Block 1 Flashcards
1
Q
Biological Theory
A
Mental illness results from brain dysfunction, biochemical, neurotransmitters- Benjamin Rush
2
Q
Overgeneralization
A
Making a negative global statement (a woman thinks that all men are untrustworthy after one man cheats)
3
Q
Excessive Responsibility
A
Blaming oneself for negative events that the person doesn’t have control over
4
Q
Arbitrary Inference
A
Making a conclusion without sufficient and necessary evidence (concluding that a spouse is unfaithful because they arrive home late)
5
Q
Catastrophizing (Magnifying)
A
Viewing a situation as considerably worse than it is- excessive reaction
6
Q
Selective Abstraction ( filtering)
A
Focusing on a detail out of context (dwelling on the one mistake you made during your presentation and ignoring the good parts)
7
Q
Dichotomous (polarized) thinking
A
Viewing people, actions and experiences in one of two extreme categories (good or bad, all or none)
8
Q
Theoretical Perspectives
A
One theory does not explain all behaviors
9
Q
Cognitive Theory
A
Behavior is influenced by the way the person thinks, how you choose to think, thoughts affect emotion; depending how an event is interpreted
10
Q
Classical Conditioning
A
Pavlov- learning in which a stimulus acquires the capacity to evoke a response that is originally evoked by another stimulus (dog and bell)
11
Q
Dog food
A
unconditioned stimulus (CC)
12
Q
Salvation
A
unconditioned response and conditioned response (CC)
13
Q
Bell
A
neutral stimulus and conditioned stimulus (CC)
14
Q
Stimulus Generalization
A
occurs when a CR is elicited by stimuli similar to the CS, not just the actual CS (hospitals) (CC)
15
Q
Stimulus Discrimination
A
occurs when a CR is elicited by ONLY the CS, not by stimuli similar to it (CC)
16
Q
Operant conditioning
A
consequence of an action determines whether the response will happen again- can strengthen or weaken the behavior, should occur immediately and consistently
17
Q
Postive Reinforcement
A
increasing a behavior by GIVING something pleasurable (food, money) (OC)
18
Q
Negative Reinforcement
A
increase a behavior by removing something aversive (waiving house chores) (OC)
19
Q
Postive Punishment
A
decreasing a behavior by applying something aversive (spanking) (OC)
20
Q
Negative Punishment
A
decreasing a behavior by removing something pleasurable (revoking privileges) (OC)
21
Q
If you get good grades, you get money
A
Positive RF (OC)
22
Q
If you get good grades, you don’t have to do chores
A
Negative RF (OC)
23
Q
If you get bad grades, you get scolded
A
Positive punishment (OC)
24
Q
If you get bad grades, you get you TV privileges revoked
A
Negative punishment (OC)
25
Learned Helplessness
Overuse of punishment may cause a person to become depressed, may become passive and not try any longer. Medication and cognitive therapy (OC)
26
Shaping
The process by which a behavior can be developed from scratch by reinforcing actions that are successively closer to the behavior that is desired (OC)
27
Operant Extinction
the process of weakening a previously reinforced behavior by stopping the reinforcement, grades diminish if child no longer gets $$ for good grades (OC)
28
OC Fixed Ratio
RF/P is given after a predictable number of responses (after every 5th action)
29
OC Variable Ratio
RF/ P is given after an unpredictable number of responses
30
OC Fixed Interval
RF/P given after a fixed period of time (last day of the month)
31
OC Variable interval
RF/P is given after an unpredictable period of time (16th day then the 2nd then the 9th)
32
OC Ratio Schedule
1. Continuous
2. Fixed
3. Variable
33
OC Interval Schedules
1. Fixed
| 2. Variable
34
Id (Psychodynamic)
I want to hit him
35
Ego (Psychodynamic)
Let's work things out
36
Superego (Psychodynamic)
it's not right to hurt people
37
Denial
refusing to believe a clear fact
38
Repression
keeping feelings or thoughts out of conscious awareness
39
Displacement
redirecting one's feelings from the true source of emotion and taking it out on another source
40
Projection
disowning one's feelings and giving ownership of those feelings to somebody else
41
Identification
patterning one's behaviors after someone else
42
Regression
reverting to a behavioral pattern associated with an earlier stage of development
43
Splitting
Viewing the world in a polarized fashion by selectively focusing on positive or negative attributes (good or bad, no in-between)
44
Isolation of Affect
stripping away emotion from a though/memory, leaving an emotionless narrative
45
Intellectualization
stripping away emotion from a thought/ memory and replacing the emotion with excessive use of intellect in the narrative (medical jargon)
46
Rationalizing
making excuses to make oneself fell/look better in a given situation (I didn't really want the job anyway)
47
Somatization
Transforming psychological distress into a physical symptom (exam stress causing headaches)
48
Acting Out
performing an externalizing behavior to express feelings that person is not able to express appropriately (anger is expressed by a tantrum rather than verbally)
49
Passive Aggression
expressing hostility though passivity/ lack of action (being late on purpose)
50
Reaction Formation
Showing the opposite behavior as to how one really feels (obsessive sexual urges expressed as prudish behavior)
51
Dissociation
Distancing/ removing oneself mentally from an experience to prevent the full distressful impact of the event (happy place)
52
Undoing
completing an action that symbolically reverses/repairs the unacceptable behavior or feeling (flirting with a colleague and later complimenting your spouse, knock on wood)
53
Altruism
performing an altruistic act with a conscious altruistic intention but also with an unconscious self serving motivation (a generous charitable donation assuages one's guilt about pas unpaid debts, kidney donation)
54
Humor
expressing distress by joking about the distressful thought
55
Sublimation
expressing an undesirable emotion/ impulse in a constructive, socially acceptable manner (anger released though exercise)
56
Suppression
consciously putting an upsetting thought temporarily out of mind for retrieving at a more appropriate time (dealing with bad new after word)
57
Psychotherapy
"Talk therapy"- therapist listens, understand, and responds
58
Cognitive therapy
Changing a pts distorted thoughts to improve one's mental state, used for depression and anxiety- goes along with behavior therapy
59
Behavioral therapy
Focus on changing behavior by using principles of classical, operant, and vicarious conditioning
1. Systematic Desensitization
2. Exposure therapy and flooding
3. Token Economy
4. Aversion Therapy
5. Biofeedback
6. Vicarious Conditioning
60
1. Systematic Desensitization
| Behavioral Therapy
1. Diaphragmatic Breathing, progressive muscle relaxation (train pts in physical states that are incompatible with anxiety)
2. Hierarchy Construction: pt develops a list from low to high fear for anxiety provoking situations
3. Desensitization: pt confronts each item on the list, the goes is to associate the anxiety-provoking scene with relaxation rather than anxiety
61
2. Exposure Therapy and Flooding
| Behavioral Therapy
Exposure Therapy: Gradual exposure to a fearful stimulus
| Flooding: non-gradual prolonged, full-intensity exposure to a fearful stimulus
62
3. Token Economies
| Behavioral Therapy
A system of reinforcing and punishing specific behaviors by giving or taking away tokens. Tokens are exchanged for rewards.
63
4. Aversion Therapy
| Behavioral Therapy
therapy to reduce an undesirable behavior by associating the behavior with an actual noxious stimulus/ consequence (pinching yourself when you have the urge to smoke)
64
5. Covert Sensitization
| Behavioral Therapy
aversion therapy in which the undesirable behavior is associated with an imagined noxious stimulus/ consequence. (imagining a breakup of a relationship because of drinking)
65
6. Biofeedback
| Behavioral Therapy
learning to control an involuntary physiological activity through feedback
- physiological activity is translated into a signal so that any change in signal reflects a physiological change
- feedback helps person learn to detect and automatically modify one's bodily state
66
7. Vicarious Conditioning
| Behavioral Therapy
learning through observing someone whose behavior has been operantly or classically conditioned (boy sees peer get punished for swearing; now the boy doesn't swear), used to develop social skills
67
Psychodynamic Therapy
Long-term therapy, analysis of relationships with parents and significant others and how they relate to a pts present day problems. ID and modification of a pts use of defense mechanisms, unconscious thoughts
1. Hypnosis
2. Free association test: stating the first word that comes to mind when a word is spoken
3. Interpreting Freudian slips: unintentional speech/ writing errors are regarded as revealing one's true feelings
4. Dream interpretation: symbolism in dreams is thought to reveal one's true feelings
Goal is to promote insight so one can change behavior and understands the reasons
68
Humanistic Therapy
"Self-actualization" maximizing one's potential by fostering problem-solving in a supportive environment
-therapist has an unconditional positive regard (empathy, acceptance, genuineness)
69
Group Therapy
1. Traditional Group Therapy: groups formed of people with the same issue, learning through peers, practice interpersonal skills
2. Family Systems/ Marital Therapy: Individual's problems result, in part, from a problem in the family system, not just with an individual
3. Self-help groups: voluntary organization composed of people with a common problem and have a mutual goal to help one another, NOT led by a health professional
70
Therapeutic Alliance
a doctor and pt engage with each other to try to effect beneficial change in the pt- all psychotherapies
71
Transference
a pts emotional reaction to the doctor
72
Countertransference
MDs emotional reaction to a pt
73
Catharsis
Psychodynamic Therapy: to release strong, repressed emotions
74
4 Medication types
1. Antipsychotics (neuroleptics)
2. Antidepressants (ADs)
3. Mood Stabilizers (anti-manic)
4. Anxiolytics (anti-anxiety)
75
Chlorpromazine
Discovered in 1950s, antipsychotic drug that calmed pts
76
Antipsychotics (neuroleptics)
For psychotic behavior ( hallucinations, delusions)
- common feature is a reduction of dopamine
- motor abnormalities are a side effect
77
Antidepressants (ADs)
Drugs that increase serotonin, norepinephrine, and dopamine
1. SSRIs: selective serotonin reuptake inhibitors
SNRIs: serotonin-norepi reuptake inhibitors
Side Effects: GI distress, sexual dysfunction
2. TCAs: tricyclic antidepressant
MAOIs: monoamine oxidase inhibitors, inhibits enzyme that degrades monoamines
Side Effects: BP changes
78
Inhibition of degrading enzymes
Enzymes break down neurotransmitters that aren't stored in vesicles in the presynaptic cell, there for less NT is available for loading into vesicles, if there is less NT in vesicles then less NT gets released into the synaptic cleft
79
Mood Stabilizers
Bipolar disorder
- lithium
- select anticonvulsants and antipsychotics
80
Anxiolytics
For anxiety
- antidepressants
- Benzodiazepines (diazepam)
- Increase GABA, which depresses brain activity
- Short term use because addiction risk
81
Medication management time
Psychotropics typically take 4-6 weeks before their therapeutic effects are evident (not Benzos)
82
Electroconvulsive Therapy (ECT)
Application of an electrical stimulus to the brain to induce a seizure to improve mood (pt given a muscle relaxant and anesthetic), used if other treatment resistant, no contraindication but possible increase bp, 3 treatments/ week for 6-12 treatments
83
Side effects of ECT
Cardiac arrhythmia, headache, confusion, memory loss
84
Effectiveness of ECT
Difficult to isolate therapeutic effect, rapid clinical improvement of mood episode, used to treat acute phase not prevention
85
Repetitive transcranial magnetic stimulation (rTMS)
Stimulation of the prefrontal cortex using electromagnetic pulses (without seizure)
- Approved for depressed pts that have failed 1 medication
- Scalp discomfort
- 4-6 weeks of daily 45 min sessions
- not as effect as ECT
86
Magnetic seizure therapy (MST)
Experimental technique for mood disorders (not yet approved)
- stimulation is done electromagnetically as in rTMS
- seizure is produce like ECT but a focal rather than generalized
- goal is to minimize memory loss
87
Vagus nerve stimulation
Electrical stimulation of the vagus nerve via an implanted wire in neck and pacemaker device in chest
- Risk of surgery, coughing, therapeutic effect takes several months
- Treatment-resistant depression
88
Deep Brain stimulation
Electrical stimulation via an implanted electrode (subthalamus) and a pacemaker device in chest
- approved for severe, treatment resistant OCD
- risk of infection, brain hemorrhage
- several months to see effects, treatment is indefinite
89
Psychosurgery
Surgery destroys brain tissue to change behavior
- Prefrontal lobotomy: cutting nerves connecting the frontal lobes
- Lesions are produced for pts with OCD
90
Benefits of Psychiatric classification
- Provides a means to identify mental illness
- assists in choosing appropriate treatment
- helps to predict prognosis
- provides an efficient manner to communicate info to professionals
- can bring relief to pts
- homogeneous sample of pts to discover important facts about the condition
91
DSM-5 Psychiatric Classification system
Includes a diagnostic criteria for each psychiatric disorder
- 300+ specific mental disorders grouped across 22 broad categories
- Bipolar, neurodevelopment disorders, schizophrenia, depressive disorders, anxiety disorders
92
Z-code condition
Other conditions that may be focus of clinical attention
-not mental illnesses but may be the focus of clinical attention
Z63.4 Uncomplicated Bereavement
Z65.4 Victim of Crime
93
Provisional
Used if one presumes that criteria are or will be met for the disorder but either pt information is unavailable or required symptoms are present, but the duration isn't met yet
-Provisional goes after the name of the specific disorder
Diagnosis: Bulimia nervosa, provisional
94
Unspecified
If a pt does not meet criteria for a specific disorder but has significant symptoms within a given diagnostic category
-Unspecified comes before the name of the diagnostic category
Diagnosis: Unspecified eating disorder
95
Prior History/ Remission
Descriptors when a pt has been previously diagnosed with a disorder but the symptoms are no longer present
Diagnosis: Bulimia Nervosa, Prior History
Diagnosis: Alcohol Use Disorder, in Remission
96
A 55-year-old man feels tremendous guilt about accidentally killing a child who ran in front of his car, even though the death was ruled not his fault. As a results of his guilt, he now gives the vast majority of his life savings to charities involving children. Which of the following defense mechanisms best explains his extremely generous behavior?
Altruism
97
A 32-year-old man is the biggest gossip in the office. Yet, he often accuses others of talking too much about other people and spreading rumors. Which of the following defense mechanisms best explains his accusatory behavior?
Projection
98
A medical student has a father who is a well known surgeon. The medical students feels pressure to become a surgeon. However, he wants to be a pediatrician and is unable to confront his family. During the surgery clerkship, he develops weakness in the right hand and is unable to hold retractors during surgeries. Which of the following defense mechanisms best explains the physical problem he developed?
Somatization
99
A woman experiences extremes in emotion—she either hates or loves people. She considers actions either absolutely wrong or absolutely right with no uncertainties. Which of the following defense mechanisms best explains her extremes in thinking?
Splitting
100
A 14-year-old girl is an unhappy teenager who feels unattractive, disliked by her peers, and inferior. She starts to act and dress like a popular female athlete in the school. Which of the following defense mechanisms best explains the unhappy teenager's behavior?
Identification
101
A 15-year-old boy is brought to the emergency department by the police because of cold exposure. He had casually left his parent’s home after destroying furniture and appliances in their house after an argument about his curfew. Parents state that their son is a loner with low self-esteem. Lately, he has had disciplinary problems at home and school. This episode marks the most exaggerated and aggressive of his many outbursts. Which of the following defense mechanisms best explains his behaviors?
Acting Out
102
While in psychotherapy, a patient describes, with little display of emotion, a horrific motor vehicle accident in which she was badly hurt as a child. Which of the following defense mechanisms best explains this patient's demeanor?
Isolation of Affect
103
Throughout early adulthood, a woman had a lot of anger for the way her abusive father treated her during childhood. She never confronted him about her feelings. Now, as a middle-aged woman, she feels at peace with her past after writing a best-selling novel in which parent-child conflict is the major theme. Which of the following defense mechanisms best explains her behavior?
Sublimation
104
While telling parents that their daughter just died on the operating table, a surgeon spends excessive time explaining in great technical detail the complications of their daughter's medical condition. Which of the following defense mechanisms best explains the surgeon's behavior?
intellectualization
105
A man who had his leg amputated makes jokes about his new prosthetic leg. Which of the following defense mechanisms best explains this man's behavior?
Humor
106
A 50-year-old man, who is happily married, has lewd thoughts about an attractive woman who passes him on the street. Feeling guilty, he then buys flowers for his wife, whom he loves very much. Which of the following defense mechanisms best explains his behavior?
Undoing
107
A 26-year-old woman did not get the promotion that she wanted and expected. After learning that her promotion was rejected, she states that she really did not want the promotion, since it would mean more time away from her two children. Which of the following defense mechanisms best explains her reaction to rejection?
Rationalization
108
A 19-year-old woman was homesick and anxious when she moved into the dorms and started her first year in college. She began to sleep with her old teddy bear again for comfort. Which of the following defense mechanisms best explains her behavior?
Regression
109
While being molested by a pedophile, an 8-year-old girl feels detached from herself, as if she were watching herself from a distance. Which of the following defense mechanisms best explains the girl's reaction?
Dissociation
110
Many people who lived in concentration camps are unable to recall events that happened in the camp during their internment. Which of the following defense mechanisms best explains their memory loss?
Repression
111
A 23-year-old girl fears that she is unattractive, and she truly has no desire for sex. Outwardly, she wears provocative clothing and uses suggestive language. Which defense mechanism best explains her behaviors?
Reaction Formation
112
A 15-year-old boy starts using drugs. The dramatic changes in his behavior made it obvious to his friends and teachers that he was abusing drugs. When the school principal called to inform his parent's of the problem, they absolutely refused to believe that their son was a drug user. Which of the following defense mechanisms best accounts for the parents' reaction?
Denial
113
Stressors activate....
The Amygdala (fear center), which stimulates the Hypothalamic-Pituitary-Adrenal (HPA) Axis and causes the release of cortisol
114
Treatment Strategies for Stress
1. Having knowledge of what to expect, have an action plan, utilize social support
2. Relaxation training
3. Cognitive Therapy
4. Medication
115
Yerkes-Dodson law
low and high levels of stress are associated with low performance, there is a relationship between performance and stress
116
Posttraumatic Stress Disorder (PTSD) (4 symptoms)
Traumatic: actual or threatened death or serious injury or sexual violence
- over the age of 6
- Must have 4 types symptoms
- MUST last greater than 1 month
- usually being within 3 months of the trauma but can begin anytime in the future
1. Intrusion symptoms
- dreams, recollections, feeling event reoccur, psychological of physiological distress when encounters symbols
2. Avoidance Symptoms
- avoid thoughts or anything that reminds you of the event
3. Negative Alterations in cognition and mood
- negative beliefs, negative emotional states, inability to experience positive emotion, bleak outlook, detach from others, dissociative amnesia
4. Alterations in arousal and reactivity
- sleep disturbance, irritable and angry outburst, reckless behavior, concentration problems, hyper vigilance, exaggerated startle response
117
Acute Stress Disorder (ASD)
Traumatic event
- same symptoms as ptsd
- DURATION 3 days to 1 month after trauma exposure
- resolve in 30 days after trauma
118
Treatment of PTSD and ASD
Psychotherapy
| -psychotherapy in general and behavior psychotherapy, pharmacological
119
Adjustment Disorder
Development of significant and disproportional emotional/ behavioral symptoms in direct response to an identifiable psychosocial stressor (divorce, moving, getting fired from job)
- brief duration symptoms resolve within a few months, not more than 6 months
- acute onset, develop within 3 months of stressor onset
- symptoms cannot be explained by another disorder
- do not represent normal bereavement
120
Adjustment with depressed mood
depressed mood
121
Adjustment with anxiety
anxiety
122
Adjustment with disturbance of conduct
doing reckless behavior (driving poorly)
123
Upon relocating to a new residence 2 months ago, a woman feels sad, disinterested, and lethargic. The woman blames her symptoms on the relocation. Diagnosis?
Adjustment order with depressed mood
124
Upon relocating to a new home two months ago, a woman feels sad, disinterested, and lethargic. she has difficulty sleeping, has lost weight, and cannot concentrate (these symptoms meet criteria for major depressive disorder). The woman blames her symptoms on the relocation. Diagnosis?
Major depressive disorder
125
PTSD symptoms 2 weeks after the trauma and lasted 2 months
PTSD
126
PTSD symptoms 3 days after the trauma and lasted 3 weeks
Acute stress disorder (ASD)
127
A 45-year-old married woman wants to travel to see her closest friend from childhood. She does not invite her husband to join her on the trip. Her husband concludes that she is unhappy in their marriage and plans on divorcing him. Which of the following cognitive distortions is the husband displaying?
Arbitrary Inference
128
A world champion female gymnast dominates the sport of gymnastics. During the balance beam competition, however, she makes a novice but major error, falls off the beam, and badly loses the competition. She concludes that she is an awful gymnast. Which of the following cognitive distortions does she display?
Overgeneralization
129
A world champion female gymnast dominates the sport of gymnastics. During a competition, she performs almost perfectly but takes an extra step in the floor routine. She easily wins first place. For the rest of the day, the woman who still knows she is a great gymnast, can only talk and think about the flaw she made in her routine. Which of the following cognitive distortions does she display?
selective abstraction
130
Over the years, you have taken pink pain killing tablets contain ibuprofen to successfully treat your discomfort. This time when you experience pain, you take a pink tablet that looks like a pain reliever, but unbeknownst to you, it does not contain the active ingredient of ibuprofen. Nevertheless, you experience pain relief when you take this tablet. What is the unconditioned stimulus?
Ibuprofen ingredient
131
A 30-year-old woman comes to the psychologist because of anxiety. After treatment using behavioral techniques, her anxiety is reduced. The woman makes another appointment with the psychologist for the following week. The act of seeing a psychologist has been:
Negatively reinforced
132
A 20-year-old man is peer pressured into using heroin for the first time. After injecting the heroin, he experiences an intense feeling of euphoria. He then uses heroin again, even when alone and without peer pressure. The act of using heroin has been
Positive reinforcement
133
A prisoner refuses to answer questions and is electrically shocked. When the prisoner answers a question, the shock is terminated. Answering questions has been:
negative reinforcement
134
A 3-year-old boy cries every night after the parents tuck him in to bed and leave the bedroom. In response to the crying, the parents come back into his room to comfort him, and the boy stops crying. The parents’ behavior of leaving the child’s bedroom at night has been:
positively punished
135
A 3-year-old boy cries every night after the parents tuck him in to bed and leave the bedroom. In response to the crying, the parents come back into his room to comfort him, and the boy stops crying. The parents’ behavior of coming back to the room and providing comfort has been:
negatively reinforced
136
A 45-year-old woman sees a dog walking down the street unaccompanied by its owner. She concludes that the dog is an abused dog who is now homeless which of the flowing cognitive distortions is she most likely illustrating?
arbitrary inference
137
A 16-year-old boy is responsible for feeding the family fish each day. He turns off the pump and drops food into the tank. The fish then swim to the top of the tank to eat the floating food. Now when he merely turns off the pump, the fish swim to the top of the tank. Which of the following elements is most likely the conditioned stimulus?
Pump turning off
138
A 7-year-old boy whines for a candy bar while at the grocery store. The mother buys him a candy bar to stop his whining. He now whines for a candy bar every time they go shopping. He starts to gain weight and have cavities, so she stops buying him candy bars even if he whines. After about a week, no longer whines from a candy bar. Which of the following learning principles best explains why he stopped whining?
operant extinction
139
A 6 year old boy is sometimes given a token when he behaves politely. He does not know which act of behaving politely will result in a token. The tokens can be traded for a desired treat. Tokens are most likely being delivered using which of the following schedules of reinforcement?
variable ratio
140
A 7-year-old girl gets to eat her favorite food every Tuesday as a reward for being left with a babysitter while the parents go out. The reward of getting to eat his favorite food is being delivered using which of the following schedules of reinforcement?
Fixed interval
141
A 45-year-old woman becomes widowed after her husband is killed by a drunk driver. To deal with her feelings of anger, she joins a part time volunteer organization that helps discourage drinking and driving. Which of the following defense mechanisms is the wife most likely using?
sublimation
142
A woman inwardly feels resentful about being a mother and having to raise a child. As a defense against the guilt she feels for disliking motherhood, she outwardly behaves as though she enjoys being a mother and showers her child with love. Which of the following defense mechanisms is the woman most likely demonstrating?
reaction formation
143
therapist begins to feel angry at the pt
psychoanalytic idea of countertransference
144
Sid wants to end his habit of smoking 3 packs a cigs a day. Ted wants to stop his serious drinking problem. Which treatment might be used for both individuals?
Aversion Therapy
145
You begin to think of your therapist in a similar way to your sister, so you begin to treat the therapist as you treat your sister. This is referred to as
transference
146
A therapist tells a pt that he is “not being genuine, not being himself.” The therapist encourages the pt to make life choices based on his true feelings. What is the therapist’s most likely theoretical framework?
humanistic
147
A young woman was mugged at gun point when she was leaving work and was terrified by the event. She has repeated nightmares about the mugging and flashbacks during the day. She also refuses to go in the general area where the mugging occurred. She is now hyperalert and over responsive to stimuli. These symptoms began the day after the mugging and have persisted for the past 90 days. Which of the following is most likely diagnosis?
PTSD
148
A 30-year-old man was in a life-threatening bike accident. Starting after the accident, he repeatedly replayed the accident in his mind, had nightmares and difficulties falling asleep, felt numb and distant from others, lost interest in his hobbies, and avoided driving any vehicle. He stopped attending weekend bike races which he enjoyed in the past. His symptoms lasted three weeks before he returned to his normal self and was able to attend bike races again. Which of the following is the most likely diagnosis?
Acute Stress disorder
149
Ever since a bitter divorce 2 months ago, a woman has been depressed with constant crying and frequent suicidal thoughts. These symptoms have affected her ability to concentrate at work, and her overall functioning so she decides to seek help from a health professional. Which of the following is the most likely diagnosis?
adjustment disorder with depressed mood
150
A 23-year old woman is brought to the MD by her parents for a exam. She has been taking a psychotropic med for the past 6 months for a bipolar disorder. Her symptoms include manic and depressive episodes. Which medication is she most likely taking?
A mood stabilizer
151
Modeling
learning behavior through observation
152
Diagnostic interview
goal to gather sufficient information to arrive at a diagnosis and treatment plan
153
Structured interview
info gathered by asking questions in a check-list fashion
154
Semi-structured interview
info gathered by asking open ended questions, but covering key topics
155
Mental Status Exam (MSE)
- clinicals observations
- screening of cognitive functioning
- ASEPTIC
- -Apearance
- -speech
- -emotion
- -perception
- -thought content
- -insight
- -Cognition (time, place, memory)
156
Mini-mental state exam
30pt screening test
157
Stanford binet intelligence test
Iq Test, good for extremes in intelligence
158
Wechsler intelligence test
most common iq test
- WAIS: 16-90
- verbal comprehension, reasoning, memory, speed
159
Wechsler intelligente scale for children WISC
6-16
160
Wechsler preschool and primary scale of intelligence WPPSI
2:6-7:7
161
Minnesota Multiphasic personality inventory (MMPI-2)
- 600 T/F questions
| - self report
162
Million clinical multi-axial inventory (MCMI)
- 175 questions
| - used to screen for serious psyc problems
163
Beck depression Inventory (BID)
21 item self report
- indicates which statement best describes the way they have been feeling
- level of depression can be quantified and monitored
164
Rorschach
10 inkblots
165
Thematic apperception test
select relevant pictures out of 30, tells a story
166
children's apperception test
child version of thematic apperception test (3-10yrs)
167
Bender gestalt test
a visuospatial abilities (parietal lobe)
168
Wisconsin card sorting test
a executive functions (prefrontal lobe)
169
Stroop test
prefrontal lobe test
170
Behavioral inventroy
provides a baseline of frequency of an undesired behavior so that any change from baseline can be monitored
171
Cognitive inventory
IDs thoughts preceding, during and after a maladaptive behavior (thoughts leading to binge eating)
172
Bodily inventory
BP, muscle tension, respiration
173
Stress
Experienced when a person perceives that demands exceed their resources
- physiological
- psychological
- behavioral
174
Physiological basis of stress
Stress activates amygdala which stimulates the HPA and cause release of the hormone cortisol and adrenaline
175
Stress treatment
| General stategies
having knowledge, being prepared, utilizing support
176
Stress Treatment
| Relaxation training
breathing exercises
177
Stress Treatment
| Cognitive Therapy
pt learns to have a productive internal dialogue
178
Stress treatment
| Medication
Benzos and antidepressants
179
Yerkes-dodson law
low and high levels of stress are associated with low performance levels
-stress exacerbates almost all mental illness
180
PTSD
-exposure to traumatic stressor
1. intrusion symptoms (dreams, feelings reoccur)
2. Avoidance symptoms
3. negative alteration in cognition and mood
4. alterations in arousal and reactivity (sleep disturbance, irritable)
Duration: must last greater than a month
Onset: any time in future
181
Acute Stress Disorder
Exposure to a traumatic stressor
- numerous PTSD like symptoms
- Duration: 3 days to 1 month after trauma exposure
- symptoms resolves within the first 30 days of trauma
182
Treatment for PTSD and ASD
Psychotherapy and behavioral therapy
| -Benzos and antidepressants (SSRIs, TCAs)
183
Adjustment disorder
Divorce
- acute onset (within 3 months of stressor onset)
- Brief durations (resolve within a few months), not more than 6 months
- symptoms not explained by another disorder
184
Upon relocating to a new residence 2 months ago, a woman feels sad and lethargic. the woman blames her symptoms on the relocation...
adjustment disorder with depressed mood
185
Adjustment disorder treatment
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Psychotherapy (coping strategies)
Crisis intervention (hospitalization, psychotropic medications)
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186
Reactive attachment Disorder
Child has a history of extremely insufficient care (before age 5)
1. emotionally withdrawn with caregivers
2. social and emotional disturbance
3. not met for autism spectrum
4. at least 9 months
5. persistant for more than 12 months
187
RAD treatment
Psychotherapy, parental education, residential treatment programs
-outcome (death, misconduct, normal)
188
Disinhibited Social Engagement Disorder
Child has a history of EXTREMEly insufficient care
- symptoms emerge before the age of 5
- overly familiar with strangers
- persistant for 12 months
- treatment: psychotherapy
- Must have 2 of the following
1. reduced of absent reticence in approaching interacting with unfamiliar adults
2. overly familiar verbal or physical behavior not appropriate for age
3. diminished or absent checking back with adult caregiver
4. willingness to go off with an unfamiliar adult
