exam 4 study guide

Biological Approach

Focuses on the role of genetics, brain chemistry, and physical health in mood disorders.

Freud’s Psychoanalytic Approach

Emphasizes unconscious conflicts, early childhood experiences, and repressed emotions as causes of mood disorders.

Beck’s Cognitive Distortion Model

Suggests that negative thought patterns (e.g., all-or-nothing thinking) contribute to depression.

Lewinsohn’s Reinforcement Model

Proposes that a lack of positive reinforcement leads to withdrawal and depression; Behavioral Activation is a treatment that increases engagement with rewarding activities.

Learned Helplessness

Explains that individuals learn to feel powerless after repeated exposure to uncontrollable events, leading to depression.

Klerman and Weissman’s Interpersonal Approach

Focuses on improving interpersonal relationships and communication to reduce depressive symptoms.

Victor Frankl’s Existential Theory

Suggests that meaninglessness in life can lead to depression; Logotherapy helps individuals find meaning in suffering.

Principle of Reciprocal Determinism

Explains how behavior, environment, and personal factors interact and influence each other.

Diathesis-Stress Models

Propose that psychological disorders arise from an interaction between genetic predispositions (diathesis) and stressful life events.

Cup Analogy

Describes how individuals have a "cup" of stress, and when it overflows (due to stressors or vulnerabilities), mood disorders emerge.

Akiskal’s Integrative Model of Depression

Combines biological, psychological, and social factors, acknowledging multiple causes for depression and treating it with diverse approaches.

Akiskal’s Model Treatment Implications

No single therapy is universally best; effective treatments should consider various factors and tailor interventions accordingly.

NIMH Multisite Study

Compared different psychotherapies for depression, emphasizing that a variety of treatments can be effective depending on the individual.

Integrative Model of Mood Disorders (Textbook p. 244)

A holistic approach that integrates biological, psychological, and social factors in understanding mood disorders and their treatment.

Positive Symptoms of Schizophrenia

Symptoms that reflect an excess or distortion of normal functioning, such as hallucinations and delusions.

Negative Symptoms of Schizophrenia

Symptoms that reflect a reduction or loss of normal functioning, such as lack of motivation or emotional expression.

Phases of Schizophrenia

Include the prodromal phase (early signs), active phase (full-blown symptoms), and residual phase (symptoms lessen but persist).

Chronic Schizophrenia Phases

Patients with chronic schizophrenia often cycle between the active and residual phases, with fluctuating severity of symptoms.

Schizophrenia Spectrum Personality Disorders

Include disorders like schizoid, schizotypal, and paranoid personality disorders, which share traits with schizophrenia, but are less severe.

Schizophrenia Spectrum Disorders Definitions

Schizoid is characterized by social detachment, schizotypal by odd behaviors and beliefs, and paranoid by persistent distrust.

Most Similar Schizophrenia Spectrum Disorder

Schizotypal personality disorder is most similar to schizophrenia due to shared symptoms like odd beliefs or magical thinking.

Type I Schizophrenia

Characterized by positive symptoms such as hallucinations and delusions; considered less severe with better prognosis.

Type II Schizophrenia

Characterized by negative symptoms like lack of motivation and emotional expression; considered more severe with a worse prognosis.

Type I vs Type II Terminology

Historically, Type I and Type II were also referred to as "reactive" (Type I) and "process" (Type II) schizophrenia.

Type I and II Differences

Type I typically responds better to antipsychotic medication, whereas Type II is more resistant to treatment.

Shared Underlying Disorder of Type I and II

Despite differences, both types are seen as part of the same disorder due to common biological and genetic factors.

Emil Kraepelin’s View of Schizophrenia

Kraepelin referred to schizophrenia as “dementia praecox” and viewed it as a progressive, degenerative brain disorder.

Kraepelin’s Contributions

Kraepelin’s work established the foundation for understanding schizophrenia as a distinct mental illness, focusing on its long-term course and prognosis.

Eugene Bleuler’s Contributions

Bleuler introduced the term "schizophrenia" and emphasized the importance of cognitive and emotional disintegration in the disorder.

Bleuler’s Four As

The Four As (associative loosening, affective blunting, ambivalence, and autism) describe the core symptoms of schizophrenia.

DSM-5 and Bleuler’s Influence

Bleuler’s Four As remain relevant in the DSM-5’s description of schizophrenia, highlighting the importance of cognitive and emotional disturbances.

Kurt Schneider’s Contributions to Schizophrenia

Schneider contributed to understanding schizophrenia by identifying key symptoms that help diagnose the disorder, especially "first-rank symptoms" (e.g., auditory hallucinations, delusions of control).

Schneider’s First Rank Symptoms

These symptoms are considered particularly diagnostic for schizophrenia, including auditory hallucinations and thoughts being controlled by external forces.

Schneider’s Influence on DSM-5

Schneider’s first-rank symptoms remain influential in how schizophrenia is diagnosed in the DSM-5.

Genetic Contribution to Schizophrenia

Genetics play a significant role in schizophrenia, with a higher risk for those with family history.

Prevalence of Schizophrenia in Western Culture

Schizophrenia occurs in about 1% of the general population in Western cultures.

Concordance Rate in Dizygotic Twins

The concordance rate for schizophrenia in dizygotic twins is about 17%, meaning if one twin has schizophrenia, the other twin has a 17% chance of developing it.

Brain Abnormality in Positive Symptoms

Enlarged ventricles and dopamine dysregulation are associated with positive symptoms of schizophrenia.

Dopamine and Positive Symptoms

High dopamine levels in certain brain areas are linked to positive symptoms like delusions and hallucinations.

Parkinson’s Disease and Schizophrenia

Parkinson’s disease is relevant because its treatment (dopamine-blocking drugs) can induce symptoms similar to schizophrenia.

Amphetamines and Schizophrenia

Amphetamines, which increase dopamine activity, can induce or worsen positive symptoms of schizophrenia.

Brain Abnormality in Negative Symptoms

Smaller hippocampus and prefrontal cortex volumes are more linked to negative symptoms of schizophrenia.

Children-at-Risk Studies

These studies look at children who show early signs of developing schizophrenia, identifying impairments such as attention and motor skills.

Neurointegrative Deficit

The neurointegrative deficit is a concept that refers to early cognitive and motor impairments in children who develop schizophrenia, proposed by researchers like Gochros.

Double-Bind Hypothesis

Proposed by Bateson, it suggests that contradictory communication patterns from parents contribute to schizophrenia.

Schizophrenogenic Mother Hypothesis

Fromm-Reichmann proposed that overprotective or rejecting mothers were responsible for causing schizophrenia in children.

Validity of Double-Bind and Schizophrenogenic Mother

These hypotheses are largely discredited as primary causes of schizophrenia, though they contributed to understanding family dynamics.

Expressed Emotion

Refers to the negative emotions expressed by family members, such as criticism or hostility, and it predicts relapse in patients with schizophrenia.

Research on Expressed Emotion

Studies show that high expressed emotion in families significantly increases the risk of relapse in schizophrenia patients.

Social Selection Theory

Suggests that people with schizophrenia may end up in lower socio-economic status due to their illness.

Increased Stress Theory

Proposes that stressful social environments can trigger or exacerbate schizophrenia symptoms.

Social Selection vs Increased Stress

These theories are not mutually exclusive, as both social factors and stressors can contribute to the development and progression of schizophrenia.

Labeling Theory and Social Stigma

Labeling theory suggests that societal labels can reinforce mental illness, while social stigma makes it harder for people with schizophrenia to function in society.

First Integrative (Biopsychosocial) Model of Schizophrenia

The first biopsychosocial model, developed by researchers like Gochros, integrates biological, psychological, and social factors to explain schizophrenia.

Neurointegrative Deficit in the Integrative Model

In this model, the neurointegrative deficit explains early cognitive and motor impairments seen in individuals later diagnosed with schizophrenia.

Schizophrenia-Spectrum Personality Disorders

These disorders are included in the biopsychosocial model as they share traits with schizophrenia, such as odd beliefs or social withdrawal.

Antipsychotic Medications and Symptom Relief

Antipsychotic medications are most effective for treating positive symptoms, such as delusions and hallucinations, due to their dopamine-blocking effects.

Major Side Effects of Antipsychotics

Common side effects include weight gain, sedation, and movement disorders like tremors.

Tardive Dyskinesia

A serious side effect of long-term antipsychotic use, characterized by involuntary, repetitive movements.

Antipsychotic Medications: Necessary and Sufficient?

Antipsychotic medications are necessary for managing schizophrenia but not sufficient alone; psychosocial treatments are also important.

Major Psychosocial Treatments for Schizophrenia

Include Cognitive Behavioral Therapy (CBT), social skills training, and family therapy.

Recovery vs Cure

Recovery refers to managing symptoms and improving quality of life, whereas cure implies complete elimination of symptoms.

Elements of Recovery

Key elements include improving functioning, enhancing social integration, and managing symptoms, rather than a full cure.

Who First Described Autism

Leo Kanner first described autism in 1943 as a unique developmental disorder.

Autism as Childhood Version of Schizophrenia

Autism was initially thought to be a childhood version of schizophrenia, though this view has since been revised.

Refrigerator Mother Hypothesis

This hypothesis suggested that cold, unloving mothers caused autism, similar to the "Schizophrenogenic Mother" theory for schizophrenia.

Behavior Modification for Autism

Developed and popularized by Ivar Lovaas, this treatment is based on behaviorism and uses reinforcement techniques to teach children with autism.

Lovaas’ 1987 Study

The study showed that early, intensive behavior modification could lead to significant improvements in social and communication skills in children with autism.

Criticisms of Lovaas Study

Criticisms include ethical concerns about the intensity of the treatment and questions about its long-term effectiveness.

Controversies in Behavior Modification for Autism

Some controversies involve whether such treatment methods are too harsh or if they genuinely lead to lasting improvements.

Lovaas’ Recommendations for Effective Treatment

Lovaas recommended intensive, early, individualized interventions with a focus on positive reinforcement and structured learning.

Predictors of Favorable vs. Unfavorable Outcomes for Home-Based Behavior Modification for Autism

Factors that predict favorable outcomes include early intervention, intensity of treatment, and family involvement; unfavorable outcomes are linked to late intervention and lack of consistency.

Critical Period in Autism

The critical period refers to the idea that early intervention is most effective during certain developmental windows in a child’s life.

Anorexia Nervosa

An eating disorder characterized by extreme restriction of food intake, intense fear of gaining weight, and a distorted body image.

Bulimia Nervosa

An eating disorder characterized by binge eating followed by compensatory behaviors like vomiting or excessive exercise to prevent weight gain.

Binge Eating Disorder

An eating disorder characterized by recurrent binge eating episodes without compensatory behaviors (e.g., no purging or over-exercising).

Treatment Goals for Eating Disorders

The main goals are to normalize eating patterns, address body image issues, and improve psychological well-being.

Treatment Modes for Eating Disorders

Treatment can include individual therapy, family-based therapy, group therapy, and inpatient or outpatient care.

Treatment Approaches for Eating Disorders

Common approaches include Cognitive Behavioral Therapy (CBT), family therapy, and nutritional counseling.

Attention-Deficit Hyperactivity Disorder (ADHD)

A neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity.

Specific Learning Disorder

A neurodevelopmental disorder characterized by difficulties in specific academic areas, such as reading, writing, or math, despite having average or above-average intelligence.

Autism Spectrum Disorder (ASD)

A neurodevelopmental disorder marked by social communication challenges, repetitive behaviors, and restricted interests.

Intellectual Disability

A neurodevelopmental disorder characterized by below-average intellectual functioning and deficits in adaptive behavior, starting before the age of 18.

Sleep-Wake Disorders

Two major types: Dyssomnias (problems with the amount, quality, or timing of sleep) and Parasomnias (abnormal behaviors during sleep, such as sleepwalking or night terrors).

Dyssomnias

Disorders like insomnia, narcolepsy, and sleep apnea, which involve issues with the quantity or quality of sleep.

Parasomnias

Disorders like sleepwalking, night terrors, and REM sleep behavior disorder, involving abnormal activities during sleep.

Sexual Dysfunctions

A category of disorders characterized by persistent difficulties in sexual response or desire, such as erectile dysfunction or premature ejaculation.

Paraphilic Disorders

Involve sexual arousal to atypical objects, situations, or individuals, such as fetishistic disorder or pedophilic disorder.

Gender Identity Dysphoria

A condition where an individual experiences a disconnect between their assigned gender at birth and their experienced or expressed gender.

Major Neurocognitive Disorder

A disorder marked by significant cognitive decline in areas such as memory, attention, or reasoning, affecting daily functioning.

Mild Neurocognitive Disorder

A less severe decline in cognitive functioning, where individuals may experience cognitive difficulties but can still maintain independence in daily life.

Alzheimer’s Disease

The leading cause of major neurocognitive disorder, characterized by progressive memory loss, disorientation, and changes in behavior.

Etiological Factors of Alzheimer’s Disease

These include genetics (e.g., APOE4 gene), aging, and environmental factors such as lifestyle choices.

Treatment Focus for Neurocognitive Disorders

Since there is no cure for irreversible neurocognitive disorders, treatments typically focus on managing symptoms, improving quality of life, and slowing progression.

Substance Use

The consumption of alcohol, drugs, or other substances in any amount, regardless of negative consequences.

Intoxication

The physiological and psychological effects of substance use, which can impair judgment, coordination, and functioning.

Substance Use Disorder

A condition characterized by compulsive use of a substance despite harmful consequences, and an inability to control use.

Addiction

A severe form of substance use disorder, marked by the compulsive need for a substance, often with tolerance and withdrawal symptoms.

Physiological Dependence

The state where the body adapts to a substance, requiring more of it to achieve the same effect, and withdrawal symptoms occur when the substance is not used.

Tolerance

The need to use increasing amounts of a substance to achieve the same effect due to the body's adaptation.