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Flashcards in Exam #3 Deck (88):
1

Suicidal self-injury

Deliberate, self-inflicted injury with any intent to die

2

Nonsuicidal self-injury (NSSI)

Deliberate, self-inflicted tissue damage with no intent to die

3

Aborted attempt

Steps taken toward suicide but stops SELF

4

Interrupted attempt

Steps taken toward suicide but stopped/prevented by OTHER

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Motivation of NSSI (most common)

To decrease sadness, anxiety, and anger

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Motivation of suicide (most common)

To escape- unpleasant emotions or negative life events

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Interpersonal theory of suicide (2 factors)

1. Desire for suicide
2. Capable of suicide

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What groups are at high-risk for suicide?

-YA Native American males
-Older white males

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Protective factors against suicide

-Mental health treatment
-Social support and connectedness
-Parental monitoring
-Means restriction
-Fear of death

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Which types of treatments aren't very helpful for suicide prevention?

Group only interventions and brief interventions

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Safety plan for suicide (6)

1. Warning signs
2. Internal coping strategies
3. People and places that provide distraction
4. People that provide help
5. Professionals/agencies that can be contacted in a crisis
6. Making the environment safe

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Effective treatments for suicide

-Individual therapy + family therapy + parent training
-Skills training (CBT and DBT)
-Target other problem behavior
-Intensive early treatment and maintenance for at least 1 year

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Schizophrenia

Significant loss of contact with reality

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Emil Kraepelin (1899)

Used term Dementia Praecox to describe SZ
-Dementia: progressive deterioration of thought, affect, and behavior
-Praecox: precocious or early ripening, showing up early in adulthood

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Eugen Bleuler (1908)

Introduced term "schizophrenia", "associative splitting", believed that some could recover (~25%)

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Organic pathology

Caused by neurochemical, structural, or physical impairment or change

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Lifetime prevalence of SZ

About 1%

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What is the hallmark of SZ?

Psychosis- significant loss of contact with reality

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SZ DSM-5 Criteria

Two (or more) of the following for 1-month (one symptom but be 1, 2, or 3):
1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms
• Continuous signs for at least 6 months
• Functioning is significantly impaired

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Delusions

-Erroneous belief
-Fixed and firmly held despite clear contradictory evidence
-Disturbance in content of thought
-Occurs in 90% during course of SZ

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Hallucinations

-Sensory experience
-Seems real but occurs in absence of any external perceptual stimulus
-Auditory more common (75%) than visual (39%)

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Disorganized speech

-Disturbance in form (not content) of thought
-"cognitive slippage" or "loosening" of associations

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Disorganized and Catatonic behavior

-Impairment of goal-directed activity
-Occurs in areas of daily functioning
-Catatonia: abnormality of movement and behavior

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Positive symptoms of SZ

Excess or distortion in normal repertoire of behavior and experience (ex: delusions and hallucinations)

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Negative symptoms of SZ

Absence or deficit of normally present behaviors (eg: affect, speech, motivation) (ex: apathy, lack of emotion, nonexistent social functioning)

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Schizoaffective disorder

Features of SZ and severe mood disorder

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Schizophreniform disorder

SZ-like psychoses lasting at least 1 month but less than 6 months

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Delusional disorder

Delusional beliefs with otherwise normal behavior

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Brief psychotic disorder

Sudden onset of psychotic symptoms or disorganized speech and catatonic behavior

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Endophenotypes

Stable and measurable traits thought to be under genetic controls, can be controlled/measured or inherited

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Brain areas reduced by SZ

-Prefrontal grey matter
-Superior temporal gyrus grey matter

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Brain area increased by SZ

Ventricles

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Disruption to medial prefrontal cortex in SZ

-Confusion about what's real vs imaginary (delusions)
-Confusion about what's internally generated (inner speech) vs externally generated (hallucination)

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Premorbid phase of SZ

1st, cognitive motor or social deficits

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Prodromal phase of SZ

2nd, brief/attenuated positive symptoms and/or functional decline

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Psychotic phase of SZ

3rd, florid positive symptoms

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Stable phase of SZ

4th, negative symptoms, cognitive/social deficits, functional decline

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What do antipsychotics do in SZ?

Block dopamine

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Social skills training

For SZ, skills broken down into discrete steps (ex: how to have a conversation), works best for negative symptoms

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Social cognition and interaction training (SCIT)

For SZ, directly train the social processes underlying social skills, such as emotion perception and ToM

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Neuroplasticity-based social cognitive training

For SZ, target neural mechanisms subserving social cognitive processes with computer training

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What treatment works best for positive symptoms of SZ?

CBT

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What is autism spectrum disorder? (2 components)

Difficulties in social communication + restricted and repetitive interests and behaviors

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Autism deficits (3)

1. Social-emotional reciprocity
2. Nonverbal communication
3. Initiating and maintaining relationships

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Autism has presence of (4)

1. Repetitive motor movements
2. Insistence of sameness
3. Highly restricted/fixated interests
4. Unusual sensory interests or aversions

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Cognitive theories of ASD

Deficits in underlying cognitive functions --> ASD (ex: deficits in ToM)

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Weak Central Coherence (WCC)

ASD has limited ability to see big picture, detail-focused (ex: state map explanation)

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Applies behavior analysis (ABA) for ASD

Targets communication and cognitive abilities, skills broken down into small steps and taught with diminishing prompts

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Addictive behavior

Behavior based on pathological need for substance or activity

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Levels of substance involvement (2)

1. Intoxication
2. Use- abuse and dependence (tolerance and withdrawal)

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Physical effects of chronic alcohol use (3)

1. Malnutrition
2. Cirrhosis of liver
3. Brain damage

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What is drug use strongly influenced by?

Environment

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What is drug abuse/dependence strongly influenced by?

Genetic vulnerability

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Positive reinforcement for substance use

Subjective pleasure and dopaminergic activation

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Negative reinforcement for substance use

Escape from pain, stress, anxiety, and depression

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Medications to block desire to drink (2)

1. Disulfiram (antabuse)
2. Naltrexone

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Medication to lower side effects of acute withdrawal

Valium

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Negative effects of marijuana

-Cognitive impairment (memory)
-Amotivation
-Hallucinations and paranoia
-Respiratory consequences

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2 types of anorexia

1. Restricting type
2. Binge-eating/purging type (out of control from normal restricting diet)

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Anorexia

Fear of gaining weight, refusal to maintain normal weight, marked disturbance in body image

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Bulimia

Frequent episodes of binge eating, lack of control (dissociate), recurrent inappropriate compensatory behavior

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Medical complications in anorexia

-Death from heart arrhythmias
-Kidney damage & renal failure
-Downy hair
-3% mortality rate

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Medical complications in bulimia

-Electrolyte imbalances
-Hypokalemia (low K+)
-Damage to hands, throat, & teeth

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Binge eating disorder

Frequent episodes of binge eating, typically overweight or obese, no compensatory weight loss behaviors

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Age of onset of anorexia

16-20 years old

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Age of onset of bulimia

Women ages 21-24

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Age of onset of BED

30-50 year olds

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Where are brain abnormalities in eating disorders?

Hypothalamus, temporal, and frontal regions + low serotonin

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Treatments for anorexia

-Emergency procedures to restore weight
-Antidepressants or antipsychotic meds
-Family therapy
-CBT

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Treatments for bulimia

-Antidepressants
-CBT
-Unified treatment for disordered eating
-DBT

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Treatment of BED

-Antidepressants
-CBT and interpersonal therapy

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Mesocorticolimbic pathway structures (3)

1. Ventral tegmental area
2. Nucleus accumbens
3. Prefrontal cortex

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What are personality disorders?

-Inflexible and maladaptive traits and behavior patterns
-Distorted perceiving, thinking about, and relating to the world

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Personality disorder contexts (4)

1. Cognition
2. Affectivity
3. Interpersonal functioning
4. Impulse control

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Personality disorder cluster A

Odd or eccentric (4%): (paranoid, schizoid), schizotypal

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Personality disorder cluster B

Dramatic, emotional, erratic (4%): (histrionic), narcissistic, antisocial, borderline

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Personality disorder cluster C

Anxiety and fearful (7%): avoidant, (dependent), obsessive-compulsive

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What is the lifetime prevalence of all personality disorders?

10-12%

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Schizoid personality disorder

Cluster A, Impaired social relationships, inability and lack of desire to form attachments to others, prevalence 1%, males > females

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Schizotypal personality disorder

Cluster A, peculiar thought patterns, oddities of perception and speech that interfere with communication and social interaction

81

Histrionic personality disorder

Cluster B, attention seeking behavior, extreme concern with attractiveness and approval

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Narcissistic personality disorder

Cluster B, grandiosity, self-promoting, preoccupation with receiving attention, lack of empathy, subtypes: grandiose & vulnerable

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How many symptoms are needed to diagnose borderline personality disorder?

5 or more out of 9, can have very different symptoms in patients (heterogeneous disorder)

84

Dialectical Behavior Therapy

Marsha Linehan, change: emotion regulation & interpersonal effectiveness, acceptance: mindfulness & distress tolerance

85

Antisocial personality disorder

Cluster B, disregard for and violation of others' rights, lack of moral or ethical development, deceitful and shameless manipulation

86

2 dimensions of psychopathy

1. Affective and interpersonal core- lack of remorse
2. Behavior-antisocial or impulsive acts

87

Psychopathy causal factors

• Heritable traits
• Fearlessness and fear conditioning deficits
• Less reactive to distress and punishment cues
• Aberrant reward processing
• Underarousal hypothesis
• Cortical immaturity hypothesis
• Parental factors: rejection, inconsistent
discipline

88

Big 5 factors related to personality disorders

1. Negative affectivity (neuroticism)
2. Detachment (extreme introversion)
3. Antagonism (low agreeableness)
4. Disinhibition (extreme low conscientiousness)
5. Psychoticism