Clinical: Clinical and Abnormal Flashcards

You will be able to identify key aspects of psychological disorders, including causes, diagnosis, treatment, and cultural considerations in mental health. (206 cards)

1
Q

What did Emil Kraeplin contribute to psychology?

A

Kraeplin created one of the first textbooks of co-occurring mental disorders, which he grouped together and classified with common symptoms. He also created the term “dementia praecox” for schizophrenic symptom clusters.

This became the ancestor to our modern Diagnostic and Statistical Manual of Mental Disorders (DSM).

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2
Q

Who was Philippe Pinel?

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Pinel was one of the first mental health professionals to treat his patients with compassion and kindness. The model set by the Parisian hospital he ran was adopted by many other asylums.

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3
Q

Which American activist fought for asylum reform in the mid-1800s?

A

Dorothea Dix

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4
Q

Who wrote The Myth of Mental Illness?

A

Thomas Szasz

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5
Q

What is The Myth of Mental Illness about?

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This book espouses the belief that labeling people as mentally ill makes them conform to the norms of society, rather than examining the societal roots of their mental problems. Szasz also espoused the belief that “mental illness” is a social construction.

To hear an excerpt of a speech by Szasz, please go here.

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6
Q

To what do the terms incidence, prevalence, and lifetime prevalence refer?

A
  • Incidence is the number of new cases that appear in a population in a given period of time.
  • Prevalence is the total number of active cases (old and new) present in a population in a given period of time.
  • Lifetime prevalence is the total proportion of people who will meet criteria for diagnosis at some point in their lives.
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7
Q

What is comorbidity?

A

It’s another term for co-occurrence.

For instance, if an individual meets diagnostic criteria for both obsessive-compulsive disorder (OCD) and alcohol dependence, then that person could be said to have comorbid OCD and alcohol dependence.

Comorbidity is very common in clinical settings, and high rates of comorbidity suggest that many mental disorders are not clear-cut categories.

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8
Q

Diagnosis and Causes:

What is a necessary cause?

A

Something that must be present for a particular illness to occur:

If illness X occurs, then A must have been present.

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9
Q

Diagnosis and Causes:

What is a sufficient cause?

A

Something that by itself may cause a particular illness to occur:

B, in the absence of other factors, can result in illness X.

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10
Q

Diagnosis and Causes:

What is a contributing cause?

A

Something that makes it more likely that a particular illness either will occur or will continue:

If C is present, then illness X is more likely to happen or continue.

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11
Q

What does ICD stand for?

What is the ICD-10?

A

The ICD-10 is the International Classification of Diseases. The ICD currently is in its tenth edition.

The ICD-11 is expected to be released in 2018. Some of the revisions in the DSM-5 were made to make it more consistent with the ICD.

The ICD is a system of classifying diseases; it is published by the World Health Organization.

The U.S. and Canada use the DSM system for diagnosing mental illnesses; most of the rest of the world uses the ICD system.

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12
Q

What are 3 important factors to consider when determining whether or not an individual’s behavior is abnormal?

A
  1. Whether the behavior causes subjective distress or suffering to the individual
  2. Whether the behavior causes impairment or dysfunction
  3. Whether the behavior is atypical or deviant with respect to the individual’s current cultural context

Most definitions include only these 3 Ds (Distress, Dysfunction, and Deviance). But another factor to consider is Danger, whether the behavior can be harmful to one’s self or others.

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13
Q

Clinicians use signs and symptoms when diagnosing mental illness. What is a symptom and a sign?

A
  • Signs: perceived by the clinician
  • Symptoms: perceived by the patient

Signs e.g., patient appears disheveled, patient speaks unusually slowly, patient does not make eye contact.

Symptoms e.g., patient feels hopeless, patient experiences intrusive thoughts, patient has suicidal thoughts.

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14
Q

Describe the diathesis-stress model of mental illness.

A

This is a model in which a person has a diathesis to mental illness which can be activated by a stressor/stressors, thus precipitating mental disorder.

Diathesis: i.e., a vulnerability, which may be a distal necessary cause or a contributory cause.

Stressor/stressors: i.e., an experience or experiences that overtax an individual’s resources.

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15
Q

Using MDD, provide an example of a diathesis.

A

Having a short short (ss) allele for the serotonin transporter gene is a diathesis for depression.

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16
Q

Using MDD, provide an example of a stress.

A

Getting divorced is a stressor.

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17
Q

What is primary prevention?

A

Refers to attempts to prevent disease or disorder onset, i.e., reducing the incidence of preventable illnesses.

Primary prevention is not (yet) achievable for mental illness.

Challenges include identifying what factors encourage the precipitation of mental illnesses (only some have been identified) and attempting to prevent these situations before they happen, via good public mental health practices (some may not be preventable).

However, some are preventable. For instance, because prenatal malnutrition doubles the risk for an individual developing schizophrenia in adulthood, providing universal prenatal care may help reduce the incidence of schizophrenia.

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18
Q

Define:

dysphoria

A

An unusually high level of negative mood.

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19
Q

Define:

anhedonia

A

An unusually low level of positive mood; inability to feel pleasure.

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20
Q

Describe what David Rosenhan reported in his classic 1973 Nature article, “On Being Sane in Insane Places.”

A

Rosenhan and several other confederates were admitted into mental health facilties presenting with illnesses. The confederates all received diagnoses and had a difficult time being released, because the staff began to classify their regular behaviors as indicative of illness. Rosenhan interpreted the results to mean that diagnoses exist in the minds of the observers.

To read the original Rosenhan article, go here.

To see a brief interview with Rosenhan, go here.

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21
Q

What were the implications of David Rosenhan’s experiment?

A

Rosenhan reported that the pseudopatients, rather than being released as never having been ill, were released with a diagnosis of schizophrenia in remission. Rosenhan noted that being labeled “insane” can persist throughout the life-span, which is dangerous. Rosenhan concluded that psychiatric diagnoses exist in the minds of observers: By naming something, we behave as if it is real (so yes, symptoms are real, but how we understand illnesses may be wrong).

Perhaps the most disturbing finding was that pseudopatients averaged less than seven minutes of direct therapeutic care per day, suggesting that patients in general received inadequate clinical care.

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22
Q

What are some limitations or critiques of Rosenhan?

A

Among other issues:

  1. The diagnosis of schizophrenia in remission was (and is) quite rare, suggesting that the psychiatrists were aware that these patients’ cases were not standard cases.
  2. Because symptoms, which are not externally visible, are used to determine diagnosis, in most situations, treaters must depend on patients to be honest to the best of their ability. The ability to fake an illness does not mean that the illness does not exist.

To read Spitzer’s critique of Rosenhan, go here.

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23
Q

From what school of thought are Beck’s cognitive therapy (for depression) and Ellis’s rational-emotive therapy?

A

They are forms of Cognitive Behavioral Therapy (CBT).

One of the important strengths of CBT is that it has empirical support. Empirical support means that is has been scientifically tested in clinical trials and found to be beneficial for patients.

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24
Q

What are the components of Beck’s Negative Cognitive Triad?

A
  • Negative views of the self: e.g., “I suck.”
  • Negative views of the world: e.g., “Everybody hates me.”
  • Negative views of the future: e.g.,” My life will always suck.”
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25
What is **Beck's theory of depression**? In other words, according to Beck, how does depression happen?
**Negative early experiences** can lead to the formation of **dysfunctional beliefs or schemas**, which may lay dormant until a critical incident of some kind occurs (e.g., losing a job or breaking up with a significant other). The individual then experiences **cognitive distortions** about the critical incident (or incidents). These cognitive distortions lead to negative, dysfunctional automatic thoughts and self-talk, which can turn into a negative feedback loop and cause the individual to experience depressive symptoms. **Cognitive errors reinforce negative schemas**.
26
Describe the experiment Martin Seligman designed that developed his theory of **learned helplessness**.
He would place dogs in cells with high walls, then electroshock the floor, causing the dogs to try to jump out of the cells. Eventually, the dogs stopped trying to escape: they had learned to be helpless. This is much like people with depression who eventually feel powerless to escape their problems.
27
What are the **steps of CBT**?
1. Identify situations that are troubling 2. Become aware of relevant thoughts and beliefs 3. Identify inaccurate, negative thinking 4. Challenge inaccurate, negative thinking Repeat until cognitive errors are reduced and adaptive thinking patterns become habitual.
28
What are some of the **benefits** of the Cognitive Behavioral paradigm?
* **Empirically validated treatments**: Research supports that CBT works for treating many disorders, such as anxiety and unipolar mood disorders. * For depression, CBT treatment is as successful as SSRIs; plus patients who do CBT have a **significantly lower recurrence rate**.
29
What are some of the **strengths of CBT**?
* **Versatility**: CBT has successfully been adapted for use with patients from a **variety of cultures**. Also, CBT has been successfully used for a variety of uses, such as helping individuals develop healthier sleeping habits. * **Empowering**: Patients do **homework** and actively **collaborate** on their treatment.
30
The cognitive behavioral paradigm has many strengths. However, it also has limitations. What are some of the **limitations**?
* CBT may not adequately address **biological factors**. * Therapists need special training; **relatively few patients have access to CBT services**. Needs better dissemination! * Research focuses on patients without comorbidity, so **short length of treatment may not be realistic for patients in the community**. * It is challenging, so **high drop out rates can be problem**.
31
According to the DSM-5, what are the two types of **mood disorders**?
1. Bipolar and Related Disorders 2. Depressive Disorders ## Footnote **Bipolar and Related Disorders** (Bipolar I Disorder; Bipolar II Disorder; Cyclothymic Disorder...) **Depressive Disorders** (Major Depressive Disorder; Persistent Depressive Disorder (Dysthymia); Premenstrual Dysphoric Disorder...)
32
Name the 9 possible **DSM-5 MDD** symptoms, and note which 2 are cardinal symptoms. ## Footnote In order to met criteria for Major Depressive Disorder (MDD), one must have 5 or more symptoms for two or more consecutive weeks; the symptoms must be a change from previous functioning, there must be no history of mania or hypomania, and must not be attributable to another medical condition. (One or both cardinal symptoms must be present to qualify for MDD.)
1. depressed mood (dysphoria) 2. general lack of interest in once enjoyable activities (anhedonia) 3. low sense of self-worth 4. hypersomnia or insomnia 5. possible suicidal ideation 6. significant weight loss/gain 7. loss of energy 8. diminished ability to concentrate 9. restlessness Symptom 1 (dysphoria) and Symptom 2 (anhedonia) are the cardinal symptoms; one or both must be presnt for a DSM-5 MDD diagnosis.
33
What is the **difference** between the DSM-IV and DSM-5 criteria for Major Depressive Disorder (MDD)?
In the **DSM-IV**, there was a **grief/loss exclusion** for diagnosing Major Depressive Disorder (MDD). This exclusion has been **removed in the DSM-5**. ## Footnote The exclusion originally was included to avoid pathologizing grief. However, MDD often is triggered by exposure to significant stressors. A compelling reason to remove the exclusion is that in a treatment study, treatment seeking individuals who otherwise met criteria for MDD responded to treatment as successfully as did treatment seeking individuals who met the full criteria. Thus a grief exclusion may have been an unintended barrier to beneficial treatment.
34
What are the diagnostic criteria for **Persistent Depressive Disorder** (Dysthymia)?
* **Depressed mood** for most of the day for more days than not for **at least 2 years** (in children and adolescents, at least 1 year). * Presence (while depressed) of **at least 2** of the following **symptoms**: Poor appetite or overeating; Insomnia or hypersomnia; Low energy or fatigue; Low self-esteem; Poor concentration/difficulty making decision; or Feelings of hopelessness. * During the 2 year period, the individual has **never been free from these symptoms for more than 2 months at a time**. * Symptoms cause **clinically significant distress or impairment** in functioning. ## Footnote Also, no history of mania, and the disorder is not better accounted for by schizoaffective, schizophrenia, delusional disorder, or another psychotic illness; not caused by a substance or medical condition.
35
# Yes or No: Is Persistent Depressive Disorder (Dysthymia) just a milder form of Major Depressive Disorder?
No ## Footnote The DSM-5 explains that although there can be wide variation in how the disorder impacts social &/or occupational functioning, "effects can be as great or greater than those of major depressive disorder" Although the symptoms may be less severe, their longstanding nature can lead to significant impairment as well as **an even higher risk for suicide than MDD**.
36
# Define: bipolar disorder
This mental disorder is characterized by **periods of depression and mania**.
37
Annie has been hospitalized. Over the last week, she has exhibited increased self-esteem, a lack of sleep, rapid-fire ideas, increased promiscuity and risk-taking behavior. What mental disorder does she have?
bipolar disorder type I
38
What are the major characteristics of **cyclothymic disorder**?
One or more periods of **hypomanic** symptoms interspersed with one or more periods of **depressive** symptoms.
39
Who first introduced **electroshock therapy** as a cure for seizures?
Cerletti and Bini ## Footnote These doctors introduced electroshock therapy in 1938. The spasms from this treatment were often so severe that their patients were often seriously injured during the therapy. However, electroshock therapy can now be performed safely and is used as a treatment for some severely depressed patients. (It is reserved for patients who are severely depressed and are not responding to or are unable to take other forms of treatment.)
40
What is an **iatrogenic** treatment?
One which makes a **condition worse**. ## Footnote Although most therapies are helpful, some treatments (e.g., debriefing for PTSD; psychoanalysis for schizophrenia) have been found to worsen outcomes. The possibility of iatrogenic treatment is one of the reasons that clinical research trials are very important.
41
Is **insane** a psychological term?
No, insane is a **legal** term. ## Footnote Mental health professionals and medical doctors cannot diagnose people as being insane. Determinations of sanity are a legal matter. Diagnosis with a mental disorder may be used as evidence in determining a defendant's fitness to stand trial, but in and of itself, diagnosis is not sufficient to determine sanity. (Sane also is a legal term.)
42
Do most people who try an addictive substance, such as alcohol, become addicted?
No. Most people who experiment with addictive substances do not become addicted. ## Footnote However, a minority will, and it is not possible to know for certain in advance whether or not one has a brain that is especially vulnerable to developing addiction.
43
What are the **disadvantages** of conceptualizing alcoholism as a disease?
* reduces addicted individual's accountability * removes incentive to abstain * places addicted individual in victim role * inconsistent with data that say "controlled" use may be achieved * self-fulfilling prophecy
44
In the development of addicition, what are the key distinctions between **early stage drug use** and **late stage drug use**?
* In **early stage**, the drug use is pleasure-based and goal-driven, i.e., **drug taking behavior**. * In **late stage**, the drug use is compulsive and habit-driven, occuring even if there are significant negative consequences, i.e., **drug seeking behavior**. ## Footnote In addiction, as time goes on, the individual likes or enjoys the drug less, but craves the drug more and more.
45
What are the **advantages** of conceptuallizing alcoholism as a disease?
* brought the problem to public awareness * achieved funding to study alcoholism * reduces stigma * promotes treatment development and funding
46
What is Alzheimer's disease?
A lethal neurodegenerative disorder.
47
What changes in the brain are associated with Alzheimer's disease?
Individuals with Alzheimer's disease experience **dementia**, progressive losses in memory and cognition, **social withdrawal**, **lapses in judgement**, and eventually **lose their ability for self care**. ## Footnote Post mortem (after death) examination of the brains of people with Alzheimer's disease reveal neurofibrillary tangles, amyloid plaques, and reduced brain volume. Currently there is no way to cure or to prevent Alzheimer's disease.
48
Which diagnosis has the highest risk for the patient **dying due to the illness**? ## Footnote According to DSM-5.
Anorexia nervosa | (AN) ## Footnote According to the DSM-5, the majority of the AN deaths are due either to medical complications (e.g., multiple organ failure) or to suicide.
49
What Feeding and Eating Disorders appear in the DSM-5?
1. Pica 2. Rumination Disorder 3. Avoidant/Restrictive Food Intake Disorder 4. Anorexia Nervosa (AN can be restricting type OR can be binge-eating purging type) 5. Bulimia Nervosa 6. Binge-Eating Disorder 7. Other Specified Feeding or Eating Disorder 8. Unspecified FEeding or Eating Disorder
50
A patient presents at your clinic; she is severely underweight from excessive control over her body. The patient believes that she weighs too much, even though she is 20 pounds underweight, and is severely malnourished. Her body weight is less than 85% of what one would expect someone her height to weigh. What mental disorder does she likely have?
anorexia nervosa
51
What are the compensatory behaviors that someone with **bulimia nervosa** might engage in after multiple large eating binges?
* purging * excessive exercise * fasting ## Footnote However, if the individual also meets criteria for anorexia nervosa, you diagnose anorexia nervosa (binging and purging subtype) instead.
52
List the **risk factors for AN** identified in the DSM-5. ## Footnote The DSM-5 addresses temperamental, environmental, genetic, and physiological risk factors for developing anorexia nervosa (AN). (There are others, but the DSM-5 addresses some significant, well-established risk factors).
1. Having developed an **anxiety disorder** as a child or having had obsessional traits as a child. 2. **Environmental**: Being in a culture or setting in which thinness is valued/idealized (e.g., modeling). 3. **Genetic**: Having a first degre relative with AN. Monozygotic (identical) twins have a higher concordance rate than dizygotic (fraternal) twins. 4. Possibly **brain abnormalities**, but it is unclear if abnormalities are the result of or a cause of AN. ## Footnote In addition, being female, being Caucasian or Asian, negative affect (neuroticism), dieting, body dissatisfaction, dieting, and perfectionism also are individual risk factors. Childhood sexual abuse also has been implicated in some research.
53
Is there a gender difference in the incidence of anorexia nervosa?
Yes! Anorexia nervosa is much more common among **females**. It is estimated that for every 1 male with AN, there are 10 females.
54
# Fill in the blank: Another mental disorder often diagnosed in early childhood is \_\_\_\_\_\_\_, which is characterized by sensitivity to sensory stimuli, impaired communication skills, few facial expressions, and repetitive behaviors.
autism
55
# Yes or No: Is Asperger's Syndrome a valid DSM-5 diagnosis?
No ## Footnote In the DSM-IV, the diagnosis Asperger's Syndrome (a very high functioning form of autism,) has been subsumed into the diagnosis of Autism Spectrum Disorder.
56
Do all people who have autism also have an intellectual disability?
No. Although it is common for people who have autism to have an intellectual disability, many individuals who meet criteria for autism do not meet criteria for an intellectual disability.
57
# Fill in the blank: In the DSM-5, the term **mental retardation** has been replaced by the term \_\_\_\_\_\_\_ \_\_\_\_\_\_\_.
Intellectual Disability
58
What is Down syndrome?
A condition associated with moderate to severe **intellectual disability**. ## Footnote In addition, individuals with Down syndrome seem to age more quickly, have increased risk for developing dementia/Alzheimer's disease, and have shortened average lifespans. There is a high rate of cardiovascular problems. Also, there are distinctive physical features (e.g., almond shaped eyes) associated with Down syndrome.
59
What causes Down syndrome?
**Trisomy** (three copies instead of two) of chromosome 21.
60
What is **Phenylketonuria** (PKU)?
A disorder in which a baby **lacks a liver enzyme** necessary to process phenylalanine, an amino acid found in many foods, including breast milk and cow's milk. ## Footnote It is a recessive disorder, occuring in approximately 1 in 12,000 births. In most cases, if it is detected soon after birth, special diet can allow the individiual with PKU to have a normal life. If it is not caught and addressed early in life, severe brain damage and intellectual disability occurs.
61
# Define: personality disorder
A disorder characterized by the **pervasive expression** of extreme, abnormal personality constructs that interfere with **normal social functioning**.
62
What is the relationship between childhood abuse/neglect and personality disorders?
Abuse and neglect are **risk factors** for developing **personality disorders**. People who experienced abuse and/or neglect as children are 4 times more likely to develop a personality disorder than are people who were not abused or neglected (Johnson, et al., 1999). ## Footnote This relationship is especially pronounced in Histrionic Personality Disorder, Narcissistic Personality Disorder, Borderline Personality Disorder, and Antisocial Personality Disorder.
63
Which personality disorder is characterized by a **blatant disregard for the rights** or interests of others which is usually manifested through repeated illegal acts and aggression towards others?
antisocial personality disorder
64
Antisocial personality disorder (ASPD) and psychopathy are overlapping constructs. ASPD appears in the DSM-5; psychopathy does not. Yet researchers tend to prefer to use psychopathy as a construct. Why?
Important critiques of **ASPD** include that it has good reliability but **lacks validity** and that a diagnosis of ASPD in many cases is just a diagnosis of criminality, not mental illness. **Psychopathy** is more challenging to consistently diagnose/quantify, but it is **more predictive of recidivism**, especially violent recidivism.
65
What therapy is showing promise as a treatment for individuals who meet criteria for **psychopathy**?
Decompression Therapy ## Footnote For more information on decompression therapy and psychopathy, please [read this resource](http://cicn.vanderbilt.edu/images/news/psycho.pdf).
66
Approximately 1% of the population meets criteria for psychopathy. Approximately what percentage of crime is committed by people who are psychopathic?
30%
67
What specific measure is commonly used to assess psychopathy?
Psychopathy Checklist - Revised | (PCL-R)
68
Who developed the **Psychopathy Checklist - Revised (PCL-R)**?
Robert Hare
69
What is an important **limitation** of the Psychopathy Checklist - Revised (PCL-R)?
Hare developed the PCL-R for use with caucasian men, and it lacks validity when used to **assess Latino or Black men, or when used to assess women**. This is highly problematic because PCL-R scores often are used in making legal determinations, such as sentencing and parole.
70
What are the key features of narcissistic personality disorder?
* Exaggerated self importance * Excessive, constant need for others' admiration * Lack of empathy for others
71
# Define: borderline personality disorder
This personality disorder is one of the more volatile personality disorders; it is characterized by **interpersonal issues**, **identity problems**, **fear of abandonment**, and often **self-injurious behavior**.
72
According to the DSM-5, in order to meet criteria for diagnosis with Borderline Personality Disorder, an individual must have five or more of nine symptoms. What are the **nine symptoms** of Borderline Personality Disorder?
1. Frantic efforts to avoid real or imagined abandonment. 2. A pattern of unstable and intense interpersonal relationships characterized by alternating betwen extremes of idealization and devaluation (This is referred to as splitting). 3. Identity disturbance--markedly, persistently unstable self-image. 4. Impulsive behavior in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, driving, eating). 5. Recurrent suicidal or self-mutilating behavior. 6. Affective instability/marked reactivity of mood. 7. Chronic feelings of emptiness. 8. Inappropriate, intense anger/difficulty controlling anger. 9. Transient stress-related psychotic-like symptoms (paranoid ideation, severe dissociation).
73
What empirically-validated treatment for Borderline Personality Disorder reduces the **risk of suicide**?
Dialectical Behavioral Therapy | (DBT) ## Footnote Marsha Linehan developed DBT in order to help severely suicidal patients. DBT combines elements of CBT and eastern philosophy with acceptance therapy. A substantial body of research supports DBT as significantly reducing the risk of suicide for individuals who have Borderline Personality Disorder.
74
If a patient exhibited excessive emotional reactions to normal, every-day stimuli, and was preoccupied with the constant need for attention, what personality disorder would you most likely diagnose?
histrionic personality disorder
75
# Fill in the blank: \_\_\_\_\_\_\_\_\_\_ personality disorder is characterized by extreme distrust and suspicion of others.
Paranoid
76
Which personality disorder is associated with **little emotional expression** and a **lack of social interactions**?
schizoid personality disorder
77
What is the defining characteristic of dependent personality disorder?
The need to be taken care of.
78
Describe the active phase of schizophrenia.
This is the period of time (usually 6 months or more) in which the patient **exhibits a mixture of positive and negative** schizophrenic symptoms.
79
What is a delusion?
A **fixed belief** that is **not amenable to change** in light of **conflicting evidence**.
80
If a patient believes he is supernaturally powerful, wealthy, or famous, what may he be suffering from?
delusions of grandeur
81
What is a delusion of persecution?
The unfounded belief that you are **being or will be harmed**, these delusions usually involve the mentally ill person believing they are the center of a plot.
82
A bio-psycho-social approach may be the best way to treat schizophrenia. In other words, including biological, psychological, and social components in one's approach to treating schizophrenia. What might a bio-psycho-social approach to therapy for schizophrenia include?
* **Biological**: Antipsychotic medication, either typical or atypical (atypicals are generally better tolerated) * **Psychological**: CBT to address hallucinations and delusions; social skills training; supportive therapy * **Social**: Family counseling; psychoeducation about schizophrenia ## Footnote Avoid psychoanalysis / psychodynamic treatment for schizophrenia because it can be iatrogenic!
83
# Define: dementia praecox
This was the original name for schizophrenia, which literally means **early dementia**.
84
List some examples of positive symptoms associated with schizophrenia.
* delusions * hallucinations * disorganized behavior * disorganized speech * catatonic behavior
85
Is schizophrenia curable?
Currently schizophrenia is not curable, but good early intervention can help individuals who have schizophrenia have longer periods between episodes, and for the episodes to be less severe. Also treatment can help people function better between episodes.
86
What is Expressed Emotion (EE)?
It helps explain the role of **stress** in the home environment in **relapse** for people who have schizophrenia. EE is measured by interviewing a patient's family member with whom she or he lives. ## Footnote A one-on-one interview is conducted by a researcher. The researcher assesses criticism (disapproval) of, hostility (animosity) towards, and emotional over-involvement (intrusiveness) with the patient. High levels of EE, especially criticism, is a risk factor for relapse High EE also is predictive for relapsee in other disorders. For additional information on EE, consult work by George Brown and work by Jill Hooley.
87
# Fill in the blank: Restricted emotional range, blunted emotional expressions, restricted thought production, lowered speech fluency, and inability to engage in goal-directed behaviors are all examples of \_\_\_\_\_\_\_\_ symptoms of schizophrenia.
negative ## Footnote One way to remember negative symptoms is to think of them as something that should be present that is missing. Avolition, anhedonia, alogia, flattened affect, & asociality.
88
What is the lifetime prevalence for schizophrenia?
Slightly over 1 %.
89
# Fill in the blank: The diagnosis \_\_\_\_\_\_\_\_\_ disorder is used to describe individuals who have features of both schizophrenia and severe mood disorder
schizoaffective
90
Name the two phases of schizophrenia
1. prodromal phase 2. active phase
91
# Fill in the blank: Not all \_\_\_\_\_\_\_\_ are a sign of mental illness. For example, if you have a migraine, you may see spots in your field of vision.
hallucinations
92
What is the **distinction** between a non-bizarre versus a bizarre delusion?
* A **non-bizarre delusion** is one which (although highly improbable) is **possible**, or seemingly possible, in the context of the individual's culture. * A **bizarre delusion** is one which is **implausible** and not understandable to same-culture peers and does not derrive from ordinary life experiences. ## Footnote Non-bizarre delusion - For instance, a persecutory delusion in which the individual thinks that the CIA is watching him or that someone is trying to poison him. Bizarre delusion - For instance, a delusion in which the individual thinks aliens are inserting or withdrawing thoughts from his or her head.
93
What is a neologism?
Literally, a neologism is a new word. (New words do arise in living languages.) However, in clinical and psychological research, the word neologism is used to describe **non-words that seem word-like**. Use of neologisms can be a symptom of some types of brain damage or of thought disorder. Thought disorder is a common symptom of schizophrenia.
94
Loose associations often can be heard in the speech of people experiencing schizophrenia. What are loose associations?
They occur when an individual speaks in such a way that his or her sentences have **semantic connections but lack logical connection**. ## Footnote For instance: "It's cold today. My cold is better, but I got it from the nurse. She is a big blonde who drinks Manhattans. I live in Manhattan with famous people." Loose associations, also referred to as cognitive slippage or derailment, are a sign of thought disorder. Thought disorder is a symptom of disorganized behavior in schizophrenia spectrum disorders.
95
What is the most common type of **hallucination**?
**Auditory** hallucinations are the most common types of hallucinations, such as hearing voices, but hallucinations can occur in any of the five sensory modalities.
96
What is the aberrant salience hypothesis? How would it explain delusions?
Often, **dopamine is misunderstood** as being primarily pleasure-related. Evolutionarily, dopamine is better understood as marking that something is important and needs our attention, motivating us to address survival needs (food, partner, etc.) According to the **aberrant salience hypothesis**: release of **excess dopamine in the striatum** of some individuals leads them to experience a **false sense of salience/meaningfulness**—ascribing importance to unimportant stimuli, then their brains try to construct a narrative to explain the feeling that the stimulus has meaning—an attempt at meaning-making. Thus, **delusions** are a **post hoc explanation** to make sense of assignment of salience.
97
# Fill in the blank: The periods of time in an individual with schizophrenia in which s/he is not actively psychotic, but has already had a schizophrenic episode are usually called \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_.
residual schizophrenia
98
# Fill in the blank: In \_\_\_\_\_\_\_\_ schizophrenia, the symptom onset is usually sudden and deep, but the prognosis is usually good.
reactive
99
Describe the **prodromal phase** of schizophrenia.
It's a period **before meeting criteria for diagnosis of a schizophrenia spectrum illness**, in which the individual is begining to exhibit some symptoms, such as social withdrawal and odd behavior.
100
Sam presents at your office claiming symptoms that have lasted for about six months. He presents with hallucinations, delusions, disorganized speech, and flat affect. What mental disease does he have?
schizophrenia
101
What are three common features of schizophrenic disorders?
1. delusions 2. hallucinations 3. disturbed or innapropriate emotional responses to environmental stimuli
102
If Jim's schizophrenia has a slow and insidious onset, what is this called and what is his prognosis?
Process schizophrenia; his prognosis is poor, as it shows a long-term deterioration.
103
Catatonia can occur in a variety of disorders, such as neurodevelopmental, psychotic, bipolar, and depressive, as well as in some other medical conditions. Catatonia involves marked psychomotor disturbance, and requires any 3 (or more) of the **12 possible symptoms**. ## Footnote Be able to recognize the symptoms of catatonia and know what they mean!
1. Stupor 2. Catalepsy 3. Waxy flexibility 4. Mutism (do not count toward diagnosis is the individual has aphasia) 5. Negativism 6. Posturing 7. Mannerism 8. Stereotypy 9. Agitation not influenced by external stimuli 10. Grimacing 11. Echolalia (mimicking another's speech) 12. Echopraxia (mimicking another's movements)
104
Who coined the term schizophrenia?
Eugene Bleuler ## Footnote Bleuler identified the lack of coherence between emotion and thought and the breaking away from reality characteristic of psychotic illness.
105
What is waxy flexibility?
A catatonia symptom in which the body can be moved into new positions and will stay there instead of going limp.
106
# Fill in the blanks: \_\_\_\_\_\_ affect is characterized by very few expressions of affect and \_\_\_\_\_\_\_ affect is characterized by consistently manifesting socially unacceptable emotional expressions.
Flat; inappropriate
107
What is the suicide risk for individuals who have schizoaffective disorder?
The lifetime risk for completed suicide for individuals who have schizophrenia or schizoaffective disorder is approximately **5%**. In other words, **1 in 20 people** who have schizophrenia or schizoaffective disorder die by suicide. ## Footnote Approximately 20% will attempt suicide one or more times.
108
What learning mechanism may help explain how compulsions arise in OCD? ## Footnote (Hint: Operant conditioning)
Negative Reinforcement ## Footnote Intermittently, an individual who has OCD will experience temporary spontaneous reduction of obsessive thoughts. Whatever action the individual was taking at the time, typically an action aimed at reducing the distress or preventing the feared harm/negative consequence, will be associated with the temporary alleviation of the symptom, i.e., negative reinforcement. (This leads to the development of habit-driven rituals.)
109
If a patient presented with involuntary, uncontrollable, intrusive thoughts that she unsuccessfully tried to control through repetitive behaviors or rituals, which disorder would she have?
obsessive-compulsive disorder
110
# Yes or No: Is checking and rechecking an effective way for someone with OCD to reassure himself or herself?
No ## Footnote Research indicates that the more times one checks, the less certain one is! (Did I lock the door? Did I unplug the toaster?). This seems to be the case because the more times one checks, the distinctive the memory is for having checked!
111
What is Body Dysmorphic Disorder? | (BDD)
BDD is an OCD-spectrum disorder in which: * The individual is preoccupied with an imagined defect in appearance (or if there is a real appearance-related issue, the individual's concern is out of proportion to the issue), * The preoccupation results in impairment in occupational/social functioning. * The preoccupation is not better accounted for by an eating disorder ## Footnote Individuals with BDD often have multiple cosmetic surgeries.
112
What is the cardinal symptom of **trichotillomania**?
Pulling out one's hair. ## Footnote In the DSM-5, trichotillomania is recognized as an OCD-spectrum disorder. (Previously it was considered an impulse control disorder.)
113
What is fear?
* A negatively-valenced, basic emotion. * Focuses one's attention on a specific stimulus. * Activates the sympathstic nervous system, readying the body for fight, flight, or freeze responses, so one can respond quickly to a potentially dangerous situation.
114
What is anxiety?
* Also is negatively-valenced. * It is a mood, so it is of longer duration than an emotion. * Future-oriented, focusing on potential future harm, rather than addressing an immediate threat.
115
Name two cognitive mechanisms that contribute to the anxious apprehension experienced by people who have an anxiety disorder:
1. Threat Hypervigilance 2. Uncertainty Intolerance
116
Feelings of dread and worry, along with constant autonomic nervous system arousal, characterize which disorder?
generalized anxiety disorder
117
People who have been exposed to high levels of violence, such as soldiers in war, are at risk for developing which disorder, characterized by recurring thoughts and anxiety linked to that trauma?
post-traumatic stress disorder
118
An individual has an enduring fear of public speaking that is so severe that it causes him clinically significant distress. He fears that because of his anxiety symptoms he will be humiliated or will unintentionally offend others. What is his likely diagnosis?
Social Anxiety Disorder | (previously called social phobia) ## Footnote Social Anxiety Disorder is one of the Anxiety Disorders.
119
**Agoraphobia** is an anxiety disorder, and it is characterized by FEAR, ANXIETY, and AVOIDANCE. What are the primary **features** of Agoraphobia?
The individual has marked fear or anxiety about 2 or more of the following: 1. Using public transportation; 2. Being in open spaces; 3. Being in enclosed spaces; 4. Standing in line/being in a crowd; 5. Being outside of the home alone The individual avoids such situations/must have a companion to do/or are endured only with great distress; these situations almost always provoke fear or anxiety; fear is out of proportion both with actual risk and sociocultural norms; symptoms cause clinically significant distress or impairment. ## Footnote If a medical disorder co-occurs (e.g., IBS, the fear, anxiety, or avoidance is clearly excessive), and the condition is not better explained by symptoms of another disorder. Agoraphobia often co-occurs with Panic Disorder, though not always.
120
# Fill in the blank: Claustrophobia, cynophobia, and homophobia are all examples of \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_.
specific phobias ## Footnote Specific objects or situations that provoke anxiety.
121
# Fill in the blanks: In order for a fear of common events or objects to be considered a phobia, it must be both \_\_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_.
persistent; irrational
122
Does everybody who has a panic attack go on to develop Panic Disorder?
No. Most people who have had a panic attack do not develop Panic Disorder. ## Footnote 3-6% of people have had a panic attack.
123
What is a panic attack?
The DSM-5 describes panic attacks as "an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes."
124
What are the symptoms of a panic attack?
1. Palpitations/pounding heart/accelerated heart rate; 2. Sweating; 3. Trembling/shaking; 4. Short of breath/feel as if being smothered; 5. Feel as if choking; 6. Chest pain/chest discomfort; 7. Nausea or abdominal distress; 8. Feeling dizzy/unsteady/light-headed/faint; 9. Chills or snsations of heat; 10. Parasthesias (numbness/tingling); 11. derealization/depersonalization; 12. fear of losing control/fear of going crazy; 13. Fear of dying
125
What symptoms characterize Panic Disorder?
1. The individual experiences recurrent, unexpected panic attacks. 2. For at least 1 month following one of the panic attacks, the individual has experienced significant worry/concern about future panic attacks (having them &/or their significance) and/or makes a significant maladaptive change in behavior related to the panic attacks (e.g., avoiding going to unfamiliar situations or avoiding exercise)
126
What is a diagnostic hallmark of conversion disorder?
Symptoms affecting the motor or sensory body systems that are real to the patient but have no apparent medical cause. This is now a rare diagnosis, though it was a relatively common diagnosis during the first part of the twentieth century.
127
# Define: depersonalization disorder
This is a mental illness in which the patient may feel as though s/he is **living outside his/her body**, but still retains contact with reality.
128
What is Factitious Disorder Imposed on Another (Munchausen's Syndrome by Proxy)?
In this disorder, an individual **seeking medical help or attention for another person** in his or her care has **intentionally, deliberatelly caused or simulated symptoms** of an illness or of illnesses in the other person. Typically, it is a parent causing symptoms in her or his own child. ## Footnote It is a very dangerous disorder; an estimated 10% of children who are victims of someone who has Factitious Disorder Imposed on Another die from the abuse (Hall et al., 2000). Hidden camera evidence often is required in order to diagnose the disorder.
129
An individual sincerely frequently misinterprets bodily symptoms and so honestly believes himself or herself to be ill. This individual frequently seeks medical treatment. What is a likely diagnosis for this individual?
Hypochondriasis
130
Which psychological disorder is characterized by physical symptoms without root in actual physical causes?
somatoform disorder
131
Hypochondriasis, factitious disorders, and malingering involve someone who is not ill behaving as if ill, yet there are very different motivations for each. What are the motivations for hypochindriasis, for factitious disorders, and for malingering?
* **Hypochondriasis** –Person actually believes he or she has an illness (based on bodily symptoms) * **Factitious Disorders** –Motive is internal; to assume the role of a sick person (or to do so by proxy); to gain the attention (and sympathy) of medical professionals * **Malingering** –Motive is external; e.g., to obtain compensation, to evade police or legal action; the individual can stop having symptoms if having symptoms is no longer useful
132
Conversion disorder and hypochondriasis both are what type of disorder?
Somatoform disorder
133
What are some common examples of paraphilias?
* zoophilia is sexual attraction to animals * pedophilia is sexual attraction to children * fetishism is sexual arousal stemming from objects or situations ## Footnote Paraphilia (or psychosexual disorder) is marked by the sexualization of objects, people, or activities that are not generally considered sexual.
134
What is the lethality scale?
A set of criteria used to assess the likelihood of an individual committing suicide.
135
# Fill in the blanks: Dissociative disorders are characterized either by a \_\_\_\_\_\_\_\_\_ of memory or a(n) \_\_\_\_\_\_\_\_\_ sense of identity.
dysfunction; altered
136
When someone is unable to remember things, but there is no physiological basis for the memory disruption, he is said to be afflicted with what kind of amnesia?
dissociative amnesia
137
In a dissociative fugue state, one first experiences a sudden and complete loss of identity which contributes to a sudden move far away from their place of origin. What happens after this loss?
The sufferer will assume a new identity because he (or she) does not remember his (or her) old identity.
138
# Fill in the blanks: \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_ is characterized by the appearance of \_\_\_\_\_ or more distinct identities in one individual. The identities may or may not be aware of each other, and the personality manifested may be dependent on environmental or social context.
Dissociative Identity Disorder (DID); two
139
# Yes or No: Is the validity of the diagnosis of Dissociative Identity Disorder (DID: previously known as Multiple Personality Disorder,) universally accepted?
No. ## Footnote The validity of DID is highly controversial. Some psychologists do not consider DID a true disorder, but rather a culture-bound manifestation of one or more other disorders.
140
Who was Sybil and how does Sybil's case call into question the validity of the diagnosis Dissociative Identity Disorder (DID)?
The most famous DID case is a patient known as Sybil. There was a best selling book (and later, a very popular movie) about Sybil. It was after the release of the book that DID (then Multiple Personality Disorder) became a common diagnosis, and even then, a small minority of therapists made the vast majority of the diagnoses of DID. Many years later, it was revealed that the book was inaccurate and the case not as described. This is a truly shocking case of ethical misconduct. ## Footnote For further information on the Sybil scandal, please see a [NY Times article here](http://www.nytimes.com/2011/10/16/magazine/a-girl-not-named-sybil.html) and [an NPR article here]( http://www.npr.org/2011/10/20/141514464/real-sybil-admits-multiple-personalities-were-fake).
141
List some of the characteristics of **attention-deficit/hyperactivity disorder** (ADD/HD)
* often diagnosed in childhood * inability to focus on demanding tasks * lack of organization * problems adhering to instructions * excessive movement * impulsivity
142
# Fill in the blanks: Tourette's disorder is characterized by \_\_\_\_\_\_ and \_\_\_\_\_\_.
motor tics; vocal tics
143
What is the **difference** between retrograde and anterograde amnesia?
* **Retrograde** amnesia, one loses memories that occurred **before** the traumatic event. * **Anterograde** amnesia, one loses memories occurring **after** the traumatic event.
144
What are the two main types of amnesia?
1. anterograde 2. retrograde
145
What is the primary **function** of the HPA-axis in response to stress?
Regulates the body's response to stress through **hormone secretion**. ## Footnote The Hypothalamic-Pituitary-Adrenal (HPA) axis is crucial for the stress response, releasing cortisol to help manage stress and maintain homeostasis.
146
# True or False: Acute stress is typically short-lived and can sometimes be beneficial.
True ## Footnote Acute stress can enhance cognitive and physical performance by increasing alertness and energy levels. However, chronic stress can have detrimental health effects.
147
Name a **coping strategy** that focuses on addressing the problem causing stress.
Problem-focused coping ## Footnote Problem-focused coping involves tackling the source of stress directly, such as time management or seeking social support to reduce stress.
148
What type of **conflict** involves choosing between two desirable outcomes?
Approach-approach conflict ## Footnote Approach-approach conflict arises when an individual is faced with two appealing choices, requiring a decision between them.
149
Describe avoidance-avoidance conflict.
It involves choosing between **two undesirable options**. ## Footnote Avoidance-avoidance conflict is stressful because neither option is appealing, leading to procrastination or indecision.
150
# Fill in the blank: \_\_\_\_\_\_ stress is characterized by long-term exposure to stressors.
Chronic ## Footnote Chronic stress results from persistent stressors and can lead to health problems like anxiety, depression, and cardiovascular disease due to prolonged activation of the stress response.
151
What is emotion-focused coping?
**Managing emotions** related to stress rather than the **stressor itself**. ## Footnote Emotion-focused coping includes strategies like meditation, exercise, or talking with friends to alleviate emotional distress.
152
Identify one key **hormone** released by the adrenal glands during the HPA-axis response.
Cortisol ## Footnote Cortisol, often called the 'stress hormone', helps mobilize energy and suppress non-essential functions in a fight-or-flight situation, aiding in stress management.
153
What are the primary **differences** between DSM and ICD in classification systems?
* **DSM**: Focuses primarily on **mental disorders**, used mainly in the United States. * **ICD**: Covers **all health conditions**, including mental and physical disorders, used internationally. ## Footnote The DSM (Diagnostic and Statistical Manual of Mental Disorders) is published by the American Psychiatric Association, while the ICD (International Classification of Diseases) is published by the World Health Organization. The ICD is more globally recognized and facilitates international data comparison.
154
# True or False: The DSM-5 uses a multiaxial classification system.
False ## Footnote The DSM-5 abandoned the multiaxial system used in previous editions (DSM-IV) and adopted a dimensional approach to better capture the complexity of mental disorders.
155
Define **'reliability'** in the context of psychological assessments.
**Consistency** of a **measurement** across time and different situations. ## Footnote Reliability refers to the degree to which an assessment tool produces stable and consistent results. It is crucial for ensuring that a diagnosis or measurement is accurate over repeated trials or assessments.
156
# Fill in the blanks: The \_\_\_\_\_\_\_\_\_\_ approach classifies disorders based on distinct categories, whereas the \_\_\_\_\_\_\_\_\_\_ approach views disorders along a continuum.
categorical; dimensional ## Footnote The categorical approach is like a checklist of symptoms to determine if a disorder is present, while the dimensional approach considers the severity and variation of symptoms across a spectrum.
157
What is **'validity'** in psychological testing?
The extent to which a test measures what it claims to measure. ## Footnote Validity ensures that a test is accurately assessing the intended construct or diagnosis. It is essential for the credibility and usefulness of psychological assessments.
158
What is a **clinical interview** in psychological assessment?
A method where a psychologist gathers information through direct conversation with the patient. ## Footnote Clinical interviews can be structured, semi-structured, or unstructured to gather qualitative and quantitative data.
159
# Fill in the blank: Self-report assessments rely on the individual's ability to \_\_\_\_\_\_.
provide accurate information about themselves. ## Footnote Self-report assessments are widely used due to their efficiency, but they can be biased by the individual's self-perception and honesty.
160
# True or False: Observation as an assessment method is always objective.
False ## Footnote Observation can be subjective, as it often involves the interpretation of behaviors by the observer, which may be influenced by their biases.
161
What are the **key psychometric properties** of a psychological test?
* Reliability * Validity * Standardization ## Footnote Reliability refers to consistency, validity to accuracy, and standardization to uniform procedures in testing.
162
How does **validity** differ from reliability in psychological testing?
Validity refers to the **accuracy** of a test in measuring what it claims to measure. ## Footnote A test can be reliable without being valid, but a valid test must be reliable.
163
List two **differences** between projective and objective tests.
* **Projective** tests use **ambiguous** stimuli to elicit responses revealing unconscious desires. * **Objective** tests use **structured**, specific questions with fixed responses. ## Footnote Projective tests, like the Rorschach Inkblot Test, are open-ended, whereas objective tests, like the MMPI, have clear answers.
164
What is **standardization** in psychological assessment?
The process of **administering and scoring** a test under consistent conditions. ## Footnote Standardization ensures that test scores are comparable across different individuals and settings.
165
What does the term **'developmental psychopathology'** refer to?
An approach to understanding the development of psychological disorders that emphasizes the **interplay between biological, psychological, and social factors**. ## Footnote Developmental psychopathology is a framework that views disorders within the context of normal development, aiming to identify how various factors interact over time to influence the emergence of disorders.
166
# Fill in the blank: Gene–environment interaction refers to the phenomenon where the effects of genes are \_\_\_\_\_\_\_\_ by environmental factors.
modified ## Footnote Gene-environment interaction suggests that certain environments can influence the expression of genes, leading to different outcomes in individual development and behavior.
167
# True or False: The diathesis-stress model posits that both a predisposition and environmental stress are necessary for the development of a psychological disorder.
True ## Footnote The diathesis-stress model is a psychological theory that explains behavior as both a result of biological and genetic factors ('diathesis') and life experiences ('stress').
168
List two **risk factors** and two **protective factors** that influence psychopathology across the lifespan.
Risk Factors: * Family history of mental illness * Exposure to trauma Protective Factors: * Strong social support * Effective coping strategies ## Footnote Risk factors increase the likelihood of developing disorders, whereas protective factors help shield against them. Both types of factors can vary in impact at different life stages.
169
How does the concept of **'cumulative risk'** relate to developmental psychopathology?
It refers to the idea that the accumulation of multiple risk factors **increases** the likelihood of **adverse developmental outcomes**. ## Footnote Cumulative risk highlights that the presence of numerous risk factors can have a greater impact than a single risk factor, emphasizing the importance of considering the overall context of an individual's life in developmental psychopathology.
170
Which **neurotransmitter** is most commonly associated with mood regulation and is often linked to depression when levels are imbalanced?
Serotonin ## Footnote Serotonin is crucial for mood balance and is a target in many antidepressant treatments, such as SSRIs, which increase serotonin levels in the brain.
171
# True or False: Dopamine is only involved in pleasure and reward systems in the brain.
False ## Footnote Dopamine also plays key roles in motor control, motivation, arousal, and executive functions. Imbalances are associated with disorders such as Parkinson's disease and schizophrenia.
172
# Fill in the blank: The \_\_\_\_\_\_\_\_\_ is a brain structure involved in emotional processing and is particularly associated with fear responses.
amygdala ## Footnote The amygdala is part of the limbic system and plays a critical role in emotional reactions, decision-making, and memory processing.
173
Name two types of **neuroimaging** methods used to study brain structure and function.
* MRI (Magnetic Resonance Imaging) * fMRI (Functional Magnetic Resonance Imaging) ## Footnote MRI provides detailed images of brain structures, while fMRI measures brain activity by detecting changes associated with blood flow.
174
What hormone, often referred to as the '**stress hormone**', is released by the adrenal glands in response to stress?
Cortisol ## Footnote Cortisol helps regulate metabolism, reduce inflammation, and control blood sugar levels. Chronic stress and prolonged cortisol release can lead to various health issues.
175
What is the primary **action** of Selective Serotonin Reuptake Inhibitors (SSRIs)?
SSRIs primarily **increase serotonin levels** in the brain by inhibiting its reuptake. ## Footnote SSRIs are commonly prescribed for depression and anxiety disorders. By preventing serotonin reuptake, more serotonin is available in the synaptic cleft, enhancing mood and emotional regulation.
176
# True or False: Atypical antipsychotics only target dopamine receptors.
False ## Footnote Atypical antipsychotics target both dopamine and serotonin receptors, which helps reduce symptoms of schizophrenia and bipolar disorder with fewer side effects compared to typical antipsychotics.
177
Name one key **difference** between psychodynamic and humanistic psychotherapies.
* **Psychodynamic** therapy focuses on **unconscious processes**. * **Humanistic** therapy emphasizes **personal growth** and **self-actualization**. ## Footnote Psychodynamic therapy often explores childhood experiences and unconscious conflicts, whereas humanistic therapy is centered on the individual's capacity for self-awareness and personal development.
178
# Fill in the blank: \_\_\_\_\_\_\_\_\_\_ are commonly used to treat anxiety disorders by enhancing GABA activity.
Benzodiazepines ## Footnote Benzodiazepines enhance the effect of the neurotransmitter GABA, which has calming effects on the brain, making them effective for short-term management of anxiety.
179
What is a major **advantage** of community care over inpatient care for mental health treatment?
* Greater integration with daily life * Reduced stigma * Continuity of care ## Footnote Community care allows individuals to receive treatment while maintaining their social ties and daily routines, potentially leading to better long-term outcomes and a reduction in the stigma associated with hospital stays.
180
What is the **difference** between incidence and prevalence in epidemiological studies?
* **Incidence** refers to the number of **new cases** of a disease that develop in a specific period. * **Prevalence** is the total number of cases, both **new and existing**, in a population at a given time. ## Footnote Incidence helps identify risk factors for a disease, while prevalence shows how widespread the disease is. Understanding both is crucial for public health planning and resource allocation.
181
# True or False: Lifetime prevalence includes both current and past occurrences of a condition in an individual's life.
True ## Footnote Lifetime prevalence measures how many people have ever had the condition at any point in their lives, providing a comprehensive picture of the burden of the condition over time.
182
What demographic risk patterns are commonly analyzed in psychological research?
* Age * Sex * Socioeconomic Status (SES) ## Footnote These demographic factors are crucial in understanding who is most at risk for certain psychological conditions, guiding targeted interventions and prevention strategies.
183
Define **comorbidity** in the context of psychological disorders.
Comorbidity is the occurrence of **two or more disorders** or illnesses in the **same** person, simultaneously or sequentially. ## Footnote Comorbidity can complicate diagnosis and treatment, as symptoms of one disorder may exacerbate or mask those of another. It also highlights the need for integrated treatment approaches.
184
# Fill in the blanks: \_\_\_\_\_-\_\_\_\_\_ samples are drawn from the general population, whereas \_\_\_\_\_\_\_\_ samples are drawn from specific treatment settings.
Population-based; clinical ## Footnote Population-based samples provide insights into the general prevalence and demographics of disorders, while clinical samples help understand disorders' characteristics in patients seeking treatment.
185
What is the **primary goal** of primary prevention in psychology?
To prevent the onset of mental health disorders by **reducing risk factors** and enhancing protective factors. ## Footnote Primary prevention aims to reduce the incidence of mental health problems before they occur, often through community-wide education and health promotion.
186
# Fill in the blank: \_\_\_\_\_\_\_\_\_ prevention focuses on early detection and intervention to halt the progression of mental health issues.
Secondary ## Footnote Secondary prevention targets individuals who are at high risk or are showing early signs of mental health disorders, aiming to minimize their impact.
187
# True or False: Tertiary prevention aims to prevent mental health disorders from occurring.
False ## Footnote Tertiary prevention focuses on reducing the impact of an ongoing mental health disorder by helping individuals manage symptoms and improve quality of life.
188
What distinguishes **universal prevention programs** from selective and indicated programs?
Universal prevention programs target the **entire population**, regardless of individual risk levels. ## Footnote Universal programs aim to provide widespread interventions that benefit all individuals, unlike selective and indicated programs which focus on specific at-risk groups or individuals.
189
List three **common barriers** to effective mental health prevention.
* Stigma surrounding mental health * Lack of funding and resources * Limited access to trained professionals ## Footnote Barriers can hinder the implementation and effectiveness of prevention strategies, often requiring targeted efforts to overcome.
190
What are public mental health **strategies** aimed at achieving?
Improving mental health outcomes for populations through **preventive and promotional** interventions. ## Footnote Public mental health strategies include policies and programs designed to enhance mental well-being and reduce the prevalence of mental disorders on a societal level.
191
What are the three main **components** of the biopsychosocial model?
* Biological * Psychological * Social ## Footnote The biopsychosocial model considers the complex interaction of biological, psychological, and social factors in understanding health and illness.
192
# True or False: The Health Belief Model is primarily concerned with predicting health behaviors based on individual beliefs.
True ## Footnote The Health Belief Model suggests that personal beliefs about health conditions, perceived benefits, and barriers to action influence health-related behaviors.
193
# Fill in the blank: The Theory of Planned Behavior adds the concept of \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ to the Theory of Reasoned Action.
perceived behavioral control ## Footnote Perceived behavioral control refers to an individual's perception of their ability to perform a given behavior and is a key predictor of behavioral intention.
194
Which model emphasizes the **role of intention** in predicting health-related behaviors?
Theory of Planned Behavior ## Footnote The Theory of Planned Behavior posits that intention is the primary driver of behavior, influenced by attitudes, subjective norms, and perceived behavioral control.
195
How does chronic stress impact physical health?
* Weakens the immune system * Increases risk of cardiovascular disease * Contributes to mental health disorders ## Footnote Chronic stress can lead to a range of health problems, as it affects the body's ability to fight off illness and maintain homeostasis.
196
Name one **mind-body intervention** used to manage stress.
Meditation ## Footnote Mind-body interventions, like meditation, aim to promote relaxation and reduce stress by focusing the mind and fostering a state of calm.
197
What factor is **not** part of the Health Belief Model?
Social support ## Footnote The Health Belief Model focuses on individual-level factors such as perceived susceptibility, severity, benefits, and barriers, rather than external factors like social support.
198
# True or False: The biopsychosocial model can be applied to both physical and mental health conditions.
True ## Footnote The biopsychosocial model provides a comprehensive framework for understanding both physical and psychological health issues by considering a wide range of influencing factors.
199
What is a culture-bound syndrome?
A mental disorder or illness that is specific to a **particular cultural or ethnic group**. ## Footnote Culture-bound syndromes are influenced by cultural beliefs and practices and may not be recognized as disorders in other cultures.
200
# True or False: Stigma can affect an individual's willingness to seek help for mental health issues.
True ## Footnote Stigma, including fear of judgment and discrimination, can discourage individuals from seeking mental health treatment, impacting recovery and well-being.
201
Which **gender** is more likely to be diagnosed with depression?
Women ## Footnote Women are about twice as likely as men to experience depression, potentially due to biological, social, and psychological factors.
202
# Fill in the blank: \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ refers to differences in the presentation and prevalence of mental disorders between men and women.
Gender differences ## Footnote Gender differences affect how disorders are expressed and experienced, influencing diagnosis and treatment approaches.
203
List three considerations for **cross-cultural assessment** in psychology.
* Language barriers * Cultural norms and values * Different expressions of psychological distress ## Footnote Cross-cultural assessments must account for these factors to avoid misdiagnosis and ensure culturally competent care.
204
What is one common **effect** of stigma on mental health?
Increased isolation ## Footnote Stigma can lead to social withdrawal, making individuals feel isolated and less likely to seek support or treatment.
205
Name a **culture-bound syndrome** found in Southeast Asia.
Koro ## Footnote Koro is characterized by an intense fear of the genitals retracting and disappearing, leading to death, and is primarily found in Southeast Asian cultures.
206
# True or False: Men are more frequently diagnosed with anxiety disorders than women.
False ## Footnote Women are more frequently diagnosed with anxiety disorders, which may be due to a combination of genetic, hormonal, and psychosocial factors.