psci 102c midterm #3

Know how experiencing emotion changes into late life- are they more negative or positive emotions

More positive emotions in late life -Less likely to have psychological disorders -Older Adults have decreased rates of depression relative to the general population in community samples

Understand which diseases can produce dementia

Alzheimer's - 1st Vascular Disease - 2nd Parkinson/Lewy Body - 3rd Frontotemporal (FTD) - younger onset, < 65

Know basic facts about depression in late life - be familiar in trends with diagnosis and treatment

-Depression is lower in older adults (3%) than the general population (13%) -Confounder between old age and depression Geriatric depression scale compensates for this -Symptoms overlap with medical illness (fatigue, appetite, sleep, etc.) -Depression is underdiagnosed and undertreated in late life This is due to aging stereotypes Depression is described differently in older adults -Primary care overemphasized medical vs. psychological -50% receive no treatment -Of those receive treatment, 33% receive inadequate treatment -Of those receive adequate treatment, only 25-60% adhere to treatment

Know key features and symptoms of Lewy Body Dementia- be able describe how LBD affects motor function, sleep, and visual abnormalities

-3rd leading cause of dementia -Caused by dopamine deficits in the nigrostriatal pathway -Also, the protein alpha-synuclein destroys this pathway -1% prevalence -If people with Parkinson's disease live longer, they end up developing dementia because it spreads to other parts of the brain -Blank facial expressions, forward tilts, slurred speech, rigidity, tremors, shuffling gait, reduced arm swinging Vivid visual hallucinations Fluctuations in cognition -REM behavior disorder: rapid eye movements and acting out dreams -Usually, the brain paralyzes the body during REM in the brain stem -Brain stem is destroyed, causing behavior disorder

Know key features and symptoms of pseudodementia- know which psychiatric disorder can have similar features to dementia

-A misdiagnosis or diagnosis error (not common but does happen) -Most common question in practice is whether patient is experiencing the depression or dementia -treatable disorders that mimic dementia. The most common is depression. Depression and dementia can both lead to reduced motivation, impaired concentration, and mental slowing. -Apparent dementia that ultimately reverses and appears to have resulted from depression -9-25% per year progression to dementia after pseudodementia -40% after 3 years go on to get dementia eventually -Depression may represent prodromal symptom of dementia in some cases -Features of dementia can look like psychological disorders other than memory which can lead to diagnosing issues

Be able to define amenorrhea, and other common medical problems associated with anorexia nervosa

-Amenorrhea: the absence of menstrual cycles in females -Other problems include: >lowered body temperature >low blood pressure >body swelling >reduced bone mineral density >slow heart rate >metabolic and electrolyte imbalances >>can lead to death by heart failure or circulatory collapse -poor nutrition causes: >skin to become rough, dry, and cracked >nails to become brittle >hands and feet to be cold and blue >lose hair from the scalp grow lanugo (the fine, silky hair that covers some newborns) on their trunk, extremities, and face

Understand the effectiveness of drug treatment in eating disorders (bulimia vs. anorexia)

-Antidepressants are more effective for treatment of bulimia -SSRIs do NOT work for anorexia -Drug treatment is more effective when paired with therapy (cognitive-behavioral)

Know key symptoms of binge eating disorder (and be able to differentiate it from other eating disorders)

-Binge eating WITHOUT compensatory behavior -Sense of lack of control together with other maladaptive aspects of eating -Obesity & other obesity-related diseases are poor outcomes -Most common eating disorder and equal rates across racial/ethnic groups ~60% recover but long duration (~14 yrs) For diagnosis -Recurrent binge eating episodes -Binge-eating episodes include at least three of these features: >>Unusually fast eating >>Absence of hunger >>Uncomfortable fullness >>Secret eating due to sense of shame >>Subsequent feelings of self-disgust, depression, or severe guilt -Significant distress -Binge-eating episodes take place at least weekly over the course of 3 months -Absence of excessive compensatory behaviors

Recognize similarities and differences between conversion disorder and dissociative disorders

-Both psychological processes -Both caused/triggered by trauma or extreme stressors -Both have body experience, however: >>Dissociation is out-of-body experiences, surrounding feels unreal, and can lead to multiple personality disorder, fugue (flight), amnesia, etc. >>Conversion is a psychological process converted to motor or physical problems

Identify habits that may occur before the onset of eating disorders - ex: dieting

-Consumption of media involving bodies ("thinspo") -Dieting: start restricting what they eat; triggers a series of cognitive behaviors -Major life stressors precede the onset and relapse

Be able to define dementia due to Alzheimer's disease

-Dementia is a clinical state (syndrome), of which mental abilities decline -Caused by Brain Disease and Injury -Alzheimer's is a specific underlying disease that causes dementia (etiology) Number one cause of dementia Neurological characteristics are listed above

Know what features define dementia

-Dementia is a clinical state, not a disease -Significant cognitive deterioration, previously called dementia, is now categorized as neurocognitive disorder. -Decline from previously higher level of cognitive function •Presence of cognitive impairment on objective testing •Neuropsychological or other cognitive testing •Memory •Attention •Executive Function •Visuospatial Ability •Language Ability •Social Function •Impaired in independent Function due to cognitive deficits -gradual deterioration of abilities -deficits in memory of recent events -caused by disease process that directly influence the brain -usually progressive and nonreversible -treatment offers only minimal benefit -prevalence increase w age -Dementia is Caused by Brain Disease and Injury •Medical issues... long list •Neurodegeneration •Vascular disease •Encephalitis (inflammation of brain tissue by viruses) •Meningitis (inflammation of membranes by bacteria) •HIV •Head traumas •Brain tumors •Nutritional deficits (B-complex vitamins)

Understand genetic and environmental influences in Alzheimer's disease

-Exponential Increase with Age after 65 years Genetic factors -Heritability 79% -Apolipoprotein e4 (APOE4) allele: >>1 copy ~ 4-7x risk >>2 copies ~ 10-14x risk Environmental factors -Low education, cardiovascular risk factors, sensory deficits, social isolation, depression increase risk >>Early education somewhat provides as a mental reserve -Mediterranean diet, exercise, cognitive engagement lower risk >>The more you stay mentally active, the lower the risk

Know key symptoms of anorexia

-Fear of eating -Distorted body image (body dysmorphia) -Extreme calorie restriction Neurobiology -Hypothalamus NOT directly involved -Dopamine system >>Reward >>Pleasure/motivation -Low levels of endogenous opioids - >>chemical abnormalities -Serotonin >>Satiety >>SSRI (don't really work with anorexia nervosa)

Neurological characteristics of Alzheimer's disease (plaques and tangles) - know the cellular location of these proteins

-First leading cause of dementia Two proteins build up in the brain and cause neurons to degenerate Plaques -Amyloid beta (Aβ) -Extracellular (between the cells/ brain tissues) Sphere-shaped deposits of betaamyloid protein that form in the spaces between certain neurons and in certain blood vessels of the brain as people age Tangles -P-Tau protein -Intracellular (inside the cells) Twisted protein fibers that form within certain neurons as people age -Causes cells to die Blood Vessels -Cerebral amyloid angiopathy Aβ -produce a range of neurocognitive symptoms that unfold over a period of years — disorientation, memory loss, erratic behavior, personality changes, progressive cognitive decline, Parkinsonian symptoms, suicidal thinking, and death

Know concerns about hypnotic sleep medication in older adults

-In older adults, sleep aids such as hypnotics or sleep medications are not a great idea -Sleeping pills increase risk of falls & cognitive dysfunction -A better medication route is Cognitive Behavioral Treatment (listed above

Know symptoms of dissociative amnesia and be able to differentiate it from other disorders

-Inability to recall important information, usually of an extremely stressful nature. -Symptoms should not be due to PTSD, substance abuse, head trauma, or other brain damage. -Memory is repressed, significant distress or impairment Amnesia may be localized, selective, generalized, or continuous: Localized: the most common type of dissociative amnesia, a person loses all memory of events that took place within a limited period of time, almost always beginning with some very disturbing occurrence Selective: the second most common form of dissociative amnesia, remember some, but not all, events that took place during a period Generalized: unable to remember earlier life events, friends, or relatives Continuous: forgetting continues into the present

Know the features required for an anorexia diagnosis

-Individuals purposely take in too little nourishment, resulting in body weight that is very low and below that of other people of similar age and gender -Individuals are very fearful of gaining weight, or repeatedly seek to prevent weight gain despite low body weight -Individual has a distorted body perception, places inappropriate emphasis on weight or shape in judgments of herself or himself, or fails to appreciate the serious implications of her or his low weight

Identify gender and age differences in the prevalence of eating disorders

-Males account for only 10 percent of all people with anorexia nervosa and bulimia nervosa -Women are 3-10x likely to develop anorexia than men >The reasons for this striking gender difference are not entirely clear >Western society's double standard for attractiveness is one reason >May be the different methods of weight loss favored by the two genders >>men are more likely to use exercise to lose weight >>women more often diet -Symptoms are the same for men and women -Onset: early to middle teens years

Recognize drug treatment options for Alzheimer's disease

-Medications (symptomatology drugs that do not deal with underlying problems) No drug reverses Alzheimer's disease Cholinesterase inhibitors -Donepezil (Aricept) -Blocks enzymes in the brain that degrade acetylcholine -Acetylcholine enhances memory and is low in people with Alzheimer's Glutamate inhibitors Galantamine (Reminyl) Blocks glutamate Aduhelm: Amyloid clearance has failed but Aduhelm (Aducamumab) was approved anyway -Disease-modifying drug -Antibodies that bind to plaques (amyloids) and cleans them out -However, they do not reverse Alzheimer's disease but were approved anyways

Define cohort effects

-People who grew up in the same era shared experiences that bias your data -Experiences that people in their 60s have that people in their 30s don't have

Know key features and symptoms of delirium- know if this could cause distractibility, disorientation, and paranoia

-Rapid onset, secondary to another medical condition -Usually reversible by treating underlying condition, but potentially fatal if cause — eg. infection or malnutrition — not treated -If caused by UTI, can sometimes be treated with antibiotics -Prevalence is highest in the very young as well as the old, most common in older people Symptoms -Individual displays significant cognitive disturbance -Over course of hours or a few days, individual experiences fast-moving and fluctuating disturbances in attention and orientation to environment -Trouble concentrating and staying with a train of thought -When a person has delirium that leads to paranoia, the paranoia may last as long as the delirium -Fluctuations over the course of a day

Know effective treatments for sleep disorders in older adults

-Sleep disturbances increase with age -Cognitive-Behavioral Treatments: Sleep hygiene: Don't watch TV before bed, Get exposed to sunlight in the afternoon Sleep diary: Document sleep style, patterns, etc. Sleep restriction: -Restrict how much they are allowed to sleep -Builds up a backlog of sleep -Allows them to sleep right away when they get in bed -Insomnia gets worse by associating negative feelings with the sleeping environment. So try to associate bed with only sleeping or sex

Understand apolipoprotein E gene and its effects on neurocognitive disorders

-The ApoE gene, located on chromosome 19, is generally responsible for the production of a protein that helps transport cholesterol in the bloodstream -About 30% of the population inherit the E4 form, called the ApoE4, and those people may be particularly vulnerable to the development of Alzheimer's disease -Promotes excessive formation of beta-amyloid proteins, helping to spur the formation of plaques and, in turn, the breakdown of the tau protein, the formation of numerous tangles, the death of many neurons, and, ultimately, the onset of Alzheimer's disease -Not everyone with this gene develops Alzheimer's

Define geropsychology

-The field of psychology dedicated to the mental health of older adults has developed almost entirely within the last four decades -At present, only 4.2% of clinicians work primarily with this age group

Be able to define dissociation

-The separation and compartmentalization of mental processes that, under usual conditions, are well integrated. -The affected processes usually include memory, identity, and consciousness. -or psychological separation: that is, they feel dazed, have trouble remembering things, experience depersonalization (feeling that their conscious state or body is unreal), or have a sense of derealization (feeling that the environment is unreal or strange)

Know symptoms of conversion disorder

-aka functional neurological symptom disorder -Primary symptoms involve loss of functioning in motor or sensory systems without medical cause -Because memory and conscious thought are "split apart," conversion disorders may be viewed as having a dissociative component. -Symptoms can onset quickly, perhaps after exposure to an extreme stressor or trauma -characterized by medically unexplained physical symptoms that affect voluntary motor or sensory functioning; -they have neurological-like symptoms — for example, paralysis, blindness, or loss of feeling — that have no neurological basis. -Presence of at least one symptom or deficit that affects voluntary or sensory function. -Significant distress or impairment. -do not consciously want or purposely produce their symptoms. -usually begins between late childhood and young adulthood; it is diagnosed at least twice as often in women as in men -often appears suddenly, at times of extreme stress -can last matter of wks -Dramatic dissociation e.g not being able to see despite eyes working fine, paralysis, loss of feeling -Often comorbid with:• Other Somatic symptom disorders• Major depressive disorder• Substance use disorders -More prevalent• In rural areas• In individuals of lower SES• In non-Western cultures -Prevalence less than 1%• More common in women than men --Onset typically adolescence or early adulthood •Often follows life stress

Understand signs and symptoms of dissociative fugue

-extreme Subtype of dissociative amnesia associated with unexpected travel over extended distances. -persons not only forget their personal identities and details of their past lives but also flee to an entirely different location. -Their fugue may be brief — a matter of hours or days — and end suddenly. In other cases, however, the person may travel far from home, take a new name, and establish a new identity, new relationships, and even a new line of work. -Sporadic, short-lived -The majority of people who go through a dissociative fugue regain most or all of their memories and never have a recurrence -Some people commit illegal or violent acts in their fugue state and later must face the consequences

Know key features and symptoms of Vascular Dementia

-follows a cerebrovascular accident, or stroke, during which blood flow to specific areas of the brain was cut off, thus damaging the areas 2nd leading cause of dementia -Usually overlaps with Alzheimer's Strokes Infarcts - blocks off blood vessels, leading to brain injury and in areas related to memory -Lack of perfusion Hemorrhages - rare; blood vessels burst and cause brain damage -Intraparenchymal Blood Vessels Atherosclerosis - inflammation in vessels, building up atheromatous plaques Arteriosclerosis - narrowing of blood vessels

Understand what factitious disorder is

-patients intentionally produce or feign physical symptoms; -Deliberate feigning of disorder for "primary" gain • Playing the sick role • Attention • Sympathy • Being viewed positively • etc -patients intentionally produce or feign (pretend to be affected. by) physical symptoms; -Presentation of oneself as ill, damaged, or hurt. -of assuming the role of a sick person. -go to extremes to create the appearance of illness -Many give themselves medications secretly.

Identify myths about late life

1) Late life is a sad and depressing time >The exact opposite is true >Older adults have decreased rates of depression relative to the general population in community samples ~3% with depression among older adults vs. ~13%+ in general population 2) Aging involves an inexorable cognitive decline They are at an increased risk but not everyone gets them 3) Late life is a lonely time >Social selectivity: carefully chosen smaller circle w quality >There is a risk of social isolation but they aren't generally lonely 4) Older people lose interest in sex >Loss of interest in sex is usually a symptom of depression and suicide

Be able to define neurocognitive disorder. Be familiar with the different domains of cognitive functioning (memory, attention, decision making, etc)

A disorder marked by a significant decline in at least one area of cognitive functioning Neurological disorders affect cognitive functioning. As age declines, these decline as well -Memory -Attention -Immediate memory -Executive functions -Processing speed

Know visual symptoms of eating disorders and how they differ/are distinguishable

Anorexia -In many cases the person is visibly underweight, small hairs cover their body (microfolia), shaking -Some people are still anorexic even if they are not (or not yet) underweight Bulimia -Normal or greater body weight -Recurrent binging and compensatory behaviors -Throat and esophageal damage from vomiting due to gastric acid (hoarse voice, bad teeth, throat cancer, sores) Binge eating disorder -Lack of control when eating -Typically overweight/obese

Key distinguishing features between bulimia and anorexia

Anorexia Nervosa: -Refusal to maintain minimally normal body weight for height and age (BMI < 18.5) Kg/m2 -In females, disruption of menstrual cycle (amenorrhea) -Intense fear of gaining weight (however, anorexia can occur in the absence of this, especially in non-Western cultures) -Distorted body image: really severe -Unrealistic perception or focus on body weight: excessive focus on body weight as index of value or identity -Almost always associated with significant medical complications -Can develop electrolyte imbalance -Heart does not pump right -At risk of sudden death -Onset: early to middle teen years -High relapse rate: die or get better Bulimia Nervosa Normal or Greater Body Weight -Recurrent episodes of binging and compensatory behaviors -Sense of lack of control while binging -Same excessive focus on body type for self worth but don't distort body shape to the same degree as anorexia -Mortality not as high as anorexia but many adverse medical effects of binge-purge

Know hallmark features of illness anxiety disorder

Anxiety related to belief that one has acquired a serious illness or medical condition -people who are anxious about their health become preoccupied with the notion that they are seriously ill despite the absence of bodily symptoms -Formally Hypochondriasis -Illness related behaviors -Person is preoccupied with thoughts about having or getting a significant illness. In reality, a person has no or, at most, mild somatic symptoms -Person displays an unduly high number of illness/ health-related behaviors (e.g., keeps focusing on the body, checking pulse) or dysfunctional health-avoidance behaviors (e.g., avoids doctors) -Person's concerns continue to some degree for at least 6 months -Prevalence: 3%-13% of population 20%-84% of the patients who consult medical practitioners fit hypochondriasis or somatic symptom disorder -have an unrealistic fear that they have a serious medical condition or fear that they're at high risk of becoming ill

Identify binge-eating/purging-type anorexia nervosa

Binge-and-Purge subtype -Uses "compensatory behaviors" such as vomiting, excessive exercise, or laxatives to control weight; may also engage in brief periods of compulsive binging of food` Remember: Even in the binge-and-purge subtype, restriction of food intake is constant

Understand cognitive-behavioral views on anorexia (ex: negative reinforcement)

Cognitions -Body dissatisfaction and fear Behavioral -Negative reinforcement >Compensatory behavior -Positive reinforcement >Self control and mastery

Understand cognitive-behavioral views on Bulimia (ex: negative reinforcement)

Cognitions -Self worth and weight -Post-binge Behavioral -Restricting -> binging -Negative reinforcement -> purging

Distinguish between depersonalization/derealization disorder and dissociative identity disorder

Dissociative Identity Disorder: develops two or more distinct sub-personalities Depersonalization/Derealization Disorder: detached from their own mental processes or body and are observing themselves from the outside, or feel as though the people or objects around them are unreal or detached

Identify locations in which older adults can go for care (ex: assisted-living facility)

Day-care facilities for patients with neurocognitive disorders have been developed, providing treatment programs and activities for outpatients during the day and returning them to their homes and families at night Assisted-living facilities in which those suffering from neurocognitive impairment live in cheerful apartments, receive needed supervision and take part in stimulating activities -Designed to meet the special needs of the residents — providing more light, enclosing gardens with circular paths so the residents can go for strolls alone without getting lost Practical devices, such as tracking beacons worn on the wrists of Alzheimer's patients and shoes that contain a GPS tracker, have been developed to help locate patients who may wander off

Symptoms of depersonalization/derealization disorder

Depersonalization-derealization disorder -defined as a dissociative disorder marked by the presence of persistent and recurrent episodes of depersonalization, derealization, or both. -persistent or recurrent, cause considerable distress, and may impair social relationships and job performance. -2% of pop. most often adolescents and young adults, hardly over age of 40 -sudden onset possibly triggered by extreme fatigue, traumatic experiences, life threatening situations, physical pain, intense stress or recovery from substance abuse depersonalization feeling that their conscious state or body is unreal -feel as though they have become separated from their body and are observing themselves from outside. -doubling: their mind seems to be floating a few feet above them -Their body parts feel foreign to them, their hands and feet smaller or bigger than usual. -sufferers describe their emotional state as "mechanical," "dreamlike," or "dizzy." -they are aware that their perceptions are distorted, and in that sense they remain in contact with reality. -some cases this sense of unreality also extends to other sensory experiences and behavior. (ex: distorted sense of touch/smell or judgment of time/space or they may feel that they have lost control over their speech or actions) derealization feeling that the environment is unreal or strange -Objects may seem to change shape or size; other people may seem removed, mechanical, or even dead. -people or objects around them are unreal or detached -cartoonish distortions

Understand genetic and environmental influences of anorexia - know the primary cause

Genetic 54-83% heritability -Diathesis component -Specific genes Environmental -Triggered by dieting and stress

Understand grounding as a treatment for dissociation

Have a person focus on their present surrounding & how their body is grounded Distract from whatever extreme psychological stress that is happening to them & calm down

Define mild cognitive impairment and what it refers to

Mild Cognitive Impairment -Intermediate stage between pre-clinical & dementia; strong risk for dementia -Preclinical: disease is brewing in the brain but no symptoms; long incubation period -MCI: memory starts to get worse but still able to function independently -Important for early diagnosis & early treatment Mild Neurocognitive Disorder A neurocognitive disorder in which the decline in cognitive functioning is modest in these areas: -Memory and learning -Attention -Perceptual-motor skills -Planning and decision-making -Language ability -Social awareness -Does not interfere with the individual's everyday independence >Cognitive functions decline faster than peers but are still able to be independent (manage meds, ADL's)

Identify restricting type anorexia nervosa

Restricting subtype -Avoids the consumption of food but does NOT engage in binging and purging behavior

Identify psychological treatments for physical disorders

The most common of these interventions are relaxation training, biofeedback, meditation, hypnosis, cognitive interventions, support groups, and therapies to increase awareness and expression of emotions. relaxation training A treatment procedure that teaches clients to relax at will so they can calm themselves in stressful situations. often in combination with medication, it has been widely used in the treatment of high blood pressure -Some help in treating somatic symptom disorders, headaches, insomnia, asthma, diabetes, pain, certain vascular diseases, and the undesirable effects of certain cancer treatments Biofeedback: client is given information about physiological reactions as they occur and learns to control the reactions voluntarily -use electrical signals from the body to train people to control physiological processes such as heart rate or muscle tension. Clients are connected to a monitor that gives them continuous information about their bodily activities. By attending to the signals from the monitor, they may gradually learn to control even seemingly involuntary physiological processes. Electromyograph (EMG): a device that provides feedback about the level of muscular tension in the body -clients "see" or "hear" when their muscles are becoming more or less tense. Through repeated trial and error, the individuals become skilled at voluntarily reducing muscle tension. -EMG feedback has also been used successfully in the treatment of headaches and muscular disabilities caused by strokes or accidents. -learned how to relax their jaw muscles at will and later reported that they had less facial pain. Meditation: turning one's concentration inward, achieving a slightly changed state of consciousness, and temporarily ignoring all stressors -report feeling more peaceful, engaged, and creative -used to help manage pain and to treat high blood pressure, heart problems, asthma, skin disorders, diabetes, insomnia, and even viral infections Hypnosis: guided by a hypnotist into a sleeplike, suggestible state during which they can be directed to act in unusual ways & feel unusual sensations -Helpful in the control of pain -Hypnosis is now used as an aid to psychotherapy and to help treat many physical conditions Cognitive behavioral interventions: teach new attitudes or cognitive responses towards ailment -therapists teach people to identify and eventually rid themselves of unpleasant thoughts that keep emerging during pain episodes and to replace them with coping self-statements instead -e.g self-instruction training (stress inoculation training) has helped patients cope with severe pain Support groups and Emotion expression -support groups, including online support groups, and from therapies that guide them to become more aware of and express their emotions and needs Combination approaches -Combinations of medication and psychological treatments such as support groups, mindfulness training, and relaxation training are often more effective than medication alone in the treatment of patients with coronary heart disease and related medical problems

Distinguish between different types of dementia (Frontotemporal, Alzheimer's, Lewy Body, Vascular)

frontotemporal: also known as Pick's disease, is a rare disorder that affects the frontal and temporal lobes -Biggest difference from normal dementia is Younger onset—most common dementia < 65 yrs -Caused by tau and TDP-43 abnormalities -Characterized by behavioral changes (cognition can be normal) -Apathy -Loss of empathy -Lack of initiation -Sit on the couch the whole day doing nothing -Disinhibited -Violation of social norms (making passes at family members) -The frontal part of brain that controls this behavior is damaged -Change in personality that leads to the diagnosis Alzheimer's: most common type of neurocognitive disorder (:A disorder marked by a significant decline in at least one area of cognitive functioning), accounting for at least two-thirds of all cases marked most prominently by memory impairment. -sometimes appears in middle age (early onset), but in the vast majority of cases it occurs after the age of 65 (late onset), and its prevalence increases markedly among people in their late 70s. -gradually progressive disease in which memory impairment is, by far, the most prominent cognitive dysfunction. -time between onset and death is typically 4 to 8 years -usually begins with mild memory problems, lapses of attention, and difficulties in language and communication. As symptoms worsen, the person has trouble completing complicated tasks or remembering important appointments. Eventually sufferers also have difficulty with simple tasks, forget distant memories, and have changes in personality that often become very noticeable. Lewy Body: -(3rd leading cause of dementia) -Dysexecutive (disorganized, difficulty planning) and visuospatial impairment with only mild memory problems -Different from Alzheimer' -characterized by a buildup of clumps of protein deposits, called Lewy bodies, within many neurons Vascular: follows a cerebrovascular accident, or stroke, during which blood flow to specific areas of the brain was cut off, thus damaging the areas

Dissociative disorders and their link to stress and trauma

dissociative disorders: group of disorders triggered by traumatic events. -one part of a person's memory or identity becomes dissociated, or separated, from other parts of their memory or identity. Depersonalization / Derealization Disorder -A strong and persistent sense of being detached from one's body and reality. --Often accompanied by derealization, the feeling that the outside world is unreal. Dissociative amnesia unable to recall important personal events and information usually of a stressful nature, about their lives. -loss of memory is much more extensive than normal forgetting and is not caused by physical factors such as a blow to the head -Typically, an episode of amnesia is directly triggered by a traumatic or upsetting event -The symptoms are not caused by a substance or medical condition. -Symptoms should not be due to PTSD, substance abuse, head trauma, or other brain damage. -may be localized, selective, generalized, or continuous -localized amnesia, the most common type of dissociative amnesia, a person loses all memory of events that took place within a limited period of time, almost always beginning with some very disturbing occurrence. -selective amnesia, the second most common form of dissociative amnesia, remember some, but not all, events that took place during a period of time. -generalized amnesia: In some cases the loss of memory extends back to times long before the upsetting period. -continuous amnesia, however, forgetting continues into the present. Dissociative identity disorder -the symptoms actually began in early childhood after episodes of trauma or abuse (often sexual abuse) 1. Person experiences a disruption to their identity, as reflected by at least two separate personality states or experiences of possession. 2. Person repeatedly experiences memory gaps regarding daily events, key personal information, or traumatic events, beyond ordinary forgetting. 3. Significant distress or impairment. 4. The symptoms are not caused by a substance or medical condition. -once known as multiple personality disorder, have two or more separate identities that may not always be aware of each other's memories, thoughts, feelings, and behavior. -Two or more distinct identities (i.e. alters)•At least two of the identities must alternate control of the individual's behavior. -Amnesia Dissociative Fugue: -extreme Subtype of dissociative amnesia associated with unexpected travel over extended distances. -persons not only forget their personal identities and details of their past lives but also flee to an entirely different location. -Their fugue may be brief — a matter of hours or days — and end suddenly. In other cases, however, the person may travel far from home, take a new name, and establish a new identity, new relationships, and even a new line of work. -Sporadic, short-lived

Understand what malingering is

intentionally feigning illness to achieve some external gain, such as financial compensation or time off from work -Deliberate pretending to be affected by disorder for "secondary" gain • Money • Not having to work • Avoiding jailtime • etc

Know hallmark features of Somatic Symptom Disorder

people become disproportionately concerned, distressed, and disrupted by bodily symptoms; At least one medical symptom that is distressing • Excessive concern with health • Behavior directed toward health problems -has true physical symptoms. But medical tests can't pinpoint a cause for the physical symptom.

Know what causes of and approaches to treatment for dissociative identity disorder that socio-cultural and psychodynamic theorists support (and which ones they agree on)

socio-cultural Dissociation is a socially learned behavior. Individuals learn dissociative behaviors that are valued by the culture, as a means of acquiring status. -Phenomena such as hypnosis merely reflect states of enhanced suggestibility -Major implications for forensic and clinical cases involved "repressed memory retrieval" through hypnosis -Dissociation is a socially learned behavior Individuals learn dissociative behaviors that are valued by the culture, as a means of acquiring status -Points to evidence that rates of this go up in sociocultural environments that promote this -Phenomena such as hypnosis merely reflect states of enhanced suggestibility -Major implications for forensic and clinical cases involved "repressed memory retrieval" through hypnosis psychodynamic individual in an uncontrollable traumatic situation splits personality from consciousness, using self-hypnosis, as a means of protecting the ego from the horror of reality. -Dissociation is due to a lifetime of repression, the ego's defensive mechanism, motivated by childhood trauma (parental abuse in particular) -Individual in an uncontrollable traumatic situation splits personality from consciousness, using self-hypnosis, as a means of protecting the ego from the horror of reality From textbook: Therapists usually try to help the clients (1) recognize fully the nature of their disorder, (2) recover the gaps in their memory, and (3) integrate their subpersonalities into one functional personality