Diagnosis And Psychopathology Flashcards
1
Q
What DSM-5 term refers to a diagnosis will eventually be met but not sufficient info for firm diagnosis
A
“Provisional”
2
Q
What does the term “provisional” mean in the DSM-5?
A
That a diagnosis will eventually be met but not sufficient info for firm diagnosis
3
Q
What DSM-5 term allows the clinition to indicate why the symptoms do not met the full diagnosis criteria?
A
“Other-specified”
4
Q
What does the term “Other-specified” mean in the DSM-5?
A
It allows the clinition to indicate why the symptoms do not met the full diagnosis criteria
5
Q
What DSM-5 term allows the clinician to indicate that symptoms don’t meet criteria when they do not want to say why?
A
“Unspecified”
6
Q
What does the term “unspecified” mean in the DSM-5?
A
That symptoms don’t meet criteria and clinician does not want to say why
7
Q
- deficit in intellectual functioning
- deficits in adaptive functioning across multiple settings in 1 or more activities of daily living
- onset during early developmental period
A
The diagnosis crtieria for an Intellectual Disability
8
Q
What are the diagnosis crtieria for an Intellectual Disability?
A
- deficit in intellectual functioning
- deficits in adaptive functioning across multiple settings in 1 or more activities of daily living
- onset during early developmental period
9
Q
A
The two basic diagnostic criteria that Autism Spectrum Disorder lies at the intersection of
- Full criteria:*
- impairments in social communication*
- Restricted, repetitive behavior patterns, interests, and activities*
- Onset during EARLY developmental period*
- Symptoms cause impaired functioning*
10
Q
- impairments in social communication
- Restricted, repetitive behavior patterns, interests, and activities
- Onset during EARLY developmental period
- Symptoms cause impaired functioning
A
The diagnostic criteria for Autism Spectrum Disorder
11
Q
What are the diagnostic criteria for Autism Spectrum Disorder?
A
- impairments in social communication
- Restricted, repetitive behavior patterns, interests, and activities
- Onset during EARLY developmental period
- Symptoms cause impaired functioning
12
Q
Intellectual Disability etiology
A
30% due to chromosomal abnormalities (Down Syndrome)
5% due to hereditary (Tay-Sach’s disease, PKU, fragile X syndrome)
10% pregnancy and perinatal complications (fetal malnutrtition, anoxia, HIV)
15-20% environmental factors and mental disorders (severe deprivation, autism)
30-40% of cases cause is unknown
13
Q
What is the largest known etiological factor for ID?
A
Down Syndrome
Accounts for 30% of cases
14
Q
What is the second-largest known etiological factor for ID?
A
Environmental factors and mental disorders (e.g., severe deprivation, autism)
(accounts for 15-20% of children with ID)
15
Q
What percentage of ID is due to pregnancy or perinatal complications?
Ex. fetal malnutrition, anoxia, HIV
A
10% of ID cases are due to these factors
16
Q
What percentage of ID is due to hereditary reasons?
(e.g., Tay-Sach’s, PKU, Fragile X syndrome)
A
5% of ID cases are due to these reasons
17
Q
strongest predictor of ID
A
low birth weight
18
Q
What are the early symptoms of Autism?
A
- Delay in lang. development (not speaking by 2) and abnormal communication (echolalia)
- Lack of social interest or unusual social interactions
- Unusual patterns of play (lining up toys)
19
Q
Best prognosis for Autism will include
A
- Development of functional language by age 5
- IQ over 70
- later onset of symptoms
- absence of comorbid disorders
20
Q
What is a major contributing etiological factor for Autism?
A
Genetics
(higher concordance between MO vs. DI twins)
21
Q
Neurotransmitters associated with Autism
A
Serotonin and GABA
22
Q
Autistic brain irregularities are found in the…
A
amygdala and cerebellum
23
Q
Best Autism Treatment?
A
Early intensive behavioral intervention in the home setting before age 5
24
Q
ADHD definition
A
Pattern of inattention and/or hyperactivity
that lasts at least six months
apparent in at least two settings
25
ADHD onset requirement
Before 12 years
26
ADHD symptom requirement (children; adults)
6 symptoms for less than 17 years
5 symptoms for 17+
27
ADHD Prevalence in children; adults
5% in children; 2.5% in adults
28
ADHD prevalence by gender (male:female)
\_\_\_\_ in children
\_\_\_\_ in adults
2: 1 in children
1. 6:1 in adults (male:female)
29
Behavioral experiences of hyperactivity and impulsivity in ADHD children vs. adults
Children more likely to experience hyperactivity;
Adults present as more inattentive
30
What four brain areas are theorized to be impacted by ADHD?
PFC
Cerebellum
Caudate Nucleus
Putamen
31
Behavioral Disinhibition Hypothesis describes ADHD as
an inability to adjust activity levels to the requirements of the situation.
32
How is ADHD treated?
combination of medication and behavioral intervention.
33
Central Nervous stimulants work on \_\_\_% of individuals.
80%
34
Specific Learning Disorder
Impairment in reading, written expression, math (lasting for six months), despite intervention
35
What percentage of children with SLD also have ADHD?
20-30% of children with SLD also have ADHD
36
SLD etiology
1. Exposure to toxins
2. Early malnutrition
3. Hemispheric dominance (incomplete dominance or mixed laterality)
4. Cerebellar-vestibular dysfunction (due to otitis media; inflammation in middle ear)
37
Childhood-Onset Fluency Disorder (colloquial term)
stuttering
38
Childhood-Onset Fluency Disorder
Impairment in fluency and time patterning of speech
39
Onset of stuttering (COFD) is between
2-7 years of age
40
Predictor of persistence in Childhood-onset Fluency Disorder?
severity of stuttering at age 8
41
COFD treatment
Habit Reversal Training
42
Stuttering increases alongside levels of
stress
43
What are the components of habit reversal training?
Awareness training
Competing response training (deep breathing)
Social support
44
Habit reversal training is a treatment for...
Stuttering.
(also--component of CBIT for Tics)
45
Criteria for Tourette's Disorder
One vocal tic and multiple motor tics
46
When is the **typical** onset of Tourette's disorder?
Between 4-6 years
47
What is the **age of** **onset criteria** for Tourette's?
Before age 18
48
What is the **criteria of duration** for Tourette's diagnosis?
at least 1 year
49
Tourette's disorder is often comorbid with
OCD and ADHD
50
Medication management for Tourette's with ADHD
Anti-hypertensive drugs (e.g., clonodine)
51
What is the criteria for **duration** in order to receive a diagnosis of Delusional Disorder?
Presence of one or more delusions **for at least 1 month**:
Erotomanic
Grandiose
Jealous
Persecutory
Somatic
Mixed
Unspecified
52
A person's overall functioning (IS/IS NOT?) markedly impaired by the delusion in Delusional Disorder?
Is Not
53
Duration of symptoms required for a diagnosis of schizophrenia
**signs of disorder for at least six months**
*active phase symptoms for at least a month*
54
Active phase symptoms of schizophrenia include:
delusions
hallucinations
disorganized speech
disorganized behavior
negative symptoms (anhedonia, avolition)
55
At least one of the symptoms of schizophrenia must be:
delusions, hallucinations, or disorganized speech
56
Schizophrenia symptoms **typically appear** between
late teens and early 30's
57
Peak age of **first psychotic episode** in schizophrenia occurs...
(early to mid 20's)
58
Best prognosis for schizophrenia includes
1. Late and acute onset
2. Insight
3. Brief duration of active phase
4. Family history of mood disorder but no family history of schizophrenia
59
Which racial group have highest rates for schizophrenia?
African Americans; may be incorrect as AA's have more delusions and hallucinations with MDD and Bipolar Disorder which could be misdiagnosed as Schizophrenia
60
Better prognosis for patients in developing countries
Schizophrenia
61
Brain-based etiology for Schizophrenia
1. Increased volume in lateral and third ventricles
2. Reduced size of hippocampus and amygdala
3. **Hypofrontality** (LOW PFC) relates to **negative symptoms**
62
Neurotransmitter hypotheses for Schizophrenia
1. Dopamine Hypothesis
2. Imbalance in Norepinephrine and Dopamine levels (see second gen. antipsychotic meds)
63
Second-generation antipsychotic medications are based on the theory that...
Imbalance in Norepinephrine and dopamine levels
64
Dopamine hypothesis for Schizophrenia posits...
Elevated dopamine receptors or oversensitive dopamine receptors
*Now expanded to include Norepinephrine, serotonin, and glutamate*
65
Schizophrenia prevalence in general population
less than 1% of gen. pop.
66
Two highest schizophrenia prevalence is found in:
Monozygotic Twins: 48%
Child of 2 parents: 46%
67
Schizophrenia genetic concordance rates for dizygotic twins and biological siblings:
Dizygotic Twins: 17%
Bio Sibs: 10%
68
Schizophrenia genetic concordance rates for child of 1 parent with Schizophrenia is:
Child of 1 parent: 13%
69
Three first-generation drugs used to treat schizophrenia.
Chloropromazine
Thioridazine
Haloperiodol
70
Four second-generation antipsychotic drugs used to treat schizophrenia
Clozapine
Risperidone
Olanzapine
Ariprazole
71
Why are second-generation drugs for the first line of treatment for schizophrenia?
Targets both positive and negative symptoms; doesn't cause tardive dyskinesia
## Footnote
*First-generation only targets positive symptoms*
72
Schizophreniform criteria for duration?
at least 1 month of active phase; continuous signs for **less than** 6 months
73
Schizophreniform vs. Schizophrenia
continuous signs of disorder for **less than** 6 months
impaired functioning **not** required
same symptom requirement
74
Brief Psychotic Disorder symptom duration
One day to less than one month
75
Brief Psychotic Disorder vs. Schizophreniform/Schizophrenia
**Only one or more** main symptoms required
Eventual return to premorbid function
onset follows stressful event
76
Schizoaffective disorder
1. concurrent psychotic symptoms and major depressive or manic episode
2. Period of **2 weeks** or more with only psychotic symptoms **w/o mood symptoms**
77
Schizophrenia vs. Schizophreniform vs. Brief Psychotic Disorder
Schizophrenia
* 2 or more symptoms, with at least one core symptom
* 1 month symptoms; **6+ months** of continuous illness
* **impaired functioning**
Schizophreniform
* 2 or more symptoms; at least one core symptom
* 1 month symptoms; **less than 6 months** of continuous illness
* impaired functioning not required
Brief Psychotic Disorder
* one symptom required
* 1 day to 1 month duration
78
Symptoms of Seasonal Affective Disorder include
1. decreased energy
2. increased sleep
3. overeating and weight gain
4. craving for carbs
79
Mahler's Object Relations Theory of BPD
"separation-individuation"
BPD vacillates between separation and fear of abandonment
80
Kernberg's Caregiver Theory of BPD
unpredictable caregivers that alternate between nurturing and depriving/punitive
causes defenese mechanism of "splitting" (all good or all bad)
81
Linehan (1978) theory for BPD
BPD caused by pervasive emotion dysregulation;
BPD people were exposed to invalidating environments;
*sharing of private experiences met with significant others --\> responded in erratic and negative ways*
82
Drugs for Premature Ejaculation
SSRI's *(fluoxetine, sertraline, paroxetine)*
TCA *(clomipramine)*
83
Drugs for Erectile Function Disorder
Sildenafil Citrate (Viagra)
Tadalafil (Cialis)
84
Drugs for Female Sexual Arousal Disorder
Testosterone
85
Parkinson's disease has low levels of _____ and \_\_\_\_.
Dopamine and Serotonin
86
Parkinson's disease often co-occurs with \_\_\_\_\_\_\_\_?
Depression
*40% of people with PD have depression*
87
Depression **IS/IS NOT?** correlated with extent of motor impairment or duration of PD symptoms
IS NOT
88
Depression precedes the onset of motor symptoms in \_\_\_\_% of Parkinson's patients
20%
89
Four categories of SUD
1. impaired control
2. social impairment
3. Risky Use
4. Pharmacological criteria (tolerance/withdrawal)
90
CBT theories of maintenance of Anorexia nervosa disorder
1. Need to control eating
2. Self worth = body weight and body image
91
Alzheimer's disorder, neuritic plaques found on
hippocampus, amygdala, entorhinal cortex
## Footnote
*medial temporal structures*
92
"Permissive" theory of depression
depression caused by low levels of serotonin and norepinephrine (early biochemical theory) low serotonin and high norepinephrine causes mania
93
"Catelcholamine" hypothesis of depression
low levels of norepinephrine; early biochemical theory
94
MDD atypical features
hypersomnia, increase in appetite, weight gain (non-vegetative)
95
CBIT components for tics
habit reversal training, psychoeducation, relaxation training
96
Most common comorbid disorders of Tourette's
ADHD and OCD
97
Best predictors for Alcohol are...
family history of alcoholism
98
Core feature of CD
violation of the rights of others and/or rules and societal norms
99
Hypokalemia
low levels of serum potassium that can lead to kidney failure and cardiac arrest; caused by anorexia due to imbalanced electrolytes
100
Ritalin works on \_\_\_\_% of people with ADHD
80%
101
Childhood-onset fluency disorder--how many children recover?
65-85%
102
Tourette's disorder is chronic, and the frequency of the symptoms\_\_\_\_\_\_\_\_\_\_ in adolescence or adulthood
Declines
103
Comprehensive Behavioral treatment (CBIT)
Empirically supported treatment for Tourette's that combines habit reversal training, with psychoeducation and relaxation techniques.
104
Bipolar I
at least one manic episode (distinct, period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy) lasts for one week
105
Bipolar I prevalence
.6% for 12 month prevalence
1.1:1 prevalence ratio; male to female
90% of individuals who have one episode have additional episodes
106
Bipolar I avg. age of onset
18
107
Bipolar I etiology
Hereditary (family history of Bipolar disorder strongest predictor of risk)
## Footnote
*Life stressors can precipitate the onset of symptoms*
108
Bipolar I Treatment
Lithium (mood-stabilizing drug--reduce periods of mania, prevent mood swings, reduce suicide risk)
Antiseizure medication (valproate, carbamazepine) alternative to those who are intolerant of lithium
109
Bipolar I Treatment (therapy)
Cognitive Behavioral Therapy--identify and alter thought patterns contributing to symptoms
Interpersonal and Social Rhythm Therapy (IPSRT)--recognize the impact on interpersonal activities and relationships on social and circadian rhythms and regularize those rhythms so they can gain control over their mood cycles
Family-focused treatment (FFT)--brief treatment for patients and their family members that includes psychoeducation, communication enhancement training, and problem-skills training
110
Bipolar II Disorder
At least one hypomanic (lasts at least four days) and one major depressive episode (lasts at least two weeks)
111
Cyclothymic
multiple periods of hypomanic and depressive symptoms (not full mdd) for at least two years;
symptoms present half the time and not without symptoms for more than two months.
112
Major Depressive Disorder
5 or more symptoms with at least one being a depressed mood or loss of interest or pleasure
113
MDD specifiers
with atypical features--significant weight gain, or increase in appetite, hypersomnia, leaden paralysis, pattern of interpersonal rejection sensitivity with peripartum onset---symptoms began during pregnancy or within 4 weeks postpartum; 10-20% have MDD after birth; .1% to .2 % develop postpartum psychosis with seasonal pattern---occurs at a particular time of year; beginning of fall and continuing into the winter months. Due to disruption of circadian rhythms resulting in increased melatonin which causes drowsiness and lower serotonin.
114
SAD symptoms
lack of energy, hypersomnia, increased appetite and weight gain, carbohydrate craving
115
MDD prevalence
7% 12-month prevalence; 18-29 3x more likely than 60+ after puberty females 1.5-3x rate of males Peak age of onset is mid-20s The initial episode triggered by stressful event; but additional episodes relate to # of prior episodes rather than presence of stressor
116
Current MDD biochemical hypothesis
high level of cortisol that causes degeneration of cells in the hippocampus
117
Behavioral and Cog. Behavioral Explanations for Depression
1. Seligmans "learned helplessness model" (1978) 2. Lewinsohn's "behavioral theory" (1974) 3. Beck's "cognitive theory of depression" (1976) 4. Rehm's "self-control" model
118
Seligman's "learned helplessness model"
Depression caused by uncontrollable negative life events. Caused by stable, internal, global factors (own incompetence).
119
Lewinson's behavioral therapy
no response-contingent reinforcement of adaptive behaviors and reinforcement of non-adaptive behaviors by sympathy from others pessimism, low self-esteem, social isolation, dsyphoria
120
Beck's "cognitive theory of depression"
negative self-statements about self, world, and future "depressive cognitive triad"
121
Rehm's "self-control" model
self-monitoring--attend more to neg. vs. pos life events self evaluation--strict standards of eval and internal attributions to neg. events self reinforcement--insufficient reinforcement and excessive punishment
122
Depression symptoms in children
physical complaints, irritability, social withdrawal
123
Depression symptoms in older adults is called...
pseudodementia--memory loss, distractibility, disorientation, and other cog. symptoms
124
Three types of Antidepressants
Tricyclics(TCA's) Selective Serotonin Reuptake Inhibitors (SSRI's) Monoamine oxidase inhibitors (MAOI's)
125
Treatment for Depression
CBT Interpersonal Therapy
126
Combo of CBT and antidepressants ______ more effective than either alone
"somewhat"
But therapy has slightly better long term effects;
overall long term prospects not good across CBT, IPT, or Tricyclics
127
Schizophrenics are most likely to have ________ hallucinations
auditory
128
Negative Symptoms of Schizophrenia
anhedonia--reduced capacity to experience pleasure avolition--reduced motivation and goal orientation alogia--absence of speech
129
Depression is linked to elevated levels of this hormone
cortisol
## Footnote
*causes a degeneration of cells in the hippocampus, which causes memory problems*
130
Agoraphobia
presence of fear or anxiety related to 2 out of 5 situations:
1) public transport
2) open spaces
3) enclosed spaces
4) standing in line or being in a crowd
5) outside the home alone
* fear that escape will be difficult or help will be unavailable if a panic attack occurs*
131
Rate for MDD for adolescent and adult females vs. males
1.5-3x rate of females to males
132
Rate of MDD for prepubescent males and females
about the same
133
Treatment of choice for most anxiety disorders
in vivo exposure with response prevention
134
Duration of seperation anxiety must last at least...{children vs. adults]
4 weeks in children and 6 months in adults
135
School refusal in children vs. adults
separation anxiety (5-7 year old) vs. depression
136
Separation Anxiety etiology
parent overprotectiveness insecurity resulting from a loss or trauma Symptoms precipitated by a major life stressor
137
Seperation Anxiety treatment (younger and older)
Behavioral therapy that incorporates younger--\>systematic desensitization older--\>CBT that focuses on replacing maladaptive behaviors with more adaptive ones
138
Specific Phobia is treated with...
exposure with response prevention
139
Specific phobia and John Watson
classical conditionining for phobia US--\> fear response US - CS CS--\>CR
140
Claustrophobia treatment
exposure with response prevention and applied relaxation
141
Blood-injection injury type
Exposure with applied tension (to avoid fainting; to increase blood pressure)
142
Social Anxiety Treatment
Exposure with Response Prevention Can be combined with cog. restructuring, social skills training, antidepressant drug (ssri), anti-anxiety drug, beta- blocker
143
Panic Disorder Treatment (therapy)
Panic Control Therapy (Brief form of CBT that combines psychoeducation, cognitive restructuring, relaxation-based strategies, interoceptive exposure, and in-vivo exposure)
144
Panic Disorder symptoms (panic attack)
Surge of fear or intense discomfort that reaches a peak within minutes and involves heart palpitations sweating trembling or shaking paresthesia derealization or depersonalization fear of losing control or dying \*\*check rule outs
145
Panic Disorder definition
recurrent unexpected panic attack with at least one month or more of persistent concern about having another attack ---OR--- maladaptive change in behavior that is related to the attack
146
Panic Disorder (drugs)
Pharmocotherapy--\> imipramine or other TCA; SSRI; or benzodiazepine Should not use medicine alone because high rate of relapse when no longer taking drugs
147
Generalized Anxiety Disorder etiology
genetic factors; behavioral inhibition; neuroticism automatic catastrophic thoughts that maintain anxiety and cause avoidance behavior
148
GAD treatment
CBT (psychoeducation, relaxation training, cognitive restructuring, exposure and relapse prevention)
149
GAD medication
First line are SSRI's and SNRI's (benzodiazepines)
150
OCD prevalence; male female adults and male female children
equal in male and female adults higher in male children than female children
151
OCD Etiology
hereditary, low levels of serotonin, abnormalities in the orbitofrontal cortex and caudate nucleus
152
OCD Treatment
combination of medication and exposure with ritual prevention Medication includes TCA (clomipramine) and fluvoxamine, sertraline (SSRI's)
153
Reactive attachment disorder
inhibited, emotinally withdrawn behavior toward adult caregiver Symptoms apparent before 5 years old
154
RAD etiology
EXTREME insufficient care as evidenced by social neglect repeated changes in primary caregivers such that the child could not for attachments rearing in unusual circumstances
155
Disinhibited Social Engagement Disorder
child actively approaches and interacts with unfamiliar adults
156
DSED etiology
EXTREME insufficient care as evidenced by social neglect or deprivation repeated changes in caregivers rearing in unusual circumstances
157
PTSD prevalence females vs. males
females have higher prevalence across lifespan experience symptoms for longer
158
PTSD treatment
multicomponent cog-behavioral intervention Cog. Processing Therapy--psychoeducation, exposure, cognitive restructuring
159
PTSD duration and Acute Stress Disorder Duration
1 month and 3 days to 1 month
160
Adjustment Disorder
development of emotional or behavioral symptoms in response to one or more psychosocial stressors within 3 months of onset of stressors; symptoms remit with 6 months of terminated stressors
161
Adjustment Disorder specifiers
with depressed mood, anxiety, mixed anxiety and depressed mood disturbance of conduct mixed disturbance of emotions and conduct unspecified
162
Biofeedback--HRV
Heart Rate Variability (electrocardiogram) monitors heart rate and cardiac activity; used to help manage stress, high blood pressure, anxiety, heartrate irregularities
163
Biofeedback--EMG
Electromyogram--measures impulses in muscles and indicated degree of relaxation or tension; tension headaches, chronic pain, stiffness, incontinence
164
Biofeedback--EDR
Electrodermal (galvanic response training); use for anxiety Skin surface changes, relation between emotional state and sympathetic system (sweat gland activity)
165
Biofeedback--EEG
Electroencephalogram--neurofeedback provides information about on brainwave activities used for ADHD, depression, and epilepsy to improve attention
166
Korsakoff's syndrome
anterograde amnesia (impaired ability to learn new info)
retrograde amnesia (impaired ability to recall previously learned info)
confabulation
*Alcohol Induced Neurocog Disorder;*
167
memory impairment in psuedodementia (depression) vs. dementia
depression--recall dementia--recognition and recall
168
Therapy for Premature ejaculation
sensate focus ; start-stop or squeeze technique;
169
Four groups of symptoms for substance use
impaired control, social impairment, risky use, pharmacological challenges of tolerance or withdrawal
170
Neurocognitive disorder = impaired functioning in one of six domains
complex attention executive function learning and memory language perceptual motor social cognition
171
Delirium
disturbance in attention and awareness that develops over a short period of time (hours to day) with symptoms worsening at night one additional disturbance in cognition Symptoms direct consequence of medical condition, susbtance, or toxin
172
Alzheimer's Disorder accounts for _____ of all cases of dementia. Duration of disease
60-90% 8-10 years
173
Early Stage of Alzheimer's
anterograde amnesia, lost in familiar places, can't recall familiar words or names (anomia) depression, impaired attention and judgement
174
Middle Stage of Alzheimer's
anterograde and retrograde amnesia; problems with reading and writing, inability to remember names of family members + friends, pronounced mood swings and personality changes, fluent aphasia
175
Late stage of Alzheimer's
severe impairment, need for assistance, urinary and fecal incontinence, bedridden, dies of respiratory infection
176
Early onset familial type
abnormal genes on chromosomes 1, 14, 21
177
Later-onset of Alzhemiers
abnormal ApoE4 gene on chromosome 19
178
Alzheimer's treatment
cholinesterase inhibitors reduce breakdown of Ach (linked to memory impairment)
179
Major or Mild Vascular Dementia
1. acute onset with partial recovery 2. stepwise decline 3. progressive course with fluctuations in symptom severity; plateaus that vary in duration
180
Autoplastic
"self-change";
181
Alloplastic
changing or adapting to the environment by changing the environment;
182
Etic
"universal" all ppl from different cultures are the same
183
Emic
"culture-bound" culture specific approach
184
Personality Disorder Age and Duration Requirments
1 year and less than 18 o.k.; Except Antisocial Personality Disorder
185
Antisocial Personality Disorder age requirements
must be at least 18 and have CD before 15
186
Medication treatment for nocturnal enuresis
Propanol and imipramine
187
ODD diagnosis duration requirement
at least 6 months
188
Erectile Dysfunction treatment
Sildenafil Citrate (Viagra)
189
Hypokelemia
reduced level of K+ in the blood typical with bulimia nervosa
190
High expressed emotion in families is associated with
increased risk of relapse for those with Schizophrenia, Depression, and Anorexia
191
Gender differences in MDD before puberty
equal
192
Gender differences in MDD as adults
Females have 1.5 to 3x rate of depression compared to males
193
ADHD prevalence boys:girls
2:1 for children
194
ADHD prevalence men: women
1.6:1 for adult males to female
195
Treatment for Alzheimer's involves
Increasing acetylcholine
196
Diabetes mellitus symptoms involves
Increased appetite and weight loss, frequent urination, thirst, apathy, confusion
197
Cushing's disease symptoms
emotional lability, memory loss, depression, obesity
198
Cushing's diseases is caused by
hypersecretion of cortisol
199
Addison's disease is caused by
hyposecretion of cortisol
200
Addison's disease symptoms
muscle weakness, fatigue, decreased appetite and weight loss, darkening skin pigmentation
201
Hyperthyroidsim or Grave's disease
speeds up metabolism, increased appetite and weight loss, accelerated heart rate, heat intolerance, insomnia
202
Example of antidepressant drug
imipramine
203
Stages of Alzheimers
1: short term memory loss (anterograde) 2: mood swings, sleep disturbances, completing complex tasks 3: lose ability to speak and recognize loved ones
204
Schizophrenia concordance rates: dizygotic twins
17%
205
Schizoprhenia concordance rates: monozygotic twins
48%
206
Schizophrenia concordance rates: sibling
10%
207
Schizophrenia concordance rates: chid of one parent with schizophrenia
13%
208
Schizophrenia concordance rates: child of two parents with schizophrenia
46%
209
Electroconvulsive Treatment used on...
nondominant hemisphere (right); less anterograde and retrograde amnesia
210
Wolpe is known for
Systematic desensitization
211
migraine headaches
throbbing on one side of head
212
tension headache
diffuse tight band of pain around head
213
cluster headache
unilateral, non-throbbing, behind the eye
214
OCD treatment
exposure with response prevention and thought stopping
215
Panic Disorder treatment
Panic Control Therapy (CBT)
216
Phobia treatment
exposure with response prevention
217
Psychoeducation, cognitive restructuring, relaxation-based strategies, interoceptive exposure, and in-vivo exposure)
Panic Control Therapy used for Panic Disorder
218
anti-hypertensive drug
clonodine; second line of treatment for Tourette's
219
Generation I drugs for schizophrenia
Based on Dopamine hypothesis Targets positive symptoms does not alleviate negative symptoms
220
New Generation drugs for schizophrenia
Based on NE, Dopamine imbalance Only positive features
221
First generation antipsychotics
chloropromazine thioridazine haloperiodol
222
Second generation antipsychotics
Clozapine Risperidone olanzapine ariprazole
223
Second generation anti-pyschotics help alleviate
both pos. and negative symptoms; -tardive dyskinesia
224
Treatment for Bipolar Disorder
Lithium Antiseizure medication
225
Antiseizure medication
valproate carbamazepine
226
Medication management for Tourette's without ADHD
antipsychotic drugs (e.g., haloperiodol and pimozide)
227
Tourette's behavioral treatment
CBIT (Comprehensive Behavioral Treatment for tics); involves habit reversal training
228
Illness Anxiety vs. Somatic Disorder
no to mild symptoms vs. actual symptoms
229
how old should you be for enuresis
5 years of age
230
tobacco withdrawal symptoms
concentration, restlessness, insomnia, irritability, increased appetite, depressed mood, anxiety
231
stuttering onset between ages of...
ages 2 to age 7
232
covert sensitization
treatment for paraphilic disorder; pairing sexual desire with aversive stimulus in imagination
233
ADHD prevalence rates in children vs. adults
5% vs. 2.5 %
234
Initial signs of neurocog. disorder due to HIV
forgetfulness, impaired concentration, apathy, irritability
235
how old should you be for encopresis?
4 years of age
236
Symptoms of tobacco withdrawal
irritability
anxiety
depressed mood
impaired concentration; restlessness
increased appetite
insomnia
237
Symptoms of Alcohol Withdrawal
Autonomic hyperactivity
hand tremor
anxiety
insomnia
238
Symptoms of Opioid Withdrawal
dysphoric mood
muscle aches
nausea/vomiting
fever
239
Symptoms of Stimulant Withdrawal
fatigue
vivid dreams
increased appetite
insomnia or hypersomnia
240
Non-REM sleep arousal disorder involves
sleepwalking and sleep terrors
## Footnote
*child cannot recall incident*
241
Nightmare Disorder occurs during the
REM cycle in the second half of sleep
242
Nightmare Disorder dreams are usually...
dysphoric; center on trying to stay alive
243
What percentage of children with ADHD go on to have subclinical ADHD concerns in adulthood?
60%
244
What percentage of children with ADHD continue to meet the full criteria into adulthood?
15%
245
Those with BPD experience a remission of symptoms by...
middle age
impulsivity--\>interpersonal--\>affective remitt
246
Narcolepsy requires that the patient has at least ____ sleep attacks per week for _____ months
3 sleep attacks/week
for 3 months
247
Which neurotransmitter is associated with OCD?
low levels of Serotonin
248
Which abnormalities in brain structures is associated with OCD?
Caudate nuclues
orbitofrontal cortex
249
What medication is used to treat OCD?
TCA's (clomipramine)
and
SSRI's (?)
250
Reactive Attachment Disorder vs. Disinhibited Social Engagement Disorder
inhibited, emotional withdrawn toward caregiver
vs.
actively approaching unfamiliar adults
251
Requirements of Reactive Attachment Disorder
1. Extreme neglect
2. Symptoms apparent before age 5
3. Developmental age of at least 9 months
252
Extreme insufficient care necessary for RAD includes
1. social neglect or deprivation from caregiver
2. repeated changes in primary caregiver
3. rearing in unusual circumstances with few opportunities for selective attachments
253
Duration criteria for PTSD
1 MONTH
254
EDMR is one treatment for
PTSD
*Due to exposure*
255
Acute Stress Disorder is a less intense version of
PTSD
256
Acute Stress Disorder duration criteria
3 days to less than 1 month
257
localized amnesia means...
can't recall any events during a period of time
258
selective amnesia means...
can't recall SOME events during a period of time
259
malingering
involves telling lies for personal gain
260
In Factitious Disorder there **is/isn't** any personal gain?
ISN'T
261
Insomnia and Narcolepsy: duration and frequency for criteria
3x3 rule
3 times a week for 3 months
262
Medication used to treat insomnia
Benzodiazepines and antihistamines
263
Requirements of Narcolepsy
1. Cataplexy (loss of muscle tone)
2. Deficiency in hypocretin (hormone)
3. REM latency 15 minutes or less
264
Non-REM Sleep Arousal disorder occurs in what part of sleep?
First 1/3 of sleep episode
## Footnote
*Stage 3 and Stage 4*
265
Non-REM sleep arousal symptoms include
sleep terrors
sleepwalking
*little to no recall of episode*
266
Nightmare Disorder occurs during the...
REM cycle in second half of sleep period
267
PICA and Rumination Disorder have duration criteria of
1 month
268
Anorexia Nervosa is associated with ______ levels of serotonin
higher
## Footnote
*food restriction creates a sense of calm by lowering serotonin levels*
269
Binge eating duration...
at least 1 week of compensatory behavior + binge eating for at least 1 month
270
Encopresis duration
2x a week for 3 consecutive months
271
Encopresis
once a month for at least 3 months
272
age criteria of enuresis
at least 5 years old
273
age criteria of encopresis
4 years old
274
Medication for Erectile Dysfunction
(sildenafil citrate) Viagra
275
Medication for Early Ejaculation
SSRI's (flouxetine, sertraline)
276
Sex therapy for Early Ejaculation
sensate focus (nondemanding pleasure)
277
Treatment for Paraphilic Disorder
covert sensitization
## Footnote
*pairing object with aversive stimuli (i.e., going to jail)*
278
Treatment for Paraphilic Disorder
orgasmic reconditioning
masturbate to bad stimulus and then when orgasm switch to appropriate stimulus
279
SUD you need two symptoms for at least ____ months
12
280
Risk of relapse is lower if an individual beleives a relaspe event is
specific, **external**, controllable factors
281
These three high-risk situations are associated with 75% of all lapses
1. Neg. emotional state
2. Interpersonal conflict
3. Social Pressure
282
Substance-Induced behaviors occur within ___ month of intoxication or withdrawal
1 month
283
Alcohol Delirium symptoms
**delirium tremens**, hallucinations, delusions, **agitation**, autonomic hypersensitivity
284
Alcohol-Induced Major Neurocog. Disorder
nonamnesic-confabulatory type
amnesic-confabulatory type
285
Amnesic-confabulatory type due to what syndrome in Alcohol-Induced Major Neurocog. Disorder?
Korsakoff syndrome
*anterograde and retrograde amnesia and confabulation due to a **thiamine deficiency***
286
What is confabulation?
fabrication of memories
## Footnote
*seen in Alcohol-Induced Major Neurocognitive Disorder*
287
Opioid Withdrawal
1. dysphoric mood
2. nausea and vomiting
3. muscle aches
4. fever
5. yawning and insomnia
288
Sedative withdrawal
1. Autonomic Hyperactivity
2. hand tremor
3. insomnia
4. nausea
5. transient hallucinations
6. anxiety
7. seizures
289
Stimulant Withdrawal
1. **fatigue**
2. insomnia or **hypersomnia**
3. **increased appetite**
4. **psychomotor** agitation or retardation
290
Stimulant crash (acute withdrawal symptoms)
intense depression and increase in appetite
291
Tobacco Withdrawal
| (within 24 hours of cessation)
impaired concentration and restlessness
anxiety and low mood
irritability and frustration
insomnia
292
anterograde amnesia
inability to form new memories
293
retrograde amnesia
facts from the relatively recent past
294
procedural memory (ex.)
remembering getting dressed; not impacted by Korsakoff's
295
Vegetative (physical) symptoms of depression
fatigue
insomnia
loss of appetite
weight loss
loss of libido
296
peak age of onset of schizophrenia for males
early to mid 20's
297
peak age of onset of schizophrenia for girls
late 20's
298
What is passive coping
assigning responsibility for pain to an outside source and allowing other areas of life to be impacted by pain
299
active coping
patient takes responsibility for pain management
300
Borderline Personality in girls shares symptoms with Antisocial Personality in boys. Specifically, in both disorders...
Both involve manipulative behavior;
*boys manipulate to gain power and females manipulate to gain attention/concern from caregivers*
301
302
Marriage reduces the likelihood of depression to a greater extend
## Footnote
*gender differences*
for men more than for women
303
More children leads to ________ risk of depression
increase
304
male coping styles differ from females by
males use more action/mastery for distraction (work, sports, going out with friends)
while females brood/dwell on problems
305
women who have multiple roles are _____ vulnerable to depression
## Footnote
*more or less?*
Less
306
Avolition
reduced motivation or goal directed activity
307
anhedonia
reduced capacity to experience pleasure
308
alogia
relative absence (poverty) of speech
309
ADHD affected brain areas
1. PFC
2. Cerebellum
3. Caudate nucleus and putament (basal ganglia)
310
Lazarus's appraisal theory (3 types of cognitive appraisal to stressors)
1. primary--decide if pos., neg., neutral?
2. secondary--decide if resources to address?
3. reappraisal--changing others appraisals as new info comes in?
311
apraxia
inability to enact purposeful movements
*caused by damage to the frontal or parietal lobes*
312
What **percentage** of women experience **"baby blues"** after pregnancy
50 - 80 percent
313
Exposure and Response Prevention is based on which behavioral theory
## Footnote
**classical extinction**
*expose client to CS without the US (break the pairing; show white rate without sound to extinguish fear reaction)*
314
Which personality disorder becomes less severe or even remits by the fourth decade in life?
Antisocial Personality Disorder
315
Why is flouxetine (SSRI) and clomipramine (TCA) used to treat OCD?
affects levels of serotonin;
neurotransmitter is hypothesized to impact OCD
316
Seperation Anxiety begins to appear at around
8 or 9 months
317
DSM-5 diagnosis for seperation anxiety duration criteria for **children** and **adults**?
4 weeks for children
6 months for adults
318
Lazarus and Folkman's 1984 **transactional model** has what **three stages?**
## Footnote
1. Primary appraisal "is this a threat"
2. Secondary appraisal "can I deal with this threat?"
3. Cognitive Reappraisal "let's look at new info..."
319
Said that how ppl respond to stress is determined by thier cognitive appraisal of the stressor
Lazarus and Folkman
*transactional model of stress*
320
Said that everyone responds the same physiologically to prolonged stressors
Selye
*General Adaptation Syndrome*
321
What are the three stages of Selye's General Adaptation Syndrome?
* Alarm
* Resistance
* Exhaustion
322
What happens in the **alarm stage** of Selye's General Adaptation Syndrome
HPA activated by stressor
E and NE released by adrenal medula
Increase in glucose, heart rate, muscle tension, etc.
323
What happens in the **resistance stage** of Selye's General Adaptation Syndrome
* With prolonged stress, hypothalamus signals pituary to release the adrenocorticotropic hormone (ACTH)
* hormone signals adrenal medula to release cortisol
324
What happens in the **exhaustion** stage of Selye's General Adaptation Syndrome?
physical reserves are depleted
325
Criteria for Binge Eating Disorder (# of binges)
1/week for a 3 months
326
Cluster A Personality Disorders are characterized by:
## Footnote
**odd or eccentric behaviors**
*Ex. Paranoid, Schizoid, Schizoptypal*
327
Characteristics associated with Cluster B Personality Disorders
## Footnote
**Emotional, erratic, dramatic behaviors**
*Ex. Antisocial, Borderline, Histrionic, and Narcissitic*
328
Characteristics associated wtih Cluster C Personality Disorders
## Footnote
**Anxiety and Fearfulness**
*Ex. Anxiety and Fearfulness*
329
Borderline Personality Disorder is characterized by
**instability** in **self-image** and **marked impulsivity**
(see ***Linehan*** for **emotion regulation)**
(***Mahler*** for object relations for *seperation-individuation* and fear of abandonment)
(***Kernberg*** for caregiver explanation and *"splitting"* )
330
Hypnogogic hallucinations occur
when you are falling asleep
*associated with narcolepsy*
331
hypnopompic hallucinations occur
when you are waking up
*associated with narcolepsy*
332
Schizoid vs. Schizotypal
Schizoid are not interested in relationships; detached; no emotional expression
Schizotypal are uncomfortable in relationships but say they want them; odd and eccentric thinking and speech
333
What disorder is associated with children of parents who have PTSD?
depression and anxiety
hyperactivity
aggression
social withdrawal
334
peripartum onset criteria (length)
during pregnancy or within 4 weeks post pregnancy
335
babies develop vision in the order of:
kinetic, binocular, pictorial
