Fair Game Sheet

Final exam Fair Game Sheet
Stress Disorders * Reactions to extreme trauma: * Intrusive recollections and acute distress upon cues that suggest the trauma * Dissociative symptoms (psychic numbing) – STRONGEST SYMPTOM FOR PTSD * Emotional detachment, being in a daze, dropping out of activities, avoidance of trauma related topics, forgetting key aspect of trauma, derealization(external world is fake) and depersonalization. * Depersonalization disorder: one feels constantly that their body is unreal or foreign. * Chronic hyperarousal: insomnia, hypervigilance, motor restlessness * Aggressiveness and survival guilt * Acute Stress Disorder and PTSD * Risk Factors: experience a traumatic
event-earthquake, rape, crash.. * Symptoms begins within four weeks and last for less than one month-ASD * If symptoms last longer than one month, then it is classified as PTSD * Can occur at any age, 2:1, * Lead to depression, substance abuse or other anxiety disorders. * Particular triggers: combat, disasters, abuse, victimization * Abnormal activity of hormone cortisol and norepinephrine. Damage in hippocampus (memories) and amygdala (emotional response). * Predisposition and inheritance. * Personality- more negative=more likely, childhood experiences- anxious and catastrophes at an early age, weak social support, multicultural factors Hispanics are more likely, and severity of trauma. * Treatment: * Drug therapy, behavioral exposure techniques-flooding and relaxation training, insight therapy, family therapy, and group therapy. * Eye movement desensitization and reprocessing * Move eyes in saccadic movements from side to side while flooding their minds with images of the objects they try to avoid. * Antianxiety drugs to ease tension and antidepressants to reduce occurrence of nightmares * Critical Incident Stress Debriefing: Basic Steps * Crisis intervention that has victims of trauma talk about feelings and reactions within days on traumatic incident. * Disaster response team was created to mobilize psychologist to talk to victims of recent trauma. * Some believe the debriefing encourage people to dwell on traumatic event or suggest problems.

Dissociated Disorders * Nature of Dissociation, typical manifestations of dissociation * Repression, escape behavior * Possible relationship of anxiety to dissociative disorders * Normal->anxiety->dissociation(can be normal; daydreaming, spacing out) * Anxiety is so intense that they go past panic attacks and just dissociate * Experiences of depersonalization and derealization * Feeling weird in their own bodies * Dissociated Amnesia * Inability to recall important personal information, exceeding normal forgetfulness * Brief episodes may be due to drug or medication side-effects * True amnesia, non-acknowledgement or selective memory * Associated with PTSD * Confined to period of time after stressful event, only retrograde, restricted to personal episodes * Failures in memory encoding or retrieval * Treatment involves anxiolytic medications and supportive psychotherapy (sometimes sedative-hypnotic meds) * May be localized( forgetting happened during a limited amount of time) , selective (remember specific events during the amnesic period) , generalized ( can’t remember what happened during the event or things that occurred earlier in his life) or continuous (forget new and ongoing experiences and what happened before and after the tragedy) * Dissociated Fugue * Suddenly found yourself in a place you don’t remember how you got there. * Confusion of identity or adoption of new identity * Retroactively diagnosed * Occurs after personal trauma, episodes can last from hours to months * Fugue statements can be results of medications * Repeated fugues, can rule out complex partial seizure disorder * Treatment is anxiolytic meds and supportive psychotherapy * May assume new identity * Dissociative Identity Disorder * Multiple personality disorder * 2 or more separate identities that may not be aware of each other’s thoughts called subpersonalities or alternate personalities. * Switching triggered by a stressful event * Caused by episodes of abuse, sometimes sexual * Mutually amnesic relationships – no awareness of other personalities. * Mutual cognizant patterns- each personality is aware of the rest. * One way amnesic relationship, awareness of personalities is not mutual * Depersonalization Disorder * People feel that they have become detached from their own mental processes or bodies, or observing themselves from the outside. * Identities seem to remain intact * Sense of self that changes. * Predominate Explanation of DID * First diagnosed in adolescents and early adulthood. Began in early childhood after episodes of abuse, sexual, before the age of 5. * View of DID as an iatrogenic illness * Therapists create this disorder by suggesting existence of another personality during therapy or inducing it in patient while under hypnosis. * “False Memory Syndrome” and “Memory Recovery Movement” * Preferred Treatments for DID * Often recover on their own.
* Psychodynamic therapy- brings forgotten experiences, due to repression to consciousness. * Hypnotic therapy- after hypnosis, guided to recall forgotten events. * Drug therapy- injections of sodium amobarbital and sodium pentobarbital – truth serums. * Recognize full nature of disorder, recover gaps in memory, integrate subpersonalities into one person. * Group therapy * TLE and Dissociative Phenomena * TLE is temporal lobe epilepsy – over active amygdala’s, mechanisms that attach meaning to objects. * Obsession with detail and meaningfulness of trivia, interpersonal viscosity ( cant end a conversation), hypermorality and diminished sense of humor ( nothing should be taken lightly), hyperreligiosity with expanded sense of personal destiny ( comes with seizure) and fetishism and sexual disinterest. * Simple partial seizures * Confined to amygdala- short lived spells. * Complex partial seizures * Spreads within temporal lobe which impairs consciousness.
Personality Disorders * Who has them? * Typical signs and symptoms for each type of personality disorder * Paranoid personality disorder
: * Distrust other people and are suspicious of motives. * Paranoid feelings * Remain cold and distant, hold grudges, and blame others for things going wrong in their lives. * Schizoid personality Disorder: avoid and remove themselves from social relationships and little emotion. * Do not have close ties with other people * Genuinely prefer to be alone. * Rarely show any feelings- neither joy or anger. * Happens more to men. * Unable to give or receive love due to abusive parents. * Cannot respond to emotional cues from others because they cannot pick up on them. * Schizotypical Personality Disorder : interpersonal problems, discomfort in close relationships, odd patterns of thinking and perceiving. * Anxious around others, seek isolation, few friends. * Some feel alone * Ideas of reference (unrelated thing are important to them) , bodily illusions ( sensing an external force). * Hard keeping attention focused. * Males have more than females. * Deficits in STM and attention are similar to schizophrenia like symptoms. * Linked this disorder to biological features found in schizophrenia * High activity of dopamine, loss of grey matter, smaller temporal lobes and enlarged brain ventricles. * Also tied to depression. * General personality disorder treatment : symptomatic treatment * Dialectical behavior therapy: * off the basis of cognitive behavioral therapy, humanistic and contemporary psychodynamic approaches to build social skills in groups and gain support and validation. * For Borderline Personality Disorder * Instable, mood swings, unstable self-image and impulsivity. * Etiological hypothesis * Early parental relationships * Lower brain serotonin activity * Self-mutilation and dissociation * Inflict pain inward and harm themselves * Physical discomfort relieves them from emotional suffering * ‘transient psychotic episodes’ and ‘splitting’ * Antisocial personality Disorder * Persistently disregard and violate others rights. * Related to adult criminal behavior * Must be at least 18 years old to receive diagnosis. * Lie * More common in men than women. * Relationship btw psychopathy and DSM-4 Antisocial Personality Disorder * DSM is unreliable and problems with validity, * Overlapping symptoms between disorders * People with different personalities have the same diagnosis * Uses categories rather than dimensions of personality * Etiology hypotheses * Absence of parental love leading to lack of basic trust. * Children become emotionally distant, bond by using power and destructiveness. * Learned through modeling or imitation * Constantly rewarding a child’s aggressive behavior. * Lower serotonin and deficits in frontal lobes. * Anxiety and physiological arousal * Treatments * Are typically ineffective because of lack of desire to change. * Atypical antipsychotic drugs and therapy. * “successful” psychopaths * Course of disorder through childhood, adolescence and adulthood * Relationship btw OCD and obsessive compulsive personality disorder * OCPD set high standards for themselves, needs everything to be right and organized before they can begin working, never satisfied with performance and do not want to work in a team because others cannot do as well at the tasks as they can * They are more likely to suffer from major depression, generalized anxiety disorder or substance related disorder than from OCD. * “ego-dystonic” vs. “ego-syntonic” symptoms
Schizophrenia
* Dementia Praecox * General Manifestations * Delusions of reference: * Attach special meaning to actions of others or various objects and events * Delusions of grandeur: * Believe themselves to be great inventors, religious saviors, or empowered persons * Delusions of control: * Feelings, thoughts and actions are controlled by other people. * Formal thought disorders * Communication is extremely difficult. * Inappropriate Affect: * Emotions that are unsuited to the situation * Hallucinations: * Olfactory, audio, somatic (something happening inside the body) and tactile (false feelings, tingling or burning). * Alogia: * Decrease is speech or content * Flat affect: * Lack of emotional expression * Avolition: * Inability to start or completion of action * Catatonia: * Psychomotor symptoms, stupor, rigidity or posturing * Risk Factors: genetic predisposition, consanguity and concordances, infectious agents, birth trauma, sperm, etc * Seasonality Effects in Schizophrenic births * People with schizophrenia are usually born in the winter * An increase of fetal exposure during that time of year * MZ twin types and implications * If one twin has it there is a48% chance the other twin will get it. * Prenatal factors that can affect both twins in utero. * There is a genetic biological factor with schizophrenia * Marijuana and Psychotogenicity * DSM-IV classical schizophrenia subtypes and problems with subtypes * Prodromal- symptoms are not yet obvious, social withdraw, express little emotion and develop strange ideas * Active- symptoms become apparent, this stage is triggered by a stressful event. * Residual- return to prodromal like stage, active stage lessens but some negative symptoms remain. * Subtypes: * Hebephrenic or disorganized * act silly and inappropriate, confusion, incoherent, social withdrawal * catatonic type * psychomotor disturbances * paranoid type * delusions and hallucinations that guides their lives. * Undifferentiated type – is when a person does not fall directly into one of the subtypes * Residual type- when a person’s symptoms lessen and seem to stay in residual stage * Positive vs. negative signs/symptoms of schizophrenia (range of symptoms) * Differences in positive (e.g. Type I) vs. negative-symptom-predominant
(e.g., Type II or deficit syndrome) schizophrenias: Type 1 schizophrenia- dominated by positive symptoms such as hallucinations, delusions and thought disorders * Type 2- negative symptoms- flat affects, poverty of speech, and loss of volition * Premorbid histories and course of illness * Blamed mothers ( schizophrenogenic maternal style) * Madness * Sex differences * Gene defects on chromosome X. * Differences in age of onset, prognosis * Neuroanatomical / neurotransmitter changes * Dopamine hypothesis- neurons fire too many dopamine neurotransmitters and transmit to many messages * Differences in medication effectiveness * Antipsychotic drugs are used for positive symptoms * Atypical antipsychotic drugs are used for positive and negative * Classical / atypical antipsychotic medications (effects, side effects, major classes of medications) * Atypical cause weight gain, dizziness, elevations in blood sugar, drop in white blood cells, * Classical- tardive dyskinesia, neuroleptic malignant syndrome, parkinsonian symptoms. * Advantages of atypical antipsychotic medications * Bind to D-2 dopamine receptors and D-1 and neurotransmitters for serotonin * Respond best to negative symptoms of schizophrenia * Role of psychotherapy in schizophrenia * Cognitive behavioral therapy- accepts the problem and learns to live with it. * Family therapy-teaches family how to deal with schizophrenic person with guidance, training, advice, education and emotional support. * Social therapy- techniques that address social skills, problem solving, decision making. * Compliance rates with antipsychotic medications * It is more difficult for men to comply to take the medications. * People refuse to take the medications because of the side effects * Motor and metabolic side effects of antipsychotic medications * Caused tremors similar to Parkinson’s disease. * Tardive dyskinesia * Drop in white blood cells * Other disorders often treated with antipsychotic medications * Bipolar * World-wide trends in schizophrenia incidence and possible causes * National interests groups are formed around the world and push for community treatment * “Rule of thirds” and newer outcome estimates in schizophrenia
Eating Disorders * Prevalence as a function of sex and Westernization, and explanations * Western standards of female attractiveness * Professions lead to eating disorders- athletics, dancers, models and performers. * High socioeconomic classes have more eating disorders than low. * Prejudice of overweight people. * Psychological problems, biological and sociocultural. * Bad parenting leads to child not knowing their own emotions. * Want control of their bodies. * Want to overcome sense of helplessness. * Care a lot about how other people think of them * Cannot identify their own emotions. * Types of males who are especially susceptible to eating disorders * 5-10% of persons with eating disorders * Men use exercise to lose weight and women use dieting. * They want to be attractive. * Pressure of job or sport. * Muscle dysmorphobia- want to be thinner and have more muscles- also see themselves as fatter than they actually are * Dsm-4 eating disorders: be able to define or identify from brief case descriptions * Binge-eating disorder * Effectiveness of dieting as a weight-loss method * When someone loses weight, the brain lowers metabolic rate and produces hunger. * Brain brings on desire to binge to gain weight that was lost. * Anorexia nervosa * Nature of body distortion * Loose period, grow lanugo, body swelling, reduced bone mineral density, slow heart rate, and low blood pressure. * Susceptible populations * 14-18 * Onset is between 14-18 years old. * May be onset of traumatic life stress. * Fear of obesity provides motivation * Overestimate body image, and distorted thoughts about food and weight. * Also suffer from anxiety and depression * Altered eating habits * Less than 300 calories a day * “two Ps” on anorexia * How anorexia nervosa is treated, and typical treatment outcome * Psychologists and family participation help them regain the lost weight and reduce malnourishment. * Offer rewards when patient gains weight or eats properly * Supportive nursing care, nutritional counseling, and a high calorie diet. Understand weight gain is under control and will not lead to obesity. * Use education, psychotherapy and family approaches to achieve goal of lasting improvement * Some psychotropic drugs * Cognitive behavioral therapy * 83% show improvements, 25% fully recover and 58% partially improved. * Relapse within 1/3 of patients * Bulimia nervosa * Susceptible populations * Begins after a period of strict dieting with social acceptance. * Do it for more social pleasing * More sexually experienced than people with anorexia * Long history of mood swings * Have trouble coping and controlling impulses. * More than 1/3 display characteristics of a personality disorder * Prone to suicide. * Have lower levels of serotonin. * Types of compensatory behavior among bulimics * Binge eating, forcing themselves to vomit, misuse laxatives, diuretics, enemas, fasting or excessive exercising. * Purging type and non-purging type. * 15-21 * Consume more than 3000 calories in one hour. * Bodily damage suffered in bulimia nervosa * Serious dental problems * Potassium deficiencies * Intestinal disorders, kidney disease, and heart damage. * How bulimia nervosa is treated, and typical treatment outcome * Eating disorder clinics, teach education as much as therapy * Cognitive behavioral, interpersonal, psychodynamic and family therapy * Antidepressant drug therapy * Group therapy * 89% show recovered fully or partially * Relapse triggered by a life stressor
Addictions
* Moral vs Medical (disease) views of addiction * Use vs abuse and sociocultural norms * Happens in families that view substances as being accepted. * In lower economic societies. * Rate increases as unemployment does. * Use substances to medicate themselves in stressful times. * Dsm-4 and non-substance addictions * Dsm-4 substance abuse vs dependence and general diagnostic criteria * Physical vs psychological dependence * Effects of alcohol ingestion: neurochemical, behavioral, cognitive * Brain damage, impairments in STM, speed of thinking, attention skills and balance * Develop cirrhosis- damage of the liver. * Risk factors for ETOH dependence; LR and predisposition to dependence * Alcoholism runs in families * Abnormalities in the D2 dopamine receptor gene. * Consequences of ETOH use: physiological damage and fetal effects * Children with FAS abnormal facial features, brain abnormalities, learning disabilities, low iq scores, hyperactivity and social problems. * Consequences of college binge drinking * Arrests, unplanned and unprotected sex, deaths, injuries, cases of sexual assault, over weight and have high blood pressure * ETOH withdrawal syndrome and management * Delirium tremens- terrifying hallucinations after one stops drinking. * Become shakey, irritable, nauseated, sweat and vomit, unable to sleep, depressed and anxious, seizures, loss of consciousness, stroke or may die due to stopping alcohol. * Korsakoff’s syndrome * Vitamin B deficiencies leads to confusion, memory loss, and other neurological symptoms. * Don’t admin not being able to remember but instead make up stories. * General modalities of addiction treatment (acute and rehabilitation phases) * General philosophy and operation of 12-step recovery groups * General effectiveness of treatment for common addictions * Trends in addiction treatment, with examples of pharmacological treatments * Replacing alcoholism with antianxiety and benzodiazepines
Alzheimer’s Disease * Risk factors * Bad health * Runs in families * Brain and neurotransmitter changes * Neurofibrillary tangles- twisted protein fibers * Senile plaques-deposits of small molecule, beta-amyloid protein that form between cells in hippocampus, cerebral cortex and some blood vessels. * Imbalance in metabolism of calcium * Early and late signs and symptoms * Course of illness * Treatments and possible preventatives * Drugs that prevent breakdown of ATC * Taking vitamin E. * Taking estrogen after menopause * Behavioral therapy * Assisted living facilities and day care facilities * Nun study and predictiveness of autobiographical writings