Psychopathology Flashcards
(255 cards)
1
Q
what does the DSM-5 define as a mental disorder
A
a disturbance in cognition, emotion regulation or behaviour associated with significant distress or disability
2
Q
what is the exception to diagnosing a disorder
A
if the distress/disability is expected/ culturally normative then we can not say it is in line with a disorder
3
Q
what does the idea of disorders being ‘fuzzy’ mean
A
they do not have discrete boundaries and there is many different ways that a disorder can present
4
Q
what are some arguments against disorders
A
- lead to bias, restricted thinking or stigmatisation
- can inhibit research if one case is narrowed down to a specific disorder
- jargon can mask what is actually being discussed
5
Q
what are some arguments for diagnosis
A
- due to the specific terminology provided by a disorder,
clearer communication between clinicians is facilitated - a label can allow people to actually seek active treatment
6
Q
in terms of descriptive psychopathology:
what is are signs
A
objective findings observed by a clinician eg. poor eye contacts
7
Q
in terms of descriptive psychopathology:
what are symptoms
A
subjective complaints from the patient
eg. anxiety
8
Q
in terms of descriptive psychopathology:
what are syndromes
A
a collection of signs/symptoms that match a pattern eg. depression
9
Q
in terms of descriptive psychopathology:
what are disorders
A
a syndrome that can be discriminated from other syndrome
10
Q
in terms of descriptive psychopathology:
what are diseases
A
has to be a physical/structural abnormality
11
Q
tests don’t give a diagnosis
A
even if a test says something is likely, the clinician still has to make the diagnosis eg. can show enough symptoms to qualify for GAD but if there is a logical reason for the behaviour the clinician can override it
12
Q
what are the two approaches to psychopathology
A
Categorical vs Dimentional
13
Q
describe the diathesis-stress model
A
diathesis - being pre-existing susceptibility for a disorder
stress - being the events/environment affecting the person
14
Q
what are the three options in response to danger
A
fight, flight and freeze
15
Q
define fear
A
describes feelings that occur when a source of harm is immediate/imminent - more associated with reflexive neural pathways
16
Q
define anxiety
A
describes feelings that occur when a source of harm is uncertain or distant in space/time - associated with anticipation which activates different neural pathways to fear
17
Q
what is the prevalence of anxiety disorders
A
~ 15-20%
18
Q
why do phobias often go untreated
A
most people have the ability to adapt their lifestyle so they can avoid the thing therefor not triggering the phobia
19
Q
what is psychotherapy
A
therapy other than medication eg. behavioural
20
Q
what is specific phobia
A
fear of a specific thing
21
Q
what are some requirements of specific phobia
A
- out of proportion
- person understands that their response is excessive/outweighs the required response
22
Q
how long must specific phobia be present for a diagnosis
A
6 months
23
Q
what is they key factor with disorders - rule number one
A
if there is no functional impairment we cannot say it is a disorder
24
Q
what are the most common phobias
A
heights, blood, the ocean, water, storms, tight spaces, flying and animals
25
specific phobia epidemiology
12-25 yo
26
what is aetiology
the cause/manner of causation of a disease or condition
27
specific phobia aetiology
- classical conditioning
- social conditioning
- through observing others
28
specific phobia treatment
exposure therapy is proven most beneficial
29
what are some types of exposure therapy
in vivo, imaginary, VR, gradual vs flooding
30
what is panic disorder
recurrent unexpected panic attacks, peaks within 5-10 minutes - can have panic attacks without having a panic disorder, however to have a panic disorder you must experience panic attacks - needs to be regular for a month to be diagnosed
31
what is a common social consequence of panic disorder
avoidance of behaviours that may cause panic or even that may feel like a panic attack eg. exercise
32
panic disorder epidemiology
13.2% lifetime prevalence of panic attacks and of that percentage, 13.2% have panic disorder
women are 1.8x more likely to get them and low income households are 1.5x more likely
33
panic disorder aetiology
- cognitive theories - say that panic attacks are caused by catastrophic over interpretations of somatic processes - countered by the fact that panic attacks occur at night too
- anxiety sensitivity theory - trait like susceptibility
- learning theory - alarm theory - freak out due to overreacting to the bodies reaction to something - creates a loop
34
panic disorder treatment
pharmacotherapy and psychotherapy have the same success - often prescribed benzo's
35
what is agoraphobia
fear, anxiety or avoidance of public spaces for fear of anxiety provoking reactions to the situation. fear is out of proportion to the actual threat. also fear that escape from the situation is impossible
36
how long does agoraphobia have to be present for a diagnosis
6 months
37
what is agoraphobia lifetime prevalence
5.3%
38
agoraphobia aetiology
a loop of external stimuli causing a bodily response, then you overreacting to your bodies response and so on
39
what is the first step in agoraphobia treatment
often good results if you can jump the first hurdle of getting the person outside and into the anxious situation
40
what is social anxiety disorder
fear, anxiety or avoidance of social situations where the person feels they are/ will be scrutinised - or be the focus of attention - associated with feelings of rejection, embarrassment and humiliation
41
key factors for SAD
- fear is out of proportion to actual situation
| - the individual realises the fear is out of proportion
42
how long does SAD have to be present for a diagnosis
6 months
43
what are some symptoms of SAD
blushing, fear of vomiting or having to go to the toilet suddenly
44
SAD epidemiology
4% lifetime prevalence
| often has comorbidity with other anxiety disorders or substance abuse
45
SAD aetiology
combination of environmental factors, genetic factors, cultural factors and situational proximity
46
SAD treatment
most effective measures are exposure therapy
47
what are the problems with treatment for SAD
often people feel that in a psychologist office they are safe and so their fear isn't comparable
48
what is important to remember about diagnosing anxiety disorders
if there is no impairment of how the person goes about their everyday life then it can not be considered a disorder
49
what is role impairment
disturbance in multiple areas of one's life
50
why does scrutiny arise when there is comorbidity with disorders
because it suggests that the disorder can be explained by another one so takes the legitimacy away from each one
51
what is GAD (generalised anxiety disorder)
excessive anxiety and worry about events - over a period of 6 months, more days than not are occupied by the anxiety - very high comorbidify with depression
52
GAD epidemiology
3.7% lifetime prevalence
53
what is a key difference between GAD and MDD (major depressive disorder)
GAD --> attention bias - more likely to notice a negative emotion
MDD --> memory bias - more likely to remember a negative emotion
54
GAD aetiology
poor emotional regulation/ dealing with emotions
55
what is the contrast avoidance theory of GAD
the fear of stark emotional change eg. feeling positive and then being hit with a heavy negative wave. Leads to the person sitting in a negative state to avoid the stark change
56
what is the main difference between bipolar and unipolar disorders
unipolar - only fluctuates to the lower pole - sadness
| bipolar - fluctuates between extreme happiness and sadness (mania and depression)
57
what is the normal range of mood fluctuation between
euthymia (happy) and dysthymia (sad)
58
define grief
appropriate sadness in response to recognised external loss
59
name four categories of clinical depression identification
intensity, precipitants (causal factors), quality and features
60
what are the four disorders in the category of depressive disorders
DMDD (disruptive mood disregulation disorder)
MDD (Major depressive disorder)
PDD (persistent depressive disorder)
PMDD (premenstrual dysphoria disorder)
61
MDD is the leading cause of what
DALY's: disability adjusted life years
62
DMDD is most common in which age group
pre schoolers
63
why was DMDD included as a disorder
many children were showing bipolar like symptoms yet the treatment for bipolar is too extreme for most children
64
what are the time requirements for DMDD
must last for around 12 months and begin before the age of 10
65
Along with showing 5 out of 9 set symptoms, to be diagnosed with MDD one of which two symptoms must be present during a two week period
'depressed mood'
| 'diminished pleasure/interest'
66
what percent of MDD sufferers exhibit a chronic course
15%
67
what percent of MDD sufferers exhibit a recurrent course
30-60%
68
what percent of MDD sufferers exhibit stable recovery (remain better)
40-60%
69
what percent of MDD sufferers relapse within 5 years
50%
70
what is the most effective treatment for MDD
neurotransmitter regulation medication ( eg. SSRI's)
71
what percentage of deaths by suicide are by MDD sufferers
60%
72
what is the requirement for PDD
depressed more days than not for at least 2 years
73
why is PDD hard to treat
most people don't notice the shift to PDD
74
what is the prevalence and heritability of PMDD respectively
1-8% and
| 30-80%
75
What is the negative triad that the cognitive component of depressive disorders refers to
1) negative views about the world
2) negative views about the future
3) negative views about oneself
76
what is mania
it is the defining emotion between bipolar and unipolar disorders, characterised by feelings of invincibility and accompanied by extreme irritability
77
what is the requirement for Bipolar 1 disorder
one or more manic episodes
78
what is the requirement for Bipolar 2 disorder
one or more hypomanic episode, accompanied by one or more depressive episode
79
what is cyclothymia disorder
persistent hypomanic, depressive symptoms for a long period of time
80
what is anorexia nervosa
the persistent restriction of energy intake leading to low body weight
81
what are the two subtypes of anorexia nervosa
AN-R - restricting type
| AN-BP - binge eating/ purge type
82
what is the ratio of females to males who usually have the anorexia and bulimia nervosa
10:1
83
what are some commonalities between patients with anorexia nervosa AN-R type
- gradually removing food groups
- strict food rituals
- preoccupation with food and food prep etc.
- perfectionism
- harm avoidance
84
what are some of the health complications associated with anorexia nervosa and bulimia nervosa
- cardiac, endocrine, gastro-intestinal etc.
85
what is bulimia nervosa
recurrent binge eating (large size and/or short time)
| followed by some form of compensatory behaviour (fasting, exercising, laxatives etc.)
86
for a bulimia nervosa diagnosis how often do these behaviours need to occur
once a week for three months
87
what is anorexia nervosa most commonly comorbid with
anxiety, depression and OCD
88
what is bulimia nervosa most commonly comorbid with
anxiety, depression and substance abuse
89
some factors seen in bulimia nervosa sufferrers
- impulsivity
- weight usually in normal range
- recognise that the behaviours are maladaptive
90
what is binge eating disorder
recurrent binge eating, meeting three or more of the set of requirements (see lecture slides)
91
for a binge eating disorder diagnosis how often do the behaviours need to be present
once per week for three months
92
what is the common onset for bulimia and anorexia nervosa
early 20's
93
which eating disorder is less gender skewed?
and
which eating disorder is more common in males?
binge eating disorder
and
ARFID (Avoidant restrictive food intake disorder)
94
what does OSFED stand for
other specified feeding or eating disorder
| - clinically significant impairment and distress but does not meet full criteria for a diagnosis
95
what are some OSFED's
atypical anorexia nervosa
purging disorder
night eating disorder
96
what does UFED stand for and what do they include
unspecified feeding and eating disorder
| - same as OSFED, yet the criteria not being met are unclear
97
what does ARFID stand for and what does it constitute
Avoidant restrictive food intake disorder
| - failure to meet appropriate nutritional and/or energy needs
98
what is 'Pica'
persistent eating of non-food substances for at least one month
99
what is one requirement for 'Pica'
the eating needs to be inappropriate for the developmental level
100
which group of people apart from young children more commonly make up Pica and rumination disorder
people with intellectual disorders
| and pica is also sees a spike during pregnancy
101
what is rumination disorder
repeated regurgitation of food
102
what is disordered eating in the DSM under the eating disorder section
distressing yet not meeting criteria for a clinical diagnosis, often a precursor to a full diagnosis
103
what is orthorexia
not a DSM-5 recognised diagnosis, involves cutting food from diet eg. sugar - and so can be perceived as clean eating - associated with social media body image issues
104
what is muscle dysmorphia
not an eating disorder but the perception that one does not have much muscle even when they have a lot - more common in men
105
what is the dual pathway of bulimia nervosa
1) eating as a result of restriction
| 2) eating as an emotional regulation method
106
what does the transdiagnostic model of eating disorders say
happiness comes from being thin and that being in control of your body weight and image is the key to happiness
107
what is the number one risk factor for developing an eating disorder
dieting
108
what percentage of gay or bisexual men have an eating disorder
15%
109
what is the heritaibility percentage of eating disorders
40-60%
110
how do risk factors of eating disorders fit together - the three P's
PREDISPOSING - contribute/ create vulnerability eg. genetics and society
PRECIPITATING - stressors leading to weight loss eg. trauma
PERPETUATING - factors maintaining weight loss and trapping individual in the often inescapable situation eg. ongoing trauma or stress
111
which eating disorders is CBT therapy most effective for
bulimia nervosa and binge eating disorder
112
what are some common barriers blocking recovery from eating disorders
- people not understanding the gravity of the condition
- deeply ingrained behaviours
- fearful of change
113
what is psychosis
a group of disorders distinguished from one another by symptom configuration and duration
114
what are delusions
fixed beliefs that are not amendable to change in light of conflicting evidence
115
what are some categories of delusions
SPREG N
somatic, persecutory, referential, erotomatic, grandiose, nihilistic,
116
differentiate between bizarre vs non-bizarre delusions as well as primary vs secondary
```
bizarre = non plausible
primary = occurs without prior reason or symptoms
```
117
what are hallucinations
perception-like experiences that occur without external stimulus
118
what are the normal hallucinations that occur when waking and falling asleep called
waking = hypnopompic
| falling asleep = hypnagogic
119
as well as diminished emotional expression, what do the four A's of psychosis' negative symptoms mean
- avolition - decreased self motivation
- alogia - decreased speech output
- anhedonia - decreased pleasure experience
- asociality - lack of interest in social interactions
120
what percentage of the normal population experiences hallucinations and delusions
5% of general population
121
what is schizotypy
a group of symptoms similar to psychotic disorders (experienced by the gen. pop.) but that don't constitute a psychotic disorder
122
what are the five types of psychotic disorder as outlined by the DSM-5
- brief psychotic disorder
- delusional disorder
- schizoaffective disorder
- schizophreniform disorder
- schizophrenia
123
what are the qualifications for brief psychotic disorder
one or more delusions, last for more than a day but less than a month
124
what are the qualifications for schizophreniform disorder
two or more psychotic symptoms for more than a month but less than six
--> same as schizophrenia but for the duration
125
what are the qualifications for delusional disorder
presence of delusions but not meeting the criteria for schizophrenia
126
what are the qualifications for schizoaffective disorder
period of two or more weeks with psychotic symptoms with the presence of a mood disorder too.
127
what percentage of the general population has schizophrenia
1.2%
128
what is the ratio of schizophrenia between males and females
chapel house minus Dana (sorry)
3:2
129
true or false: schizophrenia patients tend to be sufferers of violence and abuse rather than perpetrators of it
true
130
when was the feighner criteria developed
late 1970's
131
when was the first interpretation of schizophrenia
Morel 1860
132
when was the refined interpretation of schizophrenia
Kraepelin 1898
| Bleuler 1911
133
what were the criticisms of Kraepelin and Bleuler
mainly focused on chronic cases as seen in an asylums = poor sample to make realistic judgements
134
what is the chance of inheriting schizophrenia when one parent has it versus both
10% --> one
| 46.3% --> both
135
how does cannabis increase the prevalence of psychosis
cannabis is found to increase the presence of the COMT gene
136
what is the dopamine hypothesis in terms of psychotic disorders
the experience of delusions and hallucinations are due to an excess supply of dopamine
137
what are some other biological factors influencing psychosis
enlarged ventricles, enlarged hippocampal volume, heightened activity in the auditory and visual areas of the brain
138
what are the factors that may lead to psychosis
- cognition
- social cognition (emotional perception, social perception)
- role of family
- social (urban environment and being a minority member increases the risk)
- childhood trauma
- stress (stress-diathesis model)
- substance use (use of cannabis under the age of 18 increases chance by 2.4%)
139
if you use cannabis 50x before you're 18 how much does the risk of psychosis increase
3.1%
140
how many years lost is schizophrenia associated with
13-15 years
141
what is the best approach to schizophrenia treatment
low-dosages over high-dosages and CBT model (mainly for reducing hallucinations and delusions).
142
define somatic symptom disorders
the presence of of somatic symptoms associated with significant distress and impairment
143
define dissociative disorders
disruptions of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control and behaviour.
--> unwanted intrusions into awareness and behaviour
144
in the 17th century what term was coined to explain somatic symptom disorders
hypochondriasis
145
in the 19th century what did Freud and Breuer believe was the cause of somatic symptom disorders
early trauma - mainly sexual abuse
146
what is somatisation
distress is expressed as physical symptoms - underlies all somatic disorders
147
give an example of normal somatisation
being stressed results in a headache and taking a panadol to treat it
148
give an example of abnormal somatisation
being stressed results in a headache --> must be a brain tumour
149
how can family factors influence somatic symptom disorders
may be a learnt disorder from other family members
- eg. if a family represses emotional discussion the individual may feel the only way to get help or attention is through physical symptoms
150
why are somatic symptom disorders a huge burden on the healthcare system
sufferers often go to multiple doctors about health problems that have no underlying cause and are distrusting of their advice and so seek further treatment.
151
what are some characteristics of somatic symptom disorders outlined by the DSM-5
- multiple current distressing somatic symptoms
- individual must be distressed by the symptoms they are experiencing
- not reassured by negative test results
- frequent checking of body for ailments
152
what is illness anxiety disorder and what does the DSM-5 say about it
a pre-occupation with the fear of having or acquiring a physical illness - fear comes from having the illness rather from the actual symptoms
153
what are the somatic disorders in the DSM-5
illness anxiety disorder
conversion disorder
factitious disorder (munchausen disorder)
154
what are some factors of illness anxiety disorder
- hypersensitivity to bodily sensations
- often distrust medical professionals but still seek their help and advice
- optimistic bias in making self judgements about health and illness
155
although CBT therapy is beneficial for somatic and related disorders, why is it often hard to administer
the person often believes that their symptoms are physical and so doesn't engage in the CBT therapy - as they think it is not doing anything
156
what is conversion disorder
one or more symptoms of altered voluntary motor or sensory function with no underlying cause - cannot be explained better by any other medical event
- often associated with recent stressful event. eg. soldiers at war often were immobilised or blind with no physical damage
157
what is factitious disorder
- falsifies physical or psychological signs or symptoms
- often will injure oneself to provide evidence to others
- does it for no personal gain
158
what is factitious disorder also know as
munchausen disorder
159
what would it be called if you were displaying signs of factitious disorder, but for some sort of compensation
malingering
160
what are the three types of dissociative disorders
amnesia - losing sense of how an individual got to a certain place
depersonalisation - feeling detached from the world and themselves
absorption - unaware of passage of time - often sit daydreaming and being absorbed in fantasy
161
what is dissociative identity disorder
- F.K.A. multiple personality disorder
- recurrent episodes of dissociative amnesia
- over 2 distinct personalities
162
what is dissociative identity disorder associated with
- substance use, self-harm, other mental illness
| - 95% of sufferers report childhood trauma - usually sexual abuse
163
what does the trauma theory of dissociative identity disorder say
that dissociation is a hypnotic defence mechanism against thoughts of trauma
164
what is the controversy around dissociative identity disorder
many people use this to express stress
165
what is a common experience as a part of dissociative amnesia
inability to recall autobiographical information
166
what is the definition of personality
individual differences in characteristic patterns of thinking feeling and behaving
167
what is the definition of a personality disorder
enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individuals culture.
168
what are the three core features of personality disorders
functional inflexibility
self-defeating behavioural patterns
tenuous stability under stress (reverts to maladaptive coping mechanisms under stress)
169
what is a common observation with PD's
often a secondary disorder masking an axis one disorder
170
which PD's are in cluster A
PSS
Paranoid PD
Schizoid PD
Schizotypal PD
171
Which PD's are in cluster B
BAHN
Borderline PD
Antisocial PD
Histrionic PD
Narcissistic PD
172
Which PD's are in cluster C
DOA
Dependent PD
OC PD --> OCD PD
Avoidant PD
173
Paranoid PD
- pattern of distrust and suspiciousness in others
| - more common in relatives with sz
174
Schizoid PD
- pattern of detachment from social relationships
| - restricted range of emotional expression
175
Schizotypal PD
- pattern of social and interpersonal deficits
| - reduced capacity for close relationships
176
Antisocial PD
- a lot of the behaviour that defines this PD is behaviour that would put you in prison
- pattern of disregard for and violation of the rights to others
- for a diagnosis have to be at least 18 and have evidence of conduct before 15
177
Borderline PD
- pattern of instability of interpersonal relationships, self image and impulsivity
- frantic efforts to avoid abandonment
- 75% females
178
Histrionic PD
- uncomfortable when not the centre of attention
- using physical appearance to draw attention
- sexually seductive or inappropriate behaviour
179
Narcissistic PD
Think arrogant
- lack of empathy
- pattern of grandiosity, need for admiration
- sense of entitlement
180
Avoidant PD
- pattern of social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation
- very close to SAD
181
Dependent PD
- excess need to be taken care of
- difficulty making own decisions, need for reassurance
- belief that they are unable to deal with the world on their own
182
Obsessive Compulsive PD
- need for perfectionism interferes with task completion eg. failure to submit essay because it wasn't perfect
- different from OCD in terms of symptoms
183
what is the overall epidemiology for all PD's
~6.5
184
what do all cluster A PD's have in common
they do not occur exclusively during sz. or other disorder with psychotic features
185
what is the biopsychosocial model of PD's
the basic model of PD's
| genetics --> events --> personality
186
what is the cognitive model of PD's
moderate complexity
- personality adds another layer of complexity when looking at disorders
- the roles of 18 maladaptive schemas that act as filters when processing info
- these schemas have their origins in childhood and are reinforced and often a self fulfilling prophecy
187
in terms of PD's what are the three schemas
schema surrender
schema avoidance
schema overcompensation
188
what is the Dialectical Behaviour Therapy (DBT) model
a model developed by Lineham and based on three predispositions to PD's
- dysfunctional emotional regulation
- temperament --> high neuroticism
- subject to drastically invalidating environments
189
what are some problems with DSM diagnosis of PD's
- lots of overlap, hard criteria
- criteria are decided by consesus
- usual categorical drawbacks
190
what are some alternatives to the DSM for PD's
NEO --> based on costa McCrae's 5 factor model
| TCI --> seven dimension assessment tool by Robert Cloninger
191
What are some treatments of PD's
psychosocial:
- CBT
- group and individual treatments
pharmacological
- not a lot of research outside BPD
192
which cluster of PD's respond best to treatment
Cluster A
193
what are some issues with PD treatment
- revolve around the degree of comorbidity with axis one disorders
- no consesus on how to measure improvement
- main argument is that if you remove a persons PD are you removing a part of them/ their personality
- hence strength based approaches are the most positive takes on PD's
194
how many DSM-5 PTSD criterion are there
5 main ones: a, b, c, d, e
| 3 sub: f, g, h
195
what does each PTSD criterion in the DSM-5 overall stand for
ABCDE
ESACA
A - categorises EXPOSURE to the trauma
B - presence of SYMPTOMS
C - AVOIDANCE of stimuli
D - categorises alterations in COGNITION and mood since the trauma
E - categorises alterations in AROUSAL or reactivity since the trauma
196
what is the TRAUMA acronym
```
T - traumatic event
R - re experience
A - avoidance
U - unable to function
M - month (at least)
A - arousal
```
197
what is the difference between acute stress disorder and PTSD
criterion B, C, D and E need only be experienced for 3 days to a month
198
recall Glatzer-Levy et al 2018 four groups of trauma trajectory
~66% --> consistently show few PTSD symptoms
~21% --> initial distress then gradual remission
~11% --> initially low symptoms, increase over time
~9% --> chronic distress, high PTSD levels
199
what is the rates between men and women of trauma experience across a lifetime
65% men
| 50% women
200
what is the percentages of developing PTSD across a lifetime after experiencing trauma between men and women
men: 8 - 13%
women: 20 - 30%
201
what is the annual presence of PTSD
1.5 - 3%
202
risk factors for PTSD include
- usual factors across the rest of the DSM
- attenuated cortisol levels
- invalidating experiences post trauma eg. rape victims not being believed and having to prove their side
203
what is thought to be the link between working memory and PTSD
it is thought that people with better working memory are better able to suppress unwanted material
204
how can anger and shame effect PTSD
they can delay the recovery from PTSD
205
what is an interesting finding between classical conditioning and PTSD
classical conditioning is heavily linked with PTSD
| - large enough traumatic experiences can bring about one-trial learning
206
what separates complex PTSD from regular PTSD
has all the same features but also contains
| - dysregulation, interpersonal dysfunction and self-identity difficulties
207
how is complex PTSD (CPTSD) brought about
through chronic traumatic experiences - eg. POW's
208
what is adjustment disorder
the development of emotional or behavioural symptoms within three months of the onset of a stressor eg. illness, natural disaster, breakup, having a baby
209
what is the definition of a sub-threshold disorder
if you get diagnosed with another (bigger) disorder, the sub-threshold disorder is superseded
210
what is addiction
a term used to describe the disease process underlying a substance use disorder or problematic behavioural compulsion
211
true or false, addiction itself is not a diagnosis or label
true
212
historically what was addiction attributed to
it was seen as overindulgence and put down to moral bankruptcy
213
in terms of addiction define use
using a substance
214
in terms of addiction define misuse
harmful use of a substance (non-medial)
215
in terms of addiction define abuse
pattern of repeated substance use that often interferes with health, work or relationships
216
in terms of addiction define dependence
an adaptive state which develops after repeated abuse
| - physical or psychological withdrawal upon cessation of substance
217
out of all disorders in the DSM which is closest to a dimensional approach by nature
addiction, due to varying degrees of severity
218
what was the problem with the DSM-4's approach to addiction disorder categorisation
having legal trouble was one of the criteria, which lead to a lot of minority groups being diagnosed as having drug abuse problems
219
what is one problem when talking about abuse vs dependence criteria
although dependence is seen as a more severe step, many of the abuse criteria can be more detrimental
eg. neglected major roles vs tolerance
220
define craving
a strong desire or urge to use a substance
221
what did Sayette in 2016 say about coping vs craving
they said that a lack of coping strategies can lead to a craving in their place
222
what was Kandel et als Gateway Hypothesis (2002)
they said that weed was basically the gateway to more rogue drugs
223
separate from the gateway hypothesis how does early use of a substance affect addiction
early use of a substance = greater risk of addiction
| eg. use of a substance before 15 can increase addiction by 28%
224
which is one of the only drugs whose dependence increases over time
tobacco
225
what is the idea around the rate of drug administration
faster up = faster down = more addictive
226
what is the order of speed of substance administration
inhalation > injection > snorting > ingestion
227
what is one reason that substance use disorders (SUD's) are difficult to treat
they can often be brought on in an attempt to mask another disorder, like a coping mechanism. and if you remove the substance their could be adverse effects
228
what are the two key ideas when treating substance use disorders (SUD's)
1) the treatment needs to be individually tailored
| 2) the treatment needs to be holistically focused
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what is the debate between abstinence vs harm reduction minimisation
- abstinence says that any lapse is a relapse with focus on going ' cold turkey'
- harm reduction minimisation says that if there is a lapse, but the person can stop there and move froward that might be a more important step.
eg. an alcoholic having one beer and then going home is a big step in term of harm reduction minimisation, but they have broken abstinence
230
what is the link between cues and addiction
it is said that there is a connection between the way the brain processes certain cues and how this results in controlling impulses --> reward pathways
231
what are the three highest associated disorders to substance use disorders (SUD's)
1) PD's = 36%
2) bipolar = 23%
3) sz. = 22%
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why is gambling disorder divisive amongst some
some people view it as the most pure from of addiction whilst others see it as vastly different from other types of addiction
233
define an obsession
persistent ideas, thoughts, impulses or images that are experienced as intrusive or inappropriate and cause marked anxiety or distress
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define a compulsion
repetitive behaviour or mental act where the goal is to reduce anxiety commonly brought on by the obsessions
235
for an OCD diagnosis, how much time in the day must the obsessions and compulsions take up
over an hour
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in terms of OCD obsessions what key features do they posses
- the individual realises these obsessions are a product of their own mind
- the anxiety caused by the obsessions can be because of the nature of the thoughts or the sense of isolation in experiencing them
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what are some common OCD obsessions
contamination, sexual/horrific imagery, aggressive impulses, nonsensical thoughts/images, doubts
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what are some common OCD compulsions
washing, checking things, repeating things, mental rituals, ordering, reassurance seeking
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what is the average age of onset of OCD
~19 yo
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true or false, all people with OCD experience o's and c's
false
241
what are three main comorbidities with OCD
MDD, GAD, PD's
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what is the lifetime suicide attempt rate in OCD sufferers
10%
243
name a few causes of OCD
learned responses, genetic predispositions, brain structure, early life experience
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what is a key difference between OCD sufferers and the general population
unlike most people, OCD sufferers cannot dismiss the unwanted thoughts
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what are the cognitive factors that are thought to differentiate OCD sufferers from the gen. pop.
C - high degree on CERTAINTY about things
P - state of PERFECTION
I - feelings that they are overly IMPORTANT
C - require complete CONTROL
T - highly THREATENING
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what is body dysmorphic disorder
preconception with one or more defects or flaws in physical appearance not observable to others or appearing slight
- involves the performance of repetitive behaviours to relive the anxiety
247
what are some of the repetitive behaviours done by someone with body dysmorphic disorder
- mirror checking, constant comparison, skin picking
| - often feel worse after mirror checking
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where do body dysmorphic disorder (BDD) primarily first report
to other health professionals
| - dermatologists, dentist, ortho. etc.
249
what are some cognitive processes associated with body dysmorphic disorder
- ruminative thinking about previous negative evaluations
| - increased valuation of physical appearance
250
what is the irony of hoarding disorder and animal hoarding disorder
it comes from wanting control over things so you know where they are and can keep them safe however most of the time the animals end up dying from neglect and end up losing the things
251
what percentage of adults have hoarding disorder
2.6%
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what is trichotillomania
hair pulling
- involves repeated attempts to stop
- not better described by any other medical condition
253
what is excoriation disorder
skin picking
- repeated attempts to stop
- not better explained by any other medical condition
254
for both trichotillomania and excoriation disorder, what have sufferers reported whilst engaged in the behaviour
being in a trance like state, often with no recollection of what was occurring at the time
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with all OCD and related disorders what is the key aspect required for treatment
motivation on the part of the patient
