PSY 350 SDSU Exam #3

Prevalence of erectile disorder? Does this increase or decrease with age?

60% of men over 60 experience; Increases

sensate focus

The term was introduced by Masters and Johnson. -In this exercise, couples are instructed to refrain from intercourse or genital caressing and simply to explore and enjoy each other's body through touching, kissing, hugging, massaging, or similar kinds of behavior.

Where is anorexia nervosa most prevalent?

Western Cultures

What do the three Depressive attributional styles all lead to?

a person having a sense of hopelessness

Which of the following represents the typical profile of a patient with anorexia nervosa? a. Young, white, female, upper socioeconomic status, socially competitive environment b. Young ,white, female, any socioeconomic status, history of depression c. Young, female, any race, any socioeconomic status, highly competitive d. Any age, female, upper socioeconomic status, few friends

a. Young, white, female, upper socioeconomic status, socially competitive

Of the following, the only symptom that both patients with narcolepsy and hypersomnia experience is a. falling asleep during normal waking hours. b. sudden loss of muscle tone. c. sleep paralysis. d. hypnagogic hallucinations.

a. falling asleep during normal waking hours.

All of the following are associated with treatments for paraphilias EXCEPT a. sexual surrogacy b. covert sensitization c. orgasmic reconditioning d. chemical castration

a. sexual surrogacy

Parasomnias

abnormal behavioral and physiological events during sleep

Exhibitionist Disorder

achieving arousal by exposing genitals to strangers E.g. flasher

Prevalence of premature ejactulation and does it increase or decrease with age?

affects 21% of all adult males More common in younger, inexperienced males Problem tends to decline with age

Obstructive Sleep Apnea Hypopnea

airflow stops, despite continued activity by respiratory system working (airflow stops, resp system works)

associated feature of narcolepsy, Sleep paralysis

an associated feature of Narcolepsy which is a brief period after awakening when they can't move or speak that is often frightening to those who go through it?

Arbitrary interference

assess negatives more over positive for any given situations When a student sleeps in class and the teacher thinks it is because her lecture is boring

Which of the following is NOT usually a component of a major depressive episode? a. Feelings of worthlessness b. Flight of ideas c. Altered sleep patterns d. Change in appetite

b. Flight of ideas

What medications are used to treat insomnia

benzodiazepines and over-the-counter sleep medications, best as a short term solution

Lithium is a ____ and is prescribed as the standard treatment for ______. a. antipsychotic; very severe depression b. anticonvulsant; bipolar disorder c. mood stabilizer; bipolar disorder d. SSRI; bipolar disorder

c. mood stabilizer; bipolar disorder

Sexual dysfunction can be a(n) ______ condition. a. lifelong b. acquired c. situational d. All of the above

d. All of the above

sleep-related hypoventilation

decreased breathing during sleep not better explained by another sleep disorder? airflow does not completely stop, but is reduced

Lithium Carbonate is considered a mood stabilizer because it treats what?

depressive and manic symptoms

Female sexual interest/arousal disorder

describes lack of or significantly reduced sexual interest/arousal in females?

Male hypoactive sexual desire disorder

describes little or no interest in any type of sexual activity in males

Premature Ejaculation

ejaculation occurring within ~1 minute of penetration and before it is desired?

Reciprocal-Gene Environment Model

essentially states that some people have a genetic predisposition that leads to certain situations which end up contributing to the development of depression/etc. People who are vulnerable to depression might be more likely to enter situation that will lead to stress. Ex) shy person excludes self from others leading to depression.

Stable way of thinking

even after particular negative events passes, the attribution that "additional bad things will always be my fault" remains. believing future negative outcomes will be one's own fault,

Hypersomnolence

excessive sleeping and causes sleepiness throughout the day A person with this condition falls asleep several times a day.

electrooculograph (EOG)

eye movements, indicative of amount of REM sleep

Interpersonal therapy (IPT)

focuses on resolving problems in existing relationships and learning to form new interpersonal relationships. It is highly structured and rarely takes more than __15-20__ sessions.

Double Depression

individuals who suffer from both major depressive episodes and persistent depression with fewer symptoms are said to have double depression.

Transvestic Disorder

individuals, usually males, are sexually aroused or receive gratification by wearing clothing of the opposite sex; sexual arousal with the act of cross dressing (men; married; spouse aware)

Dyssomnias

is a broad type of sleep disorders involving difficulty falling or remaining asleep, which can lead to excessive sleepiness during the day due to the reduced quantity, quality or timing of sleep. -insomnia -hypersomnolence -narcolepsy -

Erotophobia

learned negative attitude about sexuality due to religion, family, etc

Persistent Depressive Disorder

low level depression; depressed mood most of the day on more than 50% of the days; longer lasting (minimum of two years and can go for >20 years, symptoms cannot disappear for more than 2 months)

Permissive hypothese

low levels of serotonin "permit" NE and dopamine to fluctuate wildly, increasing vulnerability to depression

electromyography (EMG)

muscle activity (myo- means muscle)

What is the most common sexual dysfunction in adult males

premature ejaculation

SSRIs

prevents reuptake of Serotonin suicide risk in teens Ex: prozac

Tricyclic

prevents reuptake of norepinephrine and other neurotransmitters negative side effects common- which is why discontinuation is popular, can be lethal in excess

Mixed-Reuptake Inhibitors

prevents reuptake of serotonin and norepinephrine fewer side effects than SSRIs Ex: venlafaxine (SNRI)

Binge eating disorder

rapid eating even when not hungry, with NO compensatory behaviors? Occurs average at least once a week for 3 months

Sleep terrors

recurrent episodes of panic like symptoms during non-REM sleep more common in children, child has little memory of it the next day Can wake child at specific time to prevent

Frotteuristic Disorder

seeking sexual gratification from rubbing against unwilling victims in crowds from which they cannot escape (typically in a crowded place such as the subway/elevator)

Voyeuristic Disorder

sexual arousal is derived from observing unsuspecting individuals undressing or naked. Observing a stranger undressing Ex: peeping

Which parasomnias occur during non-REM sleep?

sleep terrors and somnambulism

Mood

state that includes: cognitive, motivational and physical aspects

What medications are used to treat hypersomnia and narcolepsy

stimulants (modafinil/provigil)

Sexual Masochism

suffering pain or humiliation to attain sexual gratification

Ventromedial hypothalamus

suppresses hunger; Stimulation stops hunger; destruction results in eating even if full

Global way of thinking

the attribution extended across a variety of issues. believing negative events will disrupt many life activities ways.

Internal way of thinking

the individual attributes negative events to personal failings ("it was my fault"). when negative outcomes are one's own fault

Sexual dysfunction (and its three factors)

the term for issues involving desire, arousal and/or orgasms?

How do patients qualify for sex reassignment surgery

they must live in desired gender for 2 (said 7 on slides) years before

Gender Dysphoria

trapped in body of wrong sex Occurs on a continuum Desire to be another gender, cross dressing, distress

Treatment for insomnia

treated with benzodiazepines Often associated with medical and or psychological condition Unrealistic expectations about sleep

associated feature of narcolepsy, hypnagogic hallucinations

vivid and often terrifying experiences that begin at the start of sleep and are said to be unbelievably realistic because they include not only visual aspects but also touch, hearing, and even the sensation of body movement

Among which groups of people is anorexia nervosa most prevalent?

white, middle/upper class females, and socially competitive environments

Better or worse prognosis than bulimia

worse

Learned-Helplessness

A lack of perceived control over life events leads to decreased attempts to improve own situation? "Why should i even try" mentality?

Premenstrual Dysphoric Disorder

A mood disorder in women characterized by marked depressive, anxious or irritable symptoms, regularly occurring around the time of menstruation.

polysomnographic (PSG) evaluation

An assessment of sleep disorders in which a client sleeping in the lab is monitored for heart, muscle, respiration, brain wave, and other functions. -EEG -EOG -EMG

The tendency to interpret life events negatively

Cognitive errors

What is the most effective treatment for sexual dysfunction

Education

What is the most common problem for which men seek treatment?

Erectile disorder

anhedonia

Extremely depressed mood and/or loss of pleasure

Family's contribution to eating disorders

Families with patients of anorexia are concerned with: high achievement, perfectionism, concern with external appearance, and lack of open communication

What are some risk factors for suicide

Family history Low levels of Serotonin Alcohol abuse Pre-existing psychological disorder Stressful life event, especially humiliation Contagion: ie, famous person commits suicide so I want to do it now too apparently

Which type of sex reassignment conversion do more people adjust better with?

Female to male conversion

How many women have difficulty achieving orgasms?

How many women have difficulty achieving orgasms?

Disruptive Mood Dysregulation Disorder

In children, a mental disorder characterized by recurrent temper outbursts occurring against a background of irritable mood.

Stress hypothesis

Individuals prone to depression/anxiety will likely have elevated cortisol, which is produced by the adrenal gland

Sexual Sadism

Inflicting pain or humiliation to attain sexual arousal/gratification -To be diagnosed: Has to be on someone who is unconsenting; or you become distressed

When you are depressed, what are the three ways you think (aka Depressive Attributional Style)

Internal, Stable, Global

What describes getting out of bed at least once during the night and consuming a third or more of ones daily food intake?

Night eating syndrome

Which parasomnia occurs during REM sleep

Nightmares

non-demand pleasuring

Non-demand pleasuring involves affectionate, sensual, playful, and erotic touching both inside and outside the bedroom, which creates an empowering understanding that not all touching can or should lead to intercourse.

What did Henderson and Brownell find about contributions to the obesity epidemic?

Obesity is related to the spread of modernization. promotion of inactive and sedentary lifestyle and consumption of high fat energy dense diet

What describes a person who applies negatives to all situation?

Overgeneralization

Biological contributions to eating disorders

Partial genetic contribution

Biological contributions to sexual dysfunction

Physical disease, medical illness, prescription medications use and abuse of drugs and alcohol

Relaxation and stress reduction

Reduces stress and assists with sleep Modify unrealistic expectations about sleep

central sleep apnea (CSA):

Respiratory system stops for a brief period airflow stops due to some type of CNS pathology

Deficits in what hormone may contribute to binging?

Sorotonin

media and cultural contributions to eating disorders

Strongest contributions- thinness linked to success, emphasis on dieting, standards of body size

part of narcolepsy, Cataplexy and what can help treat it

Sudden loss of muscle tone (helped by antidepressants/stimulants); I.e: "sleep paralysis" Could be brought on by a positive emotion

Sleep efficiency (SE)

The percentage of time actually spent sleeping of the total time spent in bed. This is essentially the amount of sleep achieved divided by the amount of sleep attempted. Ex: try to sleep for 8 hours but only sleep for 6 hours. SE = 75%

Median lifetime # of depressive episodes for major depressive disorder

(4-7); 4-5 months in duration

Erectile Disorder

(difficulty achieving or maintaining an erection)

MAO-inhibitor

(inhibits activity of the enzyme monoamine oxidase, which breaks down norepinephrine/Sero) fewer side effects but as effective as tricyclics dietary restrictions

Female orgasmic Disorder

(marked delay, absence or decreased intensity of orgasm)

Narcolepsy

(sudden onset of REM): Sleep disorder involving sudden and irresistible sleep attacks. Rare, equally distributed between males and females

Cyclothymic Disorder

-(alternate between mild depressive & mild hypomanic symptoms) -Must last minimum of two years (one year for children and adolescents) -One third to one half develop full blown bipolar -Onset between 12-4 years

Paraphillic disorders

-(misplaced sexual attraction & arousal) socially unacceptable objects, situation, or individuals -Must be associated with distress, impairment or harm -Sexual interest in non-normative desire -Fetishistic disorder -Frotteuristic disorder -Voyeuristic disorder -Exhibitionistic disorder -Transvestic disorder -

Sleep and Depression

-(more intense and longer REM activity; decreased deep stage sleep -Sleep deprivation may improve depressive symptoms in those who are depressed -Sleep loss may bring on feelings of depression in non-depressed individuals

Insomnia

-(problem initiating or maintaining sleep

Prevalence of insomnia

-1/3 of population in a given year -females twice as likely

What is the prevalence of major depressive disorder

-16% for major depression -females are twice as likely to have major depression

Anorexia Nervosa

-An eating disorder characterized by calorie restriction relative to expenditure, leading to dangerously low body weight. -nervous loss of appetite, at least 15% below ideal body weight without any other medical explanation, often begins with dieting -Extreme caloric restriction brought on by intense fear of weight gain -Typically comorbid with OCD (and other psych disorders)

Bulimia Nervosa

-An eating disorder involving recurrent episodes of uncontrolled excessive (binge) eating followed by compensatory actions to remove the food (for example, deliberate vomiting, laxative abuse, and excessive exercise). - Binge eating with compensatory behaviors ,

Cognitive behavioral therapy for insomnia

-Changing beliefs about sleep -Extensive monitoring using sleep diary -Practicing better sleep-related habits

Chronic vs acquired

-Chronic: From first sexual encounter -Acquired: Occurs after a period of normal sexual activity

Treatment for Sexual Dysfunctions

-Education -Psychosocial behaviors

What are some consequences of purging due to bulimia

-Erosion of dental enamel can occur, electrolyte imbalance -Kidney failure, cardiac arrhythmia, seizures... etc

Social/Cultural contributions to sexual dysfunction

-Erotophobia -negative/traumatic sexual experiences, relationship problems -Deterioration of interpersonal relations and lack of communication

Generalized vs. Situational

-Generalized occurs every time the individual has sex -Situational occurs randomly in specific situations

Facts about bulimia

-Hide behavior from others -Food consumed often high in fat, sugar, carbohydrates -Food consumed is usually soft and easy to consume so they can eat it fast such as (donuts,ice cream, pudding etc.) -Most are within range of normal weight -Later onset than anorexia -Low Sero, can be treated with anti-depressants concern with body shape and fear of gaining weight -Comorbidity with other psych disorders- 80% will develop anxiety in their lifetime

Ways to assess sexual behavior

-Interview -Thorough medical examination -Psychophysiological assessment

Major depressive episode

-Lasts most of the day, nearly every day for at least two weeks -anhedonia (extremely depressed mood and/or loss of pleasure) -At least 4 additional physical or cognitive symptoms: E.g., indecisiveness, feelings of worthlessness, fatigue, appetite change (can be increase or decrease but is usually a decrease in appetite), restlessness or feeling slowed down, sleep disturbance

Fetishistic Disorder

-Long-term, recurring, intense sexually arousing urges, fantasies, or behavior involving the use of nonliving, unusual objects, which cause distress or impairment in life functioning. Inanimate objects or a specific tactile (often rubber) -sexual attraction involving nonhuman objects E.g. foot-fetish, hair-fetish, or toe-fetish

Orgasmic Reconditioning

-Masturbate to appropriate stimuli -patients are instructed to masturabte to their fantasies but then substitute desirable appropriate ones before ejaculation

What are some Sociocultural contributions to eating disorders;

-Media & cultural considerations -Families

Major depressive disorder (single vs. recurrent)

-Mood disorder involving one major depressive episode; mood disorder involving multiple (separated by at least 2 months without depression) major depressive episodes. -Single episode - highly unusual -Recurrent episodes - more common -Onset at 30, 5-10% prevalence, lifetime risk of 17%

Breathing-related Sleep Disorders

-Obstructive Sleep Apnea hypopnea -central sleep apnea (CSA): -sleep-related hypoventilation

What are the 4 antidepressents

-Selective serotonin reuptake inhibitors(SSRI's) -tricyclic antidepressants -monoamine oxidase inhibitors -Mixed reuptake inhibitors

Somnambulism

-Sleep walking may be accompanied by night eating, or dangerous situations

Psychosocial behaviors

-Squeeze technique: for premature ejaculation Penis is stimulated to a full erection by partner, and the head is squeezed to reduce arousal -Mastabatory training: for female orgasm disorder (talking out loud, using a vibrator) -Exposure to errotic material: for low sexual desire problems

Comprehensive interview

-a detailed history of sexual behavior and lifestyle -questionnaires because people provide more info on paper Patient must be comfortable talking about issues

Nightmares

-all are more common in children (10-50%) Often awaken from slumber -CBT/may involve antidepressants and or relaxation training can help -All three will typically resolve on their own without any extensive intervention

Bipolar I

-alternate between full manic episodes & major depressive episodes -Greatest suicide risk -Chronic condition -Onset 15-18 years old -Can begin in childhood

Bipolar II

-alternate between hypomanic episodes & major depressive episodes -Can progress to Bipolar I if not treated -Later onset than Bipolar I -Average onset is 19-22 years, and tends to be chronic

What is the most deadly mental disorder and why

-anorexia -Because starving body borrows energy from internal organs Most serious consequence is cardiac damage which can lead to heart attack and death

Lateral hypothalamus

-brings on hunger; -stimulation would result in eating even if full; -destruction would result in not eating

Prevalence of bipolar disorder

-equally affect males and females -Affects 2.5 million americans in any given year

Manic episode

-expansive mood for at least 1 week; Unpredictable; Judgment low, energy high. Impairment in normal functioning -Symptoms: inflated self esteem, decreased need for sleep, excessive talkativeness, flight of ideas or sense that thoughts are racing, easily distracted, increase in goal directed activity, involvement in pleasurable but risky behaviors

Convert Sensitization

-imagining aversive consequences to form negative associations with deviant behavior (e.g., pedophilic behavior & arrest) During six or eight sessions, the therapist narrates such scenes dramatically, and the patient is then instructed to imagine them daily until all arousal disappears. Most are about getting in trouble and embarrassment

Psychophysiological assessment

-measure the physiological aspects of sexual arousal (typically watch an erotic film while they measure their response) -Penile erection is measured using a penile strain gauge -Vaginal photoplethysmograph- measures the amount of light that is reflected from the vaginal walls, which indicates degree of blood flow

Psychological intervention for paraphillic disorders

-most behavioral - target deviant & inappropriate sexual associations -Orgasmic Reconditioning -Convert Sensitization

Pedophilic Disorder

-sexual attraction to prepubescent children pedophile must be at least 16; 5 years older than victims -More men than women -Roughly 95% of altercations go unreported

Hypomanic Episode

-shorter (Lasts at least 4 days), less severe version of manic episodes -Fewer and milder symptoms -Associated with less impairment than manic episodes (e.g., less risky behavior) -May not necessarily be problematic but is a part of other behaviors such as (bipolar II)

Mixed Features

-term for a mood episode with some elements reflecting the opposite mood -Example: Depressive episode with some manic features -Example: Manic episode with some depressed/anxious features

Thorough medical evaluation

-when you must rule out potential medical causes of sexual dysfunction -Drugs or surgeries may disrupt sexual desire/arousal -Specialists check levels of hormones, functioning and response

Rate of prevalence of sexual dysfunction on women and men

43% of women & 31% of men in US

What is this prevalence rate in male hypoactive sexual desire disorder? Does this increase or decrease with age?

5% increase with age

How effective are antidepressants?

50% of patients benefit low to moderate depression - no more effective then a placebo

What nationalities are suicide most common in

Caucasian and Native American

How prevalent is suicide among teenagers?

3rd leading cause of death

Differences from bulimia or anorexia

Many are obese, often older than bulimics and anorexics Not necessarily concerned about body image

What is the prevalence rate for female sexual interest/arousal disorder? Does this increase or decrease with age?

22% Decrease with age

How prevalent is suicide among college students?

2nd leading cause of death

At what ages can you diagnose someone with disruptive mood regulation disorder?

Between the ages 6 and 18

What are two forms of maladaptive eating patterns in a person who is obese?

Binge eating and night eating syndrome

What is the most common eating disorder in the US?

Binge eating disorder

electroencephalograph (EEG)

Brain wave activity

What are some psychological treatment for sleep disorders?

CBT, relaxation and stress reduction, and improved sleep hygiene

What is the treatment of choice for Bipolar disorders?

Lithium Carbonate. Dosage is strictly regulated due to potential toxicity. Used to treat bipolar disorder. Many patients abandon this treatment to be able to experience manic episodes.

3 different types of mood "episodes"

Major depressive episodes Manic episodes Hypomanic episodes

Prevalence of bulimia

Majority are female 90%+ between 18-21

What are some compensatory behaviors for bulimia nervosa, starting with the most common?

Purging diuretics or laxatives excessive exercising fasting