Abnormal Psychology Exam 2

mood disorders

psychological disorders characterized by emotional extremes

depressive spectrum disorders

major depressive disorder, dysthymic disorder, double depression

bipolar spectrum disorders

bipolar I disorder, bipolar II disorder, cyclothymic disorder

major depressive episode (MDE)

5 or more daily for 2 weeks:
sad, loss of interest, weight/appetite, energy/fatigue, sleep, suicide thoughts/death, psychomotor retardation/agitation, worthlessness/guilt, concentrating/making decisions

MDD epidemiology

recurrent episodes, average duration\= 4 months, prevalence\= 16%, 2X more common in women, average age of onset\= 25 yrs

dysthymic disorder

- milder symptoms than MDD
2 yrs or longer:
depressed mood, low energy, poor appetite/overeating, low self-esteem, hopelessness, insomnia/hypersomnia, poor concentration/difficult decision-making

dysthymic disorder epidemiology

can persist unchanged over long periods, duration\= 5 yrs, late onset\= early 20s, early onset\= before age 21, prevalence\= 3.6%

manic episode

exaggerated elation/joy/euphoria, reduced sleep requirements, hyperactivity, inflated self-esteem, unusual talkativeness, rapid speech, excessive high risk activities, distractibility, marked impairment

hypomanic episode

same symptoms of manic episode but lasts much shorter

bipolar I disorder

1 or more manic episodes, symptoms last 1 or more weeks, marked impairment, manic episodes alternate with MDE

BPDI epidemiology

age of onset\= 18 yrs, tends to be chronic, suicide common (15%)

bipolar II disorder

1 or more hypomanic episodes, symptoms last 4 or more days, observable change, hypomania alternates with MDE

BPDII epidemiology

age of onset\= 22 yrs, 10-13% cases progress to BPDI, tends to be chronic

atypical specifier

oversleep, overeat, weight gain

melancholic specifier

severe depressive and somatic symptoms

chronic specifier

major depression only, lasting 2 years

catatonic specifier

absence of movement, serious

psychotic specifier

mood-congruent hallucinations/delusions

postpartum specifier

after childbirth

seasonal affective disorder

regular relationship between MDE onset and time of year, remission at particular time of year, lasts at least 2 yrs

SAD prevalence

U.S. prevalence increases with latitude, age of onset\= mid 20s, 61% MDD/34% BPDII/5% BPDI, more common in women, mean length of MDE\= 5 months

SAD symptoms (reverse vegetative)

decreased energy, increased sleep length, increased appetite/weight, afternoon/evening mood or energy slump, carbohydrate craving

SAD prevalence (typical depression)

depressed mood, decreased interest in sex, loss of interest in activities, decreased concentration, impaired social/occupational functioning

Beck's Model

depression caused by negatively biased thoughts (negative cognitive triad)

all or nothing (cognitive distortion)

categories (not good at one thing, suck at everything)

magnification (cognitive distortion)

catastrophizing (get a C in a class, future is ruined)

mental filter (cognitive distortion)

dwell on a negative detail

overgeneralization (cognitive distortion)

a negative event is likely to happen again and again

personalization (cognitive distortion)

self-blame (if anything goes wrong, all your own fault)

learned helplessness theory

view that exposure to uncontrollable negative events leads to a belief in one's inability to control important outcomes and a subsequent loss of motivation, indecisiveness, and failure of action

hopelessness theory

expectation that desirable outcomes will not occur OR aversive outcomes will occur and cannot change this

response styles theory

Depression occurs as a result of different coping strategies used in response to potential stressors

rumination

direct attention inward on negative feelings and their causes/consequences

distraction

direct attention away from negative feelings and onto pleasant/neutral activities

etiology: interpersonal theory

interpersonal relations in depression (limited social support, elicit rejection from others, social skills deficit, reassurance-seeking)

etiology: neurobiological influences

norepinephrine (NE) \= mania/depression
serotonin (5-HT) \= depression

mood disorders CBT treatment

cognitive restructuring, behavioral activation, relapse prevention

interpersonal psychotherapy treatment

improving interpersonal relationships

mood disorders medication treatments

tricyclic antidepressants, mono-amine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), lithium

electroconvulsive therapy (ECT)

induction of brain seizures by the application of electrical current to the skull (treats severe depression)

History of Sexual Response

started with Alfred Kinsley (1900s), created the Kinsley scale

Masters and Johnson (60s)

observed sex, research led to formation of the theoretical model for sex (more representative of men)
- model: excitement, plateau, orgasm, resolution

Helen Kaplan

revised theoretical model
- model: desire, arousal, orgasm, resolution

Rosemary Basson

formulated the Circular Model for sex

dual control model

created by Erick Janssen and John Bancroft
- balancing scale of sexual excitement and sexual inhibition

St. Levine's Conceptualization of Sexual Desire

sexual desire is not one single phenomenon, but is a combination of forces
- sexual desire can be stimulated

emotional bonding cues

feeling a sense of love with a partner

implicit/romantic cues

having a romantic dinner with a partner, etc.

erotic/explicit cues

watching an erotic movie, etc.

visual/proximity cues

seeing/talking with someone wealthy/appealing

Sexual Drive vs. Sexual Motivation

physical reasons, goal attainment, emotional reasons, insecurity

desire physiology

dopamine (reward/motivation hormone), testosterone needed for desire

hypoactive sexual desire disorder

a sexual dysfunction characterized by little or no sexual desire (persistent \= more than 2 months)

sexual arousal

the motivational state of excitement and tension brought about by physiological and cognitive reactions to stimuli
- increased heart rate, perspiration, increased bloodflow, etc.

sexual arousal in females

increased bloodflow to genitals, vagina becomes 2x as long, cervix moves up, engorgement of clitoris

vaginal photoplethysmography

A physiological method used to indirectly measure vaginal blood flow associated with female sexual arousal

female sexual arousal disorder (FSAD)

The inability to attain or maintain sexual excitement, expressed as a lack of subjective excitement or as a lack of physiological excitement or both

treatment for FSAD

Eros (very expensive vibrator)
- no other treatments

sexual arousal in males

engorgement of genitals induced by artery relaxation, increased bloodflow, erection

erectile dysfunction (ED)

persistent or recurrent problems reaching or maintaining erection that allows penetration

treatment for erectile dysfunction

- over 60 drugs/medications (ex. Viagra)
- 2 evidence-based cognitive therapies

orgasm

peak sensation of intense pleasure creating an altered state of consciousness, resolving with the induction of well-being and contentment

orgasm in men

- usually accompanied by ejaculation
- followed by release of tension and reduction of penile engorgement
- vasocongestion resolved

orgasm in women

- usually accompanied by involuntary, rhythmic contractions of the pelvic musculature
- uterine and anal contractions
- vasocongestion resolved
- myotonia

myotonia

oxygen change

orgasm in the brain

- prefrontal cortex (shuts down)
- amygdala (decreased activity)
- thalamus (increased activity)

neurochemicals related to orgasm

- dopamine (released towards the end)
- oxytocin ("cuddling" hormone, studies with rats)
- vasopressin (reduced sensitivity to pain during orgasm)

point of no return

point where the PNS during arousal shifts to SNS during ejaculation in men

female orgasmic disorder

Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase

premature (rapid) ejaculation

A sexual dysfunction in which a man feels a lack of control of ejaculation/delay that results in ejaculating in less than 3 minutes (in most cases 1 minute) from the beginning of intromission.

delayed ejaculation

temporary or lifelong conditions in which it takes an extended amount of stimulation and time to reach orgasm or ejaculation (usually delay is 30 minutes or longer)

dyspareunia

pain in genitals that occurs for less than 2% of the population

Risk Factors for Orgasm Problems

age, BMI, marital status, Cesarian, pregnancy, hysterectomy, menopausal status, physical abuse, sexual abuse

Possible Causes of Orgasm Problems

- learning (sexual behaviors become associated with negative feelings through conditioning)
- context (lack of trust/safety, fear of letting go, lack of adequate stimulation, negative feelings towards sexual stimuli)

Psychosexual Treatment for FOD

directed masturbation: learning how to stimulate yourself, role-play orgasm, group treatment or bibliotherapy

Premature Ejaculation Treatment

- medications
- psychotherapy (stop-squeeze)

at risk for substance abuse

one symptom

mild substance abuse

2-3 symptoms

moderate substance abuse

4-5 symptoms

severe substance abuse & addiction

6 or more symptoms

tolerance

body compensation over time leads to \_______________.

classes of substances

depressants, stimulants, hallucinogens, over-the-counter or prescription drugs

alcohol abuse

risky behaviors, failure to meet obligations, and recurrent problems because of alcohol

alcohol dependence

alcohol abuse and physiological signs of dependence

short term alcohol effects

stimulates GABA receptors, increases dopamine/serotonin levels, inhibits glutamate receptors

Alcohol Withdrawal - Stage 1

shakes, weakness, perspiration, anxiety, restlessness, unusual perceptual experiences

Alcohol Withdrawal - Stage 2

convulsive seizures

Alcohol Withdrawal - Stage 3

delirium tremens (psychosis)

long term effects of alcohol

alcohol induced persisting amnesiac disorder, alcohol induced dementia, fetal alcohol syndrome

alcohol-induced persisting amnesic disorder

- Wernicke's encephalopathy (memory problems)
- Korsakoff's psychosis (feeling things that are not real)

alcohol-induced dementia

loss of intellectual abilities, including memory, abstract thinking, judgment, problem solving, often accompanied by personality changes. Found in 9% of chronic users.

fetal alcohol syndrome

physical and cognitive abnormalities in children caused by a pregnant woman's heavy drinking

current use

at least one drink in the past 30 days

binge drinking

drinking five or more alcoholic drinks at one sitting

heavy use

five or more drinks on the same occasion on each of 5 or more days in the past 30 days

1 drink

12 oz. beer
5 oz. wine
1.5 oz 80 proof liquor

21-25

binge use and heavy use most common in ages \___________.

Alcohol: Gender Differences

- Higher prevalence of alcohol abuse and dependence among men
- Later age of onset among women
- The gender gap is greater among women and men who endorse traditional gender roles

Alcohol: Causal Influences

- positive reinforcement
- modeling
- self-medication
- expectancies (beliefs about alcohol's effects)
- personality (impulsivity, negative emotionality)

Treatment of Alcohol Use/Dependence

- inpatient intoxication
- Antabuse (drug makes people nauseous to alcohol
- self-help (Alcoholics Anonymous)
- cue exposure and response prevention
- controlled drinking training