Final Exam Psych Disorders

The best treatment option for SUDs is meds but…

there is lots of stigma surrounding this in the public

Substance Use Disorder is…

a mental illness

Clinical significant impairment for SUD to be a disorder requires:

2-3 Mild

3-5 Moderate

6 + Severe

Substances release very large amounts of …

dopamine in the nucleus accumbens

• many reduce sensitivity of dopamine receptors so you need much more dopamine to get pleasure

SUD Impaired Control

trying to quit but can’t

SUD Social Impairment

getting in the way of functioning

SUD Risky Use

drunk driving, using at work

SUD Pharmacological

more and more use of substances to get high

• tolerance gets higher and higher

• negative reinforcement to get rid of withdrawal symptoms

There is a year pervalence of ____ for SUDs

17%

25% of those with a SUD have …

another mental illness

Biological Factors for SUD

• hereditary (50-60%)

• dopamine pathways

• age 18-25

• substance exposure in utero

  • Potential epigenetic effects

• substance exposure before 18

Psych Factors for SUD

• Classical Conditioning

• Operant Conditioning

• Other mental illnesses

Social factors for SUD

• low SES

• environmental degridation

• media and cultural influences

• poor social support and lonliness

• drug access

• gender (male)

Only 10% of people with a SUD….

are getting the best available treatment that they need

Pharmacological Treatments for SUD

• medications

• Transcranial magnetic stimulation (TMS) - more severe cases

Psychological Treatments for SUD

• motivational interviewing

• CBT

• 12 step program - most effective for alcohol use

Harm Reduction Treatment for SUD

How can we minimize the harm that we can reduce the harm of the addiction

• clean needle programs

• safe treatment options

• narcan

The percentage of those with Schizophrenia who die by suicide is….

5-10%

• while 50-90% attempt

Positive symptoms of Schizophrenia

• Psychosis

• Delusions

• Hallucinations

• Cognitive symptoms

• Inappropriate emotions

Psychosis

a break from reality

Though withdrawal delusions

thoughts are being stolen or controlled

Reference Delusions

I’m the center of things

Persecution Delusions

people are out to get me

Paranoia Delusions

I am being watched

Grandeur Delusions

I am special in some way

Delusions

Beliefs are not grounded in reality

Hallucinations

perceptual experienced are not grounded in sensory reality

Cognitive Symptoms of Schizophrenia

loosening of association - easily loosing train of thought and going all over the place

Negative Symptoms of Schizophrenia

• Amotivation

• Anhedonia

• Alogia

• Asociality

• Diminished emotional expression

Amotivation

lack of motivation

Anhedonia

lack of interest or pleasure

Alogia

loss of speech or shortening of speech

Asociality

pulling away from connection

Disorganized Symptoms of Schizophrenia

• Emotion

• Thought

• Speech - word salad

• Behavior

• Psychomotor - freezing

Anosognosia

lack of insight or awareness in what is happening

Phases of onset for Schizophrenia

1. Premorbid - childhood no symptoms

2. Predromal - some breif symptoms

3. Psychotic - full onset of symptoms

Those with Schizophrenia have a …

10-15 year lower life expectancy

• 80-90% smoke

• 20 times more likely to be unhoused

Biological Factors for schizophrenia

• genes

• nuerotransmiter dysregulation

  • dopamine

  • glutamate

• structural abnormalities in the brain

• prenatal birth complications

• chronic or early use of marijuana

Social Factors for Schizophrenia

• early exposure to abuse or trauma

• environment of expressed negative emotion

• significant emotional or physical stress

• dysfunctional family interactions

Medications for Schizophrenia

First gen - typical antipsychotics

2nd gen - atypical antipsychotics

First generation Meds for Schizophrenia

• target dopamine antagonist

• affective - clinical significant response 60-70%

Second generation Meds for Schizophrenia

• target both dopamine and serotonin

• 60-70% response rate

Very hard for daily compliance of medicine use for Schizophrenia due to…

anosognosia - don’t think they need the meds to make them better because they don’t think theres anything wrong with them

• trying to get the medicine use from daily to monthly

Psychosocial Intervention (in combo w/ meds)

• social skills training

• independent living skills program

• family therapy

• employment support

Healthy Trait → …

Extreme Trait → Disorder

Eco-dystonic

separation that your disorder is not part of you, you don’t like it and you want to get rid of it

Personality Disorders are…

Ego-syntonic

Ego-syntonic

thinks that this is you are and you accept it

• harder to treat because it is almost like cutting off your own arm

Personality Disorders

persistent patterns of emotions, cognition, and behavior that results in enduring emotional distress for person and/or for others and may cause difficult w/ work or relationships

Personality Disorders have a prevalence of…..

9%

Clusters of Personality Disorders

a. odd or eccentric '

b. dramatic, emotional, or erratic

c. anxious or fearful

Odd or eccentric Cluster types (5.7%)

• paranoid

• schizoid

• schizotypal

Paranoid Personality Disorder

• deep mistrust

• quick to hold grudges

Schizoid Personality Disorder

• detachment from social relationships - no interest in having them

• flat affect

Schizotypal Personality Disorder

• magical thinking

• eccentricity

• odd beliefs

Dramatic, emotional, or erratic Cluster type (1.5%)

• Antisocial

• Borderline

• Histronic

• Narcissistic

Antisocial Personality Disorder

• extreme lack of interest in rights and remorse for other people

• criminal behavior

• men

Borderline Personality Disorder

• women

• instability in interpersonal relationships

• fear of abandonment

Histrionic Personality Disorder

• attention seeking behavior

• “making a scene”

Narcissistic Personality Disorder

• lack of empathy for others

Anxious or Fearful Cluster (6%)

• avoidant

• dependent

• obsessive compulsive

Avoidant Personality Disorder

• avoidant of social interactions

• wants to have social interactions but is too scared

Dependent Personality Disorder

• can’t do things without others

Obsessive Compulsive Personality Disorder

perfection, sameness, ritual