Abnormal Psychology Final

An enduring, rigid pattern of inner experience and outward behavior that impairs sense of self, emotional experience, goals, and capacity for empathy and/or intimacy.
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An enduring, rigid pattern of inner experience and outward behavior that impairs sense of self, emotional experience, goals, and capacity for empathy and/or intimacy.
Personality Disorder
Approximately what % of adults in the US have a personality disorder?
10%
Is it common for a person with a personality disorder to suffer from another mental illness?
True/yes
3 Clusters in Odd or eccentric behavior
1. Paranoid personality disorder
2. Schizoid personality disorder
3. Schizotypal personality disorder
This disorder is characterized by deep distrust and suspicion of others, extremely sensitive to criticism
Paranoid personality disorder
This disorder is characterized by persistent avoidance of social relationships and limited
emotional expression
Schizoid PD
This disorder is characterized by a range of interpersonal problems, marked by extreme discomfort in close relationships, odd (even bizarre) ways of thinking, and behavioral eccentricities
Schizotypal PD
4 clusters of Dramatic, emotional or erratic behavior personality disorder
1. Antisocial personality disorder
2. Borderline Personality disorder
3. Narcissistic personality disorder
4. Histrionic Personality disorder
Sometimes described as "psychopaths" or "sociopaths," people with antisocial personality disorder persistently disregard and violate others' rights
Antisocial personality disorder
a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning in early adulthood and present in a variety of contexts
Borderline Personality disorder
is described as a pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contextsHistrionic personality disordergrandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, Many take advantage of others to achieve their own endsNarcissistic Personality disorder3 clusters of anxious or fearful behavior1. Avoidant personality disorder 2. Dependent personality disorder 3. Obsessive-compulsive disordervery uncomfortable and inhibited in social situations, overwhelmed by feelings of inadequacy, and extremely sensitive to negative evaluation, tend to fear close social relationshipsAvoidant personality disorderpervasive, excessive need to be taken care of, clinging and obedient, fearing separation from their loved ones They rely on others so much that they cannot make the smallest decision for themselves, DIFFICULTY WITH SEPERATIONDependent personality disorderso preoccupied with order, perfection, and control that they lose all flexibility, openness, and efficiencyobsessive-compulsive personality disorder, may be afraid to make decisions, rigid and stubbornWhich PD is associated with psychological disorders in the patient's parents?Schizotypal Personality disorder (odd)What % of people in the US meet the criteria for Antisocial PD?2-3.5%What area of the brain, when damaged, seems to decrease the ability to feel guilt and show concern for others?Ventromedial prefrontal cortexWhat % of people with Borderline PD are woman?75%How are serotonin levels related to impulsivity?lower serotonin-based on cognitive-behavioral treatment model combined with a psychosocial model •Help clients ID strengths and build on them •ID thoughts, beliefs, assumptions that make life harder •work on relationships with therapists and staff. role play ways of interacting with othersDialectical behavioral therapyThese 4 modules are used in Dialectical Behavior therapy•1. Mindfulness- attention brought to present experience moment to moment •2. interpersonal effectiveness- asks for needs, saying no,and coping with personal conflict •3. distress tolerance- Accepting, finding meaning for, and tolerating distress 4. emotion regulation- borderline and suicidal people are emotionallly intenseWhat is the difference between Avoidant PD, and Social Anxiety DisorderBoth fear humiliation -Avoidant: fear close social relationships -social anxiety disorder: fear social circumstancesWhat is the difference between OCD and Obsessive-Compulsive Personality Disorder?-OCD: TRUE obsessions, need for control, KNOW SOMETHING IS WRONG -OCPD:DON'T THINK SOMETHING IS WRONG- LOSE ALL FLEXIBILITYWhat are some of the concerns about diagnosing personality disorders?-rely on impression of clinician -some diagnostic criteria cannot be observed directly -disorders are similar -people with different personalities may be given the same diagnosisWhat % of children and adolescents in the US experience a diagnosable psychological disorder?20%Anxiety disorders in children are very common - what are the symptoms in children?? Are they often related to current events?-behavioral and somatic symptoms -They tend to center on specific, sometimes imaginary, objects and events -They ARE often triggered by current events-feel anxiety and panic when seperated from home or parent -develop into school phobia"Separation Anxiety Disorder"What % of adolescents experience Major Depressive Disorder?20%-headaches, stomach pain, irritability, and a disinterest in toys and gamesSymptoms of childhood depressionWhat is the difference in rates of depression between males and females pre and post puberty?-NO difference before the age of about 12 -Girls are TWICE as likely as boys to be depressed by the age of 16Name the disorder given to children with severe patterns of rageDisruptive mood dysregulation disorderDescribe Oppositional Defiant Disorder. What are the symptoms?? How does puberty effect this?-CHILDREN WITH HOSTILITY -CHILDREN WITH this disorder are argumentative and defiant, angry and irritable, and, in some cases, vindictive -More common in males -can lead to antisocial personality disorder-more severe problem, repeatedly violate the basic rights of others -may be physically cruel to people and animals -Many steal from, threaten, or harm their victims, committing crimes as shoplifting, forgery, mugging, and armed robberyDefine Conduct Disorder.What are some of the risk factors for the development of Conduct Disorder?repeatedly violate the basic rights of others-difficulty concentrating, staying on task, deciding what is important. Appear impulsive and overactivesymptoms of ADHDWhat % of children overall and what % of boys in the US are diagnosed with ADHD?-8.4% children -12% boysWhat neurotransmitters are believed to play a role in ADHD? Are these neurotrans- mitters believed to be in higher or lower concentrations in the brains of those suffer- ing from ADHD?Low NE (norephinerphrine) AND low DA (Dopamine)-Ritalin and Adderall increase NE and DA and allows for increased attention and more control of impulsivityHow do the drugs used for ADHD work?What % of children with ADHD go on to be adults with ADHD?35-60%What is the estimated % of school children on stimulant drugs?3%What type of behavioral therapy is often used for ADHD?-Positive reinforcement /operant conditioning1. extreme unresponsiveness to other people, 2. severe communication deficits, and 3. highly rigid and repetitive behaviors, interests, and activitiesmain symptoms associated with Autism Spectrum Disorder?Approximately how many children will be diagnosed with Autism Spectrum Disorder-(1/150) What % of these will be male? 4 times more likelyApproximately what % of children diagnosed with Autism will remain severely dis- abled into adulthood?90%Is a genetic component believed to be a factor in Autism?yes, Prevalence rates are higher among siblings and highest among identical twinsDescribe the treatment approaches to Autism Spectrum Disorder.1. cognitive-behavioral therapy: teach new, appropriate behaviors 2. communication training, 3. parent training, and 4. community integrationApproximately what % of the elderly struggle with depression?20%Does the prevalence of anxiety increase or decrease with age?increasesexperience decline in at least one area of cognitive functioning, such as: -memory and learning, attention, visual perception, planning and decision making, language ability, or social awarenessNeurocognitive DisorderWhich disease accounts for approximately 2/3rds of neurocognitive disorders?Alzheimer's disease-This is a gradually progressive disease in which memory impairment is the most prominent cognitive dysfunctionsymptoms of Alzheimer's disease.3 main ideas of causation of Alzheimers?1. reduced synthesis of ACH. Meds that increase ACH appear to have a + effect early in the course of the disease 2. Amyloid (a small protein)- Amyloid deposits accumulate around neurons ( a protein gone bad) with the effect being damage to dendrite, decreased synaptic input. As plaques accumulate, the brain begins to atrophy. THESE ARE OUTSIDE THE NEURON 3. Tau Protein - proteins that stabilize microtubules in neurons.THESE ARE INSIDE THE NEURONAre amyloid plaques inside or outside of the neurons?outsideLoss of contact with reality. The ability to perceive and respond to the environment is significantly disturbed; functioning severely impaired. (Symptoms: hallucinations, delusions)Psychosisperiod of psychosis that is short and not recurring. lasts from one day to one month, sudden onset of delusions, hallucinations, odd behavior or speech or catatonic behaviorBrief Psychotic Disordersymptoms of schizophrenia are present for a significant portion of the time within a one-month period, but signs are not present for the full six months required for the diagnosis of schizophreniaSchizophrenia disorderPsychosis (Schizophrenia) and a mood disorder• Commonly see delusions, hallucinations and disordered thoughts and speech.Schizoaffective disorderPatient only experiences delusions (false beliefs). No hallucinations, other thought disorders, speech disorders, mood disorders or negative symptoms (e.g. flat affect)Delusional disorder (6 types: erotonamic, grandiose, jealous, persecutory, somatic, mixed)1% of the world's Population onset 23 for men, 28 for women 25% attempt suicideSchizophrenia (symptoms can be grouped into 3 categories positive, negative, and psychomotor symptoms)ideas that are believed completely but have no basis in reality.Delusions(most common) - believe they are being spied on, discriminated against, victimizedDelusions of persecutionthey attach special meaning to the actions of others or various objects or events that makes everything have personal significanceDelusions of ReferenceAwkward movements, repeated grimaces, odd gestures that seem to have a private purposePsychomotor symptomspeople with a biological predisposition develop the disorder only with certain stressorsDiathesis-stress model"Patterns in which individuals repeatedly have intense sexual urges or fantasies or display sexual behaviors that involve objects or situations outside the usual sexual norms."Paraphilic DisordersThe key features of this disorder are recurrent intense sexual urges, sexually arousing fantasies, or behavior that involves the use of a nonliving object, -women underwear, shoes, and bootsFetishism (more common in men)(also known as transvestism or cross-dressing)• -characterized by fantasies, urges, or behaviors involving dressing in clothes of the opposite sex as a means of sexual arousalTransvestic disorder a type of Paraphilic Disorder(aka, "flashing") characterized by arousal from the exposure of genitals in a public setting Most often, the person wants to provoke shock or surprise, rather than initiate sexual contactExhibitionistic disorder a type of paraphilia disorderThis disorder is characterized by repeated and intense sexual urges to observe people as they undress or engage in sexual activityVoyeuristic Disorder a type of paraphilic disorderrepeated and intense fantasies, urges, or behaviors involving touching and rubbing against a nonconsenting person. may be fantasies, urges or behaviorsFrottueristic disorder a type of paraphilia disorderby fantasies, urges, or behaviors involving sexual arousal from prepubescent (classic type) or early pubescent children (hebephilic type) (Hebe - youth) or bothPedophilic disorder is a type of paraphilic disorderantasies, urges, or behaviors involving the act or thought of being humiliated, beaten, bound, or otherwise made to suffer. a form of this is called hypoxyphiliaSexual masochism disorder (a type of paraphilic disorder)usually a male, is repeatedly and intensely aroused by the physical or psychological suffering of another individual - dominating, cutting, strangling, even killing the victimSexual sadism disorder (paraphilic disorder)persistently feel that they have been assigned to the wrong biological sex and gender changes would be desirableGender dysphoriaA psychoactive substance that results in behavioral sedation ( including "relaxation") ; includes alcohol, sedatives, hypnotic, anxiolytic drugs, opioidsDepressantA psychoactive substance that results in elevated mood, activity or alertness: includes amphetamines, caffeine, cocaine, nicotine.stimulantsAny psychoactive substance such as LSD or marijuana that can produce delusions, hallucinations, paranoia and/or altered sensory perceptionHallucinogens% of people who qualify for substance use disorder10%GABA (the primary inhibitory neurotransmitter in the CNS) Glutamate primary excitatory (alcohol blocks glutamate)GABA & Glutamatelifetime prevalence for alcohol use disorder13%lots of glutamate activity and less GABA activity with alcohol withdrawal makes an over excited nervous system and the symptoms of DT'scause of DT'sAKA Anxiolytics (anxiety-reducing) - at low doses, relaxing effect. At higher doses, sleep inducers (hypnotics) 2 types: Barbiturates & BenzodiazepininesSedative-Hypnotic Drugs-increases activity at GABA synapses (increases sedation) 3 types are: Xanax, Ativan, ValiumBenzodiazepinesDifferent types of OpioidsMorphine (natural plant) Heroin (more fat soluble easy to get to brain) Methadone (synthetic opioid) Narcoticsanxiety, restlessness, sweating, rapid breathing, fever, vomiting, loss of appetite, high blood pressure. These symptoms peak at about day 3 and subside by about day 8-9Withdrawal symptoms of opioid usersAt what part of the brain do opioids suppress respirationMedulla (opiates suppress the medulla, suppress respiration)How many times is Fentanyl more potent than morphine and many times more potent than heroine.75-100 more times1. Cocaine 2. Amphetamines 3. Caffeine 4. NicotineStimulants (Increase activity in the CNS. Increase blood pressure, heart rate, alertness)important area of the brain for perceiving pleasure.Nucleus Accumbensblock that protein therefore block the reuptake of DA into the presynaptic cell and increase the DA concentration in the synapse.Amphetamine and cocaineMost powerful "natural" stimulant known.CocaineEffects - euphoria, increased confidence, excitation, talkativeness, increased heart rate, respiratory rate, and blood pressure, arousal and wakefulness.CocaineSymptoms of depression-like letdown and why it happens:Due to a depletion of the neurotransmitter symptoms: headaches, dizziness, fainting.stimulate the CNS by increasing DA, 5HT and NE in the synapses by blocking their reuptake into the presynaptic neuron. ( have more effect at the serotonin and NE transport proteins vs cocaine so somewhat different responses)Amphetaminesincreases risk of parkinson's dz, cognitive deficits, impaired attention/memory. 20% of meth users experience psychosis (similar to schizophrenia) that is difficult to treat long-term problems also include depression, suicide, serious heart dz, "meth mouth" (tooth decay, grind their teeth and have poor hygiene, nutrition,) skin soresMethamphetamineWithdrawal symptoms include extreme fatigue, (but sleep problems,) irritability, anxiety, can last weeks-monthsMethamphetaminesincreased arousal but can also disrupt fine motor movement and interfere with sleep. At high doses, increase respiratory rate, arrhythmias, and increased gastric acid secretionsCaffeineWithdrawal symptoms include headaches, depressive symptoms, anxiety and fatigueCaffeinepeople smoke as much as a puff every 6 seconds until they feel ill. Feelings of illness become associated with smokingaversion therapy.hallucinogen intoxication marked by increased visual perceptionsmay focus intently on small details or perceive more intense colors, objects may appear distorted or moving. May see objects or people not present (hallucinate.) May cause senses to "cross" - for example they may feel that they "hear" colorsunpredictable, perceptual, emotional and/or behavioral reactions that can occur.Primary dangers with LSDMany drugs that distort perception resembleSerotoninThis drug at low doses releases DA -At higher it affects 5-HT receptors cause long term loss of serotonin receptors, persistent depression, anxiety, impaired learning and memoryEcstasy (MDMA)cannabinoid that appears to be most responsible for psychological effects. The greater the --- the more powerful the effect.THCDoes Cannabis impair drivingYes (inhibits performance of complex sensorimotor tasks and cognitive functioning)based on classical conditioning. Patients take a drug and it's paired with something unpleasant ( a shock, something that makes them vomit, imagining a horrible scene or how their family would react to their death...)Aversion Therapy for substance usemakes incentives (cash, vouchers, privileges) contingent of clear urine specimens. seems to work (positive reinforcement)Contingency Managementhelp clients ID and change the behaviors and cognitions that contribute to their patterns of substance abuseCognitive Behavioral therapy for substance useClients taught to ID high risk situations, look at the range of options that confront them in these situations, change their choices to healthy ones.Relapse prevention trainingAn ---- is a drug that blocks the effect of another substance (drug or neurotransmitter) at the receptor site. ----- is a drug given to people who are trying to stay away from alcohol.Antagonist AntabuseIs there a major difference in outcome between inpatient residential treatment programs and good quality outpatient programs?NOFor one week or more the patient's mood is abnormally and persistently euphoric or irritable plus 3 other thingsHow long does one need to be experiencing these symptoms to receive the diagnosis?Areas of functioning used to describe the symptoms of mania1.Emotional Symptoms 2. Motivational Symptoms 3. Behavioral Symptoms 4. Cognitive symptoms 5. Physical Symptomslack of restrictions. Lack of fear. Lack of awareness of any consequences.emotional symptomswant constant involvement, excitementMotivational symptomsvery active. may talk rapidly and loudly. Become very vocal - loud jokes and efforts to show cleverness or verbal outbursts and complaints.Behavioral Symptomspoor judgement and planning.Cognitive SymptomsTypically get little sleep but do not feel tired.Physical SymptomsDo people who are experiencing a manic episode retain insight? Why is this important?FEW RETAIN INSIGHT. The more manic they are, the less insight they generally have. Manic behavior often continues until they are hospitalized or jailedWhat are the three major diagnostic subtypes of Bipolar Disorder?1. Bipolar I 2. Bipolar II 3. Mixed ManiaBouts of Depression (MDD) mixed with at least one manic episode. men = women, cross-culturalBipolar IBouts of Depression (MDD - just as severe as Bipolar I) mixed with hypomania (a milder mania - often function OK- women > menBipolar IIpatient has met criteria for both MDD and Mania nearly every day for a week or more very serious illness - agitation, impulsiveness, irritability, paranoia, RAGE, high degree of suicidal ideation. May see things like depression with racing thoughts, increased energy and rage combined.Mixed Maniaif clients experience four + episodes/year their disorder is labeledRapid CyclingBasically a mild form of bipolar disorder numerous periods of hypomanic symptoms that do not meet the criteria for hypomanic episode plus numerous periods of depressive symptoms that do not meet the criteria for major depressive episode. For at least 2 years in adults (one year in children)Cyclothymic DisorderPrevalence of Bipolar disorder Are women or men more likely to be diagnosed? What is the most common age of onset?3-5% men = women late teens can be as late as mid 40'sWhat is the average amount of time between onset of symptoms and actual diagnosis of Bipolar Disorder?Tragically under-diagnosed. On average 12-20 years between onset of symptoms and diagnosis.is an element found in salts all over the world. It's effectiveness at treating bipolar disorder was found accidentally also help with bipolar depressive symptoms but not as much as they help with manic symptoms (mood stabilizer)mood stabilizers (Lithium)Li+ doses need to be managed within a narrow range for effectiveness and lack of toxicity -toxic effects - nausea, vomiting, tremors, dizziness, slurred speech, seizures, kidney damage, deathSymptoms of lithiumRisk of relapse of Bipolar Disorder if a patient stops their "mood stabilizer" medication.Risk of relapse is 28X greater if one stops their mood stabilizing drugWhat role does psychotherapy play in the treatment of Bipolar Disorder?-doesn't work for mania. -many bipolar patients stop taking their meds - reasons - side effects, feeling well, miss the mania - psychotherapy is used an adjunct treatmentRisk of suicide attempt in patients with Bipolar Disorder?At least 25-50% of bipolar patients attempt suicide