Chapter 5 pt 4 Flashcards
what is the criteria for trichotillomania
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
trichotillomania is associated with increased incidence of co-morbid what
OCD, MDD, exhortation (skin-picking disorder)
how is tichotillomania treated
SSRIs, 2ng generation antipsychotics, N-acetylcysteine, or lithium
CBT (habit reversal training)
what is the criteria for excoriation (skin-picking) disorder
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
excoriation disorder is seen more commonly in whom
75% of cases are women
more common in individuals with OCF and 1st degree family members
excoriation disorder is seen comorbidly with what
OCD, trichotillomania, MDD
what is treatment for excoriation disorder
specialized CBT (habit reversal training) SSRIs have shown some benefit
what is PTSD
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
what is Acute Stress Disorder
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
what is the criteria for PTSD
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
what is used to treat nightmares in PTSD
PRAZOSIN
what is the lifetime prevalence of PTSD
8%
prevalence higher in women, most likely due to greater risk of expire to traumatic events particularly rape
50% of PTSD patients have complete recovery by when
3 months
how is PTSD treated pharmacologically
SSRIs first line
prazosin (alpha 1 inhibitor) for nightmares
how is PTSD treated psychotherapy wise
specialized forms of CBT (exposure therapy, cognitive processing therapy)
supportive and psychodynamic therapy
couples/family therapy
what is cognitive processing therapy
modified form of CBT in which thoughts, feelings, and meanings of the events are revisited and questioned
80% of patients with PTSD also have what
another mental disorder
symptoms of PTSD diminish with what
age
what is adjustment disorder
behavioral or emotional symptoms develop after a stressful event
what is the criterial for an adjustment disorder
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
in adjustment disorder the stressful event is what
NOT LIFE THREATENING (PTSD it is)
divorce, death of a loved one or loss of job
what are the subtypes of adjustment disorder
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
what is epidemiology of adjustment disorder
very common (5-20% of outpatient) occur at any age
what triggers adjustment disorder
psychosocial factors
adjustment disorder may be chronic if
stressor is chronic or recurrent (but by definition it resolved after 6 months of cessation of stressor)
what is treatment for adjustment disorder
SUPPORTIVE PSYCHOTHERAPY (most effective)
group therapy
occasionally pharmacotherapy to treat symptoms
