Psyc 3607- Test I Flashcards
(162 cards)
1
Q
personality
A
the enduring traits and characteristics that lead a person to behave in relatively predictable ways across a range of situations
2
Q
personality disorders
A
inflexible and maladaptive thoughts, feelings, and behaviours that arise across a range of situations and lead to distress or dysfunction
3
Q
characteristics of personality disorders
A
- heterogenous group of disorders
- long standing, pervasive and inflexible patterns of behaviour
- inner experience that deviates from cultural expectations, causes impairment in social and occupational functioning, and can cause emotional distress
4
Q
what are the ABCs of psychological functioning
A
affect, behaviour, and cognition
5
Q
affect
A
range, intensity, and changeability of emotions and emotional responsiveness
6
Q
behaviour
A
ability to control impulses and interactions with others
7
Q
cognition
A
perceptions and interpretations of events, other people, and onself
8
Q
neurological factors of personality disorders
A
- genetics are the most influential
- there is no evidence that genes underlie specific personality disorders, but they do influence temperament which plays a major role in personality disorders and create predisposition to develop personality disorders
9
Q
temperament
A
aspect of personality that reflects a person’s typical affective state and emotional reactivity via their effects on brain structure and function
10
Q
three elements of each personality disorder
A
automatic thoughts, interpersonal strategies, and cognitive distortions
11
Q
psychological factors of personality disorders
A
- personality traits involve sets of learned behaviours and emotional reactions to specific stimuli
- what is learned is in part shaped by the consequences of behaviour and how people respond to the behaviour
12
Q
diagnosing personality disorders
A
- to be diagnosed with a personality disorder, maladaptive traits:
- should date back at least to adolescence
- should not be related to a medical condition, substance use or abuse, or another psychological disorder
- are resistant to treatment but may improve over time
13
Q
other traits of individuals with personality disorders
A
- those with personality disorders tend to be less educated and more likely to have never married or be separated or divorced
- 30% of individuals who die by suicide and 40% who attempt suicide are thought to have a personality disorder
14
Q
what are personality disorder diagnoses based on
A
- what the patient says and patterns in the way it is said (pattern of complaints)
- personality inventories or questionnaires
- collateral information from family members
*clinicians should take into account the individual’s culture, ethnicity, and social background
15
Q
issues when diagnosing personality disorders
A
- culture- ensuring functioning is not merely a reflection of culture
- gender- diagnosis bias for certain disorders for certain genders
16
Q
criticisms of the DSM-V on the personality clusters
A
- treats personality disorders as categorical versus on a continua
- criteria creates an arbitrary cutoff between normal and abnormal
- clusters were organized by superficial commonalities (disorders are not distinct from one another)
- high comorbidity
17
Q
cluster A
A
- odd/eccentric
- includes paranoid, schizotypal, and schizoid
18
Q
cluster b
A
- dramatic/erratic
- includes antisocial, borderline, histrionic, and narcissistic
19
Q
cluster c
A
- anxious/fearful
- includes avoidant, dependent, and obsessive compulsive
20
Q
paranoid personality disorder characteristics
A
- persistent and pervasive mistrust and suspiciousness
- tendency to interpret other’s motives as hostile
- expect to be mistreated or exploited by others
- reluctant to confide in others
- better able to evaluate whether their suspicions are based on reality (perceived threats are of known individuals)
- cannot be easily persuaded that these beliefs do not reflect reality
- tend to be difficult to get along with
- secretive, argumentative, hold a grudge
21
Q
schizoid personality disorder characteristics
A
- no cognitive perceptual symptoms (differentiates from schizotypal)
- no desire for or enjoyment of relationships
- appear dull, bland, aloof and rarely report strong emotions
- have no interest in sex
- experience few pleasurable activities
- indifferent to praise and criticism
22
Q
schizotypal characteristics
A
- interpersonal difficulties, increased social anxiety
- eccentric symptoms identical to prodromal and residual phases of schizophrenia
- odd beliefs and magical thinking, recurrent illusions, odd speech, ideas of reference, suspiciousness, paranoid ideation
23
Q
understanding cluster A PD
A
- schizotypal is the most thoroughly researcher
- neurological factors that contribute to schizophrenia also contribute to schizotypal (genes, prenatal enviro, birth complications)
- first degree relatives of patients with cluster A are more likely to develop a schizophrenia related disorder
24
Q
treating odd/eccentric PD
A
- very little research into treatment
- most patients are uninterested in treatment and reluctant if urged or forced into it
- CBT may be beneficial for increasing social and other adaptive skills
- low doses of antipsychotics may be used to treat schizotypal
25
avoidant characteristics
- fearful in social situations
- keenly sensitive to possibility of criticism, rejection, or disapproval
- reluctant to enter relationships unless sure will be liked
26
dependent characteristics
- lack self reliance
- overly dependent on others
- intense need to be taken care of
- uncomfortable when alone
- subordinate own needs
27
obsessive compulsive characteristics
- perfectionist approach to life
- preoccupied with details, rules, schedules
- serious, rigid, inflexible, formal
- unable to discard worn out and useless objects
- does not include the obsessions and compulsions that define OCD
28
etiology of cluster C
- unknown (little data exists)
- speculation about cases have focused on parent- child relationships
29
borderline personality disorder characteristics
- impulsivity and instability in relationships, mood, and self image
- attitudes and feelings toward other vary dramatically
- emotions are erratic and can shift abruptly
- argumentative, irritable, sarcastic, quick to take offence
30
etiology of BPD
- Linehan's diathesis stress theory
- biological
- runs in families, poor functioning in the frontal lobes
- environmental
- parental neglect and abuse are typically reported by BPD patients
31
Linehan's diathesis stress theory
Biological precursor coupled with an environmental stressor which creates/maintains the development/presentation of a disorder
32
glutamate and BPD
- glutamate is the most abundant excitatory NT in the vertebrate NS and crucial in the functioning of rational cognitive functions (reward anticipation, decision making, etc.)
- glutamate is lower in individuals with BPD resulting in
33
partner violence and BPD
- people with borderline PD are often aggressive in relationships
- BPD individuals set impossibly high standards for others and blame their partner when things go wrong and they can't meet that standard
34
histrionic personality disorder characteristics
- overly dramatic and attention seeking
- use physical appearance to draw attention
- display emotion extravagantly
- self centred
- over concerned with their attractiveness
- inappropriately sexually provocative and seductive
- speech may be impressionistic and lacking in detail
35
narcissistic personality disorder characteristics
- grandiose view of own uniqueness and abilities
- preoccupied with fantasies of great success
- require almost constant attention and excessive admiration
- lack empathy, envious of others, arrogant, exploitative, entitled
36
antisocial personality disorder characteristics
- conduct disorder present before 15 and pattern of antisocial behaviour continuing through adulthood are major components
- irresponsible and antisocial behaviour
- works only inconsistently, breaks laws
- irritable and physically aggressive
- impulsive and fail to plan ahead
37
psychopathy characteristics
- poverty of emotions both positive and negative
- lack of remorse and no sense of shame or morality
- superficially charming
- manipulates others for personal gain
- grandiose sense of self worth
- pathological lying and failure to accept responsibility
- shallow affect
- normal to high on IQ test
38
psychopathy etiology
- 2 pathways lead to the development of psychopathy
- fundamental psychopathy- caused by biological predisposition
- secondary psychopathy- relies on environmental exposure
39
antisocial personality disorder and psychopathy
- related by not identical
- 20% of people with APD score high on the psychopathy checklist
- all psychopaths are diagnosed with APD but many individuals with APD do not meet the criteria for psychopathy
- up to 80% of convicted felons meet criteria for APD but only 25% meet criteria for psychopathy
40
psychopathy and aggression
- psychopaths incarcerated in Canada perpetuate 2x as many violent crimes as non-psychopathic criminals
- psychopaths commit more violence and heinous acts of violence
41
development of psychopathy
- begins in early childhood with callous and unemotional traits, delinquent behaviours, and impulsivity
- macdonald triad
42
macdonald triad
- an extended period of bedwetting past the preschool years not due to any medical problem
- precocious sadism, often expressed as profound animal abuse
- fire starting
43
role of the family and development of APD and psychopathy
- lack of affection, severe parental rejection, physical abuse, inconsistencies in disciplining, failure to teach child responsibility toward others
- limitations include:
- harsh or inconsistent disciplinary practices that are reactions to the child's anti social behaviour
- many individuals who come from disturbed backgrounds do not become psychopaths
44
genetic correlates of ADP and psychopathy
- criminality and APD have heritable components
- increase in concordance for MZ than DZ pairs
- supported by adoption studies
45
psychopathy at the genetic level
- "warrior gene" is a high risk gene for psychopathy and leads to low MAOA
- gene is sex linked on the X chromosome, thus why most psychopaths are M
46
fearlessness hypothesis
anxiety provoking events have little effect on those with APD
47
emotion and psychopathy
- unresponsive to punishments- no conditioned fear responses
- have decreased levels of skin conductance in resting situations
48
shock avoidance in psychopaths
- avoidance learning is assumed to be mediated by fear
- lykken found that psychopaths were more motivated with finding the correct lever to navigate the maze rather than on avoiding the shock
49
antisocial personality disorder treatment
- treating depression and anxiety
- treatment must be responsive to the patient's interpersonal needs
- important to form a therapeutic alliance to make them feel the treatment is voluntary and relevant
50
psychopathy treatment
- treatment should focus on changing the behaviour rather than on changing the core personality characterisitcs
- generally there is neither cure nor effective treatment; there are no medications to instil empathy and psychopaths who undergo traditional talk therapy only become more adept at manipulating others
51
anxiety
- an affective state whereby an individual feels threatened by the potential occurrence of a future negative event
- characterized by tension, apprehension, and worry
- future oriented
52
fear
emotional response to a real or perceived current threat
53
panic
extreme fear when there is nothing to be afraid of
54
fight or flight response
- increase in HR, breathing, and palm sweating
- dilation of pupils
- underlies the fear and anxiety involved in almost all anxiety disorders
55
anxiety and comorbidity
- 50% of individuals with an anxiety disorder are also depressed (three part model)
- 10-25% of individuals with anxiety disorders abuse or are dependent on alcohol
- with phobias, abuse develops after the anxiety symptoms
- with disorders, abuse may occur before or after the onset of symptoms
56
tripartite model of anxiety and depression
- high level of negative emotions (both)
- low level of positive emotions (depression)
- physiological hyperarousal (anxiety)
57
generalized anxiety disorder characteristics
- persistent and excessive anxiety often about minor items
- chronic, uncontrollable worry about everything
- primarily focused on family, finances, work, and illness
- often it is not the amount of stress in the patient's life, but the anxiety and worry they experience
- difficulty concentrating, tiring easily, restlessness, irritability, high level of muscle tension
58
GAD etiology
- decreased arousal due to highly responsive parasympathetic NS
- worry temporarily reduces arousal which suppresses negative emotions and produces muscle tension
- dopamine in frontal lobes do not function normally
- possibly dysfunction in GABA, serotonin, norepinehrine, and other NT
- 15-40% heritability
59
neurobiological perspective of GAD
- benzodiazepines are often effective in treating anxiety
- receptor in the brain for benzodiazepines are linked to the inhibitory NT GABA
- benzodiazepines may decrease anxiety by the increase in realize of GABA
60
psychological factors of GAD
- include three characteristic modes of thinking and behaving
- being particularly alert for possible threats (hypervigilence)
- feeling that the worrying is out of control
- sensing that the worrying prevents panic, giving an illusion of coping
61
panic attack
- person suffers a sudden and often inexplicable attack of alarming symptoms: laboured breathing, heart palpitations, nausea and chest pain, feelings of choking or being smothered, dizziness, sweating, trembling, intense apprehension, terror, and feelings of impending doom
- may also experience depersonalization and derealization
62
panic disorder characteristics
- panic attacks
- may be cued (associated with particular objects, situations, or sensations) or uncured (spontaneous, not associated with a particular object or situation)
- can occur anytime, even when sleeping
- diagnosed as with or without agoraphobia
63
panic disorder prevalence
- typically begins in adolescence
- onset is associated with stressful life experience
- >80% of individuals diagnosed with an anxiety disorder also experience panic attacks
64
agoraphobia
- persistent avoidance of situations that might trigger panic
- avoidance of places in which it would be embarrassing or hard to obtain help in case of a panic attack
- extreme agoraphobics may become housebound
- usually develops within the first year of recurrent panic attacks
65
panic disorder etiology
- biological
- heritable- 5x as likely to have PD if a parent has it
- neurological
- people who experience panic attacks have a lower threshold for detecting oxygen in the blood leading to hyperventilation and the strong sense of needing to escape
66
learning theory
- first panic attack is a response to a stressful or dangerous life event (true alarm)
- initial bodily sensations of panic become false alarms associated with panic attacks
- individuals comes to fear interoceptive cues or the external environment in which they had the attack and normal sensations become associated with subsequent attacks
- sensations of arousal elicit panic attacks (learned alarms)
- fear of fear
- avoidance of behaviours or situations where sensations might occur begin
67
cognitive theory
- focus on how a person interprets and then responds to alarm signals from the body
- misinterpretation of normal bodily sensations as indicating catastrophic effects
68
fear of fear hypothesis
- suggests that agoraphobia is not a fear of public places but a fear of having a panic attack in public
- misinterpretation of physiological arousal symptoms
69
social stressor on panic disorder
- tend to have had a higher than average number of stressful events during childhood and adolescence
- presence of a close relative/friend helps decrease catastrophic thinking and panicking in agoraphobia
- may perpetuate the disorder by making the person feel more alone when alone
70
social phobia
- persistent, irrational fears linked generally to the presence of other people
- can be extremely debilitating
- tend to avoid situations in which they might be evaluated because they fear they will reveal signs of anxiousness or behave in an embarrassing way
71
generalized social phobia
- involves many different interpersonal situations
- has an earlier age of onset and is more comorbid with other disorders
72
specific social phobia
involves intense fear of one particular sensation
73
social phobia characteristics
- very sensitive to criticism and rejection; worried about meeting expectations of others
- dread to be evaluated and may not perform to their potential
- diminished performance challenges self esteem increasing anxiety
- less likely to be in a romantic relationship
- may not complete school or advance at work due to avoidance of social interactions
74
neurological factors of social phobia
- amygdala is strongly activated when afraid and when shown faces
- hippocampus and the cortical areas near the amygdala do not function normally
- dopamine, serotonin, and norepinephrine may function abnormally
75
heritability of social phobia
heritability is 37% on average
76
cognitive biases and distortions of social phobia
- see the world as a very dangerous place
- become chronically hyper vigilant for potential social threats and negative evaluations by others
- distorted emotional reasoning as proof that they will be judged negatively
77
classical conditioning of social phobia
social situation paired with a negative social experience produces a conditioned emotional response
78
operant conditioning of social phobia
- avoidance of social situations in order to decrease the probability of an uncomfortable experience
- negative reinforcement of avoidance behaviour because avoidance decreases anxiety
79
social factors of social phobia
- parent child interactions
- extremely over protective parents may lead children to cope with their anxiety through avoidance
- different cultures emphasize different concerns about social interactions and these concerns influence the specific nature of social phobia
- fear of offending others in Asian cultures; fear of humiliation in western cultures
80
phobia
- disrupting, fear mediated avoidance that is out of proportion to the danger actually posed and is recognized by the suffered as groundless
- broken down into 3 subtypes: agoraphobia, specific, and social
81
specific phobia
- unwarranted fears caused by the presence or anticipation of a specific object or situation
- subdivided to 5 sources of fear
82
5 sources of a specific phobia
- blood, injuries, and injections
- situations (planes, elevators, enclosed spaces)
- animals
- natural environment (heights, water)
- other
83
neurological factors of phobias
- amygdala appears to have a hair trigger
- anxiety evoked by specific phobias is associated with too little of GABA
- different phobias appear to be influenced to different degrees by genetics and the environment
84
psychological factors of phobias
- classical conditioning
- UCS results in UCR
- UCS is paired with CS to result in UCR
- eventually CS results in CR
- extinction occurs, so you need operant conditioning for the maintenance of the phobia
85
behaviourism
- unrealistic fears of usually harmless things; believed these people myst have had a bad experience with the target of the phobia at some point
- recent research argues that conditioning cannot fully account for the onset of phobias
86
behavioural theories of phobias
- focus on learning as the way in which phobias are acquired
- several types of learning may be involved: avoidance conditioning, modelling, prepared learning
87
avoidance conditioning
- reactions are learned avoidance responses (negative reinforcement)
- avoidance conditioning formulation
- phobias develop from two related sets of learning:
- via classical conditioning
- person learns to reduce conditioned fear by escaping from or avoiding CS (operant)
88
modeling
- person learns fear through imitating the reactions of others
- learning of fear by observing others is referred to as vicarious learning
89
prepared learning
- people tend to fear only certain objects and events
- fear spiders, snakes, heights; but not lambs
- some fears reflect classical conditioning, but only to stimuli which an organisms is physiologically prepared to be sensitive
90
cognitive diathesis
- the tendency to believe that similar traumatic experiences will occur in the future or not being able to control the environment
- important in developing a phobia
91
cognitive theories of phobias
- focus on how people's thought processes can serve as a diathesis and on how thoughts can maintain a phobia
- anxiety is related to being more likely to:
- attend to negative stimuli
- interpret ambiguous information as threatening
- believe that negative events are more likely than positive ones to reoccur
92
obsessions
- intrusive and recurring thoughts, impulses, and images
- most frequent obsessions include: fear of contamination, fear of expressing some sexual or aggressive impulse, and hypochondriacal fears of bodily dysfunction
93
compulsion
a repetitive behaviour or mental act that the person feels drive to preform to reduce the distress caused by obsessive thoughts or to prevent some calamity from occurring
94
OCD in children
- childhood prevalence of 0.5-1%; gender ratio is equal
- most common obsessions are germs, fear of harm to self or others, need for symmetry
- most common compulsions are washing and cleaning, checking, counting, repeating, touching, and straightening
- children change obsessions/compulsions more than adults
95
thought fusion action
- believing that having a certain though increases the likelihood that thought will come true
- belief that having a thought is equal to behaving in that way; seen more in religious people
96
psychological factors of OCD
- obsession are caused by the person's reactions to intrusive thoughts
- trying to suppress obsession can increase their frequency (rebound effect)
97
rachman's theory of obsessions in OCD
- unwanted intrusive thoughts are the roots of obsessions
- obsessions often involve catastrophic misinterpretations of negative intrusive thoughts
- person is compelled to engage in suppression, neutralization, and avoidance
98
neurological factors of OCD
- may be caused by dysfunctional connections among the frontal lobes, thalamus, and basal ganglia
- both the frontal cortex and basal ganglia function abnormally in OCD patients
99
impulse control disorders
- onset usually occurs between 7 and 15
- impulsivity can be thought of as seeking a small, short term gain at the expense of a large, long term loss
- those with the disorder repeatedly demonstrate failure to resist their behavioural impetuosity
- impulse control disorders are considered to be part of the OCD spectrum
100
kleptomania
- occurs in fewer than 5% of shoplifters
- more common in F than M
- average age is 35; some report the onset as early as age 5
- evidence linking it with abnormalities in serotonin
- stressors, like a major loss, may precipitate kelptomaniac behaviour
101
trichotillomania
- hair loss from repeated urges to pull or twist the hair until it breaks off
- symptoms usually begin before the age of 17
- other characteristics include: uneven appearance to the hair, bare patches or al around loss of hair, being unable to stop, etc.
- may affect up to 4% of the population; F are 4x more likely than M
- typically lasts <1yr
- SSRIs may reduce symptoms
102
dermatillomania
- typically begins with the onset of acne in adolescence, compulsion continues even after acne has gone away
- linkage between dopamine and the urge to pick, stressful life events have been linked to the onset of the condition
103
pyromania
- purposely set fires on more than one occasion
- before the act of lighting the fire, the person usually experiences tension and an emotional buildup
- when around fires, the person gains intense interest or fascination and may experience pleasure, gratification, or relief
- most cases occur in children/adolescents and 90% of cases are M
104
trauma and stressor related disorders
- marked by four general types of persistent symptoms after exposure to the traumatic event
- intrusive re-experiencing of the traumatic event
- avoidance
- negative thoughts and mood and dissociation
- increased arousal and reactivity
105
reaction to traumatic stressors
- traumatic events challenge the basic assumptions that most people have about the world
- the belief in a fair and just world
- the belief that it is possible to trust others and be safe
- the belief that it is possible to be effective in the world
- the sense that life has purpose and meaning
- people react differently to stressors and traumatic events based on previous experiences, appraisal of the stressors, and coping style
106
criticisms of diagnosis PTSD
- distress and suffering experienced by people months after a traumatic event are not necessarily pathological
- many symptoms of PTSD overlap with those of depression and anxiety
- original criteria involved traumatic events far outside those normally experienced but now include more common traumatic events
- altered for second hand victimization
- has become a way to seek status as a victim for legal, financial, or psychological reasons
- only diagnosis for which people can sue for compensation, thus may be over diagnosed
107
categories of PTSD symptoms
- re-experiencing a traumatic event
- avoidance of stimuli associated with the event or numbing of responsiveness
- symptoms of increased arousal
108
PTSD vs acute stress disorder
if stressor causes significant impairment in social or occupation functioning less than one month acute stress disorder is diagnosed
109
risk factors of PTSD
- exposure to trauma and severity of trauma
- gender (more F)
- preceived threat to life
- personality traits of neuroticism and extroversion
- early conduct problems
- family history of psychiatric disorders
- stressful ocucpations
110
psychological theories of PTSD
- classical conditioning of fear
- anxiety sensitivity
111
biological theories of PTSD
- genetics
- specific domains of noradrenergic system
- trauma may raise levels of norepinephrine
- evidence for increased sensitivity of noradreergic receptors in patients with PTSD
- associated with smaller hippocampus volume
- associated with decreased anterior cingulate and medial prefrontal performance
112
biological treatments for panic disorder
- antidepressants
- both selective SSRIs and tricyclic antidepressants have been used successfully to treat PD
113
psychological treatments for panic disorder
- exposure based treatments are often useful in reducing PD with agoraphobia
- CBT
114
psychoanalytic approach for phobias
attempt to uncover the repressed conflicts believed to underlie the extreme fear and avoidance characteristic disorder
115
behavioural approach for phobias
- systematic desensitization
- in vivo exposure
- virtual reality exposure
- flooding
116
cognitive approach for phobias
- viewed with skepticism because of a central defining characteristic of phobias: phobia fear is recognized by the individual as excessive or unreasonable
- CBT
117
Biological approach for phobias
- anxiolytics (drugs that reduce anxiety- sedatives/tranquillizers)
- barbiturates: first major category of drugs used to treat anxiety disorders
- propanediols
- benzodiazepines `
118
therapies for GAD
- similar to that of phobias
- focus on restructuring cognitions
- patients taught to monitor their thoughts and beliefs, assess their validity, and develop more balanced appraisals
119
therapies for OCD
- therapists attempt to normalize the occurrence of obsessional thinking by telling patients that approx 80% of population experience intrusive or unwanted obsessions
- exposure response prevention
- CBT
- drugs that increase serotonin
120
therapies for PTSD
- combination of behavioural and cognitive methods (exposure, relaxation, breathing retraining to reduce arousal and anxiety)
- psychoeducation
- cognitive methods help patients understand the meaning of traumatic experiences and the misattributions they make about them
- ensuring that the traumatized person is as safe as possible (group therapy can provide support and a sense of safety)
- family and couples therapy can help educate family members in how they support their loved one
121
depression
- emotional state marked by great sadness, worthlessness, and guilt
- often associated with other psychological problems (panic attacks, substance abuse, sexual dysfunction, personality disorders)
122
prevalence and onset of major depressive disorder
- 10-25% of F; 5-12% of M
- different ethnicities, education levels, incomes, and marital statuses are affected equally
- can begin at any age, onset is typically mid 20s
123
comorbidity of MDD
most people with MDD have an additional psychological disorder
124
course of MDD
- more than half of those who have a single depressive episode have at least on additional episode (MDD, recurrent depression)
- periods of remission shorten with age
125
anhedonia
- difficulty or inability to feel pleasure
- activities and intellectual pursuits that were once enjoyable no longer are
- can lead to social withdrawal
126
cognitive symptoms of MDD
- feelings of worthlessness, grief, or guilt
- negative self evaluation with no objective reason
- tendency to ruminate over past events and feelings
- feelings of unwarranted responsibility for negative events (to the point of delusions)
- self deprecation (blaming self for depression)
- poor concentration, difficulty thinking, remembering, and making decisions
127
self harm
- in the US, 1 in 200 girls between 13 and 19 cut, comprising 70% of teen girls who self harm
- number of cases is on the rise
- without treatment, the behaviour will continue
128
suicidal ideation
thoughts and intentions of killing onself
129
suicide attempts
self injury behaviours intended to cause death but that do not lead to death
130
suicide gestures
self injury in which there is no intent to die
131
suicide
behaviours intended to cause death and death occurs
132
suicide statisitics
- ideators with a plan are more likely to make an attempt (31.9) than those without a plan (9.6); 43% of attempts are unplanned
- history of prior attempts is the strongest correlate of 12 month attempts
133
what to look for in someone who is suicidal
- giving away possessions
- saying goodbye to family and friends
- talking about death
- making/threatening/rehearsing plans for death
134
neurobiology and suicide
- MZ twins have a much higher concordance for suicidality than DZ twins
- decreased levels of 5-HIAA
- post mortem studies of brains of suicides and those with impulsivity revealed fewer serotonin receptors
135
evolution of suicide
- the death of one carrier of genes preserves the life of many more carriers
- worker bee dies when stinging a predator, releasing alarm pheromones- protects the greater good of the hive
136
psychomotor agitation
pacing, handwringing, difficulty sitting stillp
137
psychomotor retardation
slowed bodily movements and speech, long pauses in speaking
138
vegetative signs
- psychomotor symptoms
- changes in appetite or weight (increase/decrease)
- sleep disturbance (hypersomnia/insomnia)
139
hypersomnia
sleeping more than normal
140
insomnia
difficulty sleeping or staying asleep
141
seasonal affective disorder
- a mood disorder in which people who have normal mental healthy throughout most of the year experience depressive symptoms in the winter, summer, spring, or autumn year after year
- it is a specifier of major depression
142
neural communication in depression
not caused by too much or too little of one NT and instead raised from complex interactions among numerous NT substances
143
monoamine oxidase inhibitors (MAOIs)
- decreases the breakdown of norepinephrine (NE)
- MAO is an enzyme that breaks down monoamines (e.g. NE) left in the synapse
- MAOIs inhibit MAO so it doesn't breakdown the excess NT, leaving more to hit receptors and boost their effects
144
tricyclic antidepressants
- decreases the reuptake of norepinephrine (NE)
- TCAs stop molecules from taking excess NE back into the firing neuron, leaving more in the synapse to keep hitting the receptors and boosting their effects
145
selective serotonin/norepinephrine reuptake inhibitors (SSRIs/SNRIs)
medications that slow the reuptake of serotonin from the synapse
146
stress related hormones
- excess cortisol in the blood makes the brain more prone to overreacting to stress (stress model)
147
bipolar disorder
- mood is often persistently and abnormally upbeat or shifts inappropriately from upbeat to markedly down
- based of four building blocks:
- major depressive episode
- manic episode
- mixed episode
- hypomanic episode
148
bipolar I
- must have a manic or mixed episode
- an MDE may also occur
149
bipolar II
- must alternate between hypomanic episode and major depressive episodes
- less severe because of the absence of manic episodes
150
manic episode
period of at least one week characterized by abnormal and persistent euphoria or expansive mood or irritability
151
expansive mood
unceasing, indiscriminate enthusiasm for interpersonal, sexual, or occupation interactions
152
what happens during a manic episode
- begin projects with no skills or special training
- believe they have special relationships with famous people or superior abilities
- have less need for sleep
- talk rapidly and loudly or have pressured speech
- rarely sit still
- flight of ideas
- be highly distractible
- have poor judgement resulting gin reckless gambling, spending, or sexual behaviours
- sometimes involves rapid cycling or mixed episodes
153
mitochondria
- organelles that convert glucose to provide energy for the rest of the cell
- located in the cytoplasm of cells
- genes affect the number of these power plants
154
psychoanalytic theory of depression
- according to freud, depression is created early in childhood
- during the oral period, child's needs are insufficiently or over sufficiently gratified, causing fixation in this stage
155
learned helplessness
- an acquired tendency to give up easily or not to try at all when faces with new or difficult tasks
- repeated failure
- belief that others are in control
- having others take care of ones needs
156
merging psychology and biology
- twin studies have shown that identical twins who's co twin has MDD has a 4x higher risk of MDD than non identical twins
- possibility that genes influence stress response- sensitivity to stress could contribute to depression
- the environment plays a key role in whether genes contribute to depression and how genes have their effects
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evolution of depression
- the symptoms of depression have been found in every culture
- rank theory hypothesis
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rank theory hypothesis
in dangerous situations, pessimism and lack of motivation may give a fitness advantage by inhibiting certain actions, especially futile or dangerous challenges to dominant figures, efforts that would damage the body
159
behavioural method to treat depressive disorders
- focus on identifying and changing depressive behaviours
- behavioural activation- self monitoring, scheduling daily activities that lead to pleasure, identifying and decreasing avoidant behaviours
- superior cognitive techniques in treating both moderate and severe depression
160
cognitive method to treat depressive disorders
- aim to diminish or change depressing thoughts (often distortions of reality)
- patients encouraged to collect data to assess the accuracy of their beliefs (can relieve and prevent depressive symptoms)
- CBT is often as successful as medication
- combination of CBT and medication is the most effective
161
electroconvulsive therapy (ECT)
- may be used when a patient:
- has severe symptoms
- cannot take medications due to side effects or medical reasons
- has psychotic depression unresponsive to medication
- has sever depression that has not improved with medication or psychotherapy
- administered 2-3x/week for 6-12 weeks
- can cause memory loss
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transcranial magnetic stimulation
- sends high intensity magnetic pulses through the brain
- easier to administer and causes fewer side effects than ECT
