FAU Abnormal Psych Exam – Flashcards

inability to recall important personal information. Except for memory loss, patient's behavior is not impaired.

extensive memory loss. Person moves away from home and assumes new identity. (Incorporated into dissociative amnesia in DSM 5)

involves an alteration of a person's self-experience (sensation of detachment from body; world is not real)

presence of two different identities (alters). Formerly referred to as multiple personality disorder

inability to recall important personal events or identity

Childhood trauma - physical or sexual abuse 2. Rich fantasy life 3. High in Hypnotizability. Purpose is to escape trauma. May be a form of self hypnosis. or May be social role enactment from therapist suggestions. Ex. Ken Bianchi (Hillside strangler) from DID cases. From Lewis et al., 1997

Consciousness is normally a unified experience, consisting of cognition, emotion and motivation Stress may alter the fashion in which memories are stored resulting in amnesia or fugue DID may result from Severe physical/sexual abuse Learned social role enactment

Psychoanalytic therapy seeks to lift repressed memories Hypnosis is used in the treatment of DID Goal of therapy for DID is to Integrate the several personalities Help each alter understand that he or she is part of one person Treat the alters with fairness and empathy

Patients have bodily symptoms that suggest a physical dysfunction; yet no physiological explanation can be found. Excessive thoughts about somatic concerns; lasts for at least 6 months

chronic pain results in distress. Psychological factors are key to onset, maintenance or severity of individual's pain. Difficult to diagnose. May be differentiated by the description of the pain. Patients with physical-based pain are more specific when describing their pain compared to pain disorder patients. May allow the individual to avoid an unpleasant activity or gain attention or sympathy that is otherwise unavailable.

severe preoccupation with disease. Individual fears having a serious disease. Fears persist even when reassurance is given that there is no medical evidence of a disease. They are chronic health care consumers.

checking for signs of illness, seeking reassurance, or avoiding medical care or sick relatives. Preoccupation last 6 months. * They usually view their physicians as incompetent.

Functional Neurological Disorder - involves sensory or motor symptoms. Sudden loss of vision or hearing that suggests neurological damage, but nervous system is intact. -Not related to known physiology of the body: -Symptoms appear suddenly -Symptoms are related to stress -Symptoms are not related to a medical condition -The person experiencing this disorder is not distressed by sudden paralysis or blindness -la belle indifference - lack of concern

Distinguishing it from Malingering. Malingering is intentionally faking an illness to avoid responsibility or to achieve some gain.It is under voluntary control, whereas conversion disorder is not.

La belle indifference can be used to help diagnose. Malingers do not show it. Malingerers are also more guarded, do not like to give details.

intentionally producing physical symptoms.

- deliberately making your child sick.

Biological: Patients are oversensitive to physical sensations May have hyperactivity in somatosensory cortex Cognitive: attribution style (worst case interpretation); communicate this distress to to others Behavioral view focuses on similarity to malingering, a reward is involved. --Treatment:Clients seek help from physicians and resent referrals to psychologists --The cognitive-behavioral approach involves pointing out selective attention to physical sensations and discouraging the client from seeking medical assistance

The study of causes or origins

intrusive and recurring thoughts or urges

repetitive behaviors or mental actions that are repeated over and over in order to reduce anxiety.The lifetime prevalence of OCD is 1-2 %Women are slightly more likely than men to develop OCD

Pursuing cleanliness Avoiding particular objects (e.g. cracks in a sidewalk) Performing repetitive, magical, protective practices Checking (e.g. "is the gas off?") Performing a particular act (e.g. chewing slowly) Diagnosis: Presence of obsessions that the person tries to ignore, engaging in compulsions to reduce stress for 1 hour a day or they cause significant distress

preoccupation with an imagined physical defect. Individual may spend hours checking themselves in mirrors or avoid looking at themselves entirely.

Criteria for diagnosis: persistent difficulty parting with possessions, regardless of value. strong urge to save, and distress associated with discarding items. Accumulation of items clutter home or workplace to the extent that there intended use is no longer possible. The hoarding behavior results in maladaptive behaviors that may damage physical health, unsanitary conditions for self and others, overspending and interfere with personal relationships.New category for DSM 5.

Psychoanalytic view: arrested personality development at anal stage Behavioral view: learned behaviors reinforced by fear reduction Biological view: activation of the orbitofrontal cortex, caudate nucleus (basal ganglia) and anterior cingulate Cognitive: thought suppression; the harder you try, the more difficult it is They believe bad thoughts will come true.

Psychoanalytic procedures are not effective -ERP: Exposure and Response Prevention involves exposing the OCD client to situations that elicit a compulsion and then restraining the client from performing the compulsion -Biological treatment involves drugs that increase brain serotonin activity (SSRI'S)

Cognitive: can see correctly, but focus on features that are important to physical attractiveness. They focus more on details rather than the whole. Attractiveness is much more important to them than controls participants. Their self worth is tied to their appearance.

ERP: Exposure and Response Prevention is used as well as cognitive behavioral therapy. Forced to confront others and not allowed to check their appearance. Etiology of Hoarding Not good at categorizing, making decisions, unusual beliefs about possessions. Have an emotional attachment to their objects. Avoidance of others helps maintain the hoarding. Treatment ERP: prevent counting and sorting of objects, slowly get rid of objects. Begin with those that impede safety, then use cognitive therapy to help them consider reasons to change.

Posttraumatic Stress Disorder (PTSD) refers to an extreme response to an extreme stressor PTSD symptoms may include: Increased anxiety and arousal Re-experiencing the traumatic event Avoidance of stimuli associated with the trauma.

Symptoms in each category must last more than one month. Etiology: classical conditioning & operant conditioning Environment triggers same response as original event, avoiding triggers reduces fear; prevent extinguishment. Treatment: CISD - critical incident stress debriefing is used to try and prevent the development of PTSD. Imaginal exposure: gain mastery and eliminate anxiety

involve a disabling disturbance in emotion

Depression is an emotional state marked by Sadness Feelings of worthlessness and guilt Withdrawal from others Reduced sleep, appetite, sexual desire, interest or pleasure in usual activities.

is an emotional state marked by Intense, unfounded elation Hyperactivity, talkativeness, distractibility, flight of ideas

Major Depressive Disorder (unipolar) diagnosis requires either depressed mood or loss of interest & pleasure for 2 weeks; plus 4 of the following: Sad, depressed daily mood Loss of interest in usual activities Difficulties in sleeping (too much or too little) Poor appetite and weight loss (or increased appetite and weight gain.) Loss of energy, great fatigue Negative self-concept (feelings worthlessness or guilt) Recurrent thoughts of suicide or death Difficulty concentrating

Bipolar I disorder involves alternating episodes of mania and depression Diagnosis: elevated or irritable mood, abnormal increased activity or energy, plus 3 additional symptoms for at least 1 week. (4 if manic state is irritable) Increase in activity level (work, social, sexual) Unusual talkativeness, rapid speech Reduced requirements for sleep Inflated self-esteem, belief that one has special powers, talents or abilities Distractability, attention easily diverted Reckless spending or other excessive indulgences that have negative consequences later. Flights of ideas

involves alternating episodes of depression and hypomania (above normal elevation of mood, but not as extreme as mania) Hypomania must be present for 4 days for diagnosis. Doesn't impair social or occupational functioning.

Psychotic : delusions or hallucinations. Melanchotic: no pleasure in any activity Seasonal Affective Disorder: depression occurs at certain times of the year (usually winter). Treatment: Phototherapy - exposing people to bright light for several hours a day

refers to long-term changes in mood that are less severe than that of major depressive or bipolar disorder. Must be present for 2 years: 2 types

refers to frequent periods of depressed mood and hypomania. These periods may be separated by periods of normal mood.

involves chronic depression. It is distinguished from major depression in that only 3 of the 5 symptoms must be present. Also, the duration must be 2 months (instead of 2 wks).

Psychoanalytic theory views grief over object loss as the basis for depression. Mourner introjects lost object or person into self, but since people harbor negative feeling towards what they love, they then turn the negative feeling inward. Cognitive views of depression include: Beck's theory of depression: the way depressed people think is biased towards negative interpretations; Schema included the Negative triad: self, world & future Learned helplessness: depressed people are passive because they have been unable in the past to control traumatic events

-Arbitrary influence refers to a conclusion drawn in the absence of sufficient evidence *Ex. I'm worthless because it rained the day I wanted to go to the beach. -Selective abstraction refers to a conclusion drawn on one of many elements in a situation *Ex. New product fails, I must be worthless even though many other people worked on the project. -Overgeneralization refers to an overall sweeping conclusion drawn on a basis of a trivial event. *Ex. I failed my psych exam which proves I'm stupid and worthless. -Magnification of trivial events *Ex. I scratched my new car, it's totally ruined! I'm a jerk!

*Attribution - explanation one has for his behavior *Learned helplessness view is that depression is a response to a history of failing to control traumatic life events *The Attribution-Learned helplessness view is that depressed people make global, stable and internal attributions Ex. I failed the GRE math exam. Reason: Global - I can't do anything right Stable - I don't test well Internal - I'm stupid *Hopelessness view is that depressed persons expect that desired outcomes will not occur, their actions will have no effect

Interpersonal relations are altered in depression; Depressed people: - have limited social support networks - elicit rejection by always asking for reassurance - are low in social skills across a wide variety of situations - seek reassurance from others, but reassurance is temporary

Genetic factors - evidence in adoption & twin studies in severe cases (37% for MDD and 93% for Bipolar); but results have not been reliably replicated Neurochemistry: link high norepinephrine (NE) & Dopamine (DA) to mania & low NE and serotonin (5-HT) to depression. Low 5-HIAA (5-HT) metabolites in CSF of suicidal patients. 20% below median killed themselves, none above median killed themselves. Low-tryptophan diet triggered depression in patients on antidepressants.

Often related to depression, drug use & borderline personality disorder Suicide is the 10th leading cause of death in the US There are gender differences in the methods of suicide (men choose guns, women choose drugs)

People who talk about suicide won't do it (75% do) Suicide has no warning (most communicate their intention) All who commit suicide are depressed (just over half) Suicidal people clearly want to die (most are thankful when unsuccessful) Thinking about suicide is rare (about 10%) Factors: Neurobiology - low serotonin, genetics 48% heritability, impulsivity Social - isolation, lack of belonging, publicity, economic recession Psychological - lack of problem solving skills, hopelessness Treatment: medication, Reason for Living Inventory, CBT (cognitive behavioral therapy)

Anxiety: an unpleasant feeling of fear & apprehension Fear - reaction to immediate danger. Anxiety disorders are diagnosed when subjectively experienced feelings of anxiety are clearly present. Co-morbidity: A person may be diagnosed with more than one disorder (common with phobias)

Phobia - fear-mediated avoidance that is out of proportion to the object or situation Criteria for diagnosis: Marked intense fear triggered by an object or situation Disrupts normal functioning; object or situation is avoided or intense distress is experienced when trigger must be endured. Symptoms persist at least 6 months

Specific phobias are unwarranted fears caused by the presence of a specific object or situation Blood, injuries, or injections Situations (planes, elevators) Animals Natural environment (water, heights, lightening) Social Anxiety Disorder (social phobia) involves a persistent fear linked to the presence of other people; more intense than shyness. Can be either general or specific. Selective mutism: occurs when an extremely shy child refuses to speak in unfamiliar circumstances.

Psychoanalytic theory: phobias result from anxiety produced by repressed id impulses Behavioral theories: focus on learning as the etiological basis of phobias Phobias are learned avoidance responses Ex. Classical conditioning, operant conditioning Phobias may be acquired through modeling; EX. vicarious learning - learn phobic reactions by observing others Prepared learning: We are biologically prepared to learn certain fears (Ex. conditioned taste aversion) Cognitive theory: Thought processes result in high levels of anxiety. Attend to negative stimuli, worried about evaluation of themselves by others.

Psychoanalytic therapy attempts to uncover repressed conflicts using free association Behavioral approaches 1. systematic desensitization : while relaxed, the subject imagines a series of increasingly fearful exposure to phobic stimuli & situations - may include actual exposure at end. 2. Modeling: witness either filmed or live demonstrations of other people interacting with the phobic object. 3.Flooding: exposure to a phobic stimulus at full intensity Cognitive approach: focus on altering irrational beliefs Biological approach: uses drugs to eliminate anxiety symptoms Anxiolytic drugs - benzodiazepines (Valium, Xanax), reduces anxiety; may be addictive Antidepressants - Selective serotonin reuptake inhibitors (SSRI's) Fluoxetine (Prozac) increase brain serotonin

Panic disorder involves an attack of labored breathing, nausea, chest pain, dizziness & intense apprehension (terror) Depersonalization: feeling of being outside of one's body Derealization: the feeling that the world is not real *Also fears of losing control, going crazy or even dying. Lifetime prevalence: 2% for men and 5% for women

suggests that some people have an overly aroused nervous system and a tendency to be upset by the sensations generated by their nervous system (interoceptive conditioning) Eventually, worry about a panic attack makes a future attack more likely (vicious circle) Agoraphobia may be more of a fear of a panic attack in public, rather than a fear of public places.

Biological treatments include use of antidepressant and anxiolytic drugs (Valium & Xanax) & SSRI's Require long-term use, symptoms return upon drug cessation Psychological treatments emphasize exposure to stimuli that accompany panic PCT (panic control therapy) includes 3 main components (1) relaxation training (2) cognitive-behavioral interventions and (3) exposure to the internal cues that elicit panic attacks. PCT is usually superior to medication.

Generalized Anxiety Disorder (GAD) involves persistent anxiety & chronic (uncontrollable) worry. Tend to worry about health problems and daily concerns. Usually do not seek treatment. Lifetime prevalence of GAD is 5%. Women are twice as likely to develop GAD as men Therapies for GAD

Psychoanalytic therapy: similar to that of phobia (reveal sources of conflict) Behavioral therapy: combination of relaxation training and cognitive intervention Biological therapy: anxiolytic drugs to reduce anxiety Drug therapy is effective while the drugs are taken

Diagnosis: The classification of disorders by symptoms and signs. Advantages of classification Facilitates communication among professionals who study and treat disorders. Advances the search for causes and treatments. DSM-5 (Diagnostic and Statistical Manual of Mental Disorders 5th edition - published in May 2013) created & published by the American Psychiatric Association (APA) in 1952. DSM is categorical: Presence/absence of a disorder Either you are anxious or you are not anxious. vs. Dimensional: Rank on a continuous quantitative dimension How anxious are you on a scale of 1 to 10?

Categories do not capture the uniqueness of a person. The disorder does not define the person. The person is an individual with a schizophrenic disorder; not a "schizophrenic" 3. Classification may emphasize trivial similarities Relevant information may be overlooked. 4. Too many diagnoses - over 300; expansion of categories may turn common reactions into mental disorders Ex. acute stress disorder after trauma 5. Diagnostic label may be harmful Treated differently by others Difficulty finding a job

Techniques employed to: 1. Describe client's problem 2. Determine causes of problem 3. Arrive at a diagnosis 4. Develop a treatment strategy 5. Monitor treatment progress * Ideal assessment involves multiple measures and methods: Interviews, personality inventories, etc

Interviewer attends to how questions are answered Does client fail to answer question? Is response accompanied by appropriate emotion? Paradigm influences information sought Does the interviewer focuses on current, rather than early childhood, events. Good rapport essential Empathy and accepting attitude Formal (structured) vs. informal interview Structured: All interviewers ask the same questions in a predetermined order Informal: varies according to the paradigm employed by the interviewer

Personality Inventory Minnesota Multiphasic Personality Inventory (MMPI) Self report:yields profile of psychological functioning. Subscales to detect lying & faking 2. Projective Tests Rorshach Inkblot Test & Thematic Apperception Test (TAT) Responses to ambiguous stimuli reflect unconscious processes and/or personality 3. Intelligence tests Wechsler Adult Intelligence Scale, 4th Ed (WAIS-III); Wechsler Intelligence Scale for Children, 4th Ed (WISC-III) Assesses current mental ability

study of the nature, development and treatment of abnormal behavior

Statistical infrequency - fall at extreme end of curve Violation of norms - behavior that most members of society would consider abnormal. Personal distress - behavior that creates distress and personal suffering Disability or behavioral dysfunction - behavior that impairs the individual's functioning in an important area of life. Unexpectedness - when a response to a stressor is extreme or unexpected.

Demonology - evil being inhabits the person and controls the mind & body Treatment - exorcism (cast out evil spirits by rituals or torture) Somatogenesis - (Hippocrates; 5th century B.C. father of modern medicine) Something wrong with the physical body causes a disturbance in thought & action Psychogenesis - disturbance in thought & action has psychological origins

*13th century - witches Lunacy *15th century, asylums established - housed the mentally ill (& often times beggars) *St. Mary of Bethlehem (London) was first hospital solely for the mental ill. Became a London tourist attraction, known as Bedlam *Pinel - late 18th century, first to treat mentally ill as sick patients. This humanitarian approach became know as Moral Treatment.

(1856 - 1926)- first to point out that groups of symptoms, called syndromes, appeared together regularly in mental illnesses in the same manner that physical illnesses do. He proposed 2 categories - Schizophrenia and manic-depressive psychosis. They became the basis of the diagnostic categories used today.

deterioration of mental and physical health was designated a disease called general paresis. Syphilis helped promote the idea of a biological origin of psychopathology.

conceptual framework or approach within a scientist works Perspective that guides how problem is conceptualized. Impacts how data is collected and interpreted.

Genetic paradigm: heritability - extent that variability in behavior is due to genetic factors. Twin studies: shared environment and nonshared environment Monozygotic and dizygotic studies: concordance rate (agreement rate) Genotype (total genetic makeup) vs phenotype (observable body type and behavior) Gene - environment interactions Diathesis (inherited predisposition) -stress paradigm 2. Neuroscience - neurotransmitter levels; structure and function of the brain Psychoanalytic: Freud: Id, ego, superego Unconscious conflict developmental stages Psychodynamic: Jung: masculine and feminine traits, religious and spiritual, collective unconscious Cognitive Irrational thoughts - learn new ways of thinking to remove distress or abnormal behavior Schema: cognitive set used to organize information Behaviorism Operant conditioning - B. F. Skinner Time out - negative reinforcement token economy: positive reinforcement Humanistic People are basically good. Unconditional positive regard / empathy- Carl Rogers Client centered therapy Individual free will Focus is on intervention make people aware they change Existential Stress is unavoidable due to choices: stresses confrontation of choices both past and present. Authenticity is key in therapy and life. Goal is to make you aware of choices Gestalt Focus on therapy session; not origin of behavior abnormal behavior is result of denial of innate goodness - I language - taking responsibility Empty chair

Biological - removes personal responsibility; reductionism Psychoanalytic: Freud small sample, not representative of population Humanistic - difficult to tell if therapist understands client Behaviorism: Learning - difficult to link disorders to a particular learning experience