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Flashcards in Final Exam Deck (86):
1

Phillippe Pinel

reformed how the mentally ill were treated
emphasized improving environment, treating patents with dignity
environmental factors are a cause of disorders!

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psychopathology

illness of the mind
disorders need to be diagnosed so people can be treated

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psychological disorder

clinically significant disturbance in an individual's cognition, emotional regulation, or behavior
dysfunctional and/or maladaptive

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pattern

a colleciton of symptoms that tend to go together

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distress and dysfunction

interference by a disorder with daily life and well-being

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deviant

differing from the norm, developmentally or culturally

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Why classify disorders?

1. predict future course of disorder
2. suggest appropriate treatment
3. prompt research into causes

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ADHD

6 or more symptoms of inattention/hyperactivity for children up to 16
5 or more symptoms for adults
symptoms present for >6 months and inappropriate for developmental level

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3 presentations of ADHD

combined: both inattention and hyperactivity-impulsivity
predominantly inattentive
predominantly hyperactive-impulsive

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DSM

diagnostic and statistical manual
DSM-V is current, used to diagnose disorders
used to justify payment for treatment

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criticisms of DSM diagnosis

calls many people "disordered"
classification can be arbitrary
labels direct how we view and interpret the world (self-fulfilling prophecies) and how we are treated by others

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anxiety disorder

distressing, persistent anxiety and the dysfunctional behaviors that reduce anxiety

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what makes anxiety a disorder?

distressing: constant anxiety
maladaptive coping responses
impairing: social, academic, occupational

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generalized anxiety disorder (GAD)

continually tense, apprehensive, and in a state of autonomic nervous system arousal
difficult to control worry, across a range of activities
emotional/cognitive symptoms: worrying, anxious anticipation interfering with concentration
physical symptoms: autonomic arousal, trembling, sweating, bad sleep

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panic disorder

repeated, unexpected, and recurrent panic attacks as well as fear of the next attack
change in behavior to avoid attacks

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panic attack

minutes of extreme dread or terror
chest pains, choking, numbness
need to escape

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phobias

persistent, irrational fear and avoidance of a specific object, activity, or situation
out of proportion to actual danger, avoidance of triggers
6 months or more

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obsessive compulsive disorder

unwanted repetitive thoughts (obsessions), actions (compulsions) or both
often "rechecking"

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obsessions

thoughts, urges, or images that are experienced as intrusive and unwanted

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compulsions

repetitive behaviors or mental acts that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly

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posttraumatic stress disorder

experience of a traumatic event, followed by:
intrusive symptoms, avoidance behaviors, negative changes in thoughts and mood, hyperarousal
at least 1 month

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trauma

exposure to actual or threatened death, serious injury, or sexual violence
direct experience, witnessing, knowledge of it happening to family or friend, repeated/extreme exposure to details of trauma
form powerful associations in amygdala

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anxiety and genetics

identical twins develop similar phobias
genes regulate levels of neurotransmitters (serotonin, glutamate)
evolutionary?

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ACC

anterior cingulate gyrus
monitors actions and checks for errors
high activity in OCD brains

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disorder explanatations

classical conditioning: overgeneralizing a conditioned response
operant conditioning: rewarding avoidance
observational learning: worrying like mom

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observational learning

fears get passed down in families
when fear/avoidance is observed, it can be learned

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reconsolidation

memory is "reactivated" then must be resolidified in long-term memory
following reactivation, memory is vulnerable to disruption
possible treatment for phobias

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treatment for anxiety

anxiolytics like benzodiazepines
enhance effect of GABA at GABA-A receptor
effective during short term

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depression

the "common cold" of mental disorders
#1 reason people seek mental health services
must be distressing or dysfunctional

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major depressive disorder

MDD
depressed mood most of day, less interest/pleasure in activities
fatigue, sleep issues, worthlessness, thoughts of suicide
must last over 2 weeks
treatment not always needed

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seasonal affective disorder

seasonal pattern of depression brought on by dark, cold days of winter
crying survey b/t august and december

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bipolar disorder

"manic-depressive"
bouts of depression offset by periods of mania, energetic, euphoric, and hyperactive mood

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disruptive mood dysregulation disorder

similar to bipolar disorder but more commonly diagnosed in children
cycles of depression and rage instead of mania

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Who is more susceptible to depression?

Women

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evolutionary perspective on depression

mild, non-disordered depression may have survival value
"social-emotional hibernation" under stress that allows us to conserve energy, avoid conflicts, take time to think

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brain biology in depression

brain activity diminished
frontal lobes smaller
less norepinephrine and reduced serotonin
drugs try to restore NT levels, exercise, diet

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antidepressants

SSRIs or SNRIs (serotonin norepinephrine reuptake inhibitors
block reuptake, increase NT levels at synapse

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depressive explanatory style

mood predicted by how we analyze bad news
stable, internal, global problems instead of temp, external, specific

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suicide

at greatest risk when rebounding from depression
women more likely to attempt, men more likely to complete
public suicides increase rates

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NSSI

non-suicidal self injury
used to deal with distress, cry for help
usually does not lead to suicide
peaks at 14-19 and for females
relieves guilt, distraction

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schizophrenia

"split from reality"
negative, cognitive, then positive symptoms appear over 3-5 years
both genetic and environmental factors

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schizophrenia symptoms

+ symptoms: hallucinations, delusions, thought disorders
- symptoms: flattened emotions, speechlessness, lack of initiative, social withdrawal
cognitive symptoms: poor attention span, motor speed, learning, memory, abstract thinking, problem solving

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courses of schizophrenia

acute/reactive: some people develop + symptoms like hallucinations in response to stress, recovery is likely
chronic/progressive: develops slowly, more - symptoms like flat affect, treatment can improve but recovery is doubtful

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susceptibility hypothesis

there is a gene for schizophrenia but it must be activated by the environment
identical vs. fraternal twins and their children

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dopamine hypothesis

positive symptoms caused by overactivity of dopaminergic synapses
mesolimbic dopaminergic pathway involved in reward system is affected, hard to follow orderly thought sequences
increased activity to amygdala

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hypofrontality

decrease in dopaminergic activity in prefrontal cortex leads to - and cognitive symptoms

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dissociation

a separation of conscious awareness from thoughts, memory, bodily sensations, feelings, or even from identity
psychological escape from stress

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dissociative disorder

dysfunction and distress caused by chronic and severe dissociation

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dissociative identity disorder

multiple personality disorder
personalities are distinct, not conscious at same time, may or may not be aware of each other
debate over biological vs. cultural/societal explanations

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personality disorders

eccentric/odd: schizophrenic - symptoms
dramatic: attention-seeking, narcissistic, amoral, antisocial
anxious: avoidant personality, ruled by fear of social rejection

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antisocial personality disorder

borderline/histrionic
total lack of empathy or conscience
may be aggressive and ruthless or intelligent
irresponsible, does not conform to social norms, deceitful

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biosocial roots of crime

murderers seem to have: less tissue/activity in brain area that suppresses impulses
less amygdala response to violence
overactive dopamine

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eating disorders

extremely prevalent even among kids
unrealistic body image, desire to control food when other things can't be controlled, depression cycles, health issues

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anorexia nervosa

when someone maintains starvation diet despite being extremely underweight
results in many health issues, high mortality rate

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bulimia nervosa

vicious cycle of strict diet, craving and binge eating, then purging and shame

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psychotherapy

interaction with a trained professional, working on understanding and changing behavior, thinking, relationships, and emotions

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eclectic

treatment from various forms of therapy

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eating disorder contributors

cultural ideals of body appearance
mother focused on her and child's weight
negative self-evaluation in the family
competitiveness/protectiveness for anorexia
childhood obesity for bulemia

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humanistic therapy

Carl Rogers, person-centered therapy
is non-directive, genuine, accepting, unconditional positive regard, empathetic, active listening
help people gain self-awareness and acceptance, support personal growth

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behavioral therapies

uses learning and classical/operant conditioning to reduce unwanted responses
exposure therapy

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exposure therapy

reverses reinforcement of conditioned fear avoidance behaviors by waiting for anxiety to subside during exposure
systematic desensitization: continuously increasing exposure intensity as patient tolerates lower levels
virtual reality therapy: simulating fears

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aversion therapy

exposure to stimulus that typically elicits problematic positive response, while simultaneously introducing discomfort
adding nausea drug to booze to associate alcohol with nausea

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operant conditioning therapy

behavior modification: shaping a chosen behavior to look more like a desired behavior
desired behaviors rewarded
problematic behaviors unrewarded or punished

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cognitive therapy

helps alter negative thinking that worsens symptoms
seeks to improve explanatory style for depressive causes (internal vs. external attribution)
changes irrational, self-defeating thinking

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cognitive therapy for depression

Aaron Beck
correcting cognitive distortions, self blame, overgeneralizing

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cognitive behavioral therapy

combines cognitive and behavioral therapy, most commonly used type of therapy

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family therapy

allows therapist to work on family system
related to couples/marital therapy

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client outcomes of therapy

people often enter in crisis, need to believe it worked
generally speak kindly of their therapists
most feel better when leaving than when they enter

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therapist outcomes of therapy

therapists hear praise from successes but little from those whose problems return
one client may be a success in multiple therapists' files

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evidence-based practice

using outcome research and clinical expertise to select therapeutic interventions
based on clinical expertise, research, patient's values/preferences/circumstances

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EMDR

eye movement desensitization and reprocessing
client recalls trauma while therapist waves finger or light in front of their eyes
effectiveness does not depend on eye movement technique

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light exposure therapy

daily exposure to bright light (esp. blue) as treatment for SAD

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What might make psychotherapy effective?

Hope for demoralized people, a new perspective, an empathetic, trusting, caring relationship

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psychologists

PhD, PsyD
therapy, intelligence and personality testing

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psychiatrists

MD, DO
psychotherapy and medicine

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social workers

MSW
counselors, nurses, and other professionals that can diagnose and treat mental disorders

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biomedical therapies

change the brain's electrochemical state with psychotropic drugs, magnetic impulses, electrical currents, or surgery

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psychopharmacology

study of the effects of drugs on mind and behavior

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antipsychotic

competitive dopamine antagonist
reduce positive symptoms like hallucinations, delusions
obesity, diabetes, movement problems

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antianxiety drugs

GABA agonist
temporarily reduces worried thinking and physical agitation, can permanently erase trauma associations
slows nervous system activity in body and brain
slowed thinking, reduced learning, dependence

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antidepressant

improves mood/control over depressing and anxious thoughts
SSRI/SNRI (serotonin, norepinephrine), possible neurogenesis
dry mouth, constipation, reduced libido

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mood stabilizers

reduce the highs of mania and the depressive lows
must measure blood levels
mechanism unknown
lithium

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ADHD stimulants

control impulses, reduce distractability and need for stimulation
block dopamine reuptake
decreased appetite

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electroconvulsive therapy

gentle anesthetic, muscle relaxant
30-60 secs of mild current resulting in mild seizure
some memory loss, no brain damage
can be very effective but relapse not uncommon

85

RTMS

repeated transcranial magnetic stimulation
magnetic coil stimulates targeted brain regions via magnetic pulses
may lead to formation of new neural connections
increase activity in left frontal lobe?

86

deep brain stimulation

implanted electrode delivers periodic stimulation like pacemaker
targets bridge between frontal lobes and limbic system