Term
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Definition
Problems that appear medical, but are acutally caused by psychosocial factors.
A pattern of physical complaints with largely psychosocial causes.
-People do not consciously want or purposely produce symptoms.
--Genuinely believe their problems are actually medical.
Hysterical and Preoccupation Types of Disorders |
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Term
| Hysterical Somatoform Disorders |
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Definition
Actual changes in physical functioning occur
Conversion,Somatization, and Pain Disorder
Hysterical Vs. Medical Symptoms:
-Glove anethesia: numbness begins sharply at the wrist and extends evenly right to the fingertips
--Real neurological damage is rarely as abrupt or evenly spread
-Lack of atrophy (Muscles wasting away)
Hysterical Vs. Factitious Symptoms:
-Malinger: Intentionally fake illness to achieve some externam gain.
-Factitious Disorder
-Munchausen Syndrome
Munchausen Syndrome by Proxy |
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Term
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Definition
An illness without identifiable physical cause, in which the patient is believed to be intentionally producing or faking symptoms to assume a sick role
-Often go to extremes to create appearance of illness
-Often feel they've no control over their problem/distress |
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Term
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Definition
| Extreme, long-term factitious disorder |
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Term
| Munchausen Syndrome (Factitious Disorder) by Proxy |
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Definition
| Parents make up, or produce physical illness in their children |
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Term
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Definition
Hysterical Somatoform Disorder
A psychosocial conflict or need is converted into dramatic physical symptoms that affect voluntary motor or sensory functioning.
Symptoms often seem neurological: paralysis, blindness, or loss of feeling.
Most begin in late childhood or young adulthood
-Usually appear suddenly, at times of extreme stress, and last a matter of weeks
-Occur twice as often in women as in men
-People who develop this tend to be suggestible and most are highly susceptible to hypnotic procedures.
DSM-IV Checklist:
1)One or more physical symptoms or deficits affecting voluntary motor or sensory function that suggest a neurological or other general medical condition.
2)Psychological factors judged to be associated with symptoms/deficit
3)Symptom/Deficit not intentionally produced or feigned
4)Symptom/Deficit isn't fully explained by a general medical condition or a substance
5)Signigicant distress or impairment |
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Term
Somatization Disorder
(aka Briquet's Syndrome) |
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Definition
Hysterical Somatoform Disorder
Many long-lasting physical ailments that have little or no organic basis.
Extremely difficult to diagnose
DSM-IV Checklist:
1)A history of many physical complaints, beginning before age 30, that occur over a period of several years and result in Tx beging sought or in significant impairment
2)Physcial complaints over the period include all of the below:
-Four different kinds of pain symptoms, two gastrointestinal symptoms, one sexual symptom, and one neurological-type symptom
3)Physical complaints not fully explained by a kknown general medical condition or drug, or extending beyond the usual impact of such a condition.
4)Symptoms not intentionally produced or feigned.
Lasts much longer than a conversion disorder, for years
Rates per year:
-Women: .2-2%
-Men: less than .2%
Often runs in families.
Usually begins in adolescence or young adulthood. |
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Term
| Pain Disorder Associated with Psychological Factors |
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Definition
When psychosocial factors play a central role in the onset, severity, or continuation of pain
Fairly common
More women than men
DSM-IV Checklist:
1)Significant pain as the primary problem
2)Psychological factors judged to have the major role in the onset, severity, exacerbation, or maintenance of the pain
3)Symptom/deficit not intentionally produced or feigned
4)Signigicant distress or impairment |
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Term
| Preoccupation Somatoform Disorders |
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Definition
Disorders in which people misinterpret and overreact to minor, even normal, bodily symptoms or features.
Hypochondriasis and Body Dysmorphic Disorder |
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Term
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Definition
People unrealistically interpret normal bodily symptoms as signs of a serious illness
Often starts in early adulthood
Equal in men and women
1-5% of people suffer
DSM-IV Checklist:
1)Preoccupation with fears or beliefs that one has a serious disease, based on misinterpretation of bodily symptoms, lasting at least six motnhs
2)Persistence of preoccupation despite appropriate medical evaluation and reassurance
3)Absence of delusions
4)Significant distress or impairment |
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Term
Body Dysmorphic Disorder (BDD)
(aka Dysmorphophobia) |
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Definition
A disorder marked by excessive worry that some aspect of one's physical appearance is defective
-Minor or imagined
-Wrinkles, spots on skin, excessive facial fair, sweeling of the face, mishappen feature, odors
-Extreme: people may severly limit social situations
--May go to great lengths to fix problems
Most cases begin in adolescence
5% of the population suffers
Equal among genders
DMS-IV Checklist:
1)Preoccupied with an imagined or exaggerated deficit in appearance
2)Significant distress or impairment |
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Term
| Psychodynamic View of Somatoform Disorders |
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Definition
A conversion of underlying emotional conflcts into physical symptoms.
-Physical symptoms are more tolerable than anxiety.
Hysterical Disorders caused by two mechanisms:
-Primary Gain: Hysterical symptoms keep internal conflicts out of awareness.
-Secondary Gain: Hysterical symptoms further enable avoidance of unpleasant activities, or to recieve sympathy from others. |
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Term
| Behavioral View of Somatoform Disorders |
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Definition
Rewards teach sufferers to play them up more
Similar to psychodynamic view |
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Term
| Cognitive View of Somatoform Disorders |
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Definition
Disorder is a form of communication, letting people express emotions that are otherwise difficult to convey.
Emotions conversted to physical symptoms to communicate. |
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Term
| Multicultural View of Somatoform Disorders |
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Definition
Somatization- development of somatic symptoms- in response to personal distress
-Considered an inferior way of dealing with emotions in western cultures.
-Considered the norm in non-western cultures
--Latin countries display highest numbers |
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Term
| Biological Perspective of Somatoform Disorders |
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Definition
Placebo effect.
A belief or expectation can trigger certain chemicals throughout the body, which may produce a medicinal effect
-Hormornes, lymphocytes, and endorphines |
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Term
| Tx for Somatoform Disorders |
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Definition
Psychotheraphy and psychotropic drug therapy are usually sought as a last resort because people believe problems to be medical.
Preoccupational Somatoform Disorders:
-Typically treated in the same way as anxiety disorders (OCD):
--Antidepresants, Exposure and Response Prevention, and Cognitive Behavioral Therapies.
Hysterical Somatoform Disorders:
-Often focus on the cause of the disorder, then apply similar techniques used with PTSD
--Insign, exposure, drug therapies
-Some treat the physical symptoms
--Suggestion: emotional support, and tell patients persuasively (or hypnotically) symptoms will soon be gone
--Reinforcement: Removal of rewards system for "sick" behaviors; increase rewards for "healthy" behaviors
--Confrontational: straightforward; not very helpful... |
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Term
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Definition
Memory is key to our sense of identity; it is our faculty for recalling past events and past learning.
Dissociative Disorders are disorders marked by major changes in memory that do not have clear physical causes.
Rare disorders, but played up by media.
Symptoms can be found in other disorders, without it being a case.
Dissociative Amnesia, Dissociative Fugue, and Dissociative Identity Disorder. |
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Term
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Definition
A disorder marked by an inability to recall important personal events and information
-Much more extensive than normal forgetting.
-No physical cause.
-Usually directly triggered by a specific upsetting event
Several Types:
-Localized: a person loses all memory of events that took place within a limited period of time, almost always beginning with some very disturbing occurance
--Most common type
--Amnestic Episode: forgotten period
-Selective: Remember some, but not all, events that occurder during a period of time
--Second most common type
-Generalized: Loss of memory extends back further than the upsetting event
-Continuous: unlike the others, this type doesn't have an end, but continues into the present
--Quite rare in disociative amnesia
-All types mainly interfere with person's memory for personal material; memory for abstract or encyclopedic information usually remains.
DSM-IV-TR Checklist:
1) One or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfullenss
2)Significant distress or impairment |
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Term
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Definition
A disorder in which a person travels to a new location and may assume a new identity, simultaneiously forgetting his/her past.
-Fugue may be brief, a matter of hours or days, and then ending suddenly, not having travelled too far
-Sometimes, a person may travel far from home, take a new name, job, relationship, personality, and identity.
Usually follows a severly stressful event
Usually affects personal memories, not abstract knowledge
Approximately .2% of the population experiences this
Tends to end abruptly; people typically regain most/all of their memories over time.
DSM-IV-TR Checklist:
1)Sudden, unexpected travel away from home or one's customary place of work, with inability to recall one's past
2)Confusion about personal identity, or the assumption of a new identity
3)Siginificant distress or impairment. |
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Term
Dissociative Identity Disorder
(Multiple Personality Disorder) |
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Definition
A dramatic and disabeling disorder in which a person develops two or more distinct personalities, known as subpersonalities or alternate personalities, each with a unique set of memories, behaviors, thoughts, and emotions
-Host/primary personality: subpersonality that appears more often than the others
-Switching: transition from one personality to another; usually sudden and maybe dramatic
--Usually triggered by a stressful event
--Can be brought about through hypnotic suggestion.
Often diagnoses in late adolescence, or early adulthood
-Symptoms typically begin in early childhood aften an episode of abuse.
Occurs in women 3x more often than men.
Rare, but diagnosis is on the rise because:
-Clinicians actually believe the disorder exists now.
-Diagnostic procedures are more accurate today
-Iatrogenic: disorder unintentioally produced by practicioners
DSM-IV-TR Checklist:
1)The presence of two or more distinct identities or personality states
2) Control of the person's behavior recurrently taken by at least two of these identities or personality states
3)An inabitlity to recall improtant personal information that is too extensive to be explained by ordinary forgetfuleness
Average number of subpersonalities is 15 for women, 8 for men
-Often subpersonalities emerge in groups of two or three at a time. |
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Term
| D.I.D.- Subpersonality Interactions: |
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Definition
Mutually Amnesic Relationships:
-personalities have no awareness of one another.
Mutually Cognizant Relationship Pattern:
-Each subpersonality is well aware of the rest
--May hear one another's voices and even talk among themselves, though they may not get along.
One-Way Amnesic Relationships:
-Some subpersonalities are aware of others, but awareness isn't mutual
--Co-conscious Subpersonalities: those personalities that are aware of others, watching actions and thoughts, but not interacting with them
---"Quiet observers"
---Can make itself known while another subpersonality is present through indirect means, i.e. auditory hallucinations or "automatic writing"
-Most common relationship pattern. |
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Term
| D.I.D.: How Subpersonalities Differ |
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Definition
Often dramatically different
May have own names.
Identifying features: Age, gender, race, appearance, and family history
Abilities and Preferences: different skills, knowledge, and tastes
Physiological Responses: different brain-activity patterns, blood pressure, ANS activity, etc. |
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Term
| Psychodynamic View of Dissociative Disorders |
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Definition
Dissociative disorders arer caused by repression, the most basic ego defense mechanism...an escape behavior.
-Amnesia and Fugue are single-episodes of massive repression
-Child abuse is usually the source of D.I.D. |
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Term
| Behavioral View of Dissociative Disorders |
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Definition
Dissociation is a response learned through operant confitioning
-Reinforced for the act of forgetting and unconsciously learn that such acts help escape anxiety. |
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Term
| Cognitive-Behavioral-Biological Views |
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Definition
State-Dependent Learning:
-Learning that becomes associates with the conditions under which it occured, so that it is best remembered under the same conditions
--Can be associated with mood states
-Arousal levels have certain sets of remembered events, thoughts, and skills attatched to it.
--People who are prone to develop dissociative disorders have state-to-memory links that are unusually narrow and rigid.
--Possible each set of thoughts, memories, and skills is exclusively tied to a particular state of arousal.
Self-Hypnosis:
-The process of hypnotizing oneself, sometimes for the purpose of forgetting unpleasant events. |
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Term
| Tx for Dissociative Amnesia and Fugue |
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Definition
Psychodynamic therapies: therapist guides patients with these disorders to sesarch their unconscious in the hope of bringing forgotten experiences back to consciousness.
Hypnotic Therapy (Hypnotherapy): therapist hypnotize patients and then guide them to recall forgotten events.
Drug Therapy: intravenous injections of barbituates are used to help people regain lost memories:
-"Truth serums" really work by calmin people down and releasing inhibitions, helping them to recall anxiety-producing events
-Often used along with other therapies |
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Term
| Tx for Dissociative Identity Disorder |
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Definition
1)Fully recognize the nature of their disorder as the therapist bonds with each personality
-Introduction of subpersonalities to each other through hypnosis or videos
-Group and family therapy.
2) Recovering gaps in their memories through hypnotherapy, psyhodynamic therapy, or drug therapy
-Slow process; personalities may deny them or protect selves
3)Integration of subpersonalities into one functional personality:
-Fusion is the final merging of two or more subpersonalities
--Often distrusted; a form of death to subpersonalities.
-Psychodynamic, supportive, cognitive, and drug therapies used. |
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Term
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Definition
| A low, sad state in which life seems dark and its challenges overwhelming. |
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Term
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Definition
| A state of breathless euphoria, or, at least, frenzied energy in which people may have an exaggerated belief that the world is theirs for the taking |
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Term
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Definition
Most common mood disorder.
Depression without a history of mania.
~7% of U.S. adults suffer severely; ~5% suffer more mild forms.
-Around 17% of all adults experience a severe episode in their lives
Women are 2x more likely than men to suffer severe episodes
-26% of women; 12% of men
~50% of people with unipolar depression recover within six weeks.
-~90% recover within a year, some w/o Tx.
-Most have another episode later on in life.
Symptoms:
-Emotional: sad, dejected, empty, miserable, humiliated, loss of humor and pleasure, anxiety, anger, agitation, crying spells
--Anhedonia: an inability to experience pleasure at all.
-Motivational: Loss of desire to pursue usual activities, lack of drive, initiative, and spontaneity, loss of will power
--Suicide: ultimate escape from life's challenges; loss of will to live
---Between 6-15% of people with severe depression commit suicide.
-Behavioral: Less active and productive, spend more time along or in bed, might move and speak more slowly.
-Cognitive: Hold extremely negative views of themselves-inadequate, inferior, undesirable, evil;blame selves for everything, give selves no credit, pessimism-nothing will improve, helpless to change anything, expect the worse, procrastinate, vulnerable to suicide; poor intellectual ability- confused, unable to remember things, easily distracted, unable to problem solve.
-Physical: Headaches, indigestion, constipation, dizzy spells, and general pain, disturbances in sleep and appetite (some less, some more), fatigue.
Major Depressive Disorder, and Dysthimic Disorder.
Stress:
-Episodes often triggered by stressful events
-Reactive (exogenous) depression: follows clear-cut stressful events
-Endogenous depression: response to internal factors |
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Term
Major Depressive Episode
DSM-IV-TR Checklist |
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Definition
1) The presence of at least five of the following symptoms (nearly every day) during the same two-week period or longer:Depressed mood most of the day;markedly diminished interest or pleasure in almost all activities most of the day; significant weight loss or gain/decrease or increase in appetite; insomnia or hypersomnia; psychomotor agitation or retardation; fatigue or loss of energy; feelings of worthlessness or excessive quilt; reduced ability to think or concentrate, or indecisiveness; reoccurent thoughts of death or suicide, a suicide attempt, or a specific plan for committing suicide
-Significant distress or impairment
2)In extreme cases, it may also include psychotic symptoms, marked by a loss of contact with reality, i.e. delusions or hallucinations |
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Term
DSM-IV-TR Checklist:
Major Depressive Disorder |
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Definition
1)The presence of a major depressive episode
2)No history of a manic or hypomanic episode |
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Term
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Definition
Individuals who display a longer-lasting, but less disabling pattern of unipolar depression
-Double Depression: Dysthimic disorder leads to Major Depressive Disorder. |
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Term
| Biological View of Unipolar Depression and Tx |
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Definition
Genetic Factors:
-Family pedigree, win, and molecular biology gene studies
-Predisposition
-Certain genes on chromosomes involved
Biochemical Factors:
-Low activity of NTs norepinephrine and serotonin
-Endocrine system plays a role:
--Hormones cortisol and melatonin at higher levels
-May actually be tied to what happens within a neuron, that is unhealthy because of NT deficiencies
Brain Anatomy and Brain Circuits:
-Prefrontal cortex, hippocampus, amygdala, and Brodmann Area 25
--Lower or increased activity and blood flow in prefrontal cortex could be contributing?
--Blood flow in amygdala 50% higher than normal
--Brodmann Area 25 smaller in depressed people and more active
Tx:
-Electroconvulsive Therapy (ECT): two electrodes attached to a person's head and 65-140 volts of electricity pass through the brain for half a second at most, resulting in a brain seizure
--After 6-12 treatments over 2-4 weeks, people feel less depressed; 50-60% improve
--Controversial
--Muscle Relaxants and anesthetics used for safety.
-Brain Stimulation:
--Vagus Nerve Stimulation
---40% improve
--Transcranial Magnetic Stimulation (TMS)
--Deep Brain Stimulation (DBS)
-Antidepressants:
--1950s
---Monoamine Oxidase Inhibitors (MAOIs):
----Monoamine oxidase is an enzyme used to breakdown norepinephrine
----Stopped from destroying norepinephrine, so that norepinephrine activity rises
----Helps 50% of people
----Awful side effects and dietary restrictions
---Tricyclics:
----Help 60-65% of people
----Require maintenance therapy because of a high rate of relapse
----Blocks NT reuptake
--Second-Generation Antidepressants:
---Selective Serotonin Reuptake Inhibitors (SSRIs)
---Selective Norepinephrine Reuptake Inhibitors
---Serotonin-Norepinephrine Reuptake Inhibitors
---Less side-effects |
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Term
| Psychodynamic View of Unipolar Depression and Tx |
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Definition
Inability to accept loss causes people to regress to the oral stage, which then worsens to depression.
Symbolic or imagined loss: equating other events to the loss of a loved one.
Object Relations Theorists: Relationships leave people feeling unsafe and insecure
People whose parents pushed them toward excessive dependance or excessive self-reliance are more likely to become depressed.
Tx:
Free association, interpretations, dreams, resistance, and transference
Only occasionally helpful
-Short-term approaches work better |
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Term
| Behavioral View of Unipolar Depression and Tx |
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Definition
Results from significant changes in the number of rewards and punishments people receive
-Rewards dwindle so less constructive behaviors are preformed
-Social rewards
Tx:
-Therapist encourages a person to set up a weekly schedule that includes activities the person finds pleasurable
-Then the therapist makes sure correct rewards are given
-Finally, social skills training is given
--Group Therapy |
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Term
| Cognitive View of Unipolar Depression and Tx |
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Definition
People persistently view events in negative ways.
Theory of Learned Helplessness:
-People become depressed when they think that they no longer have control over their reinforcements and that they're responsible for this helpless state
--Dogs receiving shock in shuttle box
Attribution-Helpless Theory: People view events as beyond their control and attribute it to some internal cause that is both global and stable, they feel helpless to prevent future negative outcomes.
Negative Thinking (Beck):
-Maladaptive attitudes, a cognitive triad, errors in thinking, and automatic thoughts combine to produce depression
--Cognitive Triad: Individuals repeatedly interpret their experiences, selves, and future in negative ways.
--Errors in Thinking:
---Arbitrary Inferences:negative conclusions based on little evidence
---Minimize significance of positive experiences, but magnify those of negative ones.
--Automatic Thoughts: numerous unpleasant thoughts that help cause or maintain depression, anxiety, or other forms of psychological dysfunction
---Ruminative Responses: repeatedly dwelling mentally on mood without acting to change it.
Tx:
-Cognitive-Behavioral Therapy:
--Phase 1: Increasing activities and elevating mood
---Encourage people to become more active and confident
---Detailed weekly schedules.
--Phase 2: Challenging Automatic Thoughts
---Educate people of their negative thoughts
---Recognize and record automatic thoughts then test them against reality
--Phase 3: Identifying Negative Thinking and Biases
---Illustrate illogical thinking processes
---Guide people to realize interpretations have a negative bias and change style of interpretation
--Phase 4: Changing Primary Attitudes
---Test attitudes
--50-60% Success rate
-Acceptance and Commitment Therapy (ACT)
--Clients are guided to recognize and accept negative thoughts as simply streams of thought rather than valuable guides for behaviors and decisions. |
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Term
| Sociocultural View of Unipolar Depression and Tx |
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Definition
Family-Social Perspective:
-Decline in social rewards
-Unavailability of social support
-Divorced and separated people show 3x the depression rate
-Tx:
--Interpersonal Psychotherapy (IPT):
---Four problem areas must be addressed: interpersonal loss, interpersonal dispute, interpersonal role transition, and interpersonal deficits
---Clarifying and changing these problems
---Teach social skills
---50-60% success rate
--Couple Therapy:
---A therapy format in which the therapist works with two people who share a long-term relationship
---Behavioral Marital Therapy
Multicultural Perspective:
-Gender and Depression
--Women 2x more likely to have unipolar depression than men
--Artifact theory: both genders are equally prone to depression, but its harder to diagnose in men who display less emotional symptoms, but rather anger.
--Hormone Explanation: Hormone changes trigger depression in many women
--Life Stress: women experience more stress than men; face more poverty, menial jobs, less adequate housing, and more discrimination than men; more household responsibilities.
--Body Dissatisfaction Explanation
--Lack-of-Control Theory: women feel less control than men
---Women more likely to be victims
---Learned Helplessness
--Rumination Theory: Women more likely to dwell on depressed feelings
-Cultural Background and Depression
--Non-western cultures express more physical symptoms
--More social and economic pressures lead to higher rates
-Tx:
--Culture-sensitive therapies |
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Term
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Definition
People experience both the lows of depression and the highs of mania
Bipolar I, Bipolar II, Cyclothymic Disorder
1-2.6% of all adults suffer
Occurs equally among genders
Onset usually occurs between ages 15-44
Causes:
-Neurotransmitters
--Overactivity of norepinephrine
--Low serotonin activity
-Ion Activity
--Irregularities in transport of K+ and Na+ in neurons
---Neurons fire too easily= mania
---Neurons resist firing= depression
--Membrane defects
--Abnormal carrier protein functioning
-Brain Structure
--Smaller basal ganglia and cerebellum
-Genetic Factors
--Biological predisposition
Tx:
-Lithium Salts
-Mood Stabilizers (aka antibipolar drugs)
--Either less side effects or more effective than lithium salts
--Affect a neuron's second messenger
--Increase production of neuroprotective proteins that prevent cell death
-60% success rate
--28% risk of relapse once off drugs
-Antidepressants also used
-Adjunctive Psychotherapy used in combination with mood stabilizers
--Individual, group, or family therapies
--Emphasize the importance of continuing to take medication
--Problem solving
--Reduce hospitalization and improves social functioning, and increases patients ability to obtain and keep a job |
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Term
Symptoms of Mania and DSM-IV-TR Checklist for
a Manic Episode |
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Definition
Symptoms:
-Emotional:active, powerful emotions in search of an outlet; euphoric joy that's out of proportion with the person's life; possibly very irritable and angry
-Motivational: Desire constant excitement, involvement, and companionship; overwhelming, excessive, and domineering social style
-Behavioral: very active, move quickly, talk loud and rapidly, flamboyance, involved in a lot, sometimes even dangerous activities
-Cognitive: poor judgement and planning, optimism, inflated opinion of selves (grandiosity), sometimes they have trouble remaining coherent or in touch with reality.
-Physical: remarkably energetic, little sleep needed
DSM-IV-TR Checklist: Manic Episode
1)A period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least one week
2)Persistance of at least three of the following: Inflated self-esteem or grandiosity; decreased need for sleep; more talkativeness than usual, or pressure to keep talking; flight of ideas or the experience that thoughts are racing; distractibility; increase in activity or psychomotor agitation; excessive involvement in pleasurable activities that have a high potential for painful consequences.
3)Significant distress or impairment |
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Term
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Definition
Most severe type
DSM-IV-TR Checklist:
1)The presence of a manic, hypomanic, or major depressive episode
2) If currently in a hypnomanic (less severe), or depressive episode, a history of a manic episode
3)Significant distress or impairment |
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Term
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Definition
DSM-IV-TR Checklist:
1)The presence of a hypnomanic or major depressive episode
2)No history of just a manic episode
3)Significant distress or impairment |
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Term
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Definition
| Numerous periods of hypnomanic symptoms and mild depressive symptoms |
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Term
| Suicide Statistics and Patterns |
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Definition
Around the world, ~ 700,000 people commit suicide each year
31,000 in the U.S. alone
-600,000 make attempts that are unsuccessful
--Known as parasuicides
-11th leading cause of adult death in the U.S.
~50% of suicides result from mental disorders besides depression or from no illness at all
Country by country, rates differ
-China, Japan, and Denmark have highest rates
Religious affiliation and beliefs
-Catholics, Muslims, and Jews have low suicide rates
-Degree of Devoutness
--Very religious people are less likely to commit suicide
Gender
-3x more women than men attempt suicide
-3x more men than women succeed
-Methods used:
--Men tend to use more violent methods
--Women tend to use less violent methods, i.e. overdose
--Guns used in 2/3 of male suicides, but only 40% of women's
Social Support and Marital Status:
-50% have no close friends
--Fewer were close to families
-Divorced people have higher rates than married people
Race (in the U.S.):
-White people 2x more likely to commit suicide than African, Hispanic, or Asian Americans
-Native Americans have 1 1/2x higher rate than the national average |
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Term
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Definition
A self-inflicted death in which the person act intentionally, directly and consciously.
Types of People who Commit Suicide:
-Death Seekers: clearly intend to end their lives at the time they attempt suicide
-Death Initiators: a person who attempts suicide believing that the process of death is already underway and that he or she is simply hastening the process
-Death Ignorers: A person who attempts suicide without recognizing the finality of death
-Death Darer: A person who is ambivalent about the wish to die even as he or she attempts suicide.
Subintentional Death: a death in which the victim plays an indirect, hidden, partial, or unconscious role |
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Term
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Definition
Retrospective Analysis: a psychological autopsy in which clinicians and researchers piece together information about the person's suicide from the person's past.
-Less than 1/3 leave a note
-~50% had been in psychotherapy before
Studying people who survive their suicidal attempts:
-8-20 nonfatal attempts for every fatal suicide |
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Term
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Definition
Stressful Events and Situations:
-Immediate stress or long-term stressors
-Serious illness: believe death is inevitable; can't endure the suffering
--I/3 of people who commit suicide
-Abusive Environment: little hope of escape; can't endure it
-Occupational/School Stress: tension and dissatisfaction
-Mood and Thought Changes: increase in sadness
--Psychache: intolerable psychological pain
--Only option
--Hopelessness: a pessimistic belief that one's present circumstances, problems, or mood will not change
--Dichotomous thinking: viewing problems and solutions in rigid "either/or" terms
-Alcohol and Drug Use:
--70% of people drink right before committing suicide
--1/4 legally intoxicated
-Mental Disorders:
--50%: Severe Depression
--20%:Chronic Alcoholism
--10%:Schizophrenia
-Modeling:
--Common in young people
--Celebrities, highly publicized cases, co-workers, colleagues |
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Term
| Psychodynamic View of Suicide |
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Definition
Results from depression and anger at others redirected toward oneself
Extreme expression of self-hatred
Relationship between childhood loses and later suicidal behaviors.
Directing "death instinct" (Thanatos) on selves rather than on others, like normal |
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Term
| Sociocultural View of Suicide |
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Definition
Durkheim
Probability determined by attachment to social groups
Egoistic Suicides: committed by people over whom society has little or no control;not concerned with rules of society
-Isolated, alienated, and nonreligious
Altruistic Suicides: people are well integrated into society, and intentionally sacrifice their lives for its well-being
-Societies that encourage suicide to preserve honor (Far East) have higher rates
Anomic Suicides: people don't have stable support/social structures
-People don't have a sense of belonging |
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Term
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Definition
Genetic Factors
Serotonin low in people who commit suicide
-Might contribute to aggressive and impulsive behaviors |
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Term
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Definition
Likelihood of committing suicide increases with age
Children:
-6% of deaths between ages 10-14 are caused by suicide
-Boys outnumber girls 5-1
Adolescents:
-1,500 teens (15-19) commit suicide each year in the U.S.
-3rd leading cause of teenage death
-Stress! (More sensitive reactions to it)
-Suggestibility
-200 attempts for every one completion
-Racial rates similar to adults
Elderly:
-Age group most likely to commit suicide
-Account for 19% of U.S. suicides
--Elderly only make up 12% of the population
-Lower rate in Native American elders who are held in high regard |
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Term
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Definition
Tx after Suicide Attempts:
-Treat physical injuries
-Psychotherapy or drug therapy, group and family therapies
--Nonsuicidal state of mind and better ways of handling stress
Suicide Prevention:
-Suicide Prevention Program: tries to identify people who are at risk of committing suicide and to offer them crisis intervention
--Criss intervention: a Tx approach that tries to help people in a psychological crisis view their situation more accurately, make better decisions, act more constructively, and overcome the crisis
-Suicide Hotlines
-Therapists must initially: establish a positive relationship, understand and clarify the problem, assess suicide potential, assessing and mobilizing the caller's resources, formulating a plan (no-suicide contracts)
-Reduce public's access to common means of suicide
--Gun control, bridge barriers, car emission controls, and safer medications
-Long-term therapy need for most |
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Term
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Definition
A psychotic disorder in which personal, social, and occupational functioning deteriorate as a result of strange perceptions, unusual emotions, and motor abnormalities
-Possibly an umbrella diagnosis for a group of disorders with common features
Psychosis: a state in which a person loses contact with reality in key ways
1 of every 100 people in the world suffers
-24 million suffer worldwide
More frequent among lower classes
-Stress
-Downward Drift Theory
Equal among genders
Usually onset begins in 20s
Course:
-Prodromal Phase: symptoms not yet obvious, but individuals begin to deteriorate
-Active Phase: symptoms become apparent; may be triggered by stress
-Residual Phase: return to a prodromal-like level of functioning
Five Types:
-Disorganized, Catatonic, Paranoid, Undifferentiated, Residual
Type I:
-Dominated by positive symptoms
-Greater likelihood of improvement
Type II:
-Dominated by negative symptoms
-Brain structure is abnormal (small temporal and frontal lobes) |
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Term
| Positive Symptoms of Schizophrenia |
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Definition
Excesses of, or bizarre additions, to normal thoughts, emotions or behaviors
-Delusions: a strange false belief firmly held despite evidence to the contrary
--Delusions of persecutions: being plotted or discriminated against, spied on, slandered, threatened, attacked, or deliberately victimized
---Most common
--Delusions of Reference: attach special and personal meaning to the actions of others or to various objects or events
--Delusions of Grandeur: believe selves to be great inventors, religious saviors, or other specially empowered persons
--Delusions of Control: believe thoughts, feelings, and actions are controlled by others
-Disorganized Thinking and Speech:
--Formal Thought Disorder: a disturbance in the production and organization of thought
--Loose Associations (Derailment): a common thinking disturbance characterized by rapid shifts from one topic of conversation to another
--Neologisms: made-up words that typically have meaning only to the person
--Clang: Rhyme
-Heightened Perceptions and Hallucinations:
--Hallucinations: the experiencing of sights, sounds, or other perceptions in the absence of external stimuli
---Auditory hallucinations most common
--Inappropriate Affect: display of emotions that are unsuited to the situation |
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Term
| Negative Symptoms of Schizophrenia |
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Definition
Deficits in normal thought, emotions, or behaviors
-Poverty of Speech (Alogia): a decrease in speech or speech content
-Blunted and Flat Affect: a marked lack of expressed emotions or very little expression
--Anhedonia: general lack of pleasure of enjoyment
-Loss of Volition: experience apathy and ambivalence
-Social Withdrawal |
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Term
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Definition
Catatonia- extreme
-Catatonic Stupor: stop responding to their environment, remaining motionless and silent for long periods of time
-Catatonic Rigidity: maintained a rigid, upright posture for hours and resist movement
-Catatonic Posturing: assuming awkward, bizarre postures for long periods of time
-Catatonic Excitement: move excitedly and wildly |
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Term
DSM-IV-TR Checklist:
Schizophrenia |
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Definition
1)At least two of the following symptoms, each present for a significant portion of time during a one month period:
-Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms
2)Functioning markedly below the level achieve prior to onset
3)Continuous Signs of the disturbance for at least six months, at least one month of which includes symptoms in full and active form (as opposed to attenuated form) |
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Term
| Disorganized Schizophrenia |
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Definition
Confusion, incoherence, and flor or inappropriate affect.
Attention and perception problems, extreme social withdrawal, and odd mannerisms or grimaces are common |
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Term
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Definition
| A psychomotor disturbance of some sort |
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Term
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Definition
| Have an organized system of delusions and auditory hallucinations that may guide their lives |
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Term
| Undifferentiated Schizophrenia |
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Definition
| A wide assortment of unusual patterns |
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Term
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Definition
| Symptoms lessen in strength and number |
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Term
| Biological Perspective of Schizophrenia |
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Definition
Genetic Factors:
-More common in families
-48% of identical twins have it if the other does
--17% for fraternal twins
Biochemical Abnormalities:
-Dopamine Hypothesis
--An excessive activity of the NT Dopamine
--Antipsychotic Drugs and Parkinson's Disease
---Phenothiazines= 1st antipsychotics
---Reduction of dopamine
--Five kinds of Dopamine receptors:
---D-1, D-2, D-3, D-4, D-5
--Atypical Antipsychotic Drugs: a relatively new group of antipsychotic drugs whose biological action is different from that of the traditional antipsychotic drugs
---More effective than conventional drugs
---Serotonin involved
Abnormal Brain Structure:
-Common in Type II
-Enlarged ventricles
-Smaller temporal and frontal lobes
-Abnormal blood flow (either reduced or heightened)
Viral Problems:
-Brain abnormalities may result from exposure to viruses before birth
-Rate of schizophrenia is 5-8% higher for people born in winter
-Mothers exposed to influenza during pregnancy
-Virus antibodies found in 40% of schizophrenics |
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Term
| Psychodynamic View of Schizophrenia |
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Definition
Schizophrenia develops from two processes:
1) Regression to pre-ego stage of primary narcissism
2)Efforts to reestablish ego control
Schizophrenogenic Mothers: a type of mom, supposedly cold, domineering, and uninterested in the needs of others, was once thought to cause schizophrenia in her child |
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Term
| Cognitive View of Schizophrenia |
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Definition
Agrees with biological view, brain actually producing strange and unreal sensations triggered by biological factors
Further features of the disorder emerge when individuals attempt to understand their unusual perceptions
-Others deny their reality, so their obviously hiding the truth, they're persecuting the person |
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Term
| Sociocultural View of Schizophrenia |
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Definition
Multicultural Factors:
-Race: 2.1% of African Americans suffer compared to 1.4% of White Americans
--African Americans more prone to develop the disorder
--Economic factors
-Class: more common in lower classes
-Better recovery rates in developing countries than in developed countries
--Perhaps their psychosocial environments are more supportive and therapeutic.
Social Labeling:
-Self-fulfilling prophecy leads to the development of many schizophrenic symptoms
Family Dysfunctioning:
-Parents of people with the disorder often: display more conflict, have greater difficulty communicating, and are more critical of and overi-nvolved with their children than normal
-Family stress
-Expressed Emotion: general level of criticism, disapproval, and hostility expressed in a family.
--High rates of expressed emotion |
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Term
| Institutional Care of Schizophrenia and Other Severe Mental Disorders prior to 1950 |
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Definition
Institutionalized: restrain, feed, clothe, house people beyond any Tx
-Neglected or abused
Mental hospitals built in cheap, isolated places
State Hospitals: public mental hospitals in the U.S., run by the individual states for people who couldn't afford private hospitals
-Become overcrowded and under funded and understaffed
-Back Wards (Chronic Wards): warehouses filled with hopeless cases; poor care
Lobotomy |
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Term
| Institutional Care of Schizophrenia and Other Severe Mental Disorders after 1950 |
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Definition
Milieu Therapy: a humanistic approach to institutional Tx based on belief that institutions can help patients recover by creating a climate that promotes self-respect, responsible behavior, and meaningful activity
Token Economy Programs: a behavioral program in which a person's desirable behaviors are reinforced systematically throughout the day by the awarding of tokens that can be exchanged for goods or privileges |
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Term
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Definition
Revolutionized the Tx of schizophrenia
65% improve
First Type: Phenothiazine, Chlorpromazine, known as Thorazine.
Conventional Antipsychotics:
-Work on D-2 receptors
-Early antipsychotics
-Treat positive symptoms the most
-AKA Neuroleptic drugs
-Often cause undesired effects similar to the symptoms of neurological disorders
-Extrapyramidal Effects: unwanted movements, i.e. severe shaking, bizarre-looking grimaces, twisting of the body, and extreme restlessness
--Parkinsonian symptoms
-Tardive Dyskinesia: late-appearing movement disorder
--Occurs in 10% of people taking these drugs for a long time. |
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Term
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Definition
Atypical Drugs
Clozapine, rispendone, olanzapine, quetiapne, ziprasidone, and aripiprazole
Less D-2 receptors, more D-1 and D-4
Help 85% of people
Reduce negative and positive symptoms
Fewer extra pyramidal symptoms or tardive dyskinesia. |
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Term
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Definition
Antipsychotics
Psychotherapy:
-Cognitive-Behavioral Therapy:
--Change how people react to their hallucinatory experiences
---See it more accurately, then less fear and confusion
--1)Provide clients with education about the biological causes of hallucinations. 2)Help clients learn more about the "comings and goings" of their own hallucinations and delusions; track what triggers them. 3)Challenge inaccurate ideas about the power of their hallucinations; conduct behavioral experiments to challenge. 4)Teach people how to more accurately interpret their hallucinations. 5)Teach coping techniques for dealing with unpleasant sensations; relaxation and breathing techniques.
-New-Wave-Cognitive-Behavioral Therapy:
--Acceptance and Commitment Therapy
---Accept streams of problematic thoughts
---Become mindful of worries that overrun their thinking
---Accept such negative thoughts as harmless
--Detachment and Comfortable Observers of their hallucinations
-Family Therapy:
--50% of people with schizophrenia live with their families.
--Provide family members with guidance, training, psycho-education, practical advice, emotional support and empathy
--Develop realistic expectations, more tolerance, less guilt, and more willing to try new ways of communicating
-Social Therapy:
--Practical advice, problem solving, decision making, social skills
--Make sure people are taking the medications
-The Community Approach |
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