final 2 Flashcards
(87 cards)
1
Q
Anorexia Nervosa
A
Eating disorder
- fear of being fat, though not fat
- 90% female
- bone loss, heart strain, stops menstruation
2
Q
Bullmia Nervosa
A
Eating disorder
- self induced vomiting
3
Q
GABA
A
inhibitory transmitter
4
Q
Amphetamines
A
reduce fatigue and appetite
increase dopamine
5
Q
Endorphins
A
painkillers
6
Q
Androgens
A
Sexual desire
7
Q
Serotonin
A
feelings of happiness
8
Q
Depression
A
mood disorder
9
Q
Suicide
A
rate is reduced in worst stage of depression due to apathy
- Social support can help prevent
10
Q
Bipolar disorder
A
depression with periods of mania
Manic state - grandiose plans, no limits to what can be done. Speech rapid and unstoppable
11
Q
Causes of mood disorders
A
- Biological
Reserpine induces depression by depleting
monoamines (norepinephrine, dopamine, and serotonin
// environmental/learning - decrease in positive reinforcement from environment
// personality-based vulnerability - Freud believed early losses, rejection create vulnerability for later depression
Brown and Haris found that women who lost their mom before
age 11 were 3x more likely to become depressed because of a recent loss than women who didn’t
// Humanistic - this generation focuses too much on personal attainment instead of others and react more strongly to their own failures
// Cognitive process
Depressive cognitive triad
Depressive attributional pattern
// Sociocultural - much less depression in collectivist cultures, strong connections in family
In North American, depression = guilt/personal inadequacy
• In Chinese/African/Latin cultures, depression = fatigue, loss of appetite, sleep problems
• Women are no more likely than men to be depressed in developing countries
12
Q
Learned helplessness theory
A
Causes of mood disorders
- depression happens
when people expect bad events and believe that there is
nothing they can to prevent them
• Negative attributions are personal, stable and global:
Its my fault, I’ll always be this way, I’m a total loser
13
Q
Depressive cognitive triad
A
// Cognitive
causes of mood disorders
negative beliefs about world, oneself and future
- victimize themselves
- remember their failures, not successes
Depressive attributional pattern - bad things are personal,
good things are situational (opposite of self-severing bias)
14
Q
Cycle of depression
A
stressful experiences ➡ negative
explanatory style ➡ depressed mood ➡ cognitive and
behavioral changes ➡ stressful experiences
• Breaking the negative explanatory style breaks the cycle
15
Q
Depressive attributional pattern
A
Cognitive process
factors that cause mood disorders
- bad things are personal,
good things are situational (opposite of self-severing bias)
16
Q
Somatoform disorders
A
complaints of physical symptoms that aren’t physiologically possible
17
Q
Conversion disorder
A
Somatoform disorder
erious neurological symptoms
(blindness, paralysis, sensation loss) suddenly occur
• Strange lack of concern about symptom
18
Q
Glove anesthesia
A
losing sensation only below wrist, not neurologically possible
- caused by traumatic event
- psychodynamic: ego represses conflict by converting anxiety into physical symptom
19
Q
Hypochondriasis
A
Somatoform disorder - being alarmed about any physical symptom, convinced they have serious illness
20
Q
Pain disorder
A
experience
intense pain for no reason or out
of proportion
21
Q
Psychogenic Amnesia
A
Dissociative disorder
- Person responds to a stressful event with
extensive but selective memory loss
22
Q
Psychogenic Fugue
A
Dissociative disorder - person loses all sense of personal identity, gives up customary life, wanders to a new faraway location, and establishes a new identity - Typically ends what person suddenly remembers original identity, mystified
23
Q
Dissociative Identity Disorder (DID)
A
Dissociative disorder
multi personality 92% female
24
Q
Trauma-Dissociation Theory
A
(DID)
- new personalities occur in response to severe stress, usually from childhood
25
Schizophrenia
Severe disturbances in thinking, speech, perception,
emotion and behavior
• Schizophrenia means split-mind, but it is not same as
DID
Delusions, hallucinations, paralogic, overinclusion
26
Delusions (schizophrenia)
Schizophrenia
- false beliefs sustained in face of opposing evidence
• Delusions or persecution (out to get me) or delusions of
grandeur (extreme importance)
27
Hallucinations (schizophrenia)
Schizophrenia
- false perceptions of reality (auditory mostly, also
visual or tactile)
28
Paralogic
Schizophrenia
| California has water and sand so its the promised land
29
Overinclusion
Schizophrenia
| - "fruitful year" means pears and apples
30
Schizophrenia types 1
Paranoid, disorganized, catatonic
- motor disturbances: muscle
rigidity or random/repetitive movements.
• Alternate between stuporous states - oblivious to
reality, can be molded and stay that way for hours
• And agitated excitement - can be dangerous to
others)
31
Schizophrenia types 2
```
Type 1
- positive symptoms: delusions, hallucinations, disordered speech/thoughts
possibly treatable
Type 2
- Negative symptoms: lack of
emotion, loss of motivation,
absence of normal speech
rarely treatable
```
32
Causes of schizophrenia
// Biological factors exist
- problems with DISC 1, protein that guides new neural connections
Abnormalities in thalamus (responsible for sensory input)Structural differences in type 2, so hard to recover,
Dopamine hypothesis
// Psychological
Freud
- schizophrenia is extreme regression
Cognitive
- Defect in attention mechanism, overwhelmed by stimuli
// Sociocultural
• Social causation hypothesis - higher rates of
schizophrenia in poor areas due to the higher
stress that low income cause
• Social drift hypothesis - schizophrenia causes
lower occupational functioning, so schizophrenic
people move to low-cost urban housing populations
// Environmental
Stressful life events play important roll
• More likely to relapse if returning to home that is high in expressed emotion
33
Dopamine hypothesis
Biological
Causes of schizophrenia
- positive symptoms are produced by an over activity of dopamine in motivation, emotion and cognitive function areas
34
Antisocial Personality disorder
```
Personality disorder
- irresponsible
and antisocial, impulsive
needs, lack of empathy,
highly manipulative, no
conscience
// Causes
- Biological, amygdala or prefrontal cortex dysfunction causes
lower heart rates under stress
- Psychological/environmental - lack of conscience (no superego)
```
35
Histrionic
```
Personality disorder
- dramatic,
attention seeking,
promiscuous, highly
impressionable, out of touch
with negative feelings
```
36
Narcissistic
```
Personality disorder
- grandiose
fantasies, lack of
empathy, need for
admiration from others,
proud self-display
```
37
Borderline Personality disorder
Personality disorder
- severe instability
of self- image, relationships,
emotions. Extreme love and
hate of same person.
Manipulative and suicidal
// causes
sexual/physical abuse, parenting problems
• Splitting - failure to integrate positive and negative aspects of another person’s
behavior into a coherent whole
• Biological: problem with neurotransmitter system that regulates emotion
38
Avoidant
```
Personality disorder
- extreme
social discomfort, fear
of being negatively
evaluated
```
39
Dependent
Personality disorder
| - Extremely submissive and dependent, fear of separation
40
Obsessive-compulsive
// Personality disorder
perfectionism,
orderliness,
inflexibility
41
Schizoid
Personality disorder
- indifferent to social
relationships, restricted range
of emotions
42
Schizotypal
Personality disorder
- odd thoughts,
appearance, behavior.
Discomfort in social situations
43
Paranoid
Personality disorder
- unwarranted
tendency to interpret
behavior as threatening
44
Autistic disorder
* Extreme unresponsiveness to others
* Poor communication
* Repetitive and rigid behavior patterns
45
Psychotherapy
• Therapy through psychological techniques, not drugs
• Most therapists are eclectic therapists - use all different kinds of therapies
• “Psychologist” is a protected term. To call yourself one you must be licensed.
Usually have PhD or Masters.
• Therapist, counselor, psychotherapist and hypnotist are not protected terms,
so anyone can call themselves these
46
Psychodynamic therapy
Psychoanalysis, brief psychodynamic therapy
47
Insight
Psychoanalysis
| conscious awareness of underlying problems
48
Resistance
- defensive mechanism against therapy, sign of a sensitive topic
• Patient becomes angry, avoids topic, misses appointments
• Analyzed to promote insight and prevent therapy dropping
49
Psychoanalysis
Psychodynamic therapy
- goal is to achieve insight
Free association, Dream interpretation, resistance, transference, interpretation
50
Brief Psychodynamic therapy
Psychodynamic therapy
Brief version of psychoanalysis
Clients face the therapist directly, meet less often
• Focus on life problems rather than rebuilding
personality
• Inter-personal therapy
• 15-20 sessions max
• Focus on marital conflict, loss, or social skills
- find solutions to these problems
• Effective therapy for depression
51
Humanistic therapy
• Focus on future and present, rather than past
• We need to find out what is preventing you from realizing full potential
- Client-centered therapy (carl rogers)
- Gestalt therapy (perls)
52
Client-centered/person-centered therapy
Humanistic therapy
Carl rogers
• Relationship develops between client and therapist to foster selfexploration
• A Rogerian refers to the person as client, not patient
• Therapist attributes:
• Unconditional positive regard - trust, acceptance, nonjudgement
• Empathy - willing to view the world through their eyes,
“reflecting” (repeating) what they say
• Genuineness - therapist expresses honest feelings, positive or
negative
• Job is not to interpret your life, it is to let you talk
• Pioneered filming of sessions
53
Gestalt therapy
Humanistic therapy
• Patient is ignoring the background - important feelings,
wishes thoughts that are blocked
• Bring them into awareness, get in touch with inner self
• Often done in groups
• Much more confrontational than client-centered therapy
• Often involves role playing
• Empty-chair technique - imagine mom sitting in
chair and talk to her (playing both roles)
• Perls was much less scientific than Rogers, didn’t test his
therapy
• Others tested empty-chair technique and its quite
successful
54
Cognitive therapy
• Concerned with present rather than past
• Very directive, tell you exactly what is wrong and what to do about it
- Ellis' Rational-Emotive therapy
- Beck's Cognitive therapy
- Meichenbaum's Self-Instructional training
55
Ellis' Rational-Emotive therapy
```
Cognitive therapy
- Therapy seeks to identify irrational thought patterns, and help change underlying belief system
- People make unrealistic demands on themselves
- Often assigns homework
ABCD Model
• Activating event
• Belief system
• Consequences of that appraisal
• Disputing the erroneous belief
system
```
56
Beck’s Cognitive Therapy
Cognitive therapy
• Treated depressed patients very effectively (97%
improvements, 75% non-recurrence)
• Helps them realize that their thoughts, not their
situation makes them depressed
57
Meichenbaum’s Self Instructional Training
Cognitive therapy
| -stress and coping
58
Exposure
Behaviour therapy
Classical conditioning treatment
- assumes phobias are learned
- Flooding: extreme exposure
59
Aversion therapy
Behaviour therapy
Classical conditioning treatment
- pair unwanted behaviour, often fails to generalize, works best when paired with other treatments
60
Systematic dessensitization
Behaviour therapy
Classical conditioning treatment
- starts from low anxiety scenes to high
- not as effective as flooding but less stress
61
Operant Conditioning treatments
Positive reinforcement
Punishment
• Works well for schizophrenics, disturbed children, mental retardation
62
Positive reinforcement
```
Operant conditioning treatment
token economy (currency)
```
63
Punishment
Operant conditioning treatment
64
Modeling and Social Skills Training
* Using modeling to teach social skills and resisting peer pressure
* Increases self efficacy
65
Third wave cognitive therapies
Mindfulness Based Treatments
• Mindfulness is mental state of awareness, focus, openness and acceptive of experience
• Learn a meditation technique to focus on your sensations, thoughts and feelings and
overcome them without struggle
• Used for stress, depression, drug relapse prevention
66
Acceptance and commitment therapy
Acceptance - accept all thoughts and feelings
| Commitment - examine one's life and set goals for whats important, committing to achieve them
67
Dialectical Behaviour Therapy
Used to treat Borderline Personality Disorder
• Package of cognitive, behavioral, psychodynamic and humanist therapies
• Goal is to be able to calmly recognize situations, thoughts and their impacts rather than being overwhelmed by them
• effective in controlling self destructive behavior
68
Cultural and gender issues
• Psychotherapy used much less often by minorities, and they
drop out of treatment more
• Cultural norm against asking other cultures for help
• Language barrier
• Less access due to unemployment
• Therapists have little familiarity with other cultures
69
Solutions to cultural barriers
Need therapists with cultural competence
• Doesn’t matter if therapist is same culture as patient,
matters if therapist has been given ethnic training
70
Evaluating Psychotherapy
Psychoanalysts believe recovery would not happen without therapy
71
Dodo bird verdict
- all therapies appear to be equally effective
72
Factors that influence outcome of psychotherapy
```
Techniques
Dose response effect
Quality of
Relationship
Client Variables
• Openness to therapy
Self-relatedness -
- ability to understand self
Nature of problem -
- does it fit the therapy
```
73
Dose response effect (evaluating psychotherapy)
relationship between amount
| of treatment and outcome
74
Common factors of all types of therapy
```
• Faith in therapist
• Alternative way of looking at their
problem
• Insight into self
• Protective setting, supportive
relationship
• Opportunity to practice new
behaviors
• Increased optimism and self-efficacy
• Emotional defusing - reduce fear
• Interpersonal learning - play it out
with therapist
```
75
Drug therapies
// Biological/somatic treatment
Anti-anxiety drugs, antidepressant drugs,
Anti-mania drugs,
Antipsychotic drugs
76
Anti anxiety drugs
Drug therapy
- reduce anxiety without disturbing alertness, prone to dependency
• Tranquilizers, Xanax, Valium
• Symptoms return after drugs stop being taken
• BuSpar is slow acting, causes less fatigue, and is
less prone to abuse. It works by enhancing GABA.
• Should not used chronically and should include
other therapy
77
Antidepressant drugs
Drug therapy
• Relapse is more likely for drugs alone than drugs with therapy
// Tricyclics
• Prevent reuptake of
norepinephrine and serotonin
• Clomipramine - a tricyclic
used for OCD, depression
// Monoamine Oxidase (MAO)
Inhibiters
• More severe side effects than tricyclics
• Need daily use, special diet, 4 weeks
for effectiveness
// Selective serotonin reuptake inhibitors (SSRIs)
• Milder side effects, more effective that other options
• Seen as a wonder-drug
78
Anti-Mania drugs
Drug Therapy
Lithium Carbonate
• For bipolar disorder: eliminate manic
phase and depression does not return
• Correct dosage is critical
• Seems effective but some patients report
that they miss the initial “high” of mania.
Some stop taking it so they can get it back.
• Need talking therapy too for complete
effectiveness
79
Antipsychotic Drugs
"major tranquilizers", decrease dopamine
• Reduce positive symptoms of schizophrenia, not negative ones
• Quick relapse if patient stops taking them
• Main one is Thorazine, doesn’t work for everyone
Risk of tardive dyskinesia - uncontrollable movements
- Clozaril is alternative that doesn't cause duskiness and reduces both positive and negative symptoms, however causes fatal blood disease in 1-2% of people
80
Electroconvulsive therapy (ECT)
Schizophrenia and epilepsy don't happen together, so use shock to induce seizures to treat schizophrenia
- currently given to right hemisphere to lessen damage to verbal memory
- not useful for anxiety disorders, or schizophrenia
• Does work for depression
• Safety concerns - can cause brain damage, relapse very likely
• Approved by the APA for use in cases of major depression that doesn’t
respond to drugs
• 2.5% of depression patients receive this treatment
• May somehow increase monoamines, but scientists aren’t sure exactly why it
works
81
Psychosurgery
remove brain tissue to change disordered behaviour, in absence of obvious organic damage
• Used to be done very often, but stopped due to safety
concerns and increased availability of drugs
82
Cingulotomy
Psychosurgery
surgeon cuts corpus callosum
- treats depression and ocd as last resort
- can cause seizures
83
Disorders and society
first there was push to put everyone into asylums, then deinstitutionalization, but if community is unprepared, revolving door phenomenon occurs. Prevention programs are difficult to justify because its hard to tell when they are working
84
deinstitutionalization
- Movement to transfer focus of treatment from mental institutions to the community as a whole
85
Revolving door phenomenon
Disorders and society
| repeated hospitalizations and homelessness for mental patients
86
Situation focused prevention
- reduce environmental
causes of disorders and enhance the factors that prevent them
• Reduce unemployment, discrimination, poverty
• Increase education, family functioning, sense of connection
to community
87
Competency focussed prevention
- increase personal
resources and coping skills
• Increase stress resistance, social and vocational
competencies, self esteem
• Ex. US Army Battlemind program prevents PTSD, sleep
probs, depression
