psy 4453 unit 2

premenstrual dysphoric

disorder with significant depressive symptoms occurring prior and during periods leading to distress and impairment (must be numerous, persistent, interfering distressing- abnormal)

disruptive mood dysregulation

disorder only in children 6-18 (some criteria must be met before 10 years old) with severe temper outbursts occurring frequently along w angry/irritable mood

(NOT manic/hypomanic episode (used to help stop diagnosing every child w bipolar instead of temperament disorder)

desire

sexual response cycle stage, initial attraction and interest in someone else

arousal

sexual response cycle stage, sexual sensations of pleasure/physiological signs (male gets erection and female becomes lubricated)

performance anxiety

most common cause in male erectile disorder (or distracted)

plateau

sexual response cycle stage, period of sex before orgasm

orgasm

sexual response cycle stage, males ejaculate and females also

resolution

sexual response cycle stage, decrease in arousal after orgasm (necessary for men- break before they can be aroused again)

40 63

___% of men had trouble w erection/ejaculation and ____% of women had trouble w arousal/orgasm

female orgasmic

disorder where females have marked delay, absence, or decreased intensity of orgasm in almost all sexual encounters (1 in 4 women have difficulty achieving orgasm) not due to relationship or significant stress

penetration

disorder in females with difficulty with vaginal penetration during intercourse associated w genito-pelvic pain during intercourse, fear/anxiety about experiencing pain during sex (esp after giving birth) and tensing pelvic muscles in anticipation of penetration (causing the pain)

sensate focus

treatment for sexual dysfunction (usu desire stage), helps reduce performance fears/pressures by starting out touching non sexual areas and then working up to sexual areas (touch hierarchy) goal is to help people appreciate sense of touch and be more comfortable

premature ejaculation, decline

ejaculation occurring within ~1 minute of penetration and before it is desired (most prevalent sexual dysfunction in males - 21% of all males)

most common in younger and inexperienced

problem ___ w age

erectile, increases

disorder w difficulty achieving or maintaining an erection (but desire is still intact), most common problem sought for treatment, problem ____ w age (60% over age)

men

medication for sexual dysfunciton disorders is more effective for ___ (they all increase blood flow to area, effective for 2/3 of people) use in COMBINATION w therapy

squeeze

technique > treatment for sexual dysfunction used to treat premature ejaculation, prior to ejaculation, you apply pressure to thing and it stops u from orgasming

hypoactive sexual

male ___ ____ disorder - little to no interest in any type of sexual activity

masturbation/fantasies, etc are rare (main complaint of sex clinics)

affects 5% of men

paraphilic

disorder where sexual attraction/arousal is misplaced > focused on inappropriate people or objects, usually multiple patterns

high comorbidity with anxiety, mood, and substance use disorders (already have a compounding problem that make you abnormal)

>IS NOT A DIAGNOSIS IF THEY DO NOT ACT ON URGES<

fetishistic 6

disorder w sexual attraction towards nonhuman objects (inanimate or physical)

must have continuous or intense arousal for ___ months and cause distress/impairment

voyeurism

observing an unsuspecting individual engaging in sexual activity (or naked)

risk of being caught "peeping" may intensify arousal

exhibitionism

exposure of genitals to unsuspecting strangers, element of thrill and risk is necessary for sexual arousal (flasher does it even though he'll be arrested)

transvestic

disorder w sexual arousal w act of cross dressing

most men do NOT show masculine compensatory behaviors

known, disorded

w tranvestic disorders, many are married and behavior is ____ to spouse, disorder is only considered ___ if causes distress or impairment

sadism

sexual gratification from inflicting pain or humiliation

masochism

sexual gratification from suffering pain or humiliation

violent nonsexual

some rapists are sadists, but most are NOT - rapists show sexual arousal to _____ sexual or _______ material

relationships, early, high

paraphilic disorders can be caused by difficulty forming normal ______ (deficits in typical sexual experiences, kids are more accepting), _____ experiences (reinforced through masturbation) and ____ sex drive (suppressing fantasies may increase them)

covert sensitization

psychosocial intervention for paraphilic disorder, imagining aversive consequences to form negative associations w deviant (ex pedophilic) behavior

orgasmic reconditioning

psychosocial intervention for paraphilic disorder, masturbation to appropriate (adult) stimuli

family/marital

psychosocial intervention for paraphilic disorder, type of therapy that addresses interpersonal problems

outpatient

____ treatment is more successful w paraphilic disorders (incarcerated = high relapse, rapists/multiple paraphilias have poor outcomes)

acetate

cyproterone ___ > medication for paraphilia, reduces desire and fantasy, but they return after drug removal

gender dysphoria

feeling trapped in the body of the wrong sex, often assume the identity of desired sex (causes unclear but genetic component)

rare males

gender dysphoria is ___ and more common in ____

intersexuality

treatment of __ ( born w both sex features) is surgery at both

integrative

____ theory says that depression is combination of biological vulnerability (overactive response to stress) and psychological vulnerability (optimistic/pessimistic cognition)

NOT PRIMARILY GENETIC

Beck,triad

founder of cognitive therapy- depressed people have a negative cognitive ____ * (self/world/future/etc.)

logical thinking

Beck- depression caused by errors in ___ ____ (overgeneralizing, absolutions) (similar to maladaptive schemas > adapt to these errors)

stressful events

___ ___ often precipitate the onset of depressive/manic episodes

social support

____ ___ is a buffer for recurring manic/depressive episodes (even if something really bad happens if you have this it can help)

symptoms

risk factor for mood disorder heredity - one gene does NOT trigger disorder (multiple) but different genes are involved in different _____ (these genes cause physical symptoms, etc.)

>but DONT discount interaction between genes and environment

women

genetic risk for depression is higher in ____ (40%, 20% in other)

more

for bipolar, genes contribute ___ than environment (80%) (familial aggregation)

many smaller

there are NOT common genes that mark increased risk for mood disorders- more likely ____ genes with ___ effects that increase risk for mood disorders

stages in development stress

(mood disorders) triggers for gene expression are based on _____________ and ______

serotonin

lower levels of ______ may dysregulate norepinephrine and dopamine, triggering depression

>the BALANCE of NT is what causes disorders, not the presence of them

enzymes

biochemical theories of depression focus on dopamine, serotonin, norepinephrine, and neuropeptides which are the ____ that regulate NT (affect how NT function)

sensitivity density

biochemical theory of depression focus on postsynaptic receptor ____ and ____ (some may be more of that in depressed patients)

short

the serotonin transporter gene says that the ____ allele on one region of the 5-HTT gene may make individual vulnerable to depression in PRESENCE OF STRESS (must have stressor present)

hpa

dysfunction in __ plays a role in development of clinical depression (cortisol contributes to anxiety, depression, mania, etc)

cortisol

dexamethasone is a synthetic hormone used to study if depressed patients have suppressed ____ secretion in bloodstream (due to stress)

hormone regulation

problems in ________ may be the trigger by which genetic vulnerability to depression is expressed

(cortisol decides if genes are expressed)

prefrontal cortex

brain imaging shows that depressed patients have decreased activity in some parts (leads to decreased motivation ) and increased activity in other regions causes prolonged negative emotions

learned hopelessness

Abrahmson changed learned helplessness to ________________ - negative expectations about future events based on repeated experience that outcome of events cannot be controlled

anterior cingulate

brain imaging shows that depressed patients have decreased activation in this cortex that may reduce ability to engage in adaptive behaviors that reduce problems (no problem solving skills so just have to suffer)

elevated glucose

depressed/bipolar patients have ____ levels of resting blood flow levels and ____ metabolism in amygdala

higher

_____ metabolism is associated with more severe depression

psychotherapy

______ for depression focuses on targeting the major problem area/source and then alleviating depression by improving interpersonal relationships (relationships w other people and how you play a social role as parent, friend, etc.)

SSRI

type of medicine for depression - celexa, lexapro, prozac, luvox, paxil, zoloft

mixed reuptake inhibitor

type of medicine for depression, bupropion, venlafaxine

immediate

ECT is the most widely used medication/therapy resistant treatment, it has _____ positive effects and will dramatically reduce anxiety (but is $$ and the wait is "maddening")

ECT

this therapy is given to patients over 6-12 sessions by putting them under anesthesis and giving them controlled seizures through electricity in brain, doing both sides is most effective

vagus nerve

___ ___ stimulation is when you implant a generator that stimulates the longest cranial nerve that has widest distribution in body, provides direct projections to brain regions involved in mental disorders (pretty sure least effective)

6 months

symptoms for sex disorders/gender dysphoria (vouyer, pedophilia, etc) must be present at least __________ before can be official diagnoses

compulsion

repetitive behaviors/mental acts that person feels driven to perform according to strict rules that must be followed, goal is to prevent/reduce distress at dreaded event/encounter (non realistic fear)

contamination

a main type of obsession/compulsion- cleaning and washing to get rid of germs

doubting

a main type of obsession/compulsion, making sure you did something multiple times

60

____% of patients of multiple compulsions/obsessions

(symetry and ordering, counting, etc.)

adolescence early males

OCD typically begins in _____ or _____ adulthood (say it began around age 10) age of onset is earlier in ____ (but occurs equally across genders)

time consuming significant

OCD is __________ (engage in more than 1 hour a day) and/or implies _______ distress or impairment (if it is upsetting you enough it doesn't matter how much time you spend on it)

motor

most common OCD- ____ tics (involuntary movement and repetitive & distressing/impairing)

- most evident in kids

control

psychoanalytic theory of OCD says emphasis is on ____ issues, freud attributes to anal stage

daily reassurance

to overcome OCD you need to work on it _____ and the WORST thing you can do is _______ bc it reinforces the behavior

higher

biological theory of OCD says that there is a strong biological component- MZ twins have _____ concordance rate than DZ

>prevalence rates of anxiety disorders are ____ in families of patients w OCD (familial aggregation)

caudate nucleus

for OCD- more activation in ___________ (core of brain) when engaging in obsessions/compulsions (this thing malfunctions and cause of disorder)

stress

_____ makes obsessions WORSE but you MUST have BIOLOGICAL COMPONENT!!!!

exposure response prevention

Edna Foa created ________ (type of CBT) which is more effective in treating OCD than medicine, patients must be motivated to complete this bc it is uncomfortable, must also do trials outside office

intensity

medication lowers ______ of stressors for OCD patients but will not eliminate the cause of the stress

serotonin

antidepressants are used to medicinally treat OCD bc OCD affects _______

checking

BDD can be treated with SSRIs or ERP that aims to reduce _____ and support positive body image

intensifies

for patients w BDD getting plastic surgery _______ their disorder

trichotillomania

the urge to pull out one's own hair from anywhere on the body, leads to noticeable hair loss (usually concurs w OCD) treated with Behavioral Habit Reversal (also by creating alternative competing behavior)

excoriation

repetitive and compulsive picking of the skin leading to tissue damage (face is common target)

> treat with Behavioral Habit Reversal

mania

period of time with elevated mood, can be delusional/hallucinating, high energy, goal directed activity, talkative, racing thoughts, risky/pleasurable behavior, must last at least one week (may use substances to help sleep)

mixed feature

a mood episode with some elements reflecting the opposite valence of mood (depressive episode w manic features) can have depression/mania in the same day in a matter of hours

1

bipolar ___ is most severe - alternating between major depressive and manic episodes

(manic episodes are defining feature)

cyclothymic

___ disorder is alternations between less severe depressive and hypomanic symptoms (don't meet full criteria for bipolar but still have ups and downs)

chronic version of bipolar (2+ years) but more uncommon

rapid cycling

bipolar has all the same specifiers for depressive disorders but ___ ____ is unique- having 4 episodes of manic/depressive in a year, more disruptive in functioning, more severe, occurs in 20-50% of cases

sleep

there is a strong genetic influence in bipolar, but environmental stressors (even positive) can trigger manic/depressive episodes- lacking ____ is a quick way to trigger an episodes

lithium

___ is the "gold standard" for treating bipolar - affects GABA

anticonvulsants

medicine treatment of bipolar includes ______ that increase GABA (the inhibitory NT) or interfere w the enzymes that get rid of gaba

>>most people are on these or antipsychotics

gaba

___ modulates mood/energy stabilizing NT (neurepinephrine, serotonin, dopamine)

dopamine

mood stabilizers that act on ______ are commonly used during manic episodes (usually in combination w lithium )

somatic symptom

disorders w excessive or maladaptive response to physical symptoms or health concerns

>symptoms are present but patient is too preoccupied with those symptoms

must have one or more symptom

unmarried low SES women

somatic symptom disorder is usually rare, begins in adolescence, runs a chronic course, and more likely to affect ____________

illness anxiety

severe anxiety about the possibility of having/acquiring a serious disease (actual symptoms are mild or absent)

medical reassurance does NOT help

(can be care avoidant or seeking)

sensory sensitive genetic learned

somatic symptom disorders can be caused by being _____ ______, ____ component (run in families), and may have ____ from families (through modeling) to focus on physical sensations (learn from grandmother to go to doctor over everything)

antisocial

there is a link between severe somatic symptom disorder and ____ disorder (begin early, chronic, hard to treat, runs in families)

disinhibition

main feature of somatic symptom (and antisocial), impulsively seek sympathy and other benefits of illness (dependence)

conversion

____ disorder (functional neurological symptom) motor or sensory problems that are inconsistent w neural/medical conditions and not explained by other disorder ("hysteria")

triggered by a stressful event and your symptom removes you from that stressor (hysterical blindness so you can't drive)