Psychological Disorders and Treatments Flashcards
(89 cards)
1
Q
psychological disorder
A
any behavior that is at least partially emotional and severe enough to cause a person to harm themselves or other people, function ineffectively (show maladaptive behaviors), unusual and causes other people discomfort (this one is controversial)
2
Q
What is abnormal?
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not just statistic-Einstein’s IQ was abnormal, but he didn’t have a disorder-drug and alc addiction and ADHD common in pop, high %, but still disorder-ppl coming here from very diff cultures, abnormal behavior here may have been normal in their country, doesn’t mean they have disorder-many disorders recently found to have biological component, brain diff-best ex=schizophrenia-not just psychological
3
Q
culture-bound disorders
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only found in certain cultures
4
Q
history of psychological disorders-middle ages
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- thought ppl with disorders possessed by devil-exorcism, send you away, lock you up, drill hole in skull if you had disorder
- in Muslim cultures (Ottomans), assumed psychological disorders same as phys, had duty to take care of these ppl cuz they were weak
5
Q
history of psychological disorders-Renaissance
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treatments were improved
6
Q
history of psychological disorders-Salem Witch Trialss
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step backwards, ppl with disorders or strange people accused of being witches, killed
7
Q
history of psychological disorders-Dorothy Addix
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mid 1800s-beginning of movement to help people with disorders, put them in treatment center, instead of jail like what was happening
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Q
history of psychological disorders-Szask
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early 1950s-said no such thing as psychological disorder-what we’re seeing is unusual behaviors that make us uncomfortable-mental illness is a construct we’ve made to not deal with problems society has created-ppl just reacted to bad things in life-fix society, not them, something wrong w society, not them-partly right, but now know biological component, more to it than response to bad events
9
Q
history of psychological disorders-Rosenhan
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in 1973 published startling research on grad students who pretended to hear voices, went to mental institution, diagnosed w schizophrenia, then acted completely normal, told truth except about job-first released after 3 days, last after 2 months-these ppl didn’t have disorder but often diagnosed ppl only saw them as disorder, labeled/looked at all behaviors under than assumption-mental hospitals overcrowded-criticized system, not individual doctors and nurses
10
Q
history of psychological disorders-deinstitutionalization
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1980s-closing big, gov-run hospitals-release ppl back to communities, have programs there to help them, but 2nd part didn’t happen-huge spike in homeless ppl with mental illness-plan to get ppl better care backfired
11
Q
history of psychological disorders-late 90s to 2000s
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big shift to availability of brain imaging devices, better technology to look at blood and genes-figure out where disorders come from, what have in common, how to fix them
12
Q
Biological Theories to explain psychological disorders
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Genetic component, something wrong w brain, chemical imbalance in hormones or neurotransmitters-fix e medicine
13
Q
Psychoanalytic/psychodynamic theories to explain psychological disorders
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Don’t see any role for medicine cuz problem is unconscious-unconscious conflicts so disturbing that they’re causing you problems-Freud says sex and aggression, neo-Freudians say social relationships-fix them by finding out what they are and confronting them-treatment=talk therapy to help discover and resolve unconscious conflict
14
Q
Behaviorist Theories to explain psychological disorders
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- Behaviorists care about how you act, not interested in thoughts-said no underlying problem, behavior=the disorder, acting in some inappropriate way-acting that way cuz rewarded for it-phobias=great example, classical conditioning gone wrong
- therapist tried to make those bad connections go extinct
15
Q
Cognitive Theories to explain psychological disorders
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-if have disorder, thinking messed up-maladaptive thinking-interpreting your world incorrectly, misjudging other peoples actions, why things happen to you-become anxious of depressed because deal with this badly-underlying thoughts drive disorder, so much help ppl rethink-can’t always stop initial rxn but make them rethink, override it, be reasonable
16
Q
Humanist Theories to explain psychological disorders
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- Similar ideas to cognitive psychologists, but focus on a couple specific ideas
- incongruence between ideal self and self concept can cause disorder-goal of therapy would be to help resolve that
- did not get enough unconditional pos regard as a child-can cause disorder
- either way, treatment is relying in your free will and desire to improve-focus on what you do well, strengths, how do you take those strengths and expand them to other things
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Q
Combinations of Theories to explain psychological disorders: diathesis-stress model
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-Nature and nurture-diathesis=nature, come biologically predisposed to have a disorder-stress=nurture, environment may trigger disorder
18
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Combinations of Theories to explain psychological disorders: socioculturalbiological model
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Society, cultural background, and biology all taken into consideration, combination of them can make a person have a disorder-nature and nurture
19
Q
Combinations of Theories to explain psychological disorders: family systems model
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Family is important, esp with kids and teens-what’s going in at home, how parents treat kids, do siblings get along, safe environment or not-fam may be part of the problem, or solution
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Etiology
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History and causes of a disorder
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Psychopathology
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A disorder of the mind; a psychological illness
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Q
Comorbidity
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Overlap of 2 disorders-ex: drug abuse and anxiety disorders
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Concordance
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Degree than 2 individuals share the same disorder, disease, characteristic-we talked about this w twin studies
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Q
Prevalence
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How often a disorder occurs in the population
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Incidence
Number of new cases diagnosed in a time period-psychologists are interested in disorders where the incidence rates change over time cuz it means something environmental is causing the change in the disorder
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Diagnosing and classifying disorders-psychological assessment
Set of tests to help understand an individual and his/her life (i.e. A brief case study)-a complete assessment should include: physical exam, interview w the individual and others in his/her life, observations of the individual in various situations, psych tests (like the ones we've already talked about)-from the results of the assessments, therapists she the DSM-5, which gives operational definitions of psychological disorders, and lists symptoms but doesn't give causes-that's the therapists job
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Criticisms of the DSM-5
- Published in May 2013 after heated debates on many topics, esp autism and personality disorders
- some ppl wonder if the DSM-5 is still needed cuz the rest of the world uses another criteria for diagnosing physical and mental health (the international classification of diseases and their coding system is the one needed for health insurance reimbursement)
- DSM-5 includes those codes to help therapists, doctors, etc.
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Neurodevelopment disorders
Disorders that show up early in life-kids-intellectual disability, autism spectrum disorder, ADHD
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Neurodevelopment disorders-intellectual disability (intellectual developmental disorder)
- New term for mental retardation-impairments of general mental abilities that impact adaptive functioning (ability to take care of yourself) in 3 areas/categories: 1) cognitive abilities (school functions/reading, writing, thinking logically, planning ahead/executive functioning), 2) social skills (can you interact appropriately with others), 3) life skills (physically taking care of yourself)-symptoms have to appear in childhood, may be comorbid w autism, anxiety, depression, etc
- the whole goal of diagnosis is to help you and get you better, functioning-diff levels: moderate, severe-matters in how get treated, what treatment, not to make someone feel bad
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Neurodevelopment disorders-Autism spectrum disorder
wide range of symptoms cuz whole spectrum-Aspergers doesn't exist anymore, just part of spectrum0change made cuz confusion in field-ppl diagnosed diff based on place, symptoms-easier to make continuum, see severity of symptoms to say where place on it
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Neurodevelopment disorders-Autism spectrum disorder: symptoms
- have to show symptoms in childhood even if not realized until later
- symptoms broken down into 4 broad categories: language development, social development, cognitive development, need for routines
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Neurodevelopment disorders-Autism spectrum disorder: symptoms (language development)
- language use impaired in some way-can be mild to severe-almost as if english not first lang, know vocab and grammar but don't get ironies, expressions, etc-on severe eng, lang use limited, develops late, can't really speak
- echolalia: can't control what say, focus on some word/thing-repetition
- a lot of trouble w pronouns-refer to themselves in 3rd person
- also trouble w nonverbal cues-waving, etc-unless mild end
- prognosis and how developed lang are strongly postively correlated-stronger lang is, better prognosis is-cuz need lang for social interaction
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Neurodevelopment disorders-Autism spectrum disorder: symptoms (social development)
symptoms range broadly-very mild to very severe-some kids tend to ignore ppl around them, focus instead on things-some kids hypersensitive to touch-have trouble reading faces, picking up on social cues-have trouble moving beyond egocentric thinking-don't have imaginative play-must try to teach them things most ppl do automatically
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Neurodevelopment disorders-Autism spectrum disorder: symptoms (cognitive development)
- how much you learn is super important, cuz helps you learn adaptive living, lang, social cues
- most impacted by spectrum being broadened-IQs range all over the place, some IQs high
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Neurodevelopment disorders-Autism spectrum disorder: symptoms (need for routines)
- a lot of people across spectrum don't like change-important to keep schedule
- quirky patterns
- can get really upset if something changes, like furniture
- do things repetitively to calm them down
- like to watch things that spin, esp. w younger kids
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Neurodevelopment disorders-Autism spectrum disorder: onset
generally start to see symptoms at 2 or 3-kid doctors trained to look for this-trying to identify it earlier
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Neurodevelopment disorders-Autism spectrum disorder: prevalence
- 1/88 kids get an autism spectrum diagnosis-used to be 1/100
- Gernsbacher-went from studying lang development in normal population to looking at kids on autism spectrum-looking at this rise in prevalence-said cuz kids on mild end not getting diagnosed 20-30 years ago-also cuz rates mental retardation have gone down, kids given more specific diagnoses like autism, so not more ppl with autism, just ppl actually diagnosed and specifically diagnoses w autism and not just mental retardation
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Neurodevelopment disorders-Autism spectrum disorder: Causes
no definitive cause-research doesn't know-some labs found people w autism have diff amounts of protein in brain than other ppl-but more research needs to be done there-another lab has found antibodies in the blood of autistic kids and not in others-maybe something viral-like w schizophrenic ppl-also obese moms and older dads (over 45) both more likely to have kids w it-also mirror neuron problems found in research
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Neurodevelopment disorders-Autism spectrum disorder: treatment
teaching kids adaptive functioning skills, lang and social development-live independently on mild end-some drugs, not to help w autism but some problems that kids w autism have, like anxiety-so this helps
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Neurodevelopment disorders-ADHD
- trouble paying attention, staying quiet, organizing yourself-impulsive-sometimes have trouble making friends cuz of this
- underlying all these problems: brain has trouble filtering out unimportant stuff-can't figure out what 1 thing to pay attention to, everything is interesting
- innatention part (AD): not not paying attention, but paying attention to everything-sometimes daydream, quiet, so ppl don't notice have disorder, not diagnosed-esp w girls
- impulsiveness part too (HD)-behavior problems, many boys misdiagnosed w ADHD just cuz they have behavior problems
- if under 18, must show at least 6 symptoms, in at least 2 of: home, school, play-if over 18, only have to show 5 symptoms
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Neurodevelopment disorders-ADHD: causes
screen time for little kids under 2-quick movement is rewiring kids' brains-losing connections in brain that see slow changes-genetic component too-runs in fam-diff in neurotransmitter level-for some kids, fidgeting and impulsiveness is way to raise stimulus to optimal level (Yerkes-Dodson Law)
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Neurodevelopment disorders-ADHD: treatments
stimulants-concern that we don't know long-term effects on younger kids-kids build up tolerance, don't work as well down the line-so looking more at fixing behavior and diet-no caffeine-so start w medication, while it's working start working w kids on behavioral changes
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schizophrenia spectrum and other psychotic disorders
- NOT split personalities
- schizophrenia: mind splits from reality
- a couple diff disorders collapsed into 1, so broad spectrum, broad range symptoms
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schizophrenia spectrum and other psychotic disorders: symptoms (DSM-5 criteria)
- psychotic symptoms: hallucinations (getting false info from senses, false alarm, brain perceives something that's not there) and delusions (false belief-could be paranoid delusion or delusions about who you are)
- disorganized speech: stream of consciousness, all jumbled thoughts, ideas don't make sense or don't make sense together even though grammar is right
- have to show 2 of these 3 symptoms to be diagnosed
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schizophrenia spectrum and other psychotic disorders: symptoms (medical model)
-how do I help treat ppl? categorize symptoms diff cuz easier-group symptoms into 2 categories-pos and neg symptoms
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schizo-neg symptoms
- missing characteristics or abilities everyone else has in everyday life-these come b4 hallucinations-mostly caused by brain structure problems-cognitive deficits: thinking things-have trouble focusing on important stuff, blocking out unimportant stuff, like w ADHD-trouble encoding info, so w retrieval too-memory suffers-also trouble w executive functioning
- all these problems can be helped w behavioral treatments
- social/emotional deficits: like w autism, hard time w nonverbal cues-facial cues and body lang-also bad at fixing interpersonal relationships, cuz trouble w cognitive stuff
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schizo-pos symptoms
- things that ppl w schizo have that other ppl don't: hallucinations, delusions, disorganized speech-same as DSM-5 symptoms
- more caused by brain chemistry than structure-can be decreased w medication
- sometimes have these but not really the neg symptoms
- can function pretty normally in between psychotic episodes, w medicine can function pretty well
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schizophrenia spectrum and other psychotic disorders: onset
- late teens-early 20s-usually see decline across teen years in kid's social functioning-start to see negative symptoms-sometimes loss of interest in hygiene-rare to have sudden onset
- score high on neurotic scale, start seeing emotional instability
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schizophrenia spectrum and other psychotic disorders: prevalence
- around 1% pop has it
- gender diff-shows up later for girls, recover better, but same overall rates, just more guys at any 1 time?
- cuz it's so severe and disabling, researchers are trying to figure out how to find signs, precursors, before psychotic break
- a lot of ppl w schizo had weird problems w symmetrical body control/movement as kids-but those are often indicative of many diff disorders
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schizophrenia spectrum and other psychotic disorders: prognosis
- 1/3 really struggle, medication doesn't work, in the long term will need care and supervision-high suicide rates
- 1/3 make progress, medication and behavioral treatment helps-recover some functioning but not all-feel better once hallucinations and delusions subside (but often then they stop taking the gross medication and the symptoms come back)
- 1/3 hopeful prognosis-psychotic break, work to get better, then go back to full functioning
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biological explanations for schizophrenia
- genetic component: usually don't also have fam member w it, but still genetic component-Diathesis-Stress model (some ppl have genetic predisposition, but stress makes it show up)-maybe problems w brain development that are genetically based-problem when genes passed down
- brain chemistry and structure: high dopamine, smaller prefrontal cortex, diffs in amygdala and hippocampus-don't know if these problems came first of schizo did-ventricles also bigger, pushes brain matter out of the way
- viral infection: mom had virus, in utero did brain damage to baby-correlational data only as of now, controversial
- neural pruning gone wrong, wrong brain cells destroyed
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Bipolar disorder
*** know this-must be in mania for at least 4 days-onset in early 20s, 1% pop-no gender diff-comorbidity w substance abuse, anxiety, and heart disease-Lithium is first treatment, mood stabilizers and antidepressants used too, many choices, but after find right one prognosis positive
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Cyclothymic disorder
mild bipolar disorder-for insurance companies
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Depressive disorders: Disruptive Mood Dysregulation Disorder
kinda like bipolar disorder for kids (age 6-18), but no cycles-persistant irritability, generally unhappy, outburts of rage/temper tantrums after too old for them-2 or 3 times a week for a year in 2 of 3 settings: home, school, play-treatment mostly behavioral
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Depressive Disorders: Major Depression
*** know this-what most ppl think of as depression, in late teens/early 20s or late 30s/early 40s-more common now, esp in US, 5% for males, 10% for girls-once cause is we compare ourselves to others more now cuz social media and such-in most disorders, males considered norm, symptoms apply describe them, but here opp-depression in teen boys isn't what symptoms say, more acting out and angry instead of sad-prone to substance abuse-cognitive and behavioral therapy used for both boys and girls-medication used too short or long term, 80% recovery rate
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Depressive Disorders: Persistant Depressive Disorder
-mild depression for at least 2 years
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Depressive Disorders-Season Affective Disorder (SAD)
disorder due to lack of sunlight-same symptoms as depression-linked to melatonin levels and circadian rhythms-treatment easy, get lamps w special lightbulbs w same wavelength as sun
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Depressive Disorders-Suicide
-no hope for future-not out of the blue-more suicide attempts by girls but boys have higher completion rates-when start antidepressants at risk for suicide cuz have energy to make plans again-US not as bad as some places like Japan and Korea but still nbad
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explanations for depressive disorders: learning explanations
- if in big fam, only get paid attention to when something's wrong-reward, operant conditioning
- lack of affect and social withdrawal gives message to others to stop asking to hang out-so gets worse, even sadder
- so treatment is getting ppl back into social routines, even if don't want to-may have fun
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explanations for depressive disorders: cognitive explanation
- depressive disorders are disorders of thinking, ppl tend to misinterpret their world-see neutral events as neg
- Seligman-if have pessimistic explanatory style, ppl tend to globalize their neg problems, get depressed-dog ran away so no one will ever like you
- ppl normally have external loci of control-not in control of life
- stop eating and sleeping right, feel sick, but know not, feel like must be doing something wrong
- must change ppls thinking, interpret world better-1st thought will always be neg but can think about it longer and be pos, correct yourself
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explanations for depressive disorders
- chem imbalance: serotonin and dopamine
| - genetic component: depression runs in fams
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anxiety disorder
***know this-must be anxious for at least 6 months, underlying feeling of dread, affects life-can have specific phobia that know irrational, social anxiety disorder, panic disorder (panic attacks, sympathetic NS goes wild-sometimes random sometimes due to stressful situation-1% pop), generalized anxiety disorder (what we think of as anxiety-6% pop-sometimes one episode, sometimes forever or multiple episodes)
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Obsessive-Compulsive and Related Disorders
***know this-obsession=thought while compulsion=action-OCD (negative reinforcement gone wrong-to be diagnosed in adults must take up at least an hour every day-know irrational but can't stop-more common in women-higher glutamate levels), Body Dysmorphic Disorder, Hoarding Disorder (don't realize irrational)
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Trauma and stress-related disorders
when coping mechanisms are overwhelmed by the mount of stress-PTSD (symptoms: re-experiences, avoidance of places that remind you of event, negative thinking, arousal/destructive behaviors-must last at least 1 month, show up at least a month after trauma)
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Dissociative Disorders
- 2 parts identity/consciousness split-rare, may be temporary, controversial
- Dissociative Identity Disorder-split personalities
- Dissociative Amnesia-only forget identity things and not facts/how to do stuff-often no identifiable cause, resolves randomly
- Dissociative Fugue-temporary version of above away from home-Clay
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Somatic Symptom Disorder
hypochondriac-thinks headache is brain tumor
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Disruptive, Impulse-Control, and Conduct Disorders
symptoms: significant problems in emotional and behavioral self control-ODD, Pyromania, Kleptomania-ADHD comorbid w many
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Disruptive, Impulse-Control, and Conduct Disorders: Conduct Disorder
- person consistently violates the rights of others of major social norms
- shows low empathy, little concern for others' well being
- low ability to read others' emotions
- frequently seen in kids later diagnosed w antisocial personality disorder (30-40%)
- symptoms: aggression toward ppl and animals, destruction of property, deceitfulness or theft, willful serious violation of rules
- more common in boys
- kids who develop this in adolescence have better prognosis than younger kids
- multiple causes: some genetics, evidence that these kids have higher arousal thresholds so do things to get proper level of stimulation, environment is a trigger fo rkids predisposed to be defiant, poverty and violent media/games and lack of parental attention and problems w relationships are correlated to conduct disorder, BUT, is there a causal relationship?
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Personality Disorders
- enduring patterns of behavior that are noticeably diff that what is expected by the individual's culture
- some traits that make it hard for person to function normally
- hard to classify, diagnose, treat-typically 1st diagnosed in young adults
- generally the disorder causes problems in relations to others but the individual may not be distressed by the disorder
- unlike OCD and phobias, person may not realize their disordered behavior is inappropriate
- 10% pop meets criteria for this
- high comorbidity rates w other disorders
- can argue not disorders just extreme of normal-raises debate
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Personality Disorders: Odd-eccentric cluster-Paranoid personality disorder
unwarranted mistrust and suspicion of others-blame others for problems
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Personality Disorders: Odd-eccentric cluster-schizoid personality disorder
difficulty in forming relationships-socially isolated-shows restricted emotional expressions (the neg symptoms of schizo)
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Personality Disorders: Odd-eccentric cluster-Schizotypal personality disorder
probably a mild form of schizo-eccentric thoughts and behaviors
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Personality Disorders: dramatic, emotional, or erratic cluster-antisocial personality disorder
- pervasive pattern of disregard for others/ well being and rights
- manipulative, lack of empathy, responsibility for harm they cause
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Personality Disorders: dramatic, emotional, or erratic cluster-borderline personality disorder
- intensely unstable moods and relationships
- tend to engage in risky behaviors
- fail to evaluate relationships, self, others' feelings
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Personality Disorders: dramatic, emotional, or erratic cluster-Histrionic personality disorder
- attention-seeking and manipulative
| - excessively emotional
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Personality Disorders: dramatic, emotional, or erratic cluster-narcissistic personality disorder
- self-absorbed; preoccupied w fantasies of success and fame
| - expects special treatment and recognition
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Personality Disorders: Anxious-fearful cluster-avoidant personality disorder
- avoids relationships for fear of being rejected BUT wants social interactions
- low self-esteem, inferiority beliefs
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Personality Disorders: Anxious-fearful cluster-dependent personality disorder
-excessive need to be cared for
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Personality Disorders: Anxious-fearful cluster-obsessive-compulsive personality disorder
-preoccupation w perfection, details to extent it damages ability to meet goals
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gender diffs in psychological disorders
-psychological disorders divided into internalizing disorders (person takes problems out on themselves, negative emotions like distress, fear, and self crticism, maladaptive coping mechanisms, more common in girls) and externalizing disorders (person takes problem out on others or maladaptive coping hurts others, substance abuse, anger, violence, more common in boys)
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Psychoanalytic/dynamic treatments
- dream analysis (tells what you unconsciously wish for), free association (talk freely about lives, therapist looks for patterns), word association (say a specific word, see what comes to mind-person could be resisting or blocking, hiding something), transference (therapists blank slate, however patient reacts to them is patient projecting unconscious feelings about someone onto therapist)
- countertransference, where therapist projects their disordering behaviors on patient, bad-so psychotherapists must go through therapy themselves first
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operant conditioning treaments
- classical conditioning: systematic desensitization, exposure, implosion therapy, aversion therapy
- operant conditioning: behavioral contracting (make a plan w goals where get reward after reach each) and token economy (Cho bucks)
- social learning-sponsor in AA, good role model
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cognitive therapy treatments
- Rational Emotive Therapy-internal sentences=voice in head/thoughts-ABC model where Activating event leads to Beliefs about it which leads to Consequences/maladaptive behavior
- Beck's cognitive theory-depression result of thinking negatively about yourself, the world, and future-so job as therapist is cognitive restructuring-change way patient thinks-realize thinking is maladaptive then change it
- Cognitive-Behavioral Therapy (not only thinking diff, responding to world diff)
- Dialectic Behavior Therapy-treats Borderline Personality Disorder and suicidal ppl-hard to treat ppl: thesis+antithesis=synthesis-realize current thinking bad, life hard, may not get to normal but set goal lower and can meet it, then come up w new way to cope for thesis, becomes synthesis once get to better level cuz of it-step by step, long process
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biological treatments-psychosurgery-deep brain stimulation
new, experimental-targeted way to provide stimulation to one specific part of brain-put electrode in part of brain permanently-cord runs down chest-like pacemaker in brain
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biological treatments-electromagnetic treatments
- electroconvulsive therapy (aka shock therapy)-effective but causes memory loss
- transcranial magnetic stimulation-put magnet on head, turn current on, zap brain and depression lifts-not invasive and no known side effects
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antidepressants
- decrease neg mood, help restore sleep cycles-alter neurotransmitter levels (serotonin and epinephrine)-somehow alter brain structure
- Tricyclics-older, not used often
- MAO inhibitors-potent, highly interactive w other drugs-rarely used
- SSRIs-like Prozac, Paxil, Zoloft
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anti-anxieties
- reduce stress, relax muscles, reduce panic, sleep aid-allow GABA to be more efficient and depress overactive sympathetic NS
- Barbituates-older, highly addictive, rarely used
- Benzodiazepines like Valium, Xanax, Ativan, Klonopin
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anti-psychotics
- best treatment for schiz cuz decrease pos symptoms-dopamine antagonists (block receptors)
- older drugs had serious side affects (Tardive Dyskinesia)
- newer drugs w less side effects=Haldol, Zyprexa, Risperdal
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other important drugs
-reduce mania and depression (Lithium), reduce obsessions (SSRI-Anafranil)
