DSM IV 3 Flashcards
Factitious Disorders
sometimes called Munchausen’s Syndrome
characterized by physical or psychological symptoms that are intentionally produced or feigned
goal is to assume the sick role and there is an absence of external incentives for the behavior
Dissociative Disorders
disturbance or alteration in the normally integrative functions of consciousness, identity, memory, or perception of the environment
can be gradual, transient, or chronic
Dissociative Amnesia
one or more episodes of a sudden inability to recall important personal information that cannot be explained by ordinary forgetfulness
Dissociative Fugue
sudden, unexpected travel away from one’s home, with an inability to recall one’s past
usually confusion about one’s identity or assumption of a new identity
duration is usually brief, lasting from hours to days
Dissociative Identity Disorder
presence of two or more distinct identities or personalities, with its own pattern of perceiving, relating to, and thinking about the environment and the self
at least two of these identities recurrently take control of the person’s behavior
there is also an inability to recall important personal information that is too expensive to be explained by forgetfulness
Depersonalization Disorder
persistent or recurrent episodes of feeling detached from one’s mental processes (e.g. feeling like one is in a dream)
reality testing remains intact during the experience
Hypoactive Sexual Desire Disorder
absence of desire for sexual activity
Sexual Aversio nDisorder
aversion to and avoidance of sexual contact
Female Sexual Arousal Disorder
failure to achieve or maintain the physiological response of sexual excitement
Male Erectile Disorder
Inability to achieve or maintain an erection
Treatment of Sexual Arousal Disorders
Master’s and Johnson’s Sensate Focus
targets excitement phase of the sexual response cycle
Female/Male Orgasmic DIsorder
persistent delay in organism following sexual excitement
Dyspareunia vs. Vaginismus
Dyspareunia - occurs in both men and women; involves pain in the genitals associated with intercourse
Vaginismus - only occurs in women; involuntary spasms of the muscles in the outer third of the vagina
Paraphilias
sexual urges, fantasies, or behaviors that involve nonhuman objects, the suffering or humiliation of oneself of one’s partner, or children or other nonconsenting persons
Exhibitionism Fetishism Frotteurism Pedophilia Sexual Masochism Sexual Sadism Transvestic Fetishism Voyeurism
Fantasies, urges, or behavior involving:
Exhibitionism - exposing one’s genitals to a stranger
Fetishism - the use of nonhuman objects
Frotteurism - rubbing or touching a non-consenting person
Pedophilia - sexual contact with a prepubescent child (13 years or less); person must be at least 16 years old and at least 5 years older than person being fantasized about
Sexual Masochism - the act of being humiliated or made to suffer
Sexual Sadism - sexual excitement resulting from the physical or psychological suffering of a victim
Transvestic Fetishism - crossdressing (in a heterosexual male)
Voyeurism - observing an unsuspecting person who is naked, disrobing, or engaging in sexual activity
Treatment of sex offenders
aversive counterconditioning sometimes used
may have short-term results, but associated with high recidivism in the long-run
also - CBT, hormonal therapy (reduce recidivism rates by 30% over course of 7 years)
vast majority of offenders do offend again
Gender Identity Disorder
cross-gender identification as well as either persistent discomfort with their assigned sex or a sense of inappropriateness in that gender role
Gender Identity DIsorder - ma;e:female ratio among children and adults
5:1 among children
2-3:1 among adults
Onset of Gender Identity Disorder among children
between the ages of 2 and 4
only small minority of children with this diagnosis will continue to meet criteria in adolescence or adulthood
Anorexia Nervosa
refusal to maintain body weight at or above minimally normal weight which results in the person weighing less than 85% of the expected weight
intense fear of gaining weight
amenorrhea for at least 3 consecutive cycles
two types of Anorexia Nervosa
Restricting Type
Binge-Eating/Purging Type
treatment of Anorexia Nervosa
multi-disciplinary approach
Behavioral approaches, including contingency management, used to reinforce appropriate eating and weight gain
CBT
Psychodynamic interventions to address issues related to control and feelings of inadequacy
Structural Family Therapy to treat family dynamics
Medications may also be used to treat concomitant depression
Bulimia Nervosa
recurrent episodes of binge eating followed by inappropriate compensatory behavior to prevent weight gain
episodes occur at least twice a week for three months
two types of Bulimia Nervosa
Purging Type and Nonpurging Type
Treatment of Bulimia Nervosa
Antidipressants, including tricyclics and SSRIs, are commonly prescribed and higly effective
Primary neurotransmitters involved in eating disorders
Serotonin
Primary Insomnia vs. PRimary Hypersomnia
Primary Insomnia - difficulty initiating or maintaining sleep, or complaints of nonrestorative sleep
Primary Hypersomnia - excessive sleepiness for at least 1 month, involving either prolonged sleep episodes or daytime sleep episodes that occur almost dailyi
Narcolepsy
daily occurrence of irresistible attacks of refreshing sleep
at least three months duration
usually involves cataplex - sudden loss of muscle ton, typically occurring at times of intense emotion
recurrent intrusions of REM sleep into transition between sleep and wakefulness - manifest as hypnogogic hallucinations at the onset of sleep, hynopompic hallucinations on awakening, or as sleep paralysis at the beginning or end of sleep episodes
hypnogogic vs hypnopompic hallucinations
visual, tactile, auditory, or other sensory events, usually brief but occasionally prolonged, that occur at the transition from wakefulness to sleep (hypnagogic) or from sleep to wakefulness (hypnopompic).
Nightmare Disorder
age of onset
occurs during REM sleep, typically during the end of the night
person repeatedly awakens from sleep with detailed recall of frightening dreams
on awakening, person rapidly becomes alert and oriented
age of onset - 3 to 5 years
Sleep Terror Disorder
age of onset
recurrent episodes of abrupt awakening that begins with a panicky scream and usually occurs during the first third of the night
age of onset - ages 4 to 8
Sleep Terror Disorder episodes
last from one to ten minutes, during which person evidences intense fear, and autonomic arousal, and is generally unresponsive to efforts to be comforted
after episodes - total amnesia for episode, no recall of dream
Sleep Terrors occur…
during non-REM sleep, stages 3 and 4, which correspond to high EEG delta activity
Sleepwalking Disorder
age of onset
repeated episodes of rising from bed and walking around, typically occurring during the first third of the night
unresponsive during episode and amnesia for it afterwards
age of onset - ages 4 to 8
Intermittent Explosive Disorder
discrete episodes of serious assaultative acts or destruction of property
Personality Disorder - symptom areas
cognition affect interpersonal functioning impulse control diagnosis requires symptoms in at least two areas
Onset of personality disorders; Age of diagnosis
adolescence or early adulthood
diagnosis can be made in persons under age 18 if features have been present for at least 1 year, with exception of Antisocial Personality Disorder
Paranoid Personality Disorder
pervasive distrust and suspiciousness of others
tend to interpret actions of others as deliberately demeaning, threatening, and malevolent
Schizoid Personality Disorder
detachment from and indifference to social relationships, as well as restricted range of emotions
In contrast to the Avoidant Personality, the Schizoid Personality is content with or even prefers his/her isolation.
Schizotypal Personality Disorder
deficits in interpersonal functioning marked by discomfort with and reduced capacity for close relationships, as well as by peculiarities in cognition, perception, ideation, appearance, and behavior
tend to be detached and to lack desire for relationships
In contrast to the Schizoid Personality, Schizotypal includes cognitive or perceptual distortions.
Antisocial Personality Disorder
pervasive of disregard for and violation of the rights of others since at least age 15, characterized by irresponsible and antisocial behavior
Borderline Personality Disorder
significant impulsivity and a pattern of instability of mood, interpersonal relationships, and self-image
Histrionic Personality Disorder
excessive emotionality and attention-seeking
Narcissistic Personality Disorder
pattern of grandiosity, need for admiration, and lack of empathy
Avoidant Personality Disorder
pattern of social discomfort and inhibition, fear of and hypersensitivity to negative evaluation, and feelings of inadequacy
Dependent Personality DIsorder
pervasive and excessive need to be taken care of that results in submissive and clinging behaviors, difficulties making decisions, and fears of separation
Obsessive-Compulsive Personality Disorder
preoccupation with orderliness, perfectionism, and control that results in inflexibility and inefficiency
In contrast to Obsessive-Compulsive Disorder, there are no true obsessions or compulsions.
