Psychopathology Flashcards
(349 cards)
1
Q
What is Psychopathology
A
the scientific study of mental disorders
2
Q
What does Psychopathology study?
A
- Mental Illness
- Mental Distress
- The manifestation of behaviours
3
Q
When does the burden of Disease and mental disorders occur most in life?
A
early to middle adulthood
4
Q
Which other major diseases occur more than mental illness?
A
cancer, cardiovascular disease and Nervous system disorders
5
Q
mental illness is the ___th highest medical burden
A
4th
6
Q
What is a psychological disorder?
A
a psychological dysfunction within an individual that is associated with distress or impairment in functioning and a response that is not typical or culturally expected
7
Q
What are the 3 key indicators of a psychological disorder?
A
- psychological dysfunction
- A distress or impairment in functioning
- A response that is not typical or expected
8
Q
What is Psychological Dysfunction a breakdown in?
A
- Cognitive function (perception, attention, memory)
- Behavioural function (avoidance, disinhibition)
- Emotional function (anxiety, sadness)
9
Q
For a psychological disorder to be present you need to have…
A
Dysfunction + distress + atypical behaviour.
10
Q
Which disorders are not associated with distress?
A
Mania, OCD, Narcissim
11
Q
Why do we diagnose?
A
- Communication between professionals
- Normalises symptoms for client
- Access funding
- Select appropriate treatment
12
Q
Define Presenting problem
A
Why the client has come to the clinic
13
Q
Define Prevelance
A
How many people in the population have the disorder
14
Q
Define Incidence
A
How many new cases occur during a given period
15
Q
Define Prognosis
A
The anticipated course of a disorder
16
Q
Define Course
A
How the disorder is likely to present over time
17
Q
Define Etiology
A
The origins of the disorder
18
Q
Maria should recover quickly with no intervention necessary while John will deteriorate rapidly without treatment is an example of….
A) course
B) incidence
C) prognosis
D) prevalence
A
A) prognosis
19
Q
Three new cases of bulimia have been reported in Balmain during the past month and only one in Annandale
is an example of….
A) course
B) incidence
C) prognosis
D) prevalence
A
B) incidence
20
Q
Jana visited a mental health center because of her increasing feelings of guilt and anxiety is an example of….
A) course
B) presenting problem
C) prognosis
D) prevalence
A
B) presenting problem
21
Q
Etiology is…
A) Only Biological Contributors to a disorder
B) Physiological contributors to a disorder
C) Biological, psychological, and social influences which all contribute to a disorders
A
C) Biological, psychological, and social influences which all contribute to a disorders
22
Q
The pattern a disorder follows can be chronic, time limited, or episodic is an example of….
A) course
B) presenting problem
C) prognosis
D) prevalence
A
A) course
23
Q
The number of people in the population as a whole with OCD is an example of….
A) course
B) presenting problem
C) prognosis
D) prevalence
A
D) prevalence
24
Q
How was the moon and stars related to mental illness in supernatural times?
A
- Swiss Doctor “Paracelsus”
- 1500’s
- Studied alchemy, surgery, and medicine
- Moon’s gravity effects body fluids and mental illness
- “lunacy” and “lunatics”
25
The Biological Tradition Believe MI had...
biological causes
26
The Hippocrates (Greek 460-377 BC) believed psychopathology was...
brain pathology, head trauma, heredity
wandering uterus ( ‘hysteron’)
27
The Galen (Roman 129-198 AD) believed psychopathology was...
Humoral theory of psychopathology
Treatment: change environment
28
The Biological Tradition Believed Blood was associated with...
A) BRAIN, HIGH: APATHY, “PHLEGMATIC"
B) THE HEART, RUDDY, CHEERFUL, SANGUINE
C) SPLEEN, SADNESS, MELANCHOLIC
D) LIVER, HOT TEMPER, CHOLERIC
B) THE HEART, RUDDY, CHEERFUL, SANGUINE
29
The Biological Tradition Believed Black Bile was associated with...
A) BRAIN, HIGH: APATHY, “PHLEGMATIC"
B) THE HEART, RUDDY, CHEERFUL, SANGUINE
C) SPLEEN, SADNESS, MELANCHOLIC
D) LIVER, HOT TEMPER, CHOLERIC
C) SPLEEN, SADNESS, MELANCHOLIC
30
The Biological Tradition Believed Yellow Bile was associated with...
A) BRAIN, HIGH: APATHY, “PHLEGMATIC"
B) THE HEART, RUDDY, CHEERFUL, SANGUINE
C) SPLEEN, SADNESS, MELANCHOLIC
D) LIVER, HOT TEMPER, CHOLERIC
D) LIVER, HOT TEMPER, “CHOLERIC”
31
The Biological Tradition Believed Phlegm was associated with...
A) BRAIN, HIGH: APATHY, “PHLEGMATIC"
B) THE HEART, RUDDY, CHEERFUL, SANGUINE
C) SPLEEN, SADNESS, MELANCHOLIC
D) LIVER, HOT TEMPER, CHOLERIC
A) BRAIN, HIGH: APATHY, “PHLEGMATIC"
32
what is a neuroleptics
Antipsychotics
reserpine (high blood pressure)
“major tranqs”
33
what is benzodiazepines
Depressants
valium
“minor tranqs”
34
1930's rise of the medical model created...
often accidental discoveries
• Insulin shock therapy for psychosis
• ECT for depression
35
Psychiatrist John Grey was during what time and believed what?
1850’s
Etiology = always physical
Treatments should be rest, diet, temperature
36
The 1850's saw the introduction of what treatment approach?
Psych Facilities
Large hospitals as holding centres - waiting for the discovery of the biological basis / treatments
37
What is ICT and who developed it?
- Insulin Coma Therapy
- Developed by Manfred Sakel
- Insulin-induced coma for 2-3hours
- Adverse effects: Mortality rate varied from 1-10% of patients treated
- No longer used
38
What is a Lobotomy and who developed it?
* Walter Freeman
* trans-orbital “ice-pick” technique
* Separation of front and back parts of brain
* Initially time consuming operation
39
What is ECT and what does it treat today?
- Electroconvulsive Therapy
-
- Depression
40
The Biomedical Model believed....
* Reductionist / single factor / proximal causes
* Focus on treatment rather than prevention
* Illness is biologically determined (bacteria, viruses, genes) and out of an individuals control / responsibility
* Illness can have psychological / behavioural consequences, but not causes
41
Describe ID, ego, Super Ego
Id (pleasure principle),
Ego (mediates other 2; reality principle),
Superego (moral principle)
42
Rogers Person Centred Therapy involves what 3 key factor
* Unconditional positive regard
* Empathy
* Therapeutic relationship
43
behaviourism believes...
phobia extinguished by gradual exposure and modeling
44
what is Cognitive Behaviour Therapy (CBT) and who created it?
Beck created it
- Thought, Emotion + behaviour
* Dysfunctional beliefs
* Automatic thoughts
* Attentional bias / Memory bias
* Self-focused processing
* Behavioural experiments
45
what is RET and who created it?
Ellis created it
| Rational Emotive Therapy
46
1960's was when what was created?
cognition, Mindfulness, RET and CBT
47
what is the current model of psychology?
the biopsychosocial model involves...
* Genes / Neuroscience
* Behavioral / Cognitive Science
* Emotional / Cultural, Social, and Interpersonal Factors
* Life-Span Development
48
what are some Genetic Contributions to
| Psychopathology
* genes <50% contribution to schizophrenia (less to other disorders)
* Genes interact with environment -> diathesis-stress model
* Inherit vulnerability, experience required for expression
49
what are some factors to look for in a Clinical Interview and Mental Status Exam
* consciousness
* Behavior
* Speech
* Thought
* Mood
* Attitudes
* Intellectual functioning
50
explain categorical classifications
- either meet criteria or don’t
- Facilitates communication
- common cause = common treatment
51
explain dimensional classifications
- depends on degree of symptoms (severity, duration)
52
explain prototypical classifications
- how DSM5 classify and shifting more toward dimensional classifications
- combo of dimensional and prototypical
53
what are Residual Rules?
Rules that are not formalised (“do not steal”) but include deviant behaviour in which we might all occasionally engage (such as don’t talk to yourself)
54
Which of the following are objectives of a classification system such as the DSM-5?
A) It should define and distinguish a limited number of meaningful categories/syndromes.
B) It should assist communication and allow research samples to be precisely defined.
C) It should assist decisions about treatment.
D) All of the above
D) All of the above
55
Psychological dysfunction refers to problems with X,
Y, and Z.
A) analytical function, experiential function, and motor function.
B) cognitive function, behavioral function, and emotional function.
C) family function, work function, and medicolegal function.
D) characterological function, psychomotor function, and mania
B) cognitive function, behavioral function, and emotional function.
56
Anna saw a health professional because she was feeling very sad often. After assessing her, the professional said that Anna could expect to recover within a couple of months if she followed the recommended treatment. Feeling sad much of the time is Anna’s
___ and recovery within a couple of months is Anna’s __.
A) etiology; prevalence.
B) prognosis; presenting problem.
C) presenting problem; prognosis.
D) incidence; etiology.
C) presenting problem; prognosis.
57
Which of the following is the best description of the DSM-5?
A) A complete and comprehensive classification system for mental illness.
B) A reflection of the current state of knowledge about mental illness that should be
understood as a work in transition.
C) A complete and comprehensive classification system for mental and physical illness.
D) A reflection of the current state of knowledge about mental and physical illness that
should be understood as a work in transition.
B
58
What are the 3 key features of anxiety?
1. Negative mood state
2. bodily symptoms
3. apprehension of the future
59
What % of people with depression also have anxiety?
80%
60
What % of people with panic disorder/OCD have depression?
30-40%
61
How did Freud view Anxiety? and what are the 3 types of anxiety according to Freud?
Anxiety is a psychotic reaction to danger
Anxiety Types:
Reality, Neurotic, Moral
62
How did behaviourists view anxiety? and how was it treated?
Classical/operant conditioning: association fear
Treated with counterconditioning: flooding, desensitisation
63
What is the Triple Vulnerability Theory?
Biological (inherited)
+
Specific Psychological (beliefs/perceptions)
+
General Psychological (learned/modelled/past experience)
64
Name the 4 types of Specific Phobia
1. Blood-injection
2. Natural-environment
3. Situational
4. Animal
65
Describe the key features of a Specific Phobia
- irrational/extreme
- impairment of functioning
- recognised as unreasonable
- cope by avoidance
66
Describe Blood-injection Phobia
biological
9 yrs old
decreased heart rate / fainting
67
Describe Natural-environment Phobia
real danger
7 years old
eg. heights, storms, water
68
Describe Situational Phobia
only ever cued
early 20's
eg. transport, small spaces
69
Describe Animal Phobia
possible real danger
age 7
eg. dogs, snakes, mice
70
what is included in 'Other' specific Phobias?
Choking or separation
71
Name some causes of specific phobias
- trauma/direct exposure
- inherited
- evolutionarily relevant
- Observational learning
TIEO
72
define social anxiety
persistent fear of social situations where one is exposed to scrutiny. fear one will act in a way which is embarrassing
73
Is the prevalence of social anxiety higher or lower with age? and when is the onset?
lower with age and onset is around 8-15 yrs old
74
what are 3 main causes of social anxiety?
1. inherited (temperament)
2. environmental (relationships/upbringing)
3. trauma
75
Define GAD?
Generalised Anxiety Disorder is an intolerance to uncertainty.
- avoidance
- reassurance seeking
- muscle tension
76
How would you treat GAD?
- CBT: exposure therapy
| - ACT: Mindfulness
77
Define 3 key elements of OCD
Obsessive Compulsive Disorder
intrusive + nonsensical + Irrational beliefs one tries to resist
78
what are compulsions?
thoughts or behaviours designed to suppress the thoughts and provide relief
79
How do you treat OCD?
A - Activating Event
B - Unrealistic Appraisal of Events
C - Excessive Anxiety
D - Neutralising Ritual
80
What is Panic Disorder?
unexpected panic attacks and anxiety it will reoccur
81
What is panic disorder typically associated to?
drugs + alcohol
82
Define nocturnal attacks and what % of people with panic disorder with get
- during delta wave
- not nightmares
- "sleep terrors" in children
- 60%
83
Persistent Depressive Disorder Symptoms need to be present for:
a) 2 weeks
b) 2 years
c) 3 years
d) 2 months
B
84
What drug is used to treat bipolar?
a) SSRI's
b) Trycyclic Antidepressents
c) Lithium
d) MAOI's
C
85
Schizophrenia can be described as... and symptoms present for a minimum of __ months
- Split mind/fragmented thinking
| - 6mth onwards
86
Schitzophreniform Disorder symptoms present for how many months?
a) 6 month or more
b) 1-6 months
c) 1 month
d) 3 months
B
87
Schizoaffective Disorder is a combination of _ and _
a) Schizophrenia and anxiety
b) Schizophrenia + mood disorder
c) Schizophrenia + autism
b) Schizophrenia + mood disorder
88
Delusional Disorder consists of delusions for how long?
1 month of delusions and can be high functioning
89
What is an example of a Brief Psychotic Disorder and how long does it last?
a) up to 1 month
b) over 1 week
c) over 1 month
d) 1 day
- a) up to 1 month
| - intense period of stress eg Post-Partum
90
Describe Shared Psychotic Disorder
- its rare
- involves 2 people as primary + secondary
- eg. cults
91
what are 2 changes from DSM-IV to DSM-V criteria for schizophrenia?
1. 2 criterion A symptoms are needed to diagnose schizo
including 1 x Delusions, hallucinations or disorganised thinking/speech + abnormal behaviour, neg symptoms
2. Schizo subtypes eliminated due to their limited diagnostic stability
92
what % of the world have schizophrenia?
a) 5%
b) 8%
c) 1%
d) 13%
and of that % how many have 1 episode vs recurring episodes?
C) 1%
1 in 5 have one episode, the rest have several episodes
93
Schizophrenia onset is...
a) prepubescent
b) late adolescence or early adulthood
c) adulthood
d) anytime
b) late adolescence or early adulthood
94
What is the course of schizophrenia is characterised by?
The rate of relapse
95
1. Is Schizophrenia chronic or not?
2. Is recovery rare or common?
3. What is the time delay between symptom onset and treatment?
1. Usually chronic
2. Recovery is rare
3. Time delay of 1-2 years between symptom onset and treatment
96
1. What is the reduced life expectancy of people with schizophrenia?
2. what are are the 4 main reasons? PASS
3. what is the suicide risk of people with schizophrenia?
1. 10-25 yrs reduced life expectancy
2. Reason: PASS
- Physical illness (cardiovascular issues)
- Antipsychotic drug use
- Suboptimal Lifestyle (alcohol, substances)
- Suicide risk
3. 10-15% suicide
97
What % is the Genetic link to schizophrenia?
a) 50%
b) 60%
c) 75%
d) 80%
d) 80%
98
Very Early Onset Schizophrenia (VEOS)
1. age?
2. prevalence?
3. is it more or less complex than adult schizophrenia?
1. pre 13 years old
2. Less than 1 in 30K people
3. Less complex than adult schizo
99
What are positive symptoms?
What are some examples of positive schizophrenia symptoms?
Positive symptoms are the presence of abnormal Behaviours
eg. hallucinations, delusions, disorganised thoughts
100
What are negative symptoms?
What are some examples of negative schizophrenia symptoms?
Negative symptoms are the absence of behavioural deficits
eg. Alogia, Anhedonia, avocation, flat affect,, withdrawal, impoverished thinking, lack of drive
101
1. What are Prodromal symptoms?'
2. What % of schizophrenia patients experience prodromal symptoms?
a) 60%
b) 75%
c) 80%
d) 85%
3. What are some examples of prodromal symptoms?
1. Prodromal symptoms are the early symptoms and signs of illness
2. d) 85% with schizo experience 1-2 year period before serious symptoms appear
3. Reduced concentration, reduced motivation, depressed mood, sleep disturbance, anxiety, social withdrawal, suspiciousness, poor functioning, irritability
102
Define Psychosis
A syndrome that includes delusions, hallucinations and/or disorganised speech/thoughts/behaviours
103
Define Delusions
A false belief based on incorrect inference about an external reality that is firmly sustained despite what almost everyone else believes and despite what contributes incontrovertible and obvious proof or evidence to the contrary
104
1. what is an example of non-bizarre delusions?
| 2. what is an example of bizarre delusions?
1. Non-bizarre delusions = situations that could occur in everyday life eg. Being followed, being cheated on
2. Bizarre delusions = fantastic situations that could never occur in reality
105
1. What are Delusions of Reference?
| 2. What are Delusions of control?
1. Delusions of Reference: the belief that insignificant remarks, events or objects in ones envronment have personal meaning or significance (eg. Presenter on TV is speaking to them
2. Delusions of control: false belief that another person or people force control over ones thoughts, impulses or behaviours
106
What are Persecutory Delusions?
The false belief that there person is being followed, harassed, conspired against, obstructed in the pursuit of goals
107
1. What is Erotomania?
| 2. What is Grandiose Delusions?
1. Erotomania: the belief someone is in love with you.
| 2. Grandiose Delusions: belief you have certain skills or powers (eg. Belief I can fly)
108
Define Hallucinations
An organised sensory experience that is a product of the patients mind and does not exist in the outside world
Occurs in 5 sensory modalities, auditory most common (audio, visual, smell, touch, taste)
109
1. Explain disorganised speech/thoughts
2. What is Tangentiality?
3. What is Echolalia?
1. Problems in the organisation and logic of ideas, the rate of speech, speaking so the listener can understand. Statements are not logically connected to each other. Loose associations, derailments, incoherence
2. tangentiality: the tendency to speak about topics unrelated to the main topic
3. Echolalia: a repetition of a recently heard sound or phrase
110
# Define flat affect
Define Inappropriate affect
Flat Affect: virtually no stimulus can elicit an emotional response
Inappropriate Affect: emotional responses out of context. Likely to shift rapidly from one emotional state with no obvious reason.
111
# Define Avolition
Define Anhendonia
Avolition: Apathy, lack of energy and seeming absence of interest in usual routine
Anhendonia: inability to experience pleasure (Symptom of depression)
112
Explain the current medical model (Biochemical) model of the cause of schizophrenia
- Schizophrenics have higher sensitivity to dopamine than others.
- Seeman et al (1993) found 6x the density of D4 receptor in schizo brains (PET scans show increase in D2 receptors)
113
what is the Original Dopamine Hypothesis
Original Dopamine Hypothesis: Overactivity of dopamine in the system (Anti-psychotic drugs block dopamine)
114
what is the neuroanatomical explanation for the cause of schizophrenia?
- cell loss in limbic system
- unusual cell connections in the hippocampus
- Abnormal early brain development in 3rd trimester
- Reduced brain tissue + enlarged ventricles
115
what are 3 non-genetic factors that contribute to the cause of schizophrenia?
1. Advanced age of mother
2. Obstetric complications
3. Cannabis use
116
What are the goals of schizophrenia treatment?
1. Alleviation of positive symptoms
2. Prevent acute relapse
3. Decrease negative symptoms
117
What are the 2 types of antipsychotic medications for schizophrenia? give an example for each one and side effects
1. Standard: Chlorpromazine
side effects: emotional dysfunction, fatigue, sexual dysfunction, weight gain,
2. Atypical: Clozapine
Side effects: Weight gain 20%, diabetes, elevated cholesterol)
118
what is the primary limitation of antipsychotic medication for schizophrenia treatment?
non-adherence 50%
119
what are the 2 biological options for treatment of schizophrenia?
antipsychotics and ECT
120
what are the 2 psychological options for treatment of schizophrenia?
CBT and Mindfulness/ACT/Psycho-education
121
what are the 3 types of treatment options for schizophrenia?
Biological, Psychological or Social Interventions
122
Define Mood Disorder
extreme change in mood, physiology, behaviour, function and/or thinking
123
Describe Unipolar and Bipolar Disorders
Unipolar: Depression by itself or Mania by itself (rare)
Bipolar:
- Depression + Mania
- Dysphoric Manic Episode
- Mixed Manic Episode
124
Name some Individual Differences in Mood Disorder Experience:
- Length of episode
- Severity (mild, mod, severe)
- Onset (early/late)
- Recurrence (seasonal, cycle, doesn’t recur)
- Remission Patterns
- Other Symptoms (Catatonia, Melancholic Features, Psychotic features)
125
Name some DSM-5 Specifiers of mood disorder symptoms:
- Anxiety Symptom: Anxious Distress
- Physiological Symptom: Melancholic Features
- Psychotic Features: mood congruent or not
- Mix of features (manic if MDD, Depression if BPD
- Atypical features
- Catatonia (rare)
- Peripartum Onset (During or <4wks post partum)
- Partial/full remission
- Seasonal Pattern (SAD: Seasonal Affective Disorder)
126
What is the prevalence of mood disorders?
a) 1 in 10 F, 1 in 20 M
b) 1 in 4 F, 1 in 4 M
c) 1 in 8 F, 1 in 6 M
d) 1 in 4 F, 1 in 6 M
D) 1 in 4 F, 1 in 6 M
127
Name is 5 categories of mood disorder causes and explain each
1. Biological = Genetic influence
2. Physiological = eg Stressful life event
3. Behavioural = eg. Learned helplessness
4. Cognitive = eg. Negative views of self, world + future
5. Social/cultural = interpersonal relationships
128
After a marriage separation are men or women more likely to be depressed?
F are 3 times + M are 9 times more likely to be depressed
129
What do these acronyms stand for?
```
PDD
BPI
BPII
MDD
MDE
SAD
```
```
PDD = Persistent Dysphoric Disorder
BPI = Bipolar I
BPII = Bipolar II
MDD = Major Depressive Disorder
MDE = Major Depressive Episode
SAD = Seasonal Affective Disorder
```
130
what are the 4 major depressive episode elements? and explain their characteristics
1. Mood: Anhedonia (loss of pleasure, Low positive affect)
2. Physiology (Changes in weight/appetite, Sleep, low energy, Loss of libido)
3. Behaviour (Restless / agitation, Psychomotor retardation)
4. Cognitive (Poor attention / concentration/ Indecisiveness)
131
Name some Depressive Disorders
```
Depressive Disorders Include:
Major Depressive Disorder (MDD)
Persistent Depressive Disorder
Disruptive mood Disregulation Disorder
Premenstrual Dysphoric Disorder
Depressive Disorder Due to other Medical Condition
Other Specified Depressive Disorder
Unspecified Depressive Disorder
```
132
Define Mania
Mood: elation, joy, euphoria, extreme pleasure
Physiology: reduced sleep, increased energy, increased libido
Behaviour: Agitated, rapid speed, increased goal directed behaviour
Cognitive: Flight of ideas, grandiosity
133
what is a hypomanic episode?
Hypomanic Episode: Less severe, does not cause marked impairment in social/work functioning
134
Explain the key criteria of depressive disorders
Include MDD, Single Episode, Recurrent
Key Criteria: No evidence of mania or hypomania (if there is evidence it becomes Bipolar)
Single episode is rare (85% of single episodes reoccur)
DSM-5 does not distinguish
135
Explain Persistent Dysphoric Disorder
Persistent Dysphoric Disorder (PDD)
AKA dysthymia + was seen as milder but not anymore
> 2 yrs of symptoms for diagnosis (median of 5yrs but up to 20 yrs)
Chronic = not symptom free for > 2 months
1/4 of ppl with PDD also have Major Depressive Episode (MDE) AKA “Double depression”
136
what is double depression?
1/4 of ppl with PDD also have Major Depressive Episode (MDE) AKA “Double depression”
137
discuss how Grief + Depression relate, symptoms and treatment
depression frequently follows loss
Bereavement excision for MDE in DSM-5
Persistent Complex Bereavement Disorder
Symptoms : Intrusive memories, yearning, avoidance, Poor functioning for < 1 year
Treatment: like PTSD, exposure therapy
138
What are the 5 treatments for depression?
1. Pharmacotherapy: Antidepressants (SSRIs = few side effects
2. ECT: Electrical stimulation to induce seizure (for when you haven’t responded to meds or if suicidal) can induce memory loss
3. Interpersonal therapy: Highly structured, focuses on present, short term
4. Behaviour therapy: Pleasurable event scheduling or Exercise
5. CBT: Identify errors in thinking, Correct errors, Substitute adaptive thoughts, Correct negative schemas
139
What are the 4 domains when depression occurs
1. greif
2. Interpersonal role disputes
3. Interpersonal role transitions (eg, illness or pregnancy),
4. Interpersonal deficits (eg. Social skills)
140
Name the types of bipolar disorder
```
Bipolar I Disorder
Bipolar II Disorder
Cyclothymic Disorder
Bipolar due to medica condition
Other Specified Bipolar Disorder
Unspecified Bipolar Disorder
```
141
Discuss BPI
alternating major depressive and manic disorders
Single manic episode
Onset: 18yrs
DSM-5: Must have 1 manic episode in lifetime
142
DISCUSS BPII
alternating major depressive and manic disorders
Single Hypomanic Disorder
No Manic Episode
Onset: 19-22 yrs
10-13% of ppl later get diagnosed with Bipolar I
Suicide Attempts: BPII 24%, BPI 17%, MDD 12%
Less intense, harder to detect
143
Discuss Cyclothymic Disorder
similar to PDD
alternating manic and depressive episodes that don’t meet criteria for MDE or Manic Episode
Symptoms are less severe and persist longer (Adults: 2 yrs, Adolescents: 1 yr)
Onset: 12-14 yrs + F>M
Chronic/lifelong
15-50% of ppl risk then getting BPI/II
144
what is the key specifier of bipolar disorders?
Rapid Cycling: > 4 episodes/year of mania or depression
145
How do you treat bipolar disorder?
Lifestyle changes
Psychotherapy
Medications: Mood stabilisers, antipsychotics,
antidepressents (lithium)
146
depressants ___ GABA and ___ Glutamate
Activates GABA (inhibitory), Inhibits Glutamate (excitatory)
147
describe depressants effect on the body and some examples of depressents
Decrease CNS Activity, reduce psychological arousal, relaxation
Include hypnotics, barbiturates, alcohol, general anaesthetics, sedatives (dose dependent effect)
148
what is the primary symptom of depressants?
Impaired mood/social functioning/behaviour
149
name some depressant substances?
what are some key outcomes of taking depressants?
Include hypnotics, barbiturates, alcohol, general anaesthetics, sedatives (dose dependent effect)
physical dependence, tolerance and withdrawal
Wernicke-Korsakoff Syndrome
Fetal Alcohol Syndrome (FAS)
150
Describe what stimulant substances do and some examples of stimulants?
Alertness, energy, euphoria, increased blood pressure, lost appetite, insomnia
Includes amphetamines, cocaine, nicotine, caffeine (dose dependent effect)
151
what are opiates?
give examples of opiates
naturally occurring chemical creates initial euphoria followed by apathy, dysphoria, psychomotor agitation or retardation
morphine, heroin, methadone
152
what does intoxication of opiates look like?
Intoxication: pupillary constriction and drowsiness, slurred speech, impaired attention/memory
153
what are the physical effects and withdrawal symptoms of taking opiates?
Physical effects: analgesia, nausea, constipation
Severe withdrawals: nausea, chills, muscle aches, insomnia
154
describe the effect of hallucinogens and give some examples
Delusions, paranoia, hallucinations, altered sensory perceptions
Includes marijuana, LSD
155
what are the effects of cannabis?
does cannabis create Amotivational syndrome?
describe the intoxication effects?
what does it have an increased risk of developing?
Impaired moron coordination, euphoria, anxiety, impaired judgment
Amotivational Syndrome: Apathy or unwillingness to carry out long term plans
Intoxication: increased appetite, dry mouth, tachycardia
Used medically for pain
Increased risk of schizophrenia
156
what is Amotivational Syndrome?
Amotivational Syndrome: Apathy or unwillingness to carry out long term plans
157
describe the effect of LSD and the intoxication effects
Marked anxiety/depression, fear of losing ones mind, paranoid, impaired judgement/functioning
Perceptual changes, illusions, hallucinations
intoxication: pupillary dilation, sweating, blurred vision
158
what is Substance intoxication?
Substance intoxication: Reversible, negative behavioural/psychological changes after taking substance
159
what is Substance withdrawal?
what are the 3 factors which influence withdrawal?
Substance withdrawal: Substance-specific negative behavioural/psychological/cognitive issues with reduction of substance use (usually with dependence).
Effected by...
- route of administration (IV, smoking, oral)
- time course (rapid/slower)
- duration of effects (short/long acting)
160
Substance Use Disorders used was previously considered...
a) Substance use condition
b) social deviance
c) social disorder
d) substance use deviance
B) Substance Use Disorders previously considered a social deviance (Sociopathic personality disturbances and sexual deviance)
161
what are the 4 levels of substance involvement?
Levels of involvement:
1. Substance Use (eg, beer after work)
2. Substance intoxication (effect of substance)
3. Substance Abuse (over use)
4. Substance Dependence (tolerance and withdrawal)
162
what are the 2 cognitive factors of SUD?
Attitudes: hedonically balanced view of an object (dislike, like, neutral toward alcohol)
Expectancies: belief about effects of alcohol (drinking makes things more enjoyable)
163
what are the 2 aetiology factors of SUD?
1. Pos reinforcement
2. Neg reinforcement
- dependence, withdrawal avoidance
- Self medication
- Tension reduction
- Coping mechanism
164
explain Rat Park
Rat park by Alexander 1981
A nice environment for rat = rat doesn’t use drugs
idea that rat will take morphine over food/water
Use drugs when bored/unhappy
165
what medications treat the following?
alcohol?
Opiates?
Heroin?
Alcohol: Disulfiram
Opiates: Clonidine
Heroin: Buprenorphine
166
what are the 5 treatment pathways for treating substance use?
- Medication
- Relapse Prevention: CBT techniques
- Rehab: Support during initial withdrawal period
- Motivational Interviewing: client centred therapy
- Harm Minimisation (eg. injection facilities, Drug testing sites, AA)
167
what are the stages of the trans theoretical model?
```
Trans-theoretical Model of Change:
pre-contemplation
contemplation
determination
action
maintenance
recurrence
```
168
discuss motivational interviewing and its benefits for treating substance use?
Motivational Interviewing:
client centred to help client think differently/self-efficacy
By Miller and Rollnick
169
what are the 6 types of eating disorders?
1 Anorexia Nervosa
2 Bulimia Nervosa
3 Binge Eating Disorder
4 Pica (eating non food substances eg. Paper for 1 month)
5 Rumination Disorder (regurgitate/play with food in mouth)
6 Avoidant/Restrictive Food (young children/autism)
Other specified/unspecified feeding/eating disorder
170
what is the mortality rate of eating disorders and why?
highest mortality rate
complications of anorexia #1
Suicide 2nd most common
171
what is the ratio of suicide for anorexia and what % of anorexics suicide?
are suicide attempts higher in bulimics or anorexics?
are successful suicides higher in bulimics or anorexics?
200:1 anorexia:general Pop at 32% anorexia
Suicide attempts higher in bulimia than anorexia
Suicides less in bulimia than anorexia but more than depression
172
what is the prevalence and recovery of eating disorders?
Increasing in western countries
Increased rated in immigrants to western countries
Recovery is Low
173
what are the 2 subtypes of anorexia?
1. 50% Restricting food intake
| 2. 50% Binge Eating-purging
174
describe anorexia characteristics
what is the BMI of someone anorexic?
- Refusal to maintain minimal body weight (BMI<17.5)
- Changed to Significantly low in DSM-5
- Intense fear of gaining weight
- Significantly underweight
- Characteristics: Body image disturbance, pride in diet, rarely seek treatment
175
what are the 3 key medical consequences of anorexia?
Cardiovascular issues
electrolyte imbalance
Amenorrhea (an abnormal absence of menstruation.)
176
what is the prevalence of anorexia?
12 months, F:M 10:1, Age 18.9, high social/economic status
177
what are the treatment options for anorexia?
- No drugs
- psychoeducation
- weight restoration
- CBT
- Maudsley Family Based Treatment
178
explain Maudsley Family Based Treatment and what it is used for
treating anorexia
Phase 1: weight restoration
Phase 2: give control over eating back to child
Phase 3: focus on impact of anorexia
179
describe bulimia characteristics
- No weight criteria for DSM-5
- Repeated binges followed by compensatory behaviours
- Binge Eating (excess food/out of control)
Compensatory Behaviour: purging eg. Vomit, laxatives, enemas + 10% do Non-purging eg.excess exercise/fasting
180
what does compensatory behaviours do and what condition does them?
Bulima
Compensatory Behaviour: purging eg. Vomit, laxatives, enemas + 10% do Non-purging eg.excess exercise/fasting
181
what is the prevalence of bulimia?
- 12 months
- F:M 10:1, Age 19.7, high social/economic status
- twin studies 23% in MZ twins for bulimia
182
what are the treatment options for bulimia?
Anti-depressants (prozac)
CBT
Interpersonal Psychotherapy
183
describe binge eating disorder and how it is different to bulimia
difference: binges followed WITHOUT compensatory behaviours
Excessive food intake followed by intense guilt, shame
Occurs with or without obesity
30% ppl seeking weightless help report binge eating
50% of people seek surgery
184
what is the prevalence of binge eating disorder?
F1%, M0.6%, Age 25.4
185
what are the treatment options for binge eating disorder?
CBT
interpersonal psychotherapy
Prozac has no benefit
186
discuss obesity:
What is the % of overweight and obese M & F?
is it included in the DSM-5?
what condition is obesity associated to?
Statistics (More overweight than ever)
Males = 42% overweight + 25% obese
Females = 30% overweight + 24% Obese
Associated to Sleep apnea
187
what are some causes of obesity?
- modernisation/seditary lifestyle
- 30% genetic
- attitudes, motivation
188
what are some treatments of obesity?
self directed
programs eg.weight watchers
medication
surgery
189
what is the evolutionary explanation for eating disorders?
Evolutionary perspective:when food is scarce, we become low activity but ppl with anorexia feel unfazed.
190
what is the biological explanation for eating disorders?
Biological: genetic link, inherited tendency for perfectionism
191
what is the psychological explanation for eating disorders?
Psychological: perfectionism, low personal control, low self confidence, high preoccupation for appearance
Family influence: typical family of anorexic’s are successful, hard-driving,
192
what are some of the Eating Disorder Inventory 3 (EDI) assesses psychological dimensions
```
drive for thinness
Bulimia (binge/purge)
Body dissatisfaction
Ineffectiveness (Worthless)
Perfectionism
Interpersonal distrust
Interoceptive awareness (ignore hunger)
Maturity fears
```
193
discuss BMI
```
BMI = weight in KG/ (height in meters) squared
influenced by age, gender, ethnicity
Does not distinguish fat from muscles
Does not reflect body fat distribution
Not accurate (older adults or athletes)
Waist circumference
Underweight BMI = under 18.5
```
194
Which of the following is true of both ACT and CBT?
A) They both propose that thoughts can be associated with psychological distress.
B) They both propose that to deal with thoughts associated with psychological distress
requires thought challenging.
C) They both propose that to deal with thoughts associated with psychological distress
requires acceptance.
D) Both (a) and (b) are true.
A) They both propose that thoughts can be associated with psychological distress.
195
The key symptoms of schizophrenia can be broadly divided into the following categories:
A) social, occupational, affective
B) behavioural, emotional, affective
C) positive; negative; cognitive.
C) positive; negative; cognitive.
196
The major side effects of the 1st generation antipsychotic medications are _____________
and the major side effects of the 2nd generation antipsychotic medications are
A) Metabolic/weight gain; extrapyramidal/motor.
B) Affective; behavioural.
C) Extrapyramidal/motor; metabolic/weight gain.
D) Sexual dysfunction; social/interactional.
C) Extrapyramidal/motor; metabolic/weight gain
197
An important change in the classification of Mood Disorders between DSM-IV and DSM-5 is...
A) that the DSM-IV Mood Disorders have been re-named in DSM-5 as ‘Affective Disorders’.
B) that the DSM-IV Mood Disorders have been classified with the Anxiety Disorders in DSM-5 as ‘Disorders of Negative Affect’.
C) that the DSM-IV Mood Disorders have been separated into two chapters in DSM-5: ‘Depressive Disorders’ and ‘Bipolar and Related Disorders’.
D) that the DSM-IV Mood Disorders have been classified with the Personality Disorders in DSM-5 as ‘Mood and Personality Disorders’.
C) that the DSM-IV Mood Disorders have been separated into two chapters in DSM-5: ‘Depressive Disorders’ and ‘Bipolar and Related Disorders’.
198
The main difference between DSM-5 Bipolar I Disorder and DSM-5 Bipolar II Disorder criteria is...
A) BPI criteria requires presence of a Major Depressive Episode and BPII criteria do not.
B) the presence of manic episodes in BPI and the presence of hypomanic episodes in BBII Yes.
C) the presence of hypomanic episodes in BPI and the presence of manic episodes in BPII
D) BPI is rapid cycling and BPII is not
B) the presence of manic episodes in BPI and the presence of hypomanic episodes in BBII Yes.
199
According to the learned helplessness theory, depression is associated with attributions about negative events that are ---?
A) local, unstable and external.
B) social, developmental and biological.
C) global, stable and internal.
D) genetic, hard-wired and controllable.
C) global, stable and internal.
200
The common neural reward pathway for addictive behaviours is believed to be
__________________.
A) the mesolimbic dopaminergic pathway.
B) the nigrostriatal dopaminergic pathway.
C) the hypothalamic-pituitary adrenal (HPA) axis.
D) None of the above. No. The correct answer is (a).
A) the mesolimbic dopaminergic pathway.
201
In Dialectical Behavior Therapy the two perspectives on an individual’s problems that
comprise the dialectic are __________________________.
A) acceptance that the individual’s ways of dealing with the world make sense in light
of their past experience while at the same time recognising that change is needed.
B) identifying maladaptive thoughts and seeking to change these thoughts.
C) identifying values of the individual and the seeking to behave in a way that is
consistent with these values.
D) identifying things that the individual has been avoiding and seeking to gradually
approach these things without distress.
A) acceptance that the individual’s ways of dealing with the world make sense in light
of their past experience while at the same time recognising that change is needed.
202
The anticipated course of a psychological disorder is the ________.
Select one:
a. presenting problem
b. prognosis
c. incidence
d. prevalence
e. diagnosis
b. prognosis
203
Which of the following is the best description of the DSM-5?
Select one:
a. It is atheoretical.
b. All of these are true of the DSM-5.
c. It is multiaxial.
d. It is derived from the International Classification of Diseases.
e. It is a work in transition.
a. It is atheoretical.
204
Which of the below is NOT a valid reason discussed in lecture 1 of why psychologists diagnose mental disorders?
Select one:
a. To guide the selection appropriate treatment.
b. To help clients make sense of the symptoms they are experiencing.
c. To stigmatize people that deviate from the norm.
d. To communicate effectively among professionals.
e. To differentiate between clinical and normal mood states.
c. To stigmatize people that deviate from the norm.
205
Which major psychological theory emphasized the relationship between environmental stimuli and behavioural responses?
Select one:
a. Cognitivism
b. Behaviourism
c. Humanism
d. Psychoanalysis
e. Biopsychosocialism
b. Behaviourism
206
Which has NOT been found to be a contributing factor for the development of Post-Traumatic Stress Disorder (PTSD)?
Select one:
a. Generalised biological vulnerability
b. Distressing loss or attachment issue in childhood
c. Uncontrollability/unpredictability of the traumatic event
d. Trauma intensity
e. Lack of social support
b. Distressing loss or attachment issue in childhood
207
What is the most common Anxiety Disorder?
Select one:
a. Social Anxiety Disorder
b. Generalised anxiety disorder
c. Animal phobia
d. Post traumatic stress disorder
e. Obsessive compulsive disorder
b. Generalised anxiety disorder
208
What is the most important difference between fear and anxiety?
Select one:
a. Anxiety is concerned with apprehension about the future while fear is focused on immediate, present danger
b. Fear involves the parasympathetic nervous system while anxiety involves the sympathetic nervous system
c. Fear is concerned with apprehension about the future while anxiety is focused on immediate, present danger
d. Anxiety involves the parasympathetic nervous system while fear involves the sympathetic nervous system
e. There is no difference between fear and anxiety
a. Anxiety is concerned with apprehension about the future while fear is focused on immediate, present danger
209
Anna experiences intense distress if she has to leave her home unless she is accompanied by someone that she feels safe with. The most likely diagnosis for Anna is ____________.
Select one:
a. obsessive compulsive disorder
b. agoraphobia
c. generalised anxiety disorder
d. social anxiety disorder
e. specifc phobia
b. agoraphobia
210
Which of the below is NOT a prodromal symptom of schizophrenia?
Select one:
a. Substance abuse
b. Suspiciousness
c. Social withdrawal
d. Reduced motivation
e. Deterioration in role functioning
a. Substance abuse
211
Which of the following are all negative symptoms of schizophrenia?
Select one:
a. Hallucinations, delusions, and disorganised thoughts
b. None of these answers are correct
c. Alogia, anhedonia, and disorganised thoughts
d. All of these answers are correct
e. Avolition, flat affect, and impoverished speech
e. Avolition, flat affect, and impoverished speech
212
A common side-effect of second generation / atypical anti-psychotic medications is __________.
Select one:
a. liver failure
b. stomach cramps
c. hypersexuality
d. weight gain
e. social apathy
d. weight gain
213
Why are there high mortality rates for people diagnosed with schizophrenia?
Select one:
a. All of the reasons provided explain high mortality rates
b. There is elevated rates of suicide compared to the general population
c. Anti-psychotic drugs have negative side effects for physical health
d. Suboptimal lifestyles
e. Physical illnesses may be diagnosed late and insufficiently treated
a. All of the reasons provided explain high mortality rates
214
Which of the following is NOT a symptom of a Major Depressive Episode?
Select one:
a. Social withdrawal
b. Reduced ability to concentrate
c. Loss of energy
d. Psychomotor agitation
e. Hypersomnia
A. social withdrawal
215
The theory of Learned Helplessness was developed by ___________.
Select one:
a. Seligman
b. Pavlov
c. Thorndike
d. Skinner
e. Ellis
a. Seligman
216
What is one major difference between grief and depression?
Select one:
a. In grief you tend not to have thoughts of dying
b. Depression usually comes in waves
c. Peope who are grieving are also likely to experience symptoms of social anxiety
d. Peope who are grieving often also show positive emotions
e. Peope who are depressed tend to experience symptoms such as denial
d. Peope who are grieving often also show positive emotions
217
What kinds of drugs are likely to be prescribed for the treatment of Bipolar Disorder?
Select one:
a. Mood stabilisers
b. Antidepressants
c. Valium
d. Neuroleptics
e. Antipsychotics
a. Mood stabilisers
218
There are several behavioural explanations of substance use. Which of the following would NOT be considered a behavioural explanation of why an individual takes heroin?
Select one:
a. The person takes heroin because they have a genetic predisposition towards addiction
b. The person takes heroin to avoid experiencing cramps that occur when they stop taking heroin
c. The person takes heroin because they saw their older brother take it and he seemed to like it
d. The person takes heroin because of a chemical inbalance
e. The person takes heroin because they enjoy the feeling of euphoria
d. The person takes heroin because of a chemical inbalance
219
Motivational Interviewing (MI) has been found to be useful to help treat substance use disorder. Which of the following is NOT true about MI?
Select one:
a. MI is only used by psychologists
b. MI is client centred
c. MI was developed by Rollnick and Miller
d. MI is based on the premise of increasing self efficacy
e. MI is used by professionals such as psychologists, nurses, general practitioners, counsellors
a. MI is only used by psychologists
220
According to research from Fallon and Rozin (1985), what is the difference between females and males in terms of their current versus ideal body shape?
Select one:
a. Regardless of gender, both males and females would ideally like to be slimmer than they currently are.
b. Females would ideally like to be much slimmer than they currently are, whereas males would like to be much larger than they currently are.
c. Females are currently slimmer than their ideal body shape, whereas males are larger than their ideal body shape.
d. Females would ideally like to be much slimmer than they currently are, whereas there is little difference between males' current and ideal body shapes.
e. Both males and females report little difference between their current and ideal body shape.
d. Females would ideally like to be much slimmer than they currently are, whereas there is little difference between males' current and ideal body shapes.
221
Which of the following would you expect to be associated with Eating Disorders?
Select one:
a. Worry about physical danger.
b. Attentional bias towards threat.
c. Intolerance of uncertainty.
d. Perfectionism.
d. Perfectionism.
222
Wilktsh and Wade's (2009) intervention for high school students to prevent the development of eating disorders was based on ______________.
```
Select one:
a. media literacy.
b. cognitive behaviour therapy.
c.
interpersonal psychotherapy.
d. psychoeducation about the effects of excess dieting
```
a. media literacy.
223
What is the difference between Anorexia Nervosa and Bulimia Nervosa?
Select one:
a. Individuals with Anorexia Nervosa have significantly low body weight, whereas there is no weight criteria for Bulimia Nervosa.
b. More females than males suffer from Anorexia Nervosa whereas more males than females suffer from Bulimia Nervosa.
c. The diagnostic criteria for Anorexia Nervosa includes fears of gaining weight whereas there are no criteria for concerns about weight or body shape in Bulimia Nervosa.
d. Individuals Bulimia Nervosa use compensatory behaviours (such as purging), whereas this does not occur in Anorexia Nervosa.
a. Individuals with Anorexia Nervosa have significantly low body weight, whereas there is no weight criteria for Bulimia Nervosa.
224
Ping is a 19 year old university student who has an intense fear of giving presentations in class. He is worried that his tutor and classmates will notice his hands shaking and his face blushing, and will think that he is stupid. As a result, he has avoided giving presentations in class for the two years that he has been in university, even though this has led to lower grades. He is fine in more casual social situations such as spending time with his friends and family. If Ping is diagnosed with an anxiety disorder, it is most likely to be _________.
Select one:
a. Social Anxiety Disorder, performance only
b. Generalised Social Anxiety Disorder
c. Generalised Anxiety Disorder
d. Anxiety Disorder Otherwise Specified, as he does not meet full criteria for Social Anxiety Disorder.
e. Specific Phobia, performance type
a. Social Anxiety Disorder, performance only
225
```
What was the previous name for gender dysphoria?
A) Gender Identity Disorder
B) Gender Relapse
C) Gender Reluctance
D) Gender Diffusion
```
A) Gender Identity Disorder
226
```
Conduct disorder often comes before?
A) Borderline
B) Schizoid
C) Dependent
D) Anti-social
```
D) antisocial
227
```
Instability in relationships is associated with?
A) Borderline
B) Dependent
C) Schizoid
D) Antisocial
```
A) Borderline
228
```
Not enjoying close relationships is associated with?
A) Borderline
B) Schizoid
C) Dependent
D) Anti-social
```
Schizoid
229
```
Somatic symptom Disorder is associated with
A) western populations
B) Men
C) Extraversion
D) Neuroticism
```
D) Neuroticism
230
```
The term conversion disorder camp from?
A) Watson
B) Ellis
C) Freud
D) Jung
```
C) Freud
231
The thought that I might become ill is associated with?
A) somatic symptom disorder
B) Illness anxiety disorder
C) Conversion disorder
B) Illness anxiety disorder
232
```
The disorder that lies between malingering and conversion disorder is?
A) Derealisation
B) Somatic
C) Dissociative Disorder
D) Factitious Disorder
```
D) Factitious Disorder
233
```
Which of the following is not a specifier of anorexia?
A) Diuretic
B) Binge Eating
C) Restrictive
D) Purging
```
A) Diuretic
234
Giskes and Siu (2008) found…
A) women are more likely to get ill
B) eastern cultures are less likely to have eating problems
C) magazines impact weight
D) Men are less likely to view themselves as overweight
D) Men are less likely to view themselves as overweight
235
```
Opium is a…
A) Depressant
B) Stimulant
C) Amphetamine
D) Anxiolytic
```
A) Depressant
236
```
Which country has the highest alcohol consumption?
A) Canada
B) Australia
C) NZ
D) USA
```
Australian
237
What is normal Sexual Behaviour?
very subjective
culturally determined
Consenting adults
no distress or impairment
238
what is the study of sex in Aus called?
Australian Study of Health and Relationships (ASHR)
conducted once a decade
Telephone interview 2013
239
```
What is the Median age 1st intercourse
A) 15
B) 16
C) 17
D) 18
```
17
240
What is the average # of partners for men and women?
```
Male = 18 partners
Female = 8 partners
```
241
What are the % of gay and bisexual men and women in Australia?
```
Men = 1.9% gay, 1.3% Bisexual
Women = 1.2% lesbian, 2.2% bisexual
```
242
what % of Australia is in Hetero relationships?
What % of M and F rate their relationship as satisfying?
74% hetero relationships
86% M, 84% F rate their relationship as satisfying
243
what is the average amount of sex in a relationship per week?
1.4 x per week
>75% agree on premarital sex, oral is sex, affairs are wrong
244
What is the % of M and F that masturbate ?
What is the % of M and F that watch porn??
Masturbate: 72% M, 42% F
Porn: 63% M, 20% F
245
Sexual Difficulties Stats:
```
No interest in sex = 23% M, 11.7% F
No orgasm = 6% M, 20% F
Worry about body image = 14% M, 35% F
Worry about performance = 16% M, 17%F
Performance anxiety = highest in M < 20 yr
```
246
what are sexual self schemas?
Describe M and F sexual schemas...
core beliefs about ones self
by Anderson et al
Females report:
passionate, romantic feelings, openness, embarrassment and self consciousness
Males report:
powerful, independent, aggressive, passionate, loving, openness
247
EXAMPLES of Cultural differences in sex
Papau New Guinea: masturbation forbidden, gay oral sex to give semen. Marriage is heterosexual only
India: mutual masturbation considered normal among kids
248
Development of Sexual Orientation
genetic component = M 40%, F 20% likelihood
Twin studies 50% between MZ Twins
249
What are Paraphilic Disorders?
sexual fantasies, urges, behaviours involving socially inappropriate people or objects
Distress or impairment or harm or threat of harm to others
250
What is Fetishistic Disorder?
What is Paedophilic Disorder?
What is Voyeuristic Disorder?
Non-human objects
Children (90%M, 10% F)
Watching others
251
What is Exhibitionistic Disorder?
What is Frotteuristic Disorder?
What is Transvestic Disorder?
What is Sexual Sadism/Masochism Disorder?
exposing ones self
Touch Non consenting adults, e.g. on busy train
cross-dressing
Suffering or humiliation
252
What are some common facts about paraphillic disorders?
- May have legal implications
- Often multiple Paraphillias
- High comorbidity (anxiety, mood, substance abuse)
- Difficult to estimate prevalence
253
What are some Causes of Paraphillic disorders?
- Neurological Factors
- Low arousal to appropriate stimulus
- Strong sex drive
- Weak inhibitory control
- Early experiences (inappropriate arousal, conditioning)
254
Is Gender Dysphoria a Paraphilic Disorder?
What was Gender Dysphoria previously called?
Define Gender Dysphoria
No
previously gender identity disorder/transsexualism
Mismatch between sex and gender identity, feels trapped in body of other sex
Not Transvestic Disorder or Intersexuality, not same sex orientation
255
Define Sex, Gender and Gender Identity
Sex = biological characteristics of M or F
Gender = socially constructed roles
Gender Identity = reinforced through adolescence
256
What did Coleman (1993) establish about gender dysphoria?
Sexual Orientation unchanged after surgery
257
What is the prevalence of Gender Dysphoria?
Rare (M: 1/24K, F: 1/150K & F
258
what are the causes and treatment of gender dysphoria?
Causes:
- Gender non-conformity (neutral family influence, lack of male role model
- Genetic predisposition 62%
Treatment:
Sex reassignment surgery
259
Sexual Disfunction is...
very common/common/rare
and must be perceived as...
distressing/inconvenient/uncomfortable
Very common,
must be perceived as distressing
260
Describe the 5 Phases of sex
```
Desire Phase (need to feel sexual urges)
Arousal Phase (erection, wetness)
Plateau Phase (intercourse)
Orgasm Phase (ejaculation, Climax)
Resolution Phase (decrease in arousal)
```
261
Describe Sexual desire disorder
Sexual desire disorder (Desire Phase)
little/no interest in sexual activity
Masturbation or sex <1mth
M = 24%, F = 54%
262
Describe Sexual Arousal Disorders
Sexual Arousal Disorders (arousal Phase)
Increases with age
Main issue: Male Erectile Dysfunction
Female little/no desire for sex
263
Describe Orgasmic Disorders
```
Orgasmic Disorders (Orgasm Phase)
Can’t orgasm
Female = can’t orgasm 25%
Male = rare in males 8%
Premature ejaculation (most common dysfunction, 60%)
```
264
Describe Sexual Pain Disorders
Sexual Pain Disorders
Female only, bruning, tearing, 6%
Involuntary pelvic spasm
Strong psychological contributions
265
How do you assess sexual behaviours?
```
Sexual attitudes
Behaviours
Sexual response cycle
Relationshop issues
Physical health/medications
Psychological disorders
Psychophysiological
Sexual arousal response
```
```
M = self-report + Penile strain gauge
F = self-report + Vaginal photoplethysmograph
```
266
what are some causes of sexual dysfunction?
Causes
Diabetes
Vascular disease, cardiovascular disease
Prescription drugs, alcohol, illicit drugs
267
What are some treatments of sexual dysfunction?
Treatment (based on understanding causes)
Education about sexual function (masters and Johnson)
Eliminate performance anxiety
No Intercourse, no genital contact, genital contact, intercourse
268
Which of the following is true about conversion disorder?
A) The incidence increases with increased knowledge about the cause of the condition.
B) The incidence decreases with increased knowledge about the cause of the
condition.
C) The incidence is unrelated to knowledge about the cause of the condition.
D) None of the above is true.
B) The incidence decreases with increased knowledge about the cause of the
condition.
269
in DSM-4, Personality Disorders
are classified on
A) Axis 1
B) Axis 2
C) Axis 3
D) Axis 4
B) Axis 2
270
Personality Disorders can be described as...
A) Chronic, Pervasive and unstable
B) Life long, irreversible
C) Constant, unstable, genetic
D) Enduring, pervasive, stable predispositions
D) Enduring, pervasive, stable predispositions
271
Personality Disorders...
A) Must be present across different contexts
B) Inflexible and maladaptive
C) A and B
D) Flexible and present across different contexts
C) A and B
272
Personality Disorders have a High comorbidity with...
A) Depression and leads to poorer prognosis
B) clinical disorders and leads to poorer prognosis
C) Schizophrenia and leads to poorer prognosis
D) None of the above
B) clinical disorders and leads to poorer prognosis
273
What is a negative therapist reactions to personality disorders?
Define Transference and Counter Transference...
Countertransference
Transference: client treatment redirects feelings for others onto therapist
Counter transference: therapist transfers emotion to client (a reaction to transference)
274
What is the prevalence of Personality disorders and do people seek or avoid help for PD?
Ppl often seek help for something else
0.5 - 2.5%
Outpatient = 2-10%
Inpatient =10-30%
275
What is the Origin and Course of Personality Disorders?
A) adult, not chronic, high cormorbidity
B) adolescence, chronic, high comorbidity
C) middle adulthood, chronic, low comorbidity
B) adolescence, chronic, high comorbidity
276
what are the typical gender differences in personality disorders?
```
M = Aggressive, self-assertive, detached
F = Submissie, emotional, insecure
```
277
What did Ford & Widiger (1989) identify about gender biases within personality disorders?
A) found therapists label males and females as histrionic
B) found therapists label males as loners, females as insecure
C) found therapists label males as aggressive, females as submissive
D) found therapists label males as antisocial, females as histrionic
D) found therapists label males as antisocial, females as histrionic
278
Histronic is understood as...
A) low key
B) stereotypically female trait
C) stereotypically male trait
D) not gender related
B) stereotypically female trait
279
The DSM is...
A) Dimension
B) Categorical
B) Categorical
280
What are some Criticisms of Categorical models?
```
Reifies concepts (once named, they become real)
Less flexible (either have it or you don't)
Loose individual info
Requires judgement = arbitrary
```
281
What is an example of a Dimensional and a Categorical model?
Dimensional: 5 Factor Model “Big 5”
Categorical: DSM-5
282
Samuel & Widginer (2008) found...
A) Discredited the Big 5 Validity
B) No Relationship between the Big 5 and PD’s
C) a relationship between the Big 5 and PD’s
D) No correlation between Narcissism and PD
C) a relationship between the Big 5 and PD’s
283
What are the 3 clusters of personality disorders?
A) Odd / eccentric (issues with relationships)
B) Dramatic / Emotional / Erratic (Unstable, lack of emotion)
C) Anxious / Fearful (avoidant of relationships)
284
Cluster A (Odd / eccentric) includes...
Paranoid PD
Schizo PD
Schizotypal PD
285
Cluster B (Dramatic / Emotional / Erratic) includes...
Borderline PD
Antisocial PD
Histrionic PD
Narcissistic PD
286
Cluster C (Anxious / Fearful) includes...
Dependent PD
Avoidant PD
Obsessive Compulsive PD
287
Which cluster is Paranoid PD?
Discuss Paranoid PD features...
does Paranoid PD have pos or neg symptoms or both?
Cluster A)
Odd / eccentric (issues with relationships)
- distrust/suspiciousness of others
- interprets motives as malevolent
- Few meaningful relationships
Pos and neg symptoms
288
Discuss causes of Paranoid PD
Which cluster?
Possible relationship to schizophrenia
Possible role of early experiences (trauma/abuse)
2.3% of population
Cluster A)
Odd / eccentric (issues with relationships)
289
Discuss Treatment of Paranoid PD
Which cluster?
Unlikely to seek help due to suspiciousness
Seek help for crisis or comorbidity
Sensitive to criticism
No empirically supported treatment
Cluster A)
Odd / eccentric (issues with relationships)
290
Discuss Schizoid PD features...
does Schizoid PD have pos or neg symptoms or both?
Which cluster?
pattern of detachment from relationships
Neither enjoy nor desire relationships
limited emotions: appear cold/detached
Unaffected by praise, social skill deficits
No Pos, but neg symptoms
Cluster A)
Odd / eccentric (issues with relationships
291
Discuss causes of Schizoid PD
Which cluster?
5% population
Limited research
possibly related to
abuse/neglect, autism, dopamine
Childhood shyness
Cluster A)
Odd / eccentric (issues with relationships)
292
Discuss Treatment of Schizoid PD
Which cluster?
Unlikely to seek
No empirically supported treatment
Social skills and empathy training
Social network building
Cluster A)
Odd / eccentric (issues with relationships)
293
Discuss Schizotypal PD...
Which cluster?
social deficits, reduced capacity for close relationships
perceptual distortions and eccentric behaviour
Pos but no neg symptoms
Magical thinking, illusions
Socially isolated, highly suspicious
4.6% population
Cluster A)
Odd / eccentric (issues with relationships)
294
discuss treatments of schizotypal PD
which cluster?
Cluster A)
Odd / eccentric (issues with relationships)
Social skills training
Antipsychotics meds
295
Discuss Antisocial PD...
Which cluster?
Disregard and violation of rights of others (noncompliance)
Social predators (sociopath/psychopath)
High rate of substance abuse
Overlap with criminality
Hare Checklist = 6 criteria for psychopath
Family history of inconsistent parenting, support and violence
3.3% of population
Cluster B: Dramatic / Emotional / Erratic (Unstable, lack of emotion)
296
Discuss causes and treatments of Antisocial PD?
which cluster?
Causes: Grays model
Behavioural inhibition system: Fear and anxiety
Treatment:
Unlikely to seek help, incarceration
Prevention = improve social competence
Cluster B: Dramatic / Emotional / Erratic (Unstable, lack of emotion)
297
Discuss Borderline PD...
which cluster?
What is the prevelance?
Unstable relationships, self image
Intense moods, impulsivity, feel their needs are not met
Poor self image, fear of abandonment
affect and control over impulses
Can be functional and dysfunctional
Suicidal gestures
Often misdiagnosed as bipolar or schizophrenia
Cluster B: Dramatic / Emotional / Erratic (Unstable, lack of emotion)
1.6-5.9% of population
M in forensic setting
M: impulsivity, F: emotionality
298
Causes of Borderline PD?
which cluster?
Biological (serotonin, limbic circuit, hypersensitivity)
Cognitive Biases (abandonment, emptiness, suicide)
Early Childhood Experiences (Parental neglect/trauma)
Cluster B: Dramatic / Emotional / Erratic (Unstable, lack of emotion)
299
Treatment of Borderline PD?
Which cluster?
Very likely to seek help
Antidepressant meds not effective
- Dialectical Behavioural Therapy ‘DBT’ by Marsha Linehan: Mindfulness, Emotional Regulation, Interpersonal Effectiveness, Distress Tolerance, CBT + Validation + Dialectics, Acceptance based interventions
- Mindfulness
- Schema Therapy: Look at Maladaptive coping mechanisms developed over time. Examine in ‘parts’. Schema examples: abandoned child, Detached Protector
Chair work or imagery re-scripting
Cluster B: Dramatic / Emotional / Erratic (Unstable, lack of emotion)
300
What is DBT?
Dialectical Behavioural Therapy ‘DBT’ by Marsha Linehan:
Mindfulness, Emotional Regulation, Interpersonal Effectiveness, Distress Tolerance,
CBT + Validation + Dialectics
Acceptance based interventions
301
Discuss Histrionic PD
| which cluster?
Cluster B: Dramatic / Emotional / Erratic (Unstable, lack of emotion)
```
Excessive emotion and attention seeking
Overly dramatic, sexually provocative
appearance focused, superficial
Causes: link to antisocial
Treatment: focuses on problematic interpersonal behaviours
1.84% of population
```
302
Discuss Narcissistic PD
| which cluster?
Cluster B: Dramatic / Emotional / Erratic (Unstable, lack of emotion)
Grandiosity, need for admiration, lack of empathy, arogant
Lack of compassion
Causes: deficits in early childhood (altruism, empathy) + individual focus
Schema Therapy: The lonely child, the self aggrandiser, the self soother
303
Discuss Avoidant PD
| which cluster?
Cluster C: Anxious / Fearful (avoidant of relationships)
Social inhibition, feelings of inadequacy
hypersensitivity to negative evaluation
Difficult temperament
Causes: Early parental rejection
Treatment: increase social skills, reduce anxiety, therapeutic alliance
2.4% general population
304
Discuss Dependent PD
| which cluster?
Cluster C: Anxious / Fearful (avoidant of relationships)
Need to be cared for, submissive and clingy behaviour
fear of separation
Causes: early experiences of rejection, death of parent
Treatment: independence, confidence
0.6% of general population
305
Discuss Obsessive compulsive PD
| which cluster?
Cluster C: Anxious / Fearful (avoidant of relationships)
Preoccupation with orderliness, perfectionism, interpersonal control, rigid
Treatment: decrease rumination,
2-8% of general population
306
Where are Somatic Symptoms usually seen?
Usually found in non mental health settings with many receiving disability allowance
307
The diagnosis of Somatic Symptoms is based on....
A) Positive symptoms + subsequent related behaviours and feelings.
B) Negative somatic symptoms + subsequent related behaviours.
C) positive signs of distressing somatic symptoms + subsequent related thoughts, behaviours and feelings
D)Both Positive and Negative somatic symptoms + subsequent related behaviours and feelings
C) positive signs of distressing somatic symptoms + subsequent related thoughts, behaviours and feelings
308
Somatic Symptoms are NOT based on...
A) the absence of identifiable medical condition
B) the presence of a medical condition
C) erratic behaviours and feelings about illness
D) the absence of unidentifiable medical condition
A) the absence of identifiable medical condition
309
people with somatic symptoms are...
A) unconcerned about serious indicators of medical problems
B) the likelihood of serious illness
C) concerned with medical diagnosis
D) concerned with the functioning of their body
D) concerned with the functioning of their body
310
Somatic Symptom Disorder (SSD) was previously called
A) Linehan Disorder
B) Bodily Function Disorder
C) Briquet’s syndrome
D) Brochas Syndrome
C) Briquet’s syndrome
311
Explain Somatic Symptom Disorder (SSD)
and explain symptoms
Physical symptoms with no identifiable physical cause
Continually feel weak/ill + severe pain + avoids exercising
312
discuss Somatic Symptom Disorder Prevalence
and what other conditions it is associated to...
not known, Likely to increase with less strict criteria, Estimated 5-7% of pop.
More common in F
313
explain Illness Anxiety Disorder (IAD)
Hypochondriasis “i might become ill”
314
what is Illness Anxiety Disorder (IAD)
| often comorbid with?
Co-morbid with anxiety disorders like GAD
315
what are the 2 subtypes of Illness Anxiety Disorder?
care-seeking and care-avoiding
316
What is the onset and prevalence of Illness Anxiety Disorder?
Chronic + Relapses
Doesn’t respond to reassurance or negative
Onset early to middle childhood, peaks adult
317
What are the causes and treatment of Illness Anxiety Disorder?
is it a somatic or dissociative disorder?
Causes: major life stress, serious but benign health threat, Attention bias, distorted beliefs
Treatment: CBT - identify interpretations of physical symptoms, stress reduction
somatic
318
what are the Psychological Factors Affecting Medical Conditions?
Presence of medical condition (Asthma, Diabetes, Severe Pain)
Presence of Behavioural/psychological factors (course. Response to treatment)
319
What is Conversion Disorder?
who do they typically see before a therapist?
Neurological problem without neurological basis (Paralysis, Blindness, Aphonia, Muteness)
Sees Neurologist first, then therapist
320
what is Freuds belief surrounding Anxiety?
conversion of anxiety due to intra-psychic conflict into physical symptoms
321
what is the clinical description of Conversion Disorder?
what does 'La belle indifference' mean?
is it a somatic or dissociative disorder?
Clinical description: physical malfunctioning, no evidence of physical pathology
‘la belle indifference’ doesn’t distinguish from malingering/true medical conditions
Demonstrate functions under threat e.g. blind person avoids objects
somatic
322
what did Soon et al (2010) establish about conversion disorder?
A) person isn’t aware of their state
B) people are aware of their condition
A) person isn’t aware of their state
323
what are the causes and treatments of Conversion Disorder?
is it a somatic or dissociative disorder?
Causes: trauma that must be escaped, symptoms lead to escape (reinforcement)
Treatment: identify and address trauma/stress, reduce reinforcement
Somatic
324
what is Factitious Disorder?
is it a somatic or dissociative disorder?
between malingering and conversion disorder
Intentionally produced symptoms, no obvious benefit
somatic
325
Give an example of...
Normal dissociative symptoms
Positive dissociative symptoms
Negative dissociative symptoms
normal disassociation = reading without taking in content
Positive dissociative symptoms = fragmentation of identity, depersonalisation
Negative dissociative symptoms = amnesia
326
Define Dissociative Disorder
The disruption or discontinuity in the normal integration of consciousness, memory, perception and behaviour
Associated to trauma
327
# Define Depersonalisation - Derealisation Disorder
Define Depersonalisation
Define Derealisation
can occur in panic attack or PTSD
Depersonalisation = distortion in perception of reality, split self/participation
Derealisation = detach from the world, often visual/auditory distortions
328
Discuss Depersonalisation - Derealisation Disorder
Onset
Prevalence
Causes
Treatment
Prevalence 1-3%, high comorbidity with anxiety and mood disorders,
Onset 16 yrs old, lifelong and chronic
Cognitive deficits (attention/spacial reasoning)
Prozac not effective
329
Define Dissociative Amnesia
Can’t recall anything
Localised or selective type: can’t recall specific events (eg trauma like war)
Rarely occurs before adolescence or after 50 yrs
prevalence: 2-7%, F>M
Subtype: Dissociative Fugue
330
Define Dissociative Identity Disorder (DID)
The presence of 2 or more personality states or experience of possession
2 - 100 identities with unique characteristics (age, emotions, gender)
Host = keeps identities together
Switch = transition fro one personality to another
331
Can Dissociative Identity Disorder (DID) be faked?
Yes, Kenneth Bianchi, serial killer used multiple personality as defence
332
Discuss Dissociative Identity Disorder (DID) in the DSM-5...
how overt/prolonged the states are depend on Type, current stress, culture, emotional resilience
when alternating personalities are not observed, key symptoms include discontinuity in sense of self and recurrent dissociative amnesia
333
Discuss Dissociative Identity Disorder (DID) Prevalence, Causes and Treatment
F:M 9:1, Onset: childhood, lifelong and chronic
causes:
Biological vulnerability,
Developmental Factors: Bio, Psycho, Social
learning history: childhood trauma
Psychological factors: Autohypnotic model
Treatment: similar to PTSD
334
Define PTSD
Trauma exposure, Extreme fear, helplessness
Continued re-experiencing (memories, nightmares, flashbacks)
Avoidance, emotional numbing, interpersonal problems, dysfunction
1 month
335
What is the prevalence of PTSD
Prevalence: varies in type of trauma and proximity, 6.8% life long, 3.5% year long
Cases which meet PTSD criteria: Sexual Assault: 32%, Accidents: 15-20, Combat: 18.7%
336
PTSD Causes
Causes:
Trauma Intensity
Biological and Psychological vulnerability, social support
Neurobiological: threat cues corticotropin-releasing factor (CRF) system which activated fear/anxiety (amygdala) and increases HPA axis activation (Cortisol)
337
PTSD Treatment
CBT
EMDR
Cognitive processing therapy
Pharmacotherapy: SSRI’s (anti-depressants)
338
what are the 4 big ethical principles?
1. Autonomy: right to choose/refuse treatment
2. Beneficence: work in best interest of the client
3. Non-maleficence: do no harm
4. Justice: in terms of access to treatment
339
Discuss APS Code of ethics
Is the minimum expectation of professional conduct
Psychologists responsibility to their clients, the community, society at large and to the profession.
Psych board of Aus has adopted the Aus Psych Society code of Ethics
340
what are the 3 general principles of ethics
RESPECT + PROPRIETY + INTEGRITY
341
What does Aust Health Practitioner Regulation Agency (AHPRA) do?
To register as a Psych
To make complaints about conduct of Psychologists
National Statement on Ethical Conduct in Human Research (NHMRC 2007): Research merit and integrity
342
what is involuntary admission?
Must not be detained unless an authorised medical officer is of the opinion that …
A) They are mentally ill or disordered
B) No other less restrictive care is appropriate
343
when is someone considered mentally ill?
for the persons own protection or others protection from harm
A condition that seriously impairs mental functioning either temporarily or permanently including delusions, hallucinations, mood disturbance
344
what is serious harm?
Physical harm, harm to relationship, financial, self neglect, neglect of others
345
______________ includes two years of hypomanic symptoms with periods of depressive symptoms.
a. Cyclothymic disorder
b. Bipolar II disorder
c. Dysthymic disorder
d. Persistent depressive disorder
a. Cyclothymic disorder
346
Which of the following disorders includes the following symptoms: lack of empathy, interpersonally exploitative, envious of others.
Select one:
a. Borderline personality disorder
b. Histrionic personality disorder
c. Narcissistic personality disorder
Narcissistic personality disorder
347
Exposure therapy is a common treatment in psychology. Which of the following disorders does NOT typically have exposure therapy as a treatment?
Select one:
a. Agoraphobia
b. Social anxiety disorder
c. PTSD
d. Borderline personality disorder
d. Borderline personality disorder
348
Which of the following has the least side effects?
Select one:
a. SSRIs
b. Xanax
c. TCAs
d. MAOIs
a. SSRIs
349
Brief psychotic disorder must be shorter than ________.
Select one:
a. 2 weeks
b. One month
c. One week
d. 6 months
b. One month
