Quiz 3

• Four D's to provode diagnosis:

  • deviance: behaviours, thoughts and feelings that are not consistent with societal standards (ex. homosexuality in the past)
  • Distress: when a person is in distress they are experiencing behaviours, thoughts and feelings that are upsetting and cause pain
  • dysfunction: when behaviours or thoughts interfere with day-to-day functioning
  • danger: ones actions thoughts or feelings present a danger to oneself or others
• Phillipe Pinel and Dorothea Dix

  • both proposed a more humane treatment of "the insane"
  • suggested housing them in an asylum, which eventually became overcrowded
• Person first language:

  • acknowledges the individual's personhood first
  • a person with schizophrenia not a schizophrenic
• Changes in the DSM 5:

  • use of Arabic (non-roman) numerals
  • follows a lifespan order, addressing childhood disorders first
  • includes autism spectrum disorder
  • instead of mental retardation it now includes intellectual disability
  • new addition of hoarding disorder and binge-eating disorder
• Neurodevelopmental disorders:

  • relate to the development of the nervous system
  • mostly detected in childhood when there is a delay in aging milestones
  • for example autism
  • could be blind or deafness in extreme cases
• Schizophrenia and other psychotic disorders:

  • experience severe and persistent symptoms that significantly impair their functioning
  • classified as a serious mental illness
  • can exhibit positive or negative symptoms
• Types of schizophrenia:

  • positive symptoms: hallucinations, talking in a disordered manner, experiencing inappropriate emotions
  • negative symptoms: lack emotion in their voices, lack expressiveness and have mute or rigid bodies
  • a symptom is positive if it adds something to a person's behavioural or sensory repertoire
  • a symptom is negative if it subtracts from a person's behavioural or sensory repertoire
• Positive symptoms of schizophrenia:

  • behaviours not present before the onset of the disorder
  • not typically seen in healthy people
  • delusions: strong beliefs that are not founded in reality and they persist even in the face of evidence to the contrary
  • hallucinations: sensory experiences that do not have a source
• Negative symptoms of schizophrenia:

  • behaviours that are typically observed in healthy people that a person with psychosis does not do
  • flat effect: diminished emotional expression, failure to exhibit typical emotional reactions
  • avolition is a lack of motivation
  • alogia is a symptom that causes you to talk less
• Diagnosis spotlight of schizophrenia:

  • rare, found in more urban populations
  • Schizophrenia most often arrives as young people are maturing into adulthood
  • affects slightly more males then females
• Bipolar and related disorders:

  • the manic episode is the defining characteristic of bipolar
  • fluctuation between mania and depression
  • increased energy in mania could lead to more productivity, but impulsivity is also heightened
  • hypomania: less intense version of a manic episode, increased energy and greater activity without functional impairment
• Depressive disorders

  • long-lasting and affect not only the individual but also friends/family
  • thought and plans of suicide
  • Major depressive disorder: affects 1/14 people at any given time and 1/5 people during their lifetime
  • depression affects 2-3 times as many women as men
• Major depressive disorder symptoms:

  • major depressive disorder occurs when at least 5 signs of depression last two or more weeks and are not caused by drugs or a medical condition
  • ex. sad mood, loss of interest, unintended changes in weight, appetite or sleep
• Anxiety disorders:

  • most commonly reported psychological disorder in the US
  • fear: response to current threats, fear stimulates the fight-or-flight response
  • anxiety: is worry about the future or potential threats. related to cautious behaviours and wariness
• Agoraphobia:

  • anxiety disorder where an individual fears or avoids certain places or situations
  • fear of the market place or large open areas
• Obsessive compulsive and related disorders:

  • obsessions: refer to recurrent unwanted and intrusive thoughts, fears, urges or images
  • compulsions: behaviours that an individual feels driven to perform in a response to an obsession
• Trauma and stressor-related disorders:

  • trauma is an emotional response to a terrifying or life-threatening event
  • stress is a reaction to the demands of life
• Post-traumatic stress disorder:

  • characterized by recurring haunting memories, nightmares, social withdrawal, jumpy anxiety, and insomnia.
  • can develop as a result of an individual experiencing or witnessing a traumatic event
• Diagnosing PTSD:

  • re-experiencing: flashbacks, nightmare
  • avoidance symptoms: staying away from people
  • cognitive and mood symptoms: inability to remember important features of the traumatic event
  • arousal and reactivity: constantly feeling tense or edgy
• Dissociative disorders: symptoms

  • positive dissosiative symptoms: feelings of disconnection from one's body, feelings that ones surroundings are not real
  • negative dissociative symptoms: loss of memory or mental function
  • often associated with to traumatic experiences
• Somatic symptom and related disorders:

  • patient has an intense focus on physical illness or pain
  • feeling symptoms that are not medically there
  • other disorders must be ruled out first before diagnosing
• Factitious disorder:

  • patients with this disorder injure themselves or cause themselves to be ill, then seek treatment
• Feeding disorders:

  • mostly seen in infants and children
  • motivation- food preferences and perceived intolerances
  • selective or picky eating
• Eating disorders:

  • mostly seen in adults and adolescents
  • emotional response to food
  • intense fear of weight gain/getting fat, plus uncomfortable perception of one's body
• Pica:

  • most feeding/eating disorders are mutually exclusive meaning you can only have one (Pica is the exception)
  • defined as regular eating of non-food objects
  • can be diagnosed in combination with another condition
• Personality disorder category A

  • typified by odd and eccentric behaviours
  • characterized by social awkwardness, social withdrawal
  • disorders are similar to schizophrenia
• Personality disorders category B

  • typified by dramatic, irrational and emotional behaviours
  • ex. borderline personality disorder
  • problems with impulse control, moral reasoning and regulation of emotions
• Personality disorder category C

  • typified by behaviours that are anxious and fearful
  • shy, nervous, insecure
  • generally nit as serious as those disorder in category a and b
• Evidence based treatment:

  • relies on the proper design of research and then the application of research findings
  • before psychological treatment is approved for use its efficacy and effectiveness must be demonstrated
  • efficacy- ability for research to produce desired outcomes under strictly controlled conditions
  • effectiveness- shows ability of therapy to work in the real world
• Psychopharmacotherapy- accidental discoveries:

  • surviving fevers of malaria may alleviate psychological symptoms of syphillis
  • inducing seizures through insulin could alleviate symptoms of schizophrenia
  • eletroconvulsive therapy can alleviate symptoms of depression
• Antipsychotic drugs:

  • designed to decrease delusions, hallucinations and disorganized thinking
  • typical antipsychotics: ex. (chlorpromazine) reduce the symptoms of psychosis by blocking dopamine
  • typical antipsychotics can cause serious side effects
  • atypical antipsychotics: ex. (clozapine) address dopamine and serotonin pathways. Atypical name is used to indicate absence of serious side effects
• Antidepressant medications:

  • designed to reduce symptoms of depression
  • depression is a result of imbalance of monoamine neurotransmitters (dopamine, NE, serotonin)
  • three major classes of antidepressants: monoamine oxidase inhibitors, tricyclic antidepressants, selective serotonin reuptake inhibitors
• Monoamine oxidase inhibitors:

  • role of monoamine oxidase- breaks down neurotransmitters making them less effective
  • monoamine oxidase inhibitor helps prevent the breakdown of these monoamine neurotransmitters, so they can be effective for longer in the synapse
  • only used as a last result due to lethal food and drug interactions
• Tricyclic antidepressants:

  • most commonly prescribed antidepressant for a long time
  • inhibit the reuptake of serotonin and norepinephrine making them more available in the synapse
• Selective serotonin reuptake inhibitors:

  • most commonly prescribed antidepressants
  • selective serotonin re-uptake inhibitor is a drug that inhibits re-uptake, but works primarily on serotonin
  • serotonin remains in the synapse longer then would normally occur
  • first-line treatment for depression (prozac)
• Anxiolytics

  • antianxiety medications that help reduce anxiety by treating sensations of tension and arousal
  • are considered a class of sedative, due to they induce a state of calmness
  • ex benzodiazepines
• Benzodiazepines

  • enhance the effect of GABA (main inhibitor of CNS activity)
  • the greater the effect of GABA the calmer the CNS
  • fast-acting making them highly addictive
  • long term use is associated with aggression
• Mood stabilizing medications

  • aims to stabalize shifts in moods in bipolar disorder
  • lithium is the most effective mood-stabilizing medication
  • large side effects with lithium medications
• Non-pharmaceutical interventions:

  • electroconvulsive therapy
  • transcranial magnetic stimulation
  • psychosurgery
• Electroconvulsive therapy

  • for treatment-resistant depression or schizophrenia
  • electrical currents derived to induce seizures
  • relapse rate is high and often ECT needs to be done multiple times