fundamentals of psychopathology exam 2

somatic

presence of physical symptoms or illness not explained or entirely explained by underlying medical condition

examples of disorders with somatic symptoms

Illness anxiety disorder, factitious disorder, somatic symptom disorder, conversion disorder

factitious disorder, imposed on self

False creation of physical psychological symptoms, or deceptive production of injury or disease, even without external rewards on oneself

factitious disorder, imposed on another

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

causes of factitious disorder

extreme need for social support, poor support from parents in childhood, limited family life, grudge against medical field

treatment of factitious disorder

develop coping strategies, focus on getting support in different ways

conversion disorder

Neurologic-like symptoms inconsistent with known neurological or medical disease

conversion disorder has at least one

symptom affecting voluntary or sensory function

common symptoms of conversion disorder

seizures, tremor, numbness, pain

conversion disorder often appears

suddenly during extreme stress

somatic symptom disorder

Presence of at least one upsetting or repeatedly disruptive physical symptom.

how long do symptoms of somatic symptom disorder last?

at least six months

psychodynamic view of somatic symptom disorders

Patients carry unconscious conflicts from childhood, causing anxiety

freudian view of somatic symptom disorder

Past trauma or unconscious conflict is "converted" to a more acceptable manifestation

A cognitive behavioral view of somatic symptom disorders

somatic vigilance, rewards, communication

illness anxiety disorder

Preoccupation with thoughts about having or getting a significant illness

illness anxiety disorder is more common in

equal distribution across both genders

2 multiple choice options

when does illness anxiety disorder most commonly start?

early adulthood

Theoretical explanation and treatment of illness anxiety disorder are similar to

those for obsessive-compulsive disorder (OCD)

Common Psychophysiological Disorders

Ulcers, Asthma, Insomnia, Chronic headaches, Migraine headaches, Hypertension

Psychoneuroimmunology

Examines how physical illnesses are linked to psychosocial stress

examples of Psychoneuroimmunology

behavioral changes, Biochemical activity, social support, Personality style

biochemical activity

Stress pathways (sympathetic nervous system and hypothalamic-pituitary-adrenal pathway); cytokines, norepinephrine, chronic inflammation

behavioral changes

Anxiety or depressive disorder; unhealthy behaviors that impact the immune system

personality style

Hardy or resilient personality style; hopelessness; spirituality

social support

Loneliness; group affiliation; supportive therapy

behavioral medicine

combines psychological and physical interventions to treat or prevent medical problems

examples of behavioral medicine

- relaxation training

- biofeedback training

- meditation

- hypnosis

- support groups and emotion expression

-Cognitive-behavioral intervention

-Combination approaches

Eating disorders have the

highest mortality of any other psychiatric disorder

anorexia nervosa

Intense fear of gaining weight or becoming fat or persistent behavior that interferes with weight gain

subtypes of anorexia nervosa

restricting type and binge-eating/purging type

restricting subtype of anorexia nervosa

dieting, fasting, excessive exercise

binge-eating/purging type subtype of anorexia nervosa

recurrent episodes of binge eating or purging

medical consequences of anorexia nervosa

Amenorrhea, Dry skin,Brittle hair and nails, Sensitivity to cold temps, Lanugo, Osteoporosis, Cardiovascular problems, Electrolyte imbalance

Amenorrhea

loss of menstrual cycle

Lanugo

downy hair on limbs or cheeks

bulimia nervosa

Recurrent episodes of binge eating, sense of lack of control over eating

binge

2 hour period, eating more food than most people would eat in a similar amount of time under similar circumstances

bulimia nervose has recurrent

inappropriate compensatory behaviors

The binge eating and inappropriate compensatory behaviors both occur

on average at least once a week for 3 months

binge eating episodes

Eating excess amounts of food in a discrete period of time

Compensatory Behaviors

"Make up for" binge eating, Purging is most common, Excessive exercise, fasting, or food restriction, May use multiple methods

binge eating disorder

Binge eating without associated compensatory behaviors

binge eating episodes occur in binge eating disorder

at least once per week for 3 months

Binges in binge eating disorder may occur as response

to stressors/emotional distress

binge eating disorder is associated with

distress and/or functional impairment

eating disorders and Psychological Comorbidities are linked to

substance abuse, High rates of depression & anxiety, Higher rates of self-harm, OCD (particularly anorexia), Personality disorders

psychological influences of eating disorders

Low sense of personal control and self-confidence, Perfectionistic attitudes, Poor distress tolerance/mood intolerance

social contributions of eating disorders

media portrayals, Cultural emphasis on dieting, Standards of ideal body size

media portrayals

hinness linked to success, happiness

Standards of ideal body size

Frequently changing and difficult to achieve

Biological Contributions of eating disorders

Genetic component, Brain Structure/Function, Neurotransmitters, Hormonal influences

Genetic component of eating disorders

Increased risk if close relative has ED

Brain Structure/Function of eating disorders

Hypothalamus abnormalities

hypothalamus

important for regulating hunger and satiety

Neurotransmitters involved in eating disorders

Serotonin and dopamine are important for mood regulation and regulation of appetite, Surge in dopamine (reward) after binge or certain compensatory behaviors

hormonal influences of eating disorders

Particularly during puberty can trigger or exacerbate through their effects on eating behaviors, Cortisol influences leptin

leptin

a hormone important for appetite regulation

Comprehensive Treatment of Eating Disorders

Treatment often involves the family, Interdisciplinary approach

interdisciplinary approach of eating disorders

Weight restoration and monitoring any medical issues, mayrequire inpatient treatment

Treatment often involves the family in eating disorders

Family-based treatment has the most support from clinical trials for treating adolescents with anorexia

psychotherapy

Cognitive-behavioral therapy for Eating Disorders (CBT-E)

Cognitive-behavioral therapy for Eating Disorders (CBT-E)

Behavioral interventions, Cognitive interventions, Psychoeducation on the consequences disordered eating

effects of depressants

Mental, physical sedation

examples of depressants

alcohol, sedative, anxiolytic drugs (benzodiazepines)

effects of stimulants

Increase alertness and elevate mood

examples of stimulants

cocaine, nicotine, amphetamine

effects of opiates

Produce analgesia (painkiller) and euphoria

examples of opiates

heroin, morphine, codeine, oxycodone

effects of hallucinogens

Alter sensory perception

examples of hallucinogens

marijuana, LSD, mescaline/peyote, MDMA, PCP, mushrooms

drug

Any substance other than food affecting our bodies or minds, including alcohol, tobacco, and caffeine

substance intoxication

Cluster of changes in behavior, emotion, or thought caused by substances

substance use disorders

Maladaptive behavior patterns and reactions caused by repeated substance use

tolerance

Need for increasing doses of substances to produce desired effect

withdrawal

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

substance use disorder needs the presence of at least

two symptoms within a 1-year period

alcohol affects

cognition, social life, and work behaviors

in heavy drinkers, symptoms found are

Significant effects on brain health, impairments in memory, speed of thinking, attention skills, and balance

Psychosocial Factors of substance abuse disorders

Role of stressful environments, family beliefs around substances, Self-medication of underlying mental health conditions/symptoms, Role of conditioning

biological causes of substance abuse disorders

Genetic predisposition, Atypical form of dopamine-2 (D-2) receptor gene, Reward deficiency syndrome

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

biological treatments of substance abuse disorders

Detoxification, Antagonist drugs, Drug maintenance therapy

Drug maintenance therapy

Methadone maintenance programs are designed to provide a safe, legally and medically supervised substitute for opioid

Detoxification

Systematic and medically supervised withdrawal from a drug, High relapse rates without follow-up treatment

antagonistic drugs

Block or change the effects of a drug, create unpleasant effect, Antabuse (disulfiram), naloxone

stages of change

Precontemplation, Contemplation, Preparation, action, maintenance

precontemplation

cons of change outweigh the pros, no plans forchange

contemplation

pros of change are more evident, starting to thinkabout change

preparation

thinking about taking action soon (30 days), making small steps

action

behavior change has taken place and there is a plan to continue

maintenance

behavior change has been maintained

motivational interviewing

open-ended questions, affirmations, reflective listening, and summarizing

gambling disorder

Individual displays a maladaptive pattern of gambling, featuring at least four symptoms over the course of a full year

gambling disorder causes

Genetic predisposition, Heightened dopamine activity and dysfunction when gambling, Impulsive, novelty-seeking personality style, Repeated and cognitive mistakes

treatment of gambling disorder

Cognitive-behavioral approaches (relapse-prevention training), Biological approaches (opioid antagonists), Self-help programs (Gamblers Anonymous)

Sexual difficulties are extremely

common and not always distressing

sexual dysfunctions must be present for

at least six months

in order to consider sexual dysfunction,

lead to impairment or distress

sexual dysfunctions cannot be

solely attributable to other causes