Mood disorders
Depressive, Major depressive, Dysthymic, Depressive disorder NOS, Bipolar, Bipolar I, Bipolar II, Cyclothymic disorder, Bipolar disorder NOS, Substance related, medical or mood disorder NOS are all examples of ______.
5, 2 weeks
Clinical criteria for depression must show at least __ of the following for ____. depressed mood, anhedonia, significant weight loss-5% in 1 month, insomnia or hypersomnia, Increased or decreased motor activity, Anergia-fatigue or loss of energy, Feelings
Anhedonia
not finding pleasure in anything, or don't find pleasure in things that use to bring pleasure
Dysthymic disorder
Periods of depressed mood interspersed with depression. Normally presents with 2 of the clinical criteria symptoms.
Cyclothymic disorders
Ranges from moderate depression to hypomania. And can include periods of normal mood over a 2 year period.
Not as severe.
Beck's scale and Zung's
Self-assessment scales for depression include _________.
SSRI's
What is the number one type drug used for treatment of depression?
SSRI's
_____ act by blocking the reuptake and destruction of Serotonin, Don't block muscarinic and H2 receptors and like the TCA's thus leading to less sedation and anticholinergic effects. Work well on atypical depression and anxiety disorders. Food drug intera
Bipolar I
occurrence of one or more manic and depressive episodes (the worse of the two)
Bipolar II
less severe and consists of one or more hypo-manic and depressive episodes
Rapid cyclers
People with 4 or more episodes within a 12 month period
More resistant to treatment. 70-90% are women
Mania
_____ exhibits as discrete periods of Increased energy, activity, restlessness. Racing thoughts and rapid talking. Excessive euphoric feelings. Extreme irritability and distractibility. Decreased need for sleep psychiatrist. Uncharacteristically poor judg
Grandiose
absurdly exaggerated
Lithium
number one medication for someone in manic phase is ____.
Depakote
______ works well with rapid cyclers. Decreases aggression (weight gain) increases Gaba.
OCD Criteria
A. an anxiety disorder involving obsessions and compulsions that are time consuming, cause marked distress, or interfere with social or occupational functioning
B. At some point during the course of the disorder, the person has recognized that the obsessi
Obsessions
-persistent thoughts, impulses, or images that are experienced as intrusive, inappropriate and distressing
-not simply excessive worries about real life problems
-attempts to ignore or suppress the obsessions
-the person recognizes that the obsessions are
what are 4 common obsessions?
1)contamination - dirt, germs, bodily waste, chemicals
2)mistakes - locks, appliances, paperwork, decisions
3)impulses - violent, sexual, religious, embarrassing
4)order - neatness, symmetry, numbers
Compulsions
-repetitive behaviors (e.g., handwashing) or mental acts (e.g., praying silently) that the person feels driven to perform in response to an obsession or according to rigid rules
-aimed at reducing distress or preventing a dreaded situation: the compulsion
theories and Treatments of OCD
-Cognitive-behavioral theories = cognitive and behavioral treatment techniques
-Biological theories = serotonergic medication
----medical treatment
-widely used
-Serotonergic drugs
Learning Theory View of OCD
Obsessions give rise to anxiety or distress
Compulsions reduce obsessional anxiety
Compulsions are negatively reinforced by the brief reduction of anxiety they engender
The performance of compulsions prevents the extinction of obsessional anxiety
Behavioral Therapy for OCD Includes
Procedures that evoke obsessional anxiety
Exposure to obsessional cues (floors, driving)
Procedures that eliminate the contingency between performing compulsions and anxiety reduction
Response prevention (refrain from washing or checking rituals)
Cognitive View of OCD
Intrusive unpleasant thoughts are normal
Obsessions develop if thoughts are misappraised as highly significant
e.g., Thoughts = actions
Misappraisal increases anxiety and gives rise to neutralizing responses
Thought suppression, compulsions, neutralizatio
Cognitive Therapy for OCD Includes:
Psychoeducation about the normalcy of intrusive unpleasant thoughts
Cognitive restructuring aimed at reducing misappraisals of thoughts
Behavioral experiments
Refraining from safety behaviors (rituals
The Treatment of Fear (as OCD)
Exposure to fear-eliciting stimuli or situations
Prevention of avoidant behaviors
Anxiety increases initially, followed by habituation
exposure Procedures
1)Assessment of obsessional triggers
2)Discuss rationale for exposure
3)Develop fear hierarchy
4)Systematic prolonged and repeated confrontation
freefloating anxiety
term used to describe the type of anxiety present in GAD, because the individual is plagued by excessive anxiety under most circumstances and about anything
Generalized Anxiety Disorder
characterized by excessive anxiety under most circumstances and worry about practically anything
Symptoms of GAD
feeling restless, "keyed up," or on edge; fatigue; trouble concentrating; muscle tension; difficulty sleeping. In order for a diagnosis to be warranted, symptoms must have been present for at least 6 months
types of phobias
* animal
* natural environment
* blood- injection- injury
* situational
specific phobia
- Marked as persistent fear
* clearly connected to discernible objects or situations
- exposure causes marked anxiety response (panic attack)
- stimulus is avoided
- or endured
- creates pattern of
* avoidance
* fear/ anxious anticipation
women specific phobias
more predominate;
* 75- 90% animal/ natural environment
* 55- 70& height, blood/injection
* 75- 90% situational
familial patterens specific phobia
- aggregate w/in families by type
- especially blood and injury
Posttraumatic Stress Disorder
exposure to a major threat - may or may not be actually life-threatening
neglect in childhood also causes it
fight or flight or freeze response results in changes in the arousal system, with spontaneous hyperarousal afterwards
following trauma, this chang
PTSD - the 3 symptom clusters
1. Hyperarousal - panic, anxiety, nightmares, sleep disturbance, rage
2. Intrusion symptoms: flashbacks, preoccupation with memories, association of past with present
3. Blunting: lack of pleasure, decreased range of activities, impoverished relationships
PTSD therapy goals
Therapy is to stabilize current life, learn about the disorder, break the silence, rework the shameful cognitions, rework relations with others.
Panic disorder
a panic attack is often indistinguishable from a heart attack except that tests reveal no illness to the heart
other features may include fear of going crazy or losing control; frequent ER visits until shamed out of going again
Panic D/o: Cause?
the vulnerability to it is largely genetic
life stressors may be related to onset, or may be absent
after successful treatment it may recur later at times of stress, depression, or withdrawal from ETOH / benzos
treatment of panic disorder
two different approaches are of equal effectiveness:
1. cognitive-behavioral therapy, specialized to PD, with regular practice
2. medication regimen, which may be either:
a) all minor tranquilizer (Xanax and Klonopin) or,
b) benzo to start, transition slo
agoraphobia
medications are ineffective for treatment of agoraphobia
this includes benzos
the only treatment with positive results is cognitive-behavioral
it takes lots of time/practice, and relief is often partial only
prevention is the best treatment
the initial goal in treating Panic d/o is....
... is elimination of all panic attacks; this may require heavier benzo use than the consumer wants, at first
Childhood disorders
_____ include Depressive disorders, Anxiety disorders, Behavior disorders, Attention Deficit/hyperactivity, Conduct disorders, Tourette's disorder, Pervasive development disorders, Autistic, Asperger's, Rett's
Oppositional deficit disorder
recurrent pattern of disobedience and hostile behavior toward authority
Conduct disorder
persistent pattern of aggressive and destructive behavior with disregard for the rights of others and the norms of society
ADHD
Behavioral characteristics for _____ , Hyperactivity, Impulsivity-speak before they think, Obsessions, Compulsions, Inflexible, Affective, Labile mood, Jekyll and Hyde behavior, Explosive rage
Ritalin
Use of stimulants for ADHD Most common is ____, a=other drugs include Dexedrine, Cylert, Adderall, Provigil, Concerta.
Oppositional defiant disorder
Children with ______ are disruptive, argumentative, hostile, irritable, persistent stubbornness
Conduct disorder
May exhibit aggression towards people or animals, be bullies, Initiates fights, has used a weapon, has been physically cruel to others, has stolen, has forced sex on another.
Tourette's disorder
Vocal and motor tics, Starts between 5-9 years of age. More frequent in males. Vocal-coprolalia-involuntary use of obscene words.
Pervasive developmental disorders(PDD)
Asperger's disorder, disintegrative disorder, Autistic disorder, Rett' disorder
Asperger's disorder
people with _____ have Normal IQ, Obsessive, Rich vocabulary, Have an abrupt and awkward approach, Eye contact difficult, Severe and sustained social impairment
Autistic disorder
People with _____ have Impairment in communication and imaginative activity, Impairment in social situations-lack of friendships, Markedly restricted stereotypical patterns of behavior interest and activities. Routines and rituals, Motor mannering (clappi
Rett' disorder
Only in females. Onset prior to 4 years of age. Loss of acquired hand skills. Problems with coordination and gait. Severe psychomotor retardation. Severe problems with expressive and receptive language. Loss of interest in social interactions.
Disintegrative disorder
More common in males, Onset is between 2 and 10, Marked aggression in multiple areas of function, Loss of previously acquired skills in 2 areas, Communication deficits, Stereotypical behaviors like in autism
PTSD
when providing treatment of _____ you must be consistent for it to work. Therapies include Multidisciplinary, Work with schools, Family therapy, Parent training in behavioral techniques, Social skills, Group in the form of play, Behavior modification. Cog