Abnormal Psych Exam 3

Somatic symptom disorders

A new DSM-5 diagnosis characterized by somatic (physical) symptoms and an excessive focus (in thoughts, feelings, or behavior) on these symptoms. Many people who would have been diagnosed with hypochondriasis in DSM-IV-TR will now be diagnosed with somatic symptom disorder; Feeling physical symptoms with no physical problems

Treatment options: Building resilience, manage symptoms with living life

Alcohol's effect on the brain at lower vs higher levels

Low level: dopamine gets released, pleasure

High level: depresses brain/motor function

Why might we want to reconsider the legal definition of alcohol intoxication—a blood alcohol content of 0.08?

People have different tolerances and different reactions

Tolerance

Need for increased amounts of a substance to achieve the desired effects

Gender differences on the effects of alcohol

Women metabolize alcohol slower than men

Centers for Disease Control and Prevention (CDC) opinion on alcohol consumption during pregnancy

The U.S. Centers for Disease Control and Prevention (CDC) takes the stance that "There is no safe amount of alcohol use during pregnancy or while trying to get pregnant. . . . When a pregnant woman drinks alcohol, so does her baby"

Malnutrition in alcoholic

People who drink are more malnourished

Role of pleasure/reward pathways in substance/alcohol dependence

The mesocorticolimbic dopamine pathway (MCLP) is the center of psychoactive drug activation in the brain. This neuronal system is involved in functions such as control of emotions, memory, and gratification. Alcohol produces euphoria by stimulating this area in the brain. Research has shown that direct electrical stimulation of the MCLP produces great pleasure and has strong reinforcing properties.

Alcohol flush reaction

Some research suggests that certain ethnic groups, particularly Asians and Native Americans, have abnormal physiological reactions to alcohol—a phenomenon referred to as "alcohol flush reaction." Asian subjects have shown a tendency to have a hypersensitive reaction including flushing of the skin, a drop in blood pressure, heart palpitations, and nausea following the ingestion of alcohol. This physiological reaction is found in roughly half of all Asians and results from a mutant enzyme that fails to break down alcohol molecules in the liver during the metabolic process.

Parenting behavior & adolescent substance use

Parents don't monitor their children as often which would lead to more risk behavior

Circumstances most often lead to problematic drinking behavior

Stress, trauma, crisis periods, personal problems, marital issues

Importance of including family in treatment

Family may unknowingly maintain/enable the addiction

Opiates

the psychoactive drug most commonly associated with abuse and dependence in our society; includes opium and heroin

Barbiturate withdrawal

Most dangerous and long-lasting

LSD & flashbacks

LSD can cause flashbacks weeks/months after taking it

Marijuana withdrawal

Marijuana withdrawal is real and can be experienced

Treatment options for gambling

Family therapy

Personality disorders impact on functioning in society

An impairment in interpersonal relationships, unable to function in society well, unstable sense of self; how it looks differs with each personality disorder

Criterion for a personality disorder diagnosis

It has to be an impairing/maladaptive behaviors, stable across time (pervasive throughout existence)

Paranoid Personality Disorder

Pervasive suspiciousness and distrust of others, doubting loyalty of friends/family, struggle to forgive perceived insult, do not let go of grudges

Schizoid Personality Disorder

Inability to form social relationships or express feelings, and lack of interest in doing so; struggle to function in society with others because of this.

Best jobs for those with SPD are remote jobs, nighttime security guard, auditor, jobs that are alone and away from others=

Histrionic Personality Disorder

What it is: Rarely able to maintain stable relationships because of excessive attention seeking, manipulation, emotional instability, and self-dramatization.

Why it should be removed from DSM-5: Its highly comorbid with BPD, antisocial, narcissistic, and dependent personality disorder

Narcissistic Personality Disorder

Exaggerated sense of self importance, believe they are the star of the job/class, think people don't like them because they're so smart, believe they should be exempt from the rules, preoccupation with being admired, and lack of empathy for the feelings of others.

Difference from antisocial: think they are exempt from the rules because they are so much better, antisocial think there shouldn't be any rules

Social media use patterns

More social media use, upload more pictures of themselves

Antisocial Personality Disorder

Disorder characterized by continual violation of and disregard for the rights of others through deceitful, aggressive, or antisocial behavior, typically without remorse or loyalty to anyone; High fear of rejection, comorbid with substance abuse, unsocialized, aggressive, and irresponsible behavior

Borderline Personality Disorder

Emotional instability, impulsivity, splitting, extreme instability in every domain of life (interpersonal relationships, mood, self-image), others feel like they're "walking on eggshells"

Breaking up with someone with BPD: threatening self-harm/suicide, become violently angry

Avoidant Personality Disorder

Extreme social inhibition and introversion, hypersensitivity to criticism and rejection, avoidance of uncomfortable situations/conflicts/anything that makes them feel bad, low self-esteem, and don't have lasting relationships

Dependent Personality Disorder

Extreme dependence on others to a point of dysfunction; overly trusting in others, lack in trust of oneself to take care of themselves; the need to be taken care of, leading to clinging and submissive behavior. Ex: if I live alone, I might hang out at other people's places in fear that something might go wrong. If I'm super talented, I might not take opportunities to show off that talent (moving away from college, traveling)

Obsessive-compulsive Personality Disorder

Perfectionism and excessive concern with maintaining order, control, and adherence to rules; Ex: not being able to leave the house until your hair is perfect, ironing the same shirt; OCD is when you have one or few true obsessions and compulsions, OCPD is being obsessive and particular about everything in ur life

Challenges in treating personality disorders

They have a high dropout rate, enduring pervasive patterns of thoughts and behaviors, hard to change someone's worldview

Challenges in treating narcissistic personality disorder

Patient not believing their psychologist has the knowledge or ability to diagnose them; believes the psychologists don't know what they're doing

HiTop stands for?

Hierarchical taxonomy of psychopathology

Benefits of HiTop

HiTop helps with identifying unitary constructs and reducing diagnostic heterogeneity; identifying what an individual is specifically struggling with rather than doing multiple diagnoses

Applications of HiTop to treatment

Helps give a clinician a list of symptoms/struggles regardless of a diagnosis/label; Gives you a printout of a person's most elevated traits (ex: severe struggle with paranoia, able to use direct treatment); Can help tailor treatment

What makes HiTop unique?

Looks at diagnoses as a continuum rather than falling into rigid categories

Gender differences in treatment seeking behavior

Men are more reluctant to seeking treatment

Differences between psychologists and psychiatrists

Psychiatrists can prescribe medication

Key elements of the therapeutic relationship

Good rapport, common/agreed upon goals

Most objective ways to evaluate treatment success

Giving personality tests/other validated instruments to see if scores are changing

Concerns with therapists' rating of treatment success

They only know what the patient tells them

Effectiveness of psychotherapy

High chances of client benefitting

Disadvantages of psychopharmacology

Relapse is likely when drug use is terminated, must take medication for rest of life

What do medications used to treat mental illnesses do?

Help alleviate symptoms, but don't cure the illness

Behavior therapy

Abnormal behavior is learned and can be unlearned; Use of therapeutic procedures based primarily on principles of classical and operant conditioning

Advantages of behavior therapy

Get results in a short amount of time, patient can feel better quickly

How behavior therapy might be used with couples

Uses training, communication skills, and adaptive problem-solving to increase caring behaviors in couples

Modeling

Learning of skills by imitating another person who performs the behavior to be acquired, used in therapy. Ex: patient struggling with shyness, role play with therapist to give feedback and encouragement

Cognitive-behavioral therapy

Therapy based on altering dysfunctional thoughts and cognitive distortions; Cognition (thinking) influences our emotions and behaviors. By changing cognitions, we can change our behaviors

Client-centered therapy

Following the client's lead, involving them in the process, not being judgmental/critical, listening to the experiences, gently helping them reach the conclusions of what they need to work on. A key goal is to help clients accept and be themselves.

Transference

In psychodynamic therapy, a process whereby clients project onto the therapist attitudes and feelings that they have had for a parent or others close to them; Putting your ideas of a person onto them without letting them show their identity

Concerns with using benzodiazepine to treat anxiety

Can cause dependence and withdrawal is dangerous