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Madsen Triad EPPP > Abnormal > Flashcards

Abnormal Flashcards

1
Q

DSM-5

Categorical Approach

A

divides mental disorders into types, defined by a set of diagnostic criteria

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2
Q

DSM-5

Polythetic Criteria Set

A

clients present with a subset of symptoms, meaning two clients with the same diagnosis may have completely non-overlapping presentations

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3
Q

DSM-5

Nonaxial Assessment

A

all mental and medical diagnoses are listed together with primary diagnosis first

no more “axis 2”

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4
Q

DSM-5

Diagnostic Uncertainty

A
  • other-specified - when the clinician wants to indicate why symptoms do not meet criteria
  • unspecified disorder is when they do not want to indicate why client’s symptoms do not meet criteria
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5
Q

DSM-5

Outline for Cultural Formation

A
  1. the client’s cultural identity
  2. the client’s cultural conceptualization of distress
  3. the psychosocial stressors and cultural factors that impact the client’s vulnerability and resilience
  4. cultural factors relevant to the relationship between the client and therapist
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6
Q

Intellectual Disability

Diagnostic Criteria

2 deficits, onset

A
  1. deficits in intellectual functions (e.g., reasoning, problem solving, abstract thinking);
  2. deficits in adaptive functioning that result in a failure to meet community standards of personal independence and social responsibility and impair functioning across multiple environments in one or more activities of daily life
  3. an onset of intellectual and adaptive functioning deficits during the developmental period.
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7
Q

Intellectual Disability

Etiology

A
  • 5% heredity
  • 30% chromosomal changes, toxins
  • 10% pregnancy and perinatal problems
  • 5% acquired medical issues during infancy or childhood
  • 15-20% environmental factors
  • 30% unknown
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8
Q

Stuttering

Course/Prognosis

A
  • gets worse when there is social pressure to communicate
  • 65-85% of children recover
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9
Q

Stuttering

Treatment

A
  • Reduction of stress @ home
  • habit reversal training
  • deep breathing training, relaxing muscles in the throat
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10
Q

Autism Spectrum Disorder

Diagnostic Criteria

A

For a diagnosis of Autism Spectrum Disorder, the individual must exhibit (a) persistent deficits in social communication and interaction across multiple contexts as manifested by deficits in social-emotional reciprocity, nonverbal communication, and the development, maintenance, and understanding of relationships; (b) restricted, repetitive patterns of behavior, interests, and activities as manifested by at least two characteristic symptoms (e.g., stereotyped or repetitive motor movements, use of objects, or speech; inflexible adherence to routines, or ritualized patterns of behavior); (c) the presence of symptoms during the early developmental period; and (d) impaired functioning as the result of symptoms.

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11
Q

Autism Spectrum Disorder

Prognosis

A

The best outcomes are associated with an ability to communicate by age 5 or 6, an IQ over 70, and a later onset of symptoms.

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12
Q

Autism Spectrum Disorder

Treatment

A
  • shaping and discrimination training
  • vocational training and placement
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13
Q

ADHD

Diagnostic Criteria

onset, settings

A

ADHD is the appropriate diagnosis when the individual has at least six symptoms of inattention and/or six symptoms of hyperactivity-impulsivity and symptoms had an onset prior to 12 years of age, are present in at least two settings (e.g., home and school), and interfere with social, academic, or occupational functioning.

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14
Q

ADHD

Course/Prognosis

A

About 15% of children with ADHD continue to meet the full diagnostic criteria for the disorder as young adults and another 60% meet the criteria for ADHD in partial remission.

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15
Q

ADHD

Treatment

A
  • Ritalin/methylphenidate
  • behavioral interventions- positive reinforcement, time out, etc
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16
Q

ADHD

ADHD in Adults

A

In adults, inattention predominates the symptom profile.

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17
Q

ADHD

Etiology

A

lower-than-normal activity and smaller than normal size of the

  • caudate nucleus
  • globus pallidus
  • prefrontal cortex
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18
Q

ADHD

Multimodal Study

A

showed that the best outcome is from a mixture of medication and behavioral intervention

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19
Q

SLD

Comorbidity

A

20-30% of kids with SLD have ADHD

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20
Q

SLD

Diagnostic Criteria

A

six months of presentation (with intervention) of persistent difficulties with reading, writing, math

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21
Q

SLD

etiology

A

linked to cerebellar-vestibular dysfunction, hemispheric abnormalities, toxins

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22
Q

Tourettes

A
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23
Q

Tourettes

Diagnostic Criteria

onset age, duration

A

Tourette’s Disorder is characterized by the presence of at least one vocal tic and multiple motor tics that may appear simultaneously or at different times, may wax and wane in frequency, have persisted for more than one year, and began prior to age 18.

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24
Q

Tourettes

Treatment

A
  • haloperidol and pimozide, effective 80% of the time
  • reversal training, relaxation training, psychoeducation
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25
Q

Tourettes

Etiology

A

elevated levels of dopamine and supersensitivity of dopamine receptors in caudate nucleus

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26
Q

Behavioral Pediatrics

Hospitalization

A

Hospitalized children are at increased risk for emotional and behavioral problems, and children ages one to four tend to have the most negative reactions to hospitalization.

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27
Q

Behavioral Pediatrics

School Related Problems

A

Children and adolescents with chronic medical conditions have higher rates of school-related problems (e.g., CNS irradiation and intrathecal chemotherapy for leukemia have been linked to impaired neurocognitive functioning and learning disabilities).

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28
Q

Behavioral Pediatrics

Compliance

A

Compliance with medical regimens is a particular problem for adolescents. because of peer acceptance concerns

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29
Q

Schizophrenia

Diagnostic Criteria

A

A diagnosis of Schizophrenia requires the presence of at least two active phase symptoms - i.e., delusions, hallucinations, disorganized speech, grossly disorganized behavior, negative symptoms - for at least one month with at least one symptom being delusions, hallucination, or disorganized speech

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30
Q

Schizophrenia

Prognosis

A

best outcome associated with:

  • acute and late onset
  • female gender
  • precipitating event
  • brief duration of active-phase symptoms
  • insight
  • family history of mood disorder
  • no family history of schizo
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31
Q

Schizophrenia

Concordance Rates

A
  • Siblings- 10%
  • Fraternal 17%
  • Identical 48%
  • Child of two schizo parents 46%
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32
Q

Schizophrenia

Etiology

A
  • Elevated dopamine reason for symptoms
  • enlarged ventricles
  • smaller than normal hippocampus, amygdala, globus pallidus
  • hypofrontality
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33
Q

Schizophrenia

Treatment

A

Treatment usually includes an antipsychotic drug, cognitive-behavioral therapy, psychoeducation, social skills training, supported employment, and other interventions for the individual with Schizophrenia and psychosocial interventions for his/her family.

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34
Q

Schizophrenia

Expressed Emotion (EE)

A

family based interventions are most effective when they target high levels of of EE, which have been linked to relapse and hospitalization

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35
Q

Delusional Disorder

Diagnostic Criteria

A

one or more delusions that last a month

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36
Q

Delusional Disorder

Types

A
  • erotomanic (belief that someone is in love with you)
  • grandiose (believes they are great but unrecognized)
  • jealous (belief that spouse is unfaithful)
  • persecutory (belief that they are being conspired against, cheated on, spied on, poisoned)
  • somatic (abnormal body function/sensation)
  • mixed
  • unspecified
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37
Q

Schizophreniform Disorder

Diagnostic Criteria

A

The diagnostic criteria for Schizophreniform Disorder are identical to those for Schizophrenia except that the disturbance is present for at least one month but less than six months and impaired social or occupational functioning may occur but is not required.

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38
Q

Brief Psychotic Disorder

Diagnostic Criteria

A

Brief Psychotic Disorder is characterized by the presence of one or more of four characteristic symptoms (delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior) with at least one symptom being delusions, hallucinations, or disorganized speech.

Symptoms are present for at least one day but less than one month with an eventual return to full premorbid functioning.

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39
Q

Schizophenia

Differential Diagnosis

A
  • between 1 day and 1 month- “Brief Psychotic”
  • between 1 month and 6mo- schizophreniform
  • 6mo or more schizophrenia
  • schizoaffective- schizophrenia + major depressive or manic episode
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40
Q

Bipolar 1

Diagnostic Criteria

A

A diagnosis of Bipolar I Disorder requires at least one manic episode that lasts for at least one week, is present most of the day nearly every day, and includes at least three characteristic symptoms - e.g., inflated self-esteem or grandiosity; decreased need for sleep; flight of ideas.

Symptoms must cause marked impairment in social or occupational functioning, require hospitalization to avoid harm to self or others, or include psychotic features.This disorder may include one or more episodes of hypomania or major depression.

Onset is 18y/o

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41
Q

Bipolar 1

Treatment

A

Treatment usually includes lithium or an anti-seizure medication and cognitive-behavior therapy or other form of therapy.

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42
Q

Bipolar

Differential Diagnosis

A
  • cyclothymic- less intense, hypomanic symptoms
  • BD 2- hypomania, 4 days
  • BD 1- mania, 7 days
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43
Q

Bipolar 2

Criteria

A

shorter episodes, “hypomania,” abnormally and persistently elevated, expansive, or irritable mood

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44
Q

Disruptive Mood Dysregulation

Diagnostic Criteria

A
  • temper outbursts- verbal or behavioral
  • two of three settings (home/school/peers)
  • diagnosed between ages 6 and 18, symptoms must persist for a year
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45
Q

MDD

Diagnostic Criteria

A

A diagnosis of Major Depressive Disorder requires the presence of at least five symptoms of a major depressive episode nearly everyday for at least two weeks, with at least one symptom being depressed mood or loss of interest or pleasure

Symptoms are:

  • depressed mood (or, in children and adolescents, a depressed or irritable mood)
  • markedly diminished interest or pleasure in most or all activities
  • significant weight loss when not dieting or weight gain or a decrease or increase in appetite
  • insomnia or hypersomnia
  • psychomotor agitation or retardation fatigue or loss of energy
  • feelings of worthless or excessive guilt
  • diminished ability to think or concentrate
  • recurrent thoughts of death
  • recurrent suicidal ideation
  • suicide attempt.
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46
Q

MDD

Variations

A
  • peripartum onset
  • seasonal pattern
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47
Q

MDD

Associated features

A
  • sleep disturbances
  • anxiety (60% comorbidity)
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48
Q

MDD

Prevalence

A
  • 18-29 is 3x the 60+ prevalence
  • 7%
  • females is 1.5-3x males
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49
Q

MDD

Pseudodementia

A
  • pseudodementia- onset is sudden and is actually depression, patient is concerned about symptoms
  • dementia- onset is slow and patient is unaware
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50
Q

MDD

catecholamine hypothesis

A

deficiency in norepiphephrine

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51
Q

MDD

indolamine hypothesis

A

low levels of serotonin

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52
Q

MDD

other etiology hypotheses

A
  • elevated levels of cortisol (stress hormone)
  • shrinkage of the hippocampus
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53
Q

MDD

Behavioral Theory of Depression

A

Lewinsohn’s behavioral theory attributes depression to a low rate of response-contingent reinforcement. (operant extinction of social behaviors)

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54
Q

MDD

learned helplessness model

A

Seligman’s learned helplessness model proposes that depression is due to exposure to uncontrollable negative events and internal, stable, and global attributions for those events. A reformulation of the theory by Abramson, Metalsky, and Alloy emphasizes the role of hopelessness.

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55
Q

MDD

Beck’s Depressive Triad

A

negative illogical self-statements about oneself, the world, and the future

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56
Q

MDD

Treatments

A

TCAs, SSRIs (first-line), MAOIs (for those who don’t respond to other drugs)

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57
Q

Dysthymia

Diagnostic Criteria & Treatment

A
  • depressed mood on most days for at least two years (in adults, one year in children)
  • CBT + Medication
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58
Q

Suicide

Early Warning Signs

A

High risk for suicide is associated with a warning; previous attempts; a plan (especially one involving a lethal weapon); male gender; being divorced, separate, or widowed; and feelings of hopelessness.

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59
Q

Suicide

Age

A

For most age groups, the rates are highest for Whites; an exception is for American-Indian/Alaskan Native individuals ages 15 to 34 who have a rate 2.5 times higher than the national average for this age group.

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60
Q

Suicide

Gender

A

Suicide attempters (vs. completers) are most likely to be female.

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61
Q

Suicide

Paradoxical Depression Improvement Effect

A

suicide most likely to occur within three months of depression improving

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62
Q

Suicide

Biological Correlates

A

low levels of serotonin and 5-HIAA

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63
Q

Separation Anxiety Disorder

Diagnostic Criteria

A

Separation Anxiety Disorder involves developmentally inappropriate and excessive fear or anxiety related to separation from home or attachment figures as evidenced by at least three symptoms - e.g., recurrent excessive distress when anticipating or experiencing separation from home or major attachment figures; persistent excessive fear of being alone; repeated complaints of physical symptoms when separation from an attachment figure occurs or is anticipated.

64
Q

Separation Anxiety Disorder

Criteria Time

A

The disturbance must last at least four weeks in children and adolescents or six months in adults and must cause clinically significant distress or impaired functioning.

65
Q

Separation Anxiety Disorder

Treatment

A

systematic desensitization, cognitive approaches (identifying and replacing negative self-statements

(school refusal- first line is to return to school, cognitive work after)

66
Q

Specific Phobia

Diagnostic Criteria

A

Specific Phobia is characterized by intense fear of or anxiety about a specific object or situation, with the individual either avoiding the object or situation or enduring it with marked distress. The fear or anxiety is not proportional to the danger posed by the object or situation, is persistent (typically lasting for at least six months), and causes clinically significant distress or impaired functioning.

67
Q

Specific Phobia

Treatment

A

The treatment-of-choice is exposure with response prevention (especially in vivo exposure).

68
Q

Specific Phobia

Etiology

A
  • abnormal levels of serotonin, norepinephrine, GABA
  • classical conditioning
69
Q

Specific Phobia

Types

A
  • animal
  • natural/environmental
  • blood/injection/injury
  • situational
70
Q

Social Anxiety Disorder

Diagnostic Criteria

A

Social Anxiety Disorder involves intense fear or anxiety about one or more social situations in which the individual may be exposed to scrutiny by others. The individual fears that he/she will exhibit anxiety symptoms in these situations that will be negatively evaluated; he/she avoids the situations or endures them with intense fear or anxiety; and his/her fear or anxiety is not proportional to the threat posed by the situations.

71
Q

Social Anxiety Disorder

Treatment

A
  • Exposure with response prevention is an effective treatment, and its benefits may be enhanced when it is combined with social skills training or cognitive restructuring and other cognitive techniques.
  • medication- SSRI, SNRI, beta blocker
72
Q

Panic Disorder

Diagnostic Criteria

A

Panic Disorder is characterized by recurrent unexpected panic attacks with at least one attack being followed by one month of persistent concern about having additional attacks or about their consequences and/or involving a significant maladaptive change in behavior related to the attack.

  • women 2x as likely to have it
73
Q

Panic Disorder

Treatment

A

Cognitive behavioral interventions that incorporate exposure are the treatment-of-choice for this disorder.

74
Q

Agoraphobia

Diagnostic Criteria

A

marked fear or anxiety in at least two of:

  • public transit
  • open spaces
  • enclosed spaces
  • standing in line
  • part of a crowd
  • outside the home alone

Concern about possibility of developing panic-like, embarassing or incapacitating symptoms

75
Q

Agoraphobia

Treatment

A

in vivo Exposure and Response Prevention

76
Q

GAD

Diagnostic Criteria

A

GAD involves excessive anxiety and worry about multiple events or activities, which are relatively constant for at least six months, the person finds difficult to control, and cause clinically significant distress or impaired functioning. Anxiety and worry must include at least three characteristic symptoms (or at least one symptom for children) - restlessness or feeling keyed up or on edge; being easily fatigued; difficulty concentrating; irritability; muscle tension; sleep disturbance.

77
Q

GAD

Treatment

A

Treatment usually involves cognitive-behavioral therapy or a combination of cognitive-behavioral therapy and pharmacotherapy.

78
Q

OCDPD

Diagnostic Criteria

A

Obsessive-Compulsive Personality Disorder is characterized by a persistent preoccupation with orderliness, perfectionism, and mental and interpersonal control that severely limits the individual’s flexibility, openness, and efficiency.

At least four characteristic symptoms must be present - e.g., exhibits perfectionism that interferes with task completion; is excessively devoted to work and productivity to the exclusion of leisure activities and friendships; is reluctant to delegate work to others unless they are willing to do it his/her way; adopts a miserly spending style toward self and others.

79
Q

OCD

Treatment

A

A combination of exposure with response prevention and the tricyclic clomipramine or an SSRI is usually the treatment-of-choice for OCD.

80
Q

OCD

Gender

A

Prevalence the same, but onset is earlier in males, so there are a larger amount of males with OCD

81
Q

OCD

Etiology

A
  • over-active right caudate nucleus
  • problems with orbitofrontal cortex and cingulate cortex function
  • low levels of serotonin
82
Q

Reactive Attachment Disorder

Diagnostic Criteria

cold to caregivers

A

Reactive Attachment Disorder is characterized by a pattern of inhibited and emotionally withdrawn behavior toward adult caregivers as manifested by a lack of seeking or responding to comfort when distressed and a persistent social and emotional disturbance. The diagnosis requires evidence that the child has experienced extreme insufficient care that is believed to be the cause of the disturbed behavior. Symptoms must be apparent before the child is five years of age, and the child must have a developmental age of at least nine months.

83
Q

Disinhibted Social Engagement Disorder

Diagnostic Criteria

Warm to strangers

A

inappropriate interactions with unfamiliar adults, must be related to extreme insufficient care

84
Q

PTSD

Diagnostic Criteria

A

The diagnosis of PTSD requires exposure to actual or threatened death, serious injury, or sexual violence; presence of at least one intrusion symptom related to the event; persistent avoidance of stimuli associated with the event; negative changes in cognition or mood associated with the event; and marked change in arousal and reactivity associated with the event.

85
Q

PTSD

Treatment

A

Comprehensive CBT intervention

  • exposure
  • cognitive restructuring
  • anxiety management
86
Q

PTSD

Acute Stress Disorder

A

short term PTSD- three days to one month

87
Q

PTSD

Time requirement

A

Symptoms must have a duration of more than one month and must cause clinically significant distress or impaired functioning.

88
Q

Adjustment Disorder

Diagnostic Criteria

A

identifiable psychosocial stressors within three months of the onset of the stressors.

must remit after 6 months after the stressor goes away

89
Q

Dissociative Amnesia

Diagnostic Criteria

A

A diagnosis of Dissociative Amnesia requires an inability to recall important personal information that cannot be attributed to ordinary forgetfulness and causes clinically significant distress or impaired functioning. It is often related to exposure to one or more traumatic events. The most common forms of amnesia are localized and selective.

90
Q

Dissociative Amnesia

Types

Localized, Selective, Generalized

A
  • Localized - all events related to a circumscibed period of time
  • Selective- some events related to a circumscribed period
  • Generalized- person’s entire life

localized and selective most common

91
Q

Dissociative Amnesia

Types

Continuous, Systematized

A
  • continuous - inability to recall events subsequent to a specific time through the present
  • systematized- memories related to a certain category of information
92
Q

Somatic Symptom Disorder

Diagnostic Criteria

A
  • excessive thoughts, feelings, behaviors related to somatic symptoms
  • more than six months in duration
93
Q

Illness Anxiety Disorder

Diagnostic Criteria

A

Concern of a serious illness with absence of somatic symptoms or with mild somatic symptoms

present for 6mo

94
Q

Conversion Disorder

Diagnostic Criteria

A

The symptoms of Conversion Disorder involve disturbances in voluntary motor or sensory functioning and suggest a serious neurological or other medical condition (e.g., paralysis, seizures, blindness, loss of pain sensation) with evidence of an incompatibility between the symptom and recognized neurological or medical conditions.

95
Q

Factitious Disorder

Diagnostic Criteria

A

Individuals with Factitious Disorder Imposed on Self falsify physical or psychological symptoms that are associated with their deception, present themselves to others as being ill or impaired, and engage in the deceptive behavior even in the absence of an obvious external reward for doing so. For both types of Factitious Disorder, falsification of symptoms can involve feigning, exaggeration, simulation, or induction (e.g., by ingestion of a substance or self-injury).

96
Q

Anorexia Nervosa

Diagnostic Criteria

A

The essential features of Anorexia Nervosa are (a) a restriction of energy intake that leads to a significantly low body weight; (b) an intense fear of gaining weight or becoming fat or behavior that interferes with weight gain; and (c) a disturbance in the way the person experiences his or her body weight or shape or a persistent lack of recognition of the seriousness of his/her low body weight.

97
Q

Anorexia Nervosa

Etiology

A
  • higher than normal level of serotonin
  • high in perfectionism, high expectations for themselves and others
  • high EE in families is risk factor
98
Q

Anorexia Nervosa

Treatment

A
  • weight gain first- hospitalization sometimes necessary
  • CBT second, relapse prevention
99
Q

Bulimia Nervosa

Diagnostic Criteria

A

Bulimia Nervosa is characterized by (a) recurrent episodes of binge eating that are accompanied by a sense of a lack of control; (b) inappropriate compensatory behavior to prevent weight gain (e.g., self-induced vomiting, excessive exercise); and (c) self-evaluation that is unduly influenced by body shape and weight.

100
Q

Bulimia Nervosa

Etiology

A
  • onset linked to a period of dieting
  • low levels of endogenous beta-endorphin
  • low levels of serotonin
101
Q

Bulimia Nervosa

Binge Eating Disorder

A
  • distinct from bulimia because no purging
  • lack of control over volume of food eaten
102
Q

Enuresis

Diagnostic Criteria/Treatment

A
  • bed wetting, 5y/o and up, at least twice a week for three+ consecutive months
  • bell and pad OR medication, but bell and pad is better
103
Q

Encopresis

Diagnostic Criteria/Treatment

A
  • involuntary passage of feces
  • at least once a month for at least three months
  • at leat 4y/o
104
Q

Insomnia Disorder

Diagnostic Criteria

A

Insomnia Disorder is characterized by dissatisfaction with sleep quality or quantity that is associated with at least one characteristic symptom- difficulty initiating sleep; difficulty maintaining sleep; early-morning awakening with an inability to return to sleep. The sleep disturbance occurs at least three nights each week, has been present for at least three months, occurs despite sufficient opportunities for sleep, and causes significant distress or impaired functioning.

105
Q

Insomnia Disorder

Treatment

A
  • sleep hygiene
  • stimulus control (strengthen the bed/bedroom as cues for sleep)
  • relaxation training
106
Q

Hypersomniac Disorder

Diagnostic Criteria

A
  • difficulty becoming fully awake after an abrupt awakening
  • three times a week, three months
107
Q

Narcolepsy

Diagnostic Criteria

A

Narcolepsy is characterized by attacks of an irrepressible need to sleep with lapses into sleep or daytime naps that occur at least three times per week and have been present for at least three months. The diagnosis also requires episodes of cataplexy, a hypocretin deficiency, or a rapid eye movement latency less than or equal to 15 minutes.

108
Q

Other Sleep Disorders

Non-REM Sleep Arousal

A
  • sleepwalking
  • sleep terror (no memory in the morning)
109
Q

Other Sleep Disorders

Nightmare disorder

A

vivid nightmares during REM, lingering sense of anxiety and fear

110
Q

Erectile Disorder

Diagnostic Criteria

A

A diagnosis of Erectile Disorder requires the presence of at least one of three symptoms (marked difficulty in obtaining an erection during sexual activity, marked difficulty in maintaining an erection until completion of sexual activity, marked decrease in erectile rigidity) on all or almost all occasions of sexual activity.

111
Q

Penetration Disorder

Diagnostic Criteria

A
  • tensing of pelvic floor muscles
  • pain during penetration
  • linked to sexual/physical abuse
112
Q

Premature Ejaculation

Diagnostic Criteria/Treatment/Etiology

A
  • ejaculation in less than a minute, or before the person wants it to last
  • goes on for 6mo
  • treated with sensate focus, start-stop, squeeze techniques
  • linked to low serotonin
113
Q

Gender Dysphoria

Diagnostic Criteria

A
  • strong desire to be the opposite gender
  • duration of 6mo at least
114
Q

Paraphilic Disorder

Frotteuristic Disorder

Description and Treatment

A
  • inappropriate arousal from touching/rubbing against a non-consenting adult
  • treatment is covert sensitization (aversive conditioning in imagination)
  • DepoProvera (only effective while taking the drug)
115
Q

ODD

Diagnostic Criteria

A

Oppositional Defiant Disorder involves a recurrent pattern of an angry/irritable mood, argumentative/defiant behavior, or vindictiveness as evidenced by at least four characteristic symptoms that are exhibited during interactions with at least one person who is not a sibling - e.g., often loses temper; often argues with authority figures; often actively refuses to comply with requests from authority figures or with rules; often blames others for his/her mistakes.

116
Q

Transvestic Disorder

Diagnostic Criteria

A
  • exclusively in males
  • most are heterosexuals
117
Q

Intermittent Explosive Disorder

Diagnostic Criteria

A
  • inability to control impulses, not proportional to provocation, aggresion
  • twice a week
  • 12mo
118
Q

Conduct Disorder

Diagnostic Criteria

A

The diagnosis of Conduct Disorder requires a persistent pattern of behavior that violates the basic rights of others and/or age-appropriate social norms or rules as evidenced by the presence of at least three characteristic symptoms during the past 12 months and at least one symptom in the past six months.

119
Q

Conduct Disorder

Symptom Categories

A

Symptoms are divided into four categories: aggression to people and animals; destruction of property; deceitfulness or theft; and serious violation of rules.

120
Q

Conduct Disorder

Age

A

Symptoms must cause significant impairment in functioning, and the disorder cannot be assigned to individuals over age 18 who meet the criteria for Antisocial Personality Disorder.

121
Q

Conduct Disorder

Treatment

A

PMT- parent management training, teaches parents to reward positive behaviors

MST- alternative approach that targets individual, family, school, community

122
Q

Conduct Disorder

Types

A
  • life-course-persistent
  • adolescence-limited-type
123
Q

Substance Use Disorder

Diagnostic Criteria

A

Manifested by at least two symptoms during a 12-month period - e.g., substance used in larger amounts or for a longer period of time than intended

  • persistent desire or unsuccessful efforts to cut down or control use
  • craving for the substance
  • recurrent substance use despite persistent social problems caused or worsened by substance use
  • recurrent substance use in situations in which it is physically dangerous to do so;
  • tolerance
  • withdrawal
124
Q

Substance Use Disorders

Treatment

A
  • naltrexone, disulfiram for alcohol
  • buproprion for tobacco
125
Q

Substance Use DIsorders

Marlatt & Gordon

A

reaction to relapse is “abstinence violation effect,” they propose you see it as a mere mistake stemming from specific, external and controllable factors

126
Q

Substance Use DIsorders

Smoking Cessation Intervention

A
  • nicotine replacement therapy
  • multicomponent behavior therapy
  • support and assistance from a clinician
127
Q

Substance Induced Disorders

Diagnostic Criteria

A

The Substance-Induced Disorders include Substance Intoxication, Substance Withdrawal, and Substance/Medication-Induced Mental Disorders.The latter “are potentially severe, usually temporary, but sometimes persisting central nervous system (CNS) syndromes that develop in the context of the effects of substances of abuse, medications, or toxins” (APA, 2013, p. 487) and include Substance/Medication-Induced Psychotic Disorder, Substance/Medication-Induced Depressive Disorder, and Substance/Medication-Induced Neurocognitive Disorders.

128
Q

Substance Induced Disorders

Korsakoff

A
  • anterograde and retrograde amnesia, confabulation (invention of memories to cover for memory loss)
  • thiamine deficiency
129
Q

Substance Induced Disorders

Alcohol Withdrawal

A
  • autonomic hyperactivity
  • nausea, insomnia, illusions, hallucinations
  • tonic-clonic seizures
130
Q

Substance Induced Disorders

Stimulant Intoxication + Withdrawal

A

Intoxication

  • euphoria, affective blunting, hypervigilance, anxiety
  • after usage: tachycardia or bradycardia, irregular blood pressure, seizures

Withdrawal

  • fatigue
  • crash
  • nystagmus (involuntary rapid movement of the eyes)
131
Q

Substance Induced Disorders

Sedative Intoxication + Withdrawal

A

Intoxication

  • slurred speech
  • incoordination
  • unsteady gait
  • nystagmus

Withdrawal

  • tremors
  • autonomic hyperactivity
  • illusions, hallucinations
  • grand mal seizures
132
Q

Substance Induced Disorders

Opioid Intoxication + Withdrawal

A

Intoxication

  • euphoria followed by apathy
  • drowsiness
  • slurred speech

Withdrawal

  • dysphoric mood, nausea, lacrimation and rhinorrea
133
Q

Delirium

Diagnostic Criteria

A

A diagnosis of Delirium requires(a) a disturbance in attention and awareness that develops over a short period of time, represents a change from baseline functioning, and tends to fluctuate in severity over the course of a day and (b) an additional disturbance in cognition (e.g., impaired memory, disorientation, impaired language, deficits in visuospatial ability, perceptual distortions).

134
Q

Delirium

Etiology

A
  • older adults
  • decreased cerebral reserve (dementia, stroke, HIV)
  • postcardiotomy
  • burn victims
  • drug withdrawal
135
Q

Delirium

Treatment

A
  • treatment of underlying issue
  • reduction of agitated behaviors
  • haloperidol
136
Q

Neurocognitive Disorder Due to Alzheimerrs

Stage 1

A

Stage 1 (1 to 3 years) involves anterograde amnesia (especially for declarative memories); deficits in visuospatial skills (wandering); indifference, irritability, and sadness; and anomia.

137
Q

Neurocognitive Disorder Due to Alzheimerrs

Stage 2

A

Stage 2 (2 to 10 years) is characterized by increasing retrograde amnesia; flat or labile mood; restlessness and agitation; delusions; fluent aphasia; acalculia; and ideomotor apraxia (inability to translate an idea into movement).

138
Q

Neurocognitive Disorder Due to Alzheimerrs

Stage 3

A

Stage 3 (8 to 12 years) entails severely deteriorated intellectual functioning; apathy; limb rigidity; and urinary and fecal incontinence.

139
Q

Neurocognitive Disorder Due to Alzheimerrs

Prevalence/Course

A
  • accounts for 60-90% of cases of dementia
  • gradual onset/progressive decline
140
Q

Neurocognitive Disorder Due to Alzheimerrs

Etiology

A
  • chromosomal abnormalities (1, 14, 21)
  • ACh
141
Q

Neurocognitive Disorder Due to Alzheimerrs

Treatment

A
  • group therapy
  • behavioral therapy
  • antipsychotic drugs
  • cholinesterase inhibitors
142
Q

Vascular Neurocognitive Disorder

A

criterion for Major or Mild Neurocog met, clinical features are consistent with vascular etiology

143
Q

Neurocognitive Disorder due to HIV

Stages

A
  • 0: normal
  • 0.5: minimal or equivocal symptoms, no impairment
  • 1: functional, intellectual, motor impairment, can still function
  • 2: cannot work, can perform basic tasks of daily life
  • 3: major intellectual incapacity/motor disability
  • 4: nearly vegetative
144
Q

Paranoid Personality Disorder

Diagnostic Criteria

A
  • distrust
  • suspiciousness
  • doubts about benign remarks, grudges
145
Q

Schizoid Personality Disorder

A
  • detachment from interpersonal relationships
  • restricted range of emotional expression
  • little interest in relationships, sexual activity, lacks close friends
  • indifferent to praise/criticism
146
Q

Schizotypal Personality Disorder

A
  • ideas of reference
  • odd beliefs
  • magical thinking
  • inappropriate or constricted affect
  • usually have few friends and prefer being alone
147
Q

Antisocial Personality Disorder

A
  • violation of the rights of others
  • failure to conform to social norms
  • since 15, must have had a history of conduct disorder before age 15
148
Q

Borderline Personality Disorder

Diagnostic Criteria

A
  • frantic efforts to avoid abandonment
  • instable, intense interpersonal relationships
  • fluctuations between idealization and devaluation
  • affective instability
  • inappropriate anger, trouble controlling it
149
Q

Borderline Personality Disorder

Onset/Course

A
  • onset age range 19-34
  • substantial improvement in 15-year follow-up
  • by age 40, 75% of individuals no longer meet criteria
  • impulsive symptoms resolve fastest, affective instability resolves slowest
150
Q

Borderline Personality Disorder

DBT

A
  • group skills training to help clients regulate emotions
  • individual outpatient therapy to strengthen client’s motivation and newly acquired skills
  • telephone consultation to provide support and coaching
151
Q

Borderline Personality Disorder

Etiology

A

Stern: disturbance in the mother-child relationship
Mahler: fixation of reapprochment phase of separation-individuation
Kernberg: traced to adverse, unpredictable caregiver-child interactions that alternate between rejection and smothering

152
Q

Histrionic Personality Disorder

A
  • pervasive pattern of emotionality
  • attention-seeking
  • sexually seductive or provocative
  • shifting and shallow emotions
  • impressionistic speech
153
Q

Narcissistic Personality Disorder

A
  • grandiosity
  • need for admiration
  • fantasies of unlimited success
  • thinks theyre only understood by other high-status people
154
Q

Avoidant Personality Disorder

A
  • social inhibition, inadequacy, hypersensitivity
  • avoidant, fear of rejection/criticism
155
Q

Dependent Personality Disorder

A

need to be taken care of, submissive clinging behavior, fear of separation
needs assurances

156
Q

Obsessive Compulsive Personality Disorder

A

does not involve obsessions and compulsions
preoccupation with orderliness, perfectionism, need for control that limits flexibility
miserly, incapable of delegating

157
Q

Schizoid vs Schizotypal

A

People living with schizoid personality disorder have a limited desire for social relationships, whereas those with schizotypal personality disorder have a desire for social relationships but struggle with social interaction due to their eccentricities.

Madsen Triad EPPP (9 decks)

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