MCAT Psych #7 Flashcards
(139 cards)
1
Q
psychological disorders
A
characteristic sets of thoughts, feelings, or actions, that cause noticeable distress to the sufferer, cause maladaptive functioning in society, or are considered deviant by the individual’s culture.
2
Q
biomedical approach
A
Interventions that rally around symptom reduction
Does not take into account lifestyle or socioeconomic status.
Best when it is supplemented with a broader approach such as biopsychosocial approach
Not great because it labels people as mentally ill just because their behaviors differ from society’s
3
Q
Biopsychosocial approach
A
Assumes that there are biological, psychological, and social components to an individual’s disorder.
Bio: something in the body such as a genetic syndrome
Psych: individual’s thoughts, emotions, or behaviors
Social: individual’s surroundings, issues of perceived class in society and even discrimination or stigmatization.
Ex: depression
• Certain bio factors make you more or less susceptible
• Level of stress the individual has also plays a role.
• Social environment factors can either provide more stress or support
Provide direct therapy: treatment that acts directly on the individual such as medicine or meeting with a psychologist.
And indirect therapy: aims to increase social support by educating and empowering family and friends of the affected individual.
4
Q
Biopsychosocial approach: direct therapy
A
treatment that acts directly on the individual such as medicine or meeting with a psychologist.
5
Q
Biopsychosocial approach: indirect therapy
A
aims to increase social support by educating and empowering family and friends of the affected individual.
6
Q
what is the name of the manual created to aid clinicians in diagnosing psychological disorders and what version is it on now?
A
o Diagnostic and Statistical Manual of Mental Disorders (DSM): created to aid clinicians
Now in its 5th edition DSM-5
Classification scheme is based on symptoms.
7
Q
downward drift hypothesis
A
schizophrenia causes decrease in SES which causes worse symptoms and downward spiral.
8
Q
schizophrenia
A
psychotic disorder, individual must show continuous signs of disturbance for at least six months and this six-month period must include at least one month of “active symptoms” (delusions, hallucinations, disorganized speech)
9
Q
psychotic disorder
A
suffer from one or more of the following conditions: delusions, hallucinations, disorganized thought, disorganized behavior, catatonia (abnormality of movement and behavior), and negative symptoms.
10
Q
positive symptoms of schiziphrenia
A
behaviors, thoughts, or feelings added to normal behavior.
delusions, hallucinations, disorganized thought, disorganized behavior
11
Q
hallucinations
A
positive symptoms of schiziphrenia
perceptions that are not due to external stimuli but have a compelling sense of reality.
• Ex: auditory, hearing voices. Other sensation hallucinations are possible but are rare.
12
Q
disorganized thought
A
positive symptoms of schiziphrenia
characterized by loosening of associations. May be exhibited in speech in which one’s sentences have no structure and go all over the place.
• Word salad: random words thrown together
• Neologisms: invention of new word
13
Q
disorganized behavior
A
positive symptoms of schiziphrenia
an inability to carry out activities of daily living, such as paying bills, maintaining hygiene, and keeping appointments.
• Catatonia: refers to certain motor behaviors characteristic of schizophrenia
o Spontaneous movement and activity reduced
o OR: bizarre movements not caused by external stimuli such as:
Echolalia: repeating another’s word
Echopraxia: imitating another’s actions
14
Q
delusions of reference
A
involve the belief that common elements in the environment are directed toward the individual
o Characters in a TV show are talking to you
15
Q
delusions of persecution
A
involve the belief that the person is being deliberately interfered with, discriminated against, plotted against, or threatened.
16
Q
delusions of grandueur
A
(also common in bipolar disorder) involve the belief that the person is remarkable in some significant way, such as being an inventor, historical figure, etc.
17
Q
thought broadcasting
A
delusions
the belief that one’s thoughts are broadcast directly from one’s head to the external world
18
Q
thought insertion
A
delusions
the belief that thoughts are being placed in one’ head
19
Q
word salad
A
disorganized thought
random words thrown together
20
Q
loosening of associations
A
disorganized thought
a thought disorder characterized by discourse consisting of a sequence of unrelated or only remotely related ideas
21
Q
neologisms
A
disorganized thought
invention of new word
22
Q
catatonia
A
refers to certain motor behaviors characteristic of schizophrenia
o Spontaneous movement and activity reduced
o OR: bizarre movements not caused by external stimuli:
Echolalia: repeating another’s word
Echopraxia: imitating another’s actions
23
Q
echolalia
A
repeating another’s word
24
Q
echopraxia
A
imitating another’s actions
25
negative symptoms of schizophrenia
those that involve the absence of normal or desired behavior
disturbance of affect and avolition
26
disturbance of affect
negative symptom
• Affect: refers to the experience and display of emotion.
• Blunting: there is a sever reduction in the intensity of affect expression.
• Flat affect (emotional flattening): virtually no signs of emotional expression
• Inappropriate affect: the affect is clearly discordant with the content of the individual’s speech
o Ex: laughing when describing someone’s death
27
avolition
negative symptoms
disturbance of avolition
decreased engagement in purposeful, goal-directed actions
28
affect
disturbance of effect
| refers to the experience and display of emotion.
29
blunting
disturbance of effect
| there is a sever reduction in the intensity of affect expression.
30
flat affect (emotional flattening)
disturbance of effect
| virtually no signs of emotional expression
31
inappropriate affect
disturbance of effect
the affect is clearly discordant with the content of the individual’s speech
o Ex: laughing when describing someone’s death
32
prodromal phase
before schizophrenia, the patient undergoes a phase of poor adjustment:
Exemplified by clear evidence of deterioration, social withdrawal, role functioning impairment, peculiar behavior, inappropriate affect, and unusual experiences.
Better prognosis if the prodromal phase is fast.
33
major depressive disorder
a mood disorder, characterized by at least one major depressive episode.
34
major depressive epsiode
period of at least two weeks with at least five of the following symptoms: prominent and relatively persistent depressed mood, loss of interest in all or almost all formerly enjoyable activities (anhedonia), appetite disturbances, substantial weight changes, sleep disturbances, decreased energy, feelings of worthlessness or excessive guilt, difficulty concentrating or thinking, psychomotor symptoms (feeling slowed down), and thoughts of death or attempts at suicide.
• At least one of the symptoms must be depressed mood or anhedonia.
```
Symptoms of a major depressive episode:
SIG E CAPS
Sadness +
Sleep
Interest
Guilt
Energy
Concentration
Appetite
Psychomotor symptoms
Suicidal thoughts
```
35
what are the symptoms of a major depressive episode
```
Symptoms of a major depressive episode:
SIG E CAPS
Sadness +
Sleep
Interest
Guilt
Energy
Concentration
Appetite
Psychomotor symptoms
Suicidal thoughts
```
36
what are the two MUST symptoms of a major depressive episode (must be one of the two)
1. anhedonia (loss of interest in all or almost all formerly enjoyable activities)
2. depressed mood
37
anhedonia
symptom of major depressive episode: loss of interest in all or almost all formerly enjoyable activities
38
Persistent depressive disorder
individuals who suffer from dysthymia: a depressed mood that isn’t severe enough to meet the criteria of a major depressive episode, for at least two years.
Chronic but less severe than major depressive disorder
39
Seasonal Affective Disorder
major depressive disorder with seasonal onset.
| Treated with bright light therapy
40
bipolar disorder
major type of mood disorder characterized by both depression and mania
manic episodes
Bipolar I disorder
Bipolar II disorder
41
cyclothymic disorder
consists of a combination of hypomanic episodes and periods of dysthymia that are not sever enough to qualify as major depressive episodes.
42
dysthymia
persistent mild depression.
43
manic episodes
characterized by abnormal and persistently elevated mood lasting at least one week with at least three of the following: increased distractibility, decreased need for sleep, inflated self-esteem or grandiosity (beliefs that one is almighty, celebrity), racing thoughts, increased goal-directed activity or agitation, pressured speech or increased talkativeness, and involvement in high risk behavior.
• Generally, a more rapid onset and briefer duration than depressive episodes.
44
bipolar I disorder
has manic episodes with or without major depressive episodes.
45
bipolar II disorder
has hypomania with at least one major depressive episode.
hypomania: typically does not significantly impair functioning, nor are there psychotic features, although the individual may be more energetic and optimistic.
46
list the symptoms of manic episodes
```
DIG FAST
Distractible
Insomnia
Grandiosity
Flight of ideas (racing thoughts)
Agitation
Speech (pressured)
Thoughtlessness (risky behavior)
```
47
what must clinicians rule out for all anxiety disorders?
For all anxiety disorders, clinicians must rule out hyperthyroidism—excessive levels of specific thyroid hormones—because increasing the whole body’s metabolic rate will create anxiety-like symptoms.
48
hypomania
part of Bipolar II disorder
typically does not significantly impair functioning, nor are there psychotic features, although the individual may be more energetic and optimistic.
49
is Bipolar II or Bipolar I more severe?
Bipolar I
50
monoamine or catecholamine theory of depression
too much norepinephrine and serotonin in the synapse leads to mania, while too little leads to depression.
51
what are the highest mood disorders for women?
anxiety disorders
52
what are the highest mood disorders for women?
anxiety disorders
53
generalized anxiety disorder
common in the population and is defined as a disproportionate and persistent worry about many things for at least six months (making mortgage payments, doing a good job at work)
also have physical symptoms that accompany the worry: fatigue, muscle tension, sleep problems
54
phobia
an irrational fear of something that results in a compelling desire to avoid it.
Specific phobias: one in which anxiety is produced by a specific object or situation
• Ex: claustrophobia: an irrational fear of closed spaces
55
specific phobia
one in which anxiety is produced by a specific object or situation
• Ex: claustrophobia: an irrational fear of closed spaces
56
agoraphobia
an anxiety disorder characterized by a fear of being in places or in situations where it might be hard for an individual to escape.
Hard to leave the house for fear of a panic attack or exacerbation of another mental illness.
57
panic disorder
repeated panic attacks
Symptoms of a Panic attack: fear and apprehension, trembling, sweating, hyperventilation, and a sense of unreality.
Excess activation of the sympathetic nervous system.
58
what are the symptoms of a panic attack
fear and apprehension, trembling, sweating, hyperventilation, and a sense of unreality.
59
Obsessive compulsive disorder (OCD)
characterized by obsessions (persistent, intrusive thoughts and impulses), which produce tension, and compulsions, (repetitive tasks) that relieve tension but cause significant impairment to a person’s life.
OCD about dirt, always washing hands.
60
Body Dysmorphic Disorder
a person has an unrealistic negative evaluation of his or her personal appearance and attractiveness, usually directed toward a certain body part.
Affects day to day life and the sufferer might seek medical advice to change it.
61
Post-Traumatic Stress Disorder
occurs after experiencing or witnessing a traumatic event, such as a war, a home invasion, rape, or a natural disaster, and consists of intrusion symptoms, avoidance symptoms, negative cognitive symptoms, and arousal symptoms.
62
intrusion symptoms
PTSD
| recurrent reliving of the event, flashbacks, nightmares, and prolonged distress.
63
avoidance symptoms
PTSD
| deliberate attempts to avoid the memories, people, places, activities, and objects associated with the trauma.
64
negative cognitive symptoms
PTSD
an inability to recall key features of the event, negative mood or emotions, feeling distanced from others, and a persistent negative view of the world.
65
arousal symptoms
PTSD
| an increased startle response, irritability, anxiety, self-destructive or reckless behavior, and sleep disturbances.
66
acute stress disorder
if the same symptoms from PTSD last for less than one month but more than three days.
intrusion symptoms, avoidance symptoms, negative cognitive symptoms, and arousal symptoms.
67
dissociative disorders
the person avoids stress by escaping from their identity. Person still has an intact sense of reality.
Dissociative amnesia, dissociative identity disorder (DID), Depersonalization/derealization disorder
68
dissociative amnesia
dissociative disorders
characterized by an inability to recall past experiences
Not linked to a neurological disorder but rather to trauma
Dissociative fugue: a sudden, unexpected move or purposeless wandering away from one’s home or location of usual daily activities
• Get confused about their identity and possibly even take on another identity.
69
dissociative identity disorder
dissociative disorders
(DID, multiple personality disorder): there are two or more personalities that recurrently take control of a person’s behavior.
The components of identity fail to integrate.
Usually these people have suffered severe physical or sexual abuse as young children.
70
personalization/derealization disorder
dissociative disorders
individuals feel detached from their own mind and body (depersonalization, out of body experience) or from their surroundings (derealization, giving the world a dreamlike or insubstantial quality).
71
dissociative fugue
a sudden, unexpected move or purposeless wandering away from one’s home or location of usual daily activities
• When in a fugue state, can get confused about their identity and possibly even take on another identity.
72
somatic disorders
diagnoses are marked by somatic (bodily) symptoms that cause significant stress or impairment.
somatic symptom disorder, illness anxiety disorder, conversion disorder
73
somatic symptom disorder
somatic disorders
individuals have at least one somatic symptom, which may or may not be linked to an underlying medical condition, and that is accompanied by disproportionate concerns about its seriousness, devotion of an excessive amount of time and energy to it, or elevated levels of anxiety.
74
illness anxiety disorder
somatic disorders
characterized by being consumed with thoughts about having or developing a serious medical condition.
Always checking themselves for signs of illness OR avoid medical appointments.
75
conversion disorder
somatic disorders
characterized by unexplained symptoms affecting voluntary motor or sensory functions.
The symptoms develop after high levels of stress or a traumatic event, but may not appear immediately.
Woman going blind after watching her son die.
La belle indifference: when someone is unconcerned by a developing symptom.
76
la belle indifference
somatic disorder
conversion disorder
when someone is unconcerned by a developing symptom.
77
personality disorder
a pattern of behavior that is inflexible and maladaptive, causing distress or impaired functioning in at least two of the following: cognition, emotions, interpersonal functioning, or impulse control.
78
ego-syntonic
personality disorder
the individual perceives her behavior as correct, normal, or in harmony with her goals.
79
ego-dystonic
the individual sees the illness as something thrust upon her that is intrusive and bothersome.
80
general personality disorder
generally, a pattern of behavior that is inflexible and maladaptive, causing distress or impaired functioning in at least two of the following: cognition, emotions, interpersonal functioning, or impulse control.
81
cluster A of personality disorders
```
personality disorder
all marked by behavior that is labeled as odd or eccentric by others
1. paranoid
2. schizotypal
3. schizoid
```
82
cluster B of personality disorders
```
personality disorder
all marked by behavior that is labelled as dramatic, emotional, or erratic by others.
1. antisocial
2. borderline
3. histrionic
4. narcissistic
```
83
cluster C of personality disorders
```
personality disorder
all marked by behavior that is labeled as anxious or fearful by others
1. avoidant
2. dependent
3. obsessive-compulsive
```
84
paranoid personality disorder
cluster A
| pervasive distrust of others and suspicion regarding their motives.
85
schizotypal personality disorder
cluster A
a pattern of odd or eccentric thinking.
• Ideas of reference: similar to delusions of reference, but not as extreme
• Magical thinking: superstitiousness or a belief in clairvoyance (perceiving things in the future or beyond possibility).
86
schizoid personality disorder
cluster A
| a pervasive pattern of detachment from social relationships and a restricted range of emotional expression.
87
antisocial personality disorder
cluster B
a pattern of disregard for and violations of the rights of others
• Repeated illegal acts, people in prison, no remorse for their actions.
3x more common in males
88
borderline personality disorder
cluster B
pervasive instability in interpersonal behavior, mood, and self-image.
• May use splitting as a defense mechanism, view others as either all good or all bad.
Suicide attempts and self mutilation are common
fear of abandonment
2x more common in females
89
histrionic personality disorder
cluster B
| constant attention seeking behavior. Extroverted. May use seductive behavior to gain attention.
90
narcissistic personality disorder
cluster B
one has a grandiose sense of self-importance or uniqueness, preoccupation with fantasies of success, a need for constant admiration and attention, and characteristic disturbances in interpersonal relationships such as feelings of entitlement.
• Want to be viewed favorably by others.
fragile self esteem and constantly concerned with how others view them. May be marked with feelings of rage, inferiority, shame or humiliation if they feel not favorable view by others
91
splitting
borderline personality disorder
defense mechanism, view others as either all good or all bad.
92
avoidant personality disorder
cluster C
| : the affected individual has extreme shyness and fear of rejection.
93
dependent personality disorder
cluster C
continuous need for reassurance.
• Dependent on one person to take action or make decisions.
94
obsessive-compulsive personality disorder
cluster C
the individual is perfectionistic and inflexible, tending to like rules and order.
• Ego-syntonic
• Lifelong
95
biological causes of schizophrenia
o Most causes are genetic but trauma at birth, especially hypoxemia (low oxygen concentrations in the blood) is also considered a risk factor.
o Inherited
o Marijuana use as an adolescent is a risk factor.
o Highly associated with an excess of dopamine in the brain
Neuroleptics (antipscyhotic): block dopamine receptors
96
biological causes of depression
Abnormally high glucose metabolism in the amygdala
Hippocampal atrophy after a long duration of illness
Abnormally high levels of cortisol
Decreased norepinephrine, serotonin, and dopamine
97
biological causes of bipolar disorders
Increased norepinephrine and serotonin
Higher risk if parent has bipolar disorder
Higher risk for persons with multiple sclerosis.
98
biological causes of Alzheimer's disease
a type of dementia characterized by gradual memory loss, disorientation to time and place, problems with abstract thought, and a tendency to misplace things.
o Later in the stage of the disease: changes in mood or behavior, changes in personality, difficulty with procedural memory, poor judgement, and loss of initiative.
o If have all, definitely Alzheimer’s
o Most common in older patients
o Family history is a significant risk factor
o Large genetic component involved in Alzheimer’s
o Some biological markers:
Diffuse atrophy of the brain on CT or MRI
Flattened sulci in the cerebral cortex
Enlarged cerebral ventricles
Deficient blood flow in parietal lobes, which is correlated with cognitive decline
Reduction in levels of acetylcholine
Reduction in choline acetyltransferase, the enzyme that produces acetylcholine
Reduced metabolism in temporal and parietal lobes
Senile plaques of beta-amyloid (a misfolded protein in Beta pleated sheet form
Neurofibrillary tangles of hyperphosphorylated tau protein
99
biological causes of Parkinson's disease
characterized by bradykinesia (slowness in movement), resting tremor (a tremor that appears when muscles are not being used), pill-rolling tremor (flexing and extending the fingers while moving the thumb back and forth, as if rolling something in the fingers), masklike facies (a facial expression consisting of static and expressionless facial features, staring eyes, and partially opened mouth), cogwheel rigidity (muscle tension that intermittently halts movement as an examiner attempts to manipulate the thumb), and a shuffling gait with stooped posture.
o Some common symptoms: depression and dementia.
o Biological
Decreased dopamine production in the substantia nigra, a layer of cells in the brain that functions to produce dopamine to permit proper functioning of the basal ganglia.
• Basal ganglia is responsible for initiating and terminating movements as well as repetitive motor tasks and smoothening motions.
Treatment: with L-DOPA, a precursor converted to dopamine once in the brain.
100
what does the biomedical approach fail to take into account?
lifestyle and socioeconomic status
ex: heart disease has just as much to do with the actual disease of the heart as it does with lifestyle choices such as smoking and diet.
101
what 3 aspects of a person are considered in the biopsychosocial approach of diagnosis and treatment and what is incorporated into each aspect?
bio: something in the body, genetic
psychological: how we think, feel and act
social: results from the individual's surroundings (environment, social class, discrimination)
102
what are the two dimensions of positive symptoms
psychotic dimension: delusions and hallucinations
| disorganized dimension: disorganized thought and behavior
103
anhedonia
loss of interest in all or almost all formerly enjoyable activities
104
True or False: an individual with major depressive disorder can also be diagnosed with persistent depressive disorder?
true, when it lasts a long time.
105
seasonal affective disorder is best categorized as _____ with seasonal onset rather than being its own diagnosis
major depressive disorder
106
what is seasonal affective disorder treated with?
bright light therapy
107
what is the most common psychiatric disorder in women and men of all ages?
women: anxiety disorder
men: substance use disorder
108
social anxiety disorder
characterized by anxiety that is due to social situations.
Ex: persistent fear when exposed to social or performance situations that may result in embarrassment (public restroom, speech, socializing at a party)
109
panic disorder is frequently accompanied by _____ because of the pervasive fear of having a panic attack in a public location
agoraphobia
110
a large portion of the symptoms for panic disorder are caused by excess activation of the _____
sympathetic nervous system
111
what are the obsessions in OCD
persistent, intrusive thoughts and impulses which produce tension
112
what are the compulsions in OCD
repetitive tasks to relive tension but cause significant impairment in a person's life
113
what are the 4 symptoms associated with PTSD?
intrusion, avoidance, negative cognitive, and arousal
114
when is PTSD diagnosed as acute stress disorder instead?
when PTSD symptoms last more than 3 days but less than a month
115
is the somatic symptom in somatic symptom disorder linked to an underlying medical condition?
may or may not be
116
personality disorder leads to impairment in at least two of what functionalities?
cognition, emotions, interpersonal functioning, or impulse control.
117
clairvoyance
people with schizotypal personality disorder might have this
the supposed faculty of perceiving things or events in the future or beyond normal sensory contact
118
what is splitting and when is it used?
used to classify people as either all good or all bad and used as a defense mechanism in borderline personality disorder
119
are schizotypal or schizoid personality disorders the same as schizophrenia
no
120
compare OCD and OCPD
OCD: obsessions and compulsions that are focal and acquired. Ego-dystonic (I can't stop washing my hands because of the germs)
OCPD: lifelong. Ego-syntonic (I just like rules and order)
121
what symptoms is antipsychotic medication for schizophrenia likely to help with?
positive symptoms
122
does major depressive disorder have manic episodes?
no
123
Ex: person checks latch on door 5 times before going to sleep in fear of someone breaking in. What is the obsession and what is the compulsion
obsession: someone will break in
compulsion: checking the latch
124
what do neuroleptics do?
block dopamine receptors
125
compare seretonin and norepinerphrine levels in individuals suffering from depression and bipolar disorders?
depression: low
bipolar: high
126
Alzheimer's disease
a type of dementia characterized by gradual memory loss, disorientation to time and place, problems with abstract thought, and a tendency to misplace things.
Later in the stage of the disease: changes in mood or behavior, changes in personality, difficulty with procedural memory, poor judgement, and loss of initiative.
127
bradykinesia
Parkinson's
| slowness in movement
128
resting tremor
Parkinson's
| a tremor that appears when muscles are not being used
129
pill-rolling tremor
Parkinson's
| flexing and extending the fingers while moving the thumb back and forth
130
masklike facies
Parkinson's
| a facial expression consisting of static and expressionless facial features, staring eyes, and partially open mouth
131
cogwheel rigidity
Parkinson's
| muscle tension that intermittently halts movement as an examiner attempts to manipulate a limb
132
which hormone and neurotransmitter concentrations are elevated and reduced in depression?
reduced: dopamine, seretonin, norepinephrine
elevated: cortisol
133
what mutations are associated with alzheimer's
mutations in the presenilin genes (chromosomes 1 and 14) and Beta-amyloid precursor protein gene (chromosome 21)
134
why might medication that treats schizophrenia lead to Parkinson's disease like symptoms
both deal with dopamine levels. Reducing dopamine levels in a schizophrenic patient might reduce them to the point of exhibiting Parkinson's-disease-like characteristics.
135
how do you differentiate between major depressive disorder and bipolar disorder?
ask about manic episodes
| bipolar disorder features major depressive episodes but major depressive disorder does not feature manic episodes.
136
exhibiting signs of panic and irrational fear without any instigating object present indicates ____
panic disorder
137
splitting is characteristics of which personality disorder?
borderline personality disorder
138
are schizophrenia and bipolar disorder heritable?
yes
139
are alzheimer's and parkinson's heritable
yes
