PSYC 223 - Exam 2

Know the main neurotransmitters thought to be involved in Schizophrenia, as well as the brain areas that are implicated in the disorder.

**Dopamine** the reward-circuitry. increased brain levels of dopamine underlie schizophrenia symptoms. increased number of receptors for dopamine. dysfunction is dopamine release some of these things were discovered accidentally **Glutamine** Most abundant excitatory neurotransmitter in the brain glutamate is involved in cognitive functions such as learning and memory in the brain excess of glutamate can be neurotoxic and underlie problems seen in schizophrenia **Structural abnormalities** Increased volume of lateral ventricular areas in schizophrenic patients. (fluid-filled spaces in the middle of the brain, larger than supposed to be, and the area around them start to erode). Decreased frontal, temporal and whole brain volume frontal lobe: higher- order cognitive processes. this part of the brain evolved last. where you organize your behavior. when you have problems in that area, you have problems with disorganized speech (problems with executive functioning). hippocampus: long-term memory function. deficits here within schizophrenics

Know what differentiates neurotic versus psychotic disorders.

**Neurotic** refers to a class of functional mental disorder involving distress but not delusions or hallucinations, where behavior is not outside socially acceptable norms. A mild mental disorder not arising from organic diseases, instead it can occur from stress, depression or anxiety **Psychotic** a major personality disorder characterized by mental and emotional disruptions. Much more severe, and often impairs and is debilitating to the individual. Fundamental part is the disconnect with reality, the sense of the world around them is impaired. Include severe impairment in individuals perception and understanding of reality (includes delusional thought content, abnormalities in sensory perception)

Know the difference between the various subtypes of Schizophrenia.

**Paranoid** Preoccupation with persecutory delusions or auditory hallucinations. they hear voices, suspicious of other people, elaborate delusional belief systems. A lot of newer patients **Disorganized** prominent disorganized speech and behavior. Problems in areas with working memory (ability to recall information and use it in the immediate sense) a lot of deficits there in schizophrenics. Have tangential speech: start talking about something and then do a 180 and start a new thing. Flat or inappropriate emotional expressions Tend to be older patients. Could all be due to the long haul of the disorder, drugs or being institutionalized for so long **Catatonic schizophrenia** Motor immobility or excessive motor activity. Waxy flexibility: could be moved and manipulated but where you moved them is where they stayed

Know the difference between positive and negative symptoms in Schizophrenia, as well as define the various positive and negative symptoms discussed in class.

**Positive** definition:the presence of symptoms indicative of psychosis (break with reality) Though content: Delusions Delusions: a false belief that meets the following criteria: Certainty: held with absolute conviction Incorrigibility: Not changeable by compelling counter argument or proof to the contrary Preoccupation: delusional belief focus of thought and action impossibility or falsity of content: implausible of patently untrue Bizarre and non-bizarre delusion: Non-bizarre:theoretically possible but clearly untrue bizarre: violate the accepted laws of nature Perception: Hallucination/illusions Hallucinations: a false perception of objects or events involving the sense (auditory, visual, tactile, olfactory, somatic, gustatory) Form of Thought: vague, unfocused and seemingly pointless discourse **Negative** def: The loss/absence of normal traits or abilities Affect: flat affect, mood lability. the individual seems to be responding to the environment in a muted way. respond to bad news in a flat and mundane way Volition: Loss of drive or motivation. become amotivated, could be due to becoming depressed interpersonal relationships: social withdrawal Identity: confusion of personal identity and confused boundaries between internal and external world. Confused about who they are, think people can see their thoughts and be in their mind as well. Psychomotor Behavior: hyperactivity, catatonic rigidity. could be due to old antipsychotics (not confirmed)

Be able to identify the main symptoms of anorexia and bulimia nervosa and what differentiates the two disorders, including age of onset.

**anorexia has earlier onset*** restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex developmental trajectory, and physical health (significantly low weight is defined as a weight less than minimally normal: underweight) intense fear of gaining weight or becoming fat or persistent behavior that interferes with weight gain, even at a significantly low weight. disturbance in the way in which one's body or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight there are plenty of health consequences, but the individual isn't concerned about this Body dysmorphia: how one sees their body is different than what others see (play into anorexia but it is a separate thing) there is a heavy presence of anxiety in AN but AN is its own separate disorder personality components that determine who develops AN disorder 12-25 Bulimia Recurrent episodes of binge eating, characterized by both of the following: eating in a discrete period of time, an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances. a sense of lack of control over eating during the episodes (feeling that one cannot stop eating or control what or how much one is eating) Recurrent inappropriate compensatory behavior in order to prevent weight gains, such as self-induced vomiting, misuse of laxatives, diuretics, or other medications; fasting, or excessive exercise Body weight is what differentiates between AN and BN: either regular weight or overweight for BN. AN has a cut-off of body weight less than 85% normal weight and amenorrhea Also, AN tends to develop earlier than BN

What is temporal discounting and how might it relate to addiction?

- Individuals with addiction problems discount rewards at a greater risk - they elect short term gratification over potential future consequences - steeper discounting rate = more addictive personality

What is likely being inherited with respect to predispositions to addictive behavior?

- higher risk of finding psychoactive substances reinforcing - ignored potential consequences of risk behavior - foreshortened orientation from the future - certain brains have a predisposition to gratification, making them more susceptible to becoming addicted to many things - impulsive orientation (predisposition to behavioral control problems) - greater orientation to pleasure seeking behavior

According to the text, what were the two most notable changes between the DSM-IV and V? With respect to what was added, in general what did the research evidence suggest as to why this was a critical symptom to include?

- removed legal problems - added cravings **research highlighted the importance of cravings in the continuation of the disorder craving was associated with highest relative risk of all criteria for alcohol dependence, and linked to substance consumption

What is the role of operant and classical conditioning in substance use disorders?

- social & environmental factors produce rewards after self administration - rewarding effects following behavior increase - likely to use substance again - drug induced euphoria becomes associated with stimuli present during the euphoric state (people, location, etc...)

What aspects of the social environment can exacerbate risk for Schizophrenia or cause the worsening of symptoms?

-stress may increase the risk of psychotic episodes and worsen functional outcomes in schizophrenia -persistent social stress can worsen the course -individuals w. schizophrenia living in families characterized by high levels of negative expressed emotion have worse symptoms and are more likely to require future hospitalization

What two key pieces of evidence led researchers to focus on dopamine function as a component of schizophrenia? What research has suggested that the "too much dopamine" hypothesis is probably not valid? What evidence is there to suggest the role of glutamate in schizophrenia?

1. Drugs that reduce dopamine activity diminish psychiatric symptoms 2. drugs that increase dopamine activity exacerbate psychotic symptoms dopamine concentrations were not found to be markedly elevated in the brains of those with schizophrenia some drugs block NMDA receptors and prevent them from sensing glutamate (called NMDA antagonists), produce schizophrenia like symptoms, cause negative, positive, and cognitive symptoms. Drugs that improve NMDA receptor functioning can reduce negative symptoms and improve cognitive functioning

According to Janoff-Bulman, what are the three major assumptions may be "shattered" by a traumatic event?

1. Personal invulnerability 2. World as a meaningful and predictable place 3. Self as positive or worthy

Brewin: 2 emotional reactions:

1. Primary (durring event) fear, horror 2. Secondary (Post event) anger, shame

On what critical symptom does the diagnosis of BN center? What is the difference between an objective binge episode and a subjective binge episode?

A typical preoccupation with food and over eating including a very appetite that involves over eating followed by vomiting Objective bench episode are defined as eating more than most people would eat in a similar situation and in a discreet period of time and with a sense of loss of control over eating Subjective bench episodes episodes and watch loss of control is endorsed but where are normal or even small portions are reported

Be familiar with the symptoms in Criteria A and B for DSM-V diagnosis.

A. Criteria have been met for at least one manic episode (Table 11). The manic episode may have been preceded by and may be followed by hypomanic or major depressive episodes (see Table 9).B. The occurrence of the manic and major depressive episode(s) is not better explained by schizoaffective disorder, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.

Know the defining features of a traumatic event according to the DSM-V, as well as the typical course for PTSD symptoms following a traumatic event.

A. Exposure to actual or threatened death, serious injury, or sexual violence. Exposure through electronic media, television, movies, or pictures, unless this exposure is work related. B. Intrusion symptoms associated with the traumatic event(s) C. Persistent avoidance of stimuli associated with the traumatic event(s) D. Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more): 1. Inability to remember an important aspect of the traumatic event(s) 2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world 3. Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others. 4. Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). 5. Markedly diminished interest or participation in significant activities. 6. Feelings of detachment or estrangement from others. 7. Persistent inability to experience positive emotions E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: 1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. 2. Reckless or self-destructive behavior. 3. Hypervigilance. 4. Exaggerated startle response. 5. Problems with concentration. 6. Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). F. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. G. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. H. The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.

What personality factor seems most relevant to developing an alcohol use disorder? What aspect of this broad personality dimension seems the most predictive of alcohol problems?

An examination of personality motives in relation to risky behaviors founded a high degree of neuroticism along with a high degree of impulsivity and extroversion predicted and increased reliance and alcohol use as a coping mechanism

tension-reduction theory

Assertion that individuals drink to reduce tension which motivates aspects underlying drinking

According to Brewin, what are the two ways in which traumatic memories are thought to be stored? Which one is thought to account for the presence of nightmares, flashback, and intrusive thoughts within PTSD?

Autobiographical memories of experience referred to as verbally accessible memories- info attended to before, during, after event with conscious--> transferred to long term memory Situationally accessible memories (SAM): extensive non conscious and nonverbal info about dramatic event that cannot be accessed or easily altered. Trigger in flashbacks, intrusive thoughts

What differentiates BED from BN?

BED criteria do not require the display of over concern with way or shape that is a requirement for bulimia

Based on what rationale does the DSM-V differentiate between early and sustained remission?

Because individuals are at a particularly high risk for relapse in the first 12 months after symptoms remit Early: None of the criteria except for craving have been met for at least three months but for less than 12 months Sustained: 12 months or longer

The family environment may foster eating disorders in that they fail to teach appropriate behaviors around eating; what other characteristics are common in families of eating disordered patients?

Chaotic, conflicted, and critical, and as lower and positive expressiveness, cohesion, and caring than other families. A negative family environment could increase anxiety and depression, which in turn are associated with the later development of eating disorders

What adverse early life experiences are related to more severe bipolar disorder later in life? What evidence suggests that childhood adversity may potentiate the effects of stressful events on manic onset or recurrence?

Childhood abuse, maltreatment, stressful, traumatic events have been found to increase the risk of chronic stress within Bipolar Disorder, Stressful events that occurred in the year before the study's baseline assessment were more closely associated with onsets or recurrences of mania among genetically at risk individuals w childhood adversity than those without. Pattern suggests childhood adversity potentiates effects of stressful events on manic onset/occurrence.

Know the major risk factors for PTSD identified by DiGangi et al.'s (2013) meta-analysis.

Cognitive Factors Lower cognitive ability a risk for PTSD development (verbal ability, processing speed, retrieval of autobiographical memory) Also included negative self-evaluation, extinction learning, and military trainability Coping Styles Negative cognitive bias, rumination, and avoidant coping styles Personality neuroticism/negative affectivity, trait anger/hostility, harm avoidance, and trait dissociation Pre Trauma Psychopathology Having some form of pre trauma psychopathology is a risk for PTSD development Individuals who are already experiencing symptoms of anxiety and depression are more likely to develop PTSD than those not already anxious and depressed Social and Ecological Factors Social support networks Poverty

Memory

Coping. Flashback, intrusive memories, amnesia

Be familiar with the four domains of PTSD symptoms and what symptoms correspond to which domain. Note that it is more important to be familiar with the descriptive label for each domain (e.g., arousal and reactivity versus Criterion E).

Criterion A: An individual must have experience, witnessed or learned abt the traumatic event of a loved one, or have experienced repeated exposure to the aftermath of traumas, such as the experiences of first responders. In addition to exposure to criterion A event, an individual must also be experiencing a qualifying number of symptoms in each of the 4 cluster of symptoms (B-E) Criterion B: Intrusion Must exhibit at least 1 of the intense symptoms: persistent and distressing memories of the trauma, dissociative reactions. Criterion C: Avoidance must also exhibit at least one of the avoidance symptoms. effortful avoidance of internal cues and efforts avoid external reminders of the trauma like places, ppl or situation Criterion D: neg alterations in cog & mood must exhibit 2 or more: distorted self blame, neg beliefs abt self, range of affect from numbing and amnesia to strong neg emotions such as guilt, anger, fear Criterion E: alterations in arousal and reactivity. must meet at least 2 symptoms: sleep difficulties, conception impairment, exaggerated startle response, hypervilance

Be sure to know the different domains of PTSD symptoms and examples of the symptoms within each domain.

Criterion B (intrusions) Intense physiological and psychological response when exposed to trauma-related cues Criterion C (avoidance) Effortful avoidance of cues related to the traumatic event; such as persons, places, or situations Criterion D (negative alterations in cognition/mood) Emotional numbing Feeling distant from others, lacking positive emotions, inability to express or feel happiness/love Criterion E (hyperarousal and reactivity) Self destructive behavior

Know the evidence regarding media/cultural, peer, and family influences on eating disorders.

Culture/Media: ideals tend toward body shapes that are difficult to achieve under certain circumstances. food is everywhere and abundant, as a result, it pushes the ideal of beauty as "the thin ideal". exposure to the thin ideal may underscore greater body dissatisfaction and, in turn, engagement in behaviors that are aimed at attaining this ideal. societal pressure puts pressure on a whole demographic being women. idealization of slimness and derogation of fatness in cultures of abundance is more intense in females This is a modern invention of a disorder. The socialization agents (media) reinforce the thin-ideal body image for women through comments or actions that serve to support and perpetuate this idea (criticism or teasing regarding weight, encouragement to diet, and glorification of ultra-slender models). These sources communicate expectations concerning the benefits of thinness, such as increased social acceptance, and these expectations likely play a key role in propagation of this ideal Meta-analytic work suggests only small effects for media exposure to the thin ideal. Could be that those preoccupied with weight seek out thin ideal media representations. The media effect is SMALL. Research also shows risk of influence by thin ideals in the media moderated by other factors. It could be the combo of perfectionist and media representation that drives this.

The authors draw a parallel between our understand of schizophrenia and cancer - upon what bases do they make this analogy?

Diathesis stress model: Lifetime risk for why cancer is very low for people who do not smoke cigarettes: about 0.2% among men who do not smoke. Regular cigarette smoking dramatically increases the rate of lung cancer to about 24%. Developing lung cancer generally requires both diathesis (genetic or other predisposition) and a stressor (regular smoking).

What did Ramage et al. (2016) find with respect to the different types of emotions that associate with different types of trauma?

Disgust, guilt, shame engage different neutral systems than fear

Pathology

Disruption in cognition or memory (DSMs). Specifically, Criteria B( recurrent, intrusive recollections of event)

What are some physical consequences of continued binging/purging?

Electrolyte abnormalities, a esophageal complications, gastrointestinal system symptoms, reflex constipation and the loss of normal: function, dental problems, and large parotid glands

social learning theory

Emphasizes learning from social environments And also cognitions as important determinants of behavior Focusing on three aspects of behavior social environmental variables coping skills and cognitive factors

What, in general, is the impact of PTSD on marital status? What symptoms in particular may be particularly relevant to this phenomenon?

External people with PTSD are as likely as those without PTSD to be married, but Males and Females with PTSD are more likely to divorce multiple times. Symptoms: relationship discord, domestic violence, sexual dysfunction, mental health problems in parters with PTSD. Avoidance and numbing

Be familiar with the evidence to support genetic and biological factors in bipolar disorder, as well as the specific neurotransmitters likely involved in manic episodes and how they interrelate.

Family, twin, and adoption studies highlight that bipolar disorder aggregates in families Genetic Studies: Among the most heritable disorders Estimates are as high as 85% to 93% for concordance among identical twins Genetics: Is that there is a shared genetic loci for bipolar, schizophrenia and depression. (especially for bipolar patients that also experience psychotic delusions or hallucinations) - those affected may have close relatives affected with these different disorders. Dopamine Plays role in the reward and/or incentive motivational circuitry Research: Dopamine function is enhanced during mania and diminished during depression Dopaminergic agonists are found to trigger episodes Evidence that it is a sensitivity issue at the level of the receptor (for instance, amphetamine sensitivity develops after the 1st use, but this does not happen with bipolar patients, suggesting that they were already sensitized. (2) Also helps make sense out of findings regarding goal directed behavior. Serotonin Plays an important role in the modulation of anger/aggression, body temperature, mood, sleep, sexuality, and appetite Research: Diminished functioning of serotonin in bipolar Deficits believed to allow for greater variability in the function of dopamine

What is the general trend with respect to the difference in rates of Alcohol Use Disorder amongst men and women?

Higher incidence in men 5.42% then women 2.32% of females had nearly 2 times the increase in proportion of past year drinking compared to males 29.8% of men and 18.6% of women have at least one heavy drinking day in the past year

Be able to define a hypomanic episode, cyclothymia, and bipolar NOS.

Hypomanic episode Defined by symptoms of shorter duration (i.e; 4 or more days) and noticeable change in behavior that are not functionally impairing. The mood disturbance is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features. PERIODS OF INCREASED ENERGY THAT ARE NOT SUFFICIENTLY SEVERE TO QUALIFY AS FULL-BLOWN MANIA. Cyclothymia two or more years switching between hypomanic and depressive symptoms that do not meet criteria for a hypomanic or major depressive episode Bipolar NOS (Not otherwise specified) Patients with manic symptoms that do not meet criteria for any of the other bipolar disorders.

What is the social rhythm stability hypothesis?

Hypothesized that sleep deprivation might mediate effects of life events on episodes, noting that life events often interfere with the ability to sleep. Environmental and interpersonal influences serve the role of time keepers (social "zeitgebers") whereas other social influences (social zeitstorers) disrupt the ability of the person with B.D to maintain daily rhythms. Social rhythm disruptions may predict symptoms above and beyond the roles specific to sleep.

What are the central tenets of Fairburn's transdiagnostic theory of eating disorders?

Identifies the centrality of over evaluation of eating, shape, weight, and their control across the range of eating pathology Variations and eating symptomatology are all expressions of this over evaluation and argues that the mechanism of the score believe must be targeted in treatment

Know the impact of the cultural/societal factors on eating disorders.

Impact heightened in cultures that impede women's access to other means of self-definition. Women have a particular role and it is usually subordinate to the man Contingencies in the local social environment are often associated with eating disorders. Higher frequency in subcultures that place a special emphasis on slimness and weight control Peer influences: Peer influences on body dissatisfaction appear stronger than media effects. Peers can influence body dissatisfaction by two main routes: may actively influence women through verbal comments, communication of beauty norms, explicit verbal comparisons, and attributions of personal value based on beauty. May passively influence body dissatisfaction by provoking internal or unconscious body comparisons Family Influences:Most influential. Families often praise AN patients' slenderness, and envy the self-control and discipline required to achieve it, so this reinforcement frequently persists even when the anorexic becomes severely emaciated. Mothers of girls with ED: think that their daughters should lose more weight and describe them as less attractive than do comparison mothers or the girls themselves Are more dissatisfied with the general functioning of the family system and are themselves more eating disordered than are mothers of girls who do not have EDs Direct maternal comments appear to be more powerful influences than is simple modeling of weight and shape concerns, although even modeling does appear to affect elementary schoolchildren's weight and shape-related attitudes and behaviors. What mom is saying is the most influential Mothers' critical comments prospectively predicted ED outcomes for their daughters.

What did Kessler et al. (1995) mean by "personal" versus "impersonal" traumas and what did they find with respect to the development of PTSD?

Impersonal is diasters/ accidents and personal is direct events (rape and assault). Personal trauma is greater

What is the immigrant paradox and what makes it a surprising phenomenon?

Individuals who are born outside the United States and then immigrate there seem to have a lower risk or alcohol use disorder that their US counterparts despite the fact that the former seemingly encounter more risk factors

Although restrictive behaviors can take many forms, which one is seen as most prominent in AN and what are some examples?

Intentional dieting That results in an unhealthy loss of weight is the hallmark of anorexia Calculating calories, vegetarianism, excessive amount of water, consume very little water, weigh themselves, exercise

What do we know about the prevalence of alcohol use on U.S. college campuses? Why is early onset of alcohol use so concerning?

It is increasing and adolescence is the highest risk of alcohol use disorders

Patients with AN tend to overestimate their body size relative to their true body size. From what process is this likely the result and how is this relevant to treatment avoidance?

Likely results from a consistent and persistent over focus on the body as a whole or on specific parts of the body in an attempt to assess the success of effort's to lose weight or fat Leads to a severe distortion and evaluating the medical consequences of being severely underweight. This denial of the seriousness of malnutrition is a major source of treatment avoidance and represents a significant psychological hazard for successful weight restoration.

What is the percentage of concordance for schizophrenia for MZ versus DZ twins? What general conclusion can be drawn from the literature examining twin/adoption studies?

MZ: 30-50% of co-twins with schizophrenia will go on to develop schizophrenia DZ: share 1/2 of the same genes, 12-17% of DZ twins will develop the illness Adoptees are more likely to have schiz. if their biological parents did

personality theory

Notion that personality traits play causing roll although they are not accord component of the disorder high degree of neuroticism, along with a high degree of impulsivity or extraversion, predicted an increased reliance on alcohol use as a coping method.

When are binges most likely to occur and what are some common triggers for a binge?

One individual is alone and evenings are specially high-risk times. Common triggers for binging include lapses and self awareness into personal stressors, the presence of tempting food, feeling that the dining room has been broken, body image dissatisfaction, and skipping meals getting hungry

Be able to identify the main symptoms and diagnostic criteria of substance use disorders (e.g., alcohol use disorder).

Pattern of substance use leading to significant impairment and distress **Symptoms (need 2+ within a year)** - Taking more of the substance than intended - Desire to cut down use - Excessive time spent using/acquiring/recovering - Craving for the substance - Role disruption (e.g. can't perform at work) - Interpersonal problems - Pattern of substance use leading to significant impairment and distress **Symptoms (need 2+ within a year)** - Reduction of important activities - Use in physically hazardous situations (e.g. driving) - Keep using despite causing physical or psychological problems - Tolerance - Withdrawal **DSM-5 now spells out criteria for: Substance intoxication for different types of substances (e.g., alcohol, stimulants) Substance use disorders for different types of substances Withdrawal from different types of substances

Understand the link between tension reduction theory and expectancy theory

People drink alcohol to reduce tension, and stress (tension reduction theory) - expectancy theory states that if you expect alcohol to reduce tension because that is what it is "meant to do" you will experience those effects

Know what personality/temperamental traits are common to eating disorders and which are distinct across anorexia and bulimia.

Perfectionistic (tendency to pursue unrealistically high standards despite aversive consequences; tends to be moderated by self-esteem) Obsessive-compulsive traits: doubting, checking and need for symmetry and exactness high levels of self-criticism and sensitivity to social approval and prone to rapid deflation of self-concept and self-denigration in response to lack of recognition from others **Anorexia High constraint Low novelty seeking. rigid avoidance behaviors with marked obsessional, anxious-depressive coloring compliant, socially isolated, anxious females who gravitates towards orderliness and control reserved, compliant child with marked conflict around pubertal changes incompatibility between developmental imperatives surrounding puberty and temperament characterized by harm avoidance, hyper-reactivity to social approval, and preference for sameness. **Bullimia High impulsivity: lack of forethought and failure to contemplate future consequences of current behavior Sensation seeking: willingness to take personal/social risks to satisfy need for varied, novel and complex situations/experiences genetic self-soothing deficits expressed through affective instability and impulsiveness.

What are the three main assumptions focused on by Janoff-Bulman?

Personal invulnerability The world as a meaningful and predictable place ("Just World" assumption) Self as positive and worthy

Be able to identify and distinguish between the A and B process in addiction and how these relate to withdrawal, tolerance, and cravings.

Process A: - the effects of a substance Process B: - the opponent biological response Withdrawal: - process B lasts longer than A, and is aversive - reinitiating of process A results in reduction of symptoms experienced due to process B - user learns to use the drug to diminish the effects of the B process Tolerance: - process B is strengthened through use so more of the substance is needed to get the desired effects of process A - your body adapts to process A, making the B process stronger which therefore makes you need to use more of the substance Cravings: - body learns cues of scenarios in which the substance is used - B becomes initiated when a given cue is experienced, causing withdrawal symptoms causing one to want to take the drug

In addition to anorexia nervosa (AN) and bulimia nervosa (BN), what additional diagnostic categories were added in the DSM-V and why?

Purging disorder, Night eating syndrome, pico, rumination The hope is that these changes will facilitate research to improve our understanding of different developmental pathways encourage earlier detection and diagnosis, and promote the development of effective strategies that target specific presenting patterns

What does interoceptive awareness have to do with eating disorders?

Refers to the ability to identify internal sensations including both physiological and emotional states. Women with eating disorders report poor interoceptive awareness, and the inability to identify internal sensations prospectively predicts onset of eating disorder symptoms

What factors may associate with a person's adoption of the "thin ideal"?

Research suggests that the transmission of the fan I deal maybe occurring more in directly given date of the individuals who immigrated to Western culture and those living in relatively more urban than rule areas are at an increased risk for eating disorders. Media exposure appears to play less of a role in maintaining already established eating disorder symptoms

What is the primary symptom that distinguishes individuals diagnosed with AN from those diagnosed with BN or binge eating disorder (BED)?

Restriction of intake leading to a significantly lower weight that is less than minimally normal or less than minimally expected

Be able to identify environmental determinants of schizophrenia and their common denominator.

Schizophrenia is significantly more likely to develop in children reassured in dysfunctional families. Influence is family. More likely to occur when reared in an institutionalized setting. environmental factors affect the biological/ genetic factors epigenetic factors: changes in organisms caused by modifications of gene expression (by environmental factors) rather than alteration of genetic code itself

What is a de novo mutation

Schizophrenia may result from multiple rare genes and variants that arise through de novo mutations, mutations not present in the DNA of the parents

What three subtypes of PTSD did Miller and colleagues identify and what were the symptom profiles associated with each?

Simple PTSD- low on both internal and external External- Characterized by tendency to outwardly express distress thru antagonistic interactions with others, blaming others, coping thru acting out (personality disorder, anger, aggression) Internalizing tendency to direct PTSD inwardly thru shape, self defeating & self deprecating beliefs, anxiety, avoidance, depression and withdrawal

Be sure you understand the concepts of schema disconfirmation and confirmation, as well as accommodation and assimilation, as they pertain to responses to trauma and the development of different cluster of symptoms.

Sometimes our experiences are inconsistent with what would be expected on the basis of our schemas When confronted with schema inconsistent information, individuals either: Assimilation: • Inconsistent information is made consistent with existing schemas • Denial is a core component of assimilation. • This is when you fit outside events into your existing schema/viewpoint • This means I may need to change the nature of what happened in order to make it consistent with what you believe internally • That is why denial may be a part of this process Accommodation: • Existing schemas are altered to account for inconsistent information • Traumas or so salient that they force individuals to in some way accommodate the experience • This is when you alter your viewpoint because of a trauma or an event

Be familiar with the particular research findings relating different types of life stress to bipolar disorder.

Studies show that life stress (work stress) does precede lapse, but differences in the specific findings emerge, perhaps due to methodological differences. Some consistencies: evidence to suggest chronic stress or more severe stressors are predictive Stress ties with both depressive and manic episodes with equal frequency Life Event Stress: Onset of bipolar through the effect of life events on sleep-wake (circadian rhythms) cycles disruption of sleep, in particular, that may impact serotonin levels. May also be a third variable: Sleep plays a role in serotonin function but also is believed to play a role in recalibrating the sensitivity of dopamine receptors. Events that disrupt social rhythms: manic, but not depressive, episodes can be triggered by minor changes in sleep patterns.

Be able to identify the changes in the Schizophrenia diagnosis across the DSM-IV to DSM-V.

The DSM-V made broader changes and gave up the idea of subtypes. A greater number of symptoms are required to receive the diagnosis; two (as opposed to one) of the following (raising the bar) Delusions, hallucinations, disorganized speech, disorganized/catatonic behavior, and negative symptoms Individuals must have one of the most blatant symptoms: delusions, hallucinations, or disorganized speech Subtypes were removed research has shown that these subtypes are not supported by research or clinical evidence dimensional approach was incorporated to rate the severity of the core schizophrenic symptoms they've shifted what it means to be schizophrenic to make it slightly more difficult to diagnose. did this to differentiate it better from other problems. Need it to be accompanied by other features of very severe to be diagnosed with this.

Know the main points about genetic determinants of Schizophrenia.

The closer you are genetically, the higher the risk. research suggests that there may be 1,000 different genes contributing to the disorder. so you may have a subset of these that isn't problematic, but you may have a subset that is. you don't need all 1,000; you need the genetic component. it isn't a single gene model, set of genes that are co-occurring that increase those risks rather than just one. the concordance rates are not 100%; implicates some role of environment in expression of genetic vulnerability. it is possible we don't have perfect concordance because what one is experiencing in their life is what turns on the genes that cause schizophrenia

What is the basic idea behind Marlatt & Gordon's (1985) conceptualization of the relapse process?

This model conceptualizes relapses as resulting from the patient's lack of skills for coping with high-risk situations which leads to low levels of self efficacy believes about his ability to cope with stressful situations and expectancy is that alcohol use will help him cope effectively

According to Ehlers and Clark (2000) what is paradoxical about memories of trauma? What do they suggest accounts for this?

Trouble intentionally accessing his/ her memory of event but involuntary intrusion of parts of it (processing in idiosyncratic ways that produce threat). Because memory is encoded at time of trauma, poor regard of other memories means that there isa poor autobiographical memory

What do genetic studies indicate with respect to genetic influences on eating disorders and gender differences? What does this findings suggest about the particular biological factors that might be implicated in the development of eating disorders in girls?

Twin studies show that in females over all levels of eating disorder symptoms exhibit no genetic influences before puberty but significant genetic effects are observed from mid puberty on. This suggest that all of the genetic risk becomes more activated during puberty Results for male twins show no change in genetic effects across pre-to early puberty mid to late puberty or young adulthood Suggests that pubertal increases in the genetic influences are specific to girls and point to the possibility that the ovarian hormones that become activated during puberty and drive developmental processes in girls may be responsible

What is the central idea behind the following models of alcohol use disorder: (a) expectancy theory

Used to integrate psychological processes with the underlining biological mechanisms Refers to the process with in the nervous system that uses neurobiological in cognitive residual of experience to guide future behavior The activation of an expectancy template can directly initiate a behavior sequence previously associated with a recognize stimulus. activation of expectancy can elicit a behavior that is associated with the activation of an effective state

What are some of the physical consequences of malnutrition

What are some of the physical consequences of malnutritionBlood flow to the periphery is decreased leading to cold extremities. Skin becomes dry and hair falls out while the body becomes colder with a find out any hair meant to conserve warmth. Menstruation stops. Fertility is impaired. Calcium salts from the bone sitting to osteopenia or osteoporosis. Low heart rate low blood pressure and possible death. Shrinking of the brain

Be able to differentiate zeitstorers and zeitgebers and understand their role in bipolar disorder.

Zeitstorers Disrupt established social/circadian rhythms e.g., caretaking an infant Zeitgerbers Factors that maintain stability of rhythms e.g., job loss Feedback loop Bidirectional effects seem likely: (a) life events can impact sleep disruption, (b) sleep deprivation can trigger manic symptoms, (c) manic symptoms can trigger a more chaotic lifestyle and sleep-wake pattern

Perception of threat:

adopt various maladaptive coping strategies: avoidance which leads to an increase in symptoms, prevents change, and prevent change in trauma memory

Be familiar with Table 11.1 on the DSM-V criteria for an Alcohol Use Disorder.

alc. abuse: alc use resulting in failure to fulfill major role obligations, use in situations in which it is physically hazardous, use despite having persistent/recurrent social problems caused by alcohol - alc. dependence: tolerance, withdrawal, alc. taken in large quantities or over long period than intended, persistent desire and unsuccessful attempts to stop use, increased time consuming, obtaining, and recovering from alcohol, important activities are given up/reduced due to use, continued use despite knowledge of having difficulties, cravings

What did Greeley and Oei (1999) conclude about the empirical status of the tension-reduction theory?

alcohol at certain dosages is capable of reducing some signs of tension in some humans, under certain contextual conditions.

mediator

any factor that explains the relationship between two other variables. For instance, impulsivity may explain the link between male gender and greater risk of an alcohol use disorder. Specifically, male gender associates with a higher risk of alcohol problems, but this is because male gender associates with greater impulsivity, and greater impulsivity associates with greater likelihood of an alcohol use disorder.

Moderator

any factor that may change the nature of a relationship between two other variables. For instance, we might find that the effect of alcohol on observable symptoms of intoxication is moderated by weight (i.e., greater body weight on average will decrease the strength of the effect of alcohol on intoxication).

What is the season-of-birth effect?

elevated risk for schizophrenia among babies born shortly after a flu epidemic, disproportionate number of people w. schiz. are born in the winter months, may reflect seasonal exposure to viral infections, may give rise to brain abnormalities, making these babies more vulnerable to schiz.

PTSD and acute stress

external event. Stress and trauma

What is a mixed episode

fully syndromal manic and depressive episode occurring simultaneously, associated with more debilitating course of illness with earlier onset and greater levels of comorbidity with anxiety and substance abuse

Be able to identify the different types of common delusions.

hallucinations, delusions (thought insertion, thought broadcasting, grandiose delusions, control delusions, bizarre delusions), disorganized thoughts

Know the symptom profile for a manic episode, as well as the difference between Bipolar I and II.

include elated, expansive, or irritable mood, or increased goal directed activity with at least three of the following: inflated self-esteem (grandiosity); decreased need for sleep; racing thoughts or flight of ideas (in a rapid fashion); rapid or pressured speech; reckless and impulsive behavior; enhanced energy; distractibility. Bipolar 1 Presence of 1 manic (unipolar) or mixed episode (manic episode with a depressive episode mixed in). A mixed episode : In DSM-v there is simply a specifier about the presence of mixed features Bipolar 2 Presence of Major Depressive Disorder and one hypomanic episode. only about 1 in 10 Bipolar II patients ever experience a manic or mixed episode Bipolar II patients spend more time depressed weeks vs hypomanic (37:1). Bipolar I spend more time depressed vs manic is (3:1 weeks).

What differentiates a hypomanic from a manic episode?

manic episodes are defined by symptoms lasting at least 1 week, evidence of impairment or need for emergency treatment hypomanic: symptoms of shorter duration (4 or more days) and noticeable changes in behavior that are still functioning, changes in behavior are noticeable though

What is expressed emotion and how does it relate to bipolar disorder?

measure of family environment based on how relatives of the patient talk about the patient (criticism, hostility), High EE is a psychosocial stressor, parents with E.E. caused a 94% greater risk for relapse

What is sensory gating

neurological process of filtering out redundant or unnecessary stimuli in the environment and habituation to repeated exposure to the same sensory stimuli. This inhibition of responsiveness to repetitive stimulation helps individuals to block out irrelevant stimuli. During sensory gating tasks, individuals with schizophrenia show measurable abnormalities

What is the difference between premorbid and prodromal symptoms?

premorbid: often subtle and occur long before the onset of the illness prodromal: more immediately precede the onset of psychotic symptoms

With respect to impairments in functioning, what factors associate with less impairment in functioning?

subsyndromal depressive symptoms following a manic episode and cognitive dysfunction, presence of a supportive relationship was the best predictor of successful employment, low levels of post episode residual symptoms

What evidence suggests that bipolar disorder is associated with creativity? Are manic episodes themselves the cause of such creativity?

unaffected first degree relatives of persons with bipolar disorder show higher creativity persons w/ bipolar 2 achieve higher creativity than persons w. bipolar 1 children of persons w. bipolar disorder score higher on a measure of related to creativity than healthy control children syndromal manic episodes are not the cause of elevated creativity; mania have been related to several traits that could promote increased creativity, higher ambition may promote greater creative accomplishments

What is meant by "cognitive" symptoms of schizophrenia? What specific symptoms fall into this category?

wide variety of problems w. attention, difficulty ignoring distractions in the environment, lack of capability of simple mental tasks, problems inhibiting automatic behaviors and social cognition, impaired working memory