Flashcards in PSY280 - Exam 2 Deck (23):
Disruption of and/or discontinuity in the normal integration of consciousness/memory/identity/emotion/perception/body representation/motor control/behavior.
--Unbidden intrusions into awareness and behavior accompanied by a loss of continuity in subjective experience (depersonalization/derealization).
--Inability to access information or to control mental functions that are normally accessed/controlled easily (amnesia).
--Commonly follow traumatic events.
-Persistent/recurrent depersonalization and/or derealization.
---50% adult population experiences brief depersonalization episodes; equal rates across gender.
-Inability to recall important autobiographical information, usually of a traumatic/stressful event.
---Localized amnesia: loss of memory for a specific period of time (most common)
---Selective Amnesia: some events/pieces of an event during a period of time.
---Generalized amnesia: complete memory loss (rare)
-Women twice as likely as men
+--With Dissociative Fugue: travel associated w/ amnesia for identity/other important autobiographical info. Inability to recall past during travel. Sometimes will assume new identity. Course of Fugue often abrupt, typically remits, often one-time event.
Dissociative Identity Disorder
2+ personality states, discontinuity in sense of self and sense of personal ownership/control, accompanied by related alterations in affect/behavior/consciousness/memory/perception/cognition/sensory-motor functioning.
Gaps in recall of everyday events/personal information/traumatic events.
90%+ maltreatment in childhood, many (70%) attempt suicide.
Different from PTSD because focuses on dissociation rather than anxiety.
Begins in childhood, not diagnosed until adulthood.
Mean alters is 15.
Twice is high for women, much more severe.
Treatment: identify/neutralize triggers//confront and relive early trauma/gain psychological control over traumatic events.
Prominence of somatic symptoms associated with significant distress or impairment.
Shares features with anxiety disorders.
Often co-morbid with medical concerns/anxiety/mood/personality disorders.
Somatic Symptom Disorder
1+ somatic symptoms that are distressing or result in significant disruption of daily life.
Excessive thoughts/feelings/behaviors related to somatic symptoms or associated health concerns as manifested by at least one:
-disproportionate/persistent thoughts about seriousness of one's symptoms.
-persistently high level of anxiety about health or symptoms.
-excessive time/energy devoted to symptoms or health concerns.
Although somatic symptom may not be constant, being symptomatic is persistent (often for 6+ months).
Suffering authentic, even if no medical explanation for the somatic symptom or severity of suffering.
Sometimes normal bodily sensations/discomfort misinterpreted as signs of illness/appraised as threatening/harmful.
Can lead to invalidism. High levels of anxiety about illness.
New disorder includes those formerly with somatization disorder/pain disorder/hypochondriasis.
Depressive disorders/increased risk of suicide.
No info about gender.
Illness Anxiety Disorder
Preoccupation w/ having/acquiring a serious disease.
No somatic symptoms or are very mild.
High level of anxiety about health, easily alarmed about personal health status.
Excessive health-related behaviors/exhibits maladaptive avoidance.
Care-seeking vs. Care-avoidant type
3-8% in medical populations - but doesn't show anything because of care-avoidant type.
Equal across men and women.
Chronic w/ frequent relapses, begins early to middle adulthood, worsens with age, rare among children.
Comorbidity - 2/3 have another major psychological diagnosis.
1+ symptoms of motor or sensory deficits: suggests neurological or other medical condition.
Medical evidence --> incompatible with neurological disease (hand tremor stops if concentrating on other thing).
Psychological factors implicated.
Not intentionally faked:
-La belle indifférence - lack of concern
-Secondary Gain - unconscious ulterior motives
-Malingering - deliberate exaggerations for personal gain.
More affecting disease.
2-3x more common in women.
Common in adolescence.
Short duration with re-occurrences.
Blindness/paralysis more likely to recover than tremors and seizures.
Imposed on self or on another
Falsification of physical/psychological signs or symptoms, causing injury or disease with deliberate deception.
Present self/other as ill/impaired/injured.
Deception even w/o obvious reward.
Major depressive episode, manic episode, hypomanic episode.
Major Depressive Episode
At least 2 weeks, most of day, nearly every day.
Depressed mood (sad/hopeless/lethargic) or Anhedonia (loss of interest/pleasure).
4+ of the following:
-significant weight loss/gain.
-feelings of worthlessness or excessive/inappropriate guilt
-diminished ability to think/concentrate or indecisiveness
-suicidal ideation or attempts
Children/adolescents: irritable mood, somatization, social withdrawal.
Gradual onset over days or weeks.
Initial episodes cued by stressors.
Untreated worsens condition overall.
Antidepressants can cue mania in Bipolar.
Major Depressive Disorder
1+ major depressive episode.
No manic/hypomanic episodes.
3x higher in younger than older.
Late life onset common.
Variable/episodic (2 weeks to several years)
90% remission after 5 years.
Most have multiple episodes, median = 4
Women 1.5-3x more likely.
-introspective, ruminative cognitive style, disadvantage/negative life events, hormones.
Persistent Depressive Disorder
Depressed mood most of day every day for 2+ years.
2+ of following:
-poor appetite/overeating, insomnia/hypersomnia, low energy/fatigue, low self-esteem, poor concentration/difficulty making decisions, feelings of hopelessness.
Recovery cannot last longer than 2 months at a time.
Episode may be continuously present for the entire 2 years.
No manic or cyclothymic disorder.
Includes MDE for 2+ years, and dysthymia (chronic/mild depression).
Period of abnormally/persistently elevated/expansive/irritable mood.
At least 1 week, present most of day nearly every day.
If hospitalization necessary, duration is waived.
At least 3 of 7:
-inflated self-esteem/gradiosity, decreases need for sleep, pressured speech/talkative, flights of idea/racing thoughts, distractibility, increase in goal-directed activity or psychomotor agitation, excessive involvement in pleasurable activities w/ potential for painful consequences.
-marked impairment, necessitate hospitalization to prevent harm to self or others, involve psychotic features, personal distress not required.
Not due to substance.
Elevated/expansive/irritable mood and abnormally and persistently increased activity or energy and lasts 4 days.
3+ sxs of mania.
Not severe enough to cause marked impairment of hospitalization.
No psychotic symptoms.
History of 1+ manic episodes
Most common to have mania and depressive symptoms (Manic-depressive)
Psychotic symptoms are common.
90% will have recurrent episodes, mode = 4 in 10 years.
70-80% have full recovery between episodes.
Rapid cycling - 4 episodes in 1 year.
Suicide risk 15x general population, 25% of all suicides.
1+ hypomanic episodes, 1+ full major depressive episodes, never met full criteria for a Manic episode.
Bipolar Disorders Stats
Slightly more women in BPD II, men get mania first, women get depression.
Rare in children and after 40, bi I @ 18, bi II @ 22.
Acute onset (chronic but episodic).
2+ years hypomanic symptoms and depressive symptoms that do not meet duration/severity/pervasiveness for Manic/Major depressive episodes.
Never Symptom-free for 2+months at a time.
No MDE/manic/hypomanic episodes during 2 years.
15-50% eventually develop Bipolar I or II.
Women 3x as likely to attempt, men 4x as likely to succeed.
50+% associated with mood disorders.
Often occur after improvement.
Adults >65, physical illness/depressed/divorced/widowed, chronically ill, males, teens, native american teen boys.
Suicide Risk Factors
Previous attempts, mental illness and physical illness, impulsivity/aggressiveness, cultural/religious beliefs, child abuse/neglect, hopelessness, significant loss, alienation/isolation, knowing another who has succeeded, natural disaster.
Suicide Assessment (PALS)
Suicidality - thoughts of death, wanting to be dead.