Abnormal Behavior Exam 2 Review Slides PDF

Abnormal Behavior Exam 2 Review Session 11/20/2023 8/25/21 Lychee Tran & Danielle Oleskiewicz Jared Celniker & Jillian Kenchel Chapter 6 Mood Disorders Mood disorders overview • Mood disorders = gross (i.e., obvious) deviations in mood • Composed of different types of mood episodes, such as: • M...

Abnormal Behavior Exam 2 Review Session 11/20/2023 8/25/21 Lychee Tran & Danielle Oleskiewicz Jared Celniker & Jillian Kenchel Chapter 6 Mood Disorders Mood disorders overview • Mood disorders = gross (i.e., obvious) deviations in mood • Composed of different types of mood episodes, such as: • Major depressive episodes • Hypomanic episodes • Manic episodes Types of Depressive Disorders • Major Depressive Disorder • One or more major depressive episodes separated by periods of remission • Example symptom: anhedonia, or inability to experience pleasure • Persistent Depression • 2+ years of depressive symptoms, no more than two months of being symptom free (depressed most of day on over 50% of days) • Can occur with or without major depressive episodes • Double Depression • Combination of major depressive episodes and persistent depression with fewer symptoms (e.g., baseline persistent depression punctuated by more intense depressive episodes) • Associated with severe psychopathology and problematic future course Symptoms of Bipolar I vs Bipolar II • Bipolar I • Major depressive episodes alternate with full manic episodes • Bipolar II • Major depressive episodes alternate with hypomanic (not full manic) episodes Treating Mood Disorders • Depression • Medications – SSRIs (selective serotonin reuptake inhibitors), MAO inhibitors, mixed reuptake inhibitors • Cognitive-behavioral therapy – help patients identify cognitive distortions (e.g., negative attributional styles, overgeneralization) and behaviors to overcome them • Bipolar • Medications – Lithium, a mood stabilizer that is the gold standard • One problem with medical treatment is that patients often go off medications in hopes of having a manic episode • Psychotherapy and/or family therapy Suicide Prevalence • Suicide is the 10th leading cause of death across age groups • Suicide is a leading cause of death in those aged 15-24 & 25-34 • Those aged 45-54 have the highest number of deaths by suicide • Native Americans are at the highest risk of suicide compared to other ethnicities/races. • Rate of suicide is increasing, particularly among women Risk and Protective Factors for Suicide • Risk factors • Life history – family history of suicide or child maltreatment; history of mental disorders; substance abuse; impulsive or aggressive tendencies; previous suicide attempt(s) • Social/Contextual – epidemics of suicide; isolation/loneliness; loss or severe stress; illness; easy access to lethal methods; unwillingness to seek help • Protective factors • Family & social support (connectedness); easy access to medical treatment; problem solving and conflict resolution skills; beliefs that discourage suicide Reducing risk of suicide • Identifying risk • Thoughts/Intent (suicidal ideation); specific plan; means (access to lethal methods); motivation to die (reasons/triggering events); history of attempts • Reducing risk • Work to create an actively supportive environment for the client; arrange environment so that there is less access to lethal means (e.g., removing weapon from the home); assess pros and cons of hospitalization • Review Lecture 6.7 for full list of risks and ways to reduce risk Chapter 7 Physical Disorders & Health Psychology Leading Causes of Death: 1900 vs 2014 Psychosocial factors contributing to disease • Stress and negative emotions can disrupt biological processes and may lead to physical disorders and disease • Lack of control in life; work stress; social status; etc • Risky behaviors also contribute to physical disease • Smoking, drinking, poor eating habits, and lack of exercise are all associated with worse physical health and greater disease prevalence Stress physiology • Stress activates the sympathetic branch of the autonomic nervous system (ANS), “fight or flight” • Results in the production of cortisol • General Adaptation Syndrome (GAS): alarm, resistance, exhaustion • Stress, particularly prolonged stress, can quickly alter immune system function (e.g., increase autoimmune disease) Social Hierarchy and Stress in Primates • Lower status baboons found to have higher cortisol levels, indicative of higher levels of stress • Higher status baboons had lower cortisol, likely attributable to greater control and predictability in their environment Psychoneuroimmunology & Marital Conflict • Psychoneuroimmunology – study of psychological factors, immune system responses, and nervous system responses • Study by Janice Kiecolt-Glaser found that wounds took a day longer to heal after arguments vs supportive conversations • Also found that highly hostile couples needed more time to heal and had suppressed immune functioning compared to less hostile couples Stanford Three Community Study • Study aimed at reducing risks of coronary heart disease • Enrolled three entire communities in California and tested different types of intervention (one community was a no-intervention control group) • Found that more individualized interventions (e.g., counseling) lead to greatest reductions in heart disease risk Any questions before moving on to chapters 8 & 9? Abnormal Psychology: Week 4 CHAPTERS 8-9 Eating Disorders Bulimia Nervosa ● ● ● Involves recurrent episodes of binging followed by purging (e.g., vomiting, excessive laxative use) Subtypes: ○ Purging type (vomiting, laxatives) ○ Non-purging type (exercise, fasting) Often comorbid with anxiety and mood disorders Eating Disorders Anorexia Nervosa ● ● ● ● Involves restricting/refusing food or excessive exercise that leads to dangerously low body weight Severe body image distortion Subtypes: ○ Restricting type (limit caloric intake) ○ Binge-eating-purging type (rely on purging consistently) Up to 20% of people with known anorexia nervosa die as a result of their disorder ➢ 20-30% of these deaths are suicides Eating Disorders Binge Eating Disorder ● ● ● Involves binging repeatedly to a point of distress, but does not include purging Often end up in weight control programs May begin with dieting before binging, or may begin with binging and then attempt to diet Eating Disorders ● ● ● Tends to be mostly in Western countries, but is growing globally Adolescent girls are most at risk Gender differences: ● Men tend to desire to be heavier and more muscular ● Women tend to desire to be thinner Eating Disorders Similarities: ● ● Driven by an overwhelming drive to be thin Result in medical complications, such as cessation of menstruation Differences: ● ● Anorexia: often proud of their self-control and diets Bulimia: often ashamed of their lack of control and eating issues Eating Disorders Treatments ● ● Drug treatments: ○ Not effective for anorexia nervosa ○ Anti-depressants found to be effective for bulimia nervosa short-term Psychological treatments: ○ CBT with a focus on eating behavior and body image is effective for bulemia ○ Patients with anorexia nervosa may enter inpatient treatment until normal body weight is restored A 21-year-old woman is brought into an outpatient clinic by her mother, who complains that her daughter has been demonstrating unusual eating patterns since she moved back home 6 months ago. Her mother observes her to eat large amounts of food, such as desserts, when she is alone, often finding food wrappers hidden in her daughter’s room. She is worried that her daughter may be engaging in vomiting after these episodes of heavy eating. She often isolates herself in the bathroom for 10-20 minutes after a large meal. When the patient was asked about her eating habits, she admitted to a “loss of control. ” She described feeling deep remorse when she eats more than she would like. A. B. C. Bulimia nervosa Anorexia nervosa Binge eating disorder A 21-year-old woman is brought into an outpatient clinic by her mother, who complains that her daughter has been demonstrating unusual eating patterns since she moved back home 6 months ago. Her mother observes her to eat large amounts of food, such as desserts, when she is alone, often finding food wrappers hidden in her daughter’s room. She is worried that her daughter may be engaging in vomiting after these episodes of heavy eating. She often isolates herself in the bathroom for 10-20 minutes after a large meal. When the patient was asked about her eating habits, she admitted to a “loss of control. ” She described feeling deep remorse when she eats more than she would like. A. B. C. Bulimia nervosa Anorexia nervosa Binge eating disorder Sleep-Wake Disorders Two categories: ● ● Dyssomnias ○ Difficulties getting enough sleep, problems sleeping when you want to, and complaints about quality of sleep Parasomnias ○ Abnormal behavioral or physiological events that occur during sleep Sleep-Wake Disorders Insomnia ● One-third of the population reports some insomnia symptoms ● Involves trouble falling asleep, waking frequently or too early, sleeping a normal amount but not feeling rested ● Often comorbid with depression, substance use disorders, anxiety disorders ● Caused by a variety of medical and psychological disorders, as well as environmental factors (e.g., problems with biological clock, drug use, physical inactivity) ● Treatments: melatonin, benzodiazepines, phototherapy, stimulus control, CBT for insomnia Sleep-Wake Disorders Narcolepsy ● ● ● Recurrent periods of irrepressible need to sleep or lapsing into sleep Often accompanied by cataplexy: a sudden loss of muscle tone, sometimes resulting in physical collapse Treatments: stimulants such as Ritalin, antidepressants (helps suppress REM) Sleep-Wake Disorders Hypersomnolence Disorder ● ● ● ● Hypersomnia = sleeping too much Characterized by excessive sleepiness despite sleeping at least 7 hours Only diagnosed if other explanations for excessive sleepiness are not present Treatments: stimulants such as Ritalin A 22-year-old woman complained of her excessive daytime sleepiness and sleep attacks. Her daytime sleepiness began when she was around thirteen years old and it had been getting worse. When she was in high school, she couldn’t stay wake during her classes or exams. When she later worked at a department store she frequently dozed off standing up, and for this she was dismissed. She also got into a collision while driving due to a sudden sleep attack. Cataplexy developed as her daytime sleepiness got worse, and after the age of nineteen, it would occur almost every day. Her knees would suddenly buckle and her jaws sagged. She also complained of seeing ghosts or animals and hearing her name called when she was lying down at night. She experienced realistic and often scary dreams throughout the night; when she awoke, she was unable to move. A. Insomnia B. Narcolepsy C. Hypersomnolence disorder A 22-year-old woman complained of her excessive daytime sleepiness and sleep attacks. Her daytime sleepiness began when she was around thirteen years old and it had been getting worse. When she was in high school, she couldn’t stay wake during her classes or exams. When she later worked at a department store she frequently dozed off standing up, and for this she was dismissed. She also got into a collision while driving due to a sudden sleep attack. Cataplexy developed as her daytime sleepiness got worse, and after the age of nineteen, it would occur almost every day. Her knees would suddenly buckle and her jaws sagged. She also complained of seeing ghosts or animals and hearing her name called when she was lying down at night. She experienced realistic and often scary dreams throughout the night; when she awoke, she was unable to move. A. Insomnia B. Narcolepsy C. Hypersomnolence disorder Sexual Dysfunctions and Paraphilic Disorders Sexual Dysfunctions ● ● ● ● ● Involve problems with desire, arousal, or orgasm Must be present for 6+ months and lead to impairment or distress for diagnosis Males and female experience parallel versions of most dysfunctions Assessment → psychophysiological evaluation Treatment → education can be very effective; Masters & Johnson’s psychosocial intervention Sexual Dysfunctions and Paraphilic Disorders Sexual Dysfunctions Sexual Dysfunctions and Paraphilic Disorders Paraphilic Disorders ● ● ● Misplaced sexual attraction and arousal High comorbidity with anxiety, mood, and substance use disorders Manifest in fantasies, urges, arousal or behaviors ○ Only considered disordered when the individual experiences clinically significant distress/impairment OR acts on urges with a nonconsenting person Sexual Dysfunctions and Paraphilic Disorders Paraphilic Disorders ● ● Causes: ○ Difficulty forming normal relationships ○ Often have very high sex drive Treatment: ○ Mostly behavioral treatments that target deviant and inappropriate sexual associations ○ E.g., covert sensitization = imagining aversive consequences to form negative associations with deviant Greta and Will had been married for five years and were in their late 20s. Greta reported that she didn’t think she had ever had an orgasm—“didn’t think” because she wasn’t really sure what an orgasm was. Will certainly didn’t think Greta was reaching orgasm and thought they were going in “different directions” sexually, in that Greta’s interest was decreasing. She had progressed from initiating sex occasionally early in their marriage to almost never doing so, except for an occasional spurt every six months or so. But Greta noted that it was the physical closeness she wanted most during these times rather than sexual pleasure. Further inquiry revealed that she did become sexually aroused occasionally but had never reached orgasm, even during several attempts at masturbation mostly before her marriage. A. B. C. Female orgasm disorder Hypoactive sexual desire disorder Genito-pelvic pain/penetration disorder Greta and Will had been married for five years and were in their late 20s. Greta reported that she didn’t think she had ever had an orgasm—“didn’t think” because she wasn’t really sure what an orgasm was. Will certainly didn’t think Greta was reaching orgasm and thought they were going in “different directions” sexually, in that Greta’s interest was decreasing. She had progressed from initiating sex occasionally early in their marriage to almost never doing so, except for an occasional spurt every six months or so. But Greta noted that it was the physical closeness she wanted most during these times rather than sexual pleasure. Further inquiry revealed that she did become sexually aroused occasionally but had never reached orgasm, even during several attempts at masturbation mostly before her marriage. A. B. C. Female orgasm disorder Hypoactive sexual desire disorder Genito-pelvic pain/penetration disorder Robert, a 31-year-old, married, blue-collar worker, reported that he first started “peeping” into windows when he was 14. He rode around the neighborhood on his bike at night, and when he spotted a female through a window, he stopped and stared. During one of these episodes, he felt the first pangs of sexual arousal. Eventually he began masturbating while watching, thereby exposing his genitals, although out of sight. A. B. C. Pedophilic disorder Voyeuristic disorder Fetishistic disorder Robert, a 31-year-old, married, blue-collar worker, reported that he first started “peeping” into windows when he was 14. He rode around the neighborhood on his bike at night, and when he spotted a female through a window, he stopped and stared. During one of these episodes, he felt the first pangs of sexual arousal. Eventually he began masturbating while watching, thereby exposing his genitals, although out of sight. A. B. C. Pedophilic disorder Voyeuristic disorder Fetishistic disorder