1
Q
What was stated in the film clip on “teens & eating disorders”?
A
- trauma can cause disorders
- weight loss led to hospitalization for person in video
- recovery takes a long time and specialized care is needed
- many trauma’s can also lead to eating disorders
2
Q
What is the core issue with eating disorders?
A
- morbid fear of weight gain
3
Q
What are the 3 kinds of eating disorders?
A
- Anorexia
- Bulimia
- Binge eating disorders
4
Q
What are the diagnostic criteria’s for anorexia nervosa?
A
- “rexia” means without desire for food
- person refuses to maintain 85% of normal body weight (thinness is the goal)
- intense fears of becoming overweight
- distorted view of their body weight and shape (meaning they still see themselves as overweight no matter how thin they are)
- are very preoccupied with food (think about food but they refuse to eat)
- can experience amenorrhea (meaning an absence of ones period - at least one cycle missed since the body shuts down)
5
Q
What are the 2 subtypes of anorexia nervosa and their characteristics?
A
- RESTRICTING TYPES : cutting out/restricting “bad foods” first then they cut out all foods. They control food intake in order to cope.
- BINGE-EATING/PURGING TYPE: engage in compensatory behaviours in order to loose weight.. They may binge and want to control food intake and can’t control impulses
6
Q
What is the Minnesota starvation study (1940)? What were the results?
A
- 36 young men
- did a 12 week control period followed by 12 weeks of calorie restriction
RESULTS: - became preoccupied with food
- had urges to overeat when they didn’t have access to food
- enjoyed & prolonged time when had access to food
- had mood swings
- developed a distorted self-image but didn’t see themselves as overweight - instead they say others as overweight
7
Q
What are the medical problems associated with anorexia nervosa
A
- amhenorrea
- low body temperature
- low BP
- body welling
- reduced bone density
- decreased heart rate
- metabolic and electrolyte imbalance
- dry skin and brittle nails
- poor circulation
- lanuogo - fine and downy hair
8
Q
What are the diagnostic criteria’s of bulimia nervosa?
A
- periods of uncontrolled overeating during a limited period of time
- followed by compensatory behaviours like:
- forced vomiting (purging)
- excessive exercise
- fasting
9
Q
What are binges and the consequences the person feels after?
A
- overeating that’s uncontrolled in a limited period of time
- often caused by stress
- often followed by feelings of tension and/or powerlessness
- extreme self-blame
- guilt
- depression
- fear of weight gain and being discovered leading to compensatory behaviours
10
Q
What are the medical complications of bulimia?
A
- decay of tooth enamel
- abdominal pain
- stress on internal organs
- cavities
- dependence on laxatives
- no period
11
Q
What are the psychodynamic causes of eating disorders?
A
- disturbed mother-child interactions like care or comfort
- leads to ego deficiencies
- leads to not knowing how to fulfill own needs regarding food
12
Q
What are the cognitive causes for eating disorders?
A
- maladaptive attitudes about self image or body image/weight
- all or nothing (black or white thinking) regarding self
13
Q
What are the behavioural causes of eating disorders?
A
- rewarded by seeing weight loss which relieves anxiety
- operant conditioning
14
Q
What are some possible biological causes of eating disorders?
A
- genetic predisposition to develop and eating disorder
- relatives are 6x more likely to develop and ED
- SEROTONIN - it regulates mood and appetite
- decreased serotonin levels found in those with anorexia
- decreased levels of serotonin can lead to binges
- hypothalamus dysfunction (called SETPOINT THEORY)
15
Q
What are the societal pressures leading to eating disorders?
A
- standards of female attractiveness
- societally-accepted prejudice against being over-weight
16
Q
What are the sociocultural pressures leading to eating disorders?
A
- role of the media
- more men. Tends to be JOB-LINKED such as sports
- called REVERSE ANOREXIA - pressure or preoccupation with muscles and strength
17
Q
What are the familial pressures associated with eating disorders?
A
- communication patters called ENMESHMENT
- meaning wanting to be like parents as much as possible due to their attachment
18
Q
What are the multicultural factors for eating disorders?
A
- studies in 1995 showed boys dissatisfaction being more common in White women comparents to Black women
- BUT: eating disorders are increasing in minority groups
19
Q
What are the 2 steps for treating anorexia nervosa? Explain the 1 problem
A
- Restoring proper weight and eating
- may need to be hospitalized
- most common techniques are supportive nursing care + high calorie diets- necessary weight gain is often achieved in 8-12 weeks
- Therapy
BUT: 20% of clients struggle for years/ dont recover or it reappears/recurs with stress triggers
20
Q
List and explain the 3 types of therapies used for treating anorexia nervosa
A
- Behavioural
- monitor feelings, hunger, and eating behaviours
- look for possible links - Cognitive
- build autonomy and self-awareness about bad/maladaptive thoughts regarding food
- have them recognize their need for control
- correct contributing cognitive distortions - Family therapy
- focuses on separation and boundaries
21
Q
What are the 4 treatment steps for bulimia
A
- Eliminate binge-purging patterns
- Eliminate underlying causes
- Educate the client
- Therapy
22
Q
What are the 7 therapies for bulimia
A
- Behavioural
- Cognitive
- Interpersonal treatment (IPT)
- Psychodynamic therapy
- Family therapy
- Group therapy
- Self-help groups or self-care books
23
Q
What is done in behavioural therapy for bulimia?
A
- diaries
- exposure and response prevention
24
Q
What is done in cognitive therapy for bulimia?
A
- change maladaptive attitudes
- challenge the negative thoughts that trigger binges
25
What is done in interpersonal treatment for bulimia?
- if they have better relationships or more social supports will decrease stress
26
What are the 4 areas of interpersonal treatment (IPT)
1. Role disputes - conflicts, difficulties with forgiveness
2. Role transitions - when there’s big changes in life and client has difficulty transitioning
3. Unresolved grief - death that’s not resolves, changes in life or losing friends/family and the grief is unresolved affecting the person
4. Interpersonal deficits - isolation, social deficits
27
what are the 3 phases for interpersonal treatments
1. Looking at past conflicts
2. Learning and implementing strategies
3. Reviewing what’s been done
28
Explain why antidepressants would be used for treating bulimia.
- SSRI’s used since it could be due to low serotonin levels
- helps with 25-40% of patients
- works best with psychotherapy
29
What was said i the film clip “the downside of high”
- brain scans shows links between marijuana and schizophrenia
- Majorie Wallace was the first person to guess there’s a link between marijuana and schizophrenia
- heavy smokers at age of 18 are 6x more likely to get schizophrenia
- smoking can double changes of symptoms of clinical psychosis
- smoking at age of 16 increases chance of schizophrenia by 4x
- bipolar can also be triggered by smoking
- weed is the most used drug
- cocaine, crystal meth, and environment can increases risks of schizophrenia
- marijuana increases dopamine which can disregulate the brain
- more likely to develop schizophrenia when smoking if you have the COMT gene since it regulates dopamine
- before the plants produced a balanced amount of THC and CBD
- now the plants have been modified to create lots of THC and less if the ‘protective’ CBD
- this can lead to psychosis and other mental disorders
30
What are the effects of drugs?
- it alters the body and the mind
31
What is stated in the DSM-5 (diagnostic criteria) for substance use disorder?
- pattern of maladaptive behaviours and reactions from repeated use of substances
Causes:
- physical dependence
- develops a tolerance
- withdrawal reactions : opposite of what drugs do
32
What is the prevalence of substance use disorder?
Alcohol:
- rewarding so people keep using it
- Canadian alcohol drug survey: ages 20-24 are most likely to use alcohol in excessive amounts and report harm due to it
Cannabis:
- use increased by 15% (2017) to 21% (2021) - medical and non-medical usage
- men use cannabis more than women (men 23%, women 19%)
33
What are the 5 types of drugs?
1. Depressants
2. Stimulants
3. Hallucinogens
4. Opioids
5. Other drugs
34
What are depressants?
- decreases neural firing
- slows activity in the central nervous system (brain and the spinal cord)
35
What are some examples of depressants?
- alcohol
- opioids
- benzodiazepines
36
What does alcohols do to the body?
- alcohol increases GABA
- cases motor difficulties
37
What are some negative effects or consequences of alcohol?
- women are more likely
- societal, and physical health consequences
- liver sorosis
- KORSAKOFF - memory gaps
- FAS (fetal alcohol syndrome) - when the mom drinks during pregnancy leading to: deformities, death, or slows the system/ causes withdrawal
38
What are stimulants/what do they do to the body?
- activates neural firing
- increases activity in the central nervous system
- increases dopamine causing the ‘rush’
- affects norepinephrine and serotonin
39
What are some examples of stimulants?
- cocaine
- caffeine
- nicotine
40
What are some negatives or consequences of stimulants?
- mania
- paranoia
- withdrawal symptoms
- death
- bleeding in brain
- overdose
- seizures
41
What are the effects of hallucinogens on the body?
- causes sensory changes in the body
42
What are some examples of hallucinogens?
- cannabis
- ecstasy
- LSD
43
Explain some factors of cannabis
- can be a depressant and a stimulant?
- high in THC
- comes in many forms
44
What are some negatives or consequences of hallucinogens?
- memory issues
- anxiety
- paranoia
- accidents (for example when driving)
- affects fertility
45
What are the socioeconomic views o causes of substance abuse?
- stressful socioeconomic conditions/low socioeconomic status can lead to substance use
- develops in families or environments where substance use is values or accepted
46
What are the psychodynamic views on the causes of substance abuse?
- lack of parental nurturing leads to the development of a addictive personality
- the ID is too powerful
- self medicates as a result of unpleasant sensations, feelings or emotional pain
47
What are the cognitive-behavioural views on the causes of substance abuse?
- OPERAT CONDITIONING: drugs can reduce tension which can be rewarding. There’s an expectation that doing drugs/self-medicating can be rewarding.
- CLASSICAL CONDITIONING: conditioned stimulus (CS) is present during drug taking which can produce cravings
Initial exposure to drug: NS (environmental stimuli associated with drug use) — US (drug effects on brain) — UR (compensatory reactions to drug)
Subsequent reactions: CS (environmental stimuli associated with drug use) — CR (compensatory reactions to drug)
48
What are the biological views on the causes of substance abuse?
- GENETIC PREDISPOSITION: verified through research with animals, twin studies, & adoption studies
- ABNORMAL DOPAMINE (D2) RECEPTORS
- BIOCHEMISTRY: drugs activate pleasure pathway in the brain
- medial forebrain bundle
- dopamine is key
49
What is the incentive-sensation theory?
- biological theory of substance abuse where after chronic use of drugs/alcohol, reward pathway becomes hypersensitive to them (nothing else seems attractive or rewarding except drugs)
50
What is the reward-deficiency syndrome theory?
- biological theory where the reward pathway isn’t responding normally to “normal” pleasurable activities. They then compensate with drugs/alcohol use especially when stressed. Due to dopamine D2 receptors are abnormal
51
What are the psychodynamic treatments for substance abuse? List problems with it.
- view is that it is due to unconscious needs and conflicts leading to drug use
- free-association and bringing back up negative experiences
- problem is it is not well supported by research
- its possibly harmful since bringing back up negative memories causes stress which leads to self-medication
52
What are the behavioural treatments for substance abuse?
1. AVERSION THERAPY: based on principles of classical conditioning. Most commonly used for alcoholism since they are given a bit of alcohol mixed with something that will make the person sick given so a negative association is made.
2. COVERT SENSITIZATION: imagine something bad occurring while/after drinking (ex: car accident) so a negative association is made.
3. CONTINGENCY MANAGEMENT THERAPY: rewards are given to person when urine tests are passed. Mainly for cocaine use.
53
What is the cognitive treatment for substance abuse?
Main goal is to identify and change patterns/thoughts that are contributing to substance misuse.
- RELAPSE-PREVENTION TRAINING: gaining control over the substance related behaviours. Teaches person to intervene at each step and seek safe behaviours as well as remind self of negative past experiences.
54
What are the 5 steps in the process of relapse?
1. Activating stimuli (stress)
2. Drinking thinking
3. Facilitating beliefs
4. Fantasizing or planning to use
5. Taking action (relapsing)
55
What are the 5 steps in preventing relapses?
1. Seek safe situations
2. Control drinking thoughts
3. Control beliefs
4. Deny permission
5. Take an alternative action (resist relapsing)
56
What are the biological treatments for substance abuse? (3)
1. DRUG WITHDRAWAL AND DETOX: antidepressants or benzodiazepines used to avoid dangerous withdrawal symptoms and/or depression caused by withdrawal
2. ALCOHOL ADDICTION MEDICATION:
- naltrexone (vivitol): blocks the effects of alcohol and decreases cravings
- disulfiram (Antabuse): if you drink, it causes nausea and vomiting which makes the person not want it
3. HEROIN/OPIATE ADDICTION MEDICATIONS:
- methadone & buprenorphine: decreases cravings and withdrawal symptoms.
- methadone can be problematic since it can lead to addiction since its an opiate
- naltrexone: same as alcohol addiction med. treatment also used
57
What is the sociocultural treatment for alcohol abuse? List some problems with it.
- ALCOHOLICS ANONYMOUS (AA): most commonly used/known treatment. It’s a more self-directed social treatment where the participants help one another stay sober.
PROBLEMS:
- abstinence is crucial to the program and the question of if abstinence is really realistic come up for users.
- some research says it may worsen the matter
- ex: in a study, those in the AA group had more drop outs compared to the control group and biological treatment group.
- can lead to binge-drinking
-ex: in the study those in AA were 5x more likely to binge-drink
- AA has a religious/spiritual component where trust is put in higher power and if relapse occurs it can make person feel like they were failed by higher power which can worse substance abuse
58
What are behavioural addictions?
- when a person is addicted to a behaviour or the feeling it produces. Has very similar features to drug/alcohol abuse like:
- preoccupation with behaviour
- worsened by stress
- also go through withdrawal if behaviour isn’t possible (shown through anxiety and depression instead however)
59
What are some examples of behavioural addictions?
- gambling
- shopping
- overeating
- sex
- television or internet
60
What is personality?
Unique and long-term pattern a person has which has to be consistent in most situations. For people with healthy personalities, it is flexible meaning it can adapt to new/different environments
61
What is a personality disorder?
An inflexible and rigid pattern a person has. It is seen in most social interactions and affects the person emotionally and their relationships
62
What are the 3 clusters of personality disorders? List the disorders that fit into each cluster.
CLUSTER A (odd cluster)
- paranoid PD
- schizoid PD
- schizotypal PD
CLUSTER B (dramatic cluster)
- antisocial PD
- borderline PD
- histrionic PD
- narcissistic PD
CLUSTER C (anxious/fearful cluster)
- avoidant PD
- dependent PD
- obsessive-compulsive PD
63
What are the characteristics of cluster A personality disorders?
- displays behaviours which are similar to but to as extensive as schizophrenia
- rarely seek treatment due to lots of isolation and distrust in others
64
What are the characteristics of paranoid PD?
- deep distrust and suspicion of others that aren’t accurate
- causes issues with others
- usually not “delusional” meaning out of touch with reality but, believe others are out to get them
65
What are the characteristics of schizoid PD?
- avoids social relationships
- have very limited emotional expression
- tend to want to be aloe
- less than 1% of the population
- more men than women wome
66
What are the characteristics of schizotypal PD?
- extreme discomfort in relationships
- odd or bizarre ways of thinking/acting
- bodily illusions
- ideas of reference (ex: thinking people are laughing at you)
- poor ability to focus their attention (concentration)
- tend to jump from one idea to another during conversations
- may be hard to function in day to day life
- 2-4% of population
- more men than women
67
What is the psychodynamic cause of cluster A PD’s?
- demanding, rejecting or abusive parents
68
What is the cognitive cause of cluster A disorders?
- disorders/deficiencies in thinking (cognitive distortions) leading to personality disorders
69
what are the possible biological cause of cluster A disorders?
- unsure but it could be genetic causes
- suggests its similar to the biological causes of schizophrenia
70
What are some issues with treating cluster A personality disorders?
- often are forced into therapy by family and they dont see themselves as needing help
- have distrust in therapists leading to rebellion
- can take years
71
What are the psychodynamic treatments for cluster A personality disorders?
- have them work towards having satisfying relationships with others
72
What are the cognitive treatments for cluster A disorders?
- evaluate emotions, perceptions and maladaptive thinking
73
What are the behavioural treatments for cluster A disorders?
- try and teach them social skills
- exposure or homework
74
What medications are used for cluster A disorders and mainly for which disorder?
- antipsychotics for schizotypal PD
75
What are the characteristics of cluster B personality disorder?
- their behaviours tend to be dramatic, emotional or erratic
- causes damage to personal relationships
- most commonly diagnosed
- also hard to treat
76
What are the characteristics of antisocial PD?
- disregard or violation of others rights or societal rules
- breaking laws, little care of others feelings
- liked most to adult criminal behaviour
- have to be at least 18 to be diagnosed but some traits appear when younger but often diagnosed as conduct disorder
- addiction is common
- 2-3% of people in the US
- tend to be violent, aggressive, or sadistic
- lack empathy
77
What are the characteristics of borderline PD?
- lots of instability in one’s identity, self-image, relationships, or mood
- very impulsive
- prone to anger but often turn it to themselves
- suicidal actions and threats (self-harm)
- severe fear of abandonment
- 2-5% of people
78
What are the characteristics of histrionic PD?
- extremely overblown emotions
- tends to be attention seeking
- have big need for approval and praise
- self-catered
- lacks empathy
- 2-3% of people
79
What are the characteristics of narcissistic PD?
- have deep need for admiration
- lack of empathy
- exaggerate achievements and talents to receive admiration
- seem arogant
- ted to the advantage of others through manipulation
80
What are the psychodynamic causes of antisocial PD?
- no parental love
- may have gotten attention when misbehaving
81
what are the behavioural causes of antisocial PD?
- modeling/reinforcement
- possibly seeing a parent engage in criminal behaviour for example
82
What is the cognitive cause for antisocial PD?
- believes others needs are not important
- cognitive distortion
83
What are the biological causes of antisocial PD
- low serotonin levels since serotonin has to do with limiting impulses
- lower levels of arousal
-why they enjoy seeking risks/thrills
84
What was stated in the film clip “biological roots of sociopathy”
- was shown brain scans and made connections
- in brains with ASPD , they had damage to the orbital cortex, frontal cortexand parts of the amygdala which is in charge of controlling emotions ad reactivity
- GPER gene may be missing which is a predisposition
- MAOA gene also partially missing which is another predisposition
- person with these indications couldn’t see certain traits but family oticed it
- had the genes but whether a person with the predispositions becomes a killer depends of how a person is raised and environmental factors
- abuse, and neglect triggers the genes
85
What are the psychodynamic causes of borderline PD?
- lack of parental acceptance
- sexual abuse and other forms of abuse
86
What are the biological causes of borderline PD?
- reactive amygdala
- under active pre-frontal cortex
- important for emotional regulation and impulsivity
- low serotonin
87
What is the sociocultural cause of borderline PD?
- if the culture is changing very quickly it may impact the person
88
What are the views on the psychodynamic causes of histrionic PD
Feeling unloved/having unhealthy relationships with parents as a child leading to a development of a fear of abandonment leading to them inventing crises
89
What are the cognitive views on the causes of histrionic PD
Believes they can’t care for themselves so they find caregivers
90
What are the sociocultural views on the causes of histrionic PD?
Societal norms and expectations which lead to the development
91
What are the psychodynamic views on the causes of narcissistic PD?
Had cold or rejecting parents which causes grandiosity so they feel self sufficient meaning they don’t think they need anyone else
92
What are the cognitive-behavioural views on the causes of narcissistic PD
Have been taught to overevaluate their self worth
93
What are the sociocultural views on the causes of narcissistic PD?
Linked to “eras of narcissism” in society leading to self cantered people. It’s a cyclical situation
94
What are the treatments for antisocial PD? Are they effective?
-there aren’t any effective treatments since they often have little motivation to change and are often forced into treatment
-can try:
- cognitive therapy: try and teach them about moral issues and needs of others
95
What are the treatments for borderline PD? Is it effective?
Improvement is possible if willing however clients tend to be very difficult
- dialectical behavioural therapy (DBT): idea is to deal with relationship disturbances, poor sense of self, needs of others, and social skills
- meds can be effective but can be dangerous due to high risk of suicide attempts
96
What are the treatments for histrionic PD?
- more likely to seek treatment because of attention seeking but they are more difficult to work with
Can try:
- cognitive therapy: change them feeling helpless and have better problem solving skills
- can do psychodynamic therapy, and group therapy
- meds: not especially helpful except if depressed
97
What are treatments for narcissistic PD? Do they work? Why?
Most difficult PD to treat
- no treatment has been proven to be successful
- often manipulate therapist
- often only seek treatment due to depression caused by people not admiring them
98
What are the characteristics of cluster c disorders
- have very anxious and fearful behaviours
- research is very limited
- treatments work moderately better than other personality disorders
99
What are the characteristics of avoidant PD?
- feels anxiety and discomfort in social situations
- feelings of inadequacy
- very sensitive negative evaluation
- often have very few close friends
- very similar to social anxiety disorder but people with avoidant PD have symptoms regarding everything
100
What are the characteristics of dependent PD?
- Excessive and pervasive need to be taken care of
- have excessive fear of separation from people they’re dependent on
- incapable of making own decisions
- at risk of anxiety and depression due to loneliness occurs when not around people
- suicidal thoughts are common
101
What are the characteristics of obsessive compulsive PD?
- intense preoccupation for order, perfection and control
- more broad and encompassing that OCD
- has to be in control of everything
- unreasonably high standards for everyone and themselves
- tend to have very superficial relationships
102
What are the psychodynamic views on the causes of avoidant PD
From shame in the anal stage leading to fixation
103
What are the cognitive views on the causes of avoidant PD?
Parents may have been very rejecting or criticizing leading to the assumption that they will always be judged negatively
104
What are the views on the behaviour causes of avoidant PD?
- due to possible lack of social skills
105
What are the views on the behavioural causes of dependent PD?
May have been rewarded as a child for being clingy and then punished for their independence
- could also be modelling
106
What are the cognitive views on the causes of dependent PD?
Have learned that they’re helpless and must find someone to be a “protector”
107
What is the view on the psychodynamic causes of obsessive compulsive PD?
- have an anal regressive personality
108
How do cognitive distortion’s play a role for obsessive compulsive PD?
They help maintain the disorder
109
What are the treatments for avoidant PD?
- exposure therapy
- group therapy
- since it displays similar traits to anxiety so it can be treated similarly
Meds: anti anxiety/antidepressants can be useful
110
What are the treatments for dependent PD?
- psychodynamic: similar treatments for depression. Can also do couple/family therapy
- cognitive behavioural: targets beliefs of helplessness through assertiveness training
- meds: antidepressants can help
- group therapy: since supper through others can help
111
What are the treatments for obsessive compulsive PD?
- unlikely to seek treatments and are often coerced into treatment
- may use psychodynamic or cognitive therapy
- SSRI’s can be useful since it’s similar to OCD
Psychological Disorders
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