Psychopathology Exam 2

Abnormal Psychology Exam 2 -- includes topics like feeding disorders, sleep-wake disorders, elimination disorders, and more

Treatment for ODD

Behavioral, cognitive, and social learning approaches

• Focus on reinforcement, behavioral contracting, modeling, and relaxation training

Symptoms of ODD

• Frequent temper tantrums

• Irritability, anger, argumentativeness, and/or vindictiveness

• Refusal to obey adults’ rules or follow directions

• Difficulty making/keeping friends

• Frequently getting in trouble at school

Oppositional Defiant Disorder (Impulse-control Disorder)

Long-lasting pattern of defiance, disobedience, and hostility towards parents, teachers, and other authority figures

Angry or irritable mood, troublesome behavior, and argumentativeness and/or vindictiveness that results in significant family or school problems

• Onset between 5-10 y/o

• Symptoms evident between 8-12 y/o

• 2-11% of kids in US

  • More common in boys than girls

Symptoms & behaviors of ODD

• Frequent temper tantrums

• Irritability, anger, argumentativeness, and/or vindictiveness

• Refusal to obey adults’ rules / follow directions

• Difficulty making / keeping friends

• Frequently getting into trouble at school

Impulse-control Disorders

Individuals repeatedly engage in behaviors that are harmful and feel they cannot control

• Experience tension and anxiety until they follow their impulses and feel a sense of pleasure or gratification

  • But also may have regrets after behavior

*Everyone experiences sudden impulses or desires occasionally, but what makes them disordered is when they’re frequent and extremely difficult / impossible to ignore or regulate*

Behavioral Insomnia

Sleepwalking and such

Maintenance Insomnia

Trouble staying asleep

Onset Insomnia

Trouble falling asleep

Encopresis (Elimination Disorder)

Feces incontinence; has bowel movements in clothes or other inappropriate places at age 4 or above

Enuresis (Elimination Disorder)

Urine incontinence; pees on clothes or in bed after the age of 5

Elimination Disorder

Age-inappropriate incontinence beginning in childhood

Rumination Disorder (Eating Disorder)

infant / child regurgitates food after it has been swallowed and then either spits it out or re-swallows it

Conduct Disorder [CD] (Impulse-control Disorder)

repeated violations of the rights of others and society’s norms and laws

• Onset after adolescence

• 2-10% of children & teens

• People with this condition are more likely to have ADHD, mood disorders, and developmental disorders

• Can lead to Antisocial Personality Disorder (Psychopaths & Sociopaths)

very troubling

Symptoms & behaviors of CD

• Frequent rule breaking

• Angry outbursts

• Aggression towards others (bullying, fighting, sexual assault, etc.)

• Mistreatment of children or animals

• Dishonesty (lying or cheating)

• Excessive substance use

• Running away from home

• Skipping school (truancy)

• Criminal behavior (theft, vandalism, arson, etc.)

Intermittent Explosive Disorder [IED] (Impulse-control Disorder)

inability to hold back urges to express strong angry feelings and associated violent behaviors

Criteria for IED

outbursts cannot be related to any other mental health or medical condition and can’t cooccur while individual is taking a particular medication, drink, or doing drugs

Symptoms of IED

During episodes, individuals will [be]:

• Verbally aggressive

• Start arguments

• Physically assault others

• Destroy property / possessions

• Threaten others

Treatment for IED

• Naltrexone medication

• CBT & Aversive therapy

  • Cognitive Restructuring

• Relaxation training

Kleptomania / compulsive stealing (Impulse-control Disorder)

persistent urge to steal

• can present at any age

• NOT for monetary / personal gain, revenge, or necessity

  • often steal something they don’t actually want

• buildup of tension before stealing

• relief or pleasure after stealing

remember; stealing is addictive

Pyromania (Impulse-control Disorder)

persistent compelling urge to start fires

• NOT arson

• More common in teenagers and adult males

• no political, personal, or vindictive motives

• often involves a fascination with fire and anything related

  • “pent up”, anxious feelings before setting a fire

  • intense release of tension while watching fire burn

Other Specified Disruptive, Impulse-control, and Conduct Disorder (used to be called disruptive behavior disorder not otherwise specified — DBDNOS)

Sexual, internet use, shopping, etc.

Unspecified Disruptive, Impulse-control, and Conduct Disorder

exhibits signs and symptoms of an impulse-control disorder but the impulse(s) doesn’t/don’t fall into any of the main categories

Disorders “characterized by problems in emotional and behavioral self-control”

New category of disorders linked by varying difficulties controlling aggressive behaviors, self-control, and impulses

• Resulting actions / behaviors are considered a threat primarily to others’ safety and/or societal norms

Insomnia (Sleep-Wake Disorder)

Trouble falling and/or staying asleep, and poor sleep quality

• Happens even if you have the time or the right environment for healthful / effective sleep

• Acute or chronic

Other Specified Feeding or Eating Disorder [OSFED]

Significant distress due to symptoms similar to disorders like anorexia, bulimia, or binge-eating disorder, but who do not meet the full criteria for a diagnosis

Purging Disorder (OSFED)

Individual engages in purging behaviors such as self-induced vomiting or laxative abuse, but do not binge-eat

Night Eating Syndrome (OSFED)

Individual experiences recurring episodes of eating after awakening at night, or of eating excessively after their evening meal

• Episodes cause significant distress or impaired functioning

Pica (Eating Disorder)

Eating inedible substances such as dirt or feces

• Commonly associated with developmental disorders (esp. ASD) and MAYBE pregnancy

Avoidant/Restrictive Food Intake Disorder [ARFID) (Eating Disorder; used to be called Selective Eating Disorder)

Individuals avoid eating out of concern about aversive consequences or restrict intake of food with specific sensory characteristics

• Apparent lack of interest or concern in eating food

• May lose a significant amount of weight

• Nutritional deficiency; may become dependent on feeding tubes or oral nutritional supplements

Unique from AN & BN — NOT due to concern about physical appearance

Perspectives on feeding & eating disorders

• Biopsychosocial perspective: believed to be genetic vulnerability

  combined with experiences with eating, body image, and exposure to

  sociocultural influences

• Biological: studying role of dopamine

• Psychological: binge eaters feel relief from depression and anxiety

• Social: social activities usually paired with food

Binge-Eating Disorder [B-ED]

Ingestion of large amounts of food during a short period of time, even when full

• Lack of control over what / how much is eaten

• Usually significantly overweight (though not everyone who is overweight has B-ED)

• NO purging

• Binges must occur ≥ twice per week for 6 months

• Must involve eating past the point of fullness, eating while alone, and feelings of guilt / self-disgust afterwards

Purging

Inappropriate methods of compensating for added calories, such as vomiting, laxative or diuretic abuse, other medication abuse, fasting, or excessive exercise

Binge-eating

Eating an excessive amount of food in a short period of time

Bulimia Nervosa [BN] (Eating Disorder)

Alternations between the extremes of eating large amounts of food in short periods of time (binge-eating), and compensating for added calories by vomiting or using other extreme methods (purging)

• Each extreme must occur at least once per week

Anorexia Nervosa [AN] (Eating Disorder)

Inability to maintain normal body weight, intense fear of gaining weight, and a distorted body perception

• Results in serious health changes

  • Weak / brittle bones, muscles, and hair

  • Low blood pressure

  • Slowed breathing & pulse

  • Lethargy, sluggishness, fatigue, lack of energy

Will result in organ failure & death if untreated

Eating Disorders

Persistent disturbances of eating or eating-related behavior that result in changes in consumption or absorption of food

• Significantly impair individuals physical and psychosocial functioning

• “Coping mechanism gone wrong”

• Body dysmorphia, negative body talk, body-checking, frequent weighing, and other associated behaviors

• Compensatory (purging) behaviors

• Can co-occur with Feeding Disorders

Feeding Disorders

Extreme food selectivity (beyond pickiness)

• Direct result of food preferences or perceived intolerances

• Can co-occur with Eating Disorders

Type A Personality

• hard-driving

• competitive

• impatient

• cynical and suspicious

• easily irritated

• hostile toward others

can alter one’s mental health

Type D Personality

Individuals frequently experience emotions like anxiety, irritation, and depressed mood

can alter one’s mental health

Problem focused coping

Individual takes action to reduce stress by changing whatever it is about the situation that makes it stressful

Emotion focused coping

Person does not change anything about the situation itself, but instead tries to improve feelings about the situation

“if you don’t like the view; MOVE”

Stress

Unpleasant emotional reaction that a person has when an event is perceived as threatening

Stressful life event

An event that disrupts an individual’s life

Coping

The process through which people reduce stress in a healthy manner

Daily hassles

Relatively minor events that can add up and cause significant stress that can impair mental health

Psychological factors affecting other medical condition

Disorder in which clients have a medical disease or symptom that appears to be exacerbated by psychological or behavioral factor

• mental disorders

• stress

• emotional states

• personality traits

• poor coping skills

Secondary gain

Sympathy and attention that a sick person receives from other people

motives are internally driven, not externally

Fictitious disorder

Faking or exaggerating symptoms for secondary gains

Primary gain

Relief from anxiety or responsibility due to the development of physical or psychological symptoms

Direct benefits from occupying the sick role

e.g. disability, lawsuit, insurance benefits, time off from work

Malingering

Deliberately fabricating physical or psychological symptoms for some ulterior motive (primary gain / direct benefit or reward)

Fictitious disorder imposed on self (used to be Munchausen’s syndrome)

Faking symptoms or disorders, not for the purpose of any particular gain, but because of an inner need to maintain a sick role

Fictitious disorder imposed on another (used to be Munchausen’s syndrome by proxy)

Inducing physical symptoms in another person who is under their care

e.g. poisoning or convincing person, usually child, that they’re ill

Functional Neurological Symptom Disorder [Conversion disorder] (Somatic Symptom Disorder)

Translation of unacceptable drives or troubling conflicts into physical symptoms

• once known as “hysteria”

• physical ailments include “pseudoseizures”, disorders of movement, paralysis, weakness, disturbances of speech, blindness, and other sensory disorders, and cognitive impairment

Conversion

Presumed transformation of psychological conflict into physical symptoms

Illness Anxiety Disorder (Somatic Symptom Disorder)

Misinterpretation of normal bodily functions as signs of serious illness

• NO actual physical symptoms or ailments

• Preoccupation with concern about developing severe medical condition

• Easily alarmed about health

• Seek unnecessary tests & procedures to rule out or treat the “illnesses”

• Unsatisfied with reassurance of physicians

• Huge burden on the resources of health care facilities and providers

once known as hypochondriasis

Somatic Symptom Disorders

Somatic disorder involving actual physical symptoms, accompanied by maladaptive thoughts, feelings, and behaviors

• Symptoms suggest illness / injury but can’t be fully explained by any medical condition, mental disorder, or the direct effect of a substance

  • Medical test results appear normal, don’t explain person’s symptoms, or indicate presence of medical condition

• Excessive worry about symptoms

  • Worry must be out of proportion to severity of physical complaints

• Recurring somatic complaints for ≥ 6 months

  • Symptoms are sometimes similar in various illnesses and may last for years

• Usually, symptoms begin appearing during adolescence

  • Diagnosed before age 30

• Symptoms may occur across cultures and gender

• Can include anxiety and depression

  • However, it’s possible that these are a consequence of an actual medical condition, rather than a cause

• NOT the result of conscious

  malingering or factitious disorders

• Difficult to diagnose and treat

Somatic symptoms

symptoms involving physical problems and/or concerns about medical symptoms

Somatic

From the Greek word “soma;” meaning body

Depersonalization/derealization disorder

condition in which the individual experiences recurrent and persistent episodes of depersonalization/derealization

Derealization

Condition in which people feel a sense of unreality or detachment from their surroundings

• Most people will experience this at least once in their lives, often when they’re sick with a mild illness like the flu

Depersonalization

condition in which people feel they are detached from their own body

• the feeling of floating above yourself or observing yourself in third person

Fugue state

Traveling or wandering without knowing one’s own identity

Dissociative Amnesia

Inability to remember important personal details and experiences

• usually associated with traumatic or very stressful events

Dissociative Disorders

Involve disruptions or breakdowns of memory, awareness, identity, or perceptions

• Oftentimes involve mood, anxiety, PTSD, etc.

Dissociative Identity Disorder [DID]

Individual develops more than one-self or personality

• ≥ 2 distinct identities

  • When inhabiting identity 1, are unaware that they also inhabit any of their other identities

  • Results in large memory gaps

• Individuals with DID learn to cope with extremely stressful life events by creating “alter” personalities that unconsciously control their thinking & behavior when they’re stressed

formerly Multiple Personality Disorder