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Psychopathology 1 > Test 2 > Flashcards

Test 2 Flashcards

1
Q

Bipolar disorder core symptoms

A

Dysregulation of mood and energy

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1
Q

3 major aspects of functioning impacted by bipolar disorder

A
  1. Emotion - now called mood
  2. Intellect - now called cognition
  3. Volition - now called energy level
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2
Q

Hypomania vs mania

A

Hypomania - clear change from usual functioning, but not extreme enough to cause impairment: functioning in school. Duration requirement is shorter. 4 consecutive days. Not severe enough to warrant hospitalization.

Mania: 1 week or severe enough to warrant hospitalization.

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3
Q

Atypical depression: bipolar

A

Hypersomnia instead of insomnia
Increased appetite instead of decreased
Weight gain instead of loss
Motor retardation
Decreased energy
Rejection sensitivity

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4
Q

Bipolar I

A

Occurrence of at least 1 lifetime manic episode

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5
Q

Bipolar II

A

Best considered a form of depressive illness
Meet full criteria for a hypomanic and major depressive episode

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6
Q

Comorbidities with PDD

A

Depression
Psychosis
ADHD
Disruptive behavior disorders / ODD, CD
Anxiety
Pervasive developmental disorders/Autism spectrum disorder
Obesity and metabolic syndrome
Substance misuse

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7
Q

Mood disorders in the DSM-5 TR

A
  • Major Depressive Disorder
  • Persistent Depressive Disorder
  • Premenstrual Dysphoric Disorder
  • Disruptive Mood Dysregulation Disorder
  • Bipolar I *gen risk
  • Bipolar II *gen risk
  • Cyclothymic Disorder *gen risk
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7
Q

Two key moods and what they’re characterized by

A

Depression: feelings of extraordinary sadness and dejection

Mania: intense and unrealistic feelings of excitement and euphoria

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8
Q

Depression presentation in younger children

A

Lack vocabulary and self-awareness to specify feelings: mood and behavior might be irritable rather than sad

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9
Q

Unipolar depressive disorder

A

A person experiences only depressive episodes

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10
Q

Bipolar disorder

A

A person experiences both depressive and manic episodes

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11
Q

Depressive episode

A

Feeling markedly depressed for at least 2 weeks

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12
Q

Manic episode

A

Markedly elevated, expansive, or irritable mood for at least 4 days

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13
Q

Hypomanic episode

A

Abnormally elevated, expansive, or irritable mood for at least 4 days; the person must also have 3 other symptoms similar to those involved in mania

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14
Q

What is the most common mood disorder?

A

MDD in which only major depressive episodes occur

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15
Q

MDD DSM-5 adults vs children

A

Essentially the same, but children might present irritably rather than with depression

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16
Q

MDD Criteria

A
  1. Must be in a major depressive episode, and never had a manic, hypomanic, or mixed episode
  2. Depressed mood and/or loss of pleasure (anhedonia). In kids, this could be irritable mood.
  3. Lasts most of the day, nearly every day, for 2 weeks at least
  4. Four other physical or cognitive symptoms
    —–> Indecisiveness
    —–> Worthlessness
    —–> Fatigue
    —–> Appetite change
    —–> Psychomotor agitation or feeling slowed down
    —–> Sleep disturbance
    —–> Recurrent thoughts of death/suicide ideation/play/attempt
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17
Q

Developmental considerations of MDD in children

A
  1. More somatic complaints for kids
  2. Hypersomnia -> adolescents
  3. Boys: greater risk of suicide in late adolescence
  4. Girls at higher risk of suicide in middle adolescence
  5. Teens -> more fatigue, hypersomnia, suicidal thoughts, hopelessness/helplessness, weight loss
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18
Q

MDD most common age of onset for the first episode

A

Middle to late adolescence

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19
Q

PDD (dysthymia) age of onset

A

11 y.o

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20
Q

Prognosis re: age of onset, MDD

A

When diagnosed as adolescents, course tracks with MDD

For younger children, an early diagnosis might = a different symptom course (could become another condition during adulthood)

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21
Q

MDD Prevalence

A

Rare in childhood, rises in teen years

Pre-K: 1-2%
School age kids: 2.8%

22
Q

Gender differences MDD

A

Similar rates in childhood

12-15: rates for girls increase dramatically

Early maturing girls are at higher risk compared w/peers

Girls: more stress in general

23
Q

DSM Specifiers: MDD

A

With melancholic features

With psychotic features

With atypical features

With catatonic features

With seasonal pattern

24
Q

MDD with melancholic features

A

3 of the following

Early morning awakening, depression worse in morning, marked psychomotor agitation/retardation, loss of appetite or weight, excessive guilt

25
Q

MDD with psychotic features

A

Delusions or hallucinations that are usually mood congruent; feelings of guilt and worthlessness common

26
Q

With catatonic features

A

Psychomotor symptoms like motoric immobility and extensive psychomotor activity

Mutism
Rigidity

27
Q

MDD with atypical features

A

Mood reactivity - brightens to positive events

2 of the 4:
1. weight gain or increase in appetite
2. hypersomnia
3. leaden paralysis
4. acutely sensitive to interpersonal rejection

28
Q

With seasonal pattern

A

2+ episodes in 2 years occurring at same time - usually fall/winter - with full remission at the same time - usually spring

No other nonseasonal eps

29
Q

Persistent Depressive Disorder

A

Persistently depressed mood most of the day, for more days than not, for at least 2 years

30
Q

PDD “double depression”

A

chronic basis, but also times where person also meets MDD critera

31
Q

Disruptive mood dysregulation cannot coexist with

A

ODD
IED
BPD

32
Q

Disruptive mood dysregulation disorder can coexist with

A

MDD
ADHD
CD
SUD

33
Q

What is disruptive mood dysregulation disorder?

A

New to the DSM
Created due to excessive diagnosis of Bipolar Disorder
Symptoms: pronounces and frequent temper outbursts with rage, persistently angry mood
CONTROVERSY- really depressive? Too much like ODD/CD?

34
Q

Suicidality stats

A

15-25% of youth report ideation - not uncommon

1-4% of boys attempt, 1.5-10% of girls

Completed suicides higher for boys

Depression cited in 40% of completed suicides. Rates higher with substance use and behavior disorders

35
Q

Screening for depression

A

PHQ-9 often used in primary care/outpatient settings

36
Q

Depressive symptoms exist on a

A

continuum. DSM can give the impression of “having it” or “not having it”

37
Q

Alternative diagnosis if there is an identifiable stressor within 3 ms on symptom onset

A

Adjustment disorder w/depressed mood

38
Q

Negative affectivity is

A

HIGH in anxiety and depression

39
Q

Positive affectivity is

A

LOW in depression

40
Q

Physiological Hyperarousal

A

associated with panic disorder

41
Q

PANIC DISORDER

A

Recurrent, spontaneous, unexpected panic attacks for 1 ms

Panic attack
Change in behavior
Palpitations, pounding heart, accelerated heart rate
Sweating
Trembling or shaking
Sensations of shortness of breath, smothering
Choking sensation
Nausea, or abdominal distress
Dizzy, unsteady, light-headed, faint
Chills or heat sensations
Derealization or depersonalization
Fear of dying
Fear of losing control or going crazy

42
Q

Cues in panic disorder

A

Interoceptive cues: internal, like increased HR and physiological arousal

Exteroceptive cues: environmental cues like being in a crowd or a social situation

Physiological symptoms become a CONDITIONED STIMULUS that precedes the next attack; this increases anxiety and this spiral leads to a panic disorder
Example: running up the steps, HR picks up, conditioned stimulus leads to a panic attack
Unlearning the connection - you can have the symptoms without having a panic episode

43
Q

AGORAPHOBIA

A

Fear or anxiety of being in situations where escape would be difficult if incapacitating or embarrassing symptoms occur, 6 months, more common in females

Fear or anxiety of 2+ situations

Using public transport
Open spaces
Closed spaces
Standing in line/crowd
Being outside of the home alone
Fears/avoids these situations bc escape doesn’t seem possible

Almost always provokes fear or anxiety
Out of proportion
Avoided, need a companion, or endure with intense fear/anxiety
Persistent, 6 ms more
Clin. sig distress or impairment
Not better explained by another med condition
Not better explained by another mental disorder

44
Q

SPECIFIC PHOBIA

A

Marked fear or anxiety cued by specific objects or situations, 6 months, more common in females

Disproportionate fear of an object or situations
Any danger proposed does not provoke the level of fear in most people
The object is avoided or endured with great distress
Associated fear = major distress, impairment in functioning
6 ms duration

45
Q

PHOBIA SPECIFIERS

A

Animal (wasps)
Natural environment
Situational (flying, bridges, tunnels, elevators, ESCALATORS, automatic toilets)
Blood-injury-injection (physiological factors)
Other (clowns, loud noises, etc)

46
Q

SOCIAL ANXIETY DISORDER

A

Marked fear or anxiety cued by social or performance situations, 6 months, more common in females

Anxiety in one or more social situations with possible scrutiny by others

Fears he/she will act in a way or show anxiety symptoms that will be neg evaluated

Social situations almost always provoke fear/anxiety - Crying, tantrums, clinging

Social situations avoided or endured w/intense fear or anxiety

Out of proportion

Persistent, 6ms or more

Not attributable to substance

Not attributable to another mental disorder

Not attributable to another visible medical condition
Specify if: performance only

47
Q

GENERALIZED ANXIETY DISORDER

A

6ms
Excessive anxiety or worries about a number of events or activities

Excessive anxiety or worries (…)
Difficult to control the worry

3 or more of the following 6 symptoms

Restlessness, feeling keyed up or on edge
Easily fatigued
Difficulty concentrating or mind going blank
Irritability
Muscle tension
Sleep disturbance
Cause clinically significant stress/impairment, not due to substance effect, not better explained by another mental disorder

48
Q

SEPARATION ANXIETY DISORDER (SAD)

A

Excessive anxiety concerning separation from home or caregiver, 4 weeks for children/adolescents, 6 months for adults, more common in females

3 of the following

Distress when anticipating sep.
Persistent and excessive worry about losing figure
Refusal to go out, away from home, to work, elsewhere
Persistent and excessive fear of being alone or w/out figure
Nightmares, theme of sep.
Physical symptoms

Clin. sig distress, impairment
Not better explained by another mental disorder
Take developmental norms into account

49
Q

SELECTIVE MUTISM

A

consistent failure to speak in certain situations but not in others, 1 month grace period, equal gender distribution

Consistent failure to speak in certain (…)
Interferes with achievement or social com
Not due to lack of knowledge re: spoken language
Not attributable to a communication disorder, autism, schizophrenia, or another psychotic disorder

50
Q

RELATED disorders to OCD

A

Related: body dysmorphic, hoarding, trichotillomania & excoriation - picking at skin

51
Q

OCD

A
  1. Recurrent and persistent thoughts, urges or images that are intrusive and unwanted
  2. to ignore or suppress such thoughts with a compulsion
  3. Repetitive behaviors in response to an obsession
  4. Behaviors/mental acts aimed at preventing/reducing distress but are excessive/not connected
  5. Obsessions/compulsions are time consuming
  6. Not better explained by another disorder
  7. Not due to a substance
52
Q

BODY DYSMORPHIA

A

Preoccupation with one or more defects or flaws in physical appearance that are small or not noticeable to others
Repetitive behaviors
Significant distress
Preoccupation with body not better explained
May spend several hours a day checking body for defects

53
Q

PANDAS

A

PANDAS syndrome describes a group of symptoms, such as tics and obsessive-compulsive behavior, thought to affect certain children who’ve had strep infections.

Psychopathology 1 (2 decks)

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