Psych 281 Exam 3 WVU

Substance Use (9)

-Low/moderate use experiences

-Do not lead to problems with social, educational, or occupational functioning

Substance Intoxication (9)

-Reversible and Substance specific

-Maladaptive behavioral/ psychological changes associated with CNS

Substance Use Disorder (9)

-Taken in larger amounts than intended

-Inability to stop even though one desires to

-Time spent trying to obtain whatever it is

-Social problems due to use

-Tolerance increased

-Withdrawal Symptoms

Tolerance (9)

Diminished response to drug after repeated exposure

Withdrawal (9)

Physical symptoms associated with removal of a drug.

Licit Drugs (9)

Caffeine, Alcohol, Nicotine --Licit drugs are also known as legal drugs.

Illicit Drugs (9)

Marijuana, Amphetamines, Cocaine

Caffeine (9)

-CNS Stimulant

-Boosts energy, mood, awareness, concentration, and alertness

-Side effects: agitation, headaches, rebound fatigue, insomnia

-Most widely used drug worldwide (80% consume daily

Nicotine (9)

-CNS Stimulant and Sedative

-Highly addictive

-Largest preventable cause of death in the world

-45.3 million adults and 3 million adolescents still smoke

Alcohol (9)

-CNS Sedative/Depressant

-Second most commonly used substance, after caffeine

-Affects GABA

-Serious withdrawal symptoms (hallucinations, delirium tremens, formication)

-Serious Physical Effects (cirrhosis, fetal alcohol syndrome)

Marijuana (9)

-Most commonly used illicit drug

-Effects last for 1-3 hours

-Stimulates dopamine release

-Pleasant state of relaxation, Intensified senses, Slowed perception of time

-Side effects of heavy use: cognitive difficulties, respiratory problems, increased risk of cancer

Amphetamines (9)

-Ecstacy, Crystal Meth

-CNS Stimulant

-Increased heart rate and blood pressure

-Increased violence/aggression

-Emaciation

Cocaine (9)

-Was advocated by Freud who regularly used it and gave it to patients

-Was used as a legal pain killer

-Was a legal additive to cigars and cigarettes

-CNS Stimulant

-Comes from leaves of coca plant

-Highly addictive

-Tolerance leads to larger doses- higher risk of death

Barbiturates (9)

-Act on GABA system (like alcohol)

-Relaxation, Disinhibition

Benzodiazepines (9)

-Valium, Xanax

-Sometimes used to treat anxiety

-"mothers little helper"

Opioids (9)

-Heroin, Morphine, Codeine

-CNS Sedative/Depressant

-Mimics body's natural opioids (endorphins)

-Produce pain relief, euphoria, sedation, reduced anxiety

-Rapid tolerance(2-3 days)

Hallucinogens (9)

-Produce altered states of sensation and perception "Trips"

-LSD, Magic Mushrooms, Mescaline

-Hallucinogen Persisting Perception Disorder

-Tolerance and Withdrawal

Inhalants (9)

-Chemical vapors that lead to euphoria or sedation

-Rapid effects

-May cause permanent damage to organ systems

Stimulant (9)

sometimes called "uppers," temporarily increase alertness and energy.

Depressant (9)

"downers"

Hallucinogen (9)

Hallucinogens are a group of drugs that alter perception (awareness of surrounding objects and conditions), thoughts, and feelings. They cause hallucinations, or sensations and images that seem real though they are not.

Endorphins (9)

Endorphins interact with the receptors in your brain that reduce your perception of pain. Endorphins also trigger a positive feeling in the body

Environment associated with ___________, and _______________ associated with Genetics/Biology. (9)

1. Substance use/ Beginning of using

2. Substance use disorder/ Addiction

Behavioral (operant) and Substance Use (9)

-Positive Reinforcement: "Let me get more of that"

-Negative Reinforcement: "I want to avoid feeling like crap..."

Behavioral (classical) and Substance Use (9)

Environment associated with drug use.

Environment dependent tolerance

Cognitive and Substance Use (9)

-Focuses on expectations

-Interpretations affect drug use

-Postive outcome expectancies

-Lack of Negative Expectancies

-"I'll feel so relaxed after drinking this beer"

Age/SES and Substance Use (9)

Low SES- leads to lack of alternative reinforcers

Age- earlier age of substance initiation and use leads to greater risk of developing a disorder

Behavioral Treatments (9)

-Medical Detox

-Stimulus Avoidance

-Aversion Therapy

-Rewards

Cognitive & Behavioral Treatments (9)

-Skills Training

-Relapse Prevention

Biological Treatments (9)

-Detoxification

-Agonist Substitution (substitutes chemically safe form of drug)

-Nicotine Replacement Theory

Trans-Theoretical Model (9)

1. Pre-Contemplation

2. Contemplation

3. Preparation

4. Action

5. Maintenance

Motivational Interviewing (9)

-Strength based

-Collaborative

-Goal setting

-Helps individual get motivated to be involved in treatment

Psychosis (10)

-Severe mental condition

-Characterized by loss of contact with reality

-Unusual/odd thoughts, perceptions, and behaviors

Delusion (10)

False belief

Bizarre and Non-Bizarre Delusions (10)

Delusional disorder is characterized by the presence of either bizarre or non-bizarre delusions which have persisted for at least one month. Non-bizarre delusions typically are beliefs of something occurring in a person's life which is not out of the realm of possibility.

Hallucination (10)

False sensory perception

Positive Symptoms of Schizophrenia (10)

-Presence of symptoms

-Unusual thoughts, feelings, behaviors

-Delusions & Hallucinations

-Abnormality of Speech

-Unusual, bizarre behavior

-Catatonia

-Loose Associations

-Thought Blocking

-Clang Association

Catatonia (10)

-Person unresponsive to external stimuli

-Waxy Flexibility

Loose Associations (10)

Thoughts that have little or no logical connection to the next thought

Thought Blocking (10)

Unusually long pauses in patient's speech during a conversation

Clang Associations (10)

Speech governed by words that sound alike rather than words that have meaning

Negative Symptoms of Schizophrenia (10)

-Absent behaviors, thoughts, emotions (necessary for diagnosis)

-Blunted Affect: immobile facial expressions

-Anhedonia: lack of interest, pleasure

-Avolition: apathy, Lack of follow though

-Alogia: decreased quality/quantity of speech

-Psychomotor Retardation: slowed mental/physical activity

Cognitive Deficits of Schizophrenia (10)

-Earliest signs of schizophrenia

-Lack of social cognition

-Cognitive Impairment in:

*Visual and verbal learning/memory

*Ability to pay attention

*Decreased information processing

*Impaired abstract reasoning

*Problems with executive functioning

Persecutory Delusion (10)

False belief that one is being watched by others or an agency

Delusion of Reference (10)

Belief that random events are being directed to oneself

Grandiose Delusion (10)

False belief that one has great power, knowledge, or talent

Delusions of Being Controlled (10)

False belief that one's thoughts, feelings, or behaviors are being imposed or controlled by an outside force

Thought Broadcasting (10)

False belief that one's thoughts are being broadcast into other's minds

Thought Insertion (10)

False belief that someone or something is inserting thoughts into one's head

Thought Withdrawal (10)

False belief that one's thoughts are being removed from one's head

Delusion of Guilt or Sin (10)

False belief that one has commented a terrible act

Somatic Delusion (10)

False belief that one's appearance or part of one's body is diseased or altered

Course of Schizophrenia (10)

-Prodromal: social withdrawal, deterioration in hygiene, negative symptoms

-Acute: postive (and possibly negative) symptoms present

-Residual: psychotic symptoms no longer present, but negative symptoms remain

Why do people with schizophrenia abuse alcohol or drugs? (10)

Possible self medication?

What is more responsive to treatment, Positive or negative Symptoms? (10)

Positive Symptoms are often responsive to treatment. Negative Symptoms are usually more resistant to treatment.

What might early symptoms look like in childhood or adolescence? (10)

-Magical Thinking

-Ideas of Reference

-Delusions of Reference

Brief Psychotic Disorder (10)

-Sudden onset of psychotic disorder

-Does not last for more than 1 month

-After a significant stressor

Schizophreniform Disorder (10)

-Same symptoms as Schizophrenia

-Shorter duration (less than 6 months)

-Less likely to be functionally impaired

Schizoaffective Disorder (10)

-Both schizophrenia and mood disorder

-Controversial diagnosis

-Depression with psychotic features

-Bipolar with psychotic features

Delusional Disorder (10)

only have delusions

Shared Psychotic Disorder (10)

Two or more individuals share same delusion

Postpartum Psychosis (10)

Ex: Andrea Yates

Biological Influences of Schizophrenia (10)

-Dopamine Hypothesis: Dopamine Abnormalities (affects positive symptoms)

-Serotonin Deficits (negative symptoms similar to depressive symptoms)

-GABA and Glutamate (associated with cognitive impairment)

-Neuroanatomy: enlargement of ventricle, reduction in gray matter

-Viral Theories: (Prenatal Environment), Influenza during 2nd trimester

-Synaptic Pruning: neurodevelopmental disorder, accelerated process

Typical and Atypical Antipsychotics (10)

Typical:

-Thorazine, Haldol

-Reduce positive symptoms

-But, serious side effects

Atypical:

-Clozapine, Risperdal, Zyprexa

-Treat positive and possibly negative symptoms

-Help with cognitive impairments

-Less side effects

Biological Treatment of Schizophrenia/Psychotic Disorders (10)

Antipsychotics (typical and atypical)

Psychosocial Treatment of Schizophrenia/Psychotic Disorders (10)

-Psychoeducation (Goal: reduce family stress)

-Cognitive-Behavioral Treatment (usually paired with medication)

-Social Skills Training

-Supported Employment

Personality Trait vs. Disorder (11)

-disorders are behaviors/cognitions

-disorders are enduring

-Is there Impairment or distress?

Ego-Dystonic (11)

Ego-dystonic is the opposite of egosyntonic and refers to thoughts and behaviors (e.g., dreams, impulses, compulsions, desires, etc.) that are in conflict, or dissonant, with the needs and goals of the ego, or, further, in conflict with a person's ideal self-image.

Ego-Syntonic (11)

Egosyntonic is a term referring to behaviors, values, and feelings that are in harmony with or acceptable to the needs and goals of the ego, or consistent with one's ideal self-image.

3 P's of Personality Disorders (11)

Persistent, Pervasive, Pathological

Personality Disorder Clusters (11)

1. Cluster A (weird)

2. Cluster B (wild)

3. Cluster C (worried)

Cluster A (11)

Odd or Eccentric

-Paranoid Personality Disorder

-Schizoid Personality Disorder

-Schizotypal Personality Disorder

Paranoid Personality Disorder (11)

Four or more...

-Pervasive suspiciousness

-Unwarranted doubts of loyalty of friends

-Reluctance to confide in others

-Hidden meanings read into actions

-Grudges

-Angry reactions to perceived attacks

-Unwarranted suspicion of sexual partner

Schizoid Personality Disorder (11)

Four or more....

-Lack of desire for or enjoyment of relationships

-Preference for solitude

-Little interest in sex with others

-Few if any pleasures

-Lack of friends

-Indifference to praise or criticism

-Flat affect

Schizotypal Personality Disorder (11)

Five or more....

-Ideas of reference

-Magical thinking

-Unusual perceptions

-Peculiar patterns of speech

-Extreme suspiciousness

-Inappropriate affect

-Odd behavior

-Lack of close friends

-Discomfort around others

Cluster B (11)

Dramatic, Emotional, Erratic

-Antisocial Personality Disorder (ASPD)

-Narcissistic Personality Disorder

-Borderline Personality Disorder

-Histrionic Personality Disorder

Antisocial Personality Disorder (ASPD) (11)

Diagnosed in adults (18+) with evidence of conduct disorder by age 15 and at least 3 of.....

-Repeated law-breaking

-Deceitfulness

-Impulsivity

-Irritableness and Aggressiveness

-Disregard for safety of self or others

-Irresponsibility

-Lack of remorse

Narcissistic Personality Disorder (11)

Five or more.....

-Grandiose view of own importance

-Preoccupation with success, brilliance, beauty

-Believes he/she is "special"

-Extreme need for admiration

-Entitlement

-Tendency to exploit others

-Lacks empathy

-Envy of others

-Arrogance

Borderline Personality Disorder (11)

Five or more....

-Frantic efforts to avoid abandonment

-Instability in relationships

-Unstable sense of self

-Impulsive behavior

-Suicidal behavior

-Extreme emotional lability

-Feelings of emptiness

-Uncontrollable anger

-Paranoid or dissociative behavior

Histrionic Personality Disorder (11)

Five or more......

-Needs to be center of attention

-Inappropriately sexually seductive

-Rapidly shifting emotions

-Uses appearance to draw attention to self

-Impressionistic speech

-Theatricality

-Overly suggestible

-Misreads relationships as being more intimate than they really are

Cluster C (11)

Anxious or Fearful

-Avoidant Personality Disorder

-Dependent Personality Disorder

-Obsessive-Compulsive Personality Disorder

Avoidant Personality Disorder (11)

Four or more.....

-Avoidance of interpersonal contacts due to fear of rejection

-Involved with other only if citation of being liked

-Fear of shame, ridicule in intimate relationships

-Preoccupation with being rejected

-Feelings of inadequacy

-Feelings of inferiority

-Reluctance to try new things (fear of embarrassment)

Dependent Personality Disorder (11)

Five or more.....

-Indecisive

-Needs other to take responsibility

-Difficulty disagreeing with others

-Difficulty acting independently

-Does unpleasant things to gain favor

-Feels helpless without others

-Urgent need to be in a relationship

-Fears of needing to take care of self

Obsessive-Compulsive Personality Disorder (11)

Four or more.....

-Preoccupation with rules to the extent that the point is lost

-Perfectionism to the extent that nothing is finished

-Excessive devotion to work

-Inflexible morality

-Difficulty discarding worthless objects

-Reluctance to delegate

-Miserliness

-Rigidity and stubbornness

Five-Factor Model (11)

1. Openness

2. Conscientiousness

3. Extraversion

4. Agreeableness

5. Neuroticism

Treatment of Personality Disorders (11)

-Resistance to treatment

(usually others who want person in treatment)

-The treatment process for personality disorder is complicated with psychotherapy and medication involved to treat the personality disorder in conjunction with the psychiatric disorder (AXIS I).

Etiology of Personality Disorders (11)

The etiology of personality disorders can be quite complex with genetics and possible trauma identified as causes.

Culture

Culture is defined as an accumulation of values, rules of behaviors, forms of expression, religious beliefs, and occupational choices for a group of people who share a common language and environment.

Cultural Universality

Belief that the origin, process, and manifestation of disorders are equally applicable across cultures.

Cultural Relativism

Belief that what is judged to be normal or abnormal may vary from one culture to another

Culture and Assessment

Many researchers have argued that both IQ and personality tests are biased.

- There are group differences in scores on some tests.

- When "culturally fair" tests are used these differences are minimized.

5 Steps of a Cultural Formulation

• Step 1: Note the cultural identity of the person (you must ask this).

• Step 2: Develop an understanding of possible cultural explanations for illness.

• Step 3: Develop an understanding of any cultural factors related to psychosocial environment and levels of functioning.

• Step 4: Assess cultural elements of the relationship between the client and the clinician.

• Step 5: Conclude with a discussion of the overall cultural assessment for diagnosis and care.

Culture Bound Disorders

Combination of psychological and physical symptoms that are considered to be a recognizable disease only within a specific culture.

Examples:

-Koro: intense fear that the penis will recede into the body (South & East Asia)

- Brain Fag: occurs when student's brains become fatigued (West Africa)

- Mal de Ojo: "evil eye" (Mediterranean Cultures)

3 Goals for Clinicians to Achieve Cultural Competence

-Becoming aware of one's own assumptions, values, bias

-Understanding the worldview of culturally diverse clients

-Developing appropriate interventions

Ideographic Assessment

-Within-group differences are generally bigger than between-group differences

-Clients should be assessed ideographically

-Both cultural universality and cultural relativism have something to offer.