Psychopathology Exam 3

What are the core factors underlying eating disorders?

Body image disturbance, overestimation of body size, unrealistically low ideal size, social comparison, sensitivity to fullness

What defines binge eating?

Consuming an unusually large amount of food with a sense of loss of control, often alone, at night, after unstructured activity, and during negative mood.

What behaviors count as purging?

Self-induced vomiting, laxatives, diuretics, enemas, excessive exercise, and chewing/spitting out food.

What are the core diagnostic criteria for anorexia nervosa?

Restriction leading to significantly low body weight, intense fear of weight gain, and disturbance in body image or lack of recognition of seriousness.

What DSM-4 criterion for AN was removed and why?

Amenorrhea requirement; removed because not all individuals menstruate and bodies respond differently.

What are the two subtypes of anorexia nervosa?

Restricting type and binge-eating/purging type.

What is the mortality rate associated with anorexia nervosa?

Approximately 5–20%.

List major medical complications of anorexia nervosa.

Bradycardia, arrhythmias, electrolyte imbalance, hypothermia, osteopenia, infertility, delayed gastric emptying, and suicide risk.

What are the diagnostic criteria for bulimia nervosa?

Recurrent binge eating, recurrent compensatory behaviors, occurring at least once per week for 3 months, with undue influence of weight/shape on self-evaluation.

How does body weight typically differ in bulimia vs anorexia?

Individuals with bulimia are usually at typical body weight, unlike anorexia.

What are hallmark physical signs of bulimia nervosa?

Dental erosion, parotid swelling (“chipmunk cheeks”), electrolyte imbalance, esophageal tears, and arrhythmias.

How is binge eating disorder diagnosed?

Binge eating at least once per week for 3 months, significant distress, no compensatory behaviors.

What behavioral features are associated with BED?

Eating rapidly, eating until uncomfortably full, eating when not hungry, eating alone due to embarrassment, and feeling guilt or disgust afterward.

What does “Other Specified Feeding and Eating Disorder” mean?

Clinically significant eating pathology that does not meet full criteria for a specific eating disorder.

Examples of OSFED diagnoses?

Subthreshold AN, BN, BED, purging disorder, night eating syndrome.

What is the gender distribution of eating disorders?

More common in women than men, though men are underdiagnosed.

Why are eating disorders underdiagnosed in men?

Gender-biased diagnostic criteria, stigma, cultural assumptions, and less clinical attention.

What evidence supports the Westernization hypothesis of eating disorders?

Increased eating pathology following exposure to Western media (e.g., Fiji after introduction of TV).

Which groups show higher rates of bingeing/purging?

Gay and bisexual men compared to heterosexual men.

What family factors increase risk for eating disorders?

Maternal body dissatisfaction, parental dietary restraint, parents of higher weight.

What personal risk factors are associated with eating disorders?

Dieting, childhood obesity, body dissatisfaction, low self-esteem, anxiety, depression, OCD.

What personality traits are commonly linked to eating disorders?

Perfectionism, asceticism, control, impulsivity.

What are the main treatment components for eating disorders?

Nutritional support, medication, and psychotherapy.

What therapies are commonly used for eating disorders?

CBT, family systems therapy, interpersonal therapy, psychodynamic therapy.

What makes CBT effective for eating disorders?

Meal planning, psychoeducation, cognitive restructuring, exposure with response prevention, and relapse prevention.

What are the outcomes of CBT for eating disorders?

Significant reduction in purging and bingeing, improved eating regulation, and durable effects up to 6 years later.

What is a personality disorder?

An enduring, pervasive, inflexible pattern of inner experience and behavior that deviates from cultural norms and causes distress or impairment.

When do personality disorders typically begin?

Adolescence or early adulthood, and they are stable over time.

What domains are affected in personality disorders?

Cognition, emotions, interpersonal functioning, and impulse control.

What is inter-rater reliability and why is it problematic in PDs?

Agreement between clinicians; PDs have only moderate reliability, leading to misdiagnosis.

What is test-retest reliability and why is it low for PDs?

Consistency of diagnosis over time; poor due to symptom fluctuation and context.

Why are PDs difficult to diagnose?

High comorbidity, overlap between disorders, heterogeneity, and gender bias.

What is the categorical approach to PDs?

You either have a disorder or you do not.

What is the dimensional approach to PDs?

Personality disorders represent extremes on personality trait dimensions.

Which five traits are emphasized in dimensional models?

Extraversion, agreeableness, conscientiousness, emotional stability, openness.

What defines Cluster A personality disorders?

Odd or eccentric behavior.

What defines Cluster B personality disorders?

Dramatic, emotional, or erratic behavior.

What defines Cluster C personality disorders?

Anxious or fearful behavior.

Key features of Paranoid Personality Disorder?

Pervasive mistrust, suspicion, hostility, jealousy, emotional coldness.

Epidemiology of Paranoid PD?

~1% lifetime prevalence, more common in men.

Core features of Schizoid Personality Disorder?

Detachment from social relationships, preference for solitude, limited affect.

How does Schizotypal PD differ from Schizoid PD?

Schizotypal includes magical thinking, odd beliefs, perceptual distortions.

Which PD is most associated with schizophrenia risk?

Schizotypal Personality Disorder.

Core characteristics of Antisocial Personality Disorder?

Disregard for social norms, violation of others’ rights, deceitfulness, impulsivity, lack of remorse.

How does psychopathy differ from ASPD?

Psychopathy is broader; not all with ASPD are psychopaths and vice versa.

Epidemiology of ASPD?

~3% cis-men, ~1% cis-women; higher in low SES populations.

Major etiological factors in ASPD?

Genetic vulnerability, harsh parenting, neglect, inconsistent discipline, reward-dominant brain systems.

Why is ASPD difficult to treat?

Poor prognosis, lack of treatment-seeking, and limited effectiveness of interventions.

What are the core features of borderline personality disorder?

Unstable moods and relationships, intense fear of abandonment, impulsivity, poor self-image, and recurrent self-harm or suicidal behaviors.

Why is BPD often confused with bipolar disorder?

Both involve mood instability, but BPD mood shifts are rapid and situation-triggered rather than episodic.

What is the suicide risk in BPD?

About 70% attempt suicide; about 10% die by suicide.

What is the prevalence and gender distribution of BPD?

1–2% prevalence; more common in women.

What etiological factors are associated with BPD?

Genetic vulnerability, early trauma or abuse, and invalidating environments.

What is Linehan’s biosocial theory of BPD?

Emotional vulnerability combined with an invalidating environment leads to poor emotion regulation.

What is the best‑supported treatment for BPD?

Dialectical Behavior Therapy (DBT).

What are the goals of DBT therapy?

Emotion regulation, distress tolerance, problem-solving, and reducing self-harm.

What are the defining features of histrionic personality disorder?

Excessive emotionality, attention-seeking, dramatic behavior, shallow emotions, and sexually provocative actions.

Epidemiology of histrionic personality disorder?

Lifetime prevalence of 2–3%, more common in women.

Proposed explanations for HPD?

Psychoanalytic accounts (parental seductiveness) and possible overlap with antisocial traits.

What are treatment challenges for HPD?

Limited outcome studies and difficulty addressing ingrained interpersonal patterns.

What are the two biological pathways involved in fear responses?

Sympathetic nervous system (SNS) and hypothalamic‑pituitary‑adrenal (HPA) axis.

What is the function of the sympathetic nervous system (SNS)?

Mobilizes the body for fight‑or‑flight in threatening situations.

What is the role of the parasympathetic nervous system (PNS)?

Restores the body to a calm state (“rest and digest”).

How does the DSM‑5 define trauma?

Exposure to actual or threatened death, serious injury, or sexual violence through direct experience, witnessing, learning about it, or repeated exposure.

What kind of media exposure does NOT qualify as trauma?

Electronic media exposure unless it is repeated and work-related.

What are the diagnostic symptom clusters for PTSD?

Re-experiencing, avoidance, negative alterations in cognition/mood, and arousal/reactivity.

How long must PTSD symptoms last for diagnosis?

At least one month.

Examples of re‑experiencing symptoms?

Intrusive memories, nightmares, flashbacks, and physiological reactions to reminders.

What are avoidance symptoms in PTSD?

Avoiding trauma-related thoughts, feelings, people, places, or situations.

Examples of negative alterations in cognition and mood?

Memory gaps, negative beliefs, distorted blame, persistent negative emotions, detachment, inability to feel positive emotions.

Examples of arousal and reactivity symptoms?

Hypervigilance, exaggerated startle response, irritability, sleep problems, reckless behavior.

Why can PTSD be mistaken for ADHD?

Overlapping symptoms like concentration problems and hyperarousal.

Biological risk factors for PTSD?

Inherited vulnerability and dysregulated brain stress circuits.

Childhood risk factors for developing PTSD later?

Chronic abuse or neglect, poverty, parental conflict, catastrophe exposure.

How does social support affect PTSD risk?

Weak social and family support increases risk.

Trauma characteristics that increase PTSD risk?

Severe, prolonged, intentional trauma or sexual/physical injury.

Evidence‑based treatments for PTSD?

Antidepressants, CBT, cognitive processing therapy, prolonged exposure, EMDR, mindfulness, group and family therapy.

What are dissociative disorders?

Disorders involving disruptions in memory, identity, or consciousness, usually triggered by trauma.

When is memory change considered dissociative rather than medical?

When there is no clear physical cause.

What defines dissociative amnesia?

Inability to recall important personal information, usually trauma-related, beyond normal forgetting.

What typically triggers dissociative amnesia?

A specific upsetting or traumatic event.

What is localized amnesia?

Loss of memory for events during a specific period (most common).

What is selective amnesia?

Partial memory loss for some events in a period.

What is generalized amnesia?

Loss of memory extending back in time, sometimes including identity.

What is continuous amnesia?

Ongoing inability to form new memories (rare).

What is dissociative fugue?

An extreme form of amnesia involving sudden travel and loss of identity.

Core features of dissociative identity disorder?

Two or more distinct personality states and recurrent memory gaps.

What triggers switching between identities?

Stress.

How do subpersonalities differ?

Each has unique memories, behaviors, emotions, and perspectives.

What are mutually amnesic relationships?

Subpersonalities are unaware of each other.

What are mutually cognizant relationships?

All subpersonalities are aware of one another.

What is the most common relationship pattern in DID?

One‑way amnesic relationships.

Who is more frequently diagnosed with DID?

Women (about 3× more than men).

Typical onset and course of DID?

Childhood onset, chronic course, strong abuse history.

Main treatment goals for DID?

Recover memories, recognize the disorder, and integrate subpersonalities.