PSY 350 EXAM 3 SDSU

Anorexia Nervosa Criteria I

Individual purposely takes in too little nourishment, resulting in body weight that is very low and below that of other people of similar age and gender

Anorexia Nervosa Criteria II

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

Anorexia Nervosa Criteria III

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

Atypical anorexia nervosa

Individual purposely takes in too little nourishment

Despite significant weight loss, weight is within or above the normal range

Anorexia Nervosa Clinical Picture

Key goal is becoming thin.

-fear of losing control of body size/shape

Preoccupation with food occurs

Thought Distortions

-overestimating proportions

-maladaptive attitudes

Bulimia Nervosa Criteria I

Repeated binge-eating episodes

An episode of uncontrollable eating during which a person ingests a very large quantity of food

Bulimia Nervosa Criteria II

Repeated performance of ill-advised compensatory behaviors (e.g., forced vomiting) to prevent weight gain

Bulimia Nervosa Criteria III

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

Bulimia Nervosa Criteria IV

Inappropriate influence of weight and shape on appraisal of oneself

Bulimia Nervosa Binge Episode

Episodes of uncontrollable eating during which a person ingests a very large quantity of food in a limited amount of time

Usually preceded by great tension, which is relieved by eating

Followed by extreme self-blame, shame, guilt, depression, and weight gain fear

Bulimia Nervosa Compensatory Behavior

After a binge, engage in inappropriate compensatory behaviors

-purging

-fasting

-excessive exercise

Compensatory behaviors effectiveness

-Some *temporary( positive effects - relief of discomfort & negative feelings associated with bingeing

Binge-Eating Disorder Criteria I

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

Binge-Eating Disorder Criteria II

Significant distress

Binge-Eating Disorder Criteria III

Episodes take place at least weekly for a period of 3 months

Binge-Eating Disorder Criteria IV

Absence of excessive compensatory behaviors

What Causes Eating Disorders?

Cognitive-Behavioral Factors

-Presence of distorted thinking & maladaptive behaviors related in development and maintenance of ED

-Little control over life may result in excess control of body size

-"Core Pathology" : cognitive distortion that one should be judged based on their shape and weight and one's ability to control these factors

What Causes Eating Disorders?

Depression : Setting the Stage for ED?

High Rates of Comorbidity

-When people with eating disorders experience depression-inducing circumstances, their disordered eating intensifies

Mechanisms of depression setting stage for ED

-Similar brain circuit abnormalities are involved in those with eating disorders and depression.

-Antidepressant drugs sometimes help persons with eating disorders.

What Causes Eating Disorders?

Biological Factors : Weight Set Point

-Set Point : influenced by GENETICS & early eating practices

-Hypothalamus, related brain structures, and chemicals such as GLP-1 work together

-Responsible for keeping an individual at a particular weight level

What Causes Eating Disorders?

Societal Pressures

-Western standards for female attractiveness

-Socially accepted prejudice against overweight people

-Difference in risk based on subcultures

-Social networking, Internet activity, and television browsing

What Causes Eating Disorders?

Multicultural Factors : Racial & Ethnic Differences

Prior to 21st Century: women in minority groups in the US had healthier body outlook than those of non-Hispanic white American women.

NOW : Young women of color

-Same degree of body dissatisfaction as young non-Hispanic white American women

-Are even more likely to engage in disordered eating behaviors (particularly binge eating)

How Are Eating Disorders Treated?

Anorexia Nervosa - Immediate Goals

Restoring weight and normal eating methods

How Are Eating Disorders Treated?

Anorexia Nervosa - Lasting Change

Cognitive-Behavioral Therapy

How Are Eating Disorders Treated?

Bulimia Nervosa - CBT

Behavioral techniques tailored to unique features of bulimia nervosa

-online diaries, ERPS

Cognitive techniques

-identify maladaptive attitudes and negative thoughts

Psychophysiological disorders

Psychological factors negatively effect medical condition

*result of an interaction of biological psychological, and sociocultural factors

Psychophysiological disorders

Sociocultural perspective

Adverse social conditions that produce stress trigger and interact and biological and psychological factors

-POVERTY

-Race and ethnicity

Psychophysiological disorders

Sociocultural perspective: RACE

Black Americans

-higher rates of hypertension bc of racial discrimination

Hispanic Americans - Hispanic paradox

-similar rates of poverty, health is on average or better than whites

Psychophysiological disorders

Psychoneuroimmunology

Examines how stressful events result in viral or bacterial infection and connection between psychosocial stress, immune system, and health

-stress can slow lymphocyte activity and interfere with the immune systems ability to protect against viral and bacterial infection during times of stress

Psychophysiological disorders

PNI & stress influenced on immune system

BEHAVIORAL CHANGES

Anxiety or depressive disorder

Unhealthy behaviors that indirectly impact the immune system

Psychophysiological disorders

PNI & stress influenced on immune system

SOCIAL SUPPORT

Less social support and loneliness leads to worse immune functioning

Strong social support and affiliation with others

-may PROTECT against stress, poorer immune functioning and later illness

-can help speed recovery from illness or surgery

Conversion disorder

Aka Functional neurological symptom disorder Criteria I

One symptom or deficit that affects voluntary or sensory function

Conversion disorder

Aka Functional neurological symptom disorder

CLUES SUGGESTING CONVERSION

-Symptoms may be at odds with how we know certain body symptoms

-Physical effects may differ from those of the corresponding medical condition

possibility that this diagnosis is incorrect and the patient has an undetected neurological or other medical cause

Somatic symptom disorder Criteria I

Atleast one upsetting or repeating physical (somatic) symptom

Somatic symptom disorder Criteria II

An unreasonable (out of proportion) number of thoughts, feelings, and behaviors

Somatic symptom disorder Criteria III

Physical symptoms last 6+ months

Conversion disorder & somatic symptom disorder CAUSES

no explanation has received much research support, and the disorders are still poorly understood

1st Criteria

Factitious Disorder --imposed on OTHERaka : Munchausen Syndrome by proxy

False creation of physical psychological symptoms, or deceptive production of injury or disease in another person

2nd Criteria

Factitious Disorder --imposed on OTHERaka : Munchausen Syndrome by proxy

Presentation of another person (victim) as ill, damaged, or hurt

Conversion Disorder & Somatic Symptom Disorder Multicultural PERSPECTIVE

Formation of somatic complaints is the norm in many non-Western cultures.

-A socially & medically correct -and less stigmatizing - way to reaction to life stressors

1st criteria Illness Anxiety Disorder

Person is preoccupied with thoughts about having or getting a significant illness. In reality, person has no or, at most, mild somatic symptoms

2nd criteria Illness Anxiety Disorder

Person has easily triggered high anxiety about health

3rd criteria Illness Anxiety Disorder

Person displays unduly high number of health-related behaviors (e.g., keeps focusing on body) or dysfunctional health avoidance behaviors (e.g., avoids doctors).

4th criteria Illness Anxiety Disorder

Person's concerns continue to some degree for at least 6 months

Substance Use Disorders Definitions - Components of Dependence

Tolerance

Withdrawal

Tolerance

Need for increasing doses of substances to produce desired effect

Withdrawal

Unpleasant and sometimes dangerous symptoms occurring with drug stopping or cutting back

1st criteria Substance Use Disorders

Individual displays a maladaptive pattern of substance use leading to significant impairment or distress

2nd criteria Substance Use Disorders Criteria

Presence of at least 2 of the following symptoms within a 1-year period

Large amounts taken

physiological dependence

functional impairment

Alcohol's risk of severe or long lasting mental behavior is ___

High

Class : Depressants Definitions

Slow the activity of the central nervous system (CNS)

alcohol tolerance and withdrawal

Tolerance increases consumption levels.

Variety of negative withdrawal symptoms

-Alcohol withdrawal can be fatal - hospitalization to detox is necessary

Depressants : AlcoholPersonal & Social Impacts of AUD

Long-term excessive drinking can seriously damage physical health (cirrhosis) and cause major nutritional problems (Korsakoff's syndrome)

Depressants : Opioids Mechanism of Intoxication

Drugs attach to endorphin-related brain receptors

-After reception of opioid : pleasurable & calming feelings just like if endorphins were produced

Depressants : Opioids Dangers

Most immediate danger is overdose

Stimulants Definition

Stimulants increase the activity of the central nervous system (CNS)

Schizophrenia and Related DisordersDefinition : Psychosis

State in which a person loses contact with reality in key ways

Schizophrenia Criteria I

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

Delusions

Hallucinations

Disorganized speech

Schizophrenia Criteria II

At least one of the individual's symptoms must be delusions, hallucinations, OR disorganized speech

Schizophrenia Criteria III

Individual functions much more poorly

Schizophrenia Criteria IV

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

SchizophreniaPositive Symptoms

Delusions: Single or many

Persecution

Reference - the radio announcers are speaking directly to me

Grandeur

Control -feelings, thoughts & actions are controlled by others

SchizophreniaPositive Symptoms

Heightened perceptions and hallucinations

Perceptions in the absence of external stimuli

Auditory : spoken directly to, or overheard by, the hallucinator

The Clinical Picture of SchizophreniaNegative Symptoms

Pathological deficits

Poverty of speech (alogia)

Restricted affect

Loss of volition

Social Withdrawal

How Do Theorists Explain Schizophrenia?Biological PERSPECTIVE

inheritance and brain activity play key roles in development of schizophrenia.

Diathesis-stress model

Diathesis-stress model

Diathesis: inherited disposition (to schizophrenia)

Stress: stressors and other factors in the environment (internal, external)

The closer the biological relationship (that is, the more similar the genetic makeup), the greater the __________________

risk of developing the disorder.

How Do Theorists Explain Schizophrenia?Sociocultural PERSPECTIVE

Social labeling

Recent studies show that labeling often has a profound, negative, and stigmatizing impact that may influence further development & treatment of the disorder

Treatment for SMI Bio: 1st Gen Antipsychotics

Symptoms reduce in about 70 percent of patients diagnosed with schizophrenia.

Positive symptoms of schizophrenia are reduced more completely, or at least more quickly, than negative symptoms.

*CON : severe extrapyramidal side effects

Parkinsonian and related symptoms*

Treatment for SMI Bio: 2nd Gen Antipsychotics

More effective than conventional antipsychotic drugs, especially for negative symptoms

Fewer extrapyramidal side effects and seem less likely to cause tardive dyskinesia

Cons : May cause weight gain, dizziness, and significant elevations in blood sugar

agranulocytosis: Carry a risk of a life-threatening drop in white blood cells (agranulocytosis)

Treatment for SMIFamily TREATMENT

Many persons recovering from schizophrenia and other severe disorders live with family members.

High levels of negative expressed emotions by family members related to higher relapse rate.

When combined with drug therapy, helps relapse and hospital readmissions rates

Treatment for SMIThe Community Approach : Failures

Case Managers

Offer therapy and advice, teach problem-solving and social skills, and ensure compliance with medications*

Try to coordinate available community services for their clients, guide them through the system, and protect their legal rights

Treatment for SMIThe Community Approach : Consequences

People with schizophrenia and other SMI have become homeless.

Others with severe mental disorders are in prisons and jails.

WHY? Lack of adequate community resources

CannabisDangers

*Occasional panic reactions, automobile accidents, and decreased memory while high

What Causes SUD?Cognitive-Behavioral PERSPECTIVE

Operant conditioned by tension-reduction, rewarding effects of drugs (self-medication)

Influenced by classical conditioning when cues or objects are present during drug use

What Causes SUD?Bio PERSPECTIVE : Brain Circuits

Reward circuit (reward center)

Dopamine is the key neurotransmitter

What Causes SUD?Bio PERSPECTIVE : Brain Circuits

Reward deficiency syndrome

The reward center is not readily activated by "normal" life events, so the person turns to drugs to stimulate this pleasure pathway, particularly in times of stress.

Defects in D-2 receptors have been cited as a possible cause.

SUD TreatmentCognitive-Behavioral TREATMENT

Relapse-prevention training

The overall goal is for clients to gain control over their substance-related behaviors.

Clients are taught to identify and plan ahead for high-risk situations and to learn from mistakes and lapses.

This approach is used particularly to treat alcohol use, as well as cocaine and marijuana abuse.

SUD TreatmentSociocultural TREATMENT : Self-Help

Most common: Alcoholics Anonymous (AA)

Many self-help programs have expanded into residential treatment centers or therapeutic communities.