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Questions and Answers
What distinguishes dissociative identity disorder from other disorders?
What distinguishes dissociative identity disorder from other disorders?
What is a common trigger for the onset of dissociative identity disorder?
What is a common trigger for the onset of dissociative identity disorder?
Which factor contributes to the variation in prevalence of dissociative disorders across cultures?
Which factor contributes to the variation in prevalence of dissociative disorders across cultures?
What type of phobia is characterized by fear of natural elements?
What type of phobia is characterized by fear of natural elements?
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Which of the following is a psychological cause of specific phobias?
Which of the following is a psychological cause of specific phobias?
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What age difference is typically observed in the onset of bipolar II disorder compared to bipolar I disorder?
What age difference is typically observed in the onset of bipolar II disorder compared to bipolar I disorder?
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What percentage of individuals who commit suicide do so during a depressive episode or while in recovery?
What percentage of individuals who commit suicide do so during a depressive episode or while in recovery?
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Which neurotransmitters are believed to play a role in regulating mood states in bipolar disorder?
Which neurotransmitters are believed to play a role in regulating mood states in bipolar disorder?
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What is a characteristic of rapid cycling in bipolar disorder?
What is a characteristic of rapid cycling in bipolar disorder?
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What is the most common age group for suicide attempts?
What is the most common age group for suicide attempts?
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Which of the following factors is associated with a higher genetic contribution?
Which of the following factors is associated with a higher genetic contribution?
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Which factor is NOT mentioned as a biological causal factor related to suicide risk?
Which factor is NOT mentioned as a biological causal factor related to suicide risk?
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Which of the following is NOT considered a psychological factor contributing to bipolar disorder?
Which of the following is NOT considered a psychological factor contributing to bipolar disorder?
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What is the most common demographic group for completed suicides?
What is the most common demographic group for completed suicides?
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What treatment is commonly used for stabilizing mood in bipolar disorder?
What treatment is commonly used for stabilizing mood in bipolar disorder?
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Which treatment is indicated for preventing suicide in individuals suffering from depression?
Which treatment is indicated for preventing suicide in individuals suffering from depression?
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How do depressive symptoms vary across cultures?
How do depressive symptoms vary across cultures?
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What percentage of completed suicides is estimated to leave notes?
What percentage of completed suicides is estimated to leave notes?
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Which of the following methods is often utilized by individuals expressing suicide ambivalence?
Which of the following methods is often utilized by individuals expressing suicide ambivalence?
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What is a significant risk factor associated with all types of depression?
What is a significant risk factor associated with all types of depression?
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Which demographic group in the United States is noted to have high rates of depression?
Which demographic group in the United States is noted to have high rates of depression?
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Which of the following is NOT one of the three features required to diagnose somatic symptom disorders?
Which of the following is NOT one of the three features required to diagnose somatic symptom disorders?
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Which of the following treatments is an example of an alternative biological treatment?
Which of the following treatments is an example of an alternative biological treatment?
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Which of the following is NOT a treatment method for social phobias?
Which of the following is NOT a treatment method for social phobias?
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What percentage of individuals with panic disorder also experience serious depression at some point?
What percentage of individuals with panic disorder also experience serious depression at some point?
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Which of the following symptoms is NOT typically associated with panic attacks?
Which of the following symptoms is NOT typically associated with panic attacks?
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Which cognitive bias is associated with generalized anxiety disorder?
Which cognitive bias is associated with generalized anxiety disorder?
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Agoraphobia relates to anxiety about being in what type of locations?
Agoraphobia relates to anxiety about being in what type of locations?
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What is a common non-drug treatment option for obsessive-compulsive disorder?
What is a common non-drug treatment option for obsessive-compulsive disorder?
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Which of the following best describes the nature of obsessions in OCD?
Which of the following best describes the nature of obsessions in OCD?
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Which class of medications is considered highly addictive and problematic for generalized anxiety disorder?
Which class of medications is considered highly addictive and problematic for generalized anxiety disorder?
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Which treatment is most effective for Body Dysmorphic Disorder?
Which treatment is most effective for Body Dysmorphic Disorder?
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What is a common characteristic of Hoarding Disorder?
What is a common characteristic of Hoarding Disorder?
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What distinguishes Trichotillomania from other disorders?
What distinguishes Trichotillomania from other disorders?
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What is the main treatment for Phobias?
What is the main treatment for Phobias?
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Which symptom is typically associated with Panic Disorder?
Which symptom is typically associated with Panic Disorder?
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In Body Dysmorphic Disorder, individuals primarily fixate on what aspect?
In Body Dysmorphic Disorder, individuals primarily fixate on what aspect?
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Which of the following best describes somatic symptom disorder?
Which of the following best describes somatic symptom disorder?
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What common feature do compulsions and obsessions share in OCD?
What common feature do compulsions and obsessions share in OCD?
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Study Notes
Bipolar Disorder
- Bipolar II disorder's average age of onset is five years later than Bipolar I disorder.
- Manic and hypomanic episodes are usually shorter than depressive episodes.
- Bipolar I disorder diagnosis requires at least one manic or mixed episode in the past.
Rapid Cycling
- 5-10% of bipolar disorder patients experience at least four (manic or depressive) episodes annually.
Causal Factors
Biological Factors
- Bipolar disorder has a higher genetic contribution than unipolar disorder.
- Mood regulation involves norepinephrine, serotonin, and dopamine.
- Abnormalities in ion transport across neural membranes may occur in bipolar patients.
- Sleep and biological rhythms play a role.
- Neurophysiologic and neuroanatomic influences contribute.
Psychological Factors
- Stressful life events are a factor.
- Personality variables like neuroticism and high achievement striving can play a role.
- Low social support and pessimistic attributional style can be contributing factors.
Sociocultural Factors Affecting Unipolar and Bipolar Disorders
Cross-Cultural Differences in Depressive Symptoms
- While depression occurs in all cultures, its forms vary.
- China and Japan may exhibit somatic and vegetative symptoms instead of psychological symptoms like guilt and suicidal ideation.
- Cultural beliefs about body-mind unity and stigma surrounding mental illness might contribute to these differences.
Cross-Cultural Differences in Prevalence
- Depression rates are more variable than bipolar disorder rates.
- The lifetime prevalence of depression in the United States is 17-19%, compared to 15% in Taiwan.
- Reasons for this discrepancy in depression rates are not fully clear.
Demographic Differences in the United States
- Native Americans show high rates of depression.
- African Americans have relatively lower rates.
- In the U.S., unipolar depression rates are inversely related to socioeconomic status.
- Mood disorders are relatively common in artists.
Treatments and Outcomes
Pharmacotherapy
- Mood disorders are treated with antidepressants, mood stabilizers, and antipsychotic drugs.
- SSRIs represent the most current antidepressant generation.
- Drug effectiveness often takes several weeks.
- Lithium is frequently used for mood stabilization in bipolar disorder.
Alternative Biological Treatments
- Electroconvulsive therapy, transcranial magnetic stimulation, deep brain stimulation, and bright light therapy are alternative approaches.
Psychotherapy
- Cognitive-behavioral therapy, behavioral activation treatment, interpersonal therapy, and family and marital therapy are used.
Suicide
- Suicide risk is significant across all types of depression.
- Approximately 50-90% of suicides happen during a depressive episode or recovery.
- 90% of suicide victims had a psychiatric disorder at the time (though only half had a prior diagnosis).
- Individuals with multiple mental disorders have a higher risk.
- Suicide ranks among the top ten leading causes of death in Western countries.
- Suicide attempts are most common in the 18-25 age group.
- Completed suicides are more frequent among the elderly (65 and older).
- Women attempt suicide more often, but men are more likely to complete it.
- Suicide rates for 15-24 year olds tripled between the mid-1950s and the mid-1980s.
- Adolescent suicide risk factors include mood disorders, conduct disorder, and substance abuse.
Biological Causal Factors
- Genetics may play a role in suicide risk.
- Reduced serotonergic activity is associated with increased risk.
Suicide Ambivalence
- Some individuals might not truly desire death but seek to convey a dramatic message about their distress.
- Non-lethal methods (minimal drug ingestion or minor self-harm) might be used.
- These individuals may arrange their actions to increase intervention by others.
- Notes are left in only 15-25% of completed suicides.
Suicide Prevention and Intervention
- Treatment of the underlying mental disorder is crucial.
- Crisis intervention is essential.
- Working with high-risk groups is important for prevention.
- Antidepressant medication or lithium can be helpful for depression.
- Benzodiazepines can be useful for anxiety.
- Cognitive-behavioral therapy can reduce suicide attempts among those who have made previous attempts.
Somatic Symptom and Dissociative Disorders
- These disorders are characterized by one or more of: disproportionate thoughts about symptom seriousness, high anxiety about health or symptoms, and excessive time/energy devoted to symptoms or health concerns.
Dissociative Identity Disorder
- A dramatic dissociative disorder involving two or more distinct identities or personality states that alternate in taking control of behavior.
- Formerly called multiple personality disorder.
- Alter identities are not considered personalities in a meaningful sense.
- This disorder is rare.
- Onset typically occurs in childhood.
- Childhood abuse is common in DID patients.
Sociocultural Factors in Dissociative Disorders
- Prevalence varies based on the cultural acceptance of dissociative phenomena.
- DID has been identified in all racial groups, socioeconomic classes, and cultures studied.
- Dissociative or possession trances may occur in certain cultures.
- Amok is a dissociative rage seen in cultures like Malaysia, Laos, the Philippines, Papua New Guinea, and others.
Treatment
- Hypnosis is a treatment option for DID.
Panic, Anxiety, Obsessions, and their Disorders
Fear vs. Anxiety
- Anxiety arises from less obvious danger, while fear stems from obvious danger.
- Anxiety focuses on the future and is more diffuse than fear.
Anxiety Disorders
- Unrealistic and irrational fears to the point of disability.
Specific Phobias
- Excessive or unreasonable fear triggered by a specific object or situation.
- Types include animal phobias, natural environment phobias, blood-injection-injury phobias, and situational phobias.
Psychological Causes
-
Learned behavior/classical conditioning
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Vicarious conditioning
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Individual differences in learning
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Evolutionary preparedness: We have developed specific fears and phobias throughout evolution.
Treatments
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Exposure therapy
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Participant modeling
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Virtual reality components
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Cognitive techniques combined with other therapies
Social Phobias
- Disabling fears of one or more specific social situations.
- Fear of scrutiny, negative evaluation by others (humiliation or embarrassment).
- Also known as social anxiety disorder.
Psychological Causal Factors
-
Learned behavior
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Evolutionary factors: Predisposition based on social hierarchies
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Perceptions of uncontrollability and unpredictability
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Cognitive biases towards "danger schemas" in social situations
Treatments
-
Cognitive therapy: Cognitive restructuring
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Behavioral therapy: Exposure to social situations
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Medication
Panic Disorders
- Characterized by panic attacks that often seem to occur "out of the blue".
- Recurrent, unexpected attacks and worry about additional attacks (70% of the fear).
- 13 possible symptoms of panic attacks: 10 physical and 3 cognitive.
- Attacks are brief but intense.
Agoraphobia
- Anxiety about being in places from which escape might be difficult or embarrassing.
- Originates from the Greek word "agora," meaning public place or marketplace.
- Can be disabling for some individuals.
Comorbidity
- 83% of panic disorder patients have at least one comorbid disorder.
- 50-70% experience serious depression at some point in their lives.
- Self-medication (drugs, alcohol) is more common in those with depression or anxiety.
Panic Circle
- A vicious cycle of physical symptoms leading to thoughts about a panic attack, which intensifies physical symptoms, leading to more thoughts about the attack, and so on.
Treatments
-
Medications: Anxiolytics, antidepressants, antipsychotics
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Behavioral treatment
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Cognitive-behavioral treatments
Generalized Anxiety Disorder (GAD)
- Chronic or excessive worry about events or activities.
- Occurs more days than not for 6 months.
Causal Factors
-
Conflict between the id and ego
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Worry, whether positive or negative
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Automatic attentional bias towards threatening information
Treatment
-
Anxiolytic drugs (benzodiazepines)- Highly addictive and stop working after a few weeks.
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Buspirone (non-benzo)- Non-sedating, non-addictive, but causes severe nausea. Only reduces the severity of anxiety but not the feeling itself.
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Cognitive-behavioral therapy: "And then what?" approach
Obsessive-Compulsive Disorder (OCD)
- Unwanted and intrusive obsessive thoughts or distressing thoughts.
Obsessions
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Contamination fears
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Fears of harming oneself or others
Compulsions
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Cleaning
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Checking
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Counting
Comorbidity with Other Disorders
- Frequently co-occurs with other anxiety disorders and mood disorders.
- Also co-occurs with body dysmorphic disorder.
Treatments
-
Exposure-response prevention
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Medications that affect the neurotransmitter serotonin (SSRIs)
Body Dysmorphic Disorder (BDD)
- Obsessed with a perceived or imagined flaw in appearance.
- Causes clinically significant distress.
- May focus on any body part.
- Shares body image distortion with eating disorders.
Treatment
-
Antidepressants
-
CBT
Hoarding Disorder
- Difficulty discarding possessions, leading to accumulation.
- Disorganization interferes with daily life.
- Poorer prognosis for treatment than OCD.
- Less responsive to treatment.
Trichotillomania
- An urge to pull out hair from any part of the body.
- Preceded by tension and followed by pleasure.
- Causes clinically significant distress.
Exam Questions
- What do all mood disorders have in common?
- What are mania and depression?
- Describe the subtypes of depression.
- What is the diathesis-stress model and cognitive diathesis?
- Explain the behavioral explanations for depression.
- What is the difference between Bipolar I and II disorder?
- Who is more likely to attempt or complete suicide (gender differences)?
- What is neurotic behavior?
- What is a typical symptom of a panic attack?
- List the five primary types of anxiety disorders.
- Describe exposure therapy.
- Differentiate between the types of phobias.
- Explain vicarious learning and classical conditioning.
- What is likely to maintain a fear condition over time?
- What is the best treatment for phobias?
- What are the diagnostic criteria for panic disorder?
- Define derealization, depersonalization, and dissociation.
- Explain the origin of the term "agoraphobia."
- What is a panic disorder?
- What are the consistent and recurring thoughts in OCD?
- Differentiate between compulsions and obsessions.
- What are the diagnostic criteria for OCD?
- What are common types of obsessions in OCD and what do they have in common?
- From a behavioral viewpoint, why are compulsions repeated?
- What is a somatic symptom disorder?
- Describe hypochondriasis.
- What is malingering?
- What is somatization disorder?
- What are somatic symptoms?
- Define conversion disorder.
- Explain hysteria and hysterical blindness.
- Which type of speech-related conversion is most common?
- What are pseudoseizures?
- Explain factitious disorders.
- Which disorder makes individuals less likely to discuss their symptoms?
- Describe psychoanageic amnesia and dissociative fugue.
- What are the characteristics of Dissociative Identity Disorder?
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Description
This quiz covers various aspects of bipolar disorder, including the differences between Bipolar I and II, rapid cycling, and the biological and psychological factors that contribute to the condition. Test your knowledge on the onset, symptoms, and influences of bipolar disorder in this comprehensive assessment.
