Abnormal Psych Test #2

Cyclothymia

numerous episodes of hypomania symptoms and mild depressive symptoms -mild symptoms for 2+ years, interrupted by periods of normal mood -affects .4% of population -can blossom into bipolar I or II

Token Economy Programs

patients rewarded when they behave in socially acceptable ways & are not rewarded when they behave unacceptably (help reduce psychotic behaviors)

Diathesis-Stress Model

suggests that a person may be predisposed for a psychological disorder that remains unexpressed until triggered by stress

Definitions for Delusions

false beliefs

Definitions for Hallucinations

false sensory perceptions

General Description of Mood Disorders

-2 primary emotions --Depression --Mania (frenzied energy sometimes w a sense of euphoria and grandiosity); mania may include anger and irritability also

Definitions for Schizophrenia

-A psychotic disorder in which personal, social, and occupational functioning deteriorate as a result of unusual perceptions, odd thoughts, disturbed emotions, and motor abnormalities. -Psychosis is an aspect of this disorder

The Advent Of Phenothiazines

-A type of antihistamine (for allergies) -Found that a type of antihistamine (phenothiazine) could be used to calm patients about to undergo surgery -Reduced the schizophrenic symptoms

Theoretical Views (for bipolar): Brain Structure

-Abnormal brain structures like basal ganglia, hippocampus, cerebellum

Theoretical Explanations/Causes of Schizophrenia: Biological (Genetic, Biochemical, Abnormal Structure and Circuitry, Viral)

-Biological: --Genetic: biological predisposition to schizophrenia; family studies --Biochemical: certain neurons using dopamine fire too often- producing symptoms of schizophrenia; antipsychotic drugs block the binding of dopamine --Abnormal Brain Structure: enlarged ventricles (poor development/ damage in related brain regions); smaller temporal & frontal lobes, smaller amounts of grey matter, abnormal blood flow to certain areas --Circuitry: positive symptoms may occur due to dysfunction in substantia nigra & striatum; negative symptoms may occur due to dysfunction in hippocampus & amygdala --Viral: brain exposed to viruses before birth; exposed to the flu during pregnancy

Different Types of Psychotherapy and Their Effectiveness Including Cognitive Behavioral Therapy, Family Therapy, And Social Therapy.

-CBT: change how individuals view & react to their hallucinatory experiences; challenge clients' inaccurate ideas about the power of the hallucinations, "comings and goings", provide education of biological causes; teach techniques for coping with unpleasant sensations; teach clients to more accurately interpret their hallucinations; try to teach clients to be detached observers of their hallucinations (be mindful of them, but move on); decrease rehospitalizations by 50% -Family Therapy: those who live with relatives who display high levels of expressed emotion are at greater risk for relapse than those who live with positive members; therapy aims to create more realistic expectations and provide education about the disorder; relapse rates decrease with family therapy -Social Therapy: practical advice, problem solving, decision making, social skills training, medication management, employment counseling, financial assistance & housing; reduces rehospitalization

Theoretical Causes and Treatments: Somatic Symptom Disorder

-Causes: -Treatments: apply same techniques used in PTSD --Insight: try to discover root of suffering --Exposure: client thinks about traumatic events that triggered the physical symptoms --Drug Therapy: antidepressants --Also try to address the physical symptoms of these disorders: ---Suggestion: offering emotional support that may include hypnosis ---Reinforcement ---Confrontation

Theoretical Causes and Treatments: Illness Anxiety Disorder

-Causes: -Treatments: similar to anxiety disorders, particularly OCD --Antidepressant medication --Exposure & response prevention --CBT

Theoretical Causes and Treatments: Factitious Disorder Imposed on Self and Factitious Disorder Imposed on Another

-Causes: depression, unsupportive parental relationships during childhood & an extreme need for social support --Often receive treatment for a medical problem as a child, may hold a grudge against medical profession, may have worked in medical field (some medical knowledge) -Treatments: unable to develop dependably effective treatments

Theoretical Causes and Treatments: Conversion Disorder

-Causes: stress -Treatments: apply same techniques used in PTSD --Insight: try to discover root of suffering --Exposure: client thinks about traumatic events that triggered the physical symptoms --Drug Therapy: antidepressants --Also try to address the physical symptoms of these disorders: ---Suggestion: offering emotional support that may include hypnosis ---Reinforcement ---Confrontation

Odd Personality Disorders: Paranoid—Descriptions and Symptoms, Gender Factors

-Characterized by deep distrust & suspicion of others -Inaccurate suspicion, not "delusional'; ideas are not so bizarre or so firmly held as to clearly remove the individual from reality -Mistrust leads to being cold & distant -Clinical Info: --More in males --Prevalence: 4.4%

Odd Personality Disorders: Schizoid—Descriptions and Symptoms, Gender Factors

-Characterized by persistent avoidance of social relationships & limited emotional expression -Like being alone; don't have close ties w/others -Often seen as flat, cold, humorless, dull -Clinical Info: --More in men --Prevalence: 3.1%

Schizophrenia- Clinical Information including prevalence rate, gender, and age of onset, Suicide Risk, Factors Associated with Better Prognosis/Recovery

-Clinical Info --Prevalence Rate: 1% --3.6 million Americans currently have it --Equal in men & women --Onset: Men: 23 years, Women: 28 years -Suicide Risk: 25% will attempt suicide; those with schizophrenia will live 10-20 fewer years than others due to increased risk of physical illness -A fuller recovery is more likely in people: • with good premorbid functioning • whose disorder was triggered by stress • with abrupt onset • with later onset • who receive early treatment

How Do the Treatments for Unipolar Depression Compare from Class Lecture and The Text

-Cognitive, CBT, interpersonal therapies may lower likelihood of relapse, 30% will relapse unless maintenance therapy occurs -Combination of psychotherapy & drug therapy is more helpful than just one kind alone -Drug therapy shows faster response, but CBT & IPT show equal improvement rates after 12 weeks

The Community Approach: What Are Its Features?, How Has It Failed?, What Are the Consequences of Inadequate Community Treatment? (Including Homelessness and Incarceration in Prisons)

-Community Care Features: • coordinated services • short-term hospitalization: if outpatient basis is unsuccessful, may be transferred to short-term hospital programs • partial hospitalization: day center programs (supervised activities & programs to improve social skills); semihospital (house or building where people can get 24-hr nursing care IN the community) • Supervised Residences: halfway homes; homes run with a milieu therapy philosophy; help adjust to community life • Occupational Training & Support: paid employment provides income, independence, self-respect & the stimulation of working w others; usually in a supervised workplace for employees who aren't ready for competitive or complicated jobs -How has it failed? • Only less than half of all people who need these services receive them; 40-60% of all people receive no treatment at all in a given year • Why? Poor coordination of services and also a shortage of services -Consequences of Inadequate Community Treatment? • A great number of people become homeless; about 1/4 of the homeless population in the US have a severe mental disorder, commonly schizophrenia • US prisons and jails have become the largest mental health institutions; because of their illness, many have broken the law and are in prison; 26% of prisoners are mentally ill

The Lack of Multicultural Research in The Area of Personality Disorders

-DSM: PD must deviate from expectations of a person's culture -not much multicultural research has been done, although its very important in PD's

Dissociative Identity Disorder: General Descriptions, Clinical Information (Prevalence Rates, Gender, Etc.) & Diagnostic Criteria

-Develops two or more distinct personalities (subpersonalities) each with a unique set of memories, behaviors, thoughts & emotions -Primary (host) personality appears more often than the others -Transition from one subpersonality to the next (switching) is usually sudden & may be dramatic -Clinical Info: --Most cases are first diagnosed in late adolescence or early adulthood; symptoms generally begin in childhood after episodes of abuse; typical onset is before 5 y/old --Women receive diagnosis 3x as often as men --Prevalence Rate: about 1% -Diagnostic Criteria: --Person experiences a disruption to his or her identity, as reflected by at least two separate personality states or experiences of possession. --Person repeatedly experiences memory gaps regarding daily events, key personal information, or traumatic events, beyond ordinary forgetting

Psychophysiological Disorders (Psychological Factors Affecting Other Medical Conditions): Description and Diagnostic Criteria Along with Examples of These Conditions.

-Disorders in which biological, psychological & sociocultural factors interact to cause or worsen a physical illness -Examples: ulcers, asthma, insomnia, chronic headaches, hypertension, CAD -Diagnostic Criteria: --Presence of a general medical condition --Psychological factors adversely affecting the general medical condition in one of the following ways ---Influencing the course of the general medical condition ---Interfering w/the treatment of the general medical condition ---Posing additional health risks ---Stress-related physiological responses precipitating or exacerbating the general medical condition

Dramatic Personality Disorders: Borderline—Descriptions, Diagnostic Criteria And Symptoms, Gender Factors

-Display great instability, major shifts in mood, an unstable self-image & impulsivity -Interpersonal relationships are also unstable -Prone to bouts of anger, sometimes result in physical aggression and violence; can harm themselves too -Impulsive, self-destructive behavior: alcohol/substance abuse, reckless driving & sex, self-injury/self-mutilation, suicidal actions/threats -Clinical info: --More in females (75%) --Prevalence: 5.9%

Theoretical Explanations: Behavioral View

-Dissociation grows from normal memory processes & is a response learned through operant conditioning Momentary forgetting of trauma leads to a drop in anxiety, which increases the likelihood of future forgetting; dissociation as an escape behavior

Theoretical Explanations: Psychodynamic View

-Dissociative Amnesia: caused by repression, the most basic ego defense mechanism; people fight off anxiety by unconsciously preventing painful memories, thoughts or impulses from reaching awareness --Dissociative amnesia & fugue are single episodes of massive repression -Dissociative Identity Disorder: result from a lifetime of excessive repression, motivated by very traumatic childhood events -Most of the support for this model is drawn from case histories which report brutal childhood histories; but some of these individuals w/ DID din't seem to have experiences of abuse, and only a small amount of abused children develop DID

Unipolar Depression (Major Depressive Disorder): Symptoms/Diagnostic Criteria and Clinical Information. Statistics About Unipolar Depression Mentioned in Class

-Emotional, motivational, behavioral, cognitive and physical symptoms affected -Diagnostic Info: --Major depressive episode + no history of mania -Clinical Info: --More common in women (2x) --Prevalence Rate: 7-8% --About 20% of adults experience

Somatic Symptom Disorder; General Descriptions for All of Them & Also Be Able to Differentiate Between Them, Diagnostic Criteria, And Clinical Information for All of Them.

-Excessively distressed, concerned & anxious about bodily symptoms that they are experiencing, and their lives are greatly disrupted by the symptoms -Symptoms are longer-lasting but less dramatic than those found in conversion disorder -Repeated thoughts about their seriousness AND/OR continual high anxiety about their nature or health implications AND/OR disproportionate amounts of time & energy spent on the symptoms or their health implications -Clinical Info --More in women; also abuse victims --Onset: teen/young adulthood --Prevalence: 4%

Disorders with Somatic Symptoms: Illness Anxiety Disorder; General Descriptions for All of Them & Also Be Able to Differentiate Between Them, Diagnostic Criteria, And Clinical Information for All of Them.

-Experience constant anxiety about their health & usually experience no or very few physical symptoms -Often symptoms are merely normal bodily changes, such as occasional coughing, sores, or sweating -Although some recognize that their concerns are excessive, many don't -Person either has a high number of health-related behaviors OR dysfunctional health-avoidance behaviors -Clinical Info: --Equal in men & women --Onset: early adulthood --Prevalence: 1-5%

Anxious Personality Disorders: Avoidant Personality Disorder—Theoretical Explanations and Treatments from The Lecture and Text.

-Explained By: --Early trauma, conditioned fears, upsetting beliefs, biochemical abnormalities --Cognitive: harsh criticism & rejection, leads to belief that people will always judge them negatively --Behavioral: fail to develop normal social skills --Psychodynamic: sense of shame felt by people -Treatments: --Come to therapy seeking acceptance & affection --Group therapy help to provide practice in social interactions --Antianxiety & antidepressants help

Dramatic Personality Disorders: Narcissistic—Theoretical Explanations and Treatments from The Lecture and Text.

-Explained By: --Psychodynamic Theorists: cold, rejecting parents who expose their children to multiple traumatic empathic failures; caregivers don't provide mirroring function or idealizing function for child --Object-Relations Theorists: grandiose self-preservation as a way to convince themselves that they're self-sufficient and without need of warm relationships --CBT: may develop when people are treated too positively rather than too negatively; taught to overvalue their self-worth --Sociocultural: eras of narcissism in society -Treatments: --One of hardest PD to treat --May try to convince their therapist into supporting their sense of superiority

Odd Personality Disorders: Schizotypal: Theoretical Explanations and Treatments from The Lecture and Text.

-Explained By: --Schizotypal symptoms often linked to family conflicts and to psychological disorders in parents; high dopamine activity (biological factors) -Treatments: --Antipsychotic drugs sometimes helpful for some symptoms --CBT: (hard to get them to go and STAY in therapy) teaches patients to evaluate their thoughts & perceptions; speech lessons; social skills training

Dramatic Personality Disorders: Borderline: Theoretical Explanations and Treatments from The Lecture and Text.

-Explained By: --fear of abandonment; parental relationships & lack of early acceptance or abuse/neglect (sexual abuse possibly) --Biological Abnormalities: overly reactive amygdala & an under active prefrontal cortex; lower serotonin activity -Treatments: --Most treatable of the PDs --Psychotherapy can lead to some improvement --Balance between empathizing w/ patients dependency & anger and challenging their way of thinking --Contemporary psychodynamic therapy: central relationship disturbance, poor sense of self, pervasive loneliness/emptiness --Dialectical behavior therapy:provides clients with new skills to manage painful emotions and decrease conflict in relationships --Antidepressant, antibipolar, antianxiety, antipsychotic drugs

Odd Personality Disorders: Schizoid: Theoretical Explanations and Treatments from The Lecture and Text.

-Explained by: --Psychodynamic Theorists: Link schizoid PD to unsatisfied need for human contact --Cognitive theorists: suffer from deficiencies in their thinking; thought tend to be vague & empty; have trouble scanning for accurate perceptions -Treatments: --Social withdrawal prevents people from entering therapy; make limited progress bc of how emotionally distant they are --CBT: positive emotions & satisfying social interactions --Group Therapy --Drug therapy is of little benefit

Dramatic Personality Disorders: Histrionic- Theoretical Explanations and Treatments from The Lecture and Text.

-Explained by: --Psychodynamic Therapy: experienced unhealthy relationships in which cold parents left them feeling unloved & afraid of abandonment --Cognitive: helpless to care for themselves, seek out others to help --Sociocultural/ multicultural: caused by society's norms & expectations -Treatments: --Cognitive Therapists: change belief that they're helpless & try to develop better, more deliberate ways of thinking and solving problems --Psychodynamic & Group Therapy: help clients deal w their dependency --Drug therapy not as helpful

Anxious Personality Disorders: Obsessive-Compulsive Personality Disorder—Theoretical Explanations and Treatments from The Lecture and Text.

-Explained by: --borrow heavily from OCD --Freud: anal retentive; overly harsh toilet training, become angry and remain fixated at this stage of psychosexual development; become orderly and restrained -Treatments: --Usually dont believe theres anything wrong with them, unlikely to seek treatment --often respond well to psychodynamic of cognitive therapy --success with SSRIs

Dramatic Personality Disorders- Antisocial: Theoretical Explanations and Treatments from The Lecture and Text.

-Explained by: --Psychodynamic Theorists: begins w/ absence of parental love which leads to a lack of basic trust --Behaviorists: modeling or unintentional reinforcement --Cognitive: hold attitudes that trivialize importance of others' needs --Biological: low serotonin; deficient functioning in frontal lobes; lower levels of anxiety & arousal; biological studies -Treatments: --Typically ineffective --Individual's lack of conscience or desire to change --Cognitive Therapists: try to guide clients to think about moral issues & other people

developmental psychopathology

-The study of the development of psychological disorders with a life course perspective. -Researchers who work from this perspective emphasize how psychopathology can be understood as normal development gone awry.

Treatment for Dissociative Disorders: Psychodynamic Therapy for Dissociative Amnesia and Fugue

-Therapists guide patients to search their unconscious and bring forgotten experiences into consciousness

Odd Personality Disorders: Paranoid: Theoretical Explanations and Treatments from The Lecture and Text.

-Explained by: --Psychodynamic: trace pattern back to early interactions w/ demanding parents --Cognitive Theorists: maladaptive assumptions are to blame --Biological theorists: genetic causes (twin studies support) -Treatments: don't see themselves as needing help; few come to treatment willingly OR distrust their therapists --Object Relations Therapists: underlying wish for a satisfying relationship; problems forming relationships early in life have an effect on forming relationships later on in life --Behavioral & Cognitive Therapists: control anxiety & improve interpersonal skills; restructure maladaptive assumptions & interpretations --Drug therapy is of limited help

Odd Personality Disorders

-Extreme suspiciousness, social withdrawal, & peculiar ways of thinking & perceiving things -Behaviors leave person isolated -More common in males -Relationship to schizophrenia: display behaviors similar to, but not as extensive as, schizophrenia

Dramatic Personality Disorders: Histrionic—Descriptions, Diagnostic Criteria And Symptoms, Gender Factors

-Extremely emotional & continually seek to be center of attention -Approval and praise are everything -Vain, self-centered, demanding -Some make suicide attempts, often to manipulate others -Clinical Info: --Equal in men and women --Prevalence: 1.8%

Social Labeling from the text

-Features of schizophrenia are influenced by the diagnosis itself -Self-fulfilling prophecy that promotes the development of many schizophrenic symptoms -Called and treated as "crazy"; expectations of others subtly encourage the individual to display psychotic behaviors

Depersonalization-Derealization Disorder: General Description of Each and Statistics Mentioned in Class

-Feeling as thought they have become separated from their body & are observing themselves from outside; sense of unreality can extend to other sensory experiences & behavior -Depersonalization experiences does not = depersonalization disorder -Symptoms: depersonalization is persistent/recurrent, cause distress, & interfere w/ social relationships & job performance; comes on suddenly & is long-lasting -Clinical Info: --Gender: --Occurs most frequently in adolescents & young adults; hardly in people over 40 --Prevalence Rate:

Dissociative Amnesia: General Descriptions, Clinical Information (Prevalence Rates, Gender, Etc.) & Diagnostic Criteria

-General Description: unable to recall important information, usually of an upsetting nature, about their lives; loss of memory is much more extensive than normal forgetting & isn't caused by physical factors; episode of amnesia triggered by a specific upsetting event -Clinical Info --Prevalence Rates: 2% --Gender -Dissociative Amnesia may be: --Localized: most common; loss of all memory of events occurring within a limited period --Selective: loss of memory for some, not all, events occurring within a period --Generalized: loss of memory beginning with an event, but extending back in time; may lose sense of identity; may fail to recognize family & friends --Continuous: forgetting continues into the future; quite rare in cases of dissociative amnesia

Dramatic Personality Disorders: Narcissistic—Descriptions, Diagnostic Criteria And Symptoms, Gender Factors

-Generally grandiose, need much admiration, feel no empathy -Exaggerate their achievements & talents, often appear arrogant -Seldom interested in feelings of others; many take advantage of others -Clinical Info: --more in men (75%) --Prevalence: 6.2%

Theoretical Views (for mood disorders): Biological

-Genetic: genes play a role in the inheritability; unipolar depression may be tied to specific genes -Biochemical: neurotransmitters (serotonin & norepinephrine); endocrine system/hormone release (high levels of cortisol; released at times of stress); seasonal depression & abnormal melatonin secretion -Brain anatomy & brain circuits: circuit involves prefrontal cortex, hippocampus, amygdala; some areas over or underreactive; NT activity lowered in the circuit -Immune System Theory: do immune system problems cause depression or does depression cause immune system problems?

Treatments For Depression: Statistics Mentioned In Class, Behavioral Therapy, Beck's Cognitive (Cognitive/Behavioral) Therapy, Interpersonal Therapy, Biological Therapies Including

-Half of people with unipolar depression receive treatment -Most effective treatments include CBT, interpersonal psychotherapy, and biological therapies -Behavioral Therapy: reintroduce clients to pleasurable pleasurable activities (weekly schedule); help improve their social skills -Cognitive Therapy: Beck viewed unipolar depression as resulting from a pattern of negative thinking that may be triggered by current upsetting situations; maladaptive attitudes/ cognitive triad (viewing themselves/world/future negatively); tries to change their negative cognitive processes (50-60% effective) -Interpersonal Therapy: interpersonal loss, role dispute, role transition, deficits may lead to depression; 50-60% effective

Theoretical Explanations: Self-Hypnosis

-Hypnotic Amnesia: hypnosis can help people forget facts, events and their personal identity -Dissociative disorders may be a form of self-hypnosis

Theoretical Explanations: State Dependent Learning

-If people learn something when they are in a particular state of mind, they are likely to remember it best when they are in the same condition -People who are prone to develop dissociative disorders may have state-to-memory links that are unusually rigid & narrow; each thought, memory, & skill is tied exclusively to a particular state of arousal, so that they recall a given event only when they experience an arousal state almost identical to the state in which the memory was first required

Personality Disorders: General Definition and Characteristics (Diagnostic Criteria for A Personality Disorder in General)

-Inflexible pattern of inner experience & outward behavior -Pattern is seen in most interactions, differs from the experiences & behaviors usually expected of people, and continues for years -Only diagnosed w/ adults -Prevalence Rate: 10-15%

Milieu Therapy

-Institutions can help patients make clinical progress by creating a social climate ("milieu") that promotes productive activity, self-respect & individual responsibility -patients often leave the hospital at higher rates than patients receiving custodial care

Institutional Care In The Past

-Those with severe mental disorders were considered beyond help -People with schizophrenia were institutionalized in public mental hospitals -But because traditional therapies didn't really work, the goal was to simply restrain them, give them food, shelter and clothing

Treatments for Bipolar Disorder: Lithium and Other Mood Stabilizers for Bipolar Disorder Including the Antiseizure Drugs, Antipsychotics, And Antidepressants, Effectiveness of These Medications, How They Work

-Lithium & other mood stabilizers helped tremendously with bipolar disorder; need to determine correct dosage (too low=no effect; too high= lithium intoxication); 50% of people with bipolar disorder receive treatment -Anti seizure & antipsychotics: 60% w mania improve; these medications help treat manic episodes & also help prevent symptoms from developing; sometimes antidepressants are used in conjunction to help with depressive episodes -How they work: drugs change synamptic activity in neurons, but in a different way from antidepressants; affect a neuron's second messengers; drugs also increase the production of neuroprotective proteins, which may decrease bipolar symptoms; may change sodium & potassium ion activity in neurons

Definitions for Psychosis

-Loss of contact with reality -Ability to perceive and respond to the environment is significantly disturbed; functioning is impaired -Symptoms: hallucinations (false sensory perceptions) and/or delusions (false beliefs)

Prevalence Rate for the Most Common and Least Common Personality Disorder

-Most Common: OCPD (7.9%) -Least Common: Dependent (1%)

Treatments For Depression: Antidepressant Medications (3 Types Of Drugs, How They Work, Effectiveness, And Side Effects)

-Most common treatment is antidepressants, but for severely depressed individuals who don't respond to other forms of treatment, ECT can be used in conjunction w/ medication -3 Types: --MAO inhibitors: used to treat TB; slows down production of MAO (which breaks down serotonin and norepinephrine); require a special diet; half who take these are helped --Tricyclics: prevent re-uptake of serotonin & norepinephrine; more effective than MAO; 50-60% effective --SSRIs/SNRIs/SSNRIs: increase serotonin activity; SNRIs & SSNRIs are now available; harder to overdose on these; fewer side effects; may have a reduction in sex drive & possible weight gain; 50-60% effective

Theoretical Explanations/Causes of Schizophrenia: Sociocultural (Multicultural Including Socioeconomic, Family Dysfunction)

-Multicultural: African Americans (2.1%) more prone to develop this disorder than white people (1.4%); BUT they are also more likely to be socioeconomically disadvantaged -Different cultures have more favorable outcomes for those with schizophrenia -Family Stress also has a role in schizophrenia; 4x more likely to relapse if you live with a family that frequently expresses criticism & hostility & intrude on each others privacy

Theoretical Views (for mood disorders): Cognitive Explanations

-Negative thinking: maladaptive attitudes (self-defeating); cognitive triad (things interpreted in negative ways); errors in thinking (minimizing positive and magnifying negative); negative automatic thoughts (constant, negative stream of thoughts) -Learned helplessness: people become depressed when they think: --they no longer have control over the reinforcements in their lives --they are responsible for this helpless state --Global and Stable attributions lead to greater feelings of helplessness and possibly depression

Theoretical Views (for bipolar): Biochemical

-Neurotransmitters: low norepinephrine & mania & depression -Low serotonin levels -Low serotonin + low norepinephrine = depression -Low serotonin + high norepinephrine = mania

Exercise and Dietary Supplements from The Text on Page 233

-Nutraceuticals do not appear to be helpful for people with severe depression. However, according to research, several types of supplements are effective for mild or moderate depression. -Depressed people take nutraceuticals because... • they are not helped by conventional treatments • they developed major side effects to antidepressant drugs • they cannot afford conventional treatments • they dislike modern medications • they prefer more natural treatments

How Do Subpersonalities Differ?

-Often display dramatically different characteristics: --Identifying Features: subpersonalities may differ in features as basic as age, sex, race & family history --Abilities & Preferences: encyclopedic information is often disturbed; not uncommon for different subpersonalities to have different abilities (being able to drive, speak a foreign language, or play an instrument) --Physiological Responses: differences in autonomic nervous system activity, blood pressure levels, & allergies

Treatment for Dissociative Disorders: Hypnotic Therapy for Dissociative Amnesia and Fugue

-Patients are hypnotized & guided to recall forgotten events

Dissociative Amnesia with Fugue: General Descriptions, Clinical Information (Prevalence Rates, Gender, Etc.) & Diagnostic Criteria

-People not only forget their personal identities & details of their past, but also flee to an entirely different location --Sometimes the fugue is brief (hours or days) & ends suddenly --For others, fugue is more severe; people may travel far from home, take a new name, establish new relationships, & even a new line of work; some display new personality characteristics -Clinical Info --Prevalence Rates: .2% --Gender:

3 Steps in Treating Dissociative Identity Disorder from The Text and Lecture

-People with DID usually do not typically recover without treatment -3 Steps: 1) Recognizing the Disorder: therapists try to bond w/ primary personality & w/ each of the subpersonalities; after bonding, therapists try to educate the patients & help them recognize the nature of the disorder 2) Recovering Memories: Usually done by using psychodynamic therapy, hypnotherapy & drug therapy (these work slowly; hypnotherapy & drug therapy should be used with extreme caution) 3) Integrating the Subpersonalities: Try to merge different subpersonalities into a single, integrated identity; integration is a continuous process- fusion is the final merging; some patients' subpersonalities see integration as a form of death; once integrated, furher therapy is typically needed to maintain the complete personality

How Are Dissociative Amnesia and Dissociative Identity Disorder Treated?

-People with dissociative amnesia & fugue often recover on their own -People with DID usually require treatment to regain their lost memories & develop an integrated personality -Treatment for dissociative amnesia & fugue tends to be more successful than treatment for DID

How Common Is Dissociative Identity Disorder?

-Thought to be rare, but the number of people diagnosed with it has been increasing -This number has been increasing because: --A growing # of clinicians believe that the disorder does exist & are willing to diagnose it --Diagnostic procedures have become more accurate -BUT, many clinicians continue to question the legitimacy

personality disorder trait specified (PDTS)

-People would receive this diagnosis if they had significant impairment in their functioning as a result of one or more very problematic traits (negative affectivity, detachment, antagonism, disinhibition, psychoticism)

Persistent Depressive Disorder (Dysthymic Disorder): Symptoms/Diagnostic Criteria and Clinical Information. Statistics About Unipolar Depression Mentioned in Class

-Person experiences the symptoms of major or mild depression for at least 2 years, but no depressive episode -During 2 year period, symptoms of major or mild depression for at least 2 years -symptoms never disappear for more than two months

All the Positive, Negative, & Psychomotor Symptoms

-Positive Symptoms: bizarre additions to a person's behavior (delusions: being controlled by others, persecution (most common), disordered thinking & speech (loose associations, neologisms, preservations, clang), heightened perceptions, hallucinations, inappropriate affect) -Negative Symptoms: characteristics that are lacking in an individual (poverty of speech (alogia), blunted & flat affect, loss of volition (motivation/directness), social withdrawal) -Psychomotor Symptoms: awkward movements, repeated grimaces, odd gestures (may have a private purpose (magical) )

Prodromal, Active, And Residual Phases

-Prodromal: beginning of deterioration; mild symptoms -Active: symptoms become apparent -Residual: return to promodal-like levels --1/4 of patients fully recover; 3/4 continue to have residual problems

Adjunctive Psychotherapy for Bipolar Disorder

-Psychotherapy is rarely helpful for people with bipolar disorder, but mood stabilizing drugs are also not always sufficient (unhelpful for about 30%) -Usually used as an adjunct to lithium (or other medication) therapy -Therapy focuses on medication management, social skills, & relationship issues -Can help reduce hospitalization, improves social functioning & increases clients' ability to obtain & hold a job

Odd Personality Disorders: Schizotypal—Descriptions and Symptoms, Gender Factors

-Range of interpersonal problems, marked by extreme discomfort in close relationships, odd/bizarre ways of thinking, & behavioral eccentricities -Ideas of reference and/or bodily illusions -Great difficulty keeping attention focused; conversation is typically digressive & vague, sometimes w/loose associations -Clinical Info: --More in males --Prevalence: 3.9%

Anxious Personality Disorders: Avoidant Personality Disorder—Descriptions and Symptoms, Gender Factors

-Similar to social anxiety; co-morbidity w that -Fear of humiliation and low self-confidence -Key difference: tend to fear close social relationships -Clinical Info: --Men & women equal --Prevalence: 2.4%

Anxious Personality Disorders: Obsessive-Compulsive Personality Disorder—Descriptions and Symptoms, Gender Factors

-So preoccupied with order, perfection & control that they lose all flexibility, openness & efficiency -Unreasonably high standards for themselves and others; fearing a mistake, may be afraid to make decisions -Rigid and stubborn -Trouble expressing affections and their relationships often stiff & superficial -Clinical Info: --More in males --Prevalence: 7.9%

Theoretical Views (for mood disorders): Sociocultural Explanations

-Social context plays a role -Depression is often triggered by outside stressors --family social perspective: connection between declining social rewards &depression is a two-way street (social deficits that make others uncomfortable & may cause them to avoid depressed individuals; leads to decreased social contact & further deterioration of social skills) --multicultural perspective

Somatization & Pain Pattern

-Somatization: long list of symptoms -Pain Patterns: occurs after real injury/illness

Treatment for Dissociative Disorders: Drug Therapy for Dissociative Amnesia and Fugue

-Sometimes IV injections of barbiturates are used to help patients regain lost memories; drugs calm people & free their inhibitions

Dramatic Personality Disorders: Antisocial- Descriptions, Diagnostic Criteria And Symptoms, Gender Factors

-Sometimes described as 'psychopaths' or 'sociopaths' -persistently disregard & violate others' rights -must be at least 18 -lie repeatedly, be reckless & impulsive -Clinical info: --more in males (4x) --Prevalence: 3.6% -Oppositional defiant disorder --> conduct disorder --> Antisocial PD

Theoretical Views (for mood disorders): The Role of Stress (Exogenous Vs. Endogenous Depression)

-Stress may be a trigger --Reactive Depression (exogenous factors; due to stressful events) --Endogenous Depression: internal factors

Dramatic Personality Disorders

-The behaviors of people with these disorders are so dramatic, emotional, or erratic that it is almost impossible for them to have relationships that are truly giving and satisfying -these disorders are more commonly diagnosed than the others

Antipsychotic Drugs Including Traditional/Conventional (Neuroleptic) And Atypical Or Second-Generation Antipsychotics, All Side Effects Of Both Categories Of Antipsychotic Drugs, Effectiveness/Success Rate Of Both Types, Symptoms That Are Impacted By Each Type, Receptors That Are Impacted By Each Type Of Drug, And Examples Of Atypical Antipsychotic Drugs.

-Traditional/Conventional Drugs: • Work by reducing dopamine activity • 70% effective • Maximum level of improvement within the first 6 months of treatment; symptoms may return if patient stops taking drug too soon • Reduce the positive symptoms of schizophrenia more quickly/more completely than negative • D2 receptors impacted • Side Effects: Movement Problems (extrapyramidal effects) -Parkinsonian symptoms (muscle tremor & rigidity, bizarre movements of the face, neck, tongue & back, great restlessness, agitation & discomfort in the limbs); decrease in dopamine in structures that coordinate movement & posture; to reverse- take anti-Parkinsonian drug in addition -Neuroleptic Malignant Syndrome (1% of patients; particularly elderly); muscle rigidity, fever, altered consciousness, improper functioning of the autonomic nervous system; drug use must be discontinued -Tardive Dyskinesia: writhing or tic-like involuntary movements, usually of mouth, lips, tongue, legs or body; seen up to 1 year after starting medication; affects more than 15% taking the drugs; can be hard (sometimes impossible) to eliminate -Atypical/Second-Generation Antipsychotic Drugs: • most commonly prescribed medications for schizophrenia • % effective • More effective than conventional antipsychotic drugs, especially for negative symptoms • D1 & D4 receptors in addition to D2 receptors • Side Effects: agranulocytosis (life-threatening drop in white blood cells), weight gain, dizziness, & significant elevations in blood sugar • examples: clozril, risperdal, zyprexa, seroquel, geodon, abilify

DSM V Diagnostic Criteria

-Two or more of the following for 1 month: --Delusions --Hallucinations --Disorganized speech --Very abnormal motor activity (catatonia) --Negative symptoms -MUST have delusions, hallucinations, or disorganized speech to be considered schizophrenia -Need to show these symptoms for 5 months after

Descriptions of Type I And Type II Schizophrenia and How Each Type Responds to Treatment and Is Likely Associated with Different Causes

-Type I (more common): dominated by positive symptoms; has better adjustment, later onset of symptoms, greater likelihood of improvement; linked more closely to biochemical abnormalities in the brain -Type II: dominated by negative symptoms; may be tied largely to structural abnormalities in brain

Anxious PD

-Typically display anxious and fearful behavior -Similar to symptoms of anxiety and depressive disorders

Theoretical Views (for mood disorders): Behavioral Explanations

-depression results from changes in rewards & punishments people receive in their lives

Bipolar Disorder and Mania: Symptoms of Mania, Diagnostic Criteria, And Clinical Information. Bipolar I, Bipolar II

-experience both lows of depression and highs of mania -emotional, motivational, behavioral, cognitive and physical symptoms affected -Diagnostic Criteria: manic episode (1 week or more) and a history of mania -Bipolar I: occurrence of a manic episode & hypomanic or major depressive episodes may precede or follow manic episode -Bipolar II: presence/history of major depressive episodes, presence/history of hypomanic (4 days) episodes, no history of a manic episode (less severe than bipolar I) -Tend to experience depression more than mania (3x as often) -Clinical Info: --Prevalence: 1-2.6% ---4% will experience it (bipolar I more common) --Equal in men & women ---Women more depressive episodes & fewer manic than men; rapid cycling more common in women

Anxious Personality Disorders: Dependent Personality Disorder—Theoretical Explanations and Treatments from The Lecture and Text.

-explained by: --Freudian: unresolved conflicts during oral stage; need for nurturance --Object-relations: parental loss or rejection; fears of abandonment --Parents were over-involved & overprotected, increasing children's dependency --Cognitive: maladaptive attitudes; i'm inadequate/ i must find someone to provide protection -Treatments: --Therapy: try to get patients to accept responsibility --Couple or family therapy can help --CBT: challenge and change assumptions of incompetence & helplessness; provide assertiveness training --Antidepressants --Group therapy; receive support from others

Factitious Disorder Imposed on Self: General Descriptions for All of Them & Also Be Able to Differentiate Between Them, Diagnostic Criteria, And Clinical Information for All of Them.

-individual feigns or induces physical symptoms, typically for the purpose of assuming the role of a sick person -aka munchausen syndrome -Diagnostic Criteria: --conscious of the problem & is purposely faking symptoms/illness -Clinical Info: --more in women, but when men experience it it's stronger/more intense --Prevalence: 1% --Onset: early adulthood

Theoretical Views (for bipolar): Genetics

-inherit biological predisposition to develop bipolar disorders -10x increased risk with relatives

Factitious Disorder Imposed on Another: General Descriptions for All of Them & Also Be Able to Differentiate Between Them, Diagnostic Criteria, And Clinical Information for All of Them.

-involves a false creation of symptoms in another person such as a child --induces child w/ poison, toxin, OTC/prescription medicines to cause illness -done for attention, no other reward gained -6-30% of victims of factious disorder in another will die as a result of false symptoms induced -Red Flags: --Symptoms will stop when child is separated from caregiver --Clinical Info:

Theoretical Views (for bipolar): Sodium Ion Activity

-ions (which send incoming messages to nerve endings) may be improperly transported through the cells of individuals w bipolar disorder -cause neurons to fire too easily (mania) or resist firing (depression)

Anxious Personality Disorders: Dependent Personality Disorder—Descriptions and Symptoms, Gender Factors

-pervasive, excessive need to be taken care of -clinging and obedient, fearing separation from their loved ones -rely on others so much & cannot make any decision for themselves -difficulty w separation -feeling distressed, lonely, sad; often dislike themselves -risk for depression, anxiety, eating disorders, suicidal thoughts -Clinical Info --equal in men and women --prevalence: 1%

Course of Schizophrenia

-prodromal, active, residual -each phase may last for days or years

Disorders with Somatic Symptoms

-psychological disorder in which the symptoms take a somatic (bodily) form without apparent physical cause -thought to be medical problems but are actually psychosocial -have changes in their physical functioning

Conversion Disorder; General Descriptions for All of Them & Also Be Able to Differentiate Between Them, Diagnostic Criteria, And Clinical Information for All of Them.

-psychosocial conflict or need is converted into dramatic physical symptoms that affect voluntary or sensory functioning (like blindness, paralysis or loss of feeling) -Usually appear suddenly, at times of stress, thought to be rare -Patient unaware that there's no physical cause; they truly believe the symptoms are real -Symptoms usually only last a few weeks & disappear as quickly as they began -Clinical Info: --More in women (2x) --Onset: late childhood/ young adulthood --Prevalence: 5/1000

Treatments For Depression: ECT (Description, When It Is Used, Effectiveness, And Side Effects)

-targeted electrical stimulation to cause a brain seizure -effective & fast-acting intervention -SEVERE depression -6-12 sessions spaced over 2-4 weeks -50-80% effective -side effects: some memory loss

Are There Better Ways to Classify Personality Disorders From The Notes And Text: Pages 506-510

-these disorders are hard to diagnose & easy to misdiagnose -some of criteria cannot be observed directly (personality style of symptoms of disorder) -similarity of disorders makes it hard; could meet diagnostic criteria for several PDs -DSM's approach assumes that personality traits outside diagnosed disorder do not trouble patient -clinicians' judgements differ -Better way to classify: dimensions (degree of disorder) vs categories (present or absent) or symptoms

double depression

-when dysthymic disorder leads to major depressive disorder

Treatments For Depression: Brain Stimulation (3 Types, How They Work, Effectiveness).

1. Vagus Nerve Stimulation: indirectly stimulate brain via vagus nerve; 50-60% improve 2. Transcranial Magnetic Stimulation: stimulates prefrfontal cortex w/ electromagnetic currents daily for 4-6 weeks; 50-60% effective 3. Deep Brain Stimulation: electrodes implanted deep within brain & low voltage sent to Brodmann Area 25 (depression switch)

Risk of Suicide

15x increased risk of suicide in individuals

Types of Dissociative Disorders

Dissociative Amnesia, Dissociative Amnesia with Fugue, & Dissociative Identity Disorder

How do subpersonalities interact?

Generally, there are 3 kinds of relationships 1) Mutually amnesic relationships: subpersonalities have no awareness of each other 2) Mutually cognizant patterns: each subpersonality is well aware of the rest 3) One-Way Amnesic Relationships: most common pattern; some personalities are aware of others, but the awareness isn't mutual; those who are aware (co-conscious subpersonalities) are quiet observers -Average number of subpersonalities is 15 for women, 8 for men

Gender and Depression from The Text and Notes

artifact theory: clinicians fail to detect depression in men hormone explanation: hormone changes trigger depression in many women life stress theory: women experience more stress than men body dissatisfaction theory: females are under more pressure to be thin than men rumination theory: women ruminate about their depressed mood more than men which feeds into their depression lack of control theory: women may feel less control in their lives -women respond less successfully to treatment; have more frequent & long-lasting bouts

Malingering

faking illness for an external reward (like money) -different from factitious disorder bc a reward is involved