PSY 321-EXAM 3

What is the DSM-V dx for abnormalities that have both biological and psychological causes?
Factitious disorders.
What is the difference between factitious disorder and malingering regarding internal and external incentives (examples)? Are both intentional (consciously aware) attempts to gain an incentive?
Malingering is when the person purposely becomes sick to gain some sort of external gain (money, getting out of military, etc.). Factitious is when the person does it so that they can assume the role of a sick person. → I think in this case both factitious and malingering are both aware of their odd behavior
What is the difference between factitious disorder and conversion disorder (CD) regarding intentionality?
Factitious disorder: A disorder in which an individual feings or induces physical or psychological symptoms, typically for the purpose of assuming the role of a sick person → these people pretend they are sick when really they aren't → don't confuse for malingering
Conversion Disorder: A disorder in which bodily symptoms affect voluntary motor and sensory function, but the symptoms are inconsistent with known medical diseases
Although the term is not a DSM-V dx, what is Munchausen syndrome by proxy? What characteristics do these individuals display?
Munchausen syndrome by proxy is when parents and caretakers make up or produce physical illnesses in their children leading in some cases of repeated pain diagnostic test, medication, and surgery. Characteristics of these individuals include need for attention, emotionally needy
What is the difference between somatic symptom disorder (somatization pattern) and somatic symptom disorder (predominant pain pattern)?
Somatic Symptom disorder: Disorder in which persons become excessively distressed, concerned, and anxious about bodily symptoms that they are experiencing, and their lives are greatly and disproportionately disrupted by symptoms
→ somatization pattern: These people experience many long-lasting physical ailments that have little or no physical basis. Example include pain sx, gastrointestinal sx, sexual sx, and neurological sx → more often women than men
→ predominant pain pattern: Pain is key symptom
What is the relationship between gender and somatic symptom disorder (including both patterns)?
Women are more likely than men to have both patterns. Both patterns are the somatization pattern and the predominant pain pattern.
Regarding Conversion Disorder, what is meant by primary and secondary gain?
Primary gain: when their bodily symptoms keep their internal conflicts out of awareness.
Secondary gain: when their bodily symptoms further enable them to avoid unpleasant activities or to receive sympathy from others.
What is the behavioral explanation of CD and Somatic Symptom Disorder (SSD)? Provide examples. How might the behaviorist treat this disorder given the explanation?
Behavioral theorists propose that the physical symptoms of conversion and somatic symptoms disorders bring rewards to sufferers. Ex: Remove the individuals from an unpleasant relationship or bring attention from other people. Behavioral therapists use exposure treatments as they expose clients to features of the horrific events that first triggered their physical symptoms, expecting that the individuals will become less anxious over the course of repeated exposures and subsequently able to face those upsetting events directly rather than through physical channels.
Medical Student's Syndrome is most similar to ________________ disorder (in this chapter)?
Illness anxiety disorder: persons are chronically anxious about and preoccupied with the notion that they have or are developing a serious medical illness despite the absence of somatic sx
How might a behaviorist treat Illness Anxiety Ds?
Exposure and response prevention. The therapists repeatedly point out bodily variations to the clients while, at the same time, preventing them from seeking their usual medical attention.
Here it is again: What school focusses on the misinterpretation of bodily signals? Yes, this misinterpretation is important for many disorders!
Which medical conditions are strongly influenced by psychological factors?
Ulcers, Asthma, Insomnia, tension headaches, migraines, hypertension, Coronary heart disease.
Lack of exercise and obesity (defined quantitatively by BMI) are related to what medical condition?
Coronary heart disease.
What specific variant of Type A personality is at risk for developing heart disease?
Type A personalities that are particularly hostile and time urgent are more at risk for developing heart disease.
What is the sociocultural explanation of higher incidences of high blood pressure in African Americans?
The higher incidences of HTN in African Americans may be attributed to the dangerous environments that many of them live in and the unsatisfying jobs, along with a possible physiological predisposition to developing HTN or it may be that repeated experiences of racial discrimination constitute special stressors that help raise the blood pressure.
How do Hispanic Americans compare on blood pressure and cholesterol to White and African Americans? (The only reason I believe this one is bc I believe in science. I mean lard in the refried beans, and all that extra good comfort food!!)
They have lower rates of high blood pressure, high cholesterol, asthma, and cancer when compared to White and African Americans.
What are the effects of norepinephrine and corticosteroids on the body experiencing stress? Be sure to include the short term and long term effects. Hint: short term good; long term bad.
Norepinephrine and corticosteroids increase release during stress, which contributes to increased activity by the sympathetic nervous system. Heightened activity of sympathetic NS leads to heightened response. Long term heightened release however leads to the norepinephrine travelling to the receptors on certain lymphocyts giving them an inhibitory message to stop their activity, slowing down immune functioning. Corticosteroids are also said to contribute to poorer immune system functioning.
What is the relationship between your immune system, optimism, and spirituality?
People who generally respond to life stress with optimism experience better immune system functioning. People who are spiritual tend to be healthier than individuals without spiritual beliefs.
What are examples of psychological treatments for physical illnesses. Be sure to include relaxation training, meditation, and so on.
The field of treatment that combines psychological and physical approaches to treat or prevent medical problems is known as behavioral medicine. Relaxation training is used to relax muscles at will to ruduce feelings of anxiety or prevent or treat medical illnesses related to stress. Biofeedback training is when one is connected to machinery that gives them continuous readings about their involuntary body activities. This information enables them to gradually gain control over those activities. Somewhat helpful in tx of anxiety disorders and has been applied in a growing number of physical disorders. Meditation turns off one's concentration inward, achieving a slightly changed state of consciousness, and temporarily ignoring all stressors. Hypnosis, cognitive interventions (self instruction training: ID and rid themselves of unpleasant thoughts that keep emerging during pain episodes), support groups and emotion expression, & combination approaches.
How might a cognitive therapist treat someone who has negative self-statements? (I think I do this a lot with students! Please feel free to take my pos psych course.)
A cognitive therapist would manipulate the negative self-statements into positive self-statements by changing the patient's maladaptive thought pattern.
In addition to serotonin, what neurotransmitter has been implicated in depression?
Low levels of norepinephrine
If a friend is considering ECT, what would you tell them about its effectiveness and possible side-effects?
60-80% of ECT patients have improved sx of depression and it is safe. Side effects include memory loss with it more with the events happening before and after tx → some pts may experience gaps in more distant memory and can become permanent
What are the advantages of SRIs over MAO inhibitors?
SRI's don't have the diet restriction of MAO inhibitors and it is harder to overdose on these than MOA
How do the second generation SRIs work?
Increase serotonin activity specifically without affecting norepinephrine or other neurotransmitters. SSRIs inhibit serotonin reuptake.
Why do behaviorists believe that depressed people should improve their social skills?
Depressed persons often experience fewer social rewards than nondepressed people. Improving social skills via group therapy allows members to work together to improve eye contact, facial expressions, posture, and other behaviors that send social messages. This helps reduce depressive symptoms.
Seligman believes depression results from _________________.
When people believe they no longer have control over the reinforcements (the rewards and punishments) in their lives and that they themselves are responsible for this helpless state
What is a ruminative response? Provide examples.
Ruminative response is repeatedly dwelling mentally on their mood without acting to change it. Ex: Continuously thinking about being depressed secondary to a job loss.
How effective is cognitive therapy for depression?
Cognitive therapy is very effective for depression, specifically CBT, which about 50-60% of depressed adults show a near-total elimination of their symptoms.
Who is more depressed, divorced, married, widowed, or never been married singles?
Divorced individuals have double the rate of depression than married, non-married or widowed people
What's more effective, IPT or CBT?
About the same. Studies suggest that IPT and CBT have similar success rate. Symptoms almost totally disappear in 50-60% of clients.
What are the odds of a woman who has experienced post-partum depression experiencing it again with the birth of another child?
There is a 25-50% chance of developing it again with a subsequent birth.
What are the symptoms of a manic episode?
Sx of mania can come from emotional, motivational, behavioral, cognitive, and physical → defined as a one-week or longer period of abnormal and persistent elevated expansive, or irritable mood and abnormally and persistently increased activity or energy for most of the day nearly every day → sx include decreased sleep, increased talkativeness, distractibility, inflated self-esteem
What's the difference between Bipolar I and Bipolar II?
Bipolar I is characterized with full manic and major depressive episodes while Bipolar II is characterized with hypomanic episodes with major depressive episodes
What is a cyclothymic ds?
Person experiences numerous periods of hypomanic symptoms and mild depressive symptoms but not full-blown episodes. Think more of a chronic issue like a personality disorder.
Mania is due to low levels of ____________________.
Low serotonin levels with high norepinephrine activity can lead to mania
What are the odds of the general population have a dx of bipolar ds? Close relatives? Identical twins?
1 and 2.6% of all adults suffer from a bipolar disorder at any given time. Identical twins of persons with a bipolar disorder have a 40% likelihood of developing the same disorder. Other close relatives have a 5-10% chance.
What is the first line tx for Bipolar ds?
Lithium and mood stabilizing drugs
If your friend has bipolar ds, what is the best advice you can give them for tx?
Patients tend to fare better when mood stabilizing and/or other psychotropic drugs are combined with adjunctive psychotherapy.
Which mental disorder is the most like to commit suicide?
70% of suicide victims had been experiencing severe depression, soooo Major Depressive Disorder? Borderline personality disorder is also likely.
What aspect(s) of faith predict(s) suicide?
Religious doctrine may not help prevent suicide as much as the degree of an individual's devoutness. Regardless of their particular persuasion, very religious people seem less likely to commit suicide.
What ethnic group in America is most at risk for suicide? How do White Americans compare with African, Asian, and Hispanic Americans regarding suicide rate? How do the latter three groups compare with each other?
Most at risk is American Indian! White Americans → at least twice as high as African, Asian, and Hispanic Americans. The latter three groups are pretty close to the same level of about 2.5% female suicides and about 10% suicides for males.
What percent of individuals use alcohol preceding suicide?
70% of people have alcohol in their system before attempting suicide
Modeling and suicide. What age group is most at risk?
Most at risk are teenagers → Imitate suicide from family members, friends, co workers, celebrities, or highly publicized suicides
What is the relationship between suicide and 5-HT (serotonin)? How does serotonin work?
Low levels of serotonin may be a predictor of suicide aka people with lower serotonin levels are more likely to commit suicide or trying to do it again than those who have normal levels of serotonin
What behavioral characteristics are associated with low 5-HT?
Depression, aggression, impulsive behavior
Teenagers who attempt suicide. What percent succeed the first time? What percent try again?
Teenagers who attempt suicide is 200 to 1. Up to half of teenage attempters make new suicide attempts in the future, and as many as 14% eventually die by suicide.
What age group is most likely to commit suicide?
Persons over the age of 75 are the most likely to commit suicide.
The elderly, spousal death, and depression in the surviving spouse. What is the relationship?
Suicide rate of elderly people who have recently lost a spouse is particularly high. Elderly are most likely to commit suicide than people in most other age groups. As people grow older, all too often they become ill, lose close friends and relatives, lose control over their lives, and lose status in our society.
Why is it believed that the rate among the elderly in the Native American population is low?
The aged are held in high esteem by American Indians and are looked to for the wisdom and experience they have acquired over the years, and this may help account for their low suicide rate.
What are the sub-goals of counselors who work at suicide prevention centers? For example, one of the sub goals is to establish a positive relationship.
1. Establishing a positive relationship.
2. Understanding and clarifying the problem.
3. Assessing suicide potential
4. Assessing and mobilizing the caller's resources
5. Formulating a plan
What is the rate of suicide for those that contacted a suicide hotline?
2% of callers later committed suicide.
What is the difference between tolerance and withdrawal?
Tolerance: adjustment of the brain and the body make to the regular use of certain drugs so that ever larger doses are needed to achieve the earlier effects
Withdrawal: Unpleasant sometimes dangerous reactions that may occur when people who regularly use a drug stop taking or reduce their dosage of the drug
Alcohol binds to selective for ______________?
Alcohol binds to the neurotransmitter GABA → relaxes the drinker
What causes Korsakoff's syndrome? What are the behavioral characteristics?
Caused by mineral deficiency of vitamin B (thiamine) and can lead to memory loss, confusion, and neurological sx
What are the abnormalities associated with Fetal Alcohol Syndrome?
Mothers who drink put baby at risk for developing pattern of abnormalities that can include intellectual developmental disorders, hyperactivity, head/face deformities, heart defects, and slow growth
Withdrawal is especially dangerous for which type of sedative-hypnotic drug?
Barbiturates → can lead to nausea, anxiety, sleep problems and can cause convulsions
All opioid drugs are collectively called "narcotics." These drugs normally attach to sites receptive to WHAT neurotransmitter?
Attach to neurotransmitter site endorphins that help relieve pain and reduce emotional tensions
What is withdrawal from heroin like?
Person will have sx of anxiety, restlessness, sweating, rapid breathing that later peaks to severe twitching, aches, fever, vomiting, diarrhea, loss of appetite, high BP, fever, and weight loss of up to 15 lbs
How can one overdose from heroin (besides the obvious taking much more than one usually does)?
Person can overdose when they resume heroin after not taking it for a while → believe that they can use the same dosage amount as before and often make the mistake of taking too much which kills them
If you stop taking cocaine after you have been taking it for a prolonged period, what is your affective state?
Depression-like letdown, popularly called crashing, a pattern that may also include headaches, dizziness, and fainting.
What is the greatest danger of LSD use?
Physical sx like sweating, palpitations, blurred vision, tremors, poor coordination. Mental sx include enormous perceptual, emotional, and behavioral reactions → this can eventually lead to psychosis or mood or anxiety disorder. These people tend to injure themselves during this "trip" and
Ecstasy has both hallucinogenic and stimulant properties. If you stop taking it you have abnormally low levels of serotonin.
Ecstasy has both hallucinogenic and stimulant properties. If you stop taking it you have abnormally low levels of serotonin.
What is a synergistic effect? What are common synergists (in other words, how is it easy to overdose if you mix drug 1 with drug 2)?
An increase of effects that occurs when more than one substance is acting on the body at the same time → aka alcohol and barbiturates which decrease CNS activity → Very easy to overdose if drug 1 +2 have the same effects
How does classical conditioning explain drug cravings?
Classic conditioning: objects present in the environment at the time drugs are taken may act as classically condition stimuli and come to produce some of the the same pleasure brought on by the drugs themselves → example: Drug addict sees a needle can comfort people are are addicted to drugs
What happens to GABA if one engages in chronic and excessive use of benzodiazepines?
During use of benzodiazepines the GABA receptors bind to the drug and increase GABA's activity at those neurons. Chronic and excessive use of benzodiazepines would result in the lack of response of the body to increase GABA activity on its own and thus, GABA levels will be low when patient is not on benzodiazepines.
Most drugs of abuse involve the neurotransmitter ______________.
What is relapse prevention training? What aspect of it would AA be opposed to?
Therapists have clients keep track of their drinking behavior.
Therapists teach clients coping strategies to use when risky situations arise.
Therapists teach clients to plan ahead of time.
The aspect of techniques that control the rate of drinking like spacing their drinks or sipping would be opposed by AA since AA believes that it is a "fact" that they are powerless over alcohol and that they must stop drinking entirely and permanently if they are to live normal lives.
Why is the use of methadone in drug maintenance programs controversial?
Used to substitute one addiction with another one but under medical supervision → turns out Methadone is sometimes harder to withdraw from than other drugs and come become an addiction itself
What are the cost-benefits of Sober High Schools?
The cost is incredibly high and many sober high schools are being shut down due to large state deficits but according to supporters, "Recovery school is a fraction of the cost of incarceration." The benefits are the resources available to the students like counselors, psychologists, and ongoing mental health support.
Does DSM-V include gambling disorder, computer gaming disorder and/or Internet Use disorder as addictive disorders?
Yes → people can become addicted to behaviors and activities beyond substance abuse → Gambling considered a substance abuse