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)