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125 Cards in this Set

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persistent thoughts, ideas, impulses, or images that impinge on consciousness


repetitive behaviors or mental acts that people feel they must perform


obsessions that invade the mind, and compulsive behaviors to ease them; can be compulsions without obsessions but rarely the other way around; time-consuming and distressing

bio explanation of OCD

low serotonin activity; orbitofrontal cortex ("primitive impulses) and caudate nuclei (impulse filter)

behavioral explanation of OCD

operant conditioning

cognitive explanation of OCD

strong cognitive reactions to impulses; self-blame, high standards and responsibility

bio treatments for OCD

antidepressants that act on serotonin; 50-80% improve

behavioral treatments for OCD

exposure and response prevention therapy; 55-85% improve

cognitive treatments for OCD

education about misinterpretations; examining and challenging obsessions

OCD related disorders

hoarding, hair-pulling, skin-picking, body dysmorphic

PTSD facts

7.8 lifetime prevalence

- 10.4% for women; 5% for men

Known throughout history

- The Iliad: Ajax and herd of sheep, Herodotus and Shakespeare

- names: hysteria, shell shock, soldier's heart


event that creates demand on us; magnitude determined in part by our appraisal

stress reactions involve what structures?

hypothalamus, sympathetic nervous system, HPA Axis (endocrine system)


almond-sized brain structure; controls many non-conscious activities ex. body temp, hunger, sleep rhythms; when stressed sends out signal to other parts of the body

sympathetic nervous system

receives signal from hypothalamus to activate; fight-or-flight ex. pupils dilate, heartbeat quickens, inhibits digestion

HPA axis

hypothalamic-pituitary-adrenal axis; when activated, produces cortisol and epinephrine (adrenaline)


major stress hormone

epinephrine (adrenaline)

neurotransmitter associated with arousal and attention

5 criteria for stress disorders

1. exposure to traumatic event

2. at least 1 intrusive symptom (dreams, flashbacks)

3. avoidance of associated stimuli

4. memory loss or prolonged negative mood

5. change in reactivity ex. hyper-vigilance, startle response, sleep issues

acute stress disorder timeline

symptoms last no more than 1 month; up to 80% of acute cases develop into PTSD

post-traumatic stress disorder timeline

symptoms last more than a month

bio model for stress

increased cortisol/epinephrine production may stay high after threat has passed...impacts hippocampus (memory) and amygdala (emotions); risk my be transmitted to children

sociocultural model for stress

childhood experiences ex. poverty, divorce, abuse

multicultural factors ex. Latinos may experience higher rates of PTSD

-trauma viewed as inevitable/uncontrollable, high value on social support

-trauma severity: more direct contact with objectively bad situation

humanistic model for stress

personality factors:

-high tendency for anxiety, high levels of perceived uncontrollability = high risk for PTSD

-low meaning-making = high PTSD

-but resilience is the rule, not the exception


anti-anxiety drugs, anti-depressants; may reduce nightmares, panic attacks, flashbacks

behavioral exposure

more efficacious intervention; (re)describe traumatic event in detail and rate anxiety; relaxation training

why does behavioral exposure work?

eye-movement desensitization and reprocessing w/ bilateral stimulation; focus on exposure, not eye movement

cognitive processing therapy

imaginal exposure to traumatic event; focus on meaning of thoughts and feeling assc. w/ trauma; identify "stuck points" or maladaptive beliefs about the the world

group therapy

trauma victims share experience with each other; develop insight, gain social support, see new perspectives and ways of coping

critical incident stress debriefing

trauma victims discuss feelings and reactions extensively within days of trauma to help normalize and manage stress reactions; but may only help high-risk ppl

disorders of somatic symptoms

bodily symptoms or concerns are primary i.e. factitious disorder, body dysmorphic disorder

factitious disorder

"Munchausen syndrome"; deceptive falsification of physical symptoms or production of injury/ disease; can happen by proxy ex. mom telling child they are sick

sociocultural model for factitious disorder

most commonly seen in ppl who;

- received extensive med care as kids

- hold grudges against med profession

- worked in medical/research field

- have little social support/few relationships

- no consistently effective treatments

3 criteria for conversion disorder

1. presence of symptom(s) or deficits(s) affecting voluntary or sensory functioning ex. paralysis, blindness, loss of feeling

2. symptoms are static with known neurological/medical diseases

3. significant distress/impairment

aspects of conversion disorder

1. after time before extreme stress

2. occurs in ppl who tend to be more suggestible

3. usually identified based on unusual symptom presentation ex. paralysis without atrophy

psychodynamic model for conversion disorder

unconscious conflicts from childhood cause anxiety which is converted into more "tolerable" physical symptoms

-primary gain: keep conflict out of awareness

-secondary gain: avoid unpleasant activities or get sympathy from others

behavioral model for conversion disorder

rewards received reinforce "sick role"; often seen in ppl with relatives who recently had similar medical problems; but rewards don't outweigh the costs

cognitive model for conversion disorder

strong emotions are converted into physical symptoms to communicate them more easily

sociocultural model for conversion disorder

in some culture, expression of personal distress through physical symptoms are seen as socially and medically "correct"

research and treatment for conversion disorder

little research evidence exist for etiological models; a variety of approaches but effectiveness of treatment remains in doubt

body dysmorphic disorder

OCD-related disorder; preoccupation with one or more self-perceived defects/flaws in physical appearance or body orders; repetitive behaviors based on concerns; significant distress/impairment; relatively unknown by public; highly stigmatized

body dysmorphic disorder stats

- 50% of sufferers seek plastic surgery

- 30% confine themselves to their home

- 22% attempt suicide

- in men and women equally

treatment: same as OCD

dissociative disorders

disorders associated with major disruption of personal memory or identity i.e. dissociative amnesia, dissociative identity disorder (multiple personalities)

dissociative amnesia

inability to recall important autobiographical information that is beyond ordinary forgetting; related to traumatic/stressful events i.e. combat, child abuse, natural disaster; NOT caused by substance/medical condition

localized DA

most common type; loss of all memory during a limited period of time

selective DA

next most common; can remember some, but not all things, from a specific time period

generalized DA

memory loss extends to time long before upsetting period

continuous DA

inability to form new memories; least common

dissociative fugue

forgetting things about yourself

dissociative identity disorder

"multiple personality disorder"; a person develops two or more distinct personalities with unique sets of memories, behaviors, thoughts, and emotions i.e. 3 faces of Eve

dissociative identity disorder stats

on average;

- 15 "alters" for women

- 8 for men

- different personalities may have different abilities, brain activity, and even allergies

post-traumatic model for DID

children dissociate during traumatic experiences and develop other personalities to help cope with painful experiences and memories

sociocognitive model (iatrogenic effects) for DID

the media, overzealous therapists, and other social cues and expectations led patients to "create" alter

models for DID

not mutually exclusive, but differ in emphasis on the origin and treatment approaches

treatment for post-traumatic DID

psychodynamic therapy and hypnosis to uncover lost memories and alters; therapist try to bond alters into cohesive personality (fusion); BUT most research from single case studies, may uncover repressed memories that are not there

sociocognitive approach

more followed approach; hypnosis techniques make patients more suggestible and help promote the "creation" of new alters; therapists and media unintentionally contributing to an "epidemic" of DID

evidence for sociocultural model

abrupt changes in prevalence rate (1970: 79 cases worldwide to 1999: tens of thousands); new diagnoses associated w/ small group of therapists; individuals w/ DID may be more suggestible

explaining different knowledge between alters

state-dependent learning


temporary, subjective states of feeling i.e. sadness, anger, disgust


observable behavior that goes with emotion i.e. facial expression, body language


pervasive and sustained emotional response i.e. depression and elation

mood disorders

involve discrete period of time dominated by depressed and/or manic mood, reflected in person's behavior; absence of situational cues that would expect mood change; cause clinically significant distress, impairment, and/or harm to person

unipolar disorders

MDD, dysthymic disorder

bipolar disorders

bipolar I and II

emotional depression symptoms

sad, blue, empty, depressed, irritable

behavioral depression symptoms

decreased activity, moving slowly or being very fidgety, change in sleep routine

motivational depression symptoms

lack of interest/desire to pursue usual activities, low energy

cognitive depression symptoms

negative pessimistic view of self, future, world, concentration on difficulties

DSM-5 criteria for MDD

1. presence of 5 or symptoms during 2 week period (for most of day): depressed mood, diminished interest or pleasure, significant weight loss/gain, insomnia/hypersomnia, fatigue/loss of energy, etc.

2. significant distress or impairment

DSM-5 criteria for dysthymic disorder

1. depressed mood for most of the day for at least 2 years

2. similar symptoms to MDD

3. never without symptoms for >2 months

4. no history of (hypo)manic episode

5. significant impairment or distress

unipolar depression (MDD) stats

median age of onset 25; 8% US adult sufferers in any given year, 40% experience recurrent; women (26%) twice as likely as men (12%)

gender differences in depression

1. differences in cortisol, melatonin, and serotonin

2. increased stress in adolescence

3. rumination

causes of unipolar depression

reactive (exogenous): depression following clear-cut stressful events

endogenous: occurring as a response to internal factors (no clear reason- out of the blue)

not easy to differentiate

bio causes of unipolar depression

genetic, tied to genes of chromosomes

- 5-HTT serotonin transporter gene on chromosome 17 which is responsible for production of serotonin transporters which help transport messages from one neuron to another

biochemical factors of unipolar depression

low activity in norepinephrine; elevated levels of cortisol throughout the day

brain circuit dysregulation (unipolar depression)

PFC: regulates mood & attention; certain inhibitory areas are underactive

Amygdala: expression of negative emotions & memories; hyperactive

Hippocampus: formation and recall of emotional memories; reduced in size

Lewinsohn's model forunipolar depression

1. stressor leads to reduction in reinforcers

2. person withdraws

3. reinforcers further reduced

4. more withdrawal and depression

Beck's cognitive model forunipolar depression

thoughts are deeply connected to emotions and behaviors; depression characterized by cognitive triad: negative thinking about the self, world, future; cognitive errors: arbitrary and negative inferences based on little evidence

cognitive model forunipolar depression

automatic thoughts: negative thoughts that occur automatically in response to a situation and serve to maintain depression

schemas/maladaptive attitudes: enduring, organized representations of prior experience that guide the way ppl perceive and interpret environmental events

cognitive: learned helplessness theory (Seligman)

depression is a reaction to the beliefs that: person has no control over rewards/punishments in life, person is somehow responsible for helpless state

states of learned helplessness

1. stable vs. temperature (i'm stupid v. didn't study enough)

2. internal vs. external (i'm stupid v. test was unfair)

3. global vs. specific (i'm stupid v. bad at math but good at writing)

sociocultural model for unipolar depression

family-social perspective, decline with social reward; once depressed, may affect social relationships like excessive reassurance-seeking; social support may reduce duration

bipolar I

presence or history of manic episodes; mixed features and back and forth btwn manic and depressive episodes; causes significant distress or impairment

manic episode

a week (or longer) period of abnormally and persistently elevated, expansive or irritable mood and increased energy for most of the day; need 3 aspects ex. grandiosity, decreased need for sleep, increased (pressure to keep) talking; significant distress or impairment

bipolar II

presence or history of major depressive episodes, no history of manic episode; significant distress or impairment

hypomanic episode

same symptoms as manic, but less severe and distressing; only requires symptoms last for at least 4 consecutive days; not severe enough to impair social or job functioning or require hospitalization


shift btwn mood states in bipolar patients; one cycle per 2 years on average; depressive episode more common (3:1)

suicide rates in mental disorders

bipolar: 15-20%

schizophrenia: 10-15%

borderline personality: 10-15%

unipolar depression: 5-10%

general pop: 1/30 attempts lead to death

bipolar: 1/3

bio causes of MDD

low serotonin + low norepinephrine

bio causes of bipolar

low serotonin + high norepinephrine

permissive theory

serotonin as neuromodulator: low serotonin "opens door" for mood disorder that is then defined by norepinephrine activity

brain structure in bipolar disorder

smaller basal ganglia and cerebellum; lower volumes of gray matter; structural abnormality in raphe nucleus, amygdala, hippocampus, prefrontal cortex; role is unclear

bio-behavioral perspective for mood disorders

zeitgebers (sun/light, temp, routines) give cues to body's natural rhythms and internal clocks (sleep, hunger, etc.); z-disruption -> rhythm disturbance -> associated with onset of manic disorder

monoamine oxidase inhibitors (MAOIs)

1950s antidepressant, breaks down neurotransmitters, resulting in increased serotonin and norepinephrine but very nonspecific effects; side effects: can't eat foods with tyramine (cheese, bananas, wine) or risk hypertension


named for 3-ring structure; block reuptake of neurotransmitters leading to increased activity at synapse; effective in 60-65%; but chance of relapse and side effects include constipation, drowsiness, blurred vision

selective serotonin reuptake inhibitors (SSRIs)

increase serotonin levels (without affecting other neurotransmitters) by preventing reuptake; harder to overdose, fewer side effect: reduced sex drive, headaches, weight gain

electroconvulsive therapy (ECT)

targeted electrical stimulation of the brain leads to seizures; muscle relaxants and anesthesia used to reduce side effects; 6-12 treatments of 2-4 week period; effective w/ severe depression (60-80% improve); side effects: memory loss immediately after, can be permanent

transcranial magnetic stimulation (TMS)

electromagnetic coil placed on or above head; sends a current into the prefrontal cortex increasing activity; reductions in symptoms when administered daily for 2-4 weeks; helpful for recurrent/treatment resistant depression; does not have side effects of ECT

behavioral activation therapy

Lewinsohn's behavioral model; reintroduce clients to activities associated with sense of pleasure and accomplishment; ignore depressive behaviors; improve social skills; works well for mild-moderate depression though less commonly used


attend to and correct (negatively) distorted thinking; includes behavioral techniques; collaborative and time-limited

4 phases of CBT

1. increase activities and elevate mood (activity log)

2. challenge automatic thoughts (test reality; thought record)

3. identify negative thinking and biases (ID illogical thinking)

4. change core beliefs/schemas (behavioral experiments)

sociocultural treatment for depression

interpersonal therapy; focus on problems in current relationships and roles

4 problems must be addressed in IPT

1. interpersonal loss

2. roll dispute

3. role transition

4. interpersonal deficits

bio treatment for bipolar

pharmacotherapy: lithium but need to find correct dosage

mood stabilizers like tegretol but side effects in nausea, vomiting, diarrhea, sedation; >60% effective for manic episodes and less powerful for impact on depressive symptoms; risk of relapse

sociocultural treatment for bipolar

family-focused therapy; ID conflicts w/i fam, resolve them, reduce "expressed emotion" (critical, hostile, over-involved attitudes and behaviors towards person w/ disorder), improve communication

interpersonal social rhythm therapy

focus on maintaining rhythms and resolving interpersonal problems so family can help client cope more effectively

benefits of combo drug and therapy treatment for bipolar

reduces hospitalization, improves social functioning, increases ability to obtain and hold a job


an intentional, conscious effort to end one's life; difficult to study b/c low base rate and accidents vs. intentional; 11th leading cause of death but 3rd among ppl 15 to 24

age and gender differences

increased prevalence with increased age; women attempt more often than men but men die more often than women

cultural differences

whites (men) have the highest prevalence of rate of death by suicide; except Native Americans 1.5 higher times national average

suicide and mental health

not classified as mental disorder but co-occur w/ mental disorders; 90% of ppl who die by suicide have: depression, bipolar, schizophrenia, substance use disorder

risk factors for suicide

lack of connection to others, acute major stressors, long-term stress, consistent hopelessness, dichotomous thinking ("all or nothing"), alcohol/drug use, mental disorders, prior suicide attempts

suicide in military

more deaths by suicide than in military action in 2012

interpersonal theory of suicide

those who desire suicide have perceived burdensomeness and/or thwarted belongingness w/ acquired ability for suicide

acquired ability for suicide

getting used to the threat of pain/danger; repeated and escalating events involving pain and provocation; taboo of suicide diminished w/ habituation (Dr. Thomas Joiner) ex. Kurt Cobain and guns

perceived burdensomeness

death is worth more than my life to loved ones, fam, society; empirically speaking: predicts both ideation and attempts

thwarted belongingness

belief that the person does not (or cannot) have meaningful relationships w/ others; empirically speaking: twins and mothers with many kids at lower risk, national football team wins and lower rates of suicide


target one of three aspects in interpersonal model; belongingness may be most malleable and most powerful

problematic media coverage of suicide

dramatization, "no warning" seems like glorification; can affect someone already considering

suicide myths and stigma

it's selfish: no b/c person thinks death is worth more to ppl than their life

it's cowardly: no b/c self-preservation is real and you gotta push past that to hurt yourself

suicide occurs suddenly: there are always signs, or a planning process

mixed findings with suicide hotlines

hard to evaluate but it's better to have it than to not

treatments for ideation

hospitalization for acute risk; drug treatments (lithium), almost 80% reduction in risk of future suicide

cognitive treatment for ideation

challenge thoughts of hopelessness, replace with more realistic or balanced thinking/coping skills

less reattempts, decreased severity of self-reported depression, reduced hopelessness

what to do when someone is at risk?

look for warning signs (mood changes, prized possessions), make a safety plan, be supportive and get help

what to do when someone is actively suicidal?

remove access to harmful things, convince them to go the hospital, if that doesn't work...call the police