Psychological Disorders Part II: Electric Boogaloo
what physiological signs may respond to alter shifts?
skin conductivity, blood pressure, pupil dilation
neurogenesis
the formation of new neurons
Binge eating disorder
the out-of-control binges of bulimia, but without any compensatory behavior, leading to significant weight gain
how can omega-3s help with anxiety?
they are associated with decreased depression and anxiety
what do some people label schizophrenia as?
they say its just a collective way of referring to those who reject cultural norms (not true)
what do therapists need to be careful of when dealing with their patients (as it pertains to trauma)? when is this especially important?
they want to be careful not to "plant" any memories of a traumatic experience that never occurred (can happen if the therapist has a vested interest in the trauma being present) especially important if the patient is particularly suggestible
why did cultural norms regarding beauty in Fiji change? How?
they went from prioritizing healthy body weights to prioritizing thinness following the introduction of widespread Western TV
prefrontal Dopamine
too low in schizophrenia thinking and reasoning deficiencies lead to hypofrontality, which is common in schizophrenia
striatal Dopamine
too much in schizophrenia influences movement, balance, and walking
TMS
transcranial magnetic stimulation; use of strong magnets to briefly interrupt normal brain activity as a way to study brain regions aims to create new brain pathways that help people to escape the rut of depressive thought patterns
sleep terror
A sleep disorder occurring in non-rapid eye movement sleep in which the sleeper wakes suddenly in great distress but without experiencing the imagery of a nightmare (loud scream, can't remember anything).
the gender imbalance in depression refers to the fact that _____ tend to be diagnosed with depression MORE often than _____. Why is this? Give some genetic, social, cultural, etc. reasons.
women are diagnosed more than men can be genetic (we know that women are more influenced by their genetic predisposition to depression than men are) can be social (stigma may lead men to cover up/replace their feelings, women may have higher poverty rates (and thus, more social stress)) can be cultural (the responsibilities ascribed to men and women within certain cultures may lead to different stressors)
how does gender play a role in determining the genetic contribution to mood disorders?
women are generally more influenced by genetic contributions, whereas men are generally more influenced by environmental factors (when it comes to mood disorders)
women are more likely to _________________ than men men are more likely to ________________ than men with respect to suicide why is this the case?
women are more likely to attempt suicide, potentially because they also tend to exhibit higher rates of suicidal gesturing men are more likely to die by suicide, potentially because they are more likely to use more violent, less reversible methods of suicide (firearms, hanging, etc.)
who reports insomnia more, women or men?
women, 2:1
Kyol goeu
"Wind overload" among Khmer people of Cambodia Fear that wind cannot circulate effectively through the body Dizziness, weakness, fatigue and trembling are seen as signs of this illness
describe the general family of an individual with anorexia
-they tend to be obsessed with external appearances -also, they want to maintain harmony, which leads them to ignore problems and lack communication -they're also high achieving
prevalence of illness anxiety disorder
1-7% of the population
Bulimia gender breakdown and developments
90% + women, but its becoming more equal over time
loose association
A common thinking disturbance in schizophrenia, characterized by rapid shifts from one topic of conversation to another. Also known as derailment. finding connections in things that don't appear logical to anyone else
prevalence of delusional disorder (and gender)
0.024% to 0.06%, more males than females
lifetime prevalence of schizophreniform disorder
0.2%
prevalence of Selective Mutism
0.5% of children
what are the main focuses of DID treatment?
1) deal with the underlying trauma, being careful not to impose any undue suggestions on the patient 2) unite the patients alters into one cohesive personality
what does diagnosis of schizophrenia require with respect to symptoms?
2+ of the following, with at least one being 1, 2, or 3: 1. delusions 2. hallucinations 3. disorganized speech 4. grossly disorganized or catatonic behavior 5. negative symptoms
what are some emerging areas in the field of anxiety management (6)?
CBD Massages, Reiki, Acupuncture, Tapping Probiotics Magnesium Omega-3s Antioxidants
what is the gold standard for depression therapy?
CBT
who coined the term schizophrenia
Eugen Bleuler
Who identified the Behavioral Inhibition System (BIS)
Jeffrey Gray
Permissive hypothesis of depression
Low serotonin "permits" other neurotransmitters to vary more widely, increasing vulnerability to depression
what are the most common antidepressants?
SSRIs
schizoaffective disorder
Schizophrenic symptoms accompanied by a strong element of symptomatology associated with the mood disorders, either mania or depression
what category is PTSD part of?
Trauma and Stressor Related Disorders
Disruptive Mood Dysregulation Disorder
a childhood disorder marked by severe recurrent temper outbursts along with a persistent irritable or angry mood (occurs because the children have a hard time regulating their emotions) used to be diagnosed as childhood Bipolar disorder, which is problematic because it lead to a lot of unapproved Bipolar medications being used on children this new diagnosis is better because it allows for research into a more accurate diagnosis for children specifically, leading to more tailored (and hopefully, more effective) treatments in the future
Dhat
a culturally specific somatic symptom disorder that focuses on concern surrounding the attribution of fatigue, dizziness, and other anxiety-provoking conditions to the loss of semen via ejaculation present in some Indian cultures
Interpersonal Psychotherapy (IPT)
a form of psychotherapy that focuses on helping clients improve current relationships and develop new ones
what are some challenges to the Dopamine-schizophrenia link (3)?
a lot of people with schizophrenia aren't helped by Dopamine antagonists Neuroleptics (anti-psychotics) block Dopamine quickly, but the symptoms of schizophrenia take a while to dissipate Dopamine antagonists are only partially effective when it comes to treating the negative symptoms of schizophrenia
baby blues, and prevalence
a mild postpartum mood disorder that goes away on its own within a few days 40-80% prevalence tearfulness, temporary mood swings
prodromal stage of schizophrenia
a period of unusual, psychotic-like systems, usually lasting 1-2 years, that can sometimes precede full-blown schizophrenia can be indicative of larger problems
periodic limb movement disorder
a sleep disorder characterized by repeated involuntary movement of the legs and sometimes the arms
depression is generally more common ____ birth
after
complicated grief
after 6 months to a year of grieving, the chance of full recovery plummets (w/o treatment) suicidal thoughts emerge that focus on reunion with the fallen, you can't imagine any future events, regulating your emotions becomes difficult, and they tend to become rigid, and inflexible. basically, the symptoms of acute grief continue long-term and stop you from getting past it. Your consequent overobsession with the death and its consequences impairs your life.
psychotic features specifier
also includes hallucinations and delusions
what may a catatonic features specifier actually be?
an "end state" reaction to feelings of imminent doom
IAD is often comorbid with
anxiety and mood disorders
what should therapists dealing with conversion disorder be careful to try and mitigate?
any potential "benefits" associated with the physical symptoms that could be leading to self-defeating behaviors (must work with family and friends to stop them from reinforcing the conversion). remove the secondary gain
what is the global prevalence of Schizophrenia?
around 1% (ranges from 0.1 to 1.5)
how can severe life events during an episode of recurrent depression influence treatment and outcome?
associated with lower response to treatment and poorer outcome
cabin fever
at extreme northern and southern latitudes, where there is less sunlight in the winter, seasonal affective disorder gets more prevalent and more severe
Bipolar I disorder
at least 1 full manic and full depressive episode
Bipolar II disorder
at least 1 hypomanic and full depressive episode
how can we help people who are considering suicide?
be honest with them about your concerns, and don't be afraid to ask them directly about suicide (inspired suicide via a conversation is very rare, meaning that being wrong about someone having suicidal tendencies and getting help is far better than being wrong about them not having suicidal thoughts) Listen Offer to help them with/accompany them to therapy Convey messages of hope (i.e., that depression is real, that other people go through it to, and that there are treatments available).
why is the presence of magnesium in our diets decreasing?
because (A) the foods we tend to eat are not especially high in magnesium and (B) the soil used for major agriculture is losing its magnesium concentration
why may experiences of symptoms for mood disorders vary across subcultures in the US, even though the prevalence rate is approximately equal?
because certain cultures may have stigma associated with certain mood disorder symptoms (e.g., sadness, indecisiveness, depression, feelings of helplessness, etc.), leading to these experiences being manifested in different ways (irritability, agitation, somatic symptoms, etc.)
why do we say "died by" vs. "committed" suicide?
because committed carries criminal implications
why is asking people how they felt about a past event often ineffectual? what should we do to get around this deficit?
because current mood states can bias the ways in which we view past events. To get around this, stressors and their meanings should be assessed prospectively (as they occur)
why must people with OCD engage in compulsions (2 reasons)?
because fighting the obsessions by trying to ignore them is futile (for most people, if you try to stop thinking about something, your brain only makes you think about it more) also because of thought-action fusion (makes the thoughts "dangerous", and thus requires compulsions to mitigate the resultant anxiety)
why is the role of family vital in eating disorder treatment?
because if the same familial environment that contributed to the disorder is present, relapse risk skyrockets so, families have to be taught how to assist them through their remission
why might some people manifest their depressive emotions as irritability over, say, sadness?
because irritability may be seen as more culturally acceptable, especially in environments where sadness is misinterpreted as weakness
why does dieting not work? how can they be counterintuitive?
because its reactionary, unsustainable, and only applied in the short-term also because it may lead to cravings that spark binge eating which leads to weight gain, rather than weight loss
how do we know that dormant schizophrenia genes are present that can lead to children getting schizophrenia when there parents don't have it?
because we ran studies on the offspring of twins, and found that: children whose parents were an identical (or fraternal) twin with schizophrenia and children whose parents didn't have schizophrenia, but whose identical twin did exhibited similarly high rates of schizophrenia compared to the children of parents who didn't have schizophrenia, but whose fraternal twin did.
prognosis for schizoaffective disorder
chronic
what obsession is a cleaning compulsion usually associated with?
contamination
what did dissociative derealization disorder used to be called?
dissociative trance disorder
what are the two major categories of sleep-wake disorders?
dyssomnias and parasomnias
parenting styles that encourage stereotypical gender roles lead to _____________________. Why is this?
early psychological vulnerability to later depression and/or anxiety this is because stereotypical gender norms designate women as passive, sensitive, and dependent, and by playing into this (via smothering or overprotection), young girls may feel helpless.
what are some of the physical symptoms associated with depression?
eating way more or less than usual sleeping way more or less than usual exhaustion somatic symptoms
deep brain stimulation
electrical stimulation applied through surgically implanted electrodes; used to treat some anxiety and mood disorders
people with delusional disorder tend to ___________ compared to people with schizophrenia
fare better in the long term
what are some side effects of phototherapy
headaches, eyestrain, feeling wired
social stressors like ______________ tend to ____________ risk of depression
homelessness, natural disasters, poverty, low SES, tragedies, etc. tend to increase depression risk
echopraxia
imitating another's actions
where are eating disorders most common for men?
in sports that prioritize weight standards
COMT (schizophrenia-linked marker gene)
influences dopamine metabolism (dysregulated in schizophrenia)
primary insomnia
insomnia with no other recognized disorder or secondary condition
what disorders are classified as dyssomnias?
insomnia, hypersomnolence disorder, narcolepsy, breathing-related sleep disorders, circadian rhythm sleep disorders
where does disgust proneness come from?
it may be evolutionarily based
what is the purpose of imaginal exposure?
its not about seeing the trauma as good, but rather as something that is controllable
early concern with being overweight strongly predicts
later development of an eating disorder
hypomania
low level mania that doesn't lead to impairment
is SSD common?
no, relatively rare (5-7%)
distress tolerance
one's ability to deal with/willingness to experience uncomfortable feelings
smoking as a teenager leads to especially high rates of which two anxiety disorders?
panic disorder and GAD
how can grounding oneself in the moment help with anxiety?
people with severe anxiety are extremely concerned about the future, so grounding their senses in the moment (what can you see? hear? feel?) can stop them from spiraling.
peripartum period
pregnancy and the 6 month period following childbirth
anxious distress specifier
presence and severity of accompanying anxiety with a depressive episode
schizotypal personality disorder
schizophrenia-like symptoms, but less severe
when does integrated grief recur
significant anniversaries (birthday of a loved one, holidays, anniversary of the death, etc.)
egosyntonic
Phenomena or experiences consistent with the perceived needs, self-perception, or ideals of an individual.
put simply, why might people with anxiety be at a higher risk of smoking?
Because smoking helps them to mitigate some of the major causal factors (anhedonia, distress intolerance, and anxiety sensitivity) that contribute to more severe anxiety.
when did separation anxiety disorder become its own diagnostic category?
DSM-5, in hopes that its inclusion would lead to more research.
what are the four main avenues for treatment of PTSD?
EMDR Imaginal Exposure Debriefings (though not forced) Anxiety self-care
compulsions
Repetitive behaviors or mental acts that are performed to prevent or reduce anxiety.
imaginal exposure
Form of exposure therapy that does not involve a real stimulus. Instead, the patient is asked to imagine the feared stimulus or situation. used a lot in PTSD, with the traumatic experience being simulated via technology like VR
how does treatment for BED differ from that for the other eating disorders?
IPT, CBT, etc. all work, but some additional focus has to be given to weight management (e.g., bariatric surgery rates may be higher)
what is the most common type of hallucination? what can this lead to with respect to misdiagnosis?
auditory, can lead to people treating schizophrenia and DID as linked because both involve "hearing voices"
echolalia
automatic and immediate repetition of what others say
why is having a suicide plan a warning sign for suicide?
because it means that the person has given genuine thought to the reality/implications of their suicide
which medications are most frequently prescribed for anxiety disorders?
benzodiazepines and SSRIs (Paxil, Effexor, Prozac, etc.) benzos are dangerous because, even though they agonize GABA, they are also very prone to dependence and cause cognitive and motor impairment SSRIs are considered safer and more effective in the long-term (similar short-term effectiveness).
what are the major drawbacks of medical treatments for insomnia (3)
benzos can cause excessive sleepiness dependence is also a major risk only work short-term also, some (like ambien) may make sleepwalking and similar symptoms more common
breathing related sleep disorders
breathing interrupted during sleep, leading to arousals that worsen quality of even long periods of sleep
how can we measure learned helplessness in humans?
by gauging their sense of control
how can we measure sensitivity to threat?
by presenting ambiguous stimuli and recording how people interpret them (as threatening or passive)
Disinhibited Social Engagement Disorder (DSED)
children form attachments too easily (disinhibited), even with complete strangers, following a trauma
separation anxiety disorder
children's unrealistic and persistent worry that something will happen to their parents or other important people in their life or that something will happen to the children themselves that will separate them from their parents
what is the course of SSD like?
chronic
common compulsions
cleaning, checking, repeating, ordering/arranging, counting
sensitivity to threat. What are some potential biological and psychological causes?
common among individuals with GAD, who readily allocate more of their attention to threats because they are constantly on the lookout. originates in the generalized psychological vulnerability that the world is a dangerous place. may also be the result of an overactive amygdala
common obsessions
contamination aggressive impulses (inappropriate) sexual impulses somatic concerns need for symmetry
substance abuse psychotic disorders
delusions caused by amphetamines, alcohol, or cocaine
thought-action fusion
The tendency to overestimate the relationship between a thought and an action, such that one mistakenly believes a "bad" thought is the equivalent of a "bad" action.
what are the three kinds of SNRIs commonly prescribed for Depression?
Wellbutrin/Zyban (also used for smoking), Pristiq, and Effexor
peripartum onset specifier
depression occurring around the time of giving birth
describe the age distribution of IAD
affects all age groups relatively equally
what are the multiple personalities of DID called?
alters
where is anorexia most common? (3 factors)
among women among the middle-upper class among white people/those who identify with white culture (even if not white)
what are the major risk/etiological factors of anxiety disorders
anxiety sensitivity sensitivity to threat distress intolerance fear of the unknown disgust proneness intolerance of the uncertain
vulnerability to stress
tendency to overreact to everyday stimulus/events
how does glutamate influence schizophrenia
the NMDA glutamate receptor, when antagonized (by ketamine, phencyclidine, etc.) can lead to worsening of psychotic symptoms
What structure in the brain boosts the BIS?
the amygdala
which brain structure plays the biggest role in eating regulation? How?
the hypothalamus, by sending us our fullness and hunger signals
depression with mood incongruent psychotic features may result in _____________
the onset of schizophrenia
how can family experiences influence the content of one's somatic symptom disorder?
the somatic symptom that one focuses on in an SSD is often similar to one that someone in their family had growing up
how does attention play a role in depression? how has technology influenced this relationship?
the things that we divert our attention to change from person to person if we tend to divert our attention to the negative aspects of life, we may predispose ourselves to depression in the technological age, algorithms are designed to expose us to more of what we look for in the world. If we are looking at the negative side of reality, these algorithms will fill our world with negative things, leading to even greater vulnerability to depression.
if an adolescent's friend group diets
they are more likely to diet as well
nocturnal eating syndrome
when individuals rise from their beds and eat while they are still asleep
when is Prozac generally prescribed?
with low-energy depressed patients (i.e., those who never go out, stay in bed all day, etc.)
the prevalence of eating disorders is getting ___________, why?
younger because media messaging is becoming available to younger and younger children, leading to more and more early concern with being overweight
what are the risks of only using drug therapy for depression (4)?
"band aid effect" - only deals with the symptoms, without targeting the core issues (e.g., problematic cognitive and behavioral patterns) at the heart of depression. the carry an increased risk of relapse because of the above risk they often have side effects that, if not monitored by a therapist, can lead to harm they may lead to learned helplessness, with the patients believing themselves incapable of dealing with their depression on their own.
what factors contribute to the etiology of somatic symptom disorders
-consistent overreaction to physical signs and sensations -genetic component is present, but not the only determinant -may have learned from family to react with anxiety to physical sensations -may have also learned this from early experiences with personal or familial illness -stressful life events that raise the general level of anxiety increase vulnerability -may learn that there are benefits to illness (empathy, attention, etc.)
how does the DSM-5 characterize PTSD?
-exposure to trauma -trauma must be real-life (not online, unless work related) -trauma must lead to intrusion symptoms (dreams, thoughts, dissociation, distress at exposure, physiological response (jumpiness, easily startled)) -avoidance of stimuli, emotional detachment, inability to recall the trauma -negative thoughts associated with the event
what are the typical signs of Mania/Manic episode?
-hyperactivity -grandiose plans (can border on delusional grandiosity) -rapid speech, flight of ideas - jumping from one idea to the next in rapid, often incomprehensible, succession -impulsivity - very little inhibition, can lead to dangerous, risky behaviors with little consideration of the consequences -irritability (from being constantly keyed up)
how can suicide in the family lead to higher suicide risk?
-people may want to commit suicide to join their loved one -it may become more "acceptable" to them -it may represent a loss of a significant relationship -the factor that contributed to the suicide may have been inherited
somatic symptom disorder
-the presence of one or more somatic symptoms -the symptoms are usually medically unexplained (although this doesn't mean that they aren't real and genuinely distressing) -excessive thoughts, feelings, and behavior related to the symptoms, their implications, etc. (can lead to persistent requests for help, research into causes, health related anxiety, etc.) -substantial impairment in social or occupational functioning
what is the time span of symptoms associated with PTSD? what do we call the disorder if the symptoms have not yet reached this time span? why do they have another diagnosis just for a short-term period>
1 month before this, its called acute stress disorder (the diagnostic inclusivity allows people to get help/insurance at any stage of the disease)
what are the two reasons behind the fact that those who commit suicide often appear as if they're getting better/not at rock bottom?
1) because those that are at rock bottom don't even have the energy necessary to carry out their suicide. When they begin to improve slightly, those suicidal thoughts are still there, the only difference is that now, they have the energy to act on them. 2) also, those who have resigned themselves to suicide may feel as though they've found an "answer", making them appear calm an at peace in the days before their death
how does the BIS work? What are the two ways in which it can be activated
1) unexpected events/major changes in body functioning prompt the brain stem to send a danger signal up to the septal-hippocampal system that activates the BIS. 2) seeing something potentially threatening generates danger signals in the cortex that move down to the septal hippocampal system and activate the BIS when the BIS is activated, we usually freeze, experience anxiety, and apprehensively evaluate the situation to verify that the danger is present.
conversion disorder
1+ symptom of altered voluntary motor or sensory functioning symptoms don't match any defined medical conditions and cannot be detected with any established medical tests not better explained by another mental or medical disorder leads to significant impairment and/or distress (no belle indifference, as Freud may have suggested)
describe the statistics of IAD (prevalence, distribution)
1-7% equal across all age groups
what are the three cognitive styles composing Seligman's depressive attributional style?
1. internal (everything is somehow my fault) 2. global (one thing going wrong means everything has gone wrong (similar to overgeneralization in Beck's theory)) 3. stable (things are bad and will stay that way, regardless of what I try to do to help)
___ of patients seeking bariatric surgery have ____; why?
1/2, BED because BED leads to significant weight gain due to the lack of compensation and recurrence of bingeing
approximately ____ report insomnia symptoms in a given year
1/3
how many suicides occur on college campuses each year? it is the _________ leading cause of deaths on college campuses?
1100 second
how many alters does an individual with DID have on average?
13
Kenny
14, mutual masturbation with friend, seen as relatively abnormal
what percentage of those who die by suicide were in treatment for a psychological disorder at the time?
15%
__% of people with Anorexia die from the associated health complications
20%
onset of delusional disorder
35-55
relatives of people with an eating disorder are ___ likely to get one themselves
4-5x
Prevalence of Separation Anxiety Disorder
4.1% children, 6.6% adults
adopted children with schizophrenia-diagnosed biological mothers have a _____ chance of getting schizophrenia (compared to a _________ chance for the general population), and a _________ chance of getting a schizophrenia spectrum disorder. A good adopted family can _____________.
5%, compared to 1% 22% for any schizophrenia spectrum disorder good adopted family can decrease this risk
psychotic features appear in __ to __% of depressive episodes
5-20%
at some point, ___ to ___% of college women will experience Bulimia
6-7%
1 in __ women will experience depression around the time of birth
8
how many distinct genomes may be present for schizophrenia? what does this mean?
8 this, in addition to the wide-ranging symptoms of schizophrenia, means that the disorder can be arrived at/impact every patient differently
adolescent dieting leads to _______________
8 times higher rate of eating disorders (in general)
what percentage of those who die by suicide show clear warning signs?
80%
schizophrenogenic mother
A type of mother—supposedly cold, domineering, and uninterested in the needs of her children—who was once thought to cause schizophrenia in her child.
dysthymia (and time requirement/other name)
AKA Persistent Depressive Disorder at least 2 years of chronic mild depression
who is the father of cognitive therapy?
Aaron Beck
parasomnias
Abnormal behaviors such as nightmares or sleepwalking that occur during sleep.
dyssomnias
Abnormalities in the amount, quality, or timing of sleep.
what is the more modernized offshoot of CBT that is being used more and more in modern depression treatment?
Acceptance and Commitment Therapy
intolerance of uncertainty
An inability to tolerate uncertain outcomes, often present among people with generalized anxiety disorder. As uncertainty rises, so does anxiety. can be dealt with in therapy (learning to accept/embrace uncertainty)
what are the five negative symptoms associated with schizophrenia?
Anhedonia - can't feel pleasure (also common in Depression) Alogia - can't speak Affective flattening - no intonation/emotional expression, despite actually feeling things Avolition - no desire to do/try anything Apathy - not caring about anything, good or bad
Which eating disorder has the hardest time with treatment? Why?
Anorexia not only is it less responsive to SSRIs, but people with anorexia generally don't see anything wrong with their situation, while people with Bulimia want an escape from the cycle
how do CBT and phototherapy compare with respect to the treatment of seasonal affective disorder?
CBT had lower relapse and higher transmission rates in the long-term
exposure and response prevention therapy
CBT used for OCD exposure to obsessions and active prevention of compulsions in order to show the patient that their obsessions aren't actually dangerous and don't need to be met with compulsions.
what are the most common types of therapy for depression?
CBT, Psychodynamic, Interpersonal Psychotherapy, Existential Therapy, Adlerian Therapy, and Gestalt Therapy
How does CRF affect anxiety and depression?
CRF activates the Hypothalamic Pituitary Adrenocortical (HPA) axis, which is part of the CRF system The system affects numerous portions of the brain involved in anxiety, including the limbic system (amygdala and hippocampus, which influence emotional expression), the locus coeruleus (brain stem), the prefrontal cortex, and numerous neurotransmitter systems.
long-acting insomnia drugs
Dalmane/flurazepam sometimes doesn't stop working by the morning (long-term drowsiness)
mood-incongruent psychotic features
Delusions or hallucination whose content is entirely not consistent with the typical themes of a depressed or manic mood. e.g., for depression, delusions of grandeur rarer
mood congruent psychotic features
Delusions or hallucinations whose content is entirely consistent with the typical themes of a depressed or manic mood. e.g., for depression, your body is rotting, you hear voices convicting you of sin, etc.
inappropriate affect
Display of emotions that are unsuited to the situation; a symptom of schizophrenia.
the yearning in complicated grief is tied to which neurotransmitter.
Dopamine
which neurotransmitter is most implicated with schizophrenia?
Dopamine (often too high)
who was the first to suggest that a dysfunctional brain may be the cause of schizophrenia?
Emil Kraepelin
what are the five subtypes of delusional disorder?
Erotomanic - someone is in love with me Somatic -something is seriously wrong with my body Jealous - I am being cheated on Grandiose - I am God, have powers, etc. Persecutory - I or someone I know am/is being hunted
how was Freud right with respect to his illustration of conversion disorder? how was he wrong?
Freud was right that there is a traumatic event that, leading to a conflict that can't be escaped, is instead dealt with by getting sick (acceptable) (however, because getting sick on purpose isn't acceptable, its usually unconscious). Additionally, because this strategy works, its repeated until the underlying problem is solved. so, he was right about 1. Trauma, 2. using sickness to unconsciously deal with it, and 3. repeating this process because it produces results however, Freud was wrong in his assertion that people with conversion disorders don't feel discomfort because their symptoms are based in the unconscious (la belle indifference) (this is not true, with patients that have conversion disorder displaying equal, if not greater, anxiety than their normal counterparts).
there are ________ suicides than homicides in the US. there are ________ suicides than homicides in the world.
More; More
PANDAS
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections a severe, immediate onset of OCD caused by a strep infection in children
Double Depression, what is unique about this diagnosis?
Persistent depressive disorder with major depressive episodes on top very high suicide risk because the individual's baseline mood is already negative, making them even more vulnerable to the steep drop represented by a major depressive episode
risk factors for suicide - examples (11)
Psychological disorders suicide in the family loss of significant relationship(s) firearms in the home substance abuse stressful life events past suicidal behavior abuse and neglect academic/disciplinary crises concerns about sexuality and gender identity lack of achievement
Genain Quadruplets
Quadruplets who all got schizophrenia (genetic influence), but whose onset, symptomatic, diagnostic, course, and outcome patterns were all different (from unshared environments) differences may have also been caused by de novo mutations demonstrates the gene-environment interaction.
what is the difference between depression with a seasonal pattern specifier and SAD (seasonal affective disorder)?
SAD lasts for two years and there is no evidence of non-seasonal episodes
What are some potential alternatives to SSRIs, as far as medication for depression is concerned?
SNRIs/Mixed Reuptake Inhibitors (impact norepinephrine and Dopamine, which are the systems influenced by the serotonin deficiency often seen in depression)
what kinds of drugs can help with eating disorders? Is this benefit equivalent for all eating disorders?
SSRIs can help, but more for Bulimia than Anorexia Although, they can help for Anorexia if its being exacerbated by comorbid OCD-like behaviors
depressive attributional style
Seligman's model of the three ways of thinking about attribution (who/what is responsible for certain phenomena) that are prevalent within depressed individuals.
Elyn Saks
Stanford professor, had schizophrenia, first feeling that something wasn't right came when she was a child and her father yelled at her
what three factors tie smoking to anxiety?
distress tolerance, anxiety sensitivity, and anhedonia
how fast is phototherapy?
effective within 3-4 days, remission within 1-2 weeks
how do psychotic features influence course and outcomes?
generally worse outcomes, poor response to treatment, greater impairment
What did Aaron Beck assert about people with depression?
he saw depressed people as seeing the world in a different way that was chock-full of cognitive errors
what kinds of foods can help to foster a health gut microbiome?
high fiber foods, probiotics, yogurts, fermented foods, etc.
compared to the US population, college students have __________ prevalence of eating disorders?
higher.
what type of stressful life event is most implicated in suicide risk?
humiliating ones
when is anxiety sensitivity especially prevalent?
in panic disorders, seeing that stress over bodily sensations fuels the (anxious thought-sensation) cycle that results in panic attacks, which can lead to the maladaptive avoidance and anxiety that define panic disorder.
anhedonia
inability to experience pleasure
cognitive behavioral therapy for insomnia
involves developing a package of skills (better sleep hygiene, cognitive treatment of expectations and anxiety, relaxation, sleep restriction, etc.)
how can psychotherapy help with Bipolar individuals? What is psychotherapy not as good at treating? What does this second conclusion imply about Bipolar disorder treatment plans?
it can help them to deal with the interpersonal, occupational, and social consequences of their disorder and its symptoms however, it isn't great at dealing with the underlying causes of manic and depressive episodes thus, both mood stabilizers and psychotherapy are often needed in Bipolar treatment plans
how can magnesium help with anxiety?
it is associated with muscle relaxation and sleep
most common seasonal depression period
late fall to spring
how can B-vitamins help with anxiety?
low levels are associated with anxiety, so increasing levels via nutrition can help to mitigate anxiety
Sarah
married, 28, never had an orgasm, but doesn't report any dissatisfaction, seen as more abnormal than Mr. Jones, less than Kenny
waxy rigidity
muscles stay where they are positioned
de novo mutation
mutations in germ cells or in the fertilized egg
does everyone go through a prodromal stage?
no
atypical features specifier
oversleeping and overeating, rather than undersleeping and undereating
premenstrual dysphoric disorder (PMDD)
significant depressive symptoms occurring prior to menses during the majority of cycles, resulting in significant distress or impairment
conversion hysteria
The viewpoint, originally advanced by Freud, that specific unconscious conflicts can produce physical disturbances symbolic of the repressed conflict unconscious emotional conflicts manifest as physical symptoms (more acceptable form)
what were the two original antidepressant medications? why have these begun to fall out of the mix?
Tricyclics fell out because they can lead to overdose, which is especially dangerous in depressed patients, who have high suicide risks MAOIs fell out because they required lifestyle changes and had side effects (if you ate too much tyramine, you could die)
counting compulsion
Type of compulsion: repeatedly counting numbers in one's head or counting specific objects (ceiling/floor tiles, sidewalk cracks, tree leaves)
what are the 5 main SSRIs? what do they all share in common?
Zoloft, Paxil, Prozac, Celexa, Lexapro all increase serotonin at the synaptic gap all also have sexual side effects (ED, low sex drive, etc.)
which of the SSRIs are most often used for anxiety and anxiety-depression?
Zoloft, Paxil, and Lexapro
describe a bulimia binge
a discrete period (<= 2 hours) in which a person feels out of control while eating a larger amount of food than is considered normal for someone in a given situation.
Excoriation
a disorder characterized by the repeated picking at of one's own skin to the point of scabbing
Trichotillomania
a disorder characterized by the repeated pulling out of one's own hair
OCD
a disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions) that lead to significant distress or impairment
expressed emotion
a measure of how much hostility, criticism, and emotional over involvement are used when speaking about a family member with a mental disorder (they see the disorder as treatable and the patient's continued difficulties as them "not trying hard enough to get better") associated with higher relapse rates for people with schizophrenia some treatments for schizophrenia aim to reduce EE in family members as a supplemental measure
describe the role of learned and false alarms in anxiety disorders
a period of high stress or genuine danger (true alarm) leads to a false alarm (panic attack); this false alarm then becomes associated with the cues (internal and external) that were present during a panic attack, leading to a learned alarm (all of these cues become conditioned stimuli) this occurs because of vulnerabilities in the individual generalized psychological vulnerability may lead one to view the world as dangerous generalized biological vulnerability may make some more likely to be tense, respond to stress with anxiety, or have panic attacks (false alarms) in the first place specific psychological runs the process, making us view the unexpected cues as dangerous, beginning the cycle of sensation, anxiety, sensation, anxiety that culminates in more panic attacks
delusional disorder
a persistent delusion that is not accompanied by other schizophrenia symptoms also not caused by organic factors (seizures, severe psychosis)
disgust proneness
a personality trait that is characterized by the tendency to experience disgust as well as the tendency to find the experience of disgust aversive
what is a commonality of both Anorexia and Bulimia
a sense of self/self-image/self-worth that is overwhelmingly defined by body weight and shape
disorganized speech
a severe disruption of verbal communication in which ideas shift rapidly and incoherently among unrelated topics
PANS
a severe, immediate onset of OCD caused by other infections in children (lyme disease, CoVid, etc.)
catatonia
a state of unresponsiveness to one's outside environment, usually including muscle rigidity, staring, and inability to communicate also may include echolalia and echopraxia
Existential Therapy
a therapy that encourages clients to accept responsibility for their lives and to live with greater meaning and value
nightmare disorder
a type of sleep-wake disorder involving a pattern of frequent, disturbing nightmares that lead to impairment (occur during REM sleep)
catatonic features specifier
absence of movement or catalepsy (waxy, semirigid muscles (stay where you put them)) may also include excessive, random movement
double bind communication
according to an obsolete, unsupported theory, the practice of transmitting conflicting messages, especially to children, that was thought to cause schizophrenia
when is the onset of SSD?
adolescence
what is the general onset and course of SSD?
adolescent, chronic
what are the advantages and disadvantages of premenstrual dysphoric disorder being established as a psychological disorder?
advantages: it may increase research into the disorder, leading to more effective treatments; it recognizes/legitimizes the struggles of people who endure the disorder; etc. disadvantages: it pathologizes a completely normal experience, feeding into the already hefty body of stereotypes surrounding menstruation
Amazon "suicide kits"
algorithms put together suicide kits that functioned in a similar way to firearms in the home, playing on the impulsivity of suicide via their ready availability.
behaviors that reduce anxiety can also __________________. Why is this additional case often difficult to realize?
alleviate depressive symptoms/make depressed patients more responsive to treatment However, considering that depression may make you not want to exercise, be around others, go out into nature, etc., these behaviors can often be hard to practice for depressed patients
cyclothymia (and time requirement)
alternating between mild depression and hypomania with almost no time in between for euthymia for at least 2 years
what does most treatment for somatic symptom disorders focus on (3 main things)?
among other things, managing health anxiety, providing education, and providing consistent, comprehensive reassurance concerning one's health drugs can also help (SSRIs)
Tourette syndrome
an OCD-related disorder that involves involuntary, spasmodic, twitching movements; uncontrollable vocal sounds; and inappropriate words (tics)
hoarding disorder; how is it different from OCD?
an OCD-related disorder where: obsessions = beliefs that you are going to need everything you have at some point in the future compulsions = acquisition of things and a refusal to discard anything different from OCD because it mainly effects the elderly and because its more genetically influenced
Eye Movement Desensitization and Reprocessing
an exposure treatment in which clients move their eyes in a rhythmic manner from side to side while flooding their minds with images of objects and situations they ordinarily avoid
order the age of typical onset, from earliest to latest, for the three eating disorders discussed in class.
anorexia - early adolescence bulimia - late adolescence to early adulthood BED - later than others
Anorexia vs. Anorexia Nervosa
anorexia is the loss of appetite; anorexia nervosa is the eating disorder however, we commonly refer to anorexia nervosa as simply anorexia
what group did OCD and related disorders used to be a part of?
anxiety disorders, given the similarities present between the two
what disorders have high comorbidity rates with eating disorders?
anxiety disorders, mood disorders, substance abuse disorders, trauma
what does current thinking dictate about the link between smoking and anxiety? Explain each factor and how it relates to smoking.
anxiety sensitivity, distress tolerance, and anhedonia all contribute to smoking, which explains why smoking is so hard to quit: we stress out about unexpected sensations, leading us to stress more. This has the potential to cycle into a panic attack, so people may smoke to keep their anxiety levels down. we are intolerant of uncomfortable feelings, so we smoke in order to avoid them we are unable to experience pleasure naturally, so we smoke to synthesize it understandably, people with anxiety wouldn't want to stop smoking because its keeping these problems (see above) at bay.
what events are most likely to lead to depression onset? (3)
anything involving social rejection, humiliation, or loss (breakups, childhood sexual abuse, divorce, etc.)
what is the suicide:homicide ratio in the US?
approximately 3:2
for mood disorder, prevalence rates are _______________ (US subcultures)
approximately equal across most US subcultures
how may cultural/racial/sociopolitical factors influence schizophrenia?
areas with turmoil may have higher prevalence racial or ethnic groups who are discriminated against may have higher prevalence rates (the associated stigma/isolation may lead to higher stress levels)
how long do manic symptoms need to last in order for it to be classified as an episose?
at least 7 days, unless they result in hospitalization (then, it doesn't matter how long they've been around)
what maladaptive behaviors can separation anxiety disorder lead to?
avoiding any situation in which one must be apart from their parents (don't go to school, not sleeping alone, etc.)
why is a firearm in the home associated with higher suicide rates? what does this say about the nature of suicide?
because a firearm represents a quick, easy, and highly lethal solution reveals that, while suicidal thoughts and their accompanying negative mood state may be persistent, the actual decision to end one's life is often impulsive, an when a gun is available, this impulse may more readily manifest into suicide.
why is it important that we focus efforts on relieving anxiety?
because anxiety disorders are starting to become the most prevalent in the world because the general level of even non-diagnosable anxiety is increasing
why does the body begin to shut down in anorexia?
because it doesn't know why its starving, only that it is
why can taking sleep aids in response to a sleep disturbance be counterintuitive?
because it may lead to rebound insomnia after the meds stop being administered, which leads to more meds, which leads to more rebound insomnia, ...
why is establishing a certain weight as a cutoff for anorexia problematic?
because it precludes individuals who are exhibiting clear symptoms without hitting this exact weight from receiving a diagnosis and treatment/benefits
why is expressing that you feel like a burden to others a major warning sign for suicide?
because it removes the barrier of living for others that often keeps people from committing suicide
why are some mothers confused about getting peripartum depression? why shouldn't they be?
because its supposed to be a joyous time, but they forget that having a kid is accompanied by life changes, new schedules, exhaustion, hormonal drops, CRF in the placenta, etc. that can all contribute to depression
why is the depressive cognitive symptom of thinking that everyone would be better off without you so dangerous with respect to suicide risk?
because many people avoid suicide because others may depend on them/be negatively impacted by their loss. If they feel as though others would be better off without them, this barrier is removed.
why is research on SSD limited?
because of the recent reclassification/establishment of this class of disorders in the DSM-5
how is hunger both physical and psychological?
because our body sends us hunger messages, but how we fulfill those messages depends on context, learning, and the emotions associated with certain eating behaviors e.g. breakfast vs. dinner food foods that we grew up with make us feel better some foods are just more pleasurable
why is EMDR controversial?
because some people assert that the eye movement is merely superficial and that the exposure to the images is what's really helping
how does dieting lead to weight gain?
because the lack of food may lead to cortisol spikes and withdrawal symptoms that prompt a binge eating episode
why do adoption studies for schizophrenia last so long?
because the researchers have to wait until the subjects hit adulthood to make sure that any schizophrenia that will happen has happened
why is mania egosyntonic?
because the things that we feel during mania are frequently interpreted as being consistent with our own values, ideas, and beliefs
why does reassurance often work in treatment plans for somatic symptom disorders but not in everyday clinical settings?
because the treatment-focused version provides the kind of repeated, comprehensive assurance that these patients often need (attends to any outlying concerns, digs into the cause of the symptoms), whereas most clinicians don't have time to get into this level of depth.
why is the "must be real life" indicator a part the diagnostic criteria for PTSD?
because the writers of the DSM-5 wanted to ensure that the trauma in question was something truly inescapable (even though the modernized inescapability of the modern world makes this distinction kinda pointless)
why do children whose parents don't have schizophrenia get it anyways?
because there are often dormant genes in their parents that weren't expressed
why are increased risk taking behaviors and impulsivity warning signs for suicide?
because they (A) signify that a person no longer cares for their own safety, and (B) may feed into the impulsivity that often manifests in suicide
why are adolescents at such high risk for developing eating disorders?
because they are experiencing hormonal swings because peer influence over sense of self becomes influential during this age and behaviors because they are developing, and may see normal development as "getting fat" because their is an increased desire to be attractive
why might some people report their depression as somatic symptoms?
because they may come from a culture where depression is unacceptable/seen as a sign of weakness, thus making reporting somatic symptoms a favorable alternative
why are severe agitation and insomnia warning signs for suicide?
because they may lead to heightened distress, which increases the likelihood of suicide via the impulsive desire to get rid of said distress
Why was attenuated psychosis syndrome added to the DSM-V?
because this addition sheds more light on people for whom psychotic symptoms haven't fully set in yet (and who thus may be helped more by treatment/early intervention)
why are forced debriefings often necessary
because, in the case of crimes, victims have to relive the experience as quickly as possible to maximize the chance of police detaining the perpetrator
why is Bulimia predominantly experienced by women?
because, while bingeing and related symptoms aren't uncommon in men, the use of compensatory behaviors are (or at least they're less obvious (e.g., throwing up after binge drinking, even if a purge of sorts, won't appear that way))
why does treatment for bipolar disorder differ from treatment for depression?
because, with bipolar disorder, you also have to control manic symptoms, meaning that mood stabilizers, rather than pure antidepressants, are needed.
as psychological disorders _____________, the risk of suicide increases
become more severe (may lead to increasing distress, which may generate feelings of hopelessness that lead to suicide)
what kinds of drugs (2) are administered to individuals with insomnia? What are the two general categories of the first type of drug?
benzodiazepine and related drugs also drugs like Rozerem that directly act on melatonin short-acting and long-acting
what are the two major subtypes of anorexia?
bingeing-purging and restricting
what is the integrated theory of etiology for depression?
biological vulnerabilities + psychological vulnerabilities + stressors -> depression onset
sleep deprivation can help people with _____________ by ___________, but only under certain circumstances. This suggests that ____________. Additionally, it is also vital that, for these individuals, the deprivation is monitored closely, considering that it can easily trigger _____________.
bipolar disorder improving their depressive symptoms suggests that the brains of people with bipolar are structured/function differently during sleep can trigger a manic episode
somatic symptom
bodily symptoms: pain, fatigue, motor problems
people with eating disorders have a distorted ___________
body image
how long do schizophrenia symptoms need to be around for diagnosis?
book says 1 mo. Dr. Bonior says 6
how is complicated grief treated?
by having the person reexperience the death under supervision. They talk about the person, how it felt when they died, their emotions, and slowly come to accept the passing and associate positive emotions with the experience of grief.
how can prevention of eating disorders be achieved?
by spreading messages of body positivity, promoting normal eating behaviors, and encouraging adults to be careful with the messages that they impart upon their children
what is the time span of PTSD onset?
can be gradual, but usually it's acute (one instance of trauma resulting in onset)
fear of the unknown
can be rather common, but some individuals fear the unpredictability of the world to such an extent that it primes them for an anxiety disorder
prognosis of separation anxiety disorder
can extend into adulthood in 35% of cases if left untreated
how can IPT help with eating disorders?
can help to repair the strained romantic, familial, and social relations that often arise due to eating disorders
disorder of arousal
category of sleep disorder during NREM sleep that includes sleepwalking and sleep terrors (and incomplete awakenings)
attenuated psychosis syndrome
characterized by psychotic-like symptoms that are less severe and more transient and that lie below the threshold for a full psychotic disorder
smothering, overprotective parenting can lead to _____________________
child never developing initiative and feeling helpless, which may increase their vulnerability to depression down the road.
selective mutism (description and time frame)
childhood anxiety disorder lack of speech in an area/context where speaking is socially expected (usually in a "select" few) must be more than a month, can't be first month of school
reactive attachment disorder
children become unable to form new attachments with others following a traumatic experience
how do social and cultural influences contribute to conversion disorder?
choice of conversion symptom at least partially influenced by those seen in family members growing up low SES and education groups more likely to exhibit CD
what is the general course of schizophrenia?
chronic (even with treatment, mild to severe impairment is expected for the entirety of one's life)
how can CBT be used to treat eating disorders?
cognitive - focuses on counteracting the distorted body image, building self-esteem independent of weight, behavioral - focuses on mitigating the behavioral patterns that lead to binges and implementing coping strategies/hobbies that can help one to take their mind of bingeing when the feeling hits.
what are the five forms of psychological treatments used for insomnia?
cognitive, guided imagery relaxation, graduated extinction, paradoxical intention, progressive relaxation
narcolepsy
daytime sleepiness in addition to cataplexy (sudden loss of muscle tone, ranging from facial weakness to full-on collapse) because of sudden onset of REM sleep (sleep attack). sleep paralysis and hypnagogic hallucinations may also be common
what is the one subtype of PTSD?
delayed onset (PTSD comes on after years of trauma)
what are the four schedules of circadian rhythm disorders
delayed sleep phase advanced sleep phase irregular sleep phase (all over the place) non-24 hour (moves a bit every day)
positive symptoms of schizophrenia
delusions and hallucinations
psychotic
delusions and hallucinations
psychotic disorder associated with another medical condition
delusions caused by Huntington's and/or Alzheimer's disease (or a brain tumor)
what are some other dissociative disorders (2, 1 subtype)?
depersonalization-derealization disorder dissociative amnesia (subtype: dissociative fugue)
how is the sleep of depressed patients disturbed? how does this contribute to depression?
depressed patients tend to fall into REM sleep faster, meaning that they are getting less restful sleep they also tend to experience more intense REM sleep, signifying poorer quality of sleep poor sleep quality can be indicative of depression; at the same time, depression, as seen above, can lead to poorer sleep; this constitutes yet another vicious cycle
with respect to building blocks vs. standalone disorders: depressive episodes are ___________ ? manic episodes are __________ ? hypomanic episodes are _________?
depressive episodes are both (a Major Depressive episode is a building block for a number of mood disorders, but Major Depressive Disorder is itself a mental disorder defined by the presence of a major depressive episode. manic episodes are still both, seeing that unipolar mania can be a disorder, but it is far rarer than unipolar depression/Major Depressive Disorder. Thus, its more often used as a building block for other disorders. hypomanic disorder is, by definition, not impairing, and thus cannot be a disorder. Rather, it is a building block for disorders like Bipolar II
mixed features specifier
depressive episodes with at least three symptoms of mania
atypical features specified depression usually leads to ____________
diabetes
what does therapy for OCD generally focus on?
disconnecting the thought-action fusion
what are the 7 disorganized symptoms associated with schizophrenia?
disorganized speech loose association cognitive slippage tangentiality inappropriate affect catatonia waxy rigidity
what happens when distress tolerance is too low?
distress intolerant people can't stand uncomfortable feelings, so they avoid them at all costs
circadian rhythm sleep disorder
disturbed sleep (either insomnia or excessive sleepiness during the day) brought on by the brain's inability to synchronize its sleep patterns with the current patterns of day and night
how to talk to a friend with an eating disorder?
don't reduce them to a body by only talking about their weight, shape, size, etc. treat them like a person, express your concern, get an extra (or an expert) opinion, etc.
Which neurotransmitter systems is the CRF system related to?
dopaminergic, GABA-benzodiazepine, serotonergic, noradrenergic
how can biological implements and environmental elements contribute to insomnia?
drug use changes in light, noise, or temp major changes in environment (e.g., in a hospital) all may lead to disrupted sleep
when is schizophrenia most likely to develop? why?
early adulthood/late adolescence, seeing that this period is generally when our predispositions start to come to the surface can occur in children in very rare cases
how can nature help with anxiety
either going into nature (walking in the forest) or bringing it to you (houseplants) can help with anxiety (we may be evolutionarily primed, seeing as though our ancestors would have been rather comfortable in nature).
ECT
electroconvulsive therapy; a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient
what may be inherited that contributes to eating disorders?
emotional instability and/or impulse control problems, leading people to respond more emotionally to things, and thus be more prone to falling into binges (also won't be able to stop as easily because of the impulse control stuff)
what are the primary medical concerns of bulimia?
enamel in teeth eroding from constant exposure to stomach acids imbalanced electrolytes and dehydration from purging kidney, cardiac, and intestinal problems (both because of rapid fluctuations in stomach contents and because of the dehydration) salivary gland enlargement
with respect to the contributions of genetics and the environment to depression are concerned, how do these levels change over time?
environmental contribution tends to increase with age
what kind of ketamine can help with depression? How does this treatment help? what is a downside to this treatment?
esketamine; administered nasally; it may alter glutamate levels; the benefits may not last very long.
sleep hygiene techniques
establishing a set bedtime developing a regular sleep and wake time go to bed only if sleepy and get up if you can't sleep after 15 minutes avoid: caffeine, alcohol, tobacco, fatty foods, exercising before sleep, noise and light in room, extreme temp changes do: milk, healthy diet, regular exercise, natural and bright light during day
C-PTSD
exhibition of trauma related symptoms without fitting into the clinical description noted in the DSM
explanatory therapy
explain the nature of the disorder, how focus on the body leads to exaggeration of symptoms; explain that healthy people also experience symptoms from time to time in a word, educating the patient about the underlying reality of their condition
risk factors for suicide - definition
factors that are associated with higher suicide rates
what part of insomnia do women have a harder time with? Why?
falling asleep, potentially because of hormonal differences or differential reporting of sleep problems
how can your family's genetics influence your PTSD risk?
family history with anxiety is associated with higher rates of PTSD
how can your family psychologically predispose you to getting PTSD?
family instability may lead a child to see the world as uncontrollable, leading to a generalized psychological vulnerability
how can social time help with anxiety?
feeling as though we are integrated within a society can safeguard us from anxiety (number of social contacts doesn't matter as much as feeling that you are connected)
what are the primary medical concerns of anorexia?
feeling sensitive to cold, developing lanugo (to insulate from the cold, decreased fertility, disappearance of periods, heart problems, low blood pressure and heart rate, death from starvation
what were some of the
feeling superior, speeding, impulsivity, writing really hard, feeling everyone else is moving too slow, lower sensitivity, increased appetite, increased sexual activity, can't calm down, can't make decisions, etc.
what are the cognitive symptoms associated with depression?
feelings of helplessness feelings of worthlessness feelings of hopelessness difficulty making decisions difficulty concentrating feeling as though everyone would be better off without you (particularly high suicide risk)
How can pre and perinatal exposures influence schizophrenia?
fetal exposure to a virus (especially influenza) and complications in pregnancy (bleeding in the womb) and/or delivery (e.g., asphyxia) can lead to higher risk of schizophrenia these may activate an individuals genetically predisposed vulnerability to schizophrenia
hormones and binge eating
fluctuations may lead to binge eating
what is the general form of selective mutism treatment?
focuses on CBT involving social mishap exposure, but the social mishap is focused on speech (forces them to face what will really happen if they speak in a given environment via gradual exposure to speech in that environment) some approaches focus on modeling (seeing what happens when other children speak shows them that its not that scary), some use reward systems for speech, group time, etc.
Psychodynamic therapy for depression
focuses on building a close bond with the patient as a means of getting to the source of Depression (the original stressor/trauma), and then attempting to resolve this source
cognitive treatment of sleeping disorders
focuses on changing one's unrealistic expectations about their sleep (e.g., I HAVE to get 8 hours or I can't function). also may help to mitigate anxiety regarding sleep. Includes education concerning the normal amounts of sleep and how to compensate for lost sleep.
CBT for depression
focuses on combating/challenging the depressive thought patterns in order to change them (e.g., reminding yourself that reality is not as bad as your brain is making it out to be) also focuses on engaging in the behaviors that help to mitigate depression (going outside, cultivating friendships, exercising, etc.)
Adlerian Therapy
focuses on the process of goal setting and becoming our ideal selves. Also highlights the reality that often times, our own thoughts, even unconscious ones, can keep us back, lighting the way to getting past these thoughts and our depression
anorexia tends to be far less prevalent in countries where ________________
food isn't as available and beauty standards aren't as weight-centric
Acceptance and Commitment Therapy
for some people, fighting the negative thoughts associated with depression doesn't work ACT focuses on accepting these thoughts, rather than challenging them Doesn't assert that the thoughts are true, but rather that they are largely harmless, and can easily be moved past (after all, negative thoughts don't cause depression in and of themselves, but rather the obsession over these thoughts because they are seen as dangerous).
what treatment is ineffective/harmful when it comes to PTSD?
forced debriefings, because they recreate the helplessness of the traumatic event by forcing the patient to discuss their trauma before they're ready to do so
The course of bulimia is _________ without treatment
generally chronic
how can genes influence experiences with schizophrenia?
genes are certainly responsible for some vulnerabilities to schizophrenia (diathesis-stress model), but the type of schizophrenia exhibited by the patient may not match the type exhibited by family members
what are the four types of delusions?
grandeur - I am God/have supernatural powers, persecution - everyone is out to get me, Capgras - someone close to me has been replaced by an imposter, Cotard's - something is wrong with my body (lost a limb, organs, blood); I am dead/have lost my soul
cigarette smoking as a teenager is associated with _______________
greatly increased risk for developing anxiety disorders as an adult (especially panic disorder (15x) and GAD (5x))
how can probiotics help with anxiety?
gut health is increasingly being tied to mental health more serotonin is synthesized in the gut than in the brain thus, maintaining probiotic health can help to mitigate anxiety
Gestalt Therapy
has the goal of helping the client become aware of his or her thoughts, behaviors, experiences, and feelings and to "own" or take responsibility for them
with respect to temperature, people with insomnia ______________
have higher and more consistent body temperatures than good sleepers
people with delusional disorder tend not to ___________
have negative symptoms, but can still become socially isolated
what did Freud believe about the etiology of somatic symptom disorders (2 things)?
he believed that these disorders were caused by conversion hysteria; conversion was kept, hysteria (stigmatized) was dropped. also blamed neuroses (ego defending itself against unconscious tension), but this was dropped because its too vague
how is the endocrine system implicated in depression? how does its role represent a cyclical worsening of depression?
heightened cortisol production is often associated with depression risk when this cortisol production (and that of other stress hormones) is sustained, it can inhibit neurogenesis within the hippocampus when the hippocampus is damaged in this way, it becomes unable to turn off the stress response, leading to more stress hormones being produced, further inhibiting the hippocampus, and so on. this inhibited hippocampal neurogenesis is often associated with depression.
BED tends to be comorbid with ________ , _______, and __________
higher levels of emotional fluctuation, mood disorders, and anxiety disorders
OCD related disorders
hoarding, excoriation, trichotillomania, body dysmorphic disorder
what are some of the culturally-specific causes behind eating disorders
how a culture defines "Thin" how a culture defines the ideal body what people in a culture believe is most attractive to others
what are the psychological etiological factors of depression (5)?
how we interpret our stress/trauma reciprocal gene-environment model cognitive errors depressed attributional styles learned helplessness
how does interpretation play a role in depression?
how we interpret stressful vs. traumatic events can determine whether or not they result in the onset of diagnosis/the worsening of symptoms. "it made me stronger" vs. "the world is an uncontrollable, evil place and we can't do anything about it"
most treatment plans for conversion disorder focus on ____
identifying the underlying trauma and resolving it, maybe by reliving it (catharsis)
melancholic features specifier
if full criteria for major depressive episode has been met: many of the more severe somatic symptoms are present, such as: - early morning awakenings - decreased libido - weight loss - excessive, inappropriate guilt - anhedonia especially severe episode
how might the biological clock be related to the cause of insomnia?
if it can't regulate temperature properly (body temp doesn't drop until later at night), people may not be able to fall asleep/become drowsy until later on
how can social experiences influence SSD?
if one grew up in an environment where a sick individual got a lot of praise and attention, they may develop an SSD to gain the benefits of being ill.
how might insomnia causes present in children (4 factors)?
if parent's have negative attitudes about sleep (or depression), it may be imparted upon their children if children learn to sleep only with parents around, it may be harder when they're not unmet demands (e.g., no comfort from crying) can lead to disturbed sleep as well (via stress) overmet demands (too much positive attention when they wake up in the middle of the night may incentivize it)
how can parenting negatively contribute to anxiety?
if parents are overprotective, over-intrusive, and always "pave the way" for their kids (never allowing them to experience/cope with adversity), a sense of uncontrollability is developed, worsening anxiety.
how can parenting positively contribute to anxiety(2)?
if parents consistently respond to their child's needs when they are expressed, the child learns that they have some level of control/influence over the environment. if parents provide a safe home base, but still give their children opportunities to explore new experiences and develop coping skills when things don't go their way, this sense of control is emboldened. This sense of control can mitigate some of the uncontrollability that frequently leads to the apprehension fueling anxiety.
how might families influence one's experience with eating disorders?
if parents have a distorted image of food, they may pass this down to their children, imparting unhealthy eating behaviors and maybe even malnutritioning their children
how can learned responses cause insomnia?
if we associate the bedroom with the frustration and anxiety of insomnia, these feelings may generalize to the act of sleeping, preventing us from doing so.
how does social support play a role in depression risk?
if we see ourselves as integrated within our communities/supported by our social system, our risk for depression and/or the severity of our depressive symptoms falls off drastically.
how might cognitive factors cause insomnia?
if we think that we are not well-rested, then we'll feel it (rigid expectations about "proper" sleep).
how may postponing binges help to mitigate the allure of bingeing?
if you wait out the worst of it, you may slowly start to feel like its not that bad over time, and may begin to realize that you can control your binges.
how does the psychological aspect of hunger differ among people with eating disorders like anorexia and bulimia?
in anorexia, people may ignore their hunger cues for so long that they disappear or even become a positive phenomenon. in bulimia, people may ignore their fullness cues until they disappear.
where is disgust proneness most common?
in disgust-centric anxiety disorders (snake phobias, cockroach phobias, etc.)
seasonal pattern specifier
in major depressive and bipolar disorders, episodes only occur during certain seasons
aphantasia
inability to form mental images
tangentiality
inability to get to the point of communication due to introduction of many new topics
what is the likely cause behind the decreasing incidence of conversion disorder?
increased knowledge of the real causes of physical symptoms by both patients and loved ones eliminates much of the secondary gain often associated with the disorder.
when people's eating patterns are more rigid, _______________ tend to occur
increased stress concerning deviations, a more negative body image, and higher risk for eating disorders
as age increases, complaints regarding sleep problems ______
increases, plateaus around 65 and may begin to decrease slightly
the prevalence of mood disorders has been ____________________
increasing over time, especially during the COVID-19 pandemic
stimulus control for sleep disorder treatment
instruction to limit what you do in the bedroom to sleeping and sex
tardive dyskinesia
involuntary movements of the facial muscles, tongue, and limbs; a possible neurotoxic side effect of long-term use of antipsychotic drugs that target certain dopamine receptors
describe the role of social support within PTSD
it can protect us from PTSD in the face of trauma however, seeing that social isolation often accompanies trauma, and that most high-trauma groups (e.g., military) have stigmatized reaching out for help, the effectiveness of this social support is highly diminished.
how can looking at the bigger picture help with anxiety?
it can stop sufferers from getting caught up in the countless factors and details that bombard them on a daily basis, and can help them to direct/simplify their lives in the direction of larger goals.
how does peripartum depression specifier alter treatment, outcome, etc.?
it doesn't, its mainly just a contextual specifier
how can outdoor time help with anxiety?
it gets us away from our screens, into the daylight
how can body movement be beneficial in helping with anxiety? What other disorders can it be effective against?
it has a similar effect as SSRIs, especially when it raises one's heart rate can also be effective against depression and dementia
what have SPECT studies found with respect to Schizophrenia? what does this imply?
it has found that the auditory hallucinations of individuals with schizophrenia are associated with a lot of activity in Broca's area, which is responsible for speech production this implies that their auditory hallucinations may just be words that their brain is generating, that aren't spoken, and that are heard by the patient
how does learned helplessness relate to depression?
it increases the risk of depression, and is, in turn, made worse by depression
How does the corticotropin releasing factor system relate to anxiety disorders?
it is central to the expression of anxiety and depression
what is happening to the relationship between sexuality/gender identity concerns and suicide rates?
it may be weakening as society becomes more accepting of different sexual orientations and gender identities however, this is culturally dependent
how may eating disorders manifest differently for men?
it may present as muscle dysphoria and/or "bigarexia", with the ideal body type of "big and muscular" pushing men to (A) overobsess over their weight and size, and (B) focus on making themselves bigger and more muscular, rather than thinner (like women).
how is PTSD unique?
it requires a specific event to occur for a diagnosis to be made (trauma)
what is true about expressed emotions across cultures?
its content may differ (what is seen as hostile and critical in one culture may be interpreted as supportive in another) this suggests that perhaps EE isn't a cut-and-dry causal factor of schizophrenia
what are the emotional symptoms associated with depression
its not just feeling sad all the time. Rather, its more like an all-consuming numbness/disconnect from your emotions that prevents you from feeling pleasure and/or taking interest in anything (anhedonia) can manifest as sadness, irritability, numbness, etc.
what does "self care" really entail?
its not just the extravagant bi-annual trip you take to a spa, but rather the everyday, mundane actions that you can take to safeguard your mental health from anxiety.
schizophreniform disorder
like schizophrenia, but only 1-6 months long usually has a better course than schizophrenia if caught early no blunted or flat affect
which area of the brain is most often associated with anxiety?
limbic system, which acts as an intermediary between the brain stem and the cortex (brain stem senses changes that could be threats and sends these potential danger signals to the cortex for higher processing via the limbic system).
Mr. Jones
lost his wife, has sex twice per week, concerned, seen as relatively normal
what may be a common theme among families of Bulimia patients? how might this theme represent a bidirectional relationship with the disorder itself?
lots of outward conflict may be intensified by the guilt and frustration that parents feel because of the eating disorder
where is conversion disorder most common (demographics)
low SES, low education groups where disease knowledge is limited shows social influence on conversion disorder
how does SAD influence cognitive factors?
makes us more reactive to light, with low-light being associated with lower mood
Factitious disorder vs. malingering
malingering is when symptoms are faked for some express external motivation factitious disorders, on the other hand, see symptoms faked for a more unknown reason
why may suicide statistics be underreported?
may be miscategorized as accidents may be covered up to protect reputation of the deceased from stigma
residential treatment and eating disorders
may be needed if weight is getting dangerously low or situation at home is particularly severe here patients are constantly supported and helped to get their weights back into safe ranges, then put into treatment they are introduced to regular, structured eating they are also often taught coping mechanisms and introduced to calming hobbies
how can abuse and neglect lead to suicide?
may lead to PDs that lead to suicide may increase distress and feelings of helplessness that lead to suicide
how can substance abuse lead to increased suicide risk?
may lead to impairment that generates feelings of helplessness and hopelessness provides the means of suicide
what is the best treatment for the psychotic symptoms of schizophrenia?
medication (antipsychotics/neuroleptics)
enlarged ventricles are more common in:
men with schizophrenia older people with schizophrenia people with schizophrenia who had prenatal influenza exposure people who have had schizophrenia for longer
social stigma may lead ________ to exhibit their depression symptoms as ________
men; as anger, substance abuse problems, difficulties at work, etc.
marital dissatisfaction plays a bigger role in the depression risk of ___________
men; marriage is generally more important to men's mental health
what factors may help women get better sleep over men?
moderate alcohol and caffeine use, Mediterranean diet
one of the more influential psychological components of eating disorders is _________ intolerance
mood strong aversion to uncomfortable feelings may lead to seeking solace in food (binges), exercise/purging/laxatives/etc. (compensations), or self-restraint (especially in anorexia)
what are the two types of psychotic features that one can experience within the psychotic features specifier?
mood congruent and mood incongruent
compared to bulimia, the course of anorexia is more ___ and ___. Why?
more chronic and more resistant to treatment this is because its harder to get those with anorexia into treatment
how does the anxious distress specifier influence course and outcome?
more severe condition, more suicidal thoughts and commitment, poorer outcome
major depressive episode (DSM)
most of the day, nearly every day, for 2 weeks or more: - cognitive symptoms - physical symptoms - emotional symptoms
what obsession is an ordering/arranging compulsion usually associated with?
need for symmetry
what disorders are classified as parasomnias?
nightmare disorder, disorder of arousal (including sleep terrors, sleepwalking, and incomplete awakening), nocturnal eating syndrome
is the host alter often the same as the original personality?
no
does the mere occurrence of a stressful event lead to heightened risk for depression?
no, but if the person interprets the stressor as a negative phenomenon and their context reinforces this interpretation, then it might generate the heightened stress necessary to activate a genetic predisposition
are the compensatory behaviors of bulimia actually effective? what does this lead to?
no, considering that most of these behaviors can't do anything about the energy that's already been absorbed from a binge. This leads to people with bulimia gaining weight over time, making them feel even worse about themselves/even more out of control, thus leading to more binges.
is debriefing a traumatic event always bad?
no, it can be beneficial if the patient is in charge of the process and takes it on at their own pace
does separation anxiety disorder onset only occur in childhood?
no, it can occur in adulthood, and has the same symptoms
is depression the only mood disorder frequently characterized by sleep disturbances?
no, most mood disorders involve sleep disturbances of some kind.
do only women experience peripartum depression?
no, present, though less common, in fathers too
is the cause of somatic symptom disorders usually attributable to biological or psychological causes alone?
no, there isn't a smoking gun
sleep hygiene
nonpharmacologic recommendations that help an individual get a better night's sleep
euthymia
normal range of moods and emotions
is EMDR potentially dangerous?
not as far as we can tell
is malingering a psychological disorder?
not necessarily
bingeing-purging anorexia
not the same kind of bingeing as is seen in bulimia rather than feeling out of control and eating a lot of good, people with this subtype of anorexia don't feel out of control, but rather just feel as though they've eaten a lot (even if they haven't), and attempt to compensate for this belief.
will reactive attachment disorder and disinhibited social engagement disorder go away on their own?
not usually
how do reports of sleep problems manifest in children?
not wanting to go to sleep, throwing tantrums
contrary to popular belief, people with eating disorders are actually _____________
obsessed with food their body is deprived, and they want what they've told themselves they can't have, so they reconcile by always being around food (anorexia) for bulimia, the all-encompassing cycle that defines their life is defined by food
orthorexia
obsession with what one sees as "healthy eating" to the point that it impairs their life (e.g., won't go out to eat, even for a special occasion, because they fear that there won't be any healthy options)
three types of breathing related sleep disorders
obstructive sleep apnea hypopnea (characterized by snoring, snorting/gasping, or breathing pauses during sleep (airflow stops, keep on breathing)) central sleep apnea (stop breathing); sleep related hypoventilation (decreased respiration associated with elevated carbon dioxide levels (airflow slows, breathing keeps going, not enough air exchange with environment leads to elevated CO2)).
source-monitoring error
occurs when a memory derived from one source is misattributed to another source e.g., you may have a memory of trauma that was planted in your mind by a therapist
depersonalization-derealization disorder
occurs when episodes of depersonalization and derealization occur so frequently and/or with such severity that it causes the patient distress and impairment
how frequently must one have bulimia binges for a diagnosis?
on average: >= 1/week for >= 3 months
shared psychotic disorder (folie a deux)
one person "picks up" another's delusion over time used to be its own thing, now included under delusional disorder
what do we think causes seasonal affective disorder (2 theories)?
one theory is that an overproduction of melatonin (occurs in low-light environments, seeing that high-light inhibits the production) activates depression in vulnerable individuals another is that our circadian rhythm is delayed in the winter, influencing our mood by misaligning our sleep-wake cycles with the day-night cycles
when is ECT used? what are some drawbacks?
only used to treat severe, treatment resistant depression may lead to temporary memory problems
illness anxiety disorder
originally called hypochondriasis in previous DSMs -severe anxiety concerning the possibility of having or acquiring a serious disease -actual symptoms are mild, if present at all - strong disease conviction (which leads to medical reassurance usually failing (they are convinced that something is wrong, and won't be told otherwise))
what were some of the cognitive errors pointed out by Beck as existing in people with depression?
overgeneralization - if one bad thing happens, this means that everything has gone wrong arbitrary inference - they make connections/come to conclusions that most people would regard as nonsensical
what were the main subtypes of schizophrenia (5)?
paranoid (lots of delusions of persecution) catatonic (lots of catatonia/unresponsiveness/waxy rigidity) disorganized (lots of disorganized symptoms) residual (still left with some schizophrenia after psychotic symptoms withdrew) undifferentiated (nothing special, just baseline schizophrenia)
what does an atypical features specifier mean with respect to gender, onset, course, and outcome?
patients with this specifier can generally feel some interest or pleasure more common in women earlier onset also tied to more symptoms that are more severe, leading to more suicidal attempts, and higher comorbidity rates
how does the diathesis stress model tie into PTSD?
people may have diatheses that make them more vulnerable to developing PTSD in response to triggers the higher the diathesis, the less trauma is needed for onset however, its likely that some experiences exist that are so traumatic that the diathesis is largely irrelevant, leading almost everyone to develop some degree of PTSD
how does the reciprocal gene-environment model play a role in depression?
people who inherit a genetic vulnerability to depression may also inherit personality traits that make them more likely to end up in situations that trigger their vulnerability. may make them more likely to end up in bad relationships, go through divorce, etc.
what are the three defining characteristics of anorexia? what do these lead to? what does this response lead to?
people with anorexia: -negatively evaluate themselves (either because of their belief that they are still overweight or because of what they hear from others) -have a distorted self-image (see themselves as overweight, even if they're dangerously under) -have an intense fear of gaining weight or being fat these characteristics lead to extreme restriction of food intake this response leads to significantly low weights
what personality-related factors may lead to eating disorders?
perfectionism and related personality traits (which may be inherited) may contribute to unhealthy rigidity in one's diet, contributing to eating disorders (especially Anorexia)
what are 8 methods of self-care that can help to manage anxiety?
physical movement going outside being in nature social time B-complex vitamins grounding oneself in the moment/mindfulness focusing on the bigger picture prioritize sleep
what are the three kinds of symptoms present in schizophrenia? what do these three generally refer to?
positive, negative and disorganized positive - something is present that shouldn't be present negative - something is missing that should be present disorganized - something is "off"
brief psychotic disorder
presence of one or more positive symptoms such as delusions, hallucinations, or disorganized speech or behavior lasting 1 month or less usually preceded by extremely stressful situations
what are the primary and secondary gains of conversion, according to Freud?
primary - relief of stress secondary - increased attention and avoidance of difficult tasks/responsibilities
dissociative amnesia
problems with memory retrieval/formation that aren't associated with a known cause (lack of sleep, malnutrition, neurodegenerative disorders, brain damage, etc.) when none of these are present, it is assumed that the person cannot remember the events because they were in the midst of a dissociative state when they occurred.
Munchausen syndrome by proxy
producing physical illnesses in another person (most often a child by a parent)
progressive relaxation, who is it best for?
relax the muscles to induce drowsiness best for people who can't sleep because of tension
obsessions
repeated, intrusive, and uncontrollable irrational thoughts or mental images that cause extreme anxiety and distress
Leonard from the Marriage Plot
rush of euphoria, being loved, keep the party going soon becomes out of control and concerning
what are some antiquated familial explanations for schizophrenia? how about some more modern ones?
schizophrenogenic mothers and double bind communication are now outdated modern studies identify expressed emotion of family as a risk factor that may lead to higher relapse rates in people with schizophrenia.
separation anxiety vs school phobia
school phobias are, accordingly, fear of something related to the school. Even with a school phobia, children can separate from their parents in order to go to other, non-school environments the same is not true for separation anxiety, where any form of separation leads to anxiety and fear
people with eating disorders tend to have lower levels of _____ and ______ (psychological)
self-esteem and sense of self-control the self-esteem may be because they tie their self-worth to their weight and shape, and the self-control may worsen and be worsened by the out of control binges that they experience
synesthesia
sensory wires are crossed, leading to experiences of one sensation being expressed in terms of another (hearing colors, seeing smells, etc.)
what is the main neurotransmitter implicated in depression/mood disorder vulnerability? how does this neurotransmitter impact functioning in a way that leads to this vulnerability?
serotonin when serotonin is low, it is less effective at regulating norepinephrine and dopamine levels, leading to these neurotransmitters varying more widely, leading to the diminished mood regulation associated with mood disorders.
which neurotransmitter is most implicated with binge eating? describe the relationship between the behavior and the NT.
serotonin while lower levels of serotonin may contribute to binge eating, binge eating may also lead to lower serotonin levels
cognitive treatments for children with sleeping disorders
setting a bedtime routine
what is most often involved in the etiology of DID? how does this factor lead to DID?
severe childhood trauma, which leads the child to "escape into their own mind" and generate an alter to take their place. after this strategy works in this instance, it is more likely to be deferred to whenever the subject undergoes a significant amount of distress.
what is the relationship between mood disorder severity and heritability?
severe mood disorders are generally more genetically influenced
restricting anorexia
severely limiting food intake
over time, the gender imbalance of depression diagnoses has __________. Why?
shrunk; its becoming less stigmatized for men to talk about their mental health (there are certainly other reasons too, but stigma is a big one)
hypersomnolence disorder
sleep dysfunction involving an excessive amount of sleep that disrupts normal routines (often subjective, seeing that sleep deprivation isn't causing any issues)
why is the life expectancy for schizophrenia patients ______________ ?
slightly below average its because of a number of factors, including increased suicide rates, increased accident rates, poorer self-care, substance abuse, or homelessness
which anxiety is most implicated with selective mutism?
social anxiety disorder, seeing that the selective lack of speech isn't caused by an inability to do so, but rather by social anxiety high rates of comorbidity
kyol goeu is a culturally specific ______________ among the people of ______________
somatic symptom disorder, Khmer people of Cambodia
severe events precede all types of depression, except ________________________________________________________
some melancholic or psychotic specified patients (depression without a precipitating life event)
how can websites, social media, etc. alter one's experience with an eating disorder?
some online communities can serve as echo chambers for those struggling with eating disorders, incentivizing, rather than discouraging, the disordered behaviors because of how widespread the internet is, its impossible to escape the cultural messages that often generate the overwhelming obsession with one's weight and shape
describe the integrative model behind sleep disorders
some people may be genetically predisposed to disturbed sleep (light sleeper, family history of sleep disorders) sleep stress are events that negatively effect sleep (e.g., caffeine and alcohol usage) genetic predisposition interacts with sleep stress to generate poorer sleep overall (reciprocal influence) if a disturbance occurs and leads to maladaptive reactions (napping, medication usage, parents being too attentive), this may worsen the disturbance, leading to more maladaptive reactions, and generating more sleep disturbance.
how can psychosocial influences lead to schizophrenia?
some stressors, like living in an urban environment, participating in combat, etc. may increase one's risk of developing schizophrenia (can also lead to worsening symptoms) psychosocial stressors (e.g., averse childhood, urban childhood, membership in a minority group, migration to a new country, homelessness, etc.) can influence the onset and development of schizophrenia
what are some other methods that may be effective in treating somatic symptom disorders
stopping patients from seeking constant reassurance from doctors teaching people to relate with others on the basis of things other than their conditions removing any benefits that may be associated with being sick
how can psychological factors lead to insomnia?
stress may decrease one's ability to sleep
how is the relationship between stress and depression bidirectional?
stress triggers depression, and depression leads individuals to seek out or create stressful events
what are the six major etiological factors behind insomnia?
stress; changes in light, temp, or noise; drug use; temperature regulation/fluctuation problems; cognitions about sleep, learned anxiety and frustration in the bedroom
what treatments are used for separation anxiety disorder?
structured treatment involving parents, often with a therapist in an earpiece instructing the parents on what to do if the child begins to resist separation (real-time coaching)
Other Types of OCD-Related Disorders
substance/medically-induced OCD due to another medical condition specified OCD (Koro)
dissociative fugue
subtype of dissociative amnesia that focuses on an absence of memories surrounding travel disorder in which one travels away from home and is unable to remember details of his past, often including their identity
what are potential biological causes behind delusional disorder?
suspiciousness, jealousy, and secretiveness may be more common in the families of those with delusional disorder.
flight of ideas
symptom of mania that involves an abruptly switching in conversation from one topic to another
warning signs of suicide - examples (8)
talking about their own suicide, directly or indirectly having a suicide plan tying up loose ends and giving away their belongings increased risk taking or impulsive behaviors severe hopelessness severe shame feeling like a burden to others severe agitation or insomnia
according to the DSM, do you need both O and C for OCD?
technically, you just need one, but in the predominant majority of cases, both are present
paradoxical intention
tell people to try to stay awake as long as they can, reducing the performance anxiety associated with falling asleep
what is the message behind the Normal and Abnormal sex behavior discussion?
that a lot of contextual factors can influence how "normal" we perceive a situation to be, and that this determination may differ strongly from person to person.
what kind of messages must adults avoid imparting upon their kids with respect to eating?
that certain foods are bad and that you should feel bad for eating them and avoid them at all costs (things can be treats, you don't have to shame your kids out of eating)
what do twin studies tell us about mood disorders?
that concordance rates for identical twins are two to three times higher than for fraternal ones, indicating a genetic contribution
what is true about depression treatment, with respect to drug and therapeutic treatments?
that drugs alone are generally not enough for mild to moderate depression, therapy is better for severe depression, a mix of the two is best at any level, the addition of therapy to a treatment plan leads to better outcomes
what was the message behind the story of the freshman who came to Dr. Bonior for help with her roommate?
that sometimes, just talking about and reflecting on one's own interests and values can help to reconnect someone with their own life, leading to re-engagement and heightened interest that can help to counteract mild anhedonia
what part of the limbic system is influenced by CRF? What is another name for this system?
the CRF, along with serotonergic and noradrenergic pathways, activate the septal-hippocampal system, which is part of a circuit leading from the limbic system to the cortex that is associated with anxiety This circuit is called the Behavioral Inhibition System
compensatory behaviors of bulimia (give the five examples in addition to the definition)
the actions that a person with bulimia believes will make up for the excessive caloric intake of a binge most common compensatory behaviors are: purging excessive exercise laxatives diuretics fasting
host alter
the alter which is the most responsible, caring, and aware of the subject's condition, and thus which is most likely to bring the subject in for treatment
koro, where does it show up? why in this culture specifically?
the belief, accompanied by severe anxiety and sometimes panic, that the genitals are retracting into the abdomen occurs mainly among Chinese males, perhaps because Chinese culture places central importance on the sexual functioning of males (excessive masturbation, unsatisfactory intercourse, or promiscuity may lead to guilt/intense focus on genitals that leads to koro).
what is one of the potential reasons behind factitious disorders?
the benefits of a sick role (less responsibilities, more empathy and attention, etc.)
how do the cognitive patterns of depression resemble a cyclical pattern?
the cognitive errors predispose one to depression, which in turn, makes the cognitive errors more common/harmful
trauma
the definition is hazy, but one important aspect is the feeling of helplessness that people feel in response to trauma you feel that your life is in danger, but there's nothing you can do about it
Munchausen syndrome
the extreme and chronic form of factitious disorder, in which symptoms are not only faked, but genuinely created (for example, by poisoning)
what are the downsides of schizophrenia medication?
the first-generation medications were mostly dopamine antagonists, meaning that they often had side-effects like: Parkinson's-like side effects tardive dyskinesia also, compliance is hard because of the costs and side effects, and because of some delusions experienced by people with schizophrenia
anxiety sensitivity how does anxiety sensitivity play a role in triple vulnerability theory?
the general tendency to fear unexpected bodily sensations (anxiety over anxiety symptoms) combines with one's misinterpretation of these sensations as dangerous (specific psychological vulnerability) and one's inability to cope (generalized psychological vulnerability) to make anxiety way worse
describe how the gene-environment correlation model may influence schizophrenia
the genes that make one vulnerable to schizophrenia may lead to higher rates of pregnancy and delivery complications, which can, in-turn, activate the genetic predisposition to schizophrenia
learned helplessness
the hopelessness and passive resignation an animal or human learns when unable to avoid repeated aversive events (if they believe that they can't do anything to stop these events, then they will learn to stop trying, thus becoming helpless)
how is anorexia culturally influenced?
the ideals of beauty in a given culture largely influence how people see themselves, and if these ideals prioritize unobtainable thinness, then women may feel pressure that leads them to anorexia
Distress intolerance. What does it lead to?
the inability to deal with/strong aversion to uncomfortable feelings it leads to aversion, rather than management of, uncomfortable situations learning to overcome this aversion is key to treatment
what can knowing the specifier of major depressive episode tell a mental health professional?
the likely course and most effective treatments
what is a specifier of major depressive disorder applied to?
the most recent episode
the risk of inheriting a vulnerability to schizophrenia increases as ________________ ?
the number of genes that you share with the affected family member increase
what is the difference between psychotic/delusional grandiosity and that which is often present in manic episodes?
the two can often appear rather similar, but those which are native to mania aren't caused by false beliefs about reality, but rather by the brain simply going so fast that it can often overlook realistic considerations when it comes to making plans
why do adolescents have sleep problems?
their biological clocks shift forward, but they still have to be up ridiculously early in the morning
tics vs. compulsions two similarities
there is a lot of gray area/potential for overlap, but generally: tics are performed to scratch some sort of persistent itch compulsions are performed to deal with the anxiety most often caused by obsessions both are repetitive and impairing
how can psychedelics help with Depression? What must be the case if they are to be effective?
they (specifically psilocybin/magic mushrooms) open up our minds to new perspectives that help us to escape depressive thought patterns Must be administered in a highly controlled manner (you need a professional there to monitor you and work through the experience with you)
what do excoriation and trichotillomania represent with respect to OCD?
they are unique compulsions which can occur in response to obsessions or general distress.
how can massages and similar techniques help with anxiety?
they can help to ground one's tactile sensations in the moment and to relieve muscle tension
how can academic/disciplinary crises lead to increased risk of suicide?
they may mess with one's sense of identity/make one feel like a failure may represent a lack of achievement
what is the most common manifestation of arbitrary inference in people with depression?
they see everything as somehow being their fault, tying their actions, however unrelated they may be, to the occurrence of bad outcomes and seeing themselves as personally responsible for those outcomes.
warning signs of suicide -definition
things to be on the lookout for and potentially take action in response to if they appear in you or someone you know
endophenotypes of schizophrenia
those genes which cause the symptoms that are often associated with schizophrenia the smooth-pursuit eye movement gene is one (many with schizophrenia can't track an object smoothly across their field of vision) emotional identification genes
what other forms of treatment may help to supplement PTSD treatment?
those methods which help to reduce baseline anxiety (massages, outdoor time, B vitamins, etc.), seeing that this anxiety can often worsen the symptoms of PTSD
what is the difference between the delusions of a delusional disorder and the delusions of schizophrenia?
those of Delusional Disorder are somewhat realistic/possible, whereas those of someone with schizophrenia are generally rather bizarre also, schizophrenia generally requires more than one delusion for diagnosis
what are the three neurochemical abnormalities that have been associated with schizophrenia?
too much striatal Dopamine (D2) not enough prefrontal Dopamine (D1) altered levels of glutamate
what were the four basic processes underlying Freud's beliefs on the development of conversion disorder?
traumatic event leads to an unconscious conflict people then repress this conflict because it leads to too much tension and anxiety despite being repressed, the anxiety continues to grow, forcing the person to convert it into physical symptoms as a means of relieving it the individual receives attention and is allowed to avoid difficult tasks as a result of their physical symptom(s)
how may treatments for eating disorders work with respect to comorbidities?
treating the comorbidities that may be worsening eating disorders may help to mitigate them.
describe the causal sequence behind illness anxiety disorder
trigger leads to stress, which leads to more focus on the body more checking more arousal which leads to the "creation" of somatic symptoms which leads to preoccupation over those symptoms and their dangerous implications which leads to more focus, checking, and arousal which leads to worse symptoms etc.
Describe the etiological path to Panic Disorder and Agoraphobia that is represented by the figure on page 144 (triple vulnerability mode + standard course of events).
triple vulnerability model: generalized biological vulnerability - inherited vulnerability to stress and tendency to have a panic attack in response to stressors generalized psychological vulnerability - vulnerability to developing anxiety over having another panic attack specific psychological vulnerability - belief that unexpected bodily sensations are dangerous course of events: general biological an psychological vulnerabilities prime one to have a panic attack after this panic attack, the individual associates the interoceptive and external cues surrounding the panic attack with the discomfort of the attack itself (they become learned alarm cues) if these cues ever occur, the specific psychological vulnerability will lead to the individual experiencing anxious thoughts, which make the anxious sensations worse, cycling until another panic attack occurs because of this reality, individuals instead attempt to avoid panic attacks and develop anxious apprehension over the possibility of experiencing the cues that will lead to another panic attack this mix of maladaptive avoidance and anxiety over another panic attack define panic disorder if this avoidance is targeted at places where the individual may not be able to get help, panic disorder with agoraphobia may develop.
insomnia
trouble falling asleep or staying asleep
what is "normal eating"?
trusting your body about when you're hungry being flexible with your eating habits valuing food as an important, though not all-defining, part of life/your value system
what are the three key components of "normal" eating?
trusting your body and the hunger/fullness signals it sends you being flexible with your eating patterns and allowing for deviations from time to time allowing eating to be an important part of your life, but not the only important part
is sensitivity to threat unconscious or conscious? How do we know?
unconscious, Stroop paradigm shows that unconscious processing of threat-related words is slower in people with GAD
Unipolar vs. Bipolar
unipolar: manic or depressed bipolar: manic and depressed
which demographics are most likely to experience SSD?
unmarried, low socioeconomic status women
guided imagery relaxation, who is it best for?
use of mediation or imagery to relax people into falling asleep best for people that can't sleep because of tension
graduated extinction, who is it used for?
used for children with tantrums at bedtime and who wake up crying at night check on child after longer-and-longer periods until they fall asleep on their own
describe the bidirectional relationship between excessive phone usage and depression risk.
using your phone excessively can lead to depression via (A) comparison-/evaluation-centric use of social media, (B) blue light disturbance of sleep patterns, and (C) phone usage taking up time that could otherwise be used for depression-combating personal habits. additionally, depression can result in people using their phones more (staying inside more).
how effective are compulsions when it comes to managing anxiety?
usually only effective for a brief period of time
what are the brain structures tied to schizophrenia?
ventricles (larger in people with schizophrenia) frontal lobes (less active in people with schizophrenia (hypofrontality), especially the dorsolateral prefrontal cortex) hyperfrontality is also a possibility
how is ventricle size associated with schizophrenia?
ventricles are often very large in those with schizophrenia, indicating that some other structure has atrophied/not developed in order to allow for this growth
sleepwalking
walking or carrying out behaviors while asleep
integrated grief
we accept the finality of death and its consequences, and we adjust. bittersweet, positive memories of the deceased that don't take over our lives or impair our function emerge its okay to feel sad and have grief, maybe even hallucinate a bit, but you have generally moved on.
how can memories "drift" over time?
we begin to remember not the event itself, but rather our memory of remembering the event. With each iteration of this, the true event becomes more and more obscured.
usually, with babies, ________________________. An exception to this is _____________
we can't associate their behaviors with adult behaviors however, in the case of BIS (behavioral inhibition system), babies who are super fearful and freeze in response to everything may be vulnerable to experiencing anxiety disorders
why does lack of speech emerge as the main symptom for selective mutism, as opposed to another socially anxious behavior?
we don't know why for sure, but some may think its because parents of these children enable this behavior by stepping in and "speaking for them" when times get tough
how might early family messaging/parenting contribute to anxiety
we may learn that the world is out of our control most of the time, generating a "sense of uncontrollability" that can be a generalized psychological vulnerability for anxiety disorders.
why does TMS work for treating depression? How many treatment sessions does it take to work?
we're not really sure. Takes about 4-6 sessions to work
What are the two major differences between Bulimia and Anorexia?
weight : people with Anorexia must be significantly underweight for a diagnosis, whereas most people with Bulimia are either at or above normal weight binges: out-of-control binges are a necessary part of bulimia, but are absent in anorexia
how can sleep help with anxiety?
when we're sleep deprived, our brains are evolutionarily primed to see everything as a threat (overcompensation for dulled senses that may have allowed our ancestors to stay alive), raising our anxiety when we get sleep, our brain doesn't see everything as a threat
what is the main difference between illness anxiety disorder and somatic symptom disorder?
while both center on health related anxiety surrounding the implications of somatic symptoms that their respective patients over-obsess over, the main difference is that: in SSD, the symptom is actually present and causing distress. in IAD, the symptom isn't what's causing the discomfort, nor is it usually present. Rather, it is the fear of having or getting a serious disease that causes the distress.
how can antioxidants and anti-inflammatories help with anxiety ?
widespread inflammation (especially if it reaches the brain) is becoming more and more strongly associated with mental disorders, so avoiding it can help to mitigate these disorders.
most seasonal mood disorders revolve around ___________, which is typically accompanied by symptoms like _________________________________
winter depression, with excessive sleep, increased appetite, etc. being common
How is seasonal affective disorder treated?
with phototherapy (two hours of bright light in the morning, avoidance of light in the evening) helps realign circadian rhythm and inhibit melatonin production also some CBT
what are the 8 specifiers of a major depressive episode?
with psychotic features, with anxious distress, with mixed features, with melancholic features, with atypical features, with catatonia, with peripartum onset, with seasonal pattern
L-Dopa, a dopamine agonist often used to mitigate Parkinson's symptoms, often leads to _________, supporting that _________ what other substance also support this conclusion
worsened psychotic symptoms of schizophrenia supports the linkage of schizophrenia and Dopamine also Amphetamines (also agonize Dopamine receptors)
is separation anxiety normal? what does this mean for a separation anxiety diagnosis?
yes, but it usually fades with age this means that a clinician must judge if the degree of exhibited separation anxiety in a child is excessive for their age
Can group therapy be helpful for eating disorders? If so, under what circumstances?
yes, but you have to make sure that you don't just have a group of people that aren't ready to accept therapy yet, because then, they'll just end up feeding into each others' disorders. it is imperative that some people who are just beginning the path to recovery are placed with a number of people that have already started and can vouch for its effects
how can OCD lead to impairment?
your compulsions may take up so much time that you lose your job, ostracize yourself from friend groups, recede from society, etc.
Two types of Circadian Rhythm Disorders
Jet Lag Type Shift Work Type (because of irregular work schedule)
Body Dysmorphic Disorder (obsession and compulsion)
Obsession: rumination over a perceived flaw in appearance Compulsion: attempts to modify one's appearance to mitigate the flaw
who developed the depressive attributional style?
Martin Seligman
who developed the context-interpretation model of viewing stressors?
George W. Brown
short-acting insomnia drugs
Halcion, Sonata, Ambien cause brief drowsiness, but can lead to daytime anxiety
what are the most common somatic symptom disorders?
IAD and SSD
cognitive slippage
Ideas are not connected in a logical fashion, thoughts quickly fading
who developed the theory of learned helplessness? how?
Martin Seligman ran experiments with dogs, administering electric shocks regardless of what the dogs tried to do to stop them. Over time, the dogs stopped trying, even when a genuine path to stopping the shocks was presented
What medications are used for Bipolar treatment? what is the principal example of these medications?
Mood stabilizers, especially Lithium
which US subculture exhibits particularly high prevalence rates for mood disorders? Why might this be?
Native Americans (4 times higher than general population) might be because lower socioeconomic status, lower economic stability, increased substance use, and feelings of isolation, which are all common on reservations, tend to be associated with mood disorders.
what are the three most highly linked marker genes with schizophrenia (those that are most often inherited with schizophrenia)?
Neuregulin1, DTNBP1, and COMT
is CBD the same as THC?
No, THC causes the hallucinations, while CBD only causes the relaxation
Does the BIS cause fight or flight?
No, only freeze
