PSY-P324 Exam #4 Study Guide Lectures: 24 - 33Treatment of Mood DisordersI. Biologicala. Bipolar i. Lithium: traditional, most common1. Helps 80% of people, treats primarily mania, stabilizes NTs, prevents relapse 2. Side effects: can be toxic if dosage is too high, dulls mania ii. Anticonvulsants 1. Normally treats epilepsy 2. If given to a depressed person, may trigger a manic episodein ¼ of people. b. Depression i. Medication 1. Older Meds: a. Problematic bc NTs would return quickly to previous levels, overdosing possible 2. Newer Meds a. SSRIs: blocks reuptake of serotonin b. SNRIs: blocks reuptake of serotonin/norepinephrinec. Wellbutrin: blocks reuptake of norepinephrine and dopamine d. Side effects: weight gain, restlessness, anxiety, sexual dysfunction, vivid dreams, insomnia3. Electroconvulsive Therapy (ECT):a. Treats severe, recurrent depression when meds are ineffective b. Small electric current produces seizure in the brain c. Effective II. Behavioral: change interactions with environment and people a. Increase positive reinforcers b. Increase social skillsc. Teach mood management skills III. Cognitive: change irrational or dysfunctional a. Help client discover negative automatic thoughts b. Help client challenge negative thoughts IV. Evaluation a. CBT (Cognitive-Behavioral-Therapy) i. 75% marked improvement or complete remissionii. fewer side effects iii. best combo: CBT+medsSchizophreniaI. Definition: group of psychotic disorders characterized by major disturbances in thought, emotion and behavior II. Featuresa. Prevalence: 1%b. Onset: Men: early/mid 20s, women: late 20s/early 30s c. Gender: equal, males develop earlier and more severe cases III. Symptoms a. Very heterogeneous b. Positive symptoms: i. What causes?1. Difficulty filtering stimuli: sensation 2. Overload= sensory stimuli floods the brain3. Inability to sort and respond like a normal brain ii. Types of Positive Symptoms 1. Delusions: fixed, false beliefs that are well organized a. Persecution, Grandeur, Reference, Control 2. Hallucinations: sensory perceptions in the absence of adequate stimulia. Auditory: Usually unpleasant, accusatory b. Loose association: vague connections of thoughts c. Disorganized speechi. Neologisms, word salad, perseveration, clanging d. Derealization: separation from sense of reality e. Inappropriate affect: mood doesn’t match situationc. Negative Symptoms: i. Avolition, anhedonia, alogia, flat affect, catatonia IV. DSM Criteria: 6 months, characterized by severe social/occupational dysfunction. Two or more of the following, present for majority of 1 month: a. Delusions, hallucinations, disorganized speech, negative symptoms, disorganized or catatonic behavior. V. Etiology a. Biological i. Genetics 1. Family studies: risk increases with closeness of relatives a. More genes you share, bigger the risk b. Will not develop schizophrenia w/out environment 2. Twin studies a. MZ=48%, DZ=17%, Regular sibs=9%3. Adoptions Studiesa. Heston: focused on diathesis, have to have a biological predisposition b. Tienari: the more maladjusted the family, the more likely the kid will develop schizophrenia ii. Biochemistry: Dopamine Hypothesis1. Excess: limbic system (positive symptoms) a. Too much = too many symptoms b. Responsible for emotion 2. Underactive: a. Prefrontal cortex (negative symptoms)b. Thinking, decision making c. Can look like MDD3. Brain Structure: a. Larger ventricles: larger the ventricles, less brain.b. Cellular migration abnormalitiesi. Cell migration during fetal period doesn’t happen 1. Neurons are not getting to where they need to be c. Fingerprint ridgesi. Different ridge patterns among MZ twins 1. Not a cause, but precursor that something will happen. 4. Brain Function: a. Hypofrontality: decreased activity of frontal lobes i. Not enough frontal actionii. Related to negativesymptoms b. Sensory Gating Deficit: can’t screen out irrelevant events i. Sensation, positive symptoms VI. Treatment a. Lobotomy: connection severed between frontal lobes and rest of brain b. Antipsychotic Medsi. Traditional antipsychotics: Thorazine1. Blocks dopamine2. Reduces severity of positive symptoms 3. Decrease violent behavior 4. 30% do not benefit, 40% do not comply 5. side effects: resemble Parkinson’s disease ii. Atypical antipsychotics 1. Serotonin receptors: frontal lobes 2. Therapeutic gains in those resistant to traditional meds, improve cognitive functioning 3. Side effects: fewer motor side effects, increased weight gain, type 2 diabetes 4. Still not good compliancePersonality DisordersI. Description a. Diagnosisi. Diagnostic interviews and personality inventories b. General Criteriai. Inflexible and maladaptive 1. Behavior affects functioning and ability to get things done 2. Difficulty changing even though it’s in best interest ii. Causes functional impairment across all areas of life 1. Affects relationships, job, role as student, etc iii. Causes significant subjective distress 1. The person perceives themselves to be suffering 2. ASPD: rarely experiences distress c. Features i. 10-13% of population meets criteria for some PDii. Over ½ of diagnosed have 2 PDs bc of overlapping criteria iii. Individuals rarely seek treatment, no effective treatment for PDsII. Types of Personality Disorders a. Schizoid i. Detachment from social relationships, asocial, appears cold, aloof b. Paranoidi. Excessively mistrustful and suspicious without justification ii. Emotional detachment and hostility c. Schizotypal i. Socially isolated, excessive social anxiety (come off as being odd)ii. Want to be and interact with people but can’t bc of anxiety iii. Genetically related to Sz. Episodes not as frequent, intense d. Antisocial Personality Disorder i. Pervasive disregard for the law and rights of others ii. Tendency to lie, steal and not fulfill responsibilities iii. Lack empathy and remorse iv. Impulsive and entitled v. Primarily male: aggressive 1. No real treatment, just jail vi. Causes: 1. Genetic a. Impulsivity: doesn’t think before acting b. Cortical under arousal: seeks stimulation c. Weak behavioral inhibition system (BIS):i. Don’t stop when facing punishment 2. Environmental:a. Antisocial parents: inattentive, coercive & inconsistent discipline b. Deviant peers, violent community e. Narcisstic i. Grandiose: extremely exaggerated sense of self importanceii. Lacks empathy for others, needs constant admiration from them iii. Very entitled, arrogant, jealous iv. Causes: did