Psyc Final Exam

What is diathesis?

Is a vulnerability, or predisposition to a disorder, either biological or genetic. Diathesis increases the likelihood of a person showing symptoms of a mental health disorder.

What is a stressor

any event, situation, or demand that causes a stress response. Stress acts as a catalyst for diathesis

What do we mean by the Diathesis-Stress model of mental health?

The biological and environment components that cause mental health issues. Diathesis plus stress results in symptom expression

When would a stressor be considered diathetic predisposition

Past stress such as early life trauma, such as childhood trauma → It may not have caused the symptoms of a mental health disorder in that moment. But it may predispose the person to developing a mental health disorder later in life.

What are the criteria that we use to determine whether behavior is disordered?

If it is atypical, distressing and maladaptive. It must be all three in order to be considered disordered.

What is the DSM?

Diagnostic and Statistical Manual of Mental Disorders. This manual is specific to the united states can differ across countries

What does the DMS provide

Diagnosis: Symptom lists (primary and secondary), descriptions of those symptoms, time course for the disorder, and criteria to be associated with the disorder.

Prognosis: Includes how severe the symptoms are and how significantly they might impact someone’s life. This helps give the patient the level of treatment they need

What does the DMS not provide?

The etiology (causes) of mental health disorders or the treatments.

What is the main benefit of the DMS

Provides agreement for diagnosing someone with a mental health disorder. Makes useful for research and treatment

What are the limitations of the DMS

DMS is based on research evidence, but research is changing. DMS has categorical cutoff, you are either diagnosed or not (flase dichotomization)

What are primary symptoms

Core symptoms that are a direct result of the disorder. The person MUST match a specified number of primary symptoms in order to be diagnosed with the disorder

What are secondary symptoms

Symptoms that are a consequence of the primary symptoms. These are the co-occuring conditions, medication side effects, or environmental factors.

What are differential symptoms

Specific symptoms or features that help distinguish between two or more disorders that share overlapping symptoms.

What is a Mental health status exam?

Quick assessment that might suggest a mental health disorder (no diagnosis). Doctors etc are looking for signs of disordered behavior to see if you need to be referred to a specialist.

They look at personal hygiene, eye contact, speech pattern, thought content, memory.

What is a structured clinical review

Psychiatrist uses a system that provides a diagnosis that aligns with the DSM. They use a checklist (funneled approach) with broad questions and then get more specific to narrow down the disorder.

What is an unstructured clinical review

Psychiatrist will make an assessment based on their own experience without tools or assistance. They might be overconfident and the diagnosis won’t be consistent with other people’s diagnosis. If diagnosis is wrong, wrong treatment will be given, treatment won’t be effective and could be harmful

What is a neuropsychological assessment

• Used to assess if someone has cognitive/neurological impairment (field sobriety test)

• Used to assess whether someone should undergo imaging procedures to assess neurological damage

• Used to regularly assess (monitor) the impairment related to injury or damage to neuropsychological structures.

What are anxiety disorders

The presence of anxiety that is disproportionate to any perceived threats. More frequent, persistent, or stronger arousal of the autonomic nervous system

What are the key features of Generalized Anxiety Disorder

Anxiety that isn’t tied to any specific event or doesn’t have a specific reason (free floating anxiety). Level of anxiety is higher than normal, but less than other anxiety disorders. These people lookout for anything that may make them anxious, which makes them more anxious

What are the key features of panic disorder

Relatively short and infrequent but highly intense sudden spikes in anxiety (panic attacks). Panic attacks cause a sense of terror and can be mistaken for a heart attack. Onset of anxiety doesn’t have a known source.

What are the key features of specific phobias

The fear of a specific object or situation. The fear is out of proportion to the threat that the situation or object may have

What are the key features of social anxiety disorder

The fear of being negatively evaluated. It manifests in a way that makes people avoid social interaction

What are obsessions

Obsessions are persistent unwanted thoughts that lead to emotional distress. They are not fleeting thoughts

What are compulsions

Ritualized repetitive behaviors in an attempt to manage the stress from the obsessions

How does obsessive compulsive disorder differ from anxiety disorders?

Anxiety revolves around pervasive worry while OCD is intrusive thoughts that trigger compulsions

What are the symptoms of the features of the depressive mood disorders?

Disorders associated with significant variations in mood. This includes depressive disorders and bipolar disorders

What is major depressive disorder (MDD)

Persistent sadness and depression. They don’t ALWAYS experience a depressive mood, but they experience depressive episodes which last at least 2 weeks

What is Persistent depressive disorder (PDD)

Also known as dysthymia. In the “normal” mood pattern, the individual has good, neutral, and bad days, but the good and bad mood states are not very long lasting.

How do we distinguish between MDD and PDD?

MDD experiences periods of chronic depression, but PDD experiences a milder but consistent depressed state

What are the secondary symptoms for MDD

Anhedonia → the inability to experience positive emotional states.

Weight loss or gain, insomnia/hypersomnia, fatigue, suicidal, psychomotor agitation/retardation, feeling worthless, decreased concentration

What is a manic state?

characterized by excessively positive mood and hyperactivity

What are manic episodes

The person experiences a host of symptoms with the manic states such as loss of sleep, distractibility, hyper-agitation, racing thoughts, push of speech, impulsive behaviors, and grandiose delusions. They last at least a week, the person often regrets the aftermath

What is Bipolar I

The manic episodes are most severe and impairing. While common, you don’t need to have a depressive episode to be diagnosed with Bipolar I

What is Bipolar II

The manic episodes are less extreme and are referred to as hypomanic episodes. The episodes are not always impairing, and you MUST have at least one depressive episode to be diagnosed with Bipolar II.

What is cyclothymia

constant fluctuation between hypomanic and mildly depressed states for at least one year, with few periods of normal moods. They don’t reach full depressive episode or hypomanic episode, but they are persistent and chronic

What are positive symptoms of schizophrenia

1. excesses above what a person not diagnosed with schizophrenia experiences

2. They respond well to and can be managed with antipsychotic medications

What are negative symptoms

1. Represent a lacking in typical function that is present in others

2. Do not respond as well to medications. They tend to be associated with a worse prognosis

What is a disorganized symptom

Thoughts, speech and behavior that deviates from typical patterns but don’t fall into into positive/negative categories

What are the symptoms of schizophrenia

Delusions, hallucinations, disorganized speech/thinking/behavior, and negative symptoms

What are delusions

False beliefs that are based on a distortion of reality. The person believes in something untrue, and they can not be convinced otherwise

What are hallucinations

False perceptions which can include all the senses.

What are disorganized speech/thinking/behavior

this symptom is most often identified through a distinct speech pattern – which is sometimes referred to as word salad

What is borderline personality disorder

is characterized by an intense fear of abandonment and a hatred of being alone, which arises from a weak sense of self. People with BPD can be very manipulative and controlling in relationships and are often emotionally unstable with periods of depression, anxiety, and anger.

What is antisocial Personality Disorder

characterized by behaving in socially undesirable ways – such as breaking the law and lying — without remorse. People with APD tend to be very hedonistic, seeking immediate gratification of their own desires without regard to others. They are often quite bright and verbally skilled — able to talk their way out of situations.

What are the biomedical approaches to treatment?

Psychopharmacology, electroconvulsive therapy, lesioning and lobotomy, TMS, DBS

What are the different types of psychopharmaceuticals

Chlorpromazine, anti-anxiety, antidepressant

What neurotransmitters do each major class of psychopharmaceutical affect?

They target the process of neurotransmission by:

1. substituting for deficient neurotransmitters

2. influencing the process of neurotransmission as they communicate between neurons

What is Electroconvulsive therapy (ECT)

Electrical current is distributed across their brain through electrodes placed on the temples, inducing a seizure. The patient must be given anesthetics and muscle relaxants to confine the seizure to the brain.

Why is ECT being used less

The procedure causes memory loss for weeks or months. It is only typically used for treatment-resistant depression (last resort)

What are the replacements for ETC

Lobotomy, TMS, and DBS

What is lesioning

Surgical removal of neurological structures to treat mental health disorders.

What is a lobotomy

A type of lesioning procedure. It is the removal of the connective tissues between the prefrontal cortex to the rest of the brain. Some patients had their personality blunted and had the personality of a child or infant

What is Transcranial Magnetic Stimulation (TMS)

An electromagnetic coil is placed against the scalp that sends pulses to different regions of the brain. It can produce activation and inactivation. This does not carry this risk of memory loss and reduces the likelihood of seizures.

What is deep brain stimulation (DBS)

Invasive procedure where electrodes are surgically implanted into regions of the brain to provide continuous but mild electrical stimulation

What is psychoanalytic therapy

You have to unlock the conscious defenses of the patient to find the subconscious root cause of what is bothering them. This could be trauma, memories of the patients relationship with their parents, or anything subconsciously conflicting

What are the techniques used in psychoanalytic therapy

Dream analysis, free association, projective tests

What is psychodynamic therapy

a broader, more modern evolution, typically 1-2x/week, focusing more on present-day patterns, current relationships, and ego function, with a more active therapist role and varied, sometimes shorter-term, approaches

What is client-centered therapy

developed from the humanistic perspective. Therapist treats patient with unconditional positive regard to help them recognize their own motivations, sources of distress, and capabilities.

What is OARS

The technique used in motivational interviewing.

Open-ended questions, affirmation, reflective listening, summarizations

What is cognitive-behavioral therapy

Focuses on correcting distorted cognitions and teaching new behaviors. This can change habitual patterns of behavior that are maladaptive

What is cognitive therapy

Reversing problematic and adaptive ways of thinking that cause greater distress that exceed their capability to cope

What are the techniques in cognitive therapy

Cognitive restructuring, mindfulness, coping cards

What is cognitive restructuring

The client is asked to reflect using a journal to keep track if the experiences the’yve had that lead to distress, how they thought about/reacted to those events, and how that made them feel. The therapist uses this to identify the distress inducing habitual patterns of thought

What is mindfulness

Requires the patient to think about how they think

What is a coping card

A card or set of cards on which the client writes down things that alleviate distress to help them remember how to cope

What is behavioral therapy

Using classical and operant conditioning to change behavior. They are aimed to develop more adaptive behaviors and physical reactions.

What are strategies used in behavioral therapy

operant conditioning and systematic desensitizations, such as exposure therapy

How do we evaluate therapies

Through research called randomized controlled trial (RTC)

What is RTC

The researchers randomly assign individuals of a particular diagnosis with the treatment or the placebo and track their symptoms to see if the treatment shows a greater reduction in symptoms

What are the strengths and weaknesses as well as controversies surrounding the different therapeutic approaches?

Some therapies are iatrogenic, meaning the evidence shows that they cause more harm that good, or that they costly/time intensive with little to no benefit

What are the credentials of a clinical psychologist and what do they do

They typically have a PhD or a Psy.D, and work in hospitals, private practice, or academic settings

What are the credentials of a psychiatrist and what do they do

They have a medical degree (M.D) and work in hospitals or private practices. They are the only ones who can prescribe medication

What are the credentials of a counseling psychologist and what do they do

Have a PhD in counseling psychology. They typically help people adjust to life problems and stress

What is a dispositional attribution

When we say that a person did a behavior because of their personality, motives, needs, or desires. It is due to something internal to them

What is a situational attribution

When someone does a behavior due to the situation. Something around them encouraged, coerced, or forced them to do it. The behavior was caused by an external factor

What is the fundamental attribution error (FAE)

People tend to make dispositional attributions more than they make situational attributions because it is an easier explanation

What is the self serving bias

When we are explaining our own behavior that had a bad outcome, we attribute it situationally, but when the behavior had a good outcome, we attribute it dispositionally.

What is normative social influence?

When behavior is shaped by the desire to fulfill others’ expectations and to gain their approval (you comply)

What is informational social influence

You do a behavior/conform because you believe that what the group is doing is correct (you accept)

What is pluralistic ignorance

When the person responds to a situation based on the cues/reactions from other people. When someone relies on people who know nothing

What is the diffusion of responsibility

In a large group, people are more unlikely to call for help in an emergency situation because they assumed that someone else took to responsibility

How can we counteract these bystander apathy effects?

If you see something that seems like it may be an emergency, always react like it is one

How do we form attitudes?

Through socialization, conditioning, or mere exposure

What is socialization

When attitudes are heavily influenced by those around us

What is conditioning

Attitude change by conditioning/association

What is mere exposure

When attitudes form by being more exposed to them

What is an an explicit attitude

Attitudes that we are aware of having, able to report, and are willing to share with other

Whats an implicit attitude

attitudes that exist without us knowing that we have, or attitudes that we know exist but aren’t comfortable sharing with others

How does implicit bias affect social behaviors

Can contribute to discriminatory behavior and shows prejudice