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PSYCH 371 EXAM #2
Term | Definition |
---|---|
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) |