Intro to Mental Psycholpathological Conditions Flashcards

Question

what are the factors that make up anxiety disorders?

Answer 1

focus on threatening events, content - overly vigilant when looking at cues "the doctor examined emma's growth" - measured height vs. looking for a cancerous tumor (interpret it in an anxious or threatening way) biological factors play role inhibited temperaments related to anxiety increased CNS activation related to panic disorders

Answer 2

after hyperventilating vs. after inhaling carbon dioxide panic disorder patients had a higher percentage reporting panic controls did not have a higher percentage of panic therefore... some are more prone to biological changes that cause panic attacks

Answer 3

for specific phobias, the sources of anxiety are better addressed with cognitive-behavioral approaches than with medication alone systematic desensitization uses "fear hierarchies" to help people learn to manage dimensions of fear 1. teach person skills to manage anxiety 2. expose them gradually to their fears 3. pair relaxed state and fear together \*it is a learning theory virtual treatments can help reduce fear

Answer 4

cognitive therapy: involves helping a client identify and correct any distorted thinking about self, others, or the world * cognitive resurecting - a therapeutic approach that teaches clients to question the automatic beliefs, assumptions, and predictions that often lead to negative thinking with more realistic and positive beliefs * mindfulness meditation - teaches an individual to be fully present in each moment, to be aware of his or her thoughts, feelings, and sensations; and to detect symptoms before they become a problem cognitive behavior therapy (CBT): a blend of cognitive and behavioral therapeutic strategies used for depression treatment and other disorders like skitzophrenia and bipolar disorder (not just anxiety disorders) questions asked - what is the worst thing that can happen? how would you manage that? - ask and provide skills/ restructure world skills

Answer 5

anxiety and stress - i have to get this done immediately, i must be perfect, something terrible will happen embarrassment and social anxiety - everyone is watching me, I won't be able to make friends, people know something is wrong with me sadness, depression - I'm a loser and will always be a loser, nobody will ever love me anger, irratibility - she did that to me on purpose, he is evil and should be punished, things ought to be different \*need self talk - what is actual rational? help rethink

Answer 6

SSRI's help social phobia BUT cognitive and behavioral methods are treatments of choice * serotonin is important in treatment for depression panic disorder treatments often combine medication and CBT, but relapse is less with CBT * CBT + impiramine provides best results \*learned component is more important because it helps manage anxiety in other situations - prevents future problems

Answer 7

OCD treatments blend medication and CBT with a focus on "exposure" and "response prevention" work through irrational thoughts - unlearning\* exposes them to fears prevents them from OCD like behaviors exposure and ritual prevention + clomipramine provide best result - CBT is important because there is a large learned piece (unlearn responses to change disorder)

Answer 8

yes they are linked over 70% of people with depression experience anxiety people with these disorders that have depression... panic - 20% phobia - 15% social phobia - 40% OCD - 10%

Answer 9

white males have highest risk followed by black men white women black women

Answer 10

suicide is the 11th leading cause of death in the US and the third among high school and college students 50% of those who commit suicide do so during a depressive state there are a variety of motive for suicide * may be biological * may be "contagious" (the werther effect) - once one person commits suicide it is seen as more attainable and therefore more people kill themselves * world view becoming very distorted due to depression prediction and prevention is difficult, however warning signs are abundant * hard to tell if someone seems fine externally but internally makes a commitment (sometimes people miss this cue)

Answer 11

profound persistent period of depression that exists for 2 or more weeks as indicated... * depressed mood * markedly diminished interest and pleasure * significant weight loss or weight gain * insomnia or hypersomnia * pyschomotor agitation (irratibility - can't sit still, very moody) or pyschmotor retardation (no energy to move in normal way) * fatigue or loss of memory * feelings of worthlessness and excessive guilt * diminshed ability to think, concentrate, and make decisions * recurrent thoughts of death or suicidal ideation deep, desperate, and empty - not rational but it is there belief/ reality at the time

Answer 12

she wrote "An Unquiet Mind" - has bipolar disorder herself "I felt as though only dying would release me from the overwhelming sense of inadequacy and blackness that surrounded me" "others imply that they know what it is like to be depressed because they have gone though a divorce, lost a job, or broken up with someone. But these experiences carry with them feelings. Depression, insteadm is a flat, hollow, and unendurable. It is also tiresome. People cannot abide being around you when you are depressed. Tehy might think they ought to, and they might even try, but you know and they know that you are tedious beyond belief; you're irritable and paranoid and humorless and lifeless and critical and demanding and no reassurance is ever enough"

Answer 13

hallmarks of psychosis: delusions and hallucinations lose contact with reality - "marked impairment in reality testing" presence of pyschotic features in mood disorders is seen in: * mood-congruent delusions: depressive delusions of utter worthlessness/ repulsiveness of self, manic delusions of grandeur, unlimited power and influence - extreme sense of worthlessness * hallucinations - typically auditory (manic/ match elevated sense of mood = skitzophrenia NOT depression - need to cure depression aspect of skitzophrenia)

Answer 14

dysthymic disorder or dysthymia (neurotic depression) chronic (2 years duration or more) "low grade" depression (doesn't meet criteria for "major depression" though still very serious/debilitating) indicated by 2 or more of the following... * poor appetite or overeating * insomnia or hypersomnia * low energy or fatigue * low self-esteem * poor concentration or difficulty making decisions * feelings of hopelessness same symptoms as a major depressive episode people are impaired in function BUT not as extremely - person still functioning and doing well but not happy

Answer 15

bipolar disorder includes depression and manic episodes - alternating moods most genetically based (need medications and passed down through families)

Answer 16

manic (elevated mood) and/or hypomanic episodes bipolar disorders (include depression) cyclothymia (hypomanic and no major depression)

Answer 17

she feels as if she has a "new energy and power" her boyfriend dumped her and she is kicked out of her house but she said that she would pray for him very excited and distracted easily - happy and unstable mood doesn't sleep - says she prays instead and has a "special mission" to live by says she never felt this way before discussion: not distressed, elevated happiness, delusions, scattered and very distractable diagnosis: manic with pyschotic features

Answer 18

manic mood episodes show as a distinct period of abnormally and persistently **elevated, expansive, and/or irritable mood indicated** by three or more of the following... * inflated self esteem or grandiosity - really confident and great * dcreassed need for sleep - don't feel they need it * more talkative than usual or pressure to keep talking - "i can't speak as fast as thoughts are going" (talk very fast) * flight of ideas or subjective experience that thoughts are racing - jump from thought to thought due to "fast mind" * distractibility (i.e. attention too easily drawn to unimportnat or irrelevant external stimuli) - very unfocused state * increase in goal-directed activity or pyschomotor agitation (period of time where they are very productive - have "artist's mind" * excessive involvement in pleasurable activities that have a high potential for painful consequences (i.e. unrestrained buying spress, sexual indiscretions, foolish business investments) mind is escalating - irrational actions due to elevated state extremely debilitating

Answer 19

* restless, consumed with confidence, energized * not as prone to the gloom following mania * "of course i live near the edge - the view is better" * "ill just tell them i had a lot of coffee" * "you never sleep too much, you are on" dr jamison wrote: "exuberance" book about this... * hypomanic statse generate bursts of creative work * but there can be problems... the view may be better on the edge, but it is easy to lose your balance *

Answer 20

feels great for people while in the initial state - *collapse* is the problem can only respond effectively from medications (even though many people reject them because it eliminates the "highs") - need to be kept at level state very biological/ genetic

Answer 21

bipolar 1: * Hx of manic episode(s) * Hx of depressive epidsode(s) - for most people bipolar 2: * Hx of hypomaic episodes * Hx of major depressive episode(s) * not at same level as bipolar 1 - not as happy

Answer 22

2-year duration of numerous alternating periods of hypomanic (low-level manic) symptoms and depressive symptoms (shy of major depressive episodes) cycling mood - not fully bipolar never diagnose if they have had a manic episode

Answer 23

present mental state can be principally a "manic episode" or a "mixed episode" or a "major depressive episode" \*diagnosis is "bipolar" as long as there has been a past history of mania specifically, if currently depressed with a history of manic episodes, the diagnosis becomes "bipolar disorder, depressed" the mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others or to necessitate hospitalization to prevent harm to self of others, or there are pyschotic features * note that this criterion distinguishs hypomanic episodes from manic episodes * in hypomanic episode there is NOT "marked impairment" and NOR are there ever "psychotic features" * in manic episodes there is always "marked impairment" and sometimes pyschotic features. thus the sx's are more severe, mroe interfering with adaptive functioning, in mania than in hypomania

Answer 24

alternation between modd states within an episode the special case of "rapid cycling" - going back and forth in a rapid manner - nonfunctioning until stabalized mood never goes back to normal - go to manic to depressed (back and forth)

Answer 25

hard for her to imagine manic states because she is so deep in her depression wants release does not more - both talking and physical movement (takes a lot of evergy for them to talk - physical slowing) - NO energy "people say I have this problem" - not convinced due to mood diagnosis: bipolar current episode: depressed (previous manic episodes)

Answer 26

this video example hovers near the thresholdfor diagnosis of "bipolar dispolar, manic with pyschotic features" (in this clip we see him during, then after the presence of a manic episode) man has hallucinations talks a lot and very fast - speaks mind and has inappropriate comments when on meds he speaks slower and makes more sense a lot more normal he has grandiose illusions but they aren't outside of reality - don't have form (instead heightened sense of hearing, more under control than latifa) chatoic and always says "i am brillient"

Answer 27

there is a wide variability between persons in the "course" of the disorder look at graphs... unipolar - no manic, goes from normal to depressed bipolar - spends less time in normal mood state if not using meds, fluctuates between manic, normal, and depressed

Answer 28

depression is caused by a combination of factors: combination, situational, and biological

Answer 29

twin studies show 4x higher rates in MZ twins medications targeting norephinephrine and serotonin modulate mood - suggests role of neurotransmitters * increasing serotonin or NE = improved mood * NE too high = manic heritability estimates for major depression range from 33% to 45% depression may involve NE and serotonin, and/or diminished activity in the left prefrontal cortex and increased activity in the right prefrontal cortex * more pesimistic = more prone to major depressive episode

Answer 30

diathesis-stress models predominate: * not doomed by genes... but genes important genetic predisposition data * MZ concordance: bipolar 72% (need meds) and unipolar disorder 40% * DZ concordance 14% and unipolar disorder 11%

Answer 31

unipolar: neurotransmitter deficiencies genetically regulated? bipolar disorders have a stong biological base * concordance in MZ twins exceeds 70% * genetic research suggests polygenic causation (multiple genes) * kay jamison is a champion of combining medication with pyschotherapy - diathesis stress model applies here (dealing with stressors)

Answer 32

further support for biological basis for depression develop depression with less sunlight - anxiety increases * body responds to loss of light * treatment: prototherapy (light) therapy increases light exposure

Answer 33

the negative reactions of others to depressed persons can produce rejection and isolation in a "downward spiral" * exercise and sleep decreases * people can't snap out of it because there is no way to elevate them out of it (no energy) social support may buffer and protect vulnerable persons * quality not quantity more stressful events = higher risk for experiencing major depression

Answer 34

noted dysfunctional attitudes and negative mood states in depressed individuals helpless theory: the idea that individuals who are prone to depression automatically attribute negative experiences to causes that are internal, stable, and global (more depressive due to depressive thoughts) depressed individuals tend to have depressive biases in thinking and memory * way they interpret things (continues to feel worse) * mindsets contribute to depression - affects mood and how we feel physcially

Answer 35

beck's "cognitive traid" focuses on negative and irrational views of self, present, and future as causes * distorted - makes them feel worse "errors in logic" magnify depressive negatively more vulnerable - pessimistic, self-blaming

Answer 36

genetic and non-genetic factors are influential as predisposing factors stress is influential as a precipitating/triggering factor, but who experiences stress (and thus who is most vulnerable) is influenced not only by objective MLE's and objective hassels, but also by cognitive and personality predispositions all filtered through us - personality traits strengths and weaknesses (resilliance)

Answer 37

pyschoanalytic theory behavioral theory cognitive and social learning theories

Answer 38

freud's pyschoanalysis/pyschodynamic theories humanistic-existential approaches * carl rogers - unconditional positive regard (unconditional love) - acceptance * abraham maslow - not meeting all needs to be all we can be - physcological stress behavioral, cognitive-behavioral, and cognitive approaches eclecticism, the trend toward time-limited, disorder-specific therapy * division 12 APA standard: "efficacious and specific therapy"

Answer 39

anger turned inwards: the punishing role of the harsh superego (punishing and judgemental) goal: insight, make the unconscious conscious, expand the ego's control how? * free association - talk about whatever comes to mind * analysis of transference - experiencing and interacting with therapists (building a good relationship) to help them understand who they are through their interactions with therapist * dream analysis

Answer 40

an insufficiency of contingencies of positive reinforcement goal: change behavioral responses to increase reinforcement of non-depressed behavior ex. exercising is very impotant in motivation (helps to motivate)

Answer 41

the basic idea: emotions and moods are caused by cognitive processes (perception, thinking, cognitive appraisal, underlying reasoning processes, etc) depression and depressive mood episodes result from irrational thinking, irrational beliefs, irrational cognitions * too hard on self - change to feel better and to be realistic about strengths and weaknesses seligman's ABC model

Answer 42

borrowed from ellis the ABC's... * adversity (what we do when we encounter it) * beliefs (thoughts become beliefs, habits) * consequences (beliefs cause behaviors, results) - reporting what happened learning to argue with yourself remember: if the cost of failure is high, optimism may not be the best strategy

Answer 43

expectations of uncontrollability (pessimistic cognitive styles) * bandura's "self efficacy": low motivation, low expectation for controlling pleasure and happiness (reinforcement), low effort Tx goal? alter expectations through exploring "rationality" of cognitions and altering behavior to change reinforcement probabilities

Answer 44

sees 3 fundamental distortions in rational processing * negative view of self * negative view of the world * negative view of the futre treatment - need to change these

Answer 45

ellis says a "musterbatory" cognitive style underlies human neurotic suffering "in order to be happy i must..." commands about how things should be we make ourselves miserable with our thinking. we disturb ourselves with "internal sentences" involving many "musts, shoulds, oughts, demands, commands" over expectation to world - "i must do well otherwise i am not good" ex. lost job - different orientations lead to different thoughts (i am worthless vs. i deserve better)

Answer 46

for seligman, beck, and ellis - emotional disorders (depression in particular) result from irrational distortions in the cognitive processing of events ABC = events don't cause depression (or anxiety, or emotional distress in general), thinking about events does ABCDE = given the cause (cognitive distortions), the treatment targets cognitive distortions through disputation/reappraisal adversity (appraise as adversity), belief, consequence, dispute, evaluate again

Answer 47

pyschotropic medications affect neurotransmitter processes anti-anxiety drugs affect GABA (neurotransmitter) depression drugs affect serotonin and NE anitpyschotic drugs affect dopamine

Answer 48

biological therapies are necessary for some disorders medications work in 60% of cases MAO inhibitors - inhibit enymatic deactivation of NE and 5-HT (serotonin) - more enzyme based and complicated side effects trycyclics - inhibit reuptake of NE SSRI's - mainly use these because they have fewer side affects

Answer 49

\*look at diagram message is sent across the synaptic gap message is received; excess neurotransmitter molecules are reabsorbed by sending neuron \*prozac blocks normal reuptake of the neurotransmitter serotonin; excess serotonin in synapse enhances its mood-lifting affect

Answer 50

MAO's inhibit the breakdown of NE, serotonin, and dopamine SSRI's block the reuptake of serotonin trcyclic antidepressants block the reuptake of serotonin and NE

Answer 51

NO pyschotherapty is focused on depressive thinking and behavior (CBT) * 60% efficacy in reducing acute symptoms * shows FAR greater efficacy in reducing relapse than meds alone

Answer 52

electroconvulsive therapy records heart rate, intravenous line is sedative and a muscle relaxant, measures blood-oxygen levels, measures muscle tension, stimulating electrodes record brain waves why does it work? * used in cases of severe depression (not responding to other meds) - bound and determined to kill themselves * don't know why it works * siezing person - controlled - some memory impairment * electro balance in the brain - rearranges? helps control? * brain chem - jump starts neurotransmitter funciton

Answer 53

SAD responds to phototherapy exercise helps depression too ECT is the single most effective treatment for severe depression - saves lives, negative public views notwithstanding

Answer 54

medication (almost always need meds): lithium carbonate has unique anti-manic properties with 80% positive response in actively manic patients (also reduces depressions) * used to stabalize but metal can be toxic ( negative side effects) * often do not like meds that take away pleasure adjunctive pyschotherapy for * medication management * family and social relationships - can create stressors, want to alleviate stress and prevent breakdowns * education * problem solving and "reality testing" - "voices aren't real" (shows delusions are NOT reality)

Answer 55

only 20% of bipolar patients who maintain their meds experience relapse lithium stablizes mood, but the mechanisms are unclear, and the effect is greater on mania than depression but many patients discontinue meds because of the "intoxicating pleasure" of manic states

Answer 56

treatments that focus on behavior and cognition are superior for anxiety disorders many effective treatments are available for depression lithuim is most effective for bipolar disorder pharmacological treatments are superior for schizophrenia 60-70% respond to meds (MAO, SSRI, tricyclides) CBT is the BEST - provides skills to alter behavior, have skills when episode happens to prevent disorder

Answer 57

pyschotherapy helps, and common underlying factors contribute to all pyschological approaches: * caring therapists - empathy and support * catharsis and "confession" - theraputic in that they confess concerns and things that they are ashamed about