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Abnormal Psychology
Mood D/O, EDO, Substance Abuse, Schizophrenia, and Personality D/O Kring et al. 10th ed.
378
Psychology
Undergraduate 4
10/26/2010

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Term
Risk of death w/AN
Definition
High. 10-15% of those hospitalized die
Term
DSM-IV-TR Criteria for AN (4)
Definition
1. Refusal to meet 85% IBW
2. Intense fear of being fat/gaining weight
3. Distorted body image
4. Amenorrhea
Term
2 types of AN
Definition
1. Restricting
2. Binge-Purge
Term
Restricting Sub-Type
Definition
Low weight via calorie restriction
Term
Binge-Purge Subtype of AN
Definition
Binge eating-Eating more food than one would consider "normal"
Purging-Reduce calories via vomiting, diuretics, enemas, or laxatives
Term
Medical Effects of AN (11)
Definition
1. Thinning of heart muscle
2. Muscle wasting
3. Decr. in HR, BP, Temp
4. Bloating
5. Osteopenia
6. Low Metabolism
7. Lanugo
8. Yellow, dry skin, brittle nails
9. Irritability and fatigue
10. Hyperactive, restless
11. Dehydration
Term
Starvation study
Definition
Men given half of their req. calories
As a result: Preoccupied w/food, MDE, Anxiety, Insomnia, Poor conc. , Irritable, Hoard food
Term
AN:
*Age of onset
Definition
*14-18 y/o
Term
Key goal for people w/AN+3 driving factors
Definition
Becoming thin
*Fear of:
-obesity
-giving into desire to eat
-losing control of body shape/wt
Term
How do AN feel about food?
Definition
Obsessed
Reading/thinking about it
Term
Distorted thoughts in AN (3)
Definition
1. Low opinion of body shape
2. Overestimate size
3. Maladaptive attitudes/misperceptions
Term
Common psych problems in AN (7)
Definition
1. Depression
2. Anxiety
3. Low self-esteem
4. Insomnia
5. SA
6. OCD
7. Perfectionism
Term
AN is perpetuated by...
Definition
The vicious cycle
Term
Typical case of AN:
*Start
*Escalation
*Recovery
Definition
*Normal to slightly OW female goes on a diet
*May follow a stressful event
*Most recover, some don't
Term
Problems w/DSM AN Criteria
Definition
1. Weight may not be predictive of prognosis/health
2. Fear of wt/being fat may be a Western concept
3. Amenorrhea may never occur
Term
Does having 2 types of AN provide any use?
Definition
Doesn't really tell us anything helpful
Term
Define BN
Definition
Binge eating+Compensatory behavior
Term
Two types of BN
Definition
1. Purging: Vomiting/diuretics/laxatives/enemas
2. Non-Purging: Fasting/excessive exercise
Term
DSM-IV-TR Criteria for BN (5)
Definition
1. Recurrent Binge-Eating
2. Inappropriate compensatory behaviors
3. 2x/wk for 3 months
4. Self-eval. based on body
5. Doesn't meet criteria for AN
Term
BN:
*Age of onset
*Wt.
Definition
15-21 y.o
Healthy weight, but may fluctuate
Term
BN and media coverage and % of students that participate in occasional binge-purge episodes
Definition
After hearing about it rates increase. 50%
Term
BN and Binges
Definition
1-30/wk, in secret, consume MANY more calories than most people would during a SHORT time span
Term
Emotions before/after binges
Definition
Before: Tension/Powerlessness
After: Self-blame/guilt/depression/fear
Term
BN and Compensatory Behaviors (2)
Definition
1. Vomiting: 1/2 calories still consumed, screws w/appetite
2. Laxatives/Diuretics: Fails to reduce calories
Term
Typical BN case
Definition
Normal-slightly OW starts a diet-->Bingeing-->Guilt-->Compensating
Term
Medical Effects of BN (5)
Definition
1. Swollen salivary glands+teeth erosion
2. Heart probs
3. Permanent damage to intestines
4. Bloating, fatigue
5. Dehydration/Electrolyte problems
Term
Similarities b/n AN and BN (8)
Definition
1. Onset after dieting
2. Fear of being obese
3. Drive for thinness
4. Preoccupied w/food, wt
5. Anxiety, depression, perfectionism
6. SA
7. Distorted body image
8. Distorted eating attitude
Term
Differences in BN compared to AN (6)
Definition
1. More worried about other's opinions
2. More sexually experienced
3. Mood swings
4. Controlled by emotion
5. Characteristics of a Personality d/o
6. Less amenorrhea, more damage
Term
Problems w/DSM-IV-TR criteria for BN (3)
Definition
1. Timing of binge eating is not based on research
2. Purging v. Non-purging doesn't seem to matter
3. May not be totally separate from AN
Term
EDNOS
Definition
Don't quite meet full criteria for AN/BN
Term
Partial cases (EDO)
Definition
Meets some, but not enough criteria
Term
Subthreshold cases (EDO)
Definition
Meets all the Sxs, but at a lower level
Term
Binge Eating D/O
Definition
Not a DSM d/o...yet
Lots of out of control bingeing w/o compensation
Term
Frontal lobe in EDO
Definition
Involved in inhibition/regulation
Underactive
Term
Temporal lobe and EDO
Definition
Fear/aversive emotions-->self-endangering behavior
Underactive
Term
Parietal lobe and EDO
Definition
Representing body size
Underactive
Term
ACC and EDO
Definition
Monitoring conflict b/n competing responses
Failure to learn from ineffective behavior
Underactive
Term
Neuroimaging and AN
Definition
Loss of Grey and white matter
Term
Neurochemicals and EDO
Definition
Serotonin-->Premorbid anxiety
Anxiousness persists after recovery
Term
Heritability of EDO
Definition
AN: 33-88
BN: 28-83
Term
Psychodynamic etiology of EDO
Definition
Hilde Bruch: disturbed mother-child relationship-->EGO deficits
Term
Cognitive etiology of EDO
Definition
Deficits-->Cog. Distortions-->DE
Term
Psych factors and EDO (General)
Definition
Overvalue wt/appearance
Best 2 predictors: Dieting+Dissatisfied w/body
Term
Abstinence Violation Effect
Definition
Violating a self-imposed rule about eating=feeling out of control w/food
Food becomes black and white (eg Good vs. Bad)
Term
Operant conditioning EDO
Definition
Preoccupation w/food, wt. distracts from other issues
Restricting is + reinforced by the illusion of power
Bingeing=+ reinforcement for enjoying good food
Bingeing=Endorphins/"turns off" neg. thoughts
Purging=Decreased anxiety
Social isolation=Decreased social anxiety
Term
Perfectionism and EDO
-including Aversive self-awareness
Definition
Be perfect or extremely self-critical
-Increased awareness of your own perceived "flaws"-->Distress-->Bingeing/Purging/Restricting
Term
Harm Avoidance and EDO
Definition
Avoid harmful stimuli/situations
Term
Neuroticism and EDO
Definition
Tendency to be anxious and high in neg. affect
Term
Self-esteem and EDO
Definition
People w/low self-esteem try to use food to increase self-worth
Term
Restrained eating
Definition
Restricting food intake via food groups/calories
Term
Disinhibited eating
Definition
Bingeing on restricted food/or eating A LOT of an allowed food
Term
Last Supper Effect
Definition
Disinhibited eating triggered by upcoming diet
Term
EDO and families
Definition
Learn eating habits/body image from family
Term
EDO and friends
Definition
Criticism by them increases urge to diet+body dissatisfaction
Term
Culture and EDO
Definition
Thin ideal
N. Americans>Black
Increasing amongst Blacks and Hispanics
Term
Objectification Theory
Definition
Female bodies as objects judged by appearance
Term
Most likely cause of EDO
Definition
Diathesis-Stress Model
Term
Targeting Neuro/Bio factors in EDO
Definition
Normal, healthy eating pattern+Medical stability
Term
Refeeding Syndrome
Definition
Low wt. fed to fast=Electrolytes go screwy
Fats must be introduced SLOWLY to protect intestines
Term
Meds and EDOs
Definition
SSRIs
Prevent relapse
Help reduced BN/Depression Sxs
Prozac
Term
CBT for EDOs in general
Definition
Changing T,F,B
Considered Treatment of choice
Term
CBT for ANT
Definition
Decrease irrational thoughts, increase rational ones
Coping strategies
Relaxation
Motivational Enhancement
Term
CBT for BN
Definition
Cognitive restructuring
ERP: Anxiety provoking foods, but not allowed to purge
Term
3 Mechanisms for explaining benefits of CBT for EDO
Definition
1. Normal eating 2. Decrease diet restrictions 3. Increasing coping abilities
Term
Prognosis w/CBT not as good if...
Definition
You have a co-morbid personality d/o
Up to 1/2 still have some Sxs
Term
IPT for EDOs
Definition
4-6 mo. of Tx
Focuses on problematic relationships and improving
them
Term
Mechanisms for IPT w/EDOs
Definition
1. Reduces Interpersonal probs
2. Creates a sense of power and hope. Increases self-esteem
Term
IPT works best w/ which EDO
Definition
BN
Term
Family Tx for EDO
Definition
Addresses problems w/in the family that may be related to the EDO
Term
Maudsley Approach
Definition
Support parents while they help their daughter eat
Doesn't focus on etiology
HUGE family commitment
Term
IP for EDO
Definition
Planned in advanced
When lower level care has failed
24 hr+groups
Individ+Psychopharm Tx
Term
LT effects of IP for EDO
Definition
High relapse usually due to:
Unwillingness to change
Not doing Outpt.
$$$$
Term
Freud's Structure of Personality
Definition
1. Id: I want it, and I want it now.
2. Super-ego: Moral
3. Ego: Balancer
Term
Freud's level of awareness
Definition
1. Unconscious: Unaware of
2. Preconscious: Have access to, but aren't currently thinking about
3. Conscious: Actively focusing on
Term
Freud's 2 major drives+their purpose
Definition
1. Eros (Life/Sex drive): Survival, reproduction, pleasure
Energy comes from Eros=libido
2. Thanatos (Death drive): Goal of all life is death
May result in aggression
Term
Freud's anxiety
Definition
Aversive, inner motivational state
Warning sign to the ego
Term
Freud's 3 types of anxieties, awareness levels, and definitions
Definition
1. Neurotic: Fear of punishment b/c your Id is out of control
Unconscious
2. Reality: Fear of something in the real world
Conscious or Preconscious
3.Moral: Fear of punishment for violating social codes
Conscious or unconscious
Term
2 Possible responses to anxiety
Definition
1. Increase rational problem-oriented coping
Esp. w/Reality anxiety
2. Defense mechs
By the ego
Unconscious
Distort, transform, or falsify reality
Term
10 Freudian Defense Mechanisms
Definition
1. Repression
2. Denial
3. Projection
4. Rationalization
5. Intellectualization
6. Reaction formation
7. Regression
8. Id W/the Aggressor
9. Displacement
10. Sublimation
Term
Repression
Definition
Unconscious
Forcing something out the consciousness
Restrains Id impulses, painful memories/info/behaviors
Can be partially done
Term
Denial
Definition
Refusal to believe an event took place
Manipulation of external perceptions
Keeps anxiety down, but requires a lot of psych. energy
Not the best cost-benefit
Term
Projection
Definition
Assign impulses/desires/qualities to someone else
Alters Int/Ext. perceptions (via repressing the feeling and passing it to another)
Helps EXPRESS the Id's desires
This expression is covert
Term
Rationalization
Definition
Finding a reason for the behavior
May occur after a failure to maintain self-esteem
Can also occur after success, if done for unacceptable reasons
Term
Intellectualization
Definition
Thinking in a cold, analytical way about stressful things
Disassoc. of T from F
Intellectual part=Conscious
Emotional part=Unconscious
Happens outside of awareness
Term
Reaction Formation
Definition
Replace unacceptable impulses w/the opposite
Usually they are staunchly against the unacceptable behavior
Eg. Homosexuality
Term
Regression
Definition
Choosing coping styles from earlier psychosexual stages (fixation)
Manifestation is often symbolic
Term
Id w/the aggressor
Definition
Unconscious assumption of some traits of the feared person
May reduce original fear, or not
Term
Displacement and Sublimation
Definition
Best ones
Displacement: Shift impulse from one target to another
Sublimation: Transform impulse into a more socially acceptable form
Term
Manifest content
Definition
Actual content
Term
Latent content
Definition
Underlying meaning
Via sensory stimulation, current concerns, id impulses
Term
Job of manifest content
Definition
Allows Id urges to be satisfied in a covert way
Wish-fulfillment
Disguised so Super-Ego/Ego don't find out
Term
Symbolization and dreams
Definition
Direct, but symbolics (Manifest Content)
Term
Dream work:
Define
Operates via
Definition
Disguised latent content
Primary-Process thought
Often Chaotic
Term
2 Mechanisms of dream work + define
Definition
1. Condensation: Separate thoughts are squished into one
2. Mechanism of opposites: Element is expressed as the opposite of the latent form (eg. gay bashing instead of homosexuality)
Term
Freud's Stages of Psychosexual Dev. and Ages
Definition
1. Oral: 0-18 mo.
2. Anal: 18-36 mo.
3. Phallic: 3-6 yrs.
4. Latency:6-12 yrs.
5. Genital: 12+yrs
Term
Psychosexual dev. req. that you must complete stages____________.
Definition
In order
Term
Each of Freud's psychosexual stages is characterized by:
This influences:
Definition
A crisis
Adult personality
Term
What happens if you fail to complete a psychosexual stage?
Definition
Some libido remains=A vulnerability to regress to that stage (T, Perception, Responding) during times of stress
Term
Oral Stage (Brief Overview)
Definition
Mouth is pleasure source
Crisis=Being weaned
2 Potential Probs
1. Oral incorporative-Dependent, gullible, jealous
2. Oral sadist-Verbal aggression
Term
Oral Stage:
Key Issue+Possible responses
Personality
Definition
1. Dependency
If no=child is pessimistic/distrustful
If STRONGLY yes=naive/overly trustful
Preoccupied w/food+drink
Nail biting, smoking, eating
Verbal Aggression
Term
Anal Stage (Brief overview)
Definition
Anus
Crisis=Toilet training
Term
Anal Stage:
Key issue+Potential responses
Definition
Control
Overly demanding parents=Control freak kids
Overly lenient=Disorganized slob kids
Term
2 Orientations to toilet training and outcomes
Definition
1. Praise for doing a good job
*Value in producing things by w/e means possible
*Adult productivity/creativity
2. Punitive
*Anal expulsive (Rebels): Messy, cruel, hostile
*Anal retentive (W/holding): Rigid, obsessive, stingy, orderly
Term
Phallic Stage (Brief overview)
Definition
Gender diff. become of interest
Penis/Clitoris become pleasure centers
More direct fantasies
Term
Phallic stage
*Key issue+possible outcomes
Definition
*Self-worth
Parents respond too positively=Child's sense of self becomes overinflated (arrogant, egotistical)
Parents are too neg.=Child's sense of self is damaged (insecure, self-doubting)
Term
Fixations in the Phallic stage marked by______. Which leads to:
Definition
Difficulties switching from auto-erotic to person directed
Difficulties relating to others as complete, complex ppl
Men: Dominating/uncaring
Women: Very Submissive OR very dominating
Term
Latency (Brief overview)
Definition
Relatively calm, focus on intellectual/social growth
Term
Genital Stage (Brief overview)
Definition
Genitals
Focus on Sex
Dev. ability to form warm/caring relationships and to be worried about the other's welfare
Greater impulse control
LONG LASTING
Term
Psychoanalysts believe what about developmental stages and stress?
Definition
Each person has a tendency to regress to a particular stage.
Term
Technical Neutrality/Therapeutic neutrality
Definition
Efforts by the therapist to allow patient's transference to dev. w/o interference from therapist
Term
Client-Therapist relationship in psychoanalysis
Definition
1. Provides most undistorted info about conflicts
2. Most direct route to cure
3. Allows client to show psychological tactics
Term
Resistance
Definition
Patient's attempts to avoid insight
Term
Transference
Definition
Reactions to a person in the present that are related to an important person in your past
Term
Main Psychoanalytic Goal Achieved Via
Definition
Interpretation
*Client Behavior/Own Behavior/Reactions
Term
Counter-transference
Definition
Therapist's transference
Term
Psychoanalytic Techniques (4)
Definition
1. Free Assoc.
2. Dream Analysis
3. Freudian Slips
4. Interpretation
*Clarify
*Confront
*Interpretation
Term
Insight
Definition
Stating and understanding one's own psych processes
Usually emotional
Term
Modern Psychoanalytic Therapy is called
Definition
Psychodynamic psychotherapy
Term
Modern psychodynamic therapists emphasize
Definition
Patterns of behaviors, relationship probs, or emotional reactions outside of awareness
Term
Modern psychodynamic therapy is less_______than other therapies
Definition
Prespective
Term
Aspect of psychodynamic therapy that other approaches consider.
Definition
Transference
Term
Interpersonal Therapy
*Time
*Manualized treatment
*Hypothesizes
Definition
*12-16 weeks
*Clear directions to therapist on how to do treatment
*Improving interpersonal relations=Greatest overall improvements in functioning
Term
IPT is most extensively in treatment of...
Definition
Depression, but done with others as well
Term
IPT most closely resembles what type of therapy
Definition
Psychodynamic
Term
IPT
*Focuses on
*Believes
*Borrows techniques from
Definition
*Helping patient resolve interpersonal problems
*One's life/psychopathologies improve simultaneously
*Psychodynamic and CBT
Term
IPT Therapists
*Help client's link:
*Focus on 4 areas
Definition
*Life event-->Mood/Symptoms
*Grief, Role disputes, Role Transitions, Interpersonal deficits
Term
How IPT unfolds
Definition
1. Opening question: Very general
2. Communication analysis: Recreating emotionally important life events
3. Exploring Goals
4. Decision analysis
5. Role playing
Term
Two key emotions on the continuum
Definition
1. Depression
2. Mania
Term
Mood D/O:
*Characterized by
Definition
Disabling disturbances of emotion
Term
Unipolar Depression
Definition
Mood d/o only w/depression
Term
Bipolar (General basis)
Definition
Depression alternating w/mania
Term
Everyday usage of the word depression
Definition
General sadness/unhappiness
Term
Why is clinical depression a concern?
Definition
Can lead to severe and long-lasting psych pain that can get worse
Term
Prevalence of Depression
Definition
5-10% each year for severe depression, and rates are increasing
Term
Gender and Depression
Definition
F 2x M
Term
Recovery rate of depression
Definition
Approx. 1/2 w/in 6 wks. Some w/o help. Most will relapse
Term
Five main areas affected by depression+examples
Definition
1. Emotional: miserable, empty, humiliated
2. Motivational: Lack of drive/initiative
3. Behavioral: Less active/productive
4. Cognitive: Neg. opinions of self, blames others
5. Physical Sxs: Headaches, dizzy, pain
Term
Suicide rates among severely depressed
Definition
6-15%
Term
MDD DSM-IV-TR Criteria
Definition
1. Depressed mood AND/OR Anhedonia
*Min. of 2 wks. Not part of normal grief
2. Four or more of the following:
*Change in sleep
*Change in weight
*Psychomotor agitation/retardation
*Fatigue
*Worthlessness/Guilt
*Lack of concentration
*Suicide/Suicidal Ideation
Term
2 Types of MDD +define
Definition
1. Episodic: Sxs dissipate over time
2. Recurrent: Relapse is likely (Avg. is 4)
Term
Dysthymia DSM-IV-TR Criteria
Definition
1. Chronic subclinical depression AT LEAST 2+yrs
2. At least 2
*Appetite change
*Sleep change
*Fatigue
*Low self-esteem
*Decrease concentration
*Hopeless
Term
Double depression
Definition
Dysthymia+MDE
Term
MDE Sxs in Latino cultures
Definition
Complaints of nerves and headaches
Term
MDE Sxs in Asian cultures
Definition
Complaints of weakness and fatigue
Term
MDE Sxs in Children
MDE Sxs in Older adults
Definition
Stomach and headaches
Distractible and forgetful
Term
Mania
Definition
Intense elation/irritability
4+days or require hospitalization
Term
Mixed Episode
Definition
Sxs of mania and depression in the same week
Term
Hypomania
Definition
Subclinical mania
4 days of elevated mood
Changes in functioning, but not impaired
NOT A DSM criteria
Term
Three forms of bipolar d/o
Definition
1. Bipolar I
2. Bipolar 2
3. Cyclothymia
Term
Bipolar I
Definition
Manic episodes usually w/MDE
Term
Bipolar II
Definition
MDE+Hypomania
Term
Cyclothymia
Definition
Subclinical Bipolar D/O
At least 2+ yrs
NOT MDE
Term
DSM-IV-TR Bipolar D/O Criteria
Definition
1. Some version of mania
2. Plus 3 (4 if mania is irritable type)
*Psychomotor agitation or increase
in goal directed behavior
*Excessive talking
*Racing thoughts
*Less sleep
*Grandiosity
*Distractible
*Increased involvement in high risk pleasurable
activity (sex, spending)
Term
Rapid Cycling
Definition
4+Mood episodes/year
Term
Prev. of Bipolar
Age of Onset
Social effects
Definition
*1%
*20s
*Recurrent, 1/3 unemployed after hospitalization
High suicide rate
Term
Seasonal Depressive D/O
Definition
Episodes at a particular time of year
Term
Postpartum Depression
Definition
W/in 4 wks of birth
Term
Catatonic Depression
Definition
Excessive physical immobility or peculiar phys. movement
Term
Depression w/Psychotic features
Definition
Delusions or hallucinations
Term
Melancholic Depression
Definition
Severe anhedonia
More depressed in the morning
Early morning waking
More Severe
Term
Mood D/O and Heritability 
Definition
.85 for Bipolar .37 for MDD Set the stage for diathesis
Term
Mood D/O and NT
Definition
NE, DA, 5-HT
MDD: Low levels of NE/DA
Mania: High levels of NE/DA
But this is not a 1:1 correlation, meds take 2-3 weeks after NT levels are restored
Term
Mood D/O and Neurobiological Factors
Definition
Focus on sensitivity of post-synaptic receptors
Overly sens. to DA: Bipolar
Under sens. to 5-HT: MDD
Meds alter the working of:
Secondary messengers
G-proteins
Term
Structural MRI
Functional MRI
Definition
*Abnormalities in anatomy
*Abnormalities in activity
Term
Functional abnormality in MDD
Definition
Amygdala hyperreactivity
Term
Functional studies and MDD
Definition
Decreased volume in areas w/diminished activation
Term
HPA:
*Function
*Mood D/O
Definition
*Manages stress reactions
-releases Cortisol
*HPA may be over active
Term
High Cortisol is linked to what Mood D/O?
Definition
MDD
Term
Cushing's Syndrome
Definition
Oversecretion of Cortisol
May include Depressive Sxs
Term
Life Events and Mood D/O
Definition
Majority of ppl w/MDD recently suffered a stressful
life event
Term
Interpersonal difficulties and Mood D/O
Definition
High levels of Expressed Emotion=More likely to relapse
Depression Sxs often lead to rejection
*Excessive reassurance seeking
*Few pos. facial Sxs
*-Self disclosure
*Slow speech
Term
People w/Depression exp. what types of affect?
Depressed individuals' response to +stimuli
Definition
1. High -, and low +
2. Fewer pos. facial exp., Less pleasant emotions
Term
Freud's Theory of Depression
1. Stage
2. Results in:
3. Depression simply put is:
Definition
1. Oral Fixation
2. Excessive dependency on others
3. Anger turned inward
Term
Evidence for/against Freud's Theory of Depression (3)
Definition
1. Tend to show more anger (against)
2. Triggered by stress (might support)
3. High dependency=more susceptible (support)
Term
Evidence for/against Freud's Theory of Depression (3)
Definition
1. Tend to show more anger (against)
2. Triggered by stress (might support)
3. High dependency=more susceptible (support)
Term
Rational Emotive Behavior Theory
Definition
Natural for humans to think in irrational ways
Some handle this better than others
Can learn to handle it better
Term
Basic assumption of REBT
ABCs of REBT
Definition
Emotions are caused by beliefs about events, not
the events themselves
A: Activating Event
B: Belief
C: Consequence (emotion)
Term
Cognitive Theory of Mood D/O
Definition
Negative triad: Neg. view of-self, world, future
Neg. schemata: Tendency to see world negatively
Cog. Biases: Process info in neg. ways
Term
Learned Helplessness
Definition
Dogs eventually stopped trying to escape, even if they
could
Uncontrollable -events-->helpless
Passive in face of stress
Term
Biological treatments tend to focus on:
Three types
Definition
Physical source of dysfunction to determine treatment course
1. Drug Tx
2. ECT
3. Psychosurgery
Term
Four groups of drugs
Definition
1. Antianxiety
2. Antidepressant
3. Antibipolar (Mood Stabilizers)
4. Antipsychotic
Term
What is the most widely used treatment for mood d/o?
What % of pts show improvement?
Definition
Drug Tx
50-70%
Term
3 Major Classes of Antidepressants
Definition
1. MAOI
2. Tricyclics
3. SSRIs
Term
What class of antidepressants is most prevalent?
How long should antidepressants be used for?
What is the best treatment for mood d/o?
Definition
*SSRIs (less side effects)
*6 mo. after Sx reduction
*Psychotherapy+Drugs
Term
Cog. Therapy vs. IPT vs. Meds
*Which was most effective early on?
*"" w/less severe cases?
*'' w/most severe?
Definition
*Meds
*Placebo=Meds=IPT=CT
*Meds>IPT>Placebo
Term
Treatment for Bipolar d/o
Definition
1. Lithium
2. Anti-convulsants
3. Anti-psychotics
Often used in combo
Term
Caveat w/treating Bipolar d/o w//Anti-depressants.

Lithium
Definition
Can trigger manic episodes

80% respond positively
Dangerous side effects
Slow working
Term
Psychosurgery
Definition
Used only in extreme cases
Roots in trepanation
Term
Mood d/o and suicide
Definition
Sig. risk
About 1/2 of suicides are currently depressed ppl
90% of suicide attempts are by indiv. w/mental illness
Term
Suicidal Ideation
Definition
Thoughts of suicide
More common than attempts
Term
Neurobiological Models of Suicide
Definition
Low levels of 5-HT
Overly reactive HPA sys.
Term
Sociocultural Models of Suicide
Definition
Media coverage of prominent suicides-->Increases in suicide
Term
3 Types of Suicides+Define
Definition
1. Egoistic:Few ties to family/community
2. Altruistic:Believes action is for the good of society
3. Anomic: Sudden change in person's relation to society
Term
Psychological risk factors for suicide+correlated w/
Definition
1. Prob. Solving Deficits: Corr. w/attempts+severity
2. Hopelessness: Greater likelihood of suicide
3. Impulsivity: Corr. w/actual attempts
4. Life satisfaction: Higher satisfaction=lower risk
Term
DSM Criteria for Substance Intox
Definition
1. Reversible substance specific syndrome
2. Psych/Behavioral changes due to physiological affects of the substance
Term
DSM Criteria for Substance Abuse
Definition
1. Maladaptive pattern of use
2. One or more:
*Leads to failure to fulfill major obligations
*Using when it is physically dangerous
*Recurrent legal problems
*Recurrent use despite social probs linked to the
substance
Term
DSM for Substance Dependence
Definition
3+ of the following in 12 mo. period
1. Tolerance:
*Need more to get the same high
2. Withdrawal
3. Taken in larger amounts than previously
4. Tries often/unsuccessfully to cut down
5. A lot of time is spent in use/procurement/recovery from the substance
6. Reduction in social, occupational, rec. events
7. Continued use despite enhancement of psych/physio effects
Term
Withdrawal
Definition
Physio/Psycho effects of discontinuation of a substance e.g. Restless, anxious, cramps, death
Term
Depressants
*Effects
*Examples
*Regular use leads to:
*Discontinuation can lead to:
Definition
*Slow the body down, decrease behavioral activity/level of awareness
*Alcohol, opiates, barbiturates, benzos
*Tolerance
*Withdrawal
Term
Alcohol Dependence:
*2 Hallmark Sxs
*Withdrawal Sxs
Definition
*Tolerance and Withdrawal
*Anxiety, depression, weakness, restless, insomnia, muscle tremors, Elevated BP, pulse, temp
Term
Most alcohol abusers __________become alcohol dependent
Polydrug abuse
Definition
DO NOT
Using multiple substance
*eg. cigarettes, cocaine, marijuana
Term
Synergistic Effects:
*Define
*2 Examples
Definition
*Alcohol increases effects of some other drugs
*Alcohol and barbiturates: May cause death
*Alcohol and heroin: Alcohol reduces amt. of heroin needed to be lethal
Term
Lifetime prev. by gender
Lifetime prev.: Abuse v. Dependence
Binge drinking
Definition
*20% M, 8%F
*Abuse: 17%
*Dependence: 12%
Drink 5+drinks in an hour
Term
Heavy Use Drinking
Definition
5+drinks, 5+times in 30 days
Term
Alcohol use by ethnicity
Definition
N. Americans=Hispanics>White>Blacks>Asians
Term
Effects of consuming a lot of alcohol
Definition
1. Impaired speech/vision
2. Interference in complex thought processes
3. Poor coordination
4. Loss of balance
5. Depression and withdrawal
Term
LT Effects of alcohol
Definition
1. Malnutrition
2. B-complex vitamins and deficiency
(Amnestic syndrome)
3. Cirrhosis of liver (scar tissue)
4. Damage to endocrine glands
5. CHF
6. Erectile Dysfunction
7. HTN
8. Stroke
9. Capillary Hemorrhage
10. Destruction of brain cells (esp. memory)
Term
Fetal Alcohol Syndrome
Definition
Heavy alcohol use during pregnancy=slowed fetal growth
Recommend NO alcohol
Term
Some benefits of moderate alcohol use
Definition
Reduced risk of:
1. Stoke CHD, Cholesterol reduction
Term
3 other depressants
Definition
1. Opiates
2. Barbiturates
3. Benzos
Term
Opiates:
*Effects
*Examples
Definition
*Sedatives that relieves pain+induces sleep
*Opium, morphine, heroin, codeine, valium, oxycontin
Term
Physical/Psycho effects of Opiates
Definition
Euphoria, drowsiness, reverie, and lack of coordination, loss of inhibition, increased self-confidence
Term
Rush associated w/heroin/Oxycontin
Definition
Intense feelings of warmth/ecstasy
Term
Withdrawal of Opiates
Definition
1. Muscle soreness and twitching, tearful, yawning, cramps, chills/sweating, increase in HR/BP, insomnia, vomiting
Term
Social dangers of Opiate use
Definition
1. 1/4 die before 40 y/o
2. Engage in illegal activities
3. Exposure to infectious diseases
Term
Barbiturates:
*Used for:
*Stimulates
*Heavy dosage:
Definition
*Induces muscle relaxations, reduces anxiety, produces euphoria
*GABA
*Slurred speech
*Unsteady gait
*Impaired judgement
*Irritability/combative
*Accidental suffocation
Term
Withdrawal from synthetic opiates leads to
Definition
Delirium, convulsions
Term
Depressants affect what system?
Definition
GABAnergic
Term
GABAnergic System
Definition
1. Activates Inhibitory neurons
2. Inhibits Amygdala
3. Dulls fear and anxiety
Term
NT associated w/Depressants use
Definition
DA:rewarding
Endogenous opiods
*Deep pleasure feeling
*Withdrawal occurs if stopped (Neg. Reinforce)
Term
Type 1 Alcoholism+Genetics
Definition
*Less severe
*Later in life
*Genes can be moderated by environment
*Men and women
Term
Type 2 Alcoholism+Genetics
Definition
*Early in life
*Genes outweigh environment
*Men
Term
DTs
Definition
Withdrawal sx experienced by VERY heavy drinkers
Confusion, convulsions, hallucinations, and fever
*Could be fatal
Term
Observational learning and depressants
Definition
Use as a coping strategy
Expectations effect experience
Term
Operant conditioning and Depressants
Classical conditioning and Depressants
Definition
+Reinforcement: Post exp. of use
-Reinforcement: Relief of cravings
Drug cues=cravings
Term
Effects of family from depressants
Social effects of depressant use
Definition
Dysfunctional
$ probs+unemployment
Term
Peer use of depressants and you
Definition
Greater influence
View usage as normal
Term
Cultural norms and depressant use
Definition
*Use is increasing amongst women
*Less diverse the campus=more likely binge drinking will occur
Term
Stimulants
*Effects
*Eg
Definition
*Stimulate CNS
*Caffeine, nicotine, ritalin, MDMA, Coke, Crack
Term
Nicotine:
Causes:
Death:
Definition
Increased alertness, BP, and irritability
Number one cause of preventable death
Term
Cigarettes and Health
Definition
Lung cancer is the most common cancer
Emphysema, cancer of: larynx, esophagus, pancreas, bladder, cervix, stomach; SIDS, CHF
Term
Blacks and Cigarettes
Definition
Less likely to quit, more likely to get cancer
Term
Asians and nicotine
Definition
Metabolize it faster
Term
Secondhand smoke
Definition
Higher levels of: ammonia, CO
Term
Amphetamines
*Effects+mechanisms
Definition
*Increase alertness/motor activity, reduce fatigue, high energy, sleeplessness, reduce appetite, nervousness, agitation, confusion, paranoia
*Tolerance happens quickly
*NE and DA
Term
Chronic use of meth leads to damage in what brain area?
Definition
Hippocampus
Term
Cocaine:
*Effects
*Mechanisms
*Overdose
Definition
*Reduces pain, produces euphoria, heightens sexual desire, increases self-confidence
*DA in the mesolimbic area
*Chills, nausea, insomnia, paranoia, hallucinations, MI, death
Term
DA Reward System:
*What is it
*Activated by
Definition
*Sys. of neurons which relies on DA to produce pleasurable sensations
*Eating, sex, stimulant drugs
Term
Dopaminergic hypothesis of substance abuse
Definition
Rewarding effects of a drug (in)directly from DA system
Term
Coke/Meth and DA
Definition
Reduce movement of DA to terminal buttons so more DA is hanging in the synapse
Term
Observational learning and stimulants
Definition
Observation of use/abuse by peers, family, or celebs increases usage
High need for social approval=more likely to use
Term
Reward Craving and Substance abuse
Relief Craving and Substance abuse
Definition
Desire for gratifying effects of substance use
Temp. emotional relief that arises from substance use
Term
Operant conditioning and stimulants
Definition
+Reinforcement: Pleasant side effects
-Reinforcement: Reduction of - state
-Reinforcement: Alleviation of withdrawal Sxs
Term
Drug Cues
Definition
Stimuli assoc. w/drug use elicit conditioned responses
Term
Family relations and stimulants
Definition
Teens who progress from one drug to another, tend to not have close relationships w/their parents
Term
Peers substance use and you
Definition
Alters your PERCEPTION of norms
Term
Define Personality
Definition
Unique and LT pattern of inner experience and outward behavior
Tends to be consistent
It's flexible
Term
Person w/the Personality D/O and how they view their behavior.
What % of the pop. has a personality d/o
Definition
Not as problematic
*9-13%
Term
Diagnostic Reliability and Personality D/O
Definition
Diff't clinicians tend to give diff't diagnoses
Very unreliable
Term
Diagnostic Stability and Personality D/O
Definition
1/2 get another diagnosis 2 yrs later
"Should" be stable
Term
Gender Bias and Personality D/O
Definition
F: Histrionic, Borderline, Dependent
M: ASPD, Narcissistic, OC
Some clinicians pay attn to certain traits depending on gender
Term
Comorbidity and PD
Definition
Often w/an Axis 1 d/o
Decreases recovery rate for the Axis 1 d/o
Term
Problem w/the DSM and PD
Definition
Very categorical approach to a spectrum d/o
Personality traits form a continuum
Term
Most PD are high on which of the 5 factors?
High E is tied to:
Low E is tied to:
Definition
*Hi N, Hi Antagonism (Low A)
*Histrionic,Narcissistic
*Schizoid, Schizotypal, Avoidant PD
Term
3 Clusters+Examples
Definition
1. Odd/Eccentric:
*Paranoid, schizoid, schizotypal
2. Dramatic, emotional, erratic
*ASPD, Borderline, Narcissistic, Histrionic
3. Anxious/Fearful
*Avoidant, Dependent, OCPD
Term
Odd Personality D/O description
Definition
*Suspiciousness, Social withdrawal, Peculiar ways of thinking or perceiving
*Leave the person isolated
*May be related to schizophrenia
Term
Paranoid PD:
4+ of the following
Definition
1. Suspects, w/o reason that others are out to get them
2. Doubts about loyalty/trustworthiness
3. Reluctant to trust others
4. Reads threatening messages into benign remarks
5. Lots of grudges
6. Perceives attacks on yourself that others don't
7. Suspicion regarding fidelity of partner
Term
Superfluous sxs of Paranoid PD
Prevalence of Paranoid PD
Treatment of Paranoid PD
Definition
*Hypersensitivity, vigilance
*0.5-3%, M>F
*None are particularly effective
Term
Schizoid PD Characterized By:
Definition
Persistent avoidance of social relationships w/limited emotional expression
Flat, cold, anhedonia, low sex drive
Term
Schizoid PD and 4+ of the following
Definition
1. Neither desires/enjoys close relationships
2. Solitary activities
3. Little/No sexual interest
4. Anhedonia
5. Lacks close friends
6. Indifferent to praise or criticism
7. Flat, cold, stoic
Term
Schizotypal PD characterized by
Definition
Range of interpersonal problems, odd ways of thinking and perceiving, and behavioral eccentricities
Term
Schizotypal PD 5+
Definition
1. Ideas of reference
2. Magical thinking that is inconsistent w/cultural norms
3. Unusual perceptual experiences
4. Odd thinking and speech
5. Suspiciousness
6. Inappropriate/Constricted affect
7. Lack of close friends
8. Excessive social anxiety that doesn't go away
Term
Interactions w/ppl who have Schizotypal PD
Definition
1. Vague/digressive convos
2. Difficulty maintaining focus
3. Odd dress or appearance
Term
Most severe of the odd d/o
What sxs are most common in women
Sxs most common in men
Definition
Schizotypal
Positive sxs: Magical Thinking
Neg. Sxs: Flat, stoic
Term
Schizotypal PD has high comorbidity w/
Definition
Avoidant, Paranoid PD, and Schizophrenia
Term
Neurological findings w/Schizotypal PD
Definition
Enlarged ventricles
Less Gray matter in temporal lobe
Term
What cluster of PD are the most commonly diagnosed
Definition
Dramatic
Term
ASPD:
*Characterized by:
*Age requirement
Definition
*Persistent disregard and violation others' rights
*18
Term
ASPD 3+ of the following
Definition
1. Repeated law breaking
2. Lying
3. Impulsive
4. Irritable
5. Reckless
6. $$$$ Irresponsible
7. Lack of remorse
Term
ASPD prevalence in gender
ASPD is correlated w/high rates of:
Definition
M 4x F
Criminality, and Substance abuse
Term
Borderline PD is characterized by:
Definition
Instability and mood shifts along w/impulsivity
Can be violent or angry
Term
Impulsive, self-destructive behaviors common in people w/Borderline PD
Definition
1. Substance Abuse
2. Reckless Behavior
3. SI
4. Suicide
*May end up in the hospital or dead due to suicide attempts that are actually successful
Term
Borderline PD has at least 5 of the following:
Definition
1. Avoid real/imagined abandonment
2. Unstable intense relationships (idealized then devalued)
3. Unstable self-image
4. Impulsive in self-damaging ways
5. Suicide attempts, SI
6. Unstable mood
7. Inappropriate, intense anger
8. Paranoia or dissociation
Term
Prevalence:
*Gender
*Highest amongst what population
Definition
75% of cases are F
Clinical
Term
Common course of Borderline PD
Definition
Instability/Suicide peak at adolescents-->lessen w/age
Term
Borderline PD:
*High comorbidity w/
*High rates of
Definition
*PTSD, MDD, Substance Abuse, EDO
*Suicide
Term
3 Explanations for self-harm
Definition
1. Punishment
2. Relief from psychic pain
3. Reassurance of existence
Term
Biological factors for Borderline PD
Definition
Low 5-HT levels
Familial component
Term
Treatment for Borderline PD
Definition
Psychotherapy
LT, Specialized Therapist, Termination is difficult
Term
Histrionic PD
*Characterized by:
Definition
Extremely emotional and NEED to be the center of attn
Vain, self-centered, demanding
Term
Histrionic PD 5+ of the following
Definition
1. Uncomfortable when not the center of attn
2. Sexually seductive/provocative
3. Rapidly changing shallow emotions
4. Physical appearance as a way of getting attn
5. Impressionistic speech, lacking details
6. Dramatic, theatrical
7. Suggestible
8. Believes relationships to be more intimate than they are
Term
Treatment of Histrionic PD
Definition
Often seek help
Difficult to work with
Term
Narcissistic PD
*Characterized by
Definition
Grandiose, need admiration, no empathy
Convinced they are magnificent
Exaggerate
Term
Narcissistic PD 5+ of the following
Definition
1. Grandiose sense of self-importance
2. Fantasies of unlimited success, power, etc.
3. Belief that they are above others
4. Requires excessive admiration
5. Entitled
6. Exploitive
7. Lack empathy
8. Envious of others, or believes that others are envious of them
9. Arrogant, conceited
Term
Prevalence of Narcissistic PD: Gender Common and normal amongst
Definition
75% are M Teens
Term
Narcissistic PD and Interpersonal Relationships
Definition
1. Based on enhancement of status
2. Success, admiration>Intimacy, closeness
Term
Avoidant PD:
*Pervasive pattern of:
*Begins:
Definition
*Social inhibition, feelings of inadequacy, Hypersensitive to neg. eval.
*Early adulthood and in many contexts
Term
Avoidant PD at least 4+ following
Definition
1. Avoids jobs w/interpersonal contact
*Due to fear of criticism, disapproval, rejection
2. Unwilling to get involved w/ppl unless certain of being liked
3. Preoccupied w/being rejected/criticized in social contexts
4. Restrained intimacy
*Due to fear of being shamed/ridiculed
5. Inhibited in social sit.
*Due to feelings of inadequacy
6. Belief that they're socially inept
7. Reluctant to take risks
*Due to fear of embarrassment
Term
Avoidant PD has a high comorbidity w/
Definition
Social phobia
Term
Problems w/treating Avoidant PD
Definition
*Start avoiding therapy sessions
*Gaining trust is important
Term
Central feature of Dependent PD
Onset of Dependent PD
Definition
Difficulty w/separation
Early adulthood
Term
Dependent PD 5+ of the following
Definition
1. Needs advice/reassurance on even small everyday decisions
2. Needs others to assume responsibility for major life areas
3. Difficulty expressing disagreement
4. Difficulty initiating things, or working alone
5. Excessive lengths to get nurturing/support from others
6. Hates being alone
7. Needs relationships CONSTANTLY
8. Preoccupied w/fears of being left to care for themselves
Term
Dependent PD pts often at risk for:
Definition
MDD, Anxiety d/o, suicide
Term
Key focus for treatment of Dependent PD
Definition
Accept responsibility for themselves
Can do family or couple therapy
Term
OCPD 4+ following
Definition
1. Details, rules, lists order, schedules so extreme that the point of activities is moot
2. Perfectionism inhibits task completion
3. Dedicated to work to the pt. that friendship and fun is lost
4. Overconscientious and moral: Inflexible even
5. Can't get rid of useless objects
6. Hates to delegate unless they dictate exactly how it is done
7. Miserly
8. Rigid, stubborn
Term
Type of person most likely to get the Dx of OCPD
Definition
White male, educated, married,and employed
Term
Why is OCPD not OCD?
Definition
Lack of true obsessions and compulsions
OCPD inflexibility is more limited
Term
Possible treatment for OCPD
Definition
CT or Psychodynamic Tx
Term
3 ways substance abuse may develop
Definition
1. Unintentionally: Environmental exposure
2. Medicinal effects
3. Intentional use
Term
Gateway Hypothesis
Definition
Entry drugs-->Harder drugs
General Pattern: Initiation-->Experimentation-->Casual use-->Reg. use-->Abuse-->Dependence
Risk factors for this trajectory include:
*Young age
*Number of drugs used
Term
LSD
*Effects (4) ST
*Effects (3) LT
Definition
*Alters visual/auditory sensations, Shifting emotions, Psychotic sxs, synesthesia
*Delusions, distortions of time, Flashbacks, Tolerance, but not withdrawal
Term
Marijuana
*ST Effects (2)
*NT
*Withdrawal Sxs
Definition
*Perceptual distortions, slowed cog/motor abilities
*DA
*Irritability, anxiety, depression, decreased appetite, disturbed sleeping
Term
Prev. of Marijuana use:
Definition
Most commonly used illegal drug
M>F
USA, Europe>China, Africa
Term
Psych effects of Marijuana (5)
Definition
1. Relaxed, sociable
2. Shifts in emotion
3. Interferes w/attn., memory, IQ
4. Hallucinations, panic
5. Impairment in drivin
Term
Physiological effects of Marijuana
Definition
1. Bloodshot eyes
2. Dry mouth/throat
3. Increased appetite
4. Reduced inner eye pressure
5. Increased BP
6. Abnormal HR
7. Lung damage
Term
Marijuana and the Brain
Definition
1. Hippocampus
2. Increased blood flow to ACC, Amygdala
3. Decreased flow to Temporal lobe
Term
Marijuana and Therapeutic effects
Definition
1. Helps w/chemo (nausea, lack of appetite)
2. Relieves pain assoc. w/AIDS
Term
Two Paths to Alcohol Abuse
*Boys
*Girls
Definition
*Drinking early in adolescents and continued to increase throughout HS
*Lesser amts in adolescents, jump up during Jr. High, jump up again during HS
Term
Substance abuse diathesis and Genetics
Definition
Some ethnicities tolerate substances better than others
Term
Incentive-sensitization Theory
Definition
Distinguish wanting (craving) and liking (pleasure)
DA sys. is sensitive to the drug and the drug cues, this increases wanting
Term
Alcohol myopia may lead to:
Definition
Tension reduction: Focus on a distractor (cigarettes, alcohol) to avoid a stressful stimuli
Term
Family Factors that increase the risk of substance abuse
Definition
1. Parent alcohol abuse
2. Psych/marital/legal probs in the fam
3. Lack of emotional support
4. Lack of parental monitoring
Term
Social network and alcohol abuse
Definition
Social influence (having friends who drink)-->drinking-->Social selection (choosing friends who drink)-->
Term
Detox
Definition
Withdrawal under medical supervision
Hospital is not superior to outpatient
Term
A.A.
What is it
How does it work
Asks for:
Definition
Largest self-help group
Regular meetings, support, acceptance
Complete abstinence
Term
Couples and Family Therapy for Substance Abuse
Definition
Emphasizes support
Reduces drinking and couples' distress for up to 1 yr following treatment
Term
Contingency-Mgmt Therapy
Definition
Reinforce behaviors inconsistent w/drinking
Teach problem drinkers how to deal w/uncomfortable situations
Term
Controlled Drinking
*Basic belief
*Guided self-change
Definition
Prob. drinkers can drink in moderation
Personal responsibility/control, emphasizes neg. aspects of drinking, devise a plan for mod. drinking, more common in Canada and Europe
Term
Antabuse
Definition
If you drink you vomit
Lots of ppl quit taking it
Term
Naltrexone, Naloxone
Definition
Blocks endorphins stimulated by alcohol, reduces cravings
Helps a lot when used w/CBT
Term
Tx for Nicotine Dependence
Definition
Change social network
Rapid smoking treatment: puffing fast, focused smoking
Scheduled reduction in tobacco use
Physician advice
Nicotine replacements: Esp. when used w/antidepressants
Term
Tx for illegal drug dependence
Definition
Drug replacement tx
Not good for coke
Okay for Heroin: Esp if combined w/Tx and social suport
Term
Prevention of Substance abuse:
*Directed at:
*Potential elements
Definition
Adolescents
Increasing self-esteem
Social skills training
Peer pressure resistance
Parent involvement
Warning labels
Education
Testing
Term
Positive Sxs of Schizophrenia:
AKA
Categories
Definition
Behavioral Excesses
*Delusions, Persecutory delusions, Hallucinations
Term
Delusions
Definition
Firmly held beliefs in contrast to reality
Resistant to change
Term
Hallucinations
Definition
Sensory experiences in the absence of sensory stimuli
Term
3 Types of Hallucinations
Definition
1. Audible Thoughts
2. Voicing commenting on your T, F, B, etc.
3. Voices arguing
Term
During auditory hallucinations we see a marked increase in activation in what brain area?
Definition
Broca's
Term
Negative Sxs of Schizophrenia:
*AKA
*5 Categories
Definition
*Behavioral deficits
*Avolition, Alogia, Anhedonia, Flat Affect, Asociality
Term
Avolition
Alogia
Definition
Lack of interest or drive
Poverty of speech or cotent
Term
Disorganized Sxs of Schizophrenia:
*AKA
*General description
Definition
*Behavioral Distortions
*Obs. distortions of normal human behavior (weird)
Term
Disorganized Speech
*AKA
*2 parts
Definition
*Formal thought d/o
*Incoherence: Inability to organize ideas
*Derailment (loose assoc): Rambles, hard time sticking to one subject
Term
Inappropriate affect
Definition
Emotional responses that don't fit the situation
Term
3 Behaviors assoc. w/Schizophrenia, but not required for Dx
Definition
1. Depression
2. Suicide
3. Substance Abuse
Term
Catatonia
Definition
Motor Abnormalities
Can be repetitive, complex gestures, or wildly flailing limbs
Term
Catatonic Immobility
Definition
Maintain unusual posture for long periods of time
Term
Wavy Flexibility
Definition
Limbs can be posed by another
Term
DSM-IV-TR Criteria for Schizophrenia
Definition
1. 2+ of the following, for at least 1 mo:
*Delusion
*Hallucination
*Disorganized speech
*Disorganized catatonia
*Neg. Sxs
Social impairment
Sxs lasting 6 mo. total
Term
Disorganized Schizophrenia:
Catatonic Schizophrenia:
Definition
*Incoherence, disorganized speech+behavior, flat, inappropriate affect
*Prolonged immobility or purposeless agitation
Term
Paranoid Schizophrenia
Ideas of reference
Definition
Delusions/Hallucinations tied to persecution or grandiosity
Ideas of reference:
*Personal sig. to neutral events
Term
Undifferentiated Schizophrenia
Residual Schizophrenia
Definition
*Meet criteria for schizophrenia, but not a subtype
*No longer meets criteria, but has some signs still
Term
Problem w/dx subtypes of schizophrenia
Definition
Low reliability
Poor predictive validity
Lots of overlap
Term
Whom does Schizophrenia effect, besides the pt.
Definition
Families/friends: Hard to live w/, social skills are lacking
Employers, landlords
Term
Prev. of schizophrenia:
Age of onset
Biased ethnicitiy
Definition
Late adolescents, early adulthood
Blacks
Term
Diathesis stress model of Schizophrenia
Definition
Genetic factors set an underlying predisposition, stress triggers onset
Term
DA Theory of Schizophrenia:
*Caused by:
*Treatment
Definition
D/o due to excess levels of DA
DA blocking agents eg. Chlorpromazine
Term
Other NT involved in Schizophrenia
Definition
GABA, 5-HT, Glutamate
Term
DA Theory of Schizophrenia Revised
Definition
Excess # of DA receptors or increased sensitivity of DA receptors
Complex neural pathways mean that underactivity in some areas leads to overactivity in others (Thats why meds only work for some sxs some of the time)
Term
Brain Anatomical Explanations of Schizophrenia
Definition
Enlarged ventricles
Low activity in the PFC: Negative Sxs
Reduced gray matter in PFC
Reduction in dendritic spines
Term
Schizophrenia and damage during pregnancy or birth
Definition
Labor complications are highly correlated w/Schizophrenia (eg loss of O2)
Term
Viral Damage to fetal brain and Schizophrenia
Definition
Moms w/the flu are highly correlated to Schizophrenia rates esp. during 2 trimester
Term
Developmental factors and Schizophrenia
Definition
Need to study DA and PFC maturation
Term
Schizophrenia and SES
Sociogenic hypothesis
Definition
Most common amongst urban poor
Stress of poverty causes the d/o via poor nutrition during pregnancy etc.
Term
Social selection theory
Definition
Tendency to fall into lower SES due to impairments assoc. w/schizophrenia
Term
Of the 2 social theories of Schizophrenia the most support is for:
Definition
Social selection theory
Term
Schizophrenogenic Mom
Definition
Cold, domineering, rejecting, over-protective, fearful of intimacy, rigid, moralistic
Term
Communication Deviance and Schizophrenia
Expressed Emotion
Definition
Family CD may predict onset
High EE families=Quicker rehospitalization
Term
Bi-directional assoc. of Schizophrenia
Definition
Unusual pt thoughts<-->More critical comments (esp in high EE families)
Could be related to Higher HPA axis activation<-->DA
Term
Developmental Hx of children before they developed Schizophrenia
Definition
Lower IQ, delinquent, withdrawn, poor motor skills, more expression of neg. emotion
Term
Meds for Schizophrenia
How they work
% efficacy
Definition
Thorazine, Haldol, Navane (Antipsychotics)
Block DA
75
Term
Extrapyramidal effects
Definition
Side effect of Schizophrenia meds
Affects coordination center
Term
Parkinsonian Sxs and Schizophrenic Meds
*Prev.
*Define
*Treated
Definition
*1/2
*Tremors, shuffling gait, low facial expressiveness, dystonia, dyskinesia, akathesia
*Stopping meds or adding other meds
Term
Neuroleptic Malignant Syn
*Define
*Prev. (esp. for)
*Treatment
Definition
*Severe, possibly fatal rxn: Muscle rigidity, altered consciousness, messed up ANS
*1/100 esp. the elderly
*Stopping meds and treating neuro issues
Term
Tardive Dyskinesia
*Sxs
*Prev.
*Treatment
Definition
Involuntary movement/tics (esp. of the face and mouth), jerky motion of the limbs, May not appear immediately
*1/10 of 1st generation med users
*None
Term
What sxs of Schizophrenia are reduced using antipsychotics
Definition
Agitation, violence,
Term
"Atypical" Anti-Psychotics
*Eg
*Improve
*Caveats
Definition
*Clozaril, Risperdal, Abilify
*Neg. and Pos. Sxs
*$$$$, Significant Wt. Gain
Term
Freud's view of tx for Psychotic D/O
Definition
None
Term
Sullivan's Tx for Psychotic d/o
Definition
Trusting therapist-pt relationship
Teaching adult ways of communication
Insight
Term
Family Tx and Schizophrenia
Definition
Education about Schizophrenia
Importance of meds
Improve communication and prob. solving
Instilling hope
Expand social networks
Term
Social Tx and Schizophrenia
Definition
Social skills training, problem-solving, housing, medical care, med compliance, advice
Helpful for relapse prevention
Term
CBT and schizophrenia
Definition
Id and challenge delusional beliefs
Recognize and challenge cognitions assoc. w/-sxs
Term
ACT and Schizophrenia
Definition
Emphasizes being a detached observer of sxs
Focus on important tasks and goals. Focus on these
Term
Schizophreniform d/o
Definition
Same sxs as Schizophrenia
1-6 months
Term
Brief Psychotic d/o
Definition
Same sxs as Schizophrenia
<30 days
Term
Schizoaffective d/o
Definition
Schizophrenia+Mood sxs
>6 months
Term
Delusional d/o
Definition
Delusions, but they aren't as severe as w/Schizophrenia
Usually about persecution, jealousness, grandiosity, somatic issues
Term
Shared Psychotic d/o
Definition
Person adopts delusions held by another
Term
Substance-induced Psychotic d/o
Definition
Any psych sxs possible: usually hallucinations or delusions
Caused by a substance
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