Chapter 5 pt 4

Question 1

what is the criteria for trichotillomania

Answer 1

recurrent pulling out of one’s hair, resulting in hair loss
reported attempts to decrease or stop hair pulling
causes significant distress or impairment in daily functioning
hair pulling or loss not due to another medical condition or psychiatric condition
usually involves scalp, eyebrows, or eyelashes but may include facial, axillary, and pubic hair

Question 2

trichotillomania is associated with increased incidence of co-morbid what

Answer 2

OCD, MDD, exhortation (skin-picking disorder)

Question 3

how is tichotillomania treated

Answer 3

SSRIs, 2ng generation antipsychotics, N-acetylcysteine, or lithium
CBT (habit reversal training)

Question 4

what is the criteria for excoriation (skin-picking) disorder

Answer 4

recurrent skin picking resulting in lesions
repeated attempts to decrease or stop skin picking
causes significant distress or impairment in daily functioning
skin picking is not due to a substance or other medical condition

Question 5

excoriation disorder is seen more commonly in whom

Answer 5

75% of cases are women

more common in individuals with OCF and 1st degree family members

Question 6

excoriation disorder is seen comorbidly with what

Answer 6

OCD, trichotillomania, MDD

Question 7

what is treatment for excoriation disorder

Answer 7

specialized CBT (habit reversal training)
SSRIs have shown some benefit

Question 8

what is PTSD

Answer 8

multiple symtoms after exposure to one or more traumatic evens: intrusive symptoms (nightmares, flashbacks), avoidance, negative alterations in thoughts and mood, and increased arousal
LAST at least ONE MONTH
may occur immediately after trauma or with delated expression

Question 9

what is Acute Stress Disorder

Answer 9

patient who experience a major traumatic even and suffer similar symptoms to PTSD but for SHORTER DURATION

ONSET within 1 MONTH of trauma
symptoms LAST LESS than 1 MONTH

Question 10

what is the criteria for PTSD

Answer 10

exposure to actual or threatened deaths serious injury, or sexual violence by directly experiencing or witnessing the trauma
recurrent intrusions of re-experiancing the event via memories, nightmares, or dissociative reactions (flashbacks)
intense distress at exposure to cures relating to the trauma
physiological reactions to the cues relating to the trauma
active avoidance of triggering stimuli

at least two of the following negative conditions/mood: dissociative amnesia, negative feelings of self/other/world, self-blame, negative emotions (fear, horror, anger, guilt), anhedonia, feelings of detachment/estrangement, inability to experience positive emotions

at least two: hyper vigilance, exaggerated startle response, irritability/angry outbursts, impaired concentration, insomnia

Question 11

what is used to treat nightmares in PTSD

Answer 11

PRAZOSIN

Question 12

what is the lifetime prevalence of PTSD

Answer 12

8%

prevalence higher in women, most likely due to greater risk of expire to traumatic events particularly rape

Question 13

50% of PTSD patients have complete recovery by when

Answer 13

3 months

Question 14

how is PTSD treated pharmacologically

Answer 14

SSRIs first line

prazosin (alpha 1 inhibitor) for nightmares

Question 15

how is PTSD treated psychotherapy wise

Answer 15

specialized forms of CBT (exposure therapy, cognitive processing therapy)
supportive and psychodynamic therapy
couples/family therapy

Question 16

what is cognitive processing therapy

Answer 16

modified form of CBT in which thoughts, feelings, and meanings of the events are revisited and questioned

Question 17

80% of patients with PTSD also have what

Answer 17

another mental disorder

Question 18

symptoms of PTSD diminish with what

Answer 18

age

Question 19

what is adjustment disorder

Answer 19

behavioral or emotional symptoms develop after a stressful event

Question 20

what is the criterial for an adjustment disorder

Answer 20

development of emotional or behavioral symptoms WITHIN 3 MONTHS in response to an identifiable stressful life event

• marked distress in excess of what would be expected after such an event
• significant impairment in daily functioning

symptoms are not those of bereavement

symptoms RESOLVE in 6 MONTHS after stressor has been terminated

stress-related disturbance does not meet criteria for another mental disorder

Question 21

in adjustment disorder the stressful event is what

Answer 21

NOT LIFE THREATENING (PTSD it is)

divorce, death of a loved one or loss of job

Question 22

what are the subtypes of adjustment disorder

Answer 22

symptoms are coded base don predominance of either:
depressed mood
anxiety
mixed anxiety and depression
disturbance of conduct (such as aggression)
mixed disturbance of emotions and conduct

Question 23

what is epidemiology of adjustment disorder

Answer 23

very common (5-20% of outpatient)
occur at any age

Question 24

what triggers adjustment disorder

Answer 24

psychosocial factors

Question 25

adjustment disorder may be chronic if

Answer 25

stressor is chronic or recurrent (but by definition it resolved after 6 months of cessation of stressor)

Question 26

what is treatment for adjustment disorder

Answer 26

SUPPORTIVE PSYCHOTHERAPY (most effective)
group therapy
occasionally pharmacotherapy to treat symptoms