Somatic Sx + Dissociative Disorders
What is the defining feature of Functional Neurological Symptom Disorder?
patients experience neurological symptoms that can't be explained by a medical condition
old theory: trauma “converted” to physiological pain (aka conversion disorder)
symptom examples: paralysis, loss of sensation, tremors, blindness
Name one of the two main differences between mania and hypomania
Most symptoms are the same, but differences include
Duration of the symptoms: manic episodes last >=1 week, hypomanic episodes last >=4 consecutive days
Severity of symptoms:
-manic episodes: severe social/occupational impairment, risk to own/others’ health, or psychotic symptoms
-hypomanic episodes: change in functioning though it doesn’t impair daily life, NO psychotic symptoms
Define intoxication, tolerance, and withdrawal
intoxication- physiological effects of substance on behavior and cognition (ex: slurred speech, difficulty concentrating)
tolerance- reduced effect of same dose after repeated exposure, need more substance to achieve same effect
withdrawal- physiological & behavioral effects after stopping substance use after prolonged exposure (ex: tremors, difficulty focusing)
What is the difference between delusions and hallucinations?
delusions- false beliefs someone is completely convinced by (ex: government is going to kill me)
hallucinations- involve sensory misperceptions (ex: seeing or feeling cockroaches climbing all over body)
What is the primary difference between Somatic Symptom Disorder & Illness Anxiety Disorder?
Somatic Symptom Disorder- actually experience the symptoms and seek help
Illness Anxiety Disorder- worry about developing/having condition, but don’t always have severe physical symptoms
Carmen experiences periods of depressed mood, excess fatigue, difficulty sleeping and concentrating, along with severe physical pain for about 1 week every month. Which disorder are these symptoms most consistent with?
premenstrual dysphoric disorder
Name 2 drugs within each category: depressants, stimulants
depressants- alcohol (impaired judgement), benzodiazepines (sleepiness), barbiturates (stupor, incoordination)
stimulants- cocaine/amphetamines (euphoria, rapid HR), caffeine (insomnia, restlessness), nicotine
Name 2 symptoms from each category: positive, negative, cognitive
positive- delusions, hallucinations, disorganized/erratic thoughts/speech/behavior (catatonia)
negative- restricted affect (anhedonia), avoilition (inability to start or pursue goals), asociality
cognitive- impaired attention, memory, processing speed
What is the most common cause of Dissociative Identity Disorder?
adverse childhood experience(s) (theorized to lead to DID bc of child's unsuccessful attempt to integrate trauma)
What is one key difference between Persistent Depressive Disorder (aka dysthymia) and Major Depressive Disorder (MDD)?
Correct answers:
-PDD has depressed mood for more days than not for >= 1 year, MDD for >= 2 weeks
-PDD can’t be without symptoms for longer than 2 months within 2 year period
What do social learning theories suggest about why substance use disorder might develop?
children learn substance use behaviors from adult-figures in their lives (repeated exposure normalizes the behavior for them)
Name 2 brain regions associated with schizophrenia
grey matter reduction in medial, temporal, prefrontal cortices
reduced activation in PFC (cognitive deficits)
abnormal activation and structure of hippocampus (long term memory, storage and retrieval issues)
white matter abnormalities (working memory deficits)
What is the difference between malingering and Factitious disorder?
The motivation:
malingering- symptoms are faked for some practical/external gain (faking a cold to get out of work)
Factitious disorder- symptoms falsified, induced, or created not for external reward (parent of kid with cancer), not always intentionally done
What are some risk factors for suicide? Think of cognitive/biological/personality related variables that might contribute to suicide
personality- impulsivity (tendency to act on impulse rather than inhibit)
cognition- hopelessness (future is bleak/no way to change it)
biological- genetic predisposition (runs in families, parents, twin studies), low serotonin levels
Name 2 areas of the brain associated with substance use disorder
frontal cortex (people whose reward center OP control center > likely to have SUD)
ventral tegmentum (midbrain, alertness/arousal)
nucleus accumbens (part of limbic system)
dopamine sensitive regions hijacked by substances to produce euphoric feeling
Why did biological treatments for schizophrenia shift from typical antipsychotics to atypical antipsychotics?
typical antipsychotics cause significant neurological side effects: grogginess, depression, slowed motor activity, even tardive dyskinesia (irreversible, involuntary facial movements)
atypical antipsychotics also effective at treating schizophrenia, don’t have same side effects
Annie arrives in Seattle by bus with no recollection of who she is or how she got there. Which condition might Annie have?
Dissociative fugue- subtype of amnesia where someone loses memory of who they were and starts a new life. Can return to old life without any recollection of ever having left too.
Newer methods of brain stimulation include TMS, VNS, & DBS. Describe the main differences.
repetitive Transcranial Magnetic Stimulation- high intensity magnetic pulses focused on specific brain regions using special helmet, doesn’t require anesthesia
Vagus Nerve Stimulation- electrodes surgically placed on vagus nerve, which carries info to hypothalamus and amygdala (invasive)
Deep Brain Stimulation- electrodes surgically implanted in different areas of brain, used for treatment-resistant depression (invasive)
Describe 2 psychosocial (ex: cognitive, behavioral) treatments for substance use disorder
behavioral- nausea drug for alcoholism -> classical conditioning creates association between alcohol and vomiting; operant conditioning teaches an aversion to alcohol
covert sensitization therapy- create vivid, negative imagery in association with substance
cognitive- cognitive behavioral therapy -> identify situations/circumstances where it’s easy to spiral, teach behavioral coping mechanisms (practice assertiveness by sayying “No, I’d prefer not to drink")
motivational interviewing- solidify participant’s desire/motivation to changing substance use
When do the prodomal and residual phases occur? And which category of symptoms (positive, negative, cognitive) is expressed the most?
Prodomal- during 6 months before meeting diagnosis
Residual- during 6 months after meeting diagnosis
Think of it like ramping up and down from the active episode
Showing mostly negative symptoms, with milder positive symptoms