Abnormal Psychology Flashcards
Mild MR
IQ is 50-55 thru approx. 70; 85% of all MR cases; may not become apparent until child is school age and has difficulty meeting educational demands
Moderate MR
Approx 10% or MR population; IQ between 35-40 and 50-55; usually develop communication skills during early childhood; can be trained to performed unskilled work under close supervision
Severe MR
3-4% of the MR population; IQ between 20-25 and 35-40; communicative speech usually does not develop during early childhood, although it may be acquired during the school-age years; can learn basic self-care, but need more supervision
Profound MR
Approx 1-2% of MR population; IQ of less than 20-25; communication skills and sensorimotor functioning are significantly impaired; need nearly constant supervision and generally benefit from a one-to-one relationship with a caregiver
Assessing MR
WISC has high floor, or minimum score of about 50; this test cannot provide accurate assessment of the level of MR. Stanford-Binet best to assess MR because its floor is much lower (also to assess giftedness).
Causes of MR
Varied and etiology may be undetermined in approximately 30-40% of cases. Clear etiologies easier to ascertain w/severe or profound MR. Most common identifiable cause is abnormalities in embryonic development; maternal illness; maternal consumption of alcohol, maternal use of nicotine or drugs and chromosomal changes.
What is the most common form of LD?
Reading disorder (dyslexia). 80% of LDs and approx. 4% of all children.
What percentage of those with LD do not complete High School?
40%
What percentage of children with LD have comorbid ADHD?
20-30%
What are most cases of reading disorder due to?
Poor sound awareness and sound-symbol correspondence (phonological processing).
What are the two types of dyslexia?
Surface dyslexia (AKA orthogonal dyslexia: difficulty with irregular words, ex. might = mit) and deep dyslexia (probs with many words, even “regular” ones)
Alexia
Dyslexia due to brain damage
What percentage of LD people struggle with significant psychosocial probs as adults?
Approx 33%
Borderline Intellectual Functioning
IQ between 71 and 84
Stuttering
Onset nearly always under 10; approx 3:1 boy:girl ratio; peak onset age 5. Often resolved by age 16, but may persist to adulthood, especially with males. Must cause impairment for a diagnosis. Rarely recommended, but Verpamil may help.
Phonological Disorder
A childhood communication disorder characterized by failure to use developmentally appropriate speech sounds; when speaking, individuals with this disorder may substitute one sound for another, omit sounds, incorrectly order sounds within words of syllables, lisp, or otherwise misarticulate sounds.
Autism and Gender
Boys more likely to have AD, but when girls have it they are more likely to also have MR
What percentage of individuals with autism show MR? Have seizures?
MR - about 70%. 25% develop seizures.
What indicates good prognosis with autism?
Normal range IQ (over 70) and spoken language by age 6.
Rhett’s Disorder
A PDD in which a child demonstrates deceleration in head growth, replacement of purposeful hand skills w/stereotyped hand movements (hand-wringing), severe psychomotor agitation, severe impairment in language development,a nd loss of social engagement. Sx appear between 5 and 48 mths in age, after an apparently normal prenatal and perinatal development. Only occurs in females.
ADHD and nuerology
Frontal lobe functioning and frontal striata pathways are implicated in symptoms
Prevalence of ADHD
5-8% of children and adolescents (slightly lower in adults); sex ratio is 3:1 male:female. Comorbidity with ODD/CD, anxiety disorders, mood disorders, LD; strongly heritable (around 80%)
ODD
A disruptive behavior disorder characterized by negativistic, hostile, and defiant behavior (actively disobeying directions or parents or other caregivers, short temper, spitefulness, irritability, failure to take responsibility for one’s mistakes or misbehavior, frequent arguments w/adults) lasting at least 6 mths.
Conduct Disorder
Disruptive Behavior Disorder characterized by aggression toward people or animals, destruction of property, deceitfulness, theft, and serious rule violations, childhood precursor to Antisocial Personality Disorder.
Pica
Some normality between 18-24 mths. Regular ingetsion of non-nutritive substances, often linked to MR or PDD, can lead to serious medical complications (lead poisoning for example)
Rumination Disorder
25% of these children may die as a result of malnutrition. Repeated regurgitation and often re-chewing of food without apparent distress; may result in malnutrition or death; linked to stress in parent-child relationship, along with lack of stimulation, child neglect.
Feeding disorder of infancy or early childhood (“failure to thrive”).
Causes more probs when occurring before age 2. Failure to eat adequately for at least one month. Linked w/developmental delays, sometimes child abuse or neglect, extreme stress in the family, clear failures in parental “reading” of infant/child hunger cues, or forcing food.
Reactive Attachment Disorder
Child displays significantly disturbed social relatedness, linked directly to grossly pathological care (and not MR or PDD). Onset before age 5.
Two types of RAD
Inhibited Type: Children do not engage in many interactions, are hypervigilant, wary of letting other people come close to or make eye contact with them (“frozen watchfulness”), and often resistant toward physical affection. and Disinhibited Type: Children are indiscriminately sociable and fail to make selective attachments, act overly familiar (i.e. overly affectionate) with strangers.
Transient Tic Disorder
1+ motor or vocal tics daily for between 4 weeks and 12 months
Chronic Tic Disorder
Involves at least 12 months of daily motor OR vocal tics, but not both
Tourette’s Disorder
Involves at least 12 mths of daily motor AND vocal tics
Essential Tremors
A neurological disorder characterized by rhythmic tremors in the hands or other body parts that only occur during intentional movements (i.e. not while at rest)
Stereotypic Movement Disorder
A disorder usually first diagnosed in infancy, childhood, or adolescence characterized by repetitive, seemingly driven, and nonfunctional motor behaviors that significantly interferes with normal activities or cause self-inflicted physical injuries; often associated with MR
Percentage of children with enuresis by age
5-10% of 5-year-olds; 3-5% of 10-year-olds, and 1% of individuals aged 15 and older.
Separation Anxiety Disorder
Refusal to attend school is one of the characteristics, but only three need to be present for dx. Children under 8 more likely to worry about catastrophes befalling the attachment figure. 9-12 year olds may experience significant distress at separation or anticipation of separation.
Selective Mutism
Indicative of anxiety; not of abuse or neglect. Majority of those dx will also have sx of social phobia. Occurs in less than 1% of individuals seen in outpatient setting. Slightly more common in females than males. Onset usually between the ages of 5 and 7.
Delirium
Major disturbance in consciousness and in cognitive/perception, usually resulting from medical condition or substance intoxication or withdrawal. Sudden onset. Alternating agitation and lethargy common; emotional lability often present (anger at family; fearful during hallucination)
Who is at risk for delirium?
Adults over 60 highest risk (60% of nursing home residents over age 75 may experience delirium). Also surgery, burn patients, stroke or HIV and drug users. Children are at increased risk, especially with high grade fevers or medication reactions; may co-occur with demential. Delirium involves reduction of consciousness while those with dementia remain alert.
Brief Psychotic Disorder
A disorder characterized by presence of delusions, hallucinations, disorganized speech, or catatonic behavior. Sx last for at least a day, but for less than a month, after which individual returns to pre-morbid functioning.
Vascular Dementia
A cognitive disorder caused by a cerebrovascular disease (stroke). Sx include memory impairment, aphasia, apraxia, agnosia, and disturbed executive functioning; characterized by a sudden onset and fluctuating course with rapid changes in cognitive functioning.
Two types of CVAs
Hemmorrhagic CVA involve bleeding into brain from weakened blood vessels (often linked to hypertension). Ischemic CVAs involve obstructed blood flow related to clots or dislodged tissues; these account for 85% of CVAs.
Recovery and mortality rate for CVAs
Mortality rate is around 30%; only 10% make a full recovery.
What percentage of CVAs occur while a person is sleeping?
Approximately 1/3
Which resolves first after a CVA: physical difficulties or cognitive difficulties?
Usually physical
Stages of Demential due to HIV disease:
Subclinical (Sx result in minimal impairment without deficits in activities of daily living); Mild (unequivocal evidence of functional, intellectual, or motor impairments, but pts able to perform most ADLs and are fully ambulatory); Moderate (pts unable to work or perform demanding ADLs, but are able to perform basic self-care, require some assistance walking); Severe (pts demonstrate significant intellectual impairments and cannot walk unassisted); End Stage (pts are nearly vegetative)
What percentage of pts with Parkinson’s will eventually develop dementia?
20-60%
Parkinson’s and depression
Year before dx, those taking anti-depressants are 2x as likely to receive diagnosis of Parkinson’s.
Onset of Parkinson’s
Typically after 65 years of age
How often do those going through alcohol withdrawal experience delirium tremons?
Fewer than 10%. When it does happen, 1-5% have a fatal outcome.
Sx of alcohol withdrawal
Autonomic hyperactivity, tremors, insomnia, short-lived hallucinations or illusions, agitation, grand mal seizures