- onset is slow

- smoother, longer lasting 

most is self limiting 

total 5 criteria

either

1) sad or unhappy mood (most of the day or nearly everday)

2) decreased pleasure or interest in almost all activities (most of the day or nearly everyday) 

4 of these: 

- appetite change -->5% weight loss 

- sleep disturbance 

-psychomotor retardation or agitation 

- fatigue, loss of energy

- concentration probelms or indecisiveness

- recurrent thoughts of death not necssarily suiciede just death 

- quick onset..can go away as quick as it came 

- can run from days to months 

Mood disorder   4 criteria 

1) abnormal, persistent expansive, elevated or irritable mood

2) any 3 from this list 

- inflated self esteem

- decreased need for sleep

- talkative

- flight of ideas

- distractability

- hyperactive physical movements, agitated 

- recklessness

-Neurotic(non psychotic) vs. psychotic mood disorder

-Endogenous vs. Exogenous (reactive) 

-early vs. late onset depression 

neurotics --> non psychotic patients don't lose their ability to interact with the environment in an efficient manner

Psychotic --> lose ability partly because thinking process is disturbed by hallucination, false sensory perc, delusion, etc 

endogonous (from within)--> don't know direct cause 

exogenous (reaction) --> usually the case ...depression comes from a cause 

Somatization disorder

Conversion disorder

Pain disorder 

Hypochondriasis 

Body dysmorphic disorder 

1) rapid appearance of symptoms after trauma

2)La belle difference - don't mind because takes away internal anxiety

3) selective symptoms 

- if paralyzed, legs move during sleep 

Complaints must be before 30 years old 

4 pain symptoms, 2 GI problems, 1 sexual problem, 1 pseudoneurological symptom (like conversion blindness, fainint..etc) 

motivation of somatization disorder are the symptoms where as hypochondriasis focus is on disease 

must also significantly affect their normal life 

- Different specific stimulus causes a specific response

Wolf and Wolffe

- Gastric juice of patient

Dif people have specific ways of responding to stress

exp.  Those with gastric problems..when confronted with stress tended to have gastric problems

1) structural social support (quantitative) 

2) functional social support (qualitative) 

3) biological mediator 

 - immune system functioning 

- can be compromised by emotional stress like depression 

correlational studies..mood sucked, lower antibodies 

Dissociative Amnesia

Dissociative Identity Disorder (DID)

Dissociative fugue 

Depersonalization 

No underlying neurological or physical problems

Higher order functions are disrupted or broken down (memory, identity, perception) thus a breakdown of conscious awareness occurs 

Person dissociates from themselves 

Cannon - general activiation theory

- stress affects sympathetic nervous system. 

nervous system fires 

Hanz Selye - general adaptation syndrome 

- non specific response of body to any demand placed on

- results in a coordinate set of physical responses

1 alarm reaction-->rsistance-->exhaustian 

- feature: persistent or recurrent experience of feeling detached from the body. As if you're an outside observer of mental process and behavior

- reality testing stays intact 

- diagnosis: when depolarizing is severe and persistent enough to disrupt person's life 

State Anxiety - Natural arousal, apprehension, worry  uneasiness directly observed

trait anxiety- propensity to respond with state anxiety more frequent range of situations 

- proneness to state anxiety  depicts world as threatening 

Phobias - specific/simple, social 

OCD

General anxiety disorder

PTSD 

Panic disorders 

discrete period of intense discomfort with development of at least 4 symptoms 

-choking, derealization, nausea, racing heart, fear of dying, feeling detached, trembling, numbness, etc 

linked with panic Disorder must ask about panic disorder as well 

- fear of being in a place or situation where escape might be difficult or embarassing 

or hwere help would not be available

How many cognitive behavioral ways can you diagnose ? list and describe them.  

Which is the best? 

What are some critiques ? 

Questionaire- most response bias 

Behavioral situational observation - most expensive time consuming 

Behavioral situational in clinic - clinicians bias, unnatural 

Behavioral and situational naturalistic observation - most accurate - live with them at home or work 

Early vs. late onset depression

1st time isyounger --> more likely recurrence..more likely worse...greater risk

1st time later in life...less chance of it passing on genetically 

PSychological conflict take on somatic or physical effect. 

No neurological evidence to explain the symptoms 

- preoccupation with imagined deficit in appearance

-or if deficit exists, procupation is obsessive or exaggerated 

maybe psychological and med condition

- has physical abnormality but psych factors judged to be important to the onset of condition, severity, or exacerbation of conditon

- persons life sucked, then they break their arm, they'll complain more about the pain 

1 or more symptoms or deficits affecting voluntary motor or sensory function 

--> suggests a neurological disorder..but not present 

- preceded by a stressor or conflict

- primary gain - patient blocks awareness of internal conflict

secondary - excusing person from responsibility and attracting sympathy and attention

Diagnosis: 2 or more distinct personality states 

at least one is amnesic of experiences of other

Host and alters

two major forms: 

1) Alternating form 

-each is amnesic of other .. flipflops 

2) co-conscious form 

- one dominant , subordinate is trying to make itself known. sub knows about dom 

Feature: one or more episodes of lack of ability to recall important personal info, usually of a traumatic or stressful nature 

too extensive to be explained by ordinary forgetfulness 

- often fine with forgetting 

feature: unexpected sudden travel from home or ordinary place of work without ability to recall past 

- will have confusion about their identity --> may assume new identity 

may wake up after jolting reminder of former life 

mimics neurological disorder  

- complain about self-awareness ..

dissociates from body .. 

- shows difficulty integrating personality 

might show up in motor behavior  

excessive, unreasonable fear of specific thing

- cultural skew shows that african americans and latinos show specific phobia 

- despite trying to neutralize or negate, constant intrusion of thoughts that causes anxiety OR compulsive behaviorto relieve anxiety

- recognized by themselves as unreasonable

- affects their life in a sig. way (Time usually) 

- rare but most common cause of disability 10th leading

- 30 days or more to diagnose 

- experience or witness traumatic event usually dealing with death   

- persistent avoidance of stimuli that resembles or reminds of trauma 

- persistent arousal    on edge

- recurrence of traumatic event through toughts, dreams  

- some type of numbing to the environment 

If less than 30 days --> then acute stress disorder

PTSD broken down to acute,chronic and delayed onset 

response: fear, helplessness 

- 

-politics and money affect this 

- chronic diffuse anxiety 

More days than not diagnoses  minimum of 6 mos.  about 50% of time 

- difficulty controlling worries, restlessness, fatigue, irritability, 

must rule out physical problems

must not be caused by these:  ,

med condition anxiety,

substance induced anxiety 

 NOS 

What are neuropsychological assessments? 

- evaluates brain damage 

usually long tests ...tests allfunctionsof brain

1) screening - quick quinestionaire type made at hopkins

2) test battery- thoroughly evaluate relevant info and compare aginst normal epxpectations  (takes long time) 

Define reliability ..

describe them 

(repeatability) 

Necessary but not sufficient for validity

sets limit on validity 

good reliability can be both good or bad validity

test-retest reliability - test at different times = same results

- inter-rater reliability - different people measuring same thing get same results

internal consistency reliability - task gets harder, gets more wrong  also correlates to other tests  (introvert correlates to shyness tests) 

- persistence must be at least 6 months

preocupation with fears of having a disease 

- they feel the pain, but no physical disorder underlying it 

Unipolar  

Bipolar 

unipolar depression --> describe

What is hypomania

What is dysthymia 

What is cyclothymia? 

unipolar depression --> 2 states, depression and normal

Hypomania is milder version of mania

Dysthymia is a milder version of major depressive disorder, doesn't fit the 5 criteria completely --> must experience for at least 2 years 

Cyclothymia milder version of Bipolar II disorder

--> cycles between hypomania and depression 

Bipolar disorder is a major depressive disorder where patient cycles between 3 states, depression normal and mania/or hypomania

Bipolar I   --> w/case of mania in history

 Most recent mixed:  most recent = mix of mania and depression ...cycles between depression, normal, and mania

Most recent hypomanic: most recent= hypomanic  WITH case of mania in history 

Bipolar II --> w/o case of mania

Cycles between depression, normal, and hypomania 

1)      not otherwise specified

a.       Doesn’t have quite all the features of any of the anxiety disorders.

b.      .or they seem to fit the criteria of more than one …

c.       Or clinician judges that a significant anxiety disorder exists

                                                              i.      Not in DSM ..but clinician says there is something

                                                            ii.      Not identified ..it’s only bad if it’s             abused … 

Usually longerlasting than major depressive disorder

must have at least 2 of symptoms 

for at least 2 years  more often than not