Psychology Chapter on Rights and Commitment

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Questions and Answers

What characterizes unipolar disorders?

Swings between poor mood and mania

Only poor mood without manic episodes (correct)

Severe mood swings lasting months

Both manic and depressive episodes occurring simultaneously

Which of the following identifies a characteristic of Major Depressive Disorder (MDD)?

Episodes lasting less than one week

Absence of manic episodes (correct)

Presence of hypomanic episodes

Dysthymia lasting no more than two weeks

What is true about the onset of bipolar disorders?

Onset typically occurs between 28-33 years (correct)

Typically occurs during late childhood

Usually begins in middle age

Always starts with manic episodes

Which subtype of depression is characterized by episodes related to seasonal changes?

Seasonal Affective Disorder (SAD) Signup and view all the answers

Which statement about the course and outcome of unipolar disorders is accurate?

50% recover within six months Signup and view all the answers

What distinguishes bipolar I from bipolar II disorders?

Bipolar I requires at least one manic episode Signup and view all the answers

What aspect of depression is influenced by gender according to the prevalence data?

Women are more likely to express depressive symptoms Signup and view all the answers

Which of the following is NOT a descriptor used in the DSM-V for Major Depressive Disorder?

Recurrent episodes Signup and view all the answers

What is civil commitment primarily based on?

Imminent danger to self or others Signup and view all the answers

Which of the following statements best reflects Thomas Szasz's view on mental illness?

The label of mentally ill is a social construction. Signup and view all the answers

What does the right to refuse treatment imply in psychiatric care?

Patients can refuse treatment even if they are dangerous. Signup and view all the answers

What is a possible outcome for an individual declared legally insane?

Detention that could be indefinite Signup and view all the answers

What is one of the patients' rights regarding their treatment environment?

Right to treatment in the least restrictive environment Signup and view all the answers

How do mental health professionals typically err in predicting dangerousness?

They tend to overpredict dangerousness. Signup and view all the answers

Which statement characterizes the 'not criminally responsible on account of a mental disorder' (NCRMD) defense?

Individuals cannot appreciate the nature and quality of their act. Signup and view all the answers

What is one reason why individuals may be civilly committed?

They exhibit symptoms they cannot control. Signup and view all the answers

What are the components of the cognitive triad according to Beck’s Cognitive Theory?

Negative view of oneself, negative view of the environment, negative view of the future Signup and view all the answers

Which cognitive distortion involves interpreting situations in black and white terms?

All-or-nothing thinking Signup and view all the answers

What is the concordance rate for major depression in identical twins (MZ)?

45-70% Signup and view all the answers

Which of the following is a primary goal of cognitive therapy for depression?

To identify and change distorted thoughts and beliefs Signup and view all the answers

What is the main function of SSRIs in treating depression?

To block the re-uptake of serotonin Signup and view all the answers

Which treatment approach is typically NOT a focus of behavioral therapy for depression?

Awareness of unconscious causes Signup and view all the answers

Which factor is considered an interpersonal factor in the etiology of depression?

Self-critical behavior that elicits criticism from others Signup and view all the answers

For which disorder is lithium primarily used as a treatment?

Bipolar disorder Signup and view all the answers

What is a characteristic of Cognitive Behavior Therapy (CBT)?

It is collaborative and builds trust. Signup and view all the answers

Which principle suggests that focusing on the current processes is often more effective than discussing the past?

Here and now Principle Signup and view all the answers

What is the negative cognitive triad in the context of depression?

Negative thoughts about oneself, the world, and the future. Signup and view all the answers

Which of the following is a primary goal in the course of treatment using CBT?

To reduce symptoms through behavioral strategies. Signup and view all the answers

How effective is Electroconvulsive Therapy (ECT) in individuals with major depression who have not responded to medications?

It has significant improvement in 50-60% of cases. Signup and view all the answers

What is a common misconception about the cognitive model's view on emotional responses?

Emotions are determined only by events. Signup and view all the answers

Which demographic shows the highest likelihood of committing suicide?

Older men with few social supports and chronic illnesses. Signup and view all the answers

What is one of the key principles regarding mental health problems in CBT?

They should be viewed as exaggerations of normal processes. Signup and view all the answers

What are common positive symptoms of schizophrenia?

Hallucinations Signup and view all the answers

Which phase of schizophrenia is characterized by a full spectrum of psychotic symptoms?

Active phase Signup and view all the answers

What is a common misconception about individuals who have decided to commit suicide?

They may appear at peace Signup and view all the answers

Which type of delusion involves the belief that one is being controlled by external forces?

Delusion of being controlled Signup and view all the answers

Which symptom is NOT traditionally associated with schizophrenia?

Euphoria Signup and view all the answers

Which symptom is characteristic of negative symptoms in schizophrenia?

Poverty of speech Signup and view all the answers

In the context of suicide prevention, which approach is recommended?

Inquire about how the individual plans to commit suicide Signup and view all the answers

What does the prodromal phase of schizophrenia typically involve?

Decreased level of functioning Signup and view all the answers

Which type of hallucination is the most common in schizophrenia?

Auditory Signup and view all the answers

Which of the following is a characteristic feature of schizophrenia?

Profound disturbance in thought Signup and view all the answers

Study Notes

Balancing Rights

Psychology and psychiatry balance individual rights against society's rights.
This is important in determining if someone should be released from jail, as society's safety is a consideration.
Mental health professionals tend to overpredict dangerousness.

Psychiatric Commitment

Placing people in psychiatric institutions against their will is done on an extreme basis, usually when visible and imminent danger is present.
Legal commitment results from unlawful acts, providing clear evidence of an imminent risk, requiring a limited time.
Thomas Szasz challenged the concept of mental illness as a social construct, arguing it transforms social deviance.

Predicting Dangerousness

Mental health professionals often overpredict dangerousness, which needs careful consideration during commitment proceedings.
Psychopathy, a personality disorder, is associated with dangerousness.

Patients' Rights

Patients have the right to confidentiality, even when there is a duty to warn.
Individuals have the right to the least restrictive environment for treatment.
The right to refuse treatment is controversial and requires careful consideration.

The Insanity Defense

It is a legal defense where the individual is not accountable for a mental disorder.
To utilize this defense the individual must not understand their actions or that the actions were wrong.
It can be a partial defense where an individual may have emotional disturbances but still understands their actions.
The Insanity Defense can result in:
- Absolute discharge: no threat to the public.
- Conditional discharge: a person can be discharged under specific treatment conditions
- Detention: indefinite period of detention.

Mood Disorders & Suicide

Unipolar disorders focus on low moods, whereas bipolar disorders involve mood swings between low and manic states.
Major Depressive Disorder (MDD) includes seasonal affective disorder (SAD) and postpartum depression.
Dysthymia refers to chronic low mood.

Bipolar Disorder

Bipolar I involves manic episodes
Bipolar II involves hypomanic episodes, which are milder than manic episodes.
Cyclothymic disorder is characterized by less extreme mood swings, with periods of low mood and hypomania.

Major Depressive Disorder

MDD diagnosis requires at least two weeks of a depressed mood or lack of interest in activities.
Significant distress or impairment in social, occupational, or other areas of functioning is required.
The symptoms need to be distinct from substance use or other medical problems.
This diagnosis also excludes normal grief associated with a loss.

DSM-V MDD Subtypes and Descriptors

Psychotic features: delusions or hallucinations.
Postpartum onset: symptoms appear shortly after childbirth.
Melancholia: severe depression with distinct biological causes that may respond well to biological treatments.
Seasonal Affective Disorder: episodes occur during specific times of the year.
Rapid cycling: frequent mood swings with 4 or more episodes within a year.

Course and Outcomes in Mood Disorders

Unipolar disorders often begin in the mid-life, with around 50% of individuals recovering within 6 months.
Of those recovering, 50% are likely to relapse in 3 years.
Bipolar disorders often begin between 28-33 years old.
The average duration of an episode is 2-3 months.

Epidemiology of Mood Disorders: Unipolar Disorders

Difficulty in measuring the exact incidence and prevalence due to varying treatment-seeking behaviors.
Women are more likely to be diagnosed with depression (MDD), potentially due to different life experiences, coping styles, and societal influences.
Depression is found across cultures, with higher rates observed in some specific populations.

Cognitive Theory of Depression

Aaron Beck's theory suggests that negative thoughts contribute to the onset and maintenance of depression.
The cognitive triad: a negative view of oneself, the environment, and the future.
Cognitive distortions: thought patterns that magnify negative experiences and underplay positive ones.
Examples of cognitive distortions: all-or-nothing thinking, overgeneralization, and mental filtering.
Automatic thoughts: occur effortlessly and often reflect negative biases.

Etiological Considerations

Interpersonal factors, such as self-criticism, can create difficult circumstances that increase stress and perpetuate depressive symptoms.
Biological factors: genetics play a role in the development of mood disorders.
Concordance rates for major depression are higher in identical twins compared to fraternal twins.
Neurotransmitters: the catecholamine hypothesis suggests a deficiency of norepinephrine in depression.
SSRIs (selective serotonin reuptake inhibitors) effectively block serotonin reuptake.

Treatments for Unipolar Disorders

Cognitive therapy: helps identify and change distorted thoughts and beliefs, lasting 14-16 weeks.
Interpersonal therapy: focuses on improving relationships.
Antidepressant medications: SSRIs are commonly used.
Behavioral therapies: directly modify behaviors without focusing on underlying causes.

Treatments for Bipolar Disorders

Lithium: commonly used, but 30-40% of patients don't respond or experience side effects.
Electroconvulsive Therapy (ECT): used in severe cases when other treatments fail; often leads to significant improvements in 50-60% of individuals with major depression.
ECT effectiveness is unknown; effectiveness is disputed ethically.

Introduction to Cognitive Behavior Therapy (CBT)

CBT is a collaborative, active, and structured approach to therapy.
It focuses on how thoughts, emotions, and behaviors interact.
It emphasizes identifying and challenging unhelpful thought patterns.

The Cognitive Model of Depression

The cognitive model proposes that events lead to thoughts, which in turn influence emotions.
It emphasizes that our interpretations of events, not the events themselves, are crucial in shaping our emotional responses.
Depression is often characterized by a negative cognitive triad, leading to biased views of oneself, the environment, and the future, resulting in negative filters, overgeneralization, and distorted interpretations of situations.

Course of Treatment

The course of CBT involves identifying specific problems, introducing the cognitive model, establishing goals, and implementing strategies to reduce symptoms.
This includes challenging negative automatic thoughts (NATs) and developing relapse prevention strategies.

Suicide

Approximately 10% of men and 13% of women have considered suicide, with 2% of men and 6% of women attempting suicide.
Men are four times more likely to die by suicide.
Suicide is a leading cause of death in individuals aged 15-44.
Older men with limited social support and chronic conditions are at higher risk.
90% of individuals leave clues, such as disposing of possessions, sorting out financial affairs, drafting a will, purchasing cemetery plots, and acquiring guns.

Suicide Prevention

Draw the person out, encouraging them to discuss their difficulties.
Be sympathetic and understanding, refraining from dismissing their struggles.
Suggest alternatives to suicide, exploring other means of resolving their issues.
Inquire about the person's suicide plan to assess their risk and potential interventions.
Encourage immediate professional help, offering to accompany the person to see a mental health professional.
Avoid dismissive or degrading remarks, as this can further isolate and distress the person.

Schizophrenic Disorders

A group of disorders with a significant social impact.
In 1996, 221,000 Canadians had schizophrenia.
Key feature: psychotic symptoms—profound disturbance in thought, reality testing, and affect.
Schizophrenia is a devastating disorder that involves a loss of contact with reality.
The primary symptom is psychosis.

Course of Schizophrenia

Prodromal phase: decreased functioning, social withdrawal, behavioral changes, neglect of hygiene, and emotional fluctuations.
Active phase: full range of psychotic symptoms—more severe.
Residual phase: return to prodromal phase, with possible mild delusions, hallucinations, and negative symptoms.

Symptoms & Features

Positive symptoms: hallucinations and delusions.
Negative symptoms: reduction in normal behaviors (speech, thought, hygiene, movement).

Hallucinations

Auditory: the most common hallucinations—often insulting or instructing.
Tactile: sensations (e.g., crawling under the skin).
Somatic: bodily sensations/experiences—often connected to an alien or threat within the body.
Visual: rare—potentially caused by medication side effects.

Delusions

Persecutory: beliefs that others harm or are watching them.
Reference: everyday events have personal meaning and are related to the individual.
Grandeur: believing themselves to possess extraordinary abilities.

Other Delusions

Delusions of being controlled: feel like they're being manipulated or influenced.
Thought broadcasting: beliefs that their thoughts are being heard by others, transmitted.
Thought insertion: beliefs that thoughts are being inserted into their minds by others.
Thought withdrawal: beliefs that thoughts are being removed from their minds.

Negative Symptoms

Poverty of speech (alogia): speaking very little or using very little content in their language.
Affective flattening: lack of expression in their face or tone of voice.
Alogia: lack of spontaneous thought.
Avolition: loss of interest in or inability to engage in goal-directed activities.
Anhedonia: inability to experience pleasure.

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Description

This quiz explores the delicate balance between individual rights and societal safety in psychology and psychiatry. It addresses issues of psychiatric commitment, the prediction of dangerousness, and the rights of patients, all while considering the ethical implications involved. Delve into how mental health professionals navigate these complex dilemmas.