Exam 2 Study Guide PDF

Psychopathology Exam 2 Study Guide 1. Is weight fluctuation a diagnostic criteria for depression? Significant weight loss when not dieting or weight gain (e.g. change of more than 5% of body weight in a month), or decrease or increase in appetite...

Psychopathology Exam 2 Study Guide 1. Is weight fluctuation a diagnostic criteria for depression? Significant weight loss when not dieting or weight gain (e.g. change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day 2. What are some modifiers for major depressive disorder? With anxious distress With mixed features With melancholic features: down but can function With atypical features With mood-congruent psychotic features With mood incongruent psychotic features With catatonia With peripartum onset: mothers struggling with depressive symptoms after having children or before With seasonal pattern 3. Which neurochemicals may be responsible for contributing towards depression? Serotonin and norepinephrine 4. What are some common treatments for depression? ○ Psychiatric medications - SSRIs, Selective Serotonin Reuptake Inhibitors SSNIs, Selective Norepinephrine Reuptake Inhibitors ○ Weekly outpatient therapy ○ CBT is standard most clinicians use ○ Cannot engage ADL = practical intervention (case workers + social workers) 5. What are the behavioral symptoms of a manic episode? ○ Inflated self esteem or grandiosity (invincible, impulsive behaviors) ○ Decreased need for sleep ○ More talkative or pressure to keep talking ○ Flights of ideas or subjective experience that thoughts are racing ○ Distractibility or observed increase in goal directed activity (either socially, at work or school, or sexually) or psychomotor agitation (purposeless, non-goal-directed activity) ○ Excessive involvement in activities that have high potential for painful consequences (buying sprees, sex indiscretions, foolish business investments) 6. Are the symptoms in major depressive disorder similar to depressive episodes in Bipolar Disorder? ○ Depressive features of BD are similar to MDD ○ Main difference is cycling of depressive symptoms 7. Do clinicians diagnose those under the age of 18 with bipolar disorder? ○ Below age 18, most clinicians will rule out bipolar disorder diagnosis 8. What are the ions that may play a role in the neurochemistry of bipolar disorder? ○ Sodium and potassium ○ Positively charged sodium ions sit on both sides of neuron's cell membrane. ○ When neuron is at rest, more sodium ions sit outside membrane. ○ Neuron receives incoming message, allowing sodium ions to flow to inside ○ This strats wave of electrical activity that travels down length of neuron and results in “firing” ○ After firing, potassium ions, flow from inside of neuron across cell membrane potassium ions, flow from the inside of neuron across the cell membrane to the outside helping to return the neuron to its original resting state ○ Bipolar disorder = result of issue with process of ions going in and out of the neuron while firing a message ○ Irregularities in transport of these ions may cause neurons to: Too frequently = mania Not happening fast enough = depression 9. Which brain areas may be structurally different in those with bipolar disorder? ○ Basal ganglia and cerebellum = smaller ○ Dorsal raphe nucleus, striatum, amygdala, hippocampus, and prefrontal cortex have some structural abnormalities 10. Name some common medications for bipolar disorder. ○ Psychiatric medications Lithium is a mood stabilizer Depakote is an antipsychotic ○ Antidepressants 11. What are the consequences of long term lithium use? ○ Bad for kidney function 12. What are two conditions that happen to individuals who get repetitive, indirect exposure to trauma?  ○ Secondary Traumatic Stress: First sign of trauma work starting to have a negative effect on someone. Overall exhaustion, general fatigue, lack of empathy, burnout, anhedonia, and decreased self-care. Occur to many clinicians in the mental health field, social workers in psychiatric units, case managers in homeless shelters, emergency services ○ Vicarious Trauma: More severe condition that happen when working with trauma. Listening to someone's story and, content of story is so horrific, that it makes you feel symptoms of trauma exposure while listening. This can look like a shock response, brief dissociation and depersonalization, inability to process information, pausing, increased emotional response, and difficulties with concentration. 13. When do clinicians give a PTSD diagnosis, from a timeline perspective? ○ PTSD: at least one month after ○ Acute stress disorder: immediately after event but last less than 1 month 14. What is one neurological pathway that potentially explains PTSD? ○ Highway in brain between ventromedial prefrontal cortex and amygdala Amygdala: fight or flight response in sympathetic nervous system MOST: pathway b/w amygdala + prefrontal cortex = critical for front part of brain to communicate threats to amygdala to regulate activation ○ Dangerous situation = hypothalamus excites sympathetic nervous system Prompts response of adrenaline in adrenals Release of adrenaline produces arousal and fear When perceived danger passes, the parasympathetic nervous system activates to calm down physiological responses that occur (slows heartbeat, calms nerve endings, restores bodily temperature, etc.) 15. Which hormones get released during a traumatic event? ○ Hypothalamic-pituitary-adrenal pathway or (HPA) Stressor occur, hypothalamus signals pituitary gland, and secretes adrenocorticotropic hormone This hormone stimulates the outer layer of adrenals, and causes them to release the hormone of cortisol. In morning when you first wake up, cortisol is naturally released to awaken you. However, in fear responses, excessive cortisol may be released, to keep you alert when a threat is nearby. Releasing adrenaline + cortisol in unpredictable way results in symptoms  1. Cortisol → Derealization 2. Both → Dissociation 3. Adrenaline → Depersonalization 16. What types of hallucinations occur in someone diagnosed with schizophrenia? ○ Hallucinations Auditory (hearing) Visual (seeing) Olfactory (smelling) Gustatory (taste) Somatic (feeling) 17. What is the definition of psychosis? ○ Psychosis: state in which person loses contact with reality in key ways 18. What is the brain area potentially responsible for causing schizophrenia? ○ Central ventricles: outside of each lobe, right above ear Responsible for cerebral spinal fluid regulation which assists during sleep cycles and helps protect the brain ○ Central ventricles have swelled + abnormally large, causing brain damage 19. What drug is known to potentially cause psychotic symptoms for upwards of a year? ○ Methamphetamine 20. Individuals with PTSD are at a risk for developing which secondary conditions? ○ Acute Stress Disorder: when someone has symptoms of PTSD, but a stressful event has been within a certain month of incident. Typically, this will get diagnosed first following a traumatic event. If symptoms last longer than one month, PTSD can come into consideration Commonly missed Would help reduce stigma ○ Panic Disorder: sometimes, PTSD flashbacks can trigger a physiological response that looks like a panic attack. This can lead to a situation where one may consider a panic disorder diagnosis; however, other symptoms need to be present for a PTSD diagnosis (e.g., nightmares). 21. How did PTSD get diagnosed, from a historical perspective? What was the condition called throughout history? ○ PTSD = initial diagnosis given to veterans during 70s following war exposure ○ Right after WWI, condition known as “combat fatigue”  ○ During WWII, clinicians changed terminology to “shell shock” ○ Known as, “hysteria” when applied to women 22. What are positive and negative symptoms in schizophrenia? ○ Positive symptoms (expressive symptoms, active phase symptoms) Self dialogue behavior Hallucinations 1. Auditory hallucinations 2. Visual hallucinations Delusional thought patterns Issues with affect ○ Negative symptoms (not expressive symptoms) Not engage in ADL’s (activities of daily living) Social withdrawal Isolation Avoidant behavior Catatonia Comatose 23. What are the differences between Bipolar I, Bipolar II, and Cyclothymic disorder? ○ Bipolar I Full manic and major depressive episode Most of them experience alternation of episodes 1. (mania → period of wellness → depression) ○ Bipolar II Hypomanic (mildly manic) and major depressive episodes ○ Cyclothymic Hypomania and mild depressive episode 24. Name the major differences between Schizophrenia and Schizoaffective disorder. ○ Schizophrenia Psychotic symptoms (hallucinations, delusions, disorganized thinking) Psychotic symptoms are continuous and do not typically have a direct connection to mood episodes. Treated with antipsychotic medications to manage psychotic symptoms ○ Schizoaffective Combines symptoms of schizophrenia with mood disorder symptoms Requires period of time where mood symptoms occur simultaneously with psychotic symptoms AND at least two weeks where psychotic  symptoms appear alone (distinguishing from mood disorder with psychotic features) Treatment includes a combination of antipsychotic medications and mood stabilizers or antidepressants 25. What are the treatment options for individuals with eating disorders? ○ DIFFERENT LEVELS OF CARE ○ Therapy and Counseling: CBT: identify and modify the thoughts and behaviors with food DBT: provide strategies to cope with triggers, challenge distorted beliefs Exposure therapy ○ Nutritional Counseling ○ Inpatient Care: Severe cases require close medical supervision (24 hr care) ○ Family-Based Therapy: helps family members support recovery ○ Support Groups and Peer Support 26. Describe derealization, depersonalization, and dissociation with regards to PTSD. ○ Depersonalization: feeling detached from mental processes or body Feeling as though one were in a dream Time moving slowly Outside body (outside observer) ○ Derealization: experiences of unreality of surroundings World around seems dreamlike World does not feel real ○ Dissociation: combination of depersonalization + derealization Most severe