PSY 350 Exam #2

-Mood disorders occur when people are unable to find meaning and self-fulfillment -Loss of self-esteem drives continuing problems

Humanistic perspective for Depression

-Progressive brain disease characterized by gradual loss of memory and intellectual functioning, personality changes, and death -Affects about 10% over age 65, and about half over age 85 *Numbers have gone up as the lifespan has increased -It is not a natural consequence of aging

Alzheimer's Disease

-The criteria are met for major mild neurocognitive disorder -There is insidious onset and gradual progression of impairment in one or more cognitive domains (for major neurocognitive disorder, at least two domains must be impaired) -The disturbance is not better explained by cerebrovascular disease, another neurodegenerative disease, teh effects of a substance, or another mental, neurological, or systemic disorder. -Criteria are met for either probable or possible Alzheimer's disease as follows:

Alzheimer's Disease - DSM

-Perception of minimal side effects led to widespread prescription, as SSRIs replaced the tricyclics -Usually tested on only a narrow cross-section of patients who meet strict diagnostic criteria -However, then prescribed to a broad cross-section of population without regard to diagnostic criteria *Zimmerman found that 86% of depression patients would have been excluded from clinical trials *However, 93% of them were prescribed medication

Are SSRIs overprescribed?

-Distinct diagnosis in previous edition of DSM but now classified in DSM-5 as form of autism spectrum disorder -Refers to a pattern of behavior characterized by social awkwardness and stereotyped or repetitive behaviors but without the significant languaged or cognitive deficits associated with more severe forms of Autism Spectrum Disorder -Have remarkable verbal skills and may develop an obsessive interest in, and acquire knowledge about, a range of obscure or narrow topics

Asperger's disorder

Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person's developmental level: -Often fidgets with or taps hands or feet, or squirms in seat -Often leaves seat in situations when remaining seated is expected -Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless) -Often unable to play or take part in leisure activities quietly -Is often "on the go" acting as if "driven by a motor" -Often talks excessively -Often blurts out an answer before a question has been completed -Often has trouble waiting his/her turn -Often interrupts or intrudes on others (ex, butts into conversations or games)

Attention Deficit/Hyperactivity Disorder -DSM Hyperactivity and Impulsivity

Inattention: Six or more symptoms of inattention for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level: -Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities -Often has trouble holding attention on tasks or play activities -Often does not seem to listen when spoken to directly -Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (ex, loses focus, side-tracked) -Often has trouble organizing tasks and activities -Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework) -Often loses things necessary for tasks and activities (Ex school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobil telephones) -Is often easily distracted -Is often forgetful in daily activities

Attention Deficit/Hyperactivity Disorder -DSM Inattention

-said to be found in about 10% of autistics, though generally not at such a high level of proficiency * this stat is to be considered cautiously, as it is based on self-report data from parents

Austistic Savantism percent

-Research indicates that part of the rise in Autism rates is tied to changing diagnostic criteria, but part is tied to environment -However, meta-analysis suggests prevalence remained stable from 1990-2010 -And, as discussed before, overwhelming evidence indicates MMR vaccine has NOT affected autism prevalence -Austism "clusters" *typical rate is 4-5 per 10,000 *clusters in sub-pops reporting higher autism rates *chance or caused by environmental pollutants?

Autism - Sociobiology

-A disorder characterized by any number of various deficits in domains of communication, social behavior, fixated interests and repetitive behaviors *May be classified as mild, moderate, or severe *Milder range includes people formerly diagnosed with Asperger's Syndrome -Usually has intellectual impairment -About 75-80% of cases are boys

Autism Spectrum Disorder

-Recent research finds amygdala overreacts to faces, processing most gazes as threatening -Lack of eye contact means face perception is impaired in development -Fusiform area, needed for face perception is fine, but doesn't get enough stimulation -Also, amygdala and hippocampus found to be oversized from a very early age -Research also suggests deficits in the right hemisphere -Although something of an oversimplification, the right hemisphere is more attuned to emotional aspects of cognition, and the left more to logical -Research has found that in various tests of language, autistics show deficits similar to populations who have suffered a right-brain stroke -Sperm mutations in older fathers seem to increase rate

Autism Spectrum Disorder - Biology

Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive): 1) Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions 2) Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication 3) Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers

Autism Spectrum Disorder - DSM deficits in social communication and social interaction

-Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life) -Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning -These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make co-morbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level (Note: Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger's disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder)

Autism Spectrum Disorder - DSM other

Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive): 1) Stereotyped or repetitive motor movements, use of objects, or speech (ex., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases) 2) Insistence on sameness, inflexible adherence to routines or ritualized patterns of verbal or non-verbal behavior (ex., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day) 3) Highly restricted, fixated interests that are abnormal in intensity or focus (ex., strong attachment to or preoccupation with unusual objects, excessively circumscribed or preservative interest) 4) Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (ex., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement)

Autism Spectrum Disorder - DSM repetitive patterns

-"Suffocation false alarm theory" - minor cues of suffocation lead to disproportionate response from respiratory and alarm systems -Also low levels of GABA... thus, use of antianxiety drugs that raise GABA ex. Xanax; GABA is an inhibitory neurotransmitter which means it tones down excess neural activity in the CNS and helps quell the body's response to stress... when the activity of GABA is inadequate, neurons may fire excessively which may heighten states of anxiety or nervous tension

Biological factors of Panic Disorder

-anti-anxiety drugs are the most common treatment for anxiety-related symptoms -some success treating PTSD with beta-blocker drugs (Propranolol) *does not excise the memory; however, reduces intensity of emotional response at time of recall, and occurrence of PTSD symptoms over the long-term

Biological perspective of anxiety disorders

-Mood disorder characterized by mood swings between depression and mania *Depressive episodes have diagnostic criteria similar to those in major depression *Manic episodes can take many forms

Bipolar Disorder

-Mania and depression are reactions to each other * chemistry of brain is self-correcting, but to the extreme -Problems in inhibition/disinhibition of the pleasure centers of brain -Probably inherited *Relatives 5 times more likely to become afflicted than general public *Higher rate for offspring of older fathers

Bipolar Disorder - Biology

-Lithium carbonate alleviates all or most symptoms for 80% of individuals -Serious side effects if dosage not precise -Side effects include damage to heart & kidneys -Problematic because patients are often not conscientious (or are reluctant) about taking their meds -Anticonvulsant meds can also treat depressive episodes, but are costly and need more research

Bipolar Disorder treatments/meds

1) Bipolar I - includes one full manic episode 2) Bipolar II - includes mostly depression with at least one hypomanic episode, but no full manic episode *Hypomanic episodes must persist at least 4 days, so shorter than full manic

Bipolar Disorder two main categories

trigger stimulus (internal or external) -> perceived threat -> apprehension -> body sensations -> interpretations of sensations as catastrophic

Cognitive factors of Panic Disorder

-anxiety disorders are a product of maladaptive cognitions: *over-prediction and anticipation of fear *exaggeration of risks *oversensitivity to threat *oversensitivity to own physical cues *low level of self-efficacy -cognitive restructuring seeks to fix thinking (self-defeating thoughts to coping thoughts) -virtual reality therapy - exposure to simulated situations, to help learn to moderate response -relaxation and breathing training - may make use of biofeedback, monitoring of own physiological reactions -response prevention in OCD - to see that nothing bad happens when compulsion isn't exercised -social skills training - teaches interpersonal skills and assertiveness to deal with social phobia

Cognitive perspective of anxiety disorders

-Persistent stuttering: difficulty speaking fluently with the appropriate timing of speech sounds Characterized by one or more of the following features: *repetitions of sounds and syllables *prolongations of certain sounds *interjections of inappropriate sounds *broken words, such as pauses occurring within a spoken word *blocking of speech *circumlocutions - substituting alternative words to avoid problematic words *displaying an excess physical tension when emitting words *repetitions of monosyllabic whole words

Childhood-onset fluency disorder

-Disorders in which cognitive function is impaired via some biological cause -In DSM-5, many of these are grouped within subcategories of Mild or Major Neurocognitive Disorder, with additional specifier symptoms for specific disorders

Cognitive Disorders

-Brain abnormality allows processing of only one stimulus at a time *Right hemisphere more integrative *So, may have difficulty integrating input from various senses

Cognitive-Learning Perspective of Autism

-Persistent difficulties in understanding or using language or speaking clearly and fluently

Communication Disorders

-Children purposefully engage in antisocial behavior that violates social norms and the rights of others -Intentionally aggressive and cruel; frequently aggressive toward others, bullying, or threatening other children or starting physical altercations -Many are callous and do not experience guilt or remorse for their misdeeds -Affects about 12% of males and 7% of females

Conduct disorder

State of extreme mental confusion in which people have difficulty focusing their attention, speaking clearly and coherently, and orienting themselves to the environment

Delirium

-Most frequently identified cause of ID -Extra chromosome on 21st pair of chromosomes -Occurs in about 1 in 800 births; chromosomal abnormalities become more likely as parents age -Distinctive physical features -Nearly all have ID and many suffer from physical problems like malformations of the heart and respiratory difficulties

Down Syndrome

-Most common type of learning disorder -Accounts for perhaps 80% of cases -Have trouble reading even though they process at least average intelligence

Dyslexia

Lack of control over bowel movements that is not caused by an organic problem

Encopresis

Failure to control urination after one has reached the "normal" age for attaining such control -Child must be at least 5 years of age or at an equivalent developmental level and meet the following criteria: *the child repeatedly wets bedding or clothes (whether intentionally or involuntarily) *wetting occurs at least twice a week for three months or causes significant distress or impairment in functioning *there is no medical or organic basis to the disorder, nor is it caused by use of a drug or medication

Enuresis

-Affects nearly 1.4 in 10,000 males and about 0.9 in 10,000 females -Second most common form of ID overall, after Down syndrome -Mutation on a single gene in an area of the X chromosome that appears fragile

Fragile X syndrome

-Hans Selye's -Stress and anxiety disorders often reflect biological response or exhaustion within GAS -Alarm > Resistance > Exhaustion -Effects may be driven by nature of the stressor (good/bad, short-term/long-term) -common biological pattern of response to prolonged or excessive stress

General Adaptation Syndrome

-Negative view of oneself -Negative view of the environment -Negative view of the future -Distorted, maladaptive thinking is manifested via automatic thought

Major Depressive Disorder - Beck's Cognitive Triad Theory of Depression

-Formerly referred to (formally) as mental retardation -IQ score of 70 or below (2 SD below mean) -Impaired skills relative to others the same age -Development of the disorder before age 18 -General deficit in intellectual development -Significant and broad-ranging limitations or deficits in intellectual functioning and adaptive behaviors -Tend to have deficits in reasoning and problem-solving ability, abstract thinking skills, judgment, and school performance

Intellectual Disability

-Only occurs among males -Presence of an extra X chromosome, resulting in XXY chromosomal pattern rather than the normal XY pattern -1 to 2 cases per 1,000 male births -Fail to develop appropriate secondary sex characteristics, resulting in small, underdeveloped testes, low sperm production, enlarged breasts, poor muscular development, and infertility

Klinefelter syndrome

-Impairments in the ability to produce or understand spoken language

Language disorder

Two-factor model (Mowrer): -initial association of neutral stimulus with aversive experience; then, avoidance is rewarded with no aversive experience -so panic attacks may be triggered by associational cues, and agoraphobic behavior is reinforced by absence of panic attacks -PTSD symptoms triggered by associational cues -compulsive behaviors earn reward of relief from obsession -treatments *systematic desensitization via gradual exposure to symbolic or actual stimuli *flooding - overwhelming exposure to strong stimuli

Learning perspective of anxiety disorders

-Mild (IQ 50-70): About 85% of cases; Not necessarily outwardly noticeable; May appear a little slower or need more support at most tasks; Can achieve basic life skills -Moderate (IQ 35-49): About 10% of cases; Noticeable developmental delays; Can develop basic communication and maintenance skills, but limited in progress in academic skills; Can still function alone in limited situations -Severe (IQ 20-34): About 3-4% of cases; Marked developmental delays in motor skills; Little or no communication skills; May achieve only simple life skills (Ex, self-feeding) and certain fixed routines; Can walk, but needs lots of support and supervision -Profound (IQ < 20): About 1-2% of cases; Gross impairment, needs nursing care for survival; Needs close supervision across all circumstances; Can show basic emotional response, but may have no communication skills; No basic life skills

Levels of Intellectual Disability

-History of depression Hippocrates discussed problem of melancholy With few outside symptoms, sufferers generally weren't subjected to asylums in the middle ages -Wealthy sufferers went to spa-like sanitariums for treatment By the 1930's, psychoanalysis and ECT had become commonplace treatments

Major Depressive Disorder

Biological focus took over with 1965 catecholamine hypothesis (norepinephrine imbalance) and 1969 indolamine hypothesis (serotonin) Recent research suggests serotonin's role overstated -A 1990 study in which people were depleted of serotonin found no change in mood -Meta-analyses call SSRI efficacy into question If not serotonin, how might SSRI drugs work? -Placebo effect? -A sense of certainty may contribute to improved self-efficacy

Major Depressive Disorder - Biology

Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure -depressed mood most of the day, nearly every day -markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day -significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day -a slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down) -fatigue or loss of energy nearly every day -feelings of worthlessness or excessive or inappropriate guilt nearly every day -diminished ability to think or concentrate, or indecisiveness, nearly every day -recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

Major Depressive Disorder - DSM

-Today it is most commonly treated with SSRIs and talk therapy (cognitive and behavioral) -In case of seasonal affective disorder, may also be treated with phototherapy -As population becomes more skeptical, people take less seriously the depression of those who need the drugs

Major Depressive Disorder - Treating depression

-at first people receive unconditional support -over time supporters become angry at lack of progress -this leads to rejection, and further depression -research supports broad model, but suggest social rejection is based less on anger at actions than it is on poor social skills

Major Depressive Disorder - interactional theory

-Martin Seligman -Person learns that they are not effective in taking control over their own life, learns to rely on social support -This leads them to stop trying, which causes further problems, which in turn causes further depression -Tied into attributional style and locus of control

Major Depressive Disorder - learned helplessness theory

-Social - the stressful circumstances of people's lives -Cognitive - negative or maladaptive habits of thinking and ways of interpreting events -Diathesis-Stress model draws on all of these *Person has an underlying biological vulnerability, which is then triggered by stressors in the environment *The diathesis is widely presumed to be genetic

Major Depressive Disorder - other theories of depression

-Evidence of significant cognitive decline from a previous level of performance in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition) based on: -Concern of the individual, a knowledgeable informant, or the clinician that there has been a significant decline in cognitive function; and -A substantial impairment in cognitive performance, preferably documented by standardized neuropsychological testing or, in its absence, another quanitifed clinical assessment -The cognitive deficits interfere with independence in everyday activities (ie., at a minimum, requiring assistance with complex instrumental activities of daily living such as paying bills or managing medications) -The cognitive deficits do not occur exclusively in the context of a delirium -The cognitive deficits are not better explained by another mental disorder (ex, major depressive disorder, schizophrenia)

Major Neurocognitive Disorder

-A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently goal-directed behavior or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary) -The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. -During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and are present to a significant degree and represent a noticeable change from usual behavior: *inflated self-esteem or grandiosity *decreased need for sleep (ex, feels rested only after only 3 hrs of sleep) *more talkative than usual or pressure to keep talking *flight of ideas or subjective experience that thoughts are racing *distractibility (i.e, attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed *increase in goal-oriented activity (either socially, at work or school, or sexually) or psychomotor agitation *excessive involvement in activities that have a high potential for painful consequences (ex, engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

Manic Episode - DSM

Evidence of modest cognitive decline from a previous level of performance in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition) based on: -Concern of the individual, a knowledgeable informant, or the clinician that there has been a mild decline in cognitive function; and -A modest impairment in cognitive performance, preferably documented by standardized neuropsychological testing or, in its absence, another quanitifed clinical assessment -The cognitive deficits do not interfere with capacity for independence in independence in everyday activities (ie, complex instrumental activities of daily living such as paying bills or managing medications are preserved, but greater effort, compensatory strategies, or accommodation may be required) -The cognitive deficits do not occur exclusively in the context of a delirium -The cognitive deficits are not better explained by another mental disorder (ex, major depressive disorder, schizophrenia)

Mild Neurocognitive Disorder

-Affects 7% of Americans in any given year -Affects women more than men

Mood disorders affect how many Americans in a given year? Affects men or women more?

Involve an impairment of brain functioning or development that affects a child's psychological, cognitive, social, or emotional development

Neurodevelopmental disorders

-used to be grouped with Anxiety Disorders, but in DSM-5 now a separate category -includes related disorders: body dysmorphic disorder hoarding disorder trichotillomania (hair pulling disorder) excoriation (skin-picking) disorder

Obsessive-Compulsive Disorder

Compulsions: -repetitive behaviors (ex, hand washing, ordering, checking) or mental acts (ex, praying, counting, repeating words silently) in response to an obsession or according to rules that must be applied rigidly -the behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a way that could realistically neutralize or prevent whatever they are meant to address, or they are clearly excessive

Obsessive-Compulsive Disorder - DSM compulsions

Obsessions: -recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and cause marked anxiety and distress -the person attempts to suppress or ignore such thoughts, impulses, or images or to neutralize them with some other thought or action

Obsessive-Compulsive Disorder - DSM obsessions

-"the obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships" -affects 2-3% of population -symptoms can last a lifetime, though seriousness often ebbs over time -often compulsions used to ease anxiety of obsessions -possible problem in feedback from amygdala

Obsessive-Compulsive Disorder DSM

-More nondelinquent forms of CD -May lead to development of CD at later ages (30% of children go on to develop CD) -Children tend to be overly negativistic or oppositional. They defy authority by frequently arguing with parents or teachers and refusing to follow requests or directives -Easily lose temper and often in angry or irritable mood -Estimated to affect 1 to 11% of children and adolescents

Oppositional defiant disorder (ODD)

-Most widely diagnoses childhood disorder (about 3-5% actual estimate) -Most often diagnosed in boys -Many are skeptical of the existence of the disorder; however, there appear to be brain-level differences in the attention and motor areas of the brain -Increased rates for children of mothers who smoke during pregnancy suggests lowered prenatal blood oxygen level can play a biological role -Diagnosis rates have increased over time *The diagnostic criteria have some broadly interpretable language *People doing the diagnosing often use unsuitable or highly subjective tools

Percent of population diagnosed with ADHD? Affects boys or girls more?

at least one of the attacks has been followed by 1 month (or more) of one (or more) of the following: -persistent concern about having additional attacks -worry about the implications of the attack or its consequences (ex., losing control, having a heart attack, "going crazy") -a significant change in behavior related to the attacks

Panic Disorder Additional DSM criterion

Genetic disorder that occurs in about 1 in 10,000 to 15,000 births -Caused by recessive gene that prevents a child from metabolizing the amino acid phenylalanine, which is found in many foods, Consequently, phenylalanine and its derivative, phenylpyruvic acid, accumulate in the body, causing damage to CNS, resulting in severe ID -Children can be placed on diets low in phenylalanine soon after birth and given supplements to compensate for nutritional loss

Phenylketonuria

Alterations in arousal and reactivity: trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event: (two required) -irritable or aggressive behavior -self-destructive or reckless behavior -hypervigilance -exaggerated startle response -problems in concentration -sleep disturbance

Post-Traumatic Stress Disorder - DSM alterations in arousal and reactivity

Negative alterations in cognitions and mood that began or worsened after the traumatic event: (two required) -inability to recall key features of the traumatic event (usually dissociative amnesia; not due to head injury, alcohol, or drugs) -persistent (and often distorted) negative beliefs and expectations about oneself or the world (ex., "I am bad", "The world is completely dangerous") persistent distorted blame of self or others for causing the traumatic event or for resulting consequences -persistent negative trauma-related emotions (ex., fear, horror, anger, guilt, or shame) -markedly diminished interest in (pre-traumatic) significant activities -feeling alienated from others (ex., detachment or estrangement) -constricted affect: persistent inability to experience positive emotions

Post-Traumatic Stress Disorder - DSM alterations in cognitions and mood

Avoidance: persistent effortful avoidance of distressing trauma-related stimuli after the event: (one required) -trauma-related thoughts or feelings -trauma-related external reminders (ex., people, places, conversations, activities, objects, or situations)

Post-Traumatic Stress Disorder - DSM avoidance

Intrusion Symptoms: the traumatic event is persistently re-experienced in the following way(s): (one required) -recurrent, involuntary, and intrusive memories. Note: Children older than six may express this symptom in repetitive play. -traumatic nightmares. Note: Children may have frightening dreams without content related to trauma(s). -dissociative reactions (ex., flashbacks) which may occur on a continuum from brief episodes to complete loss of consciousness. Note: Children may reenact event in play. -intense or prolonged distress after exposure to traumatic reminders. -marked physiologic reactivity after exposure to trauma-related stimuli

Post-Traumatic Stress Disorder - DSM intrusion symptoms

Stressor: the person was exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, as follows: (one required) -direct exposure -witnessing, in person -indirectly, by learning that a close relative or close friend was exposed to trauma. if the event involved actual or threatened death, it must have been violent or accidental. -repeated or extreme indirect exposure to aversive details of the event(s), usually in the course of professional duties (ex., first responders, collecting body parts; professionals repeatedly exposed to details of child abuse). This does not include indirect non-professional exposure through electronic media, television, movies, or pictures.

Post-Traumatic Stress Disorder - DSM stressor

-severe and persistent mood changes occur around the time of childbirth that represent a form of major depression -Affects 10-15% of US women in the first year following childbirth

Postpartum Depression (PPD)

Changing of the seasons from summer to fall and winter can lead to a type of depression -Affects 3-10% of general population -Women affected twice as often as men -phototherapy to treat!

Seasonal Affective (Mood) Disorder (SAD)

-A 2007 meta-analysis found no significant difference in prevalence rates when comparing North America vs Europe and Asia -While prevalence rates for various disorders might be stable, actual diagnosis rates vary substantially by nation -Research indicates however, that drug interventions are on the rise in Europe, closing the gap with prescription rates in the US -So, culture and assumptions are a significant component of the category of developmental disorders

Prevalence rates for ADHD between North America and Europe and Asia? The role of culture?

Diagnosed if either of the following is present; otherwise, possible Alzheimer's disease shoulld be diagnosed. -Evidence of a causative Alzheimer's disease genetic mutation from family history or genetic testing -All three of the following are present: *Clear evidence of decline in memory and learning and at least one other cognitive domain (based on detailed history or serial neuropsychological testing) *Steadily progressive, gradual decline in cognition, without extended plateaus *No evidence of mixed etiology (ie, absence of other neurodegenerative or cerebrovascular disease, or another neurological, mental, or systemic disease or condition likely contributing to cognitive decline)

Probable Alzheimer's disease (Major)

-IQ shifts higher over time (Flynn Effect) -When students are tested on a renormed test, they're more likely to be classified as having a disability *In recent revision, test scores dropped 5.6 points from old version to renormed version -This brings implications for the classroom, death row inmates, and society in general

Problems with using IQ score index for Intellectual Disability

-Depression is based in mourning loss of someone or something to which you had ambivalent feelings -Interpersonal therapy focuses on identifying problems in relationships and unresolved issues

Psychodynamic perspective for Depression

-anxiety is caused by unconscious fears -may impose fear of own impulses onto objects or situations *fear of suicide and acrophobia *object may be a symbol for something else one fears *treatment focuses on freeing the ego by making it aware of these unconscious urges

Psychodynamic perspective of anxiety disorders

When level of fear or anxiety associated with separation from a caregiver or attachment figure is persistent and excessive or inappropriate for the child's developmental level -Affects an estimated 4-5% of children

Separation anxiety disorder

-Continuing and profound difficulties communicating verbally and nonverbally with other people in their natural contexts -Difficulty carrying on a conversation and may fall silent when in a group of children -Difficulty acquiring and using both spoken and written language but do not show a general low level of language or mental abilities that might explain their difficulties communicating with others

Social (pragmatic) communication disorder

-recurring experiences of intense panic, with no obvious trigger or cause -manifested in several bodily symptoms (heart rate, shortness of breath, sweating, dizziness) -panic attack can feature feelings of losing control or dying -can build up over 10-15 mins, then last several mins at their worst -uncued panic attack = comes out of the blue, no obvious trigger -situationally bound panic attack = tied to a specific, usually known trigger

panic disorder

persistent difficulty articulating the sounds of speech in the absence of defects in the oral speech mechanism or neurological impairment

Speech sound disorder

-Stimulants like Ritalin and Adderall can have an effect of activating the attention areas of the brain -Unfortunately, the typical approach is to use drugs alone, without supplemental behavior modification or therapy efforts -Placebo can achieve a lot; however, actual drugs do achieve more, so there is a real biological role for them if properly prescribed

Treating ADHD

limited options -Most rely on intensive behavioral therapy, known as Applied Behavior Analysis *40 hrs/week for multiple years improved social and intellectual skills *Very costly and labor intensive *At mild end may be based on token economies *At severe end may require repeated trials for simple behaviors

Treating Autism

-Occurs only in females -Presence of a single X chromosome instead of the normal two -Develop normal external genitals, but ovaries remain poorly developed, producing reduced amounts of estrogen -Generally short stature and infertile and have endocrine and cardiovascular problems

Turner syndrome

-Perspectives on this vary by culture -Thai and US adults shown videos of children acting out disobedience, fighting, shyness and fear -Asked adults to rate the seriousness of the behavior -Thai parents, teachers, and psychologists did not see these actions as serious as their US counterparts

What is normal child behavior?

-Affects no more than 1-2% of the population, usually appearing in early adulthood *Equally common in men and women, though men usually start with a manic episode, women with depressive -Episodes last from several days to months -Individuals cycle between mania and depression -Symptoms worsen in first decade; episodes less frequent after 20 years -Suicide attempt rate is high -> almost 20%

What percent of population is affected by Bipolar Disorder? Men or women more affected?

affects 1-4% of Americans

percent of Americans affected by panic disorder?

applies to cases of chronic depression lasting for at least two years

persistent depressive disorder

applies to those who have a major depressive episode superimposed on a longer-standing dysthymia

double depression

-an irrational fear, disproportionate to or without an objective basis -powerful or overwhelming enough that it affects the way you live your life -specific phobias typically have earlier onset (onset in childhood) -social phobia and agoraphobia usually have later onset (adulthood)

phobic disorders

-fear of a situation that is "out of proportion to the actual danger in the situation" -fear of being in a place from which it will be difficult or embarrassing to escape if a panic attack begins -typically onset around age 28, after several years of build-up -often develops as a vicious cycle: panic attacks make the person scared to go out; when they do go out, they worry about the panic attack, which triggers anxiety and reluctance to go out

agoraphobia

-characterized by abnormal levels of arousal, tensions, fear or a sense of foreboding trouble -generalized state of apprehension or foreboding -symptoms can be physical, emotional, cognitive, behavioral -used to be classified as neuroses (William Cullen); however, that category included many other disorder types no longer grouped with anxiety -most diagnosed more often in women than men

anxiety disorders

people are preoccupied with an imagined or exaggerated physical defect in their appearance, such as skin blemishes, wrinkles, body moles or spots, etc -often become obsessed with their perceived defect and often feel compelled to check themselves in the mirror or engage in compulsive behaviors aimed at fixing, covering, or modifying the perceived defect

body dysmorphic disorder

-within military populations, there are significant challenges in diagnosing and treating those with PTSD -fear of appearing weak -expectations of military role -potential undermining of career options -skepticism about treatment (Jeff's story) -lack of local support resources -photo representations of PTSD experiences among veterans

challenges surrounding PTSD

Tied strongly to coping styles: -Problem-focused coping -Emotion-focused coping When tied to or causing self-efficacy problems, can lead to a downward spiral that continues the disorder

coping styles for Major Depressive Disorder

late adolescence and early adulthood and persists for years -chronic cyclical pattern of mood disturbance characterized by mild mood swings lasting at least two years

cyclothymic disorder

excessive anxiety and worry that is not limited to any one object, situation, or activity; restlessness, jumpiness, and muscle tension -excessive and uncontrollable worry

generalized anxiety disorder (GAD)

characterized by extreme difficulty discarding stacks of unnecessary and seemingly useless possessions, which results in personal distress or in creating so much clutter that it makes a person's home unsafe to walk through or nearly uninhabitable -2-5% of population it affects daily functioning

hoarding disorder

-unusually severe or prolonged disturbances in mood 1) Depressive disorders *Major depressive disorder *Disruptive mood regulation disorder *Premenstrual dysphoric disorder *Persistent depressive disorder (dysthymia) 2) Bipolar and related disorders *Bipolar disorder *Cyclothymic disorder

mood disorders two DSM categories:

-a long-term negative reaction to a traumatic event (aka shell shock, battle fatigue, and combat exhaustion) -outlawed by Germans in WWI; those claiming it were shot -today it's tied not only to military action but to many traumatic events -triggering event is usually life-threatening with a feeling of being trapped and powerless -controversially, DSM-5 expanded PTSD diagnosis to people who did not directly experience event -treatment by flooding or systematic desensitization

post-traumatic stress disorder

more severe form of PMS range of symptoms in the week before menses such as mood swings, tearfulness, feelings of sadness, depressed mood or feelings of hopelessness, irritability or anger, anxiety, tension, being on edge, greater sensitivity to cues of rejection, and negative thoughts about oneself -also need to be associated with significant emotional distress or interference with a woman's ability to function on the job, in school, or in usual social activities

premenstrual dysphoric disorder (PMDD)

-also called Social Anxiety Disorder -fear of social interactions or situations -usually predicted on assumption that others will judge you poorly

social phobia

-an irrational and persistent fear of a specific object or situation -affects 7-11% of population over the lifespan

specific phobia

-typically characterized by elevated levels of anxiety in the nervous system -differentiated from mood disorders, where the symptoms are more about depressed levels of functionality; however, commonly co-diagnosed -diagnosis will look at biological symptoms within the environmental context and its stressors

stress and anxiety disorders

-Depression -Estimates are that it affects 10-25% of women and 5-12% of men at some point in the lifespan *However, diagnosis is a challenge *Many people think they should just be able to snap out of it, or that it's a sign of weakness

the most common psychological disorder? percentage of affecting women and men at some point in the lifespan?