Comps - Psychopathology (Disorders) Flashcards
Neurodevelopmental Disorders
A group of disorders that present in early childhood; characterized by marked deficits in brain processing that result in impairments in social, personal, or academic performance.
Intellectual Developmental Disorder
Deficits in intellectual ability such as, reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience. Onset during developmental period. (Severity Specifiers range from mild-profound).
Intellectual Functioning
Reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience.
Adaptive Functioning
Failure to meet developmental and sociocultural standards for personal independence and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more activities of daily life, such as communication, social participation, and independent living, across multiple environments, such as home, school, work, and community.
ID Comorbidities
ADHD, ASD, MDD, GAD, BP1/2
ID Cultural Considerations
Beliefs about supernatural influences and punishment for presumes of actual wrongdoing by the parents. Males are more likely than females to be diagnosed with mild and severe.
ID Etiology
Genetics, teratogens exposure in utero, brain malformations, TBI, seizure disorders.
ID Differentials
Neurocognitive Disorders: Dementia, Alzheimer’s (Progression of loss of cognitive symptoms versus stable (ID)). SLD: reading, written, math, combination (Limited to learning deficits, no intellectual/adaptive). ASD (Social-communication and behavior deficits; ID is stable. Complicates ID assessment).
Autism Spectrum Disorder
Persistent deficits in social communication and interaction across multiple contexts (social-emotional reciprocity, nonverbal communication, and difficulties in relationships) in social interaction. Restrictive patterns of behavior, interests, or activities (stereotypes/repetitive motor movements, insistence on sameness, highly restricted/fixated interests/sensory sensitivity). Onset during the developmental period. (Specifiers range from “requiring support” to “requiring very substantial support.”
Social-Emotional Reciprocity
Abnormal social approach; reduced sharing of interests, emotions, or affect; difficulty in social interactions.
Nonverbal Communication
Abnormal eye contact/body language/gestures/facial expressions.
Difficulties in Relationships
Adjusting behaviors, engaging in imaginative play, absence of interest in peers.
Stereotyped/Repetitive Motor Movements
Stimming, rocking.
Insistence on Sameness
Routines, food, clothes
Highly Restricted/Fixated Interests
Strong attachment/preoccupation
Sensory Sensitivity
Textures, sounds, temperature
ASD Comorbidities
MDD, GAD, ID, SLD, ADHD, ARFID
ASD Cultural Considerations
Males diagnosed more than females. African American children are misdiagnosed with adjustment or conduct disorder. Age discrepancies in diagnosis of diverse kids.
ASD Etiology
High heritability, advanced parental age, teratogens.
ASD Differentials
ADHD (Developmental course, absence of restricted/repetitive behaviors/unusual interests). ID (Social communication and interaction are significantly impaired relative to the development of nonverbal skills (ASD). No apparent discrepancy between level of social communication skills and other intellectual skills (ID)). OCD (Contamination, organization, compulsions (OCD - repetitive behavior). Motor movements (ASD - repetitive behavior)). Schizophrenia (Positive symptoms, normal childhood development). Personality Disorders (Developmental course is earlier in ASD).
Attention Deficit / Hyperactivity Disorder
A persistent pattern of inattention, hyperactivity, and/or impulsivity. Symptoms must have been present prior to the age of 12 though diagnosis can happen at any time. Present in 2 or more settings, and interferes with social, academic, or occupational functioning. Specifiers for inattentive type, hyperactive type, or combined type.
Inattention
Difficulty with attention to details, sustaining attention, listening, following through on instructions, organizing tasks/activities. Avoids tasks that require sustained mental effort. Loses things often, easily distracted, forgetful in daily activities.
Hyperactivity and Impulsivity
Fidgets, leaves seat often/climbs appropriately, unable to engage in leisure activities, often “on the go,” talks excessively, blurts out an answer, difficulty waiting turn, interrupts others.
ADHD Comorbidities
ODD, ASD, PD, SUDs
ADHD Cultural Considerations
More common in males than females. Underdetection may lead to misdiagnosis of ODD. High prevalence in white youth may be influenced by parental demand for diagnosis
ADHD Etiology
Reduced behavior inhibition, negative emotionality, novelty seeking increases risk. Low birth weight, prenatal exposure to smoking. High heritability, visual/hearing impairments, metabolic abnormalities, nutritional deficiencies.
ADHD Differentials
ODD (Characterized by negativity, hostility, and defiance). Intermittent Explosive Disorder (Serious aggression toward others and do not experience difficulty with attention). Bipolar Disorder 1/2 (Symptoms are episodic, accompanied by elevated mood, grandiosity, etc.).
Schizophrenia and Related Disorders
A category of disorders that involve a dissconection from reality. Usually chronic but sometimes temporary.
Delusional Disorder
The presence of one or more delusions with no other features of psychosis. If they have manic or major depressive episodes, they are brief. Functioning is not markedly impaired. Present in episodes either one or multiple. Multiple types.
Delusions
Fixed beliefs that are not amenable to change in light of conflicting evidence.
Positive Symptom
Things that are present that should not be there.
Negative Symptom
Things that are not present that should be there. Diminished emotional response.
Delusional Disorder Comorbidities
N/A
Delusional Disorder Cultural Considerations
Have to take into account cultural relativity (i.e., religious background).
Delusional Disorder Etiology
Heritability (if you have a family member that has schizophrenia, you are more likely to have delusional disorder).
Delusional Disorder Differentials
Schizophrenia and Schizophreniform (Delusions are more disorganized and part of their disorganized presentation. Delusions have more convictions about their beliefs in delusional disorder - the delusions are their reality and convinced). OCD (Anxiety is driving behavior and compensatory behavior). Bipolar 1/2 (Delusions present when you have a mood episode).
Brief Psychotic Disorder
A psychotic disturbance that lasts for one day to one month and does not occur during a manic or depressive episode, and is not better explained by the effects of medication. Must have either delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior. Specifiers include whether the psychosis is in response to something or not.
Hallucinations
Perception-like experiences that occur without an external stimulus.
Disorganized Speech
An inability to form logical or coherent thoughts.
Grossly Disorganized or Catatonic Behavior
Marked decrease in reactivity to environment.
Brief Psychotic Disorder Comorbidities
N/A
Brief Psychotic Disorder Cultural Considerations
Religiosity and bereavement considerations.
Brief Psychotic Disorder Etiology
N/A
Brief Psychotic Disorder Differentials
Other Medical Conditions (If the results (labs or exams) indicate that positive symptoms (e.g., delusions or hallucinations) are due to a medical condition, then it is not brief psychotic disorder). Substance-Related Disorders (If a person only has positive symptoms when they are using a drug, it is not brief psychotic disorder). Other Psychotic Disorders (Symptom time-frame – More than a month could be schizophreniform or schizophrenia).
Schizophreniform Disorder
Experiences at least 2 psychotic symptoms (e.g., delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and/or negative symptoms) that last for at least 1 month but less than 6 months. Does not occur during a manic or depressive episode. Symptoms must be present for the majority of a 1-month period.
Schizophreniform Disorder Comorbidities
N/A
Schizophreniform Disorder Cultural Considerations
N/A
Schizophreniform Disorder Etiology
Genetics
Schizophreniform Disorder Differentials
Substance-Related Disorders (If a person only has positive symptoms when they are using a drug, it is not schizophreniform). Other Psychotic Disorders (Symptom time-frame – More than a month could be schizophrenia and less than a month could be brief psychotic disorder). Major Neurocognitive Disorders (There is a loss of intellectual and adaptive functioning that people with schizophreniform do not experience).
Schizophrenia
Experiences a break from reality that includes hallucinations, delusions, disorganized speech, grossly disorganized or catatonic behavior, and/or negative symptoms (at least 2 for the majority of a 1-month period). Symptoms cause marked impairment, persist for at least six months, and are in the absence of a schizoaffective, manic, or depressive episode.
Schizophrenia Comorbidities
SUDs, GAD, PD (schizotypal or schizoid)
Schizophrenia Cultural Considerations
Women’s onset is later than men’s. Women’s symptoms are more affect-laden. Women’s psychotic symptoms are worse during menses. Cultural differences and interpretations of visual and auditory hallucinations – Level of fear and content of positive symptoms are different between cultural groups.
Schizophrenia Etiology
Environments (urban, refugees, migrant, socially oppressed) mixed with being socially oppressed (discrimination, deprivation, SES). ACEs (trauma and neglect). Genetics and pregnancy and birth complications.
Schizophrenia Differentials
Other Psychotic Disorders (Symptom time-frame – More than a month could be schizophreniform and less than a month could be brief psychotic disorder). ASD (Deficits in social communication and interaction (rooted in a neurodevelopmental basis), similar to schizophrenia (rooted in lack of reality testing), but the etiology is different).
Schizoaffective Disorder
Experiences a break from reality that includes hallucinations, delusions, disorganized speech, grossly disorganized or catatonic behavior, and/or negative symptoms (at least 2 for the majority of a 1-month period). An uninterrupted major mood episode (major depressive or manic) with positive or negative schizophrenia symptoms. Delusions or hallucinations for 2 or more weeks without a major mood episode. Specifiers include bipolar or depressive type.
Schizoaffective Disorder Comorbidities
SUDs and GAD
Schizoaffective Disorder Cultural Considerations
SES. Misdiagnosis of schizophrenia for African American and Hispanic populations – Evaluate for psychotic and mood symptoms).
Schizoaffective Disorder Etiology
Genetics.
Schizoaffective Disorder Differentials
Schizophrenia (Two weeks of psychotic symptoms without a major mood episode). Bipolar and Depressive Disorders (The psychotic symptoms are only occurring during mood episodes).
Bipolar and Related Disorders
A group of disorders characterized by shifts between to emotional extremes in episodes. Sometimes they have psychotic features.
Manic Episode
A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week, in which symptoms are present (any duration if hospitalization). Symptoms include: Inflated self-esteem or grandiosity, Decreased need for sleep, More talkative than usual or pressure to keep talking, Flight of ideas or subjective experience that thoughts are racing, Distractibility, Increase in goal-directed activity or psychomotor agitation, Excessive involvement in high-risk activities. The episode causes marked impairment, hospitalization, and/or there are psychotic features.
Hypomanic Episode
A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 4 consecutive days in which symptoms are present. Symptoms include: Inflated self-esteem or grandiosity, Decreased need for sleep, More talkative than usual or pressure to keep talking, Flight of ideas or subjective experience that thoughts are racing, Distractibility, Increase in goal-directed activity or psychomotor agitation, Excessive involvement in high-risk activities. The episode is not severe enough to cause marked impairment, hospitalization, and there are no psychotic features.
Major Depressive Episode
A distinct period of abnormally lowered mood that lasts for at least 2 weeks in which symptoms are present. Symptoms include: Depressed mood most of the day; nearly every day, Markedly diminished interest or pleasure in all or most activities, Significant weight loss or gain, Insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, Feelings of worthlessness or excessive/inappropriate guilt, Diminished ability to think or concentrate, Recurrent thoughts of death.
Bipolar I Disorder
A disorder characterized by extreme shifts between manic and depressive episodes. You need to have an abnormally and persistently elevated, expansive, or irritable mood for at least 1 week and is present most of the day nearly every day. You need 3 or more symptoms of a manic episode.
Bipolar I Disorder Comorbidities
GAD, SUDs, BPD, ASPD
Bipolar I Disorder Cultural Considerations
Women have more mood symptoms. Black individuals with bipolar disorder are often misdiagnosed with schizophrenia.
Bipolar I Disorder Etiology
Childhood adversity. Heritability – Genetic processes strongly affect predisposition to bipolar disorder, with heritability estimates around 90% in some twin studies.
Bipolar I Disorder Differentials
MDD (You have to meet the criteria for a manic episode for it to be BP1). BP2 (Symptom time duration is less (no manic episode)). BPD (Mood lability and impulsivity must represent a distinct episode of illness).
Bipolar II Disorder
A disorder characterized by extreme shifts between hypomanic episodes and depressive episodes. You need to have an abnormally and persistently elevated, expansive, or irritable mood for at least 4 days and is present most of the day nearly every day. You need 3 or more symptoms of a hypomanic episode and 5 or more of a major depressive episode. Never experienced a manic episode.
Bipolar II Disorder Comorbidities
SUDs, GAD, autoimmune disorders
Bipolar II Disorder Cultural Considerations
Women are more likely to experience hypomania with mixed depressive features. Women are more likely to experience rapid cycling. Childbirth can trigger a hypomanic episode in 10-20% of women.
Bipolar II Disorder Etiology
Genetics
Bipolar II Disorder Differentials
MDD (Never a manic or hypomanic episode). Schizophrenia (No major depressive episodes). BP1 (Has mania).
Cyclothymic Disorder
A disorder characterized by extreme shifts between mood disturbances that exhibit symptoms of hypomanic and depressive symptoms that do not meet the full criteria for either episode that has persisted for at least 2 years. Symptoms have been present for at least half the time and the individual has not been without the symptoms for more than 2 months at a time.
Cyclothymic Disorder Comorbidities
SUDs, sleep disorders
Cyclothymic Disorder Cultural Considerations
N/A
Cyclothymic Disorder Etiology
Genetic. May be an increased familial risk of substance-related disorders.
Cyclothymic Disorder Differentials
Bipolar and related disorder due to another medical condition (Another medical condition explains the person’s mood and episodes). BPD (Mood instability in borderline personality disorder occurs in the domains of anxiety, irritability, and sadness, whereas elation, euphoria, and/or increased energy are not characteristic features of borderline personality disorder).
Depressive Disorders
A group of disorders characterized by frequent or presistant bouts of lowered mood and reccurent thoughts of death.
Major Depressive Disorder
Five or more of the following symptoms occur and persist during the same 2-week period: Depressed mood, Markedly diminished interest or pleasure in all or almost all activities, Significant weight gain or loss, Insomnia or hypersomnia, Psychomotor agitation or retardation, Fatigue or loss of energy, Feelings of worthlessness or excessive/inappropriate guilt, Diminished ability to think or concentrate, Recurrent thoughts of death. Can sometimes include psychotic features.
Major Depressive Disorder Comorbidities
SUDs, GAD, PTSD
Major Depressive Disorder Cultural Considerations
Women are more internalizing and men are more externalizing – Women experience sleep disturbance, appetite fluctuation, gastro; Men experience more maladaptive coping - substance-use. The chronicity of major depressive disorder appears to be higher among African Americans and Caribbean Blacks. Overdiagnosis of schizophrenia for minority groups instead of MDD.
Major Depressive Disorder Etiology
Neuroticism. ACEs – Women may be disproportionately at risk for ACEs. Heritability.
Major Depressive Disorder Differentials
Bipolar Disorders (Manic or hypomanic episodes). Substance-induced Depressive Disorder. Other Depressive Disorders. Schizoaffective (Delusions or hallucinations are present for at least 2 weeks in the absence of a major depressive episode).
Persistent Depressive Disorder
Depressed mood for most of the day, for more days than not, for at least 2 years. Additionally two of the following: Poor appetite or overeating, Insomnia or hypersomnia, Low energy or Fatigue, Low self-esteem, Poor concentration, Feelings of hopelessness. During the 2-year period, the person has never been without the aforementioned symptoms for more than 2 months at a time.
Persistent Depressive Disorder Comorbidities
GAD, SUDs
Persistent Depressive Disorder Cultural Considerations
Perceived abnormality or tolerance of chronic depressive symptoms may vary across cultures.
Persistent Depressive Disorder Etiology
Neuroticism. Parental loss. Poor global functioning.