Psychopathology Final Exam

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Eating Disorders

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characterized by a persistent disturbance in eating behavior.

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Anorexia Nervosa

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intense fear of gaining weight or becoming fat, combined with behaviors that result in a significantly low body weight.

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Diagnostic Criteria for Anorexia Nervosa

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-restriction of energy intake relative to requirements, leading to a significantly low body weight.
-intense fear of gaining weight or becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
-disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.

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Typical Characteristics for Anorexia Nervosa

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-restricting type- effort is made to limit the quantity of food consumed
-binge eating/ purging type- binge, purge, or both.
-comorbid with OCD, PDs.

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Bulimia Nervosa

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characterized by uncontrollable binge eating and efforts to prevent resulting weight gain by using inappropriate behaviors such as self-induced vomiting and excessive exercise.

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Diagnostic Criteria for Bulimia Nervosa

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-recurrent episodes of binge eating
-recurrent compensatory behaviors in order to prevent weight gain
-occurs at least once a week for 3 months

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Typical Characteristics of Eating Disorders

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-prevalent in teens to young adults.
-occur primarily in women
- binge eating disorder- 2% prevalence
-less than 1% for other disorders

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Binge Eating Disorder

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after a binge, the person does not engage in any form of compensatory behavior. associated with being overweight or obese. likely have over valued ideas about the importance of weight and shape.

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Etiology of Eating Disorders

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-cultural- being exposed to cultural attitudes that emphasize thinness.
-biological- runs in families; chromosomes 1 & 10 linked to susceptibility of disorders

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Treatment of Eating Disorders

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-antidepressants (not proven to be effective).
-family therapy
-cbt- modifying distorted beliefs

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The Problem of Obesity

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-excessive, chronic fat storage
-1/3 of US adults
-high cholesterol, hypertension, heart disease, diabetes, cancer
-slightly higher in men
-the role of genes
-leptin/grehlin
-stress/comfort food
-treatments (lifestyle mods, meds, gastric bypass)

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Cluster A PDs

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-dispalying unusual behaviors such as distrust, suspiciousness, and social detachment and often come across as odd or eccentric.
-paranoid, schizoid, schizotypal,

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Paranoid Personality Disorder

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-pervasive suspiciousness and distrust of others, leading to numerous interpersonal difficulties. They are blameless and constantly expecting trickery and looking for clues to validate their expectations while disregarding all evidence contrary. Preoccupied with doubts about loyalty of friends and don't confide in others. Are quick to react with anger and sometimes violence.

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Etiology of Paranoid PD

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-psychosocial causal factors include parental neglect or abuse and exposure to violent adults.

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Schizoid PD

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-unable to form social relationships and usually lack much interest in doing so. tend not to have good friends, with the possible exception of a close relative. such people are unable to express their feelings and are seen by others as cold and distant. often lack social skills and are introverts.
-don't take pleasure in many activities
-not emotionally reactive
-appear cold and aloof

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Etiology of Schizoid PD

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-severe impairment in an underlying affiliative system.
-maladaptive underlying schemas that lead them to view themselves as self-sufficient loners and view others as intrusive.

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Schizotypal PD

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-excessively introverted and have pervasive social and interpersonal deficits, but in addition they have cognitive and perceptual distortions, as well as oddities and eccentricities in their communication and behavior.
-highly personalized and superstitious thinking is characteristic
-odd speech, paranoid beliefs, transient psychotic symptoms

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Etiology of Schizotypal PD

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-moderately heritable
-biological associations with schizophrenia

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Cluster B Personality Disorders

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-a tendency to be dramatic, emotional, and erratic.
-histrionic, narcissistic, antisocial, borderline

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Histrionic PD

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-excessive attention-seeking behavior and emotionality. tend to feel unappreciated if they are not the center of attention; their lively, dramatic, and excessively extraverted styles often ensue that they can charm others into attending to them.
-sexually provocative and seductive
-speech is vague and impressionistic
-concerned about the approval of others

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Etiology of Histrionic PD

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-very little research; many believe it is not a valid diagnosis.
-comorbid with borderline, antisocial, and dependent PDs.

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Narcissistic PD

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-show an exaggerated sense of self-importance, a preoccupation with being admired, and a lack of empathy for the feelings of others.
-grandiose- manifested by traits related to aggression, dominance, overestimate abilities of self and underestimate others.
-vulnerable- have very fragile and unstable sense of self-esteem, and for these individuals, arrogance and condescension is merely a facade for intense shame and hypersensitivity to rejection and criticism.

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Etiology of Narcissistic PD

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-grandiose- associated with parental overvaluation
-vulnerable- associated with emotional, physical, and sexual abuse, as well as parenting styles characterized as intrusive, controlling, and cold.

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Antisocial PD

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-continually violate and show disregard for the rights of others through deceitful, aggressive, or antisocial behavior, typically w/o remorse or loyalty to anyone.
-impulsive, irritable, and aggressive, irresponsible behavior
-started at age 15, symptoms of conduct disorder before 15

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Borderline PD

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-show patterns of behavior characterized by impulsivity and instability in interpersonal relationships, self-image, and moods.
-affective instablility manifested by unusually intense emotional responses to environmental triggers, with delayed recovery to a baseline emotional state.
-drastic and rapid shifts of emotion
-fears of abandonment
-self-destructive behaviors; self-mutilation

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Etiology of Borderline PD

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-genetic factors; heritable traits of impulsivity and instability
-regulation of dopamine and serotonin transmission.

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Cluster C Personality Disorders

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-often show anxiety and fearfulness.
-avoidant, dependent, and obsessive-compulsive PDs.

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Avoidant PD

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-show extreme social inhibition and introversion, leading to lifelong patterns of limited social relationships and reluctance to enter into social interactions.
-do not seek other people, but desire affection and are often lonely and bored.
-do not enjoy aloneness
-inability to relate comfortably to others causes acute anxiety and is accompanied by low self-esteem and excessive self-consciousness, which in turn are often associated withe depression.

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Etiology of Avoidant PD

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-emotional abuse, rejection, or humiliation from parents who are not affectionate
-genetic influence

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Dependent PD

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-show an extreme need to be taken care of, which leads to clinging and submissive behavior. Show acute fear at the possibility of separation or sometimes of simply having to be alone because they see themselves as inept.
-usually build lives around others and subordinate their own needs and views to keep these people involved with them.
-often fail to get appropriately angry with others because of a fear of loosing their support.
-tend to remain in abusive relationships.

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Etiology of Dependent PD

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-genetic influence (neuroticism and agreeableness)
-especially prone to the adverse effects of parents who are authoritarian due to genetic influences
-maladaptive schemas about weakness and competence and needing others to survive.

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Obsessive-Compulsive PD

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-perfectionism and excessive concern with maintaining order and control.
-careful attention to rules, order, and schedules.
-careful not to make mistakes
-use time poorly and struggle to see the larger picture
-perfectionism is dysfunctional and results in not always finishing projects.
-devoted to work and have difficulty relaxing or doing things for fun.
-difficulty delegating tasks to others are are quite rigid, stubborn, and cold.

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Etiology of OCPD

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-high levels of conscientiousness

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Treatment of PDs

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-reducing subject distress, changing specific dysfunctional behaviors, and changing whole patterns of behavior or the entire structures of the personality.
-dialetic behavior therapy (borderline)- cbt; encourage patients to accept negative affect w/o engaging in self-destructive or other maladaptive behaviors; decreasing suicidal and self-harming behavior and increasing coping skills. individual & group components.

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Substance Abuse

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generally involves an excessive use of a substance resulting in 1. potentially hazardous behavior such as driving while intoxicated or 2. continued use despite a persistent social, psychological, occupational, or health problem.

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Substance Dependence

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includes more severe forms of substance use disorders and usually involves a marked physiological need for increasing amounts of a substance to achieve the desired effects. dependence in these disorders means that an individual will show tolerance for a drug and/or experience withdrawal symptoms when the drug is unavailable.

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Tolerance

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the need for increased amounts of a substance to achieve the desired effects- results from biochemical changes in the body that affect the rate of metabolism and elimination of the substance from the body.

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Withdrawal

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refers to physical symptoms such as sweating, tremors, and tension that accompany abstinence from the drug.

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Alcohol Use Disorder

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a state, psychic and usually also physical, resulting from taking alcohol, characterized by behavioral and other responses that always include a compulsion to take alcohol on a continuous or periodic basis in order to experience its psychic effects, and sometimes avoid the discomfort of its absence; tolerance may or may not be present.

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Diagnostic Criteria for Alcohol Use Disorder

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-often taken in larger amounts or over a longer period than was intended
-there is a persistent desire or unsuccessful efforts to cut down or control use
-great deal of time spent in activities to obtain, use, or recover from effects
-cravings to use
-recurrent use resulting in failure to fulfill obligations at work, school, or home
-other activities given up or reduced

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Typical Characteristics of Alcohol Use Disorder

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-lifespan shortened by 12 years
-8.9% of population classified with substance dependence or abuse
-more common among men
-comorbid with depression, PDs and eating disorders
-high suicide rates

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Treatment of Alcohol Use Disorder

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-difficult to treat
-medications to block desire to drink by causing vomiting
-group therapy; forced to share situation and face situation and see possibilities for coping
-CBT that imparting knowledge about alcohol, developing coping skills in situations associated with increased risk of alcohol use, modifying conditions and expectancies, acquiring stress-management skills, and providing training in life skills.
-controlled drinking instead of abstinence.

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Paraphilias

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recurrent, intense sexually arousing fantasies, sexual urges, or behaviors that generally involve 1. nonhuman objects, 2. the suffering or humiliation of oneself or one's partner, or 3. children or other nonconsenting persons

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Fetishism

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individual has recurrent, intense sexually arousing fantasies, urges and behaviors involving the use of some inanimate object or a part of the body not typically found erotic to obtain sexual gratification.

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Transvestic Disorder

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-heterosexual men who experience recurrent, intense sexually arousing fantasies, urges or behaviors that involve cross-dressing as a female
-auto-gynephilia- paraphilic sexual arousal by the thought or fantasy of being a woman

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Voyeuristic Disorder

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recurrent, intense sexually arousing fantasies, urges, or behaviors involving observation of unsuspecting females who are undressing or of couples engaging in sexual activity.

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Exhibitionistic Disorder

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recurrent, intense sexually arousing urges, fantasies, or behaviors that involve exposing his genitals to others (usually strangers) in inappropriate circumstances and without their consent. Frequently the element of shock in the victim is highly arousing to these individuals.

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Frotteuristic Disorder

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sexual excitement at rubbing one's genitals against, or touching, the body of a nonconsenting person.

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Sexual Sadism Disorder

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recurrent, intense sexually arousing urges, fantasies, or behaviors that involve inflicting psychological or physical pain on another individual. Themes of dominance, control, and humiliation.

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Sexual Masochism Disorder

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recurrent, intense sexually arousing urges, fantasies, or behaviors involving the act of being humiliated, beaten, bound, or otherwise made to suffer.

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Gender Dysphoria

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discomfort with one's sexual-relevant physical characteristics or with one's assigned gender.

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Rape

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Feminists thought it was motivated by aggression and wanting to dominate and humiliate victim. Research shows it is mostly motivated by sex and attraction to young victims. Many have multiple paraphilias.

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Sociocultural Influences on Sexual Practices and Standards

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-Universal taboos against incest
-degeneracy theory- semen is necessary for physical and sexual vigor in men and for masculine characteristics (shouldn't masturbate).
-ritualized homosexuality in Melanesia- semen is important and young males practice semen exchange until after puberty.
-Homosexuality removed from DSM in the 70s.

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Schizophrenia

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characterized by an array of diverse symptoms, including extreme oddities in perception, thinking, action, sense of self, and manner of relating to others. A significant loss of contact with reality (psychosis).

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Typical Characteristics of Schizophrenia

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-prev. .7%
-higher risk of developing if father was older than 45 at time of birth
-begin in late adolescence and early adulthood

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Delusion

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an erroneous belief that is fixed and firmly held despite clear contradictory evidence. A disturbance in the content of thought.

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Hallucination

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sensory experience that seems real to the person having it, but occurs in the absence of any external perceptual stimulus.

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Positive Symptoms of Schizophrenia

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-reflect an excess or distortion in a normal repertoire of behavior and experience, such as delusions and hallucinations.

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Negative Symptoms of Schizophrenia

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-reflect and absence or deficit of behaviors that are normally present.
-flat-affect (blunted emotional expressiveness)
-alogia (little speech)
-avolition (inability to initiate or persist in goal-directed activities)
-asociality
-apathy
-anhedonia

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Schizoaffective Disorder

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-have features of schizophrenia and severe mood disorder.
-psychotic symptoms and changes in mood

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Schizophreniform Disorder

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schizophrenia-like psychoses that last at least a month but do not last for 6 months and so do not warrant a diagnosis of schizophrenia.

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Etiology of Schizophrenia

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-genetic and heritable
-higher in identical twins than fraternal or ordinary siblings.
-adopted children from mother's with schizophrenia are way more likely to develop than adopted children with no mother with the disorder (no environmental factors).
-growing up in an urban setting increases risk
-cannabis use linked to developing schizophrenia

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Treatment of Schizophrenia

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-antipsychotics (block access of dopamine)
-family therapy (help improve coping and problem solving skills and enhance communication skills).
-CBT (decrease intensity of positive symptoms, reduce relapse, and decrease social disability. Explore nature of delusions and hallucinations compared to reality).