- 1) Supernatural Explantions: Demon possesion and astrology

-2) Biolocial Explanations: "wandering uterus" by Hypocrates, Galen and the 4 Humors

-3) Psychological Explanations: Frued(all psychological), Humanists (people are good and should be left alone & Therapuetic Triad), Behaviorists (conditioning & learning). 

the cells in the brain that communicate and send messages throughout the body

send the messages both chemically and electrically

a neurotransmitter(chemical messenger)

If the body doesn't produce enough serotonin the receptor sites are not being filled so the reaction never happens. Then the original cell will reuptake the unused or unneeded serotonin. 

1) Can be structured-
- Ask same questions in the same manner. Like a "decision tree"
- Phone assessments.

- Used most frequently with children and severe mental illness

- Focuses on concepts on behaviorism

- Used with children or severely mentally ill b/c an adult will not participate in being overtly observed.

- Can prescribe a self-monitoring system for adults when observation wouldn't work.

1) Projective Tests: based in psychoanalytic theories. (TAT) Thematic Apperception Test.

Axis I: list any and all psychiatric D/O

Axis II: list personality D/O & mental retardations

Axis III: list anthying medical and/or physical

Axis IV: psychosocial stressors

Axis V: GAF(Global Assessment of Functioning)

1) Categorical Approach- either are or are not(ex: pregnant or not pregnant)

2) Dimensional Approach- rate three different dimensions which tell you the assessment of the individual.

The DSM combines these approaches by using the categorical but the individual can have dimensions or variations of the categorized diagnosis.

1) Situationally Bound(Cued)- specific to the situation

2) Unexpected(Uncued)- don't know when or where the next attack will occur

3) Situationally Predisposed- have had an attack in a specific place but don't know if it will happen there again or not.

Generalized Anxiety D/O

(definition)

Generalized Anxiety D/O

(criteria)

- excessive anxiety & worry(apprehensive expectation), occurring more days than not for @ least 6 months about a number of events or activities.

- difficulty in controlling the worry

- @ least 3 symptoms:(1)restlessness(2)fatigue (3)difficulty concentrating(4)irritability(5)muscle tension (6)sleep disturbance  

- significant distress or impairment

- anxiety isn't limited to one specific issue

Generalized Anxiety D/O

(treatments)

1) Benzodiazepines(Benzo)- Xanax, Valium.

2) CBT Therapy- involves capturing and challenging distorted thinking which leads to distressing emotions which will lead to distressing behaviors

Panic D/O WITH Agoraphobia (PDA)

(definition)

fear and avoidance of situations the person believes might induce a dreaded panic attack

has Uncued panic attacks and begins to fear more and more things that could possibly be related to the panic attack

anxiety about being in places or situations from which escape might be difficult

Not a codable D/O

Panic D/O WITHOUT Agoraphobia

(definition)

Panic D/O WITH Agoraphobia

(criteria)

- recurrent unexpected panic attacks

- one or more of the following during a month after a panic attack:(1)persistent concern about having additional attacks(2)worry about the implications of the attack(3)significant change in behavior related to attacks

- anxiety about being in places or situations from which escape might be difficult or embarrassing

Panic D/O

(treatment)

(PCT) Panic Control Treatment- cbt treatment for panic attacks, involving gradual exposure to feared somatic senstations and modification of perceptins and attitudes about them.

SSRIs such as Prozac and Paxil are also used for Panic D/O.

Specfic Phobia

(definition)

unreasonable fear of a specific object or situation that markedly interferes with daily life functioning.

Specific Phobia

(criteria)

- persistent, excessive or unreasonable fear of a specific object or situation with a duration of @ least 6 months.

- immediate anxious or fearful response upon exposure to the phobic object or situation.

- recognition that the fear is excessive or unreasonable, or marked distress about having the phobia.

- the phobic situation or object is avoided or is endured with intense anxiety or distress.

Specific Phobia (5)

(sub-types)

1)Blood-injury-injection- fear and avoidance of exposure to blood, injury, or the posibility of injection.

2)Situational- anxiety involving enclosed places or public transportation.

3)Natural Environment- fear of situations in nature, especially heights, storms, and water

4)Animal- endurin fear of animals or insects that usually develops early in life.

5)Separation Anxiety- excessive, enduring fear in some children that harm wil come to them or their parents while they are apart.

Social Phobia

(definition)

extreme, enduring, irrational fear and avoidance of social or performance situations

Real fear is negative evaluation: failing, people will think of me. They will either avoid or endure with great internal distress.

Social Phobia

(criteria)

- marked & persistent fear of one or more social or performance situations in which the person is exposed to unfamilar ppl or to possible srutiny by others, with the fear that one will be embarrassed or humiliated.

- exposure to the feared social situation almost invariably provokes anxiety, sometimes panic attack

- recognition that the fear is excessive or unreasonable 

- the feared social or performance situation is avoided or are endured with intense anxiety or distress

- the avoidance or distress in the feared social or perfomance situation interferes significantly w/ the person's life & healthy functioning

Social Phobia

(treatments)

SSRIs- Paxil, Zoloft, Effexor

if person goes off medication, its highly probable that they will relapse.

Posttraumatic Stress D/O

(definition)

enduring, distressing emotional d/o that follows exposure to a severe helplessness or fear inducing threat. 

the victim reexperiences the trauma, avoids stimuli associated w/, and develops a numbing of responsiveness and an increased vigilance and arousal.

Acute Stress D/O

(definition)

severe reaction immediately following a terrifying event, often including amnesia about the event, ameotional numbing, and derealization.

Many victims later develop PTSD after the month criteria.

Posttraumatic Stress D/O

(criteria)

- exposure to traumatic event in which the person experienced a situation involving death, threatened death, or serious injury, in response to which the person reacted w/ intense fear, helplessness, or horror.

- traumatic event is persistently reexperienced in one or more of the following:(1)recurrent distressing recollections(2)recurrent distressing dreams(3)sense that the traumatic event is recurring, including illusions,hallucinations, & flashbacks(4)intense psych distress @ exposure to internal or external cues(5)physio reaction to cues.

- persistent avoidance of stimuli associated w/ trauma & numbing of general responsiveness

- persistent symptoms of increased arousal, difficulty sleeping, irritability

- clinically significant distress or impairment in social, occupational, or other important areas

- duration of the disturbance for more than 1 month.

1) Grounding- teach the client to use 5 senses in the present moment. And use this tool when the client is having the re-experience

2) Containment- symbolic of creating a container where the client is in control of how much you release of your trauma.

Obsessive-Compulsive D/O

(definition)

anxiety d/o involving unwanted, persistent, intrusive thoughts and impulses, as well as repetitive actions intended to suppress them

Thought-Action-Fusion- OCD has thoughts of the anxiety and it automatically becomes the action without anything every happening.

Obsession

(defintion)

Compulsion

(definition)

Obsessive-Compulsive D/O

(criteria)

- Obsessions

- Compulsions

- Recognition that the obessions or compulsions are excessive or unreasonable

- the thoughts, impulses, or behaviors cause marked distress, consume more than an hour a day, or significantly interfere w/ the person's normal functioning or relationships.

Obsessive-Complusive D/O

(treatments)

Mood D/O

(definition)

Major Depressive Episode

(definition)

Major Depressive Episode

(criteria)

- 5 or more present in the last 2 weeks
Depressed mood
Anhedonia
Weight loss/gain
Insomnia/hypersomnia
Psychomotor agitation/retardation
Fatigue

Mania

(definition)

Manic Episode

(definition)

Manic Episode

(criteria)

- Distinct period of elevated, expansive, or irritable mood lasting at least 1 week
- Must have 3(4 if mood is only irritable) or more:Grandiosity, Decreased need for sleep, Increased talking, Flight of ideas, Distractibility, Goal-directed activity(money and time)
Excessive involvement in pleasurable activities like substance abuse

Hypomanic Episode

(definition)

Hypomanic Episode

(criteria)

- Distinct period of elevated, expansive, or irritable mood lasting at least four days
- Must have 3(4 if mood is irritable) or more:Grandiosity,Decreased need for sleep,Increased talking,Flight of ideas,Distractibility,Goal-directed activity, Excessive involvement in pleasurable activities
NOT severe enough to cause impairment in functioning/hospitalization; no psychotic features
If not treated it almost ALWAYS becomes Manic.

Mixed Manic Episode

(definition)

Mixed Manic Episode

(criteria)

- criteria are met both for a Manic Episode and Major Depressive Episode except Mixed must occur nearly every day during @ least a 1-week period.

- mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or hospitalization, or psychotic features.

Dysthymic D/O

(definition)

Dysthymic D/O

(criteria)

- have no Major Depressive Episodes during the first 2 yrs and no Mixed,Manic, or Hypomanic episodes.
- Criteria: must have 2
Poor appetite/overeating
Insomnia/Hypersomnia
Low Energy/Fatigue
Low Self-Esteem
Poor Concentration/Decision-making
Feelings of Hopelessness

Bipolar II D/O

(definition)

Bipolar II D/O

(criteria)

- presence(or history) of one or more major depressive episodes.

- presence (or history) of at least one hypomanic episode 

- no history of a full manic episode or a mixed episode

- mood symptoms are not better accounted for by schizoaffective d/o or superimposed on another d/o such as schizophrenia

- clinically significant distress or impairment of functioning.

- If left untreated it will go to Bipolar I

Bipolar I D/O

(definition)

Cyclothymic D/O

(definition)

Cyclothymic D/O

(criteria)

- must have at least 2 yr period of hypomanic symptoms and numerous depressive symptoms that doesn't meet criteria for major depressive episode.

- no major depressive, manic, or mixed episodes have been present during the first 2 yrs of the disturbance

Seasonal Affective D/O

(definition)

Depressive Cognitive Triad

(definition)

Electroconvulsive Therapy (ECT)

(definition)

Cognitive Therapy

(definition)

Interpersonal Psychotherapy (IPT)

(definition)

Maintenance Treatment

(definition)

Psychological Autopsy

(definition)

Tricycles

(mood d/o treatment)

- first class of medications
- Effective but have lethal side effects
- Usually given for depression
- One of the first anti-depressants
Ex: Tofranil and Elavil
- Works on the Norepinephrine system
- Lethal in large doses

Monoamine Oxidase Inhibitors (MAOIs)

(mood treatments)

- second class of medications
- Enzyme between the synapse
- Inhibits the uptake causing the enzyme to be more present than before (not increasing the original amount)
Ex: Nardil and Parnate
- Can be lethal alongside a chemical found in many common foods

Selective Serotonin Reuptake Inhibitors (SSRIs)

(mood treatments)

- Chemical can now blocks the reuptake of serotonin which allows for more serotonin left in the receptor sites which will allow for a much better chance of firing which will keep the body with more energy

- Ex: Paxil, Lexipro, Zoloft

Lithium

(mood stabilizer)

- a common salt

- Don't know how or why it works
- Nausea, hair loss, sexual side-effects
- Severe side-effects
 Have to have blood levels monitored.
- Tricky balancing act between dosage and side-effects

Anti-Convultant

(mood stabilizers)

- Created originally for epilepsy
Ex: Tegretol, Depakote
- Another example is Lamictalwhich is used more than anything else in Mood stabilizers
- 1st line of defense

Anti-Psychotic

(mood stabilizers)

- Created for psychotics
- Abilify: popularly used for mood stabilizer's

Zyprexa:used for mood stabilizers