Abnormal Psych Exam

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Major depressive disorder

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requires major depressive symptoms to be present for at least two weeks. symptoms include depressed mood and lack of pleasure, changes in appetite, concentration, desicion making

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Disthymic disorder

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choronically depressed more than half of the time plus at least 2 of the four symptoms of MDD

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Consequences of depressive disorders

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MDD=most prevalent psychiatric disorders. 16.2 percent meet criteria. twice as common in women than men.

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Seasonal affective disorders

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winter depressions might be due to slower metabolism in winter... related to changes in melatonin

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depression with age

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with each generation age of onset for major depressive disorder gets younger

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3 kinds of bipolar disorders

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bipolar 1 disorder, bipolar II disorder, and cyclothymic disorder,

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Mania

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state of intense irritability accompanied by other symptoms. might be rude and vulgar and loud.= flight of ideas
criteria===increase in goal directed activity, talkativeness, decreased need for sleep, inflated self esteem, distractibility

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mixed episodes of mania

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manic episodes mixed with MDD episodes.

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hypomania

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less extreme mania

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Bipolar 1 disorder (manic depressive disorder)

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a single episode of of mania in a persons life

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BIPOLAR II DISORDER

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person must have experienced atleast one major depressive episode and one episode of hypomania

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Cyclothymic disorder

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frquent but mild episodes of depression alternating with symptoms of mania

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Epidemiology+consequences of bipolar disorders

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1% meet criteria for bipolar 1
-2 percent experience bipolar 2
- 4percent cyclothymic
-occurs equally among genders
- average age of onset isin early 20's.

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more epidemiology of bipolar

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bipolar 1 is most severe among mental illness. 1/3 who suffer remain unemplyed for a year after treatment, highrisk for other anxiety disorders and suicide.

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subtypes of bipolar/depressive disorders

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catatonic features, seasonal/rapid cycling, psychotic features, catatonic features postpartum onset, melancholic

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Gentetic contribution of major depressive

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modest contrib. seotonin receptor disfunction... cortisol high possible change in the dopamine receptors within the reward system

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genetic contribution to bipolar disorder

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High contrib. serotonin receptor disfunction possible involvement of dopamine receptors in the reward system possible deficits in cell membranes and neural functioning.
--bipolar among most heritable of disorders 37% variance explained by genes

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neurotransmitters in mood disorders

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serotonin, dopamine, norepinephhrine. what is actually happening is that receptors are overly sensitive to different neurotransmitters

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tryptophan

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major precursor to serotonin=involved in mood disorders

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other neurotransmitter influences on mood disorders

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second messengers adjust postsynaptic receptor sensitivity
-g protiens=important role modulating activity in the post synaptic cell

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Primary brain structures involved in depression

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amygdala, hippocampus, subgenual anterior cingulate, prefrontal cortex (structures help retreive memories about previous stimuli)

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possible cause of depression

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changes in the reward pathways

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Neuroendocrine system

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Cortisol disregulation and depression

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HPA access

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biological systen that manages the reactivity to stress, Regulates CORTISOL
Receives input from structures related to the amygdala

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Cushing's syndrome

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overproduction of cortisol=frequently experience depressive episodes

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altruistic suicide

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Altruistic suicide is suicide committed for the benefit of others. Falling on a grenade is one such example

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anomic suicide

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is a suicide resulting from a lack of normative integration

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egoistic suicide

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occurs in a society where there is excessive individualism, that is, low integration into society

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Mindlfullnes based cognitive therapy

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Mindfulness-based cognitive therapy (MBCT) is psychological therapy which blends features of cognitive therapy with mindfulness techniques of Buddhism.

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MAOI

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any of a group of antidepressant drugs that inhibit the action of monoamine oxidase in the brain and so allow monoamines to accumulate

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Negative triad

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Beck's negative triad holds that depressed people have negative thoughts about themselves, their experiences in the world, and the future.

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postpartum onset

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Ocuuring after a trauma

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psychoeducational approach

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of or relating to the psychological aspects of education; specifically : relating to or used in the education of children with behavioral disorders or learning disabilities

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SSRI's

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any of a class of antidepressants (as fluoxetine or sertraline) that inhibit the inactivation of serotonin by blocking its reuptake by presynaptic nerve cell endings—called also selective serotonin reuptake inhibitor

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tricyclic antidepressants

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any of a group of antidepressant drugs (as imipramine, amitriptyline, desipramine, and nortriptyline) that contain three fused benzene rings, that potentiate the action of catecholamines (as norepinephrine and serotonin) by inhibiting their uptake by nerve endings, and that do not inhibit the action of monoamine oxidase

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tryptophan

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essential amino acid that is a precursor to erotonin

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Freud's factors in depression

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potential for depression is created in early childhood
-childhood trauma= feelings of anger and mourning become directed inwardly

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somatic arousal

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sweaty palms, fast heart rate,

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Comorbid anxiety and depressive disorders

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people who feel high negative affect, low positive affect and high somatic arousal.

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Neuroticism

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personality trait that develops from tendancy to overreact to events with greater than average negative affect.

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Extraversion

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personality trait associated with frequent experiences of positive affect.

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Beck's theory

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most important theory: proposed negative triad: people get sad because they think negatively. they create negative schemata in childhood

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Schemata

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underlying set of beliefs that underly a persons thoughts and judgements

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cognitive biases

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tendencies to process information in negative ways

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Dysfunctional attitudes scale

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tested becks theory: tests how people think about themselves and others

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Learned helplessness theory

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uncontrollable aversive event>> sense of helplessness>>depression

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attributional Reformation

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aversive event>> attribution to interna; stable and globaal factors>>Sense of helplessness;no response available to alter situation>>depression

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hopelessness

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aversive evets>>attribution>>expectation desirable outcomes will not occur>> hopelessness subtype of depression defined by specific symptoms

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casses of mania

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disruption of the reward pathway system

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criteria for substance abuse

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3 or more: tolerance/withdrawal/desire to control use, much time spent trying to obtain, continued use despite knnowing the consequences

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Criteri for substance abuse

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1 of the following: failure to meet obligations, repeated use in situations where it is dangerous, repeated legal problems, continued use despite poor health

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Delerium tremens

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when alcohol in blood drops suddenly person becomes delerious, hallucinates, tremulates.

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prevalence

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12-17% rate of lifetime prevalence of dependence-abuse respectively

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alcohol comorbidity

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comorbid with mood disorders schizophrenia anxiety

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expenditures on health care

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26 billion annually in the US

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Short term effects of alcohol

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produces effect by stimulating GABA receptors, increases serotonin and dopamine, inhibits glutamate receptors=slow thinking

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Long term effects of alcohol

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Fetal alcohol syndrome, vitamin deficiency, loss of memory, cirrhosis of the liver, ED heart failure, hypertension, stroke,

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Nicotine and Cig smoking prevalence

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440,000 die each year. responsible for 1 of 6 deaths. cost of smoking each year 157 Billion

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Second hand smoke

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40,000 deaths a year, can suffer lung damage, cardiovascular disease lung cancer. babies born prematurely. Infant death syndrome

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Marijuana

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Hashish much stronger, 15 percent of people have smoked marijuana

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physical consequences of marijuana

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effects two cannabis receptors CB1 and CB2 high number in hippocampus (CB1) ... increases blood flow to the brain and amygdala

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therapeutic effects oof weed

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reduce nausea and loss of appeite from chemotherapy treatment for discomfort of aids.

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Opiates

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morphine heroine codiene opium minor tranquilizers, synthesized barbiturates

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morphine, heroine

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separated from opium in 1806- 1874 this turned into heroin.... legal opiates=hydrocodon vicodin

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depressants
(anxiolytics, sedatives)

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Alcohol...tension reduction followed by depressed physical and psychological functioning...disorientation, loss of consciousness, death at extremely high BALs

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Alcohol age of onset

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in 2005, 34% of 8th-graders and 57% of 10th-graders reported alcohol use in the past year (Johnson et al., 2006)

15% of 8th-graders and 30% of 10th-graders reported use of an illicit drug

age at first use declined for decades, until the early 1990s (NIAAA):

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alcohol prevalence

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prevalence (Kendler et al., 2005)

lifetime prevalence of alcohol abuse and dependence about 13% and 5%, respectively

lifetime prevalence of drug abuse and dependence about 8% and 3%, respectively

about 15% of people experience some form of substance use disorder (SUD) in their lifetime

prevalence of opiate addiction increasing rapidly

large cohort effects in lifetime prevalence:

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heritability

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very high heritability of nicotine and alcohol dependence

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Alogia

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is one of the "negative" symptoms of schizophrenia, where it may take the form of speaking very little or a lack of spontaneous content in conversation, called "poverty of speech."

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asociality

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Asociality is a negative symptom frequently observed in schizophrenia patients. It is characterised by an inability to 'empathise', to feel intimacy with, or to form close relationships with others

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avolition

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Avolition is a psychological state characterized by general lack of desire, drive, or motivation to pursue meaningful goals

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catatonia

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Abnormality of movement and behavior arising from a disturbed mental state. It may involve repetitive overactivity, catalepsy

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dementia preacox

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schizophrenia: any of several psychotic disorders characterized by distortions of reality and disturbances of thought and language

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dopamine theory

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The dopamine hypothesis of schizophrenia or the dopamine hypothesis of psychosis is a model attributing symptoms of schizophrenia (like psychoses) to a disturbed and hyperactive dopaminergic signal transduction

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flat effect

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A severe reduction in emotional expressiveness. People with depression and schizophrenia often show flat affect. A person with schizophrenia may not show the signs of normal emotion, perhaps may speak in a monotonous voice, have diminished facial expressions, and appear extremely apathetic. Also known as blunted affect.

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ideas of reference

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Ideas of reference and delusions of reference involve people having a belief or perception that irrelevant, unrelated or innocuous phenomena in the world refer to them directly or have special personal significance: 'the notion that everything one perceives in the world relates to one's own destiny

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loose associations

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thought or communication pattern disorder characterized by loose or odd connections between ideas. A person having this disorder is unable to express a set of well-structured, logically related ideas.

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residual schizophrenia

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Blunted or inappropriate affect, social withdrawal, eccentric behaviour, or loose associations, but without prominent psychotic symptoms, as the remains of former psychotic symptoms of schizophrenia.

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schizoaffective disorder

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Schizoaffective disorder is a psychiatric diagnosis that describes a mental disorder characterized by recurring episodes of elevated or depressed mood, or of simultaneously elevated and depressed mood, that alternate with, or occur together with, distortions in perception.

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schizophreniform disorder

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Schizophreniform disorder is a mental disorder diagnosed when symptoms of schizophrenia are present for a significant portion of the time within a one-month period, but signs of disruption are not present for the full six months required for the diagnosis of schizophrenia.

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undiferentiated hypothesis

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Patients in this category have the characteristic positive and negative symptoms of schizophrenia but do not meet the specific criteria for the paranoid, disorganized, or catatonic subtypes.