Abnormal Psychology (DSM-5 & Neurodevelopmental disorders) Flashcards
Unspecified disorder is coded when…
the clinician does not want to indicate the reason why the client’s symptoms do not meet criteria for a specific diagnosis
provisional specifier my be used when…
the clinician does not currently have sufficient information for a firm diagnosis, but believes the full criteria for the diagnosis will eventually be met
cross-cutting symptoms measures
- used during initial interview and during treatment to monitor progress
- provide information on mental health domains that are important across psychiatric diagnoses
Level 1 cross-cutting symptom measures
-assess 13 domains for adults and 12 domains for children/adolescents and are useful for identifying areas that require additional evaluation
Level 2 cross-cutting symptom measures
provide in-depth information on specific domains (e.g. anxiety, depression, substance use) to help guide diagnosis, treatment, planning, and follow up
The World Health Organization Disability Assessment Schedule
- what is it used for?
- what are the 6 domains?
-used to assess level of disability in six domains: understanding and communicating, getting around, self-care, getting along with people, life activities, and participation in society
Personality inventories measure personality traits in which 5 domains?
- negative affect
- detachment
- antagonism
- disinhibition
- psychoticism
what are the 3 tools used to consider the impact of culture on diagnosis and treatment?
- Outline for Cultural Formulation
- Cultural Formulation Inventory (CFI)
- Cultural Concepts of Distress
Outline for Cultural Formulation
provides guidelines for assessing 4 factors: cultural identity, cultural conceptualization of distress, psychosocial stressors and cultural factors that impact vulnerability to resilience, and cultural factors relevant to the relationship between the client and therapist
Cultural Formulation Inventory (CFI) (what is it and what 4 domains does it focus on)
a semi-structured interview consisting of 16 questions designed to obtain information on the client’s views regarding the social/cultural context in his/her presenting problems
-focuses on 4 domains: cultural definition of the problem; cultural perceptions of cause, context, and support; cultural factors affecting self-coping and past help seeking; and cultural factors affecting current help seeking
Cultural Concepts of Distress
DSM-5 defines as the ways that cultural groups experience, understand, and communicate suffering, behavioural problems, or troubling thoughts and emotions
3 types of cultural concepts
Cultural syndromes
Cultural Idioms of distress
Cultural explanations
Cultural syndromes
clusters of symptoms and attributions that co-occur among individuals from a particular culture and are recognized by members of that culture as coherent patterns of experience
Cultural Idioms of distress
used by members of different cultures to express and provide shared ways for talking about personal and social concerns
Cultural explanations
explanatory models that members of a culture use to explain the meaning and causes of symptoms, illness, and distress
ataque de nervios
a syndrome recognized by members of certain Latino cultures– characterized by screaming, crying, trembling, and aggression and a sense of being out of control; often occurs in reaction to a stressful event involving the family
The DSM-5 utilizes a ____approach that divides the mental disorders into types that are defined by diagnostic criteria
categorical
To allow for heterogeneity, the DSM includes a ______ criteria set for most disorders
polythetic
In contrast to the previous DSM, the DSM-5 provides a ______ assessment system
nonaxial
Uncertainty about a person’s diagnosis is indicated by coding _________ when the clinician wants to indicate the reason why the client’s symptoms don’t meet criteria for a diagnosis
other specified disorder
3 diagnostic criteria for Intellectual Disability
- deficits in intellectual functions (reasoning, problem solving, abstract thinking) that are confirmed by clinical assessment
- deficits in adaptive functioning resulting 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
- onset of intellectual and adaptive functioning deficits during the developmental period
what are the 4 degrees of severity for intellectual disability?
mild, moderate, severe, and profound
early signs of intellectual disability include:
delays in motor development and lack of age appropriate interest in environmental stimuli; may not make eye contact during feeding; less responsive to voice and movement
For Etiology of intellectual disability what percentages are due to heredity? chromosomal changes? Pregnancy problems? acquired medical conditions? environmental factors?
heredity: 5% chromosomal changes: 30% pregnancy problems: 10% acquired medical conditions: 5% Environmental factors: 15-20%
What is another name for childhood-onset fluency disorder
stuttering
childhood-onset fluency disorder
disturbance in normal fluency and time patterning of speech that is inappropriate for the person’s age and involves sound and syllable repetitions, sound prolongations, broken words, word substitutions to avoid troublesome words, and/or monosyllabic whole-word repetitions
Onset for childhood-onset fluency disorder
between ages 2 and 7
what percentage of kids recover from childhood-onset fluency disorder?
65-85% –with severity of dysfluency at age 8 being a good predictor of prognosis
what are some possible treatment options for childhood-onset fluency disorder?
- reducing psychological stress at home
- parental instruction to reduce demands and stop reprimanding child for stuttering and help them cope with frustration
- habit reversal training
Habit reversal training
incorporates awareness, relaxation, motivation, competing response (ex. breathing), and generalized training
Criteria for autism spectrum disorder
- persistent deficits in social communication and interaction across multiple contexts
- restricted, repetitive patterns of behaviour, interests, and activities
- symptoms during the early developmental period
- impairments in social, occupational, or other area of functioning as the result of symptoms
An ASD individual must show at least two of which restrictive or repetitive patterns of behaviour
- stereotyped or repetitive motor movements, use of objects, or speech
- insistance on sameness
- inflexible adherence to routines or ritualized patterns of behaviour
- highly restricted, fixated interests that are abnormal in intensity or focus
- hyper or hyporeactivity to sensory input
What are the 3 levels of severity of ASD according to the DSM-5?
Level 1: requiring support
Level 2: requiring substantial support
Level 3: requiring very substantial support)
Associated Features of ASD
- intellectual impairments and/or language abnormalities;
- may exhibit and uneven profile of cognitive abilities
- may have motor deficits and engage in self-injurious behaviours
- decrease eye contact and impaired joint attention
only about _____ of ASD individuals achieve some degree of partial independence as adults
one third
Etiology of ASD
- rapid head growth during first year of life
- structural brain abnormalities (amygdala and cerebellum)
- neurotransmitter abnormalities (dopamine, serotonin, and others)
Treatments for ASD include:
- parent management training
- special education
- training in self-care and social interaction skills
- vocational training and placement
- behavioural techniques such as shaping and discrimination training to improve communication
for an ADHD diagnosis, the pattern of inattention and/or hyperactivity-impulsivity must persist for at least ______months
6
3 types of ADHD
- Predominantly inattentive
- Predominantly Hyperactive/impulsive
- Combined presentation
Inattention symptoms include:
- lack of attention to detail
- difficulty sustaining attention to tasks or activities
- doesn’t listen when directly spoken to
- fails to finish schoolwork/chores
- is easily distracted by extraneous stimuli
- often forgetful in daily activities
Hyperactivity-impulsivity symptoms include:
- frequently fidgets or squirms in seat
- often leaves seat at inappropriate times
- frequently runs or climbs in inappropriate situations
- talks excessively
- has difficulty waiting his/her turn
- interrupts or intrudes on others
Adults with ADHD often have problems with:
self-esteem, social relationships, and lower educational or occupational achievement
prevalence rate for ADHD in adults ___ and children____
2.5%; 5%
behavioural disinhibition hypothesis
proposes that the core feature of ADHD is an inability to regulate behaviour to fit situational demands
A diagnosis of Intellectual disability disorder requires deficits in intellectual functions, deficits in ________ and an onset during the _______
- adaptive functioning
- developmental period
The DSM-5 distinguishes between four degrees of severity based on adaptive functioning in 3 domains –conceptual, social, and ________
practical
The etiology of Intellectual disability disorder is unknown in about _____%
30%
it has been estimated that ____% of children with ADHD continue to meet diagnostic criteria in adolescence
65-80%
the National Institute of Mental Health Multimodal Treatment study of ADHD found that in terms of initial results _______ and combined medication and behavioural treatment produced a similar reduction int he core symptoms of the disorder
medication management
A child with a Specific Learning Disorder is most likely to also receive a diagnosis of:
ADHD
A person with Tourette’s Disorder is MOST likely to also have what?
obsessions and compulsions
Specific Learning Disorder
exhibits difficulties related to academic skills– need to have at least one characteristic symptom that persists for a lease six months despite interventions targeting those difficulties
ADHD is comorbid with specific learning disorder in ______% of children
20-30%
dyslexia
deficits in phonological processing
tic
a sudden, rapid, recurrent, nonrhythmic motor movement or vocalization
What are the 3 tic disorders listed in the DSM-5?
Tourette’s disorder
Persistent (chronic) motor or vocal tic disorder
Provisional tic disorder
what is the difference between persistent motor or vocal tic and provisional tic disorder?
provisional tic disorder is characterized by one or more tics being present for less than a year, and persistent is more than a year
What are some associated symptoms with Tourette’s disorder?
- obsessions and compulsions
- hyperactivity, impulsivity and distractibility
Etiology of Tourette’s disorder
-elevated dopamine and supersensitivity of dopamine receptors to the caudate nucleus
comprehensive behavioural treatment for tics (CBIT) incorporates what types of training?
habit reversal training, relaxation training, and psychoeducation
stress inoculation model provides the child with information about the procedure and uses what types of techniques?
filmed modelling, reinforcement, breathing exercises, emotive imagery/distraction, and behavioural rehearsal
children between the ages of ___ and ____ have the most negative reactions to hospitalization
one and four
Goodman (1998) found that the rate of psychiatric problems in children with ________ was at least _____ times higher than the rate for children without a physical disability
- hemiplegic cerebral palsy
- 3
Brown and Madan-Swain (1993) looked at the effects of CNS irradiation and intrathecal chemotherapy and found that both treatments were associate with____
- impaired neurocognitive functioning
- higher-than-normal learning disabilities
lack of compliance among chronically-ill children are linked to several factors including:
- a lack of knowledge or skill
- parent-child conflict
- communication difficulties
- developmental issues
research has confirmed that hospitalized children and children with physical disabilities are at increased risk for ______
emotional and behavioural problems
The best prognosis for Autism Spectrum Disorder is associated with:
verbal communication skills by age 6.
The DSM’s use of polythetic criteria sets is useful for:
recognizing the heterogeneity of symptoms for a particular diagnosis.
