abnormal psychology midterm

Stress

Response to demands or opportunities that require adaptation

Distress

Negative stress that can harm physical health and cause fatigue or burnout

Eustress

Positive stress that energizes and focuses a person and promotes growth

Stressor

The event that creates a demand (from daily hassles to traumatic events)

Stress Response

The physiological and psychological reaction to a stressor

Sympathetic Nervous System

Branch of the ANS that triggers the fight-or-flight response

Parasympathetic Nervous System

Branch of the ANS that triggers rest-and-digest and restores normal functioning after danger

Autonomic Nervous System (ANS)

Network of nerves connecting the central nervous system to the visceral organs, has sympathetic and parasympathetic branches

Cortisol

Primary stress hormone released by the adrenal glands after the hypothalamus signals the pituitary to release ACTH

Acute Stress Disorder (ASD)

Trauma disorder with intrusive symptoms and dissociation that begins within a month of the event and lasts 3 days to 1 month, 50-80% develop PTSD

Posttraumatic Stress Disorder (PTSD)

Trauma disorder with reexperiencing and avoidance and reduced responsiveness and hyperarousal lasting longer than 1 month, onset can be delayed by months or years

Trauma (APA 2013)

Exposure to actual or threatened death or serious injury or sexual violation

Four Core PTSD Symptom Clusters

Reexperiencing and avoidance and reduced responsiveness/dissociation and arousal/anxiety/guilt

Diathesis-Stress Model

Disorder results from a predisposition (diathesis) combined with stressful experiences, used in developmental psychopathology to explain PTSD

Prolonged Exposure

CBT technique where the person confronts trauma memories or situations until arousal subsides

Virtual Reality Exposure

Controlled sensory exposure to warzones or disasters, superior to covert (imagined) exposure

Eye Movement Desensitization and Reprocessing (EMDR)

Exposure therapy using side-to-side eye movements while holding trauma images in mind, controversial because eye movements are not the active element

Psychological Debriefing

Crisis method (Critical Incident Stress Debriefing) where victims talk about reactions within days of an incident, lacks empirical support and may worsen symptoms or cause therapist-induced trauma

Psychological First Aid (PFA)

Safer post-disaster approach offering supportive help only to people showing active distress and avoiding on-site therapy for non-symptomatic people

Dissociative Disorders

Major disruptions of memory or identity with no clear physical or neurological cause

Dissociative Amnesia

Inability to recall important episodic personal information far beyond normal forgetting, abstract and encyclopedic memory stays intact

Localized Amnesia

Loss of all memory within a limited time frame, the most common subtype

Selective Amnesia

Loss of memory for some but not all events during a period

Generalized Amnesia

Memory loss extending backward from the trauma and affecting personal identity

Continuous Amnesia

Memory loss that continues into the present and future, rare

Dissociative Fugue

Specifier of dissociative amnesia where the person flees to a new location and sometimes takes a new identity, ends abruptly and memories usually return without treatment

Dissociative Identity Disorder (DID)

Two or more distinct subpersonalities (alters) each with its own memories and behaviors and emotions, usually begins before age 5 after severe abuse

Host Personality

The primary subpersonality in DID that appears most frequently

Switching

Sudden stress-triggered transition from one subpersonality to another in DID

Mutually Amnesic

DID pattern where alters have no awareness of each other

Mutually Cognizant

DID pattern where each alter is aware of all the others

One-Way Amnesic

Most common DID pattern where some alters know of others but the awareness is not reciprocal, the aware alters are called co-conscious subpersonalities

Iatrogenic View of DID

Idea that DID symptoms are unintentionally produced by therapists (hypnosis or leading questions) or spread by social contagion

Biological Evidence for DID

Different alters show different blood pressure and heart rate and allergies and EEG evoked potentials that control groups faking alters cannot replicate

Misleading Postevent Information (MPI)

Loftus's finding that subtle misleading information given after an event distorts the original memory (e.g. "smashed" vs "hit" changes speed estimates)

Memory Implantation (Shaw and Porter)

Research showing 30-70% of subjects can be led to form false memories of committing crimes through visualization and suggestive questioning

Fusion

Final stage of DID therapy that integrates all subpersonalities into one identity

Phases of DID Treatment

Bond with personality and alters then psychoeducation then recover lost memories then fusion then post-fusion maintenance

Depersonalization-Derealization Disorder

Only DSM-5 dissociative disorder without memory impairment, involves detachment from self and from surroundings

Depersonalization

Feeling detached from one's own body or mental processes like an outside observer

Derealization

Feeling that the external world is unreal or artificial or changing in size or shape

Anhedonia

Inability to experience pleasure in previously enjoyable activities, core emotional symptom of depression

Unipolar Depression

Mood disorder with depressive episodes only and no mania, lifetime prevalence about 20%

Major Depressive Disorder (MDD)

At least one major depressive episode (2+ weeks with 5+ symptoms) and no history of mania or hypomania

Persistent Depressive Disorder (Dysthymia)

Depressive symptoms lasting at least 2 years, less severe but more persistent and less treatment-responsive than MDD

Premenstrual Dysphoric Disorder (PMDD)

Clinically significant depressive symptoms recurring the week before menstruation

Disruptive Mood Dysregulation Disorder (DMDD)

Severe temper outbursts plus persistent depressed mood beginning in childhood or adolescence

Peripartum (Postpartum) Depression

Depression with onset during pregnancy or within 4 weeks of delivery, about 50% recurrence in later pregnancies

Lewinsohn's Behavioral Model

Depression spiral caused by reduced positive rewards (especially social) leading to fewer constructive behaviors

Beck's Cognitive Model

Depression driven by maladaptive attitudes and the cognitive triad and logic errors and automatic thoughts

Cognitive Triad

Beck's idea that depressed people negatively interpret themselves and their experiences and their future

Automatic Thoughts

Reflexive negative thoughts that occur without conscious effort and fuel inadequacy and hopelessness

Learned Helplessness

Seligman's theory that depression occurs when people believe they have no control over rewards and punishments and are responsible for that helplessness

Acceptance and Commitment Therapy (ACT)

Mindfulness-based therapy that teaches clients to accept negative thoughts as passing mental streams rather than guides for behavior

Monoamine Oxidase (MAO) Inhibitors

Antidepressants requiring avoidance of tyramine foods (cheese and wine) to prevent dangerous blood pressure spikes

Tricyclics

Antidepressants that block reuptake of serotonin and norepinephrine

SSRIs and SNRIs

Selective reuptake inhibitor antidepressants preferred for lower overdose risk and fewer side effects, only modestly better than placebo

Ketamine/Esketamine

Glutamate-acting drugs giving rapid relief in treatment-resistant depression, effects fade after about a week and carry addiction risk

Electroconvulsive Therapy (ECT)

Somatic treatment with 60-80% improvement in severe depression, causes temporary memory loss

Deep Brain Stimulation (Depression)

Somatic treatment targeting Brodmann Area 25

Cultural Differences in Depression

Non-Western cultures show more somatic symptoms while Western cultures show more cognitive symptoms

Twin Concordance for Depression

About 46% in identical twins vs 20% in fraternal twins

Manic Episode

Abnormally elevated or irritable mood with high energy and flight of ideas and grandiosity and poor judgment and reduced sleep and rapid speech

Bipolar I Disorder

Full manic episodes alternating with major depressive episodes or mixed states

Bipolar II Disorder

Hypomanic episodes alternating with major depressive episodes

Hypomania

Less severe non-incapacitating form of mania

Cyclothymic Disorder

Fluctuating hypomanic and mild depressive symptoms lasting at least 2 years without meeting full criteria for mania or major depression, 0.4% prevalence

Rapid Cycling

Four or more mood episodes within a single year

Neurotransmitter Theory of Mood

Low serotonin + low norepinephrine = depression and low serotonin + high norepinephrine = mania

Twin Concordance for Bipolar Disorder

About 40% in identical twins vs 5-10% in fraternal twins

Lithium

Mood stabilizer that treats mania in over 60% of patients, high doses cause toxicity

Suicide

Intentional and direct and conscious act of ending one's life

Parasuicide

Any nonfatal explicit suicide attempt

Subintentional Death

Death where the person plays an indirect or covert or unconscious role (e.g. drug abuse or fights or medication mismanagement)

Nonsuicidal Self-Injury (NSSI)

Direct intentional destruction of body tissue without suicidal intent classified as subintentional

Suicide Gender Paradox

Women attempt suicide about twice as often as men but men complete more often because they use more violent methods

Social Contagion (Suicide)

Suicides by family or peers or public figures can trigger copycat attempts especially in adolescents

Egoistic Suicide

Durkheim's type committed by isolated individuals who are not integrated with or checked by society

Altruistic Suicide

Durkheim's type committed by individuals sacrificing themselves for the group (e.g. kamikaze pilots)

Anomic Suicide

Durkheim's type committed when the social environment fails to provide stable structure (e.g. economic collapse)

Joiner's Interpersonal Theory

Suicide attempt requires perceived burdensomeness and thwarted belongingness and acquired psychological capability at the same time

Perceived Burdensomeness

Belief that one's existence is a drain on others

Thwarted Belongingness

Profound isolation and alienation and lack of meaningful connection

Psychological Capability

Acquired ability to override self-preservation instincts and fear of death

Suicide Psychodynamic Theory

Introjection of repressed anger or loss turned inward as self-hatred

Five Steps of Crisis Counseling

Build nonjudgmental relationship then clarify problem as transient then assess suicide potential and stress then mobilize resources then make collaborative action plan

Factitious Disorder (Munchausen)

Deliberately feigning or inducing symptoms solely to assume the sick role and get attention with no external gain

Factitious Disorder Imposed on Another

Inducing or faking symptoms in a dependent person

Malingering

Intentional fabrication of symptoms for tangible external gain (e.g. money or avoiding military service)

Conversion Disorder

Unconscious conversion of psychological stress into neurological-like symptoms (e.g. blindness or paralysis) with no medical basis

Glove Anesthesia

Numbness of the entire hand from wrist to fingertips, anatomically impossible given nerve pathways so it points to conversion disorder

Somatic Symptom Disorder (SSD)

At least one disruptive physical complaint lasting 6+ months with excessive anxiety and health worries

Somatization Pattern

SSD pattern with diverse gastrointestinal and sexual and neurological complaints, 4% prevalence and runs in families

Predominant Pain Pattern

SSD pattern where pain is the central complaint often following a real injury

Illness Anxiety Disorder (Hypochondriasis)

Persistent anxiety about having a serious illness with minimal somatic symptoms, people misread normal body functions and repeatedly check

Primary Gain

Psychodynamic idea that bodily symptoms keep unconscious conflicts out of awareness

Secondary Gain

Practical benefit from symptoms such as avoiding unpleasant activities or getting sympathy

Somatic Vigilance

Heightened attention to bodily sensations leading to misinterpreting normal arousal as illness

Exposure and Response Prevention (ERP)

CBT technique used for illness anxiety (like OCD treatment) where the person faces fears without performing checking ritual