q

What are certain things that social anxiety and autism have in common?

A
  • gaze avoidance
  • discomfort starting conversations
  • discomfort with parties
  • difficulty interacting with strangers
  • socially withdraws
  • social avoidance
  • don’t like unexpected changes to social plans
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76
Q

What are the 4 parts of CBT models

A
  1. Phsysical reactions
  2. thouhts
  3. feelings
  4. behaviours
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77
Q

What is treatment for social anxiety?

A

Exposure-based methods

(testing to see whether social situation can be tolerated without safety behaviours)

  • performance-only subtype
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78
Q

What is performance-only subtype

A

practicing while experiencing physical sensations or anxiety

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79
Q

What is selective mutism?

A

Not speaking in one or more settings where speaking is expected (caused by social anxiety)

Affects 0.5% of population, most in childhood)

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80
Q

What is trauma?

A

any disturbing experience that results in significant fear, helplessness, dissociation, confusion, or other disruptive feelings intense enough to have a long-lasting negative
effect on a person’s attitudes, behavior, and other aspects of functioning

or

rauma is experienced when our stress response systems
are overwhelmed or ill-equipped to handle events in our lives and our bodies compensate/adjust to survive

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81
Q

What are the 4 windows of tolerance?

A

Hyperarousal
Dysregulation
Hypoarousal

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82
Q

What is hyperarousal?

A
  • abnormal state of increased responsiveness
  • feeling anxious, angry, and out of control
  • you may experience wanting to fight or run away
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83
Q

What is dysregulation?

A
  • when you start to deviate outside your window of tolerance
  • you do not feel comfortable but you are not out of control yet
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84
Q

What can stress and trauma do to your window of tolerance?

A

It can shrink it

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85
Q

What is hypoarousal?

A

An abnormal state of decreased responsiveness.
Feelings of emotional numbness, exhaustion, and depression.
May experience your body shutting down or freezing.

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86
Q

What is PTSD

A

Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following
ways:

○ Directly experiencing the traumatic event(s).

○ Witnessing, in person, the event(s) as it occurred to others.

○ Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual
or threatened death of a family member or friend, the event(s) must have been violent or accidental.

○ Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first
responders collecting human remains; police officers repeatedly exposed to details of child abuse).

○ Note: Criterion A4 does not apply to exposure through electronic media, television, movies, or pictures,
unless this exposure is work related.

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87
Q

What are intrusion symptoms?

A

Presence of one or more intrusion symptoms after the traumatic event, such as distressing memories, dreams, or flashbacks

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88
Q

How long do symptoms have to persist for PTSD?

A

1 month

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89
Q

What are the different symptom domain items?

A
  • cognitive re-experiencing
  • avoidance
  • emotional numbing
  • somatic hyperarousal
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90
Q

What are some challenges with PTSD assessment?

A
  • Many different types of traumatic events (e.g. physical violence, accidents,
    injuries, natural disasters)
  • What if there are multiple traumatic events?
  • How do you gather information without asking too many detailed
    questions?
  • What if someone describes an event as traumatic, but does not meet the
    criteria for Criterion A?
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91
Q

What is prevalance?

A

it refers to the proportion of individuals in a population who have a particular condition or disease at a specific time or over a specified period

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92
Q

What is the lifetime prevalance rate for PTSD among survivors?

A

32%

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93
Q

What are certain occupations that have increased risk for PTSD?

A

first responders, military personnel, healthcare workers

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94
Q

What is a moral injury?

A

Describes the psycho-spiritual consequences of events that seriously violate one’s core moral beliefs and expectations
(e.g. killing or injuring someone)

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95
Q

What are core features of moral injuries?

A

guilt, shame, inner conflict or sense of loss relating to ones’ identity, sprituality, or sense of meaning, loss of trust in self

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96
Q

What is the ptsd lifetime prevalance in the general population?

A

8%

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97
Q

What are treatments for PTSD

A
  • exposure-based methods
  • rewriting the narrative of the traumatic event (cognitive processing therapy)
  • SSRI medications
  • eye movement desensitization and reprocessing
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98
Q

What is EMDR

A

involves moving the eyes quickly while discussing the trauma

some controversy with the treatment since its expensive

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99
Q

What is EMDR as effective as?

A

talk-based therapy

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100
Q

Is it good or bad to discuss traumatic events right after it happens?

A

BAD, can cause PTSD symptoms

the person needs to wants to do it

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101
Q

What is acute stress disorder?

A
  • similar to PTSD

a disctinction: can be diagnosed 3 days to 1 month after a traumatic event

PTSD needs 1 month atleast

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102
Q

what is an adjustment disorder?

A

a mental health condition that can occur when someone has difficulty coping with or adjusting to a significant life change or stressful event

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103
Q

How long do symptoms last for an adjustment disorder?

A

occuring 3 months of the onset of the stressor

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104
Q

What is prolonged grief disorder?

A

the death was over a year ago

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105
Q

What are the 4 symptoms of prolonged gried disorder? (u need at least 3)

A

identity disruption

disbelief

avoidance

numbness

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106
Q

What are 2 attachment disorders

A

reactive attachment disorder

Disinhibited social engagement disorder

symptoms have to emerge before 5

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107
Q

What are dissociated disorders?

A
  • Depersonalization/derealization disorder

Dissociative amnesia

Dissociative identity disorder

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108
Q

What is dissociation?

A

disruption of and/or discontinuity in the normal integration of consciousness, memory,
identity, emotion, perception, body representation,
motor control, and behavior…frequently in the
aftermath of trauma

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109
Q

What is derealization?

A

Experiences of unreality or
detachment with respect to
surroundings

(e.g., individuals or objects are experienced as unreal,
dreamlike, foggy, lifeless, or
visually distorted)

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110
Q

What is depersonalization?

A

Experiences of unreality,
detachment, or being an
outside observer with respect to one’s thoughts, feelings, sensations, body, or actions (e.g., perceptual alterations, distorted sense of time, unreal or absent self, emotional and/or
physical numbing)

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111
Q

What is depersonalization/derealization disorder?

A

A. The presence of persistent or recurrent experiences of
depersonalization, derealization, or both

B. During the depersonalization or derealization experiences,
reality testing remains intact.

C. The symptoms cause clinically significant distress or impairment
in social, occupational, or other important areas of functioning.

D. The disturbance is not attributable to the physiological effects of
a substance (e.g., a drug of abuse, medication) or another
medical condition (e.g., seizures).

E. Not attributable to another disorder

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112
Q

What is dissociative amnesia?

A

An inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting

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113
Q

What is an exmple of dissociative amnesia?

A

A simple example could be someone who was in a car accident and afterward cannot recall any details of the accident or the events leading up to it. The memory loss goes beyond typical forgetfulness and can last for varying lengths of time.

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114
Q

What is the 12 month prevalance for dissociative amnesia among adults in a small U.S. community study?

A

1.8%

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115
Q

What is dissociative fugue

A

-a condition where a person forgets who they are and might travel to a new location, often after a stressful event.

  • They can lose memories of their past and sometimes create a new identity. This can last for a short time or much longer, and the person often doesn’t remember what happened during the fugue state afterward.
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116
Q

Go watch this youtube video

A

https://www.youtube.com/watch?v=TdOHs-6Tqdo

117
Q

Go watch this youtube video

A

https://www.youtube.com/watch?v=cjo2IQK6prs

118
Q

Watch this youtube video

A

https://www.youtube.com/watchv=n2atzoaA2NI

119
Q

What are some clinical characteristics of DID?

A
  • exact prevalance is unclear
  • average # of alters is 15
  • 97% of people who have it experienced childhood trauma
  • 68% report incest
  • some argue that it should be a subtype of PTSD
  • people with tis are highly seggestible
120
Q

What is dissociative identity disorder?

A

Formerly “Multiple personality disorder”

Highly stigmatized

someone having 2 or more personalities to forget traumatic events

Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are
inconsistent with ordinary forgetting

121
Q

What % of psychiatrists believe that DID should be included in DSM?

A

1/3

122
Q

Why do 2/3 of psychiatrists believe that DID should NOT be in the DSM?

A

highly suggestible, (false reports of assult for example)

80% of ppl who faked DID tried to get out of murder charges

123
Q

What are the three schizophrenia symptom disorders?

A
  • positive symptoms
  • negative symptoms
  • disorganized symptoms
124
Q

What are positive symptoms in schizophrenia?

A

Presence of psychotic symptoms such as delusions and hallucinations.

125
Q

What are negative symptoms in schizophrenia?

A

Absence or insufficiency of normal behavior, including avolition/apathy, alogia, anhedonia, asociality, and affective flattening.

126
Q

What characterizes disorganized symptoms in schizophrenia?

A

Disorganized speech (difficult to follow, tangential thinking), inappropriate affect (laughing or crying at odd times), and disorganized movement (catatonia, stereotypy).

127
Q

What three conditions did Emil Kraepelin recognize as being caused by the same underlying condition?

A

Catatonia, hebephrenia, and paranoia.

128
Q

Who provided a surprisingly accurate description of schizophrenia in 1899?

A

Emil Kraepelin

129
Q

What term did Emil Kraepelin coin for the disorder he described?

A

Dementia praecox

130
Q

How did Emil Kraepelin distinguish the symptoms of dementia praecox from manic symptoms?

A

Kraepelin recognized distinct symptomatology for dementia praecox separate from those of manic episodes, although specific details of his distinctions are not provided on the slide.

131
Q

Who coined the term ‘schizophrenia’?

A

Swiss psychiatrist Eugene Bleuler.

132
Q

What is the meaning of “skhizein” and “phren”, the Greek roots of the term schizophrenia?

A

“Skhizein” means split and “phren” means mind.

133
Q

What did Eugene Bleuler note about schizophrenia?

A

He noted the “associative splitting” between thoughts, emotions, perception – a lack of connection between these parts of the mind.

134
Q

Between _____ of people with schizophrenia experience
hallucinations, delusions, or both

A

50-70%

135
Q

What are bizarre delusions?

A

bizarre delusions are extremely strange beliefs that are very unlikely to be true because they are impossible or extremely unrealistic. For example, thinking that someone secretly replaced your organs without leaving a scar.

136
Q

What are persecutory delusions?

A

Beliefs that one is being targeted or harassed by others, often referred to as paranoia

137
Q

What are delusions of grandeur?

A

Beliefs that one possesses exceptional abilities, wealth, or importance.

138
Q

What are delusions of reference?

A

Beliefs that random events or actions of others are related to oneself.

139
Q

What is the delusion of thought insertion?

A

Belief that one’s thoughts are not their own and are being inserted into their mind by an external force.

140
Q

What are somatic delusions?

A

Beliefs that concern the body, often involving health or bodily functions.

141
Q

What are erotomanic delusions?

A

What are erotomanic delusions?
Back: Beliefs that another person, often of higher status, is in love with oneself.

142
Q

What is Cotard’s syndrome?

A

Belief that one is dead or does not exist.

143
Q

What is Capgras syndrome (delusion of doubles)?

A

Belief that a familiar person has been replaced by an identical imposter.

144
Q

What type of hallucination is the most common?

A

Auditory

145
Q

What are auditory hallucinations?

A

usually experienced as voices, whether familiar or unfamiliar, that are
perceived as distinct from the individual’s own thoughts

146
Q

What percentage of the general population experiences hallucinations related to sleep?

A

Up to 70% of the general population.

147
Q

What are hypnagogic hallucinations?

A

Hallucinations that occur as you are falling asleep.

148
Q

What are hypnopompic hallucinations?

A

Hallucinations that occur as you are waking up.

149
Q

What is the most common type of hallucination experienced during hypnagogic and hypnopompic states?

A

Visual hallucinations, such as geometric patterns, shapes, and light flashes.

150
Q

Approximately what % of people with schizophrenia experience negative symptoms?

A

25%

151
Q

What is avolition/apathy in the context of schizophrenia?

A

A lack of motivation or ability to complete tasks, and a general disinterest in life activities.

152
Q

What does alogia mean?

A

A reduction in the amount or content of speech; a symptom where a person doesn’t speak much and may appear unresponsive in conversation.

153
Q

Define anhedonia as a negative symptom.

A

The inability to experience pleasure from activities usually found enjoyable.

154
Q

What is asociality?

A

Lack of interest in social interactions and preference for solitary activities.

155
Q

Explain affective flattening.

A

Reduced expression of emotions through facial expression, voice tone, or body language.

156
Q

What is disorganized speech?

A

Disorganized speech is a symptom where the thinking process is difficult to follow, topics are loosely connected, and the speech may be tangential or circumstantial, making assessments challenging.

157
Q

What are the characteristics of disorganized movement in schizophrenia?

A

Disorganized movement can include catatonic behavior like stupor, stereotypy, and catalepsy, which are outlined in the DSM-5.

158
Q

What is an inappropriate affect?

A

Inappropriate affect refers to emotional expressions that are not congruent with the situation or context, such as laughing or crying without reason, or showing anger without a clear trigger.

159
Q

What does circumstantial speech refer to?

A

Circumstantial speech refers to a style of speaking where a person includes unnecessary details and struggles to get to the point.

160
Q

What does tangential thinking imply?

A

Tangential thinking implies that a person goes off on various unrelated tangents and does not answer the question directly or stick to the topic at hand.

161
Q

What is catatonia and its types?

A

Catatonia is a specifier for schizophrenia involving 12 types of movement difficulties, including stupor (no activity), stereotypy (repetitive movements), and catalepsy (limbs staying put when moved).

162
Q

What is an example of inappropriate affect in schizophrenia?

A

An example includes laughing or crying at times that don’t make sense or becoming angry without a clear or reasonable trigger.

163
Q

What is the DSM-5 criteria for Schizophrenia?

A

Two+ of the list of symptoms

Each present for a significant portion of time during a 1-month period

At least one of these must be (1), (2), or (3)

164
Q

What are the 5 symptoms of schizophrenia?

A
  1. Delusions.
  2. Hallucinations.
  3. Disorganized speech (e.g., frequent derailment or incoherence).
  4. Grossly disorganized or catatonic behavior.
  5. Negative symptoms (i.e., diminished emotional expression or avolition).
165
Q

What is the key feature for a schizophrenia diagnosis according to DSM-5 TR? (criterion A)

A

Presence of psychotic symptoms.

166
Q

What change in functioning is observed in schizophrenia?

A

Markedly below the level of functioning achieved prior to the onset in one or more major areas such as work, interpersonal relations, or self-care.

167
Q

How long must signs of disturbance persist for a schizophrenia diagnosis?

A

At least 6 months, with at least 1 month of active-phase symptoms.

168
Q

Which disorders must be ruled out before diagnosing schizophrenia?

A

Schizoaffective disorder and depressive or bipolar disorder with psychotic features.

169
Q

Can substance abuse or another medical condition be the cause for a schizophrenia diagnosis?

A

No, the disturbance must not be attributable to the physiological effects of a substance or another medical condition.

170
Q

What are the specifiers for the schizophrenia diagnosis regarding the number of episodes?

A

The diagnosis can specify the first episode or multiple (at least two) episodes.

171
Q

How is schizophrenia diagnosed in someone with a history of autism spectrum disorder or a communication disorder of childhood onset?

A

Only if prominent delusions or hallucinations are also present for at least 1 month.

172
Q

What does the specifier ‘continuous’ indicate in the context of schizophrenia?

A

The specifier ‘continuous’ indicates that symptoms meet the diagnostic criteria for the majority of the illness’s course, with only very brief periods of subthreshold symptoms relative to the overall course.

173
Q

What is catatonia?

A

Catatonia is when someone can’t move normally; they might stay very still, not talk, or move in a weird way, like repeating the same thing over and over. It’s like their body is stuck and they can’t control it right.

174
Q

How common is schizophrenia worldwide?

A

Schizophrenia affects about 1% of the population.

175
Q

Is schizophrenia a lifelong condition?

A

Yes, schizophrenia is generally a chronic condition managed throughout life.

176
Q

How does schizophrenia affect life expectancy?

A

People with schizophrenia have a life expectancy about 10 years shorter on average.

177
Q

What percentage of people with schizophrenia attempt suicide?

A

30% attempt suicide during their life.

178
Q

What percentage of people with schizophrenia die by suicide?

A

10% die by suicide.

179
Q

Do many people with schizophrenia smoke cigarettes?

A

Yes, more than 80% of people with schizophrenia smoke cigarettes.

180
Q

Is the cost of caring for schizophrenia high for healthcare systems?

A

Yes, it’s among the most expensive mental illnesses for healthcare systems.

181
Q

How common is it for someone with schizophrenia to also have depressive symptoms?

A

50% also have depressive symptoms.

182
Q

What percentage of people with schizophrenia have a substance use disorder?

A

47% also have a substance use disorder.

183
Q

What are the 3 phases of psychosis?

A
  1. Prodrome
  2. Acute
  3. Recovery
184
Q

What percentage of people with schizophrenia experience a prodromal stage?

A

85% of people with schizophrenia go through a prodromal stage.

185
Q

What are some examples of prodromal symptoms?

A

Disorganized thoughts, social withdrawal, sleep disturbance, suspiciousness, and an intense focus on particular ideas.

186
Q

How do prodromal symptoms affect a person’s risk for psychosis?

A

Prodromal symptoms put someone at an increased risk for psychosis.

187
Q

How long can the prodromal stage last before the full onset of a psychotic disorder?

A

2-10 years before the full onset of a psychotic disorder.

188
Q

What are some risk factors that can influence the progression from the prodromal stage to a full psychotic disorder?

A
  • Delaying help-seeking
  • Baseline functioning
  • Substance use
  • Rresence of negative and disorganized symptoms.
189
Q

What is considered the easiest phase to assess and diagnose in schizophrenia?

A

The acute psychotic episode

190
Q

What symptoms emerge and persist during the acute psychotic episode?

A

Positive symptoms like delusions and hallucinations.

191
Q

What can an acute psychotic episode result in?

A

Hospitalization

192
Q

How does early treatment impact the course of schizophrenia?

A

Early treatment, such as with anti-psychotic medication, can lead to a better response to treatment.

193
Q

When does the recovery phase of schizophrenia occur?

A

The recovery phase occurs after the symptoms of the acute psychotic episode have subsided.

194
Q

Do all symptoms of schizophrenia disappear during the recovery phase?

A

Some symptoms may fully disappear during the recovery phase, but some may persist.

195
Q

Is the recovery experience the same for all patients with schizophrenia?

A

No

196
Q

What are considered protective factors during the recovery phase?

A

Social support and adherence to treatment are considered protective factors during the recovery phase.

197
Q

The other disorders on the schizophrenia spectrum differ based on:

A

1) symptom type and severity

2) symptom duration

3) cause of symptoms, and

4) co-morbidity with other disorders

198
Q

What is Schizotypal personality disorder (SPD)

A

a mental health condition characterized by significant discomfort with and reduced capacity for close relationships, as well as cognitive or perceptual distortions and eccentricities in behavior

199
Q

For SPD, you need to have ____ or more of the list of symptoms

A

5

200
Q

What are common symptoms of Schizotypal Personality Disorder?

A

Symptoms include odd beliefs or magical thinking, unusual perceptual experiences, odd thinking and speech, suspiciousness or paranoid ideation, inappropriate or constricted affect, behavior or appearance that is odd, eccentric, or peculiar, lack of close friends or confidants other than first-degree relatives, and excessive social anxiety.

201
Q

What is Brief Psychotic Disorder?

A

Brief Psychotic Disorder is a mental health condition characterized by the presence of psychotic symptoms.

202
Q

How long does an episode of Brief Psychotic Disorder last?

A

An episode of Brief Psychotic Disorder lasts at least 1 day but less than 1 month.

203
Q

What is the expected outcome after an episode of Brief Psychotic Disorder?

A

After an episode of Brief Psychotic Disorder, an individual is expected to return to their premorbid level of functioning.

204
Q

Can Brief Psychotic Disorder be explained by other mental conditions?

A

No

205
Q

What are the specifiers that can be used with Brief Psychotic Disorder?

A

Specifiers for Brief Psychotic Disorder include “with and without marked stressor” and “peripartum onset.”

206
Q

What defines Schizophreniform Disorder?

A

The presence of psychotic symptoms similar to those of schizophrenia, but with an episode duration that lasts at least 1 month but less than 6 months.

207
Q

What are the specifiers used with Schizophreniform Disorder?

A

With or without good prognostic features

208
Q

What is delusional disorder?

A

The presence of one (or more) delusions with a duration of 1 month
or longer.
○ Criterion A for schizophrenia has never been met.
○ Note: Hallucinations, if present, are not prominent and are
related to the delusional theme

209
Q

What distinguishes the Grandiose type of delusional disorder?

A

A person believes they have exceptional abilities, wealth, or fame.

210
Q

What is the central theme of delusions in the Erotomanic type?

A

A person believes that someone else, often of higher status, is in love with them.

211
Q

What is the Jealous type of delusional disorder characterized by?

A

A person believes that their spouse or partner is being unfaithful without evidence.

212
Q

What belief is central to the Persecutory type of delusional disorder?

A

A person believes that they are being targeted for harm or harassment.

213
Q

What is the Somatic type of delusional disorder focused on?

A

A person feels that they have a physical defect or medical problem.

214
Q

When is the Mixed type of delusional disorder diagnosed?

A

A person has a mix of different types of delusions, with no single theme standing out

215
Q

What does the Unspecified type of delusional disorder mean?

A

A person has delusions that don’t clearly fit into any of the specific categories above.

216
Q

What symptoms characterize a Substance/Medication-induced Psychotic Disorder?

A

The presence of delusions or hallucinations (after taking drugs of some sort)

217
Q

What is schizoaffective disorder?

A

Schizoaffective disorder is a mental health condition that combines symptoms of schizophrenia with symptoms of a mood disorder, such as depression or bipolar disorder. This means that a person with schizoaffective disorder experiences psychotic symptoms (like hallucinations or delusions) along with significant mood episodes (periods of depression or mania).

218
Q

How long do the hallucinations and and delusions be persistent for?

(schizoaffective disorder)

A

2 weeks without a major mood episode during the lifetime duration of the illness

219
Q

What were the causes of psychosis before the 1980s?

A

Development factors

220
Q

What are some hypotheses of what causes psychosis?

A
  • Cat poop (toxoplasma gondii)
  • Fingerprint ridges
  • Eye-tracking differences
  • Living in cities
221
Q

What factors are MORE likely to cause psychosis?

A

Genes, dopamine, stress, social support

222
Q

What genetic component increases the chances of developing psychosis symptoms?

A

Monozygotic twins

223
Q

What is the evidence FOR dopamine’s role in psychosis symptoms?

A

Most anti-psychotic medications work by blocking dopamine in the brain

The negative side effects of anti-psychotic drugs are similar to Parkinson’s (which is caused by insufficient dopamine)

Drugs that treat Parkinson’s, increase
dopamine levels, which can cause psychosis

Amphetamines (e.g. crystal meth) and related drugs that work on dopamine (e.g. cannabis, cocaine) can lead to psychosis

224
Q

What is the evidence AGAINST dopamine’s role in psychosis symptoms?

A

Many people with schizophrenia do not
benefit from anti-psychotic medications that
influence dopamine

Anti-psychotic medications block dopamine quickly, but changes in symptoms are not seen for days or weeks

Anti-psychotic medications are only
somewhat helpful for negative symptoms

Clozapine is an extremely effective
medication for schizophrenia, but only acts weakly on dopamine

225
Q

What medication is prescribed for psychosis?

A

Second-generation anti-psychotics are
commonly prescribed (e.g. risperidone,
olanzapine)

226
Q

What medication is given for psychosis if other medications don’t work?

A

Clozapine

227
Q

What are some side-effects of anti-psychotic medications?

A

Metabolic problems (weight gain)

Sedation and grogginess

Clozapine: Lower white blood cell count/affecting immune system

Movement issues

228
Q

What are the big 5 factor theory of personality ?

OCEAN acronym

A

Extraversion

Agreeableness

Conscientiousness

Neuroticism

Openness to experience

229
Q

What is extraversion?

A

Extraversion is the tendency toward being predominantly concerned with and obtaining gratification from what is outside the self.

230
Q

What does the NEO-PI measure in relation to extraversion?

A

The NEO-PI measures six subscales of extraversion.

231
Q

What are the 6 subscales?

A
  1. Warmth
  2. Gregariousness
  3. Assertiveness
  4. Activity level
  5. Excitement-seeking
  6. Positive emotion
232
Q

What is the definition of Agreeableness in the context of personality traits?

A

Agreeableness is the state or quality of being pleasant, friendly, and cooperative in socializing with others.

233
Q

What is the definition of conscientiousness in context of personality?

A

Concerned with doing it RIGHT

234
Q

Subscales on the NEO-PI for conscientiousness

A

○ Self-efficacy
○ Orderliness
○ Dutifulness (Sense of duty)
○ Achievement striving
○ Self-discipline
○ Cautiousness

235
Q

What are the six subscales of Agreeableness according to the NEO-PI?

A
  1. Trust in others
  2. Morality
  3. Altruism
  4. Cooperation,
  5. Modesty
  6. Sympathy.
236
Q

What is neuroticism/Negative
Emotionality in terms of personality?

A

The tendency towards experiencing intense negative
emotions

One of the most robust predictive factors for experiencing a
mental health problem

237
Q

What are the subscales on the NEO-PI for neuroticism?

A

○ Anxiety
○ Anger
○ Depression
○ Self-consciousness
○ Immoderation/impulsiveness
○ Vulnerability to stress

238
Q

What is the openness to experience factor in terms of personality?

A

Enjoying trying new things, even when they are less practical

239
Q

What are the subscales on the NEO-PI for openness to experience?

A

○ Imagination
○ Artistic interest
○ Emotionality
○ Adventurousness
○ Curiosity
○ Liberal values

240
Q

What is self-monitoring?

A

A personality trait that determines how much people regulate their behaviour
based on the context

241
Q

Do high-self monitors adjust their behaviours based on who is around?

A

YES

242
Q

Do low-self monitors filter themselves based on context?

A

No

243
Q

What is the Myers-Briggs Type Indicator (MBTI)?

A

MBTI is a personality assessment tool that categorizes people into 16 personality types based on Carl Jung’s theories.

244
Q

What are the four dichotomies of personality according to the MBTI?

A
  1. Extraversion (E) vs. Introversion (I)
  2. Sensing (S) vs. Intuition (N)
  3. Thinking (T) vs. Feeling (F)
  4. Judging (J) vs. Perceiving (P).
245
Q

What does psychometric evidence suggest about the MBTI?

A

Psychometric evidence suggests that the MBTI has poor validity and reliability.

246
Q

What is the BARNUM/FORER effect?

A

people endorse vague and general information as highly accurate to their
specific circumstances

ASTROLOGY

247
Q

There are 10 distinct personalities in the DSM-5, one being PARANOID personality disorder, describe it

A

People with this disorder tend to be extremely distrustful and suspicious of others without sufficient basis. They often believe that others are trying to harm or deceive them.

248
Q

There are 10 distinct personalities in the DSM-5, one being SCHIZOID personality disorder, describe it

A

Individuals with schizoid personality disorder are detached from social relationships and often show a limited range of emotions in interpersonal situations

249
Q

There are 10 distinct personalities in the DSM-5, one being SCHIZOTYPAL personality disorder, describe it

A

These individuals display acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities in behavior

250
Q

There are 10 distinct personalities in the DSM-5, one being ANTISOCIAL personality disorder, describe it

A

Characterized by a disregard for, and violation of, the rights of others. Individuals with this disorder often have a history of criminal activity, lying, and exploiting others.

251
Q

There are 10 distinct personalities in the DSM-5, one being BORDERLINE personality disorder, describe it

A

Unstable relationships
Unstable identity
Impulsivity
Unstable affect

252
Q

There are 10 distinct personalities in the DSM-5, one being HISTRIONIC personality disorder, describe it

A

This involves a pattern of excessive emotionality and attention-seeking, including an excessive need for approval and inappropriate seductiveness.

253
Q

What treatment is used for histrionic personality disorder?

A

social skills training

psychodynamic therapy

254
Q

There are 10 distinct personalities in the DSM-5, one being NACISSISTIC personality disorder, describe it

A

Individuals believe they are superior or special and have a deep need for admiration. They often lack empathy for others and may exploit others to benefit themselves.

255
Q

There are 10 distinct personalities in the DSM-5, one being AVOIDANT personality disorder, describe it

A

Characterized by social inhibition, feelings of inadequacy, and hypersensitivity to criticism or rejection. These individuals often avoid social interaction for fear of not being liked.

256
Q

There are 10 distinct personalities in the DSM-5, one being DEPENDENT personality disorder, describe it

A

This disorder is marked by an excessive need to be taken care of, leading to clingy and submissive behavior and fears of separation.

257
Q

There are 10 distinct personalities in the DSM-5, one being OCD, describe it

A

Not to be confused with obsessive-compulsive disorder (OCD), this is a condition characterized by a preoccupation with perfectionism, control, and orderliness, which can lead to inflexibility and inefficiency in life.

258
Q

Cluster A: “odd” and “eccentric” personality disorders are….

A

paranoid

schizoid

schizotypal

259
Q

Cluster B: dramatic, emotional, erratic personality disorders are….

A

Borderline

Narcissistic

Histrionic

Antisocial

260
Q

Cluster C: anxious and fearful personality disorders include….

A

Dependent

Avoidant

OCD

261
Q

What personality disorders have the highest co-morbid rate?

A

Schizotypal and paranoid

262
Q

What is a categorical approach?

A

Personality disorders are clear categories and have a clear physiology and underlying cause

263
Q

What is a pro and con of diagnosing personality disorders?

A

Advantage: simplicity

Disadvantage: co-morbidity; overlapping symptoms

264
Q

What is a dimensional approach?

A

Personality traits exist on a
continuum: someone might be
mildly narcissistic or extremely
narcissistic

265
Q

What is the advantage of a dimensional approach?

A

captures the full range
of personality concerns

266
Q

what are disadvantages of a dimensional approach?

A

when does a
personality trait become a
“disorder”?

267
Q

What is a prototypical approach?

A

has elements of categorical and dimensional

268
Q

What are pros and cons of prototypical approach?

A

Advantage: captures a wide range of
personality traits

Disadvantage: the presentation of the
personality disorder may vary

269
Q

what is antagonism?

A

Antagonism describes behaviors that are hostile, aggressive, and unfriendly.

It includes attitudes such as manipulativeness, deceit, and arrogance.

Antagonistic behaviors are often the opposite of AGREEABLE behaviors

270
Q

What is disinhibition?

A

Impulsivity, risk-taking, lack of restraint, immediate gratification

It is opposite to conscientiousness in personality models

271
Q

What is psychoticism?

A

It’s a trait associated with a tendency for psychological detachment from reality.
Often linked to higher levels of creativity or nonconformity, in extreme cases, can indicate vulnerability to psychosis

opposite of lucidity

272
Q

What is lucidity?

A

Clarity of thought or expression.
Awareness and the ability to think rationally, often highlighted in contrast to confusion or delirium.

273
Q

What describes antisocial personality disorder?

A

Impairment in personality functioning, 2 or more of 4 descriptions:

Identity

Self direction

Empathy

Intimacy

274
Q

Which trait indicates a lack of concern for the feelings or problems of others?

A

Callousness (an aspect of Antagonism).

275
Q

Do people with schizoid personality disorder prefer be in groups or alone?

A

alone

276
Q

What treatment is used for paranoid personality disorder?

A

CBT

277
Q

Underarousal hypothesis

A

evidence that people with Anti-Social PD are chronically
understimulated

278
Q

Fearlessness hypothesis

A

people with Anti-social PD do not experience fear to the same degree as
other people

279
Q

What is the Dark Triad?

A

a concept in psychology that encompasses three personality traits: psychopathy, Machiavellianism, and narcissism.

280
Q

What is psychopathy

A

impulsive behavior

a lack of empathy or emotional coldness, and a lack of remorse

281
Q

What is machiavellianism

A

manipulative

Focused on their own interests

282
Q

What is narcissism

A

a sense of entitlement

a preoccupation with fantasies of unlimited success

power

brilliance

283
Q

What % of population has BPD?

A

1.6-5.9 %

10% die by suicide

76% report childhood sexual trauma

75% achieve full remission 6 years after treatment

284
Q

What’s a good treatment for BPD?

A

Dialectical behaviour therapy

285
Q

What are 4 components of dialectical behaviour therapy?

A

Distress tolerance

emotion regulation

interpersonal effectiveness

mindfulness

286
Q

What is a dependent personality disorder?

A

A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present

287
Q

What is an avoidant personality disorder?

A

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation,
beginning by early adulthood and present in a variety of contexts

288
Q

What is obsessive-compulsive personality disorder?

A

A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at
the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of
contexts

Psychopathology (3 decks)

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