Abnormal Psychology: Mood Disorders, Schizophrenia, Substance-Related Disorders, and Eating Disorders

Comprehensive practice flashcards covering DSM-5 diagnostics, etiology, neurobiology, and psychological therapies for mood disorders, suicide, schizophrenia, substance use disorders, and eating disorders.

What diagnostic criteria define major depressive disorder (MDD) according to the DSM-5?

The diagnosis requires the presence of at least $5$ symptoms for at least $2\,\text{weeks}$, with at least one symptom being either depressed mood or loss of interest and pleasure.

In Aaron Beck's cognitive theory of depression, what are the three components of the "negative triad"?

Pessimistic, negative views of the self, the world (perceiving an inability to cope with environmental demands), and the future.

How did Abramson, Seligman, and Teasdale's attributional reformulation revise the original learned helplessness theory of depression?

It introduced causal attributions along three dimensions—internal versus external, stable versus unstable, and global versus specific—positing that attributing negative life events to internal, stable, and global factors produces depression and lowers self-esteem.

What biochemical finding was identified by Jeffrey Meyer and colleagues (2006) in untreated individuals with major depression?

Monoamine oxidase A ($\text{MAO-A}$) density was elevated by almost $35\%$ throughout the brain, identifying it as the primary monoamine-lowering process during major depression.

What core cognitive capability is targeted and developed in Mindfulness-Based Cognitive Therapy (MBCT) to prevent depressive relapse?

Metacognitive awareness, which is the ability to step back from negative thoughts and feelings and perceive them as transient mental events rather than reflections of reality.

What three types of suicide were distinguished by sociologist Émile Durkheim based on social integration?

Egoistic suicide (committed by alienated individuals with few social ties), altruistic suicide (committed as a response to societal demands or for the perceived good of society), and anomic suicide (triggered by sudden societal disorientation or disrupted living conditions).

According to Thomas Joiner's interpersonal theory of suicide, what two interpersonal constructs must combine to produce the desire to die?

A thwarted need to belong (feeling disconnected, alienated, and alone) and perceived burdensomeness (the belief that one is an intolerable burden and others would be better off without them).

How did Eugen Bleuler's definition of schizophrenia diverge from Emil Kraepelin's concept of dementia praecox?

Bleuler asserted that the disorder did not inevitably have an early onset or progress to irreversible dementia; instead, he proposed the core underlying mechanism was the "breaking of associative threads" that connect words and thoughts.

How are positive symptoms differentiated from negative symptoms in schizophrenia?

Positive symptoms represent behavioural excesses or distortions (such as delusions, hallucinations, and disorganized speech), whereas negative symptoms represent behavioural deficits (such as avolition, alogia, anhedonia, flat affect, and asociality).

According to the expanded dopamine theory of schizophrenia, how are positive and negative symptoms accounted for in different neural tracts?

Positive symptoms stem from dopamine receptor hyperactivity localized within the mesolimbic pathway, while negative symptoms stem from dopamine neuron underactivity within the prefrontal cortex (mesocortical pathway).

What is expressed emotion (EE), and what relapse rate did George Brown and colleagues observe among discharged schizophrenia patients returning to high-EE versus low-EE homes?

Expressed emotion consists of family criticism, hostility, and emotional overinvolvement; over a $9\text{-month}$ follow-up, $58\%$ of patients returning to high-EE homes relapsed compared to only $10\%$ of those returning to low-EE homes.

What milestone in North American psychiatric treatment is attributed to Canadian psychiatrist Heinz E. Lehmann?

In 1954, Lehmann published the first North American clinical report on using the neuroleptic chlorpromazine (Thorazine) to eliminate psychotic hallucinations and delusions at the Douglas Hospital in Montreal.

What are the core operating features of the Assertive Community Treatment (ACT) model for individuals with severe mental illness?

A multidisciplinary shared-team approach providing assertive, time-unlimited outreach, and individualized services directly in the community, with up to $80\%$ of services delivered outside clinic settings alongside $24/7$ crisis response.

What were the primary conclusions of the Mental Health Commission of Canada's national "At Home/Chez Soi" project?

The Housing First model rapidly ends homelessness, is cost-effective, can be successfully implemented across diverse cities, and improves lives beyond anticipated clinical outcomes.

How did the DSM-5 alter the diagnostic classification of substance use disorders relative to the DSM-IV?

It eliminated the qualitative distinction between substance abuse and substance dependence, collapsing them into a single continuous category titled "substance-related and addictive disorders."

According to M. Lynne Cooper's model, what four drinking motives arise from the dimensions of reinforcement valence and locus?

Enhancement motives (positive, internal), coping motives (negative, internal), social motives (positive, external), and conformity motives (negative, external).

What is the Drug-Stroop Effect observed in substance abuse research?

A cognitive interference phenomenon where individuals prone to addiction exhibit slower response latencies when identifying the ink colour of drug-related words compared to neutral words, reflecting automatic attentional bias.

How does Shepard Siegel's conditioning theory explain drug tolerance?

Tolerance is a learned Pavlovian response where environmental cues paired with drug ingestion become conditioned stimuli that elicit anticipatory, compensatory physiological responses (feedforward mechanisms) attenuating the drug's effect.

What were the three interventions compared in Project MATCH, and what was the main finding regarding client-treatment matching?

The treatments were 12-Step Facilitation (TSF), Motivational Enhancement Therapy (MET), and Cognitive-Behavioural Therapy (CBT); the study found no general matching interactions between client attributes and outcomes, with all three therapies producing equivalent improvements.

What core philosophy defines G. Alan Marlatt's Harm Reduction Therapy (HRT)?

Compassionate pragmatism that meets clients where they are, viewing addiction as an adjustment problem rather than a moral failing or disease, and prioritizing harm reduction strategies over mandatory total abstinence.

On what legal basis did the Supreme Court of Canada rule in 2011 to keep Vancouver's supervised injection site (Insite) open?

The court ruled unanimously that closing Insite would violate Section 7 of the Canadian Charter of Rights and Freedoms (the right to life, liberty, and security of the person), noting that Insite saves lives.

What key changes were made to the diagnostic criteria for anorexia nervosa in the DSM-5?

The requirement of weighing less than $85\%$ of expected body weight was replaced by restriction of energy intake leading to significantly low body weight, and the criterion of amenorrhea was removed.

How does the DSM-5 clinically differentiate binge eating disorder (BED) from bulimia nervosa and anorexia nervosa?

BED requires recurrent binge eating episodes without the severe weight loss of anorexia nervosa and without the compensatory purging, fasting, or excessive exercise characteristic of bulimia nervosa.

How does the mortality risk of anorexia nervosa compare to other psychiatric disorders and the general population?

Anorexia nervosa has the highest mortality rate of any psychological disorder, with an estimated $5.1$ to $5.35$ deaths per $1,000\,\text{person-years}$, a rate $5$ to $10$ times higher than that of the general population.

What is the "Scarlett O'Hara effect" described by Pliner and Chaiken?

The phenomenon in which women deliberately eat light meals to project an image of femininity and avoid being perceived as unfeminine.

What four dysfunctional family characteristics did Salvador Minuchin identify in his family systems theory of eating disorders?

Enmeshment (extreme overinvolvement), overprotectiveness, rigidity (inflexible maintenance of the status quo), and lack of conflict resolution.

According to Christopher Fairburn's cognitive-behavioural maintenance model of bulimia nervosa, what cycle perpetuates the disorder?

Low self-esteem and overconcern with weight lead to rigid dietary restriction; minor rule infractions cause the diet to be broken, triggering a binge that creates fear of weight gain, which is alleviated by purging, reinforcing low self-esteem.

What is the Maudsley Approach in the treatment of adolescent anorexia nervosa?

An intensive, family-based therapy that recruits parents as primary, unblamed agents of change tasked with taking control of feeding and restoring their child to a healthy weight before promoting age-appropriate autonomy.

What diagnostic criteria define cyclothymic disorder in the DSM-5?

Frequent periods of hypomanic and depressive symptoms that do not meet full criteria for major depressive or hypomanic episodes, occurring for at least $50\%$ of the time across at least $2\,\text{years}$ (with normal mood lasting no longer than $2\,\text{months}$).

In Sidney Blatt's psychoanalytic model of depression, how are anaclitic and introjective personality styles differentiated?

The anaclitic style centers on interpersonal dependency, neediness, and fear of abandonment, whereas the introjective style centers on harsh self-criticism, perceived failure, and chronic guilt.

What neuroendocrine abnormality is commonly observed in major depression regarding the hypothalamic-pituitary-adrenocortical (HPA) axis?

Hyperactivity of the HPA axis leading to excessive secretion of cortisol and adrenal enlargement, clinically demonstrated by a failure of the dexamethasone suppression test to suppress cortisol.

What brain area was targeted by Helen Mayberg and colleagues using deep brain stimulation (DBS) for treatment-resistant depression?

The subgenual cingulate white matter (Brodmann area $25$), a limbic-cortical region that is metabolically overactive in treatment-resistant depression.

According to Edwin Shneidman, what primary psychological construct serves as the proximal cause of suicide?

Psychache, defined as intense, intolerable psychological pain and anguish that self-destruction is consciously chosen to terminate.

What neurodevelopmental link was identified during the Helsinki influenza epidemic regarding schizophrenia risk?

Maternal viral infection during the second trimester of pregnancy disrupted fetal neurodevelopment and neuronal cell migration, significantly elevating adult risk for schizophrenia.

What motor disturbance in schizophrenia is characterized by waxy flexibility and prolonged posturing?

Catatonia, a condition marked by unusual motor behaviors ranging from wild agitation to complete immobility, where a person can maintain awkward postures for hours.

What movement disorder is caused by prolonged use of conventional antipsychotic medications?

Tardive dyskinesia, an extrapyramidal syndrome characterized by involuntary, repetitive movements of the mouth, tongue, face, and limbs that is typically irreversible.

What acute syndrome characterized by terrifying hallucinations and autonomic arousal can occur during severe alcohol withdrawal?

Delirium tremens (the DTs), a state involving severe physiological tremors, autonomic instability, confusion, and vivid visual or tactile hallucinations.

How does the concept of \"alcohol myopia\" explain the tension-reducing effects of alcohol?

Claude Steele and Robert Josephs proposed that alcohol constricts cognitive focus to immediate external cues, preventing drinkers from processing deeper internal worries.

What condition caused by prenatal alcohol exposure is the leading preventable cause of intellectual disability?

Fetal alcohol syndrome (FAS), characterized by slowed physical development, central nervous system abnormalities, and distinctive craniofacial malformations.

In eating disorder research, what is the \"thinspiration effect\" described by Jennifer Mills and colleagues?

The paradoxical phenomenon wherein viewing images of ultra-thin models temporarily makes chronic dieters feel thinner and inspires continued dietary restriction.

In the context of body dissatisfaction, what does the term \"fat talk\" describe?

A conversational norm among peers, especially young women, involving mutual verbal disparagement of their own body shape and weight to build social bonding and seek reassurance.

What is Cognitive Enhancement Therapy (CET), and what neurobiological effect does it have in schizophrenia?

A computerized neurocognitive and social-cognitive intervention developed by Gerard Hogarty that has been shown to protect against grey-matter volume loss in the brain.

5-HTTLPR gene-environment interaction in depression

The genetic finding by Caspi and colleagues ($2003$) showing that individuals carrying one or two copies of the short allele of the serotonin transporter gene exhibit significantly higher rates of depression following severe life stress.

Dysfunctional Attitudes Scale (DAS)

A self-report measure developed by Weissman and Beck assessing cognitive vulnerability to depression, structured around $2$ primary dimensions: approval need and achievement perfectionism.

Distinction between Bipolar I and Bipolar II disorder

Bipolar I requires at least one full manic or mixed episode, whereas Bipolar II requires major depressive episodes accompanied by hypomania without full manic episodes.

Behavioural activation system (BAS) dysregulation theory of bipolar disorder

A model by Alloy and Abramson positing that mania stems from an oversensitive, hyperresponsive reward system that excessively triggers approach behavior and positive affect.

Perfectionism Social Disconnection Model (PSDM)

A model by Hewitt and colleagues proposing that interpersonal perfectionism and perfectionistic self-presentation foster perceived alienation and social isolation, thereby amplifying suicide risk.

Reasons for Living (RFL) Inventory

A psychological assessment tool developed by Marsha Linehan measuring $6$ protective belief domains that prevent individuals from engaging in suicidal behavior.

Unilateral electroconvulsive therapy (ECT)

A somatic treatment administration where electrical currents pass solely through the non-dominant right cerebral hemisphere to minimize retrograde memory impairment.

Social-selection theory of schizophrenia

The hypothesis that schizophrenia causes downward social mobility, leading affected individuals to drift into low-income urban neighborhoods due to cognitive and motivational impairment.

Sociogenic hypothesis of schizophrenia

The theory proposing that severe environmental stressors, degradation, and lack of opportunity associated with lower socioeconomic status actively contribute to triggering schizophrenia in vulnerable individuals.

Duration of untreated psychosis (DUP)

The time interval between the first psychotic symptom and the initiation of antipsychotic pharmacotherapy, where longer durations predict higher relapse rates and worse symptom remission.

Mednick and Schulsinger Danish high-risk study findings

A prospective investigation revealing that negative-symptom schizophrenia was predicted by pregnancy and birth complications, whereas positive-symptom schizophrenia was predicted by early family instability.

Defeatist beliefs in schizophrenia

Dysfunctional attitudes identified by Grant and Beck that mediate the relationship between neurocognitive deficits and negative symptoms, particularly within the deficit syndrome.

Biphasic effect of alcohol

The physiological pattern where rising blood alcohol levels initially produce stimulation and sociability, followed by sedation and depression as blood alcohol concentrations decline.

Disulfiram (Antabuse)

A pharmacological treatment for alcohol use disorder that prevents the breakdown of alcohol by blocking acetaldehyde dehydrogenase, triggering violent vomiting and nausea upon alcohol ingestion.

Denormalization belief

A tobacco cessation factor defined as an individual's recognition of societal disapproval toward smoking and distrust of tobacco corporations, which significantly boosts quit rates.

Dual-process model of addiction

A cognitive framework by Wiers and Stacy positing that substance dependency arises from an imbalance between deliberate, reflective cognitive control and hyperactive, automatic impulsive processing.

Purging disorder

An eating disorder characterized by recurrent self-induced vomiting or misuse of laxatives to influence weight in normal-weight individuals without objective binge eating episodes.

Endogenous opioid hypothesis in anorexia nervosa

The biological model suggesting that prolonged food restriction and excessive exercise stimulate beta-endorphin release, generating a positively reinforcing euphoric state that maintains starvation.

Sociocultural Attitudes Towards Appearance Scale (SATAQ)

A psychological instrument developed by Kevin Thompson to evaluate the extent to which individuals internalize unrealistic media and cultural standards of physical appearance.

Schema-focused cognitive behaviour therapy (SFCBT) for bulimia

A psychological intervention developed by Glenn Waller aimed at identifying and transforming deeply ingrained negative core schemas about the self to reduce bingeing and purging.

Stress generation theory of depression

A model proposed by Constance Hammen positing that depression-prone individuals actively contribute to causing interpersonal stress and conflict in their own lives (dependent stressors), which subsequently triggers and maintains depressive episodes.

Minnesota Starvation Experiment (Keys et al., 1950)

A study of conscientious objectors subjected to semi-starvation that demonstrated food restriction directly produces intense food preoccupation, social withdrawal, emotional instability, irritability, and depressive symptoms.

Schneiderian first-rank symptoms

Specific delusions and hallucinations—such as audible thoughts, voices arguing or commenting, thought insertion, and somatic delusions of control—that German psychiatrist Kurt Schneider considered central diagnostic markers of schizophrenia.

Controlled drinking approach (Mark and Linda Sobell)

A behavioural treatment paradigm demonstrating that individuals with mild to moderate alcohol problems can acquire self-control skills and maintain moderate drinking without requiring absolute lifetime abstinence.

Tryptophan depletion paradigm in depression research

An experimental procedure lowering dietary tryptophan—the biochemical precursor of serotonin—which triggers an acute return of depressive symptoms in approximately $67\%$ of vulnerable individuals in remission.

Diagnostic crossover in eating disorders

The clinical transition between diagnoses over time, where approximately $18\%$ of individuals with anorexia nervosa transition to bulimia nervosa, and about $7\%$ of those with bulimia nervosa crossover to anorexia nervosa.

Sequenced Treatment Alternatives to Relieve Depression (STAR*D) findings

A large-scale multicenter clinical trial demonstrating that cumulative remission across four consecutive treatment steps remained under $70\%$, and that anxious depression predicted poorer response to pharmacotherapy.

Neuroleptic malignant syndrome (NMS)

A life-threatening adverse reaction to antipsychotic medications occurring in about $1\%$ of patients, characterized by extreme muscle rigidity, high fever, autonomic instability, and potential coma.

Hilde Bruch's psychodynamic theory of anorexia nervosa

The formulation that anorexia stems from early parent-child interactions where parental overdirection deprives the child of autonomy and competence, driving the adolescent to use rigid starvation to exert self-control and establish identity.

Vancouver's Four Pillars Drug Strategy

A municipal public health framework addressing drug addiction through four coordinated components: harm reduction, prevention, treatment, and enforcement.

Co-rumination

An interpersonal coping style in which friends repeatedly discuss, brood over, and speculate about personal problems, which strengthens social bonds while significantly increasing vulnerability to depression.

Scaffolding instruction in cognitive remediation for schizophrenia

A targeted educational technique that tailors cognitive tasks to an individual's current developmental capabilities to systematically foster independent problem-solving skills, leading to lasting improvements on executive functioning tasks.

Three-factor interactive model of bulimia nervosa

An etiological model proposing that bulimic symptoms develop when elevated perfectionism interacts simultaneously with body dissatisfaction and low self-esteem.

Hypofrontality in schizophrenia

A neurofunctional deficit observed in PET and fMRI studies characterized by abnormally low glucose metabolism and diminished prefrontal activation during executive functioning and memory tasks.

Neurotransmitter actions of acute alcohol consumption

Alcohol produces its acute physiological and subjective effects by stimulating inhibitory $\text{GABA}$ receptors, increasing serotonin and dopamine release, and inhibiting excitatory glutamate receptors.

Night eating syndrome

An 'other specified feeding or eating disorder' characterized by recurrent awakenings from sleep accompanied by excessive nocturnal food consumption and substantial clinical distress.

Command hallucinations in schizophrenia

Auditory hallucinations instructing an individual to perform specific, often dangerous actions, whose lethality and compliance are driven by overarching 'power beliefs' regarding the voice's omniscience and authority.

Congruency hypothesis of depression

A cognitive-personality diathesis-stress model positing that depression occurs when a specific personality vulnerability matches the nature of an experienced stressor (e.g., achievement failure in an autonomous individual or interpersonal loss in a sociotropic individual).