90 Cards in this Set
| Front | Back |
|---|---|
|
Somatic Symptom Disorder
|
Core Symptoms: one or more somatic symptoms with abnormal/excessive thoughts, feelings and behaviors regarding the symptoms
Epidemiology: 0.4-0.7%, women more likely
Treatments:
Etiology: High anxiety about health, reinforcement of being sick
|
|
Conversion Disorder
|
Core Symptoms: motor deficits, sensory decifits, non-seizures (paralysis, blindness etc.)
Epidemiology: 0.04%
Treatments:reveal symptoms, SSRIs
Etiology: sensory arise after stressor, reinforcement of being sick
|
|
Three main types of conversion disorder
|
1. Motor symptoms/deficits: muscle weakness, globus hystericus
2. Non-seizures & convulsions
3. Sensory deficits: Glove anesthesia, patterns of paralysis do not follow what is known about the human body
|
|
Glove Anesthesia
|
A conversion disorder in which all feeling is lost below the wrist
-the skin ares served by nerves in the arm make this symptom physiologically impossible
|
|
Illness Anxiety Disorder
|
Core Symptoms: Preoccupation with having a serious illness
-comorbidity w/ anxiety and depression
Epidemiology: 4.5-7.7%
Treatments: reveal symptoms, SSRIs
Etiology: stress, reinforcement of being sick
|
|
Factitious Disorder
|
Core Symptoms: physical or psychological symptoms are internally produced
-desire to assume sick role
-aware that they are producing symptoms, don't know why, actually harms self
Epidemiology: attention seekers, mothers, etc
Treatments: no controlled trials for treatment
|
|
Etiology of Factitious DIsorders
|
Theories:
-gain mastery or control, masochism, deprived childhood, attempt to master trauma
Behavioral: positive reinforcement (ex: attention)
|
|
Factitious disorder imposed on others
|
physical or psychological symptoms internally produced in someone else
Epidemiology: child by parent (usually mother)
-Considered child abuse
|
|
two types of factitious disorders
|
1) imposed on self
2) imposed on other
|
|
Somatic Symptom Etiology
|
Cognitive: Prevalence of sickness
-meaning of bodily symptoms
-Course and treatment of illness
behavioral: sickness reinforcement
psychoanalytic: psychological or emotional stress
|
|
Dissociative Amnesia
|
Core Symptoms: inability to recall important personal information, usually follows a traumatic event
-psychological, not medical
Epidemiology:
Treatments: usually resolves on its own, no controlled trials: reintegration: working together to improve quality of life
Etiology: trau…
|
|
Depersonalization/derealization disorder
|
Core Symptoms: feelings of being detached from one's body of mind(DP) and/or feelings of unfamiliarity about one's physical or interpersonal environment (DR)
Epidemiology: 16-23 yrs, comorbidity with mood & anxiety disorders
Treatments: usually resolves on its own, no controlled tri…
|
|
Dissociative Identity Disorder
|
Core Symptoms: two or more distinct personality states
-unable to recall important personal information, everyday events, or traumatic events
Epidemiology:
Treatments: usually resolves on its own, no controlled trials: reintegration: working together to improve quality of life
…
|
|
5 types of dissociative experiences
|
-depersonalization
-derealization
-amnesia
-identity confusion
-identity alteration
|
|
Difference between amnesia and dissociative amnesia
|
-amnesia is the inability to recall important information bc of a MEDICAL cause
-dissociative amnesia is a PSYCHOLOGICAL cause
|
|
Iantrogenic Disorders - how do they develop
|
therapist creates disorder
|
|
Difference between factitious disorders and malingering
|
factitious is actually harming self and malingering is not harming self and has desire for personal gain
|
|
Why DID may be a controversial diagnosis
|
-Few research studies
-Inconsistent diagnosis: lack of reliability
-no clear definitions or alters or how they 'control someone's behavior'
-lack of validity
|
|
Malingering
|
Factitious Disorder
-physical symptoms are intentionally produced in order to GAIN INCENTIVES
-fake injury for lawsuit
-Blatant faking for personal gain, does not actually harm self
|
|
Role of Trauma in dissociative disorders
|
Mental desire to forget trauma, body completely blocks it out
|
|
Major Depressive Disorder
|
Emotional: sadness & anhedonia
Physical: Insomnia/hyperinsomnia, weight loss. fatigue
Cognitive: trouble concentrating, irritability, worthlessness, hopelessness
Epidemiology: 17% prevalence
|
|
Major Depressive Disorder Peripartum Onset
|
6-13% of all new mothers
-25-50% chance of reoccurring episodes
-Temperamental, emotional, social cognitive & behavioral difficulties
|
|
Anhedonia
|
Loss of interest in everything, not emotional when they do something enjoyable (MDD)
|
|
Dysphoria
|
Opposite of euphoria
-persistent low or sad mood (MDD)
|
|
How is MDD different from Bipolar disorder?
|
MDD doesn't have any symptoms of mania of mood fluctuations
|
|
Know cognitive and behavioral theories of how depression develops
|
-withdrawal of reinforcement
-learned helplessness
-overgeneralizing
-catastrophizing
-personal ineffectiveness
|
|
Specifiers for MDD:
-Peripartum onset
-Single Episode
-Recurrent episodes
|
single episode & recurrent in MDD (at least two weeks)
|
|
Dysthymia
|
Core Symptoms: Chronic state of low mood
-same symptoms but less severe
-must last two years
-social isolation, high suicide risk
-mislabeled as moody or difficult
|
|
Differentiate between dysthymia and major depressive disorder
|
Dysthymia is less severe
|
|
Bipolar I vs. Bipolar II
|
Bipolar I
Core Symptoms: Full blown, dramatic shift in mood, depressed mood AND episodic mania
Bipolar II
Core Symptoms: hypomania, doesn't impair functioning, lack impulsivity, lapses in judgement
|
|
Cyclothymic Disorder
|
Fluctations between hypomanic and dysthymic symptoms
-present for at least 2 years, never two weeks without symptoms
|
|
Disruptive Mood Dysregulation Disorder
|
Severe and recurrent temper outbursts that are grossly out of proportion in intensity or duration to the situation
Epidemiology: children 6-18
|
|
Premenstrual Dysphoric Disorder
|
-In the last week before menstruation: mood swings, irritability/anger, depressed mood, anxiety
-also anhedonia, change in appetite
|
|
Controversies with this diagnosis in children
|
Need for additional diagnosis
-poor reliability
-overmedicalizing: turning temper tantrums into mental illness
|
|
Depression vs. Sadness
|
Depression is chronic, sadness is a symptom
|
|
Mania versus Hypomania
|
mania = impairs functioning
Hypomania = mood elevation is clearly abnormal but not severe to impair functioning
|
|
Negative Cognitive Triad
|
...
|
|
Double depression
|
Combination of episodic major depression superimposed on chronic low mood (dysthymia)
|
|
Risk Factors for Suicide
|
-Family History
-Psychiatric Illness (90% of suicides)
-Biological Factors: low serotonin
|
|
Active vs. passive suicidal ideation
|
active: existing wish to die with plan
passive: desire to die, but no plan
|
|
Suicide prevention
|
-Crisis interventions: hotlines
-Societal Level Prevention: education
-Preventing suicidal contagion: media portrayal
-Focus on high risk groups: early detection/treatment
|
|
Selecting treatment for mood disorders
|
-Depends on symptoms
Major depression: pharmacology & psychotherapy
Bipolar: Lithium, antidepressants, anti convulsants, anti psychotics
Psychotherapy alone is not effective
|
|
Epidemiology of bipolar and depressive disorders
|
Women: twice as likely women suffer and men don't (depression)
-bipolar also more common
-MDD post-partum = 80%
Depression in children: 2.5% of children and 8.3% of adolescents
Bipolar disorder: some children as young as 4
|
|
Etiology for mood disorders
|
Psychodynamics: "Anger turned inward"
-melancholia
Bipolar/hypomania: defenses against depression
-exaggerated self-esteem
Biological: famililal link (especially in bipolar disorder)
-serotonin abnormalities
-abnormalities in limbic system
Behavioral Therapy: Withdrawal of rei…
|
|
Treatment of Depressive Symptoms
|
Seasonal Affective Disorder (SAD)
-subtype of major depression, episodes vary by season (usually winter)
Light therapy: exposure to artificial light, same time each day 30-90 minutes
|
|
Treatment for Major Depression
|
Biological: anti-depressents (SSRIS, MAOIs)
Behavioral Activation: increasing positive life events, establish life goals, skill building
Interpersonal Psychotherapy (IPT): interpersonal problems can trigger depression. Expression of mood, feelings, communication
Psychological: CB…
|
|
Treatment of Bipolar Disorder
|
Cognitive Behavioral Therapy:
Family baed treatment, psychoeducation
Interpersonal and social rhythm therapy (IPSRT): adherence to regular routines, reasonable and consistent social events
Biological: requires treatment by psychiatrist, may need hospitalization
-Lithium
-SSRIs, a…
|
|
Anti-depressant medications, advantages and disadvantages of each type
|
SSRIS: inhibit reuptake of serotonin (prozac)
-possible suicide ideation in children and adolescents
|
|
Etiology of Mood Disorders
|
Biological and environmental factors (diathesis-stress model)
Cognitive Therapy: Negative cognitive schemas, automatic thoughts, lead to self-fulfilling prophecies.
-Negative cognitive triad
|
|
Anorexia Nervosa
|
Core Symptoms: intense fear of gaining weight or persistent behavior that interferes with weight fain
-weight is too high
-denial of illness
-patients are thin, low body temp, amenorrhea, dehydration
-SUBJECTIVE BINGE: small amount of food
Epidemiology: 1% of population, 0.9% women…
|
|
Two subtypes
|
Restricting: reduce caloric intake, increase physical activity
Binge eating/purging: not both necessarily, eating large amount of calories
|
|
Purging
|
Self induced vomiting, laxatives, produce weight loss
|
|
Amenorrhea
|
Absence of menstruation for at least 3 months
-shutting down reproductive
|
|
Bulimia Nervosa
|
Core Symptoms: recurrent episodes of binge eating, lack of control, followed by compensatory behavior
-individuals normal or overweight
-OBJECTIVE BINGE: eat large amount of food, binge
-fatigue, calluses, lethargy
Epidemiology: 1-3% of women, 0.1-0.5% of men, 80% comorbidity
Treat…
|
|
Binge Eating Disorder
|
Core Symptoms: regular binge eating disorder without compensatory behaviors
-eating rapidly, past feeling full, eating alone/embarrassed
Etiology: (personality) impulsivity
|
|
Men and BN
|
usually use non-purging compensatory behaviors
-exercise, fasting
|
|
Pica
|
Core Symptoms:persistent eating on non-nutritive, non-food substances (dirt, rocks)
Epidemiology: children with developmental delays, intellectual disability, schizophrenia
Etiology: iron and zinc deficiencies, environmental factors, stressful events
|
|
Rumination Disorder
|
Core Symptoms: Recenting eating food is regurgitated then re-chewed, re-swallowed and spit out
Epidemiology: children 3-6 months, with developmental delays
Treatments: most children outgrow it
Etiology: physical illness, severe stress, neglect
|
|
Avoidant-restrictive food intake disorder (ARFID)
|
Core Symptoms:any eating/feeding disturbance that leads to persistent failure to meet nutritional needs
-weight loss, dependence on supplements
-avoidance of certain foods
|
|
Binging and purging can occur in both Anorexia Nervosa and Bulimia Nervosa - how do you determine which diagnosis to give?
|
-Whether or not they're restricting their food then purging, or if they're eating thousands of calories then purging.
-Also you can look at personality traits
|
|
Course of Anorexia Nervosa - high rates of relapse
|
higher death rates: 10.5x more likely to die, not just a "phase"
|
|
Personality characteristics of people with Anorexia Nervosa vs. Bulimia Nervosa
|
AN: perfectionism, obsessionality, neuroticism, anxiety/depression
BN: perfectionism, impulsivity, higher-novelty seeking behavior
|
|
Compensatory Behavior
|
getting rid of what you ate (purging, restriction, excessive exercise)
|
|
Gender differences in eating disorder behavior, how might men show eating disorder symptoms differently than women?
|
Men are more likely to use non-purging techniques and they generally have a lower percentage of eating disorders than women
|
|
Treatment of eating disorders - what works?
|
Biological:
AN: no proof of anything
BN: Prozac (SSRI)
Nutritional Conseling:
AN: Set goal weight, re-normalize
BN: portion sizes, normal eating
CBT: challenge distorted thoughts about weight, food, eating, and body shape
-recovery rate 35-70% but high relapse
Dialectical B…
|
|
Relation between obesity and BED
|
-only found in 5-8% of obese individuals
-obesity and dieting behaviors start earlier
-more psychological features of eating disorders
|
|
Sex vs. Gender
|
Sex= biological construct
gender= cultural construct based on role expectations
|
|
Gender Dysphoria
|
Core Symptoms: marked incongruence between assigned and experienced gender
-persistent discomfort w/ sex
Epidemiology: often detected between 2-4
Treatments: sexual reassignment surgery, live in gender role for at least 2 years before surgery
|
|
Etiology of GD
|
Biological:transsexual men & women have similar brain structures
-Congenital Adrenal Hyperplasia (CAH) --> too much androgen
Psychosocial: parental rejection, reinforcement of masculine/feminine behaviors
|
|
Male hypoactive sexual desire disorder
|
Core Symptoms: deficient/absent sexual thoughts or desires
Etiology: low sexual satisfaction, presence of other sexual dysfunction, negative thoughts about sexuality
|
|
Female sexual interest/arousal disorder
|
Core Symptoms: lack of/reduced sexual interest or arousal
Treatments: Sensate focus
|
|
Erectile disorder
|
Core Symptoms: persistent and recurrent inability to maintain erection throughout sexual activity
Epidemiology:
Treatments: Sensate focus viagra, levitra, cialis
|
|
Female orgasmic disorder
|
Core Symptoms: delay or absence of orgasm, markedly reduced sensations
Treatments: directed masturbation
|
|
Delayed ejaculation
|
Core Symptoms: Delay of ejaculation or inability to achieve orgasm despite adequate sexual stimulation
|
|
Genito-pelvic pain/penetration disorder
|
Core Symptoms: consistent genital pain associated with intercourse
Epidemiology: 14% of homosexual men
|
|
Vaginimus
|
Core Symptoms: Painful, involuntary spasms, interfere with intercourse
treatment: Systematic Desenitization
|
|
Treatment of Sexual Disorders
|
Biological: testosterone replacement therapy - increases sexual desire
-SSRIs: may help with desires and premature ejaculation
-Viagra, Levitra, Cialis
Psychosocial
-Sensate focus
#VALUE!
-Directed masturbation
-Systematic Desensitization
|
|
Etiology of Sexual Disorders
|
Biological: Hormonal imbalances, physical disorders, lower levels of androgens, alcohol &drugs, SSRIs
Psychosocial: anxiety, depression & stress, couple stress, negative life events, traumatic events
|
|
Paraphilias vs. Paraphilic Disorder
|
Paraphilias is the persistent sexual urge and a disorder is when it causes impairment to the person or can cause harm to them or another
|
|
Fetishistic Disorder
|
Core Symptoms: sexual arousal that involves nonliving object or non-genital body areas
|
|
Tranvestic Fetishism
|
Core Symptoms: cross-dressing, arousal results from wearing women's clothing
Epidemiology: almost exclusively in men
|
|
Exhibitionistic Disorder
|
Core Symptoms: Recurrent fantasies, urges, behavior involving exposing one's genitals to an unsuspecting stranger
Epidemiology: male perpetrator, female victim
- shock of stranger arousing
-masturbation may occur
|
|
Frotteuristic Disorder
|
Core Symptoms: sexually arousing urges, fantasies, behaviors that involve touching/rubbing against a non-consenting person in public places
|
|
Voyeuristic Disorder
|
Core Symptoms: Sexual arousal associated with observing an unsuspecting person who is naked, undressing, or engaging in sexual activity
-Limited social skills, sexual knowledge, sexual dysfunction and intimacy problems
|
|
Epidemiology of Paraphilic disorders
|
Most are male
-Sexual masochism: 20 males - 1 female
-Women pryer less pain than men during sexually masochistic activities
-Average age of onset = 16
|
|
Etiology of Paraphilic Disorders
|
Etiology unknown
-Behavioral: person engages in paraphilic behavior, achieves sexual release --> reinforcement
-Lack of research
|
|
Treatment of Paraphilic Disorders
|
Requires significant distress or impairment
-Not motivated to change because sexual pleasure
-Do not seek treatment unless mandated then discontinue
|
|
Treatment: Assessment
|
Plethysmography
-Method to measure sexual arousal in men and women
-show which stimuli
-can distinguish between offenders and non offender
|
|
Treatments: Biological
|
Past: surgical castration
-SSRIs
-Anti-androgen medication: reduce sexual drive
|
|
Treatment: Psychosocial
|
Behavioral and CBT
-social skills training, anger management, empathy training
-couples therapy, sex ed
-covert sensitization
|
PSYC 281: EXAM 1