Midterm 2 Flashcards

Question

social ecology

Answer 1

pattern of association between peer regard and rates of ASB moderated by neighborhood - generally a negative correlation between the amount of ASB you are and the amount of friends/people who like you (inverse correlation) - in low SES that negative slope is switched, the more ASB you are the more you are regarded socially

Answer 2

Childhood/early-onset | Adolescent - onset/limited

Answer 3

if you look at the prevalence of ASB as a function of age - in something called the age crime curve - there is something around 13+ or - a year or so there is a huge increase in overall prevalence of ASB and increase in the number of offenders (a new group of kids around 13 or 14 start becoming antisocial that weren't before) explanation for these 2 things by Moffitt - there are 2 distinct groups of kids, around 13 or 14 years old, one (far less prevalent) are chronically antisocial (through each stage of development 6, 9, etc) "life-course persistent", the other "Adolescence Limited" group (more prevalent) aren't showing ASB throughout development (6, 7, 9-12) and around 13/14 are suddenly antisocial when you follow them past 18/19 etc. they show less ASB - this isn't a perfect representation of all kids but as a whole it is a pretty good representation

Answer 4

Life course persistent group - few, mostly boys (~25:1) - ADHD comorbidity and ODD - physical aggression - maternal depression/CD; paternal ASPD (much more diverse for family history in psychopathology - long lineage for psychopathical issues) - neuropsychological deficits and low IQ (particularly low verbal IQ) - account for majority of (violent) crime - 2/3 to 3/4 of all crime - poor prognosis (ie persistent) - the most severe/worst subgroups of kids with conduct problems

Answer 5

- greater gender equity - few child risk factors - social mimicry - Desist by early adulthood for most s

Answer 6

don't differ typically with kids with no ASB at all for family history of psychopathology and IQ - listen to recording

Answer 7

"tension" between biological maturation and limited status/privileges - you feel like an adult biologically but you don't have the status/privilege to do what you want - can't drive, don't have a job, etc. - ASB as effort to obtain status/privileges (these kids tend to hang out in quadrant C)

Answer 8

not all especially in low SES context maturation of PFC lines up with the time at which ASB tends to take a significant dip - this could be a factor

Answer 9

Odd has earlier onset (6 years) vs CD (9 years) similar risk factors for ODD and CD (eg family, peer) but magnitude is stronger for CD CD is often preceded by ODD and many children with CD continue to display ODD; most children with ODD do not progress to CD - if you can recognize the signs of CD before it escalates to setting fires or killing animals then (listen to recording) this may be ODD Odd and CD are separable factors

Answer 10

``` Sexual Promiscuity (other examples?) Classification of disorders ```

Answer 11

other examples: - it isn't age appropriate, we would have to define differently for both boys and girls - quality of sexual promiscuity would need to be defined there are lots of behaviors that may be like CD but it gets tricky to define

Answer 12

more inclusive and sex specific norms vs universal criteria impact on other forms of psychopathology? gender paradox

Answer 13

one of the tensions in classification of CD - do we try to get specific or have inclusive criteria (and ultimately overdiagnosis)

Answer 14

should we calibrate diagnostic criteria so that all disorders are gender equitable?

Answer 15

lower base rates are associated with greater impairment (MR - mental retardation) refers to the fact that we know there are sex differences in disorders - this tells us that in the gender where that disorder is less common, often times that gender has worse outcomes - we don't know what mediates that - this could reflect that gaps in what we know (how to treat the other gender) - if you are in the gender in which it is less prevalent, you will stand out more than someone in the gender in which it is more prevalent indirect/relational aggression - the mean girls clip - more covert, nondestructive, target of the aggressive act is different (social status, reputation) what kind of damage can you do through social means

Answer 16

if these are different things should they be treated differently? they looked at twin studies that separately measured overt (aggression) and Covert (rule breaking) and look at relative heritability found that the relative contribution of genetic, shared and nonshared environments are different between overt and covert, doesn't prove anything but is consistent with the idea that aggression and rule breaking behavior are meaningfully separate

Answer 17

-there are individual differences in the population who, when exposed to different experiences, interactions with other people that are vague, they have a tendency to attribute intentionality of hostility to the behavior of others (especially when the intentions are vague) Integrates normal theories of attribution Measurement: videotape and vignettes child abuse --> aggression/ASB

Answer 18

we rely a lot and borrow from long standing theories in psychology

Answer 19

videotape and vignettes - show intentionally vague video | -you can measure individual differences - how can we make sense of a situation that is ambiguous (this is a risk factor)

Answer 20

Hypothesized mediator: Hostile attribution bias partially mediated this relationship what is the explanation? what does that tell us about how child abuse impacts socio-cognitive processes? - HAB may underly it - the child will develop this in social cognition or attribution which may facilitate aggression and antisocial

Answer 21

Gentetic influences - biologically based traits like difficult early temperament or hyperactivity-impulsivity may predispose certain children - adoption and twin studies support genetic contribution, especially for overt behaviors - different pathways reflect the interaction between genetic and environmental risk and protective factors - maternal smoking and conduct problems

Answer 22

this WILL be on the test!! mothers who smoked? Heritability of conduct problems very low mothers who did not smoke? heritability of conduct problems very high looked at relative heritability of conduct problems - all of the kids in the study have conduct problems heritability differed substantially as a function of being born to a mother who smoked vs being born to a mother who didn't smoke - the mother who smoked conduct problems due to the smoking and not as much genetics - those whose mothers didn't smoke behaved similar to what would be expected in the population - so conduct problems were due to genetics - EQUIFINALITY

Answer 23

not a DSM disorder but highly studied likely a "subset" of individuals with antisocial personality disorder (in it's extreme form it is rare in the population) difficult to diagnose because it is LESS about observable behavior and MORE about motivation and internal states

Answer 24

psychopathy is not the same thing as criminal behavior but they are related Psychopathy: - cleckley's (1941) the Mask of Insanity - specific form of personality disorder Criminal Behavior: - violation of laws, norms, or rights of others - relatively common in the population (even normative) exclusive focus on behavior will lead to the over-diagnosis of psychopathy (eg forensic settings) the bar is lower for criminal behavior than it is for psychopathy - you can't assume that all criminals are going to be psychopathic - you can't assume that it is that common in the population (and you CANT focus on behavior)

Answer 25

- superficial charm and good intelligence - absence of delusions or other irrational thoughts - absence of nervousness/neuroses - unreliability - insincerity - lack of remorse or shame - antisocial behavior - failure to learn from experience - pathological egocentricity - poverty in affective relations - lacking in insight and interpersonal relations - fantastic and uninviting behavior with or without drink - suicide rarely committed - impersonal sexual acts - failure to follow any life plan often it will include a criminal act but there is a ruthlessness, urgency and superficiality associated with psychopathic traits- parasitic lifestyle (go from person to person and use/abuse/manipulate)

Answer 26

Factor 1 | Factor 2

Answer 27

personality based - charm, grandiosity (well spoken) - lying, manipulation - lack of remorse - lack of empathy - lack of emotional depth not that they don't experience emotion, they just don't experience it to the same depth - especially when it involves other people's distress they show diminished physiological indicators that reflect emotional reactivity

Answer 28

Behavioral representation - early behavior problems - juvenile delinquency - boredom - irresponsibility - violence

Answer 29

one of the defining characteristic traits of psychopathy low empathy, lack of guilt, shallow emotions - core feature of psychopathy - associated with earlier onset of ASB, greater variety of offending, and more "official" police contact - more treatment resistant - less affected by negative consequences of their behavior, especially on others, or punishment (failure to learn from experience) - differences in processing negative emotional stimuli (no differences for positive emotional stimuli)

Answer 30

deafness to fear in boys with psychopathic tendencies - had them listen to voice recordings of people saying neutral words and the tone conveyed the emotion (happy, disgust, anger, sadness, fear) - more inaccurate in identifying fear compared to comparison group - if fear is knocked down, there are many things that they would be willing to do that others (normal) would avoid because of the fear of consequences

Answer 31

how do we know psychopathy is a real thing and not just antisocial criminal behavior excessive use of instrumental aggression executive function deficits blunted response to fear and sadness in others

Answer 32

-reactive aggression is also elevated but instrumental is more specific to psychopathy compared to criminals in general

Answer 33

- cognitive/behavioral inflexibility (eg gambling tasks) - sometimes really impulsive but sometimes very good at paying attention to details - inability to alter stimulus-response associations to changing contingencies (have trouble changing strategies on the card task)

Answer 34

- no response to "moral social referencing" | - parenting and callous-unemotional traits

Answer 35

``` Increased heart rate fatigue increased respiration nausea stomach upset dizziness blurred vision dry mouth muscle tension heart palpitation blushing vomiting numbness sweating ``` these symptoms are not SPECIFIC to anxiety

Answer 36

worry, apprehension, thoughts concerned with emotional or bodily danger, poor concentration ``` thoughts of being scared or hurt thoughts or images of monsters or wild animals self-deprecatory or self-critical thoughts thoughts of incompetence or inadequacy difficulty concentrating blanking out or forgetfulness thoughts of appearing foolish thoughts of bodily injury images of harm to loved ones thoughts of going crazy thoughts of contamination ``` attention problems are not just common in ADHD -burden the responsibility of the psychologist to decide if the attention problems are due to ADHD, anxiety or another disorder

Answer 37

compulsions, escape/avoidance, aggression ``` avoidance crying or screaming nail biting trembling voice stuttering trembling lip swallowing immobility twitching thumb sucking avoidance of eye contact physical proximity clenched jaw fidgeting ```

Answer 38

a mood state characterized by strong negative emotion and bodily symptoms of tension in anticipation of future danger or misfortune (future-oriented)

Answer 39

Present-oriented emotional reaction to current danger, characterized by alarm and strong escape tendencies (often but not always irrational...anxiety disorders)

Answer 40

sudden and unexpected fight/flight response in absence of obvious danger/threat, hallmark features: physiology and unexpected

Answer 41

these are all expressions of negative mood know what they have in common and what is different

Answer 42

both involve physiological arousal both can be adaptive -fear trigger "fight or flight" -anxiety increases preparedness

Answer 43

may save life eg unusual strength or endurance body reacts in a way that will utilize the proper/necessary resources for survival

Answer 44

moderate levels improve performance | eg achievement on tests or athletic achievement during games/competition

Answer 45

yerkes dodson law: arousal and performance optimal level of memory is at the mid level of arousal or stress (of the arc) increasing alertness -->optimal level --->increasing emotional arousal optimal level of performance is somewhere in between no arousal and high arousal

Answer 46

moderate fear and anxiety are adaptive, and emotions and rituals that increase feelings of control are common (not pathological or uncommon)

Answer 47

from the developmental perspective: what is normal at one age can be debilitating at an older age whether a fear is normal also depends on its effect and how long it lasts the number and type of fears change/decline over time (ie developmental perspective is necessary!)

Answer 48

heterogeneity - spans a range of physical, cognitive and behavioral disorders very diverse symptoms and we need to be mindful that there are commonalities but also significant differences within the types of anxiety disorders ``` 7 Primary DSM 5 anxiety disorders separation anxiety disorder (SAD) selective mutism specific phobia social anxiety disorder (social phobia) panic disorder with versus without specifier agoraphobia generalized anxiety disorder (GAD) ```

Answer 49

- excessive (more than expected), uncontrollable anxiety and worry about many events and activities on most days (unfocused or diffuse anxiety - anxiety about a whole range of things - nonspecific) - worry excessively about minor everyday occurrences (what they're going to wear), even when they see they are making themselves and others unhappy (it's not an awareness issue) - accompanied by at least one somatic symptom (eg headaches, stomach aches, muscle tension, trembling)

Answer 50

3% to 6% of children - equal rate in boys and girls High rates of other anxiety disorders and depression

Answer 51

average age of onset: 10-14 years (rare in young children) older children have more symptoms that may diminish with age symptoms more likely to persist over time when it appears earlier (earlier symptoms emerge, the more severe the course- worse prognosis)

Answer 52

social anxiety/social phobia is a marked, persistent fear of social or performance requirements that expose the child to scrutiny and possible embarrassment - anxiety over mundane activities-concern with being negatively evaluated - negative emotions pertaining to social evaluation of their performance - most common fear is doing something in front of others - eating in front of people, public speaking - more likely than other children to be highly emotional, socially fearful adn inhibited, sad, and lonely - when they experience negative emotions it tends to last longer - generalized social phobia: the most severe form involves fear of most social situations - this is not just about eating 0 this is most social activities - if there are 2 or 3 other ppl in the room

Answer 53

- 6-12% of children (more prevalent than GAD) - more common in girls, who are more concerned with social competence and interpersonal relationships than are boys - two-thirds also have another anxiety disorder - most common comorbid disorders: specific phobia or panic disorder; 20% of social phobic adolescents suffer from major depression and may self-medicate with alcohol and other drugs (high comorbidity) - common age of onset: early to mid-adolescence; rare under age 10 (at puberty, both genders are venturing on new social navigation - up until this point, boys played with boys and girls played with girls - prevalence increases with age and may be predicted by early rejection by peers selective mutism - failure to talk in specific social situations - may be a form of social phobia; seen in 0.5% of children

Answer 54

sudden, overwhelming period of intense fear or discomfort accompanied by characteristics of the fight/flight response (identical to the feeling of almost being hit by a truck) rare in young children, common in adolescents; related to pubertal development, not age (increases in prevalence across development)

Answer 55

recurrent unexpected panic attacks followed by at least one month of persistent concern about having another attack, constant worry about the consequences, or a significant change in behavior related to the attacks (anticipatory anxiety - they think about the panic attack trying to figure out the rhyme or reason to what may trigger it and what will happen the next time it comes - high anticipatory anxiety and situation avoidance may lead to agoraphobia (negative reinforcement is powerful in our understanding of how anxiety disorders emerge, maintained and how they can be treated - avoidance is a classic example of negative reinforcement because it gets rid of the thing we fear - momentarily)

Answer 56

fear of being alone in or avoiding certain places or situations fear of having a panic attack in situations where escape would be difficult or help is unavailable

Answer 57

panic attacks common (3-4% of teens) panic disorder less common (about 1% of teens) panic attacks are more common in females than males and are related to stressful life events (gender is a moderator of the relationship between risk factor and the stressful life events) comorbidity: most commonly other anxiety disorders or depression (may be at risk for suicidal behavior or alcohol/drug abuse)

Answer 58

age of onset for first panic attack: 15-19 years; 95% of PD adolescents are postpubertal (largely if not exclusively postpubertal onset) worst prognosis of all anxiety disorders (most difficult to treat and worst outcomes academically, socially, etc.)

Answer 59

fight or flight response - requires activation by some perception of harm/danger - physiological correlates: blood pressure increases, heart rate increases, digestion slows down - cognitive system: attentional shift, hyper-vigilance, nervous, difficulty concentrating - behavioral system: aggression and/or avoidance

Answer 60

trigger stimulus (internal or external) --> perceived threat (key to getting anxiety started) --> apprehension (applies to everyone) --->bodily sensations (applies to everyone) --> catastrophic misinterpretation (key breakdown cognitively - in response to bodily sensations, people with panic disorder or at risk for it are more likely to misinterpret the bodily sensations) --> perceived threat cognition and behavior, cognition and anxiety are interrelated when you have physiological symptoms - interoceptive anxiety - when we misunderstand, misattribute those physiological signs and symptoms - inaccurately interpret what they actually mean

Answer 61

rest and digest response - conservation of energy, digestion occurs, low BP - restorative properties

Answer 62

cognitive disturbances (within and across anxiety disorders)

Answer 63

(within and across anxiety disorders) - disturbance in how info is perceived and processed - threat-related attentional biases - cognitive errors and biases - social and emotional deficits - anxiety and depression

Answer 64

selective attention to potentially threatening/dangerous info -anxious vigilance or hypervigilance permits the child to avoid potentially threatening events - if you have some degree of awareness or concern around germs and threat-related attentional biases you will pay extreme attention to the people around you and whether they sneeze and wash their hands -really good at perceiving threat in an environment where there is no threat

Answer 65

- perceptions of threats activate danger-confirming thoughts -see themselves as having less control over anxiety-related events than other children - if you ask them to rate themselves they are more inclined to rate themselves as being more in control of their anxiety than others

Answer 66

- low social performance/high social anxiety - social withdrawal, loneliness, low self-esteem, difficulty initiating and maintaining friendships - deficits in understanding emotion/differentiating between thoughts and feelings (when they become intertwined is when we have problems)

Answer 67

family and twin studies suggest - 33% of the variance in childhood anxiety symptoms is genetic, although identical twins do not have the same types of anxiety disorders (adhd is substantially more heritable) - a general disposition to become anxious is what is inherited; the form of anxiety that takes place is a function of shared/non-shared environmental influences (influence on genetic predisposition to become anxious) - highest genetic influence for obsessive-compulsive behaviors and shyness/inhibition - serotonin and dopamine systems are related to anxiety (Glutamate an GABA as well) - genes are linked to broad anxiety-related traits (eg behavioral inhibition); small contributions from multiple genes, not direct link with specific genes

Answer 68

social phobia, GAD, SAD, and multiple anxiety disorders (not specific phobia) commonly associated with depression

Answer 69

Higher incidence in girls likely due to genetic vulnerabilities and gender role orientations cultural differences in patterns of referral (which kind are referred or not is not random), help-seeking behaviors, diagnoses, and treatment may be related to parental education the experience of anxiety is pervasive across cultures ethnicity and culture may affect the expression, developmental course, and interpretation of anxiety symptoms cultural differences in traditions, beliefs, and practices affect occurrence and symptoms of anxiety behavior lens principle: child psychopathology reflects a mix of actual child behavior and the lens through which others view it in a child's culture - (is it a character flaw, a behavioral flaw, how does the culture see that disorder)

Answer 70

no single structure/neurotransmitter controls the entire anxiety response system; several interrelated systems work together - hypothalamic-pituitary-adrenal (HPA) axis (regulates stress reactivity), limbic system, prefrontal cortex, other cortical and subcortical structures (emotional reactivity and regulation are related but separable constructs) - overactive behavioral inhibition system (BIS) implicated; BIS may be shaped by early life stressors (part of - listen to recording - that regulates inhibitory control) - brain abnormalities: over-excitable amygdala have been implicated in children who are anxious and/or behaviorally inhibited (shyness or negative emotion - passive, nervous)

Answer 71

``` parenting practices (eg rejection, over-control, overprotection, modeling anxious behaviors) may be contributors to childhood anxiety disorders parents of anxious children seen as over-involved, intrusive, or limiting child's independence; critical and fewer positive interactions with their children (helicopter parent - hover, overinvolved - self efficacy - listen to recording) lower parental expectations for children's coping abilities (what they think their children are able to cope with - under predict incorrectly that they will struggle with adversity) ```

Answer 72

Temperament (relatively stable and relatively enduring - listen to recording) -reactivity and regulation (Rothbart) - two facets of temperament -kagan proposed temperamental differences related to inborn differences in brain structure and chemistry (focused on behavior inhibition) -inhibited children have: higher resting heart rates greater increase in pupil size in response to unfamiliar (novel things) higher levels of cortisol (released) - measure of stress reactivity listen to recording for slide 22 this is related to ADHD but they are different - this has more of an emotional construct

Answer 73

Exposure Coping modeling reinforcement the fear thermometer

Answer 74

central "ingredient" is most, if not all, effective treatments (exposure related therapies) what is exposure? - multiple, controlled, strategic exposure to anxiety producing situations/objects/occasions - imaginal stimuli: images, memories (imagine situations that make them anxious) - interoceptive: sensations associated with anxiety/fear (having the person experience physiology associated with fear/anxiety producing situation - get them habituated - accustomed - to it, process of being exposed to something with greater regularity so you don't have the reactivity you're used to) - in vivo - situations, people, places, objects "in the moment" - real world experience Exposure based therapies are highly effective for many anxiety disorders (ie "trans-diagnostic" - larger spanning multiple diagnoses - multiple types of anxiety disorders) listen to recording

Answer 75

(adaptive strategies other than avoidance, escape) avoidance and escape negatively reinforce maladaptive strategies -control your breathing patterns - trying to improve regulation of physiology

Answer 76

decatastrophize what the patient thinks is going to happen - do it so they can see that it won't be as bad as they think

Answer 77

praise when they make progress, etc.

Answer 78

a way to gage if it's too much fear exposure

Answer 79

teaches how thinking contributes to anxiety - "maladaptive" thoughts increase anxiety symptoms and ineffective coping strategies (eg avoidance) - goal is to provide skills and combat problematic thinking - example: "I KNOW that if I meet strangers, something TERRIBLE and embarrassing will happen" - cognitive restructuring: gently CHALLENGE the (rational) basis for the negative cognition (reconstruct people's thoughts) - "didn't you go out last week? nothing catastrophic happened from what I remember..."

Answer 80

DSM-IV listed as anxiety disorders PTSD now included in DSM-5 in section on "Trauma - and stress or -related Disorders" OCD now within "Obsessive Compulsive and Related Disorders" (eg hoarding, body dysmorphic disorder)

Answer 81

OCD recurrent, time-consuming, disturbing (to the person) obsessions (persistent and intrusive thoughts, ideas, impulses, or images) and compulsions (repetitive, purposeful, and intentional behaviors) performed to relieve the anxiety -OCD is extremely resistant to "reason" -OCD children often involve family members in rituals (they get so distressed that they are - listen to recording) -rituals fail to provide long-term relief from anxiety, resulting in time-consuming, never-ending cycle of obsessions and compulsions -often leads to severe disruptions in normal activities, health, social and family relations, and school functioning

Answer 82

obsessions increase anxiety intrusive, recurring, and uncontrollable thoughts or urges experienced as irrational (they know they are irrational)

Answer 83

compulsions decrease or reduce anxiety (negatively reinforcing) impulse to repeat certain behaviors or mental acts (eg hand washing, checking, repeating a word, counting) extremely difficult to resist the impulse (this is driven by affect) may involve elaborate behavioral rituals

Answer 84

Post-traumatic Stress Disorder Symptoms grouped into 3 categories: 1. re-experiencing the traumatic event 2. Avoidance of stimuli 3. Increased arousal

Answer 85

nightmares, intrusive thoughts, or images (listen to recording)

Answer 86

Refuse to walk on street where rape occurred (behavioral manifestation) Emotional Numbing

Answer 87

decreased interest in others feels distant or separate from others unable to experience positive emotions

Answer 88

insomnia, hypervigilance, exaggerated startle response

Answer 89

difficulty falling asleep and also difficulty staying asleep (due to nightmares, etc.) (listen to recording)

Answer 90

difficulty relaxing, hyper aware of one's environment (listen to recording)

Answer 91

listen to recording

Answer 92

although at least 2/3 of children experience at least one potentially traumatic event by age 16, most don't develop PTSD a large national sample: 6-month prevalence for adolescents ages 12-17 was 3.7% for boys, 6.3% for girls -comorbidity: depression and/or substance abuse

Answer 93

onset and course depend on age of child when trauma occurs and nature of the trauma; onset may be delayed for months or years (typically more recent than years - but weeks or months is a common timeline) in some cases may persist for a lifetime many factors affect recovery, like nature of the traumatic event, child characteristics, social support -cognitive - behavioral therapy may be helpful

Answer 94

How negative (listen to recording)

Answer 95

how well can we regulate that negative emotion (reactivity)?

Answer 96

goal: to examine three forms of verbalization during exposure therapy - tension btwn purely behavioral approaches vs cognitive and behavioral approaches (it's thought that maybe cognitive part doesn't add all that much) listen to recording reappraisal distraction affect labeling - how might it work? (people verbalize their emotional states) - neuroimaging and treatment evidence additional exposure on day 2 then 1 week follow-up

Answer 97

create and speak a sentence including a negative word to describe the spider and a negative word or two to describe their emotional response to the spider

Answer 98

create and speak a sentence including a neutral word to describe the spider and a neutral work to describe reaction reconstruct your appraisal of a negative stimulus

Answer 99

create and speak a sentence involving object or piece of furniture at home and where it is found distract from the negative stimulus

Answer 100

Skin conductance reactivity - affect labeling subjects show less of a physiological response to exposure to spider behavioral approach - how close did they get to the spider? - affect labeling may better help (not perfectly) the ability to regulate negative affect (not reappraisal or distraction)

Answer 101

run the spectrum from severe depression to extreme mania and involve extreme, persistent, or poorly regulated emotional states

Answer 102

depressive disorders | bipolar disorder

Answer 103

``` excessive unhappiness (dysphoria) and loss of interest in activities (anhedonia) -irritability is one of the most common symptoms, occurs in 80% of clinic-referred, depressed children ```

Answer 104

mood swings from deep sadness to high elation (euphoria) and expansive mood (mania)

Answer 105

what used to be pleasurable is no longer pleasurable

Answer 106

MDD 5 or more of 9 symptoms (including at least 1 of depressed mood and anhedonia) in the same 2-week period; each symptom must be a change from previous functioning MDD is often said to be episodic recurrent subclinical depression

Answer 107

symptoms tend to dissipate over time | -they don't last for years - it is a discrete period of time

Answer 108

once depression occurs, future episodes likely (known as kindling) - once you develop one episode, you become more vulnerable to a recurrence of episodes -average number of episodes is 4

Answer 109

sadness plus 3 other symptoms for 10 days | significant impairments in functioning even though full diagnostic criteria are not met

Answer 110

``` this WILL be on the test Depressed mood (subjective or observed) loss of interest or pleasure change in weight or pleasure insomnia or hypersomnia psychomotor retardation or agitation (observed) loss of energy or fatigue worthlessness or guilt impaired concentration or indecisiveness thoughts of death or suicidal ideation or suicide attempt ``` depressed mood may present as irritability in children: very relevant in assessment of pediatric bipolar

Answer 111

as many as 90% of youngsters with depression have one or more other disorders; 50% have two or more - most common comorbid disorders in clinic-referred youngsters are anxiety disorders (especially GAD), specific phobias, separation anxiety disorders - depression and anxiety are more visible as separate, co-occurring disorders as severity of disorder increases and child gets older - other common comorbid disorders are dysthymia, conduct problems, ADHD, substance-use disorder - 60% have comorbid personality disorders, especially borderline personality disorder

Answer 112

depressed mood for most of the day, for more days than not, for 2 years or longer (difference btwn this and MDD is the timing/chronicity and severity) Presence of 2 or more symptoms

Answer 113

Poor appetite or over-eating insomnia or hypersomnia low energy or fatigue low self esteem impaired concentration or indecisiveness hopelessness (never without symptoms for more than 2 months) children/adolescents: mood can be irritable and duration must be 1 year or longer

Answer 114

Eyore from winnie-the-pooh

Answer 115

same criteria for adult and child depression -irritability may be 'substituted' for depressed mood Developmental aspects -less dysphoria and hopelessness and more depressed 'appearance' and somatic complaints (pre-adolescents) -anhedonia & psychomotor retardation increase whereas somatic low self-esteem decrease w/age -comorbidity: separation anxiety disorder among younger children and eating disorders and substance abuse among teens

Answer 116

6 months of prevalence: 1-3% school age, 5-6% teens lifetime: 15-20% adolescents clinical: 8-15% school-age, adult more stable than child -->adult

Answer 117

equal in childhood; 2x girls>boys | -this persists throughout the rest of development

Answer 118

dropout, suicide, substance abuse, etc.

Answer 119

``` median odds ratio: 8.2 anxiety 6.5 CD 5.5 ADHD one disorder causes another; comorbidity is a distinct disorder listen to recording for more details ```

Answer 120

not all stressful life events affect everyone the same way risk of MDD is much higher for affected MZ and DZ co-twin with the presence of severe life event than unaffected MZ or DZ co-twin Affected MZ co-twin highest because of genetic pairing either variable could be the moderator (listen to recording) G x E (listen to recording) - slide 10

Answer 121

this WILL be on the test Tripartide model you can use these three facets (Negative Affect, Positive Affect, Somatic Arousal) to give additional grasp of what disorder you're dealing with negative affect alone doesn't help us at all because all 3 groups are high in negative affect Positive affect helps with Anxiety disorders (moderate) but not depressive disorders or comorbid anxiety disorders and depressive disorders (low) somatic arousal helps with depressive disorders (moderate) but not anxiety disorders or comorbid anxiety disorders and depressive disorders (high)

Answer 122

MDD twice as common in women than men -similar discrepancy occurs in many countries (but not all) some biological and psychological factors: -girls twice as likely to experience sexual abuse -women more likely to experience chronic stressors (importance of "relationship stress") -girls and women more likely to worry about body image -women may react more intensely to interpersonal loss -women spend more time ruminating; men tend to distract (ruminating may intensify and prolong sad moods) listen to recording

Answer 123

Cognitive Theories: - Beck's theory of mood disturbance - negative triad - negative schemata - negative schemata cause cognitive biases ``` Overgeneralization Arbitrary Inference Selective Abstraction Learned Helplessness Pessimistic Attributional Style Hopelessness Theory ```

Answer 124

negative view of: self world future

Answer 125

tendency to see the world negatively

Answer 126

tendency to process info in negative ways

Answer 127

Cognitive: negative or maladaptive belief systems - thinking errors - cognitive schemas

Answer 128

negative automatic thoughts - mind reading: "he thinks I'm a loser" - labeling: "I'm a failure" - catastrophizing: "It's awful if I get rejected. I can't bear it." - All or nothing: "Things never work out for me." - discounting positive: "It's no big deal. Anyone could do that."

Answer 129

internal structures that guide info processing and stimulate self-criticism - "he doesn't like me. I must be unloveable." - "I have no reason to be depressed." - "If I fail this, I must be a failure."

Answer 130

Drawing a sweeping generalization based on a single event | -you walk by a friend who fails to say hello and you think, she hates me

Answer 131

``` drawing a conclusion in the absence of sufficient information -you notice a student in your class sleeping and you conclude, I'm a boring instructor ```

Answer 132

focus on one element while ignoring all others | -you see a small dent on your car and lament, my car is ruined

Answer 133

Seligman's experiments with dogs uncontrollable negative events --> person learns to be "helpless" (what's the point of going out if everyone hates me) -tendency to attribute negative outcomes to internal, global and stable factors vs. positive outcomes to external, specific and unstable -cycles: expectations often unrealistic which help perpetuate dissatisfaction

Answer 134

"attributional biases" internal: "it's my fault" stable: "i'll always fail" global: "i fail at everything"

Answer 135

listen to recording (slide 16)

Answer 136

Cognitive Behavioral Therapy - monitor and identify automatic thoughts - behavioral activation

Answer 137

help them to recognize that what we think affects how we feel and what we feel influences what we do, etc. - dispute automatic negative thoughts - replace negative thoughts with more neutral or positive thoughts

Answer 138

largely assigning homework to patient - pleasant activity scheduling - dismantling studies show BA by itself to be as efficacious as complete CBT protocol

Answer 139

negative thoughts (there's no point trying) lead to low mood (feel guilty, discouraged, inadequate and worthless) lead to reduced behavior (become less active, avoid people and situations)

Answer 140

BD a striking period of abnormally and persistently elevated, expansive, or irritable mood, alternating with or accompanied by one or more major depressive episodes -elation and euphoria can quickly change to anger and hostility if behavior is impeded; elation and euphoria may be experienced simultaneously with depression -controversy involves difficulty in identifying BP in young people, who show extreme variability and overlap of symptoms with other childhood disorders -significant impairment: previous hospitalization, MDD, medication, co-occurring disruptive behaviors, anxiety disorders, psychotic symptoms, suicidal ideation/attempts -symptoms include restlessness, agitation, sleeplessness, pressured speech, flight of ideas, sexual disinhibitiion, surges of energy, expansive grandiose beliefs

Answer 141

unipolar | bipolar

Answer 142

unipolar single episode unipolar recurrent dysthymia

Answer 143

bipolar I bipolar II cyclothymia

Answer 144

``` Mania Hypomania Normal mood Mild Depression Major Depression ```

Answer 145

This WILL be on the test Bipolar I: most common type: have the full range of Mania to Major Depression Bipolar II: in terms of positive mood it tops out at hypomania but goes all the way down to Major Depression Cyclothymia : goes from hypomania to mild depression

Answer 146

psychological treatments Family focused treatment (FFT) lithium newer mood stablizers

Answer 147

not the first line or sole treatment | psychoeducational approaches: provide info about symptoms, course, triggers and treatments

Answer 148

-educate family about disorder, enhance family communication, improve problem solving

Answer 149

up to 80% receive some relief with this mood stabilizer potentially serious side effect -lithium toxicity

Answer 150

anticonvulsants (eg depakote) antipsychotics (eg zyprexa) both also have serious side effects

Midterm 2 Flashcards

(174 cards)