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final exam Flashcards

1
Q

Myers-Briggs Test

A
  • Widely used but not by psychologists
  • Not supported
  • Appeal in generic descriptions, capitalizing on the Barnum Effect
    o Viewing vague personality descriptions as specific to them (e.g., “Aries, you are going to have a gangbuster of a day!!”
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2
Q

What is the five factor model

A

Openness
Conscientiousness
Extraversion
Agreeableness
Neuroticism

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3
Q

What is a personality disorder?

A

o Persistent pattern of emotions, cognitions, behaviour resulting in enduring emotional distress for affected person and others

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4
Q

What is Cluster A

A

odd or eccentric

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5
Q

What disorders fall into Cluster A

A
  • Paranoid Personality Disorder
  • Schizoid Personality Disorder
  • Schizotypal Personality Disorder
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6
Q

Paranoid Personality Disorder Description

A

o Suspicious, mistrustful, argumentative, complain, quiet, hostile towards others, suicidal

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7
Q

Causes of Paranoid Personality Disorder

A

o Genetics (Kendleretal.,2015)? Relatives with schizophrenia
o Mistreatment in childhood–be vigilant against Those who could cause harm
o Schema of being on guard– vigilance and confirmatory bias
o Cultural: second language, immigration, hearing impairments, prisoners–prone to interpret ambiguity in a suspicious way, e.g., people laughing must be laughing at you

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8
Q

Schizoid Personality Disorder Description

A

o Detachment from social relationships, no desire to enjoy closeness with others, cold, aloof

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9
Q

Causes of schizoid personality disorder

A

o Childhood shyness, abuse and neglect, low density dopamine receptors – aloofness also found in those with schizophrenia

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10
Q

Schizotypal Personality Disorder description

A

o Social deficits, psychotic-like symptoms, paranoia, ‘magical thinking’, hypersensitive to criticism as children

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11
Q

Causes of schizotypal personality disorder

A

o Genetics – lots of overlap with schizophrenia?
o Left hemisphere damage – memory and learning deficits in some?

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12
Q

What disorders fall into cluster B

A
  • Antisocial personality disorder
  • Borderline personality disorder
  • Histrionic personality disorder
  • Narcissistic personality disorder
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13
Q

Antisocial Personality Disorder Description

A

o Aggressive, lying, cheating, no remorse, substance abuse, unnatural death in boys with this disorder

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14
Q

causes of antisocial personality disorder

A

o Gene-environment interaction: kids with convict moms offend in their adopted homes but less so if they spent less time in an interim foster situation
o Under arousal of cortex? U shed distribution, theta in wake
o Defective x chromosome (gets canceled out by the y in girls)
o Fearlessness: less reactivity to shocks
o They are impervious to reward info – they don’t stop when reward is unlikely
o Coercive parenting: yell at kid then back down when kid escalates
o Trauma leads to turning off emotions

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15
Q

borderline personality disorder description

A

o Turbulent relationships, fear abandonment, self-mutilating behaviours, no control over emotions

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16
Q

borderline personality disorder causes

A

o Genetics: higher concordance with monozygotic twins
o Early trauma (76-91% reporting trauma); 20-40% have no reported trauma
o Invalidating parental styles “you’re not hungry”
 Parents deny them and invalidate them of emotional experiences
o There is an attentional bias for words like abandonment, emptiness

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17
Q

histrionic personality disorder description

A

o Dramatic, theatrical, self-centred, seek constant reassurance
o Hugging, excessive emotional displays, vain, impressionistic

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18
Q

causes of histrionic personality disorder

A

o Overlap with antisocial personality disorder–sexist notion that women are HPD (wandering uterus) and men are antisocial – both appear as charming and manipulative to get what they want

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19
Q

narcissistic personality disorder description

A

o Unreasonable sense of self-importance, grandiosity, no compassion for others, envious, arrogant

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20
Q

causes of narcissistic personality disorder

A

o Failure of empathic “mirroring” in parents?
o Lots of overlap with psychopathy

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21
Q

what disorders fall into cluster c

A
  • Avoidant personality disorder
  • Obsessive compulsive personality disorder
  • Dependent personality disorder
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22
Q

avoidant personality disorder description

A

o Interpersonally anxious, fear rejection, pessimistic about future

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23
Q

causes of avoidant personality disorder

A

o Born with difficult temperament, parental rejection, uncritical love

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24
Q

obsessive compulsive personality disorder description

A

o Rigidity, poor interpersonal relationships, quest for perfectionism

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25
Q

cause of obsessive compulsive personality disorder

A

genetics

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26
Q

dependent personality disorder description

A

o Interpersonally dependent, anxious

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27
Q

causes of dependent personality disorder

A

o Disruptions in early childhood lead to fears of abandonment

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28
Q

Emil Kraepelin on the categorization of schizophrenia

A

o Combined previously distinct disorders of insanity:
o Catatonia: immobile at times; agitated excitation at others – Hebephrenia: immature emotionality
o Paranoia: delusions of grandeur/persecution

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29
Q

Dementia praecox and manic depressive illness

A

used to capture this cluster of symptoms; thought that had the same underlying cause; later added hallucinations, delusions, negativism, and stereotyped behavior

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30
Q

Eugin Bleuler

A

Introduces the term Schizophrenia
o “splitmind”
o They can’t connect one idea/experience/perception to the next
o “Associativesplitting”ofpersonalityfunctions–thereisadisconnection/a “breaking of associative threads”
o Associations allow us to think and function efficiently, if there is a breakdown, there is a breakdown of thought and other processes

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31
Q

Difference between Kraeplin and Bleuler

A

Kraeplin was someone who focused on early adverse experiences and Bleuler: this is a thought disorder that connects all the symptoms into a heterogeneous presentation

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32
Q

polytheistic disorder

A
  • Several behaviours or symptoms not shared by all people given diagnosis of schizophrenia
  • Clusters of symptoms identified: Positive symptoms(include delusions and hallucinations); negative symptoms (deficits e.g., diminished emotional expression), disorganized symptoms or catatonia (rambling speech, erratic behavior).
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33
Q

Positive negative and disorganized symptoms of schizophrenia

A
  • Positive symptoms: delusions and hallucinations
  • Negative symptoms: avolition
  • Disorganized symptoms: inappropriate affect
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34
Q

Positive symptoms of schizophrenia

A
  • 50%–70%people with schizophrenia experience positive symptoms: hallucinations, delusions, or both
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35
Q

Positive symtom: delusions

A

o A disorder of thought content
o Delusion of grandeur
o Delusions of persecution
o Cotard’s syndrome
 Believe part of body has died or been removed (often brain)
o Capgras syndrome
 Believe that someone has been replaced

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36
Q

Positive symtom: hallucination

A

o Experience of sensory events without input from surrounding environment
o Auditory hallucinations: hearing things that aren’t there
 Associated with listening to own thoughts
 Abnormal activation of primary cortex
 Increased metabolic activity in left auditory cortex

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37
Q

negative symptoms of schizophrenia

A
  • Absence or insufficiency of normal behaviour
  • Seen in approximately 25% with schizophrenia
  • Avolition: inability to initiate/persist in activities
  • Alogia: absence of speech; brief replies
  • Anhedonia: lack of pleasure experienced
  • Asociality: lack of interest in social interactions
  • Affective flattening: no open reaction to emotional situations
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38
Q

disorganized symptoms of schizophrenia

A
  • Disorganized speech: communication problems
  • Inappropriate affect and Disorganized behaviour: laughing or crying at inappropriate times
  • Catatonic immobility: keeping body and limbs in the position they are put in by someone else
39
Q

Prevalence of schizophrenia

A

o 0.2% to 1.5% in general population
o Less than average life expectancy
o Men and women affected at same rate

40
Q

genetic influence of schizophrenia

A

o Multiple gene variances combine to produce vulnerability Family Studies
o Children of schizophrenic parents likely to have it too
o Seen within families
o Predisposition may be inherited

41
Q

dopamine (neurobiological) influence of schizophrenia

A

o Dopamine
 Clues to the role of dopamine in schizophrenia:
* Neuroleptics (dopamine antagonists) effective in treating
* Neuroleptics produce negative side effects
* L-dopa (agonist) produces schizophrenia-like symptoms
* Amphetamines, which activate dopamine, can worsen some symptoms in schizophrenia

42
Q

Brain structure (neurobiological) cause of schizophrenia

A

 Abnormally large lateral and third ventricles in people with schizophrenia
 Hypofrontality (less active frontal lobe)
* Associated with negative symptoms
 Brain damage

43
Q

Viral infections (neurobiological) cause of schizophrenia

A

 In utero events may be associated with schizophrenia
 Prenatal brain damage

44
Q

stress cause of schizophrenia

A

o Stress
 Retrospective and prospective approaches to examine impact of stress
 Tendency for people with schizophrenia to be found in lower social classes
 Sociogenic hypothesis
 Social selection hypothesis

45
Q

families and relapse cause of schizophrenia

A

 Schizophrenogenic: mothers with cold, dominant, rejecting nature
 Double bind: conflicting messages
 Expressed emotion (EE): disapproval, animosity, intrusiveness
 Predictor of relapse

46
Q

biological treatment of schizophrenia

A

o Neuroleptics: dopamine antagonists
o When effective, neuroleptics help people think more
o clearly
o Reduce or eliminate delusions and hallucinations
o Effective for 60%–70% persons who try them
o Newer antipsychotics have fewer side effects (TD)
o Help in improving cognitive functioning
o Psychosocial interventions include medication- taking compliance
o Transcranial magnetic stimulation(TMS)treatment for hallucinations
o TMS also improves auditory hallucinations: effect is brief

47
Q

psychosocial intervention of schizophrenia

A

o Psychoanalytic approach: not beneficial; maybe harmful
o Behavioural family therapy: must be ongoing if patients and families are to benefit from it
o Multilevel treatments reduce relapses

48
Q

Impact of dementia

A
  • 46.8 million people worldwide were living with dementia in 2015
    o 75 million by 2030
  • As of 2016, there are 564,000 Canadians living with dementia
    o 937,000 by 2031
  • Incidence: 25,000 cases every year
  • In Canada 1 in 20 individuals over age 65 and around ¼ of those over age 85 has AD
49
Q

Alzheimer’s type

A
  • Multiple cognitive deficits that develop gradually and steadily
  • Cognitive impairments
    o Aphasia, apraxia, agnosia, anomia
     Speak differently(aphasia), difficulty with motor behaviour (apraxia), can’t recognize objects (agnosia), being able to name things
    o Mini mental state examination
    o Clock test
     Draw analog clock; loss of understanding what a clock is, numbers, where the numbers go
50
Q

Sporadic or late-onset AD

A
  • Accounts for more than 95% of all AD cases
  • Environment and lifestyle and their interaction with Apolipoprotein E )Apo E) gene on chromosome 19
    o ApoE gene has 3 different isoforms, e2, e3, e4
    o Around 20% of the population has at least one copy of ApoE4
    o Half of individuals who have sporadic AD
51
Q

familial or early onset AD

A
  • Accounts for 1-5% of all AD cases
  • Autosomal-dominant genetic disease
  • Due to mutations in 1 or more of the following genes
    o Amyloid precursor protein (APP gene on chromosome 21)
    o Presenilin 1 gene (chromosome 14)
    o Presenilin 2 gene (chromosome 1)
52
Q

Atrophy for AD

A

o Atrophy due to neuronal loss (neurons have died)
o Extracellular amyloid plaques
o Intracellular neurofibrillary tangles

53
Q

Beta-amyloid plaques

A
  • Amyloid precursor protein (APP) is a transmembrane protein
    o Play roles in growth and repair of neurons
    o Normally it is cleaved with alpha and y-secretase
    o Cleared with beta and y secretase under unknown conditions
    o Leading to beta amyloid plaques formation
54
Q

Neurofibrillary tangles

A
  • Outside the neurons, the microtubules disintegrate and the proteins get tangled and strangle the neuron
55
Q

Specificity of tangles and plaques

A
  • There is evidence that pathology of plaques and tangles can be present in an individuals brain without the individual ever showing symptoms of AD
  • Can this be due to higher level of reserve
  • In a study by Stern (2012), those with higher reserves (high cognitive test scores) are resilient longer in the presence of these tangles
    o A lot more connections so they can stand to lose more and more neuronal loss
56
Q

Cholinergic hypothesis

A
  • Cholinergic neurons in the basal forebrain degenerate
    o Acetylcholine neurotransmission is reduced in the cerebral cortex
  • The cholinergic dysfunction interferes with attentional processing
    o Causes cognitive impairment
57
Q

Neurotoxicity

A
  • There is evidence also for glutamate-mediated neurotoxicity in the pathogenesis of AD
  • Glutamate receptors N-methyl-D-aspartate (NMDA) are overactive
58
Q

Neuroinflammation

A
  • There is evidence also for glutamate-mediated neurotoxicity in the pathogenesis of AD
  • Glutamate receptors N-methyl-D-aspartate (NMDA) are overactive
59
Q

mild cognitive impairment

A
  • An impairment in memory and/or non-memory domains more than normal, but not sufficient to cause impairment in functional abilities
    o Amnestic MCI
    o Non-Amnestic MCI
    o 15-20% of people age 65 or older have MCI
    o Contradictory results in relation to sex differences
    o MCI looks like an early stage of AD
60
Q

vascular dementia

A
  1. Caused by a stroke or a large vessel cerebral vascular accident
  2. Caused by cerebral small vessel disease
    - Damage to small arteries, arterioles, capillaries and small veins in the brain ‘white matter lesions’
61
Q

Fronto Temporal dementia: behavioural type

A
  • Socially inappropriate behaviours
  • Personality changes
  • Apathy
  • Impulsiveness
  • Odd behaviours
  • Inability to concentrate
  • Inability to make plans
62
Q

Fronto Temporal dementia: language type

A
  • Non-fluent aphasia
  • Primary progressive aphasia
  • Memory impairment occurs later in disease progression
63
Q

Lewy Body

A
  • Progressive cognitive impairment initially affecting attention and executive function
  • Learning and memory impairment at later stage
  • Visual hallucinations
  • Delusions
  • Sleeping difficulties
  • Fluctuations in cognitive abilities
  • Repeated falls
64
Q

Alcohol-related dementia

A
  • Excessive and chronic use of alcohol permanent damage to the structure and function of the brain
  • Uncertainty of the exact pathophysiological profile
    o Thiamine (vitamin B1) deficiency
    o Neurotoxicity
    o Nutritional deficiencies
    o Co-morbidities such as psychiatric illness
    o Cerebrovascular disease related to alcohol
    o Head injury from fall
    o Abusing other substances
  • If cognitive deficits are recognized early, they may be reduced or reversed if the individual stops drinking alcohol
65
Q

Somatic symtom

A
  • Preoccupation with health or body(“soma” meaning body)
  • Exaggeration of slightest symptoms
66
Q

dissociative disorders

A

o Loss of identity due to an intense or an extreme experience

67
Q

Somatic symptom disorder

A
  • Pain or other physical symptom complaints exacerbated by psychological factors
  • May not be a clear physical reason for complaint, or the complaint is far in excess of the problem
    o Leads to anxiety and distress
    o Secondary/coping behaviours
    o They seek reassurance and sympathy
    o The support from others reinforces the situation
68
Q

illness anxiety disorder

A
  • Formerly known as “hypochondriasis”
    o Physical symptoms are absent or mild
    o They detect a benign physical sensation, misinterpret it as dangerous, become obsessive monitors for physical sensations and become anxious – they then misinterpret the physical symptoms of anxiety as evidence of illness and so on.
    o Concern is “idea” of being sick
    o Reassurance from physicians is not helpful
69
Q

causes of somatic symptom disorder and illness anxiety disorder

A
  • Enhanced perceptual sensitivity to illness cues
  • Interpret ambiguous stimuli as threatening
    o Genetic causes
    o Negative life events
    o Attention seeking through illness
70
Q

Conversional disorder

A
  • Clinical description: Physical malfunctioning: paralysis, blindness but can avoid something coming at them, difficulty speaking (aphonia) but without damage, seizures without EEG activity
    o Unconscious conflicts expressed through (converted to) physical symptoms
    o ‘Functional’: severe physical dysfunction without an organic cause
    o Comorbidity
     Especially somatization disorder
    o Low SES, women, men under stress
71
Q

Causes of conversional disorder

A

o Traumatic event leads to conflict = anxiety
o Repression of conflict (unconscious)
o When anxiety becomes conscious person converts it to physical symptoms
o Person gets attention
o Interpersonal factors: conflict
o Social and cultural factors: associated with religious experiences

72
Q

differential diagnosis

A
  • It is important to distinguish between conversions Disorder and closely related disorders:
  • Malingering (i.e faking): secondary gain, often not an identifiable stressor
  • Factitious disorder: fakes symptoms with no obvious secondary gain
  • Factitious disorder imposed on another: Munchausen
73
Q

depersonalization derealization disorder

A
  • Severe feelings of detachment
    o Outside observer of own body or mind
  • Significant distress or impairment
    o Emotion, perception
  • Rare; onset usually in adolescence
  • No conclusive evidence regarding effectiveness of psychological and drug treatments
    o We treat stress reactions and tend to use treatments similar to CBT for panic
74
Q

dissociative amnesia

A
  • Generalized: inability to remember anything, including identity
  • Localized: inability to remember specific events (usually traumatic)
  • Usually adult onset
  • Often resolves when stressors resolves
    o Therapy attempts to retrieves lost info
75
Q

dissociative identity disorder

A
  • Several identities (alters) co-exist simultaneously; the average number of alters in a client with DID is 15
  • Aspects of a person’s identity are dissociated
  • Host identity: asks for treatment
  • Switch: instantaneous transition from one personality
    o 37% report changes in handedness to another
76
Q

causes of dissociative identity disorder

A

o Childhood abuse: physical and sexual
 Take on different identities as escape is not possible
 Escape sought from physical and emotional pain
o DID sub-type of PTSD?
o Temporal lobe epileptic seizures can be associated with dissociative symptoms
o Sleep deprivation

77
Q

DID: Real and False memories

A

o Memories could be a result of suggestions from therapists
o False memories can be created
o Severity of trauma related to severity of amnesia

78
Q

criterial for civil commitment

A
  1. Mental disorder
  2. Danger to themselves or others
  3. In need of treatment
    - Differences in definition/interpretation
    - Varies across provinces
    o Conservative definitions can delay treatment and expose patient to risk and poorer prognosis
    o Liberal definitions can infringe on liberties
79
Q

laws designed to protect

A

designed to protect
o People who display abnormal behaviour and
o Society
o Family with a child with delusions who wants them committed to protect them, but they are seen as not being an imminent threat

80
Q

defining mental illness

A

o Legal concepts: severe emotional or thought disturbance
o Mental illness is not synonymous with mental illness
o Some provinces have a functional definition: effect of illness on the person (and their behaviour)
o Ontario is broad: ‘ a disease or disability of the mind’
 Receiving DSM5 diagnosis does not mean that the person fits the legal definition
o Various definitions, ambiguity leading to flexibility

81
Q

civil commitment: dangerousness

A
  • Dangerousness
    o Hallucinations, delusions, comorbid personality disorder
    o Risk assessment
     Traditionally not great at this but incremental improvements
     Example, in those who have committed a violent offence: unmarried, high psychopathy score and a lapse on a previous release, predict violent reoffending
     Example, predictors of suicide in the hospital include: aggression towards others in hospital, history of self-harm, suicidal or self harm behaviour in the two weeks before the admit
    o Suicide, self-harm
82
Q

two major influences on commitment are:

A
  • Deinstitutionalization (closures of mental hospitals) and increased homelessness
  • poor economic conditions
83
Q

when can the government go against someone’s will

A
  1. Parens patriae the government can act as a surrogate parent when it appears the person cannot act in their own best interest
    o If they are refusing or not understanding the need for their treatment, or they arnt’ capable of securing food, shelter, etc
  2. Police power: the government is responsible for public safety so you can take people into custody
    - People can request to enter a facility voluntarily too
84
Q

criminal commitment

A
  • Criminal commitment is the process by which people are held because
    o They have been accused of committing a crime and are detained in a mental health facility until fit to participate in legal proceedings, or
    o They have found not criminally responsible due to a mental disorder (NCRMD)
     Formerly not guilty by reason of insanity
85
Q

the insanity defence

A

o Not criminally held responsible on account of mental disorder (NCRMD)
o M’Naghten rule: they have to know right from wrong
o If someone is suffering from delusions and believe they are meant to kill someone they believe to be a devil, should they be jailed or treated?
o Differences between not guilty by reason of insanity and not criminally responsible due to a mental disorder
 Term insanity replaced by mental disorder
 Defendant now considered not criminally responsible instead of not guilty
 Wrong actions legally or morally wrong

86
Q

Not fit to stand trial

A

o Conditionally discharged
o Detailed in hospital
o Ordered to receive treatment

87
Q

Fitness interview rest-revised

A

o Do they understand the nature of proceedings
o Do they understand the possible consequences of the proceedings
o Can they participate in their defence, e.g. communicate with lawyers

88
Q

duty to warn

A

o Client’s potential victims (Tarasoff)
o Limits to confidentiality: imminent harm to self or others, child abuse
o Risks to patient

89
Q

psychologists ethics to protect children

A
  • Boundary issues
    o Psychologists to avoid dual relationships
    o Psychologists should not exploit relationships with clients
  • Do not harm
    o Minimize harm to clients
  • Recognizing limits of competence
    o Practice within limits of competence
90
Q

rights of patients

A
  1. Right to treatment
    - Least restrictive setting possible
  2. Right to refuse treatment
    - Must be competent to make decision
    - Drugs side effects
    - E.g anti psychotics
    - Controversial
91
Q

the rights of research participants

A
  • Dignity of participants
  • Informed consent: lots of horrific tales of violation
    o Psychic driving put them in coma and play subliminal messages: “experimental treatment’ but patients thought they were part of care as usual
     No consent from these patietns family
92
Q

what is cluster B

A

dramatic, emotional, erratic

93
Q

what is cluster C

A

anxious, fearful

psy325 exam (1 decks)

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