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Abnormal Psychology Final Exam Review 2
from exam 2
70
Psychology
Undergraduate 2
04/27/2011

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Term
Dissociative Identity Disorder (DID)
Definition
- formerly MPD
- 2+ personalities or personality states
- at least 2 of these personalities/states recurrently take full control of person's behavior
- inability to recall important personal info that is too extensive to be explained by ordinary forgetfulness (amnesia)
Term
Typical case of DID
Definition
- mean of 10 personalities (children, protector, persecutor, opposite sex)
- severely disturbed (majority sexually abused, attempted suicide, hospitalized, PTSD)
Term
Diagnostic Controversy in DID
Definition
look for symptoms of : amnesic periods of dominant personality, severe physical/sexual childhood abuse, turbulent psychological history, highly hypnotizable, nickname incongruent with dominant personality
Term
Dissociative Amnesia
Definition
- formerly psychogenic amnesia
- predominant disturbance is 1+ episode of sudden inability to recall important personal info, usually of traumatic stress
- 4 types
Term
Localized Dissociative Amnesia
Definition
lost memory of specific event, most common
Term
Selective Dissociative Amnesia
Definition
lost memory of disturbing past
Term
Generalized Dissociative Amnesia
Definition
forget whole life (rare)
Term
Continuous Dissociative Amnesia
Definition
unable to form new memories, La Belle indifference (very rarely psychologically driven; more likely due to head injury)
Term
La Belle Indifference
Definition
lack of concern for symptoms or disability
Term
Dissociative Fugue
Definition
- formerly psychogenic fugue
- amnesia on the run
- predominant disturbance is sudden, unexpected travel away from home/work with inability to recall past
- assumption of new identity
Term
Depersonalization Disorder
Definition
- persistent/recurrent experiences of feeling detached from one's mental processes/body - "outside observer"
- out of body experience
- 50% in threatening situations
Term
Derealization Disorder
Definition
- odd changes in perception of one's surroundings or weird sense of passage of time
Term
Psychodynamic - Kluff's theory(Theoretical Perspectives of DID)
Definition
- have capacity to dissociate (hypnotizable)
- experience trauma
- develop imaginary friend, turn into another person (becomes an alter)
- feel conflicts about testing out reality of other & telling anyone
Term
Learning & Cognitive (Theoretical Perspectives of DID)
Definition
- within biological capacity, learn to shift to other (usually following trauma)
Term
Treatment for DID - Psychodynamic
Definition
uncover memories (hypnosis), have alters share their memories
Term
Treatment for DID - Biological
Definition
none
Term
Treatment for DID - Behavioral
Definition
reinforce use dominant, find functionality of each alter and teach skills to dominant
Term
Treatment for DID - Spiegel's Eclectic Treatment
Definition
(with alters): confront the trauma, process and grieve trauma, confess, make dissociative material conscious, achieve control
Term
Conversion Disorder (Somatoform Disorders)
Definition
- hysteria (wandering uterus - Hippocrates)
- la belle indifference
- 1+ of symptoms or deficits affecting voluntary motor/sensory function that suggest a neurological/medical disorder
- psychological factors judged to be etiologically related to the symptom because a temporal relationship exists between a psychological stressor and initiation or exacerbation of the symptom
- not intentionally producing symptoms
- not a culturally sanctioned response
- cause impairment in daily functioning
Term
Hypochondriasis (Somatoform Disorders)
Definition
- preoccupation with the fear of having or the belief of having a serious disease, based on misinterpretation of physical sensations
- preoccupation persists despite appropriate medical evaluation and reassurance
- significant stress/impairment
- duration of at least 6 months
Term
Somatization Disorder (Somatoform Disorders)
Definition
- what lay people call hypochondriacs
- a history of many physical complaints or belief of illness, before age 30, persisting for years, resulting in sought treatment or significant impairment in daily functioning
- must have 4+ pain sxs (symptoms), 2+ gastrointestinal sxs, 1+ sexual sxs, 1+ pseudoneurological sxs
- either: 1) after investigation, each of the sxs can't be fully explained by medical condition or substance use, or 2) when there is related medical condition, complaints/impairment excessive according to what would be expected from history, physical exam, or lab tests
- sxs not intentionally produced/feigned
- heavy user of med care
- 10x women vs men
- 1 in 1,000
Term
Body Dysmorphic Disorder (Somatoform Disorders)
Definition
- preoccupation with an imagined defect in appearance; if slight anomaly is present, concern is excessive
- causes distress/impairment in daily functioning - social, occupational, etc.
- preoccupation is not better accounted for by another mental disorder e.g. anorexia
Term
Factitious Disorder (Somatoform Disorders)
Definition
- Munchausen's
- intentional production/feigning of physical/psychological sxs
- motivation: assume sick role
- external incentives absent (economic gain, avoiding legal responsibility, etc.)
Term
Factitious Disorder by Proxy (Somatoform Disorders)
Definition
- present history with drama
- vague when asked details
- extensive medical knowledge
- will choose invasive procedures
- ex: movie Sixth Sense, mother poisoning child
- difficult to diagnose and prosecute; child removed to see if improve in parents' absence
Term
Mood
Definition
enduring states of feeling that color our psychological lives, affect behavior/relationships
Term
Mood disorder
Definition
disturbance in mood serious enough to cause suffering, impair daily functioning
Term
Major Depressive Episode (MDE)
Definition
- 5+ of following symptoms for 2 week period & represent change from previous functioning, must include either #1 or #2:
1. depressed mood
2. loss of interest/pleasure (anhedonia) most of day every day
3. weight loss/gain or increased appetite
4. insomnia/hypersomnia
5. psychomotor agitation or retardation
6. fatigue or loss of energy
7. feelings of worthlessness or excessive/inappropriate guilt
8. diminished ability to think/concentrate, indecisiveness
9. recurrent thoughts of death, suicide ideation, or a plan (15% eventually commit)
- more common in women
Term
Seasonal Affective Disorder (SAD)
Definition
- symptoms: weigh gain, sense lethargy, hypersomnia, social withdrawal
- caused by cabin fever, cold air, less sunlight?
- treatment: phototherapy and antidepressants
Term
Depression statistics
Definition
- "common cold" of psych disorders
- 55% who have had 1 episode will have another - most by age 25, 25% by age 18

Comorbidity:
- panic w/ MDE increase suicide 3x
- substance abuse
- personality disorders
- eating disorders
Term
Dysthymia
Definition
- literally "hard or bad spirit"
- low grade, chronic depression
- pessimism, self-pity, inactivity, inadequacy, low self-esteem
- symptoms must last 2+ years
- problem of double depression with MDE
Term
Etiology of Depression - Psychodynamic
Definition
- "eaten anger or stress"
- grief or loss of other means loss of self
Term
Etiology of Depression - Humanistic
Definition
- loss of meaning & purpose
Term
Etiology of Depression - Learning Models
Definition
- Lewin Sohn: too little reinforcement
- Coyne's Interpersonal Theory
Term
Etiology of Depression - Cognitive Models
Definition
- Beck's cognitive trend
- Allow & Abramson's depressive realism
- Seligman's learned helplessness
Term
Etiology of Depression - Stress-Diathesis Model
Definition
- biological vulnerability & life stress
Term
Manic Episode
Definition
- distinct period of abnormal and persistently elevated, expansive, or irritable mood lasting at least a week
3+ of the following symptoms:
1. inflated self-esteem/grandiosity
2. decreased need for sleep
3. more talkative than usual or pressure to keep talking (pressured speech)
4. flight of ideas or objective experience that thoughts are racing
5. distractability
6. increase in goal-directed activity or psychomotor agitation
7. excessive involvement in pleasurable activities which have high potential for painful consequences

- disturbance causes impairment and enough to require hospitalization
- hypomaniac if all sxs present excluding hospitalization
Term
Bipolar Disorder
Definition
- cycling between depression and mania
- begins late teens/20s
- chemical nature of cycling
types:
- Bipolar 1: 1+ manic episodes, may or may not have had MDE
- Bipolar 2: 1+ MDEs, at least 1 hypomaniac or manic
Term
Bipolar Disorder Treatment
Definition
Medication + psychotherapy
- lithium, depalcote, lamictal, other neuroleptics
- compliance problems
Term
Cyclothymia
Definition
- "circle spirit"
- low grade cycling like bipolar
- hypomania and depression
- late teens/early 20s
- usually progresses into bipolar - requires preventative intervention
Term
Anorexia Nervosa
Definition
- refusal to maintain weight above 85% expected
- intense fear of gaining weight or being fat
- disturbed body image
- amenorrhea (modern day problematic criteria)

subtypes:
- restricting type
- binge/purge type
Term
Bulimia Nervosa
Definition
- "ox hunger"
- recurrent episodes of binge eating
- recurrent compensatory behavior (2x a week for 3 months)
- self-evaluation unduly influenced by weight and shape
- purging and nonpurging type
Term
Binge Eating Disorder
Definition
- recurrent episodes of binge eating; discrete period time, lack of control
- episodes must include rapid eating, uncomfortably full, not hungry, eating alone, disgusted, depressed, guilty
- marked distress
- 2 days a week for 6 months
Term
Prevalence of eating disorders
Definition
- anorexia most lethal but least common
- bulimia 2nd most common
- binge eating most common
Term
Biopsychosocial Model & Etiology of eating disorders
Definition
- cultural
- psychological: comorbid MDE, OCD, substance use, impulse problems
- personality: anxiety, perfectionism, lack of coping stress, interpersonal isolation, inability to express emotions, nonassertive
- biological: puberty, genetic link MDE
- high risk subgroups: dieters, athletes; body image disturbance, teased
- familial: poor communication, less nurturing, issue food & weight
Term
Eating Disorder Treatment
Definition
- inpatient vs. outpatient
- cognitive-behavioral therapy
- interpersonal therapy
- family systems treatment

Inpatient treatment: multidisciplinary/interdisciplinary
- behavioral structure
- psychologists, psychiatrists, medical doctors, dietitians, family therapists, nurses, exercise scientists

- mirror work/exposure (cognitive-behavioral)
Term
Eating Disorder Recovery
Definition
- favorable outcome: ability to separate from parents, establishment of support network, early intervention/treatment, insight into illness, small weight loss, onset <30 yrs, educational and work interests

- unfavorable outcome: older age of onset, lower social class, being male, having eating disorder for 5+ years, body weight <60% of average, premorbid obesity, poor childhood adjustment

10% anorexics die within 10 years with treatment
25% anorexics die within 10 years without treatment
Term
Personality Disorders
Definition
- rigid patterns of behavior and ways of relating to others
- not able to adjust to environmental demands
- very resistant to change
- ego-syntonic
- Axis I bothers them
- Axis II bothers you
Term
ego-syntonic
Definition
creating own problems
Term
ego-dystonic
Definition
doesn't feel like self
Term
Cluster A Personality Disorders
Definition
- "odd or eccentric"
- Paranoid P.D.
- Schizoid P.D.
- Schizotypal P.D.
Term
Cluster B Personality Disorders
Definition
- "dramatic and emotional"
- Antisocial P.D.
- Borderline P.D.
- Histrionic P.D.
- Narcissistic P.D.
Term
Cluster C Personality Disorders
Definition
- "anxious or fearful"
- Avoidant P.D.
- Dependent P.D.
- Obsessive Compulsive P.D.
Term
Paranoid Personality Disorder (A)
Definition
- pervasive suspiciousness
- easily angered and hold grudges
- few friends/relationships
Term
Schizoid Personality Disorder (A)
Definition
- socially isolated, lacks interest; may have strong relationship to pets
- blunt or shallow emotions (cold)
- indifferent to criticism or praise
- rarely date or marry
- symptoms similar to autism?
Term
Schizotypal Personality Disorder (A)
Definition
- peculiar behavior, thoughts, mannerisms
- lacking relationships
- unusual perceptions/illusions (not hallucinations or delusions)
- inappropriate emotions
- genetic link to schizophrenia
Term
Antisocial Personality Disorder (B)
Definition
- psychopath/sociopath
- violates norms/breaks laws
- dysfunctional work, stormy relationships - lies, harms, uses others
- substance use, don't respond to reinforcements/punishments like normal, often attachment problems and conduct disorder in childhood
- 4% adults, 5x more men than women, 50% of prison inmates
Term
Borderline Personality Disorder (B)
Definition
- pervasive pattern of instability of self-image, interpersonal relationships, and affect
- frantic efforts to avoid real or imagined abandonment
- pattern unstable and intense relationships with alternating extremes of idealization and devaluation
- self-mutilation (cut off emotions, numb, feel alive)
- frequent suicidal ideation
- transient psychotic episodes
- impulsivity in 2+ areas: spending, sex, substance abuse, binge eating
- developmental theories: attachment problems, emotionally sensitive plus chaos/abuse
- prevalence is 2% - 10% outpatients, 20% inpatients
Dialectical behavior therapy (DBT)
Term
Histrionic Personality Disorder (B)
Definition
excessively emotional, dramatic, crave glamour/attention/novelty, provocative, strained/superficial relationships, low self-esteem, seek careers like acting/modeling/rock stars
Term
Narcissistic Personality Disorder (B)
Definition
patterns grandiosity, need for admiration, superficial relationships (lack of empathy for others but expect it), preoccupied with glamour, success, believe they are special/unique, arrogant
Term
Avoidant Personality Disorder (C)
Definition
terrified of criticism or rejection, won't enter into relationships without guarantees, meet most criteria for social phobia, feel inadequate, won't problem solve
Term
Dependent Personality Disorder (C)
Definition
excessive need to be taken care of, can't make decisions, difficulty being alone, avoid responsibility, somatic complaints, get taken advantage of, often in abusive relationships
Term
Obsessive Compulsive Personality Disorder (C)
Definition
preoccupied with order, perfection, control to point where lose flexibility; difficulty being warm or expressive, impaired social relationships; not full-blown obsessions/compulsions - not as intense as OCD
Term
Substance Intoxication
Definition
development of reversible substance specified syndrome due to ingestion of a substance; significant maladaptive behavioral or psychological changes due to effects of substance on CNS (central nervous system)
Term
Substance Withdrawal
Definition
development of substance specific syndrome due to cessation or reduction of substance after heavy and prolonged use; syndrome causes significant distress/impairment
Term
Substance Abuse
Definition
maladaptive pattern of substance use leading to clinically significant impairment/distress as manifested by one or more of the following within a 12 month period:
1. recurrent substance use resulting in a failure to fulfill major role obligations at work, school, home
2. recurrent substance use in situations where physically hazardous
3. recurrent substance related legal problems
4. continues substance use despite having persistent/recurrent social or interpersonal causes

DSM defined by effect, not by amount
Term
Substance Dependence
Definition
maladaptive pattern of substance use leading to clinically significant impairment/distress with 3+ of:
1. tolerance: need for increased amounts to achieve intoxication, diminished effect with continued use of same amounts
2. withdrawal: char: syndrome for that substance; same drug used to relieve/avoid withdrawal
3. substance often taken in larger amounts or over longer period than intended
4. persistent desire or unsuccessful efforts to cut down on use
5. much time spent in activities necessary to obtain drug, use drug, or recover from effects
6. important activities given up/reduced due to drug use
7. use continues despite knowledge of having persistent, recurrent physical/psychological problems from drug
specify as: with physical dependence or without
Term
Opponent Process
Definition
prolonged use of certain substances creates body defense, body prepares by moving in opposite direction, explains tolerance, craving, classical conditioning of substance stimuli
Term
Substance Abuse/Dependence Treatment
Definition
medical detox (28 day), AA (12 step + sponsor, spiritual model, abstinence), Cognitive-Behavioral Therapy ( trained recognition of irrational thinking, replacing function of substance, controlled use), Motivational Interviewing Therapy (humanistic interviewing/feedback), Project MATCH (random assignment to programs, found they all had similar success rate)
Term
Smoking
Definition
#1 preventable cause of disease and death
over 450k deaths/yr, social, political & economic issue
decreasing men, increasing women
large # of cardiac problems, cancers, housefires
involuntary smoking, prenatal, secondhand - heart disease, lung cancer; SIDS, asthma, ear infections in children
nicotine affects CNS & neurotransmitters, perfect mood drug, stimulant & addiction, promotes cardiovascular disease
carbon monoxide depletes hemoglobin, starves cells of oxygen
nicotine & opponent process, tolerance, craving, withdrawal, stress relief, classical conditioning - learning trials primary reinforcement, cues
Term
Smoking Cessation
Definition
most do it on own, 90% would like to but can't, 5% success rate, health reasons, social pressure, save $
Techniques: physical and psychological dependence separation - nicotine replacement, behavioral therapies
Behavioral techniques: aversive therapies, hypnosis, breaking CC bonds, delay techniques, stimulus control
Science of effectiveness:
nicotine replacement - increase odds of succes by 1.7
DRI/NRI
Behavioral techniques: motivational interviewing, behavior modification
social support - face-to-face regular sessions with physician, using stages of change
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