Abnormal Psychology: Stress, Mood, Somatoform, and Eating Disorders

Vocabulary practice flashcards covering diagnostic criteria, clinical presentations, etiologies, and treatments across trauma, mood, suicide, somatoform, dissociative, and eating disorders.

Stressor

An event or environmental demand that creates physical or psychological strain on an individual.

Stress Response

A person's physiological, cognitive, and behavioral reactions to environmental demands, heavily determined by their appraisal of the event and their perceived coping resources.

Acute Stress Disorder

A trauma- and stressor-related condition where fear, arousal, and dissociative symptoms begin within $4\text{ weeks}$ of a traumatic event and resolve in less than $1\text{ month}$, with up to $80\%$ of cases progressing to PTSD.

Posttraumatic Stress Disorder (PTSD)

A trauma-related disorder triggered by exposure to actual or threatened death, serious injury, or violation, where debilitating symptoms emerge either immediately or years later and persist for longer than $1\text{ month}$.

Resiliency (Hardiness)

A constellation of personality traits, positive attitudes, and adaptive coping mechanisms that buffer an individual against developing psychological stress disorders following extreme trauma.

HPA axis

The endocrine stress system in which the hypothalamus signals the pituitary gland to secrete adrenocorticotropic hormone ($\text{ACTH}$), prompting the adrenal cortex to release stress-regulating corticosteroids into circulation.

Psychophysiological Disorders

Genuine physical illnesses (formerly labeled psychosomatic disorders and currently termed psychological factors affecting medical condition) resulting from an interaction of biological, psychological, and environmental factors that produce verifiable organic tissue damage.

Psychoneuroimmunology

The interdisciplinary field examining the connections between psychosocial stress, central nervous system activity, and immune suppression, specifically through the deceleration of lymphocyte function.

Behavioral Medicine

An applied treatment field integrating psychological modalities (such as biofeedback, progressive relaxation, meditation, and cognitive restructuring) with conventional medical treatments to prevent and manage physical conditions.

Unipolar Depression

A mood disorder characterized solely by recurrent or persistent episodes of clinical depression without any historical incidence of mania or hypomania.

Major Depressive Episode

A distinct clinical state defined by $5$ or more depressive symptoms (must include depressed mood or loss of interest/pleasure) present during the same $2\text{-week}$ period, occasionally accompanied by psychotic hallucinations or delusions.

Dysthymic Disorder

A chronic form of unipolar depression characterized by less severe, milder depressive symptoms that persist continuously for at least $2\text{ years}$ without long-term symptom-free intervals.

Double Depression

A clinical progression wherein a chronic baseline dysthymic disorder is compounded by the emergence of an acute major depressive episode.

Cognitive Triad

Aaron Beck's cognitive framework positing that depressed individuals hold automatic, deeply ingrained negative evaluations regarding the self, current experiences, and the future.

Bipolar I Disorder

A severe mood disorder characterized by the occurrence of at least $1$ full manic episode, typically alternating with major depressive episodes or manifesting as mixed episodes.

Bipolar II Disorder

A mood disorder defined by alternating patterns of hypomanic episodes and major depressive episodes, in the complete absence of any full-blown manic episodes.

Bipolar Disorder: Rapid Cycling

A formal course specifier applied when an individual experiences $4\text{ or more}$ mood episodes (depressive, manic, or hypomanic) within a single $1\text{-year}$ timeframe.

Cyclothymic Disorder

A chronic mood disorder marked by fluctuating periods of hypomanic symptoms and mild depressive symptoms lasting for at least $2\text{ years}$, punctuated by brief periods of euthymia.

Permissive Theory of Mood Disorders

The biochemical proposition stating that low serotonin ($5\text{-HT}$) acts as an open gate: low serotonin combined with low norepinephrine produces depression, whereas low serotonin combined with elevated norepinephrine produces mania.

Monoamine Oxidase (MAO) Inhibitors

A class of antidepressant medications that inhibit the degradation of norepinephrine; requires strict dietary elimination of tyramine to avoid hypertensive crises.

Tricyclics

A family of antidepressant drugs characterized by a three-ring chemical structure that work therapeutically by inhibiting the neuronal reuptake of serotonin and norepinephrine.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Second-generation antidepressants that selectively block serotonin reuptake without targeting other monoamines, presenting fewer side effects and lower lethality in overdose relative to older agents.

Electroconvulsive Therapy (ECT)

A somatic biological therapy for severe unipolar depression wherein targeted electrical stimulation induces a controlled brain seizure, usually delivered across $6$ to $12\text{ sessions}$ over $2$ to $4\text{ weeks}$.

Lithium

A naturally occurring mineral salt that acts as an exceptionally effective mood-stabilizing agent for controlling acute manic episodes and preventing bipolar recurrences.

Suicide

A self-inflicted, conscious, and intentional act directed explicitly toward terminating one's own life.

Parasuicide

A non-fatal suicide attempt or deliberate act of self-harm that does not result in death.

Retrospective Analysis

A psychological autopsy method where researchers reconstruct a deceased person's mental state and motives using medical records, suicide notes, and interviews with surviving contacts.

Suicide Contagion (Modeling)

The phenomenon whereby an individual attempts or completes suicide following direct or media-driven exposure to the suicidal act of a peer, family member, or celebrity.

Somatoform Disorders

A diagnostic category characterized by physical complaints or bodily concerns that lack an identifiable medical etiology and are driven by psychosocial processes.

Conversion Disorder

A condition in which psychological conflicts are expressed as actual physical deficits affecting voluntary motor or sensory functions (such as blindness or paralysis) without medical explanation.

Somatization Disorder

A chronic pattern of recurrent, medically unexplained physical ailments across multiple physiological systems, including pain, digestive, sexual/reproductive, and neurological domains.

Malingering

The deliberate, voluntary manufacturing or exaggerating of physical or mental illness explicitly for secondary gain, such as monetary compensation or military deferral.

Factitious Disorder

The intentional feigning or self-induction of medical symptoms solely to assume the sick role and receive clinical care, without external material incentives.

Munchausen Syndrome by Proxy

A dangerous variant of factitious disorder where a caregiver deliberately induces or fabricates physical symptoms in a dependent to elicit medical attention and praise.

Hypochondriasis

A preoccupation disorder marked by persistent, unrealistic anxiety that minor or normal bodily sensations indicate a severe, undiagnosed medical illness.

Body Dysmorphic Disorder (BDD)

A severe preoccupation with an imagined or exaggerated flaw in physical appearance, commonly involving the face, hair, or skin, causing profound functional impairment.

Dissociative Amnesia

A dissociative condition characterized by an inability to recall important personal autobiographical information following a stressful or traumatic event, while generalized knowledge remains intact.

Dissociative Fugue

An extreme dissociative state involving sudden travel away from home, loss of personal memory, and occasional adoption of a completely new identity.

Dissociative Identity Disorder (DID)

A complex dissociative condition in which a person manifests $2\text{ or more}$ distinct personality states (subpersonalities), each possessing unique memories, behaviors, and physiological profiles.

One-Way Amnesic Relationship

The most prevalent personality interaction in DID, where certain subpersonalities remain aware of others as quiet observers (co-conscious), while this knowledge is unreciprocated.

Fusion in DID Therapy

The final stage and clinical objective of treatment for dissociative identity disorder, defined as the permanent integration and merging of all discrete subpersonalities into a single identity.

Anorexia Nervosa

An eating disorder marked by the relentless pursuit of thinness, refusal to maintain body weight above $85\%$ of expected norms, distorted body image, and intense terror of gaining weight.

Restricting-Type Anorexia Nervosa

A subtype of anorexia nervosa where weight loss is achieved purely by cutting out sweets and snacks, severely restricting overall food consumption, and showing minimal dietary variability.

Binge-Eating/Purging-Type Anorexia Nervosa

A subtype of anorexia nervosa in which an individual maintains a significantly low weight while engaging regularly in cycles of bingeing followed by purging or laxative misuse.

Bulimia Nervosa

An eating disorder defined by recurrent episodes of out-of-control binge eating followed by compensatory behaviors, typically occurring in individuals within a normal weight range.

Compensatory Behaviors

Actions utilized by individuals with bulimia nervosa to counteract the caloric intake of a binge, classified into purging mechanisms (vomiting, laxatives) and nonpurging mechanisms (fasting, excessive exercise).

Lanugo

Fine, unpigmented downy hair that develops over the trunk, face, and extremities as a thermoregulatory adaptation to extreme starvation in anorexia nervosa.

Binge-Eating Disorder (BED)

An eating disorder characterized by recurrent episodes of rapid, uncontrollable eating accompanied by marked emotional distress, occurring without compensatory purging behaviors.

Multidimensional Risk Perspective

The biopsychosocial model asserting that eating disorders develop from an accumulation of psychological vulnerabilities, biological factors, and sociocultural pressures.

Muscle Dysmorphia (Reverse Anorexia)

A body-image disturbance observed predominantly in males who perceive their bodies as small and underdeveloped despite having substantial muscular hypertrophy.

Nutritional Rehabilitation

The initial medical stabilization phase for anorexia nervosa involving structured refeeding, caloric supplementation, and supportive nursing care to reverse starvation safely.

Diagnostic Criteria: Acute Stress Disorder

Exposure to actual or threatened trauma followed by at least $9$ symptoms across intrusion, negative mood, dissociation, avoidance, and arousal, emerging within $4\text{ weeks}$ of the event and lasting between $3\text{ days}$ and $1\text{ month}$. Example: A robbery victim suffers intrusive nightmares and hyperarousal that begin $2\text{ days}$ post-trauma and subside within $3\text{ weeks}$.

Diagnostic Criteria: Posttraumatic Stress Disorder (PTSD)

Exposure to trauma resulting in persistent intrusion, active avoidance of reminders, negative alterations in cognitions and mood, and hyperarousal lasting for more than $1\text{ month}$. Example: A combat veteran experiences flashbacks, severe emotional numbing, and panic responses to loud noises that begin $6\text{ months}$ after military discharge and persist indefinitely.

Diagnostic Criteria: Major Depressive Disorder (MDD)

A clinical presentation requiring at least $5$ depressive symptoms (at least one being depressed mood or anhedonia) present during the same $2\text{-week}$ window, causing severe functional disruption, in the lifelong absence of manic or hypomanic episodes.

Diagnostic Criteria: Dysthymic Disorder

Depressed mood for most of the day, for more days than not, lasting for at least $2\text{ years}$ ($1\text{ year}$ for children/adolescents), accompanied by at least $2$ supplementary depressive symptoms, without remissions lasting longer than $2\text{ months}$.

Diagnostic Criteria: Bipolar I Disorder

Requirement of at least $1$ lifetime manic episode featuring abnormally elevated or irritable mood and heightened energy lasting at least $1\text{ week}$ (or any duration if hospitalization occurs), causing marked impairment.

Diagnostic Criteria: Bipolar II Disorder

Presence of at least $1$ hypomanic episode lasting at least $4\text{ consecutive days}$ along with at least $1$ major depressive episode lasting at least $2\text{ weeks}$, with no historical manic episodes.

Diagnostic Criteria: Cyclothymic Disorder

Numerous periods of hypomanic symptoms and depressive symptoms that do not meet full episode criteria, recurring consistently over a span of at least $2\text{ years}$ without being symptom-free for more than $2\text{ months}$.

Diagnostic Criteria: Conversion Disorder

One or more symptoms of altered voluntary motor or sensory function that show clinical incompatibility with recognized neurobiological disease. Example: An individual experiences sudden functional bilateral lower extremity paralysis immediately after witnessing a violent altercation, despite completely normal electromyography and neurological reflexes.

Diagnostic Criteria: Somatization Disorder

A pattern of numerous recurrent physical complaints starting prior to age $30$ that occur across several years, historically requiring a minimum of $4$ pain symptoms, $2$ gastrointestinal symptoms, $1$ sexual/reproductive symptom, and $1$ pseudoneurological deficit.

Diagnostic Criteria: Hypochondriasis

Preoccupation with fears of having a serious, progressive disease based on misinterpretation of bodily sensations, persisting for at least $6\text{ months}$ despite thorough medical reassurance. Example: A person interprets transient abdominal cramps as advanced colon cancer and seeks continuous medical scans.

Diagnostic Criteria: Body Dysmorphic Disorder (BDD)

Excessive preoccupation with an imagined or slight flaw in physical appearance, leading to repetitive compulsive actions (such as mirror checking or reassurance seeking) and marked occupational or social distress.

Diagnostic Criteria: Dissociative Amnesia

An inability to recall important, usually traumatic or stressful autobiographical information that is too extensive to be explained by ordinary forgetfulness, in the absence of organic brain trauma or substance intoxication.

Diagnostic Criteria: Dissociative Fugue

Sudden, purposeful travel away from home or customary surroundings accompanied by an inability to recall one's personal history, resulting in identity confusion or the assumption of an entirely new persona. Example: An individual survives a catastrophic explosion, disappears, travels $300\text{ miles}$, and establishes a new life under a different name with no recollection of their prior family.

Diagnostic Criteria: Dissociative Identity Disorder (DID)

The existence of $2\text{ or more}$ distinct personality identities or states that recurrently take control of behavior, accompanied by extensive gaps in recall of everyday events or trauma.

Diagnostic Criteria: Anorexia Nervosa

Restriction of energy intake relative to requirements leading to significantly low body weight (typically under $85\%$ of expected body mass), intense fear of gaining weight, and severe perceptual disturbance regarding body weight or shape.

Diagnostic Criteria: Bulimia Nervosa

Recurrent episodes of objective binge eating accompanied by a sense of loss of control, paired with recurring compensatory methods (such as self-induced vomiting or excessive exercise) occurring at least once weekly for $3\text{ months}$, while maintaining normal body weight.

Diagnostic Criteria: Binge-Eating Disorder (BED)

Episodes of uncontrollable overeating associated with eating rapidly, eating until uncomfortably full, and experiencing profound post-binge guilt, occurring at least once weekly for $3\text{ months}$ with an absolute absence of regular compensatory purging.

Treatment Options: Trauma- and Stressor-Related Disorders

Multimodal care including behavioral exposure (flooding, systematic desensitization), Eye Movement Desensitization and Reprocessing (EMDR), trauma-focused cognitive therapy, group/family support, and pharmacotherapy with SSRIs or antianxiety agents.

Treatment Options: Psychophysiological Disorders

Behavioral medicine techniques combining standard physical medical management with relaxation training, biofeedback, cognitive stress management, meditation, and support groups to attenuate autonomic nervous system reactivity.

Treatment Options: Unipolar Depression

Psychological therapies including Beck's cognitive therapy ($4\text{ phases}$, under $20\text{ sessions}$), behavioral activation, and Interpersonal Psychotherapy (IPT); biological approaches include SSRIs, tricyclics, MAOIs, Electroconvulsive Therapy (ECT, $6$ to $12\text{ sessions}$), and neurostimulation (VNS, TMS, DBS).

Treatment Options: Bipolar Disorders

Primary biological management utilizing mood stabilizers (specifically lithium or anticonvulsants); psychotherapy is applied strictly as an adjunct to improve medication compliance, manage family distress, and enhance social functioning.

Treatment Options: Somatoform Disorders

Preoccupation disorders (hypochondriasis, BDD) are managed with SSRIs and Exposure and Response Prevention (ERP); hysterical disorders (conversion, somatization) utilize psychodynamic insight therapy, trauma exposure, suggestion, and reinforcement modification.

Treatment Options: Dissociative Disorders

Dissociative amnesia and fugue frequently remit spontaneously or respond to psychodynamic hypnotherapy; DID requires long-term psychotherapy focused on establishing alliances with all subpersonalities, processing dissociated trauma, and achieving fusion.

Treatment Options: Anorexia Nervosa

Initial nutritional rehabilitation (high-calorie meal plans, supportive nursing care, or tube feeding) to achieve weight restoration; followed by cognitive-behavioral therapy, family-based therapy, and motivational interviewing.

Treatment Options: Bulimia Nervosa and Binge-Eating Disorder

Specialized clinic programs using cognitive-behavioral therapy (CBT), exposure and response prevention (ERP to break binge-purge cycles), interpersonal psychotherapy, and antidepressant medications (which reduce binges by $67\%$ and vomiting by $56\%$).

Clinical Intervention and Prevention Strategies for Suicide

Immediate post-attempt medical and cognitive-behavioral stabilization; preventive measures include 24-hour crisis lines, lethality assessments, mobilizing social support networks, public education, and restriction of lethal means (such as firearm controls and vehicle emission standards).

Methodological Challenges and Underreporting in Suicide Data

Suicide statistics are systematically underestimated due to intentional deaths being misclassified as accidents (e.g., vehicular crashes, overdoses), social stigma causing families to obscure the cause of death, and suicide not being classified as a formal DSM mental disorder.

Research Methodologies for Studying Suicide

Investigators rely on two primary approaches: (1) Retrospective analysis (the psychological autopsy), piecing together notes, clinical charts, and informant interviews; and (2) Clinical research conducted directly with individuals who survived serious suicide attempts.

High-Risk Populations and Demographics for Suicidality

The elderly have the highest completion rates; adolescents have an exceptionally high attempt-to-completion ratio (up to $200:1$); women attempt suicide more frequently, while men complete suicide at higher rates due to lethal means; Native Americans exceed national averages by $1.5\text{ times}$; high-stress professions include healthcare providers, psychologists, dentists, lawyers, and police officers.

Differential Diagnosis: Eating Disorders

Anorexia nervosa is differentiated by an abnormally low body weight (under $85\%$ of expected); Bulimia nervosa is differentiated by recurrent binges paired with compensatory behaviors at normal weight; Binge-Eating Disorder is distinguished by recurrent binges without compensatory purging, often leading to obesity.

Differential Diagnosis: Mood Disorders

Unipolar depression involves depressive episodes without mania; Bipolar I requires at least $1$ full manic episode; Bipolar II requires hypomania plus a major depressive episode (no full mania); Cyclothymia features chronic, mild hypomanic and depressive fluctuations for at least $2\text{ years}$ without full-blown episodes.

Differential Diagnosis: Trauma- and Stressor-Related Disorders

Acute Stress Disorder presents within $4\text{ weeks}$ of trauma and resolves in less than $1\text{ month}$; PTSD lasts beyond $1\text{ month}$ and may feature delayed onset; Psychophysiological disorders present with verified organic physical tissue pathology rather than psychological intrusion or avoidance clusters.

Differential Diagnosis: Somatoform vs. Factitious Disorder vs. Malingering

Somatoform disorders involve genuine belief in physical illness without conscious deception; Factitious disorder involves conscious, deliberate symptom fabrication driven by an internal need to assume the sick role; Malingering involves conscious faking for external material incentives.