Psychopathology Exam #2

Front 1

Diagnosis

Back 1

Label we attach to a set of symptoms that occur together

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Syndrome

Back 2

Set of symptoms that represent a psychological disorder
*not everyone experiences the same symptoms at the same severity

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Idiographic

Back 3

evaluating past experiences and selecting and comparing information about a specific individual or event

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Nomothetic

Back 4

tendency to generalize, and is typical for the natural sciences. It describes the effort to derive laws that explain objective phenomena in general.

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Diagnostic Classification

Back 5

Categories based on commonalities

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Taxonomy

Back 6

The branch of science concerned with classification, esp. of organisms; systematics.

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Nosology

Back 7

The branch of medical science dealing with the classification of diseases.

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Nomenclature

Back 8

The devising or choosing of names for things, esp. in a science or other discipline.

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Nature and Form of Approach

Back 9

Classical (or pure) category
Dimensional
Prototypical

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Critical Issues

Back 10

Reliability
-decreases bias
Validity
-improved coherence

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Purposes

Back 11

Communication
Prognosis
Treatment Planning

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DSM I (1952) DSM II

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Low precision
Very Vague
Based on unproven theories
Poor reliable
Highly psychodynamic

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Anxiety Neurosis

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Due to internal conflicts
Various manifestations

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DSM III (1980) DSM III-R (1987)

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Atheoretical
Removal of the term "neurosis"
Multiaxial System
Low relaiblity
Reliance on consensus

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DSM IV and DSM IV-TR

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Comprehension
Clear inclusion and exclusion criteria
Broad categorization headings
Empirically grounded
Prototypic approach

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The Five DSM IV Axes

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I. Major Disorders
II. Stable, enduring problems
III. Medical Conditions
IV. Psychosocial Problems
V. Rating of adaptive functioning

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Anxiety

Back 17

The state of tension and apprehension that is a natural response to a perceived threat

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Anxiety Disorders

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The frequency and intensity of anxiety responses are out of proportion to the situations that trigger them, and the anxiety interfered with daily life

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Four Components of Anxiety

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Subjective-Emotional: feelings of tension and apprehension
Cognitive: worrisome thoughts and an inability to cope
Physiological: increased heart rate, muscle tension, etc.
Behavioral: avoidance of certain situations, impaired task performance.

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Anxiety Disorders

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Generalized Anxiety Disorder
Panic Disorder with or without Agoraphobia
Specific Phobias
Social Phobia
Post traumatic Stress Disorder
Obsessive Complusive Disorder

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Somatic Symptoms

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Muscle tension, fatigue, mental agitation, soreness
Irritable bowel syndrome

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Specific Phobia: Animal Type

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Typically childhood onset

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Specific Phobia: Natural environment type

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i.e. storms, heights or water
Typical childhood onset

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Specific Phobia: Situational type

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i.e. public transportation, tunnels, bridges, elevators, flying, enclosed places
Common in childhood AND in mid twenties

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Specific Phobia: Blood-injection-injury type

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Seeing blood or injury or receiving injections
Strong vasovagal response

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Treatment: Social Phobia

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Cognitive-behavioral treatment
-Exposure
-Rehearsal
-Role-play
-Group settings

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Events that precipitate PTSD

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Disasters
Common Traumatic Events
Combat and War-Related Traumas
Violent personal assault

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Obsessions

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thoughts, images, ideas, or impulses that are persistent, that uncontrollably intrude upon consciousness, and that cause significant anxiety or distress.
Ego-dystonic - separate from the self

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Compulsions

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repetitive behaviors or mental acts that an individual feels he or she must perform.

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Treatment: Anxiety Disorders

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Somatic management: relaxation techniques to treat physiological symptoms
Cognitive restructuring: identification and modification of negative thoughts that elicit and prolong anxiety
Problem solving: step-by-step active, behaviorally-oriented approach for coping
Exposure: systematic and controlled exposure to the stimuli and situations that are associated with anxiety
Relapse prevention: maintenance and generalization of improvements

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Treatment: PTSD

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Cognitive behavioral therapy: Systematic desensitization is used to extinguish fear reactions to memories; cognitive techniques are used to challenge irrational thoughts. Prolonged exposure
Stress management: Therapist helps client solve concrete problems to reduce stress; may use thought stopping strategies to quell intrusive thoughts
Biological therapies: Antianxiety and antidepressant drugs are used to reduce symptoms

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Acute Stress Disorder

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Occurs in response to similar traumas as does PTSD
Diagnosed when symptoms arise within 1 month of exposure to the stressor and last no longer than 4 weeks
At high risk of developing PTSD

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Insidious

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Treacherous; stealthy; denoting a disease that progresses gradually with inapparent symptoms.

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Chronic

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lasting a long time

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Bulimia Nervosa

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Binge eating & Compensatory behaviors

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Purging

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Vomiting, diuretics, laxatives

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Binge eating: Bulimia Nervosa

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Excess amounts of food
Perceived as ‘out of control’
Lab studies: Binges ranged btw 3013-4477 calories

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Associated Psychological Disorders: Bulimia Nervosa

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Anxiety (75%)
-Social phobia and GAD
Mood disorders (50-70%)
Substance abuse (36.8%)
-Alcohol & Stimulants typically
Pro mia

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Medical Consequences: Bulimia Nervosa

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Salivary gland enlargement
Erosion of dental enamel
Electrolyte imbalance
Kidney failure
Seizures
Intestinal problems
Permanent colon damage

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Anorexia Nervosa

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15% below expected weight
Intense fears
-Gaining weight
-Losing control of eating
Relentless pursuit of thinness
Often begins with dieting
Pro Ana

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Anorexia Nervosa: Subtypes

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Restricting (most common)
Binge-eating-purging

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Medical Consequences: Anorexia Nervosa

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Amenorrhea
Dry skin
Brittle hair and nails
Sensitivity to cold temps
Lanugo
Cardiovascular problems
Electrolyte imbalance

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Binge-Eating Disorder

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Food binges
No compensatory behaviors
Appendix B of DSM-IV-TR
Experimental diagnostic category

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Bulimia: Stats

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90%-95% caucasion, upper class women
5%-10% caucasion, upper class, gay/bi, athlete men
16-19yrs old

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Anorexia: Stats

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90%-95% caucasion, middle to upper class women
13-15yrs old
high relapse rate

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Causes of Eating Disorders

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Cultural imperatives
Ideal body size standards
Media standards
Social and gender standards

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Treatment: Bulimia

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Antidepressants
-May enhance psychological treatment
-No long-term efficacy
CBT (treatment of choice)
Interpersonal psychotherapy
Medications
-Prozac (not effective)

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Treatment: Anorexia Nervosa

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Weight restoration
Psychoeducation
Target dysfunctional attitudes
Long-term prognosis

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Mood Episodes

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Major Depressive
Manic
Mixed
Hypomanic

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Associated Features: Manic Episode

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Multiple days without sleep --> still energized
Racing thoughts
risky behavior
increased sociability
Poor judgement
50%-60% depression precedes right after

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Mixed Episode

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Must meet full criteria for MDE and a Manic Episode
Mood impairment causes dysfunction