Psy 100-Psychological Disorders & Treatment

What is exposure therapy?

A form of intervention in which the patient engages with a problematic (usually feared) situation without avoidance or escape

What is mindfulness-based therapy (MBT)?

A form of psychotherapy grounded in mindfulness theory and practice, often involving meditation, yoga, body scan, and other features of mindfulness exercises

What is posttraumatic stress disorder (PTSD)?

A sense of intense fear, triggered by memories of a past traumatic event, that another traumatic event might occur. PTSD may include feelings of isolation and emotional numbing.

When agoraphobia develops in the absence of panic attacks, it is considered:

A separate disorder in DSM-5 (but agoraphobia often accompanies panic disorder)

What is magnetic resonance imaging?

A set of techniques that uses strong magnets to measure either the structure of the brain (e.g. gray matter and white matter) or how the brain functions when a person performs cognitive tasks (e.g. working memory or episodic memory) or other types of tasks

30-80% of children diagnosed with ADHD continue to show symptoms in:

Adulthood

Higher prevalence rates of MDD are associated with lower SES, particularly for what group of people?

Adults over 65 years old

Psychoactive drugs can either increase activity at the synapse (_____) or reduce activity at the synapse (_____)

Agonists, antagonists

If the person begins to avoid several places or situations, or still endures these situations but does so with a significant amount of apprehension and anxiety, then the person also has:

Agoraphobia

Panic disorder is closely related to:

Agoraphobia

Antidepressants such as SSRIs and SNRIs are the primary choice of treatment for depression, whereas for BD, _____ is the first line treatment choice

Lithium

What is a treatment for bipolar disorder (BD)?

Lithium (for manic episodes)

How does lithium work?

Lithium acts on several neurotransmitter systems in the brain through complex mechanisms, including reduction of excitatory (dopamine and glutamate) neurotransmission, and increasing of inhibitory (GABA) neurotransmission

Metabolism involves the breakdown of psychoactive drugs, and this occurs primarily in the:

Liver

What is anhedonia?

Loss of interest or pleasure in activities one previously found enjoyable or rewarding

Higher prevalence rates of MDD are associated with higher or lower SES?

Lower

Prevalence of MDD among older adults is much lower or higher than it is for younger cohorts?

Lower

PDD has overlapping symptoms with:

MDD

Approximately 3%-6% of women who have a child experience _____ with peripartum onset

MDE (less frequent and different from the baby blues or when women feel transient mood symptoms usually within 10 days of giving birth, which are experienced by most women)

Obsessive-compulsive personality disorder is largely a disorder of which one trait?

Maladaptive conscientiousness

Histrionic personality disorder is largely a disorder of which one trait?

Maladaptive extraversion, including such traits as attention-seeking, seductiveness, melodramatic emotionality, and strong attachment needs

Which group has a higher prevalence rate of MDD than European Americans, African Americans, or Hispanic Americans?

Native Americans

Because the lifetime prevalence for MDD is 16.6%, this means:

Nearly one in five Americans will meet the criteria for MDD during their lifetime

Are positive or negative symptoms more difficult to treat?

Negative (different underlying causes)

Haloperidol and chlorpromazine have little to no effects on:

Negative symptoms

Some of the most debilitating symptoms of schizophrenia are difficult for others to see-these include what people refer to as:

Negative symptoms

By contrast, the contribution of shared environmental effect by siblings is:

Negligible (insignificant)

Psychoactive drugs exert their effects on behaviour by altering:

Neuronal communication in the brain

Virtually all psychoactive drugs interfere with or alter how:

Neurons communicate with each other

Persons who have very high elevations on _____ (i.e. persons with borderline personality disorder) experience life as one of pain and suffering, and they will seek treatment to alleviate this severe emotional distress

Neuroticism

Borderline personality disorder is largely a disorder of which one trait?

Neuroticism, including such traits as emotionally unstable, vulnerable, overwhelmed, rageful, depressive, and self-destructive

Minor stress events may predict which MDEs?

Subsequent episodes rather than the initial episode

What is reappraisal/cognitive restructuring?

The process of identifying, evaluating, and changing maladaptive thoughts in psychotherapy

An important aspect of the PCT relationship is the therapist's _____ for the patient's feelings and behaviours

Unconditional positive regard

Psychoanalysis stresses that mental health problems are rooted in:

Unconscious conflicts and desires

Whereas _____ had the highest lifetime prevalence (4.4%), _____ had the lowest (0.1%)

United States, India

Beck and Ellis strove to help patients identify maladaptive appraisals, which are:

Untrue judgments and evaluations of certain thoughts

The likelihood of developing schizophrenia is also higher for kids who grow up in what settings?

Urban settings

As with MDD, _____ is known to be a significant risk period for BD

Adolescence

What characterizes Persistent depressive disorder (PDD; dysthymia)?

"Depressed mood most of the day, more days than not, for at least two years"

Many of the atypical antipsychotics are associated with side effects referred to as the:

"Metabolic syndrome"

Whereas most people when they have a strange or frightening thought are able to let it go, a person with OCD may become:

"Stuck" on the thought and be intensely afraid that they might somehow lose control and act on it (or worse, they believe that having the thought is just as bad as doing it)

How does deep brain stimulation work and what is it used for?

- Deep brain stimulation involves implanting an electrode in the brain, the electrode is connected to an implanted neurostimulator, which electrically stimulates that particular brain region (although there is some evidence of its effectiveness, additional research is needed) -A treatment option for patients who did not respond to more traditional treatments like those already described (ECT & TMS)

Give an example of how someone with schizophrenia or another psychotic disorder could appear like:

- They may have been dressed in an unusual way, perhaps disheveled or wearing an unusual collection of clothes, makeup, or jewelry that did not seem to fit any particular group or subculture -They may have been talking to themselves or yelling at someone you could not see - If you tried to speak to them, they may have been difficult to follow or understand, or they may have acted paranoid or started telling a bizarre story about the people who were plotting against them

Flat affect and reduced speech (alogia) reflect:

-A lack of showing emotions through facial expressions, gestures, and speech intonation -A reduced amount of speech and increased pause frequency and duration

Give examples of people who have phobias:

-A patient at a clinic turned down a prestigious and coveted artist residency because it required spending time near a wooded area, bound to have insect -Another patient purposely left her house two hours early each morning so she could walk past her neighbor's fenced yard before they let their dog out in the morning

Give examples of how SAD can interfere with someones life:

-A patient compromised her perfect 4.0 grade point average because she could not complete a required oral presentation in one of her classes, causing her to fail the course -Fears of negative evaluation might make someone repeatedly turn down invitations to social events or avoid having conversations with people, leading to greater and greater isolation

Give an example of how personality disorders are heterogeneous:

-A person can meet diagnostic criteria for the antisocial, borderline, schizoid, schizotypal, narcissistic, and avoidant personality disorders and yet have only one diagnostic criterion in common -For example, only five of nine features are necessary for the diagnosis of borderline personality disorder; therefore, two persons can meet criteria for this disorder and yet have only one feature in common

What are criteria to receive a diagnosis of OCD?

-A person must experience obsessive thoughts and/or compulsions that seem irrational or nonsensical, but that keep coming into their mind -Engaging in obsessions and/or compulsions must take up a significant amount of the person's time, at least an hour per day, and must cause significant distress or impairment in functioning

How do typical antipsychotics work?

-A strong block of the D2 type dopamine receptor -Help reduce hallucinations, delusions, and disorganized speech -Do little to improve cognitive deficits or negative symptoms and can be associated with distressing motor side effects

Most phobic reactions cause:

-A surge of activity in the sympathetic nervous system -Increased heart rate and blood pressure -Maybe even a panic attack

What combination of traits is antisocial personality disorder?

-Antagonism (e.g. dishonest, manipulative, exploitative, callous, and merciless) -Low conscientiousness (e.g., irresponsible, immoral, lax, hedonistic, and rash)

Describe how borderline personality disorder includes some traits from other domains:

-Antagonism (e.g. manipulative and oppositional) -Low conscientiousness (e.g. rash)

Describe how histrionic personality disorder includes some traits from other domains:

-Antagonism (e.g. vanity) -Low conscientiousness (e.g. impressionistic)

Give examples of how people with personality disorders impact on the treatment of other mental disorders:

-Antisocial persons will tend to be irresponsible and negligent -Borderline persons can form intensely manipulative attachments to their therapists -Paranoid patients will be unduly suspicious and accusatory -Narcissistic patients can be dismissive and denigrating -Dependent patients can become overly attached to and feel helpless without their therapists

What are some cognitive factors of anxiety disorders?

-Attention to and perception of threat-Ambiguous stimuli (e.g. "At the meeting, your contribution elicits reactions") -Classical and operant conditioning (e.g. in OCD)

Common symptoms (across anxiety disorders) include:

-Autonomic system arousal -Worry/anxiety/tenseness -Restlessness -Excessive startle response

What can result from postpartum depression?

-Because motherhood is conventionally thought of as a joyous event and not associated with sadness and hopelessness, responding to a newborn baby in this way can be shocking to the new mother as well as those close to her -It may also involve a great deal of shame for the mother, making her reluctant to divulge her experience to others, including her doctors and family

Anxiety disorders develop out of a blend of:

-Biological (genetic) factors -Psychological factors -Stress

How do tricyclics work, and what are their side effects?

-Block the reabsorption of norepinephrine, serotonin, or dopamine at synapses, resulting in their increased availability -Most effective for treating vegetative and somatic symptoms of depression -Serious side effects, the most concerning of which is being cardiotoxic

There is agreement within the field with regard to the empirical support for which personality disorders?

-Borderline -Antisocial -Schizotypal

How does psychodynamic therapy differ from psychoanalytic therapy?

-Briefer -Makes more of an effort to put clients in their social and interpersonal context -Focuses more on relieving psychological distress than on changing the person

What are some advantages of CBT?

-CBT interventions tend to be relatively brief, making them cost-effective for the average consumer -CBT is an intuitive treatment that makes logical sense to patients -CBT can also be adapted to suit the needs of many different populations

Describe what auditory hallucinations are like:

-Can involve one or more voices talking about the person, commenting on the person's behaviour, or giving them orders -The content of the hallucinations is frequently negative ("you are a loser," "that drawing is stupid," "you should go kill yourself") -Can be the voice of someone the person knows or a complete stranger -Sometimes the voices sound as if they are coming from outside the person's head -Other times the voices seem to be coming from inside the person's head, but are not experienced the same as the person's inner thoughts or inner speech

Some psychotropic drugs that are likely to interact with grapefruit juice include:

-Carbamazepine (Tegretol), prescribed for bipolar disorder -Diazepam (Valium), used to treat anxiety, alcohol withdrawal, and muscle spasms -Fluvoxamine (Luvox), used to treat obsessive compulsive disorder and depression

Give examples of how agoraphobia can cause disruption in a person's life:

-Causing them to go out of their way to avoid situations, such as adding hours to a commute to avoid taking the train -Only ordering take-out to avoid having to enter a grocery store

People with BD experience what following a severe life stressor?

-Have substantially increased risk of relapse -Suffer more depressive symptoms

Problems in working memory and cognitive control in schizophrenia caused by problems in the DLPFC include:

-Changes in how the DLPFC works when people are doing working-memory or cognitive-control tasks -Problems with how this brain region is connected to other brain regions important for working memory and cognitive control, including the posterior parietal cortex, the anterior cingulate, and temporal cortex

A major depressive episode (MDE) refers to symptoms that co-occur for how long and cause what?

-Co-occur for at least two weeks -Cause significant distress or impairment in functioning, such as interfering with work, school, or relationships

Give an example of how CBT works:

-Consider how a CBT therapist would view a patient who compulsively washes her hands for hours every day -First, the therapist would identify the patient's maladaptive thought: "If I don't wash my hands like this, I will get a disease and die" -The therapist then identifies how this maladaptive thought leads to a maladaptive emotion: the feeling of anxiety when her hands aren't being washed -And finally, this maladaptive emotion leads to the maladaptive behaviour: the patient washing her hands for hours every day

The treatments used in MBCT have been used to address a wide range of illnesses, including:

-Depression -Anxiety -Chronic pain -Coronary artery disease -Fibromyalgia

What are the side effects of SSRIs and SNRIs?

-Difficulty having orgasms -Gastrointestinal issues -Insomnia

For someone with OCD, these thoughts and compulsive behaviours:

-Don't just come and go -Are taken to mean something much more important and real, maybe even something dangerous or frightening

Some examples of obsessions include:

-Doubting thoughts (such as doubting a door is locked or an appliance is turned off) -Thoughts of contamination (such as thinking that touching almost anything might give you cancer) -Aggressive thoughts or images that are unprovoked or nonsensical

How does Electroconvulsive therapy (ECT) work, what is it used for, and what are its side effects?

-ECT involves inducing a seizure after a patient takes muscle relaxants and is under general anesthesia -ECT is viable treatment for patients with severe depression or who show resistance to antidepressants although the mechanisms through which it works remain unknown -A common side effect is confusion and memory loss, usually short-term

To receive a diagnosis of PTSD, exposure to the event must include:

-Either directly experiencing the event -Witnessing the event happening to someone else -Learning that the event occurred to a close relative or friend -Having repeated or extreme exposure to details of the event (such as in the case of first responders)

What characterizes manic episodes?

-Elevated mood -Increased activity -Diminished need for sleep -Grandiose ideas -Racing thoughts -Extreme distractibility

Describe extinction learning/exposure therapy with the example of someone fearing spiders:

-Exposure therapy for someone terrified of spiders might begin with him looking at a cartoon of a spider, followed by him looking at pictures of real spiders, and later, him handling a plastic spider -After weeks of this incremental exposure, the patient may even be able to hold a live spider -After repeated exposure (starting small and building one's way up), the patient experiences less physiological fear and maladaptive thoughts about spiders, breaking his tendency for anxiety and subsequent avoidance

Give an example of avoidance of certain external cues in PTSD:

-External stimuli that were present during the trauma can also become strong triggers -For example, if a woman is raped by a man wearing a red t-shirt, she may develop a strong alarm reaction to the sight of red shirts, or perhaps even more indiscriminately to anything with a similar colour red -A combat veteran who experienced a strong smell of gasoline during a roadside bomb attack may have an intense alarm reaction when pumping gas back at home

What is a disadvantage of PCT?

-Findings about its effectiveness are mixed-one possibility for this could be that the treatment is primarily based on UNSPECIFIC treatment factors -That is, rather than using therapeutic techniques that are specific to the patient and the mental problem (i.e. SPECIFIC treatment factors), the therapy focuses on techniques that can be applied to anyone (e.g. establishing a good relationship with the patient) -Similar to how "one-size-fits-all" doesn't really fit every person, PCT uses the same practices for everyone, which may work for some people but not others

There is compelling multivariate behaviour genetic support with respect to (in terms of personality disorders):

-Five-Factor Model -Childhood antecedents -Universality -Temporal stability across the lifespan -Ties with brain structure -Molecular genetic support for neuroticism

Obsessive compulsive disorder (OCD) involves:

-Frequent intrusive thoughts and compulsive actions -Anticipated catastrophe and loss of control

Primary anxiety-related diagnoses include:

-Generalized anxiety disorder -Panic disorder -Specific phobia -Social anxiety disorder (social phobia) -Post traumatic stress disorder -Obsessive-compulsive disorder

What 2 factors influence development of schizophrenia?

-Genetic component -Environmental stress

What are some biological factors for mood disorders?

-Genetics -Monoamine deficiency (e.g. serotonin) -Biological rhythms

What are some biological factors of anxiety disorders?

-Genetics; inhibited temperamental style -Abnormal brain activity (e.g. caudate in OCD)

Give an example of a reinforced response caused by worrying:

-If a mother spends all night worrying about whether her teenage daughter will get home safe from a night out and the daughter returns home without incident, the mother could easily attribute her daughter's safe return to her successful "vigil" -What the mother hasn't learned is that her daughter would have returned home just as safe if she had been focusing on the movie she was watching with her husband, rather than being preoccupied with worries -In this way, the cycle of worry is perpetuated, and, subsequently, people with GAD often miss out on many otherwise enjoyable events in their lives

Give an example of how a therapist plays a receptive role in psychoanalytic therapy:

-If during therapy a patient begins to express unjustified anger toward the therapist, the therapist may recognize this as an act of transference (the patient may be displacing feelings for people in his or her life (e.g. anger toward a parent) onto the therapist) -At the same time, though, the therapist has to be aware of his or her own thoughts and emotions, for, in a related process, called countertransference, the therapist may displace his/her own emotions onto the patient

Give an example of a maladaptive appraisal:

-If it's your first time meeting new people, you may have the automatic thought, "These people won't like me because I have nothing interesting to share" -That thought itself is not what's troublesome; the appraisal (or evaluation) that it might have merit is what's troublesome

Give examples of how specific vulnerabilities may work:

-If we learned that physical illness is dangerous, maybe through witnessing our family's reaction whenever anyone got sick, we may focus our anxiety on physical sensations -If we learned that disapproval from others has negative, even dangerous consequences, such as being yelled at or severely punished for even the slightest offense, we might focus our anxiety on social evaluation -If we learn that the "other shoe might drop" at any moment, we may focus our anxiety on worries about the future

What are some side effects of lithium?

-Impaired cognitive function -Nausea -Tremor -Weight gain -Fatigue

What makes a person with GAD worry more than the average person?

-Individuals with GAD are more sensitive and vigilant toward possible threats than people who are not anxious-this may be related to early stressful experiences, which can lead to a view of the world as an unpredictable, uncontrollable, and even dangerous place -People with GAD worry as a way to gain some control over these otherwise uncontrollable or unpredictable experiences and against uncertain outcomes -People with GAD worry as a way to avoid feeling distressed

How do monoamine oxidase inhibitors (MAOIs) work, and what are their side effects?

-Inhibit monoamine oxidase, an enzyme involved in deactivating dopamine, norepinephrine, and serotonin -Although effective in treating depression, patients taking MAOIs may develop dangerously high blood pressure if they take certain drugs (e.g. antihistamines) or eat foods containing tyramine, an amino acid commonly found in foods such as aged cheeses, wine, and soy sauce

What combination of traits is avoidant personality disorder?

-Introversion (e.g. socially withdrawn, passive, and cautious) -Neuroticism (e.g. self-consciousness, apprehensiveness, anxiousness, and worrisome)

What are some advantages of PCT?

-It is highly acceptable to patients (people tend to find the supportive, flexible environment of this approach very rewarding) -Some of the themes of PCT translate well to other therapeutic approaches

Describe how antisocial personality disorder includes some traits from other domains:

-Low neuroticism (e.g. fearlessness and glib charm -Extraversion (e.g. excitement-seeking and assertiveness)

What are some situational/environmental factors for antisocial personality disorder?

-Low socio-economic status -Dysfunctional families -Childhood abuse

What are some biological factors for antisocial personality disorder?

-Lower levels of arousal -Lack of fear/anxiety -Amygdala abnormalities -Deficits in frontal lobe functioning

If there is no sharp line between normal and abnormal, what criteria do psychologists use to determine whether someone's behaviour is normal or abnormal?

-Maladaptive behaviour (not just abnormal) -The behaviour must interfere with at least one important aspect of the person's life

Why may have specific and explicit treatment manuals have not been developed for the other personality disorders?

-May reflect a regrettable assumption that personality disorders are unresponsive to treatment -May also reflect the complexity of their treatment

What are some other symptoms of GAD along with worrying?

-Muscle tension -Fatigue -Agitation or restlessness -Irritability -Difficulties with sleep (either falling asleep, staying asleep, or both) -Difficulty concentrating

Give examples of how other people with personality disorders besides borderline and avoidant don't seek treatment:

-Narcissistic individuals will rarely seek treatment to reduce their arrogance -Paranoid persons rarely seek treatment to reduce their feelings of suspiciousness -Antisocial people rarely (or at least willfully) seek treatment to reduce their disposition for criminality, aggression, and irresponsibility

Like MDD, the symptoms of PDD:

-Need to cause significant distress or impairment -Cannot be due to the effects of a substance or a general medical condition

Individuals with schizophrenia who have more problems with social cognition also tend to have more of what kinds of symptoms?

-Negative and disorganized symptoms -Worse community function

What combination of traits is dependent personality disorder?

-Neuroticism (anxious, uncertain, pessimistic, and helpless) -Maladaptive agreeableness (e.g. gullible, guileless, meek, subservient, and self-effacing)

Narcissistic personality disorder includes traits from:

-Neuroticism (e.g. reactive anger, reactive shame, and need for admiration) -Extraversion (e.g. exhibitionism and authoritativeness) -Antagonism (e.g. arrogance, entitlement, and lack of empathy) -Conscientiousness (e.g. acclaim-seeking)

Schizotypal personality disorder includes traits from:

-Neuroticism (e.g. social anxiousness and social discomfort) -Introversion (e.g. social withdrawal) -Unconventionality (e.g. odd, eccentric, peculiar, and aberrant ideas) -Antagonism (e.g. suspiciousness)

Give an example of a situation representing thought-action fusion:

-One patient was plagued by thoughts that she would cause harm to her young daughter -She experienced intrusive images of throwing hot coffee in her daughter's face or pushing her face underwater when she was giving her a bath -These images were so terrifying to the patient that she would no longer allow herself any physical contact with her daughter and would leave her daughter in the care of a babysitter if her husband or another family was not available to "supervise" her -In reality, the last thing she wanted to do was harm her daughter, and she had no intention or desire to act on the aggressive thoughts and images, nor does anybody with OCD act on these thoughts, but these thoughts were so horrifying to her that she made every attempt to prevent herself from the potential of carrying them out, even if it meant not being able to hold, cradle, or cuddle her daughter

The specific social situations that trigger anxiety and fear include:

-One-on-one interactions, such as starting or maintaining a conversation -Performance-based situations, such as giving a speech or performing on stage -Assertiveness, such as asking someone to change disruptive or undesirable behaviour

What are 2 things that patients learn in CBT?

-Patients learn how the automatic "appraisals" or thoughts they have about a situation affect both how they feel and how they behave -Similarly, patients learn how engaging in certain behaviours, such as avoiding situations, tends to strengthen the belief that the situation is something to be feared

What are some cognitive factors for mood disorders?

-Pessimistic (vs. optimistic) explanatory style -Beck's "cognitive triad"

Describe what Bipolar I Disorder (BD I) is characterized by:

-Previously known as manic-depression -Characterized by a single (or recurrent) manic episode - A depressive episode is not necessary but commonly present for the diagnosis of BD I

What are examples of some environmental factors that increase the risk of developing schizophrenia?

-Problems during pregnancy such as increased stress, infection, malnutrition, and/or diabetes -Complications that occur at the time of birth and which cause hypoxia (lack of oxygen) -Children born to older fathers

What are some examples of deficits in social cognition in people with schizophrenia?

-Problems with the recognition of emotional expressions on the faces of other individuals -Problems inferring the intentions of other people (theory of mind)

Hispanic Americans with BD have been shown to receive fewer:

-Psychiatric medication prescriptions -Specialty treatment visits

Name some stereotypes of psychological disorders:

-Psychological disorders are incurable -People with psychological disorders are often violent and dangerous -People with psychological disorders behave in bizarre ways and are very different from normal people

How does Transcranial magnetic stimulation (TMS) work, what is it used for, and what are its side effects?

-Repetitive TMS is a noninvasive technique administered while a patient is awake, brief pulsating magnetic fields are delivered to the cortex, inducing electrical activity -A promising treatment for patients with MDD who have shown resistance to other treatments -Has fewer side effects than ECT

Some examples of compulsive behaviours are:

-Repetitive washing (often in response to contamination obsessions) -Repetitive checking (locks, door handles, appliances often in response to doubting obsessions) -Ordering and arranging things to ensure symmetry -Doing things according to a specific ritual or sequence (such as getting dressed or ready for bed in a specific order)

Give an example of cognitive bias modification:

-Researchers might use a mobile app to train alcohol abusers to avoid stimuli related to alcohol -One version of this game flashes four pictures on the screen—three alcohol cues (e.g. a can of beer, the front of a bar) and one health-related image (e.g. someone drinking water) -The goal is for the patient to tap the healthy picture as fast as s/he can - Games like these aim to target patients' automatic, subconscious thoughts that may be difficult to direct through conscious effort, that is, by repeatedly tapping the healthy image, the patient learns to "ignore" the alcohol cues, so when those cues are encountered in the environment, they will be less likely to trigger the urge to drink

What did Brooke Shields reveal about her experience with postpartum depression?

-Revealed that entering motherhood was a profoundly overwhelming experience for her -She vividly describes experiencing a sense of "doom" and "dread" in response to her newborn baby

The spectrum of psychotic disorders includes:

-Schizophrenia -Schizoaffective disorder -Delusional disorder -Schizotypal personality disorder -Schizophreniform disorder -Brief psychotic disorder -Psychosis associated with substance use or medical conditions

What are the most recently introduced antidepressant medications?

-Selective serotonin reuptake inhibitors (SSRIs; e.g. Fluoxetine) -Serotonin and norepinephrine reuptake inhibitors (SNRIs; e.g. Duloxetine)

People with schizophrenia who have more severe cognitive problems also tend to have more or what kinds of symptoms?

-Severe negative symptoms -More disorganized speech and behaviour

What are some answers as to why mental illness may have increased over the years?

-Some believe that greater public awareness has contributed to increased teacher and parent referrals -Others argue that the increase stems from changes in criterion currently used for diagnosing -Still others suggest environmental factors, either prenatally or postnatally, have contributed to this upsurge

Give an example of manifest and latent content in a dream:

-Someone may have a dream that his/her teeth are falling out—the manifest or actual content of the dream -However, dreaming that one's teeth are falling out could be a reflection of the person's unconscious concern about losing his or her physical attractiveness—the latent or metaphorical content of the dream

Give an example of avoidance of certain internal cues in PTSD:

-Someone might avoid watching intense or emotional movies in order to prevent the experience of emotional arousal -Avoidance of conversations, reminders, or even of the experience of emotion itself may also be an attempt to avoid triggering internal cues

Give examples of how one may begin to avoid a number of situations or activities that produce the same physiological arousal that was present during the beginnings of a panic attack:

-Someone who experienced a racing heart during a panic attack might avoid exercise or caffeine -Someone who experienced choking sensations might avoid wearing high-necked sweaters or necklaces

What are 3 types of phobic disorders?

-Specific phobia (e.g., BII) -Social phobia (or social anxiety disorder) -Agoraphobia (with or without panic attacks)

Psychopaths are often:

-Superficially charming and rational -Insincere -Unsocial -Incapable of love -Lacking insight -Shameless

Prevalence estimates of bipolar spectrum disorders are highly dependent on:

-The diagnostic procedures used (e.g. interviews vs. self-report) -Whether or not sub-threshold forms of the disorder are included in the estimate

What are criteria to receive a diagnosis of SAD?

-The fear and anxiety associated with social situations must be so strong that the person avoids them entirely, or if avoidance is not possible, the person endures them with a great deal of distress -The fear and avoidance of social situations must get in the way of the person's daily life, or seriously limit their academic or occupational functioning

What causes someone to fear social situations to such a large extent? Give examples:

-The person may have learned growing up that social evaluation in particular can be dangerous, creating a specific psychological vulnerability to develop social anxiety (e.g. the person's caregivers may have harshly criticized and punished them for even the smallest mistake, maybe even punishing them physically) -Someone might have experienced a social trauma that had lasting effects, such as being bullied or humiliated -Someone else might react so strongly to the anxiety provoked by a social situation that they have an unexpected panic attack

What are the symptoms of PTSD after the event happens?

-The person subsequently re-experiences the event through both intrusive memories and nightmares (may have flashbacks) -The individual may avoid anything that reminds them of the trauma, including conversations, places, or even specific types of people -They may feel emotionally numb or restricted in their ability to feel, which may interfere in their interpersonal relationships -The person may not be able to remember certain aspects of what happened during the event -They may feel a sense of a foreshortened future, that they will never marry, have a family, or live a long, full life -They may be jumpy or easily startled, hypervigilant to their surroundings, and quick to anger

Give an example of a homework assignment that would be given to the hand-washing patient:

-The therapist may give the hand-washing patient a worksheet to take home; on this worksheet, the woman is to write down every time she feels the urge to wash her hands, how she deals with the urge, and what behaviour she replaces that urge with -When the patient has her next therapy session, she and the therapist review her "homework" together

How do therapy sessions work in PCT?

-The therapist tends only to ask questions and doesn't provide any judgment or interpretation of what the patient says -The therapist is present to provide a safe and encouraging environment for the person to explore these issues for him- or herself

Both MDE's and manic episodes can be further described using standardized tags based on:

-The timing of symptoms -Other symptoms that occur during the mood episode

Consider someone receiving a prescription for an antidepressant-what would the consequences be if they were either an ultra-extensive metabolizer or a poor metabolizer?

-The ultra-extensive metabolizer would be given antidepressants and told it will probably take 4 to 6 weeks to begin working, but they metabolize the medication so quickly that it will never be effective for them -In contrast, the poor metabolizer given the same daily dose of the same antidepressant may build up such high levels in their blood (because they are not breaking the drug down), that they will have a wide range of side effects and feel really badly - also not a positive outcome

Newer developments in the treatment of anxiety disorders are focusing on novel interventions, such as:

-The use of certain medications to enhance learning during CBT -Transdiagnostic treatments targeting core, underlying vulnerabilities

SSRIs and SNRIs have fewer serious side effects than do MAOIs and tricyclics, in particular:

-They are less cardiotoxic -Less lethal in overdose -Produce fewer cognitive impairments

What is psychoanalytic therapy?

Sigmund Freud's therapeutic approach focusing on resolving unconscious conflicts

Describe the method and goal of mindfulness-based stress reduction (MBSR):

-Uses meditation, yoga, and attention to physical experiences to reduce stress -The hope is that reducing a person's overall stress will allow that person to more objectively evaluate his or her thoughts

Fear of social evaluation might even extend to such things as:

-Using public restrooms -Eating in a restaurant -Filling out forms in a public place -Reading on a train

The "metabolic syndrome" includes:

-Weight gain and increased risk for cardiovascular illness -Type-2 diabetes -Mortality

What may be a solution to figuring out which type of dose of drug is right for which person?

-What if - instead - prior to prescribing an antidepressant, the doctor could take a blood sample and determine which type of metabolizer a patient actually was? -They could then make a much more informed decision about the best dose to prescribe - There are new genetic tests now available to better individualize treatment in just this way-a blood sample can determine (at least for some drugs) which category an individual fits into -We need data to determine if this actually is effective for treating depression or other mental illnesses -Currently, this genetic test is expensive and not many health insurance plans cover this screen, but this may be an important component in the future of psychopharmacology

Give examples of why antidepressants can be problematic:

-Why one antidepressant that helps one individual has no effect for another -Antidepressants can take 4 to 6 weeks to start improving depressive symptoms, and we don't really understand why -Many people do not respond to the first antidepressant prescribed and may have to try different drugs before finding something that works for them -Other people just do not improve with antidepressants

The 12-month prevalence for PDD is approximately __%

0.5%

__ in __ adults experiences a serious mental illness

1 in 17

How many women experience postpartum depression?

1 in 20

__ in __ people have an anxiety disorder during their lifetime

1 in 4

As many as __ in __ children between the ages of 5 and 17 may have some type of mental disorder (e.g. ADHD, autism, anxiety, depression)

1 in 5

It is now estimated that __ in __ children have been diagnosed with an autism spectrum disorder

1 in 88

MDD is defined by:

1 or more MDEs, but no history of manic or hypomanic episodes

The mood disturbance in a manic or hypomanic episode must be present for:

1 week or longer in mania (unless hospitalization is required) or 4 days or longer in hypomania

Diagnoses of what 3 other disorders across the lifetime are common for people with MDD?

1. 59% experience an anxiety disorder 2. 32% experience an impulse control disorder 3. 24% experience a substance use disorder

In PCT, the patient should experience what 2 things?

1. A vulnerability to anxiety, which motivates the desire to change 2. An appreciation for the therapist's support

What are 2 key advantages of mindfulness-based therapies?

1. Acceptability to patients 2. Accessibility to patients

What are 2 main forms of therapy for depression?

1. Antidepressants 2. Cognitive-behavioural therapy

What are 2 different forms of pharmacological treatment for schizophrenia?

1. Antipsychotics 2. Atypical (second generation) antipsychotics

What are the 10 types of personality disorders?

1. Antisocial 2. Avoidant 3. Borderline 4. Dependent 5. Histrionic 6. Narcissistic 7. Obsessive-compulsive 8. Paranoid 9 Schizoid 10. Schizotypal

What are 3 different types of psychosocial treatments?

1. Behaviour therapy 2. Cognitive therapy 3. Interpersonal therapy

Beck observed that these automatic thoughts arise from 3 belief systems, or schemas (a mental representation or set of beliefs about something):

1. Beliefs about the self 2. Beliefs about the world 3. Beliefs about the future

What are the major 3 types of bipolar disorders?

1. Bipolar I Disorder (BD I) 2. Bipolar II Disorder 3. Cyclothymic disorder

What are 4 major subtypes of specific phobia?

1. Blood-injury-injection (BII) type 2. Situational type (such as planes, elevators, or enclosed places) 3. Natural environment type for events one may encounter in nature (for example, heights, storms, and water) 4. Animal type

Which disorders are 2 exceptions to personality disorders being ego-syntonic?

1. Borderline 2. Avoidant

What are 6 examples of symptoms that are associated with psychotic disorders?

1. Delusions 2. Hallucinations 3. Disorganized speech and behaviour 4. Abnormal motor behaviour (including catatonia) 5. Negative symptoms such as anhedonia/amotivation 6. Blunted affect/reduced speech

Give 4 examples of positive symptoms in schizophrenia:

1. Delusions 2. Hallucinations 3. Loosening of associations 4. Disorganized behaviour

According to the fifth edition of the Diagnostic and Statistical Manual, the criteria for an MDE require 5 or more of the following 9 symptoms, including 1 or both of the first 2 symptoms, for most of the day, nearly every day:

1. Depressed mood 2. Diminished interest or pleasure in almost all activities 3. Significant weight loss or gain or an increase or decrease in appetite 4. Insomnia or hypersomnia 5. Psychomotor agitation or retardation 6. Fatigue or loss of energy 7. Feeling worthless or excessive or inappropriate guilt 8. Diminished ability to concentrate or indecisiveness 9. Recurrent thoughts of death, suicidal ideation, or a suicide attempt

What are 2 treatments for borderline personality disorder?

1. Dialectical behaviour therapy 2. Mentalization therapy

Other environmental factors related to increased risk for MDD include experiencing what 3 things?

1. Early adversity (e.g. childhood abuse or neglect) 2. Chronic stress (e.g. poverty) 3. Interpersonal factors (e.g. marital dissatisfaction predicts increases in depressive symptoms in both men and women)

What are other 3 biological treatments for people with depression?

1. Electroconvulsive therapy (ECT) 2. Transcranial magnetic stimulation (TMS) 3. Deep brain stimulation

The cognitive deficits that are present in schizophrenia are widespread and can include problems with what 3 things?

1. Episodic memory 2. Working memory 3. Other tasks that require one to "control" or regulate one's behaviour

For DSM-5 it was originally proposed that which 4 personality disorders be deleted?

1. Histrionic 2. Schizoid 3. Paranoid 4. Dependent

What are the 4 components of dialectical behaviour therapy?

1. Individual therapy 2. Group skills training 3. Telephone coaching 4. A therapist consultation team, that will typically last a full year

Concurrently, at least 3 of the following symptoms must be present in the context of euphoric mood (or at least 4 in the context of irritable mood) with manic or hypomanic episodes:

1. Inflated self-esteem or grandiosity 2. Increased goal-directed activity or psychomotor agitation 3. Reduced need for sleep 4. Racing thoughts or flight of ideas 5. Distractibility 6. Increased talkativeness 7. Excessive involvement in risky behaviours

What is dialectical behaviour therapy?

A form of cognitive-behaviour therapy that draws on principles from Zen Buddhism, dialectical philosophy, and behavioural science

What are the 2 most rapid routes of administration for drugs?

1. Inhalation (i.e. smoking or gaseous anesthesia) 2. Intravenous (IV) in which the drug is injected directly into the vein and hence the blood supply

What are 3 of the biggest changes found in the DSM-5?

1. Integration of dimensional and categorical approaches to diagnosis and assessment 2. Greater consideration of cross-cultural variation 3. Greater consideration of variation across the lifespan

Give 5 examples of negative symptoms in schizophrenia:

1. Isolation, withdrawal 2. Apathy 3. Blunted emotion 4. Slowed, monotonous speech 5. Slowed movement

What are 2 major types of unipolar disorders described by the DSM-5?

1. Major depressive disorder 2. Persistent depressive disorder (PDD; dysthymia)

The World Health Organization ranks what 2 disorders among the top 10 leading causes of disability worldwide?

1. Major depressive disorder (MDD) 2. Bipolar disorder (BD)

In Freudian theory, what are 2 components of dreams?

1. Manifest (or literal) content 2. Latent (or symbolic) content

What are 2 types of MBT that have become popular in recent years?

1. Mindfulness-based stress reduction (MBSR) 2. Mindfulness-based cognitive therapy (MBCT)

People with avoidant personality may also seek treatment for their high levels of what 2 things?

1. Neuroticism (anxiousness and self-consciousness) 2. Introversion (social isolation)

Personality disorders are divided into what 3 groups?

1. Odd or Eccentric Behaviour 2. Dramatic, Emotional, or Erratic Behaviour 3. Anxious or Fearful Behaviour

What are 5 different subtypes of schizophrenia (removed from DSM-5)?

1. Paranoid type 2. Disorganized type 3. Catatonic type 4. Undifferentiated type 5. Residual type

What are some alternative therapies for depression?

1. Phototherapy 2. Exercise 3. Electroconvulsive therapy (ECT) 4. Transcranial magnetic stimulation (TMS) 5. Deep brain stimulation (DBS)

At least 2 of the following 6 symptoms are also required to meet criteria for PDD:

1. Poor appetite or overeating 2 Insomnia or hypersomnia 3. Low energy or fatigue 4. Low self-esteem 5. Poor concentration or difficulty making decisions 6. Feelings of hopelessness

What are 3 other types of therapies besides CBT?

1. Psychoanalytic therapy 2. Person-centered therapy 3. Mindfulness-based therapies

What are 2 problems with anti-anxiety medications/antidepressants?

1. Relapse rates are high once medications are stopped 2. Some classes of medications (minor tranquilizers or benzodiazepines) can be habit forming

What are 2 components of mindfulness?

1. Self-regulation of attention 2. Orientation toward the present moment

What 3 things are needed to qualify for cyclothymic disorder?

1. The periods of depression cannot meet full diagnostic criteria for an MDE 2. The person must experience symptoms at least half the time with no more than two consecutive symptom-free months 3. The symptoms must cause significant distress or impairment

Compulsions are distinct in what 3 ways?

1. They must be repetitive or excessive 2. The person feels "driven" to carry out the behaviour 3. The person feels a great deal of distress if they can't engage in the behaviour

What are the 2 primary types of antipsychotic medications?

1. Typical 2. Atypical

The general population falls into what 4 categories in terms of metabolizing drugs?

1. Ultra-extensive metabolizers-break down certain drugs (like some of the current antidepressants) very, very quickly 2. Extensive metabolizers-are also able to break down drugs fairly quickly 3. Intermediate metabolizers-break down drugs more slowly than either of the two above groups 4. Poor metabolizers-break down drugs much more slowly than all of the other groups

A number of studies have suggested that delusions in psychosis may be associated with problems in "salience" (something standing out from the rest) detection mechanisms supported by what 2 areas of the brain?

1. Ventral striatum 2. Anterior prefrontal cortex

About __% of the population has met criteria for OCD over the course of a lifetime

1.6%

It is estimated that __% to __% of the general population meets criteria for at least one of the 10 DSM-IV-TR personality disorders, and quite a few more individuals are likely to have maladaptive personality traits not covered by one of the 10 DSM-5 diagnoses.

10% to 15%

As many as __% of the general population suffer from social phobia at some point in their lives, making it one of the most common anxiety disorders, second only to specific phobia

12.1%

__% of the population of the United States report a lifetime history of fears significant enough to be considered a "phobia"

12.5%

Between __% and __% of therapists have identified their own approaches as integrative or eclectic

13% to 42%

In a nationally representative sample, lifetime prevalence rate for MDD is __%

16.6%

Schizophrenia is a very heterogeneous disorder, which means that:

2 different people with "schizophrenia" may each have very different symptoms (e.g. one has hallucinations and delusions, the other has disorganized speech and negative symptoms)

A recent cross-national study (Merikangas et al. 2011) sample of more than 60,000 adults from 11 countries, estimated the worldwide prevalence of BD at __%, with BD I constituting __% of this rate

2.4%, 0.6%

When was the DSM-5 published?

2013

__% of adults experience a mental health issue in any given year, and this affects:

25%, not only the individual but their friends and family

It is estimated that __%-__% of people diagnosed with BD will attempt suicide at least once in their lifetimes

25%-50%

When high risk individuals with psychotic symptoms are followed over time, around __% of them develop a psychotic disorder, most frequently schizophrenia

35%

The lifetime prevalence rate of bipolar spectrum disorders in the general U.S. population is estimated at approximately __%, with BD I constituting about __% of this rate

4.4%, 1%

About __% of the population has met criteria for PD or agoraphobia over their lifetime

4.7%

The incidence of bipolar disorder in children and adolescents has also increased __ times in the past decade

40

As our population ages, some estimate that the proportion of people 65 or older will reach 20% of the U.S. population by 2030, with this group consuming __% of the prescribed medications

40%

Recovery begins within 3 months for __% of people with MDD and within 12 months for __%

40%, 80%

About __% of the population has met criteria for GAD at some point during their lifetime, making it one of the most common anxiety disorders

5.7%

Antisocial personality disorder may be diagnosed in as many as __% of inmates within a correctional setting

50%

The prevalence of personality disorders within clinical settings is estimated to be well above __%

50%

Typically __% to __% of patients receiving drugs or CBT will show a good initial response, with the effect of CBT more durable

50% to 80%

The prevalence of PTSD among the population as a whole is relatively low, with __% having experienced PTSD at some point in their life

6.8%

As many as __% of inpatients within some clinical settings are diagnosed with borderline personality disorder

60%

As of 2013, there are at least __ drugs shown to adversely interact with grapefruit juice

85

One group of researchers found that __% of adults in their study sample with social phobia experienced severe teasing and bullying in childhood, compared with only __% to __% among people with other anxiety disorders

92%, 35% to 50%

What is the "fight or flight" response?

A biological reaction to alarming stressors that prepares the body to resist or escape a threat

What is schizophreniform disorder?

A briefer version of schizophrenia

People with panic disorder tend to interpret even normal physical sensations in:

A catastrophic way

What is a neurotransmitter?

A chemical substance produced by a neuron that is used for communication between neurons

Anxiety and closely related disorders emerge from "triple vulnerabilities":

A combination of biological, psychological, and specific factors that increase our risk for developing a disorder

What does the DSM provide?

A common language and standard criteria for the classification and diagnosis of mental disorders

Because each personality disorder represents a constellation of personality traits, the etiology for the syndrome will involve:

A complex interaction of an array of different neurobiological vulnerabilities and dispositions with a variety of environmental, psychosocial events

What is social anxiety disorder (SAD)?

A condition marked by acute fear of social situations which lead to worry and diminished day to day functioning

What is panic disorder (PD)?

A condition marked by regular strong panic attacks, and which may include significant levels of worry about future attacks

To the extent that one considers the DSM-5 personality disorders to be maladaptive variants of general personality structure, as described, for instance, within the Five-Factor Model, there would be:

A considerable body of research to support the validity for all of the personality disorders, including even the histrionic, schizoid, and paranoid

Each of the 10 DSM-5 (and DSM-IV-TR) personality disorders is what concerning personality traits?

A constellation of maladaptive personality traits, rather than just one particular personality trait

Everyone experiences brief periods of sadness, irritability, or euphoria-this is different than having a mood disorder, such as MDD or BD, which are characterized by:

A constellation of symptoms that causes people significant distress or impairs their everyday functioning

What is obsessive-compulsive disorder (OCD)?

A disorder characterized by the desire to engage in certain behaviours excessively or compulsively in hopes of reducing anxiety. Behaviours include things such as cleaning, repeatedly opening and closing doors, hoarding, and obsessing over certain thoughts.

What is tardive dyskinesia?

A disorder resulting in involuntary, repetitive body movements-they have a slow or belated onset

The CORE criterion for a manic or hypomanic episode is:

A distinct period of abnormally and persistently euphoric, expansive, or irritable mood and persistently increased goal-directed activity or energy

What is an antagonist?

A drug that blocks a neurotransmitter's effect

What is a psychotropic drug?

A drug that changes mood or emotion, usually used when talking about drugs prescribed for various mental conditions (depression, anxiety, schizophrenia, etc.)/drugs that affect mental processes

What is a psychoactive drug?

A drug that changes mood or the way someone feels

What is an agonist?

A drug that increases or enhances a neurotransmitter's effect

What is cognitive-behavioural therapy (CBT)?

A family of approaches with the goal of changing the thoughts and behaviours that influence psychopathology

Humanistic and person-centred therapy, like psychoanalysis, involves what kind of conversation between the therapist and patient?

A largely unstructured conversation

What is a conditioned response?

A learned reaction following classical conditioning, or the process by which an event that automatically elicits a response is repeatedly paired with another neutral stimulus (conditioned stimulus), resulting in the ability of the neutral stimulus to elicit the same response on its own

In all of these cases of panic disorder, what was once an adaptive natural alarm reaction now becomes:

A learned, and much feared, false alarm

About 5%-10% of people who experience an MDE will later experience:

A manic episode

In terms of symptoms, people with BII type phobias usually experience:

A marked DROP in heart rate and blood pressure and may even faint (in this way, those with BII phobias almost always differ in their physiological reaction from people with other types of phobia)

What is schizoaffective disorder?

A mixture of psychosis and depression/mania symptoms

Longitudinal studies show that those diagnosed with BD PRIOR to adulthood experience what kind of course of illness relative to those with adult onset?

A more harmful course, including more episode recurrence, higher rates of suicidality, and profound social, occupational, and economic repercussions

What is anxiety?

A negative mood state that is accompanied by bodily symptoms such as increased heart rate, muscle tension, a sense of unease, and apprehension about the future

What is extinction learning?

A neurobiological and cognitive process by which the patient "unlearns" the irrational fear

What is a function of dopamine?

A neurotransmitter in the brain that is thought to play an important role in regulating the function of other neurotransmitters

There is little consensus as to whether _____ (sentence) in response to an emotional stimulus among people with BD compared with healthy controls

A particular brain region becomes more or less active in response

Unlike psychoanalysis, though, a THERAPIST using PCT takes what kind of role?

A passive role, guiding the patient toward his or her own self-discovery

Exploring childhood memories, through free association or otherwise, can provide therapists with insights into:

A patients' psychological makeup

What is socioeconomic status (SES)?

A person's economic and social position based on income, education, and occupation

What is dependent personality disorder?

A pervasive and excessive need to be taken care of that leads to submissive and clinging behaviour and fears of separation

What is schizoid personality disorder?

A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings

What is antisocial personality disorder?

A pervasive pattern of disregard and violation of the rights of others. These behaviours may be aggressive or destructive and may involve breaking laws or rules, deceit or theft. Also called psychopathy.

What is histrionic personality disorder?

A pervasive pattern of excessive emotionality and attention seeking

What is narcissistic personality disorder?

A pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration, and lack of empathy

What is borderline personality disorder?

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity

What is obsessive-compulsive personality disorder?

A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency

What is schizotypal personality disorder?

A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as perceptual distortions and eccentricities of behaviour

What is avoidant personality disorder?

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation

What is mindfulness?

A process that reflects a nonjudgmental, yet attentive, mental state/a process that tries to cultivate a nonjudgmental, yet attentive, mental state, is a therapy that focuses on one's awareness of bodily sensations, thoughts, and the outside environment

Schizophrenia and the other psychotic disorders are frequently associated with:

A profound negative effect on the individual's educational, occupational, and social function

What are enzymes?

A protein produced by a living organism that allows or helps a chemical reaction to occur (proteins that speed up a chemical reaction)

What is interpersonal and social rhythm therapy (IPSRT) for people with BD?

A psychosocial intervention focused on addressing the mechanism of action posited in social zeitgeber theory to predispose patients who have BD to relapse, namely sleep disruption

Anhedonia and amotivation do not seem to reflect a lack of enjoyment in pleasurable activities or events, but rather:

A reduced drive or ability to take the steps necessary to obtain the potentially positive outcomes

What is alogia?

A reduction in the amount of speech and/or increased pausing before the initiation of speech

What is flat affect?

A reduction in the display of emotions through facial expressions, gestures, and speech intonation

What is anhedonia/amotivation?

A reduction in the drive or ability to take the steps or engage in actions necessary to obtain the potentially positive outcome

What is countertransference?

A situation in which a therapist, during the course of therapy, unconsciously develops positive or negative feelings toward the patient

What is psychomotor retardation?

A slowing of physical activities in which routine activities (e.g. eating, brushing teeth) are performed in an unusually slow manner

What is agoraphobia?

A sort of anxiety disorder distinguished by feelings that a place is uncomfortable or may be unsafe because it is significantly open or crowded

What are biological vulnerabilities?

A specific genetic and neurobiological factor that might predispose someone to develop anxiety disorders

What does the acronym ADME stand for?

A standing for absorption (how the drug gets into the blood), Distribution (how the drug gets to the organ of interest, e.g. the brain), Metabolism (how the drug is broken down so it no longer exerts its psychoactive effects), and Excretion (how the drug leaves the body)

What is positron emission tomography?

A technique that uses radio-labelled ligands to measure the distribution of different neurotransmitter receptors in the brain or to measure how much of a certain type of neurotransmitter is released when a person is given a specific type of drug or does a particularly cognitive task

What is acceptance and commitment therapy (ACT)?

A therapeutic approach designed to foster nonjudgmental observation of one's own mental processes/patients are taught to observe their thoughts from a detached perspective

What is person-centred therapy (PCT)?

A therapeutic approach focused on creating a supportive environment for self-discovery

Give an example of integrative/eclectic psychotherapy:

A therapist may employ distress tolerance skills from DBT (to resolve short-term problems), cognitive reappraisal from CBT (to address long-standing issues), and mindfulness-based meditation from MBCT (to reduce overall stress)

What is dialectical behaviour therapy (DBT)?

A treatment often used for borderline personality disorder that incorporates both cognitive-behavioural and mindfulness elements

What is one tragic case of agoraphobia seen by a clinic?

A woman suffering from agoraphobia had not left her apartment for 20 years and had spent the past 10 years confined to one small area of her apartment, away from the view of the outside

Another form of treatment that also uses mindfulness techniques is:

Acceptance and commitment therapy (ACT)

Clinician-supervised online CBT modules allow patients to:

Access treatment from home on their own schedule—an opportunity particularly important for patients with less geographic or socioeconomic access to traditional treatments

How does clozapine work?

Acts on numerous neurotransmitter receptors, also treats negative symptoms, much lower risk of motor impairment, though not without their own significant side effects

The goal of CBT is to help people make what kind of appraisals?

Adaptive, instead of maladaptive, appraisals (e.g. "I do know interesting things!")

What is integrative or eclectic psychotherapy?

Also called integrative psychotherapy, this term refers to approaches combining multiple orientations (e.g. CBT with psychoanalytic elements)

What is the ego?

Also partly conscious—mediates between the id and superego

Virtually any drug that changes the way you feel does this by:

Altering how neurons communicate with each other

What characterizes bipolar disorder (BD)?

Alternating periods of depression and mania

What is the difference between CBT and MBCT?

Although cognitive behavioural therapy (CBT) may seem similar, it focuses on "pushing out" the maladaptive thought, whereas mindfulness-based cognitive therapy focuses on "not getting caught up" in it

If this alarm reaction (fight or flight) came "out of the blue," for no apparent reason, or in a situation in which you didn't expect to be anxious or fearful, this is called:

An "unexpected" panic attack or a false alarm

What kind of environment does unconditional positive regard create?

An environment free of approval or disapproval, where patients come to appreciate their value and to behave in ways that are congruent with their own identity

In humanistic/person-centred therapy, the belief is that mental health problems result from:

An inconsistency between patients' behaviour and their true personal identity

What is metabolic tolerance?

An increase in the enzymes produced by the liver (enzyme induction)

One area that has received interest in terms of treatment recently has to do with:

An individualized treatment approach

What is Applied Behavioural Analysis (ABA)?

An intensive treatment for autism, based on the principles of operant conditioning

What kind of approach does psychoanalysis take with its patients?

An intensive, long-term approach in which patients and therapists may meet multiple times per week, often for many years

To meet criteria for a diagnosis of specific phobia, there must be:

An irrational fear of a specific object or situation that substantially interferes with the person's ability to function

What can also be experienced during a panic attack?

An overwhelming urge to escape

Give an example of negative symptoms:

Anhedonia or amotivation reflect a lack of apparent interest in or drive to engage in social or recreational activities-

As a therapist spends more time with a patient, the therapist can come to view his or her relationship with the patient as:

Another reflection of the patients' mind

What is another medication commonly used to treat patients with BD?

Anticonvulsant medications (e.g. carbamazepine, valproate) either alone or in conjunction with lithium

The first line of treatment for schizophrenia and other psychotic disorders is the use of:

Antipsychotic medications

Many of the people with a substance use disorder will have _____ personality traits

Antisocial

A considerable body of research has accumulated to help understand the etiology, pathology, and/or treatment for some personality disorders (e.g._____), but not so much for others (e.g._____)

Antisocial, schizotypal, borderline, dependent, and narcissistic & histrionic, schizoid, and paranoid

What are the hopes for anxiety disorder treatment?

Anxiety can once again become something useful and adaptive, rather than something debilitating

We know far less about the safety and efficacy in young populations of the drugs typically prescribed for treating:

Anxiety, depression, or other psychiatric disorders

Generally, what can become a feared social situation?

Any type of situation that could potentially draw attention to the person

During a manic episode, people often behave in ways that:

Are risky or place them in danger-they may spend money excessively or have unprotected sex, often expressing deep shame over these decisions after the episode

Approximately 65% of people with BD meet diagnostic criteria for:

At least one additional psychiatric disorder-most commonly anxiety disorders and substance use disorders

What does the DSM-5 criteria specify for GAD?

At least six months of excessive anxiety and worry of this type must be ongoing, happening more days than not for a good proportion of the day, to receive a diagnosis of GAD

It should be noted though that a complete description of each DSM-5 personality disorder would typically include:

At least some traits from OTHER domains

What does behavioural therapy attempt to do?

Attempts to modify maladaptive behaviours and the environments that trigger them (reconditioning)

What does cognitive therapy attempt to do?

Attempts to modify maladaptive thought patterns (e.g. cognitive restructuring)

In order to identify these high risk individuals, a new category of diagnosis, called "_____," was added to Section III (the section for disorders in need of further study) of the DSM-5

Attenuated Psychotic Syndrome

People's _____ style have also been examined in the etiology (cause) of MDD

Attributional

What is the newer generation of antipsychotics?

Atypical

The most common hallucinations in psychosis (at least in adults) are:

Auditory

Beck used the term _____ to refer to the thoughts depressed patients report experiencing spontaneously

Automatic thoughts

What is interoceptive avoidance?

Avoidance of situations or activities that produce sensations of physical arousal similar to those occurring during a panic attack or intense fear response

Compared with European Americans with BD, African Americans tend to be underdiagnosed for _____ (and over-diagnosed for _____)

BD, schizophrenia

_____ phobia runs in families more strongly than any phobic disorder we know

BII

Why do CBT-enhancing pharmaceutical agents work?

Based on research from animal experiments, researchers have found that certain drugs influence the biological processes known to be involved in LEARNING-thus, if people take these drugs while going through psychotherapy, they are better able to "learn" the techniques for improvement

Psychodynamic therapy has the same _____ as psychoanalytic therapy

Basic tenets

Why aren't SSRIs or SNRIs used in the treatment of BD?

Because SSRIs and SNRIs have the potential to induce mania or hypomania in patients with BD

Why is IV administration the most dangerous?

Because if there is an adverse drug reaction, there is very little time to administer any antidote (e.g. IV heroin overdose)

Why doesn't CBT teach such skills training found in DBT?

Because of the concern that the skills—even though they may help in the short-term—may be harmful in the long-term, by maintaining maladaptive thoughts and behaviours

Are cognitive deficits in schizophrenia present before or after the onset of the illness?

Before

What do MDD rates look like in terms of gender differences before puberty?

Before puberty, boys exhibit similar or higher prevalence rates of MDD than do girls

In addition to thoughts, though, another important treatment target of CBT is maladaptive:

Behaviour

What is disorganized behaviour?

Behaviour or dress that is outside the norm for almost all subcultures (acting in strange or unusual ways)

CBT uses _____ goals to improve one's mental illness

Behavioural

What is the treatment for ADHD?

Behavioural therapy & medication

What is catatonia?

Behaviours that seem to reflect a reduction in responsiveness to the external environment. This can include holding unusual postures for long periods of time, failing to respond to verbal or motor prompts from another person, or excessive and seemingly purposeless motor activity.

Cognitive impairments in schizophrenia reflect part of the risk for the development of psychosis, rather than:

Being an outcome of developing psychosis

What did Carl Rogers believe in particular?

Believed that all people have the potential to change and improve, and that the role of therapists is to foster self-understanding in an environment where adaptive change is most likely to occur

Often, these behavioural goals of CBT involve:

Between-session homework assignments

What do antipsychotics (neuroleptics) do?

Block dopamine, reduce positive symptoms of schizophrenia (e.g. hallucinations, delusions)

How do SSRIs work?

Block the reabsorption of serotonin

How do SNRIs work?

Block the reabsorption of serotonin and norepinephrine

Manualized and/or empirically validated treatment protocols have been developed for only one personality disorder:

Borderline

Many of the people with mood disorder will have _____ personality traits

Borderline

Schizophrenia is primarily a _____ disorder

Brain (e.g. enlarged ventricles)

In addition to the genetic contribution, biological explanations of BD have also focused on:

Brain function

In treatment, the therapist and patient work together to develop healthy behavioural habits (often tracked with worksheet-like homework), so that the patient can:

Break this cycle of maladaptive thoughts and behaviours

What is metabolism?

Breakdown of substances

What is the goal of psychoanalytic therapy?

Bringing unconscious struggles (where the id demands one thing and the superego another) into conscious awareness to relieve the stress of the conflict

What are some controversies surrounding who is going to be tested in clinical trials for the safety and effectiveness of drugs in adolescents and children?

Brings up a variety of ethical questions about who decides what children and adolescents will participate in these clinical trials, who can give consent, who receives reimbursements, etc.

How do neurons communicate with each other?

By releasing a chemical (neurotransmitter) across a tiny space between two neurons (the synapse). When the neurotransmitter crosses the synapse, it binds to a postsynaptic receptor (protein) on the receiving neuron and the message may then be transmitted onward.

How does worrying in people with GAD make them feel like they have control over the situation?

By repeatedly going through all of the possible "What if?" scenarios in their mind, the person might feel like they are less vulnerable to an unexpected outcome, giving them the sense that they have some control over the situation

This technique of reappraisal, or cognitive restructuring, is a fundamental aspect of:

CBT

What kind of intervention is CBT?

CBT is a relatively brief intervention of 12 to 16 weekly sessions, closely tailored to the nature of the psychopathology and treatment of the specific mental disorder

Give an example of a psychoactive/psychotropic drug?

Caffeine (almost everyone has used this type of drug at some point)

There is a difference of opinion with respect to the empirical support for which personality disorder?

Dependent personality disorder

_____ alone is predicted to be the second largest contributor to disease burden by 2020

Depression

Using what drug increases risk for developing psychosis, (especially if you have other risk factors)?

Cannabis

PCT was developed by a psychologist named:

Carl Rogers

Abnormal motor behaviour can include:

Catatonia

There is not a unique enzyme for each drug; rather:

Certain enzymes can break down a wide variety of drugs

What can certain types of food do to drugs someone is taking?

Certain types of food in the stomach can alter the rate of drug absorption, and other foods can also alter the rate of drug metabolism

What is personality?

Characteristic, routine ways of thinking, feeling, and relating to others

What is antisocial personality disorder (APD) characterized by?

Characterized by a lack of empathy and remorse

What characterizes schizophrenia?

Characterized by alterations in perceptions, emotions, thoughts, or consciousness

What is borderline personality disorder characterized by?

Characterized by disturbances in identity, affect, and impulse control

Describe what cyclothymic disorder is characterized by:

Characterized by numerous and alternating periods of hypomania and depression, lasting at least 2 years

Describe what Bipolar II Disorder is characterized by:

Characterized by single (or recurrent) hypomanic episodes and depressive episodes

Sometimes, free association exercises are applied specifically to:

Childhood recollections

Many psychotropic drugs used for treating psychiatric disorders have been tested in adults, but few have been tested for safety or efficacy with:

Children or adolescents

Give an example of how enzyme induction happens:

Chronic drinking results in alcohol being broken down more quickly, so the alcoholic needs to drink more to get the same effect (until it is damaged)

Who is the DSM manual used by?

Clinicians, researchers, health insurance companies, and policymakers

Give an example of an atypical (second generation) antipsychotic:

Clozapine

What is a particular version of cognitive remediation?

Cognitive Enhancement Therapy (CET)

Although various therapies have been shown to work for specific individuals, _____ is currently the treatment most widely supported by empirical research

Cognitive behavioural therapy

What is the most effective modern approach of therapy?

Cognitive behavioural therapy (CBT)

When we think of the core symptoms of psychotic disorders such as schizophrenia, we think of people who hear voices, see visions, and have false beliefs about reality (i.e. delusions), however, problems in _____ are also a critical aspect of psychotic disorders and of schizophrenia in particular

Cognitive function

Autism Spectrum Disorder (ASD) may or may not be associated with:

Cognitive or learning impairments, savant abilities (very rare)

Even though there are no pharmacological treatments that work consistently to improve cognition in schizophrenia, there is a type of psychological intervention, referred to as:

Cognitive remediation

What is postpartum depression/perinatal depression?

Depression of a mother following the birth of her child

What is the main symptom of Generalized Anxiety Disorder (GAD) and what does it lead to?

Hypervigilance → fatigue, irritability, headaches, etc.

Although both psychoanalysis and PCT are still used today, another therapy, _____, has gained more widespread support and practice

Cognitive-behavioural therapy (CBT)

_____ and _____ are the most common precipitating traumas

Combat, sexual assault

Give an example of the importance of evidence-based assessment:

Comorbidity

Sample sizes for BD tend to be relatively small, making what difficult?

Comparisons between subgroups

What is considered to be the etiology of borderline personality disorder?

Considered to be the result of an interaction of a genetic disposition to negative affectivity interacting WITH a malevolent, abusive, and/or invalidating family environment

What is considered to be the etiology of antisocial personality disorder?

Considered to be the result of an interaction of genetic dispositions for low anxiousness, aggressiveness, impulsivity, and/or callousness, WITH a tough, urban environment, inconsistent parenting, poor parental role modelling, and/or peer support

What does the stigma of depressive and bipolar disorders contribute to?

Contributes to people not always receiving the necessary support and treatment for these disorders

In this study (Merikangas et al. 2011), the prevalence of BD varied somewhat by:

Country

Many psychoactive drugs are broken down by the same family of enzymes, the:

Cytochrome P450 superfamily

What is the primary difference between DBT and CBT?

DBT employs techniques that address the SYMPTOMS of the problem (e.g. cutting oneself) rather than the problem itself (e.g. understanding the psychological motivation to cut oneself)

In schizophrenia, there is _____ dysfunction

DLPFC (dorsolateral prefrontal cortex)

Are the number of therapists practicing psychotherapy increasing or decreasing?

Decreasing

Is the age of onset of MDD increasing or decreasing?

Decreasing with people born more recently

What are negative symptoms in schizophrenia?

Deficits in functioning

Give examples of how delusions are often culturally influenced in their content:

Delusions involving Jesus in Judeo-Christian cultures, delusions involving Allah in Muslim cultures

While many people face traumatic events, not everyone who faces a trauma:

Develops a disorder (some, with the help of family and friends, are able to recover and continue on with their lives)

The authoritative manual for what constitutes a personality disorder is provided by the American Psychiatric Association's (APA):

Diagnostic and Statistical Manual of Mental Disorders (DSM) (current version is DSM-5)

BT is founded on the perspective of a _____ worldview

Dialectical

Mindfulness and acceptance—in addition to being therapies in their own right—have also been used as "tools" in other cognitive-behavioural therapies, particularly in:

Dialectical behaviour therapy (DBT)

Since not everyone with a family history, genetic predisposition, childhood trauma, etc., will develop a psychological disorder, and not everyone who experiences a stressful life event will develop a psychological disorder, how can we predict who might develop a psychological disorder?

Diathesis-stress model

This emphasis on cognition in schizophrenia is in part due to the growing body of research suggesting that cognitive problems in schizophrenia are a major source of:

Disability and loss of functional capacity

What is chronic stress?

Discrete or related problematic events and conditions which persist over time and result in prolonged activation of the biological and/or psychological stress response (e.g. unemployment, ongoing health difficulties, marital discord)

The APA currently conceptualizes personality disorders as qualitatively distinct conditions, meaning:

Distinct from each other and from normal personality functioning

What is the problem with "what-if"-ing?

Doesn't get the person any closer to a solution or an answer and, in fact, might take them away from important things they should be paying attention to in the moment (e.g. such as finishing an important project)

There is good evidence that problems in working memory and cognitive control in schizophrenia are related to problems in the function of a region of the brain called the:

Dorsolateral prefrontal cortex (DLPFC)

CBT developed from clinical work conducted in the mid-20th century by which 2 people?

Dr. Aaron T. Beck, a psychiatrist, and Albert Ellis, a psychologist

Describe how oral drugs get absorbed:

Drugs enter the stomach and then get absorbed by the blood supply and capillaries that line the small intestine

The young brain continues to mature until probably well after age 20, so some scientists are concerned about what with certain drugs?

Drugs that alter neuronal activity in the developing brain could have significant consequences

This gender difference in rates of MDD emerges when?

During puberty

What is the key symptom of Autism Spectrum Disorder (ASD)?

Dysfunctional social communication (Underdeveloped theory of mind; communication difficulties may be very extreme or barely noticeable)

Researchers and clinicians are now shifting toward a more dimensional understanding of personality disorders, wherein:

Each is understood as a maladaptive variant of general personality structure, thereby bringing to bear all that is known about general personality functioning to an understanding of these maladaptive variants

Neuroticism is the domain of general personality structure that concerns inherent feelings of:

Emotional pain and suffering, including feelings of distress, anxiety, depression, self-consciousness, helplessness, and vulnerability

What does rational-emotive-behavioural therapy (REBT) also do?

Encourages patients to evaluate their own thoughts about situations

Atypical antipsychotics are not necessarily more helpful for schizophrenia but:

Have fewer motor side effects

The evidence that cognitive deficits also contribute to functional impairment in schizophrenia has led to an increased search for treatments that might:

Enhance cognitive function in schizophrenia

Often, new treatment approaches focus on:

Enhancing existing treatments, such as cognitive-behavioural therapies, through the use of technological advances (e.g. internet- and mobile-delivered therapies make psychological treatments more available, through smartphones and online access)

Within the psychosocial level, research has focused on the _____ contributors to BD

Environmental

Some drugs, like alcohol, can cause what in terms of enzymes?

Enzyme induction

It has become increasingly clear that problems with the DLPFC also make important contributions to _____ in schizophrenia, probably because this part of the brain is important for controlling our use of memory

Episodic memory deficits

Little is known about the specific _____ for most of the DSM-5 personality disorders

Etiology (cause)

Independent of SES, results from a nationally representative sample found what kind of MDD rates between European Americans, African Americans, and Hispanic Americans?

European Americans had a higher prevalence rate of MDD than did African Americans and Hispanic Americans, whose rates were similar

With regard to ethnicity, data from studies not confounded by SES or inaccuracies in diagnosis are limited, but available reports suggest rates of BD among _____ are similar to those found among _____ and _____

European Americans, African Americans, Hispanic Americans

What has cognitive remediation done for the symptoms of schizophrenia?

Evidence of helping cognition and function

Our understanding of abnormal behaviour and mental illness is also constantly:

Evolving

Assessment for psychological disorders involves:

Examining a person's mental state in order to diagnose (and treat) possible psychological disorders

What are positive symptoms of schizophrenia?

Excesses in behaviour

Anxiety disorders are characterized by:

Excessive anxiety in the absence of true danger

What is hypersomnia?

Excessive daytime sleepiness, including difficulty staying awake or napping, or prolonged sleep episodes

What is generalized anxiety disorder (GAD)?

Excessive worry about everyday things that is at a level that is out of proportion to the specific causes of worry (these worries become difficult, or even impossible, to turn off-may find themselves worrying excessively about a number of different things, both minor and catastrophic)

MDD tends to be a recurrent disorder with about 40%-50% of those who experience 1 MDE:

Experiencing a 2nd MDE

Psychoanalysis identifies and addresses unconscious struggles by:

Exploring one's early childhood experiences that may have continuing repercussions on one's mental health in the present and later in life

A key aspect of CBT is:

Exposure exercises, in which the patient learns to gradually approach situations they find fearful or distressing, in order to challenge their beliefs and learn new, less fearful associations about these situations

For many mental health problems, especially anxiety disorders, CBT incorporates what is known as:

Exposure therapy

What are effective psychosocial treatments for anxiety disorders?

Exposure-based cognitive behavioural therapies (CBT)

What are mood disorders?

Extended periods of depressed, euphoric, or irritable moods that in combination with other symptoms cause the person significant distress and interfere with his or her daily life, often resulting in social and occupational difficulties

These situations during a panic attack become _____ for panic

External cues

The goal of exposure therapy is to reduce the fear associated with the situation through:

Extinction learning

What are delusions?

False beliefs that are often fixed, hard to change even in the presence of conflicting information, and often culturally influenced in their content (false personal beliefs based on incorrect inferences about reality)

Enzymes exist in:

Families

A meta-analysis of neuroimaging studies showed that when viewing negative stimuli (e.g. picture of an angry face, picture of a car accident), compared with healthy control participants, participants with MDD:

Have greater activation in brain regions involved in stress response and reduced activation of brain regions involved in positively motivated behaviours

How to atypical antispsychotics work?

Have more mixed mechanisms of action in terms of the receptor types that they influence, though most of them also influence D2 receptors

Most people who suffer from specific phobia tend to:

Have multiple phobias of several types

The key to psychoanalytic theory is to:

Have patients uncover the buried, conflicting content of their mind

It is clear that there are important genetic contributions to the likelihood that someone will develop schizophrenia, with consistent evidence from what kinds of studies?

Family, twin, and adoption studies

Criteria for PDD are:

Feeling depressed most of the day for more days than not, for at least 2 years

What are CORE symptoms of a major depressive episode (MDE)?

Feeling down or depressed or experiencing anhedonia

Treatment always involves interactions between practitioner and client/patient, which means it is important to:

Find the right practitioner

What do some fMRI findings for BD show?

Findings show that regions of the brain thought to be involved in emotional processing and regulation are activated differently in people with BD relative to healthy controls

Both functional and structural brain changes are seen, again to a milder degree, in:

First-degree relatives of people with schizophrenia

There are literally hundreds of different personality traits, and all of these traits can be organized into the broad dimensions referred to as the:

Five-Factor Model (five broad domains or dimensions that are used to describe human personality)

What is the medical model for abnormal behaviour?

Focus on biological causes, views abnormal behaviour as a disease

What does psychoanalytic & psychodynamic therapy focus on?

Focus on bringing unconscious struggles into consciousness (free association, dream analysis)

CBT is a present-focused therapy, meaning:

Focused on the "now" rather than causes from the past, such as childhood relationships

What does Short-Term Psychodynamic Therapy for Depression focus on?

Focuses on a limited number of important issues, and the therapist tends to be more actively involved than in more traditional psychodynamic therapy

Whereas other therapies work to modify or eliminate certain sensations and thoughts, mindfulness:

Focuses on nonjudgmentally accepting them (e.g. whereas CBT may actively confront and work to change a maladaptive thought, mindfulness therapy works to acknowledge and accept the thought, understanding that the thought is spontaneous and not what the person truly believes)

What is a reinforced response?

Following the process of operant conditioning, the strengthening of a response following either the delivery of a desired consequence (positive reinforcement) or escape from an aversive consequence

What is the other part of why cigarette smoking is so addicting?

For a cigarette smoker a cue could be something as normal as finishing dinner or waking up in the morning (if that is when the smoker usually has a cigarette)

Give an example of something that could be a cue associated with a drug:

For a crack user, this could be the pipe that they use to smoke the drug

What did Borkovec and Hu (1990) find with worrying?

Found that those who worried when confronted with a stressful situation had less physiological arousal than those who didn't worry, maybe because the worry "distracted" them in some way

What is one common technique used in psychoanalysis?

Free association

What is comorbidity?

Having multiple mental or physical disorders at once

Every time a person engages in maladaptive behaviour (e.g. never speaking to someone in new situations):

He or she reinforces the validity of the maladaptive thought, thus maintaining or perpetuating the psychological illness

The liver produces enzymes that:

Help catalyze a chemical reaction that breaks down psychoactive drugs

What does the therapist do with the information of their patients' dreams?

Help discover the latent content underlying one's manifest content through dream analysis

What did Freud INITIALLY suggest where mental health problems arose from?

From efforts to push inappropriate sexual urges out of conscious awareness

What part of the brain is dysfunctional in ADHD?

Frontal/prefrontal lobe dysfunction

During exposure therapy, a patient confronts a problematic situation and:

Fully engages in the experience instead of avoiding it (e.g. imagine a man who is terrified of spiders-whenever he encounters one, he immediately screams and panics, in exposure therapy, the man would be forced to confront and interact with spiders, rather than simply avoiding them as he usually does)

People with more cognitive problems have worse:

Function in every day life

Research across family and twin studies has provided support that _____ factors are implicated in the development of MDD

Genetic

Twin studies suggest that familial influence on MDD is mostly due to:

Genetic effects AND that individual-specific environmental effects (e.g. romantic relationships) play an important role, too

The development of an ideal or fully healthy personality structure is unlikely to occur through the course of treatment for someone with a personality disorder, but:

Given the considerable social, public health, and personal costs associated with some of the personality disorders, such as the antisocial and borderline, even just moderate adjustments in personality functioning can represent quite significant and meaningful change

What is the most well known food/drink to alter the rate of drug metabolism?

Grapefruit juice

What does grapefruit juice do?

Grapefruit juice suppresses cytochrome P450 enzymes in the liver, and these liver enzymes normally break down a large variety of drugs (including some of the psychotropic drugs)-if the enzymes are suppressed, drug levels can build up to potentially toxic levels (in this case, the effects can persist for extended periods of time after the consumption of grapefruit juice)

Currently, psychologists have not come to a consensus on the efficacy of MBT, though:

Growing evidence supports its effectiveness for treating mood and anxiety disorders (e.g. one review of MBT studies for anxiety and depression found that mindfulness-based interventions generally led to moderate symptom improvement)

Mood symptoms start by adolescence in roughly _____ of BD cases

Half

Nearly _____ of all Americans will experience mental illness at some point in their lives, and mental health problems affect more than _____ of the population in any given year

Half, one-quarter

When you see a person on the street talking to themselves or shouting at other people, they are experiencing:

Hallucinations

Antipsychotics _____ and _____ revolutionized the treatment of schizophrenia

Haloperidol, chlorpromazine

Describe the work done by Jim van Os in the Netherlands and psychotic symptoms within the population:

Has shown that a surprisingly large percentage of the general population (10%+) experience psychotic-like symptoms, though many fewer have multiple experiences and most will not continue to experience these symptoms in the long run

In a case involving maladaptive thoughts, instead of teaching that a thought is entirely bad, DBT tries to:

Help patients be less judgmental of their thoughts (as with mindfulness-based therapy) and encourages change through therapeutic progress, using cognitive-behavioural techniques as well as mindfulness exercises

What do cognitive therapies primarily focus on?

Helping patients identify and change distorted automatic thoughts and assumptions

Give an example of something that MBCT is helpful for:

Helps prevent relapses in depression by encouraging patients to evaluate their own thoughts objectively and without value judgment

There is compelling evidence for biological causes of BD, which is known to be highly:

Heritable

Each DSM-5 personality disorder is a:

Heterogeneous constellation of maladaptive personality traits

Why are borderline and avoidant exceptions to being ego-syntonic?

High levels of neuroticism and emotional pain may motivate them to seek help

Both the factors of urban settings and minority ethnic groups may reflect what?

Higher social and environmental stress in these settings

What is a consequence of this degree of diagnostic overlap and heterogeneity of membership of personality disorders?

Hinders tremendously any effort to identify a specific etiology, pathology, or treatment for a respective personality disorder as there is so much variation within any particular group of patients sharing the same diagnosis

Another large community-based study found that although prevalence rates of mood disorders were similar across ethnic groups, _____ and _____ with a mood disorder were more likely to remain persistently ill than _____

Hispanic Americans, African Americans, European Americans

During an MDE, people often feel:

Hopeless about the future, and may even experience suicidal thoughts

What are specific vulnerabilities?

How our experiences lead us to focus and channel our anxiety

Encouragement of personal growth through self-understanding reflects what approach?

Humanistic (in client/person-centred therapy)

The humanistic perspective was based on the idea that:

Humans have an inherent drive to realize and express their own capabilities and creativity

What is the most dangerous route of administration?

IV

Because schizophrenia is a very heterogeneous disorder, this makes it more difficult to:

Identify specific genes associated with risk for psychosis

In CBT, therapy INITIALLY focuses on what?

Identifying automatic thoughts (e.g. "If I don't wash my hands constantly, I'll get a disease"), testing their validity, and replacing maladaptive thoughts with more adaptive thoughts (e.g. "Washing my hands three times a day is sufficient to prevent a disease")

How can you tell if a drug has a high risk for abuse and addiction?

If a drug activates the reward circuits in the brain AND it reaches the brain very quickly

How can you tell if a drug exerts an effect on your brain and nervous system?

If a drug changes your perception, or the way you feel or think

How can someone be diagnosed with PDD and MDD?

If someone meets criteria for an MDE during a PDD episode

Unlike a crack smoker, cigarette smoking MAY be more difficult to quit because:

If their cues are be something as normal as finishing dinner or waking up in the morning, how can someone avoid eating? Or avoid waking up in the morning?

How do psychological vulnerabilities work?

If we were confronted with unpredictable stressors or traumatic experiences at younger ages, we may come to view the world as unpredictable and uncontrollable, even dangerous

Give an example of free association:

If you took a pen and paper and just wrote down whatever came into your head, letting one thought lead to the next without allowing conscious criticism to shape what you were writing, you would be doing free association

What is psychopathology?

Illnesses or disorders that involve psychological or psychiatric symptoms

All personality disorders are notoriously difficult to treat, although not:

Impossible

Cognitive Enhancement Therapy (CET) has been shown to:

Improve cognition, functional outcome, social cognition, and to protect against grey matter loss in young individuals with schizophrenia

What does Interpersonal Therapy for Depression focus largely on?

Improving interpersonal relationships by targeting problem areas, specifically unresolved grief, interpersonal role disputes, role transitions, and interpersonal deficits

Describe what mindfulness-based cognitive therapy (MBCT) does:

In MBCT, rather than reducing one's general stress to address a specific problem, attention is focused on one's thoughts and their associated emotions

Give another example of work done in Kenya portraying psychotic symptoms within the population:

In a general population of adolescents and young adults in Kenya-has also shown that a relatively high percentage of individuals experience one or more psychotic-like experiences (~19%) at some point in their lives, though again most will not go on to develop a full-blown psychotic disorder

Magnitude resonance neuroimaging studies have also identified changes where in people with schizophrenia?

In cellular architecture, white matter connectivity, and grey matter volume in a variety of regions that include the prefrontal and temporal cortices

What is unconditional positive regard?

In person-centred therapy, an attitude of warmth, empathy and acceptance adopted by the therapist in order to foster feelings of inherent worth in the patient/the therapist is never to condemn or criticize the patient for what s/he has done or thought

What is free association?

In psychodynamic therapy, a process in which the patient reports all thoughts that come to mind without organizing them or censoring them, and these thoughts are interpreted by the therapist

We now know that there are genetic differences in terms of what (in breaking down drugs)?

In some of the cytochrome P450 enzymes and their ability to break down drugs

Where does metabolic tolerance take place?

In the liver

What is an alternative view of personality disorders from the APA mentioned in the DSM-5?

Included within an appendix to DSM-5 is an alternative view that personality disorders are simply extreme and/or maladaptive variants of normal personality traits

What does the DSM have for when someone does not fit into one of the 10 personality disorders?

Includes a "wastebasket" diagnosis of other specified personality disorder (OSPD) and unspecified personality disorder (UPD) (diagnosis is used when a clinician believes that a patient has a personality disorder but the traits that constitute this disorder are not well covered by one of the 10 existing diagnoses)

What is a 5th category of phobias?

Includes phobias that do not fit any of the four major subtypes (for example, fears of choking, vomiting, or contracting an illness)

What does Autism Spectrum Disorder (ASD) include?

Includes what were previously four separate diagnostic categories (e.g. Autism, Asperger's syndrome, etc.)

Consistent with the social zeitgeiber theory, studies have shown that life events that involve a disruption in sleep and daily routines, such as overnight travel, can do what in people with BD?

Increase bipolar symptoms

What is insight?

Increase patient's understanding of their own psychological processes (in psychodynamic/psychoanalytic therapy)

Because a growing body of literature provides support for the central role of sleep dysregulation in BD, IPSRT aims to:

Increase rhythmicity of patients' lives and encourage vigilance in maintaining a stable rhythm

What is psychomotor agitation?

Increased motor activity associated with restlessness, including physical actions (e.g. fidgeting, pacing, feet tapping, handwringing)

What are standardized tags used for?

Increasing diagnostic specificity and informing treatment

What do behaviour therapies focus on?

Increasing the frequency and quality of experiences that are pleasant or help the patient achieve mastery

Several psychosocial treatments have received strong empirical support, meaning that:

Independent investigations have achieved similarly positive results-a high threshold for examining treatment outcomes

What characterizes individuals at "high clinical risk" or schizophrenia?

Individuals who are showing attenuated (milder) symptoms of psychosis that have developed recently and who are experiencing some distress or disability associated with these symptoms

How are the symptoms of PTSD perpetuated?

Individuals with a psychological vulnerability toward viewing the world as uncontrollable and unpredictable may particularly struggle with the possibility of additional future, unpredictable traumatic events, fuelling their need for hypervigilance and avoidance, and perpetuating the symptoms of PTSD

What is grandiosity?

Inflated self-esteem or an exaggerated sense of self-importance and self-worth (e.g. believing one has special powers or superior abilities)

What are psychological vulnerabilities?

Influences that our early experiences have on how we view the world

The presence of a personality disorder will often have an impact on the treatment of other mental disorders, typically:

Inhibiting or impairing responsivity

PCT was developed during a time of:

Significant growth in the movements of humanistic theory and human potential

In discussing therapeutic orientations, it is important to note that some clinicians incorporate techniques from multiple approaches, a practice known as:

Integrative or eclectic Psychotherapy

If there is no apparent reason or cue for the alarm reaction, you might react to the sensations with:

Intense fear, maybe thinking you are having a heart attack, or going crazy, or even dying

What are personality disorders characterized by?

Interacting with the world in maladaptive and inflexible ways, over a long period of time, resulting in social/work problems and personal distress

A person with PTSD is particularly sensitive to both _____ and _____ cues that serve as reminders of their traumatic experience

Internal, external

Avoidance of these internal bodily or somatic cues for panic has been termed:

Interoceptive avoidance

Research has found that people with MDD generate some of their _____ stress

Interpersonal

In psychoanalytic and psychodynamic therapy, the therapist plays a receptive role, meaning:

Interpreting the patient's thoughts and behaviour based on clinical experience and psychoanalytic theory

Schizoid personality disorder is largely a disorder of which one trait?

Introversion (e.g. withdrawn, cold, isolated, placid, and anhedonic)

Mindfulness is thought to improve mental health because:

It draws attention away from past and future stressors, encourages acceptance of troubling thoughts and feelings, and promotes physical relaxation

What is one disadvantage of CBT?

It involves significant effort on the patient's part, because the patient is an active participant in treatment-therapists often assign "homework" (e.g. worksheets for recording one's thoughts and behaviors) between sessions to maintain the cognitive and behavioral habits the patient is working on

For someone with OCD, the urge to engage in some behaviour, such as straightening a picture, can become so intense that:

It is nearly impossible not to carry it out, or causes significant anxiety if it can't be carried out

What happens if the ventral striatum and anterior prefrontal cortex misfire?

It may lead individuals with psychosis to mistakenly attribute importance to irrelevant or unconnected events

What is the diathesis-stress model?

It's the combination of BOTH of these things (genetics and environment) determines how likely someone is to develop a mental disorder

In what country is the BD prevalence rate related to SES?

Japan, a high-income country with a very low prevalence rate of BD (0.7%)

There is a plan to release more frequent revisions of the DSM-5 in the future, in order to:

Keep updated with current research

Metabolism of drugs is often slowed considerably for elderly populations, so:

Less drug can produce the same effect (or all too often, too much drug can result in a variety of side effects)

Both inhalation and intravenous routes of administration can get the drug to the brain in how much time?

Less than 10 seconds

What are situational/environmental factors for mood disorders?

Life stressors, particularly interpersonal loss

For both the crack user and the cigarette smoker, the cues associated with the drug may actually cause craving that is alleviated by:

Lighting a cigarette or using crack (i.e. relapse)

What are arguments AGAINST the addition of the category "Attenuated Psychotic Syndrome"?

Many scientists and clinicians have been worried that including "risk" states in the DSM-5 would create mental disorders where none exist, that these individuals are often already seeking treatment for other problems, and that it is not clear that we have good treatments to stop these individuals from developing to psychosis

On the other hand (in terms of marriage/interpersonal factors) depressive symptoms also predict increases in:

Marital dissatisfaction

Latest version, DSM-5, released in:

May 2013

An important research area on risk for psychosis has been work with individuals who:

May be at "clinical high risk"

In terms of understanding episodic memory problems in schizophrenia, many researchers have focused on what parts of the brain?

Medial temporal lobe deficits, with a specific focus on the hippocampus

The neurons that release neurotransmitters, for the most part, are localized within specific circuits of the brain that:

Mediate certain behaviours

Many exposure-based cognitive behavioural therapies (CBT) actually show greater treatment effects than _____ in the long term

Medication

Some of the side effects of lithium can improve with continued use, however, what is an ongoing concern in the treatment of patients with BD?

Medication noncompliance

patients meeting diagnostic criteria for one personality disorder will often:

Meet diagnostic criteria for another

_____ contribute to more disability in western countries than all other illnesses including cancer and heart disease

Mental illnesses

What is one kind of tolerance?

Metabolic tolerance

Although the onset of MDD can occur at any time throughout the lifespan, the average age of onset is:

Mid-20s

Which therapy was born out of age-old Buddhist and yoga practices?

Mindfulness

Psychologists have adapted the practice of mindfulness as a form of psychotherapy, generally called:

Mindfulness-based therapy (MBT)

The likelihood of developing schizophrenia is also higher for what kinds of groups?

Minority ethnic groups

What were the earliest antidepressant medications?

Monoamine oxidase inhibitors (MAOIs)

What are some risk factors for suicide (for youth)?

Mood disorders, recent and extremely stressful life events, etc.

Increased understanding of the causes of a mental disorder does not necessarily lead to:

More effective treatment strategies

What characterizes Major depressive disorder (MDD)?

More severe than PDD; requires the presence of at least one major depressive episode (MDE)

How many neurons are there in our nervous system?

More than 100 billion

To meet criteria for PDD, a person cannot be without symptoms for how long?

More than two months at a time

Personality disorders are relatively unique because they are often "ego-syntonic", meaning:

Most people are largely comfortable with their selves, with their characteristic manner of behaving, feeling, and relating to others

None of the environmental risk factors is specific enough to be particularly useful in a clinical setting because:

Most people with these "risk" factors do not develop schizophrenia

How do some of the themes of PCT translate well to other therapeutic approaches?

Most therapists of any orientation find that clients respond well to being treated with nonjudgmental empathy

How is anxiety be a good thing?

Motivates us to plan for the future (e.g. motivates us to study for that test, practice harder for that game, or be at our very best on that date)

Currently, there is very little high-quality evidence to guide prescribing for older people - clinical trials often exclude people with:

Multiple comorbidities (other diseases, conditions, etc.), which are typical for elderly populations (this is a serious issue because the elderly consume a disproportionate number of the prescription meds prescribed)

Compulsions may be carried out in an attempt to:

Neutralize some of these thoughts, providing temporary relief from the anxiety the obsessions cause, or they may be nonsensical in and of themselves

What are the most frequently prescribed drugs for treating mental health issues?

Newer antidepressants

Do humanistic therapists try to change patients' thoughts or behaviours directly?

No

Do most people who commit mass murders have schizophrenia?

No

Do the 10 personality disorders cover all of the different ways in which a personality can be maladaptive?

No

Is there a "schizophrenia gene"?

No

Was the variation between the United States and India about BD related to SES?

No

What are people who experience an MDE and then later experience a manic episode diagnosed with?

No longer meet criteria for MDD but instead meeting them for BD I

Is depression limited to industrialized or western culture?

No-it is found in all countries that have been examined

Are feelings of shame unique to postpartum depression?

No-stigma applies to other types of depressive and bipolar disorders

Rogers's original name for PCT was:

Non-directive therapy

Do the vulnerabilities by themselves cause anxiety disorders?

None of these vulnerabilities directly causes anxiety disorders on its own—instead, when all of these vulnerabilities are present, and we experience some triggering life stress, an anxiety disorder may be the result

Some of the DSM-5 personality disorders are confined largely to traits within:

ONE of the basic domains of personality (e.g. obsessive-compulsive, schizoid, borderline, histrionic)

Whereas OCD was previously categorized as an Anxiety Disorder, in the most recent version of the DSM it has been reclassified under the more specific category of:

Obsessive-Compulsive and Related Disorders

Disorganized behaviour can include:

Odd dress, odd makeup (e.g. lipstick outlining a mouth for 1 inch), or unusual rituals (e.g., repetitive hand gestures)

The prevalence of BD is substantially lower in _____ adults compared with _____ adults (1% vs. 4%)

Older, younger

There is some evidence that non-invasive treatments such as _____ and _____ may help reduce the development of full-blown psychosis in people who have high-risk symptoms

Omega-3 fatty acids, intensive family intervention

Just like many of the other forms of psychopathology, the types of psychotic symptoms that characterize disorders like schizophrenia are:

On a continuum with "normal" mental experiences

Give an example of distress tolerance:

People who feel an urge to cut themselves may be taught to snap their arm with a rubber band instead

How do positive life events impact the course of BD?

People with BD suffer more manic symptoms after life events involving attainment of a desired goal

Give an example of how a situation that could potentially draw attention to the person became a feared situation:

One patient went out of her way to avoid any situation in which she might have to use a public restroom for fear that someone would hear her in the bathroom stall and think she was disgusting

Reality is that no drugs currently available work:

Only exactly where we would like in the brain or only on a specific neurotransmitter

The most common route of drug administration is:

Oral

Many studies also now suggest that at least some of the genes potentially associated with schizophrenia are also associated with:

Other mental health conditions, including bipolar disorder, depression, and autism

BD often co-occurs with:

Other psychiatric disorders

No single gene directly causes anxiety or panic, but:

Our genes may make us more susceptible to anxiety and influence how our brains react to stress

For people with anxiety disorders, anxiety is:

Overwhelming and hard to control

Why does postpartum depression have stigma around it?

Owes in part to a widely held expectation that motherhood should be a time of great joy

What were OSPD and UPD referred to as in previous editions?

PDNOS (personality disorder not otherwise specified)

In some cases, agoraphobia develops in the absence of:

Panic attacks

Unexpected panic attacks such as these are at the heart of:

Panic disorder (PD)

What are compulsions?

Particular acts that one feels driven to perform over and over again; often include cleaning, checking, and counting

How has the efficacy of IPSRT has been demonstrated?

Patients who received this treatment show reduced risk of episode recurrence and are more likely to remain well

Because we don't always have the ability to consciously recall deep memories, psychoanalysts also discuss:

Patients' dreams

One of the biggest deterrents in seeking out mental help is:

People don't understand what psychotherapy really entails

What is a consequence of personality disorders being ego-syntonic?

People rarely seek treatment for their antisocial, narcissistic, histrionic, paranoid, and/or schizoid personality disorder because they typically lack insight into the maladaptivity of their personality

How does pessimistic attributional style serve as a vulnerability to developing MDD?

People tend to make internal (versus external), global (versus specific), and stable (versus unstable) attributions to negative events

Which people with MDD have higher relapse rates in terms of the involvement of relatives or spouses?

People with MDD whose relatives or spouses can be described as critical and emotionally overinvolved have higher relapse rates than do those living with people who are less critical and emotionally overinvolved

What are hallucinations?

Perceptual experiences that occur even when there is no stimulus in the outside world generating the experiences. They can be auditory, visual, olfactory (smell), gustatory (taste), or somatic (touch). False sensory experiences.

What are the most common delusions?

Persecutory-involve the belief that individuals or groups are trying to hurt, harm, or plot against the person in some way; these can be people that the person knows (people at work, the neighbours, family members), or more abstract groups (the FBI, the CIA, aliens, etc.)

One of the next developments in therapy for mental illness, which arrived in the mid-20th century, is called humanistic or:

Person-centred therapy (PCT)

When personality traits result in significant distress, social impairment, and/or occupational impairment, they are considered to be a:

Personality disorder

What is more effective in inducing an emotional response from someone with BD?

Personally engaging stimuli, such as recalling a memory, may be more effective in inducing strong emotions

A further reason for the weak progress in treatment development in personality disorders is that:

Persons rarely seek treatment for their personality disorder (e.g. it would be difficult to obtain a sufficiently large group of people with, for instance, narcissistic or obsessive-compulsive disorder to participate in a treatment outcome study, one receiving the manualized treatment protocol, the other receiving treatment as usual)

What kind of attributional style do people with MDD have?

Pessimistic attributional style

What treatments are most effective for schizophrenia?

Pharmacological

Patients with BD are typically treated with:

Pharmacotherapy

What may be the most beneficial treatment treatment approach for many psychiatric conditions?

Pharmacotherapy with psychological therapy

Anhedonia or amotivation can manifest as a great amount of time spent in:

Physical immobility

What are internal bodily or somatic cues?

Physical sensations that serve as triggers for anxiety or as reminders of past traumatic events

The symptoms of MDE cannot be caused by:

Physiological effects of a substance or a general medical condition (e.g. hypothyroidism)

The term _____ refers to the use of multiple drugs, which is very common in elderly populations in the United States

Polypharmacy

The co-occurrence of BD with other psychiatric disorders is associated with:

Poorer illness course, including higher rates of suicidality

Describe what treatment is like for antisocial personality disorder:

Problems with treatment → prognosis is poor overall

What is enzyme induction?

Process through which a drug can enhance the production of an enzyme

What does neurodevelopmental mean?

Processes that influence how the brain develops either in utero or as the child is growing up

Individuals with schizophrenia also have difficulty with what is referred to as "_____" and are frequently slower than healthy individuals on almost all tasks

Processing speed

_____ are also frequently used to treat mental disorders, including schizophrenia, bipolar disorder, depression, and anxiety disorders

Psychiatric medications

We call drugs that change the way you think or feel _____ or _____ drugs

Psychoactive, psychotropic

The earliest organized therapy for mental disorders was:

Psychoanalysis

Although psychoanalysis is still practiced today, it has largely been replaced by the more broadly defined:

Psychodynamic therapy

_____ represent the most extreme version of APD

Psychopaths

Genetics may be more important for _____ than other forms of the antisocial personality disorder

Psychopathy

For personality disorders, there is empirical support for clinically and socially meaningful changes in response to:

Psychosocial and pharmacologic treatments

The triggers that determine how and when this genetic vulnerability to BD is expressed are not yet understood; however, there is evidence to suggest that:

Psychosocial triggers may play an important role in BD risk

What is brief psychotic disorder?

Psychotic symptoms that last only a few days or weeks

Although there are some reviews that seem to indicate that long-term psychodynamic therapies might be beneficial, other researchers have:

Questioned the validity of these reviews

What is a dialectical worldview?

Rather than thinking of the world as "black and white," or "only good and only bad," it focuses on accepting that some things can have characteristics of both "good" and "bad" (a perspective in DBT that emphasizes the joint importance of change and acceptance)

Ellis (1957) took a comparable approach to CBT, in what he called:

Rational-emotive-behavioural therapy (REBT)

ACT encourages patients not to attempt to change or avoid thoughts and emotions they observe in themselves, but to:

Recognize which are beneficial and which are harmful

What are obsessions?

Recurrent, intrusive, and unwanted thoughts or ideas or mental images; often include fear of contamination, of accidents, or of one's own aggression

What is suicidal ideation?

Recurring thoughts about suicide, including considering or planning for suicide, or preoccupation with suicide

There is evidence that psychotropic medications can do what to bones?

Reduce bone density (worsens the consequences if someone falls)

Psychoanalysis was made famous in the early 20th century by who?

Sigmund Freud

Individuals are sometimes prescribed one psychotropic drug but then may also have to take additional drugs to:

Reduce the side effects caused by the initial drug

Many of the catastrophic outcomes people with GAD worry about are very unlikely to happen, so when the catastrophic event doesn't materialize, the act of worrying gets:

Reinforced

Because yoga and meditation are already widely known in popular culture, consumers of mental healthcare are often interested in trying:

Related psychological therapies

What is the oral route of administration like?

Relatively slow and often the most variable and complex route of administration

Someone with OCD might become preoccupied with the possibility that the behaviour wasn't carried out to completion and feel compelled to:

Repeat the behaviour again and again, maybe several times before they are "satisfied"

What is the id?

Represents pleasure-driven unconscious urges (e.g. our animalistic desires for sex and aggression)

Attention Deficit/Hyperactivity Disorder (ADHD) is characterized by:

Restless, inattentive, and impulsive behaviours (behavioural profiles vary greatly, causes may vary greatly as well)

What is another symptom of Autism Spectrum Disorder (ASD)?

Restricted, repetitive behaviours or interests (e.g. Julia, new Sesame Street muppet)

When do schizophrenia and the other psychotic disorders manifest?

Right at time of the transition from adolescence to adulthood, just as young people should be evolving into independent young adults

If the fear is limited to performance-based situations, such as public speaking, a diagnosis of _____ is assigned

SAD performance only

What is the most commonly prescribed antidepressant medication?

SSRIs

Give an example of an antidepressant:

SSRIs → increase serotonin levels

Describe client (or person) centred therapy:

Safe and comfortable setting, empathy, reflective listening

Mixed findings for a particular brain region becoming more or less active to an emotional stimulus in BD are in part due to:

Samples consisting of participants who are at various phases of illness at the time of testing (manic, depressed, inter-episode)

A few of the individuals who have committed some of the recently highly publicized mass murders may have had:

Schizophrenia

What is the primary disorder that comes to mind when we think of "psychotic" disorders?

Schizophrenia

What are some of the most impairing forms of psychopathology?

Schizophrenia and the other psychotic disorders

MDD and BD cause significant problems for people at:

School, at work, and in their relationships and affect people regardless of gender, age, nationality, race, religion, or sexual orientation

What is an example of a tactic used by psychoanalytic therapists to promote a freer self-disclosure for the patients?

Seating patients to face away from them

What drugs are more subject to tolerance?

Sedative drugs like alcohol or opiate-based painkillers

Maladaptive personality traits will be evident in many individuals who are:

Seeking treatment for other mental disorders, such as anxiety, mood, or substance use

The mode of inheritance is not fully understood although no single genetic variation has been found to increase the risk of MDD significantly, instead:

Several genetic variants and environmental factors most likely contribute to the risk for MDD

A series of studies show that environmental stressors, particularly _____ stressors (e.g. loss of a significant relationship), can adversely impact the course of BD

Severe

What kind of stressful events are strongly related to depression?

Severe stressful life events-those that have long-term consequences and involve loss of a significant relationship (e.g. divorce) or economic stability (e.g. unemployment)

What do anti-anxiety drugs do?

Short-term treatment of anxiety → increase GABA activity

What is seen in people with schizophrenia in terms of their brain volume?

Show REDUCED overall brain volume, and reductions in brain volume as people get older may be larger in those with schizophrenia than in healthy people

Drugs also have effects on other neurotransmitters than the ones they are targeting, which results in:

Side effects

What is early adversity?

Single or multiple acute or chronic stressful events, which may be biological or psychological in nature (e.g. poverty, abuse, childhood illness or injury), occurring during childhood and resulting in a biological and/or psychological stress response

DBT, often used in the treatment of borderline personality disorder, focuses on:

Skills training (it often employs mindfulness and cognitive behavioural therapy practices, but it also works to teach its patients "skills" they can use to correct maladaptive tendencies)

How can smartphones help with therapy?

Smartphones help extend therapy to patients' daily lives, allowing for symptom tracking, homework reminders, and more frequent therapist contact

What is PART of the reason for cigarette smoking being so addicting?

Smoking gets the nicotine into the brain very quickly (and indirectly acts on dopamine neurons)

What is SAD performance only?

Social anxiety disorder which is limited to certain situations that the sufferer perceives as requiring some type of performance

Some people with schizophrenia also show deficits in what is referred to as:

Social cognition (it is not clear whether such problems are separate from the cognitive problems described above or the result of them)

What are some forms of therapy other than pharmacological for schizophrenia?

Social skills training, intensive form of CBT

MDD is inversely correlated with:

Socioeconomic status (SES)

How is anxiety a bad thing?

Some people experience anxiety so intensely that it is no longer helpful or useful (e.g. they may become so overwhelmed and distracted by anxiety that they actually fail their test, fumble the ball, or spend the whole date fidgeting and avoiding eye contact)

Understanding something about the actions of drugs of abuse and their routes of administration can help us understand why:

Some psychoactive drugs are so addictive

Give an example of a pessimistic attributional style when someone, for instance, fails an exam:

Someone who when he fails an exam thinks that it was his fault (internal), that he is stupid (global), and that he will always do poorly (stable)

Medications (anti-anxiety drugs and antidepressants) have been found to be beneficial for disorders other than:

Specific phobia

_____ is one of the most common psychological disorders in the United States

Specific phobia

What is loosening of associations?

Speech pattern in which thoughts are disorganized or meaningless

What are external cues (in panic disorder)?

Stimuli in the outside world that serve as triggers for anxiety or as reminders of past traumatic events

Most people have occasional strange thoughts and may even engage in some "compulsive" behaviours, especially when they are:

Stressed

One environmental stressor that has received much support in relation to MDD is:

Stressful life events

Evidence from the life stress literature has also suggested that people with mood disorders may have a circadian vulnerability that renders them sensitive to:

Stressors that disrupt their sleep or rhythms

The advent of neuroimaging techniques such as _____ and _____ opened up the ability to try to understand the brain mechanisms of the symptoms of schizophrenia as well as the cognitive impairments found in psychosis

Structural and functional magnetic resonance imaging, positron emission tomography

The id, superego, and the ego make up Freud's:

Structural model

What is a flashback?

Sudden, intense re-experiencing of a previous event, usually trauma-related (some memories may come back so vividly that the person feels like they are experiencing the event all over again)

What did Freud LATER suggest where mental health problems arose from?

Suggested more generally that psychiatric problems are the result of tension between different parts of the mind: the id, the superego, and the ego

What kind of relationship did Rogers suggest should be between a patient and a therapist?

Suggested that the therapist and patient must engage in a genuine, egalitarian relationship in which the therapist is nonjudgmental and empathetic

What does people with BD suffering more manic symptoms after life events involving attainment of a desired goal suggest?

Suggests that people with BD may have a hypersensitivity to rewards

MDD and BD carry a high risk of:

Suicide

In terms of MDD, what may differ between cultures?

Symptom presentation as well as prevalence rates vary across culture

In the regard that they are a constellation of maladaptive personality traits, rather than just one particular personality trait, personality disorders are considered:

Syndromes

Give an example of behavioural therapy:

Systematic desensitization (fear hierarchy, relaxation training, exposure therapy)

What may cause some of these structural changes in the brain in people with schizophrenia?

Taking antipsychotic medications or taking drugs such as marijuana, alcohol, and tobacco (however, these structural changes are not completely explained by medications or substance use alone)

Haloperidol and chlorpromazine have significant side effects such as:

Tardive dyskinesia

What are patients taught in CBT?

Taught skills to help identify and change problematic thought processes, beliefs, and behaviours that tend to worsen symptoms of anxiety, and practice applying these skills to real-life situations through exposure exercises

Cognitive-behavioural therapy (CBT) incorporates:

Techniques from both cognitive therapy and behavioural therapy to correct faulty thinking AND change maladaptive behaviours (e.g. cognitive restructuring + systematic desensitization)

Since functional and structural brain changes are seen in first-degree relatives of people with schizophrenia, what does this suggest?

That neural changes associated with schizophrenia are related to a genetic risk for this illness

The limited research that has been conducted on psychoanalysis and related treatments suggests:

That they do not reliably lead to better mental health outcomes

The DSM-5 is the first major revision since:

The 1990's

What is functional capacity?

The ability to engage in self-care (cook, clean, bathe), work, attend school, and/or engage in social relationships

What are negative symptoms?

The absence of certain things we typically expect most people to have

What is the greatest strength of CBT?

The abundance of empirical support for its effectiveness-studies have consistently found CBT to be equally or more effective than other forms of treatment, including medication and other therapies; for this reason, CBT is considered a first-line treatment for many mental disorders

What is pharmacokinetics?

The action of a drug through the body, including absorption, distribution, metabolism, and excretion (refers to how the body handles a drug that we take)

Give an example of a CBT-enhancing pharmaceutical agent:

The antibiotic d-cycloserine improves treatment for anxiety disorders by facilitating the learning processes that occur during exposure therapy

Even though European Americans have a higher prevalence rate of MDD:

The course of MDD for African Americans is often more severe and less often treated than it is for European Americans

For drugs that reach the brain very quickly, not only is the drug very addictive, but what else about it can be addictive?

The cues associated with the drug

OSPD and UPD are often one of the most frequently used diagnoses in clinical practice, suggesting that:

The current list of 10 personality disorders is not adequately comprehensive

The pharmacological treatment of certain neurodegenerative diseases such as Parkinson's disease tells us something about:

The disease itself

While drugs and CBT therapies tend to be almost equally effective, choosing the best intervention depends on:

The disorder and individual being treated, as well as other factors—such as treatment availability and comorbidity

Drugs and their primary mechanism of action (agonists & antagonists):

The drug's trade name, which is the name of the drug provided by the drug company, and generic name (in parentheses) are provided

Other approaches besides CBT are used, though:

The effectiveness of these treatments aren't as clear as they are for CBT

Another population that has not typically been included in clinical trials to determine the safety or effectiveness of psychotropic drugs is:

The elderly

One of the greatest risk factors for elderly populations is falling (and breaking bones), which can happen if:

The elderly person gets dizzy from too much of a drug

What is delusional disorder?

The experience of only delusions

Stressful life events are more likely to predict which MDEs?

The first MDE rather than subsequent episodes

Cognitive deficits in schizophrenia are present in a milder form in:

The first-degree relatives (e.g. a person's parent, sibling, or child) of people with schizophrenia

The notion of non-directive therapy is reflected in:

The flexibility found in PCT

Much depression research, particularly brain imagining research using functional magnetic resonance imaging (fMRI), has centred on examining neural circuitry, which is:

The interconnections that allow multiple brain regions to perceive, generate, and encode information in concert

What is the greatest disadvantage of psychoanalysis and related approaches?

The lack of empirical support for their effectiveness

Together, the environmental factors are giving clue to:

The neurodevelopmental factors that may lead someone to be at an increased risk for developing this disease

Psychoanalysis was once:

The only type of psychotherapy available (history's first attempt at formal treatment of mental illness)

In CBT, what happens in LATER stages of treatment?

The patient's maladaptive schemas are examined and modified

Psychoanalysts and psychodynamic therapists employ several techniques to explore:

The patients' unconscious mind

What are referential delusions?

The person believes that events or objects in the environment have special meaning for them (e.g. that song on the radio is being played specifically for me)

What are grandiose delusions?

The person believes that they have some special power or ability (e.g. I am the new Buddha, I am a rock star)

Disorganized speech can even be present when:

The person is writing

What are examples of other specific types of delusions?

The person may believe that others are controlling their thoughts and actions, their thoughts are being broadcast aloud, or that others can read their mind (or they can read other people's minds)

What is the criteria to receive a diagnosis of panic disorder (PD)?

The person must not only have unexpected panic attacks but also must experience continued intense anxiety and avoidance related to the attack for at least one month, causing significant distress or interference in their lives

A panic attack may become associated (conditioned response) with a social situation, causing:

The person to fear they will panic the next time they are in that situation

Many of the studies using fMRI techniques to characterize BD have focused on:

The processing of emotional stimuli based on the idea that BD is fundamentally a disorder of emotion

What is meant by "12-month prevalence"?

The proportion of people who meet criteria for a disorder during a 12-month period

The most well-established psychotropics prescribed for children and adolescents are:

The psychostimulant drugs used for treating attention deficit hyperactivity disorder (ADHD) (there are clinical data on how effective these drugs are)

The rate of oral drug absorption can be affected by a variety of factors including:

The quantity and the type of food in the stomach (e.g. fats vs. proteins)-this is why the medicine label for some drugs (like antibiotics) may specifically state foods that you should or should NOT consume within an hour of taking the drug because they can affect the rate of absorption

What is the best way of learning about the mind and behaviour?

The scientific method

What is the superego?

The semi-conscious part of the mind where morals and societal judgment are internalized (e.g. the part of you that automatically knows how society expects you to behave)

What is processing speed?

The speed with which an individual can perceive auditory or visual information and respond to it

What is a limitation of the biomedical model?

The stigma of mental illness

What is psychopharmacology?

The study of how drugs affect behaviour

Since there is no "schizophrenia gene", it is likely that genetic risk for schizophrenia reflects:

The summation of many different genes that each contribute something to the likelihood of developing psychosis

The medical model is an improvement from other earlier models, such as:

The supernatural (e.g. demon possessions)

What is attributional style?

The tendency by which a person infers the cause or meaning of behaviours or events (their general ways of thinking, interpreting, and recalling information)

What is thought-action fusion?

The tendency to overestimate the relationship between a thought and an action, such that one mistakenly believes a "bad" thought is the equivalent of a "bad" action

What do the patient with BD and therapist aim to do in IPSRT?

The therapist and patient work to develop and maintain a healthy balance of activity and stimulation such that the patient does not become overly active (e.g. by taking on too many projects) or inactive (e.g. by avoiding social contact)

What is a synapse?

The tiny space separating neurons

A diagnosis of PTSD begins with:

The traumatic event itself (an individual must have been exposed to an event that involves actual or threatened death, serious injury, or sexual violence)

According to psychoanalysis, in order to resolve a mental illness:

The unconscious struggles must be identified and addressed

Misdiagnosis of BD can result in:

The underutilization of treatment OR the utilization of inappropriate treatment, and thus profoundly impact the course of illness

What is less effective in inducing an emotional response from someone with BD?

The use of a standardized stimulus (e.g., facial expression of anger) may not elicit a sufficiently strong response

What is polypharmacy?

The use of many medications

Psychoanalysts believe a person's childhood relationships with caregivers often determine:

The way that person relates to others, and predicts later psychiatric difficulties

Approaches like cognitive bias modification are promising because of:

Their accessibility

Manic episodes are distinguished from hypomanic episodes by:

Their duration and associated impairment

People with OCD often confuse having an intrusive thought with:

Their potential for carrying out the though

Why may it be difficult to talk to someone with schizophrenia?

Their speech may be difficult to follow, either because their answers do not clearly flow from your questions, or because one sentence does not logically follow from another (this is called disorganized speech)

These five broad domains from the Five-Factor Model are inclusive, meaning:

There does not appear to be any traits of personality that lie outside of the Five-Factor Model (this even applies to traits that you may use to describe yourself)

The is the biggest problem in abnormal psychology?

There is NO sharp line between "normal" and "abnormal"

What are arguments FOR the addition of the category "Attenuated Psychotic Syndrome"?

There is evidence that individuals with high-risk symptoms develop psychosis at a much higher rate than individuals with other types of psychiatric symptoms, and that the inclusion of Attenuated Psychotic Syndrome in Section III will spur important research that might have clinical benefits

It may be argued that a high rate of heritability demonstrates that BD is fundamentally a biological phenomenon, however:

There is much VARIABILITY in the course of BD both within a person across TIME and across PEOPLE

What are CBT-enhancing pharmaceutical agents?

These are drugs used to improve the effects of therapeutic interventions

What are the functions of the ventral striatum and anterior prefrontal cortex?

These are regions of the brain that normally increase their activity when something important (aka "salient") happens in the environment

Psychostimulants like amphetamine or cocaine are examples of drugs that have high risk for abuse because:

They are agonists at dopamine neurons involved in reward AND because these drugs exist in forms that can be either smoked or injected intravenously

What was the rationale for the proposed deletions of the 4 personality disorders?

They are said to have less empirical support than the diagnoses that were at the time being retained

Psychiatric drugs are commonly used, in part, because:

They can be prescribed by general medical practitioners, whereas only trained psychologists are qualified to deliver effective psychotherapy

How can delusions be terrifying to a person?

They can be terrifying for the person, who may remain convinced that they are true even when loved ones and friends present them with clear information that they cannot be true

Personality disorders are among the most difficult of disorders to treat because:

They involve well-established behaviours that can be integral to a client's self-image

One of the reasons individuals that enroll in drug treatment programs, especially out-of-town programs, are at significant risk of relapse is:

They later find themselves in proximity to old hangouts, friends, etc which act as cues for the drug, which result in cravings and therefore relapse

Give examples of behaviours that someone with PTSD may engage in:

They may engage in a host of behaviours intended to protect themselves from being vulnerable or unsafe, such as constantly scanning their surroundings to look for signs of potential danger, never sitting with their back to the door, or never allowing themselves to be anywhere alone

Why are the symptoms associated with psychosis difficult for us to understand compared to depression or anxiety?

They may seem far outside the range of our normal experiences-unlike depression or anxiety, many of us may not have had experiences that we think of as on the same continuum as psychosis

Why do many lead personality disorder researchers not hold this alternative view of the DSM-5 that personality disorders are simply extreme versions of normal personality traits?

They suggest that there is something qualitatively unique about persons suffering from a personality disorder, usually understood as a form of pathology in sense of self and interpersonal relatedness that is considered to be distinct from personality traits (e.g. it has been suggested that antisocial personality disorder includes impairments in identity (e.g. egocentrism), self-direction, empathy, and capacity for intimacy, which are said to be different from such traits as arrogance, impulsivity, and callousness)

What can an overwhelming urge to escape during a panic attack cause?

This can lead to a sense that certain places or situations—particularly situations where escape might not be possible—are not "safe"

Why are panic attacks in SAD not considered PD?

This is not considered PD, however, because the person's fear is more focused on social evaluation than having unexpected panic attacks, and the fear of having an attack is limited to social situations

What are automatic thoughts?

Thoughts that occur spontaneously; often used to describe problematic thoughts that maintain mental disorders

Cognitive-behavioral therapies are based on the rationale that:

Thoughts, behaviours, and emotions affect and are affected by each other

What is the premise of CBT?

Thoughts, behaviours, and emotions interact and contribute to various mental disorders

What is the goal of CBT?

To alleviate psychological symptoms by changing their underlying cognitions and behaviours

What is the goal of PCT?

To create conditions under which patients can discover their self-worth, feel comfortable exploring their own identity, and alter their behaviour to better reflect this identity

With reappraisal/cognitive restructuring, what is the therapists' job?

To help point out when a person has an inaccurate or maladaptive thought, so that the patient can either eliminate it or modify it to be more adaptive

Rather than trying to change patient's thoughts or behaviours directly, the therapists' role in PCT is:

To provide the therapeutic relationship as a platform for personal growth

Whereas PTSD was previously categorized as an Anxiety Disorder, in the most recent version of the DSM, it has been reclassified under the more specific category of:

Trauma- and Stressor-Related Disorders

The majority of drugs reach the brain by:

Travelling in the blood

In the past century, a number of psychotherapeutic orientations have gained popularity for:

Treating mental illness

What is psychodynamic therapy?

Treatment applying psychoanalytic principles in a briefer, more individualized format

Psychoanalysis is often expensive because:

Treatment usually lasts many years

What is the second-oldest class of antidepressant medications?

Tricyclics

According to social zeitgeiber theory stressors that disrupt sleep, or that disrupt the daily routines that entrain the biological clock (e.g. meal times) can:

Trigger episode relapse

What is a consequence of interpreting normal bodily sensations in a catastrophic way?

Triggers more anxiety and, ironically, more physical sensations, creating a vicious cycle of panic

What is the older generation of antipsychotics?

Typical

What does the analyst do with the free association?

Uses his or her expertise to discern patterns or underlying meaning in the patient's thoughts

What is cognitive bias modification?

Using exercises (e.g. computer games) to change problematic thinking habits (patients are given exercises, often through the use of video games, aimed at changing their problematic thought processes)

Some patients and therapists find the prolonged and detailed analysis:

Very rewarding

What is cognitive-behavioural therapy (CBT) successful at treating?

Very successful at treating anxiety and mood disorders, particularly over the long-term

As the empirical data shows, CBT has proven to be highly efficacious for:

Virtually all psychiatric illnesses

One skill DBT teaches patients is called distress tolerance, which is:

Ways to cope with maladaptive thoughts and emotions in the moment

The pharmacological treatments used to treat psychiatric conditions such as schizophrenia or depression have undergone amazing development since the 1950s, and the drugs used to treat these disorders tell us something about:

What is happening in the brain of individuals with these conditions

Personality traits are integral to each person's sense of self, as they involve:

What people value, how they think and feel about things, what they like to do, and, basically, what they are like most every day throughout much of their lives

What is peripartum onset specified with mood episodes?

When a mood episode has an onset during pregnancy or within 4 weeks of the birth of a child

When is seasonal pattern specified with mood episodes?

When a mood episode occurs at the same time of year for 2 consecutive years-most commonly occurring in the fall and winter

What is transference?

When an individual redirects emotions and feelings, often unconsciously, from one person to another

What is a personality disorder?

When personality traits result in significant distress, social impairment, and/or occupational impairment

When are psychotic features specified with mood episodes?

When the episodes are accompanied by delusions (rigidly held beliefs that are false) or hallucinations (perceptual disturbances that are not based in reality)

When do personality traits become particularly evident?

When the person is an adult

Describe how manic episodes are distinguished from hypomanic episodes by their duration and associated impairment:

Whereas MANIC episodes must last 1 week and are defined by a significant impairment in functioning, HYPOMANIC episodes are shorter and not necessarily accompanied by impairment in functioning

What do we need to know in order to help people in distress easier and more rapidly?

Why individuals differ

It is quite possible that in future revisions of the DSM some of the personality disorders included in DSM-5 and DSM-IV-TR:

Will no longer be included

What is tolerance?

With repeated exposure, the drug produces less of an effect over time, so more of the drug is needed to get the same effect

Psychoanalysis is not appropriate for some types of patients, including those:

With severe psychopathology or mental retardation

What is the difference between men and women in terms of rates of MDD?

Women experience 2 to 3 times higher rates of MDD than do men

Give examples of maladaptive conscientiousness:

Workaholism, perfectionism, punctilious, ruminative, and dogged

An earlier age of onset of MDD predicts a better or worse course?

Worse

Can personality disorders themselves be treated?

Yes

Does lithium have a strong efficacy for the treatment of BD?

Yes

Is anxiety a natural part of life?

Yes, at normal levels helps us to function at our best

Is dialectical behaviour therapy an expensive form of treatment?

Yes, but research has indicated that its benefits far outweigh its costs, both financially and socially

Can you meet someone with schizophrenia without even knowing they have it?

Yes-they may suffer in silence or stay isolated to protect themselves from the horrors they see, hear, or believe are operating in the outside world

What happens after having a panic attack?

You might begin to associate the physical sensations you felt during this attack with this fear and may start to go out of your way to avoid having those sensations again (the person may begin to avoid a number of situations or activities that produce the same physiological arousal that was present during the beginnings of a panic attack)

What is the social zeitgeiber?

Zeitgeber is German for "time giver." Social zeitgebers are environmental cues, such as meal times and interactions with other people, that entrain biological rhythms and thus sleep-wake cycle regularity.