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65 Cards in this Set

  • Front
  • Back
symptoms of PTSD
- Person continues to re-experience event

- View event as outside their control

- Avoidance of cues that serve as reminders of the traumatic event

- Emotional numbing and interpersonal problems

- Physiological hyperarousal

- Markedly interferes with one’s ability to functions
How is PTSD similar to other anxiety disorders with regard to criteria?
- Requires exposure to an event resulting in extreme fear, helplessness, or horror
What plays a role in the development of PTSD?
- lack of social support
- direct conditioning and observational learning
- uncontrollability and unpredictability
- trauma intensity
compulsions
thoughts or actions to suppress the thoughts and provide relief
obsessions
intrusive and nonsensical thoughts, images, or urges that one tries to resist or eliminate
symptoms of OCD
- Causes anxiety if rituals aren’t performed

- Thought-action fusion (view the thought of an action just as bad as the action itself)

- Recognize rituals are nonsensical and irrational
risks for development of OCD
- Most people with OCD are female

- Onset is typically in early adolescence or young adulthood

- Tends to be chronic

- Caused by early life experiences and learning that some thoughts are dangerous/unacceptable
treatment of OCD
- Clomipramine and other SSRIs

- Relapse is common with medication discontinuation

- Psychosurgery is used in extreme cases

- Cognitive-behavioral therapy is most effective (involves exposure and response prevention)

- Combining medication with CBT does not work as well as CBT alone
Hypochondriasis Features
- Physical complaints without a clear cause

- Severe anxiety focused on the possibility of having or developing a serious disease

- Medical reassurance doesn’t seem to help
Hypochondriasis Causes
- Cognitive perceptual distortions
- Familial history of illness
Hypochondriasis Treatment
- Challenge illness-related misinterpretations

- Provide more substantial and sensitive reassurance

- Stress management and coping strategies
Clinical description of somatization disorder
- Extended history of physical complains before age 30

- ***Concerned over the symptoms themselves, not what they might mean, as in the case with hypochondriasis

- Symptoms become the person’s identity

- Numerous visits to physicians
Features of conversion disorder
- Physical malfunctioning without any physical or organic pathology (ex: losing sight due to trauma)

- Persons show “la belle indifference” (indifference to the loss of functioning, especially over time)

- Internal conflict so overwhelming that the person unconsciously represses it and it turns into a physical symptom (akin to stress and headaches, zits)

- Retain most normal functions
Treatment of conversion disorder
- Remove sources of secondary gain and supportive consequences of talk about physical symptoms
Features of Dissociative Identity Disorder (DID)
- Involves adoption of several new identities

- Identities display unique sets of behaviors, voice, and posture

- Defining feature is dissociation of certain aspects of personality

- Formerly known as multiple personality disorder
Unique Aspects of DID
- Alters – Refers to the different identities or personalities in DID

- Host – The identity that seeks treatment and tries to keep identity fragments together

- Switch – Often instantaneous transition from one personality to another
Causes of Somatization Disorder
- Familial history of illness
- Weak behavioral inhibition system
T/F
Most depressed persons are not anxious
False
most depressed are anxious
T/F
Stress is strongly related to mood disorders
True
Features of major depression
- Extremely depressive mood state lasting at least 2 weeks

- Feelings of worthless, indecisiveness

- Vegetative or somatic symptoms (central to the disorder!)

- Anhedonia (loss of pleasure/interest in usual activities)

- There is a relationship between depression and sleep (enter REM sleep quicker, deeper).

- Single episodes highly unusual; recurrent episodes more common
Etiology of Major depression
- High genetic component

- Tend to run in families, highest in bipolar disorder

- Concordance rates for mood disorders are high in identical twins

- Heritability rates are higher for females compared to males

- Mood disorders are related to low levels of serotonin
Dysthymia Features
- Persistant depressed mood that continues for at least 2 years

- Symptoms can persist unchanged over long periods

- Symptoms of depression are milder than major depression
What's age is considered late onset of dysthymia?
early 20s
Early onset of dysthymia...
before 21
- greater chronicity
- poorer prognosis
Bipolar I Disorder
- what?
- medicine?
- Alternations between full manic episodes and depressive episodes

- Lithium is primary drug of choice for bipolar disorders.

Prescribing an anti-depressant alone can trigger a manic episode.
Bipolar II Disorder
Alternations between major depressive episodes and hypomanic episodes

(Hypomania – similar to mania, but less severe)
Cyclothymic disorder
- Chronic, low-grade bipolar disorder

- must experience numerous hypomanic episodes and numerous periods of depression for at least 2 years (1 year for children and adolescents)

Must be no history of major depression

High risk for developing bipolar I or II disorder

Cyclothymia tends to be chronic and lifelong.

Most are female.

Average age on onset is early adolescence (12 to 14 years of age)
Types of DSM-IV depressive disorders
major depressive disorder
dysthymic disorder
double depression
Types of DSM-IV bipolar disorders
Bipolar I
Bipolar II
Cyclothymic disorder
Manic episodes, people...
People do very risky things such as quit a job, get a divorce, take out all money, wtc so when they are in the depressive mood they are severely depressed and think about suicide
T/F
Most anxious people are not depressed
True
Internal attributions
negative outcomes are one’s own fault (ex: “I failed because I’m stupid.”)
Stable attributions
believing future negative outcomes will be one’s own fault (ex: “Negative events will continue to happen and continue to be my fault.”
Global attribution
believing negative events will disrupt many life activities (ex: “These budget cuts will really affect my life.”
Two types of cognitive errors
Arbitrary interference
Overgeneralization
Arbitrary interference
overemphasize the negative (discount positives)
Overgeneralization
generalize negatives to all aspects of a situation (ex: “I suck for missing those 2 even though I got an A.”)
Medication for mood disorders
- Tricyclic medications - Block reuptake or norepinephrine and other neurotransmitters

- Monoamine oxidase (MAO) inhibitors – block monoamine oxidase (an enzyme that breaks down serotonin/ norepinephrine); slightly more effective than tricyclics

- Selective Serotonergic Reuptake Inhibitors (SSRIs) – specifically block reuptake of serotonin (ex: Zoloft, Prozac); pose no unique risk of suicide or violence
Psychological treatment of mood disorders
- Cognitive therapy – addresses cognitive errors in thinking; can be just as effective if not more as/than medicine

- Interpersonal psychotherapy – focuses on problematic interpersonal relationships
Suicide: Facts
- 8th leading cause of death in the United States

- Overwhelmingly a white and Native American phenomenon

- Suicide rates are increasing, particularly in adolescents

- Gender differences: 3:1
------Males are more successful at committing suicide
-------Females attempt suicide more often

- Suicide in the family increases risk

- Psychological disorder, low serotonin levels (depression), experience of a shameful/humiliating stressor, publicity about suicide and media coverage increase risk

- Past suicidal behavior increases subsequent risk
Features of Bulimia Nervosa
- Most are over concerned with body shape, fear gaining weight

- Most have co-morbid psychological disorders

- Most are within 10% of target body weight

- Binge eating (Eating is perceived as uncontrollable)

- Compensatory behaviors
Subtypes of Bulimia Nervose
- Purging (most common) - vomiting, laxatives)

- Nonpurging – excess exercise, fasting
Features of Anorexia Nervosa
- Severe weight loss; intense fear of obesity and losing control over eating

- Show a relentless pursuit of thinness, often beginning with dieting

- 15% below expected weight

- Most show marked disturbance in body image and are co - morbid for other psychological disorders
Subtypes of Anorexia Nervosa
- Restricting – limit caloric intake via diet and fasting

- Binge-eating-purging – 50% of anorexics
Etiology of Anorexia Nervosa
- Majority are female and while, from middle- to upper- middle class families; average intelligence

- Likely to come from competitive environments
Pica
repetitive eating of inedible substances
Rumination disorder
Chronic regurgitation and re-swallowing of partially digested food
Causes of Bulimia/Anorexia
- cultural imperative for thinness translates into dieting

- low sense of personal control and self-confidence

- food restriction often leads to a preoccupation with food
What affects males' sexual lifestyle
social status set for men

- sex for fun or in committed relationships
T/F
Females have more sexual partners than males
False
Gender Identity Disorder
- Person feels trapped in the body of the wrong sex, assume the identity of the other sex, but the goal is not sexual

- Causes are unclear, develops between 18 months and 3 years of age
Fetishism
Sexual attraction to nonliving objects
Transvestic Fetishism
- Sexual arousal with the act of cross-dressing

- Males may show highly masculinized compensatory behaviors (most don’t show compensatory behaviors)

- Many are married and the behavior is known to spouse/partner
Sexual Masochism
Suffer pain or humiliation to attain sexual gratification
Sexual sadism
Inflicting pain or humiliation to attain sexual gratification
Voyeurism
- Practice of observing an unsuspecting individual undressing or naked

- Risk associated with "peeping' is necessary for sexual arrousal
Frotteurism
- Rubs themselves against unsuspecting victims

- In most cases, victim doesn't realize
Exhibitionism
- Exposure of genitals to unsuspecting strangers

- element of thrill and risk is necessary for sexual arrousal
Premature ejaculation
- Ejaculation occurring before the man or partner wants it to

- Most prevalent sexual dysfunction in adult males

- Common in younger, inexperienced males

Treatment - squeeze technique
Sexual desire disorder
(Hypoactive Sexual Desire Disorder)
-Little or no desire in any type of sexual activity

- masturbation, sexual fantasies, and intercourse are rare

Treatment - exposure to erotic material
Female orgasm disorder
inability to achieve orgasm despite adequate sexual desire or arousal

Treatment - training
Sexual aversion disorder
Little interest in sex

- Extreme fear, panic, or disgust related to physical or sexual contact
Dyspareunia
Extreme pain during intercourse

(rule out medical reasons for pain)
Vaginismus
Outer 3rd of vagina undergoes involuntary spasms

Treatment - use of dilators
Male erectile disorder
Difficulty achieving and maintaining an erection

treatment
-- viagra, levitra
-- inject vasodilation drugs
-- penile prosthesis or implants
-- vascular surgery
-- vacuum device therapy