Exam 3 Psychopathology

Anorexia Nervosa

• Individual purposely restricts food intake, resulting in low body weight or at least below that of other people of similar age and gender.

• Individual is very fearful of gaining weight, or repeatedly seeks to prevent weight gain despite low body weight.

• Individual has a distorted body perception, places inappropriate emphasis on weight or shape in self-judgments, or fails to appreciate the serious implications of their low weight

75

What % of anorexia cases are reported among women and girls?

60%

What % of anorexia cases are reported in western countries?

14-20

Peak age of onset in anorexia?

restricting and binge eating/purging type

2 types of anorexia

6

What % do not recover and die from medical complications due to anorexia?

Becoming thin

What is the key goal in anorexia?

fear

What is the driving motivation in anorexia?

Thinking distortions in anorexia

• Usually have a low opinion of their body shape

• Tend to overestimated their actual proportions

• Hold maladaptive attitudes and misperceptions

Anorexia medical problems

• Amenorrhea (absence of or failure to begin menstrual cycle)

• Lowered body temperature, low blood pressure, body swelling, reduced bone mineral density, slow heart rate

• Metabolic and electrolyte imbalances

• Can be fatal; heart failure or circulatory collapse

• Skin, nail, and hair problems

Depression, anxiety, low self-esteem, sleep disturbance

What psychological problems are associated with anorexia?

Bulimia Nervosa

• Repeated binge-eating episodes.

• Uncontrollable eating within a limited period of time

• Repeated performance of compensatory behavior (e.g., forced vomiting, using laxatives) to prevent weight gain.

• Symptoms take place at least weekly for a period of 3 months.

• Inappropriate influence of weight and shape on appraisal of oneself.

1

What % of people develop bulimia?

83

What percent of bulimia cases are women?

No

Does weight leave a healthy range in bulimia?

Shame

What is a central emotion in bulimia?

Compensatory Behaviors

vomiting and laxatives

Binge Eating Disorder

• Recurrent binge-eating episodes that include at least three of these features:

• Unusually fast eating

• Absence of hunger

• Uncomfortable fullness

• Secret eating due to sense of shame

• Subsequent feelings of self-disgust, depression, or severe guilt

• Absence of excessive compensatory behaviors.

• Significant distress.

• Binge-eating episodes take place at least weekly over the course of 3 months.

3

What % of the population experience Binge eating disorder?

67

What % of binge eating disorders cases are women?

Different

Are medical problems with binge eating the same or different than those with bulimia and anorexia?

underestimate food portions, no intense dieting

What are other features of binge eating disorder?

Ego deficiencies

Psychodynamic factors that contribute to eating disorders:

Loss of control, self-worth based on appearance, depression

Cognitive Behavioral factors that contribute to eating disorders:

Genes, brain circuit dysfunction, irregular neurotransmitters, weight set point

Biological factors that contribute to eating disorders:

beauty standards, social media, shame overweight people

Societal pressures that contribute to eating disorders:

Schizophrenia

Psychotic disorder in which personal, social, and occupational functioning deteriorate as a result of unusual perceptions, odd thoughts, disturbed emotions, and motor irregularities

Psychosis

State in which a person loses contact with reality. Cannot properly perceive and respond to environment

Poverty, drug use, suicide

Risk Factors for schizophrenia

Schizophrenia Diagnostic Criterea

• For 1 month, individual displays two or more of the following symptoms much of the time:

  • Delusions

  • Hallucinations

  • Disorganized speech

  • Very irregular motor activity, including catatonia

  • Negative symptoms

• At least one of the individual’s symptoms must be delusions, hallucinations, or disorganized speech.

• Individual functions much more poorly in various life spheres than was the case prior to the symptoms.

• Beyond this 1 month of intense symptomology, individual continues to display some degree of impaired functioning for at least 5 additional months.

Positive Symptoms

• Pathological excesses or bizarre addition to a person’s cognition and behavior

• Most often found

  • Delusions

    • Strong belief in ideas that have no factual basis

    • Delusion of persecution is the most common

  • Disorganized thinking and speech

  • Heightened perceptions and hallucinations

  • Inappropriate affect

Auditory hallucination

what type of hallucination is the most common?

Negative Symptoms

• Pathological deficits (rather than excesses)

• Poverty of speech (alogia)

§Reduction of speech or speech content

• Restricted affect

§Show less emotion than most people

§Sometimes no emotions at all – flat affect

§Poor eye contact; expressionless face; monotonous voices

• Loss of volition (apathy; lack of interest and motivation)

§Feeling drained of energy and interest in goals

§Inability to start or follow through on a course of action

§: Conflicted feelings about most things

• Social withdrawal

§Withdrawal from social environment and attention only to their own ideas and fantasies

§Withdrawal leads to worsening of social skills, including ability to accurately recognize needs and emotions of others

Psychomotor Symptoms

§Awkward movements, repeated grimaces, and odd gestures

§Symptoms may take extreme forms, collectively called catatonia

Types of Catatonia

§Catatonic stupor: Motionless and silent; lack of response

§Catatonic rigidity: Rigid, upright posture; resist being moved

§Catatonic posturing: Awkward, bizarre postures for a long period of time

§Catatonic Excitement: Move excitedly or wildly

late teens, mid-thirties

when does schizophrenia usually appear?

Prodromal, Active, and Residual

3 phases of shizophrenia

Prodromal Phase

Beginning of deterioration; milder symptoms

Active Phase

Symptoms become apparent, may be triggered by stress

Residual Phase

Return to prodromal-like levels. A majority of patients have some residual symptoms for the rest of their life.

Fuller schizophrenia recovery

§With good premorbid functioning

§Whose disorder was triggered by stress

§With abrupt onset

§With later onset (during middle age)

Who receive early treatment (e.g., prodromal phase

Diagnosing Schizophrenia

§Symptoms of the disorder continue for 6 months or more.

§People have active symptoms for at least one of those months and show a deterioration from previous levels of functioning.

Type 1

Does Type 1 or Type 2 schizophrenia have better functioning prior to the disorder, have later onset, and are more likely to improve?

Type 1

Which Type of schizophrenia with positive symptoms is more common?

Dopamine

Which neurotransmitter is implicated in schizophrenia when too much is present?

Phenothiazines

What was the drug discovered to work as an antipsychotic drug?

Second

What generation of antipsychotics targets multiple neurotransmitters, has better outcomes, and challenges the dopamine hypothesis?

Parts of brain in Schizophrenia

prefrontal cortex, hippocampus, amygdala, thalamus, striatum, substantia nigra

Viral Problems

What is a potential alternative explanation to the cuases of schizophrenia that triggers an immune response in the mother that interrupts development?