Self Made Flashcards
What are the four main objectives of abnormal psychology?
Describing what behaviours are evident Explaining why it is evident Predicting outcome Managing behaviours that are considered abnormal #Lecture 1
What is the difference between incidence and prevalence?
Incidence = number of new cases of a disorder in a population in a specific time period Prevalence = total number of active cases in a given population during specific period of time #Lecture 1
What changes in psychology did the psychoanalytic revolution bring about?
Psychological factors affect behaviour
Talking treatment more effective than harsh physical and moral treatments
Behaviour influenced by thoughts, impulses and wishes (unaware of)
Non-psychotic disorders are worthy of treatment
#Lecture 1
What did the biopsychosocial framework (Meyer, 1940s) consider abnormal behaviour to be a combination of?
Biological factors (genetics, disease) Psychological factors (feelings) Social factors (family, social support structure) Environmental factors (quality of food and schooling, smog) Note: Posits that no single model can fully explain abnormal behaviour #Lecture 1
When were psychotropic drugs introduced, and how were they discovered?
When did deinstitutionalisation begin?
1930s and 1940s, and accidentally
1970s. Led to out-patient psychiatric clinics and community mental health centres
#Lecture 1
What is a symptom?
A manifestation of pathological condition. In some uses of the term it is limited to subjective complaints – also includes objective signs of pathological conditions (mood) #Lecture 1
What is a syndrome?
A group of symptoms that occur together that constitute a recognisable condition
In DSM-V most disorders are syndromes
Classification that lists a series of symptoms, like a checklist that must be met
#Lecture 1
What is the purpose of a classification system? What is the major problem with this approach?
Enables clinicians to diagnose a person’s problem as a disorder
Information retrieval
Facilitates research
Facilitates communication
Facilitates treatment selection (sometimes, not as straightforward as with other kinds of illnesses)
What are the major criticism of diagnostic practice?
Distinct entity vs continuum approach Results in labels and associated stigmas Issues with reliability and validity Affected strongly by bias #Lecture 1
List the types of clinical assessments and an example of each
Projective tests (Rorschach, Thematic Apperception); Personality inventory (Minnesota Multiphasic Personality Inventory (MMPI), California Psychological Inventory, Eysenck Personality Inventory); Intelligence Tests; Neuropsychological tests (CAT scan, EEG); Behavioural assessment (direct observation, self monitoring); Physiological assessment (skin conductance, sweat, etc) #Lecture 1
What is the scientist-practitioner approach of psychology
Psychologists use research findings to guide assessment, diagnosis and treatment of people with mental health disorders. Models are used to explain origins of abnormal behaviour, how to treat it and how to prevent it. #Lecture 2
What are the main five models of psychology?
Biological Psychodynamic Humanistic/existential Behavioural Cognitive #Lecture 2
What methods are used to determine if genetics plays a role in aetiology? (Biomedical model)
Pedigree (family history) Twin study (monozygotic and dizygotic comparison) Adoption studies Molecular genetics (is one allele more frequent in people with disorder?) #Lecture 2
What does serotonin do?
Serotonin system regulates behaviour, mood & thought processes
Low serotonin activity associated with Aggression, Suicide, Impulsive overeating, Hyper-sexual behaviour
#Lecture 2
What does Gamma Amniobutyric Acid (GABA) do?
Inhibits a variety of behaviours & emotions
Seems to reduce overall arousal (Anxiolytic effects)
Benzodiazepines make it easier for GABA molecules to attach themselves to the receptors of specialized neurons
#Lecture 2
What does noradrenaline do?
Induces alarm responses in dangerous situations #Lecture 2
What does dopamine do?
Merge and cross with serotonin circuits, relays messages to control movements, mood and thought processes #Lecture 2
In what situations could the endocrine system function aetiologically?
Prolonged stress- Hypothalamic-pituitary-adrenal-cortical axis is where hypothalamus and endocrine system interact and controls stress reactions, responsible for signalling prediction of adrenalin and cortisol #Lecture 2
What are the arguments against pharmacotherapy?
Peter Gøtzsche claims that they are a leading cause of death due to dishonesty in research and marketing, that few benefit from medications and that randomised control trials are bad. People with serious psychological issues tend to do better in developing countries than in developed countries #Lecture 2
What do the id, ego and super ego do?
Id: Biological instincts, pleasure principle and wish fulfilment Ego: reality principle, achieve what id wants in socially acceptable way, has defense mechanisms Super Ego: Conscience and ego ideal, what is the right thing to do #Lecture 2
How does the psychodynamic model suggest symptoms form and are removed?
Traumatic childhood experience leads to defence mechanisms that become symptoms over time Free association leads to recovery of material, then awareness and interpretation #Lecture 2
What is the Acceptance and Commitment Therapy (ACT) theory of change?
ACT uses mindfulness and acceptance process to produce greater psychological flexibility
Psych. problems originate from thought and language, triggering emotional pain and pysch. discomfort.
#Lecture 2
How does the humanist theory explain psychological disorders?
A lack of unconditional positive regard leading to self-deception and a distorted view of one’s experiences. #Lecture 2
What are Eugene Bleuler (1911)’s four core disturbances of schizophrenia?
Affect Ambivalence Associations Preference for fantasy over reality #Lecture 3
What is the average age of onset for male and female schizophrenic patients, and what percent of them attempt suicide?
Male: 15-25
Female: 25-35
50% attempt suicide
#Lecture 3
What are the characteristic symptoms of schizophrenia in the DSM-5 and what specific requirements are there?
- Delusions
- Hallucinations
- Disorganised speech
- Grossly disorganised or catatonic behaviour
- Negative symptoms (affect flattening, alogia, avolition)
Have to have two or more during one month, and one of them has to be 1, 2 or 3
#Lecture 3
What are the non-characteristic criteria for schizophrenia in the DSM-5?
Social Occupational Dysfunction
Duration continuous signs for 6 months
Schizoaffective & Mood Disorder Exclusion (Can’t also be schizophrenic)
Substance/general Medical Condition Exclusion (can’t also be schizophrenic)
Relationship to Autism Spectrum Disorder or a communication disorder
#Lecture 3
What are the different forms of association loosening?
Neologism (using words that are not words, made up) Perseveration (repeat a particular point over and over) Word salad (all the words being said are being jumbled together, unintelligible) Circumstantiality (going off topic and losing the point) Tangentiality (never get back to the point) #Lecture 3
What are the three different types of changed affect?
Restricted affect (less emotional expression) Blunted affect (more) Flat affect (none) #Lecture 3
What is the difference between catatonic stupor and catatonic rigidity?
Catatonic stupor (slowing or reduction in movement, may persist for long periods of times, may resist attempts to be made to move) Catatonic rigidity (adopt a singular position for a very long period of time; waxiflexibility is where a limb is moved and they stay where it has been moved.) #Lecture 3
What is the difference between the two types of schizophrenia?
Type I: (Sudden onset, Normal intellect, No brain damage, No negative symptoms, Good drug response) Type II: (Slower onset, Intellectual deterioration, Brain abnormality, Prominent negative symptoms, Poor drug response) #Lecture 3
What are the three phases of a schizophrenic episode, and their characteristics?
Prodromal phase
A minority have an abrupt onset, with rapid deterioration
Typically a long prodromal phase, gradual onset of symptoms
Some snap out, but with schizophrenia the person continues to deteriorate until it is seriously interfering with their life
Active phase
Active features of psychosis
Normal function is affected seriously
Potentially danger to themselves
Can be hospitalised until they improved
Residual phase
Some symptoms still present, less serious
#Lecture 3
What is the prognosis for a diagnosis of schizophrenia?
~ 20-30% are able to lead “normal” lives
~ 20-30% experience moderate symptoms
~ 40-60% remain significantly impaired
#Lecture 3
What did social skills training for schizophrenics have a moderate effect size for (3 things)?
Performance based measures of social and daily living skills
Community functioning
Negative symptoms
#Lecture 3
What is the difference between anxiety and fear?
Anxiety: Associated with the anticipation of future problems, Involves more general or diffuse emotional reactions, The emotional experience is out of proportion to the threat Fear: Experienced in the face of real, immediate danger, Usually builds quickly in intensity, Helps behavioral responses to real threats #Lecture 4
What are the essential features and specifiers for specific phobia?
Marked fear or anxiety about a specific object or situation
Exposure to the phobic stimuli invariably provokes immediate fear or anxiety
Phobic stimuli is actively avoided or endured with intense fear or anxiety
Fear or anxiety is out of proportion to the actual danger posed
Specifiers: Animal, Natural Environment, Blood-Injection, Situational
#Lecture 4
What are the essential features and clinical features of social anxiety disorder?
Essential Features:
Marked fear or anxiety about one or more social or performance situations in which the person is exposed to possible scrutiny by others
Fears that he or she will act in a way or show anxiety that will be negatively evaluated (humiliation, embarrassment, rejection, offend)
Other features:
Belief that others see them as inept, stupid, foolish
Often demonstrate a vicious cycle of anxiety social deficits anxiety; Hypersensitive to criticism; Non-assertive; Low self-esteem; Comorbid anxiety common; Safety behaviours common; Take ‘observer perspective’ vantage point for social memories; Information processing biases
#Lecture 4
What are the DSM-5 criteria for panic disorder?
Recurrent unexpected panic attacks
At least one attack has been followed by one month or more of the following:
1. Persistent concern about additional attacks or their consequences
2. Significant maladaptive change in behaviour (avoidance)
Rule out specific phobia/other conditions/attacks that are the direct result of a substance (i.e., drug abuse)
#Lecture 4
What are the features of a panic attack?
An abrupt surge of intense fear or discomfort, in which four or more of the following develop rapidly, and peaks within minutes: Palpitations/pounding heart, Sweating, Trembling/shaking, Sensation of shortness of breath, Feelings of choking, Chest pain or discomfort, Nausea or abdominal distress, Dizziness/lightheadedness, Chills/Hot flushes, Paresthesias (numbness/tingling), Derealisation (unreality)/Depersonalization (detached), Fear of losing control or going crazy, Fear of dying. #Lecture 4
What are the essential features of agoraphobia
Marked fear or anxiety about two or more of the following: 1. Using public transport 2. Being in open spaces 3. Being in enclosed places 4. Standing in line or being in a crowd 5. Being outside of the home alone Anxiety about being in places from which escape might be difficult or embarrassing in the event of having a panic attack #Lecture 4
What are the DSM-5 criteria for generalised anxiety disorder?
Excessive anxiety & worry about numerous events or activities
Difficulty in controlling worry
Experience three (or more) of the following:
1. Restlessness/on edge
2. Easily fatigued
3. Difficulty concentrating / mind blank
4. Irritability
5. Muscle tension
6. Sleep disturbance
Anxiety, worry or physical symptoms cause significant interference
#Lecture 4
List a couple obsessive-compulsive and related disorders.
Body dysmorphic disorder (fixated on one specific part of their body that they believe is flawed)
Hoarding disorder (as it sounds)
Trichotillomania (hair pulling disorder)
Excoriation
Substance/medication-induced obsessive-compulsive and related disorder
Obsessive-compulsive and related disorder due to another medical condition
Other specified obsessive-compulsive & related disorder
Unspecified obsessive-compulsive & related disorder
Obsessive-compulsive disorder (OCD)
#Lecture 4
What is an obsession, and what is a compulsion?
Obsessions
Thoughts, images or impulses
Repetitive, intrusive - uncontrollable (rebound effects)
Not just excessive worries about real life problems
Cause anxiety or distress
Compel the person to ignore, suppress or neutralize the obsessions in some way
Compulsions
Repetitive overt behaviors (handwashing, ordering, checking) or covert mental acts (praying, counting, repeating words)
Goals are usually to “undo” obsession, to prevent harm associated with obsession, or to alleviate anxiety.
However, these obsessions are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive
#Lecture 4
What are the DSM-5 Criteria for obsessive compulsive disorder?
Either obsessions, compulsions, or both
Obsessions or compulsions cause distress, are time consuming (>1 hour/day), or significantly interfere
Content of obsession or compulsion is not restricted to another Axis I disorder (e.g., food obsession in an eating disorder)
Not due to a substance or medical condition
Specify if with good or fair insight, with poor insight, with absent insight/delusional beliefs
#Lecture 4
What are the three forms of obsessions, and the three most common contents of obsessions?
Forms: Thoughts, images, impulses Content: contamination, pathological doubt, somatic obsessions #Lecture 4
What are the four most common compulsions?
Checking, washing, counting and need to ask/confess #Lecture 4
What are the DSM-5 Criteria for post-traumatic stress disorder?
Exposure to actual or threatened death or serious injury, or sexual violence via:
1. Directly
2. Witnessing
3. Learning about it happening to someone close or
4. Experiencing repeated or extreme exposure to aversive details (e.g., first responders)
Presence of one or more of the following intrusions:
1. Involuntary and intrusive distressing memories
2. Distressing dreams
3. Dissociative reactions e.g. flashbacks
4. Distress or reactivity to cues that resemble traumatic event
Avoidance of stimuli associated with the event
Negative alterations in cognitions and mood
Physiological arousal symptoms (two or more)
1. Irritability or anger outbursts
2. Reckless or self-destructive behaviour
3. Hypervigilance
4. Exaggerated startle response
5. Difficulty concentrating
6. Sleep disturbance
What are the DSM-5 Criteria for acute stress disorder?
Duration - symptoms last from three days to one month following exposure to traumatic events
Nine or more symptoms from any of the five categories:
Intrusive symptoms
Negative mood
Dissociative symptoms
Avoidance symptoms
Arousal symptoms
Clinically significant distress or impairment
#Lecture 4
What are the DSM-5 Criteria for adjustment disorder?
Marked emotional or behavioural symptoms in response to an identified stressor occurring within three months of onset of stressor
Distress is out of proportion to the severity or intensity of the stressor
Significant impairment in functioning
Does not meet criteria for another mental disorder
Not normal bereavement
Once stressor or consequences have terminated, symptoms do not persist for more than an additional six months
#Lecture 4
How does the psychodynamic perspective explain anxiety aetiology?
Anxiety arises from psychic conflict between unconscious sexual or aggressive wishes, and corresponding threats from the superego #Lecture 4
What is the evolutionary perspective of anxiety aetiology?
Anxiety developed as a means of enabling protective behaviour to be activated at appropriate times; anxiety part of an adaptive system
Anxiety disorders – problems in regulation of system which evolved to deal with particular threat
#Lecture 4
How heritable are anxiety disorders?
Moderately to modestly heritable across different disorders. Agoraphobia highest. #Lecture 4
What is the current psychological perspective on anxiety disorder aetiology?
Classical conditioning explains development, operant conditioning explains maintenance; modelling explains some development not caused by experience. Maladaptive cognitive processes cause people to misinterpret ambiguous situations as dangerous, bias attention to threat. Begin to fear fear. #Lecture 4
How is anxiety treated?
SSRIs (antidepressants helping increase serotonin levels)
Interpersonal psychotherapy targeting interpersonal conflicts (for social anxiety and PTSD)
CBT: psychoeducation, relaxation, cognitive techniques, exposure therapy
#Lecture 4
What is mood?
“A pervasive and sustained emotional response that can color perception” (APA, 2013)
What are the symptom domains of bipolar disorder?
Manic mood and behaviour Psychotic symptoms Dysphoric/negative mood and behaviour Cognitive symptoms #Lecture 5
What are the criteria for a manic episode?
Distinct period of abnormally and persistently elevated, expansive or irritable mood & goal-directed activity, energy – at least one week
Three or more of the following:
1. Inflated self-esteem/grandiosity
2. Decreased need for sleep
3. Increased speech, talkativeness, or pressure of speech
4. Flight of ideas or racing thoughts
5. Distractibility – reported or observed
6. Increased goal-directed activities or psychomotor agitation
7. Excessive involvement in pleasurable activities with high potential for painful consequences
Marked impairment in functioning or needs hospitalization or psychotic features
Not due to effects of substances or another medical condition
#Lecture 5
What are the criteria for a hypomanic episode?
Meets most of the criteria for Manic episode, except not as severe:
1. Lasts only for four consecutive days
2. Associated with a change in functioning that is uncharacteristic
3. Observable to others
4. Not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalisation, and no psychotic features
#Lecture 5
What are the criteria of a major depressive episode?
Five (or more) present during same two week period and represents change from previous functioning; at least one of the symptoms is either (I) depressed mood or (II) loss of interest or pleasure
1. Depressed mood
2. Diminished interest or pleasure
3. Significant weight loss
4. Insomnia or hypersomnia
5. Psychomotor agitation or retardation
6. Fatigue
7. Feelings of worthlessness or excessive/inappropriate guilt
8. Diminished ability to concentrate/indecisiveness
9. Recurrent thoughts of death/suicidality
Cause clinically significant distress or impairment in functioning
Not attributed to substance or another medical condition
#Lecture 5
What are the differences between bipolar I and bipolar II?
BIPOLAR DISORDER I
Most recent episode: Hypomanic, Manic, Depressed or Unspecified
BIPOLAR DISORDER II
One or more Major Depressive episodes accompanied by at least one Hypomanic episode; Never had a manic episode
#Lecture 5
What is cyclothymic disorder?
A mild form of bipolar disorder
At least a two year period (one in children/adolescents): hypomanic symptoms and depressive symptoms but do not reach episodes
Not without symptoms for two months in the two year (one year) period
1/3 develop a major mood disorder (Bipolar I)
#Lecture 5
What are good prognosis for bipolar disorder?
Short duration of manic episodes Older age of onset Few suicidal thoughts Few co-existing psychiatric/medical problems No depressed/mixed symptoms #Lecture 5
What are the criteria for persistent depressive disorder?
A. Present for at least two years (one year in children & adolescents)
B. Presence, while depressed, of two or more of the following
1. Poor appetite or overeating
2. Insomnia or hypersomnia
3. Low energy or fatigue
4. Low self-esteem
5. Poor concentration or difficulty making decisions
6. Feelings of hopelessness
C. Not without symptoms for a two month period
D. MDD may be present for two years
E. Never met manic episode, hypomanic or cyclothymic disorder
F. Not better accounted for by another disorder
G. Not attributed to substance or another medical condition
H. Causes clinical significant distress or impairment
#Lecture 5
What is the suicide risk for those with unipolar or bipolar mood disorders, and how many times the general population risk is this?
15%, 30x general population #Lecture 5
What disorders are frequently comorbid with depression?
Eating disorders Personality disorders Schizophrenia Alcohol and drug abuse Anxiety disorders #Lecture 5
How long does a typical treated and untreated depressive episode last?
Treated: ~3 months
Untreated: 6-13 months
#Lecture 5
How does the reduced positive reinforcement theory (1975) explain depression?
Depression occurs as a result of a reduction in response-contingent positive reinforcement
This reduction may occur when:
The probability that the individual’s behaviour will be followed by reinforcement is low OR
The probability that the individual will be reinforced when he does not emit the behaviour as high
Three ways in which insufficient reinforcement may occur:-
Environment produces a loss of reinforcement
Lack of requisite skills
Unable to enjoy or receive satisfaction from reinforcement
#Lecture 5
What is Beck’s cognitive model (1979) and how does it explain mental illnesses (e.g. depression)?
Negative Triad (Pessimistic view of self, world, & future) ↓ ↑ Negative Schemata or Beliefs Triggered by Negative Life Events (e.g., the assumption that I have to be perfect) ↓ ↑ Cognitive Biases (e.g., arbitrary inference) ↓ DEPRESSION #Lecture 5
How do the neurochemical theories of depression explain it aetiologically?
Excess (especially noradrenaline) causes mania and too little causes depression, serotonin also linked. Too simple a hypothesis to explain various differences in expression. #Lecture 5
Why has elector-convulsive therapy for treating depression declined, and when is it still used?
An invasive procedure, Past abuses, Medical complications, Effectiveness of antidepressants
Used when:
Prominent psychotic or melancholic features
Severe depression doesn’t responded to medication
Severe life-threatening situations require rapid response
Prior clinical response to ECT +ve
#Lecture 5
