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5. Psychiatry > 1- Impulse Control Disorders > Flashcards

1- Impulse Control Disorders Flashcards

1
Q

What is the premise behind CBT?

A

Thoughts influence feelings which alter behavior → changing the thought process will change the behavior

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2
Q

CBT includes what three elements?

A

Thought, behavior, emotion

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3
Q

CBT will provide the pt with what are a means to slowly change the behavior?

A

Homework, bibliotherapy, journaling assignments, etc..

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4
Q

Impulse control disorders are a continuum ranging from what to what?

A

Impulsivity to compulsivity

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5
Q

What disorder has the following cycle?

Preoccupation → Pleasure/satisfaction/relief → Binge/Intoxication → Withdrawal/negative affect → restarts

A

Addiction

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6
Q

Addiction, impulse control disorders, compulsive disorders are have reinforcement of a behavior through what?

A

Vicious behavioral cycles

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7
Q

What disorder has the following cycle?

Tension/arousal → impulsive acts → pleasure/relief/gratification → regret/guilt/self-reproach → restarts

A

Impulse control

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8
Q

What disorder has the following cycles?

Anxiety/stress → repetitive behaviors → relief of anxiety/stress →obsessions → restarts

A

Compulsive disorder

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9
Q

What are the DMS5 criteria for intermittent explosive disorder?

A
  1. Recurrent aggressive behavior or verbal aggression (< 30 min)
  2. Aggression is out of proportion to stressors
  3. No premeditated
  4. Cause distress/consequences
  5. ≥ 6 y.o (starts in late childhood)
  6. Behavior not accounted for by another mental disorder
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10
Q

Can an individual feel guilty for their actions if they have intermittent explosive disorder?

A

Yes

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11
Q

Trauma, genetics, serotonin disruption in limbic system and front/limbic cortex are RF for what disorder?

A

Intermittent explosive disorder

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12
Q

What is the tx for IED?

A

SSRIs, CBT + med, desensitization behavior modification

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13
Q

Conduct disorders are dx in children great than what age?

A

> 7 yo (one of the most common ped psych disorders)

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14
Q

Parental rejection/neglect, difficult infant temperament, harsh discipline, physical or sexual abuse, unstable family, familial psychopathology are RF for what disorder?

A

Conduct disorder

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15
Q

What is the DSM5 criteria for CD?

A

A. Major rights of others/societal norms are violated 3x in past 12 months

  • aggression to people and animals
  • destruction of property
  • deceitfulness or theft
  • violation of rules

B. Causes social, academic or occupational impairment

C. If pt 18+ yo, & does not meet criteria for Anti-social personality disorder

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16
Q

Lack of remorse.guilt, callous/lack of empathy, unconcerned about school performance, shallow or deficient affect are associated w/ what disorder?

A

Conduct disorder

17
Q

What is the tx for CD?

A

Individual and group therapy, parental behavioral therapy, pharmacotherapy (ADHD meds, antidepressants, mood stabilizers, antipsychotics)

18
Q

What disorder is classified as a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures?

A

Oppositional Defiant disorder

19
Q

It is normal for preschool children to be defiant. What is next step if symptoms increase?

A

Assessment for oppositional defiant disorder (usually starts before 8 y/o)

20
Q

Are the sx of ODD or CD more severe?

A

CD (CD dx will take precedent over ODD)

21
Q

What is the tx for ODD?

A

Behavioral modification, family therapy

22
Q

What disorder is more common in disruptive households and can be associated w/ ADHD?

A

Oppositional defiant disorder

23
Q

What is the DSM5 criteria for dx of Oppositional defiant disorder?

A

A. Negativistic, hostile, defiant behavior > 6 month w/ 4+ of the following:
- Often lose temper
- Argues w/ adults
- Defies adults requests/rules
- Deliberately annoys people
- Blames other for their behavior
- Easily annoyed
- Often angry/resentful
- Often spiteful or vindictive
B. Clinically significant impairment in social, academia or occupational functioning
C. Behavior do not occur during psychotic or mood disorder
D. Criteria is not met for CD & if > 18 y/o and criteria not met for ASPD

24
Q

What disorder is defines are impulsive stealing of objects not needed for profit or personal use (often discarded after stolen)?

A

Kleptomania

25
Q

What is the DSM5 criteria for Kleptomania?

A

A. Recurrent impulse to steal, not for personal use of money
B. Increase tension before act of stealing
C. Pleasure, gratification or relief at time of committing theft
D. Stealing not to express anger and not in response to delusion or hallucination
E. Stealing not accounted for by Cd, mania or ASPD

26
Q

What is the tx for kleptomania?

A

CBT, Desensitization behavior mod, aversion

SSRI or naltrexone

27
Q

What should you look for if pt w/ Kleptomania disorder?

A

Psych co-morbidities (can co-occur w/ mood, eating, anxiety, personality and addictive disorders)

28
Q

What i the DSM5 criteria for pyromania?

A

A. Deliberate and purposeful fire setting on 1+ occasion
B. Build up of tension before setting fire
C. Fascination w/ fire
D. Pleasure, gratification or relief when setting fires/witness or participating in aftermath
E. Fire setging not done for monetary gain
F. Not accounted for by CD, mania or ASPD

29
Q

What is the TX for pyromania?

A

Psychotherapy (determine primary cause)

No clear med indication

30
Q

What is the only compensatory behavior disorder in the DSM5?

A

Pathological gambling

31
Q

Pathological gambling is a/w what?

A

High divorce rates, stress-related physiological comorbidities, higher rates of mood d/o, ADHD, substance abuse, ICDs, and cluster B personality d/o

32
Q

What is the progression of pathological gambling?

A
  1. Winning phase
  2. Losing phase
  3. Desperation phase
  • Mimics curve for alcohol and drug dependency
33
Q

What is the DSM5 criteria for pathological gambling?

A

A. Persistent and recurrent maladaptive gambling behavior as indicted by 4+ w/in 12 month period:

  • Preoccupation w/ gambling
  • Desired excitement achieved w/ increased amount of $ gambled
  • Unable to stop or cutback (despite harm)
  • Restless or irritable when trying to cut down
  • May serve to escape problems or relieve dysphoric mood
  • Chasing losses: after loosing $, goes back to gamble to get even
  • Has jeopardized relationships, employment or career
  • Relies on others to provide money to relieve desperate financial situation

B.Behavior is not better accounted for by manic episode

34
Q

What is the tx for pathological gambling?

A 
Psychotherapy
Behavior mod
CBT (addresses erroneous belief, role of chance)
Group support
Meds (mild-mod benefit)
35
Q

Low serotonin levels in CSF have been shown to be associated w/ what?

A

Impulsiveness and agression

36
Q

Is IED more common in men or women?

A

Men

37
Q

Is Kleptomania more common in men or women?

A

Women

38
Q

Is pyromania more common in men or women?

A

Men

5. Psychiatry (19 decks)

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