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130 Cards in this Set
- Front
- Back
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Neurodevelopmental Disorders
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intellectual disability
communication disorders autism spectrum disorder attention deficit/hyperactivity disorder (ADHD) neurodevelopmental motor disorders specific learning disorder |
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Autism Spectrum Disorder is characterized by:
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deficits in social communication and interaction
restricted and repetitive behaviors, interests, and activities abnormal or significantly delayed development in social functioning and communication very restricted set of skills of activities and interests |
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Autism Spectrum Disorder Characteristic features:
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social communication impairments
language deficits repetitive behaviors, interests, or activites stereotyped behavior |
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Autism Spectrum Disorder onset
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before age 3
abnormalities are apparent early chronic some children grow into adults who are incapable of living independently |
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Autism Spectrum Disorder prevalence
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4x more in males
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DSM-5 Autism Spectrum Disorder includes:
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Autism
Asperger's Disorder Pervasive Developmental Disorder NOS NOS=not otherwise specified |
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Autism Spectrum Disorder levels of severity
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1: Requiring support
2: Requiring substantial support 3: Requiring very substantial support |
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Austism is defined at 3 different interdependent levels:
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1: neurological disorder related to brain development
2: psychological disorder of cognitive, emotional, and behavioral development 3: relationship disorder in which there is a failure of normal socialization |
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Autism neurological impairement
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Autistic people have neurological impairment:
children show reduced EEG activity in frontal and temporal regions 23.6% autistic patients have EEG abnormalities autistic people show abnormalities of attention to both novel and language stimuli autistic people process things differently |
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Autism genes
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chromosome 7 and 15 are being studied
HOXA1 gene-located on chromosome 7 |
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Pervasive Developmental Disorders (PDDS) characterized by:
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severe disruption in social interaction and communication skills
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DSM-5 PDD list (5)
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Rett's Disorder
Austistic Disorder Asperger's Disorder Childhood Disintegrative Disorder Pervasive Developmental Disorder NOS |
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Rett's Disorder characterized by:
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deceleration of head growth
brain dysfunction intellectual disability significant loss of functional abilities normal development disrupted |
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Rett's Disorder onset
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between 5 and 48 months
normal prenatal and perinatal development |
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Rett's Disorder prevalence
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only seen in females
very rare |
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Social Communication Disorder
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children with social communicative impairments
**no restricted/repetitive behavior** Don't meet the criteria for Autism Spectrum Disorder |
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Asperger's Disorder characterized by:
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severe and sustained impairment in :
social interactions and development of restricted and repetitive patterns of behavior and activities |
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Asperger's Disorder prevalence
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5x more common in males
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Asperger's Disorder development
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language and cognitive development are normal
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Asperger's Disorder vs. Autism
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Asperger's has a higher level of verbal functioning
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Asperger's Disorder treatment
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use verbal cues and verbal problem-solving techniques
verbally mediated treatment programs structured and problem-oriented psychotherapy and counseling treat any existing comorbid conditions (ex: depression) |
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3 Eating Disorders
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Anorexia Nervosa
Bulimia Nervosa Binge-Eating Disorder |
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Anorexia criteria
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body weight is significantly below normal
BMI less than 18.5 for adults intense fear of gaining weight intense fear of being fat distorted body image or sense of body shape |
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Anorexia onset
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early to middle teen
triggered by dieting and stress |
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Anorexia prevalence
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10x in women
0.5-2% found in many cultures-even those not under Western influence-may not include fears of getting fat |
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Anorexia comorbidity
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depression, OCD, phobias, panic, alcoholism, personality disorders
in men: substance dependence, mood disorders, schiz |
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Anorexia physical changes
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low BP
decrease in heart rate problems with kidney and gastrointestines brittle nails dry skin hair loss lanugo-soft, downy body hair depletion of potassium and sodium electrolytes tiredness, weakness, death |
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Anorexia prognosis
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50-70% recover-eventually (6-7 years)
relapse common high suicide rates- 5% completing, 20% attempting 10x higher death rates than gen pop 2x higher death rates than other psychologic disorders |
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Anorexia key changes from DSM-IV
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restricted behaviors promote healthy weight rather than refusal to eat
focus of behaviors that interfere with weight gain loss of menstrual period no longer required for diagnosis subtypes specified for past 3 months rather than just current episode |
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Anorexia personality traits
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greater harm avoidance
persistence conscientiousness perfectionism |
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Anorexia associated clinical features
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compulsivity
overcontrol |
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Anorexia etiology
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focus on body dissatisfaction
focus of fear of fatness restrictive eating and excessive exercise are negatively reinforcing feelings of self control brought by weight loss is positively reinforcing perfectionism and personal inadequacy lead to excessive concern about weight criticism from family and peers regarding weight can lead to anorexia |
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Anorexia treatment
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Hospitalization
Medication Psychological Treatment *long term success depends on attitude change |
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Anorexia hospitalization
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treat hypotension (low BP)
treat irregular heart rate |
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Anorexia medication
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serotonin-enhancing medication
increases happiness and feeling of well-being |
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Anorexia psychological treatment
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family therapy (traditional treatment)
psychodynamic psychotherapy cognitive-behavioral therapy |
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Bulimia criteria
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uncontrollable eating binges followed by compensatory behavior to prevent weight gain
recurrent episodes of binge eating excessive amount of food consumed in under 2 hours feeling of loss of control over eating recurrent compensatory behaviors to prevent weight gain (purging, fasting, excessive exercise, laxatives) body shape and weight are extremely important for self-evaluation binge eating and compensatory behaviors both occur, on average, at least once a week for 3 months |
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Bulimia onset
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late adolescence or early adulthood
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Bulimia prevalence
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90% women
1-2% among women |
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Bulimia comorbidity
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depression, personality disorders, anxiety, substance abuse, conduct disorder
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Bulimia physical changes
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normal BMI
menstrual irregularities potassium depletion from purging laxative use depletes electrolytes-cardiac irregularities loss of dental enamel from stomach acid from purging 4% mortality rate |
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Bulimia prognosis
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suicide attempts and completions higher than gen pop but much lower than anorexia
75% recover (approx) 10-20% remain fully symptomatic early intervention linked with improved outcomes poorer prognosis when depression and substance abuse are comorbid or more severe symptomatology |
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Bulimia key changes from DSM-IV
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min freq of binging/purging changed to once a week instead of twice a week for atleast 3 months
non-purging subtype removed eating binges triggered by stress or negative emotions or negative social interactions typical food choices: cakes, cookies, ice cream, etc avoiding a craved food can later increase likelihood of binge typically occur in secret reports of losing awareness or dissociation shame and remorse often follow |
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Bulimia personality traits
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greater novelty seeking
negative emotionality social insecurity feelings of ineffectiveness stress reactivity perfectionism |
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Bulimia associated clinical features
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affective dysregulation
impulsivity undercontrol |
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Bulimia etiology
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being overweight leads to dieting
low self-esteem rigid restrictive eating triggers lapses many "off-limit" foods disgust with oneself for binging fear of gaining weight negative stress triggers binges restrained eating plays central role in bulimia low levels of opioids promote craving and reinforce binging |
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Bulimia treatment
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psychological treatments
medications + inpatient treatment program medications + self-help manual |
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Bulimia psychological treatments
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cognitive-behavioral therapy
interpersonal therapy (IPT) dialectical behavior therapy (DBT) |
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Bulimia medications + inpatient treatment program
and Bulimia medications + self-help manual |
serotonin-specific reuptake inhibitors (SSRIs)
increase serotonin levels increase happiness and feeling of well-being |
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Binge-Eating Disorder criteria
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recurrent episodes of binge eating, on average, at least once a week for three months
binge eating episodes includes 3 of the following: eating more rapidly than normal eating until uncomfortably full eating large amounts when not hungry eating alone due to embarrassment of food amount feeling disgusted, guilty, or depressed after binge **no compensatory behavior is present** associated with obesity and history of dieting BMI > 30 must report binge eating episodes and a feeling of loss of control over eating 2-25% of obese people may qualify (approx) |
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Binge-Eating Disorder onset
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early adulthood
increasingly common in childhood |
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Binge-Eating Disorder prevalence
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equal among euro-, african-, asian-, and hispanic americans
most common of 3 eating disorders |
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Binge-Eating Disorder comorbidity
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depression
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Binge-Eating Disorder risk factors
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childhood obesity
early childhood weight loss attempts having been taunted about weight low self-concept depression childhood physical or sexual abuse |
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Binge-Eating Disorder prognosis
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60% recover (between 25-82%)
lasts longest of 3 eating disorders- 14.4 years on avg |
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Binge-Eating Disorder key changes from DMS-IV
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Binge-Eating Disorder is a new category in DSM-5
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Binge-Eating Disorder treatment
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cognitive-behavioral therapy
Interpersonal Therapy (IPT) behavioral weight-loss programs |
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Binge-Eating Disorder cognitive-behavioral therapy
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shown to be effective method of treatment
teaches restrained eating through: self monitoring self control problem solving skills more effective than medication |
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Binge-Eating Disorder IPT
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equally as effective as CBT
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Binge-Eating Disorder behavioral weight-loss programs
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may promote weight loss, but do not curb binge eating
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Etiology of Eating Disorders- genetics
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family and twin studies support genetic link
1st degree relatives more likely to have disorder higher MZ concordance rates for anorexia and bulimia heritable:body dissatisfaction, desire for thinness, binge eating and weight preoccupation environmental factors play an even greater role in etiology |
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Etiology of Eating Disorders- neurobiological factors
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hypothalamus not directly involved
low levels of endogenous opioids: reduce pain, enhance mood, suppress appetite released during starvation serotonin related feelings of feeling full (satiety) dopamine related feelings of pleasure and emotion |
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Etiology of Eating Disorders- sociocultural factors
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american society values thinness in women
dieting has become more prevalent body dissatisfaction and preccupation with thinness societal objectification of women-sex objects unrealistic media portrayals overweight individuals are viewed with disgust |
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Etiology of Eating Disorders- gender factors
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objectification of women's bodies
aging and changes in life roles associated with decreased eating-disorder symptoms Western cultures have increased prevalence |
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Etiology of Eating Disorders- other factors
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eating behaviors impacts personality
personality characteristics impact eating family conflict child abuse-physical and sexual |
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Depressive Disorders list
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major depressive disorder (MDD)
dysthymia (persistent depressive disorder) disruptive mood dysregulation disorder premenstrual dysphoric disorder substance/medication-induced depressive disorder depressive disorder due to another med condition |
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Emotion-related symptoms of depression
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persistent periods of feeling down, depressed, or sad
tearfulness or crying increased irritability, anxiety, or loss of temper reduced interest in things which used to be enjoyable |
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physiological symptoms of depression
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changes in weight (10% of body weight change)
changes in appetite changes in sleep habits |
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cognitive symptoms of depression
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changes in concentration
changes in decision making thinking negatively about oneself and/or ones future feeling guilty or remorseful self-denigration (may be delusional) recurrent thoughts of death or suicide |
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behavioral symptoms of depression
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psychomotor retardation
psychomotor agitation functioning less effectively than usual at work or school reduced level of social participation lack of energy feeling unmotivated |
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Disruptive Mood Dysregulation Disorder criteria
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severe recurrent temper outbursts in response to common stressors
temper outbursts are inconsistent with developmental level temper outbursts occur 3 times per week on avg temper outbursts are present in at least 2 settings temper outbursts are severe in at least 1 setting age 6 or higher symptoms present for at least 12 months symptoms don't clear for more than 3 months at a time |
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Disruptive Mood Dysregulation Disorder onset
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before age 10
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Persistent Depressive Disorder
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lower level of depression, lasts longer, chronic
2 years of symptoms in adults 1 year of symptoms in children |
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Premenstrual Dysphoric Disorder criteria
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emotional liability
irritability or anger or increases interpersonal conflicts depressed mood change in appetite-overeating or specific food cravings sense of being overwhelmed or out of control breast tenderness or swelling joint or muscle pain sensation of "bloating" or weight gain hypersomnia or insomnia lack of energy easily fatigued difficulty in concentration |
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Symptoms of MDD across life span
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children: stomach and headaches
adults: distractibility and forgetfulness |
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Lewinsohn's behavioral model of depression
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stressful life events-->
reduction in reinforcers--> person withdraws--> further reduction in reinforcers--> more withdrawal and depression |
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Cognitive theories of depression
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Beck's Theory
Hopelessness Theory Attributional Style Rumination Theory |
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Beck's Theory of depression
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negative triad: negative view of self, world, future
negative schema: tendency to see the world negatively cognitive bias: tendency to process info in neg ways negative schema causes negative bias |
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Hopelessness Theory
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most important trigger of depression is hopelessness
desirable outcomes will not occur person has no ability to change style |
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Attributional Style
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stable and global attributions can cause hopelessness
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Rumination Theory
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specific way of thinking: tendency to repetitively dwell on sad thoughts
most detrimental is to brood over causes of events |
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Seligman's Learned Helplessness Model
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depression results from being in aversive situations in which one has no control over the outcome
3 attributional dimensions: internal/external global/specific stable/unstable internal, global, and stable attributions are most likely to lead to depression |
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Mood Disorders etiology- genetic factors
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37% MDD heritability
93% Bipolar Disorder heritability DRD4.2 gene related to MDD DRD4.2 gene influences dopamine function |
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Mood Disorders etiology- neurobiological factors
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NTs: norepinephrine, dopamine, serotonin
low levels of NTs: MDD high norepin & dopamine, low serotonin: mania NEW MODEL: dopamine receptors may be overly sensitive in bipolar disorder but lack sensitivity in MDD |
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Hypothalamic Pituitary Adrenal Axis (HPA) in MDD
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HPA has been indicated in etiology of MDD
overactivity of HPA axis triggers release of cortisol: stress hormone |
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Cushing's Syndrome
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causes oversecretion of cortisol
symptoms include depression |
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Dexamethasone suppression test
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lack of cortisol suppression in people with history of depression
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Psychological treatment of major depression
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cognitive therapy
behavioral therapy psychodynamic therapy |
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Cognitive therapy for depression
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challenge and change maladaptive thoughts
short term reduces likelihood of depressive thoughts in the future |
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behavioral therapy for depression
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avoid social isolation
restriction of activities that contribute to depression |
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psychodynamic therapy for depression
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strengthen social relationships that provide personal satisfaction
work on how to deal with losing a relationship and how to develop new relationships IPT: short term approach |
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Bipolar and Related Disorders list
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Bipolar I Disorder
Bipolar II Disorder Cyclothymia Bipolar and Related Disorder due to another medical condition |
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Bipolar I Disorder criteria
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at least one episode or MANIA
major depression and mania |
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Bipolar II Disorder criteria
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at least one major depressive episode with at least one episode of HYPOMANIA
major depression and hypomania |
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Cyclothymia criteria
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numerous periods with hypomania and depressive symptoms
milder, chronic form of bipolar disorder lasts at least 2 years in adulthood lasts at least 1 year in children low grade depression and hypomania |
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affective symptoms of a manic episode
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persistent periods of feeling great/better than usual
euphoria increased irritability, anxiety, loss of temper |
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physiological symptoms of a manic episode
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decreased need for sleep + high levels of arousal
extraordinary increase in activity level |
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cognitive symptoms of a manic episode
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distractibility, impulsivity
racing thoughts feeling extremely powerful, special, or gifted inflated self-esteem grandiosity |
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behavioral symptoms of a manic episode
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hyperactivity
excessive engagement in pleasurable activities increased level of social participation |
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Mania, Hypomania, Euthymia (normal) in increasing level of severity
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Euthymia (normal) --> Hypomania --> Mania
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Hypomania symptoms
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feel high
feel overactive dominate the conversation speak quickly need less sleep increased activity some grandiosity starts activities but doesn't finish most |
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Bipolar I, Bipolar II, Cyclomania in increasing order of severity
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Cyclomania --> Bipolar II --> Bipolar I
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Bipolar I Disorder prevalence
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1% in US
0.6% world wide (lower than MDD) |
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Bipolar II Disorder prevalence
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0.4-2%
(lower than MDD) |
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Cyclothymia prevalence
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4%
(lower than MDD) |
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Bipolar and Related Disorders onset
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20s
no gender differences in Bipolar I Disorder |
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Bipolar and Related Disorders consequence
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severe mental illness
suicide rates high 1/3 unemployed a year after hospitalization |
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Bipolar Disorders social and psychological factors
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triggers are similar to those of major depressive episodes:
negative live events neuroticism negative cognitions expressed emotion lack of social support |
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Bipolar Disorders psychological treatment
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interpersonal psychotherapy (IPT):
focus on current relationships cognitive therapy: monitor and identify automatic thoughts mindfulness-based cognitive therapy (MBCT): meditation behavioral activation (BA) therapy: increase participation in positively reinforcing activities behavioral couples therapy: enhance communication and satisfaction, treatment of mood disorders, psychological treatment of BD psychoeducational approaches: provide info about symptoms, triggers, and treatments family-focused treatment (FFT): educate family about disorder, enhance family communication, improve problem solving |
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Personality Disorder general characteristics
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personality trait is not flexible
can't change who you are to fit the situation you're in *disturbance in one's sense of self or identity *chronic interpersonal disturbances |
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Cluster A
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Odd, Eccentric
paranoid schizoid schizotypal |
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Cluster B
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Dramatic, Emotional, Erratic
antisocial borderline histrionic narcissistic |
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Cluster C
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Anxious, Fearful
avoidant (should also be in Cluster A??) dependent obsessive-compulsive |
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Paranoid Personality Disorder
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Cluster A
unjustified suspiciousness of being harmed, exploited secretive, jealous, unforgiving, hostile, rigid, sarcastic read hidden meanings into actions of others |
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Schizoid Personality Disorder
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Cluster A
lack of desire for close relationships lack of enjoyment of close relationships prefer solitude to companionship little interest in sex few or no pleasurable activities lack of friends indifference to praise or criticism flat emotion emotional detachment **believed to be genetically related to schiz** |
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Schizotypal Personality Disorder
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Cluster A
eccentric thoughts and behavior: clothes, talks to self odd beliefs or magical thinking: telepathic, clairvoyant illusions: feels presence of a force emotion is flat similar to schizophrenia 60% heritable enlarged ventricles |
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Antisocial Personality Disorder
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Cluster B
before age 15 disregard for rights of others irritability and aggressiveness history of illegal or socially disapproved activity disregard for the truth reckless and impulsive behavior |
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Antisocial Personality Disorder etiology
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fearlessness
impulsivity deficits in empathy |
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Borderline Personality Disorder (BPD)
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impulsive, self-damaging behaviors
unstable, intense relationships frantic efforts to avoid abandonment anger-control problems chronic feelings of emptiness recurrent suicidal gestures |
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Borderline Personality Disorder etiology-neurobiological factors
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decreased functioning of serotonin system
increased activation of amygdala |
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Personality Disorder overall treatment
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targeted pharmacotherapy
psychotherapy and skills therapy |
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Targeted Pharmacotherapy
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antipsychotic medications for impulsive self-harm
SSRIs for boderline-type emotional stability |
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Psychotherapy and Skills Therapy
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assertiveness training for dependency issues
anger management for aggressive behavior relaxation therapy for various reasons |
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Schizotypal PD treatment
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antipsychotic and antidepressant medications
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Avoidant PD treatment
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antidepressant medications
social skills training |
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Psychopathy/Antisocial PD treatment
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psychotherapy: cognitive-behavior or psychodynamic
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Borderline PD treatment
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difficult to treat-tries to manipulate therapist
antidepressants, mood stabilizers Dialectical Behavioral Therapy *group therapy (essential) *hospitalization (essential) |
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Dialectical Behavioral Therapy
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Linehan
blends almost every kind of therapy *ultimate goal is to accept and then change how one reacts to emotional experiences |
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Antisocial PD treatment
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medications not recommended
individual therapy behavior therapy- limit setting group therapy not recommended |
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Avoidant PD treatment
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systematic desensitization
graduated exposure social skills training cognitive-behavioral therapy SSRIs |
