Test 3 ch 9-13

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Depersonalization
the experience of not experiencing the reality of one's self
-can include feeling detached, or observing one's self as if you were an outside observer
Derealization
the experience that the external world is not solid
-includes a sense of detachment as if in a fog/dream
Dissociative Amnesia
-Inability to recall important autobiographical info
-Now includes dissociative fugue home or workplace
-Involves first person memory loss, not global loss of memory
-May last for only days, or for years, appears most often in people's 30s or 40s
Dissociative Fuge
-dissociative amnesia along with traveling away form home or workplace
Dissociative Identity Disorder (symptoms)
-Characterized by a poorly integrated sense of self, different "personalities" at different times
-Involves disruption of memory, loss of ability to do learned skills, finding things done the person doesn't remember doing
-The host personality is sometimes replaced by "alters," and alters may even argue with each other in the person's mind
Dissociative Identity Disorder was previously referred to as :
multiple personality disorder
DID is a complex disorder related to:
related to trauma occurring before age 6
prevalence of DID
between 1% and 3%
the ______ is a screening test for DID developed by Marlene Steinberg
SCID-D
DID and the brain:
Patients show a smaller hippocampus & amygdala, may show function patterns similar to PTSD patients
Somatic Symptom Disorder
Disorders where the person feels there is something wrong with them and shows unnecessary anxiety over it as well as seeking medical attention
Somatic Symptom Disorders Symptoms and prevalence
-Persistent thoughts about the seriousness of symptoms, high levels of anxiety about health, spending excessive time and energy on health
-Symptoms have lasted longer than 6 months
-Prevalence between 5% and 7%
Illness Anxiety Disorder
Preoccupation with the possibility of having a serious illness. Experiences few if any symptoms (formerly referred to as hypochondriasis)
when comparing symptoms in another person or themselves, those with _________ saw symptoms in themselves as more severe than those in others
Illness Anxiety Disorder
Those with _______ Have a more restrictive concept in that they saw bodily symptoms as incompatible with good health
Illness Anxiety Disorder
Conversion Disorder
-Sensory or motor symptoms such as not being able to hear or see or feel pain or move a part of the body
-Symptoms do not follow known physiological or neurological patterns, e. g. glove anesthesia, which is physiologically impossible
-Symptoms are involuntary, unconscious
Malingering
Distinguished from conversion in that person is faking the illness consciously for gain
Factitious Disorder
-the person engages in deliberate sabotage in order to seek medical treatment
-Attempts to manipulate the health care system by seeking extra medical tests or even medical procedures such as surgery
-When the person does not receive the attention they seek, they may become angry and claim mistreatment
Feeding Disorders
-Pica
-Rumination Disorder
-Avoidant/restrictive food intake disorder
pica
eating things that aren't food, such as clay or chalk
-can lead to vitamin deficiency, health problems, poisoning
Rumination
Regurgitating food then either re-chewing it, re-swallowing it, or spitting it out
Avoidant/restrictive food intake disorder
-person doesn't eat certain foods, leading to health/nutritional problems
Anorexia Nervosa
-serious restriction of food
-below normal body weight
-fear of gaining weight
-lack of recognition of the seriousness of their weight loss
-distorted body perception
2 Subtypes: (restricting and binging/purging)
Causes of Anorexia Nervosa
-Global attitudes toward food, including restriction of eating, binge eating, and self-induced vomiting have genetic connections
-Anorectics show reductions in brain volume and in brain metabolism in frontal, cingulate, temporal and parietal areas
-Anorexia rates are higher in countries with more developed economies
-Gut bacteria may play a role
Medical consequences of Anorexia
-Problems with lack of nutrition, lower estrogen, higher cortisol levels
-Decreased bone density, coupled with increased risk of fractures
-Cardiovascular problems, reduced motility of the gastrointestinal tract
-Much higher likelihood of death
Bulimia Nervosa
-Periods of overeating in which the person feels out of control, followed by purging
-Far more commonly reported in women
-Generally associated with an over concern related to weight and appearance
-often occurs late in the day when the person is alone
Bulimia's 3 aspects
-binge eating
-purging
-self worth being seen as tied to body weight or shape
Bulimia Nervosa health problems
-Can lead to medical problems like dental erosion, menstrual disturbances, and deadly electrolyte imbalances
Binge Eating Disorder
Involves eating huge amounts of food without purging
-as much as 10,000 calories in one session
-common in overweight people, but not directly tied to obesity
-may run in families
Categories of Sexual Dysfunction:
problems with :
-desire
-arousal
-orgasm
-sexual pain
Treatment of Sexual Dysfunction: Sexual Therapy (Masters and Johnson's Sensate Focus method)
-Pleasuring: kissing, touching, massaging for pleasure but not genital contact
-Teasing body and genital stimulation, but no attempt at orgasm
-Full sexual contact and intercourse, but focus remains on pleasure, not on accomplishing a particular sex act
Early Ejaculation can be treated with
-ejaculation delay practice
-the squeeze technique
Sexual pain/vaginismus problems can be addressed by:
practicing vaginal muscle control, then practicing inserting one and then two fingers into the vagina while controlling her muscles and forcing them to relax
Sexual Therapy: Drugs
-Lubricants and estrogen creams can be used for painful sexual activity problems in women
-Male erectile disorder problems respond about 50% of the time to Cialis, Viagra, or Levitra, drugs that increase genital blood flow
Exhibitionistic Disorder
-arousal to exposing genitals to an unsuspecting person
-make up 1/3 to 2/3 of all sex offenders
-high recidivism rates
-Treated with cognitive/behavioral therapy to teach empathy and realistic assessments, SSRIs
Voyeristic Disorder
becomes sexually aroused by intentionally spying on unsuspecting people who are naked, getting undressed, or participating in sexual activities.
Pedophilic Disorder
-Persistent sexual interest in prepubescent or early pubescent children
-Person gains more arousal from children than adults, has acted on these urges or been distressed by them, urges have lasted longer than 6 months
-Develops in adolescence
-Reduction in the right amygdala, decrease in gray matter found in pedophiles
Frotteuristic Disorder
-Becoming aroused by touching or rubbing against a non-consenting person
-Individuals seek crowded situations such as crowded subway cars so that contact can be seen as "accidental"
-Observed only in males
Sexual Masochism
-Deriving sexual arousal from being humiliated, beaten, bound or made to suffer
-Becomes a disorder when urges cause significant distress and last 6 months or more
-Desire for asphyxiation during sex may also be involved
Sadism Disorders
-Deriving sexual pleasure from inflicting pain or humiliation on others
-Person must act on the impulses with a non-consenting person or experience distress or impairment as a result of the desires for 6 or more months
-Often comorbid with impulse control disorders, antisocial personality disorder, and borderline personality disorder
Transvestism / transvestic disorder
Person experiences intense sexual arousal from cross-dressing in fantasies, urges, or behaviors lasting 6 or more months and causing distress or impairtermment
transsexualism
where the person feels they are the opposite sex and dresses that way because of their feeling rather than a sexual thrill
Gender Dysphoria
-significant feelings of distress due to the feeling one has been born the wrong sex
-Found in 1 out of 10,000 people
Transgender
...
Voyeuristic Disorder
-Obtaining sexual arousal from watching unsuspecting people when they are undressing, naked, performing sexual acts or going to the bathroom
-Generally appears in males prior to age 15
-Must involve a nonconsenting person, or cause marked distress or impairment
Intoxication
typically impairment to psychological processes and behavioral abilities
Tolerance
...
Withdrawal
symptoms when the substance is reduced or no longer used
Relapse
...
The reward of drugs comes form release of _____ in the _______ system
dopamine in the mesolimbic dopamine system
Those with low dopamine levels show:
compulsive behaviors, hypersexuality and gambling when it is raised
the "high" from a drug is affected by:
speed of entering the brain
dysfunction in the _____ context is associated with drug addiciton
prefrontal cortex
Hallucinogens (3 major effects)
-alter perceptual experiences
-Do not directly affect dopamine, produce dependence, or cause withdrawal, but can cause fearful or anxious experiences
-Tend to be similar to serotonin in chemical structure
3 major effects of Hallucinogens
-oceanic boundlessness
-anxious ego dissolutions
-visionary reconstructionalization
Examples of Hallucinogens
-mescaline
-psilocybin
-LSD
-MDMA
-MDA
-PCP
Opioids
-derived from poppy and similar artificial drugs
-used to control pain and bring on feelings of euphoria
-highly addictive
-affects receptors in the brain and body that respond to endorphins
Examples of Opioids
-heroine
-opium
-morphine
-methadone
-oxycodone
Cocaine
-derived from the coca plant.
-stimulant and euphoric effects
Effects of Cocaine
-interferes with normal dopamine repute
-affects nucleus accumbent and prefrontal cortex in new users
long term Cocaine users:
The striatum, amygdala, hippocampus become involved with long-term use, and changes in the amygdala reduce information available from the prefrontal cortex
Amphetamine
-stimulant effect similar to cocaine, but laboratory-produced
long term effects of amphetamines
-compulsive patterns of use
-negative brain changes consistent with brain injury
-changes in cognitive functioning
Amphetamines brain problems occur most with:
methamphetamine
Tobacco (Nicotine)
-combination of stimulant and depressant effects
-increases dopamine levels, alters inhibitory effects of GABA
Treatment of Addiction
Remove the drugs from the person's body
Psychosocial treatment to help the person understand addiction and develop a plan of action
Help the person gain control over substance use
What are the most commonly used forms of drug abuse treatment?
Behavioral Therapies - including individual, family, or group counseling
Psychosocial Treatments
-Cognitive behavioral therapy
-12 step programs
-controlled drinking
-medication (agonist, antagonist, and aversive drugs)
Schizophrenia
-psychotic disorder
-loss of touch with reality, delusions, hallucinations, disorganized thinking and speech, abnormal motor behaviors, and negative symptoms
Effects of Schizophrenia
Affects ability to express ideas clearly, have close social relationships, express positive emotions, & make future plans
Schizophrenia Prevalence
-affects 1% of population
-males show earlier onset (late teens) than females (20s)
Course of Symptoms for schizophrenia
Symptoms wax and wane and may spontaneously remit
Some argue symptom variation suggests we're dealing with multiple similar illnesses
positive symptoms of schizophrenia
-Hallucinations
-Delusions
-Disorganized thinking and behavior
Negative Symptoms of schizophrenia
-Avolition (lack of motivation or will)
-Alogia (lack of interest in talking)
-Anhedonia (inability to feel pleasure)
Delusions include:
-paranoid
-grandiose (grandeur)
-persecution
-erotomanic
Grandious (grandeur) delusions
false belief that they possess superior qualities such as genius, fame, etc.
Persecution delusion
believes that they are being treated with malicious intent, hostility, or harassment. Currently or in the future.
Erotomanic Delusion
believes that another person is in love with him or her. This belief is usually applied to someone with higher status or a famous person, but can also be applied to a complete stranger.
Paranoid Delusions
fixed, false belief that one is being harmed or persecuted by a particular person or group of people. These delusions are known technically as a "persecutory delusion."
schizophrenia is more likely to be concordant between people who:
share more genes
schizophrenia is more likely when:
many genes interact in certain combinations
Schizophrenia and synapses:
impaired elimination of synapses during adolescence appears likely
Schizophrenics and brain changes
-lower levels of gray matter
-gray matter reduction tied to neurons being more closely packed
-white matter reduction in the cortex
Until the 1960's schizophrenics were:
warehoused in mental hospitals, with little treatment other than controlling them
What medication address positive symptoms of schizophrenia
-chlorpromazine and other first-generation antipsychotics
-side affect includes tradeoff dyskinesia
what may cause tradeoff dyskinesia
chlorpromazine and other first generation antipsychotics
what addresses the negative symptoms of schizophrenia
-second generation antipsychotics.
-opperate differently on dopamine receptors
(seratonin-dopamine antagonists)
Cognitive/behavior psychosocial intervention for schizophrenia
therapists help client understand the psychotic experience, cope, and reduce stress
Psychosocial interventions for schizophrenia: relationships and environment:
-Interpersonal relationships and success at work are also stressed
-Emotional environment at home predicts relapse, with those whose relatives make warmth and positive remarks less likely to relapse
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