PSYC 2351 Exam 3

delusional disorder

1 or more delusions for 1 month never met criteria for schizo only linked to delusion content delusional beliefs with normal behavior -unusual and rare

schizophrenia prevalence and comorbidity

1% found in almost all cultures higher in poor communities (social drift and increased risk for perinatal diseases) 1.4:1 men -anxiety, depression, substance use (cigs)

MDD remission (not meet criteria)

2 mos without significant symptoms

schizophrenia DSM 5

2 or more of the following at least one month: -delusions -hallucinations -disorganized speech (at least 1/3) -disorganized/catatonic behavior -negative symptoms total disturbance lasts at least 6 mos rule out mdd or manic episodes

unipolar mood disorder: biological factors

31-42% depression variance accounted by genetic influences hormonal abnormalities (elevated cortisol)

Major depressive episode

5 of these for at least 2 weeks: depressed mood, loss of interest/pleasure, appetite disturbance, sleep disturbance, shaking/slowed down, fatigue, worthlessness or inappropriate guilt, difficultly concentrating, thoughts of harm

brief psychotic disorder

< 1 month no mdd or bipolar sudden onset only requires one symptom (not negative) lasts 1 day-->1 month

__________ are the most common type of hallucination found in schizophrenia, being present in approximately 75% of people with this diagnosis. A. Tactile hallucinations B. Visual hallucinations C. Auditory hallucinations D. Delusional hallucinations

C. Auditory hallucinations

what kills the most people in the US each year?

Suicide (3:2 suicide over homicide; 2:1 suicide over AIDs

positive symptoms

adding something that wasn't there (media)

disorganized speech: word salad

after the salad was on fire, i bought an earthquake

cognitive behavioral perspective

attribution theory (process of assigning causes to things that happen) attributional styles

stressful life events a. are only related to the first episode of depression. b. are important in triggering episodes of depression. c. play little role in the onset of depressive episodes. d. mediate the relationship between genetics and environment.

b. are important in triggering episodes of depression.

There is some debate as to whether ________ is a variant of schizophrenia or a form of mood disorder. a.residual type b.schizoaffective disorder c.schizophreniform disorder d.bipolar schizophrenia

b.schizoaffective disorder

what is the difference between unipolar depression and bipolar depression?

bipolar is depression with mania

dif psychotic disorders

brief psychotic disorder schizophreniform schizophrenia schizoaffective delusional disorder

Which of the following diagnoses present a challenge to clinicians in terms of relying on patients' self-reported impairment or distress? a. Social anxiety disorder and panic disorder b. Major depression and generalized anxiety disorder c. Bipolar disorder and schizophrenia d. Persistent depressive disorder and major depression

c. Bipolar disorder and schizophrenia

PDD (previously dysthymia)

characterized by chronicity (time frame) (doesn't go too low but not normal and lasts a while)

MDD definition

characterized by persistent depressed mood and/or loss of interest/pleasure occurring more days than not

which of the following best describes hypomania? a. A type of mania that alternates with depression. b. A type of mania more common in dysthymic patients. c. A more severe form of mania. d. A less severe form of mania.

d. A less severe form of mania.

the inability to initiate or persist in goal-directed activity is called_______ a.alogia. b.blunted affect. c.aproxia. d.avolition.

d. avolition

What is the term anhedonia and how does it apply to the Tripartite Model of Depression and Anxiety? a.Decreased goal persuit; more common symptom of anxiety b.Increased goal pursuit; less common symptom of depression c.Increased positive affect; more common symptom of anxiety d.Decreased positive affect; more common symptom of depression

d.Decreased positive affect; more common symptom of depression

Positive symptoms of schizophrenia include___________, whereas negative symptoms include____________ a.Poverty of speech; hallucinations b.Delusions; hallucinations c.Anxiety; mania d.Delusions; social withdrawal

d.Delusions; social withdrawal

DSM 5 dropped bereavement

death and grief (good to be treated but makes sense to grieve)

high negative affect and low positive affect is related to______; whereas high negative affect and high arousal is related to_____

depression; anxiety

Beck's Model

depressogenic schemas, negative automatic thoughts

disorganized behavior

disruption in goal directed activity can't maintain hygiene disregard for safety unusual dress catatonic behavior (absence of all movement)

manic episode

elevated, expansive, irritable mood lasting at least 1 week (clinically significant) 3 or more: inflated self-esteem, decreased sleep, talkative, flight of ideas, distractibility, goal directed activity, excessive pleasurable/risky behaviors

positive symptoms: delusions

false belief that is firmly held despite evidence bizarre (wild) and non-bizarre (possible but mistaken) -thought broadcasting, persecution, reference, thought insertion/withdrawal

schizophrenia: psychosocial and cultural factors

family dysfunction expressed emotion (hostility and criticism) leads to increased stress and cortisol -cannabis -urban environment -immigration

schizophrenia: treatment: psychosocial

family therapy, case management, social skills training, cbt

negative symptoms def

feelings that are not usually present (withdrawal, depression)

schizophrenia: treatments: medications

first gen blocked dopamine receptors -tardive dyskinesia (movements of face and mouth) -motor side effects (rigid, tremors, agitation, involuntary postures) new gen affect dopamine and serotonin -sedation and weight gain (better, not ideal)

negative symptoms

flat affect (flat responses) alogia: poverty of speech asociality: withdrawn apathy: little interest in events avolition: lack of drive to pursue goals anhedonia: decreased ability to experience pleasure (depression) -hard to manage negative with meds

schizophrenia: biological factors: neurodevelopment

genetic and prenatal risk -not apparent until brain more mature (most think adhd)

bipolar: biological factors

genetic: one of the most heritable disorders polygenic

CBT depressed response

global, stable, internal

CBT non-depressed self-serving bias to positive

global, stable, internal

better prognosis of schizophrenia if...

good premorbid functioning acute onset no negative symptoms later onset female treatment with meds good inter-episode functioning no family history

schizophrenia

hallucinations, delusions, bizarre behavior, social withdrawal symptoms need to last at least 6 mos most common form of psychosis

2 general prevention strategies

high risk: focus on ppl who you know are at risk universal: prevent onset in everyone

why do people die by suicide?

hopelessness, depression, psychache

disorganized speech: neologisms

looks and sounds like a word but isn't

cognitive triad

maintained by cognitive biases or errors all or none thinking (out of proportion) selective abstraction (generalize, negative everywhere) -future, self, world

manic episodes vs depressive episodes vs mdd

manic tend to be much shorter depressive tend to be more severe than unipolar depression episodes shorter than mdd but more severe and greater # of episodes

glutamate hypothesis

meds that block glutamate receptors result in positive and negative symptoms -ppl w schizo have low glutamate levels

MDE specifiers

melancholic, psychotic, atypical, catatonic, seasonal features

who is more likely to die by suicide?

men (3:1 women for attempts; 4:1 men death by suicide)

delusions: reference

messages from tv/radio have special meaning only for you

bipolar: treatment

mood stabilizers, interpersonal and social rhythm therapy

tripartite model of anxiety and depression

negative affect (distress common to anxiety and depression) low positive affect (distinguishing feature of depression) arousal (distinguishing feature of anxiety)

MDD recurrence

new occurrence of disorder after remission likely to come back likelihood increases as # of MDEs increase

cyclothymic disorder

numerous periods of hypomanic symptoms and subclinical depression symptoms no symptom free periods of 2 mos no mde or manic (persistent bipolar)

who is more likely to die by suicide (age)?

older adults (1 every 97 minutes, 4 attempts every death)

how many MDEs do you have to have to meet criteria for MDD?

one single episode, however an episode itself is not a disorder (depends on other factors)

course of schizophrenia

onset early adulthood men earlier and more severe women have bimodal onset

delusions: thought broadcasting

others can hear your thoughts-->anxiety

dopamine hypothesis

over-activation of dopamine pathways is associated with schizo based on: -meds that block dopamine help treat -meds that increase cause psychotic symptoms

interpersonal theory of suicide

people die by suicide because they want to and because they are able to (access)

unipolar depressive disorders

person experiences only depressive episodes

bipolar disorders

person typically experiences both manic and depressive episodes

helplessness theory

pessimistic attributional when faced with uncontrollable negative life events -internal, stable, global -hopelessness expectancy -ruminative response styles theory (focus on how they feel)

bipolar 2 disorder

presence or history of one or more MDEs and one or more hypomanic episodes -no manic episode

bipolar 1 disorder

presence or history of one or more manic episodes could just have manic and have bipolar history of mde is not required but usually present (usually mania and major depression)

3 phases of schiz.

prodromal (milder symptoms) active/acute (meet criteria) residual (milder symptoms, medicated)

mood disorder treatments

psychotherapy (CBT-as effective as meds, behavioral activation, interpersonal therapy)

MDD relapse (before 2 mos)

return of symptoms within short period of time (meds discontinued)

hypomanic episode

same as manic except: at least 4 days noticeable by others but not as severe (probably like it)

schizophreniform disorder

same symptoms as schizophrenia but 1-6 months

schizoaffective disorder

schizo with mood disorder symptoms co-occur w a mood episode but not just the episode

schizophrenia word roots

schizo: to split phren: the mind

positive symptoms: hallucinations

sensory experience that seems real but occurs in the absence of any real stimulus -auditory: most common -visual -olfactory -tactile -gustatory

delusions: persecution

someone out to get you

disorganized speech: clang associations

sounds rather than meanings guide words (rhyming)

CBT non-depressed response

specific, unstable, external

unipolar mood disorder: psychological factors

stressful life events (independent vs dependent), personality (neuroticism, introversion/low positive affectivity)

relationship between anxiety and depression

super high correlation -60% with MDD have at least one anxiety disorder in their lifetime -anxiety often precedes depression

PDD diagnosis criteria

symptoms must persist at least 2 years, normal moods occur very briefly (never more than 2 mos)

disorganized speech: loose associations

tangential speech (scattered)

delusions: thought insertion/withdrawal

thoughts being put into your brain or taken out by external forces

t/f loose associations can occur with or without word salad

true loose associations could be a perfect sentence within another sentence

t/f genetic factors are clearly implicated in schizophrenia

true (twin studies) explain 48% of variance enlarged ventricles (white matter)