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Abnormal Psych Exam #4
Terms in this set (65)
What are the characteristics of personality disorders?
Enduring pattern of perceiving and thinking about the environment and oneself that is exhibited in a wide range of social and personal contexts.
Causes functional impairment.
Begins in early childhood (Although DSM-V states that one should not be diagnosed with a personality disorder if they are not 18 or over)
Five Factor Model of Personality
Neuroticism- proneness to distress
Extraversion- tendencies towards social situations
Openness- willingness to experience novel events
Agreeableness- tendencies towards kindness
Conscientiousness- tendencies towards organization
Prevalence in Personality Disorders
4.4-14% of the general population
10-30% of Inpatient settings
2-10% of Outpatient settings
Gender differences vary by each disorder
-Pervasive distrust and suspicion
-Reads hidden threatening meanings into benign comments
-Persistently bears grudges
Genetics and social learning are known causes
Treatment includes cognitive therapy focused on changing their beliefs, but no evidence of effectiveness
-Pervasive social detachment
-Restricted expression of emotions
Causes are related to dopaminergic dysfunction (a dysfunction of the reward system observed in some individuals taking dopaminergic medications for an extended length of time.)
Treatment include social skills training but no evidence of effectiveness.
-Discomfort with and reduced capacity for relationships.
-Interesting world view, similar to psychosis as they try to create the things that they are thinking about.
Causes by shared genetic influence with schizophrenia.
Treatments include social skills training and anti-psychotic medications.
-Excessively emotional and attention seeking
-Inappropriately sexual or provocative
-Rapidly shifting and shallow expression of emotion
-Self-dramatization but theatrically
Caused by genetic links to Anti Social Personality Disorder
Behavior modification is the most common treatment but there is little proven evidence.
-Grandiose sense of self-importance
-Believes that they are unique and should only associate with those who are like them.
-Sense of entitlement
History of abuse and certain parenting practices are known causes.
Treatment includes cognitive therapy and relaxation training.
-Repeated lawbreaking, deceitfulness, conning, impulsivity, aggressiveness, recklessness, irresponsibility and lack of remorse.
-*Evidence of conduct disorder prior to age 15
Causes include genetic, neurobiological, underarousal, and fearlessness.
Prevention through parent training can serve as treatment.
-Frantic efforts to avoid abandonment
-Unstable and intense relationships alternating between idealization and devaluation.
-Acting on impulse
Genetics, early trauma/abuse and invalidation are known causes.
Dialectical behavioral therapy is a common form of treatment.
-Avoids interpersonal contact because of fears of criticism, disapproval, rejection
-Shows excessive social restraint for fear of being shamed or ridiculed.
-Preoccupied with being criticized or rejected
-Views self as socially inept, unappealing, and inferior.
Causes are genes and paternal practices.
Treated similar to social phobia/social anxiety. Systematic desensitization and Behavior rehearsal are known treatments.
-Difficulty making everyday decisions without excessive advice and reassurance
-Needs others to assume responsibility
-Difficulty initiating projects
-Difficulty expressing agreement
-Seeks nurturance and support excessively
-Feels uncomfortable and helpless when alone
Genes and poor parenting practices are causes.
No evidence of treatment but the goal is to increase independence in these individuals.
Obsessive Compulsive PD
-Preoccupied with details, rules, lists, order, organization, or schedules to extent that the point of activities is lost
-Perfectionism that interferes with task completion
-Excessively devoted to work/productivity
-Over conscientious, scrupulous, inflexible
-Unable to discard objects
Treatments include exposure and attacking of fears and promoting relaxation.
Characterized by a significant loss of contact with reality.
Causes illusions and hallucinations that can be visual, auditory, olfactory (smell), gustatory (taste), or tactile (touch).
One may also experience delusions and disorganized speech/behavior.
Characterized by 2+ of the following symptoms, lasting at least a large portion of 1 month:
Social/Occupational dysfunctions are common.
Disturbance is present for 6+ months.
Negative symptoms of schizophrenia
Avolition, Alogia, Anhedonia, & Affective flattening
Lack of motivation for purposeful tasks.
The inability to speak because of mental defect, mental confusion, or aphasia
Inability to feel pleasure.
A condition of reduced emotional reactivity in an individual.
(People with schizophrenia don't often display the full range of emotional expression that others do.)
Positive vs. negative symptoms
Positive symptoms add and negative symptoms take away.
(Positive symptoms include hallucinations, delusions and repetitive movements that are hard to control; A negative symptom is when a normal behavior, thought pattern or emotion is missing.)
Positive symptoms of schizophrenia
*Paranoid- Preoccupation with 1 or more delusions or frequent auditory hallucinations
*Disorganized-Disorganized speech, behavior, and affect
*Catatonic-Waxy flexibility, Excessive motor activity, Extreme negativism or mutism, Echolalia or Echopraxia
Meaningless repetition of another person's spoken words
(common symptom in psychiatric disorders)
Prevalence and onset of schizophrenia
- Likelihood is 0.3 - 0.7%, depending on factors such as background and environment.
- Gender differences: males more likely to develop negative symptoms and have a longer duration of disorder.
- Peak onset is early twenties for males and late twenties for females.
- Patients who show psychotic episodes earlier than late adolescence appear more likely to have worse prognosis for long-term.
Characterized by the presence of a depressive or manic episode as well as schizophrenia symptoms.
Psychotic symptoms persist for 2+ weeks in the absence of mood symptoms.
Mood episode present for majority of illness.
DSM-5 states that the mood symptoms must be present 50% of the time.
Characterized by the presence of non-bizarre delusions that last for at least 1 month.
No notable behavior impairment.
Usually absence of other psychotic symptoms, but if present, are congruent with delusion.
Delusional Disorder Subtypes
Erotomanic: belief that one is loved by another person, usually of higher status; e.g., celebrity stalkers
Grandiose: belief in one's inflated power, knowledge, identity, or special relationship to a deity or famous person
Jealous: believes sexual partner is unfaithful
Somatic: feels afflicted by a physical defect or general medical condition
Shared Psychotic Disorder (Folie a Deux)
A rare delusional disorder shared by 2 or, occasionally, more people with close emotional ties; Two people share the same delusion or delusional system and support one another in this belief. They have an unusually close relationship.
What are the talked about Psychotic Disorders in this unit?
-Shared Psychotic Disorder
Causes of Psychotic Disorders
Biological causes such as genes; including many twin, family and adoption studies.
Neurological causes such as the effect on certain transmitters such as Dopamine and Glutamate.
Psychosocial causes include older views such as the "schizophrenic mother" theory and newer views based on expressed emotions.
(Gregory Bateson, 1956) proposed that schizophrenic symptoms are an expression of social interactions in which the individual is repeatedly exposed to conflicting injunctions, without having the opportunity to adequately respond to those injunctions, or to ignore them.
Schizophrenic mother theory
Theory that states that schizophrenic behaviors were a way for the child to make sense of this toxic home environment.
According to the DSM-5, this disorder can be diagnosed if at least two of the following symptoms appear, and one of the two symptoms is delusions, hallucinations or disorganized speech. People with this disorder often withdraw from loved ones and avoid social activities.
Brief psychotic break
Brief psychotic disorder is an uncommon psychiatric condition characterized by sudden and temporary periods of psychotic behavior, such as delusions, hallucinations, and confusion. ... In most cases brief psychotic disorder does not indicate the presence of a chronic mental health condition.
Expressed emotions theory in Schizophrenia
Family members with high expressed emotion are hostile, very critical and not tolerant of the patient. They feel like they are helping by having this attitude. They not only criticize behaviors relating to the disorder but also other behaviors that are unique to the personality of the patient.
Psychotic Disorder Treatments
Old approaches such as ECT and psychosurgery.
Inpatient Hospitalization, Behavioral Therapy
Token Economy (form of behavior modification designed to increase desirable behavior and decrease undesirable behavior with the use of tokens. Individuals receive tokens immediately after displaying desirable behavior. The tokens are collected and later exchanged for a meaningful object or privilege.)
Cultural Differences/Views towards sex
A group of persistent sexual behavior patterns in which unusual objects, rituals, or situations are required to fulfill sexual satisfaction.
Attraction to non-living objects
Sexual or erotic interest in cross-dressing.
It differs from cross-dressing for entertainment or other purposes that do not involve sexual arousal and is categorized as a paraphilia in the Diagnostic and Statistical Manual of the American Psychiatric Association.
Gaining sexual pleasure from watching others when they are naked or engaged in sexual activity.
(Observing others or exposing oneself to others)
Sexual Sadism and Sexual Masochism
Inflicting psychological or physical suffering (including humiliation and terror) on a sexual partner.
Causes of Paraphilias
Little empirical evidence.
Reinforcement of early on sexual fantasies.
Treatments for Paraphilias
Covert desensitization (form of behavior therapy in which an undesirable behavior is paired with an unpleasant image in order to eliminate that behavior.)
Orgasmic reconditioning (a behavioral treatment aimed at altering the deviant sexual preferences of individuals who commit sex offenses or those who suffer from paraphilias.
Medications such as Cyproterone Acetate and Medroxyprogesterone Acetate
Strong personal identification with masculinity or femininity.
Gender Identity Disorders
Characterized by a strong and persistent desire to be the other sex, and 4 or more of the following:
-Stated desire to be opposite sex
-Desire to live and be treated as other sex
-Frequently passes as other sex
-Discomfort with own sex
-Independent of sexual attraction arousal
Treatments include sex reassignment surgery which has a 75% reported successful adjustment.
What are the three phases of the Sexual Response Cycle?
Desire-sexual urges in response to sexual cues
Arousal-Sense of sexual pleasure and physiological arousal
Lifelong vs. Acquired Sexual Dysfunctions
With lifelong, the problem is present from the time of sexual maturity; Acquired, occurs after a period of normal sexual functioning.
Generalized vs. Situational
Generalized isn't limited to certain sex partners or certain kinds of stimulation. Situational occurs only under certain circumstances.
Prevalence in Sexual Dysfunctions
What are the 4 categories of Sexual Dysfunctions?
Desire disorders —lack of sexual desire or interest in sex.
Arousal disorders —inability to become physically aroused or
excited during sexual activity.
Orgasm disorders —delay or absence of orgasm (climax)
Pain disorders — pain during intercourse.
Hypoactive Sexual Desire Disorder
Little or no desire to have sex.
Sexual Aversion Disorder
Extreme aversion to and avoidance of sexual contact.
Often experience panic attacks.
Male Erectile Disorder
Difficulty attaining or maintaining an erection.
(5% of men; Increases with age)
Female Sexual Arousal Disorder
Difficulty attaining or maintaining lubrication or develops a swelling response
(14% of women.)
Inhibited Orgasm Disorder (Male and Female)
Delay in or absence of orgasm despite desire and arousal.
Ejaculation with minimal sexual stimulation.
Usually less than 1-2 minutes after penetration.
21% of men.
Intercourse associated with severe pain.
1-5% of men.
10-15% of women.
Pelvic muscle spasms in outer third of vagina.
5% of women.
Causes of sexual dysfunctions
Biological causes such as certain medical conditions (chronic illnesses, cardiovascular disease.)
Anti depressants, excess use of drugs such as heroine and cocaine and alcohol are known substances to cause them.
Early Sexual Trauma, Social learning, Avoidance of sexual awareness.
Treatments for Sexual Dysfunctions
Proper sexual education, Reducing performance anxiety, and increase in communication with sexual partner.
Medical treatments such as surgical procedures, oral medications, and injection of vasoactive substances which are known to treat these disorders.
Vacuum device therapy- Noninvasive tool that a man can use to get and maintain an erection.
A person who emotionally and psychologically feels that they belong to the opposite sex.
Sexual arousal of a natal male associated with the idea or image of being a woman.
What area of the brain is shown to be most affected in people with schizophrenia?
The "Broca's area" which is responsible for producing language. It controls motor functions involved with speech production. People who have damage to this area of the brain can understand words but struggle to put them together in speech.
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