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PSYCH 371 EXAM #2

TermDefinition
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)
Anxiety disorders class of disorders characterized by excessive or maladaptive anxiety reactions → more long term
Anxiety disorders include: 1. physical features 2. behavioral features 3. cognitive-emotional features
Physical features- anxiety sweating, dizzyiness, shaking, muscles tension
Behavioral features- anxiety affect behaviors / avoid certain situations
Cognitive-emotional features- anxiety thoughts/ emotions → ruminating: thinking abt problems but not actually solving it, thinking abt it over/ over again
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
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
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
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)
Symptoms- GAD (6 months/ need 3+) (1-3) 1. Sleep difficulties/ insomnia 2. Difficulity concentrating → attention will be limited 3. Fatigue
Symptoms- GAD (4-6) 4. Restlessness/ “keyed up” feeling 5. Irritability 6. Muscle tension
Prevalence GAD Lifetime = 2.6% across all genders
Panic Disorders have repeated episodes of intense anxiety/ panic
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
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
Prevalence (panic disorder/ attack) Lifetime panic ATTACK= 23% (almost 1 in 4 experience panic attacks) Lifetime panic DISORDER= 5%
Phobic disorders fear of object/ situation that is disproportionare to the threat it poses has to create daily dsyfunction in one’s life
3 types- phobic disorders (6+ months is duration for diagnosis) 1. specific phobia 2. social anxiety disorder 3. agoraphobia
1. specific phobia prevalence (12.5% lifetime prevalence) particular fear of something
2. social anxiety disorder prevalence (12% lifetime prevalance- social phobia) excessive fear in social situations
3. agoraphobia prevalence (1-2%- lifetime prevalence) fear of places that it would be difficult or embarrassing to escape
Social anxiety disorder Excessive fear of social situtations/ interactions → very dsyfuncional for daily living
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
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
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
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
Agoraphobia Fear of being out in open, busy areas where it will be difficult to escape
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
Theoretical Perspectives on GAD + Phobias 1. psychodynamic perspective 2. learning perspective 3. cognitive perspective 4. biological perspective
1. Psychodynamic perspective GAD + Phobias intrusion of unacceptable impulses into conscious awareness → fear of certain situations/ objects
2. Learning perspective GAD + Phobias generalized anxiety / fear across many situations → starts w/ one thing, but generalized across many situations (classical/ operation)
3. Cognitive perspective GAD + Phobias distorted thoughts / beliefs underlie worry → fear of terrible consequences
4. Biological perspective GAD + Phobias irregularities in neurotransmitters activity (low GABA- calming effect) / genetic predisposition
Theoretic Perspectives- Panic Disorder 1. cognitive perspective 2. biological perspective
1. Cognitive perspective Panic disorder misperceptions of underlying causes/ physiological reactions → some ppl think they have a heart attack/ hyperventilation
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
Treatment Apporaches to GAD + Phobias 1. psychodynamic 2. cognitive-behavioral 3. learning 4. biological
1. psychodynamic GAD + Phobias increase awareness how clients fear manifest in inner conflicts Contemporary: focus on relationships
2. cognitive behavioral GAD + Phobias work on thoughts/ thinking more rationale when start having fears in mind/ working on cognitive challenge
3. learning GAD + Phobias through exposure, start w/ hierarchy of fears and work your way up (systematic desenization)
4. biological GAD + Phobias medications (ex: Xanax or SSRIs- common to prescribe for GAD) → combo of mediciation/ therapy has BEST OUTCOME for GAD
Virtual Therapy for Phobia A behavior therapy apporach that uses computer-generated stimlated environments as therapeutic tools
Obessive-Compulsive Disorder (OCD) Characterized by a pattern of compulsive or repetitive behaviors associated w/ significant personal distress or impaired functioning
OCD prevalence 2-3% lifetime prevalence
Hoarding disorder prevalence 2-5%
Excoriation disorder prevalence 1.4%
OCD Requirements Requires reccurent obessions, compulsions, or BOTH → ONLY NEED 1 OF THOSE
Obsession requirement persistent unwanted thought that a person cannot control → start ruminating on it or may neutralize it
Compulsion requirement ritualistic behaviors that person feels compelled to perform
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
Obsession type 1. Contamination 2. Symmetry/ Ordering 3. Aggressive/ Harm obsessions 4. Scrupulsoity 5. Doubts 6. Sexual
Complusion type 1. Washing & cleaning behaviors 2. Arranging/ symmetry 3. Checking 4. Neutralizing
Hoarding Disorder Accumulation of unnecessary/ useless possessions and a need to retain them causing personal distress or resulting in unsafe living conditions
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
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
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
Body Dsymorphic Disorder Preoccupaton w/ an imagined/ exaggerated physical defect causing individuals to feel they are ugly ot even disfigured
Body Dsymorphic Specifiers Insight level (imagined) or do they think its real Poor insight Absence insight- completely convinced dsymorphy is true
Other OCD types 1. trichotillomania 2. excoration
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
Excoration repetitive skin picking resulting in lesions - Scratching, picking, rubbing, digging - Arms, legs → cause noticeable lesions - Reducing one’s anxiety - May be self-soothing
Theoretical Perspectives of OCD 1. psychodynamic perspective 2. biological perspective 3. learning perspective 4. cognitive perspective
Psychodynamic perspective OCD Obsessions- leakage of unconscious impulses into consciousoness Compulsions- ease conscious anxiety → projecting unconscious on outside environment
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
Learning perspective OCD Compulsions negatively reinforced (operant conditioning
Cognitive perspective OCD Intrusive, negative thoughts take over Exaggeration/ perfectionist beliefs
Treatments of OCD 1. CBT 2. Biological (meds)
CBT- exposure w/ response prevention (ERP) OCD Exposure- repeated/ prolonged exposrue to stimuli that provoke obsessions (anxiety) Response prevention- resist compulsions/ rituals
Biological (medications) OCD SSRI antidepressants (mild anti-anxiety effect) also provide therapeutic benefit for OCD, increase availability of serotonin → THERAPY + MEDS= MOST EFFECTIVE
Mood disorders psychological disorders characterized by unusually severe or prolonged disturbances of mood
Types of Mood disorders Major depressive disorder Persistent depressive disorder Bipolar disorder Cyclothymic disorder Disruptive mood dysregulation disorder
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
bipolar related disorder lifetime prevalence 4.4%
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
Major Depressive Disorder (MDD) Severe mood disorder characterized by 1+ major depressive episodes - impacts how person feels, thinks, functions in life
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
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
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
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)
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
Risk Factors for MDD (5-8) 5. Female 6. Family history of depression 7. Childhood history of sexual abuse 8. Domestic violence
Specifiers of MDD 1. with seasonal pattern 2. with perinatal onset
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
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
Prevalence MDD past estimates= 10-15% → Recent global meta-analyses= 17-25% (more common than viewed/ underestimate it)
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
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
Prevalence PDD 4% lifetime
Double depression have PDD, but while experiencing it u have major depression episode on top of it
Premenstrual Dysphoric Disorder (PMDD) Phyiscal/ mood-related symptoms occuring during a woman’s premenstrual period - not gonna meet critieria ONLY associated w/ menstration
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)
PMDD DSM-5 Distress + dysfunction necessary for diagnosis → new in DSM-5 (2013)
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
Bipolar disorder (BPD) mood swings between states of extreme elation / depression → feeling really really good and then really really bad
2 Types of BPD 1. Bipolar I 2. Bipolar II
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
Bipolar 2 disorder- hypomanic episodes AND have had a major depressive episode → NO hallucinations → short (4 days)
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
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)
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)
Extreme euphoria (ME) you need 3 other symptoms
Irritability (ME) you need 4 other symptoms
ME Episodes + Features 1. hypomanic episode 2. rapid cycling specifier for BPD 1 or 2
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
Rapid cycling specifier for BPD 1 or 2 4 or more severe mood distrubances within a single year
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%
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
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
Theoretical perspective- depression 1. Psychodynamic: 2. Humanistic 3. Learning 4. Cognitive 5. Biological 6. Neurological
Psychodynamic (depression) Anger directed inward rather than against significant others Internalize anger
Humanistic (depression) Lack of meaning in one’s life → existential crisis NOT living up to potential Focus relationships w/ others
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
Cognitive (depression) Negative filter of self, world, future (cognitive traid- Beck)
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
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)
Cognitive Distortions David Burns’ cognitive distortions associated w/ depression
Cognitive Distortions (1-5) 1. All or nothing thinking 2. Overgeneralization 3. Mental filter 4. Disqualifying the positive 5. Jumping to conclusions
Cognitive Distortions (6-10) 6. Magnification/ minimization 7. Emotional reasoning 8. “Should” statements 9. Labeling / mislabeling 10. Personalization
Causal Factors in Bipolar Disorders Genetic factors play a BIG role in BP disorder → 80-85% genetic
Diathesis stress model BPD stressful life factors/ other biological influences interact w/ genetic predisposition leading to disorder development EX: miscarriages or divorces
Depression Treatments 1. psychodynamic 2. humanistic 3. CBT 4. behavioral 5. thoughts 6. biological- antidepressants
1. Psychodynamic (depression) Able to explore/ express one’s conflicting feelings turing anger inward to outward
2. Humanistic (depression) Meaning in person’s life (not having meaning is realted to depression) What gives someone meaning in life/ explore meaning
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
6. Biological- antidepressants (1-2) 1. Tricyclic antidepressants- tofranil/ elavil 2. Monoamine oxidase inhibitors (MAOIs)- nardil / emsam
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
Research SAYS (for depression treatments) THERAPY + MEDS= Best Outcome
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
Emerging or Controversial MDD Treatments - Electroconvulsive therapy (ECT) - TMS- transcranial magnetic stimulation - Psilocybin- mushrooms - Ketamine
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
Psychosis a severe mental condition charatcerized by a loss of contact w/ reality
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
Schizophrenia chronic, pervasive disorder characterized by distrubed behavior, thinking, emotions, percpetions → most considered abnormal
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
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
Sex differences- Men (schizophrenia) 1. Develops younger 2. Higher severity 3. Less responsive to medication 4. Greater cognitive impairment 5. More behavioral deficits
Culture (schizophrenia) Schizophrenia affects men/ women abt equally Females have a better long-term prognosis
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
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
Psychotic Episode Features (schizophrenia) 1. prodromal phase 2. acute episode/ phase 3. residual phase
1. Prodromal phase “before”, gradual deterioration → gradual increase of symptoms/ intensity (see negative symptoms)
2. Acute episodes phase “during, positive symptoms occur → complete break of reality
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)
Schizophrenia Diagnosis 2+ symptoms for abt 1 month (acute phase- peak of symptoms in number/ intensity)
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)
Diagnostic features (schizophrenia) positive symptoms - Delusions Disorganized thought Grossly disorganized behavior Stereotypy → repetitive movements (ongoing) Hallucinations
Positive symptoms a break w/ reality → something added that should NOT be there
Types of Delusions (schizophrenia) - Persecution - Reference (ideas of reference) - Being controlled - Grandeur - Thought broadcasting - Thought insertion/ withdrawal
Delusion false beliefs
Thought Disorder Component- Disorganized Thought Breakdown in organization, processing, control of thoughts/ incoherent speech Includes: poverty of speech, neologisms, perseveration, clanging
Halluncinations (schizophrenia) Sensory perceptions in the absence of external stimuli - Auditory → MOST COMMON --> hearing voices
Diagnostic Features- Negative Symptoms (schizophrenia) negative symptoms - Lack of emotions/ expression Loss of motivation/ apathy Anhedonia Social withdrawal Limited speech
Negative symptoms absence of “normal” experiences
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)
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
Theoretical perspectives (schizophrenia) 1, psychodynamic 2. learning 3. family systems
Psychodynamic (schizophrenia) ego overwhelmed by impulses from the id Breakdown of ego causes detachment from reality
Learning (schizophrenia) bizarre behavior is reinforced (conditioning or mimic others- social learning) Maybe mimicking others in some way
Family systems (schizophrenia) looks at communication deviance in the family / expressed emotion → does family communicate in healthy way
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
Biochemical (schizophrenia) dopamine hypothesis Viruses → viral infections/ prenatal infections (lack of vitamin D) Dopamine (in synapse) → overactive in the brain
Treatment (schizophrenia) 1. psychodynamic 2. learning / behavioral
Psychodynamic treatment (schizophrenia) NOT well-suited/ does not help
Learning/ behavioral treatment (schizophrenia) Reinforce desired behavior Reality testing Extinguish undesired, bizarre behavior Token economy (hospitals) Psychoeducation (social skills)
Treatment- Biological (schizophrenia) 1. Antipsychotic medication- reduces positive symptoms 2. Atypical antipsychotics (newer; 1990s)- fewer side effect, lower risk of TD
Permant side effect- Tardive dyskinesia (TD) involuntary movements of the face, mouth, neck, trunk - antipsychotic med
Psychosocial Rehabilitation (schizophrenia) 1. self-help clubs/ rehabilitation centers- provide social support 2. mutli-service rehabilitation centers (skills training)
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
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
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)
Diathesis stress model Diathesis (genetic vulnerability) → stress (birth complications/ cruel fam environment) → schizophrenia
Brief psychotic disorder positive symptoms of schizophrenia (ex: halluncinations or delusions) - Lasts less than one month - Typically precipitated by trauma or stress
Schizophreniform Disorder Psychotic symptoms lasting 1-6 months (> 6 months) would be diagnosed as schizophrenia Associated w/ relatively good functioning - prevalence: 0.2%
Schizoaffective Disorder Syptoms of scizophrenia + additional experience of a major mood episode (depressive or manic) - psychotic symptoms must occur OUTSIDE mood distrubance
Delusional Disorder characterized by delusions that are contrary to reality Lack other positive/ negative symptoms - better prognosis than schizophrenia
Classification of Substance-related disorder (DSM 5-TR) - substance-induced - intoxication - withdrawal - substance-use
Substance-induced disorder induced by using psychoactive substances
Substance-use disorder patterns of maladaptive use of substances that lead to impaired functioning or personal distress
Substance Use Disorders criteria 2+ (of many) symptoms in 12 months
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
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
Dependence (substance related disorders) 1. physiological dependence 2. psychological dependence
Physiological dependence: body is dependent on supply of substances requires BOTH: tolerance + withdrawal
Psychological dependence: use to avoid negative emotional withdrawal (anxiety, depression)
Fatal withdrawal few drugs cause this if physiological dependence / cut off substance when physiological dependence= DEATH
Pathway to Addicition (Stages) Theorized 1. experimentation 2. routine use 3. addicition or dependence
1. Experimentation stage (addicition) curiosity / wants to try the substance to see what it is like
2. Routine use stage (addicition) starts doing after school and starts to become a routine
3. Addcition or dependence stage (addicition) become dependent/ use it everyday
Risk Factors for Developing Addicition 1. Gender- male 2. Age- 20-40 3. Antisocial personality disorder 4. Fam history 5. sociodemographic factors
Stimulants- uppers (drug of abuse) drugs that increase the activity of the nervous system (CNS) / many elevate mood (depending on the drug)
Types of stimulants → amphetamines & meth- aderal / drop appetite → cocaine- mood elevating / sense of euphoria → nicotine- more relaxed → MDMA (molly) → caffine- most common
Stimulants INVOLVE: Dilation of pupils Heart/ breathing rate increase Drop in appetite - Moderate to high risk of OD/ addiction
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
Hallucinogens INCLUDE: LSD PCP Mescaline Psilocybin Marijuana → has depressant effects too (debated) LOW risk of OD/ addiction
Depressants (highest risk) tranquilzier/ alcohol - barbiturates - benzodiazepines - opiates - moderate to High risk of OD/ addiction
Brain changes (for alcohol) - slow movement processing - disrupts memory/ impairs cognition - loss of brain matter/ tissue in cortex - fatal withdrawal (OD high)
Disease model (substance abuse) belief that alcoholism is a medical illness or disease
Gambling disorder patterns of gambling that leads to impairment or distress - nonchemical addiciton - 4 symptoms in 12 month period
Gender dysphoria: significant distress or impaired functioning due to conflict between biological sex/ gender identity
Diagnosis Gender dysphoria distress due to internal identity not matching external body
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
Criteria GD NEED 2 out of the 6 for adults/ adolescents for at least 6 months)/ seen distress/ impairment:
Gender identity: psycholgical sense of being female or male (or nonbinary/ genderqueer)
Gender expression: how a person presents their gender to the world (appearance, behavior, identity-pronouns)
Transgender: ender identity (internal) / gender expression differs from biological sex (external) → may not be a diagnosis unless there is stress
GD Treatment 1. social transition 2. hormones 3. gender affirming surgeries
GD Treatment models 1. gender affirming 2. watchful waiting 3. live in your own skin
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)
Fetishism Recurrent , powerful sexual urges, fantasies or behaviors involving inanimate objects (ex: a balloon)
Created by: lils33
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