PSYCH 371 EXAM #2
Help!
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| Anxiety | physiological arousal, unpleasant feelings of tensions, and a sense of apprehension or foreboding --> based in fear
- notice in body (ex: butterflies)
- worrying abt something (ex: future of health)
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| Anxiety disorders | class of disorders characterized by excessive or maladaptive anxiety reactions → more long term
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| Anxiety disorders include: | 1. physical features
2. behavioral features
3. cognitive-emotional features
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| Physical features- anxiety | sweating, dizzyiness, shaking, muscles tension
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| Behavioral features- anxiety | affect behaviors / avoid certain situations
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| Cognitive-emotional features- anxiety | thoughts/ emotions
→ ruminating: thinking abt problems but not actually solving it, thinking abt it over/ over again
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| Ethnic Differences- Anxiety Disorders | 1. Women more affect by anxiety disorders than men
2. African/ latino americans have lower rates of anxiety disorders compared to European Americans
3. European americans have higher lifetime rates of panic disorder
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| Generalized Anxiety Disorder (GAD) | General feelings of dread, foreboding (feeling something bad could happen), heightened bodily arousal (6+ months duration)
- DSM requires it to last 6 months, but it can last for years
- most common out of the other anxiety disorders
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| Features- GAD (1-2) | 1. Excessive / uncontrolled worrying (ex: money, grades, health)
2. No specific trigger or cause; free floating anxiety that will latch on to anything
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| Features- GAD (3-4) | 3. Avoidance of situations that will cause anxiety → avoid sitting w/ the discomfort bc they don’t want to deal w/ that
4. Emotional distress or impairment in daily life → doesn’t feel good / maybe causing certain physical symptoms (headaches)
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| Symptoms- GAD (6 months/ need 3+) (1-3) | 1. Sleep difficulties/ insomnia
2. Difficulity concentrating → attention will be limited
3. Fatigue
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| Symptoms- GAD (4-6) | 4. Restlessness/ “keyed up” feeling
5. Irritability
6. Muscle tension
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| Prevalence GAD | Lifetime = 2.6% across all genders
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| Panic Disorders | have repeated episodes of intense anxiety/ panic
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| Symptoms- Panic Disorder (repeated, unexpected attacks + one of these symptoms) | 1. 1+ months of fear of subsequent attacks
2. Worry abt implications / consequences of panic attacks
3. Significant changes in behavior
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| Panic attack- symptoms (intense, acute anxiety reactions come with) | 1. physical: unctrollable crying, shaking, sweatness, nausa
2. Cognitive/ emotional: crazy, fear of death/ danger, fear of heart attack
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| Prevalence (panic disorder/ attack) | Lifetime panic ATTACK= 23% (almost 1 in 4 experience panic attacks)
Lifetime panic DISORDER= 5%
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| Phobic disorders | fear of object/ situation that is disproportionare to the threat it poses
has to create daily dsyfunction in one’s life
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| 3 types- phobic disorders (6+ months is duration for diagnosis) | 1. specific phobia
2. social anxiety disorder
3. agoraphobia
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| 1. specific phobia prevalence | (12.5% lifetime prevalence)
particular fear of something
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| 2. social anxiety disorder prevalence | (12% lifetime prevalance- social phobia)
excessive fear in social situations
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| 3. agoraphobia prevalence | (1-2%- lifetime prevalence)
fear of places that it would be difficult or embarrassing to escape
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| Social anxiety disorder | Excessive fear of social situtations/ interactions → very dsyfuncional for daily living
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| Symptoms (social anxiety disorder) (1-3) | 1. Intense fear/ panic → based in social situations
2. Fear of looking foolish
3. Fear of criticism/ judgement/ embarrassment
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| Symptoms (social anxiety disorder) (4-5) | 4. Shakiness, blushing, heart racing, sweating when in social situations → others will read them as judgmental, cold
5. Spotlight effect → think ppl paying attention way more than others actually are
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| Anxiety Provoking Siutations (1-5) | Meeting new people (small talk)
Being teased or critcized
Being the center of attention
Being watched while doing something
Having to say something in formal, public situation
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| Anxiety Provoking Siutations (6-9) | Meeting people in authority
Feeling insecure in social situations (“I dont know what to say”)
Talking in class, groups, talking to any strangers
Asking for help from others
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| Agoraphobia | Fear of being out in open, busy areas where it will be difficult to escape
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| Fear situations- agroaphobia | shopping in crowded stores, walking through crowded streets, crossing a bridge, traveling on a bus, train, car, eating in restaurants, even leaving the house
- Strucutre life to avoid fearful situations
- may become home-bound= won't leave house
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| Theoretical Perspectives on GAD + Phobias | 1. psychodynamic perspective
2. learning perspective
3. cognitive perspective
4. biological perspective
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| 1. Psychodynamic perspective GAD + Phobias | intrusion of unacceptable impulses into conscious awareness → fear of certain situations/ objects
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| 2. Learning perspective GAD + Phobias | generalized anxiety / fear across many situations → starts w/ one thing, but generalized across many situations (classical/ operation)
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| 3. Cognitive perspective GAD + Phobias | distorted thoughts / beliefs underlie worry → fear of terrible consequences
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| 4. Biological perspective GAD + Phobias | irregularities in neurotransmitters activity (low GABA- calming effect) / genetic predisposition
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| Theoretic Perspectives- Panic Disorder | 1. cognitive perspective
2. biological perspective
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| 1. Cognitive perspective Panic disorder | misperceptions of underlying causes/ physiological reactions → some ppl think they have a heart attack/ hyperventilation
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| 2. Biological perspective Panic disorder | bodily sensations perceived as threats; induces anxiety / activation of the sympathetic nervous system (SNS) → the flight or fight mode willl get activated
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| Treatment Apporaches to GAD + Phobias | 1. psychodynamic
2. cognitive-behavioral
3. learning
4. biological
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| 1. psychodynamic GAD + Phobias | increase awareness how clients fear manifest in inner conflicts
Contemporary: focus on relationships
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| 2. cognitive behavioral GAD + Phobias | work on thoughts/ thinking more rationale when start having fears in mind/ working on cognitive challenge
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| 3. learning GAD + Phobias | through exposure, start w/ hierarchy of fears and work your way up (systematic desenization)
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| 4. biological GAD + Phobias | medications (ex: Xanax or SSRIs- common to prescribe for GAD) → combo of mediciation/ therapy has BEST OUTCOME for GAD
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| Virtual Therapy for Phobia | A behavior therapy apporach that uses computer-generated stimlated environments as therapeutic tools
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| Obessive-Compulsive Disorder (OCD) | Characterized by a pattern of compulsive or repetitive behaviors associated w/ significant personal distress or impaired functioning
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| OCD prevalence | 2-3% lifetime prevalence
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| Hoarding disorder prevalence | 2-5%
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| Excoriation disorder prevalence | 1.4%
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| OCD Requirements | Requires reccurent obessions, compulsions, or BOTH → ONLY NEED 1 OF THOSE
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| Obsession requirement | persistent unwanted thought that a person cannot control → start ruminating on it or may neutralize it
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| Compulsion requirement | ritualistic behaviors that person feels compelled to perform
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| Other OCD requirements | Take up at least 1+ hours/day or causes distress / dysfunction
These rituals make OCD ppl feel better/ reduce anixety in the moment
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| Obsession type | 1. Contamination
2. Symmetry/ Ordering
3. Aggressive/ Harm obsessions
4. Scrupulsoity
5. Doubts
6. Sexual
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| Complusion type | 1. Washing & cleaning behaviors
2. Arranging/ symmetry
3. Checking
4. Neutralizing
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| Hoarding Disorder | Accumulation of unnecessary/ useless possessions and a need to retain them causing personal distress or resulting in unsafe living conditions
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| Hoarding Criteria (1-4) | 1. Difficult departing w/ their items
2. Distress associated w/ discarding items
3. Clutter areas
4. Unclutter is by family/ friends
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| Hoarding Criteria (5-7) | 5. Cause impairment that allows to diagnosis it
6. Social life impaired → not invite ppl over bc its too cluttered and not seeing family members in a while
7. Personal distress is NOT required → could just have the IMPAIRMENT
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| Hoarding Controversy | closely related to OCD but theorized to have important differences
→ thoughts not intrusive/ unwanted
→ no rituals urge
→ pleasure via keeping / collecting rather than anxiety
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| Body Dsymorphic Disorder | Preoccupaton w/ an imagined/ exaggerated physical defect causing individuals to feel they are ugly ot even disfigured
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| Body Dsymorphic Specifiers | Insight level (imagined) or do they think its real
Poor insight
Absence insight- completely convinced dsymorphy is true
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| Other OCD types | 1. trichotillomania
2. excoration
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| Trichotillomania | repetitive hair pulling resulting in hair loss
- Scalp or other bosy parets, noticeable bald spot
- Pick out hair to reduce anxiety
- Could be eyebrows, eyelashes
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| Excoration | repetitive skin picking resulting in lesions
- Scratching, picking, rubbing, digging
- Arms, legs → cause noticeable lesions
- Reducing one’s anxiety
- May be self-soothing
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| Theoretical Perspectives of OCD | 1. psychodynamic perspective
2. biological perspective
3. learning perspective
4. cognitive perspective
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| Psychodynamic perspective OCD | Obsessions- leakage of unconscious impulses into consciousoness
Compulsions- ease conscious anxiety → projecting unconscious on outside environment
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| Biological perspective OCD | Genetic factors / neurological factors
Over arousal of the amygdala, which is related to fear, agression, etc
Failure of prefrontal cortex to control the amygdala
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| Learning perspective OCD | Compulsions negatively reinforced (operant conditioning
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| Cognitive perspective OCD | Intrusive, negative thoughts take over
Exaggeration/ perfectionist beliefs
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| Treatments of OCD | 1. CBT
2. Biological (meds)
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| CBT- exposure w/ response prevention (ERP) OCD | Exposure- repeated/ prolonged exposrue to stimuli that provoke obsessions (anxiety)
Response prevention- resist compulsions/ rituals
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| Biological (medications) OCD | SSRI antidepressants (mild anti-anxiety effect) also provide therapeutic benefit for OCD, increase availability of serotonin
→ THERAPY + MEDS= MOST EFFECTIVE
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| Mood disorders | psychological disorders characterized by unusually severe or prolonged disturbances of mood
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| Types of Mood disorders | Major depressive disorder
Persistent depressive disorder
Bipolar disorder
Cyclothymic disorder
Disruptive mood dysregulation disorder
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| Epidemiology of Mood Disorders | Worldwide prevalence of MDD= 16%
→ Incidence= 6% in last year
Women twice as likely to be diagnosed w/ MDD than men
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| bipolar related disorder lifetime prevalence | 4.4%
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| MDD Risk follows a U-shape | Risk higher in adolescence/ youth adulthood / older adulthood
Some cultures express depression as somatic concerns
Higher mood disorder prevalence in women / Native Americans / indigenous folks in US
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| Major Depressive Disorder (MDD) | Severe mood disorder characterized by 1+ major depressive episodes
- impacts how person feels, thinks, functions in life
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| Episode symptoms (MDD) 1-5 | 1. Anhedonia: lack of pleasrue or interest in activities that use to enjoy
2. Sad/ unhappy mood
3. Concentration problems
4. Fatigue
5. Thoughts of death
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| Episode symptoms (MDD) 6-9 | Feeling guilty / inadequate
Eating changes- weight gain or lose of weight
Insomina/ hypersomnia (sleeping more than usual)
Psychomotor retardation or agitation: slowing down movements, moving quickly or moving slowly / other ppl can notice
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| How long experience symptoms MDD | 2 weeks → have to have a certain set number of
- Have to have either ANHEDONIA OR SAD/ UNHAPPY MOOD → have to have one or the other in that 2 week period & 5 + other symptoms
Depressive episode is all that is required for MDD diagnosis
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| Severity MDD | mild (sorta affect daily life, but not cause a whole lot of dysfuntion)
moderate (affect daily life or symptoms gonna be more instense/ dysfunctional, but somewhat function)
severe (regularly hosptialized/ not be able to get out of bed most days)
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| Risk Factors for MDD (1-4) | 1. Younger age adolescence/ young adulthood
2. Age- Older age (65+)
3. Lower SES/ poverty
4. Separated or divorced
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| Risk Factors for MDD (5-8) | 5. Female
6. Family history of depression
7. Childhood history of sexual abuse
8. Domestic violence
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| Specifiers of MDD | 1. with seasonal pattern
2. with perinatal onset
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| With seasonal pattern | MDD associated w/ specific seasons
When it gets darker earlier in fall → some ppl have hard time w/ this
Phototherapy (bright light) is effective
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| With perinatal onset | depression/ mood changes that occur after during pregnancy or after childbirth
Typically not as severe or long-lasting as MDD
Happen during pregnancy or 6 months after childbirth
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| Prevalence MDD | past estimates= 10-15%
→ Recent global meta-analyses= 17-25% (more common than viewed/ underestimate it)
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| Persistent Depressive Disorder (PDD) | milder than MDD, but CHRONIC (2 years +)
→ chronic mental disorder that causes a person to have a depressed mood for most of the day, most days, 2 years in adults or 1 year in children and adolescents
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| PDD Features | Depressed mood more than 50% of the time, but less severe (fewer symptoms/ less intense) + very long experience
- 90% go on to develop MDD → low level of depression could turn into major depression
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| Prevalence PDD | 4% lifetime
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| Double depression | have PDD, but while experiencing it u have major depression episode on top of it
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| Premenstrual Dysphoric Disorder (PMDD) | Phyiscal/ mood-related symptoms occuring during a woman’s premenstrual period
- not gonna meet critieria ONLY associated w/ menstration
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| PMDD Features | Symptoms most intense the week (9-10 days mood disruption) before the menstrual period
TOO SHORT- doesn’t hit 2 weeks) / improve within a few days following the onset of menstruation --> very consistent (every period)
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| PMDD DSM-5 | Distress + dysfunction necessary for diagnosis → new in DSM-5 (2013)
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| Developmental Factors in Bipolar Disorder | Rate of bipolar diagnosis in children has increased over time → very controversial
- adults 60 or older= manic / depressive symptoms often develop in association w/ medical illness → could create mood fluctuation/ cognitive disorders
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| Bipolar disorder (BPD) | mood swings between states of extreme elation / depression → feeling really really good and then really really bad
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| 2 Types of BPD | 1. Bipolar I
2. Bipolar II
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| Bipolar 1 disorder- have had a full manic episode (all thats required) | → big life changes can happen during manic episode
→ has psychotic symptoms
→ impulsive behaviors
→ NOT experience major depressive episode
→ last 1 week
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| Bipolar 2 disorder- hypomanic episodes AND have had a major depressive episode | → NO hallucinations
→ short (4 days)
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| Manic Episode (ME) | extreme euphoria OR irritability, excessive activity, impairment in functioning, PLUS 3-4 symptoms:
- have psychotic symptoms w/ this → delusions OR hallucinations w/ manic episode
Has to last 1 week
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| Manic episode symptoms (1-4) | 1. Inflated self-esteem/ grandiose (some form of delusion)
2. Decreased need for sleep
3. Distractibility
4. Increase in goal-directed activity (have things they want to get done) or psychomotor agitation (can’t sit still)
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| Manic episode symptoms (5-7) | 5. Excessive talkativeness
6. Flight of ideas/ racing thoughts
7. Impulsive involvement in activities that are pleasurable but risky (ex: gambling/ drug use)
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| Extreme euphoria (ME) | you need 3 other symptoms
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| Irritability (ME) | you need 4 other symptoms
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| ME Episodes + Features | 1. hypomanic episode
2. rapid cycling specifier for BPD 1 or 2
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| Hypomanic episode | shorter duration (4 days at least), less severe than manic episodes / are less disruptive
→ don’t need to be hostpialized / not see delusions or hallucinations
→ overly talkative
→ mixed episode= symptoms of mania and depressed mood
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| Rapid cycling specifier for BPD 1 or 2 | 4 or more severe mood distrubances within a single year
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| Cyclothymic Disorder | Chronic cyclical pattern of mild mood swings / level of dysfunction
Mood swings (elevation/ depression) not severe enough to qualify as hypomania or major depressive episode
Lasts 2+ years
Very rare → under 1%
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| Disruptive Mood Dsyregulation Disorder (DMDD) | Severe recurrent temper outbursts that are grossly out of proportion in intensity or duration to the situation
Lack emotional regulation
ONLY diagnosed in children 6-18
New in DSM-5
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| Controversy DMDD | some people say why we have a diagnosis for temper tantrum
Arguments: Lower rate of children diagonsed with BP disorder
NOT consistent across therapists
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| Theoretical perspective- depression | 1. Psychodynamic:
2. Humanistic
3. Learning
4. Cognitive
5. Biological
6. Neurological
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| Psychodynamic (depression) | Anger directed inward rather than against significant others
Internalize anger
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| Humanistic (depression) | Lack of meaning in one’s life → existential crisis
NOT living up to potential
Focus relationships w/ others
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| Learning (depression) | Lack of positive reinforcements to change behavior (operant conditioning)/ secondary reinforcement of symptoms (sympathy, reduction in responsiblity)
Reinforced to be helpless in a way/ more help when experience depression
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| Cognitive (depression) | Negative filter of self, world, future (cognitive traid- Beck)
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| Biological- genetic (depression) | 1.5 to 3 times more likely if parent has depression
Twin studies= MZ (identitical) if one twin → 75% other will develop
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| Neurological (depression) | Hypothesized Irregularity in use of serotonin in brain
Reduced size/ activity of prefrontal cortex (inhibits negative emotions)/ limbic system
Newer research: gut health, inflammation, nutrient deficiency (vitamin D)
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| Cognitive Distortions | David Burns’ cognitive distortions associated w/ depression
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| Cognitive Distortions (1-5) | 1. All or nothing thinking
2. Overgeneralization
3. Mental filter
4. Disqualifying the positive
5. Jumping to conclusions
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| Cognitive Distortions (6-10) | 6. Magnification/ minimization
7. Emotional reasoning
8. “Should” statements
9. Labeling / mislabeling
10. Personalization
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| Causal Factors in Bipolar Disorders | Genetic factors play a BIG role in BP disorder
→ 80-85% genetic
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| Diathesis stress model BPD | stressful life factors/ other biological influences interact w/ genetic predisposition leading to disorder development
EX: miscarriages or divorces
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| Depression Treatments | 1. psychodynamic
2. humanistic
3. CBT
4. behavioral
5. thoughts
6. biological- antidepressants
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| 1. Psychodynamic (depression) | Able to explore/ express one’s conflicting feelings turing anger inward to outward
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| 2. Humanistic (depression) | Meaning in person’s life (not having meaning is realted to depression)
What gives someone meaning in life/ explore meaning
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| 3. CBT (depression) | Increase behavior/ change one’s behaviors → make new friends or go out and do things- behavioral
Change thoughts relating to self, world, future → challenge negative thinking/ stop identify w/ negative thoughts
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| 6. Biological- antidepressants (1-2) | 1. Tricyclic antidepressants- tofranil/ elavil
2. Monoamine oxidase inhibitors (MAOIs)- nardil / emsam
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| Biological- antidepressants (3-4) | 3. Selective Serotonin Reuptaje inhibitors (SSRIs)- block reuptake of serotonin / keeps serotonin active longer in brain- paxil/ zoloft/ prozac
4. Serotonin-Nonrepinephrine Reuptake Inhibitors (SNRIs)- cymbalta/ effexor
- takes 4 weeks to work
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| Research SAYS (for depression treatments) | THERAPY + MEDS= Best Outcome
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| Depression Med Treatment Issues | antidepressants vs. placebo have similar rates of improvement
Expectations / beliefs matter
Blinding problem → hard to fully double blind researchers/ people taking the meds
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| Emerging or Controversial MDD Treatments | - Electroconvulsive therapy (ECT)
- TMS- transcranial magnetic stimulation
- Psilocybin- mushrooms
- Ketamine
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| Bipolar Disorder Medications | Bipolar disorder is most commonly treated w/ mood stabilizing drugs
→ Lithium (commonly used, reduce mania)
- anticonvulsant drugs- depakote, lamictal, tegretol
- antipsychotics- risperidone
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| Psychosis | a severe mental condition charatcerized by a loss of contact w/ reality
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| Psychosis features | Most often associated w/ schizophrenia, but delusions/ halluncinations → complete break of reality
Related to halluncinations/ delusions, part of the break w/ reality / believing things that are not accurate → some positive symptoms
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| Schizophrenia | chronic, pervasive disorder characterized by distrubed behavior, thinking, emotions, percpetions → most considered abnormal
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| Schizophrenia characteristics | Charatcerized by break w/ reality bc that is what psychosis is
Most disabling disorder
Develops= late teens through the 20s
→ earlier for men (early/ mid 20s), later for women (late 20s) → could develop later for both
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| Prevalence (schizophrenia) | 1% of the world’s population/ pretty consistent
→ 1 million ppl (US) treated for schizophrenia each year
- considered one of the most serious among psychological conditions
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| Sex differences- Men (schizophrenia) | 1. Develops younger
2. Higher severity
3. Less responsive to medication
4. Greater cognitive impairment
5. More behavioral deficits
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| Culture (schizophrenia) | Schizophrenia affects men/ women abt equally
Females have a better long-term prognosis
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| Cultural factors (schizophrenia) | 1. Psychotic behaviors not always patholoized
2. Schizophrenia is found at similar rates in all cultures
3. Racial bias in diagnosis of schizophrenia
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| Inaccurate diagnosis may also result from other cultural factors (schizophrenia): | Inattention to cultural differences in behavior
Lack of cultural competence among clinicians
Language barriers
Inadequate clinical interviews
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| Psychotic Episode Features (schizophrenia) | 1. prodromal phase
2. acute episode/ phase
3. residual phase
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| 1. Prodromal phase | “before”, gradual deterioration → gradual increase of symptoms/ intensity (see negative symptoms)
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| 2. Acute episodes phase | “during, positive symptoms occur → complete break of reality
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| 3. Reisdual phase | “after”, return to the level of functioning of the prodeomal phase → symptoms start to decline, but still experience some symptoms but not as many (negative symptoms)
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| Schizophrenia Diagnosis | 2+ symptoms for abt 1 month (acute phase- peak of symptoms in number/ intensity)
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| Schizophrenia symptoms | Delusions
Halluncnations
Disorganized speech
Grossly disorganized or catatonic behaviors
Negative symptoms
→ PLUS presence of a few symptoms for 6 months when NOT in acute phase (lower severity or negative symptoms)
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| Diagnostic features (schizophrenia) | positive symptoms
- Delusions
Disorganized thought
Grossly disorganized behavior
Stereotypy → repetitive movements (ongoing)
Hallucinations
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| Positive symptoms | a break w/ reality → something added that should NOT be there
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| Types of Delusions (schizophrenia) | - Persecution
- Reference (ideas of reference)
- Being controlled
- Grandeur
- Thought broadcasting
- Thought insertion/ withdrawal
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| Delusion | false beliefs
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| Thought Disorder Component- Disorganized Thought | Breakdown in organization, processing, control of thoughts/ incoherent speech
Includes: poverty of speech, neologisms, perseveration, clanging
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| Halluncinations (schizophrenia) | Sensory perceptions in the absence of external stimuli
- Auditory → MOST COMMON --> hearing voices
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| Diagnostic Features- Negative Symptoms (schizophrenia) | negative symptoms
- Lack of emotions/ expression
Loss of motivation/ apathy
Anhedonia
Social withdrawal
Limited speech
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| Negative symptoms | absence of “normal” experiences
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| Catatonia | People in a catatonic state may remain in unusual, difficult positions that can last for hours, even though their limbs become stiff or swollen (unusal motor responses)
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| Catatonia features | Severe, but very rare / not fully aware of surroundings
They may seem oblivious to their environment during these episodes / fail to respond to people who are talking to them→ might have to be in a hospital for a while
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| Theoretical perspectives (schizophrenia) | 1, psychodynamic
2. learning
3. family systems
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| Psychodynamic (schizophrenia) | ego overwhelmed by impulses from the id
Breakdown of ego causes detachment from reality
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| Learning (schizophrenia) | bizarre behavior is reinforced (conditioning or mimic others- social learning)
Maybe mimicking others in some way
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| Family systems (schizophrenia) | looks at communication deviance in the family / expressed emotion → does family communicate in healthy way
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| Genetic (schizophrenia) | strong genetic factors
Some research suggests hertiability is as high as 80%
1st degree relatives have 10x the risk of developing schizophrenia as general population
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| Biochemical (schizophrenia) | dopamine hypothesis
Viruses → viral infections/ prenatal infections (lack of vitamin D)
Dopamine (in synapse) → overactive in the brain
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| Treatment (schizophrenia) | 1. psychodynamic
2. learning / behavioral
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| Psychodynamic treatment (schizophrenia) | NOT well-suited/ does not help
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| Learning/ behavioral treatment (schizophrenia) | Reinforce desired behavior
Reality testing
Extinguish undesired, bizarre behavior
Token economy (hospitals)
Psychoeducation (social skills)
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| Treatment- Biological (schizophrenia) | 1. Antipsychotic medication- reduces positive symptoms
2. Atypical antipsychotics (newer; 1990s)- fewer side effect, lower risk of TD
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| Permant side effect- Tardive dyskinesia (TD) | involuntary movements of the face, mouth, neck, trunk
- antipsychotic med
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| Psychosocial Rehabilitation (schizophrenia) | 1. self-help clubs/ rehabilitation centers- provide social support
2. mutli-service rehabilitation centers (skills training)
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| Family Intervention Programs (schizophrenia) | Focusing on practical aspects of everyday living
Educating family members abt schizophrenia
Teaching family how to relate to member w/ schizophrenia
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| Socialcultural Factors in Treatment (schizophrenia) | Response to psychoatric medications may vary w/ patient ehtnicity
→ Asian- americans + latinx Americans may require lower doses than european americans
Ethnicity may also play a role in the family’s involvement
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| Brain abnormalities | Whenever u see a big butterfly on a CT scan= BAD NEWS
→ serious loss of grey matter/ black spots are cerebral spinal fluid= loss of brain matter
→ Abnormal functioning in prefrontal cortex
→ Front lobe is impaired (control impulses)
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| Diathesis stress model | Diathesis (genetic vulnerability) → stress (birth complications/ cruel fam environment) → schizophrenia
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| Brief psychotic disorder | positive symptoms of schizophrenia (ex: halluncinations or delusions)
- Lasts less than one month
- Typically precipitated by trauma or stress
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| Schizophreniform Disorder | Psychotic symptoms lasting 1-6 months (> 6 months) would be diagnosed as schizophrenia
Associated w/ relatively good functioning
- prevalence: 0.2%
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| Schizoaffective Disorder | Syptoms of scizophrenia + additional experience of a major mood episode (depressive or manic)
- psychotic symptoms must occur OUTSIDE mood distrubance
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| Delusional Disorder | characterized by delusions that are contrary to reality
Lack other positive/ negative symptoms
- better prognosis than schizophrenia
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| Classification of Substance-related disorder (DSM 5-TR) | - substance-induced
- intoxication
- withdrawal
- substance-use
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| Substance-induced disorder | induced by using psychoactive substances
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| Substance-use disorder | patterns of maladaptive use of substances that lead to impaired functioning or personal distress
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|
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| Substance Use Disorders criteria | 2+ (of many) symptoms in 12 months
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| Substance use symptoms (1-3) | 1. tolerance
2. Spending excessive time seeking/ using the substance
3. Using the substance in ways that pose a risk to the person’s safety or others’ safety
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| Substance use symptoms (4-6) | 4. Continuing to use even if causes problems in relationships
5. Not managing what you should do (at school, home)
6. Cravings / taking the substance for longer than supposed to
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| Dependence (substance related disorders) | 1. physiological dependence
2. psychological dependence
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| Physiological dependence: | body is dependent on supply of substances requires BOTH: tolerance + withdrawal
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|
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| Psychological dependence: | use to avoid negative emotional withdrawal (anxiety, depression)
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|
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| Fatal withdrawal | few drugs cause this if physiological dependence / cut off substance when physiological dependence= DEATH
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|
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| Pathway to Addicition (Stages) Theorized | 1. experimentation
2. routine use
3. addicition or dependence
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|
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| 1. Experimentation stage (addicition) | curiosity / wants to try the substance to see what it is like
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|
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| 2. Routine use stage (addicition) | starts doing after school and starts to become a routine
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|
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| 3. Addcition or dependence stage (addicition) | become dependent/ use it everyday
🗑
|
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| Risk Factors for Developing Addicition | 1. Gender- male
2. Age- 20-40
3. Antisocial personality disorder
4. Fam history
5. sociodemographic factors
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|
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| Stimulants- uppers (drug of abuse) | drugs that increase the activity of the nervous system (CNS) / many elevate mood (depending on the drug)
🗑
|
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| Types of stimulants | → amphetamines & meth- aderal / drop appetite
→ cocaine- mood elevating / sense of euphoria
→ nicotine- more relaxed
→ MDMA (molly)
→ caffine- most common
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|
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| Stimulants INVOLVE: | Dilation of pupils
Heart/ breathing rate increase
Drop in appetite
- Moderate to high risk of OD/ addiction
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|
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| Hallucinogens | evoke sensory stimulation without sensory input/ created by the mind
- Low risk of OD/ addicition
Cant really function when doing certain things + dream like scenes
🗑
|
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| Hallucinogens INCLUDE: | LSD
PCP
Mescaline
Psilocybin
Marijuana → has depressant effects too (debated)
LOW risk of OD/ addiction
🗑
|
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| Depressants (highest risk) | tranquilzier/ alcohol
- barbiturates
- benzodiazepines
- opiates
- moderate to High risk of OD/ addiction
🗑
|
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| Brain changes (for alcohol) | - slow movement processing
- disrupts memory/ impairs cognition
- loss of brain matter/ tissue in cortex
- fatal withdrawal (OD high)
🗑
|
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| Disease model (substance abuse) | belief that alcoholism is a medical illness or disease
🗑
|
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| Gambling disorder | patterns of gambling that leads to impairment or distress
- nonchemical addiciton
- 4 symptoms in 12 month period
🗑
|
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| Gender dysphoria: | significant distress or impaired functioning due to conflict between biological sex/ gender identity
🗑
|
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| Diagnosis Gender dysphoria | distress due to internal identity not matching external body
🗑
|
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| Child onset usually (Gender dysphoria) | 1. Brief period of gender identity confusion during adolescence
2. May end by adolescence
3. May persist beyond adolescence/ be stable for life
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|
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| Criteria GD | NEED 2 out of the 6 for adults/ adolescents for at least 6 months)/ seen distress/ impairment:
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|
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| Gender identity: | psycholgical sense of being female or male (or nonbinary/ genderqueer)
🗑
|
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| Gender expression: | how a person presents their gender to the world (appearance, behavior, identity-pronouns)
🗑
|
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| Transgender: | ender identity (internal) / gender expression differs from biological sex (external) → may not be a diagnosis unless there is stress
🗑
|
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| GD Treatment | 1. social transition
2. hormones
3. gender affirming surgeries
🗑
|
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| GD Treatment models | 1. gender affirming
2. watchful waiting
3. live in your own skin
🗑
|
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| Paraphilia: | pattern of sexual attraction that involves sexual arousal w/ atypical objects, activites,
🗑
|
||||
| Paraphilia diagnosis | Personal distress/ dysfunction OR when it causes harm / risk or harm to others
Includes: leather, underwear, shows → pain/ humiliation in self or others or involve persons who can’t consent (children)
🗑
|
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| Fetishism | Recurrent , powerful sexual urges, fantasies or behaviors involving inanimate objects (ex: a balloon)
🗑
|
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