Abnormal Psychology - University of Calgary (Midterm 2)

When did eating disorders begin to be included in the DSM?

DSM-IV

Bulimia Nervousa

Binge eating and then compensating for the binge, one of the most common psychological disorders on university campuses

Purging techniques

Self-induced vomiting, laxatives, fasting, excessive exercise

Medical consequences of purging

Salivary gland enlarged, eroded dental enamel

Anorexia Nervousa

Nervous loss of appetite, proud of their diets and extraordinary control, intense fear of obesity and relentlessly pursue thinness

Medical consequences of Anorexia

Cessation of menstruation, dry skin, brittle hair and nails, intolerance to cold temperatures, cardiovascular problems

Binge-eating disorders (BED)

Individuals who experience marked behaviours from binge-eating but do not engage in extreme compensatory behaviours, greater likelihood to occur in men, often found in weight loss programs

Statistic on Bulimia

Only declared a distinct psychological disorder in the 1970s, 90-95% of individuals are women, age of onset is 16-19, chronic if untreated

Statistics on Anorexia

90-95% of individuals are women, onset can begin as early as 15, chronic, more resistant to treatment than bulimia

Causes of eating disorders- Social dimension

Looking good is more important than being healthy, competitive environments, standards are increasingly difficult, increases in dieting, attitudes

Causes of eating disorders: biological dimensions

Seems to have a genetic component, low serotonin activity, role of exercise

Causes of eating disorders: psychological dimensions

Diminished sense of personal control and confidence in their own abilities, display more perfectionist attitudes (control), difficulty tolerating any negative emotions

Treatment of eating disorders - drug treatment

Generally not as effective in anorexia, drugs used for mood and anxiety disorders are typically also effective in people with Bulimia

Treatment of eating disorders - psychosocial treatment

Developing a better self-identity, family interactions, communication, CBT, CBT-E

behavioural therapy, self-help procedures

The physiology of stress

Activating effect on our sympathetic nervous system, increase in activity, stress hormones, HPA axis

Stress - Sapolsky and Baboons

Subordinate animals, unlike dominant animals, continually secrete cortisol, probably because their lives are so stressful; most important factor in regulating stress seems to be a sense of control

Self efficacy (Bandura)

Sense of control and confidence that we can cope with stress or challenges

The immune system and physical disorders

Stress has a large influence on whether your exposure to colds results in a cold, humans under stress show clearly increased rates of infectious disease

AIDS/HIV & stress- factors that increase the progression of the disease

Depression, high levels of stress, low social support

AIDS/HIV & stress- treatment options

Medication, psychosocial stress-reduction, group therapy

Cancer & stress - treatment options

Mindfulness based stress reduction, problem solving skills, distraction, breathing techniques

Cardiovascular problems and stress

Hypertension (high blood pressure), coronary heart disease

Pain

The subjective experience

Pain behaviours

Overt manifestations of the pain experience

Suffering

Emotional component of pain

Gender differences in pain

Men and women experience different types of pain, endogenous opioid system is more powerful men

Chronic fatigue syndrome

Attributed to extremely stressful environments

Psychosocial treatment for physical disorders

Biofeedback, relaxation and meditation, stress-reduction program, drugs

Poly-substance use

Using multiple substances

Psychoactive substances

Alter mood, behaviour or both

Levels of involvement: use

Ingestion in moderate amounts that do not significantly interfere with functioning

Levels of involvement: Intoxication

Physiological reaction to ingested substances; impaired judgement, mood changes, lowered motor ability

Levels of involvement: disorder

Amount of substance ingested is a problem; dependence, tolerance, withdrawal

6 Categories of substances

Depressants, stimulants, opiates, hallucinogens, other, gambling disorder

Depressants

Behavioural sedation and relaxation, decrease central nervous system activity

Alcohol related disorders

Apparent stimulation is the initial effect, despite being a depressant; inhibitory parts of the brain are slowed; motor coordination is impaired, reaction time is slow, confusion and ability to make judgement is reduced, vision and hearing are affected

Withdrawal delirium

Condition that can produce frightening hallucinations and body tremors

Sedative, hypnotic, anxiolytic related disorders

Sedative (calming), Hypnotic (sleep inducing), Anxiolytic (anxiety reducing)

Stimulants

Elevate mood, make an individual more active and alert; most commonly consumed of all the psychoactive drugs

Amphetamines

Manufactured in labs, designer drug, stimulates the nervous system by enhancing the activity of norepinephrine and dopamine

Cocaine

Effects are short lived, paranoia is common, can be snorted or injected

Tobacco related disorders

No intoxication patterns, high withdrawal symptoms, stimulates the central nervous system

Caffeine-related disorders

Most common of the psychoactive substances, gentle stimulant, in small doses can elevate your mood and decrease fatigue

Opiates

Natural chemicals that come from the opium poppy that has a narcotic effect, reduces pain and euphoria, examples- morphine and oxycodone

Hallucinogens

Alter sensory perception and can produce delusions, paranoia and hallucinations

Cannabis

Heightened sensory experiences, medical uses, mood swings, talk of decriminalization

LSD

Sometimes referred to as acid, produced synthetically in labs

Inhalants

Highest use is in adolescents, these drugs are rapidly absorbed into the bloodstream, example - hairspray, spray paint, gas

Steroids

Derived from testosterone, have legit medical uses, can improve physical abilities

Gambling disorder

Ingestion of given substance and then unable to resist the urge to gamble

Causes of addiction: biological

Genetics, reward centers in the brain, sensitization

Causes of addiction: psychological

Positive and negative reinforcement

Causes of addiction: cognitive

Expectancy effect, cravings, conditioning

Causes of addiction: social

Exposure, parents behaviour and monitoring

Causes of addiction: cultural

Economic conditions, social pressures

Treatment for addiction: motivational enhancement therapy

Used to help individuals with substance use disorders increase their motivation to change and move toward a stage where they are ready to work on modifying their problematic substance use

Treatment for addiction: biological

Agonist substitution, hard reduction, averse treatment, medication

Treatment for addiction: psychosocial

Inpatient facilities, programs like AA, controlled use, component treatment, relapse prevention

Harm reduction

Recognize that the substance use occurs in society and seeks to minimize the harm associated with it, an example of this is safe injection sites

Somatic symptom disorder

Fear of having a serious illness or acquiring a serious illness

Possible causes of somatic symptom disorder

Developing a maladaptive understanding of health threats; triggering events

Treatments for somatic symptom disorder

Drugs (benzodiazepines, SSRIs); Psychotherapy (CBT, therapeutic reassurance)

Conversion Disorder (Functional Neurological Symptom Disorder)

Physical malfunctioning cause by psychological rather than organic causes

Possible causes of conversion disorder

The original threat is over but the paralysis continues, often associated with lower education and SES

Treatment for conversion disorder

Try to identify the source of the trauma or current stressor, use CBT

Dissociative amnesia

Two types: general and localised. Usually occurs in adulthood and continues on to old age

Dissoviatative identity disorder (DID)

Multiple personalities, changes in physiological markers, FMRI differences

Possible causes of dissociative identity disorder

Usually starts with an imaginary friend, strong history of child abuse, could be a sub-type of PTSD

Treatment of dissociative identity disorder

Difficult to treat, recruit help from loved ones, explore stressors, hypnosis

5 factor model of personality

Extraversion, agreeableness, conscientiousness, neuroticism, openness to experience

Personality disorder clusters: Cluster A

Odd or eccentric cluster

Personality disorder clusters: cluster B

Dramatic, emotional, or erratic cluster

Personality disorder clusters: cluster C

Anxious or fearful cluster

Cluster A: Paranoid personality disorder

Excessive mistrust and suspicion of others without any justification

Causes: genes, early mistreatment or traumatic event, maladaptive schemas

Treatment: establishing a meaningful therapeutic alliance, cognitive therapy

Cluster A: schizoid personality disorder

Magnified preference for isolation, pattern of detachment from social relationships, limited range of emotions in interpersonal situations

Causes: genetics, abuse or neglect, overlap with Autism

Treatment: demonstrate value of social relationships, social skills training, role playing

Cluster A: Schizotypal personality disorder

Socially isolated, tend to be suspicious and have odd beliefs, magical thinking

Causes: genes (have similar genes as an individual with schizophrenia but are expressed differently), gene-environment interaction, abnormalities in semantic association abilities

Treatment: Antipsychotic medication, community treatment, social skills treatment, CBT

Cluster B: Antisocial personality disorder

History of failing to comply with social norms, tend to be irresponsible, impulsive and deceitful, called conduct disorder in children (Childhood onset- before 10, adolescents onset- after 10)

Causes: Genes, gene-environment interaction, cognitive deficits, difference in executive functioning , underarousal, fearlessness, cortical immaturity, family influence, role of stress

Treatment: CBT, parent training

Cleckly criteria

Superficial charm and good intelligence, absence of delusions and other signs of irrational thinking, absence of nervousness, unreliable, untruthfulness and insincerity, lack of remorse or shame, inadequately motivated antisocial behaviour, poor judgement and failure to learn by experience, pathological egocentricity and incapacity for love, general poverty in major affective reactions, specific loss of insight, unresponsiveness in general interpersonal relations, fantastic and uninviting behaviour, suicide is rarely carried out, sex life impersonal, trivial and poorly integrated, failure to follow any life plan

Underarousal hypothesis

Suggests that people with this disorder have abnormally low levels of cortical arousal

Fearlessness hypothesis

This is evidenced by lower galvanic skin response to things that evoke fear

Cluster B: borderline personality disorder

Moods and relationships are unstable, low self-image, high suicide risk, one of the most common personality disorders

Causes: genetic, comorbid with mood disorders, thought processes, influence of early trauma

Treatment: medication, DBT

Cluster B: histrionic personality disorder

Overly dramatic, exaggerated emotions, tend to be vain and self-centred, seek reassurance and approval constantly, higher diagnosis among women

Causes: relationship with antisocial personality disorder

Treatment: modify behaviours, therapy focused on interpersonal relationships

Cluster B: Narcissistic personality disorder

People who think highly of themselves and believe they deserve better treatment, exaggerated sense of self-importance and preoccupied with receiving attention

Causes: Socialization, failure of empathetic mirroring by parents, increasing prevalence in Western culture

Treatment: Therapy aimed at their grandiosity, hypersensitivity to evaluation, and lack of empathy, cognitive therapy aimed at replacing attitudes, coping strategies

Cluster C: avoidant personality disorder

Extremely sensitive to the opinions of others, low self-esteem, fear of rejection, limited relationships and very dependent on those they do have relationships with

Causes: predisposed personality characteristics, rejection by parents, childhood experiences, social anxiety, behavioural inhibition

Treatment: behavioural intervention techniques, social skills training, systematic desensitization, behavioural rehearsal

Cluster C: dependent personality disorder

Interpersonal dependent behaviour motivated by anxiety, sometimes agree with others in order to not be rejected even if they have another opinion

Causes: socialization, disruptions in childhood, genetic influences

Treatment: therapy to increase confidence in patients ability to be independent

Cluster C: obsessive-compulsive personality disorder

Fixation on things being done the right way, tend to have poor interpersonal relationships, related to OCD

Causes: Moderate genetic contribution, predisposed to favoring structure in their life

Treatment: Therapy aimed at relaxation, cognitive reappraisal, CBT