Exam 3 Flashcards
(57 cards)
1
Q
Factitious Disorder Imposed on Self (or Munchausen syndrome)
A
- people feign or induce physical symptoms on themselves, typically for the purpose on themselves, typically for the purpose of assuming the role of a sick person
- will research their supposed ailments and impressively knowledgeable about medicine
- eagerly undergo painful testing/surgery
- will deny charges that symptoms are factitious
2
Q
Factitious Disorder Imposed on Another (or Munchausen syndrome by proxy)
A
- false creation of physical or psychological symptoms, or deceptive production of injury or disease in another person
- presentation of another person as ill, damaged, or hurt
- This is a form of child abuse
- This is a fine line between this being fraud/child abuse – there are a subset of people doing it on their psychological distress/need for others to support them in this role
3
Q
What is typically seen in the development of Factitious Disorder Imposed on Self (or Munchausen syndrome)
A
beings during early adulthood
common among people who:
1. received extensive treatment for a medical problem as children
2. carry a grudge against the medical profession
3. worked as a nurse, lab technician, or medical aide
- also have poor social support, few enduring social relationships, little family life
4
Q
What do we know about the cause of Factitious Disorder Imposed on Self (or Munchausen syndrome)
A
- not much
- factors like depression, unsupportive parental relationships during childhood, extreme needs for attention/social support that are not possible otherwise
- clinicians have not been able to develop dependably effective treatment
5
Q
Conversion Disorder (or Functional Neurological Symptom Disorder)
A
- Display physical symptoms that affect voluntary motor or sensory functioning
- Symptoms are inconsistent with known medical diseases
- significant distress
- More commonly diagnosed in women
- Often misdiagnosed → first presented as Freud’s hysteria
- appears suddenly, at times of extreme stress
- can last a matter of weeks
- very rare
6
Q
Somatic Symptom Disorder
A
- Excessive distress, concern, and anxiety about a variety of bodily symptoms
- Somatization pattern
- Predominant pain pattern
- Physically ill from their stress
7
Q
What is the somatization pattern in Somatic Symptom Disorder?
A
experiencing long-lasting physical ailments that have little or no physical basis.
- pain symptoms, gastrointestinal symptoms (nausea/diarrhea), neurological-type symptoms (double vision/paralysis)
- will go from doctor to doctor, describing symptoms in dramatic and exaggerated terms
- lasts for many years
8
Q
What is the predominant pain pattern in Somatic Symptom Disorder?
A
- if primary feature of the disorder is pain, it’s this pattern
- source of pain is known or unknown
- may begin at any age
9
Q
What causes Conversion and Somatic Symptom Disorders - Psychodynamic View
A
it is a conversion of underlying emotional conflicts into physical symptoms and concerns
- there is the primary gain when bodily symptoms keep internal conflicts out of awareness
- secondary gain when bodily symptoms further enable them to avoid unpleasant activities or to receive sympathy from others
10
Q
What causes Conversion and Somatic Symptom Disorders - Cognitive-Behavioral View
A
- some people are more attentive than others to their bodies, and that attentiveness causes them to focus more on their bodily discomforts, experience more arousal, worry more
- these physical symptoms then yield importnat benefits because it removes patients from an unpleasant relationship, bring attention
- may be a way to communicate
11
Q
What causes Conversion and Somatic Symptom Disorders - Multicultural View
A
- it is not that somatic reactions to stress are superior to psychological ones or vice versa, but both bodily and psychological reactions are often influenced by one’s culture
- overlooking this can lead to mislabels or misdiagnoses
12
Q
How are Conversion and Somatic Symptom Disorders Treated?
A
- people with these disorders seek psychotherapy as a last result b/c they believe their problems are completely medical
- can do it though + psychotropic drugs
- therapists focus on causes of the disorders and apply insight and exposure
13
Q
Illness Anxiety Disorder
A
- Experience chronic anxiety about their health
- Concerned about developing serious medical illness, despite absence of symptoms
- starts in early adulthood, and equally distributed across both genders
- Theorists typically explain illness anxiety disorder much as they explain anxiety-related disorder
- treatments like OCD
14
Q
Substance intoxication
A
a cluster of temporary undesirable behavioral or psychological changes that develop during or shortly after the ingestion of a substace
15
Q
Substance use disorders
A
a pattern of long-term maladaptive behaviors and reactions brought about by repeated use of a substance
Habitual patterns of intentional, appetitive behavior
Produce serious consequences
16
Q
Tolerance
A
the brain’s and body’s need for ever-larger doses of a drug to produce desired effects
17
Q
Withdrawal
A
unpleasant, sometimes dangerous reactions that may occur when people who use a drug regularly stop using it or reduce the dosage
18
Q
Psychodynamic View of Substance Use Disorder
A
- people with SUD have powerful dependency needs that can be traced back to their early years
- people respond to early deprivations by developing a SUD personality that leaves them prone
- WEAKNESS: wide range of personality traits that have been tied to SUDs.
18
Q
Sociocultural View of Substance Use Disorder
A
- most likely to develop substance use disorders when people live under stressful socioeconomic conditions
- particularly high in marginalized individuals (specific stressors)
- more likely if people are part of a family or social environment in which substance use is valued or at least accepted
19
Q
Cognitive-Behavioral View of Substance Use Disorder
A
- operant conditioning is playing a key role
- temporary reduction of tension or temporary elevation of spirits has a rewarding effect so increases likelihood user will seek the reaction again
- rewarding effects leads to higher dosages/more powerful methods of ingestion
- classical conditioning playing a role too, things associated with the substance are comforting so substance becomes comforting
20
Q
Biological View of Substance Use Disorder
A
- genetic predisposition
- neurotransmitters: brain will make an adjustment when the drug is taken and reduces its own production of the neurotransmitters. Person needs to continuously use the drug to achieve the affects of the neurotransmitter
- brain’s reward circuit: dopamine gets activated (cocaine!) Dopamine is connected to the experience of pleasure; substances we can ingest vary → some have a very direct increase in dopamine, others increase dopamine in roundabout ways; we are left with a sense of pleasure → over time, the brain begins to adapt to the feeling of this overwhelming dopamine level → begins down-grading the number of dopamine receptors to regain homeostasis → people need to take more to get high → phenomenon of tolerance
21
Q
Developmental Psychopathology View of Substance Use Disorder
A
road to SUD begins with genetically inherited predispositions –> changes increase if there is stressors through childhood, inadequate parenting, satisfying substance use experiences, relationships with peers who use substances, and significant adult stressors
22
Q
Psychodynamic Therapies for Substance Use Disorder
A
- guide clients to uncover and work through the underlying needs/conflicts
- not very effective
23
Q
Cognitive-Behavioral Therapies for Substance Use Disorder
A
- aversion therapy: repeatedly presented with unpleasant stimulus at the same time they are taking the drug, and the repeated pairings cause them to crave it less
- contingency management: offers clients incentives that are contingent on the submission of drug-free urine specimens
- relapse prevention training: gain control over substance-related behaviors, taught to identify high-risk situations, appreciate range of decisions
1. clients keep track of drinking
2. therapists teach coping strategies
3. therapists teach clients to plan ahead - acceptance and commitment therapy (ACT): mindfulness techniques are taught to clients
24
Biological Therapies for Substance Use Disorder
- detoxification: medically supervised withdrawal, take smaller and smaller doses until they are off OR take drugs that reduce the symptoms of withdrawal
- antagonist drugs: block or change the effects of the addictive drug
- drug maintenance therapy
25
Sociocultural Therapies for Substance Use Disorder
- self-help and residential treatment programs: example is AA
- community prevention programs
26
Culturally Responsive Treatment for Substance Use Disorder
- address a client's unique cultural issues
27
Relapse in SUD
complex and dynamic
- Initial setback (lapse) is highly probable; may lead to relapse (return to previous problematic behavior)
- Following lapse: vulnerable to “abstinence violation effect”
- Lapse → negative emotions (guilt, shame) → full relapse
Determinants of relapse
- Intrapersonal
- Self-efficacy (how much a person believes in their ability to stop and live a fulfilling life without the substance)
- Outcome expectancies (people can have positive expectancies for the substance use → this will make me feel better)
- Craving
- Motivational factors
- coping/self-regulation
- Emotional states
- Interpersonal
- Social support
- Promotes a sort of acceptance of lapse to help prevent relapse
28
Stages of Change in SUD
Precontemplation
Contemplation
Preparation
Action (CBT is great for people at THIS stage)
Maintenance
Relapse
29
Motivational Interviewing
RULE – during one of the early motivational stages
R: resist talking with them about what to do
U: understand their motivations
L: listen with empathy
E: empower them
30
Anorexia Nervosa
- Restricted intake/significantly low weigh
- Intense fear of gaining weight
- Disturbed body perception
- Most commonly seen in women and adolescent girls
- The most fatal in psychiatric disorders
- Beyond suicide risk, it really declines the cardiac system
31
Bulimia Nervosa
- Recurrent binges (multiple binges a week) (done in secret)
- Recurrent inappropriate compensatory behaviors to prevent weight gain – it offsets
- Forcing themselves to vomit, take laxatives, exercise
- Undue influences of weight on self-evaluation
32
Compare & Contrast Anorexia & Bulimia
- compare: believe they weigh too much and look too heavy regardless of actual weight/appearance; preoccupied with food; struggling with depression/anxiety/perfection
- contrast: people w/ bulimia are more concerned with pleasing others, being attractive to others, experiencing intimacy. Long histories of mood swings, easily frustrated
- contrast: medical complications are different
33
Binge-Eating Disorder
Recurrent binges (large amount + loss of control)
Marked distress
No compensatory behaviors
34
Psychodynamic View of Cause of Eating Disorders
- disturbed parent-child interactions lead to serious ego deficiencies in child and severe perceptual disturbances
35
Cognitive-Behavioral View of Cause of Eating Disorders
- When a person is starving, their cognition is affected
- Thought distortion
- Thoughts consumed by food
- Thoughts of shame, guilt, self-hatred
Repeated behaviors
- Modeling
- Operant conditioning
36
Biological View of the Cause of Eating Disorders
Biological component quite prominent
Organic cause can affect weight
Genetic contribution
Serotonin dysfunction
Hypothalamus - both produces hunger when activated and reduces hunger
37
Sociocultural View of the Cause of Eating Disorders
Societal pressures
Gender differences → societal body standards
Sociocultural messaging around body size
Sports and activities can affect things
Family environments
Multicultural factors
38
Treatments for eating disorders
- proper weight/healthy eating is restored: nutritional rehabilitation, motivational interviewing
- CBT: clients are required to monitor feelings, hunger levels, food intake, and the ties between those variables
- taught alternative ways of coping with stress and solving problems
- changing family interactions
- antidepressant medications
39
Personality Disorder
- Enduring, rigid pattern of inner experience and outward behavior that impairs sense of self, emotional experience, goals, and capacity for empathy and/or intimacy
- 10 disorders, 3 groupings → we will not discuss all 10 (many are not well-understood and the classification system is generally largely critiqued)
- Affect cognition, affectivity, interpersonal functioning, and impulse control
- last for years and are recognizable in adolescence or early adulthood
40
Dramatic Personality Disorders
- includes: antisocial, borderline, histrionic, and narcissistic
behavior is so dramatic, emotional, or erratic that it is almost impossible for them to have relationships that are truly giving and satisfying
41
antisocial personality disorder
general pattern of disregard for and violation of other people's rights
- tend to lie repeatedly, impulsive, irritable, aggressive, reckless
- linked to crimes of violence, higher rates of substance use
42
Personality
Relative consistency throughout the lifespan (supported with decades and hundreds of studies)
Trait approach
Big 5
43
Clusters of Personality Disorders
Cluser A: Odd or eccentric behavior
Paranoid
Schizoid
Schizotypal
Cluster B: Dramatic or emotional behavior
Antisocial ~ act without any regard for others
Borderline
Narcissistic
Histrionic
Cluster C: Anxious or fearful behavior
Avoidant
Dependent
Obsessive-Compulsive
44
How do theorists explain antisocial personality disorder?
- psychodynamic factors: absence of parental love, significant stress in childhood
- cognitive-behavioral factors: learned by conditioning/modeling/imitation; operant conditioning
- biological: inherit predisposition, lower serotonin activity, deficient functioning in brain structures that help people follow rules/sympathy/judgment/empathy
45
Borderline personality disorder
Instability: emotions, behaviors, relationships, sense of self
46
How do theorists explain borderline personality disorder?
Emotional vulnerability
- High sensitivity to emotional stimuli
- Emotional intensity
- Slow return to emotional baseline
Biological underpinnings
- Difficulties in limbic system reactivity (low threshold for activity)
- Influences could range from genetics to intrauterine events to early environment effects on brain development
Environmental Influences
- “Poorness of fit”
- Invalidating environment most likely to facilitate development of BPD.
- Interactions between child and family can lead to coercive behaviors
47
Dialectical Behavior Therapy (DBT)
Genetic vulnerability + early experiences → enhanced sensitivity to emotional stimuli and inability to modulate emotions
Targets pervasive emotion dysregulation
- Mindfulness skills
- Emotion regulation skills
- Distress tolerance skills
- Interpersonal effectiveness skills
4 components
Individual DBT Therapy
Skills group
Phone coaching
Therapist consults with the team
48
Histrionic Personality Disorder
pattern of excessive emotionality and attention seeking
49
Histrionic Personality Disorder Explanations
- people had parents that were cold and controlling, so kids behave dramatically to cause a parent to intervene
- Cognitive-Behavioral looks at lack of substance and extreme suggestibility that people with HPD have
50
Histrionic Personality Disorder Treatments
- change their belief that they are helpless, and develop deliberate ways of thinking and solving problems
51
Narcissistic Personality Disorder
Grandiose, need admiration, little empathy
52
Narcissistic Personality Disorder Theories
- psychodynamic: cold, rejecting parents so people repeatedly tell themselves that they are actually perfect and desirabe
- cognitive behavioral: people are treated too positively rather than too negatively
- sociocultural: link between this disorder and 'eras of narcissism' in society
53
Narcissistic Personality Disorder Treatments
- clients may be unable to acknowledge weakness, appreciate effect of their behaviors, or incorporate feedback from others
- psychodynamic therapists: help people with NPD recognize and work through underlying insecurities and defense
- cognitive/behavioral: focus on self-centered thinking, try to redirect client's focus on the opinion of others, change their all-or-nothign
54
What country has the highest reported rate of personality disorders?
The United States
55
What is the Big Five Theory of Personality
Basic structure of personality may consist of 5 super traits:
Openness to experience
Conscientiousness
Extraversion
Agreeableness
Neuroticism/Emotional stability
Contain subfactors
56
DSM 5 Approach to Personality Disorders
begins with notion that peopel whose traits significantly impair their functioning should receive a diagnosis called: personality disorder - trait specified
5 groups of problematic traits would be eligible:
1. negative affectivity: people experience negative emotions frequently and intensely
2. detachment: withdraw from people and social interactions
3. antagonism: puts them at odds with other people
4. disinhibition: behave impulsively, without reflecting on potential future consequences
5. psychoticism: unusual and bizzare experiences
