Abnormal Psych Exam 2

Dissociative disorder

 involve a disruption or dissociation of identity, memory, or consciousness

Dissociative identity disorder (DID)

Dissociative disorder in which a person has 2 or more personalities. 

Clinical Features of DID

Well-defined traits and memories for each personality. 2 or more distinct personalities. May vie for control, may/ may not be aware of each other. 

Controversies of DID

Arguments about legitimacy of diagnosis. May be over diagnosed. Maintained through social reinforcements.

Dissociative Amnesia

Memory loss without any identifiable organic cause. Includes inability to remember personal information, usually associated with traumatic events. Most common type of dissociative disorders.

Localized Amnesia

Inability to recall events from a specific limited timeframe.

Selective Amnesia

Inability to remember some aspects of an event, usually the most distressing.

Generalized Amnesia

Most severe. Complete loss of memory.

Continuous Amnesia

Not being able to form new memories.

Systematized Amnesia

Actively forgetting specific stimuli in the past and future.

Dissociative Fugue

A person experiencing a fugue may suddenly flee, travel to a new location, assume a new identity, amnesia of personal information, show not other signs of mental disorder.

Depersonalization/Derealization Disorder

Episodes of feeling detached from one’s self or one’s body or having a sense of unreality about one’s surroundings. May be a culture bound syndrome in the US.

Depersonalization

Temporary loss or change in the usual sense of reality. Episodes characterized by feelings of detachment from oneself. 

Derealization

A sense of unreality about the external world.

Psychodynamic views on Dissociative Disorders

Involve a lot of repression. Defending the self from troubnling memories. Serves an adaptive function of disconnecting or dissociating. 

Social Cognitive Theory on Amnesia/Fugue

Learned responses to psychologically distract from disturbing memories or emotions. 

Social Cognitive Theory on DID

Form of role-playing acquired through observational learning and reinforcement. May forget that a role is being enacted.

Brain Dysfunction Theory of DID

Structural differences in brain areas involved in memory and emotion.

Brain Dysfunction Theory of Depersonalization/Derealization Disorder

Differences in brain metabolic activity. May result from disruptive sleep patterns.

Diathesis Stress Model

Associated with childhood maltreatment. DID- higher risk among individuals who experience sever abuse and are also prone to fantasize, highly hypnotizable, and open to altered states of consciousness. 

Treatment of Dissociative Disorders

May focus on treating anxiety/depression associated with the disorder. Focus on integrating the alter personalities. Work through memories of early childhood trauma. 

Somatic Symptom Disorder

Complaints of physical symptoms without identifiable physical causes. Excessive concerns about the nature or meaning of the symptoms. Symptoms interfere with daily functioning. 

Diagnosis of Somatic Symptom Disorder

Persistent physical symptoms lasting 6 months or longer. Physical symptoms that cause personal distress or interfere with daily functioning. 

Illness Anxiety Disorder

Preoccupation with the belief that one is seriously ill. Emphasis on the anxiety associated with illness rather then the distress the symptoms cause. Care-avoidant and Care Seeking.

Functional Neurological Symptom Disorder (Conversion Disorder)

Intentional fabrication of psychological or physical symptoms for no apparent gain. Factitious disorder imposed on self or on another. 

Psychodynamic Theory on Somatic Symptom Disorder

Hysterical symptoms are functional primary gain and secondary gain.

Primary gain

Allows the individual to keep internal conflicts repressed.

Secondary gain

Allows the individual to avoid burdensome responsibilities and to gain support, rather than condemnation, of those around them.

Learning Theory on Somatic Symptom Disorder

Focuses on reinforcing properties of the symptom. How symptom helps the individual avoid or escape anxiety-evoking situations. Benefits of “sick role” may include relief from responsibilities and sympathy from others. 

Cognitive Theory on Somatic Symptom Disorder

Somatic symptoms may represent a self-handicapping strategy, a way of blaming poor performance on failing health, a diversion of attention to physical complaints to avoid life problems, distorted thinking that leads the person to misinterpret benign symptoms as signs of serious illness. 

Brain Dysfunction Theory on Somatic Symptom Disorder

May involve a disconnect or impairment in the neural connections between parts of the brain. Being researched for biological underpinnings and connections between anxiety and brain functions.

Psychoanalysis Treatment of Somatic Symptom Disorder

Seeks to uncover and bring into conscious awareness unconscious conflicts that originated in childhood. 

Behavioral Approach Treatment of Somatic Symptom Disorder

Focuses on removing sources of secondary reinforcement that may become connected with physical complaints.

Cognitive Behavior Therapy Treatment of Somatic Symptom Disorder

Restructures distorted thinking and replaces exaggerated beliefs with rational alternatives.

Psychosomatic disorders

Physical disorders in which psychological factors are believed to play a causal or contributing role.

Headaches

May be classified as stress related in the absence of other symptoms. 

Tension headaches

Most frequent kind of headache, resulting from stress. May involve increased sensitivity of the neural pathways that send pain signals to the brain.

Migraine headaches

Lasting hours or days, piercing or throbbing sensation. Possible underlying central nervous system disorder, neurotransmitter serotonin, strong genetic component.

Headache Treatment- Drug Therapy

Tension Headaches- aspirin/ibuprofen/acetaminophen. Migraines- drugs that work on serotonin receptors. 

Headache Treatment- Psychological treatments

Biofeedback training, relaxation, coping skills training, CBT. 

Cardiovascular Disease

Disease or disorder of the cardiovascular system. Age, family history, and lifestyle risks. 

Coronary heart disease (CHD)

Major form of cardiovascular disease. Leading cause of death for men and women. 

Factors affecting heart disease

Negative emotions- frequent emotional distress anger, anxiety, depression, hostility, epinephrine & norepinephrine. Social Environmental Stress may heighten risk of coronary heart disease.

Asthma

Respiratory disorder in which the bronchi constrict and become inflamed, and large amounts of mucus are secreted. Causes attacks of wheezing, coughing, and struggling to breathe in enough air.

Causal factors of Asthma

Allergic reactions, exposure to environmental pollutants, genetic and immunological factors.

Triggers for Asthma

Exposure to allergens, cold/dry air and hot/humid air, emotional responses.

Psychological factors of Asthma

Stress, anxiety, depression.

Links between stress and cancer

Effects of stress on the immune system. Possible increased susceptibility to cancer due to weakened/compromised immune system. 

Acquired Immunodeficiency Syndrome (AIDS)

Attacks immune system leaving it helpless to fend off diseases. Anxiety and depression are common psychological problems associated with it.

Major Depressive Disorder

A severe mood disorder characterized by major depressive episodes. Changes in emotional states, motivation, functioning and motor behavior, cognition. 

Risk factors in Major Depression

Age (most common among young adults), SES (people with lower SES are at greater risk), marital status (divorced/separated higher risk), gender (women higher rates), childhood trauma and family history. 

Seasonal Affective Disorder

Depression associated with the changing of the seasons from summer to fall and winter. 

Treatments for SAD

Phototherapy, antidepressants, cognitive behavioral therapy. 

Postpartum Depression

Persistent and severe mood changes that occur after childbirth. May last for months or years. Increases the risk of future depressive episodes. 

PPD risk factors

Domestic violence, family history of psychiatric disorders, mood disorder prior to pregnancy. 

Persistent Depressive Disorder

Chronic depression lasting at least two years. Either chronic major depressive disorder or chronic y milder form of depression. 

Premenstrual Dysphoric Disorder

Significant changes in mood during the premenstrual period. More sever form of PMS, manifests the week before menses. Associated with significant emotional distress or interference with the woman’s ability to function. 

Bipolar Disorder

Extreme swings of mood and changes in energy. Extreme elation and depression.

Bipolar I disorder

Applies to people who have had at least one full manic episode at some point in their lives. 

Bipolar II disorder

Applies to people who have had episodes of major depression that alternate with hypomanic episodes, without ever having a full-blown manic episode.

Manic episode

Unrealistically heightened euphoria, extreme restlessness, and excessive activity. Disorganized behavior and impaired judgement. Rapid speech and flight of ideas.

Hypomanic episode

Less severe than manic episodes. Not accompanied by severe social or occupational problems.   

Cyclothymic disorder

Chronic cyclical pattern of mild mood swings lasting at least 2 years. Usually begins in late adolescence or early adulthood. Milder than bipolar, can significantly impair daily functioning, can increase risk of developing bipolar disorder. 

Stress and Depression in Mood Disorders (Causal Factors)

Increased risk for major depression and bipolar disorder from experiencing stressful life events.

Classic Psychodynamic Theories of Mood Disorders

Anger directed inward. Shifting dominance between ego and superego. 

Recent Psychodynamic Theories of Mood Disorders

Self-focusing model, how people allocate their attentional processes after a loss.

Humanistic Theories of Mood Disorders

Reflects a lack of meaning and authenticity in a person’s life. Focuses on loss of self-esteem from losing loved ones or experiencing occupational setbacks. 

Learning Theories of Mood Disorders

Emphasize situational factors, such as role of reinforcement. Imbalance between behavior and reinforcement. Changes in frequency or effectiveness of reinforcement. Inactivity and social withdrawal. 

Interactional Theory (James Coyne)

Based on the concept of reciprocal interaction. Influence of our behavior on how other people respond to us, influence of how other people respond to us on how we respond to them in turn. 

Cognitive Theories of Mood Disorders

Relate the origin and maintenance of depression to the ways in which people see themselves and the world around them. 

Cognitive Triad of Depression (Aaron Beck)

The view that depression derives from adopting negative views about oneself, the environment or world at large, and the future. 

Cognitive distortions associated with depression

All-or-nothing thinking, overgeneralization, mental filter, disqualifying the positive, jumping to conclusions, magnification and minimization, emotional reasoning, “should” statements, labeling/mislabeling, personalization. 

Learned Helplessness (Attributional) Theory of Mood Disorders

Features 3 attributions for negative events that increase vulnerability to depression. Internal factors (beliefs that reflect personal inadequacies), global factors (beliefs that failures reflect sweeping flaws in personality), stable factors (beliefs that failures reflect fixed personality factors)

Genetic Factors in Depression

Play a significant role in determining risk of mood disorders. Tendency to run in families. interact with environmental factors. Links between variations of genes regulating serotonin and greater risk of depression in the face of life stress. 

Biochemical factors in depression

Irregularities in the number of receptors on receiving neurons where neurotransmitters dock. Abnormalities in the sensitivity of the receptors to particular neurotransmitters. Irregularities in how specific chemicals bind to receptors. Reduced volume and lower metabolic activity in certain areas of the brain.

Causal Factors in bipolar disorders

Genetic factors such as abnormalities in the brain. Stressful life factors and other biological influences (diathesis-stress model).

Psychological Treatment of Mood Disorders

CBT, help clients develop adaptive behaviors. Behavior Therapy, helps client develop more effective social skills.

Biomedical Treatment of Mood Disorders

Antidepressant drugs, Electroconvulsive therapy (ECT), lithium and other mood stabilizers, psychological treatments. 

Antidepressant drugs

4 major classes. Tricyclics (TCAs), Monoamine Oxidase (MAO) inhibitors, Selective serotonin-reuptake inhibitors (SSRIs), Serotonin-norepinephrine reuptake inhibitors (SNRIs).

Risk factors in Suicide

Serious mood disorders, age (older higher risk), gender and ethnicity (more likely attempt cis women, cis men succeed more, more likely among white people), prior suicide attempts, role of stress. 

Psychodynamic Theory on Suicide

Depression turned inward

Sociocultural Theory on Suicide

Environment isn’t nuturing

Learning Theory on Suicide

Social contagion- learning from others who engage in self-harm. Maladaptive coping skills. 

Social Cognitive Theory on Suicide

Interpersonal theory of suicide (burdensome, belonginess, acquired capability)

Biological Theory on Suicide

Some people are more predisposed to stare down self preservation instincts. 

Substance use Disorder

Maladaptive use of a psychoactive substance. Significant personal distress or impaired functioning. Problems meeting responsibilities, physically dangerous behavior, social/interpersonal problems, withdrawing from activities. 

Physiological Dependence

Repeated use of a substance alters the body’s physiological reactions. 

Tolerance

With frequent drug use, higher doses are needed to achieve the same effect. 

Withdrawal

Specific physiological reaction upon cutting back or stopping use of the drug

Addiction

Compulsive use of a drug, accompanied by signs of physiological dependence.

Psychological Dependence

Compulsive use of a substance to meet a psychological need.

Depressants

Drugs that slow down or curb the activity of the central nervous system. Slow movement, impaired cognitive processes, can cause death in high doses. Alcohol and opiods

Alcohol

Contains depressant drug called Ethyl Alcohol.

Alcohol use disorder/ Alcoholism

3 in 10 adults at some point in their life. 

Risk factors for alcoholism

Male, 20-40, antisocial personality disorder, family history, lower income and educational levels. May be ethnic differences in alcohol use.

Psychological effects of alcohol

Relaxation, impaired senses, balance, coordination, motor ability, judgement, ability to curb impulses, risk taking, violence.

Physical Health and Alcohol

Chronic, heavy alcohol use affects virtually every organ and body system. Increases risk of many serious health concerns. Liver disease, some forms of cancer, coronary heart disease, neurological disorders. 

Barbiturates

Depressants with sedating effects that are used to ease anxiety, reduce pain, and treat epilepsy and high blood pressure. Highly addictive. 

Opioids

Classified as narcotics. Drugs that have pain-relieving and sleep-inducing properties. Stimulate the brain’s pleasure circuit. 

Morphine

A strongly addictive narcotic derived from the opium poppy that relieves pain and induces feelings of well-being.