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From Flashcardlet > PSYCH 241 - Midterm #2 > Flashcards

PSYCH 241 - Midterm #2 Flashcards

0
Q

Perpetuating factors are?

A
  • refer to the physical and psychological symptoms that serve to maintain the disorder
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1
Q

Precipitating factors are ?

A

Refers to events or situations that trigger the eating disorder

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2
Q

What is amenorrhea? Who does it often occur in?

A
  • often occuring in women with anorexia nervosa

- is the absence of 3 consecutive menstrual cycles

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3
Q

What psychiatric disorder has the highest mortality rate?

A
  • eating disorders

- 5-8%

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4
Q

What are the 2 subtypes of anorexia?

A
  1. Restriction type

2. Binge-eating/ purging type

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5
Q

Define the subtype of anorexia, the restriction type:

A
  • individuals attain thier extremely low body weights through strict dieting and sometimes excessive exercise
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6
Q

Define the subtype of anorexia, binge-eating/ purging type:

A
  • individuals not only engage in strict dieting but also regularly engage in binge eating and or purging behaviours
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7
Q

Describe the symptoms of anorexia, it’s distortions and traits:

A
  • distortions are: 1. Perceptions of body weight or shape
    2. Lack of recognition of the seriousness of their current [low] weight
    3. Determining self-worth based primarily on body weight or shape
  • have a morbid fear of fatness
  • starve themselves, or excessive exercise in means for losing weight
  • life time prevalance is .5% in femals and is seen mainly in females
  • typical onset is 14-18
  • morality rate is over 10%
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8
Q

Describe what symptoms you must present in order to be deemed as having a binge-eating disorder?

A

-eating very rapidly, in large amounts even when not hungry
- eating alone due to embarrassment about the amount they are eating
- eating so much it makes yourself uncomfortably full
- feeling disgusted with oneself after eating
-do not perceive themselves as fat or have a distorted perception of their body weight or shape
- has to occur at least once a week for 3 months
-

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9
Q

Describe the qualifications you must have in order to be classified as a Bulimia Nervousa? What are the two seperate types

A
  • two types: 1. Purging
    2. Non-purging
  • often having low self-esteem
  • use weight and shape as their primary method of self-evaluation
  • patients are typically within normal weight range
  • due to purging, much of weight loss occurs as a result of dehydration
  • after food is eaten it is followed by attempts to compensate by either Vomitting, using laxatives, hyper exercising or even starving oneself
  • mainly in femals
  • lifetime prevalence rate of 1-3%
  • typical onset is late adolescence and early adult hood
  • has a high rate of self-injurious behaviour
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10
Q

What does DSM-5 classify ALL eating disorders under?

A
  • feeding disorders
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11
Q

Describe the eating disorder pica:

A
  • eating non-food substances, such as dirt or paper
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12
Q

Describe the eating disorder rumination disorder:

A
  • repeatedly regurgitating food

- not actually digesting food

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13
Q

Describe the eating disorder avoidant/restrictive food intake disorder:

A
  • (ARFID)
  • characterized by a feeding disturbance that leads to being underweight and/ or an inability to eat enough food to meet nutritional/energy needs
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14
Q

What is an objective binge?

A
  • is eating large amounts of food in a specific time period
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15
Q

What is considered a large amount of food?

A
  • roughly two full meals

- dependent on age and gender

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16
Q

What are 5 other disorders classified under “feeding disorders”:

A
  1. Sub-threshold anorexia nervosa
  2. Sub-threshold bulimia
  3. Sub- threshold purging disorder
  4. Sub-threshold binge eating disorder
  5. Night eating syndrome
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17
Q

Is it likely one person will remain anorexic for their entire lives?

A

No, it is more likely to find a person who has transitioned amongst several eating disorders over the course of their life

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18
Q

How much more likely are children who have anorexia nervosa to die when compared to other children in their class?

A

These children are 10 times more likely than the child WITHOUT an eating disorder to die

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19
Q

How many Americans currently are suffering from an eating disorder?

A

9 million

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20
Q

Are eating disorders in males similar to that of females?

A
  • yes symptom presentation is very similar but there is more comorbidity and impairments in social functioning among males with eating disorders
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21
Q

Describe some of the key points the video watched in the eating disorder lecture pointed out:

A
  • parents are not the cause of their child’s eating disorder
  • more focus should be directed on society
  • there is not a lot of funding for treatment and studies regarding eating disorders
  • NO SINGLE FACTOR CAUSES AN EATING DISORDER
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22
Q

What is the common belief about eating disorders within socio-cultural theorists?

A

-that eating disorders are a result of pressure on women in western society

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23
Q

What are factors that can contribute to a person’s formation of an eating disorder?

A
  • personality/ individual factors: perfectionism, obsessiveness, low self-esteem, and depression
  • family factors: parental modelling/ criticism, genetics
  • adverse events: childhood sexual abuse
  • maturational issues: puberty, dating
  • peer environment: peer groups can have a high commonality of eating disorders
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24
Q

What are the 3 common forms of treatments for eating disorders:

A
  1. Cognitive behavioural therapy
  2. In paitent therapy
  3. Family based treatment
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25
Q

Regarding eating disorders describe the cognitive behavioural therapy approach, and which disorder it is most commonly used as a treatment for.

A
  • bulimia in adults
  • to modify thoughts surrounding body weight and ways to change such behaviour
  • main part of family based treatment
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26
Q

Describe what In-patient treatment would look like for an eating disorder patient:

A
  • stay in hospital
  • helpful for symptom reduction
  • ## high relapse rates once leaving hospital
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27
Q

Describe what family based treatment is regarding eating disorders:

A
  • outpatient form of treatment
  • only treatment with empirical support for adolescents with anorexia nervosa
  • most supported form of treatment for adolescents with bulimia
  • support that parents nor the patient are to blame for the eating disorder
  • look at the eating disorder as being separate from the patient and in the form of a disease
  • the therapist is a coach to the parents
  • there is 3 stages generally over a 20 session period
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28
Q

Describe the 3 stages in family based treatment for eating disorders:

A
  1. Re-feeding
    - parents are in charge of re-feeding or normalizing the patterns of eating
  2. Gradually gaining control over eating is returned to the patient
    - uses careful monitoring
  3. Trying to resolve issues related to healthy adolescent development, model problem solving and the termination of such preconceived ideas of the ideal
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29
Q

Describe the “family meal” and when it occurs within family based treatment:

A
  • occurs in the second session of 20
  • parents are instructed by the therapist to bring in a meal that will help re-nourish their child into the session itself
  • goal: support parents in having their daughter to be eating more then the child wishes to
  • intervention by the therapist occurs with the patient decides that they will not eat anymore
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30
Q

What does chronicity mean?

A
  • is the duration of illness
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31
Q

What does the term heterogeneity mean?

A
  • the tendency for people with schizophrenia to differ from each other in symptoms, family, and personal background, response to treatment, and differing in the ability to live outside of the hospital
  • this makes it hard for further predictions to be made in general
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32
Q

When referring to schizophrenia what is a positive symptom regarded as?

A
  • is an exaggerated/ distorted adaptation of normal behaviour
  • often the development of positive symptoms mark the onset of the first episode of schizophrenia
  • 4 different types: delusions, hallucinations, disorganized speech and thought disorder, grossly disorganized or catatonic behaviours
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33
Q

When referring to schizophrenia what is a negative symptom classified as?

A
  • refers to the absence of or loss of typical behaviours and experiences
  • 4 different symptom categories: flat effect, avolition, alogia, anhedonia
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34
Q

What are the two huge misconceptions regarding schizophrenia:

A
  1. It is NOT spilt personality or a multi personality disorder
  2. It is NOT associated with high risk violence
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35
Q

What is the prevalence and onset information regard schizophrenia ?

A
  • prevalence is approx. 1%
  • most frequently diagnosed between 20-40
  • men and women are equally at risk
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36
Q

Describe the prodromal phase of the course of schizophrenia:

A
  • a variety of clinical significant symptoms may emerge slowly over time
  • social isolation and withdrawal
  • impairment in personal hygiene
  • impairment in school or work
  • lack of interest
  • becoming more suspicious
  • has mood disturbances
  • difficulty thinking/ concentrating
  • this is often discovered when looking back on patient behaviours and after the patient has been diagnosed as schizophrenia
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37
Q

Describe what is classified as being a delusion experienced by someone who is diagnosed as schizophrenic:

A
  • positive symptom
  • patient has implausible beliefs that persist despite evidence contradicting them
  • the 4 types are, persecutory, referential, religious, and delusions of grandeur
38
Q

Describe what a persecutory delusion is:

A
  • paranoid belief they are being pursued, targeted, ridiculed, and someone is trying to harm them
  • most common form of delusion
39
Q

Describe what a referential delusion is:

A
  • belief that common, meaningless occurrences have significant and personal meaning
40
Q

Describe delusions of grandeur:

A
  • belief that they posses special abilities or knowledge
41
Q

Describe the characteristics of having a hallucination:

A
  • misinterpreting sensory perceptions that occur while you are awake and conscious
  • people hear, see, smell, and or feeling things that are either not really present or not as how others experience them
42
Q

What type of hallucination is most common amongst individuals diagnosed as schizophrenic?

A

Auditory hallucinations

43
Q

Describe what disorganized speech and thought disorder is in regards to schizophrenia:

A
  • loosening of associations
  • lack of logical connections between ideas and speech
  • frequent derailment and incoherence
  • least common symptom in the positive symptoms
44
Q

Describe grossly disorganized or catatonic behaviours in regards to schizophrenic patients:

A
  • is a positive symptom
  • can range from agitated movements to immobility
  • catatonic behaviour is holding rigid, usual postures and resisting efforts by others to change these postures
45
Q

What is wax flexibility?

A
  • a subtype of catatonic behaviour

- will allow others to move their bodies into new positions but will maintain these new positions firmly

46
Q

Describe what ‘flat affect’ is in regards to be schizophrenic:

A
  • is a negative symptom

- having limited emotional expressions

47
Q

Describe what avolition is in regards to being schizophrenic:

A
  • negative symptom
  • lacking energy
  • limited ability to persist in what are usual daily routines
  • this can result in difficulties with grooming and basic hygiene
48
Q

Describe what alogia is in regards to being schizophrenic:

A
  • negative symptom
  • can take on several forms
  • poverty of speech
  • poverty of content of speech [vague or repetitive speech]
49
Q

Describe what anhedonia is in regards to being schizophrenic:

A
  • negative symptom

- inability to experience pleasure

50
Q

What is the DSM-5 criteria in being diagnosed as schizophrenic :

A
  • 2 + symptoms identified under the positive/ negative symptoms
  • one of those 2 or more symptoms has to be either delusions, hallucinations or disorganized speech
  • must maintain a significant amount of time since onset where level of functioning is way below what it use to be
  • continuous signs of the disturbance must persist for 6 months
  • DSM-5 does not recognize symptom- based subtypes as they had little reliability and validity
51
Q

Describe attenuated psychosis syndrome:

A
  • is under the other specified schizophrenia spectrum and other psychotic disorders
  • does not meet full criteria for full criteria for schizophrenia
  • must have either delusions, hallucinations, or disorganized speech
  • symptoms must be present for at least 1 week in the last month
  • insight is maintained
52
Q

What is the percentage of having a child with schizophrenia when the parent who has schizophrenia?

A
  • 13% more chance of being diagnosed as schizophrenic if your parent is also schizophrenic.
53
Q

What is the percentage of identical twins both having schizophrenia:

A

48%

54
Q

Describe the dopamine hypothesis: original beliefs, evidence:

A
  • original belief was that schizophrenia was related to an excess of dopamine
  • evidence: postmortem Brian tissue showed an increased number of dopamine receptors, the use of antipsychotic medication as treatment works in blocking dopamine receptors, and cocaine/ amphetamine use increases dopamine and can cause psychosis like symptoms and paranoid ideation
55
Q

What are some doubts regarding the Dopamine hypothesis?

A
  1. Brian tissue was from patients who were on antipsychotic medication, which causes an increase Ina. Number of dopamine receptors
  2. Dopamine byproducts are not universally elevated in people with schizophrenia
56
Q

What are the first generation/ typical antipsychotics used in treatment for schizophrenia:

A
  • chlorpromazine also known as Thorazine
  • haloperidol also known as handol
  • reduces dopaminergic transmission
  • side-effects are : dry mouth, muscle stiffness, and weight gain
57
Q

Define what tardive dyskinesia is:

A
  • a movement disorder characterized by repetitive, involuntary body movements
58
Q

Describe the second generation/ atypical antipsychotics treatment for patients with schizophrenia :

A
  • first line treatment for schizophrenia
  • allows more normal dopamine transmission
  • rise riding, olanzapine, seroquel, abilify
  • is believed to be associated with fewer side effects
  • improve positive and some negative symptoms but do little for mental impairment
59
Q

What are the low-risk drinking guidelines for men and women:

A
  • men can have 3 drinks during a time and weekly intake shouldn’t exceed 15
  • women can have 2 drinks during a time and a weekly intake shouldn’t be over 10
60
Q

What is an AUDIT:

A
  • alcohol use disorders identification test
  • is a 10 question screening tool
  • elements were developed to minimize cultural differences in alcohol use and attitudes
61
Q

What is ethyl alcohol?

A
  • is an effective chemical compound in alcoholic beverages
  • reduces anxiety
  • produces euphoria
  • creates a sense of well-being
62
Q

What are the four categories that clinicians use inorder to diagnosis someone:

A
  1. Symptoms related to impaired controls
  2. Symptoms related to social impairment
  3. Symptoms related to risky use
  4. Pharmacological criteria
63
Q

Describe what symptoms fall under the “symptoms related to impaired controls” in regards to substance abuse:

A
  • ingestion of substance in larger amounts or over a longer period that was originally intended
  • desired to cut down with or without successful efforts to reduce or discontinue
  • a great deal of time spent obtaining, using, or recovering from use of a substance
  • craving
64
Q

Describe what symptoms fall under “symptoms related to social impairment” in regards to substance abuse:

A
  • failure to fulfill major obligations at work, school or home
  • continuing to use despite persistent social and interpersonal problems exacerbated by the effects of the substance
  • loss of social, occupational, or recreational activities because of substance abuse
65
Q

Describe “ symptoms related to risky use” in regards to substance abuse:

A
  • recurrent substance use in situations in which it is physically hazardous
  • continued use despite knowledge of having a persistent or recurrent psychological problem that is likely to have been cause or exacerbated by the substance
66
Q

Describe symptoms related to “pharmacological criteria” in regards to substance abuse:

A
  • tolerance

- withdrawal symptoms

67
Q

How many symptoms is needed in order to be classified as mild/moderate or severe substance disorder?

A
  • 2/3= mild
  • 4/5= moderate
  • 6+ severe substance disorder
68
Q

What percent of university students report having consumed alcohol in the last year?

A

86%

69
Q

What is the alcohol expectancy theory ?

A
  • ## individuals drinking is determined by the reinforcements they expect to obtain from it
70
Q

Describe Dissociative identity disorder: [DID]

A
  • when an individual has two or more distinct identities that alternate control of his or her behaviour
  • has severe disruptions in consciousness, memory, and identity
  • very controversial disorder
  • one of the multiple personalities is identified as the host while the others are known as alters
  • most common number of alters is between 13-16
  • average age of onset is in late adolescents or early adulthood
  • onset of symptoms typically occur before the age of 5
  • women are diagnosed with this 3 times more often then men
  • 75% of poeple with DID have a history of suicidal attempts and more than 90% report recurrent suicidal thoughts
71
Q

Describe Somatic symptom disorder:

A
  • people who have long-standing beliefs that they have serious illnesses
  • usually these people have high levels of anxiety
  • typically have multiple, recurrent somatic symptoms such as pain, fatigue, nausea, muscle weakness, numbness, or indigestion
  • must be very distressing to the individual and disrupt daily life
  • frequently going to doctors seeking help
  • often describing there problems in an exaggerated manner, but with little factual information
  • .2% -2% of all women in the U.S experience Somatization
  • less that 0.2% of men experience somatization
72
Q

Describe dissociative fugue disorder:

A
  • is extremely rare and unusual form of amnesia
  • individuals have a loss of memory for their past and personal identity
  • travel suddenly and unexpectedly away from home
  • usually in brief duration, can last from a few days to a few weeks
  • individuals are able to function normal and may even successfully adopt a new life
  • least understood dissociative disorder
73
Q

Describe depersonalization:

A
  • a condition in which individuals have a distinct sense of unreality and detachment from their own thoughts, feelings, sensations, actions, or body
  • can occur in several other disorders as well
  • third most common reported clinical symptom among psychiatric patients after depression and anxiety
  • just because you have symptoms doesn’t mean you have the disorder
  • common onset is in adolescents and young adults and hardly ever in people over the age of 40
74
Q

Describe derealization disorder :

A
  • involves a feeling of unreality and detachment with respect to one’s surroundings rather than the self
75
Q

Define the Trauma Model:

A
  • similar to the diathesis-stress model
  • believe dissociative disorders or a result of severe trauma in childhood
  • believed that the behaviours are a coping mechanism for childhood experiences
76
Q

What is the socio-cognitive view on dissociative identity disorder?

A
  • don’t view it as a legitimate disorder
  • believe that it is a form of role-playing in which individuals come to construe themselves as possessing multiple selves and begin to act in ways that demonstrate that character
  • assert that it is entirely possible to alter ones personal history so that it is consistent with the belief that one has DID
77
Q

What does Iatrogenic mean?

A
  • caused by treatment
78
Q

Describe the psychotherapy techniques when approaching dissociative identity disorder patients:

A
  • focus is on helping patients resolve distress associated with past traumas and learn more affective ways of coping with stress in their lives
  • multiple stages to go through:
    1. Establishing trust and a safe environment
    2. Developing new coping skills
    3. Integration of personalities
  • goal is for the alters to merge into a single personality
79
Q

Describe conversion disorder:

A
  • most traumatic of the somatic symptom and related disorders
  • loss of functioning in part of their body that appears to be due to a neurological or other medical cause
  • may have motor deficits such as paralysis or localized weakness, impaired coordination/balance, inability to speak, difficulty swallowing
  • called ‘conversion’ disorder because Clincial theorist use to believe that individuals with the disorders are converting psychological needs into neurological symptoms
  • onset is late adolescent- young adult
  • diagnosed in women twice as often as in men
80
Q

Describe glove anaesthesia:

A
  • involves a loss of all sensation throughout the hand with the loss sharply demarcated at the wrist
  • doesn’t follow a pattern consistent with the sensory innervation of the hand and forearm
81
Q

Describe ‘la belle indifference’:

A
  • a lack of concern about the nature and implications of one’s symptoms
  • found only in a minority of cases
82
Q

Describe somatic symptom disorder with predominant pain:

A
  • individual must have pain in one or more body sites that is severe enough to cause significant distress or to disrupt the individuals daily life
  • individuals must have excessive, unrealistic thoughts, feelings or behaviours related to the pain
  • exaggerate concerns about its seriousness,
  • individuals devote excessive time and energy to dealing with problem
83
Q

Describe fictitious disorder:

A
  • deliberately faking or generating the symptoms of illness or injury to gain medical attention
  • involve faking psychiatric symptoms, such as hallucinations or delusions
  • there must NOT be an obvious external reward for this behaviour such as insurance money
  • motivation for this disorder is needing sympathy, care, and attention that accompany a sick role
84
Q

Describe body dimorphic disorder: [BDD}

A
  • excessive preoccupation with an imagined or exaggerated body disfigurement
  • individuals need to have severe distress or impairment in social, occupational, or another aspects in life
  • usually begins in adolescents
  • can persist throughout lifetime
85
Q

Describe the transtheoretical model of change:

A
  • originated with Prochaska and DiClemente in 1984
  • framework for understanding behavioural change
  • had 5 stages: pre contemplation, contemplation, preparation, action, and maintenance
  • believes change is very difficult and that relapse is common
  • is considered a spiral model, that you can enter within any stage and go in a different order
  • interventions match individuals stage of change
86
Q

Describe a motivational interview: (MI)

A
  • believe lasting change is unlikely to occur until individuals can resolve their ambivalence
  • ambivalence is expected and understandable experience
  • has four general principles:
    1. Express empathy
  • reflective listening
  • reassuring ambivalence is normal
    2. Developing discrepancy
  • between present behaviours and future goals/thoughts
    3. Role with resistance
  • don’t argue
  • change your approach
    4. Support self-efficacy
  • try to boost a person’s sense of the client having the ability to change
87
Q

What are the strategies for motivational interviews: OARS?

A

Open ended questions
- goal is to get client talking

Affirmations

  • belief that paitents doubts in their abilit to change hinders the process
  • resourcefulness
  • reflect on qualities of the patient that may facilitate change

Reflective listening

  • make statements not questions
  • simple and complex reflections
  • simple adds little to what patient has said where complex adds an inferred meaning

Summarizing

  • type of complex reaction
  • selective and directive
  • start summarizing when patient begins to speak of changing
  • state positive associated with change and the cons associated with current behaviour
88
Q

Describe localized diassociative amnesia:

A
  • most common type

- is the loss of all memory of events occurring within a limited time period

89
Q

Describe selective diassociative amnesia:

A
  • loss of memory for some but not all events occurring within a select period of time
90
Q

Describe generalized dissociative amnesia:

A
  • loss of memory from everything occurring before the event

- may fail to recognize family or friends

91
Q

Describe continuous dissociative amnesia:

A
  • loss of memory in total
92
Q

What are the 3 different ways alters can interact with eachother?

A
  • mutually amnesia [no alter is aware of the other]
  • mutually cognizant patterns [each is well aware of the other ]
  • one-way amnesia [most common, where some are aware of others but it isn’t reciprocated]

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