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PSYC112 > Psychopathology > Flashcards

Psychopathology Flashcards

1
Q

Elements of mental disorders

A

infrequency
deviance
distress
disability
danger

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2
Q

Depression prevalence rates

A

Life % = 10-20% for women; 5-12% for men

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3
Q

Schizophrenia prevalence rates

A

Lifetime % = 0.5 - 1.5 %

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4
Q

Any Disorder prevalence rate

A

Lifetime % = 48.0 %

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5
Q

psychological disorder

A
  • psychological dysfunction
  • distress or impairment
  • Atypical response `
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6
Q

biological treatments

A
  • see mental illness as a disease
  • focus on changing some aspect of physical functioning
  • treat with medication or surgery
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7
Q

psychological treatments

A
  • psychodynamic approaches
  • humanistic approaches
  • behavioral approaches
  • cognitive behavioral approaches
  • integrated/eclectic treatments (variety of techniques)
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8
Q

psychodynamic aka psychoanalytic

A
  • focus on the PAST
  • see behavior as driven by powerful unconscious inner forces
  • sees psychological difficulties as stemming from unresolved tension based on early life traumas/conflicts/frustrations/deprivations

goal is for :
- therapist and patient to work together to identify “hidden blocks” (unconscious) that have developed as a result of past conflicts
- then guide the patient to discover the relationship between root causes and current symptoms
- insight orientated

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9
Q

behavioural

A
  • focus is on the PRESENT
  • modify problem behaviours by applying the principles of conditioning (pairing)
  • treatment focuses on using techniques like exposure, reinforcement, ignoring, and punishment

Goal is to:
- extinguish non-productive/upsetting behaviours
- reinforce desirable behaviours

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10
Q

Cognitive

A

focus on HOW and WHAT we think
- how you interpret a situation (thought) influences how you feel about the situation
- thoughts - emotions

goal is to:
- identify maladaptive thoughts
- challenge these thoughts
- replace with more adaptive thoughts

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11
Q

humanistic

A

focus is on teaching the patient to seek fulfilment and reach their potential

goal is to:
- help the patient discover and then achieve their potential

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12
Q

Eclectic

A

therapist selects techniques from various types of therapy to design a treatment that best suits the case

goal is to:
- meet the individual needs of the patient
- mix and match techniques to suit patients needs

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13
Q

what is anxiety

A

apprehension about an anticipated issue

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14
Q

what is fear / panic

A

apprehensive response to immediate threat or danger
instinct

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15
Q

fight/flight response

A

sympathetic nervous system
- sweat
- shake
- heart racing
- shallow breathing

automatic perception of threat
- physical
- social
- thoughts

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16
Q

Yerkes dodson law

A

performance increases with mental arousal (stress) but only up to a point

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17
Q

types of anxiety disorders

A
  • phobias
  • panic disorder
  • generalised anxiety disorder
  • obsessive compulsive disorder
  • post traumatic stress disorder
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18
Q

generalised anxiety disorder

A
  • charcterised by apprehensive expectation
  • anxiety is generalised and persistent
  • free floating anxiety not situational
  • worried about a number of events and activities
  • person finfs it very difficult to control their worry
  • feel distressed due to constant worry
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19
Q

panic disorder

A
  • discrete period of intense fear in the absence of real danger
  • sudden in onset
  • builds rapdily
  • accompanied by a sense of imminent danger and the urge to escape
  • not predictable or confined to a given situation
  • concern about future attacks leads to avoidance
  • otherwise relatively free of anxiety between attacks
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20
Q

agoraphobia

A

marked fear or anxiety about at least 2 of the following situations
- using public transport
- being in open spaces
- being in enclosed spaces
- standing in line or being in a crowd
- being outside of the home alone

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21
Q

social anxiety disorder

A
  • fear or anxiety about one or more social situations where the individual is exposed to possible scrutiny by others
  • the individual fears that they will act in a way that will be negatively evaluated by others
  • the social situations are avoided or endured with intense fear or anxiety
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22
Q

obsessive compulsive related disorders

A

disorders
- obsessive compulsive disorder (OCD)
- body dysmorphic disorder (BDD)
- hoarding disorder (HD)

common features
- repetitive thoughts and behaviours which cause distress, feel uncontrollable, and time intensive
- 1/3 BDD comorbid OCD
- 1/4 HD comorbid OCD

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23
Q

OCD

A

obsessions:
- intrustive and recurring thoughts, images, or impulses that are persistant uncontrollable and irrational

compulsions:
- repetitive excessive behaviors or mental acts a person is driven to perform to reduce anxiety caused by obsessive thoughts or prevent expected consequences

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24
Q

DSM - 5 PTSD

A
  • EXPOSURE to acutal or threatened death, serious injury or sexual violence
  • presence of one or more INTRUSIVE symptoms
  • persistant AVOIDANCE of associated stimuli
  • negative alterations in COGNITION AND MOOD
  • marked alterations in AROUSAL and REACTIVITY
  • duration - one month
  • clinically significant distress, impairment, not sue to substance/medical condition
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25
Q

psychological treatment

A

common techniques
- relaxation
- cognitive restructuring
- exposure therapy and behavioral experiments to challenge, habituate and learn

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26
Q

exposure therapy

A

exposure therapy
- prolonged and consistent
- in vivo vs imaginal (During imaginal exposure, patients retell the trauma memory. During in vivo exposure, patients do activities where they gradually approach trauma-related memories)

systematic desensitisation
- with relaxation strategies

  • effective in 70-90%
  • comprehensive for long term maintenance
27
Q

Snake phobia video

A

Used extreme exposure therapy

Believes she is going to have heart failure if a snake goes near her

Strong belief in catastrophe which is driving Mariam’s fear

Motivation to succeed is the most successful for exposure therapy

As she stayed exposed to the snake for a prolonged period of time her anxiety response decreased

Psychological principles that accounted for improvement – habituation which leads to extinction – banduras ideas from a cognitive view self-efficacy – positive reinforcement and modelling

28
Q

symptoms of major depressive episode

A
  • deppressed mood most of the day
  • dimished interest or pleasure in most activities (anhedonia)
  • weight loss or gain
  • insomnia or hypersomnia
  • psychomotor agitation or retardation
  • fatigue or loss of engergy
  • feelings of worthlessness or guilt
  • inability to think or concentrate
  • recurrent thoughts of death, plan or attempt
29
Q

DSM-5 depressive disorders

A
  • major depressive disorder (MDD)
  • persistant depressive disorder (dysthymia)
30
Q

biological factors - biochemical

A

3 major Nuerotransmitters in depressions (receptor sensitivity)
- norepinephrine (increasing energy)
- serotonin (mood and mood regulation)
- dopamine (processing rewards)

Hormones (dysregulation)
- hypothalamic pituitary adrenal axis (HPA)
- cortisol (released in times of stress, breaks down nuerotransmitters such as serotonin - lower mood)

31
Q

biological factors - brain abnormalities

A

emotional or limbic system projects to prefrontal cortex
- serotonergic pathway
(emotional information comes to awarenes
these areas are very important for regulating emotions
if pfc is not functioning then ability to inhibit our maladaptive reaction to experience will not work leading to depression )

emotional regulation system
- amygdala
- subgenual anterior cingulate
- dorsolateral prefrontal cortext
- hippocampus

left frontal hemisphere asymmetry
- people with depression left side of frontal cortex was not as active as right side (right side related to calmness)

32
Q

cognitive theories Aaron beck

A

Aaron beck is one of the founders of cognitive theories of depression and cognitive therapy

He found the way people think about things (events in enviroment) leads to how they are going to feel

Hopelessness – major factor in contributing to depression

Rumination – thinking about negative things in their life over and over again

33
Q

becks cognitive therapy

A
  • four phases 20 sessions
    1. increase activities and elevate modd
    2. challenge automatic thoughts
    3. identify negative thinking and biases
    4. change primary attitudes/schemas
34
Q

biological form of treatment - antidepressant drugs

A

Mono amine oxo inhibitors
- MAO inhibitors breaks down neurotransmitters in the body, so inhibiting MAO will increase the neurotransmitters that result in MDD, however also breaks down other things such as components in wine and cheese which can have an nehvative effect so not the first choice of treatment

Tricyclics
- Range of difficult side effects

Selective serotonin reuptake inhibitors
- Reuptake of serotonin in synapse enhancing mood, side effects but not as serious as tricyclics

35
Q

schizophrenia vs psychosis

A

Psychosis -
- not specific to a certain mental disorder - breaking from reality - having altered states of consciousness

Schizophrenia -
-Type of mental disorder that is characterized by a set of some psychotic symptoms

36
Q

three symptom clusters of psychoses

A

positive symptoms
- symptoms in a excess of what would be typical
negative symptoms
- absence of something that would be typical
disorganised symptoms
- affects ability to process thoughts and communicate

37
Q

DSM - 5 criteria for schizophrenia

A

2 or more of the following
1. delusions
2. hallucinations
3. disorganised speech
4. disorganised or catatonic behaviour ( rare type of disorganised behaviour causing inability)
5. negative symtoms

38
Q

positive symptoms: delusions schizophrenia

A

Persecution – belief that someone is out to get you

Grandeur – believing that one has a special power

Reference – objects or things in an environment are communicating even when there is no basis

Erotomania – fixed or rational belief that another person is in love with them (rare)

Somatic - fixed irrational belief that something is wrong with you – something extreme like you are dying from a terminal illness no matter what doctors says

Nihilistic – the world is ending

39
Q

positive symptoms: hallucinations schizophrenia

A

Auditory – most common type of hallucinations (hear what other people can’t – hear voices from other people or their own – voices are usually mean and say hurtful things.)

Visual – typically defused see things like strange clouds or shadows

Olfactory – smells, smelling things that aren’t there hard to determine

Gustatory – taste

Tactile – sense of touch

40
Q

negative symptoms schizophrenia

A

affective flattening
- shallow emotions

alogia
- poverty of speech

thought blocking

avolition
- lack of drive/motivation

anhedonia
- inability to experience pleasure

41
Q

etiology of schizophrenia

A

Neurodegenerative hypothesis
-Individuals with schizophrenia have lower brain volumes than individuals who do not have schizophrenia
-Individuals with schizophrenia have a faster deuteration of brain matter than what you would see in non-individuals without schizophrenia

Enlarged ventricles
-Space in the brain that contains cerebral spinal fluid
-What they have found in schizophrenia is that these ventricles are far larger in patients
- Enlarged ventricles is an index of overall lower brain volume

Prefrontal hypometabolism
-Information that is processed in the pre frontal lobe tends to be slower
- Less activity in frontal lobe in patients with schizophrenia

42
Q

dopamine paradox in schizophrenia

A

excessive dopamine in subcortical areas leads to positive psychotic symptoms (hallucinations, delusions)

reduced dopamine in prefrontal cortex leads to negative psychotic symptoms (implications for learning)

43
Q

cognitive perspective: treatment

A

cognitive rehabilitation
- modify over and under attention

cognitive restructuring
- challenge delusional beliefs
- psychoeducation

44
Q

bipolar disorder: manic episode

A
  • one week of elevated, expansive, or irritable mood
  • three changed of the following

Grandoise self esteem – developing beliefs about being superior to others or thinking that they can achieve a lot more than possible
Lower need for sleep – report that they have so much energy and don’t need sleep
Overly talkative -
Racing thoughts – individuals that are experiencing a manic episode often report that their thoughts are running through their minds faster than they can process them
Easily distracted
Increased activity or agitation
Engagement in high risk activities

45
Q

4 different biopolar disorders

A

MDE - major depressive episode
ME - manic episode
HME - hyper manic episode
PPD - psycho dynamic disorder

46
Q

treatments for bipolar disorders

A

Biological
- Psychotropic medication

Lithium – most effective medication (type of salt)
First method of treatment
Not all patients can tolerate lithium because it comes with severe side effects
Requires very careful monitoring as it is very easy to overdose

  • Anticonvulsants
    Found to be effective in bipolar disorder
    Effective mood stabilisers
    Can also have calming effect and help with sleep regulation
47
Q

2 types of anorexia nervosa

A

restricting type: no binging or purging
binge eating/purging type: with regular binging or purging

48
Q

disorders that originate in childhood

A

nuerodevelopmental disorders
- intellectual disability
- learning disorders
- autism spectrum disorders
- adhd

behavior disruptive disorders
- oppositional defiant disorder
- conduct disorder
- aka externalising disorders

49
Q

autism spectrum disorder

A
  • defecits in social communication
  • restricted, repetitive behavior patterns
  • onset in early childhood
  • spectrum disorder so ranges from mild to severe

Epidemiology
- symptoms usually recognised during 2nd year of life
- 4 times more common in boys than girls
- Neurodevelopmental disorder
- Brain developed differently than neurotypical individuals

etiology
- Genetic heritability is very high approx. 90%
- If one identical twin meets the bracket for ASD it is 98% likely for the other twin to develop

Implicated in disorder
- Mother having rubella
- Toxic exposure

treatment
- modelling and operant conditioning
- communication training
- parent training (psychoeducation)
- community integration

50
Q

attention deficit hyperactivity disorder (adhd)

A

3 substypes
- predominantly inattentive type
- predominantly hyperactive impulsive type
- combined type

inattention
hyperactivity/ impulsivity

etiology
- 60-80% heritability rate
- under responsive prefrontal and striate regions
- abnormalities in dopamine

treatment
- biological - stimulant and non stimulant medications
- psychological - behavior therapy

51
Q

conduct disorder

A
  • aggression to people and animals
  • destruction of property
  • deceitfulness or theft
  • serious violation of rules
  • limited prosocial emotions

etiology
-81% of externalizing disorders that have in common is theat they have genetic vulnerability
Number of risk factors linked to externalising disorders
- Exposure to abuse
- Exposure to family violence
- Social cultural risk factors (growing up in poverty)

treatment
Multi systemic therapy – full family system
Conduct disorder and ODD usually come from family dynamics

Child focused more behavioral approach
Rewarding positive punishing negative

What can be implemented to prevent full development of ODD
Identifying risk factors and intervening

52
Q

definitions of addiction, tolerance, withdrawl

A

addiction is a severe substance use disorder (6 or more symptoms)

tolerance - larger doses required, effect of drug less

withdrawl effects - physcial (shaking, flu symptoms etc) psychological (anxiety, irritability, depression)

53
Q

NZ alcohol

A

20% of adults drank alcohol in a way that could harm them selves or others in the last year

hazardous drinking rates were higher in maori than european nz

hazardous drinking rates were higher in men than women

rates of hazardous drinking were highest in youth ages 18-24 years

adult drinkers in economically deprived areas were 1.7 times more likely to be hazardous drinkers than adult drinkers in least deprived areas

54
Q

affects of drug classes

A

Most common depressants opioids and alcohol

Reduces functioning of pre frontal cortex which reduces inhibition

Depressing effect on central nervous system so functioning is reduced

Prescribed opioids tend to have depressing effect where a person doesn’t feel pain

More synthetic types like heroin have the same but more addictive potential

Stimulants increase activity in central nervous system to seek out more pleasurable rewarding behavior

Hallucinations altered state of consciousness

Polysubstance use = using 3 different substances and meet criteria for all 3

55
Q

nucleus accumbens

A

related to reward system – dopaminergic system – people who are more prone to condition positive rewards find the use rewarding and get a positive affect – becomes reinforced and wants to use drug again – people who have sensitive reward system are going to be more prone to want to try

56
Q

aversion therapy

A
  • psychotherapy designed to cause patient to reduce or aviod an undesirable behaviour pattern by conditioning the person to associate the behavior with an undesirable stimulus
57
Q

personality disorder clusters

A

cluster A - odd thoughts and behavior
(paranoid, schizoid, schizotypal)
paranoid pd - deep suspicion or mistrust of others
schizoid pd - social detachment, cold emotional expression
schizotypal pd - magical ideation, social isolation and anxiety

cluster B - dramatic, emotional or erratic
(antisocial, borderline, histronic, narcissitic)
antisocial - disregard for social norms and standards
borderline - emotional dysregulation, attachment disturabnce
histronic - self centeredness and need for attention
narcissistic - entitlement and arrogance, self obsession, lack of empathy

cluster C - anxious or fearful
(avoidant, dependant, obbessive compulsive)
avoidant - social anxiety, fear of rejection
dependant - seperation anxiety, rely on others
obsessive compulsive - need for order

58
Q

Antisocial PD

A
  • disregard social norms
  • reckless behavior
  • impulsivity
  • irresponsibility
  • prone to anger/aggression
  • deceitfulness/manipulative
  • lack of guilt or remorse

50-80% of correctional inmates

59
Q

two process model for etiology psychopathy

A

factor 1 (affective/interpersonal)
- amygdala - poor fear conditioning, inability to read distress cues

factor 2 (antisocial behavior)
- orbiofrontal cortext - disinhibition, poor emotional decision making

60
Q

etiology and treatment of borderline pd

A

etiology
- psychodynamic - early parent relationships
- object relations - lack of early acceptance by parents

biopsychosocial theory
- vulnerability to emotional dysregulation
- invalidating childhood enviroments

treatments
- dialectical behavior therapy
- mentalization based therapy

61
Q

limitations with DSM - 5 system

A
  • excessive comorbidity
  • inadequate coverage
  • excessive within diagnosis heterogeneity
  • no clear boundary between normal and pathological personality
  • marked temporal instability
62
Q

ICD - 11 personality disorder

A

ICD - international classification of diseases

ICD-11 has changed personality disorder diagnosis from categorical to dimensional

A categorical approach to assessment relies on diagnostic criteria to determine the presence or absence of disruptive or other abnormal behaviors

whereas a dimensional approach places such behaviors on a continuum of frequency

personality disorder is a dimensional impariment continuum

63
Q
A

PSYC112 (4 decks)

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