TCU Abnormal Psych Exam 2 - Broom

Persistent Depressive Disorder (Dysthymia)

- Eeyore from Winnie the poo - Chronic depressive disorder - depressed mod for at least 2 years - poor appetite/overeating -sleeping too much/little - feelings of hopelessness - the younger in life = the more severe - Difficult to treat because this is part of the personality and do not react to therapy or meds.

Symptoms of Bipolar Disorder

- Manic/Hypomanic episodes: distinctly elevated or irritable mood for most of the day/nearly every day with abnormally increased activity and energy - increase in goal-oriented activity and psychomotor agitation, unusual talkativeness and rapid speech, thoughts are racing, decrease need for sleep, increased self-esteem, distractibility, excessive involvement in bad behavior such as sexual activity, spending money.

Depersonalization

- Persistent or recurrent experiences of detachment from one's mental process or body, as though one is a dream, despite intact reality testing. - they feel like they are outside of their body or detached from it

Major Depressive Disorder

- Sad mood OR loss of interest or pleasure (anhedonia) - Lack interest/energy to do things you like - feeling empty with loss of energy - must be careful when they first get on medication because they may get energy to commit suicide.

Premenstrual Dysphoric Disorder

- Stigmatize women for this - when women experience PMS symptoms (irritability, anxiety, lack of energy, sleeping too much/little, change in appetite) - Treat with diet, birth control - Relationship with PMDD and being a victim of abuse. Could be a 3rd variable of unresolved response to abuse and its showing up in a different manner.

Disruptive Mood Dysregulation Disorder

-Huge temper tantrums -temper outburst are inconsistent with developmental level - temper outburst occur at least 3 times a week. - Present in at least 2 settings. - Onset before 10 but most be at least 6.

3 Forms of Bipolar Disorders

1. Bipolar 1 2. Bipolar 2 3. Cyclothymia

3 major somatic symptom disorders:

1. Complex somatic symptom disorder 2. Illness anxiety disorder 3. Functional neurological syndrome

4 Types of Depressive Disorders:

1. Disruptive Mood Dysregualtion Disorder 2. Major Depressive Disorder 3. Persistent Depressive Disorder 4. Premenstrual Dysphoric Disorder

Social Contributions to Mood Disorders:

1. Life Events --lack of social support may be one reason a stressor triggers a disorder -- Ex: romantic breakup, loss of loved one 2. Interpersonal Difficulties -- homes with high emotions can cause it more -- Marital conflict predicts depression 3. Behavior of depressed people often leads to rejection by others --excessive reassurance seeking -- few positive facial expressions -- slow speech & long silences -- needy and attention seeking

Psychological Contributions to Mood Disorders:

1. Neuroticism -- tendency to react with higher levels of negative affects -- predicts onset of depression

4 Symptoms of PTSD:

1. intrusively re-experiencing the trauma (through nightmares) 2. avoidance of stimuli (at least one symptom) (ex: refusal to walk on street where rape occurred/avoids traumatic event) 3. Mood and cognitive changes (ex: memory loss, negative thought and emotions, self-blame, withdrawal) 4. increased arousal and reactivity (ex: irritability, aggressiveness, reckless, self-destructiveness, insomnia)

Heritability of MDD:

37%

Heritability of Bipolar:

93%

Intentionally faking psychological or somatic symptoms to gain from those symptoms. A. Malingering B. Factitious Deception C. Somatic Deception D. Functional Factitious Influence

A

The DSM mentions psychological factors in the diagnosis of pain disorder. A. True B. False

A

The difference between anxiety and fear is: A. fear is a response to immediate threat and anxiety is apprehension about future threat. B. fear and anxiety are both related to future threat, but anxiety is a disorder diagnosed by the DSM5

A

Cognitive Theories of Mood Disorders: Rumination Theory

A specific way of thinking: tendency to repetitively dwell of sad thoughts Most detrimental is too brood over causes of events

Two Major Theories of Dissociative Identity Disorder A. __________ Model - DID results from severe ___________ and/or _____ _____ in childhood B. ___________ Model - DID a form of ________ in suggestible individuals occurs in response to prompting by therapist or media. No conscious _________. Evidence raised in theory debate

A. Posttraumatic Model, psychological and/or sexual abuse in childhood B. Sociocognitive Model, form of role-play, No conscious deception

4 A's of Schizophrenia

Associations Affect Autism Ambivalence

Dissociative Fugue

Assume a new identity more often of brief duration Person not only goes into an amnesic state but also leaves his or her home surroundings and becomes confused about his or her identity, sometimes assuming a new one

Dana's baby, Sophie, participated in a study that indicated that Sophie had high levels of behavioral inhibition. Compared with babies who demonstrated low levels of behavioral inhibition, Sophie is likely to develop a) panic disorder. b) social anxiety disorder. c) OCD.

B

Pain disorder is diagnosed more frequently in men than in women and is very frequently comorbid with anxiety and/or mood disorders, which may occur first or may arise later as a consequence of the pain disorder A. True B. False

B

Mary M. reported feeling a lack of energy, difficulty sleeping, loss of appetite, difficulty concentrating, and loss of interest in activities she previously enjoyed. Based on this information, which of the following is the most likely diagnosis for Mary M.? a. Eating Disorder b. Major Depressive Disorder c. Bipolar Disorder d. Generalized anxiety disorder

B.

Jesse is fearful of interactions with others and prefers to shop on line rather than go to the mall. Jesse most likely has a) specific phobia. b) panic disorder with agoraphobia. c) social anxiety disorder. d) paranoia.

C

Studies of neurochemistry and suicide have found low levels of ____________ major metabolite in suicide victims. a) norepinephrine's b) dopamine's c) serotonin's

C

Which of the following is an obsession? a) Repeatedly checking that the water is turned off. b) Humming a tune over and over. c) Having a recurring fear that one is giving others illnesses when they actually are not. d) Worrying over finances.

C

There are three forms of bipolar disorders: Bipolar 1, Bipolar 2, and ____________ with _______ defining feature of each, and _________ considered the most severe of the three.

Cyclothymia Mania Bipolar 1

Unlike a malingerer, a person with factitious disorder a) does not exhibit "la belle indifference." b) has primarily psychological, not physical, symptoms. c) has physical symptoms that are not under voluntary control. d) has no clear motivation for adopting the symptoms.

D

With dissociative fugue, a) The inability to recall previously stored information cannot be accounted for by ordinary forgetting b) The person manifests at least two or more distinct identities that alternate in some way in taking control of behavior. c) Patterns of symptoms or deficits affecting sensory or voluntary motor functions, leading one to think there is a medical or neurological condition. d) Person not only goes into an amnesic state but also leaves his or her home surroundings and becomes confused about his or her identity, sometimes assuming a new one

D

Given the inconsistent evidence about levels of neurotransmitters in people with mood disorders, researchers have begun to focus research efforts on a) whether specific levels of serotonin or dopamine are important. b) understanding the types of people who have no disturbances in their absolute levels of neurotransmitters. c) finding a new neurotransmitter. d) the sensitivity of postsynaptic receptors

D)

Which of the following best describes hypomania? a) A type of mania that alternates with depression. b) A type of mania more common in dysthymic patients. c) A more severe form of mania d) a less severe form of mania

D.

4 Categories for Suicides and what they are

Death Seekers: want to end their life; looking forward to it Death initiators: that they are hurrying death; that death is inevitable Death Ignoreres: want life to end but not their existence; they will live on in another form Death Darers: ambivalent about death; risky behaviors

Delusional Disorder

Delusions like jealousy, being followed, erotomania (loved by a famous person) rare in general because people can function with it everything else functions okay

2 Broad types of Mood Disorders and what are they?

Depressive Disorders- involves only depressive symptoms Bipolar Disorders- Involves Manic Symptoms

Bipolar 1

Depressive episode NOT required, at least one episode of mania (most severe)

Bipolar 2

Depressive episode required, at least one major depressive episode with at least one episode of hypomania

Phobias

Disruptive fear of a particular object or situation. Fear is out of proportion to actual threat, awareness is excessive Must be severe enough to cause distress or interfere with job or social life.

A process whereby a group of mental processes is split off from the main stream of consciousness or behavior loses its relationship with the rest of the personality. Some aspect of cognition or experience becomes inaccessible to consciousness:

Dissociation

_____________________ ( _____ )- once called _________ _________ Disorder. Characterized by the presence of ___ or more unique personality states that regularly take control of the individual's behavior.

Dissociative Identity Disorder (DID) Multiple Personality Disorder 2

____________ ( ___________ Depressive Disorder) is a chronic depressive disorder. There is discussion that this might be a __________ trait rather than a disorder, but suffering evident and it should be treated either way.

Dysthymia (Persistant Depressive Disorder) Personality

3 types of Major Depressive Disorders:

Episodic: symptoms tend to dissipate over time Recurrent: once depression occurs, future episodes likely (average 4) Subclinical Depression: sadness plus 3 other symptoms for 10 days. Significant impairments in functioning even though full diagnostic criteria are not met

Facts and personal experiences are __________ memory. Memories of skills (e.g., riding your bike) is ________ memory.

Explicit Implicit

Panic Disorder

Frequent panic attacks unrelated to specific situations ex: heavy breathing, nausea, sweating, lightheadedness randomly about nothing specific

Contributions to mood disorders (4)

Genetic Neurobiological Social Psychological

3 most common voices:

God, President, and Satan

__________ really triggers depression or depressive symptoms.

Hopelessness

What is the defining feature of each type of Bipolar Disorder?

Mania: state of intense elation or irritability

Cyclothymia

Milder, chronic form of the disorder. Lasts at least two years in adults and one year in children. Numerous periods with hypomanic and depressive symptoms.

Cognitive Theories of Mood Disorders: Hopelessness Theory

Most important trigger of depression Attributional Style: everything is always bad

Cognitive Theories of Mood Disorders: Beck's Theory

Negative Triad: negative view of self, world, future Negative Schema: underlying tendency to see the world negatively Negative schema cause cognitive biases: tendency to process information in negative ways

What approach is used to address Dissociative Disorders?

Psychoanalytic or Psychodynamic

Chris is a shy, anxious-looking, 31-year-old carpenter who has been hospitalized after making a suicide attempt. He asks to meet with the psychiatrist in a darkened room. He is wearing a baseball cap pulled down over his forehead. Looking down at the floor, Chris says he has no friends, has just been fired from his job, and was recently rejected by his girlfriend. "It's my nose . . . these huge pockmarks on my nose. They're grotesque! I look like a monster. I'm as ugly as the Elephant Man! These marks on my nose are all that I can think about. I've thought about them every day for the past 15 years, and I think that everyone can see them and that they laugh at me because of them. That's why I wear this hat all the time. And that's why I couldn't talk to you in a bright room . . . you'd see how ugly I am." The psychiatrist couldn't see the huge pockmarks that Chris was referring to, even in a brightly lit room. Chris is, in fact, a handsome man with normal-appearing facial pores. Later Chris says, "I've pretty much kept this preoccupation a secret because it's so embarrassing. I'm afraid people will think I'm vain. But I've told a few people about it, and they've tried to convince me that the pores really aren't visible, but all I can think about is my face. I spend hours a day looking at the marks in the mirror. I started missing more and more work, and I stopped going out with my friends and my girlfriend and stay in the house most of the time." Chris also reports experiencing a detachment and altered relationship to the surrounding world and feels like the world is a distorted and dream-like. Q1. Chris likely is suffering from: A. Fictitious disorder B. BDD C. Dissociative fogue D. OCD Q2. Chris also is likely experiencing A. Derealization B. Dissociative Identity Disorder C. Reactive manic symptoms

Q1. B Q2. A

This 38-year-old married woman, the mother of five children, reports to a mental health clinic with the chief complaint of depression, meeting diagnostic criteria for major depressive disorder. Her marriage has been a chronically unhappy one; her husband is described as an alcoholic with an unstable work history, and there have been frequent arguments revolving around finances, her sexual indifference, and her complaints of pain during intercourse. The history reveals that the patient describes herself as nervous since childhood and as having been continuously sickly beginning in her youth. She experiences chest pain and reportedly has been told by doctors that she has a "nervous heart." She sees physicians frequently for abdominal pain, having been diagnosed on one occasion as having a "spastic colon." In addition to M.D. physicians, she has consulted chiropractors and osteopaths for backaches, pains in her extremities, and a feeling of anesthesia in her fingertips. She was recently admitted to a hospital following complaints of abdominal and chest pain and of vomiting, during which admission she received a hysterectomy. Following the surgery, she has been troubled by spells of anxiety, fainting, vomiting, food intolerance, and weakness and fatigue. Physical examinations reveal completely negative findings. (Adapted from Spitzer et al., 2002). Which is the best diagnosis for her? A. Conversion disorder B. DID C. Somatization disorder D. Hypochondriasis

Q1. C

Suicide Epidemiology

Related to feelings of depression Men are 4x more likely than women to kill themselves but women are more likely to make suicide attempts that do not result in death. Men usually hang/shoot themselves. Women are more likely to use pills Rates increase with old age Highest Rate: white males over 50 Adolescents and children rates are increasing dramatically under 15 jump off buildings or run into traffic Being divorced or widowed elevates suicide risk four or fivefold.

Symptoms of Depression

Sad mood OR loss of interest or pleasure (anhedonia). Symptoms are present nearly everyday, all day, and for at least two weeks.

Schizophreniform Disorder

Same symptoms as schizophrenia - both + & - symptoms symptom duration greater than 1 month but less than 6 months have insight

_____ ________ is a predictor of onset mania

Sleep Disruption

Brief Psychotic Disorder

Symptom duration of 1 day to 1 month triggered by extreme stress, such as bereavement (death or birth of child) typically don't medicate for this. even shorter than schizophreniform

Schizoaffective Disorder

Symptoms of both schizophrenia and mood disorder Primary disorder is schizophrenia Secondary moods

Suicide Ideation

Thoughts of killing oneself

Agoraphobia

anxiety about inability to flee anxiety - provoking situations ex: crowds, stores, malls, churches, trains, bridges, tunnels, etc. Causes significant impairment

Suicide Attempt

behavior intended to kill onseself

non-suicidal self-injury

behaviors intended to injure oneself without intent to kill oneself

Generalized Anxiety Disorder (GAD)

chronic, excessive, uncontrollable worry for at least 50% of days surrounding at least 2 domains ex: constantly worrying about finances that you have poor concentration, restlessness, irritability or muscle tension

Reactive Attachment Disorder

consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers (not seeking comfort when distress; not responding when comforted) common in foster kids ex: creating big boundaries and wont allow others to get close.

Disinhibited Social Engagement Disorder

cuddliness with strangers is the most significant factor present these kids are little older (12-14) so the behavior is inappropriate getting close to adult very quickly and crawling on their lap etc.

Psychological Treatment of Mood Disorders: Interpersonal Psychotherapy (IPT)

current relationship where therapist is working with you on goals on how to cope with decision making and coping mechanism within your relationships (i.e. boundaries, time limits)

suicide

death from deliberate self-injury

Specific Phobia

disproportionate fear of a particular object or situation ex: fear of flying, snakes, heights must impede your life and be there for at least 6 months in order to be clinical

Psychomotor Retardation

inability to function and do normal activities

Explicit Memory:

involves conscious recall of experiences (prom, birthday party)

hypomania

less sever episode of mania

What explains emotional behaviors while high?

marijuana increases blood flow to brain regions associated with emotions.

Marijuana interferes with ______. impairs ______ ______ _____, complex _____ ______

marijuana interferes with cognitive functioning. Impairs short term memory, complex motor skills.

Social Anxiety Disorder

marked and disproportionate fear consistently triggered by exposure to potential social scrutiny. causes more life disruptions than other phobias. tend to be underemployed ex: not being able to go to speak in front of people, goes to extreme lengths

Hypermania

more sever episode of mania

Anxiety Disorders

most common psychiatric disorders and most common are phobias. U.S. has the highest rate of anxiety

What is the difference between obsessions and compulsions:

obsessions are recurrent thoughts and images the person tries to ignore or neutralize and compulsions are the repetitive behaviors and mental acts that a person feels compelled to perform to prevent distress of a dreaded event. The person feels driven to perform compulsions in response to obsessions. ex: obsession about being clean so they are compelled to scrub their hands raw to get rid of germs. OCD symptoms are NOT due to taking medicine or other drugs, or pre-existing medical conditions

Symptoms of PTSD are grouped into which of the following major categories?

re-experiencing of traumatic event, avoidance of stimuli associated with event and symptoms of increased arousal.

Hoarding

repetitive thoughts about possessions and cannot part with acquired objects. -extremely attached to objects - resistant to relinquishing objects ex: holding on to string, tin foil, rubber bands, etc.

Body Dysmorphic Disorder

repetive thoughts and urges about personal appearance. They have a preoccupation with an perceived (not real) or exaggerated defect in tehir appearance and perceived themselves as ugly or monstrous. -- engage in compulsive behaviors (ex: checking appearance in mirrors)

Hallucinations: what types?

sensory experiences in the absence of sensory stimulation. auditory, visual, hearing voices

Adjustment Disorders

significant life events, whether positive or negative, causing emotional and psychological stress and impairs ability to function. You can't quite get over it. ex: goes to college, cant get settled, very upset

Disorder

some extreme difference with the highs and lows of mood, negatively impact their life (dysfunction)

Acute Stress Disorder (ASD)

symptoms similar to PTSD (response to severe stressor, re-occurring dreams, fear, and anxiety over the trauma) ex: getting in a car accident and then avoiding and stressing about cars for the next 2 day to 4 weeks

Implicit Memory

underlines behaviors based on experiences that cannot be consciously recalled (playing tennis, writing a check)