Clinical Psych Exam #3

Childhood factors that promote resilience

Childhood factors that promote resilience are positive experiences, relationships, and environmental supports that help children adapt to stress, overcome challenges, and recover from adversity. Examples include supportive caregivers, stable environments, positive peer relationships, and healthy coping skills.

The developmental psychopathology perspective on depression

The developmental psychopathology perspective on depression - Developmental Psychopathology Perspective on Depression: Examines how depression develops and changes across the lifespan through interactions between biological, psychological, social, and environmental factors. Emphasizes that early childhood experiences, genetics, family relationships, and stressful life events can influence vulnerability to depression. It also considers how depression may appear differently at various developmental stages (childhood, adolescence, and adulthood). Risk and protective factors interact over time, meaning early adversity can increase the likelihood of depression, while supportive relationships and healthy coping skills can promote resilience.

Behavioral activation -

Behavioral Activation: A therapeutic technique, commonly used to treat depression, that encourages individuals to engage in meaningful, enjoyable, or rewarding activities, even when they lack motivation. It helps break the cycle of inactivity, avoidance, and low mood by increasing positive experiences and a sense of accomplishment.

Internal attribution

- An internal attribution (also known as a dispositional attribution) is a cognitive process where an individual assumes that an event or a person's behavior is caused by internal, personal factors rather than outside forces.

Attribution helplessness theory - .

Attribution helplessness theory - . Attribution–Helplessness Theory: Suggests that depression develops when individuals believe negative events are caused by internal (“my fault”), stable (“will never change”), and global (“affects everything”) factors. This thinking pattern can lead to learned helplessness, where individuals feel powerless to change their circumstances, increasing their risk of depression.

Rumination/ ruminative responses -

Repeatedly focusing on negative thoughts, emotions, and problems without actively solving them. Rumination can intensify and prolong depression by reinforcing negative thinking patterns.

Causes of depression-

high stressors, low social support, biological predisposition/increased likelihood, genetics

Loss of rewards -

A behavioral explanation of depression suggesting that reduced access to positive reinforcement (such as enjoyable activities, relationships, or accomplishments) contributes to low mood, withdrawal, and decreased motivation.

Deep brain stimulation -

an electrode is inserted in the brain in an invasive procedure where the individual can control the electrode activity

Transcranial magnetic current stimulation

- A treatment in which an electromagnetic coil, which is placed on or above a patient’s head, sends a current into the individual’s brain. - Transcranial magnetic stimulation (TMS) is another technique that is being used to try to stimulate the brain without subjecting depressed patients to the undesired effects or trauma of ECT. In TMS, the clinician places an electromagnetic coil on or above the patient’s head. The coil sends a current into the prefrontal cortex. As you’ll remember, some parts of the prefrontal cortex of depressed people are underactive. TMS appears to increase neuron activity in that structure, and, in turn, may improve functioning throughout the rest of the brain’s depression-related circuit.

Vagus nerve stimulation

- A treatment for depression in which an implanted pulse generator sends regular electrical signals to a person’s vagus nerve; the nerve then stimulates the brain. A number of years ago, a group of depression researchers suspected that they might be able to stimulate the brain by electrically stimulating the vagus nerve. They were hoping to mimic the positive effects of ECT without producing the undesired effects or trauma associated with ECT.

Electroconvulsive therapy- precautions taken -

Clinicians and patients alike vary greatly in their opinions of electroconvulsive therapy (ECT). Some consider it a safe biological approach with minimal risks; others believe it to be an extreme measure that can cause troublesome memory loss and even neurological damage. Despite this controversy, ECT is used frequently, largely because it can be a very effective and relatively fast-acting intervention for unipolar depression. ECT Today Administering ECT has changed significantly since the treatment’s early days. Today, patients are given drugs to help them sleep, muscle relaxants to prevent severe jerks of the body and broken bones, and oxygen to guard against brain damage.

Antidepressants- mechanism -

Antidepressants work by altering brain chemistry—specifically by regulating neurotransmitters (chemical messengers) and promoting neuroplasticity (the brain's ability to adapt and grow new connections).

1. Monoamine Modulation: Most traditional antidepressants increase the availability of key chemical messengers—serotonin, norepinephrine, or dopamine—in the synaptic cleft (the space between nerve cells)

2. Reuptake Inhibition: Classes like SSRIs and SNRIs block the reabsorption (reuptake) of these chemicals back into the presynaptic nerve terminal, leaving them active longer

3. Enzyme Inhibition: Monoamine oxidase inhibitors (MAOIs) block the enzyme monoamine oxidase, which normally breaks down these neurotransmitters

4.  There are four kinds of drugs available to reduce the symptoms of depression: monoamine oxidase (MAO) inhibitors, tricyclics, the second-generation antidepressants, and ketamine-based drugs.

Ketamine – mechanism and modes of administration

- The fourth group of antidepressants is ketamine-based drugs. In recent years, researchers have learned that the drug ketamine brings significant relief to many people with depression This drug has actually been available as a short-acting anesthetic since 1970, often used in surgery or to reduce pain in injured persons, and it has also gained notoriety as a party drug that can be abused its antidepressant effect has now caught the attention of the clinical field. It has been hailed as a “breakthrough” by the (FDA) and as the “first truly new medication for depression” since the approval of the second-generation antidepressant Prozac in 1987 MODES OF ADMINISTRATION (IV, nasal spray or intramuscular injection)

Biological perspective on causes of depression

- Three kinds of research — family pedigree studies, twin studies, and gene studies — suggest that some people inherit a predisposition to unipolar depression. researchers have found that as many as 30 percent of such a person’s relatives are depressed. researchers have found evidence that unipolar depression may be tied to genes on at least two-thirds of the body’s 23 chromosomes. Low activity of two neurotransmitter chemicals, norepinephrine and serotonin, has been strongly linked to unipolar depression

Treatment for depression

- Usually, biological treatment means antidepressant drugs. for people whose depression does not respond to these medications or to psychotherapy, biological treatment sometimes means brain stimulation. The ketamine-based treatments appear to alleviate the symptoms of depression by increasing the activity of the neurotransmitter glutamate in the brain.

Cognitive behavioral therapy goals

- Cognitive-behavioral therapists reintroduce clients to pleasurable events, reinforce nondepressive behaviors, teach interpersonal skills, and help the clients change or accept their dysfunctional cognitions. - - - To identify and change unhelpful thinking patterns and behaviors that contribute to psychological distress. CBT aims to improve coping skills, emotional regulation, problem-solving, and overall functioning.

Acceptance and commitment therapy -

A therapy that teaches individuals to accept difficult thoughts and emotions rather than fight or avoid them, while taking actions aligned with their personal values. The goal is to increase psychological flexibility.

Family social perspective -

Explains how family relationships, communication patterns, conflict, parenting styles, and family stress can contribute to the development or maintenance of psychological disorders, including depression.

Area of the brain specific to depression

- An array of brain-imaging studies point to several brain structures that are likely members of this depression-related brain circuit, including the prefrontal cortex, hippocampus, amygdala, and subgenual cingulate

Types of depression

major depressive disorder (The disorder may be further described as seasonal if it changes with the seasons (for example, if the depression recurs each winter), catatonic if it is marked by either immobility or excessive activity, or melancholic if the person is almost totally unaffected by pleasurable events.) & persistent depressive disorder & premenstrual dysphoric disorder (a diagnosis given to people who repeatedly have clinically significant depressive and related symptoms during the week before they menstruate.)& postpartum depression (a syndrome in which a major depressive episode typically begins within 4 weeks after delivering a child; many cases actually begin during pregnancy).

Genetic contributions to depression -

Genetic contributions to depression - researchers have found evidence that unipolar depression may be tied to genes on at least two-thirds of the body’s 23 chromosomes.

Twin studies about depression -

If a predisposition to unipolar depression is inherited, you might also expect to find a particularly large number of cases among the close relatives of depressed persons. Twin studies have supported this expectation. When an identical twin has unipolar depression, there is a 38 percent chance that the other twin has already had or will eventually have the same disorder. In contrast, when a fraternal twin has unipolar depression, the other twin has only a 20 percent chance of having the disorder

Family pedigree studies about depression -

Three kinds of research — family pedigree studies, twin studies, and gene studies — suggest that some people inherit a predisposition to unipolar depression. Family pedigree studies select people with unipolar depression, examine their relatives, and see whether depression also afflicts other members of the family. If a predisposition to unipolar depression is inherited, the relatives of a person with depression should have a higher rate of depression than the population at large. In fact, researchers have found that as many as 30 percent of such a person’s relatives are depressed, compared with less than 10 percent of the general population

Medications for bipolar disorder

- oldest is lithium, then there are new ones like lamotrigine, Effective alternative mood stabilizers include lamotrigine (Lamictal), carbamazepine (Tegretol), and valproate (Depakote) — antiseizure drugs that originally were used to treat brain seizure disorder (epilepsy). If a patient’s depression does not respond to mood stabilizers, a practitioner typically will add antidepressant drugsSOMETIMES even certain antipsychotic drugs, originally developed to treat schizophrenia, are often included in the mix to help stabilize the moods of persons with bipolar disorders

Treatment for Bipolar Disorder

Treatment for Bipolar Disorder : As Jamison stated in her memoir, psychotherapy alone is rarely helpful for persons with bipolar disorders. At the same time, clinicians have learned that mood-stabilizing drugs alone are not always sufficient either.

Types of bipolar disorder -

Bipolar I and Bipolar II.

Bipolar I = a type of bipolar disorder marked by full manic and major depressive episodes.

Bipolar II = A type of bipolar disorder marked by mildly manic (hypomanic) episodes and major depressive episodes.

Mania and creativity -

: Mania involves elevated mood, increased energy, racing thoughts, and reduced need for sleep. These changes may increase idea generation, but severe mania often impairs judgment, organization, and the ability to complete creative work.

Mania

Mania, the opposite of depression, is a state of breathless euphoria, or at least frenzied energy, in which people may have an exaggerated belief that the world is theirs for the taking. The behavior of people with mania is usually very active. They move quickly, as though there were not enough time to do everything they want to do. They may talk rapidly.

Hypomania -

\ hypomanic — that is, mildly manic…  A less severe form of mania involving elevated or irritable mood, increased energy, confidence, and activity. Lasts at least four consecutive days and does not cause the severe impairment associated with full mania. Common in bipolar II disorder.

Rapid Cycling

Without treatment, the mood episodes tend to recur for people with either type of bipolar disorder. If a person has four or more episodes within a one-year period, their disorder is considered to be rapid cycling

Factors that make suicide more likely -

bullying, being depressed, being 85+, having certain types of mental illness, poor quality of life. - 

Risk factors include previous suicide attempts, mental disorders (especially depression and bipolar disorder), hopelessness, substance misuse, social isolation, trauma, major life stressors, and access to lethal means. Risk increases when multiple factors occur together.

Genes related to depression -

Using such techniques, researchers have found evidence that unipolar depression may be tied to genes on at least two-thirds of the body’s 23 chromosomes. No specific one gene.

Relaxation training vs meditation vs biofeedback

Relaxation Training: Uses techniques like deep breathing and progressive muscle relaxation to reduce physical tension and stress.

Meditation: Practices focused attention or mindfulness to increase awareness, emotional regulation, and acceptance of thoughts.

Biofeedback: Uses electronic monitoring of bodily functions (heart rate, muscle tension, etc.) to teach individuals how to consciously regulate physiological responses.

Causes of high suicide rates among elderly

- Death initiators also clearly intend to end their lives, but they act out of a belief that the process of death is already underway and that they are simply hastening the process. Some expect that they will die in a matter of days or weeks. A number of suicides among older adults or people who are very sick fall into this category.

Postvention -

Related to Modeling - Postvention is an organized intervention and support strategy implemented in the aftermath of a suicide death. The term describes helpful, healing actions that follow a suicide to support the bereaved and protect the wider community.

• Immediate & Long-Term Support: Moving beyond one-time check-ins to provide multi-year touchpoints, support groups, and counseling for survivors, especially around difficult milestones like anniversaries and holidays

• Goals of Postvention: 1. Facilitate Grief and Healing: Help family, friends, coworkers, classmates, and community members cope with the complex trauma, guilt, and isolation of suicide loss. 2. Mitigate Risk and Contagion: Prevent further suicides ("suicide clusters" or "contagion") among high-risk individuals who were exposed to or affected by the death 3. Encourage open conversations, safe messaging, and proper media reporting to remove the shame and silence often surrounding suicide

Social contagion effect -

The social contagion effect in relation to suicide—often referred to as suicide contagion or the Werther effect—is a process where exposure to the suicide, suicide attempt, or suicidal behavior of one person increases the likelihood that others in their community, peer group, or media network will engage in similar behavior. EXAMPLE: The Event: The show 13 Reasons Why depicted the suicide of a high school student in explicit detail The Contagion Effect: A time-series analysis published in JAMA Psychiatry found a statistically significant increase in monthly suicide rates among U.S. youth aged 10 to 19 in the three months following the show's release.

Modeling

- It is not unusual for people, particularly teenagers, to attempt suicide after observing or reading about someone else who has done so (King, 2021; Hawton et al., 2020). Perhaps they have been struggling with major problems and the other person’s suicide seems to reveal a possible solution, or perhaps they have been thinking about suicide and the other person’s suicide seems to give them permission or finally persuades them to act. Either way, one suicidal act apparently serves as a model for another. Suicides by family members and friends, those by celebrities, and suicides by coworkers or colleagues are particularly common triggers.

Populations most at risk for suicide

1. elderly (often because of poor quality of life or maybe they are “death initators”) & young adults (often because of cyberbullying and feelings of hopelessness) & LGBTQ people (often because they are rejected by family or friends) 

2. American Indian or Alaska Native (AIAN) People: This group consistently records the highest age-adjusted suicide death rates in the United States (22.5 per 100,000 in 2024), driven by historical trauma, socioeconomic challenges, and limited mental health resources in remote areas

3. People with low social support & the rate of attempted suicides among women is 50 percent higher than among men,  

4. Research suggests that as many as 70 percent of all suicide attempters had been experiencing severe depressive or bipolar disorders, 20 percent substance use disorder, and 10 percent schizophrenia. Correspondingly, as many as 20 percent of people with each of these disorders try to end their lives. People who are both depressed and substance-dependent seem particularly prone to suicidal impulses (Ashrafioun et al., 2020). Certain anxiety disorders, posttraumatic stress disorder, and borderline personality disorder have also been linked to suicide (Nordentoft et al., 2020).

Role of alcohol/drugs in suicide

- Autopsies reveal that about one-quarter of people who attempt suicide are legally intoxicated at the time of their act (Schreiber & Culpepper, 2022). It may be that the use of alcohol lowers a person’s inhibitions, reduces fears of suicide, releases underlying aggressive feelings, or impairs judgment and problem-solving ability. & The likelihood of completing suicide is seven times greater among those who engage in extended drug use

Role of bullying

- Bullying plays a major, well-documented role as a risk factor for suicidal ideation, suicide attempts, and suicide deaths among children, adolescents, and young adults. Rather than acting as a singular or isolated cause, bullying operates as a severe chronic stressor that deeply erodes a person's mental health

The role of stressful events in suicide

1. combat stress. Research indicates that combat veterans from various wars are more than twice as likely to die by suicide as nonveterans

2. immediate stress seen in cases of suicide are the loss of a loved one through death, divorce, or rejection; loss of a job; significant financial loss; and stress caused by hurricanes, earthquakes, or other natural disasters

3. Four such stressors are particularly common — social isolation, serious illness or injury, an abusive or repressive environment, and occupational stress.

The role of hopelessness in suicide

- Suicide attempts may also be preceded by shifts in patterns of thinking. People may become preoccupied with their problems, lose perspective, and see suicide as the only effective solution to their difficulties (Schreiber & Culpepper, 2022). They often develop a sense of hopelessness — a pessimistic belief that their present circumstances, problems, or mood will never change (King, 2021; Hawton et al., 2020). Some clinicians believe that a feeling of hopelessness is the single most likely indicator of suicidal intent,

Dichotomous thinking

- Many people who attempt suicide use dichotomous thinking, viewing problems and solutions in rigid either/or terms. Indeed, Shneidman said that the “four-letter word” in suicide is “only,” as in “Suicide was the only thing I could do.” In the following statement a woman who survived her leap from a building describes her dichotomous thinking at the time. She saw death as the only alternative to her pain.

Social risk factors

- No or little social support network is a big risk factor. Examples include: low number of close social contacts, not married & distressing relationships. Economic and Employment Factors Poverty and severe financial stress Job loss or chronic unemployment

Homelessness or housing instability *Interpersonal Factors**

Social isolation and loneliness Divorce, breakup, or relationship conflict Bullying and victimization History of trauma or abuse Community and Systemic Factors Lack of access to mental healthcare Stigma against seeking help Systemic discrimination or community neglect Easy access to lethal means

Interpersonal theory

Interpersonal theory - For more than a decade, clinical researcher Thomas Joiner and his colleagues have been developing the interpersonal theory of suicide. Interpersonal-psychological theory, asserts that people will be inclined to pursue suicide if they hold two key interpersonal beliefs — perceived burdensomeness and thwarted belongingness — and, at the same time, have a psychological capability to carry out suicide, a capability that they have acquired from life experiences. The theory does not dismiss the importance of the other factors you have been reading about in this chapter. However, says Joiner, without the further presence of perceived burdensomeness, thwarted belongingness, and acquired capability, those factors are not likely to result in self-inflicted death. 

According to this theory, people with perceived burdensomeness believe that their existence places a heavy and permanent burden on their family, friends, and even society. This belief — typically inaccurate — may produce the notion that “my death would be worth more than my life to my family and friends.”

People with thwarted belongingness feel isolated and alienated from others — not an integral part of a family or social network. Their sense of social disconnect may be overstated or it may be accurate, but, either way, it feels enduring, unchangeable, and confining. 

Research indicates that people who experience both of these interpersonal perceptions are inclined to develop a desire for suicide. However, studies also indicate that such individuals are unlikely to attempt suicide unless they further possess the third variable cited by the theory — the psychological capability to inflict lethal harm on themselves.

Types of suicide

Types of suicide - 1. Death seekers clearly intend to end their lives at the time they attempt suicide. 2. Death initiators also clearly intend to end their lives, but they act out of a belief that the process of death is already underway and that they are simply hastening the process. Some expect that they will die in a matter of days or weeks. 3. Death darers experience mixed feelings, or ambivalence, about their intent to die, even at the moment of their attempt, and they show this ambivalence in the act itself. Although to some degree they wish to die, and they often do die, their risk-taking behavior does not guarantee death. The person who plays Russian roulette — that is, pulls the trigger of a revolver randomly loaded with one bullet — is a death darer. 4. When people play indirect, covert, partial, or unconscious roles in their own deaths, Shneidman classified them in a suicide-like category called subintentional deaths. Traditionally, clinicians have cited drug, alcohol, or tobacco use, recurrent physical fighting, and medication mismanagement

Relaxation training

- A treatment procedure that teaches clients to relax at will so they can calm themselves in stressful situations.

Meditation -

Meditation - A technique in which a client is given information about physiological reactions as they occur and learns to control the reactions voluntarily.

Biofeedback -

A technique in which a client is given information about physiological reactions as they occur and learns to control the reactions voluntarily.

Emotion expression / emotional disclosure

- The process of communicating or expressing emotions, particularly those related to stressful or traumatic experiences. Can improve emotional processing, reduce emotional suppression, and promote psychological well-being, although benefits vary.

Mindfulness

- mindfulness meditators pay attention to the feelings, thoughts, and sensations that are flowing through their mind during meditation, but they do so with detachment and objectivity and, most importantly, without judgment. By just being mindful but not judgmental of their feelings and thoughts, including feelings of pain, they are less inclined to label them, fixate on them, or react negatively to them.

Social support

- Finally, people who have few social supports and feel lonely tend to have poorer immune functioning in the face of stress than people who do not feel lonely. The high-loneliness group showed lower lymphocyte responses during a final exam period.

Religious and spiritual engagement

- in a related vein, several studies suggest that people who are spiritual tend to be healthier than people without spiritual beliefs, and a few studies have linked spirituality to better immune system functioning.

Neurotransmitters and hormones that play a role in stress-related disorders; how these chemicals interact with the immune system

- Researchers have also come to appreciate that stress can interfere significantly with the activity of lymphocytes and other parts of the immune system. - there are two brain–body stress routes by which stressors produce arousal throughout the brain and body. One is the sympathetic nervous system, which, among its many actions, triggers the release of the neurotransmitter norepinephrine. It turns out that in addition to its role in producing arousal, an extended release of norepinephrine can influence the immune system adversely. Research indicates that if stress continues for too long a period, norepinephrine eventually travels to receptors on certain lymphocytes and gives them an inhibitory message to stop their activity, thus slowing down immune functioning. - longer not necessary to know know: Recall also that the other brain–body stress route is the hypothalamic-pituitary-adrenal (HPA) axis, which, among its various actions, triggers the release of cortisol and other stress hormones. In addition to producing bodily arousal, an extended release of cortisol and other stress hormones can contribute to poorer immune system functioning. As in the case of norepinephrine, if stress continues for too long, the stress hormones travel to receptor sites located on certain lymphocytes and give an inhibitory message, again causing a slowdown of the activity of the lymphocytes - IMPORTANT: another action of norepinephrine and the various stress hormones is to trigger an increase in the production of cytokines, proteins that bind to receptors throughout the body. At moderate levels of stress, the cytokines, another key player in the immune system, help combat infection. But as stress continues and more norepinephrine and stress hormones are released, the growing production and spread of cytokines, particularly so-called pro-inflammatory cytokines, lead to chronic inflammation throughout the body, contributing at times to heart disease, stroke, and other illnesses

HPA axis -

As you learned previously in the chapter about trauma and stress, whenever we confront stressors in life, our brain triggers into action two stress-related routes throughout the brain and body. One of those routes, the hypothalamic-pituitary-adrenal (HPA) axis, ultimately brings about the release of hormones at various locations throughout the body, and those hormones spur assorted body organs into action, causing us to temporarily experience a heightened state of arousal. You may recall that the HPA axis of people with posttraumatic stress disorder (PTSD) and certain anxiety disorders consistently overreacts when those individuals confront stressors. Research indicates that the HPA axis of people with depression is also overly reactive in the face of stress, causing excessive releases of cortisol and related hormones at times of stress. it is possible that the HPA axis overreactivity and heightened hormone activity found in depressed people either reflect or help produce dysfunction in a depression-related circuit in the brain, the biological focus that we turn to next.

Cortisol

Cortisol - Cortisol is a steroid hormone produced by the adrenal glands that acts as the primary chemical mediator of the body’s fight-or-flight response and stress system. In psychology and psychoneuroendocrinology, it serves as the key biological link between environmental or psychological stress and physical changes in the brain and body. Involved in stress Response: Released via the hypothalamic-pituitary-adrenal (HPA) axis when a person perceives a physical or psychological threat, mobilizing energy (glucose) to help the body cope with the challenge

Sympathetic nervous system

- The sympathetic nervous system (SNS) acts as the body's primary driver for the fight-or-flight response, mobilizing physical energy and altering mental state when encountering stress, danger, or high-arousal emotions

Lymphocytes

- When people are under intense stress for a while, their immune systems may become dysregulated, leading to slower functioning of important white blood cells called lymphocytes and to increased production of pro-inflammatory cytokines, proteins that spread throughout the body and cause inflammation and various illnesses. There is a growing belief among some researchers that immune system dysregulation of this kind helps produce depression

Antigen

- A foreign invader of the body, such as a bacterium or virus.

Psychoneuroimmunology

- The study of the connections between stress, the body’s immune system, and illness.

Social readjustment rating scale -

The Social Readjustment Rating Scale (SRRS) is a psychological tool created by Thomas Holmes and Richard Rahe in 1967 to measure the amount of stress caused by major life events. Comprised as 43 Life Events: The scale lists 43 common life occurrences (such as marriage, job loss, mov ing, or the death of a spouse). Stress and Illness Link: It helped pioneer psychoneuroimmunology and health psychology by showing that cumulative life changes correlate with physical and mental health issues (e.g., heart disease, depression, or lowered immune function). Ignores Individual Appraisal: It assumes every event impacts everyone the same way, ignoring how an individual cognitively appraises or copes with an event (e.g., a divorce might feel devastating to one person but liberating to another)

Factitious disorder

- when someone is doing something to make themselves physically sick (example: injecting yourself with bacteria to cause gastrointestinal issues). This disease is common among people who 1. Recieved extensive treatment for a medical problem as children. 2. Carry a grudge against the medical profession. 3. Have worked as a nurse, lab tech or medical aide. 4. Have poor social support.

Hypochondriasis

- A disorder in which people are chronically anxious about and preoccupied with the notion that they have or are developing a serious medical illness, despite the absence of significant somatic symptoms. Proper term for this is Illness Anxiety Disorder.

Malingering

- intentionally feigning illness to achieve some external gain such as financial compensation or time off work or avoiding some other responsibility like taking an exam.

Factitious disorder imposed on another

- also called Much syndrome by Proxy. With this disorder parents or caretakers make up or produce illness in their children. The motivation for this is often craving attention, praise they receive for their dedicated care of a sick child.

Somatic symptom disorder (somatization pattern) -

Somatic symptoms: headaches, body pain, chest pain, nausea. Person experiences at least one somatic system. An unreasonable amount of thoughts about it. Always have distress and dsyfunction. People learn to display their symptoms and get a social support reward. People do not know they are “making up” they are genuinely convinced their symptoms are real and medical. At first they reject someone explaining it by saying it is psychological then as a last resort they often go to therapy.

Somatic symptom disorder (predominant pain pattern) -

People with somatic symptom disorder become excessively distressed, concerned, and anxious about bodily symptoms that they are experiencing, and their lives are greatly disrupted by those symptoms (APA, 2022e) (see Table 9-3). The symptoms last longer but are less dramatic than those found in conversion disorder. In some cases, the somatic symptoms have no known cause; in others, the cause can be identified. Either way, the person’s concerns are disproportionate to the seriousness of the bodily problems. - Somatic symptoms: headaches, body pain. WHEN PAIN IS THE MAIN SYMPTOM.

Functional neurological disorder

- A disorder in which bodily symptoms affect voluntary motor and sensory functions, but the symptoms are inconsistent with known medical diseases. Also known as functional neurological symptom disorder. People with conversion disorder display physical symptoms that affect voluntary motor or sensory functioning, but the symptoms are inconsistent with known medical diseases (APA, 2022e). In short, they have neurological-like symptoms — for example, paralysis, blindness, or loss of feeling — that have no neurological basis. - Neurological symptoms: numbness, motor symptoms, sensory, tremors, stiffness, tingling, paralysis, blindness, feeling.

Conversion disorder-

Also referred to as Functional Neurological Disorder. It is called conversion disorder because converting psychological needs to neurological symptoms - long version: A disorder in which bodily symptoms affect voluntary motor and sensory functions, but the symptoms are inconsistent with known medical diseases. Also known as functional neurological symptom disorder.

Hypochondriasis -

A disorder in which people are chronically anxious about and preoccupied with the notion that they have or are developing a serious medical illness, despite the absence of significant somatic symptoms. Proper term for this is Illness Anxiety Disorder.

Illness anxiety disorder

- Previously known as hypochondria. Cognitive Behavioral Therapists believe the cause is classical conditioning and modeling. They receive the same treatment as  people with OCD. They are treated with antidepressants. PEOPLE WITH illness anxiety disorder, previously known as hypochondriasis,

OPEN ENDED Q = publication bias and relation to antidepressant effectiveness

Publication Bias and Antidepressant Effectiveness

• Publication bias: Studies with positive or statistically significant results are more likely to be published than studies with negative or insignificant results.

• Antidepressant research: Studies showing antidepressants work are more likely to be published, while studies showing little or no benefit may remain unpublished.

• Overestimation of effectiveness: This creates a misleading impression that antidepressants are more effective than they actually are.

• Research findings: A major study found that approximately 94% of published antidepressant trials appeared positive, compared with only 51% of all FDA-registered trials.

• Actual effectiveness: Antidepressants are effective for many people, but their average benefits over placebo are generally more modest than published research alone suggests.

• Key takeaway: Publication bias distorts scientific evidence and can influence doctors’ treatment decisions and patients’ expectations.

Important: Publication bias does not mean antidepressants don’t work. It means their effectiveness can be exaggerated when negative findings are underreported.