PSYC3003 - Introduction to Clinical Psychology (Abnormal Psychology) Flashcards

Question

Validity

Answer 1

Extent to which the test measures what it is intended to measure.

Answer 2

* Structured interviews * Questionaires * Daily diaries

Answer 3

A structured interview involving Initial & probe/follow-up questions. Follows a manual including: * Glossary of terms - definitions * Standardised scoring * Guide to intepretations Yields information about frequency, nature and (often) severity of presenting problems.

Answer 4

Self-report with close ended questions

Answer 5

Confirms the diagnosis of participants using structured interviews. Questionaires are usefull as screening measures and often appropriate for monitoring progress in clinical practice & research. (but they do not provide specific details about the nature, occurance or impact of client's problems.

Answer 6

They inform treatment decisions - because if we understand why a problem occurs, we're in a better position to try and solve it. Theory - \> Therapy

Answer 7

Explanation for the development & maintenance of a disorder.

Answer 8

1. Learning theory (behavioural) [classical conditioning, operant conditioning, observational learning) 2. Cognitive theory

Answer 9

Stimulus -\> Response UCS-\> UCR An Unconditioned Stimulus (UCS) causes an unconditioned response (UCR). By repeatedly pairing a Neutral Stimulus (NS) with the UCS the NS becomes a conditioned stimulus (CS) which will cause a conditioned response (CR) (of what used to be the UCR)

Answer 10

Relatively harmless neutral stimuli, through pairing with aversive UCS, can develop the ability to produce problematic CRs.

Answer 11

By repeatedly presenting the CS in the absence of the UCS, this should lead to the **extinction** of the CR

Answer 12

Repeatedly presenting the CS in the absence of the UCS, until the CS no longer leads to the CR

Answer 13

UCS (sudden noise/movement) causes UCR (fear) CS (bird) paired with UCS CS (bird) now causes CR (fear) Can now be generalised to other birds, birds on TV, feathers etc

Answer 14

Treatment = presenting CS in the absense of UCS; should extinguish CR BUT ALSO.... The CR (fear etc) is very aversive and exposure must be done gradually and skillfully

Answer 15

Graded exposure to a problematic stimulus. The idea being that anxiety diminishes with onging exposure to the feared stimulus. This is known as Habituation. exposure can be imaginal, virtual or in vivo, but must be done gradually in stages.

Answer 16

An 'outdated' therapy that tried to link CS with a state incompatible with the CR namely, relaxation. It is a predecessor to modern exposure therapy, which does not rely on relaxation techniques, though they can be helpful.

Answer 17

1. Imaginal 2. Virtual 3. In vivo (in real life)

Answer 18

Many behaviours depend on their consequences. Positive consequences -\> repeat behaviour Negative consequences -\> do not repeat behaviour

Answer 19

* **Positive Reinforcement** - maintenance or increase because an event/stimulus occurs as a consequence. (something plesant occurs) * **Negative Reinforcement** - maintenance or increase because an event/stimulus ceases or is prevented as a consequence (something unpleasant ceases) e.g., NEG: client with bird phobia avoided or ran way from birds - these behaviours were negatively reinfoced by prevention (because there was less anxiety)

Answer 20

* **Positive punishment** - unplesant event/stimulus occurs as a consequence * **Negative punishment** - plesant even't/stimulus is removed as a consequence also. .. * **Extinction** - reduction or cessation of behaviour because reinforcement is discontinued

Answer 21

Stimuli that signal the likely reinforcement or non-reinforcement (or punishing consequence) of a behaviour ## Footnote Signals to an organism that, should a particular response be made, reinforcement is available. Such a response is said to be under stimulus control because the response is usually made when only the discriminative stimulus is present. Example: Alicia knows that her business partner is in a good mood if she is smiling, is not wearing her suit jacket, and has opened the blinds. These discriminative stimuli inform Alicia that she can approach her partner with a new idea (Alicia's particular response) and expect her partner to be supportive (reinforcement). Alicia's behavior is under stimulus control because Alicia will not approach her partner unless the discriminative stimuli are present.

Answer 22

* **Reinforce desirable behaviours** * Reinforce behaviours incompatible with undesirable behaviours * Withdraw reinforcement for undesirable behaviour (**Extinction**) * Prevent punishment of desirable behaviour (**Teach skills**) * **Stimulus control procedures** (e.g., alco man avoids pub, then drives past, then walks past) * **Shaping**: reinforcing succssive approximations to the desire behaviour (e.g., for a client with bird phobia, for successfull steps taken in graded exposure)

Answer 23

Learning behaviours by observing someone else (model) perform them. Whether we perform observed behaviour depends on cosequences of the behaviour for the model. * positive consequences - increased chance * negative consequences - decreased chance

Answer 24

* Model desired behaviour e. g., holding a bird to show a client with bird phobia that it is safe.

Answer 25

Cognitive theories emphasise people's appraisal of events/stimuli, and underlying beliefs. Thus, abnormal behaviour is thought to be caused by abnormal beliefs, intepretations and thoughts.

Answer 26

An Underlying belief. Schemata affect attention, interpretation, memory. In psychological disorders, schemata are abnormal negative.

Answer 27

Ways of misintepreting info/event to fit schemata

Answer 28

Spontaneous thoughts about a given situation.

Answer 29

Schemata (Stable) -\> cognitive distortions (biases in processing of a given situation) -\> negative automatice thoughts (situation-dependant)

Answer 30

* **Schemata** - birds are dangerous and unpredicatable, I can't cope if I see a bird * **Cognitive distortions** - magnifiy and overgenearalise negative infor about birds; arbitary inference (inferring ngative things about birds with no evidence) * **Negative Automatic Thoughts** - "that bird will peck my eyes", "it knows I am afraid"; "my hearts pounding, I'll pass out"

Answer 31

AIM - identify & change negative automatic thoughts * Monitor & challenge negative automatic thoughts and dysfunctional beliefs * Substitute alternative adaptive thoughts * Often involves keeping a diary

Answer 32

1. **Recurrent and persistant** **thoughts**, **urges,** or **images** that are... intrusive or unwanted, and in most individuals cause marked **anxiety** or **distress** 2. The person attempts to ignore, supress or 'neutralise' them. Themes include: dirt/contamination; death/injury; violence/sex. Obsessions often occur in response to a recognised trigger.

Answer 33

1. Repetitive behaviours (e.g., washing, ordering, checking)... or metal acts (e.g., praying, counting, repeating words) that the person feels driven to perform in response to an obsession. 2. ...aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation" excessive and not relistically connected to their purpose. Compulsions are intended to achieve one of the following * Avoidance (of triggers/obsessions) * Prevention * Putting things right; verification \*compulsions reduce anxiety\*

Answer 34

1. Washing & cleaning 2. Checking 3. Repeating 4. Hoarding 5. Ordering 6. Mental acts

Answer 35

A compulsion to wash & clean in an excessive and ritualised way our of a fear (obsession) with contamination. e.g., 37 Y.O women who washes 20-30 times per day

Answer 36

A compulsion to check repeatedly to ensure a task has been succesfully carried out or that a particular negative event has not occured. e.g., Women who checked door - obsession triggered by leaving house; pedestrians; phone; gas and power switches

Answer 37

The compulsion to repeat a task/s in a particular way until it 'feels right'. e.g.., 2 x rituals to safeguard car

Answer 38

Associated with a fear with losing information or objects, or a fear that objects can harm others (e.g., family or strangers)

Answer 39

Ritualistically placing objects in a particular way. e.g., symmetrically, blinds, matchboxes

Answer 40

* Counting * Repeating phrases e.g., "I hate the devil, I hate the devil" * Neutralising anxiety-provoking image by imagining the opposite

Answer 41

How much awareness one has of their OCD * Good or fair insight * poor insight * absent insight (Delusional)

Answer 42

Deppression, anxiety disorders; tourette's disorder (5-7%).

Answer 43

* Work * School work * Social * Family relationships * Health (e.g., avoid seeing medical practitioner; taking medicines; skin lesion from washing)

Answer 44

Based on Mowrer's (1960) two-stage theory - combines classical conditioning and operant learning. **Classical conditioning**: Neutral objects/situations/thoughts (e.g., locking door, passing though of car accident) become anxiety-provoking through being paired with an anxiety-provoking event (or anxious thoughts). Genaralisation to similar stimuli can occur. **Operant Learning** (consequences): Avoidance (e.g., of triggers & obsession) is negatively reinforced by decreasing or prevention of anxiety but.... Many tiggers obsessions cannot be avoided, so... Compulsions used to prevent harm or neutralise obsession, thus compulsions are negatively reinforced (Reduced anixety)

Answer 45

* Individuals with OCD **overestimate** the **probability** & **severity** of threat. * Intrusive thoughts become obsessions when they are associated with negative automatic thoughts about **responsibility**. for causing (and preventing) **harm**. * Also importance of controlling thoughts; overestimation of importance of thoughts (e.g., that they increase risk) * Obsessions lead to perceptions of danger * Person feels they must act to avert/lessen danger, leading to compulsions.

Answer 46

1. * Quite a few studies using PET scans and other neuroimaging techniques suggest abnormal activity in the **nerve pathways connecting the basal ganglia and orbitofrontal cortex** - **these pathways use serotonin** * There is a relationship between OCD & other disorders associated with **abnormalities of the caudate nucleus** 2. NO The biological abnormalities may or may not be causal. Behavioural changes have been shown to cause brain changes.

Answer 47

1. Exposure and Response Prevention (ERP) - behavioural therapy 2. Cognitive Therapy 3. Drug Therapy The behavioral and cognitive therapy are often combined (CBT!)

Answer 48

**Exposure and Response Prevention (ERP)** Technique: 1. Exposure to avoided situations & direct contact with feared stimuli 2. Prevention of compulsions, including thoughts - graded! and individually tailored!! Self-directed ERP needed; but therapist-guided initially better outcomes * **Exposure** = In-session practice; guided practice in real life setting, therapise MODELs behaviour * **Homework** (self-guided ERP) = agreed tasks (dailyl diary), home work adherance is a strong predictor of therapeutic outcomes.

Answer 49

Each episode of exposure must continue until anxiety diminishes, because if client leave before anxiety diminishes - the fear/avoidance etc will be negatively reinforced i.e., it will be just another experience of anxiety regarding obsession/triggers.

Answer 50

1. Ongoing exposure to feared stimulus without performing the compulsions (though anxiety intially increase) results in **habituation** (Reduced anxiety) 2. Successively lower levels of anxiety break association between feared stimuli & anxiety (**Extinction** of conditioned response) Non-performance of the compulsion also weakens the association between obsessions (thoughts & fears) & compulsions

Answer 51

**Cogitive Therapy** * Aims to **challenge negative automatic thoughts & change underlying beliefs** (Schemata), challenge and replace dysfunctional beliefs about the **probability of harm** and **personal responsability**. * Cognitive restructuring - client taught to **(1)** Identify anxiety-provoking thoughts **(2)** Challenge them **(3)** Rehearse more constructive alternatives. **_Cognitive therapy elements:_** * Evidence for & against obsession-related beliefs * Re-assign probabilities * In session & homeword - homework= correct dysfunctional thoughts and beliefs in **daily diary**

Answer 52

Usually antidepressant medications.

Answer 53

There are few direct studies. When studies are done-well, ERP can be as good as full CBT and better than CT alone (but possibly comparable) ERP tends to have larger effects than CT alone, but not always.

Answer 54

Probably CBT, but a combination can be effective (Depending on baseline severity) While the short-term effects of drugs can be as good as CBT, the long-term gain of drugs is poor and relapse is common when drugs are ceased. Drugs also have side-effects and many people do not want to take drugs or drop-out

Answer 55

Partly because agoraphobia can exist in the absence of panic attacks or PD nearly all previous research (both aeiological & treatment) on agoraphobia has been done in the context of Panic Disorder

Answer 56

Anxiety Disorder

Answer 57

4 of the following symptoms * Palpatations, pounding&/or rapid heart rate * Sweating * Trembling or shaking * Sensation of shortness of breath * Feelings of choking * Chest pain/discomfort * Nausea/abdominal distress * Dizziness, faintness or unsteadiness * Chills or heat sensations * Paraesthesia (numbness of tingling) * Derelisation (unreality) * Fear of losing control or going mad * Fear of dying

Answer 58

1. **at least one Panic attack.** unexpected with no obvious cues/triggers. (usually more) 2. at least one of the attacks has been followed by 1 month (+) of one or both of the following * **Persistant concern about having additional panic attacks or their consequences** (e.g., of a heart attack or "going crazy", includes concern of life-threatening illness, cardiac problems, social, losing control [including bladder], insanity) * **A significant maladpative change in behaviour related to attacks** (e.g., avoids exercise or unfamiliar places - includes avoiding increasd heartrate & places where PA might be embaressing or help might not be available; repeatedly seeking medical help; work absenteeism or resign job.

Answer 59

* MUST be uncued (unexpected or 'out of the blue') * Central features (and the starting point for worry and behaviour change) * Probably more frequent

Answer 60

Study of 1168 people with PD * Mean of 4 (SD=5) uncued attacks a week * Mean of 2.5 (SD=3) situational (cued) attacks/week

Answer 61

1. Marked fear/anxiety about 2(+) of the following situations * Using public transport * Open spaces (parking lots, market places) * Enclosed spaces (shops, cinemas) * Standing in a line or in a crowd * Being outside of the home alone 2. The individual **fears or avoids** these situations **because of thoughts that escape might be difficult** or help **might not be available** in the event of having **panic-like symptoms or other incapacitating or embaressing symptoms ** 3. Agoraphobia are avoided, require the prescence of a companion, orr are endured with intense fear or anxiety. 4. The fear/anxiety is excessive Avoidance \<------\> Agoraphobia

Answer 62

1. Hyperventilation 2. Cognitive theory 3. Learning - classical conditioning, operant conditioning

Answer 63

When we exhale, we excrete carbon disoxide (CO2) from our lung. When people are frightened they hyperventilate - over-breath. 1. Hyperventilation -\> decrease CO2 2. Decreased CO2 -\> increased alkalinity 3. increased alkalinity -\> physical & psychological symptoms of panic

Answer 64

* **Individuals have an enduring disposition to intepret bodily sensation in a catastophic way** (e.g., they will have a heart-attack, stroke, go mad or die) Anxiety increased, bodily sensations increase; continues in vicious cycle -\> panic attack Increasing attentiveness to boily sensations and avoidance of place where panic could occur.

Answer 65

1. Catastrophic cognitions about physical sensation can follow rather than precede the very first attack. 2. Some people (30%) do not report fearing that bodily symptoms indicate impending mental or physical disaster 3. Panic attacks can occur during non-dreaming sleep i.e., not caused by the intepretation of bodily sensations in a catastrophic way.

Answer 66

Combined operant and classical conditioning Classical: * Stressfull experience -\> anxiety & first panic * Other internal & external stimuli present at the time become conditioned stimuli (CSs) that can lead to further attacks (CRs) Operant: * **Avoidance** (e.g., **of physical sensations** associated with panic attacks [e.g., exercise]; **general places** that increase concern about having a PA; **specific places** where a PA occured before. * **Avoidance is maintained by negative reinforcement** (prevention/reduction of anxiety and panic attack themselves)

Answer 67

Awareness of internal physical bodily sensations

Answer 68

Cognitive theory i.e. beliefs -\> avoidance * Dysfuntional beliefs about the meaning of bodily sensations -\> panic attacks and avoidance Learning theory i.e., body sensation/panic -\> beliefs * Conditioned associations between bodily sensations (&situations) and panic --\> beliefs/fears about bodily sensations. Avoidance neg. reinforced by reduced anxiety.

Answer 69

Breathing retraining (to prevent/stop hyperventilation)

Answer 70

* Antidepressant medications (a range of types) * Benzodiazepines (sedatives/sleeping pills) substantial risk of tolerance & dependence - not a good idea.

Answer 71

Cognitive Behavioural Therapy (CBT)

Answer 72

**Cognitive Behavioural Therapy** The most empirically supported psychosocial treatment for PD/A. The central focus is repeated exposure to feared situations and sensations supported by a set of control-based coping skills. "coping skills" = cognitive therapy plus breathing retraining and relaxation. It involves: * Teaching client to identify catastropihic intepretations of boidly symptoms * Challenege; replace with rational response * Diary & daily homework exercises (often workbook)

Answer 73

Exposure therapy to 1. sensations and 2. situations **Graded Interoceptive Exposure (to sensations)**

Answer 74

Used to treat Panic Disorder (and Agoraphobia) * Graded exposure to physical sensations associated with panic attacks (CSs that trigger attacks) * Initially in presence of therapist; later, by the client at home. * Daily exercises Purpose: to breain associations b/t internal (interoceptive) sensations and panic reactions - extinction of CR

Answer 75

**Graded exposure** to feared situations/stimuli * Usually therapist-assisted initially, because therapist-guided has a better outcome for PD with agoraphobia. * Self-direct exposure also essential - daily homework

Answer 76

Recent meta-analyses indicated exposure (interoceptive & in-vivo) combined with breathing retraining has the largest therapeutic effects for PD ("Exposure is the treatment of choice") * CT useful for panic attacks * Exposure therapy useful at managing avoidance * Introceptive exposures alone, improves beliefs about panic attacks. * Exposure for agoraphobia improves cognitions re. panic attacks & reduces frequency of panic attacks.

Answer 77

* Antidepressant medications and CBT either comparable, or CBT better. * Drop-outs tend to be lower for CBT than for drug therapy * More relapse with medication than CBT They can be COMBINED, this sometimes results in better outcomes than either alone (e.g., quicker response), particularly for those with severe symptoms and comorbid deppression.

Answer 78

1. Positive - presence of abnormal behaviour 2. Disorganised 3. Negative - Deficit in normal behaviour

Answer 79

Delusions, hallucinations etc

Answer 80

Disorganised speech, grossly disorganised or catatonic behaviour

Answer 81

Affective flattening, alogia, avoilation

Answer 82

essentially - A. symptoms, B. Dysfunction, C. Duration **_A_** Symptoms: two (+) of the following symptoms, each present for a significant portion of time in a 1-month period (or less if successfully treated. Must include 1, 2 or 3 . 1. Delusions 2. Hallucinations 3. Disorganised speech (e.g., frequent derailment or incoherence) 4. Grossly disorganised or catatonic behaviour 5. Negative symotms (e.g., affective flattening, alogia, avoilition, anhedonia) **_B_** Dysfunction - for a sig. portion of time since onset, lvl of functioning in one or more major areas, asuch as work, interpersonal relations or self-care, is markedly below the level achieved prior to onset. **_C_** Duration - continuous signs of disturbance for 6+ months. at least 1 month of criterion A symptoms (unless successfully treated) may include preodromal (leading up to) or residual symptoms (after the acute phase)

Answer 83

Delusions, hallucinations or disorganised speech

Answer 84

Delusions are bizzare false beliefs.

Answer 85

belief that someone/something is trying to harm them (e.g., spying following, posioning)

Answer 86

* Thought broadcast - belief that someone or something is reading thoughts * Thought insertion - belief that something is making them think things * Made acts - belief that something is making me do things.

Answer 87

Belief the one has extraordinary powers (control the sun or wind) or that one is a very important person (e.g., God, bill gates, sent to prevent WW1)

Answer 88

Seeing personal significance/messages in events unrelated to them.

Answer 89

Flase perceptual experiences (mostly auditory 70%, mostly hearing voices)

Answer 90

Threatening, critical, bossy, nice (or funny) They may comment on what a person does, or be 2-voices discussing the person, or they may repeat throughts (mimic)

Answer 91

Primary auditory cortex.

Answer 92

Frequent dereailment or incoherence

Answer 93

Movement abnormalities, profoundly dettached, stationary, catatonic posturing. In appropriate, purposless, unable to plan and execute tasks.) examples include: * ties a ribbon around toe * points at nothing * standing in a corner * Inappropriate verbal behaviour and affect, e.g., mumbling, swearing, giggling.

Answer 94

Poverty of speech

Answer 95

Reduction in goal-directed behaviour.

Answer 96

Reduction in the ability to experience pleasure.

Answer 97

Lifetime prevalence 1% male:female = 1:1, BUT - sex differences in the natur of the disorder trajectory. Age of onset = late to adolescent to early adulthood//// MEN - 15-24, drops of quickly WOMEN - age of onset late for women

Answer 98

ONSET - can be gradual or acute (Sudden) COURSE - highly variable * Frequency of relapse (Acute episodes) * Chronicity (persistance of symptoms) * Level of functioning between episodes * Symptoms * Cognitive functioning (Executive function, memory) following acute episodes - 25-30% have chroni/persistant symptoms., 50%+ of schizophrenia is episodic (i.e., relapses), 45% have periods of recovary./remission (approximations based on a number of studies)

Answer 99

* Premorbid adjustment (is the BEST predictor) - people with good premorbid adjustment have a better prognosis. * Onset - gradual & earlier has a poorer prognosis. * Duration of untreated psychosis - longer -\> worse * Symptoms - prominent negative symptoms lead to more chronic disorder, poorer social and work adjustment, less symptom relief from medication& cognitive impairment. * Sex - women tend to be better adjusted.

Answer 100

Scizophrenias OR schizophrenic spectrum disorder

Answer 101

Overall, there probably is a higher rate of aggressive behaviour in people with schizophrenia than in the general population, but “the vast majority are not aggressive” (DSM‐5, p. 101), & serious violence is rare.

Answer 102

Poorly operationalised/definitions 'aggressive behaviour', lack of comparison group, time and place of measure (e.g., police allowed to forcibly remove person suffering psychosis = understandable aggressive/defensive response.

Answer 103

* socioeconomic and occupational status * homelessness * drug dependence * exposure to violence * apprehension by authority.

Answer 104

Part-genetic, part-environmental. Twin studies have shown a cocordance rate of 50% (approx) between monzygotic twins (i.e., identical twins). Adoption studies have shown that BIOLOGY rather than rearing environment determines the risk of developing schizophrenia. BUT the genetic picture is COMPLEX - spcific gene sunknown, multiple genes over multiple chromosomes are candidates, this might explain why it is so diverse.

Answer 105

* Ventricuular enlargement (atrophy), correlated with negative symptoms. * Reduced activity in frontal lobe, particularly during cognitive tasks - greatest with negative symptoms. * Neurotransmitter abnormalities - Dopamine hypotheses(more detail in another Q)

Answer 106

**That schizophrenia reflects abnormalities of dopamine (DA)** * **Underactivity in frontal cortex (might) develop first and lead to overactivity in subcorticol areas!** * underactivity in the frontal cortex -\> negative symptoms * Overactivity in subcorticol parts -\> positive symptoms.

Answer 107

1. Antipsychotic drugs WORK because they reduce subcorticol dopamine activity. 2. Antipsychotics side-effects - can produce symptoms of parkinson's due to inadequote DA activity in the nigrostriatal pathway that deals with movement. 3. Side effects of drugs that cause an increase in Dopamine e.g., ampetamines ---\> psychotic symptoms. 'amphetamine psychosis'. OR L-dopa used to treat parkinsons disease can lead to psychosis.

Answer 108

Underactivity (negative), Overactivity (positive)

Answer 109

* Biological vulnerability + environmental stressor = schizophrenia. * Stressors include prenatal and birth complications, e.g., maternal infections and other illnesses, obstetric (e.g., oxygen deprivation, CNS trauma)

Answer 110

Diathesis-stress hypothesis

Answer 111

Drug treatment, antipsychotics and neuroleptics.

Answer 112

* They decrease DOPAMIE activity in the lower parts of the breain by blocking post-synaptic DA receptors (attach/bind them without activation them and prevent DA from attaching to them)

Answer 113

50%+ over 12 months reduce dose or stop

Answer 114

* Remission * Perception thtat they don't work (this can be correct) * Lack of insight * other drug problems, inadequote social support, homelessness * side effects of antipsychotic drugs.

Answer 115

Extra-pyramidal are movement symptoms and relate to the drugs effect on the nigrostriatal pathway (dopamine pathway). e.g., * Akathisia = restelessness * Actue dystonic reactions - sudden, painful muscle spasms * Drug-induced parkinsons * Tardive dyskinesia - mouth and tongue movements.

Answer 116

Acute Dystonic reactions

Answer 117

Drug induced parkinsons

Answer 118

Tardive dyskinesia

Answer 119

dizziness, dry mouth, constipation, trouble urination, sedation, anxiety and depression + extra-pyramidal.

Answer 120

Extra-Pyramidal

Answer 121

* Greater potential to reduce negative symptoms (& disorganised symptoms) * Extra-pyramidal (movement) side-effects are less common and less sever (but may still occur).

Answer 122

* They both block dopamine receptors, but 2nd gen to a lesser extent * 2nd gen also block certain serotonin receptos (5-HT, 2A) to help prevent extrapyramidal side-effects by preserving the DA function in nigrostriatal pathway.

Answer 123

* sedation, sleepiness, dry mouth, insomnia, dizziness, headaches, sexual problems, increase blood cholesterol, weight gain, diabetus.

Answer 124

* Promote management of symptoms * Reduce relapse * Promote self-care skills and social & occupational skills where relevant * coping with symptoms such as delusions and hallucinations * treat comorbid conditions such as depression or drug dependance.

Answer 125

Negative - activity scheduling Positive - teaching people to .... * consider possibilitthat hallucinations come from within their own minds * evaluate the plausibility of delusions by considering evidence & alternative explanations * Using behavioural experiments.

Answer 126

A. **MAJOR DEPRESSIVE EPISODE** five of the following symptoms must be present for at least 2 weeks. Must include 1 or 2. 1. depressed mood (sad, empty, hopeless, tearful) 2. loss of interest/pleasure in usual activities 3. Poor appetite & weight loss, or increased appetite and weight gain 4. Sleeping difficulties 5. Psychomoto agitation or retardation 6. fatigue 7. feelings of worthlessness or excessive inappropriate guilt 8. reduced concentration or ability to think 9. recurrent thoughts of death or suicide plans/attempts. B. Symptoms -\> clin sig. distress or impairment in social occupational or other important area of functioning. C. never been a manic or hypermanic episode

Answer 127

**A. Manic episode** - distinct period of abnormal & persistantly elevated expansive, or irritable mood and persistently increased goal-directed activity or energy lasting at least 1 week and present most of the day, every day (or any duraction if hospitalisation is required) + B. At least 3 of the following (or 4 if only irritated not elevated mood) * inflated self-esteem or grandiosity (includes grandiose dellusions) * decreased need for sleep * more talkative than usual or pressure to keep talking * flight of ideas or subjective impression thoughts are racing * distractability; attention easily diverted * increase in goal-directed activity * excessive involvement in pleasurable activities that have high potential for painfull consequences C. the mood disturband is sufficiently severe to cause marked IMPAIRMENT (note: no distress criteria)

Answer 128

approx 40%

Answer 129

* Bipolar better than schizophrenia * full functioning recovary between episodes more likely in bipolar * BUT substatial proportion of those with bipolar still experience sig. ongoing problems (residual symptoms, impaired functioning)

Answer 130

Depressed or mixed symptoms in 1st episode( rather than pure mania) earlier onset comorbid drug dependence

Answer 131

90% 50% (1/2)

Answer 132

up to 16% experience severe incapacitating depression

Answer 133

Enourmasly elevated in bipolar 1 disorder, but still elevated in major depression.

Answer 134

identical twins 40%, fraternal twins 20% - (rubbery evidence though!) A probably genetic component.

Answer 135

identical twins 50-60%, fraternal twins 20% A probably genetic component.

Answer 136

Neurotransmitters – Dopamine, noradrenaline (norepinephrine) ELEVATED; serotonin deficient.

Answer 137

– Serotonin, noradrenaline and dopamine deficient.

Answer 138

Behaviour/learning theory – Extinction of desirable behaviours (inadequate reinforcement for desirable behaviour – lack of skill or poor environment). non-reinforced behaviours are extinguished - person becomes withdrawn, avoidant and inactive - negative affect Reinforce depressed behaviour – sympathy/enabling.

Answer 139

Cognitive theory –Beck’s negative self-schema model – depression due to negative thinking. Cognitive biases. * Person vulnerable to depression owing to cognitive schemata in whcih the self, world and future are seen as negative (from negative childhood events) (these schemata are stable). * Stressfull events can activate the schemata * Cogntive distortions/biases = life events interpreted in a way consistant with schemata (e.g., exaggerate failures, minimise successes) - strengthen schemata * Negative automatic thoughts reflect congitive distortions in a given situation.

Answer 140

Neurotransmitter abnormalities affect behaviour & mood Behaviour and mood affect neurotransmitter activity e.g., chronic environmental stress reduces noradrenaline physical activity affects neurotransmitters Behaviour/mood \<----\> neurotransmitter activity

Answer 141

* Personalisation (attributing personal responsability) * selective abstraction (focusing on only neg aspects of an event) * Magnification & minimisation (magnify negative, minimise positive) * Arbitary inference (mind-reading) * Expecting the worse * over-generalisation * all or nothing thinking * catastrophising

Answer 142

MDD: depressed mood associated with reduced serotonin and noradrenalin. antidepressant medicine aims to increase these. bipolar 1: associated with increase noradrenaline and dopamine so drug treatments aim to optimise serotonin and stabalise Dopamine and noradrenaline (and other excitory neurotransmitters)

Answer 143

2-3 weeks up to 6 weeks for full therapeutic effect.

Answer 144

Monoamine oxidase inhibitors (MAOI) Tricyclic acid (e.g., amitriptyline, imipramine) Selective serotonin reuptake inhibitor (SSRIs) (e.g., fluoxetine, sertraline, paroxetine, fluvoxamine, citralopram) Serotonin & noradrenaline reuptake inhibitors (SNRIs) (e.g., bupropion, venlafaxine)

Answer 145

requires heavy dietary restrictions.

Answer 146

They block the reuptake of serotonin the neuron synapse, such that more serotonin stays in the synapse and is more availiable for tramission along the pathway.

Answer 147

DRUGS! ## Footnote Mood stabalisers e.g., lithium (effective dose is close to toxic dose) or valproate. Anti-psychotics for acute mania anti-depressants.

Answer 148

* Remission * side-effects and fear of them * perceived ineffectiveness * comorbid drug-dependance * homelessness, low social support * they ENJOY the highs of mania

Answer 149

* promotes adherance to meds * helps recognise signs of relapse * protection during manic episodes * activity monitoring * sleep and stress maintenance (reduces relapse) * social/interpersonal problems) * others concerns (mood swings, maintaining jobs) * comorbid problems such as drug dependance.

Answer 150

Major depressive disorder. Designed to increase activity and positive consequences and increase skills in gaining reinforcement and reducing avoidance COMPONENTs * pleasant activities (Reinforcement potential) * tasks that need to be done * pre-agreed * self-monitored (e.g., diary) * Graded * may also include skill training

Answer 151

* AIM: teach clients to identify and challenge/refute irrational cognitions. * clients ask themself questions regarding the evidence, alternative intepretations and logical errors of their beliefs/cognitions. reinterpretation and thought diary.

Answer 152

testing a prediction that a bad thing will happen when X happens. 1. make a prediction "if i disagree with her she won't like me" 2. what evidence is there for and against the predicition 3. plan specific way of testing the prediction 4. test it. If necessary, learn positve new ways of engaging in the behaviour 5. note the results and draw conclusions.

Answer 153

Best? * CT = BT * BT = CBT * CBT(60=70%) \> drug (40-60%), high placebo-drug effect (30%). Medication does not require skill & might make CBT easier, but drugs have a high dropout rate.

Answer 154

preferences

Answer 155

- **DSM-5 more GENERAL,** A. disruption of identity characterized by two or more distinct personality states (like possessions), alterations in affect, consciousness, memory, perception, cognition and/or sensory functioning. B. gaps in recall of everyday events/important personal info C. clinically significant distress or impairment. D. disturbance not part of culture/religion.

Answer 156

- DSM-4 required two or more distinct identities or personality states, that take over behaviour. - DSM-5 more GENERAL, just a disruption of identity.

Answer 157

Differential diagnosis (i.e., other disorders with which DID could be confused with/misdiagnosed)

Answer 158

Deliberate faking for financial or legal gain

Answer 159

deliberate production of symptoms to gain proffesional attention.

Answer 160

Large number of studies suggest that it is more common in women female:male = 3:1--\>9:1 DSM-5 now says similar rates in women and men - but this is based on one small community study (bad!)

Answer 161

incredibly rare - but increasing. General adult population = 0.001/0.4 - 1.5 - 1.1% (Depending on the study) Psychiatrict outpatients - 29%; 0.3% (Study differences) Psychiatrict inpatients - 0.4- 12/14% children - VERY rare.

Answer 162

Sexual abuse (thought not always, estimates vary from 60-90%, and is much lower in some countries.)

Answer 163

DID develops as a way of coping with overwhelming abuse in childhood, particularly if abuse occurs before age 5 * Dissociation (separating memories from awareness) and amnesia (repression of memories) * Differen alters 'own' different threatening emotional states (e.g., fear, rage) and different memories, so the primary personality is protected and not aware of them * high hypnotisability facilitates this.

Answer 164

Sexual and physical abuse during childhood; high scores hypnotisability and dissociative capacity; PTSD, self-mutilation, suicide, aggressive behaviour; numerous other DSM-IV disorder.

Answer 165

* Diagnostic bias (incorrect or overdiagnosis) * suggestion and shaping during therapy - including hypnotic suggestion * publicity * simulation

Answer 166

1. Diagnostic criteria: nature and application - highly vague, 'personalities' are actually so, overlap of symptoms with other disorders 2. Changes in frequency of diagnosis (200-\>1000s) 3. culture-bound phenomenon - mos cases in US, rare in france/brittain/russia/NZ/finland//india, none in Austria. lower rates of child-abuse cause in japan and fewer personalities 4. Who diagnoses?? - DID is seen and reported by only a small proportion of psychiatrists and psychologists, controversial diagnosis, not believed by all. 5. Changes in personalities over time - number of personalities has increased in recent decades and non-human alters started being reported in the 1980s-90s) 6. DID is supposed to develop in childhood by age 6 - but childhood DID is RARE.

Answer 167

* better knowledge/awareness of the disorder * narrowing of the definition of other disorders with which it could be confused * closer examination when client fails to respond * increased awareness of child sexual abuse.

Answer 168

* could be overlooked or misdagnoses as ADHD, schizphrenia, sleep disorders, mood disorder, seizure disorders etc.

Answer 169

a disorder created/cause by therapy (e.g., through leading questions.)

Answer 170

* Leading questions are a big part of "finding" alters, active-role of therapists * multiplicity usually not evident before therapy(only evidence under hypnosis) * prior to therapy even close friends do not meet/see alters * DID usually detected by therapise * "signs" of alters are vague (e.g., glancing around, momentarily falling silent) * DID rarely present in kids * Varacity of childhood memories from age 1-2 years - children probably can't remember stuff from this age! * Symptoms of DID can be GENERATED through hypnosis in highly hypnotisable adults - can produce amnesia +aletes with leading.

PSYC3003 - Introduction to Clinical Psychology (Abnormal Psychology) Flashcards

(201 cards)