PSYCH 3720 Test 2
--What characterizes Hoarding Disorder?
• Acquire and fail to discard limited value possessions • Disorganization in living space interferes with daily life • Poorer prognosis for treatment than OCD
- -Why is adolescence considered a difficult period in time? -Are all youth traumatized by bullying in the same way?
Adolescence can also be a difficult period o Physical and sexual changes, social and academic pressures, personal doubts, and temptation cause many teenagers to feel anxious, confused, and depressed o Over one-quarter of students report being bullied frequently, and more than 70% report having been a victim at least once
-What is Dissociative Amnesia vs. Dissociative Amnesia with a Fugue state?...how are these two now diagnosed in DSM-5?
Dissociative Amnesia o People with dissociative amnesia are unable to recall important information, usually of an upsetting nature, about their lives o The loss of memory is much more extensive than normal forgetting and is not caused by physical factors o Often an episode of amnesia is directly triggered by a specific upsetting event o Localized - most common type; loss of all memory of events occurring within a limited period o Selective - loss of memory for some, but not all, events occurring within a period o Generalized - loss of memory beginning with an event, but extending back in time; may lose sense of identity; may fail to recognize family and friends o Continuous - forgetting continues into the future; quite rare in cases of dissociative amnesia Dissociative Fugue o People with dissociative fugue not only forget their personal identities and details of their past, but also flee to an entirely different location o For some, the fugue is brief - a matter of hours or days - and ends suddenly o For others, the fugue is more severe: people may travel far from home, take a new name and establish new relationships, and even a new line of work; some display new personality characteristics o Fugues tend to end abruptly
What are characteristics/criteria for Depersonalization/Derealization Disorder?
o DSM-5 categorizes DepersonalizationDerealization Disorder as a dissociative disorder, even though it is not characterized by the memory difficulties found in the other dissociative disorders o Its central symptom is persistent and recurrent episodes of depersonalization (the sense that one's own mental functioning or body are unreal or detached) and/or derealization (the sense that one's surroundings are unreal or detached) o People with this disorder feel as though they have become separated from their body and are observing themselves from outside o This sense of unreality can extend to other sensory experiences and behavior o Depersonalization experiences by themselves do not indicate a depersonalization disorder o Transient depersonalization reactions are fairly common o The symptoms of a depersonalization disorder are persistent or recurrent, cause considerable distress, and interfere with social relationships and job performance
-In treatment, what is the first thing that needs to occur for Anorexia Nervosa patients?
- regain their lost weight, recover from malnourishment, and eat normally again
-What are characteristics/criteria for Dissociative Identity Disorder (DID)? Characteristics of DID's sub-personalities?
- A person with Dissociative Identity Disorder (DID; formerly multiple personality disorder) develops two or more distinct personalities (subpersonalities) each with a unique set of memories, behaviors, thoughts, and emotions -
-What are the two long-term disorders than may occur in childhood/adolescence?
- ASD - IDD
-What are challenges treating hypochondriasis type symptoms?
- Challenge illness-related misinterpretations - Provide more substantial and sensitive reassurance and education - Stress management and coping strategies - CBT - Antidepressants offer some help
-What are the key elements of Autism Spectrum Disorder (ASD)? What did the DSM-5 task force decide regarding Asperger's Syndrome?
- Children with this disorder are extremely unresponsive to others, uncommunicative, repetitive, and rigid - Symptoms appear early in life, before age 3 Around 80% of all cases appear in boys - As many as 90% of children the disorder remain significantly disabled into adulthood - Even the highest-functioning adults with autism spectrum disorder typically have problems in social interactions and communication, and have restricted interests and activities - Lack of responsiveness and social reciprocity - Language and communication problems take various forms One common speech peculiarity is echolalia, the exact echoing of phrases spoken by others - Another is pronominal reversal, or confusion of pronouns - The DSM-5 task force determined that Asperger's Disorder is not a distinct disorder. Those who would previously receive a diagnosis of Asperger's should now receive a diagnosis of autism spectrum disorder
-What are some DSM-5 changes to somatic symptom disorder discussed in class compared to the DSM-IV-TR.
- DSM-5: Now called "Somatic Symptom Disorders" (no longer "Somaoform d/o") Types of DSM-IV-TR somatoform disorders o Hypochondriasis o Somatization disorder o Conversion disorder o Pain disorder o Body dysmorphic disorder DSM-5 CHANGES... •Somatic Symptom Disorders - Includes: • Hypochondriasis 75% • Somatization Disorder • Pain Disorder •Illness Anxiety Disorder •Conversion Disorder •Factitious disorder
- -How are symptoms of depression different in children and youth compared to adults? What did the DSM-5 task force conclude regarding diagnosis of bipolar disorder in youth?
- Depression in the young may be triggered by negative life events (particularly losses), major changes, rejection, or ongoing abuse - Childhood depression is characterized by such symptoms as headaches, stomach pain, irritability, and a disinterest in toys and games - Clinical depression is much more common among teenagers than among young children - Suicidal thoughts and attempts are common in teenagers - that the childhood bipolar label has been overapplied over the past two decades. To help rectify this problem, DSM-5 now includes a new category, disruptive mood dysregulation disorder (DMDD)
-What are the key elements of separation anxiety disorder? What is often the self-talk fear/thoughts of a child that suffers from this disorder?
- Displayed by 4 to 10% of all children - Extreme anxiety, often panic, whenever they are separated from home or a parent - scared something bad is going to happen to their parent
How is this different than Somatization type?
- Lasting several years - Beginning before age 30 - Not adequately explained by independent findings of physical illness or injury - Leading to medical treatment or to significant life impairment o Substantial impairment in social or occupational functioning o Concern about the symptoms, not what they might mean o Symptoms become the person's identity o Causes o Familial history of illness o Relation with antisocial personality disorder o Weak neurobiologically based behavioral inhibition system o Antisocial personality disorder (ASPD) in men and somatization disorder women often occur together.
-What are the Individual Risk Factors for Eating Disorders? (HINT: Gender? Internalized Ideal? Perfectionism? Negative Body Image? Dieting? Negative Emotionality? Childhood Abuse?)
- Low sense of personal control and self-confidence - Perfectionistic attitudes - Distorted body image - Preoccupation with food - Mood intolerance • Socio-cultural • Family Influences • Gender • Idealize the Thin Ideal • Perfectionism • Negative Body Image • Diet (obsessions) • Negative Emotionality (Negative Affect/Mood)
What are the 4-level features of IDD?
- Mild (IQ 50-70) Approximately 80% to 85% of all people with intellectual developmental disorder fall into the category of mild IDD (IQ 50-70) Interestingly, intellectual performance seems to improve with age - Moderate (IQ 35-49) Approximately 10% of persons with intellectual developmental disorder function at a level of moderate IDD (IQ 35-49) They can care for themselves, benefit from vocational training, and can work in unskilled or semiskilled jobs - Severe (IQ 20-34) Approximately 3% to 4% of persons with intellectual developmental disorder display severe IDD (IQ 20-34) They usually require careful supervision and can perform only basic work tasks They are rarely able to live independently - Profound (IQ below 20) About 1% to 2% of persons with intellectual developmental disorder fall into the category of profound IDD (IQ below 20) With training they may learn or improve basic skills but they need a very structured environment
-Name some myths of suicide.
- People who talk about suicide won't follow through. - Anyone who attempts suicide is crazy - Talking about suicide to someone will give them the idea - If a person is determined, nothing will stop them
- What is most common medication for bipolar disorder? (HINT Know a bit about drugs to treat mania & bipolar other than also SSRI's which are also used in bipolar but other drugs include Lithium and sometime new Anticonvulsant drugs are found to be helpful.)
- The use of lithium (a metallic element naturally occurring as mineral salt) and other mood-stabilizers has dramatically changed this picture - Lithium is extraordinarily effective in treating bipolar disorders and mania - Determining the correct dosage for a given patient is a delicate process - Too low = no effect - Too high = lithium intoxication (poisoning) - All manner of research has attested to the effectiveness of lithium and other mood stabilizers in treating manic episodes - More than 60% of patients with mania improve on these medications -Mood stabilizers also help those with bipolar disorder overcome their depressive episodes to a lesser degree
Treatments for ASD
- Treatment can help people with autism spectrum disorder adapt better to their environment, although no known treatment totally reverses the autistic pattern - Treatments of particular help are cognitive- behavioral therapy, communication training, parent training, and community integration In addition, psychotropic drugs and certain vitamins have sometimes helped when combined with other approaches - Cognitive behavioral theory - communication training - parent training: - community integration:
-What are some of the pattens & statistics related to suicide by demographics? Men vs. women, by ethnicity? By age?
- Women have a higher attempt rate (3x men) - Men have a higher completion rate (4x women) - The suicide rate of white Americans is almost twice as high as that of African Americans, Hispanic Americans, & Asian Americans - A major exception to this pattern is the very high suicide rate of Native Americans, which overall is 1.5 times the national average
What are binges? What is meant by "ritualized behaviors" tied to purging? Or binges? What are compensatory behaviors?
- an episode of uncontrollable eating during which a person ingests a very large quantity of food
-What is the clinical picture of Anorexia Nervosa?
- becoming thin is the key goal but fear provides their motivation - afraid of becoming obese - Depression (usually mild) - Anxiety - Low self-esteem - Insomnia or other sleep disturbances - Substance abuse - Obsessive-compulsive patterns - Perfectionism
-How are Anorexia and Bulimia similar vs. different?
- both usually begin after a period of dieting by people who are fearful of becoming obese; driven to become thin; preoccupied with food, weight, and appearance; and struggling with depression, anxiety, obsessiveness, and the need to be perfect - both high suicide rates - anorexia: more worried about pleasing others and their appearance, long histories of mood swings of easily frustrated r bored, and have trouble controlling their impulses/emotions - bulimia: personality disorder characteristics Anorexia can lead to • Death from heart arrhythmias • Kidney damage • Renal failure - Bulimia can lead to • Electrolyte imbalances • Hypokalemia (low potassium) • Damage to hands, throat, and teeth
-What are some of the types of suicide or typologies via Shneidman? (see slides).
- death seekers: clearly intend to end their lives - death initiators: intend to end their lives because they believe that the process of death is already underway - death ignorers: do not believe that their self-inflicted death will mean the end of their existence - death darers: have ambivalent feelings about death and show this in the act itself sub intentional: play an indirect role in ones death
--What are the key elements of Intellectual Developmental Disorder (IDD)?
- deficient intellectual functioning: reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience - deficient in adaptive functioning in at least one are of life, such as communication, social involvement, or personal independence. The limitations extend beyond those displayed by most others persons of their age and necessitate ongoing support at school, work, or independent living The most consistent sign of intellectual developmental disorder is that the person learns very slowly Other areas of difficulty are attention, shortterm memory, planning, and language Those who are institutionalized with intellectual developmental disorder are particularly likely to have these limitations
- -What are the key elements of Disruptive Mood Dysregulation Disorder?
- displays severe outbursts of temper that are extremely out of proportion to triggering situations and different from ones displayed by most other people their own age - the outbursts occur at least three times per week and are present in at least two settings (home, school, with peers) - individual repeatedly displays irritable or angry mood between the outbursts - individual receives initial diagnosis between 6 and 18
- What is the clinical picture of Binge Eating Disorder?
- engage in repeated binges during which they feel no control over their eating, however they do not perform inappropriate compensatory behavior - Many persons with binge-eating disorder are obese - Concerns about shape and weight - Often older than bulimics and anorexics - More psychopathology vs. non-binging obese people
What are the key elements of ADHD and how is it treated via medication and therapy?
- great difficulty attending to tasks, behave over actively and impulsively, or both - The primary symptoms of ADHD may feed into one another, but in many cases one of the symptoms stands out more than the other About 80% of all children and adolescents with ADHD receive treatment There is, however, heated disagreement about the most effective treatment for ADHD The most commonly applied approaches are drug therapy, behavioral therapy, or a combination Millions of children and adults with ADHD are currently treated with methylphenidate (Ritalin), a stimulant drug that has been available for decades
-What is the story about the research on Dogs conducted by Seligman which led to the first Learned Helplessness Model?
- learned helplessness: the perception based on past experiences that one has no control over the reinforcements in ones life - people become depressed when 1) they think they no longer have control over the reinforcements of their lives, and 2) that they themselves are responsible for their helpless state - dogs were shocked no matter what they did, placed in shuttle box with a barrier, expected them to jump when shocked, they laid down and quietly wined, believed they were helpless no matter the environment
-What length of time is needed to diagnose Major Depression? vs. Bipolar I & II Disorder? vs. Persistent Depressive Disorder? vs. Cyclothymic Disorder?
- major depression: Extremely depressed mood lasting at least two weeks/ Persists for longer than 2 months... - Bipolar 1: manic episodes that last for at least 7 days (nearly every day for most of the day) or by manic symptoms that are so severe that the person needs immediate medical care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. - Bipolar 2: - Persistent depressive disorder: - Cyclothymic disorder: at least 2 years
- -What are the issues facing "Shani" case study.
- wanted to eat but felt guilty, often contemplated eating - definition of a good day was not feeling guilty at all
-What are some of the signs of possible suicide? Stressful events associated with it?
-Isolation -Depression (mood change) -change in sleep -change in nutrition -mood swings -Substance abuse -Giving away personal items/ final arrangements -Talking about suicide -Hopelessness -Suddenly happy -Four out of Five teens who attempt suicide have given clear warning signs Long-term stressors can include: - Social isolation: individuals without social support are particularly vulnerable - Serious illness: especially those which cause great pain or severe disability - Abusive environments: from which there is little or no hope of escape - Occupational stress: Psychiatrists and psychologists, physicians, nurses, dentists, lawyers, police officers, farmers, and unskilled laborers have particularly high suicide rates
-How can one help a friend who you suspect may have suicidal ideation?
-Talk about it -"Do you have thoughts of suicide" -"Do you have a plan" -"Do you have a time or place" -"Do you have a method" -Refer them to a professional/group -Give them self help ideas * Remember you are not a health professional, but you can help prevent suicide!
-Define differences between Bipolar I vs. Bipolar II vs. Cyclothymic Disorder?
Bipolar I disorder • Includes at least one manic or mixed episode Bipolar II disorder • Includes hypomanic episodes but not full-blown manic or mixed episodes Cyclothymic Disorder 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 o Overview and defining features o Chronic version of bipolar disorder o Manic and major depressive episodes are less severe o Manic or depressive mood states persist for long periods o Must last for at least two years (one year for children and adolescents)
-What is Conversion Disorder and what sets of symptoms may manifest themselves with this disorder?
Conversion disorder is when a person's bodily symptoms impact their voluntary motor and sensory functions even though symptoms are usually inconsistent with known medical diseases. Some ways symptoms can manifest are through paralysis, blindness, or loss of feeling.
Characteristics of manic episodes?
Emotional symptoms • Active, powerful emotions in search of outlet Motivational symptoms • Need for constant excitement, involvement, companionship Behavioral symptoms • Very active - move quickly; talk loudly or rapidly • Flamboyance is not uncommon Cognitive symptoms • Show poor judgment or planning • May have trouble remaining coherent or in touch with reality Physical symptoms • High energy level - often in the presence of little or no rest
- -What is enuresis? What is encopresis?
Enuresis: repeated involuntary (or in some cases intentional) bedwetting or wetting of one's clothes Typically occurs at night during sleep but may also occur during the day • The problem may be triggered by a stressful event Children must be at least 5 years of age to receive this diagnosis Most cases of enuresis correct themselves without treatment Encopresis- is less common than enuresis and less well researched • • • • Is usually involuntary - Seldom occurs during sleep - Starts after the age of 4Is more common in boys than girls
- What are obsessions vs. compulsions?
Obsessions • Persistent thoughts, ideas, impulses, or images that seem to invade a person's consciousness Take various forms: • Wishes • Impulses • Images • Ideas • Doubts Have common themes: • Dirt/contamination • Violence and aggression • Orderliness • Religion • Sexuality Compulsions • Repetitive and rigid behaviors or mental acts that people feel they must perform to prevent or reduce anxiety • Cleaning • Checking • Repeating • Ordering/arranging • Counting
-What are the key elements of Opposition Defiant Disorder and Conduct Disorder?
Oppositional defiant disorder: Children with this disorder are repeatedly argumentative and defiant, angry and irritable, and, in some cases, vindictive. - Characterized by repeated arguments with adults, loss of temper, anger, and resentment - Children with this disorder ignore adult requests and rules, try to annoy people, and blame others for their mistakes and problems o Conduct Disorder Children with conduct disorder, a more severe problem, repeatedly violate the basic rights of others Often aggressive and may be physically cruel to people and animals Many steal from, threaten, or harm their victims Begins between 7 and 15 years of age
- What are some ways those with IDD can someday, as adults have a more quality life?
People need to feel effective and competent to move forward in life Those with intellectual developmental disorder are most likely to achieve these feelings if their communities allow them to grow and make many of their own choices Socializing, sex, and marriage are difficult issues for people with intellectual developmental disorder and their families With proper training and practice, individuals with intellectual developmental disorder can learn to use contraceptives and carry out responsible family planning The National Association for Retarded Citizens offers guidance in these matters Some clinicians have developed dating skills programs Adults with intellectual developmental disorder need the financial security and personal satisfaction that comes from holding a job Many can work in sheltered workshops, but there are too few training programs available Additional programs are needed so that more people with intellectual developmental disorder may achieve their full potential, as workers and as human beings
-What is the new DSM-5 name for what was once called Dysthymic Disorder? Describe symptoms of this?
Persistent Depressive Disorder "mild but chronic" o Depression is longer lasting but less disabling o Consistent symptoms for at least two years o When dysthymic disorder leads to major depressive disorder, the sequence is called "double depression" o Symptoms are milder than major depression o Persists for at least two years o No more than two months symptom free o Symptoms can persist unchanged over long periods (≥ 20 years)
What are some of the possible causes of ASD
Psychological causes - Some theorists say people with autism spectrum disorder have a central perceptual or cognitive disturbance - Individuals fail to develop a theory of mind - an awareness that other people base their behaviors on their own beliefs, intentions, and other mental states, not on information they have no way of knowing - It has been theorized that early biological problems prevented proper cognitive development sociocultural causes - Some clinical theorists have proposed that a high degree of family dysfunction, social and environmental stress is a factor in the disorder • Research does not support this theory Biological causes • While a detailed biological explanation for autism spectrum disorder has not yet been developed, promising leads have been uncovered Examination of relatives keeps suggesting a genetic factor in the disorder • Prevalence rates are higher among siblings and highest among identical twins Researchers have also identified specific biological abnormalities that may contribute to the disorder, particularly in the cerebellum
-What might be some of the triggers of suicide, meaning what is often associated with it?
Risk factors Suicide in the family Low serotonin levels Preexisting psychological disorder Alcohol use and abuse Stressful life event Past suicidal behavior Suicide contagion No Treatment for Mental Illness psycho social factors - impulsivity - aggression - pessimism - family psychopathology or instability - genetics - sociocultural factors
What is now the umbrella term for these disorders and what were the 3 disorders from the earlier DSM that are now under this one disorder? (HINT Hypochondriasis, Somatization Disorder and Pain Disorder? )
Somatic symptom disorders
What are some of the possible causes of IDD and what treatments are often used?
The primary causes of moderate, severe, and profound IDD are biological, although people who function at these levels are also greatly affected by their family and social environment Sometimes genetic factors are at the root of these biological problems o Other biological causes come from unfavorable conditions that occur before, during, or after birth - chromosomal causes - metabolic causes - prenatal and birth related causes - childhood problems - therapy for emotional and behavioral problems
What is Aaron Beck's Cognitive Theory involving the Cognitive Triad? (HINT: self vs. social & environment vs. future)
Three forms of negative thinking, negative view of one's experiences, oneself, and the future
-What is Premenstrual Dysphoric Disorder?
a disorder marked by repeated experiences of significant depression and related symptoms during the week before menstruation
What are neurodevelopmental diorders?
are a group of disabilities in the functioning of the brain that emerge at birth or during very early childhood and affect the individual's behavior, memory, concentration, and/or ability to learn.
-What was the Revised Learned Helplessness Model and why? (HINT: internal/external vs. stable/unstable vs. global/specific)
attribution-helplessness model: when people view events as beyond their control, they ask themselves why this is so - if they attribute their present lack of control to some internal cause that is both global and stable they may feel helpless to prevent future negative outcomes and they may experience depression - if they make other kinds of attributions, they are unlikely to have this reaction
-How are men vs. women different regarding Major Depression vs. Bipolar disorder?
bipolar - The disorders are equally common in women and men - Women may experience more depressive episodes and fewer manic episodes than men and rapid cycling is more common in women
-What are social-cultural factors in eating disorders? Family influences?
family influences - High-fat, high-calorie diet - Eating to alleviate distress or show love - Overfeeding - "Socially contagious" obesity
- What is malingering? What is primary gain and why does this sustain symptoms?
intentionally faking illness to achieve some external gains, such as financial compensation or military deferment - primary gain is when a person's physical symptoms keep their internal conflicts out of consciousness - Primary gain might help explain conversion disorder and somatic symptom disorder because maybe these people are feeling dysfunctions dues to unconscious forces or unresolved trauma/fears.
-What are the symptoms of Major Depression? (HINT: Emotional, Behavioral, Cognitive, Physical, Motivational)?
o Extremely depressed mood lasting at least two weeks/ Persists for longer than 2 months... o Cognitive symptoms - feelings of worthlessness, indecisiveness o Disturbed physical functioning o Anhedonia - loss of pleasure/interest in usual activities • It influences the way you see yourself and the way you see other people. - Sad all day—2 weeks an more...(persists for longer than 2 months) - Cognitions-worthless, indecisive, can't see things changing, they will always be like this... - Anhedonia—loss of energy & pleasure in things - Physical: weight change, sleep problems, fatigue anxiety/distress - Suicidal ideation in some cases - Diminished ability to concentrate, think, - Separate from grief yet not the changes in DSM-5 NOT EXCLUDED MOURNING/BEREAVEMENT
-What are the differences between a full manic episode and hypomania?
o Features of a manic episode o Elevated, expansive mood for at least one week o Inflated self-esteem, decreased need for sleep, excessive talkativeness, flight of ideas or sense that thoughts are racing, easy distractibility, increase in goal-directed activity or psychomotor agitation, excessive involvement in pleasurable but risky behaviors o Impairment in normal functioning o Hypomanic episode o Low grade version of mania (usually Bipolar II) o Dysphoric manic episode or mixed manic episode
What are some OCD symptoms?
o Obsessions - intrusive and nonsensical thoughts, images, or urges o Symmetry 26.7%, forbidden thoughts 21%, cleaning and contamination 15.9% and hording 15.4% o Compulsions - thoughts or actions to neutralize thoughts o Thought-action fusion - the thought is similar to the action o Affects about 1.6% of the general population o Onset is typically in early adolescence or young adulthood
-Which neurotransmitter acts like the "traffic police" or "balancing" demonstrating its importance via the Permissive Hypothesis? (HINT: Serotonin)
o Permissive hypothesis—when serotonin levels are low, other neurotransmitters are permitted to range more widely, become dysregulated, contribute to mood problems.
- What are some side effects of sleep experienced by many with Major Depression? HINT what happens with REM sleep?
o REM and depression—REM occurs in a shorter period of time after falling asleep. o REM (normal is after 90 minutes of being asleep) o More intense REM in depressed patients and begins about 30 to 20 minutes too soon. o Less deep wave sleep (slow wave) in depressed patients. o Relation between depression and sleep
-What is a "double depression?" How is a "double depression" a risk for suicide? What are some of the signs of possible suicide?
o When dysthymic disorder leads to major depressive disorder, the sequence is called "double depression" o Overview and defining features o Major depressive episodes and dysthymic disorder o Dysthymic disorder often develops first o Facts and statistics o Associated with severe psychopathology o Associated with a problematic future course
How are ways that intelligence and adaptive functioning are assessed?
of a variety of questions and tasks that rely on different aspects of intelligence - Many theorists have questioned whether IQ tests are indeed valid - Intelligence tests also appear to be socioculturally biased - If IQ tests do not always measure intelligence accurately and objectively, then the diagnosis of intellectual developmental disorder may also be biased - Diagnosticians cannot rely solely on a cutoff IQ score of 70 to determine whether a person suffers from intellectual developmental disorder - Several scales, such as the Vineland and AAMR - Adaptive Behavior Scales, have been developed to assess adaptive behavior - For proper diagnosis, clinicians should observe the functioning of each individual in his or her everyday environment, taking both the person's background and the community standards into account
- -In the DSM-5, Know there are two groups—1) Unipolar and 2) Bipolar. What are each of the disorders of the mood disorders?
unipolar • Only depressive episodes period of 2 or more weeks marked by at least 5 symptms of depression • Major Depression • Persistent Depressive Disorder • Premenstrual Dysphoric Disorder • Peripartum Depression • (Children)- Disruptive Mood Dysregulation Disorder • Mania Bipolar depressive disorders • Manic and depressive episodes • Bipolar I Disorder • Bipolar II Disorder • Cyclothymic Disorder
- What is the clinical picture of Bulimia Nervosa?
• Binge eating - hallmark of bulimia - Binge • Eating excess amounts of food - Eating is perceived as uncontrollable • Compensatory behaviors - Purging • Self-induced vomiting, diuretics, laxatives - Some exercise excessively, whereas others fast • DSM-5 subtypes of bulimia - Purging subtype - most common subtype (• Vomiting • Laxatives• Diuretics) - Nonpurging subtype - about one-third of bulimics (fasting and exercise) • Associated medical features - Most are within 10% of target body weight - Purging methods can result in severe medical problems • Erosion of dental enamel, electrolyte imbalance • Kidney failure, cardiac arrhythmia, seizures, intestinal problems, permanent colon damage
- What are some of the themes or content typical of Obsessions?
• Contamination fears • Fears of harming oneself or others • Lack of symmetry • Pathological doubt
- What are medical complications involved with Anorexia nervosa? For Anorexia, what is the first thing that needs to happen?
• Death from heart arrhythmias • Kidney damage • Renal failure
Behavioral Theories? (HINT: Loss of hope that rewards and/or reinforcers from others or material reinforcers will ever happen)
• Depression results from changes in rewards and punishments people receive in their lives • Lewinsohn suggests that the positive rewards in life dwindle for some people, leading them to perform fewer and fewer constructive behaviors, and they spiral toward depression • Research supports the relationship between the number of rewards received and the presence or absence of depression • Social rewards are especially important
How is this different from pain disorder?
• Experience of persistent and severe pain in one or more areas of body • Not intentionally produced or feigned
-Theories of depression according to Psychodynamic? (HINT: Loss of something/someone)
• Link between depression and grief • When a loved one dies, an unconscious process begins and the mourner regresses to the oral stage and experiences introjection - a directing of feelings for the loved one onto oneself • For most people, introjection is temporary • For some, grief worsens over time; if grief is severe and long lasting, depression results • Those with oral stage issues (unmet or excessively met needs) are at greater risk for developing depression • Instead of actual loss, some people experience "symbolic" (or imagined) loss instead • Newer psychoanalysts (object relations theorists) propose that depression results when people's relationships leave them feeling unsafe and insecure
- -What are possible causes of Eating Disorders (pgs. 258-269) and what is NOT a DSM diagnosis?
• Media and cultural considerations - Being thin = success, happiness....really? - Cultural imperative for thinness • Translates into dieting - Standards of ideal body size • Change as much as fashion - Media standards of the ideal • Are difficult to achieve • Biological considerations - Can lead to neurobiological abnormalities • Psychological and behavioral considerations
- What is the clinical picture of Obesity?
• Not a formal DSM disorder • Statistics - In 2000, 30.5% of adults in the United States were obese; 33.8% in 2008 - Mortality rates • Are close to those associated with smoking - Increasing more rapidly • For teens and young children - Obesity • Is growing rapidly in developing nations - Genetic inheritance - Hormones - Sociocultural influences - Family influences - Stress and "comfort food"
--What characterizes: Body Dysmorphic Disorder?
• Obsessed with perceived or imagined flaw in appearance • Causes clinically significant distress • May focus on any body part
-Factors that may predispose/cause hypochondriasis cluster of symptoms?
• Preoccupation with fears of having or getting serious disease • Treatment o Physical complaints without a clear cause o Severe anxiety about the possibility of having a serious disease o Strong disease conviction o Medical reassurance does not seem to help • Causes - Cognitive perceptual distortions - Familial history of illness
--What characterizes Trichotillomania?
• Urge to pull out hair from any body location • Preceded by tension and followed by pleasure • Must cause clinically significant distress
-What is Illness Anxiety Disorder and how might this be related to vs. unlike the old Hypochondriasis diagnosis?
•Experience high anxiety about having or developing a serious illness
