Abnormal Psych Exam 3

erectile disorder

persistent inability to attain or maintain an adequate erection during sexual activity for least at 6 months and occurs in 10% of male population; can be due to hormonal imbalances, depression, vascular problems, or medications/substances

excitement phase

arousal phase

exhibitionistic disorder

exposure of one’s genitals to an unsuspecting stranger, to obtain diagnosis they must have acted on their urges and can co-occur with pedophilic disorder

fetishistic disorder

fantasizes or has urges about non-living objects (ex. female undergarments) or nongenital body parts (ex. feet)

frotteuristic disorder

touching and rubbing against a nonconsenting person, can happen in public to unsuspecting victims and the victim may not even know it is sexual and must be happening for about 6 months for diagnosis; paraphillia that can co-occur with voyeurism and exhibitionism

gender dysphoria

refers to psychological distress that results from an incongruence between one’s sex assigned at birth an one’s gender identity

paraphilias

atypical sexual preferences, disorder is characterized by (1) nonhuman objects, (2) non-consenting adults, (3) suffering or humiliation of oneself or partner, and (4) children

pedophilic disorder

sexual activity with a prepubescent child or children

premature ejaculation

recurrent ejaculation within 1 minute of initiation of partnered sexual activity when not desired, most common form of orgasmic disorder in males

sexual masochism disorder

real acts of being humiliated, beaten, bound, or otherwise made to suffer

sexual sadism disorder

disorder characterized by obtaining gratification through inflicting pain on one’s partner

transvestic disorder

cross-dressing

avoidant personality disorder

a pattern of social inhibition, feelings of inadequacy, and a fear of being criticized which leads to the avoidance of social interactions and nervousness; involved low self-esteem and severe anxiety around close social relationships but still has desire to have them

borderline personality disorder

disorder involved great instability, major shifts in mood, an unstable self-image, and impulsivity; have bouts of anger either directed towards people or themself (NSSI), and are clingy with hypersensitivity to abandonment

dependent personality disorder

dialectic behavior therapy

treatment for borderline personality disorder that focuses on gaining more realistic and positive sense of self, learning adaptive skills for problem solving and emotional regulation, and influences dichotomous or black and white thinking.

histrionic personality disorder

challenges or difficulties related to a drive or need to receive attention and seek approval from others; make decisions to get attention (seen as vain, self centered, demanding), can make suicide attempts to manipulate others and have problems with self 

narcissistic personality disorder

needs admiration in particular, not just attention, lack of empathy, and grandiosity; think they are superior to others manic symptoms

obsessive-compulsive personality disorder

a pattern of preoccupation with orderliness, extreme perfectionism, and control, leading to emotional constriction, rigidity in one’s activity and relationships, and anxiety about even minor disruptions in one’s routines

paranoid personality disorder

a pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent

personality

patterns of thinking, emotions, and behavior that tend to be enduring

personality disorder

chronic pattern of maladaptive cognition, emotion, and behavior that begins by adolescence or early adulthood and continues into later adulthood

schizoid personality disorder

personality disorder characterized by pervasive detachment from social relationships and a restricted range of emotional expression (draw attention inward versus to the outside world), describes as aloof or blunt

schizotypal personality disorder

a life long pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior (peculiar behavior and odd thinking); strong relationship to schizophrenia (considered a mild version of it)

trait

personality trait is a prominent aspect of personality that is relatively consistent across time and situations

Alternative Model for Personality Disorders

aims to address the symptom overlaps among personality disorder diagnostic criteria; categorize personality disorders along two dimensions (1) impairments in personality functioning in terms of identity and interpersonal relationships and (2) pathological personality traits

antisocial disorder and conduct disorder

antisocial personality disorder- must be 18 and often lie repeatedly, reckless, impulsive, have little regard for others, cruelty, etc. conduct disorder is required for this diagnosis because of the limited prosocial emotions, compared to the “psychopathy” of antisocial personality disorder

amenorrhea

discontinuation of menstrual periods

anorexia nervosa

people restrict caloric intake for long periods of time and are significantly underweight; fears of becoming fat, severely disturbed/distorted body images, and amenorrhea. there is the restricting type and binge/purge type

binge-eating/purging type anorexia nervosa

people engage in binge eating or purging behaviors, lose weight by forcing themselves to vomit after meals or by abusing laxatives or diuretics

restricting-type anorexia nervosa

lose weight by cutting out sweets and fattening snacks, eventually eliminating nearly all food, shows almost no variability in diet

binge

eating a large amount of food in one sitting

binge-eating disorder

recurrent episodes of binge eating without compensatory behavior, eating more rapidly than normal, eating until uncomfortably full, often leading to obesity; often leads to obesity and depression/anxiety are common

bulimia nervosa

binge-ing followed by behaviors to prevent from weight gain(laxatives or vomiting, etc.), usually have normal weight, defined as a greater amount most people would eat in a period

hypothalamus

lowered functioning of the hypothalamus causes abnormalities in the levels of several hormones important to its functioning like weight set-points/settling points

night eating disorder

characterized by the regular intake of excessive amounts of food after dinner and into the night

obesity

excess body fat (BMI of 30 or over), not in the DSM as a mental disorder. common in those with binge eating disorder

weight set point

controlled by hypothalamus

substance categories

depressants, stimulants, opioids, hallucinogens and phencyclidine (PCP)l, cannabis

reward pathway

mesolimbic dopamine pathway: reward center, VTA —> nucleus accumbens

Mesocortical: VTA —> frontal cortex

alcohol

A depressant that contains ethyl alcohol, which blocks messages between neurons by increasing GABA; reduces judgment, inhibition, speech production, and memory

amphetamines

stimulant including methamphetamines prescribed for attention problems, narcolepsy, and chronic fatigue; made in a lab that is often in pill form or also can be innjected or smoked

symptoms: increase energy and alertness while reducing apetite, produce a rush intociation, and psychosis in high doses

antagonist drugs

block or change the effects of an addictive drug, reducing the desire for the drug (help those become less addicted to things like alcohol)

barbiturates

a sedative-hypnotic depressant prescribed for anxiety and sleep problems in the early 20th century. at low levels they have similar effects to alc (GABA receptors facilitate inhibitory effect) but at high levels they can halt breathing, lower BP, and lead to coma/death

benzodiazepines

a sedative-hypnotic depressant often prescribed for anxiety (xanax, ativan, valium, klonopin, restoril); depressant effect on the CNS by binding to GABA receptors and increase GABA activity

relieve anxiety without drowsiness so less likely to slow breathing and lead to death by overdose

caffeine

stimulant used by 80% of the world which releases dopamine, serotonin, and norepinephrine

cannabis

produced from varieties of the hemp plant with the active ingredient being tetrahydrocannabinol (THC); a mixture of a hallucinogenic, depressant, and stimulant that lasts from 2-6 hours

cocaine

most powerful natural stimulant and most addictive because of dopamine transporters, which produces an instant euphoric rush (rush of well-being) but wears off quickly

at high doses it can lead to grandiosity, impulsiveness, hypersexuality, agitation, and paranoia, intoxication includes mania, paranoia and impaired judgement  with depression like symptoms after (crashing)

detoxification

systematic and medically supervised withdrawal from a drug, which can be outpatient or inpatient

hallucinogen

produce powerful changes in sensory perceptions that include natural ones (mescaline and psilocybin), lab produced (LSD and MDMA/ectsasy) and phencyclidine (PCP, made as a powder to be snorted or smoked)

heroin

opiate

dependence: after a few weeks, users may become caught in a pattern of abuse and often dependence

tolerance: built quickly and experience withdrawal (anxiety and restlessness with later symptoms being twitching, aches, fever, vomitng, diarrhea, and weight loss from dehydration)

LSD (lysergic acid diethylamide)

one of the most powerful hallucinogens, brings a state of hallucinogen intoxication (hallucinosis) with increases/altered sensory perception and hallucinations or synesthesia; binds to serotonin recepptors involved in emotions and visual info

methamphetamine

stimulant related to amphetamines that can be snorted (crank) or smoked (Crystal meth/ice)

morphine

opiate; pain reliever but highly addictive

opioid

substances that produce euphoria followed by a tranquil state and in severe intoxication can lead to unconsciousness, coma, and seizure (including morphine and heroin)

opium

sap of opium poppy makes opioids

relapse-prevention training

CBT where clients are taught to identify and plan ahead for high-risk situations and to learn from mistakes and lapses with the overall goal being to gain control over their substance related behaviors (mainly for alcohol use but also used for cocaine and weed)

residential treatment center

“rehab”, provide 24/7 support for people in a non-hospital setting. Patients in these programs may benefit from various forms of behavioral therapy, peer support, psychoeducation, medications for substance use disorder, and more, all in a safe, sober environment

reward center

chronic use results in alteration creating a craving (ex. dopamine receptors in the brain become less sensitive)

sedative-hypnotic drug

depressants or anxiolytic drugs (barbituates and benzodiazepines) low doses have a caliming or sedative effect, and at high doses they are sleep-inducers or hypnotics; sold as sedatives for treating anxiety and insomnia with intoxication and withdrawal simlar to alcohol

substance intoxication

refers to the acute effects associated with substance use; behavioral and psychological changes resulting from the physiological effects of a substance on the central nervous system

substance use disorder

includes impaired control, social impairment, risky use, pharmacological (tolerance, withdrawal)

tolerance

diminished effects from the same dose

• Or when greater amounts of a substance are needed to achieve intoxication • Results from adjustments made by the brain and body to the regular use of a substance

withdrawal

set of physiological and behavioral symptoms that result from discontinuation of substance after a prolonged period of heavy use.

• Unpleasant, sometimes dangerous reactions

• Can occur with reductions in the dosage of the drug as well

behavioral treatment

contingency modification (reward (incentives with drug free urine specimen/pos. rein.) or aversive conditioning (aversive esp. with alc.))/classical or operant conditioning, can be used alone or with medication

cognitive treatment

interventions based in the cognitive models help clients identify situatons in which they are most likely to drink and lose control or their expectations that alcohol will help them cope in those situations

biological treatment

• antagonist drugs (disulfram/antabuse or naltrexone for alc and naloxone for narcotics)

• detoxification (gradual withdrawal or induce withdrawal with medication to block symptoms)

• drug maintenance therapy: drug related lifestyle may be a greater problem than the effects (use substitute like methadone to provide safe sub for heroin)

spectator role

cognitive explanation for ED emphasizes performance anxiety, can generate fear and worry during sexual encounters, a man mentally detaches himself from activity which causes performance anxiety and ED

onset and course of anorexia nervosa (both types)

onset 14-18 years and 90-95% are females (.5-3.5% in western countries), the course is a person of normal to slightly overweight who has recently been dieting with escalation following a stressful event (ex. separation of parents); also high risk for CV problems, stomach expansion, weak bones, kidney damage, impaired immunity and amenorrhea

onset and course of bulimia nervosa

onset: 15-21 years, 90-95% are females, the course is that a person of normal weight on an intense diet, 1-30 episodes of binging a week

alcohol risk and tolerance

risk: 6.6% of the world’s population will fall into a pattern of abuse or dependence, 7.4% in US in one year period (2:1 man to woman)

tolerance: women have less alcohol dehydrogenase (metabolizes it before it enters the blood, so they feel it more). after a physiological tolerance, need greater amount to feel effects

abuse:

alcohol withdrawal

nausea and vomiting, some experience dramatic and dangerous withdrawal known as delirium tremens (the DTs), withdrawal can be fatal

stage 1: beginns a few hours after dependent drinking is stopped (weakness and sweating, anxiety, headache, nausea, EEG may be abnormal)

stage 2: begins 2nd or 3rd day, often includes convulsive seizures

stage 3: delirium tremens: auditory, visual, and tactile hallucinations with scary delusions, death may occur from hyperthermia

amphetamine tolerance

develops fast as does physical dependence, withdrawal symptoms are bad as chronic users may experience mood instability, memory loss, confusion, paranoid thinking; overuse can also lead to medical problems

barbituate tolerance and withdrawal

lethal dose of drug remains the same even while the body can build tolerance for sedative effects; withdrawal can lead to convulsions; can cause abuse, dependence, and overdose

LSD tolerance/withdrawal

tolerance and withdrawal are rare, with only dangers, including a potential for a bad trip or flashbacks which can occur days or months after last drug

opioid withdrawal

dysphoric mood/emotional distress, nausea or vomiting, sweating, fever, diarrmuscle aches, tearing or nasal mucus discharge; highly addictive