Test 2 Flashcards
what are the 2 components of mood disorders?
- depression
- mania
what is a major depressive episode (mde)?
not the symptoms, but the brief outline of the disorder
- lowest end of the spectrum
- 2 week period, 5 or more of the symptoms
what are the 9 symptoms of a major depressive episode?
- depressed mood most of the day, nearly everday
- dimished interest/pleasure
- changes in apetite/weight
- changes in sleep patterns
- pychomotor retardation/agitation
- fatigue/loss of energy
- feelings of worthlessness or inappropriate guilt
- dimished concentration/ability to make decisions
- recurrent thoughts of death or suicide
if you have no history of mania or hypomania, and you have only 1 MDE, what does this result in?
major depressive disorder single episode
if you have no history of mania or hypomania, and you have more than 1 MDE, what does this result in?
major depressive disorder recurrent
the likelihood of having another mde ____ the more you experience them
increases
1e - 50% | 2e - 70% | 3e - 90%
what is dysthymic disorder? what is another name for it?
not the symptoms, but the brief outline of the disorder
- depressed mood most of the day, more tha not, for at least 2 years
- during a 2 year period, person has never been without symptoms for more than 2 months at a time
- aka persistent depressive disorder in the dsm-v
what are the 6 symptoms of dysthymic disorder?
- poor appetite or overeating
- insomnia or hypersomnia
- low energy or fatigue
- low self-esteem
- poor concentration or difficulty making decisions
- feelings of hopelessness
presence, while depressed, of 2 or more ^^^
what is double depression?
persistent depressive disorder + major depressive episode = double depression
what is mania/a manic episode?
- distinct period of abnormally elevated, expansive, or irritable mood
- abnormally and persistently increased goal-directed activity/energy
- must occur for more than one week OR have been hospitalized
what are the 7 symptoms of a manic episode?
- inflated self-esteem or grandiosity
- decreased need for sleep
- more talkative than usual/pressure to keep talking
- racing thoughts (“flight of ideas”)
- distractability
- increase in goal-directed activity
- excessive involvement in pleasurable activities with a potential for negative consequences
markes impairment in social and occupational functioning
what is hypomania/a hypomanic episode?
- one step down from mania
- same critieria BUT…
- must persist for 4+ days and have NOT been hospitalized
what are the symptoms for hypomania?
- same as mania
- does NOT cause marked impairment
what are the 2 types of bipolar I disorder?
- one or more manic episode(s) only
- mde and manic episodes
- stretches across the spectrum
what is bipolar II disorder?
presence of history of mde and hypomania (not mania)
what is cyclothymic disorder?
- hypomanic + depressive symptoms
- pattern lasts at least 2 years (1 year for children)
- one step down from bipolar I (does not include the extreme ends)
what are the biological factors that cause mood disorders?
- genetic predisposition
- nt imbalances: serotonin, norepinephrine, domapnie (too much = mania, too little = depression)
- endocrine system: cortisol
- sleep disruption: destablizes mood
what are the psychological factors that cause mood disorders?
- stressful life events
- learned helplessness
- pessimism
- neuroticism
which medication is used to treat depressive disorders?
- those that inhibit reuptake of nts
- tycyclic antidepressants
- monoamine oxidase inhibitors
- SSRIs
which medication is used to treat bipolar disorders?
- lithium: regulates rate of neurotransmission
- valproate: increases GABA
what are psychological treatments for mood disorders? specially those that target behaviour.
- behaviour activation: building mastery, pleasure, self-efficacy
- sleep
- routine
- medication adherence
what are psychological treatments for mood disorders? specially those that target cognitive.
target the negative and biased thinking
risk of suicide is ____ among those with mood disorders
which disorder, particularly?
significantly increased, particularly in bipolar
what are the risk factors associated with suicide and mood disorders?
- male gender
- history of previous suicide attempts
- comorbid substance use
- periods of severe depression or mania
- feelings of hopelessness or worthlessness
- lack of social support
what is the difference between pessimism and neuroticism?
- P is a way of thinking, N is a personality trait that influences emotional regulation
- P fuels hopelessness and depression
- N makes individuals emotionally reactive and prone to anxiety, depression, and mood swings
emotional disorders occur ____ after a traumatic inccident
one month
what are ‘criterion a’ stressors?
exposure to actual or threatened death, serious injury, or sexual violence through direct exposure, witnessing, learning that it happened to a close relative/friend or indirect exposure to aversive details of the trauma
who are more likely to experience indirect exposure of a traumatic experience?
- therapists
- first responders
what are the 4 PTSD symptom categories?
- re-experiencing
- avoidance
- negative changes to mood and cognition
- reactivity
explain the ‘re-experience’ component/symptom of ptsd
- nightmares, intrusive memories, flashbacks
- e.g., a car accident survivor hears a car horn and suddenly feels as though they are back in the crash
explain the ‘avoidance’ component/symptom of ptsd
- avoidance of the feelings or reminders of the event through emotional numbing, avoiding people/places/circumstances
- e.g., a first responder who witnessed a tragic event at work starts avoiding certain parts of the town where it occured
explain the ‘negative changed to mood and cognition’ component/symptom of ptsd
- affects thoughts, emotins, and beliefs about oneself, others, and the world
- e.g., a police officer feels emotionally detached and unable to feel joy, even in positive situations
explain the ‘reactivity’ component/symptom of ptsd
- disturbed sleep, hypervigilance, increased startle response
- e.g., a shooting survivor umps or panics when hearing fireworks or loud noices
what are the 2 ptsd specifiers?
- with delayed expression
- with dissociative symptoms
what is delayed expression in ptsd?
- symptoms do not fully appear until at least 6 months after the traumatic event
- some surpress or disconnect from the trauma until a trigger brings them to the surface
- trigger for onset may be a lack of distraction (e.g., retirement)
what are dissociative symptoms of ptsd?
applies when an individual with ptsd experiences dissociation in response to trauma
what is dissociation?
- a disconnection between thoughts, memories, identity, emotions, and perception of reality
- depersonalization/derealization
- coping mechanism to help manage extreme distress or overwhelming emotions
- normative to disordered
not a single disorder, but a symptom that appears in various disorders
what is depersonalization?
- feelinng detached from oneself
- e.g., i feel like i’m watching myself from the outside
what is derealization?
- feeling like the world isn’t real
- e.g., everything looks foggy or dreamlike
what are causes for ptsd?
- anxious predisposition
- intensity and severity of trauma
- lack of social support
- brain changes explain why ptsd patients stuck in their trauma and react strongly to reminders
how does an overactive amygdala change/affect ptsd?
- excessive fear responses
- hypervigilance
- emotional deregulation
how does a shrinking in hippocampus change/affect ptsd?
- flashbacks
- memory gaps
- difficult separating past/present
what is neuroplasticity and how is it a ptsd maintenance factor?
- brain adpats to trauma by reinforcing fear pathways in the amygdala and weakening memory regulation in the hippocampus
- repeated stress exposure keeps these circuits active
- avoidance behaviour reinforce these changes by preventing reprocessing of traumatic memories
what are some ptsd psychological treaments?
- imaginal exposure with relaxation training
- eye-movement desensitization and reprocessing (EMDR)
- retrain brain
what is imaginal exposure with relaxation training?
- clients mentally revisit traumatic events in a safe setting while practicing relaxation techniques
- helps reduce avoidance, desensitize emotional distress, and reprocess trauma
what is eye movement desensitization and reprocessing?
- clients recall traumatic memories while following bilateral stimultion (eye movements, tapping)
- helps the brain reprocess trauma and reduce emotional intensity
how can you retrain your brain as a ptsd treatment?
- reducing amygdala hyperactivity (lowering fear response)
- strengthening hippocampal function (improve memory processing)
- rewiring trauma memories from survival mode (amygdala) to rational processing (pre-front cortex)
- allowing new, adaptive beliefs to replaces fear-based thinking
what are the biological treatments for ptsd?
- SSRIs
- Repetitive Transcranial Magnetic Stimulation (rTMS)
how does ssri treat ptsd?
regulate brain’s overactive fear response and mood alternations
what is a repetitive transcranial magnetic stimulation?
- magnetic pulses stimulate underactive brain regions associated with ptsd symptoms
- strengthens connections between the prefrontal cortex (thinking brain) and the amygdala (fear center) to improve emotional regulation and reduce hyperarousal
what is an acute stress disorder?
- occurs up to 1 month after a traumatic event
- can be short-term ptsd precursor
- may reslve and not lead to ptsd, but is a significant risk factor (40-80%)
what is an adjustment disorder?
- emotional and/or behvaioural reactions to life stress (divorce, job loss, move) that is out of proportion to the stressor
- may include depression, anxiety, and connduct problems (e.g., aggression, rule breaking)
what is complex-ptsd?
- caused by prolonged exposure to traumatic events, often interpersonal in nature (long-term abuse)
- includes symptoms of ptsd + emotional dysregulation, interpersonal problems, complex changes in self-concept (e.g., lacking identity)
which type of ptsd is not currently recognized in the dsm-5-tr? where is it recognized?
complex-ptsd, and is recognized in the icd-11
how does complex-ptsd impact relationships?
problems with trust, intimacy, and a tendency
to avoid relationships or to seek out unhealthy relationships
what is a treatment for complex ptsd?
May require longer-term psychotherapy that focuses on coping with traumatic memories + improving emotional regulation, self-concept, and relationship skills (eg., DBT)
what are the 3 criteria for anorexia nervosa (a.n.)?
- dietary restriction -> low body weight (guideliine is less than 18.5 BMI, severity level is based on weight)
- intense fear of weight gain or becoming fat OR behaviours that inerfere w/ weight gain
- disturbed perception of body OR undue influence of body on self-evaluation OR denial of seriousness of low weight
what are the 2 sub-types of anorexia nervosa?
- restrictive type (AN-R)
- binge-purge type (AN-BP)
what is the restrictive type of anorexia nervosa?
- restrictive eating as hallmark
- absence of regular bingeing of purging
- compulsive exercise common
what is the binge-purge type of anorexia nervosa?
- recurrent binges AND/OR
- recurrent purging
what are the issues with the bmi criteria?
- binge-purge frequency should be considered as electrolyte imbalances, psychological distress and behaviours
- rapid weight loss can be unhealthy, even if BMI is still in the “normal” range
- delay diagnosis, discourage treatment, overlook serious cases (they don’t look “sick/thin enough”)
in bulimia nervosa, what is a binge?
- time frame: unusually large amount of food in a 2-hr time span
- quantities: unusually large amount of food, generally high-fat, high-calorie
- loss of control: where the person cannt stop themselves from overeating
what is bulimia nervosa (BN)?
- recurrent binge eating
- recurrent inappropriate compensation (e.g., laxative use, fasting, vomiting, excessive exercise)
- over-evaluation of shape and weight
- anorexia nervosa criteria not met (weight)
- often restricted eating outside of binges
- 1 time a week for 3 months
what is binge eating disorder?
- recurrent binge eating episodes
- marked distress about binge eating
- no recurrent inappropriate compensation
- 1 time a week for 3 months
what are some associated features with eating disorders?
- mortality: highest of all psych disorders since suicide is most common cause of death followed by cardiac arrest
- cardiac problems: electrolyte imbalances, prolapse, reduced muscle mass, slowed heart rate
- dental problems: stomach acid coming up due to purge
- anemia
- comorbid psych disorders
what is the prevalence in eating disorders/related disorders in men?
- around 25% of individuals with eating disorders are men, though underdiagnosis is common
- men are less likely to seek treatment due to stigma and misconceptions
what is the differences in presentation in eating disorders/related disorders in men?
- more likely to focus on muscle gain, leanness, and control over physique
- especially true in gay communities and athletes
- gay and bisexual men: 7x more likely to develop an eating disorder
- may engage in excessive exercise, supplement use, and rigid dieting
what type of eating disorder is most common in men?
body dysmorphic disorder with muscle dysmorphia
how do men have barriers to treatment in eating disorders?
- social stigma: eating disorders are seen as a “female issue”
- medical professional may overlook symptoms in men
- less research and targeted treatment approaches for men with EDs
what are the main causes for the glorification of thinness?
- media and advertising
- health and fitness culture
- cultural and social rewards
accompanied by the stigmatization and discrimination against larger body
adolescent girls who diet have ____ times the changes of developing ____ within ____
18, an eating disorder, 6 months
what can food restriction lead to?
- food obsession
- binge eating
- rapid weight gain
- impair cognitive functioning
what are the biological factors associated with eating disorders?
what are the key findings in twin studies?
- both AN and BN have more than 50% heritability
- higher condorance in monozygotic twins than in dizygotic twins
- genetic factors contribute to personality traits linked to EDs (e.g., perfectionism, impulsivity, anxiety)
what are the psychological factors in eating disorders?
- developmental experiences: high control or family relationships/attitudes, criticism or pressure
- trauma and abuse: trauma survivors may develop eating disorders due to shame, negative body image and/or as a way to cope
- peer pressure and comparison culture, especially during adolescence
how can personality associate with eating disorders?
- perfectionism: high self-expectations, fear of failure/criticism/rejection
- anxiety sensitivity: avoiding risk, strong need for control, obsessiveness
- impulsivity: more common in bulimia/binge-eating disorder
how do cognitive factors affect eating disorders?
- black-and-white thinking about food, weight, and self-worth
- distorted perception of body image
- low self-esteem and identity struggles
how does emotional regulation difficulties affect eating disorders?
- difficulty coping with distress
- restriction = emotional numbing thru bingeing = emotional escape
what are some barriers to seeking help in eating disorders?
- functions being served by the eating disorder may deter help-seeking
- e.g., emotion regulation, trauma avoidance, social reward
- shame and denial
- barriers related to access
what are some cognitive-behavioural treatment to eating disorders?
- exposure necessary
- weight restoration
- eating feared foods
- regular eating schedule
- moderate exercisses
- mindfulness/dbt
eating disorders are similar to what?
- phobias
- obsessive-compulsive problems
what are the stages/cycles of sleep?
- stages 1 to 4: non-REM sleep
- stage 5: REM sleep, rapid-eye movement, muscle atonia, vivid dreaming
how long does each sleep cycle last?
90 minutes, with multiple cycles per night
REM sleep becomes ____ in later cycles
longer and more frequent
what happens to stage 4 if you go to bed late?
- disappears after the first few cycles, while REM dominates in the morning
- if you go to bed late, your body prioritizes REM and you won’t get deep sleep which is important for physical recovery
why is REM sleep important?
crucial for memory consolidation and emotional processing
what is the restoration theory in relation to theories on why we sleep?
- suggests sleep is essential for repairing and rejuvenating the body and brain
- helps in muscle growth, tissue repair, and protein synthesis
what is the evolutionary theory in relation to theories on why we sleep?
- sleep evolved as a survival mechanism
- conserves energy and protects individuals from predators during parts of the day where there’s little value or danger in being awake
- preserves energy so we don’t need to eat as much as well
what is the information consolidation theory in relation to theories on why we sleep?
- sleep plays a role in processing and cosolidating memories from the day
- strengthens neural connections and supports learning and memory formation
what is the waste clearance theory (glymphatic theory) in relation to theories on why we sleep?
- sleep facilitates the clearance of waste products from the brain, including toxins associated with neurodegenerative diseases (e.g., dementia), through the glymphatic system
how many hours a night do you need to be considered a ‘deprevation’?
< 6 hours
what are the cognitive effects of sleep deprivation?
- irritability
- cognitive/moral judgement impairment
- memory lapses or loss
- severe yawning
- hallucinations
- symptoms related to ADHD
what are some health effects of sleep deprivation?
- risk of type 2 diabetes, heart disease, obesity
- impaired immune system
- decreased reaction time, accuracy, and temperature
- tremors and aches
- growth supression
what are the psychological effects of sleep deprivation?
losing sleep for one night can lead to deficits equivalent to having a blood alcohol concentration of 0.1% which is above the legal limit for driving in many jurisdictions
has historically been used as a form of torture
according to the dsm-5-tr, what are the two major types of sleep disorders?
- dyssomnias
- parasomnias
what is dyssomnia?
- difficulties getting enough sleep or quality of sleep
- insomnia disorder, hypersomnolence disorder, narcolepsy, breathing-related sleep disorders, circadian rhythm disorders
what is parasomnias? what are its type?
- abnormal events that occur during sleep
- nightmare disorder
- sleep terrors
- sleep-walking
what is the ‘equation’ for sleep disturbance?
biological vulnerability <–> sleep stress (e.g., poor sleep hygiene, cultural demands on sleep) –> sleep disturbance <–> maladaptive reactions (e.g., naps, sleep schedule changes, parental reactions, self-medication)
what is insomnia disorder’s symptoms according to dsm-5?
- dissatisfaction with sleep quality/quantity associated with at least one of the following difficulties:
- initiating sleep or;
- maintaining sleep (frequent awakenings); and/or
- early morning awakening with inability to return to sleep
- clinically significant distress/impairment
- occurs at least 3 nights a week for at least 3 months
- occurs despite adequate opportunity for sleep
what are the medications for sleep disorders?
- e.g., benzodiazepines and sedatives
- prolonged use of meds cause dependence
- rebound insomnia
- CBT is more effective
- melatonin: hormone that regulates sleep cycle. helps with sleep onset but no sustained sleep
relative to good sleepers, those with insomnia are more likely to:
- distorted perception of sleep length and quality
- increased instrusive worries when trying to sleep
- endorse unhelpful, negative beliefs about sleep (unrealistic expectations, catastophizing)
- endorse positive meta-beliefs about benefits of worrying in bed
- conserve energy during waking hourse (e.g., cancel appointments, avoid exercise, avoid social events, etc.)
what are some cbts for insomnia?
- individualized treatment, outlining behaviours for night-time and day-time symptoms
- improve sleep hygiene
- correct misperceptions of sleep and daytime deficits; reduce worring, rumination, and unhelpful beliefs
what are some healthy sleep tips?
- same bed/wake time, even on weekends
- avoid naps
- exercise daily
- use bright light to help manage circadian rhythms
- avoid alcohol, cigarettes and heavy meals in the evening
- wind down
- if you can’t sleep, go into another room and do something relaxing until you feel tired
