DSM Flashcards
Mental Retardation
percentage of people in:
mild, moderate, severe, profound
modle 85%; moderat 10%; severe 3-4%; profound 1-2%
ADHD
percentage of all kids; ratio of boys:girls; percentage of kids with ADHD that also have CD; percentage of kids with LD
3-5% of all kids; 4-9 times more boys; 50% of ADHD kids have Conduct Disorder; 20% of kids iwth ADHD have LD
ADHD
neurological areas affected and problems related to ADHD
right frontal lobe, striatum which is part of the basal ganglia and composed of the caudate nucleus and putamen; cerebellum
smaller corpus callosum; genetic influence 57%; twins 80%, globus palladus and caudate nucleus
Tourettes Disorder
diagnostic criteria
co morbidity
treatment
multiple tics, multiple times per day for 12 months
co existing diagnosis: obsession and compulsions, ADHD, LD, depression and social problems
Tx: school, individual, family, drugs: ?Haloperidol and pimozide, clonidine (hypertension)
antidepressants: clomipramine, fluxetine to decrease obsessions and compulsions
Dementia of the Alzheimer’s Type
Stage 1
Stage 2
Stage 3
Alzheimers
Stage 1: 1-3 years; anterograde amnesia/declarative/explicit memory; deficits in visuospatial skills; indifference, irritability, sadness, anomia (1: MEMORY)
Stage 2: 2-10 years; increasing deficits in recent and remote recall/retrograde amnesia; falt or labile mood; restlessness and agitation; delusions; fluent aphasia, acalculia, and ideomotor apraxia/insbility to translate an idea into movement (2:COGNITIVE)
Stage 3: 8-12 years; severely deteriorated intellectual functioning; apathy; limb rigidity; urinary and fecal incontinence
Alzheimers Dementia
Etiology
neurotransmitter
neurological abnormalities
linked to genetics; low levels of ACh; neurofibrilarry tangles and plaques in certain areas of the cebral cortex especially in the temproal lobes, hippocampus and other areas of the brain
Jane smokes marijuana every weekend. She also smokes occasionally during the week, in response to a particular stressful event. Based on this informaiton, we know that Jane, in terms of DSM IV TR diagnostic classification, is suffering from
a. substance abuse
b. substance dependence
c. cannabis inducted psychotic disorder
d. none of the above
D - none of the above;
there is no indication from the quesion that the criteria for substance absue or dependence are met. in other words, just because someone regularly uses a substance does not mean that there is a maladaptive pattern of use leading to significant impairment or distress (the key criterion for dependence and abuse)
Marlatt and Gordon:
an initial relapse in a recovering alcoholic is most likely to lead to further relapses if the person:
a. attributes the relapse to internal and stable causes
b. attributes the relapse to external and unstable causes
A - the abstinence violation effect (AVE) occurs when an initial relapse leads to feelings such as guilt and depression, which in turn lead to further relapses. the AVE is most likely to occur if the person makes internal, stable attributions for the relapse (e.g. “I am worthless”), as opposed to external, unstable attributions (e.g. “I drank because temprorary relapses are to be expected”)
Caffeine Intoxication is associated with
diuresis, boundless energy, significant distress for the person who is intoxicated
Korsakoff’s Syndrome
alcohol inducated persisting amnestic disorder
due to a thiamine deficiency that causes damage to the thalamus. primary sumptoms is impaired recent memory. also disorientation, lack of insight into probelms, retrograde amnesia and confabulation (filling in memory gaps randomly)
- SUBSTANCE ABUSE
: In DSM-IV, a Substance-Use Disorder characterized by a maladaptive pattern of substance use involving clinically significant impairment or distress as manifested by the presence of at least one symptom during a 12-month period.
- SUBSTANCE DEPENDENCE:
A Substance-Use Disorder involving the continued use of a substance despite significant substance-related problems, as evidenced by the presence of at least three characteristic symptoms during a 12-month period. Dependence may or may not involve tolerance and withdrawal (physiological dependence). Substance Dependence is more serious than Substance Abuse.
- DELIRIUM TREMENS (A.K.A. ALCOHOL WITHDRAWAL DELIRIUM):
- DELIRIUM TREMENS (A.K.A. ALCOHOL WITHDRAWAL DELIRIUM): Disturbances in consciousness and other cognitive functions, autonomic hyperactivity, vivid hallucinations, delusions and/or agitation following a period of prolonged or heavy use
Schizophrenia is a disturbance of ______or more that includes _______________of active-phase symptoms.
Active phase symptoms include ____
Schizophrenia is a disturbance of six months or more that includes at least one month of active-phase symptoms (one week in DSM-III-R). Active phase symptoms include delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior and/or negative symptoms (e.g., flat affect, avolition, alogia).
Rates of Schizophrenia are:
males:females
twin studies
Rates of Schizophrenia are about equal for males and females.
Twins: monozygotic (identical)=48%; Dizygotic (fraternal) -16%; biological siblings -10%; unrelated/general population=1%
Treatment of Schizophrenia
Rates of Schizophrenia are about equal for males and females. Treatment usually includes a neuroleptic family therapy, and social-skills training.
etiology
eltiology has been linked to genetics, oversensitivity to dopamine and other neurotransmitter abnormalities, and several structural brain abnormalities including enlarged ventricles and hypofrontality
prognosis
better prognosis is associated with abrupt and later onsent, a precipitating stressor, female gender, absence of anosognosia and absnence of structural brain abnormalities
Dopamine hypothesis of schizophrenia
schizophrenia is linked to excess dopamine; also serotoninin, large ventricles and decreased activity in the frontal lobes, small cerebral cortex and small thalamus
Antipsychotics:
positive symptoms
negative symptoms
positive symptoms - delusions, hallucinations, disorganized speech, disorganized or catatonic behavior - easier to treat + sxs; treated with typical antipsychotics
negative symptoms: alogia (restricted fluency/productivity of thought and speech), avolition (restricted initiation ofgoal directed beahvior), flat affect, anhedonia.
atypical antipsychotics treat + and - sxs w/o tardive dyskinesia
Schizophreniform Disorder
same diagnostic criteria as schizophrenia EXCEPT only present for 1 month but less than 6 months and impaired functioning is not required for this diagnosis
Brief Psychotic Disorder
delusions, hallucinations, disorganized speech, and/or grossly disorganized or catatonic behavior that are present for at least 1 day but less than 1 month
Schizoaffective Disorder
concurrent symptoms of schizophrenia and major depressive, manic, or mixed episode except for a period of at least two weeks without prominent mood symptoms. (psychotic without mood for 2 wks)
Paranoid Schizophrenia
vs.
Delusional Disorder
Paranoid Schizophrenia - bizarre delusions; “yellow men with purple feet are following me”
vs.
Delusional Disorder - persistent, non bizarre delusional systemt; “whenI slow down, all of the cars behind me slow down - I’m being followed” - the logic is off; can function much better generally and they look pretty normal.