PSYCH 2AP3 EXAM FLASHCARDS (40%) - April 15th

Textbook & Lecture content.

The four Ds of psychopathology

Dysfunction, distress, deviance, dangerousness.

Define dysfunction

Interfere with a persons ability to function in daily life.

Define distress

Cause emotional or physical pain.

Define deviance

Outside cultural norms.

Define dangerousness

Can harm or scare self or others.

Ancient theories of psychopathology

Driving away evil spirits - treat via exorcism or trephination, sections of the skull are drilled or cut away to allow evil spirits to go out of the body.

Ancient China; balancing out yin and yang - behavioural dysfunction caused by imbalance of positive (yang) and negative (yin) forces in the body. Emotions controlled by internal organs, evil winds/ghosts bewitching people.

Ancient Egypt, Greece, Rome - biological causes of behavioural dysfunction, rejected supernatural explanations. “wandering uterus” and hysteria.

Medieval views of psychopathology

Caused by severe emotional shock and physical illness or injury. Many who practiced witchcraft may have been mentally ill.

Mental hygiene movement

Proposed more humane treatment of people with mental health problems. People living in asylums, wards, etc.

Interpersonal synchrony

Rhythmic and temporal coordination of actions, emotions, thoughts, and neuro-physiological processes between two or more individuals; clapping as an audience.

Function of synchrony

Suggested as an evolutionary-based mechanism for facilitating social cohesion and bonding. Along with, efficiency, communication, escalation/de-escalation (therapy). Mix of synchrony and no synchrony is good.

Examples of synchrony

Mob behaviour, group conformity, synchrony isn’t always good.

Co-rumination

Anxiety that manifests (synchrony) in more than one person about the same thing.

Diathesis-stress model

When risk factor/vulnerability and trigger/stress come together in same individual, a full-blown disorder emerges. Biological, psychological and sociological stressors.

Forebrain; cerebral cortex

The part of the brain that regulates complex activities such as speech and analytical thinking.

Thalamus

Directs incoming information from sense receptors to cerebrum.

Hypothalamus

Regulates eating, drinking, sexual behaviour, and processes basic emotions.

The limbic system

Set of structures that regulate many instinctive behaviours such as reactions to stressful events and eating.Located around the central core of the brain and closely interconnected with the hypothalamus.

Amygdala

Structure of the limbic system that is critical in emotions such as fear.

Hippocampus

Part of the limbic system that plays a role in memory.

Types of neurotransmitters

Serotonin (5HT), dopamine, norepinephrine (noradrenaline), Glutamate and GABA.

Serotonin (5HT)

Regulate mood, may be involved in depression, anxiety, aggression.

Dopamine

Pleasure & reward activity, affected by substances; may be involved in schizophrenia.

Norepinephrine (noradrenaline)

Bodily functions, alarm responses.

Glutamate and GABA

Inhibits some nerve impulses, implicated in anxiety disorders.

The endocrine system

System of glands that produces chemicals called hormones released directly into the blood → too much cortisol, Hormone: carries messages throughout the body and affects: mood, energy, reactions to stress.

Biological therapies

Electroconvulsive therapy (ECT), typically last resort for MDD. Repetitive transcranial magnetic stimulation (rTMS), shooting targeted pulses at different areas of the brain, shooting pulses at amygdala's that are over-active in people with anxiety. Deep brain stimulation, “Pacemaker for your brain” - shoots intervals of pulses into areas of the brain for symptom relief, mainly for MDD. Vagus nerve stimulation, Same as deep brain stimulation.

Aversion therapy

Ex; introducing a punishment for people that have the sexual disorder of experiencing pleasure when flashing their genitalia un-consensually.

Systemic desensitization

Principles of CC to unlearn habits of extreme fear and anxiety in situations.

Cognitive approaches are successful with disorders like;

Sexual disorders, depressive disorders, substance use disorders.

Humanistic therapy

• Goal - help clients discover their potential through self-exploration.

• Client-centered therapy: therapists communicates a genuineness in his or her role as helper.

  • Acting as an authentic person not an authority figure.

  • Showing unconditional positive regard for the client.

  • Communicating with empathetic understanding.

Reflection: a method of response in which therapist expresses an attempt to understand what client is experiencing and trying to communicate.

Validity

Accuracy of a test/method in assessing what it is supposed to measure.

Reliability

Consistency of a test/method in assessing what it is supposed to measure.

Standardization

Strict guidelines regarding the method of administration (SAT, GRE).

Neuropsychological testing; type I and type II

Type I: false positive, Type II: false negative.

Images of brain structure

CAT scan, MRI.

Images of brain functioning

PET scan, SPECT, fMRI.

Electroencephalogram (EEG)

• Event-related potential (ERP).

• Evoked potential. Same as ERP

• Measuring electrical impulses within the brain, detects issue but not specifically where.

  • Ex; one hemisphere of the brain isn’t functioning right.

Electrodermal response (skin conductance)

• How sweaty your palms get, stress responses.

• Not a perfect indicator, but pretty good.

Classical categorical approach

Yes/no responses.

Dimensional approach

Scale of 1-10.

Prototypical approach

Identify essential characteristics of a disorder, building a prototype around the symptoms and create a checklist.

HPA axis

Hypothalamus → Pituitary gland → adrenal glands

What is the hypothalamus responsible for in the HPA axis

Control centre, detects threat, sends alarm signal.

What is the pituitary gland responsible for in the HPA axis

Messenger, releases ACTH, carries message to adrenal glands.

What is the adrenal glands responsible for in the HPA axis

Responders, release cortisol and adrenaline, fuels the “fight-or-flight” response.

How is the nervous system involved in anxiety

Somatic nervous system and parasympathetic nervous system involved, SNS goes into overdrive when fearful, PNS returns body it normal resting state.

Physical components of anxiety

Heightened level of arousal and physiological activation, higher heart rate, shortness of breath, dry mouth.

Cognitive components of anxiety

Subjective perception of the arousal, worry, rumination, future-focus.

Behavioural components of anxiety

Avoidance, safety behaviours.

Anxiety disorders (4)

Specific phobia, panic disorder and agoraphobia, generalized anxiety disorder (GAD), social anxiety disorder.

Common phobias

Illness/injury, storms, animals, agoraphobia, death, crowds, heights.

Specific phobia

Irrational fear of an object or situation that markedly interferes with an individuals ability to function. 12.5% of adults.

Blood-injury-injection phobia

Vasovagal syncope, parasympathetic nervous system activation (fainting).

Brief criteria of Specific Phobia

Marked and out of proportion fear, immediate anxiety response, phobic situation avoided, person knows its out of proportion, fear lasts 6 months or more, interferes significantly with routine, distress.

Panic attacks

Abrupt experience of intense fear accompanied by physical symptoms. Somatic symptoms, cognitive symptoms.

Brief criteria of Panic Attacks

Abrupt surge of fear that reaches peak within minutes, 4 or more of these symptom; palpitations/pounding heart, sweating, trembling or shaking, sensations of shortness of breath, feelings of choking, nausea, feeling dizzy, fear of losing control, etc.

Panic disorder

Panic disorder, someone who has had at least one panic attack and worries about having more panic attacks. May worry about what panic attacks mean, may avoid behaviour or situations because they are afraid a panic attack may occur.

Brief criteria of Panic disorder

Recurrent unexpected panic attacks, persistent concern or worry about additional panic attacks, significant maladaptive change in behaviour due to attacks, disturbance is not attributive to substance abuse/medical condition, not better explained by a mental disorder.

Agoraphobia

Fear of marketplace, they fear these situations that they will experience incapacitating/embarrassing symptoms and won’t be able to get help. Intense fear when exposed. 3.7% of adults have panic disorder and no agoraphobia, 1.4% has panic disorder and agoraphobia.

Brief criteria of Agoraphobia

Public transportation, being in open spaces, being in enclosed spaces, standing in line or crowds, being outside of the home alone, individual fears or avoids situations, developing panic-like symptoms, situations actively avoided, out of proportion, significant distress or impairment.

Generalized Anxiety Disorder (GAD)

Excessive anxiety and worry most days for at least 6 months, muscle tension, mental agitation, irritability, difficulty sleeping, “always find something to worry about”. More common in females and children.

Brief criteria of GAD

Worry or anxiety for at least 6 months, individuals find it hard to control worry, restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance, not better explained by medical disorder, mental disorder or substance abuse.

Social Anxiety disorder

Fear of social situations, Can be detected as young as 8 years old, social situations cause distress (speaking, eating, drinking, writing), average episode is 18 years, fear others will detect anxiety, can impair education, career, social functioning, these people often use alcohol in social situations.

Brief criteria of Social Anxiety

Marked fear or anxiety, fear of being negatively evaluated, social situations almost always provoke fear or anxiety, out of proportion, lasts 6 months or more, not better explained by mental disorder/medical disorder/substance abuse.

Social Anxiety disorder

Chronic, pervasive, dysfunction, avoidance prevents appropriate social behaviours.

Anxiety disorder heritability

Heritable, 34% in monozygotic, 17% in dizygotic.

Brain areas implicated in social anxiety disorder

Amygdala, insula.

Brain areas in OCD

Orbital prefrontal cortex, caudate nucleus.

Disorder: Fear of unwanted and intrusive thoughts/obsessions, repeated ritualistic actions or thoughts designed to neutralize unwanted thoughts, 1.6-2.3% of Canadians.

Obsessive-Compulsive Disorder (OCD)

Brief criteria of OCD

Presence of obsessions, compulsions or both, recurrent and persistent thoughts, marked anxiety or distress, individual attempts to ignore or suppress other action, repetitive behaviours, preventing or reducing distress with behaviours, time-consuming obsessions or compulsions. Not better explained by a mental disorder.

Comorbidity in OCD

GAD, panic attacks, debilitating avoidance, depression.

Symptom subtypes of OCD

Symmetry, forbidden thoughts or actions, cleaning/contamination, hoarding.

OCD stats

1:1 female to male ratio, chronic when develops.

Cingulotomy

For OCD - insert thin probes to selectively burn tissue.

Capsulotomy

For OCD - a form of radiation treatment makes precise lesions.

Body Dysmorphic Disorder

Preoccupation with imagined defect in appearance, although looks reasonably normal, repetitive behaviours (looking in mirrors), co-occurs with OCD, prevalence is 2.2%, onset in early adolescence. Excessive grooming, skin-picking, mirror checking, suicidal, compensating rituals.

Top 3 areas of concern for individuals with BDD

Skin (80%), hair (58%), nose (39%).

Treatment for BDD

SSRI’s, CBT - exposure and ritual prevention.

Hoarding Disorder

Excessive acquisition, difficulty discarding, living with excessive clutter, appears separate in DSM 5, hording starts early in life, can be hazardous, patients come for treatment after age 50, CBT given.

Post-Traumatic Stress Disorder (PTSD)

Intense psychological and physiological reactions to events or situations that symbolize or resemble an experienced trauma, fear or re-experiencing event, nightmares/flashbacks, intrusive thoughts, avoidance of intense feelings.

Brief criteria of PTSD

Exposure to actual or threatened death, injury, sexual violence, directly experiencing events, witnessing, learning of events, repeated or extreme exposure, intrusion symptoms, distressing dreams, dissociative reactions, exposure to internal or external cues, physiological reactions, persistent avoidance of events, negative alterations on cognitions and mood associated with event. Irritable behaviour/outbursts, reckless behaviour, hypervigilance, exaggerated startle response, problems with concentration, sleep disturbance.

PTSD in first responders

Increase in prevalence, suicide rates high, bill supporting treatment and resources for the condition, first responders consistent of’ firefighters, paramedics, police officers, etc.

Acute Stress Disorder

Severe early reactions to trauma, but couldn’t be diagnosed with PTSD (one month). PTSD that occurs in the first month. Approx. 50% of individuals with acute stress disorder develop PTSD.

Adjustment Disorders

Anxious or depressive reactions to life stress. Milder than acute stress disorder or PTSD. Impair life in domains such as work, school, relationships, etc. Stressful events not considered traumatic, but the individual is unable to cope with the demands of the situation. If symptoms persist for more than six months after the removal of the stressful situation, disorder is considered chronic.

Brain implication in PTSD

Brain stem and up is limbic system → constant feelings of danger/distress, reduced activation in brain regions involved in arousal modulation and emotion regulation, increased activations of regions involving fear conditioning.

Dissociative subtype of PTSD

Between 14-30% of individuals with PTSD have this subtype (PTSD-DS), comes with depersonalization and derealization, brain and body connection.

Why do some people develop PTSD-DS

Coping strategy, predisposition, personality traits, severe traumatic events, childhood trauma, low social support.

Minority Stress Model

Minority stress model - posits that sexual minorities experiences distinct, uncontrollable, and chronic stressors, related to their stigmatized identities.

Distal stressors - discrimination, violence, hate crime.

Proximal stressors - internalized homo-negativity.

Adaptive behaviour

Behaviours, thoughts, feelings are following: typical for the social context, not distressing to the individual, not interfering with social life or work/school, not dangerous.

Maladaptive behaviour

Behaviours, thoughts, and feelings are one or more of the following: highly unusual for the social context, the source of significant individual distress, significantly interfering with social or occupational functioning, highly dangerous to the individual or others.

The 4 Ds of psychopathology

Dysfunction, distress, deviance, dangerousness.

Trephination

Procedure in which holes were drilled in the skulls of people displaying maladaptive behaviour, presumably to allow evil spirits to depart their bodies; performed in the Stone Age.

Mental hygiene movement

Movement to treat patients with mental illness more humanely and to view mental disorders as medical diseases.

General paresis

Disease that leads to paralysis, mental deterioration, and eventually death; discovery of this disease helped establish a connection between biological diseases and mental disorders.

Mesmerism

Treatment for patients with hysterical disorders based on the idea that magnetic fluids in the patients’ bodies are affected by the magnetic forces of other people and objects; the patients’ magnetic forces are thought to be realigned by the practitioner through their own magnetic force.

Biopsychosocial approach

Approach to psychopathology that seeks to integrate biological, psychological, and social factors in understanding and treating psychopathology

Diathesis-stress model

A diathesis (biological factor, social factor, or psychological factor) + a stress (biological stress, social stress, psychological stress) = disorder.

Behavioural genetics

Study of the processes by which genes affect behaviour and the extent to which personality and abnormality are genetically inherited.

4 types of drug therapies for psychological disorders

Antipsychotic drugs, antidepressant drugs, lithium, antianxiety drugs.

What does an antipsychotic do?

Reduce symptoms of psychosis (loss of reality testing, hallucinations, delusions).