COMPLETE Abnormal Psychology Notes: Part 1 (got 92% in the course)

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Boston University
Psychological & Brain Sciences
CAS PS 371

Diagnostic  Criteria   Distinguishing  Features   Associated  Features   Prevalence   Course   Treatment   • Bulimia  Nervosa   • Patients  are  often  within  10%   • Loss  of  dental  enamel   • 1  to  1.5%  among   • Begins  adolescence,   • Aims:  eliminate  binge-­‐ • Binge  eating-­‐  more  than  normal,   normal  weight.     • Salivary  gland  enlargement   adolescent  females.   early  adult   purge  cycle,  establish   out  of  control.   • High  calorie  foods  consumed  in   • Electrolyte  imbalance   • >6%  college  females   • Follows  intense  dieting   good  eating  habits,  and   • Recurrent  inappropriate   huge  amounts.     • Abnormal  menstrual  cycle   • Females>males   • Chronic  or  intermittent   eliminate  underlying   compensatory  behavior-­‐  purging   • Before  binge:  powerlessness   • Anxiety   • Whites>others     causes.     (vomiting,  laxatives)  or  non-­‐ • During  binge:  pleasure   • Depression   • Anti-­‐depressants-­‐  reduce   purging  (fasting)   binge  eating  and   • After  binge:  guilt,  self-­‐blame   • Mood  swings   • Self-­‐image  shaped  by  perception   • Bingeing-­‐Purging  cycle   • Substance  abuse   purging,  but  no  lasting   of  weight,  shape.   effects.   • Symptoms  occur  at  least  once  a   • Cognitive  Behavioral  and   week  for  at  least  3  months.         Interpersonal  Therapies.     Patients   • Increase  control,  change   cognition,  exposure  and   response  prevention.   • Significant  improvement   in  40%  of  cases.     • 10  years  after   treatment-­‐  75%  recover.   • Relapse  triggered  by   stress  and  could  happen   to  those  who  had  history   of  symptoms,  substance   abuse  or  interpersonal   problems.     • Anorexia  Nervosa   • Two  subtypes:  restricting  and   • Amenorrhea-­‐  absence  of   • Approximately  0.4%   • Mean  onset  around  17.     • Aims:  regain  lost  weight,   • Refuse  to  maintain  weight  above   binge  eating/purging.     period  in  newly  menstruating   among  young  females   • Associated  with   recover  from   minimum.   • Weight  is  less  than  25 -­‐30%  of   women.   • Females>males     stressful  life  event.   malnourishment,  eat   normal   • Dry  skin,  brittle  hair  and  nails.   normally   • Intense  fear  of  gaining  weight.   2 • Increase  rates  in  recent   • Variable  course   • Disturbed  body  perception-­‐   • Severity:  mild  (>17  kg/m )  to   • Sensitivity  to  cold.   decades.     • Nearly  10%  hospitalized   • Family  therapy  (early),   denial  of  seriousness  of  low   severe  (<15  kg/m ).     • Low  blood  pressure   die.     CBT  and  IPT  (late)   weight.   • Electrolyte  imbalance   • Likelihood  decreases   • Self-­‐monitoring  and   • Concentration/memory   with  age.     altering  intake.   problems   • Examine  and  challenge   • Irritability   beliefs.     • Depressed  mood   • 65-­‐70%  have  good   • OC  features  and  impulse   outcome.   problems   • Relapse  is  about  50%.   3+  of  following  symptoms:   • Marked  distress           • Eating  more  rapidly  than  normal.   • Symptoms  occur  at  least  once  a   • Eating  until  uncomfortably  full.   week  for  at  least  3  months.         • Eating  a  lot  when  not  hungry.   • No  compensatory  behavior.   • Eating  alone  because   • Severity  is  in  frequency.   embarrassed.   • Feel  disgusted  by  self,  guilty,   depressed.   Biological   Social   Psychological   Cultural   Gender   • No  causal  factor  identified   • Image  and  competition-­‐  desire  to   • No  causal  factor  established   • White  people  at  greater  risk.   • Relatively  higher  rate  among  gay   • 25%  concordance  for  identical   look  one’s  best  and  remain   • Diminished  self-­‐esteem,  self   • Immigrants-­‐  acculturation   men.     twins.   competitive.   control  and  self-­‐confidence     • Men  more  reluctant  to   seek   • 9%  for  fraternal   • Increase  emphasis  on   • Distortions  in  perceived  body   treatment   • Non-­‐specific  risk   diet/exercise  vs.  increase  obesity   image.       rates   • Binge  eating-­‐  low  serotonin   • Dieting  could  be  predictor  of  ED.   • Media  influence     Similarities   Differences   • Begin  after  period  of  dieting.   • Bulimia  patients:   • Fear  of  becoming  obese.   o More  concerned  with  pleasing  others  and  having  intimate  relationships.   • Drive  to  become  thin.   o More  sexually  active   • Preoccupation  with  weight  and  appearance.   o Histories  of  mood  swings,  frustration,  poor  coping   • Distorted  body  perception   o 1/3  display  characteristics  of  personality  disorders  (borderline)   • Feelings  of  anxiety,  depression,  obsessiveness  and  perfectionism.   o ½  of  women  experience  amenorrhea  compared  to  anorexia   o Damage  from  purging   • Risk  of  suicide   • Substance  abuse   • Disturbed  attitudes  towards  eating.     Chapter  12-­‐  Substance  Related  Disorders     • Drug-­‐  any  substance  other  than  food  that  affects  our  body  and  mind.  Substance  used  to  include  alcohol,  tobacco  and  caffeine.     • Substances  may  cause:   o Temporary  changes  in  behavior,  emotion,  and  thought.     o Intoxication-­‐  state  of  poor  judgment,  irritability,  slurred  speech,  mood  swings  and  poor  coordination.     • Unlike  DSM-­‐IV  conditions:   o Dependent  on  some  external  agent.   o Almost  always  involve  a  willing  host.     o Previously  viewed  as  sociopathy  à  in  introduced  as  separate  diagnostic  category  in  DSM  III  (1980)   o WHO  focuses  on  dependence  syndrome  concept-­‐  central  characteristic  of  desire/drive  to  use.     • Basic  Diagnosis:   o Emphasize  patient’s  distress/disability   o Impaired  control  over  use   o Social  impairment  continues  despite  consequences   o Risky  patterns  of  use   o Physical  or  emotional  adaptation   • Long-­‐term  problems:   o Substance  Use  Disorder  (all  but  caffeine)-­‐  need  more  than  two  symptoms:   § Behavior  where  reliance  on  drugs  is  excessive  and  chronic.   § Damages  relationships     § Affects  work  functioning   § Puts  self/others  in  danger   § Tolerance  and  withdrawal   § Time  spent  obtaining/using/recovering  is  high   o Dependence  (addiction):  centers  life  around  it   § Tolerance:  increase  dosage  to  feel  effects   o Withdrawal:  unpleasant  or  dangerous  symptoms  when  drug  intake  stops.     • Associative  Problems   o Males>females  in  terms  of  earlier  and  greater  quantities   o Inverse  correlation  with  education,  employment   o Alcohol  and  sedatives  could  lead  to:   § Withdrawal  delirium   o Lower  rates  for  most  drugs  since  1990s.     § Neurocognitive  disorder  (inhalants)   o New  England,  Pacific>  other  regions   § Sexual  dysfunction  (opiates,  stimulants)   o Urban>rural   o Most  cause:   o High:  Native  Americans,  Alaskans/Low:  Asians   § Psychotic  disorders   • Ranking   § Mood  disorders  (NO:  caffeine,  nicotine,  PCP)   o Tobacco/Nicotine:  >50  million  (dependence  is  25%)   § Anxiety  disorders  (NO  PCP)   o Alcohol:  >10  million  binge  drink  (>5  drinks  at  once)  at  least   • Prevalence   once  a  week  (dependence  is  14%)   o 25%  experience  significant  problems-­‐  mostly  involving  legal   o Marijuana:  >10  million  (dependence  is  4%)   substances.   o Psychotherapeutic  drugs:  >3  million   o First  time:  adolescence/first  substances:  alcohol  and  nicotine   o Cocaine:  >1.5  million  (dependence  is  3%) o Peak  at  18-­‐20  years  old   • Biological  effects   o Lipid  solubility   o Breech  blood-­‐brain  barrier   o
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