Psychology Test 3

One reason why guilt and negative thoughts about the self may be common in Western but not in Asian cultures is that Western cultures view the individual as ________ so when failures occur, internal attributions are made

independent and autonomous

Which one of the following is the most common symptom to occur prior to the onset of a manic episode

lack of sleep

Mary was already depressed, so at the end of the day she could only remember the bad thing that had happened to her, which made her more depressed

the vicious cycle of depression

Racial/ethnic differences regarding suicide are seen --% of suicides in the US are classified as people who are white

90

Biological factors

- genetic factors - Neuro-physical & neuro-anatomical influences - Altered neuro-transmitter activity - Hormone & immune system regulation abnormalities

The Precalence of Mood Disorder

-Lifetime prevalence of unipolar depression is nearly 17% -12-month prevalence rates are nearly 7% -About twice as common in women than men (women 21%, men 13%) -Lifetime prevalence for bipolar disorder is near 1%

Unipolar Depressive Disorder (MDD Major Depressive Disorder)

A major depressive episode without having manic, hypomanic, or mixed episodes Relapse and recurrence May begin at any point in lifespan, incidence rises during adolescence May include additional symptoms (specifiers)

The incidence of depression rises sharply during

Adolescence

Basic biological causes

All have genetic component and this may be nonspecific to a disorder

Specific Phobias Subtypes

Animal Natural environment Blood-injection-injury Situational Other

Suicide Mental Disorder Treatment

Antidepressant or mood stabilizing medication: SSRI, Bupropion, and Nefazodone Benzodiazepines for anxiety:Alprazolam (Xanax), Clonazepam (Klonopin) Cognitive-behavioral therapy

Treatments for body image disorders

Antidepressants: Some studies of SSRIs show moderate to limited effectiveness but research is limited; higher doses may be necessary CBD

At the diagnostic level, there are very high levels of comorbidity between depressive and _______ disorders

Anxiety

Agoraphobia

Anxiety about being in places from which escape might be difficult or embarrassing: Crowds Theaters Malls Cars, buses, trains, planes Standing in line Elevators Other similar situations

Treatments for generalized anxiety

Anxiolytic drugs: Commonly used and misused Buspirone and other antidepressants: Data for effectiveness and non-addictive Cognitive-behavioral therapy: Good data on effectiveness

Which of the following statements about BD is true

BD occurs equally in males and females

Other forms of depression

Bereavement-triggered depressed Postpartum depression (more than postpartum blues).

Causal Factors

Biological causal factors Psychological causal factors

Generalized Anxiety Disorder

Chronic or excessive worry about multiple events and activities DSM-5: occurs more days than not for 6-month period Accompanied by at least 3 of 6 symptoms

Treatment for Socail phobias

Cognitive Therapy- Cognitive restructuring to change distorted automatic thoughts Behavior Therapy- Prolonged and graded exposure to social situations that evoke fear Medication- Antidepressants Relapse rate with medication is higher than with therapy

Psychological Caudual factor panic disorder

Comprehensive learning theory of panic disorder: initial panic attacks become associated with initially neutral internal (interoceptive) and external (exteroceptive) cues through an interoceptive conditioning (or exteroceptive conditioning) process, which leads anxiety to become conditioned to these CSs, and the more intense the panic attack, the more robust the conditioning that will occur. Cognitive theory of panic people with panic disorder are hypersensitive to their bodily sensations and are very prone to giving them the most dire interpretation possible (automatic thoughts) Anxiety sensitivity and perceived control: people who have high levels of anxiety sensitivity—a trait-like belief that certain bodily symptoms may have harmful consequences—are more prone to developing panic attacks and perhaps panic disorder Safety behaviors and persistence of panic Cognitive biases and maintenance of panic

A less severe version of bipolar disorder in which the person experiences a phase of being especially creative and productive because of increased physical and mental energy is

Cyclothymic disorder

Criteria for Persistent Depressive Disorder (Dysthymic Disorder)

Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least two years.

Hopelessness theory

Depression prone individuals not only tend to make global and stable attributions for negative events but also tend to make negative inferences about other likely negative consequences of the event and negative inferences about the implications of the event for the self-concept.

Psychological Causal Factor

Depression- Stressful life events Independent vs. dependent Risk-related vulnerability factors- e.g., those more at risk are more sensitive to stressful events Neuroticism or negative affectivity Early adversity or parental loss

Social Phobia (Soical anxiety disorder)

Disabling fears of one or more specific social situations Fear of exposure to scrutiny and potential negative evaluation of others Subcategories Performance Nonperformance

Biological Causal Factor

Disruptions- In several areas of the brain including ventromedial prefrontal cortex, orbital prefrontal cortex, dorsolateral prefrontal cortex, hippocampus, anterior cingulate cortex, and amygdala Sleep- Reduced latency to enter REM sleep and decreased amount of deep sleep Circadian rhythms- Nature of the dysfunction is unknown. May be size and magnitude of circadian rhythms is blunted or rhythms become unsynchronized Exposure to Sunlight- Majority depressed in fall or winter, associated with decreased amount of sunlight, responsive to light therapy

Bipolar Disorders

Distinguished from unipolar disorders by presence of manic or hypomanic symptoms

Alternative Biological Treatments

Electroconvulsive therapy Transcranial magnetic stimulation Deep brain stimulation Bright light therapy

Treatment for OCD

Exposure and response prevention Medications that affect neurotransmitter serotonin See Bokor and Anderson (2014) for a compiled list of pharmacological treatments of Obsessive Compulsive Disorder.

The Fear and Anxiety

Fear or Panic is a basic emotion that involves activation of the "fight-or-flight" response of the autonomic nervous system. Fear with no external cause can result in a panic attack and that generally includes a sense of impending doom.

Psychotherapy

Forms of effective psychotherapy Cognitive-behavioral therapy Behavioral activation treatment Interpersonal therapy Family and marital therapy

Psychological Caudal factors for generalized panic

Free floating anxiety from inadequate defense mechanisms Perceptions of uncontrollability and unpredictability; low tolerance for uncertainty Sense of Mastery Feeling less in control can increase anxiety Negative consequences of worry People who worry about something tend subsequently to have more negative intrusive thoughts than people who do not worry Cognitive biases for threatening information Anxious people tend to preferentially allocate their attention toward threatening cues when both threat and nonthreat cues are present in the environment.

Psychological Causal Factors: Theorists

Freud-depression was anger turned inward Behaviorists-used conditioning to explain depression Cognitive model-proposed by Beck, focuses on cognitive distortions

Sertonin-Transporter Gene

From prior research, there has been found in individuals with major depressive disorder (MDD) a difference in thalamic structure. ), found that individuals who carry the short allele variant in the 5HTTLPR gene also are more prone to MDD.

Anxiety

General feeling of apprehension about possible danger Future-oriented and diffuse Cognitive, physiological, and behavioral components

Biological Causal Factors for OCD

Genetics: OCD is modestly heritable and is genetically related to Tourette's Syndrome Brain Functions Abnormalities: Slight structural abnormalities in the basal ganglia-specifically the caudate nucleus Dysfunction in the cortico-basal-ganglionic-thalamic circuit Serotonin:

Biological Causal Factors for panic attack

Genetics: moderate heritable component- 33% to 43% due to genetic factors Panic and the brain- amygdala ("fear network") hippocampus higher cortical centers Biochemical abnormalities-- panic provocation procedures noradrenergic & serotonergic systems Low levels of GABA Panic disorder is likely to develop in people who have abnormally sensitive fear networks that get activated too readily to be adaptive

Effective treatments

Graduated exposure to fears is a common treatment. All (except specific phobias) respond to antianxiety and antidepressant drugs.

Biological Causal Factors of Bipolar

Heredity There is a greater genetic contribution to bipolar disorder than to unipolar disorder Norepinephrine, serotonin, and dopamine These neurotransmitters all appear to be involved in regulating our mood states Abnormalities in transportation of ions across neural membrane: Bipolar patients may have abnormalities in the way ions are transported across the neural membranes

Reformulated Helplessness Theory

Humans are capable of asking why, and they formulate attributions to explain the aversive events. There are three types of attributions: Internal/external Global/specific Stable/unstable People who develop depression have a Pessimistic Attribution Style

Bipolar I

Includes at least one manic or mixed episode

Bipolar II

Includes hypomanic episodes but not full-blown manic or mixed episodes

What is the difference between fear and anxiety?

It is difficult to completely distinguish between fear and anxiety Anxiety - General fear about possible future danger Fear - Alarm response that occurs due to immediate danger

Interpersonal Effects

Lack of social support or social skills can contribute to depression Depression can elicit sympathy and care or hostility and rejection from others Depression and marital dissatisfaction correlate highly.

Cyclical Mood Swings

Less severe than those of bipolar disorder Symptoms present for at least 2 years Lacking severe symptoms and psychotic features of bipolar disorder

_________ has been more widely studied as a treatment of manic episodes than of depressive episodes

Lithium

Bipolar depressive disorders

Manic and depressive espisodes

Treatment Panic Disorder

Medications: Anxiolytics Antidepressants Behavioral treatments: Interoceptive exposure Cognitive-behavioral treatments

Trichotillomania

Moved from impulse-control disorders to OCD-related disorders in DSM-5 Urge to pull out hair from any body location Preceded by tension and followed by pleasure or relief Must cause clinically significant distress Not much is known about the disorder

Body Dysmorphic Disorder

Moved from somatoform disorders to OCD related disorders because of its commonalities with OCD Obsessed with perceived or imagined flaw in appearance Causes clinically significant distress May focus on any body part- men- body build, balding and genitals; women- skin, stomach, breasts, buttocks, hips and legs Causation of BDD is still being researched There is some heritability and some issues with self-schema High comorbidity with depression, social phobia and obsessive-compulsive disorder

Psychological Causal Factors in ocd

Mowrer developed the two-process theory of avoidance learning Neutral stimuli become associated with fearful thoughts via classical conditioning Rituals and resulting avoidance decrease anxiety Research also shows: Obsessions with contamination and dirt appear to have evolutionary roots (preparedness) Attempting to suppress unwanted thoughts may increase those thoughts (cognitive factors) Cognitive biases toward material relevant to one's obsessive concerns (cognitive factors)

Demographic Differences in the USA

Native Americans have relatively high rates of depression African-Americans have relatively low rates U.S. rates of unipolar depression inversely related to socioeconomic status Mood disorders appear relatively common in artists

Researchers have concluded that _________ is/are the primary personality variables that serve as a vulnerability factor for depression

Neuroticism

OCD

New category of disorders in DSM-5: obsessive-compulsive and related disorders Includes OCD which has occurrence of unwanted and intrusive obsessive or distressing images usually accompanied by compulsive behaviors Also includes Hoarding, Excoriation Disorder, BDD and Trichotillomania

Obsessions vs Compulsions

Obsessions: Contamination fears Fears of harming oneself or others Need for symmetry Sexual obsessions Religion, aggression Compulsions: Cleaning Checking Repeating Ordering/arranging Counting

Panic Disorder

Occurrence of panic attacks that seem to come "out of the blue" Recurrent, unexpected attacks Worry about additional attacks Must be abrupt onset of 4 out of 13 symptoms Attacks are brief but intense

Bipolar Disorders Characteristics

Occurs euqally in male and females Usually start in adolescence or young adulthood Average age of onset is 18 to 22 years About three times as many days are depressed as manic/hypomanic

Unipolar Deoressive Disorder

Only depressive disorder

Basic psychological causes

People with these disorders tend to be high in neuroticism Classical conditioning plays a role in all of these disorders. People who feel no control over their situation are at a greater risk for anxiety disorders

Treatments and Outcomes: Pharmacotherapy

Pharmacotherapy: Antidepressants, mood-stabilizing, and antipsychotic drugs are used to treat mood disorders. Lithium is the most common mood stabilizer for bipolar disorder SSRI's and atypical antidepressants (Wellbutrin, Effexor) are the most commonly prescribed for unipolar disorders Antidepressant drugs usually require at least 3 to 4 weeks to take effect Discontinuing the drugs when symptoms have remitted may result in a relapse

_________ occurs in as many as 50 to 70% of women within 10 days of the birht of their child

Postpartum blues

Hoarding

Prevalence may be 3-5% of general population Acquire and fail to discard possessions that have limited value Disorganization in living space interferes with daily life Occurs in approximately 10-40% of people with OCD Poorer prognosis for treatment than OCD Compulsive hoarding may be neurologically distinct from OCD

Psychological Causes

Psychoanalytic viewpoint defense against anxiety stemming from repressed id impulses Learned behavior

Which one of the following psychological theories of depression posits that depression is anger turned inward?

Psychodynamic

Because of the side effects of other drugs, physicians have increasingly chosen to prescribe one of the antidepressants from the ________ category

Selective serotonin reuptake inhibitor

Suicide victims often have alterations in ---- functioning

Serotonin

Understanding the disturbances in the neurotransmitters ---- may be key to understanding bipolar disorder

Serotonin, Norepinephrine, and dopamine

Pessimistic Attribution Style

Some individuals possibly through social learning have a higher diathesis for depression due to the attributions they place upon uncontrollable negative life events (internal/stable/global)

Type of Anxiety Disorders (5)

Specific phobia Social anxiety disorder (social phobia) Panic disorder Agoraphobia Generalized anxiety disorder

Psychological Causal Factors

Stressful life events Personality variables e.g., neuroticism and high levels of achievement striving Low social support Pessimistic attributional style

Specifc Phobia

Strong and persistent fear recognized as excessive or unreasonable Triggered by a specific object or situation Avoidance of trigger cardinal characteristic

___________ is a noninvasive technique that allows focal stimulation of the brain in patients who are awake. It delivers brief but intense pulsating magnetic fields that induce electrical activity in certain parts of the cortex

TMS

Response to Stress differs in a Normal Subject and a Patient with MDD

The hypothalamic-pituitary-adrenal (HPA) axis has been a focus of research, particularly in regard to the hormone cortisol

A recent study of American poet emily Dickinson provided evidence that.......

The intense negative emotional experience of depression provide material for creative activity

Excessive Rumination

The theory that depression is the by-product of intense focus on how an individual feels and why they feel that way. Rumination is the process of repeating a mental script consistently.

Learned Helplessness

Theory that animals and people exposed to uncontrollable aversive events learn that they have no control over these events and this causes them to behave in a passive and helpless manner when later exposed to potentially controllable events.

Current Preventive Efforts

Treatment of person's current mental disorder(s) Crisis intervention Working with high-risk groups

Anxiety Disorders

Unrealistic, irrational fears or anxieties Cause significant distress and/or impairments Disabling intensity

The symptoms for depression in different countries

Vary widely

Phobias as learned behavior

Vicarious conditioning Person to person Individual differences in learning Risk factors Protective factors Evolutionary preparedness Prepared fears

Hippocrates hypothesized that depression was caused by

an excess of black bile in the system

For a person to be diagnosed with a manic episode, the symptoms must persist

for at least a week

Biological Causal Factor for generalized anxeity

genetics: It is modestly heritable; similar genetic predisposition as MDD Neurotransmitters: The neurotransmitters GABA, serotonin, and perhaps norepinephrine all play a role in anxiety. CRH: Corticotropin-releasing hormone (CRH) also plays a role

The two key mood involved in mood disorders are

mania and depression

Which one of the following statements about suicide prevention and intervention is true?

preventing suicide is extremely difficult

As many as 5 to 10% of persons with BD experience at least 4 episodes every year, a pattern known as

rapid cycling