Disorders Flashcards
1
Q
What are the goals of compulsions
A
to reduce anxiety or prevent an undesirable situation from happening. Often excessive and not connected in a realistic way to the goal.
2
Q
Mean age of onset for specific phobia is
A
10 years old
3
Q
Most common comorbid disorders with OCD
A
Anxiety disorders followed by depressive or bipolar disorder, impulse control disorder, and substance use disorder
4
Q
How long must sxs last for a diagnosis of Separation Anxiety Disorder for children & adolescents and for adults
A
at least 4 weeks in children and adolescents, at least 6 months in adults
5
Q
Most prevalent mental disorders worldwide
A
Anxiety Disorders
6
Q
_____% of people with OCD have co-morbid disorders
A
90
7
Q
Specifiers for specific phobia include
A
Animal, natural environment (lighting, heights), blood-injection-injury (seeing blood, having invasive medical procedure), situational (bridges, elevators), other (vomiting, choking, catching illness)
8
Q
Why is combining in vivo exposure with relaxation or cognitive techniques not really effective in significantly improving outcomes for treatment of Agoraphobia
A
Because the person needs to be exposed and learn to tolerate high levels of fear or anxiety
9
Q
Lower than normal levels of _______ and elevated activity in _______ ______ ___________ and _________ are linked to OCD
A
Serotonin; caudate nucleus, orbitofrontal cortex, cingulate gyrus, and thalamus
10
Q
Deliberately exposing a person to physical sxs associated with panic attacks including having the person run, spin in circle, breath through a straw
A
interoceptive exposure to treat panic attacks
11
Q
Used as a treatment for blood-infection-injury phobias
A
Applied tension—repeatedly tensing and relaxing the body’s large muscle groups to increase pressure and prevent fainting
12
Q
Mowrer’s 2 Factor Theory explains that the development of phobias is a combination of
A
Classical conditioning and Operant conditioning
13
Q
What are treatments for Phobias
A
Exposure and Response Prevention, flooding, graded/graduated exposure
14
Q
Repetitive bxs or mental acts that a person feels the drive to perform. Rigid rules typically apply
A
Compulsions
15
Q
Preoccupation with a perceived defect or flaw in physical appearance which isn’t observable or appears minor to others
A
Body Dysmorphic Disorder
16
Q
Sxs of Agoraphobia must be persistent for at least __________ months
A
6
17
Q
First line treatment for Social Anxiety are
A
CBT and Antidepressants (SSRI and SNRI)
18
Q
Hyperthyroidism, cardiac arrhythmia, and other conditions should be ruled out before diagnosing this disorder
A
Panic Disorder
19
Q
___________ have earlier age of onset for OCD and slightly higher prevalence rates in childhood
A
males
20
Q
3 reasons why a person fears or avoids situations when they have agoraphobia
A
fear that escape will be difficult, that help with be unavailable, fear that it will be embarrassing
21
Q
Combined ERP and __________ is most effective in circumstances when issues are severe, to help with comorbid sxs, and when treatments haven’t been effective individually
A
SSRI
22
Q
Fear or anxiety reactions to at least one social situation in which someone could be exposed to scrutiny
A
Social Anxiety
23
Q
Recurrent, unexpected panic attacks with at least one attack being followed by at least _________ month(s) of persistent concern about having an additional attack or maladaptive change in bx related to the attack
A
1 Month (Panic Disorder)
24
Q
_________ Conditioning is when a previously neutral object/event becomes a conditioned stimulus and elicits a conditioned response after being paired with an unconditioned stimulus
A
Classical conditioning
25
A sxs of this disorder is Delusion of Reference. What is the Disorder and what are delusions of reference?
Body Dysmorphic Disorder; believing others are mocking or taking special notice of physical appearance
26
Effectiveness of treatment (CBT) for Separation Anxiety Disorder in children is increased by what other intervention
Parent training
27
Recurrent and persistent thoughts, urges, or images that are intrusive or unwanted
obsessions
28
Developmentally inappropriate and excessive fear or anxiety about being away from attachment figures
Separation Anxiety Disorder
29
Specific Phobia is twice as common for ______
girls
30
________ Conditioning to described the development of a specific phobia and happens when a person learns that avoiding conditioned stimulus allows them to avoid anxiety. So, person's avoidance bx is negatively reinforced and the conditioned response is not extinguished because the person never has the opportunity to experience the conditioned stimulus without the unconditioned stimulus
Operant Conditioning
31
Marked fear of anxiety that occurs in at least 2/5 situations:
using public transit
being in open spaces
being in enclosed spaces
standing in line or being in a crowd
being outside the home alone
Agoraphobia
32
2 Types of Exposure
In vivo and Imaginal (in vivo may be more effective than imaginal and therapist led exposure may be more effective than client led).
33
Person may perform repetitive bxs such as mirror checking and skin picking with this disorder
Body Dysmorphic Disorder
34
_________ have slightly higher prevalence rates of OCD in adulthood
Females
35
____________ and ______________ have been found useful for alleviating panic attacks but are associated with high relapse rates when used alone
Antidepressants and benzidiazepines
36
Criteria for Specific Phobia
Fear/Anxiety must be out of proportion to actual danger, must be persistent (usually lasting at least 6 months), must cause significant distress or impairment
37
First line treatment for Agoraphobia
Exposure and Response Prevention
38
Intense fear or anxiety about a specific object or situation accompanied by avoiding it or enduring it with intense distress
Specific Phobia
39
Virtual reality exposures may be as effective as in vivo exposures especially for what types of phobias
acrophobia-fear of heights and fear of flying
40
Preferred treatment for Separation Anxiety Disorder
CBT including psychoeducation, exposure, relaxation techniques and cognitive restructuring
41
First line treatment for OCD
Exposure and response prevention
42
Fear or anxiety related to social anxiety must be excessive for the threat or situation, cause significant distress, and avoidance must be persistent for at least how long
6 months
43
Persistent eating of non-nutritive, non-food substances
Pica
44
How long must sxs persist for a diagnosis of Pica
1 month
45
Pica is most common among which populations
kids and pregnant women
46
What must be present for a diagnosis of Anorexia Nervosa
-Intense fear of gaining weight/becoming fat or engaging in bxs that interfere with weight gain
-Self-evaluations are unduly influenced by weight/shape and lack of awareness about the seriousness of low weight
47
Specifiers for type of Anorexia
restricting or binge eating/purging types
48
Severity of Anorexia is determined by what
BMI
49
Anorexia often co-occurs with what other diagnoses
Depression and Anxiety. Anxiety often precedes Anorexia
50
Why is Anorexia difficult to treat
Denial of problem and resistance to change
51
In the short term, the prognosis for Anorexia tends to be _________ than the prognosis for Bulimia. But this changes in the long term.
poorer; over time the prognosis becomes similar to Bulimia
52
Research supported treatments for Anorexia include
CBT for anorexia
CBT-E (enhanced CBT)
FBT (family based treatment)
Pharmacology
53
Outpatient treatment for Anorexia and Bulimia that includes parents.
FBT (Family Based Treatment)
54
What is a post hospitalization intervention that's based on the assumption that shape and weight concerns engender dietary restriction and extreme methods of weight control. It uses behavioral strategies to establish regular eating patters and eliminate body checking. It uses cognitive strategies to identify and replace problematic thinking and enhance motivation.
CBT for Anorexia
55
Transdiagnostic treatment that proposes eating disorders share same core psychopathology---excessive value given to physical appearance and weight. It's personalized, flexible, and focusus on the factors that are maintaining patient's sxs.
CBT-E (Enhanced CBT)
56
What are compensatory bxs related to Bulimia?
vomiting, excessive exercise (things done to prevent weight gain)
57
There are inconsistent findings about the use of pharmacotherapy to treat Anorexia. Still, some say the antipsychotic drug Olanzapine and the SSRI Fluoxetine are useful for what?
Olanzapine: fostering initial weight gain; Fluoxetine: improving weight maintenance
58
For a diagnosis of Bulimia, binge eating and compensatory bx must occur at least ___ times per week for at least _____ months
1 x/week for at at least 3 months
59
Severity of Bulimia is based on what?
The average number of episodes of inappropriate compensatory bx per week
60
Bulimia frequently is comorbid what what disorders
Depression and/or Anxiety ; Anxiety frequently precedes the dx
61
Recurrent episodes of binge eating that are accompanied by a sense of lack of control, inappropriate compensatory behavior to prevent weight gain, and self-evaluation that's excessively influenced by body shape and weight
Bulimia Nervosa
62
Most people with this disorder are within the normal weight range, overweight or obese
Binge Eating Disorder
63
Purging can cause
dental erosion and gastroesophageal reflux, dehydration, heart arrhythmias, and death
64
Research supported treatments for Bulimia include
CBT*
CBT-E*
IPT (interpersonal therapy)
FBT (Family Based Treatment)
* = preferred treatment (takes less time than IPT)
65
Family Based Treatment for this eating disorder tends to be more collaborative because clients are more motivated to change and see their sxs and ego-dystonic
Bulimia
66
Which drug treatment has been found effective for alleviating comorbid Depression and for reducing binge eating and purging in patients without Depression
SSRI (especially fluoxetine)
67
When is comes to Bulimia, some research has found that combined treatment (medication and CBT) is more effective than medication alone. Other studies have found that combined treatment (CBT and medication) is no more effective than _________ alone
CBT is found to be very effective, even without medication
68
Most effective version of CBT for patients with Bulimia
CBT-E
69
What are the 4 stages of CBT-E
Stage 1: engaging patients in treatment and developing formulation of what is maintaining problem (bxs, feelings, thoughts, events, etc.)
Stage 2: reviewing progress, identifying new problems, and updating formulation
Stage 3: identifying triggers and addressing patient's over-evaluation of shape and weight. Addressing perfectionism, low self-esteem, and interpersonal problems
Stage 4: reducing relapse and identifying ways to maintain progress
70
As far as treatment for Bulimia, does telepsychology and in person treatment yield same results?
Yes. However, those in face to face treatment abstained from purging slightly more and had greater reduction in eating -disordered cognitions than those doing telepsychology
71
Who is more distressed by their sxs, those with Anorexia or those with Bulimia?
Those with Bulimia are more distressed by sxs and have more autonomous (intrinsic) motivation to reduce sxs which predicts a greater reduction in sxs
72
What is the diagnostic criteria for Binge-Eating Disorder/ Sxs of Binge Eating Disorder?
Requires recurrent episodes of bing eating that involves eating an amount of food that is larger than what most people would eat during similar period of time and a lack of control over eating during episodes. Also, other sxs including eating more rapidly than usual, eating until uncomfortably full, eating large amounts when not feeling hungry, feeling alone due to embarrassment about binge eating, feeling disgusted, depressed, or very guilty about binge eating
73
Binge eating episodes must occur on average at least ____ times per week and at least _____ months
1 x week ; 3 months
74
Severity (mild, moderate, severe, extreme) for Binge Eating Disorder is determined by what?
Number of binge episodes per week
75
Binge Eating is how many more times common in women than men?
2-3 x more common in women
76
People with this disorder tend to be of normal weight, overweight, or obese
Binge Eating Disorder
77
Who tends to have a better response to treatment, those with Bulimia or those with Binge Eating Disorder?
Those with Binge Eating Disorder because they do not engage in compensatory behaviors
78
Evidenced based treatments of Binge Eating Disorder are
CBT-E
IPT (interpersonal therapy)
Some studies have found CBT-E to be more effective
79
True of False: Medication alone is less effective than CBT and Medication to treat Binge Eating Disorder?
True
80
Repeated voiding of urine into the bed or clothing
Enuresis
81
For a diagnosis of Enuresis, must urinate in bed or clothes at least _____ times per week for at least _____ consecutive months
Must pee in bed/clothes at least 2 times per week for at least 3 consecutive months
82
For a diagnosis of the Elimination Disorder Enuresis, the person must be at least _____ years old or at the equivalent developmental level
5 years old
83
Specifiers for the Elimination Disorder Enuresis include what?
Nocturnal only, Diurnal only, or Nocturnal an Diurnal
84
What is the most common treatment for Enuresis?
Moisture alarm (Bell and pad)
85
What are the 3 sleep problems that can effect someone with Insomnia?
1. Difficulty initiating sleep (sleep onset-initial)
2. Difficulty maintaining sleep (sleep maintenance-middle)
3. Early morning awakening with an inability to return to sleep (late insomnia)
86
For a dx of Insomnia, sleep disturbance must occur at least _____ nights a week and be present for at least _____ months
Must occur at least 3 nights a week for 3 months
87
Most common single type of insomnia?
Sleep maintenance- involves frequent or extended waking up during the night
Of note, combination of all three types is the most common form of insomnia
88
Subjective Reports by those with insomnia vs Objective Measured reports (polysomnography) of those with insomnia tend to show what?
People with insomnia tend to overestimate how long it took them to fall asleep, tend to overestimate time awake during the night, and tend to underestimate total amount of sleep
89
Non-pharmacological treatment of choice for insomnia is what?
Multi-component cognitive behavioral intervention that incorporates stimulus control, sleep restriction with sleep hygiene, relaxation training, and/or cognitive therapy
-stimulus control: strengthening the bedroom and bed for sleep cues
-sleep restriction: restricting the time allotted for sleep each night so time spent in bed matches sleep requirements
90
Repeated occurrences of extended, extremely dysphoric, and well-remembered dreams that involve efforts to avoid threats to survival, security, or physical integrity
Nightmare Disorder
91
When does Nightmare disorder typically occur?
During REM sleep in the second half of a major sleep period
92
Sleep walking and Sleep terrors are what kind of sleep disorders?
Non-Rapid Eye Movement Sleep Disorders
93
Sleepwalking and Sleep terrors usually occur during which stage of sleep
Stage 3 or 4 in the first third of a major sleep period
94
An abrupt arousal from sleep that usually starts with a panicky scream and accompanied by intense fear and autonomic arousal (tachycardia and rapid breathing)
Sleep terror
95
During these sleep disorders, the person is unresponsive to attempts to awakening them and they tend to have little memory of what happened during sleeping
Sleepwalking and Sleep Terrors
96
Sleep walking and Sleep terrors usually occur most often for who?
Children
97
Attacks of irrepressible need to sleep
Narcolepsy
98
People with Narcolepsy have to fall asleep or have daytime naps at least _____ times per week for at least _____ months
3 x per week for at least 3 months
99
Hypnagogic hallucinations
vivid hallucinations just before falling asleep
100
Hypnopompic hallucinations
vivid hallucinations just after awakening
101
People with these sleep disorder tend to have vivid hallucinations just before falling asleep or just after awakening from sleep
Narcolepsy; hypnagogic and hypnopompic hallucinations
102
In Narcolepsy, this symptom is often triggered by strong emotion so people with this disorder attempt to control their emotions to avoid sleep episodes
Cataplexy (loss of muscle tone)
103
Persistent pattern of inhibited & emotionally withdrawn bx toward adult caregivers as demonstrated by lack of seeking or responding to comfort when distressed and persistent social and emotional disturbances that include 2 of the following:
-minimal social and emotional -responsiveness to others
-limited positive affect
-unexplained irritability, sadness, or fearfulness when interacting with adult caregivers
Reactive Attachment Disorder
104
For a diagnosis of Reactive Attachment Disorder there must be a hx of what?
There must be a history of extreme insufficient care that is believed to be responsible for the person's symptoms;
105
For a dx of Reactive Attachment Disorder the onset of symptoms must be before what age and the person should have a developmental age of at least what age?
Before 5 years old; Developmental age of at least 9 months.
106
This disorder involves a persistent pattern of behavior that's characterized by inappropriate interactions with unfamiliar adults
Disinhibited Social Engagement Disorder
107
Sxs of this diagnosis include:
-reduced or absent reticence in approaching or interacting with strangers
-overly familiar behavior with strangers
-diminished or absent checking with adult caregivers after being separated from them
-willingness to accompany a stranger with little or no hesitation
Disinhibited Social Engagement Disorder
108
Diagnosis of Disinhibited Social Engagement Disorder requires a hx of what?
History of extreme insufficient care that's believed to be responsible for their sxs
109
You must have a developmental age of ____ for a Reactive Attachment Disorder and Disinhibited Social Engagement Disorder
9 months
110
For a diagnosis of PTSD, sxs must last for more than how long?
More than one month
111
Diagnostic criteria for PTSD includes
Cause significant distress and impaired functioning and be due to exposure to actual or threatened death, serious injury, or sexual violence;
Symptoms include 4 types:
-Intrusion (recurrent, distressing memories of the event)
-Persistent avoidance of stimuli associated with the traumatic event
-Negative changes in mood or cognition
-Alterations in arousal and reactivity
112
Brain abnormalities associated with PTSD
- hyperactive amygdala
- hyperactive anterior cingulate cortex
- hypoactive ventromedial prefrontal cortex
- reduced volume of the hippocampus
113
PTSD is associated with what neurotransmitter activity
increased dopamine, norepinephrine, and glutamate; decreased levels of serotonin and GABA
114
Recommended treatments for PTSD
CBT
CPT (Cognitive Processing Therapy)
Cognitive Therapy
Prolonged Exposure
Conditional Recommendations for:
brief eclectic therapy
EMDR
narrative exposure therapy
115
This treatment for PTSD combines challenging negative cognitions and writing and reading detailed description of the trauma
Cognitive Processing Therapy (CPT)
116
Effects of single-session psychological debriefing and group psychological debriefing
Found to be ineffective and may worsen symptoms
117
Telepsychology and in person treatment for PTSD are found to be of different effectiveness in what way?
Some therapists reported barriers to developing therapeutic alliance; comparable in attendance, drop out rates, and client satisfaction.
118
Pharmacological treatments with conditional support for PTSD
SSRI (fluoxetine, paroxetine, sertraline) ; SNRI (venlafaxine)
119
For Acute Stress Disorder, sxs must persist for how long?
Between 3 days and 1 month
120
Acute Stress Disorder requires what?
Exposure to actual or threatened death, severe injury, or sexual violation. Must have at least 9 sxs from 5 categories (intrusion, negative mood, dissociative ss, avoidance, arousal)
121
This disorder requires the death of a person close to the bereaved person (the patient) some time ago
Prolonged Grief Disorder
122
For a diagnosis of Prolonged Grief Disorder, how long ago must the person have died for adults? How long ago for children?
12 months ago for adults; 6 months ago for children
123
These disorders involve a disruption of and/or discontinuity in normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior
Dissociative Disorders
124
Inability to recall ALL events that occurred during a circumscribed period of time
localized amnesia (most common)
125
Inability to recall SOME events that occurred during a circumscribed period of time
selective amnesia
126
Complete loss of memory for one's entire life
Generalized amnesia
127
Loss of memory for a specific category of information
Systematized
128
Inability to remember new events as they happen
Continuous
129
Purposeful travel or purposeless wandering that associated with loss of memory
Dissociative fugue specifier
130
Disorder involves an inability to recall important personal information that cannot be attributed to ordinary forgetfulness and causes significant distress or impaired functioning; often related to victimization or exposure to a traumatic event
Dissociative Amnesia
131
Sense of unreality, detachment, or being an outside observer of one's thoughts, actions, etc
Depersonalization
132
Sense of unreality or detachment with regard to one's surroundings
Derealization
133
A diagnosis of this disorder requires persistent or recurrent episodes of unreality and detachment accompanied by intact reality testing and significant distress or impaired functioning
Depersonalization/Derealization Disorder
134
Disorder involves a preoccupation with a serious illness with no or mild somatic symptoms, excessive anxiety about health, and either excessive health-realted behaviors or avoidance of healthcare
Illness Anxiety Disorder
135
For a dx of illness anxiety, sxs must be present for how long?
at least 6 months, though the nature of the symptoms may vary over time
136
This disorder involves one or more somatic sxs that are distressing or cause significant disruption to daily life. Sxs are associated with excessive concerns about health including: disproportionate thoughts about seriousness of sxs, persistently high levels of anxiety about health, excessive time and energy spent on health concerns
Somatic Symptom Disorder
137
For a diagnosis of Somatic Symptom Disorder, sxs must be present for how long?
At least 6 months
137
Functional Neurological Symptom Disorder is also referred to or called
Conversion Disorder
138
For this disorder, one or more sxs must involve a disturbance in voluntary motor or sensory functioning (paralysis, blindness, etc) that is incompatible with any known neurological or medical condition and causes significant distress or impaired functioning
Functional Neurological Symptom Disorder (Conversion Disorder)
139
This disorder can involve Psychogenic Non-Epileptic Seizures (PNES) in which the EEG patterns don’t correspond with the normal seizure like activity
Functional Neurological Symptom Disorder (Conversion Disorder)
140
This disorder can involve self or other imposed sxs that falsify or induce physical or psychological symptoms that are associated with deception (but no obvious external reward for doing so)
Factitious Disorder
141
What distinguishes Factitious Disorder from malingering?
Malingering involves deception due to trying to obtain drugs, financial compensation, or another external reward. Factitious Disorder involves deception, but without an obvious reward
142
Malingering should be suspected when...
A personal seeks a medical evaluation for legal reasons, there's a marked discrepancy between person's sxs and objective findings, the person is uncooperative with evaluation or treatment, and/or the person has antisocial personality disorder
143
The forced choice method is used for what
to help detect malingering. It involves presenting the person with test items that require the person to choose the correct answer from 2 or more alternatives. Malingering is suggested when the person answers more than 50% of items incorrectly (more than what would happen by chance alone)
144
This diagnosis requires a recurrent pattern of angry/irritable mood, argumentative/defiant bx, and/or vindictiveness ---loses temper often, angry and resentful, often deliberately annoys others or blames them for their mistakes and misbehavior. These bxs occur during interactions with at least one person who is not a sibling and last for at least 6 months
Oppositional Defiant Disorder
145
In young children, ODD is more common in who? But in older children and adolescents, it occurs about equally between boys and girls
boys
146
About ______ % of children who have a dx of ODD eventually receive a dx of conduct disorder
30%
147
This diagnosis requires a persistent pattern of bx that violates the basic rights of others and age appropriate norms or rules. Sxs represent 4 categories: aggression to people and animals, destruction of property, deceitfulness or theft, serious violation of rules.
Conduct disorder
148
For a dx of conduct disorder, 3 characteristic sxs during the past 12 months and at least 1 sxs in the past ___ months
6
149
The dx of conduct disorder cannot be assigned to individuals over 18 who meet criteria for _____ disorder
antisocial personality disorder
150
Which onset type of conduct disorder is associated with a higher degree of aggressiveness and greater risk of future dx of antisocial personality disorder and/or substance related disorder
childhood onset (at least one sxs before age 10
151
Research shows that decreased _____________ and ________ neurotransmitters contribute to increased aggression, reduced sensitivity to punishment, and increased risk taking bxs (associated with conduct disorder)
serotonin and dopamine
152
Research has found that children with conduct disorder and those without it have similar levels of _______ in the morning hours, but those with conduct disorder had higher levels and cardiovascular responses to stressful procedures in the afternoons
cortisol
153
Heredity, abnormalities in brain structure and functioning, neurotransmitter and neuroendocrine abnormalities, prenatal exposure to opiates or alcohol, and negative parenting practices (harsh or inconsistent punishment) has been linked to what child/adolescent disorder
conduct disorder
154
Moffitt states that there are 2 types of antisocial bx that correspond to childhood and adolescent onset.
1. life course persistent type- increasing serious and antisocial bx across situations that continues into adulthood due to neuropsychological deficits, temperament, cognitive abilities, environment
2. Adolescence limited type which is due to a __________ _________ and therefore antisocial bxs are a ways to gain status
Maturity gap between adolescents biological and sexual maturity and their social maturity
155
For most individuals with conduct disorder that had adolescent onset, it remits by when
adulthood
156
This child focused intervention is for those with. conduct or other disruptive disorders and focuses on cognitive processes that underlie children's problematic bxs and helps the accurately perceive the feelings of others, understand the consequences or their actions, and identify prosocial ways to resolve interpersonal problems and consequences
Problem solving skills training
157
This intervention is for parents of children aged 2-7 who have severe bx problems and also children who have experienced or at risk for experiencing maltreatement.
PCIT; parent child interaction therapy
158
Intervention for families with a child 11-18 who has an externalizing bx disorder or substance use problem and is at high risk for deliquency. It's based on the assumption that problematic bxs within a family regulate relational connections by fostering interdependence or independence and regulate relational hierarchies by creating power structures. Goal is to replace problematic bx w/ non problematic bxs that serve the same fxs
FFT; Functional Family Therapy
159
This intervention is for families that have a member 11-21 years old with a substance use disorder and comorbid internalizing and externalizing sxs and delinquency. Incorporates family systems theory, ecological theory, and developmental psychology. Primary goals are to reduce or eliminate the adolescents substance use, aggression, and other sxs to improve adolescent and family functioning by facilitating change in four independent domains: adolescent, parents, family interactions, and extrafamiliar sources of influence
Multidimensional family therapy
160
This intervention is a family and community based intervention for adolescents 12-18 who are at imminent risk for out of home placement due to antisocial bxs, substance use problems, and/or serious psychiatric problems. Based on Bronfenbrenner's ecological model and assumes problematic bxs are result of multiple risk factors at individual, family, peer, school, and community levels and that interventions must be provided at all levels
Mutlisystem therapy (multimodal intervention)
161
This intervention is an alternative to residential care for children and adolescents who need intensive support due to child maltreatment, severe emotional disturbance, and/or juvenile delinquency. It involves developing a bx management plan that is tailored to the child and administered by a treatment team in the child's home, school, and community. Children reside with highly trained and supervised foster parents while their biological parents receive training and support for positive reunification
Multidimensional treatment foster care (multimodal intervention)
162
Programs like scared straight and confrontational "rap sessions" have what kind of effects
tend to be harmful and increase the likelihood that at risk juveniles will engage in criminal bxs in the future
163
This disorder is diagnosed when individuals have recurrent bx outbursts that are due to a failure to control aggressive impulses as manifested by: verbal or physical aggression, physical aggression (not resulting in damage to property or physical injury to others or animals). Requires the level of aggressiveness not be proportional to provocation or any precipitating social stressor. Outbursts must not be premeditated or committed to achieve tangible outcomes.
Intermitted Explosive Disorder
164
For a dx of intermittent explosive disorder, verbal and physical aggression occurs on average _____ weekly for at least ______ months that did not result in damage or destruction to people or property. And ______ bx outbursts in a 12 month period that resulted in damage or destruction to property or physical injury to people or animals
twice weekly : 3 months ; 3
165
When assigning a DSM-5 dx of conduct disorder, severity is determine by what
number of conduct problems and severity or harm to others
166
For a dx of intermittent explosive disorder, the client must be at least how old
6 years old
167
A pattern of emotional dysregulation is characteristic of which disorder?
Oppositional defiant disorder or conduct disorder
oppositional defiant disorder
(angry and irritable mood)
168
The sxs of oppositional defiant disorder are grouped into 3 DSM categories which are:
argumentative/defiant bx
Vindictiveness
Angry/irritable mood
168
169
170
Hyperactivity in the ventromedial prefrontal cortex and hypoactivity in the dorsolateral prefrontal cortex is associated with what diagnosis
Depression
171
Higher than normal levels of melatonin have been linked to what diagnosis
major depressive disorder with seasonal pattern
172
Electroconvulsive therapy (ECT) is used to treat _____________. What is likely to be it's effect on memory
Treatment Resistant Depression;
Both anterograde amnesia (inability to form new memories) and retrograde amnesia (loss of memories before ECT). Anterograde amnesia usually resolves in a few weeks. And older remote memories usually come back first before more recent memories, although there is likely to be games in long term memory
173
Sxs of persistent depressive disorder and cyclothymic disorder have to be present for how long
2 years
174
This has been found useful for treating treatment resistant depression
Ketamine
175
Sxs of mania last at least how long while sxs of hypomania last last at least how many days
1 week ; 4 consecutive days
176
inflated self esteem or grandiosity, decreased need for sleep, and flight of ideas along with marked impairment in functioning that could require hospitalization or include psychotic features is characteristic of what
mania
hypomania sxs are not severe enough to cause marked impairment, hospitalization, and do not include psychotic features. It includes increased activity and energy
177
For children and adolescents, cyclothymic disorder sxs have to last ____ compared to adults which have to last _____
1 year ; 2 years
178
Bipolar disorder has a strong genetic component with a concordance rate of .67 to 1 for who
monozygotic twins
.2 concordance for dizygotic twins
179
Sxs shared by ppl with bipolar disorder and adhd include
irritability, distractibility, and accelerated speech
Distractibility in adhd typically associated with wondering while in mania typically associated with acceleration of thoughts
180
ADHD does not seem to be associated with hypersexuality, but some research shows it is associated with what
higher rates of sexual disorders and greater involvement with risky bxs
181
Lithium is usually most effect pharmacotherapy treatment for traditional bipolar disorder, while __________ and __________ are used to treat "atypical bipolar disorder" which is characterized by mixed mood states, rapid cycling, lack of full recovery between episodes
anticonvulsants and second generation antipsychotics
182
This disorder requires the presence of at least 12 months of severe and recurrent temper outbursts that are verbal and/or behavioral, are grossly out of proportion to the situation or provocation, and occur three or more times each week. And a persistently irritable or angry mood that is observable to others most of the day and nearly every day between outbursts
Disruptive Mood Dysregulation Disorder
183
About ______% of women experience baby blues after the birth of their children
80
184
Phototherapy is a treatment for what
SAD
Phototherapy is exposure to bright light that suppresses the production of melatonin which, when too high, contributes negatively to the the sleep wake cycle
185
Who is likely to describe somatic sxs (appetite and sleep disturbances, headaches, heart palpitations) rather than affective or psychological (loneliness, depressed mood, hopelessness) sxs when it comes to Depression
older adults &
those from Latino, mediterranean, middle eastern, asian, and other non western cultures
186
This disorder involves recurrent and intense sexual arousal for at least 6 months related to fantasies, urges, and/or behaviors involving sexual activity with a child or children 13 years or younger. This person much have acted on these urges or must have experienced significant distress or interpersonal problems because of them. Must be at least 16 years old and at least 5 years older than child or children
Pedophilic Disorder
187
This disorder involves recurrent and intense sexual arousal for at least 6 months from touching or rubbing against a nonconsenting adult as manifested in fantasies, urges, and/or behaviors. For this diagnosis the person must have acted on urges with a nonconsenting person or experienced significant distress or impaired fx as a result of fantasies or urges
Frotteuristic Disorder
188
This disorder involves cross dressing for the purpose of sexual arousal for at least 6 months as manifested in fantasies, urges, and/or bxs that cause significant distress or impaired fx. Most men with this disorder identify themselves as heterosexual but may have had occasional sexual relations with me, especially when cross dressed
Transvestic Disorder
189
This disorder involves recurrent and intense sexual arousal for at least 6 months in response to nonliving objects or specific non-genital body part with the arousal causing significant distress or impaired fx
Fetishistic Disorder
190
This disorder involves recurrent and intense sexual arousal for at least 6 months from exposing one's genitals to an unsuspecting person as manifested by fantasies, urges, or behaviors. The person must have acted on the urges with an unsuspecting person or experienced significant distress or impaired fx as a result of sexual urges or fantasies
Exhibitionistic Disorder
There are 3 subtypes: sexually aroused by exposing genitals to prepubertal children, to physically mature individuals, or both prepubertal children or physically mature individuals
191
What are the 2 approaches to treatment of gender dysphoria
Dutch Protocol: based on belief that gender dysphoria or transgender identity persists into adolescence for only a small minority of people. For kids under 12 parents engage in watchful waiting. Can start puberty blocking drugs at first signs of puberty. Should wait to do cross sex hormone therapy and surgeries until sure, closer to 18
Gender-affirmative model- more widely accepted approach and based on the assumption that a child of any age may be aware of their authentic identity and can benefit from social transition at any stage of development
192
This disorder involves a marked incongruence between one's assigned gender and one's experienced or expressed gender. Sxs of children and adults must be present for at least 6 months
Gender dysphoria
193
Who tends to have somewhat more positive outcomes from gender confirmation surgery
Transgender males
Research shows that these surgeries decrease gender dysphoria, improve self-satisfaction, and have a low incidence of regret
194
This diagnosis requires the presence of marked delay in, infrequency of, or absence orgasm or markedly reduced intensity of orgasmic sensations on all or most all occasions of sexual activity for at least 6 months
Female Orgasmic Disorder
195
What is directed masturbation used for
the most empirically supported technique for treating female orgasmic disorder (especially for lifelong FOD)
Other treatments include sex education, sensate focus, anxiety reduction techniques, mindfulness training, communication skills training, and CB techniques
196
This disorder involves persistent or recurrent problems with at least one of the following: vaginal penetration during intercourse, marked vulvovaginal or pelvic pain during intercourse or penetration attempts; marked anxiety about vulvovaginal or pelvic pain during or as a result of vaginal penetration; marked tensing of pelvic floor muscles during attempted vaginal penetration. Sxs must last 6 months or longer and cause significant distress
Genito-Pelvic Pain/Penetration Disorder
This disorder is linked to a hx of sexual and/or physical abuse and for some an onset after a hx of vaginal infections.
197
interventions are relaxation training, sensate focus, topical anesthetic, vaginal dilators, and Kegels for what disorder
Genito Pelvic Pain/Penetration Disorder
198
This disorder involves a persistent or recurrent pattern of ejaculation during partnered sexual activity within approximately one minute of vaginal penetration and before the person desires it. Sxs must be present for 6 months or more and occur during 75- 100% of all sexual activity
Premature (Early) Ejaculation
199
Taking what medication can delay ejaculation for some men
SSRI (especially paroxetine)
200
For this disorder the person must have at least one of three on 75-100% of occasions of sexual activity: marked difficulty obtaining an erection during sex, marked difficulty maintaining an erection until completion of sexual activity, marked decrease in erectile rigidity. Sxs must be present at least 6 months
Erectile Disorder
201
What causes an organic etiology to be ruled out for erectile disorder
if the person has spontaneous erections when not planning to engage in sexual activity, if they have morning erections, or erections when masturbating, or a partner other than their usual sexual partner
202
This is a method to treat erectile disorder, genito pelvic pain disorder, and female orgasmic disorder. It is a method for reducing performance anxiety and consists of a series of activities for a couple that are designed to promote intimacy and reduce performance anxiety by having partners focus on pleasurable sensations associated first with non sexual touching, then sexual touching, and finally with sexual intercourse
sensate focus
203
What are the 4 sxs of Gerstman's Syndrome?
Finger agnosia
Left right confusion
Agraphia (difficulty writing)
Acalculia (difficulty performing math operations)
