Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
41 Cards in this Set
- Front
- Back
|
Anxiety Disorders |
- When one has a negative affect and an emotional response is followed - Somatic symptoms of tension --> physiological - Future oriented anticipation of danger --cognitive FEAR = abrupt activation of sympathetic NS |
|
|
Specific Phobia |
- Marked fear of an object or situation - Immediate fear/anxiety - Disproportionate to danger - Avoidance -Distress/impairment TYPES: Animal, blood, situational, natural environment, other (i.e., vomiting, choking) EPIDEMIOLOGY: Lifetime prev. = 12%, medium age of onset is 7yrs, chronic course, >females ETIOLOGY: Psycho: Repressed id impulses/projection Behavioral: Learning, 2 factor model (maintained through operant cond. = avoidance) Cognitive: Maladaptive thoughts (over-estimate danger) Genetic: Family and twin studies suggest a role TREATMENT: 1. Psychoanalytic: Uncover repressed conflicts 2. Behavioral: exposure to stimuli (desensitization) 3. Cog. Therapy: Cog. restructuring 4. Cog. Behav. 5. Medication: Anxiolytic drugs (valium), MAOI's (problematic because it inhibits exposure effect) |
|
|
Panic Attack |
- Abrupt, intense fear/discomfort accompanied by 4 or more symptoms. Symptoms: palpitations, sweating, trembling, shortness of breath, choking, chest pain, nausea, dizziness, chills, flush etc. - Depersonalization: feeling outside one's body - Derealization: feeling the world is unreal |
|
|
Panic Disorder (know the diff. between this and attack) |
- Unexpected panic attacks - Lasts one month+ (worry about future attacks/avoidance) - Agoraphobia: fear/avoidance of situations/events outside of home, where escape would be difficult in panic EPIDEMIOLOGY: Lifetime prev = 4.7%; avg. age of onset = 25-29; 2x more common in females - Psycho: id impulses come to awareness - Cog.: Catastrophic misinterpretation of bodily symptoms - Behavioral: Interoceptive cond. (panic attack=UCS-->fear=UCR; Panic like sensations/symp. =normal--> full panic attack=UCS; mild autonomic arousal=CS-->fear=CR) ETIOLOGY: 1. Bio model: Overly sensitive suffocation alarm symptoms, genetic diathesis - medications=anti depress. and anxiolytic drugs 2. CBT: relaxation training, breathing retraining, interoceptive exposure, in-vivo exposure to agoraphobic situations*, cog. therapy TREATMENT: - Best option = CBT, taking drug can cause relapse of disorder
|
|
|
Social Anxiety Disorder (Social phobia) |
- Fear in social and/or social performance situations - Negative evaluation - Avoid situations endured w/ stress - Distress/impairment - Commonly feared situations: conversing, eating, urinating, speaking, writing sig., etc. EPIDEMIOLOGY: lifetime prev =13%, peak age of onset = 11-13 yrs., men more likely to seek help ETIOLOGY: 1. Biological: Bio and evolutionary vulnerability 2. Behavioral: Cond., observational learning, info transmission 3. Cognitive: Social evaluation = dangerous TREATMENT: - Medical: Beta blockers, tricyclic antidepressants and MAOI's, SSRI Paxil (increased rates when med. is discontinued) - CBT: Exposure to social situations in group therapy, cog therapy, social skills training (HIGHLY EFFECTIVE) |
|
|
Generalized Anxiety Disorder (GAD) |
- Excessive, uncontrolled worry - 3 or more symptoms: muscle tension, restlessness, fatigue, irritability, trouble concentrating EPIDEMIOLOGY: Lifetime prev=4-7%, onset in early adulthood, 2x more common in females, more common in racial/ethnic minorities and families with low SES ETIOLOGY: - Psychoanalytic: unconscious conflicts between ego and id - Cog. behavioral: worry as avoidance - Cognitive: Intolerance of uncertainty - Biological: GABA deficiency; tendency to be anxious runs in families TREATMENTS: - Psychoanalytic therapy: Reveal sources of conflict - Cog. Behavioral: Worry exposure, stimulus control, relaxation training Medication: anxiolytic drugs |
|
|
PTSD |
- Exposure to traumatic events - One month or longer (or acute stress disorders) 1. re experience-->(1min#)-->Intrusive memories/flashbacks 2. Avoidance-->(1min#)-->Avoid memories/external reminders 3. Arousal-->(2min#)-->Exaggerated startle 4. Cog. Affective-->(2min#)-->amnesia, neg. beliefs, self blame, emotions EPIDEMIOLOGY: - Lifetime prev=7% civilians, 18.5% veterans - Common traumas = sexual assaults, accidents - Risk factors: trauma (severe and caused by human acts), uncontrollable and unpredicted events, family history, low ss after trauma ETIOLOGY: - Behavioral: Direct cond. and observable learning; negative reinforcement maintains symptoms - Cognitive: Guilt/self blame -Biological: small hippocampus TREATMENT: - Behavioral: prolonged exposure to memory - Cog.: correct perceptions of self blame - Medications: SSRI's
|
|
|
OCD |
Obsessions = intrusive, recurring thoughts (contamination, aggression, sexual, symmetry) Compulsions = Repetitive behaviors/mental actions repeated to reduce anxiety (cleaning/washing, checking, mental rituals, arranging) EPIDEMIOLOGY: Lifetime prev=1.6%, onset in early adolescence/young adulthood, chronic course ETIOLOGY: - Psychoanalytic: arrested personality dev. at anal stage - Behavioral: Comp. (-) reinforced - Cog.: Thought-action-fusion - Bio: Frontal lobes/basal gangli activation TREATMENTS: - Psych = noneffective - Behavioral: exposure and response prevention -Bio = Drugs that increase serotonin (clomipramine and SSRI's); psycho surgery
|
|
|
Trichotillomania/ Excoriation disorder |
Tri. = repetitive hair pulling - Can produce feelings of pleasure - Sensory stimulation = important Ex. = skin picking resulting in skin lesions - 1.4% of population - Must be some social/occupational impairment |
|
|
Body Dysmorphic Disorder (BDD) |
- Preoccupation with imaged defect in appearance (i.e., face, head, sex organs, body) - Repetitive acts - Distress/impairment - Common: suicide ideation, cosmetic surgery EPIDEMIOLOGY: Prev. = unknown, mean age = 18-19, chronic and equally affects males and females, women focus on hips/breasts, men on height, influenced by social standards
|
|
|
Hoarding Disorder |
- Difficulty discarding (distress) - Perceived need to save - Clutter
|
|
|
Body Image Disturbance |
- Overestimate actual size - Unrealistically low ideal size - Social comparison - Sensitivity to fullness
|
|
|
Binge Eating |
- Unusually consume large amounts of food - Lack of control - Typically dessert/snack food - Most likely at home, alone, at night, after unstructured activity, in a negative mood |
|
|
Purging |
- Attempts to compensating for binge eating and prevent weight gain - Self-induced vomiting, laxative, diuretics, enemas, excessive exercise, chewing/spitting food out
|
|
|
Bing-Purge-Cycle |
- Inadequate coping leads to negative affect - Extreme dieting leads to hunger - Bing-->guilt-->purge-->anxiety reduction-->guilt/depression |
|
|
Anorexia Nervosa (AN) |
- Significantly low weight due to restriction - Intense fear of gaining weight/becoming fat - Denial of how serious low weight is - Disturbance in way body weight/shape is experienced - Specify: restricting or binge (eating-->purge) |
|
|
Binge Eating Disorder (BED) |
- Binge eating at least 1x/week for 3 months - Symptoms 3+: eating rapidly, uncomfortably full, eating alone (embarrassment), disgusted, depressed, guilty - Must cause distress |
|
|
Other Feeding/ Eating disorders |
- Sub threshold AN - Sub threshold BN - Sub threshold BED - Purging Disorder - Night eating syndrome
|
|
|
Eating Disorder Prevalence |
AN: 0.9% women, 0.3% men BN: 1-3% women, 0.1-0.5% men BED: 3.5% women, 2% men Subclinical AN: 1-3% Subclinical BD: 5-6% Women more likely to have disorder |
|
|
Medical Complications: Anorexia |
- Weight loss - Hypothermia - Suicide - Mortality - Amenorrhea - Delayed Gastric Emptying - Dental Problems (highest mortality rate of any psych disorder) |
|
|
Bulimia |
- Electrolyte imbalance - Metabolic alkalosis - postural irregularities - Esophageal tears/raptures - Weight fluctuations - Chronic renal failure |
|
|
Eating Disorder Risk factors |
Family: - Maternal body dissatisfaction, internalization of ideals, dietary restraint, bulimic symptoms - Overweight/obese parents Sociocultural: - "Thin ideal" Personal: - Dieting, childhood obesity, body image dissatisfaction, low self esteem Peer influences: - Teasing, peers value thin-ideal, peers diet/purge Overvalued beliefs: - Perfectionism, asceticism Personality: - Control and impulsivity Early menarche Athletic participation: - elite athletes in sports, emphasizing thinness - dance/ performance sports
|
|
|
Eating Disorder Treatments |
Nutrition Support: nasogastric tube, nutritional supplements Medication: Antidepressants, neuroleptic and anti psychotics, appetite stimulus - MEDICATION DOES NOT TARGET DISORDER Psychotherapy: cognitive/behavioral
|
|
|
CBT--Eating Disorder |
- Nutrition interventions (meal planning, weekly goals, hydration - Psycho education (food pyramid, truth about purging) - Distraction/alternative beliefs - Cognitive restructuring - Body image interventions (no weighing/checking and vivo body exposure) - In vivo food exposure - Exposure with response prevention - Relapse prevention EFFICACY: - purging = 79% reduction; 57% remission - Binge = 86% reduction; 55% remission - Broad effects: decrease dietary restraint, regulates eating, improves associated psychopathology |
|
|
Eating Disorder Prevention |
- Psycho education = failure (info causes consequences) - Dissonance-based programs = possessing inconsistent cognitions create psychological discomfort, motivates people to alter beliefs to restore consistency |
|
|
Schizophrenia--Historical Background |
Emil Kraepelin: "Dementia praecox" - Early deterioration - Subtypes: Catatonia, hetephrenzia, and paranoia
Eugen Bleuler: "schizophrenia" - Splitting of the mind - Breaking of association threads
|
|
|
Schizophrenia vs. Psychosis |
Schiz: Psychotic disorder involving disturbance of thought, emotion, and behavior -Heterogeneous symptoms Psychosis: Broad term (involving hallucinations/delusions)
|
|
|
Positive symptoms (something not normal) |
Hallucinations: sensory experiences in absence of environmental stimulation - Auditory= most common (command is the worst because indication of bodily harm) - Can involve any sense = tactile, somatic (spiders), visual, olfactory (smell), gustatory (taste)
Delusions: beliefs contrary to reality |
|
|
Types of Delusions |
Delusions of.... - Persecution (most common); grandeur (thinking one is a higher being); reference (relating irrelevant things to self); influence (being controlled)
Thought... - Broadcasting (one's thoughts projected outlaid); insertion (thoughts in one's head); withdrawal (thought's sucked out of mind)
Capgras syndrome: "Someone I know has been replaced by a double" |
|
|
Negative Symptoms of Schizophrenia (behavioral deficits) |
- Avolition (apathy): lack of inhibition/persistence - Alogia: Reduction in speech - Anhedonia: Lack of pleasure - Affective Flattening: Little Expressed emotion - Associality: Severe relationship impairment
|
|
|
Disorganized symptoms of Schizophrenia (severe and erratic disruptions in speech, behavior and emotion) |
- Disorganized speech (thought disorder): Word salad, loose associations, neologisms, perseverations, clanging - Disorganized affect: Inappropriate emotional behavior - Disorganized behavior: unusual behavior (catatonia--spectrum of motor dysfunctions) |
|
|
DSM-5 classification for Schizophrenia |
2 active phase symptoms for > 1 month - Delusions*, hallucinations*, disorganized speech*, disorganized/catonic behavior, neg. symptoms - Continuous signs for greater than 6 months |
|
|
Epidemiology of Schiz. |
- Lifetime prevalence is 1% - Onset in early adulthood - Abrupt or gradual onset - Chronic course - Moderate-to-severe impairment - Slightly to below average life expectancy - INCREASED RISK FOR MORTALITY |
|
|
Gender and sociocultural differences with Schiz. |
Gender: - Slightly more common in men - Age: men = 18-25; women =25-35 - Females have better long-term prognosis
Socio-cultural: - In US diagnosed more frequently in African Americans than whites - Associated with low SES |
|
|
Other Disorders with Psychotic Features |
- Schizophreniform disorder: premorbid functioning (few months of schizo symptoms) - Schizoaffective Disorder: Symptoms of schizophrenia - Delusional disorder: Delusions w/out +/- symptoms (grandiose, persecutory, erotmatic, jealous, somatic - Brief psychotic disorder: one or more positive symptoms for more than 1 month; precipitated by stress, remits on own - Shared psychotic disorders: Delusions from one person manifest in another - Schizotypal personality disorder: less severe form of schizo.
|
|
|
Etiology of Schizophrenia (genetic influences) |
- Family studies: inherit tendency for schizo/psychosis; greater risk with relatedness - Twin studies: MZ twins =44-48% concordant, DZ=12-17% - Linkage studies: Inconclusive - Schizophrenia likely involves multiple genes and results from gene-environment interactions
|
|
|
Neurotransmitter association |
Dopamine Hyp: Limbic (excess and symptoms); cortical (low, neg. symptoms) - Drugs that increase dopamine result in schizo like behavior (e.g., amphetamines and L Dopa for Parkinson's) - Drugs that decrease dopamine reduce symptoms (i.e., neuroleptics) |
|
|
Other things that cause an onset of schizophrenia |
- Brain abnormalities: brain ventricles, under/over active frontal lobes, grey matter loss (synaptic pruning) - Influenza during prenatal period |
|
|
Psychological and Social influences of Schizo. |
- Stressful life events -- (may activate vulnerabilities, increase relapse) - Family interactions -- (high expressed emotion-critical, hostile, over involved; also increases relapse) - Majority of high E.E.: US = 70% communication style (tells us how families would react with a schizophrenic child) |
|
|
Medical treatments for Schizo. |
- Historical Precursors: Prefrontal lobotomy - Antipsychotic (neuroleptic) drugs: traditional (Thorzine), newer antipsychotics (Clozaic), reduce/eliminate positive symptoms, side effects are common, and compliance is often a problem
|
|
|
Psychological Treatments |
- Case management - Behavior Therapy (token economies on inpatient units, social and living skills training) - Cog. Behavioral Therapy - Family therapy - Vocational rehabilitation - These interventions do play a role in helping reduce relapse |
