Chapter 7: Psychological Disorders Flashcards
1
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Psychological disorder
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Characteristic sets of thoughts, feelings, or actions that cause noticeable distress to the surfer are considered deviant by the individual culture or cause maladaptive functioning in society, meaning that some aspect of the individuals behavior negatively impacts others or leads to self defeating outcomes. Their trade or behaviors that differ from the cultural norm.
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Biopsychosocial approach.
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A broader classification system commonly used for the psychological disorders. This method assumes that there are biological, psychological, and social components to an individual’s disorder. The biological component or disorder is something in the body, The psychological component stems from the individual’s thoughts, emotions, and behaviors, and the social component results from the individual surroundings.
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Direct therapy.
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Treatment that acts directly on the individuals, such as medication or periodic meetings with the psychologists.
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Biomedical Approach.
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Biomedical therapy emphasizes inventions that rally around symptoms reduction of psychological disorder. Assumes that any disorder has roots in biomedical disturbances and thus the solution should also be a biomedical nature.
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Indirect therapy.
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Aims to increase social support by educating and empowering family and friends of the affected individual.
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How do you classify psychological disorders?
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With the Diagnostic and Statistical Manual of Mental Disorders (DSM). a compilation of many known psychological disorders and it is based on description of symptoms.
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Delusions
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False belief discordant with reality and not shared by others in the individual culture.
5
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Psychotic disorder.
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Present with one or more of the following symptoms: Delusions, hallucinations, disorganized thoughts, disorganized behavior, catatonia, and negative symptoms. These symptoms are divided into positive and negative.
6
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Positive symptoms.
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Our behaviors, thoughts, or feelings added to normal behavior. Features that are experienced in individuals with psychotic disorders that are not present in the general population. Positive symptoms are considered by some to be two distinct dimensions. The psychotic dimension (Delusions and hallucinations) and the disorganized dimension (Disorganized thought and behavior). Negative symptoms are those that involve the absence of normal or desired behavior, such as disturbances of affect and avolition.
7
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Delusions of reference.
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involve the belief that common elements in the environment are directed towards the individual.
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What are the positive symptoms?
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Delusions and hallucinations, disorganized thoughts, and disorganized or catatonic behaviors.
9
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Delusions of persecution.
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Involve the belief that the person is being deliberately interfered with, discriminated against, plotted against, or threatened.
10
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Thought insertion.
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Believe that thoughts are being placed in one’s head.
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Delusions of grandeur.
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Involved the belief that the person is remarkable in some significant ways, such as being an inventor, historical figure, or religious icon.
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Thought broadcasting.
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Believes that once thoughts are broadcasted directly from one to head to the external world.
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Thought withdrawal.
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Believe that thought are being removed from one’s head.
13
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Disorganized thought.
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Characterized by loosening of associations. This may be exhibited a speech in which ideas shift from one subject to another in such a way that a listener would be unable to follow the train of thought.
13
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Catatonia
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Refers to certain motor behaviors characteristic of some people with schizophrenia.
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Hallucinations.
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Perceptions are not due to external stimuli, but which nevertheless seem real to the person perceiving them. Hallucinations is Auditory involves voices that are perceived as coming from inside or outside the patient’s head.
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Disorganized behavior.
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Inability to carry out activities of daily living such as paying bills, maintaining hygiene and keeping appointments.
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Neologism
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Person with schizophrenia may even invent new words.
14
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Word salad.
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Words thrown together incomprehensibly.
14
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Echolalia
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Repeating in others words.
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Echopraxia
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Imitating another’s actions.
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What are the negative symptoms of psychotic syndrome?
Disturbances in affect and avolition.
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Affect
Refers to the experience and display of emotion, So disturbance of affect is any disruption to disabilities.
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Blunting.
Severe reduction in intensity of affect expression.
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Emotional Flattering.
There are virtually no signs of emotional expression.
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Schizophrenia.
Characterized by a break between an individual and reality. In fact, the term schizophrenia literally means “split mind”
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Inappropriate affect.
Affect is clearly discordant with the content of the individual speech.
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Avolution
Marked by decreased engagement in purpose, goal, directed actions.
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phases of schizophrenia.
Prodromal phase: Patient often goes through a phase characterized by poor judgment, Before schizophrenia diagnosed. It is a simplified by clear evidence of deterioration, social withdrawal, role functioning impairment, peculiar behavior, inappropriate effect and unusual experience.
Active phase: Pronounce psychotic symptoms are displayed.
Residual phase, Also called recovery phase: Occurs after an active Episode. It is characterized by mental clarity, often resulting in concern.
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Schizotypal personality disorder.
Include both personality disorder and psychotic symptoms, with the personality symptoms having been already established before psychotic symptoms present.
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Delusion disorder.
Psychiatric symptoms are limited to delusions that are present for at least a month.
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Brief Psychotic disorder.
Positive psychotic symptoms are present for at least a day but less than a month.
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Schizophreniform disorder.
Same diagnosis criteria as schizophrenia except in duration; The required duration for this diagnosis only one month.
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Schizoaffective disorder.
Major mood episodes while also presenting psychotic symptoms.
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Depressive Disorders.
Conditions characterized by feelings of sadness there are severe enough in both magnitude and duration to meet specific diagnostic criteria.
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9 depressive symptoms.
Sadness: Depressive mood, feeling of sadness and emptiness.
Sleep: insomnia or hypersomnia.
Interest: lots of interest in pleasure, in activities that previously sparked joy, termed, anhedonia
Guilt: feeling of inappropriate guilt or worthlessness.
Energy: lower levels of energy throughout the day.
Concentration: decrease in ability to concentrate.
Appetite: pronounced change in appetite.
Psychomotor symptoms: psychomotor retardation, and psychomotor agitation.
Suicidal thoughts: Recurrent suicidal thoughts.
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How do you classify depressive disorders?
Based on duration, timing and cause of depressive symptoms.
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Major Depressive Disorder (MDD)
Is the presence of major depressive episodes. A major depressive episode is defined as a two week. In which 5. Of the 9 defined, depressive symptoms are encountered and must include either depressed mood or anhedonia. It has to be severe enough to impair once daily social or work related activities.
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Persistent depressive disorder (PDD) also known as dysthymia
Given when an individual experienced a period lasting at least two years in which they experienced had depressed mood on the majority of the days. A person can receive both PDD and MDD diagnosed if they met both the duration and severity requirements of both disorders.
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Disruptive mood dysregulation disorder.
Typically diagnosed between the ages of 6 and 10 and has the key diagnosed feature of persistent and requiring emotional irritability in multiple environments.
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Premenstrual dysphoric disorder.
Characterized by mood changes, often depressed mood occurring a few days before menses and resolving after menses onset.
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Seasonal affective disorder (SAD)
The dark winter months are believed to be the source of depressive symptoms, and thus the disorder is best characterized as major depressive disorders with seasonal onset. It is often treated with bright light therapy where the patient is exposed to a bright light.
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Postpartum depression.
Rapid changes in hormone levels just after giving birth is the cause of depressive symptoms.
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Bipolar and related disorders.
This category of disorders characterized by the presence of maniac and depressive symptoms.
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Maniac symptoms.
Are associated with an exaggerated elevation in mood accompanied by an increase in goal, directed activity and energy.
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What are the seven maniacs symptoms?
DIG FAST
Distractibility: inability to remain focused on activity.
Irresponsibility: engaging in risky activity without considering future consequences.
Grandiosity: exaggerated and unrealistic. Increasing self esteem.
Flight of thoughts: Racing through self reported or revealed through rapid speech.
Activity or agitation: increase in goal oriented work or social activity.
Sleep: decreased need for sleep.
Talkative: Exaggerated desire to speak.
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Hypomanic Episodes.
If the symptoms are present for at least four days and include at least three or more of the seven defined manic symptoms. However, they are not severe enough to impair the person's social or work activities.
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Manic episode.
If the manic symptoms (three or more of the defined 7) are severe enough to impair a person's social or work activity and persist for at least seven days.
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Bipolar I disorder.
When manic episodes are present, a diagnosis of bipolar I disorder is likely to be made. While most diagnosis of bipolar I disorder also include depressive symptoms, they are not a requirement.
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Bipolar II disorder.
The presence of both a major depressive episode and an accompanying hypomanic episode, but not a manic episode. He captures individuals who experienced major depressive episodes in the lesser hypomanic episode.
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Cyclothymic disorder.
Presence of both manic and depressive symptoms that are not severe enough to be considered episodes. The patient has not experienced major depressive, manic, or hypomanic episodes.
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Monoamine or catecholamine Theory of depression.
Neurotransmitters, norepinephrine and serotonin are linked together. Too much norepinephrine and seratonin In the synapse leads to mania, while too little leads to depression.
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Anxiety Disorders.
In the case of anxiety, fears the associated motion. Anxiety can be viewed as fear of the upcoming or future event. It is only considered an anxiety disorder when irrational and excessive fear or anxiety effects and individuals lately functioning.
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Phobia
Irrational fear of something that results in a compelling desire to avoid it. A specific phobias, one in which fear and anxiety are produced by a specific object or situation.
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Separation anxiety disorder.
Separation anxiety is the excessive fear of being separated from one's caregivers or home environment. It is common in kids, but when this anxiety is excessive and persists beyond the age, it is called separation anxiety disorder. These persistent beliefs may result in avoidant behaviors such as refusal to leave the home.
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Social anxiety disorder.
Has an accompanying Ideation in which individuals think that they will be perceived negatively by others. Is fear of anxiety towards social situations with the belief that the individual will be exposed, embarrassed or simply negatively perceived by others. Avoiding behavior to the point of social or occupational impairment is necessary for a social anxiety diagnosed.
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Selective mutism.
Heavily characterized by the consistent inability to speak in situations where speaking is expected. The patient has a fear of being negatively evaluated for what the patient might say.
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Panic disorder.
Recurrent of unexpected panic attacks. Panic attack is the misfiring of sympathetic nervous system resulting in an unwanted fight or flight response. It is the intense fear and a sense of impending danger. A panic attack is the certain urge of fear in which individuals feel that they are losing control of their body and that they are dying. An individual may become anxious at the thought of having an unexpected panic attack.
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Expected panic attacks.
Associated with specific triggers.
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Unexpected panic attacks.
No clear trigger in the panic attacks are seemingly random.
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Agoraphobia.
Anxiety disorder characterized by a few of being places or situation where it might be difficult for an individual to escape. Due to agoraphobia is association with panic attacks and fear of being negatively evaluated by others It is often comorbid with panic disorder, social anxiety disorder, and specific phobias.
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Generalized anxiety disorder (GAD)
Define as a disproportionate and persistent worry about many different things for at least six months. The worrying is difficult to control.
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Obsessive compulsive and related disorders.
Individuals perceive a particular need and respond to the need by completing a particular action.
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Obsessive compulsive disorder (OCD)
characterized by obsession (Persistent intrusive thoughts and impulses) which produce tension and compulsion (Repetitive tasks) that relieve tension but cause significant impairment in a person's life. Obsessions raises the individual stress level, compulsions relieve the stress.
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Obsessions
Perceived needs, with the accompanying indication that if a particular need is not met, then disastrous events will follow.
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Compulsions
Action paired with obsessions.
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Body dysmorphic disorder.
A person has an unrealistic negative evaluation of personal appearance and attractiveness, usually directed towards a certain body part. This is known as preoccupation, type of worry which lacks the disastrous ideation that accompanies obsession.
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Muscle dysmorphia
Individuals believe that their body is too small or unmuscular and respond through working out.
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Hoarding disorder.
need to save or keep items and is often paired with excessive acquisition of objects.
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Trichotillomania
Individuals are compelled to pull out their hair. Patients have previously attempted to stop their body focused compositions but have so far failed.
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Excoriation disorder.
Individuals are compelled to pick their skin. Patients have previously attempted to stop their body focused compositions but have so far failed.
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Trauma and stressor related disorder.
Traumatic event is the source of the symptoms and thus is a diagnosed requirement in these disorders. The typical response to traumatic events include fear, helplessness and perhaps anxiety. Individuals also presented with maladaptive symptoms like anhedonia, dysmorphia, aggression or dissociation.
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Post traumatic stress disorder (PTSD)
after experiencing our witness a traumatic event. Consist of intrusion symptoms, arousal symptoms, avoiding symptoms, and negative cognitive symptoms.
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Dissociative Disorders.
Avoid stress by escaping from part of their identity. They have an intact sense of reality.
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Behaviorist perspectives on PTSD symptoms.
Intrusion and arousal symptoms can be explained by associated learning, specifically classical conditioning, in which the event has become associated with traumatic triggers. Avoidance symptoms can be explained through operant conditioning, specifically avoidance learning, in which an individual learns behaviors to avoid unpleasant stimuli.
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Dissociative Amnesia.
Characterized by an inability to recall past experiences. Often linked to trauma.
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Acute stress disorder.
If the same symptoms as PTSD lasts for less than one month but more than three days.
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What are the symptoms of PTSD?
Intrusion symptoms include recurrent reliving of the event, flashbacks, nightmare. Arousal symptoms include an increased startle response, irritability and anxiety. Avoiding symptoms include deliberate attempt to avoid the memories, people or places. Negative Cognitive symptoms Inability to recall key features of the event.
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Dissociative Fugue.
Sudden unexpected move or purposeless wandering away from ones home or location of usual daily activities.
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Dissociative identity disorder (DID, formerly multiple personality disorder)
There are two or more personalities that recurrent take control of the patient behavior. It results when the components of Identity failed to integrate.
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Depersonalization Disorder
Individuals feel detached from their own minds or bodies. An out of body experience.
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Derealization Disorder
Individual feel detached from their surrounding.
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Somatic symptom disorder.
Have at least one somatic symptom, which may or may not be linked to an underlying medical condition. It is accompanied by disproportionate concerns about seriousness, devotion of excessive amount of time and energy to it, or elevated levels of anxiety.
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Illness Anxiety disorder.
Characterized by being consumed with thoughts about having or developing a serious medical condition. Individuals are quick to become alarmed by their health and either excessively check themselves for signs of illness or avoid medical appointments altogether. Most patients classified under hypochondriacs now fit into either somatic symptom disorder if somatic symptoms are present OR Illness, anxiety disorder if they are not.
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Conversion disorder.
It is also known as functional neurological symptom disorder. Characterized by symptoms affecting voluntary motor or sensory functions that are incompatible with patients Neurophysiological conditional. The patient may be surprisingly unconcerned by the symptom, which is called la Belle indifference.
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Personality disorders.
Pattern of behavior that is inflexible and maladaptive, causing distress or impairment functioning in at least two of the following: cognition, emotion, interpersonal functioning, or impulsive control. Personality disorders can be considered ego-syntonic OR ego-dystonic. This diagnosis is the criteria for general personality disorder.
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Ego-syntonic
Meaning that the individual perceived their behavior as correct, normal, or in harmony with their goals.
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Ego-dystonic.
Individuals see the illness as something thrust upon them that is intrusive and bothersome.
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What are the 10 personality disorders?
They are grouped into three clusters: cluster A (paranoid, schizotypal and schizoid), cluster B (antisocial, borderline, histrionic, and narcissistic), and cluster C (Avoidant, depending, and obsessive compulsive).
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Paranoid personality disorder.
Marked by a pervasive distrust of other and suspicion regarding their motives.
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Cluster A Personality disorders.
All marked by behaviour that is labeled as odd or eccentric by others.
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Schizoid personality disorder.
Pervasive pattern of detachment from social relations and a restricted range of emotional expression. Little desire for social interactions and poor social skills.
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Schizotypal personality disorder.
pattern of odd or eccentric thinking as well as magical thinking such as superstitiousness
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Cluster B Personality disorders.
All marked by behavior that is labeled as dramatic, emotional, or erratic by others.
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Antisocial personality disorder.
Pattern of disregard for and violations of the right of others. Repeated illegal acts, deceitfulness, aggressiveness or lack of remorse for said actions.
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Borderline personality disorder.
There is persuasive instability in interpersonal behavior, mood, and self-image. Interpersonal relationships are often intense and unstable. There is uncertainty about self-image, sexual identity and long term goals, and an intense fear of abandonment. Suicide attempts and self mutilations are common.
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Histrionic personality disorder.
Constant attention seeking behavior. They may also use seductive behavior to gain attention.
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Splitting
It is a defense mechanism used by borderline personality disorder individuals in which they view others as either all good or are bad.
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Narcissistic personality disorder.
Has a grandiose sense of self importance or uniqueness, preoccupation with fantasies of success and need for constant induration and attentions and feelings of entitlement. Fragile self-esteem and constantly concerned with how others view them.
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Dependent personality disorder.
Continuous need for reassurance. They tend to remain dependent on one specific person.
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Cluster C personality disorders.
All marked by behavior that is labeled as anxious or fearful by other.
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Avoidant personality disorder.
Affected individuals have extreme shyness and fear of rejection. Intensifier for social affection and acceptance.
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Obsessive compulsive personality disorder (OCPD)
perfectionist and inflexible, tend to like rules and order. OCD is also ego-dystonic whereas OCPD is ego-syntonic.
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Schizophrenia.
Most potential causes are genetic, but trauma birth, specifically hypoxemia (low oxygen concentration in the blood) is also considered to be a risk factor. Excessive marijuana use in adolescence is associated with increased risk. It is highly associated with the excess of dopamine in the brain; many medications used to treat schizophrenia, such as neuroleptics, block dopamine receptors.
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Neuroleptic
These medications depress nerve function. They are also known as antipsychotics.
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What are the markers associated with depression?
1) Abnormally high glucose metabolism in the amygdala.
2) Hippocampal atrophy after long duration of illness.
3) Abnormally high levels of glucocorticoids.
4) Decrease norepinephrine, serotonin and dopamine.
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What are the markers associated with bipolar disorder?
1) Increase norepinephrine and serotonin.
2) Higher risk if parent has bipolar disorder.
3) Higher risk for persons with multiple sclerosis.
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Alzheimer's disease.
Type of dementia characterized by gradual memory loss, disorientation to time and place, problems with abstract thought, and a tendency to misplace things. Patients older than 65 and women are at higher risk than men.
There is a genetic component to Alzheimer disease. Mutations in the presenilin genes and chromosomes 1 and 14. Mutations in the apolipoprotein E gene on chromosome 19 and betha-amyloid precursor protein gene on chromosome 21.
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What is the biological basis of Parkinson's disease?
Decrease dopamine production in substantia nigra, a layer of cells in the brain that functions to produce dopamine to permit proper functioning of basal ganglia. Basal ganglia help with smoothening motions. It can be managed with l-DOPA, a precursor that is converted to dopamine once in the brain, replacing that which is lost due to Parkinson's disease.
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What are the biological markers that are found in patients with Alzheimer's disease?
1) Diffuse atrophy of the brain on CT or MRI
2) Flattened sulci in the cerebral cortex.
3) Enlarge cerebral ventricles
4) Deficient blood flow in parietal lobes.
5) Reduction in levels of acetylcholine.
6) Reduce metabolism in temporal and parietal lobes.
7) Misfold protein in beta-pleated sheet form.
8) Neurofibrillary tangles of hyperphosphorylated Tau protein.
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Parkinson's disease.
It's characterized by bradykinesia (Slowness in movement), resting tremor (a tremor that appears when muscles are not being used), pill-rolling tremor (flexing and extending the fingers while moving the thumb back and forth as if rolling something in the fingers), mask like facies (static and expressionless face features, staring eyes an open mouth), cogwheel rigidity (muscle tension that intermittently halts movement as an examiner attempt to manipulate a limb) and shuffling gait with stooped posture.
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Connection between schizophrenia and psychosis and Parkinson's disease
Antipsychotic medication often leads to “parkinsonian” side effects, like muscle rigidity. Medications used in Parkinson’s disease is often lead to psychotic side effects, such as hallucinations and delusions.
