Abnormal Psych Exam 2 (Schizophrenia, Bipolar, Anxiety)

schizophrenia

a disorder with a range of symptoms involving disturbances in content of thought, form of thought, perception, affect, sense of self, motivation, behavior, and interpersonal functioning

• onset age of 16-30

delusion

an engrained false belief, not consistent with the client’s level of intelligence or cultural background

hallucination

a false perception, not corresponding to the objective stimuli present in the environment

paranoia

the irrational belief or perception that others wish to cause you harm

disorganized speech

language that is incomprehensible and incoherent

loosening of association

flow of thoughts that is vague, unfocused, and illogical

neologism

invention of new words that have meaning to only the inventor

inappropriate affect

the extent to which a person’s emotional expressiveness fails to correspond either to the social cues present in a situation or to the context of what’s being discussed

what symptoms of schizophrenia must be present for the majority of one-month with some level of disturbance being present for six months?

• delusions

• hallucinations

• disorganized speech

• catatonic behavior

• reduced ability to function

catatonic behavior

a neuropsychiatric syndrome that disrupts a person’s movement, speech, awareness, and response to the environment

prodromal stage of schizophrenia

social withdrawal, decline in functioning, trouble with concentration, and mild forms of psychosis (like odd beliefs or unusual perceptual experiences)

active phase of schizophrenia

more severe psychotic symptoms, hallucinations, delusions, disorganized behavior, etc.

residual phase of schizophrenia

positive (added) symptoms mainly decrease while negative (removed) symptoms will continue

positive symptoms

symptoms of schizophrenia that represent exaggerations or distortions of normal thoughts, emotions, and behaviors

negative symptoms

symptoms of schizophrenia that involve functioning below the level of normal behavior

schizophrenia spectrum

range of disorders that reflect a similar underlying disease process as that involved in schizophrenia

biological factors of schizophrenia

• dopamine overactivity

• serotonin-dopamine interaction

• reduced frontal/temporal lobe activation (impaired connectivity)

• 80% heritability

psychological factors of schizophrenia

• cognitive deficits (difficulty filtering information)

• neuroplasticity issues (forming too many associations)

• stress-vulnerability (stress diathesis) model (symptoms emerge when biological risk meets stress)

environmental factors of schizophrenia

• prenatal risks (viral infections, malnutrition, toxins)

• childhood adversity and chronic stress

• social isolation (substance use)

sociocultural factors of schizophrenia

• high family conflict

• low support

• socioeconomic stress

dopamine & schizophrenia

receptor dysfunction —→ excessive dopamine = positive symptoms

glutamate (NMDA) & schizophrenia

abnormalities —→ cognitive and sensory disruptions

serotonin & schizophrenia

interacts with dopamine ——> influences mood-psychosis connection

GABA & schizophrenia

inhibitory system affected through NMDA changes ——> abnormal neural oscillations

brief psychotic disorder

• 1 day to 1 month of delusions, hallucinations, disorganized speech/behavior

• often triggered by major stressors or postpartum onset

schizophreniform disorder

• 1-6 months with the same symptoms of schizophrenia

• better prognosis with rapid onset, confusion, good premorbid functioning, few/no negative symptoms

related schizoaffective disorder

• combination of mood disorder + psychosis

• schizophrenia-like symptoms and mood disorder symptoms

• psychosis with and without mood symptoms

delusional disorder

• delusions are the only schizophrenia symptoms present

• person cannot tell what is real from what is imagined

• erotomanic, grandiose, jealous, persecutory, somatic

shared psychotic disorder

shared delusion between closely connected individuals; more common with social isolation

psychological perspective of schizophrenia

• impairment in attention, declarative memory, executive functioning, and processing speed

• lack social cognition

sociocultural perspective of schizophrenia

• environment plays a role in the development

• families expression of emotion

• downward shift

• developmental cascade hypothesis (damage during prenatal/early childhood, drug use)

biopsychological perspective of schizophrenia

• genetics

• grain structure

• neurochemistry

• neurodevelopmental hypothesis (changes in genes during brain maturation)

negative affect

a reduced or limited range of outward emotional expression, where a person shows fewer facial expressions, gestures, or voice-tone changes than expected

loosening of associations

a formal thought disorder characterized by disorganized speech and a lack of logical connection between ideas

marked psychomotor disturbances

significant, observable changes in a person’s physical movements, speech, and thought processing caused by underlying medical or psychiatric conditions

depressive disorder

characterized by periods of symptoms in which an individual experiences an unusually intense sad mood

major depressive disorder

at least five persistent depressive symptoms for at least two weeks

depressive symptoms

• depressed mood most of day

• insomnia or hypersomnia

• diminished interest or pleasure in daily activities

• unintended weight loss

• psychomotor agitation or retardation

• fatigue or loss of energy

persistent depressive disorder

chronic but less severe mood disturbance in which the individual does not experience a major depressive disorder

disruptive mood dysregulation disorder

children who exhibit chronic and severe irritability and have frequent temper outbursts that are developmentally inappropriate

premenstrual dysphoric disorder

depressed mood or changes in mood, irritability, dysphoria, and anxiety during the premenstrual phase that subside after the menstrual period begins for most of the cycles of the preceding year

bipolar disorder

a mood disorder involving manic episodes with symptoms that are present nearly everyday for at least a week

manic episode

intense and disruptive experiences of heightened mood, possibly alternating with major depressive episodes

• may experience episodes of euphoria

bipolar I

one or more manic episodes and the possibility of one or more major depressive episodes

bipolar II

one or more major depressive episodes and at least one hypomanic episode

symptoms of bipolar disorder

• inflated self-esteem or grandiosity

• decreased need for sleep

• more talkative mood than usual

• higher distractibility

• increase in goal-oriented activities

• excessive engagement in potentially painful activities

biological theories and treatment of bipolar disorders

medications for depressive/bipolar disorders

• SSRIs (selective serotonin reuptake inhibitors)

• SNRIs (serotonin -norepinephrine reuptake inhibitors)

• TCAs (tricyclic antidepressants)

• MAOIs (monoamine oxidase inhibitors)

• lithium carbonate

psychological theories and treatments for bipolar disorders

• psychodynamic approach

  • unconscious conflict and past experiences

• behavioral approach

  • activity and positive reinforcement

• cognitive approach

  • negative thought patterns

• interpersonal psychotherapy & CBT

sociocultural perspective of bipolar/depressive disorders

• stressful life events

• lack of family and social support

• financial and environmental stressors

• cultural influences and discrimination

• mental health care access

panic disorder

experience frequent, unexpected, and lasting panic attacks

agoraphobia

• experience intense fear triggered by exposure to situations outside of their home

treatment of panic disorder & agoraphobia

• benzodiazepines

• CBT & exposure therapy

• relaxation training

generalized anxiety disorder

• excessive, ongoing, and difficult-to-control worry about everyday events

• tendency to expect the worse

• no specific root for anxious feelings

theories and treatment of GAD

• biologically focused on the amygdala’s emotional regulation

• benzodiazepines

• CBT

• ACT (acceptance and commitment therapy)

separation anxiety disorder

• intense and inappropriate anxiety about leaving home or being left by attachment figures, or people close

• excessive distress, fear and worry when away from attachment figure

treatment for separation anxiety disorder

• CBT, focused on exposure therapy

• occasionally antidepressant prescription

selective mutism & treatment

• the refusal to speak in specific situations

• capable of speaking normal language

• treatment is behavioral therapies with reinforcement of desired progress

specific phobias

• the incapacitating fear or anxiety of specific objects or situations

• categories:

  • insects and animals

  • natural environment

  • blood-injection-injury

  • engaging in particular activities

biological perspective/treatment of specific phobias

• abnormalities in the anterior insular cortex

• amygdala’s fear response

• symptom management

• medication (benzodiazepines)

anterior insular cortex of the brain

area between the temporal and frontal lobes, associated with emotion and self-awareness

(associated with phobias)

behavioral perspective/treatment of specific phobias

• conditioning and learned association

• exposure therapy

• flooding (imaginal or in vivo)

cognitive-behavioral perspective of specific phobias

• overactive alarm systems when perceiving danger

• overestimating the likelihood of danger when exposed to feared stimuli

social anxiety disorder

the fear of becoming humiliated or embarrassed in front of other people

(not a fear OF other people)

biological perspective/treatment of social anxiety

• genetic influence through generations

• possible hyperactivity of the amygdala’s fear response

• CBT and sometimes medication

cognitive-behavioral perspective/treatment of social anxiety

• unable to gain a realistic view of how others perceive them

• thought reframing

• exposure therapy

• positive self-talk

• meditation and mindfulness

obsessive-compulsive disorder

individuals experience either obsessions or compulsions to such an extent that they find it difficult to conduct their daily activities or experience distress when trying to engage in social life or work

obsessions

recurrent and persistent thoughts, urges, or images that an individual experiences as intrusive and unwanted

compulsions

repetitive behaviors or mental acts the person feels driven to carry out according to rigid rules

biological perspective/treatment of OCD

• abnormalities in the basal ganglia (subcortical areas of the brain active in motor control)

• failure of the prefrontal cortex to inhibit unwanted thoughts, images, or urges

• SSRIs

cognitive-behavioral perspective/treatment of OCD

• maladaptive thought patterns

• exposure therapy and CBT

body dysmorphic disorder

• the belief that their body is defective, ugly, or out of shape

• preoccupation with their belief, setting off dysfunctional thoughts and repetitive behaviors

• treatment: SSRIs, interpersonal therapy, cognitive techniques

hoarding disorder

• persistent difficulties parting with possessions

• distressed when faced with discarding the items

• treatment: SSRIs, compassion-focused therapy

trichotillomania

• hair-pulling disorder

• increasing urge to pull out hair for temporary relief, but faced with shame afterwards

• treatment: antidepressants, awareness training, habit-reversal training

excoriation disorder

• skin-picking disorder

• repeatedly picking at own skin

reactive attachment disorder

diagnosis given to children who appear to have lost the ability to turn to attachment figures for comfort, support, and protection

(likely related to childhood abuse and insecure attachment)

disinhibited social engagement disorder

a child with a history of trauma engages in overly familiar behavior with strangers

(likely related to childhood abuse and insecure attachment)

acute stress disorder

developed after exposure to a traumatic event

• intrusive memories

• dissociation

• avoidance

• hyperarousal

symptoms last 3 days-1 month

post traumatic stress disorder

develops from exposure to trauma and involves persistent psychological distress

• flashbacks/nightmares

• avoidance

• heightened arousal

symptoms last more than 1 month

theories of PTSD

biological:

• trauma impacts brain functioning, making certain areas hypersensitive to danger

• changes may affect memory processing

psychological:

• individuals perceive ambiguous situations as dangerous and overestimate subjective risk

treatment:

• CBT (exposure therapy)

• SSRIs

• trauma informed care and psychotherapy

eye movement desensitization and reprocessing

bilateral stimulation as psychological regulation to access raw memories and replace negative beliefs

what is the percentage of those over 60 with anxiety or depression?

8.7-9%

virtual reality exposure therapy

clients are immersed in computer-generated environments that resemble the situations they fear

tardive dyskinesia

a movement disorder that causes involuntary, repetitive, and uncontrollable muscle movements

prevalence of ADHD

10.5% of U.S. children (6.5 million) and about 6.0% of U.S. adults (15.5 million)

delusion of self reference

an unshakable false belief that neutral, unrelated, or ordinary events in the external world hold direct, personal significance meant specifically for the individual

somatic delusion

a fixed, false belief that a person has a serious physical illness, medical problem, or strange bodily defect

who was emil kraepelin?

a German psychiatrist who coined the name schizophrenia

agranulocytosis

• severely low white blood cell count

• side effect of clozaril

• kills jews due to gene issues

what could an habitual procrastinator have?

ADHD

neuroprogression

gradual worsening of mental health conditions through continuous, harmful changes in the brain's structure, chemistry, and immune response over time

extrapyramidal

a group of movement disorders caused primarily by changes or blockages in the brain's dopamine system, most often as a side effect of antipsychotic medications

what psychiatric disorder has the highest rate of inheritability?

schizophrenia

what is the IQ level of those who are developmentally disabled?

70 or below generally indicates an intellectual disability

dyslexia

learning disability that affects how the brain processes written and oral language, particularly reading, spelling, and decoding

insertion type of delusion

a false, fixed belief where a person experiences their own thoughts as if they have been placed or implanted into their mind by an external force, person, or device

rett syndrome

• a rare genetic neurodevelopmental disorder that primarily affects young girls

• it severely impacts brain development, leading to the loss of purposeful hand use, spoken language, and motor skills after a period of normal early growth