Abnormal Psychology (Diagnosis) Flashcards
What are the three diagnostic criteria for Intellectual Disability?
- deficits in IQ
- deficits in adaptive functioning
- onset early in development
What percent of ID cases have unknown etiology?
For those without an known cause, what is the strongest predictor of ID?
30% due to unknown causes
Low birth weight is the strongest predictor of all levels of severity of ID
Childhood onset fluency disorder
Stuttering
Falls in the category of Communication Disorders
Childhood onset fluency disorder
- typical age of onset:
- percent of children who recover:
- best predictor of prognosis:
Onset between ages 2 and 7
65-85% recover in childhood
Severity at age 8 is a good predictor of prognosis
Treatment for Childhood Onset Fluency Disorder
Young children- reduce stress at home
Older children - habit reversal training
- teach the competing reaponse of slow regulated breathing
What are the earliest signs of Autism Spectrum Disorder?
Abnormalities in social orientin and responsivity
Evident by 12 months
What are the predictors of the best prognosis in autism spectrum disorder?
- ability to communicate verbally by age 5-6
- IQ over 70
- later symptom onset
What are some biological/neural development differences seen in ASD?
- unusually rapid head growth in the first year
- structural brain abnormalities (particularly in amygdala and cerebellum)
- neurotransmitter abnormalities (serotonin, dopamine)
According to the DSM5, what is the prevalence rate of ADHD?
5% in children
2.5% in adults
Gender and ADHD:
ADHD overall is more common in ______
______ subtype is more common in males
______ subtype is more common in females
More common in males (2:1)
Combined presentation is more common in males
Inattentive subtype is more common in females
Course of ADHD: for children with ADHD…
____% meet criteria in adolescence
____% meet full criteria in adulthood
____% meet criteria for parital remission (still show some symptoms) in adulthood
65-80% meet criteria in adolescence
15% meet full diagnositic criteria in adulthood
Up to 60% are in partial remission in adulthood
ADHD: behavioral disinhibition hypothesis
Barkley (1990)
Core feature of ADHD is an inability to regulate behavior to fit situational demands
The most frequent comorbid disorder with Specific Learning Disorder (SLD) is :
ADHD
20-30% of children with SLD have ADHD
What medical factor has been linked to specific learning disorder?
Reccurent ear infections (otitis media)
Tourettes Disorder is highly related to which two other categories of disorders
- Obsessive Compulsive Disorder (higher rates of OCD in individuals with Tourette’s and family members)
- ADHD/attention disorders
Neurobiology of Tourettes
Elevated levels of dopamine and super sensitivity of dopamine receptors in rhe caudate nucleus
Pharmacological treatment for Tourettes
Antipsychotic drugs (haloperidol, pimozide) are effective in ~80% of cases)
SSRI - help with OC symptoms
Attention/impulsive symptoms are usually treated with clonidine as stimulants are contra-indicated
What techniques are used to help children reduce anxiety about medical procedures?
Filmed modeling Reinforcement Breathing exercises Emotive imagery/distraction Behavioral rehearsal
Techniques are based on Michenbaum’s stress innoculation model
Delusional disorder
Presence of one or more delusions for at least one month
Overall fx is not markedly impaired, and any impairment is directly related to the delusion(s)
Schizophrenia- key features
Presence of at least 2 of the following sx for at least one month:
- delusions
- hallucinations
- disorganized speech
- grossly disorganized behavior
- negative symptoms
One sx has to be delusions, hallucinations, disorganized speech
Contiuous signs of the disorder must be present for at least 6 months
In schizophrenia- anosognosia:
Poor insight into illness
Contributes to treatment noncompliance and relapse
A commonly comorbid diagnosis with schizophrenia is:
Substance use disorder
Tobacco use disorder is particularly high
Schizophrenia- prevalence rate
0.3-0.7%
Slightly higher for males
What is associated with a better prognosis in schizophrenia?
- good premorbid adjustment
- acute and late onset
- female gender
- presence of a precipitating event
- brief duration of active phase symptoms
- insight into illness
- no family history of schizophrenia
Brain abnormalities associated with schizophrenia
- enlarged ventricles
- smaller hippocampus, amygdala, globus pallidus
- lower activity in the frontal cortex (associated with negative sxs)
Schizophrenia: concordance rates
Biological sibling:
Fraternal twin:
Identical twin:
Child of 2 parents with schizophrenia:
Biological sibling: 10%
Fraternal twin: 17%
Identical twin: 48%
Child of 2 parents with schizophrenia: 46%
Dopamine hypothesis
Schizophrenia is related to ELEVATED dopamine levels or OVERSENSITIVE dopamine receptors
Research on prenatal risk factors and schizophrenia shows:
There is a link between schizophrenia and prenatal exposure to influenza
In the northern hemisphere a high proportion of individuals with schizophrenia are born in late winter/early spring- thought to be realted to high rates of infectious diseases in winter
Traditional/first generation antipsychotic drugs
Haloperidol
Fluphenazine
Most useful for eliminating positive symptoms
Can have severe side effects, including tardive dyskenesia
Atypical (second generation) antipsychotic drugs
Clozapine
Risperidone
Can be effective at reducing both positive and negative symptoms
Less likely to cause tardive dyskinesia
Impact of expressed emotion (EE) in schizophrenia
High levels of “expressed emotion” in the family members of individuals with schizophrenia is linked to higher relapse/rehospitalization
Can involve open criticism/hostility OR overprotectiveness/emotional involvement
Family based intervention is helpful in these cases
Schizophreniform disorder
Diagnostic criteria are the same as schizophrenia, but
- disturbance is present for at least one month but less than 6 months
- impairment may occur but is not required
Brief psychotic disorder
One of four sxs:
- delusions
- hallucinations
- disorganized speech
- disorganized behavior
Present for at least one day but less than one month
