UCSD psyc 100 final practice

Personality psychopathology

involves inflexible, longstanding personality traits that cause impairment or adaptive failure in the person's daily life

Paranoid personality disorder

• Distrust, sus of others, and belief that others intend to harm them 

• Distant from others due to mistrust

• Critical of others

Borderline Personality Disorder DSM-5

Pervasive pattern of instability of interpersonal relationships, self-image, and affect, with notable impulsivity that begins by early adulthood and is present in various contexts, as indicated by 5+ of the following:

• Frantic efforts to avoid real or imagined abandonment

• A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

• Identity disturbance: notably and persistently unstable self-image or sense of self

• Impulsivity in at least two areas that are potentially self-damaging (eg, spending, sex, substance misuse, reckless driving, binge eating)*

•  Recurrent suicidal gestures, or threats or self-mutilating behaviour

•  Affective instability caused by a distinct reactivity of mood (eg, intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

• Chronic feelings of emptiness

• Inappropriate intense anger or difficulty controlling anger (eg, frequent displays of temper, constant anger, recurrent physical fights)

• Transient, stress-related paranoid ideation or severe dissociative symptoms

What are emotions?

• Emotions describe complex pattern of physiological sensations, expressions and actions

• Labels used to describe a pattern of physiological sensations relevant to the current context

Substance use

• Taking moderate amounts of a substance in a way that doesnt interfere with functioning

Substance abuse/dependence

• Use in a way that is dangerous or causes substantial impairment (affecting job or relationships)

• Can be defined by tolerance and withdrawal

• Wide-ranging psychological, physiological and behavioral effects

Tolerance:

• need more of a substance to get the same effect

Withdrawal

• physical reaction when substance is discontinues after regular use

Substance-use disorders in DSM-5

• Pattern of substance use leading to significant impairment and distress 

• Symptoms (need 2+ within a year)

  • Taking more of the substance than intended

  • Desire to cut down use

  • Excessive time spent using/acquiring/recovering

  • Craving for the substance 

  • Role disruption (life)

  • Interpersonal problems

  • Reduction to important activities

  • Use in physically hazardous situations (driving

  • Keep using despite causing physical or psychological problems

  • Tolerance

  • Withdrawal

Depressants

1. Behavioural sedation (alc, sedative, anxiolytic drugs)

2. Psychological and physiological effects

   1. Central nervous system depressant (‘downers’)

   2. Influences several neurotransmitter systems

   3. Specific target is GABA

      1. Inhibitory effects; decreases neural firing

3. clinical/ recreational use

   1. To relax, relieve anxiety, treat insomnia, muscle spasms, manage seizures, anesthesia

   2. Alc, benzodiazepines (xanax), sedative-hypnotics

Stimulants

1. Increase alertness and elevate mood (cocaine, nicotine)

2. Psychological and physiological effects

   1. Central nervous system stimulant (‘uppers’)

   2. Feelings of increased alertness, focus and energy

   3. Influences several neurotransmitters systems

   4. Most widely consumed drug in the US

3. Clinical / recreational 

   1. To stay awake, energized/focuses, treat narcolepsy, ADHD, fatigue obesity etc

   2. Nicotine, caffeine, cocaine, amphetamines (adderall)

Opioids

1. Produce analgesia and euphoria (heroin, morphine, codeine)

2. Psychological and physiological effects

   1. Analgesics that specifically target the opioid receptors

   2. Activate body’s enkephalins and endorphins

   3. Low doses induce euphoria, drowsiness and slowed breathing; high doses can result in death

3. clinical /recreational use

   1. To treat and manage moderate to severe pain, for feeling of euphoria

   2. Morphine, heroin, codeine, oxycodone, hydrocodone and fentanyl

Hallucinogens

1. Alter sensory perception (psychedelics LSD, psilocybin)

2. Psychological and physiological effects

   1. Alters sensation and perception; can change the way the user perceives the world

   2. May produce delusions, paranoia, hallucinations, altered states of consciousness

3. clinical /recreational use

   1. To treat various mental health conditions (depression, anxiety, substance use disorders for typical drug effects and euphoria)

      1. PCP psychedelics like DMT, LSD, and psilocybin

Other drugs

1. Includes inhalants, anabolic steroids and designer drugs (MDMA)

2. Psychological and physiological effects

   1. MDMA’ecstasy’, ketamine ‘special k’, BDMPEA ‘nexus’

   2. Often heightened auditory and visual perception, sense of taste/touch, pain relief, dissociative sensations

   3. Drugs were originally produced by pharmaceutical companies to target diseases

   4. Tolerance and dependence

3. clinical /recreational use

   1. To treat various mental health conditions (ketamine for depression, MDMA for PTSD) for typical drug effect and euphoria

What is a sexual problem?

• Sexual problems and dysfunctions are problems w the sexual response

• Sexual difficulties (problems) are common

• ~40% report problems in sexual functioning

Spectatoring

masters and johnson's term for acting as an observer or judge of one's own sexual performance

Cognitive interference:

• negative thoughts that distract a person from focusing on the erotic experience

DSM-5  Criteria A-D commonalities of Sexual Dysfunctions

• A. name symptoms of disorder

• B. symptoms persist for a minimum duration of approximately 6 months

• C. the symptoms in criterion A cause clinically significant distress in the individual 

• D. the sexual dysfunction is not between by a nonsexual mental disorder or as a consequence of severe relationship distress

• Male hypoactive sexual desire disorder

• Erectile disorder

• Female sexual interest/arousal disorder

• Premature (early) ejaculation)

• Delayed ejaculation

• Female orgasmic disorder

• Genito-pelvic pain penetration disorder

What is gender?

• Behaviors, attitudes, and traits that are associated with roles or characteristics assigns to a certain sex or are considered more typical of one sex over another

• Culture and time specific–women used to not been able to work, that changed ofc

WHAT IS Sex?

• chromosomal/genetic (XX or XY)

  • XX or YY

  • Or XXX or XO or XYY or XXY

  • Secondary sexual characteristics

  • Hair on chest, facial hair, breasts, waist to hip ratio, 

  • Gynecomastia

Gender identity:

individuals sense of self as a given gender

Gender expression:

expression of gender based on ones behavior and attributes

Labels of gender identity:

• man, woman, gender queer, non-binary, gender fluid/neutral, agender, demiman, demiwoman

• Hijra in india

• Fa’afafine in samoa

• Winkte in lakota

gender dysphoria

• occurs when this congruence causes distress or significant impairment

• occurs more frequently in people assigned female at birth or assigned male at birth and who develop secondary sexual characteristics congruent w their assigned sex at birth

• may also occur among intersex people

  • May be due to being assigned male or female at birth or further interventions to induce sexual development consistent w that assigned sex

DSM-5 Criteria for Gender dysphoria

1. Marked congruence between one's experiences/expressed gender and assigned gender, of at least 6 months duration w at least 2 of the following

   1. Primary and/or secondary sex characteristics

   2. Strong desire to be rid of primary or secondary sex bc of incongruence

   3. Strong desire to have characteristics of other gender

   4. A strong desire to be of the other

   5. To be treated as the other gender

   6. A strong conviction that one has typical feelings and reactions of the other gender

2. The condition is associated with clinically significant distress or impairment in social, school, or other important areas of functioning

Gender development

• develops between 18 months and 3 years of age

• Several studies have shown that children who are insistent, persistent and consistent that their gender identity is different than their assigned sex at birth are unlikely to feel differently in adulthood

Why diagnose?

• Diagnosis determines eligibility for treatment

  • Medical and social interventions to reduce dysphoria (gender affirmation process)

  • Psychotherapy (treaties related concerns, not dysphoria itself)

How do mental disorders develop?

• Marked by both abnormality and pathology: not a typical response

  • Distress and impairment

• The DSM-5 criteria 

  • Provides definitions and symptoms presentations

  • Important rule outs

• There is no single ‘cause’ of a mental disorder

  • Interacting variables over time

  • Multifinality and equifinality

  • Contributors not causes