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EPPP 2019 > Diagnosis And Psychopathology > Flashcards

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”

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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

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3
Q

What DSM-5 term allows the clinition to indicate why the symptoms do not met the full diagnosis criteria?

A

“Other-specified”

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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

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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”

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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

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7
Q
  1. deficit in intellectual functioning
  2. deficits in adaptive functioning across multiple settings in 1 or more activities of daily living
  3. onset during early developmental period
A

The diagnosis crtieria for an Intellectual Disability

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8
Q

What are the diagnosis crtieria for an Intellectual Disability?

A
  1. deficit in intellectual functioning
  2. deficits in adaptive functioning across multiple settings in 1 or more activities of daily living
  3. onset during early developmental period
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9
Q
A

The two basic diagnostic criteria that Autism Spectrum Disorder lies at the intersection of

  • Full criteria:*
    1. impairments in social communication*
    1. Restricted, repetitive behavior patterns, interests, and activities*
    1. Onset during EARLY developmental period*
    1. Symptoms cause impaired functioning*
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10
Q
  1. impairments in social communication
  2. Restricted, repetitive behavior patterns, interests, and activities
  3. Onset during EARLY developmental period
  4. Symptoms cause impaired functioning
A

The diagnostic criteria for Autism Spectrum Disorder

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11
Q

What are the diagnostic criteria for Autism Spectrum Disorder?

A
  1. impairments in social communication
  2. Restricted, repetitive behavior patterns, interests, and activities
  3. Onset during EARLY developmental period
  4. Symptoms cause impaired functioning
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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

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13
Q

What is the largest known etiological factor for ID?

A

Down Syndrome

Accounts for 30% of cases

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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)

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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

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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

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17
Q

strongest predictor of ID

A

low birth weight

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18
Q

What are the early symptoms of Autism?

A
  1. Delay in lang. development (not speaking by 2) and abnormal communication (echolalia)
  2. Lack of social interest or unusual social interactions
  3. Unusual patterns of play (lining up toys)
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19
Q

Best prognosis for Autism will include

A
  1. Development of functional language by age 5
  2. IQ over 70
  3. later onset of symptoms
  4. absence of comorbid disorders
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20
Q

What is a major contributing etiological factor for Autism?

A

Genetics

(higher concordance between MO vs. DI twins)

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21
Q

Neurotransmitters associated with Autism

A

Serotonin and GABA

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22
Q

Autistic brain irregularities are found in the…

A

amygdala and cerebellum

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23
Q

Best Autism Treatment?

A

Early intensive behavioral intervention in the home setting before age 5

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24
Q

ADHD definition

A

Pattern of inattention and/or hyperactivity

that lasts at least six months

apparent in at least two settings

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25
Q

ADHD onset requirement

A

Before 12 years

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26
Q

ADHD symptom requirement (children; adults)

A

6 symptoms for less than 17 years

5 symptoms for 17+

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27
Q

ADHD Prevalence in children; adults

A

5% in children; 2.5% in adults

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28
Q

ADHD prevalence by gender (male:female)

____ in children

____ in adults

A

2: 1 in children
1. 6:1 in adults (male:female)

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29
Q

Behavioral experiences of hyperactivity and impulsivity in ADHD children vs. adults

A

Children more likely to experience hyperactivity;

Adults present as more inattentive

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30
Q

What four brain areas are theorized to be impacted by ADHD?

A

PFC

Cerebellum

Caudate Nucleus

Putamen

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31
Q

Behavioral Disinhibition Hypothesis describes ADHD as

A

an inability to adjust activity levels to the requirements of the situation.

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32
Q

How is ADHD treated?

A

combination of medication and behavioral intervention.

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33
Q

Central Nervous stimulants work on ___% of individuals.

A

80%

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34
Q

Specific Learning Disorder

A

Impairment in reading, written expression, math (lasting for six months), despite intervention

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35
Q

What percentage of children with SLD also have ADHD?

A

20-30% of children with SLD also have ADHD

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36
Q

SLD etiology

A
  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)
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37
Q

Childhood-Onset Fluency Disorder (colloquial term)

A

stuttering

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38
Q

Childhood-Onset Fluency Disorder

A

Impairment in fluency and time patterning of speech

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39
Q

Onset of stuttering (COFD) is between

A

2-7 years of age

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40
Q

Predictor of persistence in Childhood-onset Fluency Disorder?

A

severity of stuttering at age 8

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41
Q

COFD treatment

A

Habit Reversal Training

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42
Q

Stuttering increases alongside levels of

A

stress

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43
Q

What are the components of habit reversal training?

A

Awareness training

Competing response training (deep breathing)

Social support

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44
Q

Habit reversal training is a treatment for…

A

Stuttering.

(also–component of CBIT for Tics)

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45
Q

Criteria for Tourette’s Disorder

A

One vocal tic and multiple motor tics

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46
Q

When is the typical onset of Tourette’s disorder?

A

Between 4-6 years

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47
Q

What is the age of onset criteria for Tourette’s?

A

Before age 18

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48
Q

What is the criteria of duration for Tourette’s diagnosis?

A

at least 1 year

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49
Q

Tourette’s disorder is often comorbid with

A

OCD and ADHD

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50
Q

Medication management for Tourette’s with ADHD

A

Anti-hypertensive drugs (e.g., clonodine)

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51
Q

What is the criteria for duration in order to receive a diagnosis of Delusional Disorder?

A

Presence of one or more delusions for at least 1 month:

Erotomanic

Grandiose

Jealous

Persecutory

Somatic

Mixed

Unspecified

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52
Q

A person’s overall functioning (IS/IS NOT?) markedly impaired by the delusion in Delusional Disorder?

A

Is Not

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53
Q

Duration of symptoms required for a diagnosis of schizophrenia

A

signs of disorder for at least six months

active phase symptoms for at least a month

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54
Q

Active phase symptoms of schizophrenia include:

A

delusions

hallucinations

disorganized speech

disorganized behavior

negative symptoms (anhedonia, avolition)

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55
Q

At least one of the symptoms of schizophrenia must be:

A

delusions, hallucinations, or disorganized speech

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56
Q

Schizophrenia symptoms typically appear between

A

late teens and early 30’s

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57
Q

Peak age of first psychotic episode in schizophrenia occurs…

A

(early to mid 20’s)

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58
Q

Best prognosis for schizophrenia includes

A
  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
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59
Q

Which racial group have highest rates for schizophrenia?

A

African Americans; may be incorrect as AA’s have more delusions and hallucinations with MDD and Bipolar Disorder which could be misdiagnosed as Schizophrenia

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60
Q

Better prognosis for patients in developing countries

A

Schizophrenia

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61
Q

Brain-based etiology for Schizophrenia

A
  1. Increased volume in lateral and third ventricles
  2. Reduced size of hippocampus and amygdala
  3. Hypofrontality (LOW PFC) relates to negative symptoms
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62
Q

Neurotransmitter hypotheses for Schizophrenia

A
  1. Dopamine Hypothesis
  2. Imbalance in Norepinephrine and Dopamine levels (see second gen. antipsychotic meds)
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63
Q

Second-generation antipsychotic medications are based on the theory that…

A

Imbalance in Norepinephrine and dopamine levels

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64
Q

Dopamine hypothesis for Schizophrenia posits…

A

Elevated dopamine receptors or oversensitive dopamine receptors

Now expanded to include Norepinephrine, serotonin, and glutamate

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65
Q

Schizophrenia prevalence in general population

A

less than 1% of gen. pop.

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66
Q

Two highest schizophrenia prevalence is found in:

A

Monozygotic Twins: 48%

Child of 2 parents: 46%

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67
Q

Schizophrenia genetic concordance rates for dizygotic twins and biological siblings:

A

Dizygotic Twins: 17%

Bio Sibs: 10%

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68
Q

Schizophrenia genetic concordance rates for child of 1 parent with Schizophrenia is:

A

Child of 1 parent: 13%

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69
Q

Three first-generation drugs used to treat schizophrenia.

A

Chloropromazine

Thioridazine

Haloperiodol

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70
Q

Four second-generation antipsychotic drugs used to treat schizophrenia

A

Clozapine

Risperidone

Olanzapine

Ariprazole

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71
Q

Why are second-generation drugs for the first line of treatment for schizophrenia?

A

Targets both positive and negative symptoms; doesn’t cause tardive dyskinesia

First-generation only targets positive symptoms

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72
Q

Schizophreniform criteria for duration?

A

at least 1 month of active phase; continuous signs for less than 6 months

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73
Q

Schizophreniform vs. Schizophrenia

A

continuous signs of disorder for less than 6 months

impaired functioning not required

same symptom requirement

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74
Q

Brief Psychotic Disorder symptom duration

A

One day to less than one month

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75
Q

Brief Psychotic Disorder vs. Schizophreniform/Schizophrenia

A

Only one or more main symptoms required

Eventual return to premorbid function

onset follows stressful event

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76
Q

Schizoaffective disorder

A
  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
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77
Q

Schizophrenia vs. Schizophreniform vs. Brief Psychotic Disorder

A

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
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78
Q

Symptoms of Seasonal Affective Disorder include

A
  1. decreased energy
  2. increased sleep
  3. overeating and weight gain
  4. craving for carbs
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79
Q

Mahler’s Object Relations Theory of BPD

A

“separation-individuation”

BPD vacillates between separation and fear of abandonment

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80
Q

Kernberg’s Caregiver Theory of BPD

A

unpredictable caregivers that alternate between nurturing and depriving/punitive

causes defenese mechanism of “splitting” (all good or all bad)

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81
Q

Linehan (1978) theory for BPD

A

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

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82
Q

Drugs for Premature Ejaculation

A

SSRI’s (fluoxetine, sertraline, paroxetine)

TCA (clomipramine)

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83
Q

Drugs for Erectile Function Disorder

A

Sildenafil Citrate (Viagra)

Tadalafil (Cialis)

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84
Q

Drugs for Female Sexual Arousal Disorder

A

Testosterone

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85
Q

Parkinson’s disease has low levels of _____ and ____.

A

Dopamine and Serotonin

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86
Q

Parkinson’s disease often co-occurs with ________?

A

Depression

40% of people with PD have depression

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87
Q

Depression IS/IS NOT? correlated with extent of motor impairment or duration of PD symptoms

A

IS NOT

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88
Q

Depression precedes the onset of motor symptoms in ____% of Parkinson’s patients

A

20%

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89
Q

Four categories of SUD

A
  1. impaired control
  2. social impairment
  3. Risky Use
  4. Pharmacological criteria (tolerance/withdrawal)
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90
Q

CBT theories of maintenance of Anorexia nervosa disorder

A
  1. Need to control eating
  2. Self worth = body weight and body image
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91
Q

Alzheimer’s disorder, neuritic plaques found on

A

hippocampus, amygdala, entorhinal cortex

medial temporal structures

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92
Q

“Permissive” theory of depression

A

depression caused by low levels of serotonin and norepinephrine (early biochemical theory) low serotonin and high norepinephrine causes mania

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93
Q

“Catelcholamine” hypothesis of depression

A

low levels of norepinephrine; early biochemical theory

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94
Q

MDD atypical features

A

hypersomnia, increase in appetite, weight gain (non-vegetative)

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95
Q

CBIT components for tics

A

habit reversal training, psychoeducation, relaxation training

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96
Q

Most common comorbid disorders of Tourette’s

A

ADHD and OCD

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97
Q

Best predictors for Alcohol are…

A

family history of alcoholism

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98
Q

Core feature of CD

A

violation of the rights of others and/or rules and societal norms

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99
Q

Hypokalemia

A

low levels of serum potassium that can lead to kidney failure and cardiac arrest; caused by anorexia due to imbalanced electrolytes

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100
Q

Ritalin works on ____% of people with ADHD

A

80%

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101
Q

Childhood-onset fluency disorder–how many children recover?

A

65-85%

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102
Q

Tourette’s disorder is chronic, and the frequency of the symptoms__________ in adolescence or adulthood

A

Declines

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103
Q

Comprehensive Behavioral treatment (CBIT)

A

Empirically supported treatment for Tourette’s that combines habit reversal training, with psychoeducation and relaxation techniques.

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104
Q

Bipolar I

A

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

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105
Q

Bipolar I prevalence

A

.6% for 12 month prevalence

1.1:1 prevalence ratio; male to female

90% of individuals who have one episode have additional episodes

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106
Q

Bipolar I avg. age of onset

A

18

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107
Q

Bipolar I etiology

A

Hereditary (family history of Bipolar disorder strongest predictor of risk)

Life stressors can precipitate the onset of symptoms

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108
Q

Bipolar I Treatment

A

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

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109
Q

Bipolar I Treatment (therapy)

A

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

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110
Q

Bipolar II Disorder

A

At least one hypomanic (lasts at least four days) and one major depressive episode (lasts at least two weeks)

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111
Q

Cyclothymic

A

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.

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112
Q

Major Depressive Disorder

A

5 or more symptoms with at least one being a depressed mood or loss of interest or pleasure

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113
Q

MDD specifiers

A

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.

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114
Q

SAD symptoms

A

lack of energy, hypersomnia, increased appetite and weight gain, carbohydrate craving

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115
Q

MDD prevalence

A

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

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116
Q

Current MDD biochemical hypothesis

A

high level of cortisol that causes degeneration of cells in the hippocampus

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117
Q

Behavioral and Cog. Behavioral Explanations for Depression

A
  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
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118
Q

Seligman’s “learned helplessness model”

A

Depression caused by uncontrollable negative life events. Caused by stable, internal, global factors (own incompetence).

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119
Q

Lewinson’s behavioral therapy

A

no response-contingent reinforcement of adaptive behaviors and reinforcement of non-adaptive behaviors by sympathy from others pessimism, low self-esteem, social isolation, dsyphoria

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120
Q

Beck’s “cognitive theory of depression”

A

negative self-statements about self, world, and future “depressive cognitive triad”

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121
Q

Rehm’s “self-control” model

A

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

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122
Q

Depression symptoms in children

A

physical complaints, irritability, social withdrawal

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123
Q

Depression symptoms in older adults is called…

A

pseudodementia–memory loss, distractibility, disorientation, and other cog. symptoms

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124
Q

Three types of Antidepressants

A

Tricyclics(TCA’s) Selective Serotonin Reuptake Inhibitors (SSRI’s) Monoamine oxidase inhibitors (MAOI’s)

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125
Q

Treatment for Depression

A

CBT Interpersonal Therapy

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126
Q

Combo of CBT and antidepressants ______ more effective than either alone

A

“somewhat”

But therapy has slightly better long term effects;

overall long term prospects not good across CBT, IPT, or Tricyclics

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127
Q

Schizophrenics are most likely to have ________ hallucinations

A

auditory

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128
Q

Negative Symptoms of Schizophrenia

A

anhedonia–reduced capacity to experience pleasure avolition–reduced motivation and goal orientation alogia–absence of speech

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129
Q

Depression is linked to elevated levels of this hormone

A

cortisol

causes a degeneration of cells in the hippocampus, which causes memory problems

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130
Q

Agoraphobia

A

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*

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131
Q

Rate for MDD for adolescent and adult females vs. males

A

1.5-3x rate of females to males

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132
Q

Rate of MDD for prepubescent males and females

A

about the same

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133
Q

Treatment of choice for most anxiety disorders

A

in vivo exposure with response prevention

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134
Q

Duration of seperation anxiety must last at least…{children vs. adults]

A

4 weeks in children and 6 months in adults

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135
Q

School refusal in children vs. adults

A

separation anxiety (5-7 year old) vs. depression

136
Q

Separation Anxiety etiology

A

parent overprotectiveness insecurity resulting from a loss or trauma Symptoms precipitated by a major life stressor

137
Q

Seperation Anxiety treatment (younger and older)

A

Behavioral therapy that incorporates younger–>systematic desensitization older–>CBT that focuses on replacing maladaptive behaviors with more adaptive ones

138
Q

Specific Phobia is treated with…

A

exposure with response prevention

139
Q

Specific phobia and John Watson

A

classical conditionining for phobia US–> fear response US - CS CS–>CR

140
Q

Claustrophobia treatment

A

exposure with response prevention and applied relaxation

141
Q

Blood-injection injury type

A

Exposure with applied tension (to avoid fainting; to increase blood pressure)

142
Q

Social Anxiety Treatment

A

Exposure with Response Prevention Can be combined with cog. restructuring, social skills training, antidepressant drug (ssri), anti-anxiety drug, beta- blocker

143
Q

Panic Disorder Treatment (therapy)

A

Panic Control Therapy (Brief form of CBT that combines psychoeducation, cognitive restructuring, relaxation-based strategies, interoceptive exposure, and in-vivo exposure)

144
Q

Panic Disorder symptoms (panic attack)

A

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
Q

Panic Disorder definition

A

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
Q

Panic Disorder (drugs)

A

Pharmocotherapy–> imipramine or other TCA; SSRI; or benzodiazepine Should not use medicine alone because high rate of relapse when no longer taking drugs

147
Q

Generalized Anxiety Disorder etiology

A

genetic factors; behavioral inhibition; neuroticism automatic catastrophic thoughts that maintain anxiety and cause avoidance behavior

148
Q

GAD treatment

A

CBT (psychoeducation, relaxation training, cognitive restructuring, exposure and relapse prevention)

149
Q

GAD medication

A

First line are SSRI’s and SNRI’s (benzodiazepines)

150
Q

OCD prevalence; male female adults and male female children

A

equal in male and female adults higher in male children than female children

151
Q

OCD Etiology

A

hereditary, low levels of serotonin, abnormalities in the orbitofrontal cortex and caudate nucleus

152
Q

OCD Treatment

A

combination of medication and exposure with ritual prevention Medication includes TCA (clomipramine) and fluvoxamine, sertraline (SSRI’s)

153
Q

Reactive attachment disorder

A

inhibited, emotinally withdrawn behavior toward adult caregiver Symptoms apparent before 5 years old

154
Q

RAD etiology

A

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
Q

Disinhibited Social Engagement Disorder

A

child actively approaches and interacts with unfamiliar adults

156
Q

DSED etiology

A

EXTREME insufficient care as evidenced by social neglect or deprivation repeated changes in caregivers rearing in unusual circumstances

157
Q

PTSD prevalence females vs. males

A

females have higher prevalence across lifespan experience symptoms for longer

158
Q

PTSD treatment

A

multicomponent cog-behavioral intervention Cog. Processing Therapy–psychoeducation, exposure, cognitive restructuring

159
Q

PTSD duration and Acute Stress Disorder Duration

A

1 month and 3 days to 1 month

160
Q

Adjustment Disorder

A

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
Q

Adjustment Disorder specifiers

A

with depressed mood, anxiety, mixed anxiety and depressed mood disturbance of conduct mixed disturbance of emotions and conduct unspecified

162
Q

Biofeedback–HRV

A

Heart Rate Variability (electrocardiogram) monitors heart rate and cardiac activity; used to help manage stress, high blood pressure, anxiety, heartrate irregularities

163
Q

Biofeedback–EMG

A

Electromyogram–measures impulses in muscles and indicated degree of relaxation or tension; tension headaches, chronic pain, stiffness, incontinence

164
Q

Biofeedback–EDR

A

Electrodermal (galvanic response training); use for anxiety Skin surface changes, relation between emotional state and sympathetic system (sweat gland activity)

165
Q

Biofeedback–EEG

A

Electroencephalogram–neurofeedback provides information about on brainwave activities used for ADHD, depression, and epilepsy to improve attention

166
Q

Korsakoff’s syndrome

A

anterograde amnesia (impaired ability to learn new info)

retrograde amnesia (impaired ability to recall previously learned info)

confabulation

Alcohol Induced Neurocog Disorder;

167
Q

memory impairment in psuedodementia (depression) vs. dementia

A

depression–recall dementia–recognition and recall

168
Q

Therapy for Premature ejaculation

A

sensate focus ; start-stop or squeeze technique;

169
Q

Four groups of symptoms for substance use

A

impaired control, social impairment, risky use, pharmacological challenges of tolerance or withdrawal

170
Q

Neurocognitive disorder = impaired functioning in one of six domains

A

complex attention executive function learning and memory language perceptual motor social cognition

171
Q

Delirium

A

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
Q

Alzheimer’s Disorder accounts for _____ of all cases of dementia. Duration of disease

A

60-90% 8-10 years

173
Q

Early Stage of Alzheimer’s

A

anterograde amnesia, lost in familiar places, can’t recall familiar words or names (anomia) depression, impaired attention and judgement

174
Q

Middle Stage of Alzheimer’s

A

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
Q

Late stage of Alzheimer’s

A

severe impairment, need for assistance, urinary and fecal incontinence, bedridden, dies of respiratory infection

176
Q

Early onset familial type

A

abnormal genes on chromosomes 1, 14, 21

177
Q

Later-onset of Alzhemiers

A

abnormal ApoE4 gene on chromosome 19

178
Q

Alzheimer’s treatment

A

cholinesterase inhibitors reduce breakdown of Ach (linked to memory impairment)

179
Q

Major or Mild Vascular Dementia

A
  1. acute onset with partial recovery 2. stepwise decline 3. progressive course with fluctuations in symptom severity; plateaus that vary in duration
180
Q

Autoplastic

A

“self-change”;

181
Q

Alloplastic

A

changing or adapting to the environment by changing the environment;

182
Q

Etic

A

“universal” all ppl from different cultures are the same

183
Q

Emic

A

“culture-bound” culture specific approach

184
Q

Personality Disorder Age and Duration Requirments

A

1 year and less than 18 o.k.; Except Antisocial Personality Disorder

185
Q

Antisocial Personality Disorder age requirements

A

must be at least 18 and have CD before 15

186
Q

Medication treatment for nocturnal enuresis

A

Propanol and imipramine

187
Q

ODD diagnosis duration requirement

A

at least 6 months

188
Q

Erectile Dysfunction treatment

A

Sildenafil Citrate (Viagra)

189
Q

Hypokelemia

A

reduced level of K+ in the blood typical with bulimia nervosa

190
Q

High expressed emotion in families is associated with

A

increased risk of relapse for those with Schizophrenia, Depression, and Anorexia

191
Q

Gender differences in MDD before puberty

A

equal

192
Q

Gender differences in MDD as adults

A

Females have 1.5 to 3x rate of depression compared to males

193
Q

ADHD prevalence boys:girls

A

2:1 for children

194
Q

ADHD prevalence men: women

A

1.6:1 for adult males to female

195
Q

Treatment for Alzheimer’s involves

A

Increasing acetylcholine

196
Q

Diabetes mellitus symptoms involves

A

Increased appetite and weight loss, frequent urination, thirst, apathy, confusion

197
Q

Cushing’s disease symptoms

A

emotional lability, memory loss, depression, obesity

198
Q

Cushing’s diseases is caused by

A

hypersecretion of cortisol

199
Q

Addison’s disease is caused by

A

hyposecretion of cortisol

200
Q

Addison’s disease symptoms

A

muscle weakness, fatigue, decreased appetite and weight loss, darkening skin pigmentation

201
Q

Hyperthyroidsim or Grave’s disease

A

speeds up metabolism, increased appetite and weight loss, accelerated heart rate, heat intolerance, insomnia

202
Q

Example of antidepressant drug

A

imipramine

203
Q

Stages of Alzheimers

A

1: short term memory loss (anterograde) 2: mood swings, sleep disturbances, completing complex tasks 3: lose ability to speak and recognize loved ones

204
Q

Schizophrenia concordance rates: dizygotic twins

A

17%

205
Q

Schizoprhenia concordance rates: monozygotic twins

A

48%

206
Q

Schizophrenia concordance rates: sibling

A

10%

207
Q

Schizophrenia concordance rates: chid of one parent with schizophrenia

A

13%

208
Q

Schizophrenia concordance rates: child of two parents with schizophrenia

A

46%

209
Q

Electroconvulsive Treatment used on…

A

nondominant hemisphere (right); less anterograde and retrograde amnesia

210
Q

Wolpe is known for

A

Systematic desensitization

211
Q

migraine headaches

A

throbbing on one side of head

212
Q

tension headache

A

diffuse tight band of pain around head

213
Q

cluster headache

A

unilateral, non-throbbing, behind the eye

214
Q

OCD treatment

A

exposure with response prevention and thought stopping

215
Q

Panic Disorder treatment

A

Panic Control Therapy (CBT)

216
Q

Phobia treatment

A

exposure with response prevention

217
Q

Psychoeducation, cognitive restructuring, relaxation-based strategies, interoceptive exposure, and in-vivo exposure)

A

Panic Control Therapy used for Panic Disorder

218
Q

anti-hypertensive drug

A

clonodine; second line of treatment for Tourette’s

219
Q

Generation I drugs for schizophrenia

A

Based on Dopamine hypothesis Targets positive symptoms does not alleviate negative symptoms

220
Q

New Generation drugs for schizophrenia

A

Based on NE, Dopamine imbalance Only positive features

221
Q

First generation antipsychotics

A

chloropromazine thioridazine haloperiodol

222
Q

Second generation antipsychotics

A

Clozapine Risperidone olanzapine ariprazole

223
Q

Second generation anti-pyschotics help alleviate

A

both pos. and negative symptoms; -tardive dyskinesia

224
Q

Treatment for Bipolar Disorder

A

Lithium Antiseizure medication

225
Q

Antiseizure medication

A

valproate carbamazepine

226
Q

Medication management for Tourette’s without ADHD

A

antipsychotic drugs (e.g., haloperiodol and pimozide)

227
Q

Tourette’s behavioral treatment

A

CBIT (Comprehensive Behavioral Treatment for tics); involves habit reversal training

228
Q

Illness Anxiety vs. Somatic Disorder

A

no to mild symptoms vs. actual symptoms

229
Q

how old should you be for enuresis

A

5 years of age

230
Q

tobacco withdrawal symptoms

A

concentration, restlessness, insomnia, irritability, increased appetite, depressed mood, anxiety

231
Q

stuttering onset between ages of…

A

ages 2 to age 7

232
Q

covert sensitization

A

treatment for paraphilic disorder; pairing sexual desire with aversive stimulus in imagination

233
Q

ADHD prevalence rates in children vs. adults

A

5% vs. 2.5 %

234
Q

Initial signs of neurocog. disorder due to HIV

A

forgetfulness, impaired concentration, apathy, irritability

235
Q

how old should you be for encopresis?

A

4 years of age

236
Q

Symptoms of tobacco withdrawal

A

irritability

anxiety

depressed mood

impaired concentration; restlessness

increased appetite

insomnia

237
Q

Symptoms of Alcohol Withdrawal

A

Autonomic hyperactivity

hand tremor

anxiety

insomnia

238
Q

Symptoms of Opioid Withdrawal

A

dysphoric mood

muscle aches

nausea/vomiting

fever

239
Q

Symptoms of Stimulant Withdrawal

A

fatigue

vivid dreams

increased appetite

insomnia or hypersomnia

240
Q

Non-REM sleep arousal disorder involves

A

sleepwalking and sleep terrors

child cannot recall incident

241
Q

Nightmare Disorder occurs during the

A

REM cycle in the second half of sleep

242
Q

Nightmare Disorder dreams are usually…

A

dysphoric; center on trying to stay alive

243
Q

What percentage of children with ADHD go on to have subclinical ADHD concerns in adulthood?

A

60%

244
Q

What percentage of children with ADHD continue to meet the full criteria into adulthood?

A

15%

245
Q

Those with BPD experience a remission of symptoms by…

A

middle age

impulsivity–>interpersonal–>affective remitt

246
Q

Narcolepsy requires that the patient has at least ____ sleep attacks per week for _____ months

A

3 sleep attacks/week

for 3 months

247
Q

Which neurotransmitter is associated with OCD?

A

low levels of Serotonin

248
Q

Which abnormalities in brain structures is associated with OCD?

A

Caudate nuclues

orbitofrontal cortex

249
Q

What medication is used to treat OCD?

A

TCA’s (clomipramine)

and

SSRI’s (?)

250
Q

Reactive Attachment Disorder vs. Disinhibited Social Engagement Disorder

A

inhibited, emotional withdrawn toward caregiver

vs.

actively approaching unfamiliar adults

251
Q

Requirements of Reactive Attachment Disorder

A
  1. Extreme neglect
  2. Symptoms apparent before age 5
  3. Developmental age of at least 9 months
252
Q

Extreme insufficient care necessary for RAD includes

A
  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
Q

Duration criteria for PTSD

A

1 MONTH

254
Q

EDMR is one treatment for

A

PTSD

Due to exposure

255
Q

Acute Stress Disorder is a less intense version of

A

PTSD

256
Q

Acute Stress Disorder duration criteria

A

3 days to less than 1 month

257
Q

localized amnesia means…

A

can’t recall any events during a period of time

258
Q

selective amnesia means…

A

can’t recall SOME events during a period of time

259
Q

malingering

A

involves telling lies for personal gain

260
Q

In Factitious Disorder there is/isn’t any personal gain?

A

ISN’T

261
Q

Insomnia and Narcolepsy: duration and frequency for criteria

A

3x3 rule

3 times a week for 3 months

262
Q

Medication used to treat insomnia

A

Benzodiazepines and antihistamines

263
Q

Requirements of Narcolepsy

A
  1. Cataplexy (loss of muscle tone)
  2. Deficiency in hypocretin (hormone)
  3. REM latency 15 minutes or less
264
Q

Non-REM Sleep Arousal disorder occurs in what part of sleep?

A

First 1/3 of sleep episode

Stage 3 and Stage 4

265
Q

Non-REM sleep arousal symptoms include

A

sleep terrors

sleepwalking

little to no recall of episode

266
Q

Nightmare Disorder occurs during the…

A

REM cycle in second half of sleep period

267
Q

PICA and Rumination Disorder have duration criteria of

A

1 month

268
Q

Anorexia Nervosa is associated with ______ levels of serotonin

A

higher

food restriction creates a sense of calm by lowering serotonin levels

269
Q

Binge eating duration…

A

at least 1 week of compensatory behavior + binge eating for at least 1 month

270
Q

Encopresis duration

A

2x a week for 3 consecutive months

271
Q

Encopresis

A

once a month for at least 3 months

272
Q

age criteria of enuresis

A

at least 5 years old

273
Q

age criteria of encopresis

A

4 years old

274
Q

Medication for Erectile Dysfunction

A

(sildenafil citrate) Viagra

275
Q

Medication for Early Ejaculation

A

SSRI’s (flouxetine, sertraline)

276
Q

Sex therapy for Early Ejaculation

A

sensate focus (nondemanding pleasure)

277
Q

Treatment for Paraphilic Disorder

A

covert sensitization

pairing object with aversive stimuli (i.e., going to jail)

278
Q

Treatment for Paraphilic Disorder

A

orgasmic reconditioning

masturbate to bad stimulus and then when orgasm switch to appropriate stimulus

279
Q

SUD you need two symptoms for at least ____ months

A

12

280
Q

Risk of relapse is lower if an individual beleives a relaspe event is

A

specific, external, controllable factors

281
Q

These three high-risk situations are associated with 75% of all lapses

A
  1. Neg. emotional state
  2. Interpersonal conflict
  3. Social Pressure
282
Q

Substance-Induced behaviors occur within ___ month of intoxication or withdrawal

A

1 month

283
Q

Alcohol Delirium symptoms

A

delirium tremens, hallucinations, delusions, agitation, autonomic hypersensitivity

284
Q

Alcohol-Induced Major Neurocog. Disorder

A

nonamnesic-confabulatory type

amnesic-confabulatory type

285
Q

Amnesic-confabulatory type due to what syndrome in Alcohol-Induced Major Neurocog. Disorder?

A

Korsakoff syndrome

anterograde and retrograde amnesia and confabulation due to a thiamine deficiency

286
Q

What is confabulation?

A

fabrication of memories

seen in Alcohol-Induced Major Neurocognitive Disorder

287
Q

Opioid Withdrawal

A
  1. dysphoric mood
  2. nausea and vomiting
  3. muscle aches
  4. fever
  5. yawning and insomnia
288
Q

Sedative withdrawal

A
  1. Autonomic Hyperactivity
  2. hand tremor
  3. insomnia
  4. nausea
  5. transient hallucinations
  6. anxiety
  7. seizures
289
Q

Stimulant Withdrawal

A
  1. fatigue
  2. insomnia or hypersomnia
  3. increased appetite
  4. psychomotor agitation or retardation
290
Q

Stimulant crash (acute withdrawal symptoms)

A

intense depression and increase in appetite

291
Q

Tobacco Withdrawal

(within 24 hours of cessation)

A

impaired concentration and restlessness

anxiety and low mood

irritability and frustration

insomnia

292
Q

anterograde amnesia

A

inability to form new memories

293
Q

retrograde amnesia

A

facts from the relatively recent past

294
Q

procedural memory (ex.)

A

remembering getting dressed; not impacted by Korsakoff’s

295
Q

Vegetative (physical) symptoms of depression

A

fatigue

insomnia

loss of appetite

weight loss

loss of libido

296
Q

peak age of onset of schizophrenia for males

A

early to mid 20’s

297
Q

peak age of onset of schizophrenia for girls

A

late 20’s

298
Q

What is passive coping

A

assigning responsibility for pain to an outside source and allowing other areas of life to be impacted by pain

299
Q

active coping

A

patient takes responsibility for pain management

300
Q

Borderline Personality in girls shares symptoms with Antisocial Personality in boys. Specifically, in both disorders…

A

Both involve manipulative behavior;

boys manipulate to gain power and females manipulate to gain attention/concern from caregivers

301
Q
A
302
Q

Marriage reduces the likelihood of depression to a greater extend

gender differences

A

for men more than for women

303
Q

More children leads to ________ risk of depression

A

increase

304
Q

male coping styles differ from females by

A

males use more action/mastery for distraction (work, sports, going out with friends)

while females brood/dwell on problems

305
Q

women who have multiple roles are _____ vulnerable to depression

more or less?

A

Less

306
Q

Avolition

A

reduced motivation or goal directed activity

307
Q

anhedonia

A

reduced capacity to experience pleasure

308
Q

alogia

A

relative absence (poverty) of speech

309
Q

ADHD affected brain areas

A
  1. PFC
  2. Cerebellum
  3. Caudate nucleus and putament (basal ganglia)
310
Q

Lazarus’s appraisal theory (3 types of cognitive appraisal to stressors)

A
  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
Q

apraxia

A

inability to enact purposeful movements

caused by damage to the frontal or parietal lobes

312
Q

What percentage of women experience “baby blues” after pregnancy

A

50 - 80 percent

313
Q

Exposure and Response Prevention is based on which behavioral theory

A

classical extinction

expose client to CS without the US (break the pairing; show white rate without sound to extinguish fear reaction)

314
Q

Which personality disorder becomes less severe or even remits by the fourth decade in life?

A

Antisocial Personality Disorder

315
Q

Why is flouxetine (SSRI) and clomipramine (TCA) used to treat OCD?

A

affects levels of serotonin;

neurotransmitter is hypothesized to impact OCD

316
Q

Seperation Anxiety begins to appear at around

A

8 or 9 months

317
Q

DSM-5 diagnosis for seperation anxiety duration criteria for children and adults?

A

4 weeks for children

6 months for adults

318
Q

Lazarus and Folkman’s 1984 transactional model has what three stages?

A

  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
Q

Said that how ppl respond to stress is determined by thier cognitive appraisal of the stressor

A

Lazarus and Folkman

transactional model of stress

320
Q

Said that everyone responds the same physiologically to prolonged stressors

A

Selye

General Adaptation Syndrome

321
Q

What are the three stages of Selye’s General Adaptation Syndrome?

A
  • Alarm
  • Resistance
  • Exhaustion
322
Q

What happens in the alarm stage of Selye’s General Adaptation Syndrome

A

HPA activated by stressor

E and NE released by adrenal medula

Increase in glucose, heart rate, muscle tension, etc.

323
Q

What happens in the resistance stage of Selye’s General Adaptation Syndrome

A
  • With prolonged stress, hypothalamus signals pituary to release the adrenocorticotropic hormone (ACTH)
  • hormone signals adrenal medula to release cortisol
324
Q

What happens in the exhaustion stage of Selye’s General Adaptation Syndrome?

A

physical reserves are depleted

325
Q

Criteria for Binge Eating Disorder (# of binges)

A

1/week for a 3 months

326
Q

Cluster A Personality Disorders are characterized by:

A

odd or eccentric behaviors

Ex. Paranoid, Schizoid, Schizoptypal

327
Q

Characteristics associated with Cluster B Personality Disorders

A

Emotional, erratic, dramatic behaviors

Ex. Antisocial, Borderline, Histrionic, and Narcissitic

328
Q

Characteristics associated wtih Cluster C Personality Disorders

A

Anxiety and Fearfulness

Ex. Anxiety and Fearfulness

329
Q

Borderline Personality Disorder is characterized by

A

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
Q

Hypnogogic hallucinations occur

A

when you are falling asleep

associated with narcolepsy

331
Q

hypnopompic hallucinations occur

A

when you are waking up

associated with narcolepsy

332
Q

Schizoid vs. Schizotypal

A

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
Q

What disorder is associated with children of parents who have PTSD?

A

depression and anxiety

hyperactivity

aggression

social withdrawal

334
Q

peripartum onset criteria (length)

A

during pregnancy or within 4 weeks post pregnancy

335
Q

babies develop vision in the order of:

A

kinetic, binocular, pictorial

EPPP 2019 (10 decks)

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