Clinical Flashcards
Which therapist trait is related to most successful therapy outcome
empathy
Treatment for chronic pain
hypnotherapy
CBT
Mental disorder most consistently linked with genetic factors
bipolar I (65-80% for mz twins)
Parallel process in supervision
When therapist feels and acts towards supervisor like the patient acts to the therapist (process of supervision is paralleling the process of therapy)
Projective identification
involves both loving and hateful feelings being transferred from the client into the therapist in an unconscious effort to evoke empathy and understanding
Acting out (psychoanalysis)
patient acting out on transference feelings as opposed to talking about transference in session
Factitious disorder
characterized by intentional feigning symptoms or creating a disorder, motivation to be in sick role (not motivated by external gains)
Malingering
feigning or creating symptoms for secondary gain
Key symptoms of schizoaffective disorder
Concurrent schizophrenia symptoms with major mood episode, with delusions/hallucinations also present without mood symptoms
primary prevention
preventing onset of disorder
secondary prevention
early identification and prompt treatment of disorder
tertiary prevention
reducing residual effects or optimizing functioning of patients with chronic condition
Essential features for autism diagnosis
persistent deficits in social communication and interaction, and restricted, repetitive patterns of behavior
According to Howard’s meta-analytic psychotherapy outcome research: __% of patients demonstrate measurable improvement in 6 months; __% by end of 8 sessions
75% of patients demonstrate measurable improvement in 6 months; 50% by end of 8 sessions
Most effective treatment for older adults with paranoia?
Neuroleptics/antipsychotics and managing the environment
Signs of opioid intoxication
pupillary constriction,
drowsiness,
slurred speech
Substances which cause hallucinations during withdrawal
alcohol,
sedatives,
hypnotics, and
anxiolytics
withdrawal can be fatal
Symptoms of amphetamine withdrawal
dysphoria,
fatigue,
unpleasant dreams,
increased appetite,
psychomotor agitation or retardation
Symptoms of opioid withdrawal
flu-like symptoms
Jungian definition of transference
part of the personal or collective unconscious that is projected out
James-Lange theory (of emotions)
emotions result from perceiving bodily reactions or responses (e.g., notice heart pounding, assume you are anxious)
Cannon-Bard theory
emotions and bodily responses occur simultaneously
Schacter’s two-factor theory (of emotion)
emotion results from both internal information and external information
Selye’s general adaptation syndrome
a model or response to severe stress consisting of three stages (alarm, resistance, exhaustion)
Concordance rates for monozygotic and dizygotic twins for schizophrenia
MZ=50%
DZ=10-15%
Concordance rates for monozygotic and dizygotic twins for bipolar disorder
MZ=80%
DZ=20-25%
Sleep changes related to MDD
Decreased REM latency, reduced slow-wave (stage 3-4) sleep, prolonged sleep latency, increased REM density (more rapid eye movements)
Most common type of dyslexia
phonological dyslexia (aka dysphonic, dysphonetic, auditory dyslexia) - inability to sound out words
Symptoms of neurocognitive disorder with Lewey bodies
fluctuating cognition that involves changes in attention and executive functions
recurrent and detailed visual hallucinations
spontaneous features of parkinsonism
Perseverative, stereotyped, or compulsive/ritualistic behavior is a diagnostic criterion for _______neurocognitive disorder.
frontotemporal
Relation between stimulant medication for ADHD and children and SUD later in life
stimulant use does not increase nor decrease risk for SUD
some evidence that stimulant treatment at younger ages and higher dose less likely to develop SUD than those who started stimulants at older ages and lower doses
According to Moffitt, life-course persistent antisocial behavior is due to ______, where as adolescence-limited antisocial behavior is explained by ________.
neuropsychological vulnerabilities and an adverse social environment
a maturity gap
Role of dopamine in schizophrenia: DA _____ in subcortical regions of brain causes ______ symptoms; DA _____ in cortical regions causes _____ symptoms
DA hyperactivity…. positive symptoms (subcortex)
DA hypoactivity… negative symptoms (cortex)
Medication treatment for Tourette’s and other tic disorders (med class, neurotransmitter affected)
anti-psychotics
block dopamine receptors
Peripartum depression rates according to DSM vs other estimates
DSM: 3-6%
others: 10-20%
Psychogenic nonepileptic seizures (PNES) are best detected using which imaging technique?
Video electroencephalography (vEEG)
Trauma-focused CBT used to treat _______
children/adolescents with sexual trauma or other trauma
Creutzfeldt-Jakob disease is categorized in the DSM-5 as a neurocognitive disorder due to prion disease. It’s caused by ________ that has a ____ latency period; deterioration in functioning is _____.
a slow-acting virus
long
rapid
Externalizing the problem is a core strategy of _______ and involves “reframing the problem from an internal deficiency or pathological condition in the individual to an objectified external and unwelcome narrative with a will of its own to dominate their lives”
narrative family therapy
Meichenbaum’s (1977) self-instructional training to help impulsive children control their behaviors while completing certain tasks involves five steps:
cognitive modeling,
overt external guidance,
overt self-guidance,
faded overt self-guidance
covert self-instruction
A primary goal of _______ family therapy is to disrupt destructive family games (“dirty games”) that involve deceit and power struggles and lead to and maintain symptoms.
Milan systemic
Helms’s White racial identity development model distinguishes between six stages (statuses):
(in order)
contact,
disintegration,
reintegration,
pseudo-independence,
immersion-emersion, and
autonomy
3 phases of stress inoculation training (SIT)
conceptualization,
skill acquisition and
rehearsal
Boyd-Franklin developed the _________ family therapy specifically for African American families. It consists of two main axes: Axis I consists of ____, while Axis II consists of ____.
-multisystems model of
-the components of the treatment process (e.g., joining, assessing, restructuring)
-the various levels at which the components can be applied (e.g., individual, family, nonblood kin, friends, church, community)
Nonpharmacological evidence-based treatment for autism
early intensive behavioral intervention (EIBI)
Gender ratio of ADHD in adults
1.6 males : 1 females
Up to __% of school-age children with ADHD continue to meet the diagnostic criteria for the disorder in adolescence, and up to __% continue to do so into adulthood
80%
30%
Neurotransmitters implicated in ADHD
dopamine,
norepinephrine, and
serotonin
Criteria for Tourette’s
1+ vocal tic
multiple motor tics
persisted more than one year
onset before 18
Typical age of onset of tics
4-6 years old
Medication treatment for tic disorders (class)
antipsychotics
3 components of Beck’s cognitive triad
negative beliefs about self, the world, and the future
Self-instructional training (Meichenbaum, 1977) was initially developed to teach ______ skills to ______.
problem-solving
children with high levels of impulsivity
5 stages of Self-Instructional Therapy (Meichenbaum)
Cognitive Modeling
Overt External Guidance
Overt Self-Guidance
Faded Overt Guidance
Covert Self-Instruction
4 skills taught in Self-instructional training
-identifying the nature of the task
-focusing attention on the task and the behaviors needed to complete it
-providing self-reinforcement that sustains appropriate behavior
-evaluating performance and correcting errors
3 phases of stress inoculation training (Meichenbaum)
conceptualization/education
skills acquisition and consolidation
application and follow-through
Six core processes of ACT (hexaflex)
-(Experiential) acceptance
-(Cognitive) defusion
-Being present/Contact with the present moment
-(Awareness of) self-as-context
-Values (-based actions)
-Committed action
Format of mindfulness-based stress reduction (MBSR)
eight-session group program
mindfulness-based stress reduction (MBSR) is used to treat
stress, pain, and illness
MBCT was originally designed to treat ____.
Recurrent Depression
According to Holzel, what 4 mechanisms are responsible for the effectiveness of mindfulness-based interventions?
-attention regulation
-emotion regulation
-body awareness (awareness of one’s internal states)
-decentering (reperceiving; the ability to separate oneself from one’s thoughts and emotions)
Cognitive therapy for suicide prevention (CT-SP) was designed for _____.
Brief cognitive-behavioral therapy for suicide prevention (BCBT) was designed for ____.
Cognitive-behavioral therapy for suicide prevention (CBT-SP) was developed for _____.
-adults who recently attempted suicide
-active-duty members of the military
-adolescents and combines strategies of CBT and dialectical behavior therapy
Three phases of cognitive therapy for suicide prevention (CT-SP) and brief cognitive-behavioral therapy for suicide prevention (BCBT) target ___, ____, and ____.
emotion regulation
cognitive flexibility
relapse prevention
Criteria for Brief Psychotic Disorder
1 of 3 symptoms below present for more than 1 day but less than 1 month
-delusions
-hallucinations
-disorganized speech
-(grossly disorganized or catatonic behavior also possible)
Criteria for schizophreniform disorder
at least 2 of 5 symptoms below (1 must be of first 3 listed) for more than 1 month, but less than 6 months
-delusions
-hallucinations
-disorganized speech
-also: grossly disorganized or catatonic behavior
-negative symptoms
Criteria for schizophrenia
an active phase that lasts for at least one month and includes at least two of five characteristic symptoms, with at least one symptom being
-delusions,
-hallucinations, or
-disorganized speech.
The other two characteristic symptoms are
-grossly disorganized or catatonic behavior
-negative symptoms
There must also be continuous signs of the disorder for at least six months that may include prodromal and/or residual phases in addition to the required active phase. Prodromal and residual phases consist of two or more characteristic symptoms in an attenuated form or negative symptoms only.
Concordance rates of schizophrenia:
Parent
Bio sib
Child of one parent with schizophrenia
Dizygotic twin
Child of two parents with schizophrenia
Monozygotic twin
Parent 6%
Biological sibling 9%
Child of one parent with schizophrenia 13%
Dizygotic (fraternal) twin 17%
Child of two parents with schizophrenia 46%
Monozygotic (identical) twin 48%
Over half of individuals with schizophrenia also meet criteria for ______
Tobacco Use Disorder