Abnormal Psychology Exam #2 Review: Diathesis-Stress, Bipolar Disorders, and Trauma-Related Disorders

Comprehensive vocabulary flashcards covering the diathesis-stress model of depression, diagnostic criteria and biological treatments for Bipolar I disorder, lithium mechanisms, and DSM-5 PTSD and Acute Stress Disorder symptom clusters.

Diathesis-Stress Model

A cognitive behavioral model used to explain depression, positing that depressive symptoms are triggered when a stressful life event interacts with an underlying cognitive, biological, or trauma-related vulnerability.

Diathesis

An underlying vulnerability—which can be genetic, neural, biological, or trauma-related—that predisposes an individual to developing a psychological disorder such as depression.

Stress (in Diathesis-Stress Model)

A stressful life event that serves as the trigger for depressive symptoms in an individual with an underlying vulnerability.

Biological Diathesis

A biological or genetic predisposition that increases vulnerability to depression, such as a genetic factor that interferes with serotonin levels.

Psychological Diathesis

A cognitive vulnerability or history of predisposing childhood trauma that heightens an individual's susceptibility to depressive episodes.

Bipolar I Disorder

A disorder diagnosed by the presence of at least one manic episode lasting at least $1\text{ week}$, marked by inflated self-esteem, impulsivity, risky behaviors, frenzied energy, and marked impairment often requiring hospitalization.

Manic Episode Criteria (DSM-5)

A distinct period lasting at least $1\text{ week}$ of abnormally elevated energy featuring at least $3$ symptoms: grandiosity or extreme self-esteem, reduced sleep need, talkativeness, racing thoughts, attention pulled in many directions, heightened activity, or risky behavior.

Rapid Cycling

A pattern in bipolar disorder marked by experiencing $4+$ mood episodes within a given period.

First-Line Treatment for Bipolar I Disorder

Medication targeting norepinephrine and serotonin—specifically mood stabilizers (such as lithium) and antipsychotics for mania, alongside antidepressants—combined with psychoeducation and cognitive behavioral therapy (CBT).

Healy (2022)

A study reporting that approximately $60\%$ of patients demonstrated clinical improvement when treated with mood stabilizers and antipsychotics.

Lithium

A first-line mood stabilizer that alters synaptic activity, affects secondary messengers in neurons, stimulates neurotrophic factor production, and increases hippocampal gray matter volume to stabilize mood.

Brain-Derived Neurotrophic Factor (BDNF)

A key protein whose production is enhanced by lithium to protect cell health, prevent neuronal death, and reduce bipolar symptoms.

Anand et al. (2020)

Research showing that lithium increases the size of the hippocampus and consequently increases gray matter volume in the brain.

Adjunctive Psychotherapy

A non-pharmacological supplementary treatment that doubles the likelihood that bipolar individuals take medication, reduces hospitalizations, improves social functioning, and increases job retention.

Re-experiencing the Traumatic Event

A DSM-5 PTSD symptom cluster characterized by the involuntary recurrence of trauma memories, such as having nightmares about the traumatic experience.

Increased Arousal

A DSM-5 PTSD symptom cluster characterized by heightened vigilance and emotional reactivity, such as feeling excessively alert.

Reduced Responsiveness and Dissociation

A DSM-5 PTSD symptom cluster or feature defined by psychological separation, emotional numbing, and diminished responsiveness to the external environment.

Avoidance

A DSM-5 PTSD symptom cluster characterized by deliberate attempts to avoid activities, places, or reminders associated with the traumatic event.

Acute Stress Disorder Timing

A diagnostic timeframe distinguishing Acute Stress Disorder from PTSD, requiring symptoms to begin within $4\text{ weeks}$ of the traumatic event and last for less than one month.

Acute stress disorder is defined as symptoms that begin within 4 weeks if the traumatic event and last for less than month. PTSD is classified as symptoms that last for more than a month and having onset during various portions of time after the stressful event (right after the team a months or even years). An example of how acute stress disorder would be being exposed to a traumatic natural distasteful, experiencing flashbacks, avoiding distress, experiencing negative changes, displaying auroral issues, but the symptoms subsiding after a month. In PTSD, the symptoms from the natural disaster would persist past one month. Causing it to be chronic and need more serious treatment.

Describe how timing diffrentiates acute stress disorder from PTSD

The three relationships are mutually amnesiac, mutually cognizant, and one way amnesia. In a mutually amnesiac relationship, none of the personalities are aware of each other. An example of this relationship would be an individual with DID who becomes extremely anxious when switching due to lack of knowledge about the other personalities being perceived as potentially large gaps in memory. Mutually cognizant relationships are when each sub personality is aware of the other. An example of this would be a person whose sub personalities are well of each other and even communicate when switching or not at the presenting. One way amnesiac relationships are where some sub personalities are aware that there are other personalities present while some are not. In this relationship there are coconcious sub personalities that act as quiet observers within the system. An example of this relationship would be a subpersonality that is aware of other subpersonalities within the system but those subpersonalities not being aware of the sub personality that is aware.

Describe the difference between the typed of relationships between sub personalities in DID and provide a brief example for each

Bulimia nervosa is characterized by recurrent binging episodes at least once a week for three months followed by compensatory behaviors of punching through exercise, throwing up, chewing and spitting, etc. to avoid weight gain. Binge eating disorder is characterized by recurrent binge eating episodes at least once a week for three months that are characterized by fast eating, absence of hunger, uncomfortable fullness, and feelings of guilt. The biggest difference between bulimia nervosa and binge eating disorder is that in BED, there are no excessive compensatory behaviors to avoid excess weight gain. Dieting and negative reinforcement work together to maintain the binge purge cycle due to purging being used to suppress guilt. In negative reinforcement, the negative stimulus is removed which reinforcement the behavior that was done to remove the negative stimulus. The binge cycle is marked by a drive for thinness leading to extreme dieting which leads to hunger, which then leads to binging. Binging then leads to guilt and to remove the guilt purging is taken part in to remove the feelings of guilt and anxiety, therefore perpetuating the binge-purge cycle.

Compare Bulimia nervous an and binge eating disorder. Then explain how dieting and negative reinforcement work together to maintain the binge-purge cycle.

The Fiji Television Study did research on a group of adolescent girls who were introduced to western television in 1995. The study found that after three years of the television being introduced, eating disorder rates had soared from only one case being document in fiji to percentages of disordered eating skyrocketing, with 15% if Fijian women utilizing throwing up as a weight loss technique. The studies point out that the thin-deal prevent in western media is not a cross cultural experience, further suggesting that sociocultural influences play a big role in the development of eating disorders. When you remove the likelihood of the thin ideal being internalized due to that societal pressure not being a focus, eating disorders seemed to be less prevalent. Sociocultural influences from the culture we live in as well as family and peer environments play a large role in the development of eating disorders alongside biological factors and certain needs for control. A limitation of drawing conclusions from this study is that it is not generalizable due to the smaller testing size and the focus in only one region. This study would not be able to be applied across cultures. Additionally, it is on the older end of studies making it less reliable.

Describe the finishing of the Fiji television study and explain what they suggested about sociocultural influences on eating disorders. Identify one limitation of drawing casual conclusions from this study.

The diagnosis that is most likely is Borderline Personality Disorder. The clients symptoms of unstable relationships, rapidly shifting moods, and engagement in self harm when feeling abandoned, indicating an underlying fear of abandonment, all aligning with borderline personality disorder. Four other DSM-5 criteria of BPD are Identity disturbance, Impulsivity in at least two areas that are potentially self damaging, transient stress related paranoid ideation or severe dissociative symptoms, and chronic feelings of emptiness. To be officially diagnosed, five out f the nine BPD symptoms needed to be present, meaning the clients would not be able to me officially diagnosed but their symptoms insinuate that the diagnosis is most likely.

A client reports intense, unstable relationships, rapidly shifting moods, and engages in self-harm when feeling abandoned: What diagnosis is likely? Identify at leads four DSM-5 Criteria for this diagnosis and state how many criteria are required.

The best treatment for the client who is likely struggling with BPD would be a combination of antidepressant, mood stabilizing, antipsychotics, or anti anxiety drugs. and psychotherapy in the form of Dialectical Behavioral Therapy. Biological medicines on their on may exacerbate the symptoms of the client, but many believe they are great when used with psychotherapy. While the drug therapy may be useful, DBT will be the most powerful tool to help the client. Over the past 25 years DBT has received significant research support. DBT consists of individual therapy and group skill-building sessions held weekly for approximately one year. DBT places a special emphasis on combatting self-harm, which is something the client struggles with. DBT therapists empathize with their borderline clients and with the emotional turmoil they are experiencing, locate kernels of truth in the clients’ complaints or demands, and examine alternative ways for them to address valid needs. Many clients who undergo DBT become more able to tolerate stress, develop more social skills, respond more effectively to life situations, and develop a more stable identity, gains that typically continue for years. They also display significantly fewer self-harm and suicidal behaviors and require fewer hospitalizations than those who receive other forms of treatment

A client reports intense, unstable relationships, rapidly shifting moods, and engages in self-harm when feeling abandoned: Descrive the first-line evidence asked treatment, or combination of treatments for thi client, and explain why.

Neurological Kindling Diagram of Bipolar Disorder

Stress it the environment → mania or depression crisis → cell damage → pathological reorganization; as more episodes more damage occurs, which then leads to more bipolar episodes due to brain damage

Lienhan’s Biosocial theory

Explanation for BPD that relates to stemming from ill treatment of emotions during childhood; emotional deregulation in child → great demands on family → invalidation by parents → emotional outbursts by child in which parents attend; this causes the child to think hey have to act erratically for attention to be gained

Beck’s Triad

A model for depression by Aaron beck to describe thinking patterns in depression. Three components are the self, the world, and the future, Thus triad is stimulated by automatic thoughts which then leads to reaction due to the components of the triad.

Beck’s model of the symptoms of depression

Causal chain initiated by a negative event and/or negative/dysfunctional thoughts that end to negative automatic through to/cognitive assumptions, which then lead to symptoms of depression.

Hopelessness theory

A theory on depression by Lyn Y. Abramson, Gerald I. Metalsky, and Lauren B. Alloy that suggests that a person who experiences a negative life event—such as having an argument with an acquaintance—and interprets it using internal, stable, and global attributions , leading to the expectation that nothing will change and depression will follow (hopelessness depression)