Psych Disorders exam 3

substance use

taking moderate amounts of a substance in a way that doesn’t interfere with functioning

Substance abuse

Use in a way that is dangerous or causes substantial impairment

symptoms of physiological dependence

COULDN‘T Find definition

delirium tremens

the frightening hallucinations and tremors that result when a heavy drinker withdrawals alcohol

stimulants definition and examples

increase alertness and energy and elevate mood (ex cocaine, nicotine, caffeine, and amphetamines). Intoxication physical changes: change in heart rate and blood pressure, dilated pupils, weight loss, vomiting, weakness, chills)

depressants definition and ex

behavioral sedation (ex alcohol, sedative, anxiolytic drugs)

opiates definition and ex

produce analgesia and euphoria, natural chemical in the opium poppy with narcotic effects

opioids

natural and synthetic substances with narcotic effects. Activate body’s enkephalins and endorphins; low doses induce euphoria, drowsiness, and slowed breathing; high doses can result in death; withdrawal symptoms can be lasting and severe

hallucinogens definition and ex

alter sensory perception (ex marijuana, LSD); change the way the user perceives the world; may produce: delusions, paranoia, hallucinations, altered sensory perceptions

other drugs of abuse definition and ex

include inhalants: substances found in volatile solvents, breathed directly into lungs (spray paint, hair spray, paint thinner, gasoline, nitrous oxide); anabolic steroids: used to increase body mass, doesn’t produce a high; medications: like designer drugs (originally produced by pharmacies for diseases, but others began producing for recreational use) ex: ecstasy → MDMA was a diet pill

sedatives

calming (ex barbiturates)

hypnotics

sleep inducing

anxiolytics

anxiety reducing (ex benzodiazepines)

How does alcohol work

central nervous system depressant, influences several neurotransmitter systems. Specific targe is GABA (increases inhibitory effects - makes neural cells worse at firing)

alcohol withdrawal

can get hallucinations and delirium tremens

nicotine withdrawal

insomnia, increased appetite, restlessness, trouble concentrating, anxiety and depression, irritability

personality disorders

enduring and inflexible predispositions; maladaptive, causing distress and/or impairment; high comorbidity; poorer prognosis; Ego-syntonic: unlike other disorders, often feel consistent with one’s identity, patients don’t feel that treatment is necessary

categorical systems

personality disorders have traditionally been assigned as all-or-nothing categories

dimensional systems

individuals are rated on the degree to which they exhibit various personality traits

Cluster A personality disorders

Odd or eccentric cluster, includes: paranoid personality disorder, Schizoid PD, Schizotypal PD,

Cluster B personality disorders

dramatic, emotional, erratic cluster, Includes: antisocial PD, Borderline PD, Histrionic PD, Narcissistic PD

Cluster C personality disorders

fearful or anxious cluster, Includes: Avoidant PD, Dependent PD, Obsessive-Compulsive PD,

Paranoid Personality Disorder

pervasive and unjustified mistrust and suspicion. Causes: biological and psychological contributions are unclear; Treatment: few seek professional help on their own, treatment focuses on development of trust, cognitive therapy to counter negativistic thinking, lack of good outcome studies

Schizoid Personality Disorder

Pervasive pattern of detachment from social relationships, very limited range of emotions in interpersonal situations; Causes: etiology is unclear, childhood shyness, preference for social isolation resembles autism; Treatment Options: few seek help on their own, focus on the value of interpersonal relationships, building empathy and social skills, lack of good outcome studies

Schizotypal personality disorder

behavior and dress is odd and unusual, socially isolated and highly suspicious, magical thinking, ideas of reference, and illusions, many meet criteria for major depression, some conceptualize this as resembling a milder form of schizophrenia; Causes: a phenotype of schizophrenia genotype?, more generalized brain deficits; Treatment options: main focus is on developing social skills, address comorbid depression, medical treatment is similar to that used for schizophrenia, treatment prognosis is generally poor

Antisocial Personality disorder

failure to comply with social norms, violation of the rights of others, irresponsible, impulsive, and deceitful, lack of conscience, empathy, and remorse

comorbid conditions with schizotypal disorder

30-50% meet criteria for major depressive disorder

Borderline PD

unstable moods and relationships, impulsivity, fear and abandonment, very poor self-image, self-mutilation and suicidal gestures; Causes: high emotional reactivity, runs in families, may have impaired functioning of limbic system, early trauma/abuse play a causal role for some; Treatment: few good outcome studies, antidepressant medications provide some short-term relief, Dialectical behavior therapy is most promising treatment

Histrionic PD

Overly dramatic, sensational, and sexually provocative, often impulsive and need to be the center of attention, thinking and emotions are perceived as shallow, more commonly diagnosed in females; Causes: etiology is unknown, Treatment: focus on attention seeking and long-term negative consequence, targets may also include problematic interpersonal behaviors, little evidence that treatment is effective

Narcissistic PD

exaggerated and unreasonable sense of self-importance, preoccupation with receiving attention, lack sensitivity and compassion for other people, highly sensitive to criticism; envious, and arrogant; Causes: failure to learn empathy as a child, sociological view - product of the “me” generation; Treatment: focus on grandiosity, lack of empathy, unrealistic thinking, little evidence that treatment is effective

Avoidant PD

Extreme sensitivity to the opinions of others, highly avoidant of most interpersonal relationships, are interpersonally anxious and fearful of rejection, low self esteem; Causes: numerous factors have been proposed, difficult temperament and early rejection; Treatment: several well-controlled treatment outcome studies exist, treatment is similar to that used for social phobia, treatment targets include social skills and anxiety

Dependent PD

Reliance on others to make major and minor life decisions, unreasonable fear of abandonment, clingy and submissive in interpersonal relationships; Causes: still largely unclear, linked to early disruptions in learning independence; Treatment: research on treatment efficacy is lacking, therapy typically progresses gradually, treatment targets include skills that foster independence

Obsessive-compulsive PD

excessive and rigid fixation on doing things the right way, highly perfectionistic, orderly and emotionally shallow, obsessions and compulsions are rare; Causes: largely unknown, weak genetic link; Treatment: address fears related to the need for orderliness, rumination, procrastination, and feelings of inadequacy

fearlessness hypothesis for antisocial personality disorder

fail to respond to danger cues

underarousal hypothesis for antisocial

cortical arousal is too low

cortical immaturity hypothesis for antisocial

cerebral cortex is not fully developed

gray’s model for antisocial

inhibition signal are outweighed by reward signals

positive symptoms of psychosis

Hallucination: sensory experiences in the absence of sensory input (ex hearing voices)

Delusions: strong, inaccurate beliefs that persist in the face of evidence to the contrary

endophenotype

genetic mechanism that contributes to the underlying problems causing the symptoms and difficulties experienced by people with disorders (ex: shaky eye tracking for schizophrenia)

diagnostic criteria for schizophrenia

Must persist for at least 6 months, 2 or more in one month: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms

alogia

relative absence of speech

expressed emotion and role it has in relapse in schizophrenia

This is associated with relapse (EE=criticism, hostility, and emotional overinvolvement)

timeline of brief psychotic disorder

psychotic symptoms last less than 1 month

persecutory delusions

Someone’s coming after you (getting followed by FBI etc)

grandeur delusions

Thinking you’re Jesus or Superman

jealous delusions

Convinced your partner is cheating with absolutely no evidence

negative symptoms of schizophrenia

absence of insufficiency of normal behavior

Avolition (or apathy): lack of initiation and persistence

Alogia: relative absence of speech

Anhedonia: lack of pleasure, or indifference

Affective flattening: little expressed emotion

positive symptoms of schizophrenia

active manifestations of abnormal behavior, distortions or exaggerations of normal behavior

Disorganized symptoms of schizophrenia

Confused or abnormal speech, behavior, and emotion

Cognitive slippage: illogical and incoherent speech

Tangentiality: “going off on a tangent”

Loose associations: conversation in unrelated directions

Nature of disorganized affect: inappropriate emotional behavior

Nature of disorganized behavior: includes a variety of unusual behaviors

ex: Catatonia