ch 14: OCD, MDD, biploar, suicide

Question 1

What are the two types of panic attacks?

Answer 1

expected & unexpected

Question 2

What is agoraphobia? What is usually co-occurring with agoraphobia?

Answer 2

Agoraphobia: fear of being in places in which it would be difficult to escape/get help in the event of unpleasant physical symptoms

PANIC and agoraphobia usually occur together

Question 3

What contributes to the development of anxiety disorders?

Answer 3

• Biased thinking
• Neutral stimuli perceived as threatening
• Focus excessive energy on threatening stimuli
• Fears may be learned and then generalize
• Biological factors → kids w inhibited temperamental (shy, doesn’t like to interact) style → more likely to develop anxiety disorders

Question 4

What is the difference between obsessions and compulsions?

Answer 4

Obsessions: recurrent intrusive, unwanted, nonsensical thoughts, images, urges

Compulsions: particular acts that people with OCD feel driven to perform over and over again to reduce anxiety

Question 5

What are the four components of the OCD cycle and in what order do they appear?

Answer 5

1: anxiety (ex: forced to shake hands)

#2: compulsion (ex: run to bathroom)
#3: relief: (wash hands)
#4: obsession: fear of contamination

Question 6

What percentage of the population is diagnosed with OCD?

Answer 6

1-2%

Question 7

What are some common obsessions and compulsions associated with OCD?

Answer 7

Common obsessions: fear of contamination, accidents, one’s own aggression

Common compulsions: cleaning, checking, counting
- Ex: continually checking to make sure door is locked

Question 8

What are the causes for OCD?

Answer 8

Classical conditioning: anxiety tied to specific event
Operant conditioning: engages in behavior to reduce anxiety, gets reinforced
Learning that some thoughts are dangerous/unacceptable
Partially genetic: runs in families
related genes appear to control glutamate excitatory neurotransmitter, causing neural firing
Environmental: streptococcal infection causes severe OCD in some children – damage to caudate

Question 9

What is hoarding disorder characterized by?

Answer 9

Characterized by excessively collecting or keeping items regardless of their value and difficulty discarding items, usually due to a fear that one will need them later
Causes clinically significant distress or impairment (e.g. house too cluttered to live in, arguments with family members)

Question 10

What psychological disorders are included in trauma and stressor related disorders?

Answer 10

Include PTSD and acute stress disorder, adjustment disorders & attachment disorders

Question 11

What is PTSD? What are the most common traumas?

Answer 11

Trauma exposure and response
- Reexperiencing (memories, nightmares)
- Avoidance
- Emotional numbing
- Interferes w one’s ability to function

Most common: combat and sexual assault

Question 12

What percentage of people experience PTSD in their lives?

Answer 12

Approx 7% of ppl, more common in women

Question 13

What are the causes of PTSD?

Answer 13

Intensity of the trauma and one’s reaction to it (i.e., true alarm, fear for one’s safety)

Learning – direct conditioning and observational learning

Biological vulnerability
genetic markers related to serotonin production memories related to activation in amygdala

Uncontrollability and unpredictability
Social support post-trauma reduces risk

Question 14

What are depressive disorders?

Answer 14

Presence of sad, empty, or irritable mood
Bodily symptoms & cognitive problems

Question 15

What psychological disorders are included in depressive disorders? Which ones are new to the DSM-5?

Answer 15

Included: Major depressive disorder, Persistent depressive disorder

New: Premenstrual dysphoric disorder, Disruptive mood dysregulation disorder

Question 16

What characterizes a major depressive episode?

Answer 16

One or more major depressive episodes separated by periods of remission

sad, empty, irritable mood

to be diagnosed: must have MDD everyday for at least 2 weeks

Question 17

What percentage of Americans have major depressive disorder at any given times? What is the lifetime prevalence?

Answer 17

7-8% of americans at ANY GIVEN time
16% lifetime prevalence

Question 18

What is the leading risk factor for suicide?

Answer 18

Major depressive disorder

Question 19

What are the criteria for persistent depressive disorder (PDD)?

Answer 19

PDD: mild to moderate severity, symptoms are less intense than MDD

At least TWO years of depressive symptoms
Depressed mood most of the day on more than 50% of days
No more than two months symptom free
periods of depressed mood last 2-20 years

Question 20

What role does culture have in depressive disorders?

Answer 20

Stigma is especially strong in developing countries → Barriers to treatment

Question 21

What role does gender have in depressive disorders?

Answer 21

Twice as many women suffer from depression
May be related to overwork and lack of support

Question 22

What are the biological causes of depressive disorders?

Answer 22

Genetic component
- identical twins 2 – 3x higher than rates forfraternal twins

May involved 1 or more monoamines (neurotransmitters that regulate emotion and arousal and motivate behavior)

Question 23

What are the situational causes of depressive disorders?

Answer 23

Life stressors → interpersonal loss (loss of loved one or divorce)

how one reacts to stress = influenced by Interpersonal relationships

social relationships can protect from depression; quality over quantity

Question 24

How do cognitive processes play a role in depressive disorders? explain cognitive triad.

Answer 24

ppl w depression view themselves, their future, and world negatively

COGNITIVE TRIAD:
Negative views about the world
Negative views about the future
Negative views about one’s self

Question 25

What are the logical errors?

Answer 25

Cognitive biases Overgeneralization Black and white thinking Responsibility for bad events Global, stable attributions

Question 26

Explain the methodology and results of Seligman’s study on learned helplessness.

Answer 26

people come to see themselves as unable to have any effect on events in their lives. Seligman’s study: when animals are placed in aversive situations that they can’t escape → animals become passive/unresponsive - End up lacking motivation to try new methods of escape when given opportunity Ppl who experience learned helplessness → come to expect bad things will happen to them, believe they are powerless to avoid negative events

Question 27

Define mania and describe its manifestations.

Answer 27

Elevated mood that feels like being “on top of the world” Inflated self-esteem, decreased need for sleep, excessive talkativeness, racing thoughts, distractibility, increase in goal-directed activity or psychomotor agitation, excessive involvement in high-risk behaviors

Question 28

What is the difference between Bipolar I disorder and Bipolar II disorder?

Answer 28

Bipolar 1: usually alternates between full manic episodes and major depressive episodes - Avg age of onset: 15-18 years - Tends to be chronic Bipolar 2: alternates between hypomanic episodes and major depressive episodes - Avg age of onset: 19-22 years - Tends to be chronic

Question 29

What is the difference between hypomania and mania?

Answer 29

HYPOMANIA: shorter, less severe version of manic episodes Last at least 4 days fewer/milder symptoms Associated w LESS impairment than manic episode

Question 30

What percentage of Bipolar II disorder cases are chronic? Life prevalance? Any differences by gender?

Answer 30

10-25% are chronic Overall prevalence: 3-4% EQUALLY prevalent among gender

Question 31

What are the concordance rates associated with bipolar disorders?

Answer 31

For identical twins: 70% For fraternal twins: 20%

Question 32

What age group has the highest number of suicides?

Answer 32

Ages 85 AND OLDER → highest rate of suicide

Question 33

almost all suicides take place w little to no warning T/F?

Answer 33

FALSE

Question 34

women account for nearly 78% of suicide deaths T/F?

Answer 34

FALSE

Question 35

Giving away valued possessions is a clue that a person may be considering suicide. T/F?

Answer 35

TRUE

Question 36

Someone who is recovering from severe depression and suddenly develops a positive outlook on life rarely commits suicide T/F?

Answer 36

FALSE

Question 37

Talking to someone abt suicide increases their risk of suicide T/F?

Answer 37

false

Question 38

What are the trends of suicide by race/ethnicity?

Answer 38

American indian/alaska native and then white→ highest black/african american, hispanic, asian → lowest

Question 39

What are the current rates of suicide as proposed by the CDC?

Answer 39

Suicide rates are growing → particularly among WOMEN More than 1,000,000 ppl in US attempted suicide in the last year Nearly 3,000,000 ppl in US made a plan abt how they would attempt suicide

Question 40

What risk factors are associated with suicide?

Answer 40

- Family history of suicide - Previous suicide attempts - History of mental health disorders (particularly clinical depression) - History of alcohol and substance abuse - Feelings of hopelessness impulsive/aggressive tendencies - Cultural and religious beliefs Isolation, feeling of being cut off from other ppl - Barriers to accessing mental health treatment - Loss (work, financial, social, relational) - Physical illness - Easy access to lethal methods → highest risk factor (like gun) - Unwillingness to seek help because of stigma attached

Question 41

What are the gender differences regarding suicide? What are the reasons behind these differences?

Answer 41

Women have higher attempt rate (three times of men) Men have a higher completion rate (three times of women) Why? Men use more violent methods (shooting) than women (Poisoning) Guns are used in nearly 66% of male suicides in the US compared to 40% of female suicides

Question 42

What triggers a suicide?

Answer 42

Recent events/current conditions in a person’s life, may not be the basic motivation for the suicide → can precipitate it (ex: losing ur keys → losing it bc of that small thing) Common triggers → stressful events, mood/thought changes, alcohol/drug use

Question 43

At what age does suicidal actions become more common?

Answer 43

after age of 14

Question 44

What are the rates of suicide for adolescents in the U.S. each year?

Answer 44

About 1,500 teens commit suicide in the US each year At least 1 in 12 makes a suicide attempt Far more teens attempt suicide than succeed

Question 45

What are the rates of suicidal ideation? (forming the idea of suicide)

Answer 45

Among students in grades: 22.4% of females and 11.6% of males seriously considered attempting suicide in last year

Question 46

What are the differences in adolescent suicide by ethnicity?

Answer 46

Teen suicide rates vary by ethnicity in the U.S. - Native American / Alaskan Native youths have highest rate of suicide-related fatality - Hispanic youth have higher rates of attempt than black and white, non-Hispanic youth Youth who report involvement in bullying-related behavior are more likely to report high levels of suicide-related behavior

Question 47

What are the differences in suicide by ethnicity and culture in America?

Answer 47

In the U.S., the suicide rate of white Americans (12 per 100,000) is almost twice as high as that of African Americans, Hispanic Americans, and Asian Americans - major exception is very high suicide rate of Native Americans, which overall is 1.5 times the national average

Question 48

What role does religious devoutness have on suicide rates?

Answer 48

Suicide rates vary from country to country, with religious devoutness (not simply affiliation) helping to explain some of the difference

Question 49

What roles does marital status have on suicide differences?

Answer 49

- Divorced men’s risk of suicide was twice that of married men - No effect of marital status on suicide risk among women - Being single or widowed had no effect on suicide risk - Women tend to have a more diverse social support network compared to men → men tend to lean on their partner

Question 50

Based on the suicide death data from 16 National Violent Death Reporting System states in 2010, what percentage tested positive for alcohol, antidepressants, and opiates?

Answer 50

33.4% tested positive for alcohol 23.8% tested positive for antidepressants 20% tested positive for opiates, including heroin and prescription painkillers

Question 51

What are the results of research looking at the contagion of suicide?

Answer 51

Some research indicates that a person is more likely to commit suicide after hearing about someone else committing suicide 5% of adolescent suicides may be due to contagion After Marilyn Monroe died in August 1962, 12% jump in suicide rate in U.S.

Question 52

What role might media have in the suicide contagion?

Answer 52

Sensationalizing/romanticizing suicide Describing lethal methods of committing suicide Describing suicide as escape for troubled person

Question 53

What are some ways to prevent suicide? What can we do?

Answer 53

- Physician education in depression recognition - restricting access to lethal methods reduce suicide rates - education is the ultimate form of suicide prevention - Take suicidal threats seriously - Do not be afraid to ask directly. It will NOT put the thought into someone’s mind - Get help - Remind the person how much you care about them, that you care about their well-being, that you would be devastated if they were not in your life