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DSM IV > DSM IV 2 > Flashcards

DSM IV 2 Flashcards

1
Q

Substance Use Disorders

A

person is having a problem with problematic, excessive use

dependence or abuse

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2
Q

Substance Induced Disorders

A

problems that come about from using substances

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3
Q

Substance Dependence

A

impaired control and continued use despite adverse consequences
3 symptoms over a 12 month period

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4
Q

Tension Reduction Hypothesis

A

1950s
mixed reviews
people drink to reduce tension, unpleasant stress

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5
Q

Substance Abuse

A

pattern of using a substance that results in problems

1 or more symptoms within a 12 month period

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6
Q

Substance Intoxication

A

effects of immediate consumption of substance

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7
Q

Substance Withdrawal

A

when you’ve stopped or cut down on substance

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8
Q

Effects of alcohol are identical to…

A

Sedatives, hypnotics, and anxiolytics

identical intoxication and withdrawal

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9
Q

alcohol intoxication

A

slurred speech, lack of incordination, stupor or coma, impaired memory and concentration

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10
Q

alcohol withdrawal

A 
sympathetic branch of autonomic nervous system may become hyperactive
psychomotor agitation
seizures
can be fatal
insomnia
nausea and vomiting
transient hallucinations or illusions
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11
Q

Amphetamine intoxication

A

similar to cocaine intoxication
makes you UP
euphoria, hypervigilance, anger, impaired judgment
psychomotor agitation, tachycardia, nausea or vomiting, muscular weakness, perspiration or chills, respiratory problems, weight loss, confusion, seizures, coma
PUPILLARY DILATION

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12
Q

Amphetamine WIthdrawal

A

OPPOSITE of intoxication

dysphoria, fatigue, unpleasant dreams, increased appetite, psychomotor agitation or retardation

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13
Q

Caffeine Intoxication

A

restlessness, flushed face, diuresis (excessive urination), gastrointestinal disturbance, muscle twitching, insomnia, rambling speech, agitation, tachycardia

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14
Q

Cannabis Intoxication

A

impaired motor coordination, sensation of slowed time, euphoria, anxiety, increased appetite, dry mouth, tachycardia

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15
Q

Hallucinogen-Related Disorders

A

e.g. LSD - cause you to hallucinate
perceptual changes, illusions, hallucinations, depersonalization, paranoid ideation, ideas of reference, impaired judgment, feeling like you’re losing your mind

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16
Q

Hallucinogen Persisting Perception Disorder

A

After consuming hallucinogens, you can have flashbacks for months or even years

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17
Q

Inhalant-Related Disorders

A

belligerence, assaultiveness, impaired judgment

dizzy, slurred speech, problems with reflects, muscle weakness

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18
Q

Nicotine Withdrawal

A

within 24 hours of ending or reducing use
dysphoria, insomnia, irritability, anxiety, problems with concentration, restlessness, slowed heart rate, increased appetite, weight gain

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19
Q

Nicotine dependence

A

one of hardest drugs to quit
15-20% success rate considered good program
many people make multiple attempts before success
Zyban (antidepressant)
Nicotinue patch

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20
Q

Opioid-Related Disorders

A

e.g. heroin, Codein
initial period of euphoria followed by apathy, dysphoria, psychomotor agitation or retardation, and impaired judgment
PUPILLARY CONSTRICTION

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21
Q

Opioid Withdrawal

A

flu-like symptoms - nausea and vomiting, muscle aches, diarrhea, fever, insomnia, dysphoric mood
PUPILLARY DILATION

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22
Q

PCP-Related Disorders

A

belligerence, assaultiveness, impulsivity, unpredictability, impaired judgment

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23
Q

Sedative, hypnotic, or anxiolytics-related disorders

A

symptoms identical to alcohol intoxication and alcohol withdrawal

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24
Q

Schizophrenia

A

2 or more symptoms present more often than not during 1 month period
must have had signs of disturbance for at least 6 months

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25
Q

Symptoms of Schizophrenia

A

Delusions - always about beliefs
Hallucinations - perceive something that’s not there
Disorganized Speech
Grossly Disorganized or Catatonic behavior
Negative symptoms (flat affect, poverty of speech, avolition)

if delusions are bizarre or if hallucinations involve running commentary or two or more voices are conversing with each other, only one symptoms required

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26
Q

Schizophrenia, Paranoid Type

A

one or more delusions or frequent auditory hallucinations

NO disorganized speech, catatonic behavior, flat or inappropriate affect

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27
Q

Schizophrenia, Disorganized Type

A

disorganized speech, disorganized behavior, and flat or inappropriate affect

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28
Q

Schizophrenia, Catatonic Type

A

at least two of following: motoric immobility, excessive and purposeless motor activity, negativism or mutism, peculiarities of voluntary movement, echolalia

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29
Q

Schizophrenia, Undifferentiated Type

A

does not meet criteria for any subtype, but meets overall criteria

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30
Q

Schizophrenia, Residual Type

A

absence of prominent delusions, hallucinations, disorganized speech, and disorganized/catatonic behavior, but there is continuing evidence of Schizophrenia, such as negative symptoms or a weakened form of at least two characteristic symptoms (e.g. odd behavior)

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31
Q

MRIs on individuals with Schizophrenia

A

enlarged lateral and third ventricles (fluid-filled spaces; no brain tissue)
smaller cerebral cortex
smaller thalamus (filter for sensory input)

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32
Q

PET scans on individuals with Schizophrenia

A

decreased frontal love activity
frontal lobe abnormalities have been associated predominantly with the negative symptoms of Schizophrenia (e.g. flat affect, avolition, amotivation)

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33
Q

age of onset for Schizophrenia

A

typically late teens to early 20s

median age of onset is in early to mid 20s for men and late 20s for women

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34
Q

onset of Schizophrenia

A

may be abrupt or gradual

most cases involve prodromal phase - characterized by deterioration in overall functioning before symptoms

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35
Q

Remission of Schizophrenia

A

full remission rather uncommon

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36
Q

Schizophrenia and SES

A

more common among lower SES

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37
Q

male: female ratio for Schizophrenia

A

about equal

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38
Q

prognosis of Schizophrenia

A

prognosis is best with good prior functioning, late onset, abrupt onset, concomitant Mood Disorder, presence of a stressor

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39
Q

_____ type has best prognosis

A

Paranoid Type

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40
Q

Prevalence rate of Schizophrenia

A

1%

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41
Q

First degree relatives of Schizophrenia concordance rate

A

10%

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42
Q

Identical twins concordance rate (Schizophrenia)

A

50%

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43
Q

Concordance rate of Schizophrenia when both parents have the disorder

A

about 45%

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44
Q

Relatives of people with Schizophrenia also have increased risk of developing ______

A

other Schizophrenia spectrum disorders, including Schizotypal and Paranoid Personality Disorder, and other nonaffective psychotic disorders (e.g. Delusional Disorder)

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45
Q

Treatment of Schizophrenia - medications

A

antipsychotics
traditionals - e.g. Thorazine (Chlorpromazine), Prolixin (fluphenazine), Haldol (haloperidol)
These people have confusion, flight of ideas, and hallucinations

atypical/novel antipsychotics - Clozaril (Clozapine), Risperdal (Risperidone), Zyprexa (Olanzapine), Seroquel (quantiapine)
Can rude zebras see crocodiles running on aQuatics
Many end with “azine” “apine”’

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46
Q

Non-medication treatment of Schizophrenia

A

skills training - particularly social skills

family treatment that focuses on reducing expressed emotion (e.g. criticism, hostility, and emotional over-involvement)

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47
Q

Schizophreniform DIsorder

A

identical to Schizophrenia except in terms of duration of symptoms
made when between 1 months and 6 months

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48
Q

Schizoaffective Disorder

A

period of illness in which you have a mood disorder as well as symptoms of schizophrenia
must have period where you have psychotic symptoms of at least 2 weeks WITHOUT mood symptoms

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49
Q

Delusional Disorders

A

involve non-bizarre delusions that last at least 1 month

apart from delusion, person relatively unimpaired and not obviously odd

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50
Q

Delusional Disorder, Erotomanic Type

A

believe a person of higher status in love with you (e.g. president)

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51
Q

Delusional Disorder, Grandiose Type

A

delusions of inflated self-worth, power, knowledge, or special relationship to a deity or famous person

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52
Q

Delusional Disorder, Jealous Type

A

person believes sexual partner is being unfaithful

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53
Q

Delusional Disorder, Persecutory TYpe

A

person believes he/she (or someone close to him/her) is being persecuted or ill-treated

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54
Q

Delusional Disorder, Somatic Type

A

delusions of having a physical defect or medical problem

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55
Q

Onset of delusional disorder

A

middle to late adulthood

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56
Q

Brief Psychotic Disorder

A

looks like Schizophrenia, except up to one month

57
Q

Shared Psychotic Disorder

A

aka Folie a Deux

person becomes delusional in the context of being in a relationships with someone else who is delusional

58
Q

Major Depressive Episode

A

five or more symptoms during a two week period

59
Q

Manic episode

A

abnormally elevated, expansive, or irritable mood that lasts at least one week, with three or more symptoms present
causes marked impairment in functioning or necessitates hospitalization to prevent harm to self or others

60
Q

Mixed Episode

A

criteria for a Manic Episode and for a Major Depressive Episode are met nearly every day for a one-week period

61
Q

Hypomanic Episode

A

period of elevated, expansive, or irritable mood that lasts at least four days, with three or more symptoms present
hypomanic episode is not severe enough to impair functioning or to necessitate hospitalization

62
Q

Major Depressive Disorder, Single Episode

A

Individual must meet criteria for a Major Depressive Episode, but have no history of a Manic, Mixed, or Hypomanic Episode, or a history of a prior Major Depressive Episode

63
Q

Major Depressive Disorder, Recurrent

A

two or more Major Depressive Episodes without a history of a Manic, Mixed, or Hypomanic Episode

64
Q

average age of onset for Major Depressive Disorder

A

mid-20s

most prevalent in 25-44 year old range

65
Q

Major Depressive Episodes often occur….

A

after significant stressors

66
Q

% of individuals with Major Depressive Disorder, Single Episode have a second episode

A

50-60%

67
Q

Rate of MDD in prepubertal girls and boys

A

equal

68
Q

Rate of MDD in adolescent and adult females and males

A

twice as common in adolescent and adult females

69
Q

MDD is _____ times more common among first degree biological relatives

A

1.5-3

70
Q

Concordance rates of MDD for identical twins is _____%

A

55-60%

71
Q

Concordance rates of MDD for fraternal twins and siblings is _____%

A

20%

72
Q

Treatment for depression - medication management

A

Triciclycs (TCAS) - Elavel (amitryptyline), Anafranil (Clomipramine), Tofranil (Imipramine)
Even animals (would) take a car instead
SSRIs (most popular) - Prozac (Fluoxetine), Zoloft (Sertraline), Paxil (Paroxetine)
MAOIs (not used much anymore)- Nardil (Phenelzine)

can sometimes be recognized by the ending “amine” or “tyline”

73
Q

Non-medication treatments for MDD

A

CBT, interpersonal therapy

74
Q

Suicide - men vs. women

A

men complete suicide four times more often than women, but women attempt suicide more often

75
Q

Suicide is higher in ___ states and lower in _____ states

A

Suicide is higher in western states and lower in eastern and midwestern states

76
Q

Suicide rate among ethic groups

A

highest among Native Americans and then Whites
African Americans in between
lowest among Hispanics and Asian Americans
Whites are 2X as likely to commit suicide as AAs

77
Q

Which age group has the highest suicide rate?

A

over 65 years

78
Q

Within 65+ age group, _____ are at the most risk for suicide

A

divorced and widowed

79
Q

Suicide rate among ____ has been rising sharply

A

Suicide rate among adolescents has been rising sharper, most rapidly among African American adolescents

80
Q

___% of people who commit suicide have a mental disorder, most often _______

A

90% of people who commit suicide have a mental disorder, most often depression or substance abuse

81
Q

______ are a stronger predictor of suicide than ________

A

Expressions of hopelessness are a stronger predictor of suicide than presence and severity of depression

82
Q

Best predictor of completed suicide

A

history of serious suicide attempts, greatest risk occurring within three months of the first attempt

83
Q

Dysthymic Disorder

A

depressed mood for most of the day, more days than not, for at least two years
no MD episode during first two years of the disorder, nor history of Manic, Mixed, or Hypomanic Episode

84
Q

Dysthymia among children and adults, boys vs. girls

A

for children, equally common in girls and boys

for adults, 2-3X more common in females

85
Q

Postpartum depression

A

looks most like MDD

10-15% of new mothers

86
Q

Postpartum blues

A

not in DSM
50-80% of all new mothers
symptoms less severe and relatively short-lived than depression
usually goes away within days to a couple weeks

87
Q

Postpartum psychosis

A

rare (0.2% of population)
very debilitation
psychotic symptoms developed after delivery

88
Q

Bipolar I Disorder

A

1 manic episode or 1 mixed episode

do not need MD episode - could have one, not required

89
Q

Bipolar disorder males vs. females

A

equal

90
Q

Bipolar concordance rates for identical twins

A

80%

91
Q

Bipolar concordance rates for fraternal twins and siblings

A

20-25%

92
Q

medication for BIpolar disorder

A

mood stabilizer - Lithium
anticonvulsants - Tegretol, Depakene (Valproic Acid), Depakote (divulproex)

The DVDD

93
Q

Bipolar II

A

at least 1 MD episode and at least 1 Hypomanic Episode (NOT manic)

94
Q

Cyclothymic Disorder

A

parallels dysthymia
lower grade but more chronic
cycling for at at least two years

95
Q

Panic Attack

A

period of intense fear or discomfort
symptoms tend to peak over ten minute period - palpitations or pounding heart, sweating, trembling, shortness of breath, etc.
panic attacks can be mistaken for heart attack

96
Q

treatment of Panic Attacks

A

antidepressants rather than anti-anxiety meds

anti-anxiety meds lead to addiction

97
Q

Agoraphobia

A

anxiety about being in places or situations from which escape might be difficult or embarrassing
e.g. being alone outside home, being in crowd, standing in a line, being on a bridge, traveling on a bus, train, in a car

98
Q

Panic DIsorder without Agoraphobia

A

recurrent, unexpected Panic Attacks

fear, worry of having another Panic Attack

99
Q

Panic Disorder without Agoraphobia concordance rate between identical twins

A

25-30%

100
Q

Panic Disorder without Agoraphobia concordance rate between fraternal twins

A

0-10%

101
Q

Panic Disorder without Agoraphobia males vs. females

A

twice as common in females

102
Q

Panic Disorder with Agoraphobia

A

meet diagnostic criteria for Panic Disorder and Agoraphobia

103
Q

Onset of Panic Disorder with Agoraphobia

A

typically between adolescence and mid 30s

104
Q

Panic Disorder with Agoraphobia males vs. females

A

3X as common in females

105
Q

Agoraphobia without History of Panic Disorder

A

meet criteria for Agoraphobia, but have never met criteria for Panic Disorder

106
Q

Treatment for Agoraphobia

A

flooding (exposure with response prevention)

massed in vivo exposure more effective than graded in vivo exposure

107
Q

Specific Phobia

A

persistent fear that is excessive or unreasonable, caused by presence or anticipation of a specific object or situation
exposure to stimulus provokes an immediate anxiety response (which may include a Panic Attack)
subtypes: animal type, natural environment type (e.g. heights, storms), blood-injection type, situational type (e.g. elevators), or other type

108
Q

Treatment for Specific Phobia

A

FLOODING - massed exposure results in the most robust clinical improvements
systematic desensitization

109
Q

Social Phobia

A

fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to potential scrutiny by others
person fears behavior will be embarrassing or humiliating

110
Q

Treatment for Social Phobia

A 
social skills training
relaxation
exposure
cognitive therapy
most effective - exposure-based procedures combined with cognitive restructuring
111
Q

Obsessive Compulsive Disorder

A

obsessions - recurrent thoughts and impulses that are experienced as intrusive and cause distress or anxiety
compulsions -repetitive behaviors or mental acts the person feels driven to perform to reduce or prevent distress or prevent some dreaded situation

112
Q

treatment of OCD

A

Anafranil (clomipramine) - Tricyclic
Prozac (fluoxetine) - SSRI
flooding
though stopping to interrupt obsessions

113
Q

OCD - males vs. females

A

males develop OCD between ages of 6 and 15
females develop OCD between 20 and 29
OCD much more common in boys than girls
OCD is equally common among adult males and females

114
Q

Posttraumatic stress disorder

A

reexperiencing
avoidance
increased arousal
more than one month

115
Q

PTSD - Acute vs. Chronic

A

Acute: less than three months
Chronic: more than three months

116
Q

PTSD with Delayed Onset

A

onset of symptoms was at least 6 months after the stressor

117
Q

treatment for PTSD

A 
stress inoculation
Cognitive Processing Therapy (CPT)
Prolonged Exposure (PE)
Psychological Debriefing (PD)
Eye Movement Desensitization Retraining (EMDR)
118
Q

Psychological Debriefing

A

group intervention lasting up to a few hours shortly after traumatic event
involves “debriefing” or relating what happened during the trauma
does not decrease likelihood of developing PTSD, may make recovery more difficult for some

119
Q

Eye Movement Desensitization Retraining (EMDR)

A

effective, but no more so than other treatments based on exposure
may be better tolerated than other exposure-based treatments and may provide relief a little bit more quickly

120
Q

Acute Stress Disorder

A

minimum of two days, maximum of four weeks (vs. PTSD)

occurs within four weeks of traumatic event

121
Q

Generalized Anxiety Disorder

A

excessive fear, anxiety, and worry about a number of situations
three or more symptoms

122
Q

GAD men vs. women

A

somewhat more frequently in women than men

123
Q

treatment for GAD

A 
Behavior Therapy (e.g. progressive muscle relaxation, graduated exposure, involvement in pleasurable activities)
CBT - somewhat superior
124
Q

Somatization Disorder

A

history of recurrent and multiple somatic complaints, which begins before age 30, and of at least several years duration

125
Q

Four criteria for Somatization Disorder

A

four pain symptoms
two gastorintestinal symptoms
one sexual symptom other than pain
one pseudoneurological symptom (e.g. paralysis, weakness, difficulty swallowing)

126
Q

Somatization Disorder men vs. women

A

more common in women and rarely occurs in me in the US

in other cultures, actually more common among men

127
Q

Undifferentiated Somatoform Disorder

A

one or more physical complaints that cannot be fully explained medically
at least 6 months

128
Q

Conversion Disorder

A

one or more symptoms or deficits affecting voluntary movement or sensory function

129
Q

Conversion disorder men vs. women

A

occurs more frequently in women

130
Q

prevalence of Conversion Disorder - SES, setting

A

tends to be more prevalent in rural and lower SES populations

131
Q

Pain Disorder

A

pain in one ore more sites that is of sufficient severity to warrant clinical attention

132
Q

Hypochondriasis

A

preoccupation with fear of having or belief that one has a serious illness, based on one’s perception of bodily symptoms
assessment and reassurance by medical providers doe snot lessen the preoccupation or fear
at least 6 months

133
Q

Hypochondriasis men vs. women

A

equally common

134
Q

Body Dysmorphic DIsorder

A

person is preoccupied with an imagined defect in appearance

if slight abnormality is present, person’s concern is markedly excessive

135
Q

Body Dysmorphic Disorder men vs. women

A

equally frequent

136
Q

Body Dysmorphic Disorder - age of onset

A

usually starts in adolescence

137
Q

Meds for anxiety reduction

A 
Anxiolytics (Benzodiazepines)
Xanax (alprazolam)
Klonopin (clonazepam)
Valium (diazepam)
Ativan (lorazepam)
Xavier Kardashian (is) Very Animated and Can Do Lots
Benzos tend to end on "pam" or "lam"
138
Q

Meds to induce sedation and improve sleep

A 
Sedative/Hypnotics (Benzodiazepines)
Restoril (temazepam)
Halcion (triazolam)
Doral (quezepam)
Benzos tend to end in "pam" or "lam"

Resting has done the trick quite (well)

Non-Benzodiazepine Sedative/Hypnotics
Ambien (zolpidem)
Sonata (zaleplon)

DSM IV (3 decks)

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