Psych303 - 2

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Psych303 - 2
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2011-05-09 11:31:21
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Psych 2
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  1. Male erectile disorder
    • early ejaculation
    • inability to achieve or maintain an erection sufficient for successful intercourse
    • because of anxiety, cognitive distractions
    • 90% of men on antidepressant medications
    • can be result of vascular disease
    • Viagra
  2. how does Viagra work for erectile dysfunction
    • Viagra makes nitric oxide more available
    • only promotes erection if some excitation is present
  3. Female sexual arousal disodrer
    • lack of interest in having sex can lead to an absence of feelings of sexual arousal and unresponsiveness to most forms of erotic stimulation
    • can't produce characteristic swelling/lubrication of hte vulva
    • people think this diagnostic is controversial because it is being pushed on the public by pharmaceutical companies
    • often there are partner factors involved
  4. female orgasmic disorder
    • not well defined
    • delay/absense of orgasm or reduced intensity of orgasmic sensation
    • AND causes significant stress/impairment
    • treatment by learning to masturabate
    • as many as 80% of women have difficulty reaching orgasm during intercourse alone
  5. Genito-Pelvic Pain/Penetration Disorder
    • mostly for women
    • thought to be psychological - now its more about a pain
    • cause - Vulvar Vestibulitis
  6. vulvar vestibulitis
    • causes genito-pelvic pain/penetration disorder in women
    • the inflammation of skin surrounding the vaginal opening (treatable)
  7. Vaginismus
    • involuntary spasm of hte muscles at hte entrace to the vagina that prevents penetration and sexual intercourse
    • very rare
    • treatment: training of the vaginal muscles
  8. Dyspareunia
    • painful coitus
    • persistent genital pain with sexual intercourse
    • far more common in women
    • can be because of physical cause
  9. Gender Identity Disorder
    • 1 - a strong and persistent cross - gender identification (desire/insistence that one is the opposite sex)
    • 2 - gender dysphoria - persistent discomfort about one's biological sex/sense that the gender role of that sex is inappropriate
  10. paraphilias
    • recurrent, intense sexual urges, fantasies, or behaviors that involve unusual objects, activities, situations
    • tend to occur only in men
    • without the weird object orgasm is not possible
    • tend to co-occur in the same individual
    • tend to begin around puberty
    • very strong sex desire
  11. 8 specific paraphilias
    • fetishism
    • transvestic fetishism
    • voyeurism
    • exhibitionism
    • sexual sadism
    • sexual masochism
    • pedophilia
    • frotteurism
  12. serial killers tend to be....
    • sexually deviant (sadists or necrophilic)
    • psychopathic
    • narcissistic (center of the world)
    • prefer knives and ropes because its more hands on
    • Ted Bundy, Dennis Rader, Gary Ridgeway
  13. pedophilia
    • sexual attraction to an immature body (prepubertal)
    • can't be defined by age of the child but by body maturity
    • mostly males - and most of the victims are girls
    • some appear to be shy but want power over another
    • some idealize aspects of childhood
    • begin in adolescence usually
    • perturbations of early neurodevelopment can create vulnerability to the disorder
  14. consequences childhood sexual abuse
    • post-traumatic stress disorder
    • sexual inappropriateness
    • fears
    • poor self-esteem
    • no symptoms
    • adult psychopathology
    • sexual symptoms
  15. characteristics of rapists
    • low SES
    • young man
    • sexual abused
    • date rapists motives
    • paraphilias
    • impulsivity/loss of temper
    • insensitivity to cues
    • deficits in communicaiton skills
  16. psychological treatments for rapists
    • modify patterns of sexual arousal
    • cognitive restructuring
    • social skills training
    • change habits
    • lower sexual drive
    • aversion therapy - covert sensitization, assisted covert sensitization
  17. biological/surgical treatments for rapists
    castration or chemical castration - lowers testosterone - lowers sexual drive
  18. anxiety
    • blend of unpleasant emotions and cognitions
    • not really an emotion, but an emotional mood-state
    • oriented to the future (anticipate negative events)
    • cognitive, physiological, psychological components
    • much more diffuse than fear
    • prepares/primes someone for the fight or flight response should the activated danger occur!
    • no immediate urge to flee as there is with fear!
    • helps us plan
    • usually are learned
  19. components of anxiety
    • hear palpations, headaches, sweating, tension
    • negative mood states, bad appraisals, worry, self-preoccupation, concern about lack of knowledge on the future
    • avoid situations that may lead to negative consequences
  20. Contributing Factors for Anxiety
    • genetically predisposed (a gene) - stuff with the limbic system
    • personality/temperament - neuroticism, negative affectivity
    • psychosocial - intrusive/over controlling parents
    • family styles
    • psychological - classical conditioning, perceptions of uncontrollability, distorted patterns of cognition
  21. treating anxiety
    • medications (anxiolitics) - faster responses, but big side effects, addicting, only treats the symptoms
    • cognitive behavioral therapy - most effective, learning why we have anxiety about certain stuff
    • exposure to feared cues
    • cognitive-restructuring - change patterns of thinking about anxiety situations
  22. generalized anxiety disorder
    • chronic, excessive, unreasonable, uncontrollable worrying
    • anxious all the time, in almost all situations
    • future-oriented mod state of anxious apprehension
    • anxious apprehension - increased vigilance for perceived signs of threat!
    • muscle tension, fatigue, irritability
    • more for women, older adults, tends to occur with other Axis-I disorders
  23. psychological factors for GAD
    • attentional bias - biased toward negative things
    • uncontrollability/unpredictability
    • childhood trauma
    • lack of safety signals
    • believe that worry is effective and productive (avoidance of emotional topics (protective function), avoid catastrophes, coping, preparation)
    • intrusive thoughts/inability to cope with them
  24. biological GAD factors
    • modest heritability
    • common underlying genetic predisposition with depression
    • neuroticism
    • functional deficiency in GABA (GABA inhibits anxiety)
    • also serotonin and norepinephrine roles
    • effect of CRH hormone
  25. GAD treatments
    • medications - benzodiazapines/anxiolytics, buspirones (less side effects)
    • CBT - more effective, muscle relaxation, cognitive restructruing (make appraisals more realistic, know what you have control over/don't), coping skills
  26. symptoms of panic attacks
    • cardio symptoms
    • gastrointestinal symptoms
    • neurological symptoms (dizzy, numbness)
    • LIKE A HEART ATTACK
    • depersonalization, derealization, fear of losing control or going crazy/dying
  27. catagelophobia and agyrophobia
    • catagelophobia - fear of ridicule in social situations
    • agyrophobia - fear of streets/crossing streets
  28. prevalence/age/gender of panic disorder
    • more women than men (men maybe more prone to tough it out because of societal expectations)
    • typically in teh 20s-30s
    • like 5% of adults
  29. Biological causal factors of panic disorder
    • moderate heritable component
    • neuroticism
    • large overlap in genetic vulnerabilities for panic disorder/phobias
    • norepinephrine and LOCUS COERULEUS
    • increased activity in amygdala (sensitive fear network)
    • hippocampus/limbic system involved
    • noradrenergic/serotonergic neurotransmitter symptoms
    • GABA
  30. learning theory of panic disorders
    • panic attacks are conditioned to internal cues (interoceptive awareness)
    • internal cues becomes associated with feeling of panic (noticing the physical cues triggers a panic attack!)
  31. cognitive theory to panic disorder
    • individuals with panic disorder are hypersensitive to bodily sensations/prone to give them the best direct possible interpretation
    • anxiety sensitivity - concerned with anxiety attacks!
    • *catastrophize* about meaning of bodily sensations - automatic thoughts lead to triggers of panic!
  32. anxiety sensitivity and panic disorder and perceived control
    • trait like belief that certain bodily symptoms have harmful consequences
    • perceived control reduces anxiety/blocks panic!
  33. safety behaviors and persistence of panic
    people with panic disorders engage in safety behaviors - they attribute the lack of catastrophe to the fact that they did this safety behavior! - reinforced
  34. the integrated model of panic disorder
    • its a cycle
    • biological vulnerability --> catastrophic cognitions (awareness for future) --> attacks --> hypervigilance --> back to biological vulnerability
  35. treatment for panic disorder
    • medications -
    • anxiolytics - act quickly, but have side effects (benzodiazeprines)
    • antidepressants - no dependence, slow acting (tricyclics, SSRI's)
    • CBT - most effective
    • interoceptive exposure
    • cognitive restructuring techniques - help people identify cognitions
    • relaxation exercises
    • systematic desensitization
  36. prevalence/gender for specific phobias/social phobias
    • 12%, way more women = specific
    • 12%, slightly more women = social

    more men than women b/c men may have more exposure therapy b/c of teasing, and women are more in tune with emotions
  37. Biological causal factors to specific phobias
    • behaviorally inhibition, fear
    • some genetic contribution
    • genetic temperatment that makes you learn/strengthen the fear/association
  38. psychological causes to specific phobias
    • evolutionary preparedness
    • defense against anxiety that stems from repressed id impulses
    • learned behavior - classical conditioning, neg. experience with stimulus, observing other people with phobias (monkeys with snakes)
    • importance of prior familiarity with object/situation
    • inflation effect
  39. inflation effect for phobias
    an experience after a conditioning experience that strenghtenss/maintains that conditioned fear

    for example - person with mild fear of driving after a minor crash will develop full blown phobia is later is physically assulated
  40. psychological factors of social phobia
    • childhood/adolescent experiences of bad social situations (vicarious/direct learning)
    • evolutionary contributions (because of dominance hierarchies in primates social arrangements - stay submissive)
    • perceptions of uncontrollability/unpredictability
    • cognitive biases (think ambiguous situations are more dangerous - danger schemas, attribute a negative evaluation of themselves by others)
  41. biological causal factors to social phobia
    • 20% heritability
    • behavioral inhibited temperament (emotionally negative - respond negatively to stimuli)
    • tendency for high reactivity
  42. high reactivity in social phobias
    they have exaggerated physiological responses to social stimulations - so all of hteir resources are devoted to modulating these responses - not much left to devote to social situations
  43. treatment for social phobias
    • antidepressants (SSRIs, MAOIs, d-cycloserine with exposure therapy)
    • CBT - longest lasting, best, cognitive restructuring (how to deal with social phobia, identify negative underlying thoughts, LOGICAL REANALYSIS)
    • exposure to social situations
    • challenge the negative thoughts
  44. obsessive compulsive disorder - what makes it beyond normal?
    • everyday thoughts/actions are brought to an extreme
    • unwanted/intrusive obsessive thoughts/distressing images accompanied by compulsive behaviors to neutralize these

    • excess time
    • reasons why you do the behavior - to relieve anxiety?
    • How much distress does it cause?
  45. prevalence/age/gender of OCD
    about 1%, more divorced people, late adolescence, more adult women than men, more boys than girls
  46. psychological factors to OCD
    • avoidance learning - behavior makes them feel better about an obsession (an obsession that resulted from classical conditioning) - reinforcing
    • preparedness - obsessions with dirt and contamination - related to safety!! and displacement ativities to reduce anxiety
  47. cognitive factors for OCD
    • trying to suppress their thoughts (thought suppression leads to an increase in OCD symptoms)
    • inflated sense of responsibility (having a thought about doing something is just as bad as doing it - thought-action fusion)
    • perceived awfulness of any harmful consequences
    • cognitive biases to focus on negative stuff
  48. biological causal factors
    • more strongly associated in OCD than in any other anxiety disorders
    • genetic basis varies with the OCD type
    • brain abnormalities (cortico-basal-ganglionic-thalamic circuit - the circuit involved in social behavior - stuff of obsessions) (prevention of normal inhibition of thoughts)
    • Neurotransmitters (excess serotonin), GABA
  49. tourettes syndrome
    • tic related - severe chronic motor and vocal tics
    • big genetic basis
    • OCD type
  50. treatment of OCD
    • medications - SSRIs, d-cycloserine to reduce number of exposure therapy needed
    • Exposure/ritual prevention = the best - exposed to obsession but can' act on it
    • Psychosurgery in extreme cases (remove parts of social behavior circuit, target tissue damage areas)
  51. what predisposes you to stress?
    • nature of stressor
    • perception of stressor
    • stress tolerance
    • external resources/social supports
  52. two ways to respond to stress
    • task-oriented response - deal with requirements posed by stressor
    • defense - oriented - protect self from hurt/disorganization
  53. effects of severe stress
    • personality (psychological) decompensation (lowering of adaptive psychosocial functioning)
    • General Adaptation Syndrome - alarm reaction, resistance, exhaustion
    • effects on the sympathetic nervous system
    • effects on the immune system
  54. adjustment disorder
    • response to common stressor is maladaptive
    • occurs within 3 months of a stressor
  55. PTSD
    • an anxiety disorder
    • response to a trauma (threatened/actual death/injury, unexpected death of others, threat to physical integrity)
    • recurrent reexperiencing of it
    • emotional numbing/detachment
    • hypervigilance, increased arousal, insomnia
  56. PTSD is more likely if...
    • feel responsible
    • feel trapped, feel unsafe (military combat)
    • if intense recurrent stress
    • suddenness (mass catastrophes)
    • intentional cruelty/inhumanity
  57. symptoms of military PTSD
    • irritability
    • anger anger control problems
    • substance abuse with aggression
    • sleep distrubances
    • recurrent nightmares
    • if not injured = bigger PTSD than if injured
  58. causes of PTSD
    • nature of traumatic event
    • level of stress
    • females get it more
    • low social support
    • neuroticism
    • pre-existing problems
    • negative appraisals
    • if feel responsible/trapped, multiple stresors, very sudden
  59. protection from PTSD
    good cognitive ability (better able to make meaning out of trauma experiences and translate them to meaning)
  60. bio causes of PTSD
    • not baseline cortisol (except women do have higher baseline cortisol)
    • gene involved
    • smaller hippocampus
  61. sociocultural causes of PTSD
    • if believe mission is valid = less PTSD
    • if identify with combat unit - less PTSD
    • returning to negative/unsupportive place = more PTSD
  62. treatment of PTSD
    • CBT - desensitization, relaxation, challenge the distorted thinking
    • MEds - SSRI's, Benzodiazapines
  63. prevalence/onset of anorexia nervosa
    • about 1.5% of the population (lifetime)
    • onset is around aolescence
  64. Bio causes to eating disorders
    • high heritability
    • genes for suceptibility to anorexia
    • involved with serotonin/serotonergic system
    • we each have a biological set point and if we deviate our bodies will go through physiological opposition to get back to that start point
  65. family influences on eating disorders
    rigid, overprotective, controlling, marital discord, perfectionist parents, preoccupation with food
  66. individual risk factors for eating disorder
    • gender - more in women than in men
    • internalizing the thinness ideal
    • Perfectionism - more likely to subscribe to thin ideal and pursue the perfect body
    • negative body image - perceptual biases on themselves - body dissatisfaction
    • dieting - usually starts with normal dieting (when efforts to diet fall short - we feel bad abotu ourselves)
    • negative affect - risk factor for body dissatisfaction - self-critical - eating provides comfort
    • childhood sexual abuse - abuse may increase risk for having the risk factors for eating disorders
  67. treatment of anorexia
    • Meds - antidepressants/antipsychotics
    • Family Therapy - considered the best treatment (refeed, negotiations of relationships, termination phase)
    • CBT - change behavior/maladaptive thinking - but htere are limits for the efficacy
  68. treatment of bulimia
    • Meds - antidepressants
    • CBT - best choice, normalize eating patterns, change behaviors/thinking about the binge cycle
  69. treatment of binge-eating
    • antidepressants
    • appetite suppressants
    • anticonvulsant medications
    • sibutramine - inhibits reuptake of serotonin/norepinephrine
    • CBT/therapeutic programs
  70. causes of obesity
    • genes - thinness runs in families/same with obesity, seems to be a genetic mutation associated with binge eating
    • hormones - leptin, grehlin
    • sociocultural
    • family/relationships
    • stress/comfort food
    • pathways to obesity (binge eating, low support, pressures, negative affect)
  71. grehlin and obesity
    • hormone produced by stomach - powerful appetite stimulator
    • levels rise before a meal and fall after a meal
    • causes hunger!
    • Prader Willi syndrome = high levels of grehlin
  72. treatment for obesity (3 steps)
    • lifestyle modifications (diet, exercise, behavioral)
    • medications - supress appetite, prevent absorption
    • surgery - bariatric surgery (gastric bypass = most effective in the long run)
  73. Neurobiologial factors for addiction
    • pleasure center activation (MCL pathway - enjoyment of that thing)
    • people are affected differently by the same substance
    • physical dependence (changes in brain functioning/sensitivity to neural receptors)
  74. psychological factors in addiction
    • positive and negative reinforcement (take drugs = get high = positive) (get low = take drugs = no more negative feelings = negative)
    • mediating effects of the substance - affects how other things are processed (nicotine makes all the things associated with smoking much more reinforcing)
  75. substance abuse disorder
    • maladaptive use of a substance
    • impairment in at least one domain (work, school, home)
    • legal problems
    • social/interpersonal problems
    • no substance dependence!
  76. substance dependence disorder
    • higher tolerance
    • withdrawal causes irritability, problems concentrating, fidgeting
    • amount and time is beyond the original intent
    • desires to cut down/control their use
    • activities to obtain, use or recover from use of substance
    • sacrifice social, occupational, recreational activities
    • continue despite negative physical or psychological effects
  77. actual effects of alcohol (bio, cognitive, social, psychological)
    • suppressed thinking, slower physical response times, decreased perception of the long term, morality, thinking about reputation
    • chronic fatigue
    • mental health problems - alcohol withdrawal delirium
    • Korsakoff's condition - memory defect
    • inhibits glutamate - slowed activity in brain
    • cirrhosis of liver
  78. korsakoff's syndrom
    • memory defect
    • falsification of events
    • alcohol amnestic disorder
  79. biological causes of alcoholism
    • activation of pleasure pathway (MCLP) - Dopamine
    • runs in families
    • inherited predisposition for alcohol abuse/impulsive
    • GABA - usually controls the reward-pleasure system and opiates can inhibit the control
    • alcohol increases brain activity for other regions
    • inhibition of neurotransmitters for anxiety
  80. psychological causes to alcoholism
    • positive and negative reinforcement (self-medication, tension reduction, coping with negative affect)
    • opponent-process theory - need to take more and more of the same drug --> higher and higher highs, lower and lower lows
    • expectancy effects (positive reinforcements for social acceptance)
    • tension reductions
  81. psychosocial causes to alcoholism
    • exposure to drugs - media/family/peers
    • societal views abotu drug abuse
    • cultural factors (interaction with bio factors like Asian flush)
    • failures in parental guidance
    • marital/other intimate relationships
  82. the integrative model of substance-related disorders
    • expsoure/access to a drug
    • social/cultural expectations
    • pleasurable effects
    • more complex reasons too like stress, learning factors, genetics, etc.
  83. bio treatment of alcohol disorders
    • meds - to reduce cravings/ease detoxification process
    • disulfiram (vomiting if drink)
    • naltrexone - opiate antagonist - reduces craving for alcohol
    • drugs to reduce the symptoms of detoxification/withdrawal
    • can be agonists/antagonists/aversive treatments
  84. psychological treatment for alcohol dependence
    • best once the drinking is under control
    • group/individual therapy -
    • environmental intervention - alleviate aversive life
    • CBT - aversion therapy/sensitization (classical conditioning)
    • AA - self help
    • teach controlled use - for those with less severe use
    • relapse prevention
  85. causal factors in opiate abuse
    • pleasure, curiosity, peer pressure
    • changes in neurotransmitter systems that regulate motivation and ability to manage stress
    • chronic underproduction of endorphins = cravings for narcotic drugs
  86. treatment of opiate addiction
    drug - methadone

    buprenorphine

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