Abnormal Psychology311 Midterms 1st Sem

Severe abuse during childhood.

"Fantasy life" is the only escape.

The process becomes automatic and then involuntary.

What are the environmental Factors for Anxiety Disorder?

Heredity

What is the Biological Factors of Anxiety Disorder?

Dissociative Identity Disorder (DID)

Long-term psychotherapy may reintegrate separate personalities in 25% of patients.

Treatment of associated trauma similar to PTSD.

Dissociative Amnesia (DA)

- Usually self-correcting when the current life stressor is resolved.

- If needed, therapy focuses on retrieving the lost memory.

Depersonalization/Derealization Disorder (D-DD)

- Psychological treatments similar to those for panic disorder.

- Stress associated with onset of disorder should be addressed.

DISSOCIATIVE IDENTITY DISORDER

A. Disruption of identity characterised by two or more personality states, accompanied by related alterations in:

1. Affect

2. Behavior

3. Consciousness

4. Memory

5. Perception

6. Cognition

7. Sensory-memory functioning

B. Recurrent gaps in the recall of events.

C. Causes clinically significant distress or impairment.

D. Symptoms are not a normal part of a broadly accepted cultural or religious practice.

E. Not attributable to the physiological effects of a substance.

DISSOCIATIVE AMNESIA

A. An inability to recall important autobiographical information, usually of a traumatic or stressful nature which can be either localized, selective, or generalized.

B. Cause clinically significant distress.

C. Not attributable to the psychological effects of a substance.

D. Not better explained by other mental disorders.

Specify if:

With dissociative fugue

DEPERSONALIZATION/DEREALIZATION DISORDER

A. The presence of persistent or recurrent experiences of depersonalization, derealization, or both:

1. Depersonalization: experiences of unreality, detachment, or being an outside observer with respect to one's thoughts, feelings, sensations, body or actions.

2. Derealization: experiences of unreality or detachment with respect to surroundings.

B. Reality testing remains intact.

C. Cause clinically significant distress or impairment.

D. Not attributable to the physiological effects of a substance.

E. Not better explained by another mental disorder.

SOMATIC SYMPTOM DISORDER

A. One or more somatic symptoms that are distressing.

B. Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns as manifested by at least one of the following:

1. Disproportionate and persistent thought about the seriousness of one's symptoms.

2. Persistently high level of anxiety about health or symptoms.

3. Excessive time and energy devoted to these symptoms or health concerns.

C. The state of being symptomatic is persistent typically more than 6 months.

Continual development of new symptoms followed by immediate sympathy and attention

What is the Environmental Factors of Somatic Symptom Disorder?

Heredity

What is the Biological Factors of Somatic Symptom Disorder?

Cognitive-Behavioral Therapy (CBT) to provide reassurance, reduce stress, and minimize help-seeking behaviors.

What is the treatment for Somatic Symptom Disorder?

ILLNESS ANXIETY DISORDER

A. Preoccupation with having or acquiring a serious illness.

B. Somatic symptoms are not present or, if present, are only mild in intensity.

C. High level of anxiety about health.

D. Performs excessive health-related behaviors or exhibits maladaptive avoidance.

E. Present for at least 6 months.

F. Not better explained by another mental disorder.

Faulty interpretation of physical sensations

Intensified focus on sensation

Increased anxiety

What is the Environmental Factors of Illness Anxiety Disorder?

Heredity

What is the Biological Factors of Illness Anxiety Disorder?

CONVERSION DISORDER

A. One or more symptoms altered voluntary motor or sensory function.

B. Incompatibility between the symptom and recognized neurological or medical conditions.

C. Not better explained by another medical or mental disorder.

D. Causes clinically significant distress or impairment.

Life stresses or psychological conflict.

Symptoms learned from observing real illness or injury.

What is the Environment Factors of Conversion Disorder?

Heredity

What is the Biological Factors of Conversion Disorder?

FACTITIOUS DISORDER IMPOSED ON SELF

A. Falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception.

B. Presents himself or herself to others as ill, impaired or injured.

C. Evident even in the absence of obvious external rewards.

D. Not better explained by another mental disorder

FACTITIOUS DISORDER IMPOSED ON ANOTHER

A. Falsification of physical or psychological signs or symptoms, or induction of injury or disease, in another, associated with identified deception.

B. Presents another individual (victim) to others as ill, impaired or injured.

C. Evident even in the absence of obvious external rewards.

D. Not better explained by another mental disorder.

- The first goal of treatment is to change the person's behavior and reduce their misuse of medical resources.

- In the case of factitious disorder imposed on another, the main goal is to ensure the safety and protection of any real or potential victims.

- Once the first goal is met, treatment aims to resolve any underlying psychological issues that may be causing the behavior.

- Treatment likely will focus on changing the thinking and behavior of the individual with the disorder (CBT and/or Family Therapy)

What is the treatment for Factitious Disorder Imposed on Another?

Pseudocyesis

A false belief of being pregnant that is associated with objective signs and reported symptoms of pregnancy.

MAJOR DEPRESSIVE DISORDER

A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

1. Depressed mood most of the day

2. Markedly diminished interest or pleasure in all, or almost all

3. Significant weight loss when not dieting or weight gain

4. Insomnia or hypersomnia nearly every day.

5. Psychomotor agitation or retardation

6. Fatigue or loss of energy nearly every day

7. Feelings of worthlessness or excessive or inappropriate guilt

8. Diminished ability to think or concentrate, or indecisiveness.

9. Recurrent thoughts of death

B. Cause clinically significant distress or impairment.

C. Not attributable to the psychological effects of a substance.

D. Not better explained by another mental disorder.

E. There has never been a manic episode or a hypomanic episode.

PERSISTENT DEPRESSIVE DISORDER

A. Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years.

B. Presence, while depressed, of two (or more) of the following:

1. Poor appetite or overeating

2. Insomnia or hypersomnia

3. Low energy or fatigue

4. Low self-esteem

5. Poor concentration or difficulty making decisions

6. Feelings of hopelessness

C. During the 2-year period (1 year for children or adolescents) of the disturbance, the individual has never been without symptoms in Criteria A and B for more than 2 months at a time.

D. Criteria for a major depressive disorder may be continuously present for 2 years.

E. No history of manic nor hypomanic episodes.

F. Not better explained by another mental disorder.

G. Not attributable to the physiological effects of a substance.

H. Cause clinically significant distress or impairment.

BIPOLAR I

A. Criteria have been met for at least one manic episode (Criteria A-D under "Manic Episode").

B. The occurrence of the manic and major depressive episode(s) is not better explained by another mental disorder.

BIPOLAR II

A. Criteria have been met for at least one hypomanic episode (Criteria A-F under "Hypomanic Episode" above) and at least one major depressive episode (Criteria A-C under "Major Depressive Episode" above).

B. There has never been a manic episode.

C. The occurrence of the hypomanic episode(s) and major depressive episode(s) is not better explained by another mental disorder.

D. Causes clinically significant distress or impairment.

CYCLOTHYMIC DISORDER

A. For at least 2 years, there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode.

B. During the above 2-year period, the hypomanic and depressive periods have been present for at least half the time and the individual has not been without the symptoms for more than 2 months at a time.

C. Criteria for a major depressive, manic or hypomanic episode have never been met.

D. The symptoms in Criterion A are not better explained than another mental disorder.

E. Not attributable to the physiological effects of a substance.

F. Cause clinically significant distress or impairment.

Familial and Genetic Influences

Neurotransmitter Systems

Endocrine System

Sleep Disturbance

What is the the Biological Factors of Mood Disorder?

Personal perception towards negative stressful life events

Striving to achieve stressful goals

Learned helplessness

Negative cognitive styles

What is the the Psychological Factors of Mood Disorder?

Marital relations

Gender bias

Social support

What is the the Social Factors of Mood Disorder?

Monoamine Oxidase Inhibitors

Tricyclic Antidepressants

Selective Serotonin-Reuptake Inhibitors (SSRIs)

What are the 3 Antidepressant Drugs?

Monoamine Oxidase Inhibitors

Antidepressant Drugs

_________ ______ ______

- Iproniazid was the first antidepressant drug in the market.

- It increases the levels of monoamine such as norepinephrine

- These MAO inhibitors have several side effects and the most dangerous is the cheese effect which elevates blood pressure that increases the risk of stroke.

Tricyclic Antidepressants

- It blocks the reuptake of the norepinephrine and serotonin from the synapses, thus increasing their levels in the brain.

- Imipramine was the first tricyclic antidepressant which was initially thought to be an antipsychotic drug.

- They are safer alternatives to MAO inhibitors.

Selective Serotonin-Reuptake Inhibitors (SSRIs)

- It blocks the reuptake of serotonin from synapses.

- Fluoxetine (Prozac) was the first SSRI in the market.

- It was immediately accepted by the psychiatric community because they have fewer effects than tricyclic antidepressant and MAO inhibitors and can also be applied in a wide range of psychological disorders.

Cognitive-Behavioral Therapy

- It involves helping the individual examine things that they think and they do.

- The way we think about the situations can affect the way we behave.

Interpersonal Therapy

- It involves resolving the conflict with other people which serves as the causal factor of the disorder.

Antidepressant Drugs

Cognitive-Behavioral Therapy

Interpersonal Therapy

What are the 3 Treatments of Mood Disorder?

PICA DISORDER

A. Persistent eating of nonnutritive, nonfood substances over a period of at least 1 month.

B. Inappropriate to the developmental level of the individual.

C. The eating behavior is not part of a culturally supported or socially normative practice.

D. If the eating behaviors occur in the context of another mental disorder, they are sufficiently severe to warrant additional clinical attention.

RUMINATION DISORDER

A. Repeated regurgitation of food over a period of at least 1 month. Regurgitated food may be re-chewed, re-swallowed, or spit out.

B. Not attributable to an associated gastrointestinal or other medical condition.

C. Does not occur exclusively during the course of anorexia nervosa, bulimia nervosa, binge-eating disorder, or avoidant/restrictive food intake disorder.

D. If the symptoms occur in the context of another mental disorder, they are sufficiently severe to warrant additional clinical attention.

AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER

A. An eating or feeding disturbance as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:

1. Significant weight loss (or failure to achieve expected weight gain or faltering growth in children).

2. Significant nutritional deficiency.

3. Dependence on enteral feeding or oral nutritional supplements.

4. Marked interference with psychosocial functioning.

B. Not better explained by lack of available food or by an associated culturally sanctioned practice.

C. Does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one's body weight or shape is experienced.

D. Not attributableto concurrent medical conditions or not better explained by another mental disorder.

ANOREXIA NERVOSA

A. Restriction of energy intake relative to requirements, leading to a significantly low body weight that is less than minimally normal or, for children and adolescents, less than that minimally expected.

B. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.

C. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.

BULIMIA NERVOSA

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

1. Eating, in a discrete period of time, in larger amounts than what most individuals would eat in a similar period of time under similar circumstances.

2. A sense of lack of control over eating during the episode.

B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise.

C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months.

D. Self evaluation is unduly influenced by body shape and weight.

E. The disturbance does not occur exclusively during episodes of anorexia nervosa.

BINGE-EATING DISORDER

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

1. Eating, in a discrete period of time, in larger amounts than what most individuals would eat in a similar period of time under similar circumstances.

2. A sense of lack of control over eating during the episode.

B. The binge-eating episodes are associated with three (or more) of the following:

1. Eating much more rapidly than normal.

2. Eating until feeling uncomfortably full.

3. Eating large amounts of food when not feeling physically hungry.

4. Eating alone because of feeling embarrassed by how much one is eating.

5. Feeling disgusted with oneself, depressed, or very guilty afterward.

C. Marked distress regarding binge eating is present.

D. The binge eating occurs, on average, at least once a week for 3 months.

E. The binge eating is not associatedwith the recurrent use of inappropriate compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.

Societal Standards

What is the Social Dimensions of Bulimia Nervosa?

Chemical Imbalances on the brain

Genetic Predispositions

What is the Biological Dimensions of Bulimia Nervosa?

Cognitive Distortions

What is the Psychological Dimensions of Bulimia Nervosa?

Drug Treatment (Anti-Depressants)

Short-term Cognitive-Behavioral Therapy

Family Therapy

Interpersonal Psychotherapy

Hospitalization (Anorexia Nervosa)

Self-help Approaches

What is the Treatment for Bulimia Nervosa