PSY 350 SDSU Exam #3
Prevalence of erectile disorder? Does this increase or decrease with age?
60% of men over 60 experience; Increases
sensate focus
The term was introduced by Masters and Johnson. -In this exercise, couples are instructed to refrain from intercourse or genital caressing and simply to explore and enjoy each other's body through touching, kissing, hugging, massaging, or similar kinds of behavior.
Where is anorexia nervosa most prevalent?
Western Cultures
What do the three Depressive attributional styles all lead to?
a person having a sense of hopelessness
Which of the following represents the typical profile of a patient with anorexia nervosa? a. Young, white, female, upper socioeconomic status, socially competitive environment b. Young ,white, female, any socioeconomic status, history of depression c. Young, female, any race, any socioeconomic status, highly competitive d. Any age, female, upper socioeconomic status, few friends
a. Young, white, female, upper socioeconomic status, socially competitive
Of the following, the only symptom that both patients with narcolepsy and hypersomnia experience is a. falling asleep during normal waking hours. b. sudden loss of muscle tone. c. sleep paralysis. d. hypnagogic hallucinations.
a. falling asleep during normal waking hours.
All of the following are associated with treatments for paraphilias EXCEPT a. sexual surrogacy b. covert sensitization c. orgasmic reconditioning d. chemical castration
a. sexual surrogacy
Parasomnias
abnormal behavioral and physiological events during sleep
Exhibitionist Disorder
achieving arousal by exposing genitals to strangers E.g. flasher
Prevalence of premature ejactulation and does it increase or decrease with age?
affects 21% of all adult males More common in younger, inexperienced males Problem tends to decline with age
Obstructive Sleep Apnea Hypopnea
airflow stops, despite continued activity by respiratory system working (airflow stops, resp system works)
associated feature of narcolepsy, Sleep paralysis
an associated feature of Narcolepsy which is a brief period after awakening when they can't move or speak that is often frightening to those who go through it?
Arbitrary interference
assess negatives more over positive for any given situations When a student sleeps in class and the teacher thinks it is because her lecture is boring
Which of the following is NOT usually a component of a major depressive episode? a. Feelings of worthlessness b. Flight of ideas c. Altered sleep patterns d. Change in appetite
b. Flight of ideas
What medications are used to treat insomnia
benzodiazepines and over-the-counter sleep medications, best as a short term solution
Lithium is a ____ and is prescribed as the standard treatment for ______. a. antipsychotic; very severe depression b. anticonvulsant; bipolar disorder c. mood stabilizer; bipolar disorder d. SSRI; bipolar disorder
c. mood stabilizer; bipolar disorder
Sexual dysfunction can be a(n) ______ condition. a. lifelong b. acquired c. situational d. All of the above
d. All of the above
sleep-related hypoventilation
decreased breathing during sleep not better explained by another sleep disorder? airflow does not completely stop, but is reduced
Lithium Carbonate is considered a mood stabilizer because it treats what?
depressive and manic symptoms
Female sexual interest/arousal disorder
describes lack of or significantly reduced sexual interest/arousal in females?
Male hypoactive sexual desire disorder
describes little or no interest in any type of sexual activity in males
Premature Ejaculation
ejaculation occurring within ~1 minute of penetration and before it is desired?
Reciprocal-Gene Environment Model
essentially states that some people have a genetic predisposition that leads to certain situations which end up contributing to the development of depression/etc. People who are vulnerable to depression might be more likely to enter situation that will lead to stress. Ex) shy person excludes self from others leading to depression.
Stable way of thinking
even after particular negative events passes, the attribution that "additional bad things will always be my fault" remains. believing future negative outcomes will be one's own fault,
Hypersomnolence
excessive sleeping and causes sleepiness throughout the day A person with this condition falls asleep several times a day.
electrooculograph (EOG)
eye movements, indicative of amount of REM sleep
Interpersonal therapy (IPT)
focuses on resolving problems in existing relationships and learning to form new interpersonal relationships. It is highly structured and rarely takes more than __15-20__ sessions.
Double Depression
individuals who suffer from both major depressive episodes and persistent depression with fewer symptoms are said to have double depression.
Transvestic Disorder
individuals, usually males, are sexually aroused or receive gratification by wearing clothing of the opposite sex; sexual arousal with the act of cross dressing (men; married; spouse aware)
Dyssomnias
is a broad type of sleep disorders involving difficulty falling or remaining asleep, which can lead to excessive sleepiness during the day due to the reduced quantity, quality or timing of sleep. -insomnia -hypersomnolence -narcolepsy -
Erotophobia
learned negative attitude about sexuality due to religion, family, etc
Persistent Depressive Disorder
low level depression; depressed mood most of the day on more than 50% of the days; longer lasting (minimum of two years and can go for >20 years, symptoms cannot disappear for more than 2 months)
Permissive hypothese
low levels of serotonin "permit" NE and dopamine to fluctuate wildly, increasing vulnerability to depression
electromyography (EMG)
muscle activity (myo- means muscle)
What is the most common sexual dysfunction in adult males
premature ejaculation
SSRIs
prevents reuptake of Serotonin suicide risk in teens Ex: prozac
Tricyclic
prevents reuptake of norepinephrine and other neurotransmitters negative side effects common- which is why discontinuation is popular, can be lethal in excess
Mixed-Reuptake Inhibitors
prevents reuptake of serotonin and norepinephrine fewer side effects than SSRIs Ex: venlafaxine (SNRI)
Binge eating disorder
rapid eating even when not hungry, with NO compensatory behaviors? Occurs average at least once a week for 3 months
Sleep terrors
recurrent episodes of panic like symptoms during non-REM sleep more common in children, child has little memory of it the next day Can wake child at specific time to prevent
Frotteuristic Disorder
seeking sexual gratification from rubbing against unwilling victims in crowds from which they cannot escape (typically in a crowded place such as the subway/elevator)
Voyeuristic Disorder
sexual arousal is derived from observing unsuspecting individuals undressing or naked. Observing a stranger undressing Ex: peeping
Which parasomnias occur during non-REM sleep?
sleep terrors and somnambulism
Mood
state that includes: cognitive, motivational and physical aspects
What medications are used to treat hypersomnia and narcolepsy
stimulants (modafinil/provigil)
Sexual Masochism
suffering pain or humiliation to attain sexual gratification
Ventromedial hypothalamus
suppresses hunger; Stimulation stops hunger; destruction results in eating even if full
Global way of thinking
the attribution extended across a variety of issues. believing negative events will disrupt many life activities ways.
Internal way of thinking
the individual attributes negative events to personal failings ("it was my fault"). when negative outcomes are one's own fault
Sexual dysfunction (and its three factors)
the term for issues involving desire, arousal and/or orgasms?
How do patients qualify for sex reassignment surgery
they must live in desired gender for 2 (said 7 on slides) years before
Gender Dysphoria
trapped in body of wrong sex Occurs on a continuum Desire to be another gender, cross dressing, distress
Treatment for insomnia
treated with benzodiazepines Often associated with medical and or psychological condition Unrealistic expectations about sleep
associated feature of narcolepsy, hypnagogic hallucinations
vivid and often terrifying experiences that begin at the start of sleep and are said to be unbelievably realistic because they include not only visual aspects but also touch, hearing, and even the sensation of body movement
Among which groups of people is anorexia nervosa most prevalent?
white, middle/upper class females, and socially competitive environments
Better or worse prognosis than bulimia
worse
Learned-Helplessness
A lack of perceived control over life events leads to decreased attempts to improve own situation? "Why should i even try" mentality?
Premenstrual Dysphoric Disorder
A mood disorder in women characterized by marked depressive, anxious or irritable symptoms, regularly occurring around the time of menstruation.
polysomnographic (PSG) evaluation
An assessment of sleep disorders in which a client sleeping in the lab is monitored for heart, muscle, respiration, brain wave, and other functions. -EEG -EOG -EMG
The tendency to interpret life events negatively
Cognitive errors
What is the most effective treatment for sexual dysfunction
Education
What is the most common problem for which men seek treatment?
Erectile disorder
anhedonia
Extremely depressed mood and/or loss of pleasure
Family's contribution to eating disorders
Families with patients of anorexia are concerned with: high achievement, perfectionism, concern with external appearance, and lack of open communication
What are some risk factors for suicide
Family history Low levels of Serotonin Alcohol abuse Pre-existing psychological disorder Stressful life event, especially humiliation Contagion: ie, famous person commits suicide so I want to do it now too apparently
Which type of sex reassignment conversion do more people adjust better with?
Female to male conversion
How many women have difficulty achieving orgasms?
How many women have difficulty achieving orgasms?
Disruptive Mood Dysregulation Disorder
In children, a mental disorder characterized by recurrent temper outbursts occurring against a background of irritable mood.
Stress hypothesis
Individuals prone to depression/anxiety will likely have elevated cortisol, which is produced by the adrenal gland
Sexual Sadism
Inflicting pain or humiliation to attain sexual arousal/gratification -To be diagnosed: Has to be on someone who is unconsenting; or you become distressed
When you are depressed, what are the three ways you think (aka Depressive Attributional Style)
Internal, Stable, Global
What describes getting out of bed at least once during the night and consuming a third or more of ones daily food intake?
Night eating syndrome
Which parasomnia occurs during REM sleep
Nightmares
non-demand pleasuring
Non-demand pleasuring involves affectionate, sensual, playful, and erotic touching both inside and outside the bedroom, which creates an empowering understanding that not all touching can or should lead to intercourse.
What did Henderson and Brownell find about contributions to the obesity epidemic?
Obesity is related to the spread of modernization. promotion of inactive and sedentary lifestyle and consumption of high fat energy dense diet
What describes a person who applies negatives to all situation?
Overgeneralization
Biological contributions to eating disorders
Partial genetic contribution
Biological contributions to sexual dysfunction
Physical disease, medical illness, prescription medications use and abuse of drugs and alcohol
Relaxation and stress reduction
Reduces stress and assists with sleep Modify unrealistic expectations about sleep
central sleep apnea (CSA):
Respiratory system stops for a brief period airflow stops due to some type of CNS pathology
Deficits in what hormone may contribute to binging?
Sorotonin
media and cultural contributions to eating disorders
Strongest contributions- thinness linked to success, emphasis on dieting, standards of body size
part of narcolepsy, Cataplexy and what can help treat it
Sudden loss of muscle tone (helped by antidepressants/stimulants); I.e: "sleep paralysis" Could be brought on by a positive emotion
Sleep efficiency (SE)
The percentage of time actually spent sleeping of the total time spent in bed. This is essentially the amount of sleep achieved divided by the amount of sleep attempted. Ex: try to sleep for 8 hours but only sleep for 6 hours. SE = 75%
Median lifetime # of depressive episodes for major depressive disorder
(4-7); 4-5 months in duration
Erectile Disorder
(difficulty achieving or maintaining an erection)
MAO-inhibitor
(inhibits activity of the enzyme monoamine oxidase, which breaks down norepinephrine/Sero) fewer side effects but as effective as tricyclics dietary restrictions
Female orgasmic Disorder
(marked delay, absence or decreased intensity of orgasm)
Narcolepsy
(sudden onset of REM): Sleep disorder involving sudden and irresistible sleep attacks. Rare, equally distributed between males and females
Cyclothymic Disorder
-(alternate between mild depressive & mild hypomanic symptoms) -Must last minimum of two years (one year for children and adolescents) -One third to one half develop full blown bipolar -Onset between 12-4 years
Paraphillic disorders
-(misplaced sexual attraction & arousal) socially unacceptable objects, situation, or individuals -Must be associated with distress, impairment or harm -Sexual interest in non-normative desire -Fetishistic disorder -Frotteuristic disorder -Voyeuristic disorder -Exhibitionistic disorder -Transvestic disorder -
Sleep and Depression
-(more intense and longer REM activity; decreased deep stage sleep -Sleep deprivation may improve depressive symptoms in those who are depressed -Sleep loss may bring on feelings of depression in non-depressed individuals
Insomnia
-(problem initiating or maintaining sleep
Prevalence of insomnia
-1/3 of population in a given year -females twice as likely
What is the prevalence of major depressive disorder
-16% for major depression -females are twice as likely to have major depression
Anorexia Nervosa
-An eating disorder characterized by calorie restriction relative to expenditure, leading to dangerously low body weight. -nervous loss of appetite, at least 15% below ideal body weight without any other medical explanation, often begins with dieting -Extreme caloric restriction brought on by intense fear of weight gain -Typically comorbid with OCD (and other psych disorders)
Bulimia Nervosa
-An eating disorder involving recurrent episodes of uncontrolled excessive (binge) eating followed by compensatory actions to remove the food (for example, deliberate vomiting, laxative abuse, and excessive exercise). - Binge eating with compensatory behaviors ,
Cognitive behavioral therapy for insomnia
-Changing beliefs about sleep -Extensive monitoring using sleep diary -Practicing better sleep-related habits
Chronic vs acquired
-Chronic: From first sexual encounter -Acquired: Occurs after a period of normal sexual activity
Treatment for Sexual Dysfunctions
-Education -Psychosocial behaviors
What are some consequences of purging due to bulimia
-Erosion of dental enamel can occur, electrolyte imbalance -Kidney failure, cardiac arrhythmia, seizures... etc
Social/Cultural contributions to sexual dysfunction
-Erotophobia -negative/traumatic sexual experiences, relationship problems -Deterioration of interpersonal relations and lack of communication
Generalized vs. Situational
-Generalized occurs every time the individual has sex -Situational occurs randomly in specific situations
Facts about bulimia
-Hide behavior from others -Food consumed often high in fat, sugar, carbohydrates -Food consumed is usually soft and easy to consume so they can eat it fast such as (donuts,ice cream, pudding etc.) -Most are within range of normal weight -Later onset than anorexia -Low Sero, can be treated with anti-depressants concern with body shape and fear of gaining weight -Comorbidity with other psych disorders- 80% will develop anxiety in their lifetime
Ways to assess sexual behavior
-Interview -Thorough medical examination -Psychophysiological assessment
Major depressive episode
-Lasts most of the day, nearly every day for at least two weeks -anhedonia (extremely depressed mood and/or loss of pleasure) -At least 4 additional physical or cognitive symptoms: E.g., indecisiveness, feelings of worthlessness, fatigue, appetite change (can be increase or decrease but is usually a decrease in appetite), restlessness or feeling slowed down, sleep disturbance
Fetishistic Disorder
-Long-term, recurring, intense sexually arousing urges, fantasies, or behavior involving the use of nonliving, unusual objects, which cause distress or impairment in life functioning. Inanimate objects or a specific tactile (often rubber) -sexual attraction involving nonhuman objects E.g. foot-fetish, hair-fetish, or toe-fetish
Orgasmic Reconditioning
-Masturbate to appropriate stimuli -patients are instructed to masturabte to their fantasies but then substitute desirable appropriate ones before ejaculation
What are some Sociocultural contributions to eating disorders;
-Media & cultural considerations -Families
Major depressive disorder (single vs. recurrent)
-Mood disorder involving one major depressive episode; mood disorder involving multiple (separated by at least 2 months without depression) major depressive episodes. -Single episode - highly unusual -Recurrent episodes - more common -Onset at 30, 5-10% prevalence, lifetime risk of 17%
Breathing-related Sleep Disorders
-Obstructive Sleep Apnea hypopnea -central sleep apnea (CSA): -sleep-related hypoventilation
What are the 4 antidepressents
-Selective serotonin reuptake inhibitors(SSRI's) -tricyclic antidepressants -monoamine oxidase inhibitors -Mixed reuptake inhibitors
Somnambulism
-Sleep walking may be accompanied by night eating, or dangerous situations
Psychosocial behaviors
-Squeeze technique: for premature ejaculation Penis is stimulated to a full erection by partner, and the head is squeezed to reduce arousal -Mastabatory training: for female orgasm disorder (talking out loud, using a vibrator) -Exposure to errotic material: for low sexual desire problems
Comprehensive interview
-a detailed history of sexual behavior and lifestyle -questionnaires because people provide more info on paper Patient must be comfortable talking about issues
Nightmares
-all are more common in children (10-50%) Often awaken from slumber -CBT/may involve antidepressants and or relaxation training can help -All three will typically resolve on their own without any extensive intervention
Bipolar I
-alternate between full manic episodes & major depressive episodes -Greatest suicide risk -Chronic condition -Onset 15-18 years old -Can begin in childhood
Bipolar II
-alternate between hypomanic episodes & major depressive episodes -Can progress to Bipolar I if not treated -Later onset than Bipolar I -Average onset is 19-22 years, and tends to be chronic
What is the most deadly mental disorder and why
-anorexia -Because starving body borrows energy from internal organs Most serious consequence is cardiac damage which can lead to heart attack and death
Lateral hypothalamus
-brings on hunger; -stimulation would result in eating even if full; -destruction would result in not eating
Prevalence of bipolar disorder
-equally affect males and females -Affects 2.5 million americans in any given year
Manic episode
-expansive mood for at least 1 week; Unpredictable; Judgment low, energy high. Impairment in normal functioning -Symptoms: inflated self esteem, decreased need for sleep, excessive talkativeness, flight of ideas or sense that thoughts are racing, easily distracted, increase in goal directed activity, involvement in pleasurable but risky behaviors
Convert Sensitization
-imagining aversive consequences to form negative associations with deviant behavior (e.g., pedophilic behavior & arrest) During six or eight sessions, the therapist narrates such scenes dramatically, and the patient is then instructed to imagine them daily until all arousal disappears. Most are about getting in trouble and embarrassment
Psychophysiological assessment
-measure the physiological aspects of sexual arousal (typically watch an erotic film while they measure their response) -Penile erection is measured using a penile strain gauge -Vaginal photoplethysmograph- measures the amount of light that is reflected from the vaginal walls, which indicates degree of blood flow
Psychological intervention for paraphillic disorders
-most behavioral - target deviant & inappropriate sexual associations -Orgasmic Reconditioning -Convert Sensitization
Pedophilic Disorder
-sexual attraction to prepubescent children pedophile must be at least 16; 5 years older than victims -More men than women -Roughly 95% of altercations go unreported
Hypomanic Episode
-shorter (Lasts at least 4 days), less severe version of manic episodes -Fewer and milder symptoms -Associated with less impairment than manic episodes (e.g., less risky behavior) -May not necessarily be problematic but is a part of other behaviors such as (bipolar II)
Mixed Features
-term for a mood episode with some elements reflecting the opposite mood -Example: Depressive episode with some manic features -Example: Manic episode with some depressed/anxious features
Thorough medical evaluation
-when you must rule out potential medical causes of sexual dysfunction -Drugs or surgeries may disrupt sexual desire/arousal -Specialists check levels of hormones, functioning and response
Rate of prevalence of sexual dysfunction on women and men
43% of women & 31% of men in US
What is this prevalence rate in male hypoactive sexual desire disorder? Does this increase or decrease with age?
5% increase with age
How effective are antidepressants?
50% of patients benefit low to moderate depression - no more effective then a placebo
What nationalities are suicide most common in
Caucasian and Native American
How prevalent is suicide among teenagers?
3rd leading cause of death
Differences from bulimia or anorexia
Many are obese, often older than bulimics and anorexics Not necessarily concerned about body image
What is the prevalence rate for female sexual interest/arousal disorder? Does this increase or decrease with age?
22% Decrease with age
How prevalent is suicide among college students?
2nd leading cause of death
At what ages can you diagnose someone with disruptive mood regulation disorder?
Between the ages 6 and 18
What are two forms of maladaptive eating patterns in a person who is obese?
Binge eating and night eating syndrome
What is the most common eating disorder in the US?
Binge eating disorder
electroencephalograph (EEG)
Brain wave activity
What are some psychological treatment for sleep disorders?
CBT, relaxation and stress reduction, and improved sleep hygiene
What is the treatment of choice for Bipolar disorders?
Lithium Carbonate. Dosage is strictly regulated due to potential toxicity. Used to treat bipolar disorder. Many patients abandon this treatment to be able to experience manic episodes.
3 different types of mood "episodes"
Major depressive episodes Manic episodes Hypomanic episodes
Prevalence of bulimia
Majority are female 90%+ between 18-21
What are some compensatory behaviors for bulimia nervosa, starting with the most common?
Purging diuretics or laxatives excessive exercising fasting