Test III Pt I Flashcards
Multifactorial polygenic disorders
Disorder that arises as a result of more than two relevant genes as well as environmental contributors
Schiz: diathesis stress theory
hizophrenia symptoms are triggered or worsened when environmental stressors (stress) act upon a biological vulnerability (diathesis) to the disease
Features of polygenic disorders
Gradations of severity
Not rare
Ill relatives appear in families of both parents
Predisposition to schiz
Polygenic disorder that causes predisposition
Schiz: assets and liabilities
Things that protect one from schiz
Lifetime risk for relatives of people with schiz
3% for second degree
10% for first degree
Morbid risk for children of schiz twins
Q
Concordance rate for MZ twins (schiz)
48%
Concordance rates for DZ twins (schiz)
17%
Concordance rate for identical twins reared apart (schiz)
64%
Most research for schiz supports which hypothesis?
Drift
4 Adoption research strategies (schiz)
- Examine grown up, adopted away offspring of parents w schiz
- Begin w grown up adoptees w schiz, and then evaluate psych status of bio and adoptive relatives
- Cross fostering
- Examine adopted away children of parents w schiz, and study their adoptive families longitudinally to contrast the families of those who develop schiz and those who don’t.
Hestons adoption study 1966
Morbid risk w schiz mom was 16% as compared to 0% in other adoptees
The Kety strategy
Begin with grown up adoptees w schiz, then evaluate psych status of bio and adoptive relatives. Kety found that schiz was far more prevalent in bio relatives.
Wender’s cross fostering research
4.8% of cross fostered group developed schiz
Why are psychosocial factors difficult to study? (4)
- Difficult to measure events occurring 10-20 years before onset of disorder
- Psychosocial processes are more subtle
- Events likely to act cumulatively
- Events interact with individual vulnerabilities
Schofield & Balian study of family risk factors
Examined what?
Findings?
Examined self reported early life histories of a group of people w schiz and a normal control group
Found normal controls and people w schiz did not differ in reports of early family problems
Schizophrenogenic mother
Schizo causing mother, who set it in motion by appearing to be self sacrificing but in reality are using the child as a means to meet their own needs
Vaughn and Leff’s study of relapse rates as a function of EE and medication
Suggests going home to family w high EE is a factor in relapse, especially when a lot of time is spent together.
Effectiveness of family intervention to prevent relapse
Studies suggest if you work w families on lowering EE it lowers the risk of relapse
Psychodynamic explanation (schiz)
Regression to pro ego stage
Efforts to reestablish ego control
Result of cold or unnurturing parents or trauma
Little research support
Behavioral view (schiz)
Operant conditioning reinforced for bizarre behaviors, but not reinforced for positive behaviors
Cognitive view (schiz)
Problems w attention, got confused and form unusual schemas. Delusions are their way of making sense of the schemas
Ethnic differences (schiz)
More blacks diagnosed with schiz and over represented in hospitals. More Mexicans than whites also
Course and outcome in developing countries (schiz)
Is better in less developed countries, probably due to family support
Social labeling (schiz)
Becomes self fulfilling prophecy that promotes its development
Double bind hypothesis (schiz)
Theory that some parents repeatedly communicate pairs of messages that are mutually contradictory, helping to produce schiz in their children
Expressed emotion (schiz)
General level of criticism, disapproval, and hostility expressed in a family
RD Laing’s perspective
People try to Cure themselves of the confusion and unhappiness caused by their social environment, usually have difficult obstacles, experienced confusing communications from others
Cross fostering
Study children of normal parents, some of whom are adopted into a home where the parent later developed schiz
Bio mom w schiz, adopted mom w out
4%
Bio mom w out schiz, adopted mom w out
0%
Bio mom w out schiz, adopted mom w
5%
Bio mom with schiz, bio mom with schiz
14%
What does family factor research suggest in relation To schiz?
Quality of parenting does not predict who gets 1st episode
4 key components of preventing relapse (schiz)
Accept illness
Find humor
Find balance
Realistic expectations
Cross fostering research suggests what in relation to schizophrenia?
There is both a genetic and environmental component to schiz
Diagnosis anorexia
Restricted intake of nourishment, intense fear of gaining weight, significantly underweight, disturbed body perception
Anorexia prevalence
1/2-4% of women
Anorexia prognosis
1/4 aren’t responsive to treatment
Anorexia medical complications
Amenorrhea Lower body temp and blood pressure Body swelling Skin problems Heart failure
Restricting type anorexia
Restrict their diet
Binge purge type anorexia
Cycles similar to bulimia
Amenorrhea
Absence of menstrual cycles
Bulimia diagnosis
Recurrent binge episodes
Recurrent compensatory behavior
Symptoms continuing at least once a week for three months
Influence of weight on self evaluation
Prevalence bulimia
Q
Definition of a binge
I
Compensatory behaviors bulimia
Forcing vomit
Using laxatives
Fasting
Exercising excessively
Prognosis bulimia
20% don’t get any better
1/3 eventually relapse
Medical complications bulimia
W
Binge eating disorder
Eat large amounts of food without engaging in compensatory behaviors
Multidimensional risk perspective eating disorders
Identifies several kinds of risk factors that are thought to combine to help cause a disorder
Psychodynamic causal factors eating disorders
Disturbed mother child interactions that cause ego deficiencies and poor sense of independence and self control
Cognitive causal factors eating disorders
Improperly label internal sensations and needs generating little feeling of self control and desire to obtain the control; result of poor parenting
Depression as a causal factor of eating disorders
Many more people with eating disorders qualify for major depressive disorder than those of the general population
Serotonin and eating disorders
Many people with ED have low serotonin activity
Hypothalamus and eating disorders
Regulates eating
Lateral hypothalamus and eating disorders
Produces hunger when its activated
Ventromedial hypothalamus and eating disorders
Reduces hunger when activated
Weight set point
Weight level that a person is predisposed to maintain controlled in part by the hypothalamus
Enmeshed family pattern and ED
Can increase chances of relapse and are usually more emotionally charged and involved
Racial and ethnic differences ED
Q
Gender differences ED
95% women for all disorders except binge
Hospitalization and refeeding Anorexia
Can save lives but makes patient become even more untrusting and resistant to further treatment
CBT for anorexia
Keep food diary
Challenges attitudes that they should be judged by weight
Family therapy and anorexia
Research shows it’s helpful in treating and preventing relapse
Behavioral therapy for bulimia
Food diary
Exposure and response prevention
Cognitive therapy for bulimia
Works on challenging maladaptive attitudes and thoughts that make them binge and change self concept
Medication for bulimia
Often helped by antidepressants especially when used in combination with therapy but usually a last resort
Treatments for binge eating disorder
Similar to bulimia but more specialized programs are being developed
Gender gap binge eating disorder
Not a large gender gap
