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80 Cards in this Set
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- Back
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Major Depressive Episode |
Depressed mood most of the day, every day Has lasted 2 weeks or more Cognitive symptoms: feelings of worthlessness and indecisiveness Physical dysfunction: sleep, eating, motor agnition/ retardation Anthedonia Duration 4-9 months, unreated |
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Anhedonia |
lack of interest in things you love and no longer enjoying them |
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Manic Episode |
Exaggerated elation, joy, euphoria, energy, or irritability Can cause overconfidence which can lead to impulsive decisions that greatly impact life Last 1 week or less Cognitive symptoms: flight of ideas, grandiosity Physical dysfunction: Reduced sleep, hyperactive, pressured speech Duration 3 to 4 months, untreated
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Hypomanic |
just below diagnosis threshold, can still function |
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Unipolar Disorders |
Depression or mania alone Typically depression |
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Bipolar Disorders |
Depression and mania Mixed episodes |
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Major Depressive Disorder |
No mania/ hypomania single episode possible but rare usually recurrent average 4 to 7 episodes (lifetime) Average duration 4 to 5 months |
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Prevalence in Major Depressive Disorder |
16% lifetime, 6% annual Onset: 30 Female:male ration 2:1 |
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Prevalence in Bipolar Disorder |
1% lifetime, .8% annual Fairly consistent across cultures |
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Persistent Depressive Disorder (Dsythymia) |
Milder symptoms 2+ years to get diagnosis chronic and persistent Average onset: early 20s Early onset: before 21= greater chronicity, poor prognosis, stronger family history Median duration= 5 years--depends on comorbidity |
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Double Depression |
Major depressive episodes and dysthymia Dysthymia occurs first Severe psychopathology--poor course and high recurrancy |
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Common Misdiagnosis in Children and Adolescence for Mania |
ADHD and conduct disorder |
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Biological etiology for mood disorders |
Heritability-- 20% for men, 40% for women, higher for bipolar disorders Low levels of seretonin= depression high levels of dopamine= mania Endocrine system: elevated cortisol, supressed hippocampal neurogenesis |
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Pharmacological Tx for mood disorders |
SSRIs- sexual side effects and possible suicide risk for children Tricyclics- can be dangerous if not taken properly MAOIs- fewer side effects; lots of interactions with food and drugs Litium( for mania)- very significant weight gain, takes client off his or her high, increase blood toxicity levels |
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Electroconvulsive Therapy |
Brief electrical current to brain that induces seizures 6 to 10 Tx; high efficiancy for severe depression Few side effects-- short term memory loss Relapse is common |
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Etiology Psychological |
stress and negative life events can trigger depressive episodes learned helplessness/ hopelessness Negatively based attributional process cognitive triad (aaron beck) Automatic thoughts/ cognitive errors negative schemas/ core beliefs |
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Cognitive Triad (Aaron Beck) |
Negative thoughts about self, world, future |
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Cognitive Behavioral Therapy |
4 Phases 1. Behavioral Activation--Greater suicide risk 2.chellenging automatic thoughts 3. identify negative thinking biases 4. Changing primary attitudes |
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Automatic thoughts |
Beliefs about the moment occurences in life
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Attributions |
explanations for events |
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Assumptions |
Beliefs about the nature of the world on a basic level- develops in childhood |
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Schemas |
basic beliefs about nature or self |
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Cognitive Tx for Mood Disorders |
Thought records 1. Situation 2. Emotions 3. Automatic thoughts that precede emotion 4. Rational Response 5. Outcome |
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Internal/External |
Degree to which the event is caused by something within oneself or outside world |
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Global/Specific |
Degree to which the cause will influence many events or few events |
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Stable/Unstable |
Degree to which the course will be present in the future or for only a limited time |
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Combined Tx for Mood Disorders |
Possible benefits above individual Tx 48% benefit from meds or CBT alone 73% benefit from combined |
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Abuse |
Interference with life; could impact education, job, family, etc |
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Dependence |
Symptoms: Tolerance and Withdrawl |
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Depressants |
Alcohol Initially slows inhibition the inhibits judgement, coordination, reflexs, etc. |
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Effects of chronic alcohol use |
Intoxication, withdrawl (delirium tremors), dementia, medical and social problems |
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Alcohol Statistics |
Males>Females, binge drinking=23% Disorders flunctuations in involvement course of dependence: progressive course of abuse: variable
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Stimulants |
Most widely consumed drug (US) Amphetamine, cocaine, nicotine, caffeine Increase alertness and energy |
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Effects of Amphetamine |
"Up"- elation, vigor, reduced fatigue "Crash"- extreme fatigue, depression |
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Effects of Stimulants |
Highly addictive, family and financial destruction, risk of stroke (cocaine), physiological destruction |
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Opiates |
Heroin, morphine, codeine, opium Effective analgesis- pain relief
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Opiates Effects |
Euphoria, Drowsiness, slow breathing--fatality risk due to OD |
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Opiate Withdrawl |
Severe illness for a few days Symptoms: excessive yawning, vomiting, nausea, chills, muscle aches, diarrhea, stomach aches, insomnia |
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Hallucinogens |
Marijuana, Psilocybin Mushrooms, LSD Alter sensory perceptions Can produce delusions, paranoia, and hallucinations |
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Marijuana |
Most frequently used illegal drug Become tolerant Withdrawl and dependence uncommon but can become psychologically addicted |
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Causes of Substance Abuse |
Genetic Predisposition Environment: Acceptability, attitudes, access Psychological: Positive reinforcement- adding really good and high feelings/ tendency to seek rewards Negative Reinforcement- escape from unpleasntness / self-medication/ tension reduction/ coping mechanism for negative effect |
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Agonist substitution |
safer drug introduced |
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Antagonist drugs |
block or counteract the effects of psychoactive drugs |
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Aversive Tx |
perscribed drugs that make ingesting the abused substance extremely unpleasant |
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Psychological Tx for Substance Abuse |
Impatient facilities 12 step program put on in AA and its variations Contingency Managment CBT helps prevent relapse |
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Dissociative Disorders |
all have to do with serious loss in memory that is not organically caused |
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Amnesia |
Loss of memory, usually traumatic events |
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Fugue |
sudden travel with new identity or confusion |
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Tx for Fugue |
None usually necesarry, onset and remission are both typically rapid |
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Dissociative Trance |
Not in the DSM bc it doesnt occur in western cultures Symptoms: sudden shift in personality, sterotypic behavior of being possesed, distressing to individual, not culturally accepted Etiology: Life stress or Trauma NO TX |
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Depersonalization and Derealization Disorder (DDD) |
Feelings of unreality and detachment from self or surrounding Severe/ frightening Significant impairment |
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Etiology of DDD |
People who have developed this disorder tend to have cognitive defects ( attention, short-term memory, spatial reasoning, easily distracted) and decreased emotional response |
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Statistics of DDD |
.8-2.8% / female: male ratio 1:1 High comorbidies with anxiety and mood disorders Tx has not been studied--Prozac not effective |
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Dissociative Identity Disorder |
Dissociation of personality adopt several new identities or alters--average 15 Unique characterisitics--no limitations May be aware of each other or not |
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Etiology of DID |
Severe abuse and trauma history- links with PTSD High Suggestibility Latrogenic |
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Latrogenic |
may be inadvertly caused in Tx by well intentioned therapist asking leading questions |
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Statistics of DID |
1.5% year/ Female: male Ratio= 9:1/ onset= childhood (typically before the age of 9)/ lifelong chronic course |
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DID Tx |
CBT reintegration of identities identify and neutralize cues and trigger visualization coping skills Antidepressants may help in some cases |
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Bulimia and Anorexia |
Intense fear of obesity Driven to be thin Preocupied with food, weight, and appearance High need for perfection--Struggle with anxiety and depression Distorted body image often begin after a period of dieting |
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Bulimia Nervosa |
Binge eating followed by a compensatory behavior Belief that popularity and self-esteem are determined by weight and body shape Most are within 10% of normal weight |
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Medical Consequences of Bulimia Nervosa |
Salivary Gland enlargment Erosion of dental enamel Electrolyte imbalance (potentially fatal) Intestinal problems and permanent colon damage |
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Bulimia Nervosa Statistics |
Female: Mostly caucasian females of middle to upper class, onset is teenage years, lifetime pervalence is 1.5% and is more prevalent among college women Chronic if untreated Male: Mostly caucasian middle to upper class, bisexual or gay, athletes with weight restricitons, onset is earlier |
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Anorexia Nervosa |
Overly successful weight loss-- 15% below expected weight Intense fear of gaining weight and losing control of eating Relentless pursuit of thinness Often begins with dieting body image disturbance pride in diet and control rarely seek Tx |
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Anorexia Nervosa Medical Consequences |
Amenorrhea, dry skin and brittle hair and nails, sensitivity to cold, lanugo, cardiovascular problems--low blood pressure and heart rate Electrolyte imbalance Severe malnutrition |
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Anorexia Nervosa Statistics |
Mostly caucasian, middle to upper class Onset=15 years Chronic, resistant to Tx Comorbid with anxiety, mood, and substance abuse disorders Suicide is very prevalent with anorexia |
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Eating Disorders Etiology Social and Cultural |
Cultural imperatives (Thinness= success) Ideal body size standards-change rapidly and culturally bound Media Standards Social and Gender standards-femal perceptions of ideal weight is lower than males actual prefrences |
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Eating Disorders Etiology Psychological |
Diminished sense of personal control in life Low confidence and self-esteem High standards of perfectionism Preoccupation with how others view self Isolation-both a cause and result Mood tolerance- leads to binging and burging as an effect to regulate mood |
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Dyssomnias |
problems with quality, quanity, and sleep onset Insomnia, sleep apnea, and narcolepsy |
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Parasomnia |
Abnormal behavior, physiological events: sleep terrors and nightmares
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Type of sleep disorder assesment |
Polysomnographic (PSG) evaluation |
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Electroencephalogram |
(EEG) brain waves |
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Electrooculogram |
(EOG) eye movement |
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Electromyogram |
(EMG) muscle movement |
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Electrocardiogram |
(EKG) heart activity |
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Actigraph |
watch-like device that meausres wrist movement |
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Insomnia |
Disrupted sleep or nonrestorative sleep Prevalence 33% (year) Female:Male= 2:1 Frequently associated with anxiety, deprsession, substance use (alcohol) NUMEROUS CASES- biological, psychological, environmental... |
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Narcolepsy |
Daytime sleeiness plus cataplexic attacks-- direct transition into REM sleep--sudden loss of muscle tone--triggered by strong emotion Sleep paralysis Hypnagogic hallcinations Prevalence .03%-.16% Female:Male 1:1 Onset= adolescense Cataplexy, sleep paralysis and hallucinations improve over time, daytime sleepiness persisit |
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Hypnagogic Hallucinations |
very vivid experience that can include all senses, occur at sleep onset (sensation of falling) |
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Sleep Apnea |
10-20% lifetime prevalence, mostly male Disrupted sleep at night and daytime sleepiness--restricted airflow, brief cessations of breathing, can be fatal but rare Associated with Obesity Tx: CPAP machine |
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Psychological Tx for Sleep-Wake disorders |
Combined medication/ behavioral Tx Stimulus control-improved sleep hyqiene Modify unrealistic expectations about sleep Reduce stress and anxiety Relaxation techiques- Diaphragmatic breathing, progressive muscle relaxation
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