Description
Exam 2 Abnormal Study Guide
a. Mood Disorders
a. Depression
i. What are symptoms of depression?
1. Emotional symptoms
• Feeling “miserable,” “empty,” “humiliated”
• Experiencing little pleasure
2. Motivational symptoms
• Lacking drive, initiative, spontaneity
• 6 15% with severe depression commit suicide
3. Behavioral symptoms
• Less active, less productive
4. Cognitive symptoms
• Hold negative views of themselves
• Blame themselves for unfortunate events
• Pessimistic
5. Physical symptoms
• Headaches, dizzy spells, general pain
ii. What is the difference between Major Depressive Disorder, Persistent Disorder, and Premenstrual Dysphoric Disorder? 1. Major Depressive Disorder
a. People who experience a major depressive episode with no
history of mania
2. Persistent Disorder
a. Individuals who experience a longerlasting (at least two
years) but less disabling pattern of depression
3. Premenstrual Dysphoric Disorder
a. A diagnosis given to women who repeatedly experience
clinically significant depressive symptoms during the week
before menstruation
iii. Is depression more common than men or women?
1. Women
iv. Is there a genetic basis to depression?
1. Yes
a. Family Pedigree studies
i. Propends
1. Relative that suffers depression If you want to learn more check out Which of the terrestrial planets is closest to the sun?
2. 30% depressed vs.<10% general population
b. Twin studies
i. Monozygotic: 46% chance
ii. Dizygotic: 20% chance
c. Molecular studies
i. Serotonin transporter gene
ii. Affects levels of serotonin
v. What neurotransmitters, hormones, and other neurochemicals are associated with depression?
1. Neurotransmitters Don't forget about the age old question of What determines the charge of an atom?
a. Serotonin (5HT)
i. Involved in emotion regulation, may regulate NE
b. Norepinephrine (NE)
i. Discover
1. Medications that decrease NE or 5HT
caused depression
2. Accidental discovery of antidepressant drugs
2. Hormones
a. Cortisol
i. Released in response to stress
b. Melatonin
i. Hormone involved in sleepwake cycle; prepares
body for sleep
vi. What is the behavioral theory of depression?
1. Less positives in life stressor leads to reduction in reinforcers Person withdraws Reinforces reduced further More withdraw and depression
2. What does the treatment based on behavior theory look like? a. Rewards and positives go up and the depression decreases vii. What is the cognitive theory of depression? Don't forget about the age old question of What is sensory adaptation and how does it occur?
1. Aaron Beck
The
a. Negative thinking
b. Triangle If you want to learn more check out How do changes in population affect politics?
The
future
i.
Self
The
World
2. What is learned helplessness?
a. a condition in which a person suffers from a sense of powerlessness, arising from a traumatic event or persistent failure to succeed. It is thought to be one of the underlying causes of depression.
3. What are they types of attributional styles? What type of attributional style do depressed individuals demonstrate? a. Internal vs. External
i. Internal
1. About me (more prone to depression
ii. Externa
1. About the world or someone else
b. Global vs. Specific
i. Applies to everything (more prone)
ii. Specific
1. Specific to category of thing We also discuss several other topics like What is the meaning of sexual contact?
c. Stable Vs. Unstable
i. Stable
1. Persistent quality
ii. Unstable
1. About this event in time
d. Type that depressed individuals have
i. Internal Global Stable
4. How does cognitive behavioral therapy work? a. Behavior
i. Reintroduce pleasurable activities
ii. Appropriately reinforce their depressive
and non-depressive behaviors If you want to learn more check out What is pattern recognition?
iii. Help them improve their social skills
iv. Schedule to increase activity
b. Thought
i. 3 C’s
1. Catch
a. Identify the thought that
caused the emotion
2. Check
a. Reflect on how accurate and
useful the thought is
3. Change
a. Change the thought to a
more accurate or helpful one
viii. What does interpersonal therapy focus on? 1. 4 Problems that lead to depression
a. Loss
b. Role dispute
c. Role transition
d. Deficits
i. Social skills
ix. What is electroconvulsive therapy?
1. The application of brief electrical shock to the brain 2. Relapse is common
3. 60-80% recover
x. What are the different types of antidepressant drugs?
1. MAOI’s
a. Monoamine oxidase inhibitors
b. Neurotransmitters (monoamine)
i. Norepinephrine
ii. Dopamine
c. Oxidase
i. Things that break them down
d. Inhibitors
i. Prevents monoamine oxidase from
breaking down the transmitters
e. Last line of treatment
2. Tricyclics
a. Block reuptake of norepinephrine and other
neurotransmitters
b. Takes 2 to 8 weeks to take effect
c. May take a while for neurons to adapt to the drugs
d. Negative side effects include dry mouth and constipation
e. When discontinued, risk of relapse is high
f. Some people respond better to MAOIs and some to
tricyclics
3. SSRI’s
a. Secondgeneration antidepressant
b. Specifically block reuptake of serotonin
c. Side effects are common but more innocuous than other
antidepressants (weight gain, reduced sex drive)
b. Per partum Depression
i. What are the actual criteria?
1.
ii. What are the potential causes?
1. Changes in hormone levels
2. Changes in body from pregnancy and delivery
3. Changes in work and social relationships
4. Less time and freedom for yourself
5. Lack of sleep
6. Worries about ability to be a good mother
iii. How common is postpartum psychosis?
1. Rare
c. Bipolar Disorders
i. What are the symptoms of mania?
1. Inflated self esteem
2. Decreased need for sleep
3. Increased talkativeness
4. Racing thoughts
5. Distractibility
6. Increase in goaldirected activities
ii. What does the term schizophrenia mean?
1. “split mind”
iii. What are the diagnostic criteria for schizophrenia?
a. 2 or more of the following symptoms occurring for at least 1 month:
1. Delusions
2. Hallucinations
3. Disorganized speech
1. Severe disruptions in the process of speech
4. Grossly disorganized or catatonic behavior
2. Bizarre/disrupted behavioral patterns
a. i.e., dishevelment, childishness, agitation
5. Negative Symptoms
3. Lack of emotion, speech, or motivation
b. Social/occupational dysfunction and decline
c. Continuous signs of the disorder for 6 months
iv. What are the different types of symptoms of schizophrenia? 1. Positive
a. Delusions
b. Hallucinations
c. Disorganized speech, thought, and behavior
2. Negative
a. Flat affect
b. Loss of motivation
c. Lack of speech
3. Psychomotor
a. Unusual movements or gestures
v. What are delusions and what are the different types of delusions? 1. False beliefs
a. Bizarre
i. Abducted by aliens
b. Nonbizarre
i. Person on TV is talking about you
c. Delusions of persecution
i. Plotted against
ii. Under surveillance
d. Delusions of grandeur
i. Thinking you’re the Mosiah
e. Delusions of reference
i. Event specific to you
f. Delusions of control
i. Someone putting thoughts in your head
vi. What are hallucinations and what are the different types? 1. Experiencing sensory events without input of the environment
a. Auditory
i. Sounds and voices
b. Visual
i. Vague perceptions
c. Olfactory
i. Odors
d. Gustatory
i. Food or drink tasting weird
e. Somatic
i. Feeling that something is happening inside the body
such as pregnancy, broken bones, on fire
f. Tactical
i. Perceptions of burning
2. What area of the brain is active during hallucinations?
a. Boca’s area
vii. What are the types of disorganized thought and speech? 1. Loose association
a. “the next day when I’d be going out you know, I took
control...”
2. Neologisms
a. Made up words that typically have meaning only to the
person using them
3. Preservation
a. Repeat words over and over
4. Clang associations
a. Rhymes
5. Echolalia
a. Repeating another person’s vocalizations
6. Word Salad
a. “Why do people comb their hair?
i. “because it makes a twirl in life, my box is broken
help me blue elephant. Isn’t the lettuce brave?”
viii. What are the four negative symptoms of schizophrenia? 1. Avolition
a. Ability to initiate and persist activities
2. Alogia
a. Relative absence of speech
3. Anhedonia
a. Lack of pleasure
4. Affective flattening
a. Don’t show emotions, stare vacantly, flat tone of speech ix. What are the psychomotor symptoms of schizophrenia? 1. Disorganized behavior
a. Wide variety of bizarre or disrupted behavioral patterns
i. Catatonia
1. Motor dysfunction ranging from wild
agitation to immobility
ii. Waxy flexibility
iii. Moving fingers or arms in stereotypical way
x. What are the phases?
1. Prodromal
2. Active
3. Residual
xi. What are the subtle signs that can be detected in childhood? 1. Home videos from the childhood of people with schizophrenia a. Walker and Levine 1990
b. Strange behaviors
xii. Genetics
1. Is there a genetic component?
a. Identical twins 48% chance
b. Fraternal twins 17%
c. Whole genome study
i. 128 genes identified
ii. some involved in dopamine neurotransmission
2. What is synaptic pruning?
a. Getting rid of excess neurons to strengthen existing
connections
xiii. Neurotransmitters
1. Which neurotransmitter is commonly associated with
schizophrenia?
a. Dopamine
2. What is the evidence for and against this hypothesis?
a. For
i. Antipsychotic drugs that reduce hallucinations and
delusions partly block dopamine
ii. Parkinson’s disease is caused by not enough
dopamine
1. Drugs used to treat Parkinson’s cause
schizophrenia
2. Vice versa
iii. Amphetamines active dopamine when patients with
schizophrenia use amphetamines it makes their
symptoms worse
b. Against
i. Many people not helped by antipsychotics
ii. Never antipsychotics only weakly block dopamine,
but are still effective
iii. Other neurotransmitters at play
1. Glutamate
xiv. Brain
1. What parts of the brain are abnormal in size in schizophrenia? a. Larger lateral ventricles
2. What do enlarged ventricles reflect?
a. A biological factor in predicting schizophrenia
xv. Environmental factors
1. What prenatal factors are associated with increased risk for schizophrenia?
a. Viruses such as the flu due to hormones or stress
2. Which trimester in pregnancy appears to be the most important? a. 3rd
xvi. Treatment
1. What types of medication are used to treat schizophrenia? a. Antipsychotics
i. Older
ii. Newer
2. What are the side effects?
a. Older
i. Parkinson’s like tremors
ii. Tardive dyskinesia
b. Newer
i. Fewer
3. What is transcranial magnetic stimulation?
a. A noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve
symptoms of depression.