Unit 2 (terms and DCs) Flashcards
beta blockers
help with the physical symptoms of social anxiety disorder- not habit forming
SSRIs
- help 80% panic disorder patients
- long term treatment
- after few years, 25% find it no longer alleviates symptoms of depression
- 6 mo to year of taking it for best results
- hardest to overdose and fewest side effects (side effects come after discontinuation)= most commonly prescribed
- (can trigger manic episode if given to BP patient)
ERP
exposure to stressor, discussion on tactic to handle it= best for OCD
localized amnesia
complete amnesia for a specific period of time (trauma)
selective amnesia
partial loss of memory during a specific period of time
generalized amnesia
begins with particular event and extends back in time
-wandering
arousal and fear paths
sympathetic NS
hypothalamic-pituitary adrenal pathway
major depressive episode
2 weeks for diagnosis
-40% who’ve had DE with exp another episode in life
manic episode
1 week or hospitalization
hypomanic episode
4 days
MDD
-18% lifetime prev
-85% symptom free within year (w/o therapy)
-2x risk if 1st degree relative has one
monoamine= depletion in Its causes MDD
**depressive episode must last 2 weeks for diagnosis
PDD
depressive episode must last 2 years, fewer symptoms
-1/10 develop MDD
BP I
1 week or hospital for diagnosis
BP II
4 days of elevated mood WITH depressive crash for diagnosis
Lewisohn’s behavioral therapy
most effective for helping mild MDD if coupled with 2 other techniques
MAOIs
help 50% of people with depression, but lead to dietary restrictions due to increase in BP
tricyclic ADs
dry mouth and constipation, but help 60% with depression and no BP increase
psychotherapy as MDD treatment
- prevents relapse
- cope with life events and stressors
- 50% see improvement
6 components of TLC
- exercise
- sleep
- sunlight
- omega-3
- social interaction
- decrease negative thinking
- 70% people saw 1/2 reduction of depressive symptoms
lithium
helps 60% patients with BP
-most commonly prescribed
(anticonvulsants and anti psychs also used)
*lamictal (anticonvulsant)= best for bipolar depression
anticonvulsants
calm hyperactivity (best for depressive) and helps rapid cycling; increased suicide risk
BP and suicide
most common to attempt during changing moods- mania to depression
permissive theory
serotonin opens gate for mood disorder, NE determines the type
- low 5HT + high NE = mania
- low 5HT + low NE = depression
phobias
- fear/ anxiety of object, with immediate anxiety response and extreme avoidance; fear is disproportionate to the danger; must cause distress/ dysfunction; MUST have symptoms for more than 6 months
- common= animal, nature, situation, medical
- 9% lifetime prev; 2:1 women:men
- exposure therapy, systematic desens; best= actual contact with the fear and fear hierarchy
social anxiety disorder
anxiety of being watched and negatively judged by others
- avoidance and distress in social situations
- performance and generalized types
- 12% lifetime prevalence
- teenage onset
- therapy= cognitive (reframing) and SSRIs and beta blockers
panic disorder
- recurrent and persistent panic attacks; apprehensive for over one month; OR avoidance behaviors - rule out drug use
- unpredictable attacks (unexpected PAs); 83% are comorbid for another anxiety disorder
- 3-4% pop
- increased activity in fear network (amygdala) and heightened startle response; GABA is also lower
- SSRIs (increase 5HT and decrease NE)= improve 80%
- CBT to break misinterpretation pattern
agoraphobia
fear of public places where escape is difficult; must have symptoms for at least 6 months
-behavioral therapy, family therapy, anti anxiety meds and psychotherapy help
GAD
-unreasonable anxiety in most situations; “anxious apprehension; hard to control; physical symptoms (3+); distress and dysfunction; symptoms must last over 6 months (not due to drugs)
-6% lifetime prev
-women: men 2:1
ellis’s rational emotive therapy (RET)
-SSRIs and SNRIs
-break down worrying with psychoeducation
OCD
causes great distress or takes up over one hour per day
- only need obsession OR compulsion for diagnosis
- increased basal ganglia activity and abnormal 5HT
- 3% lifetime prev; equal women: men
- 40% seek treatment
- ERP= best 55-85% find help in ERP (not helpful for those with ONLY obsessions)
- SSRIs and Anafrinil (tricyclic) also help
benzodiazepines
agonist for GABA; addictive; tolerance, drowsiness
adjustment disorder
psych response to STRESSOR within 3 months of exposure; significant symptoms of distress and dysfunction - not from trauma
- can be chronic or acute, recurrent or continuous
- symptoms aren’t explained by another disorder and disappear when stressor is alleviated
- 5-20% pop
- therapy aimed at increasing coping ability
acute stress disorder
symptoms begin within 4 weeks of trauma and last 3-30 days - allows diagnosis to be made without waiting 30 days for ptsd
-80% cases develop into PTSD
ptsd
symptoms begin after trauma (usually within 3 months) and persist over 1 month; reoccurring trauma, avoidance of trauma linked stimuli; changes in arousal and reaction
*event must be experienced personally (not media)
-hyperarousal/ vigilance
types= disasters (10x more common than combat), combat, sex abuse, terrorism and torture
-3.5% US/yr… 7-9% life prev
women: men = 2:1
-2/3 seek treatment
-1/2 PTSD resolve in 6 months; goal of treatment= decrease stress reactions, SSRIs= only approved- 60% effective
-CBT= best (uncovering= reliving in safe environment; covering= supportive therapy and stress management
DID
2+ distinct personalities; lapses in memory; not due to drug
-1% prev; 70% attempt suicide; therapy seeks to reintegrate personalitites
depersonalization/ derealization disorder
persistent and recurrent depersonalization OR derealization or both; the person is in touch with reality
risk factor= abuse; emotional neglect
-50% people experience dreal at some point; recurrence= rare; comes on suddenly and is long lasting
-antidepressants and psychotherapy
dissociative amnesia
psychological cause; no recall of episodic memory; distress/ dysfunction
localized= most common, loss of all. memories in selective period
selective= loss of some memories during a select period
generalized= begins with event and extends backwards in time, confusion and wandering
-2% prev/ yr
-often recover on own (memory triggers)
dissociative amnesia with fugue
unexpected travel; unaware that they don’t know who they are; confusion of ID; may last days to years; people appear normal to crowd; no drugs
major depressive episode
time limited period in which intense symptoms are present need 5 symptoms in 2 week with symptoms nearly every day -appetite/ weight change -sleep loss -guilt -agitation -fatigue -suicidal thoughts
manic episode
persistently elevated mood and increased activity for over one week or hospitatlization; AND increase self esteem/ grandiose, or decrease sleep, racing thoughts etc…
hypomanic episode
4 days for diagnosis; not as severe as manic; very functional
MDD
have had DE; never had ME or HME
-2x risk for 1st relatives
-18% life prev; women>men; highest prev among 18-25 yos; leading cause of disability in the world (WHO)
-85% with MDD will be symptom free within year even without treatment
monoamine hypothesis= depression caused by depletion in Its; 5HT, NE, DA
-cortisol (depressed 50%, have more cortisol
-melotonin= low in MDD, high in SAD
cognitive Beck view of MDD
- maladapt attitudes
- cognitive triad (neg views of world, self and future)
- errors in thinking (arbitrary inferences, minimization, magnification)
- automatic thoughts (steady stream of neg thoughts)
PDD (dysthymia)
milder than MDD= fewer symptoms
- distress and long lasting- must be depressed for 2 years for diagnosis ( 1 year for <18 yo)
- no HME or ME
- 1/10 develop MDD; early and gradual onset
premenstrual dysphoric disorder PMDD
mood symptoms 7 days before period- significant low mood; severe enough for distress/ dysfunction
3-8% women in menstrating years
-SSRI antidepressants; birth control; Ca pills; exercise; sleep; decrease caffeine
bipolar I
- 1+ manic episode at some point; may or may not be followed by DE or HME; distress and dysfunction
- rapid cycling= 4+ mood episodes in one year
- worsens without treatment; usually YA onset; 2-4% life prevalence; 1/3 will attempt suicide (15% complete without treatment)
- Lithium; anticonvulsants (rapid cycle and physical)
- 60% ME followed by DE
- lithium decreases DA and decreases manic behavior
BP II
1+ DE; at least 1 HME; NO ME at all
-overactive NE; low 5HT
permissive theory
low 5HT opens door for mood disorder; NE level determine the type
-high NE= mania; low= DE
cyclothymic
at least 2 years of numerous SYMPTOMS (no full on episodes) of mild depression and hypomania; chronic mood flux; not symptoms free for over 2 months; may develop into BP I or II; overactive NE;
1% pop; sleeping loss may trigger mania
