Exam 2 Flashcards
1
Q
schizo- positive s/s
A
change in behavior/thoughts
ex. delusions, hallucinations
2
Q
schizo- phase 1-premorbid
A
poor peer relationships/school performance
shy
first noticed by family
3
Q
schizo- phase 2- prodromal
A
cognitive impairment, OCD, social withdrawal
4
Q
schizo- phase 3- schizophrenia
A
full blown psychosis
delusion, hallucinations, dec functioning
5
Q
schizo- phase 4- residual
A
flat affect
no s/s of active psychotic phase
6
Q
schizo- negative s/s
A
withdrawn, social isolation, risk for suicide (anhedonia) (can’t experience pleasure)
volition (no goal-oriented activity)
waxy flexibility- consistent degree of resistance against passive mvmnt
posturing
7
Q
schizophrenia
A
inability to differentiate btw what’s real and what’s not real
affects speech, affects, motor mvmnts
8
Q
depression vs blues
A
depression questioned when pt unable to adapt and s/s impair daily functioning
*major depressive disorder most common
distress interferes w/ social, occupational, cognitive and emotional functioning
9
Q
depression and bipolar
A
bipolar disorder misdiagnosed as depression
10
Q
depression- epidemiology
A
x2 women v men- less pronounced w/ age
effects low and high socioeconomic
inc risk if single
seasonal (seasonal affective disorder is separate condition)
11
Q
depression- biochemical component
A
inc acetylcholine
dec serotonin (cognition, irritability, appetite)
dec dopamine (regulates mood)
dec norepinephrine (ability to deal w/ stressful situations)
12
Q
depression- endocrine disturbances
A
HPA- excessive cortisol (inc neurotoxicity and reduced neurogenesis)
HPTA- dec TSH= blunts circadian rhythm
13
Q
depression- physiological predisposing factors
A
med side effects, electrolyte disturbance, hormonal disorder, nutritional deficiencies
14
Q
depression- childhood depression-
A
disruptive mood dysregulation disorder
hard to diagnose w/ changing hormones
onset <10 yrs
15
Q
depression- adolescence
A
2nd leading cause death for 15-24 yrs old
16
Q
depression- senescence (elderly)
A
males >85 yrs have 4x national rate
17
Q
depression- postpartum
A
1-2/1000 have severe depression
50-85% have “the blues”
10-20% have moderate depression
18
Q
psychoanalytical theory- depression
A
S. Freud
loss is internalized and becomes directed against the ego
(loss of connection)
19
Q
learning theory- depression
A
Seligman
learned helplessness
depressed bc feel helpless
20
Q
object loss- depression
A
renee spitz
loss of signif other during first 6mo of life
(attachment theory)
21
Q
cognitive theory
A
aaron beck
depression is cognitive v than affective
negative expectations- environment, self, future
Pt is causing the depression bc they are thinking negatively
22
Q
major dep. disorder- diagnostic criteria
A
change in sleeping, eating patterns (dec 5%. body weight in 30 days)
loss of interest in usual activities
s/s must be present for at least 2 weeks
NO hx of manic behavior (bipolar not depression)
s/s represent a change from baseline functioning
23
Q
major d d- s/s criteria
A
sad, lack of interest 2 wks or more and at least 4 other symptoms
changing in eating habits
hypersomnia/insomnia
impaired concentration, decision making/problem solving
worthlessness, hopelessness, despair
thoughts of death/fatigue
overwhelming fatigue, negative thinking
24
Q
persistent depressive disorder v MDD
A
s/s more mild
no evidence of psychotic s/s
not suicidal
depressed for most of the day, more days than not
present for at least 2 YEARS
25
premenstrual dysphoric disorder
onset of s/s week b4 start of menses
improve after start menses
s/s present for most cycles the previous yr
lethargy, diff concentrating, anxiety, irritabitli, depressed mood, change in sleep/eating
s/s must interfere w/ ability to function
26
substance-induced depressive disorder
can be assoc with withdrawal of seizure and HTN meds
27
childhood depression criteria- s/s based on age
<3- feeding problems, lack of playfulness, tantrums
3-5 - accident prone, phobias, self blame
6-8- aggressive beh, clinging beh, physical complaints
9-12 - morbid thoughts, excessive worrying
28
childhood depression- trtmnt
precipitated by loss
therapy- alleviate sx and strengthen coping skills
parental/family therapy
29
adolescent depression- diagnosis/ trtmnt
beh change that lasts for several weeks
results from perception of abandonment (parents or peers)
trtmnt- supportive psychosocial intervene
SSRI
30
consideration w/ ssri and kids/ adolescents
inc risk of suicidality
31
senescence- depression trtmnt
antidepressant meds, electroconvulsive therapy, psychosocial therapy
32
postpartum depresion- trt/ s/s
trt- antidep, psychosocial therapy
s/s- fatigue, dec appetite, sleep disturbances, concern abt inability to care for infant
33
transient depression
s/s not impair functioning
tired, self blame, crying
34
mild depression
usually assoc. w/ grieving
affective- anger, anxiety
behavioral- tearful
cognitive- preoccupied w/ loss
physiological- anorexia, insomnia
35
moderate depression
affective- helpless
behavioral- limited verbalization, slowed movements
cognitive- difficulty concentrating/ critical thinking
physiol- ha, sleep disturbance
36
severe depression
inc s/s of MDD and bipolar depression
total despair, flat affect
absence of communication
delusional thinking, confusion, suicidal thoughts
general slow down of the body
37
depression disorders trtmnt
individual psychotherapy (interpersonal realtions_
group therapy
family therapy
cognitive therapy (changing thoughts)
transcranial magnetic stim
light therapy
electroconvulsive therapy (initiate a grand mal seizure)
neuromodulation (deep brain stim and vagal nerve stim)
38
depression disorders- meds
SSRI
SNRI
MAOI
Tricyclics
ketamine nasal spray
39
SSRI
ae- dry mouth, dec libido
do not take w/ MAOI- SS
nsaids, warfarin inc lvls
work 4-8 wks
40
SNRI
dry mouth, dec libido
withdrawal s/s
MAOI, haldol, lithium, tramadol, nsaids, warfarin contraindicated - SS
work 4-8 wks
41
Noraderenergic -dopaminergic antidepr
ex. wellbutrin
can be used for ADHD or to counteract sexual dysfunction w/ SSRI
ae- dec seizure threshold
contraind w/ MAOI
6-8 wks full effect
42
heterocyclics
ex. trazadone
ae- urinary retention, priapism
instant onset- works for sleep aid
MAOI contraind
full effect 3-4 wks
43
tricyclics
2nd or 3rd line agent for MDD
ae- wt gain
*do not prescribe for suicidal pts
OD IS LETHAL (monitor cardiac functioning (wide qrs)
avoid MAOI- SS
clonidine- HTN crisis (used for htn or adhd)
frequent EKG- monitor blood lvls
work 3-4 wks
44
MAOI
3rd line agent for trtmnt resistant depression
more commonly used for parkinsons (selegiline)
LETHAL OD
HTN crisis w/ tyramine foods, SS
smoked/aged cheese, processed meats, alcohol, chocolate, beef/chicken liver, yeast products, soy beans, diet pills
45
bipolar def
mood swings from profound depression to extreme mania
can have delusions and hallucinations
s/s can reflect seasonal pattern
46
hypomania- bipolar
period of abnormal and persistent elevated or irritable mood lasting 4 days
no impaired functioning
no psychotic s/s
47
bipolar epidemiology
presents in ages 20-30
48
bipolar 1- timeline
lows at least 2 wks, extreme highs at least 1 wk
or need for hospitalization
can last 3-6mo
49
bipolar 2- def
bouts of MDD w/ episodic hypomania
NOT meet criteria for full manic episode
lows just as low as BP1 but manic episodes are milder
50
cyclothymic disorder- criteria
subcat of bipolar
cyclic
mood disturbance
at least 2 yr duration
longest time w/o s/s is 2 mo
many episodes of hypomania and depressed mood
51
bipolar- biologic theories
has genetic component
GABA disregu
inc noradrenergic activity
ion channel abnormal
kindling (inc severity of responses w/ recurrent exposure to triggers)
52
bipolar- childhood
inc comorbid w/ ADHD
adhd meds can exacerbate mania
53
bipolar childhood- trtmnt
lithium, divalproex, atypical antipsychotics
carbamzaepine
family psychoeducation about disorder
communication training
problem-solving skills
54
bipolar- mania meds
lithium
anitconvulsants (mood stabilizer)
cardiogenic drugs for vascular effect
histmine blockers for tension
antipsychotics
55
bipolar- depressive phase meds
mood stabilizers
SSRI (with care!!! can trigger mania)
56
lithium contraindications
nsaids and etoh
need to maintain consistent blood volume lvls
57
lithium range
0.5-1.2 mEq/L
draw a trough 12 hrs post dose
toxicity dependant upon each person
58
lithium ae
polyuria, polydipsia, wt gain, sexual dysfunction
59
lithium lab tests
TSH, PTH, UA, CBC, EKG, Na, Ca, phosphorus
60
lithium toxicity
ae- n/v, tremor, seizures
trtmnt- IV fluids, whole bowel irrigation
61
SILENT- lithium
syndrome of irrev lithium effectuated neurotoxcicity
truncal ataxia, scanning speech, incoord
62
lithium- pt ed
notify dr if diarrhea or vomiting occur
check lvls every 1 to 2 months
maintain consistent diet
don't skimp on dietary sodium intake
63
anticonvulsants (mood stabilizer) pt ed
do not discont abruptly
report rash, brusing, sore throat, fever, malaise, dark urine
avoid use of etoh
64
Ca channel blocker pt ed
take if GI upset occurs
orthostatic hypotension
blurred vision, dizziness, drowsiness
65
antipsychotics pt ed
use sunscreen
orthostatic hypotension
avoid etoh
report- sore throat, persistent n/v, ha, rapid hr, change in urination, yellow skin, muscular incoordination
66
suicide-def
BEHAVIOR (not diagnosis or disorder)
15x inc in ppl w/ bipolar or depression vs normal pop
67
suicide risk factors- marital, age, religion, socioeconomic and ethnicity
martial status (single 2x)
gender (men more successful, women attempt more)
Age (inc risk w/ age, espec men) (white men >80 highest risk)
religion (dec risk if have a religion)
Socioeconomic status (high and low classes greater risk than middle) (higher rates in unemployed) (if employed- dr., dentist, artist, lawyers and insurance agents)
ethnicity (whites have highest risk) then indians, black, hispanic, asian
68
suicide r/factors- other
substance abuse, mood disorder
(schizo, personality disorder, anxiety, trauma)
insomnia, etoh abuse, psychosis w/ command hallucinations
fam hx of suicide
chronic disease
LGBTQ
69
physical dependence v psychological dependence
physical- need for inc amnts to produce same effects
psychological- desire to repeat use of a particular drug for pleasure
70
substance-induced disorder- subst. intoxication
reversible syndrome
s/s after excessive use of substance
direct effect on CNS
social and occupational functioning disturbed
100-200 mg/dl
death at 400-700 mg/dl
71
substance-induced- withdrawal
s/s after stopping substance
s/s specific to substance used
disrupts beh, thinking and feeling
w/in 4-12 hrs after cessation
monitor for seizures for up to 10 days
give gabapentin
72
substance abuse- personality factors
low self-esteem
freq depression
inability to relax/defer gratification
inability to communicate
73
phases of alcoholism
1- prealcoholic- use to relieve everyday stress
2- early alcoholic- blackouts, etoh required
3- crucial phase- no control, physiological dependence
4- chronic phase- (IV)- emotional/physical disintegration
74
alcoholic myopathy
from vitamin B (thiamine) deficiency
acute- sudden onset muscle pain, weakness, reddish tinge to urine
chronic- graduate wasting of muscles
75
Wernicke's encephalopathy
most severe form of thiamine deficiency in alcoholics
76
ae of alcohol abuse
esophagitis,
gastritis,
cardiomyopathy,
pancreatitis (epigastric pain),
cirrhosis (portal htn, esophageal varicies, ascites, hepatic encephal- cannot covert ammonia to uria),
hepatitis (can cause ascites- use fluid centesis, monitor bp, r/f infection)
77
ae of alcohol abuse
esophagitis,
gastritis,
cardiomyopathy,
pancreatitis (epigastric pain),
cirrhosis (portal htn, esophageal varicies, ascites, hepatic encephal- cannot covert ammonia to uria),
hepatitis (can cause ascites- use fluid centesis, monitor bp, r/f infection)
78
alcohol and preg- ae
FASDs fetal alch. spectrum disorders
FAS- fetal alch syndrome
alterations in memory, learning, hearing, vision, communication
s/s- abnormal facial features, sleep and sucking problems, hyperactive beh, poor coordination
79
etoh withdrawal s/s
tremors, irritability, seizures, hallucinations, delirium
autonomic act is worst in the first 5 days
80
alcohol assessment tools
drug hx and assessment
CIWA clincial institute w/drawal assessment of etoh scale
cage questionnaire
81
ciwa
mild, mod or severe
q3h
bp,hr,rr
clonidine for high bp
82
cage
cut
annoyed
guilty
eye-opener (drink first thing in the morning)
83
barbiturates, nonbarbit hypnotics, antianxiety and club drugs- priority assessment
CNS depression
respiratory rate
hr
bp
(all are dec)
84
sedative/ hypnotic affects on the body
respir depression
hypotension
jaundice
dec body temp
rebound insomnia
85
intoxication vs withdrawal of hypnotics
intox- can be aggressive or comatose
w/drawal- can be fatal
86
stimulant affects on the body
tremor, inc motor activity
inc bp, hr, arrhythmias (inc contracitlity= inc 02 requirements)
pneumonia- relaxes bronchial smooth music
GI- anorexia
87
stimulant intoxication
euphoria, impaired judgement, confusion
88
stimulant w/drawal
DO NOT die
n/v, muscle pain, fatigue, irritability
89
inhalant- trtmnt
supportive care
most common in 12-17 yrs old
90
inhalant affects on the body
CNS depressant, ataxia, tremor, encephalopathy, parkinsons
dyspnea
renal failure
91
inhalant intoxication
during or shortly after use
ataxia, dizziness, hypoactive reflexes, blurred vision, slurred speech
92
opioid intox
last several hrs- depends on half life of drug
euphoria, followed by agitation and apathy
respiratory depression
93
opioid withdrawal- shrt v long acting
shrt acting (heroin) w/in 6-8hrs, peak 1-3 days and subside in 5-10days
long acting (methadone) 1-3 days, peak 4-6d and dec 14-21 days
COWS
94
opioid withdrawal- s/s
n/v, muscle aches, pupil dilation, sweating, yawning, fever, abdominal cramping
95
hallucinogen intoxication
dec thermoregulation
metabolic brain injury
depersonalization, tachydardia, synesthesia (experience one sense through another)
formication (bugs on skin)
can be assaultive
96
cannabis- intox v withdrawal
intox- impaired motor skills can last 8-12 hrs
withdrawal- occur w/in a week, irritability, dec hunger, tremors, anxiety (rebound syndrome), depressed mood
97
substance abuse management
coping skills
nutrition
problem solving
relaxation skills (deep breathing)
98
substance abuse at work- clues
high absenteeism, discrepancies in documentation
99
gambling- trtmnt
first ID underlying cause (mental illness)
CBT, psychoanalysis, gamblers anonomys
meds- SSRIs, clomipramine (tricyclic antidep for OCD), lithium (mood stabil )carbamazepine (anticonv), naltrexone
100
codependecy steps
survival- let go of denial
reidentification- accountibility
core issues- recog things beyond indiv control
reintegration- get power back
101
meds for alcoholism
disulfiram (antabuse) IM
causes sevre illness, flusing, n/v and dizziness if used w/ etoh
naltrexone IM
SSRIs
102
meds for substance intoxication and withdrawal
benzodiazepines (lower brain act.) (seizures, anxiety etc)
anticonvul
multivitmains
thiamine (etoh)
103
meds for opioid abuse
naloxone, naltrexone (prevents relapse)
methadone (opioid agonist that reduces s/s of withdrawal)
buprenorphine (partial opioid agonist)
104
meds for stimulant abuse
antidep
tranquilizers
anticonvulsants
105
WRAP model
6 steps
develops safety plan at DC
wellness recovery action plan
106
s/s/ of thiamine deficiency
ataxia, peripher neuropathy
107
benzodiazepine withdrawal s/s
anxiety, tremors, tachycardia
108
anxiety def
emotional response to anticipation of danger
not the same as stress! (stress leads to the disorder)
stimulus is unidentifiable
109
mild anxiety
inc sensory stimulation
110
moderate anxiety
nervous, difficulty concentrating
still able to utilize coping skills
111
severe anxiety
inc vital signs, restless, irritable, angry
112
panic anxiety
enlarge pupils, focused on defense
113
anxiety- epidemiology
most common disorder
inc in women
minority children and children with low SES at risk
dysregulated family orientation
114
panic disorder
recurrent panic attacks
onset unpredictable
impending doom
115
s/s panic attack
sweating, SOB, chest pain, dizziness, numbness, fear of losing control (going crazy
116
panic attack- trtmnt
safety number one priority
use anxiolytics
benzodiaz, buspirone (take 4x day)
SSRI
Clonidine, propranolol
117
agoraphobia
fear of being in situations where can't escape easily
ex. cinema, crowds, traveling in public transportation
118
causes of anxiety- medical v substance
medical- CHF, MI, low BG, asthma, seizures
substance intoxication or withdrawal- all (incl caffeine)
119
OCD- obsessions v compulsions
O- thoughts/images cannot stop by logic or reasoning
repeat the activity to avoid anxiety
C- ritualistic beh to prevent distress or dreaded situation
can be associated w/ hallucinations (crash if take eyes of the road)
120
OCD trtmnt-meds
meds- 2nd line
SSRI, tricylic antidep, SSRI+ atypical antipsycho, SSRI+ lithium
121
hoarding trtmnt
difficult, relapse high
assoc. w/ unorganized thoughts, perfectionsim, depression
122
OCD- psychoanalytic theory
Freud
egos are underdeveloped (anxiety and fraught with guilt)
123
OCD- learning theory
conditioned response to traumatic event
produce actions that lead to less resistance
124
OCD and serotonin
possible dec
125
OCD trtmtn
cogn behavioral therapy (beh modification) GOLD STANDARD
behavioral therapy - desensitization
exposure therapy to dev coping skills
implosion therapy- flooding - continue to do anxiety-provoking actions repeatedly until desensitized
126
anxiety meds- action
block serotonin, norephinephrine
potentiate GABA
depress lvls CNS
127
anxiety meds- ae
lethargy, orthostatic hypoten, n/v, inc CNS effects
128
buspirone
trts anxiety
does not affect cns
works on serotonin, norepin, dopamine
used for chronic trtmnt 60-80% effective
dec lvls w/ caffeine and smoking
10-14 delayed onset
129
anxiety meds- shrt v long term
"am"s- short term/acute
bridge meds
Chronic trtmnt- SSRI/ Busiprone
130
antianxiety and caffeine
dec serum drug lvls
r/f dependence w/ benzos (Xanaxz)
131
pattern of abuse
cyclical
abusers were abused as children
132
abuse predisposing factors
toxic stress
alt in norepinep, serotonin and dopamine
alterations in neurophysical and neurocognitive dis
133
abuse- psychodynamic theory
Freud
underdev ego
poor self concept
unmet needs for satisfaction
violence gives power to person and inc self esteem
134
abuse- learning theory
children learn how to behave by imitating role models
more likely to abuse if physically disip as. achild
135
abuse- societal influences
american cult
violence means of solving problems
136
intimate partner violence- def
battering
pattern of coercive control founded on violence of threat of violence
137
IPV- predisposing victim factors
women (affects all age, race, relgion, cult and socioecon)
low self-esteem
inadeq support systems
abusive childhood
138
IPV abuser profile
low self-esteem
limited coping
severe stress rxns
views spouse as personal possession
controls through intimidation
139
cycle of battering- phases
1- tension building- can take wks to yrs
2- acute incident (24hrs), victim can try and hide
3- calm, loving, (honeymoon phase)- victim thinks perosn will change
140
child abuse- emotional
pattern of beh by caretakers that results in serious impairment of child's social, emotional or intellectual functioning
indicators-
extremes of beh
delayed dev (phys/emotional)
dec attachment to parent
suicide attempts
141
child abuse- beh indicators of neglect
freq absent from school
begs/steals
lacks medical care
consist dirty
abuses drugs/alcohol
142
child abuse- sexual indicators
nightmares
bedwetting
sudden change in app
attaches quickly to strangers
suddenly refuses. to particip in physical activities
143
child abuse general influences
substance abuse inc risk for neglect/abuse
numerous stresses
poverty
social isolation
lack of knowledge abt child care needs
144
child incest characteristics
lack. trust
low self esteem
poor sense of id
absence of pleasure w/ sexual act
145
child incest- complications (at r/f)
PTSD
sexual dysfunc
depression, anxiety
eating dis
substance dis
alteration in response to intimacy
146
rape epidemiology
any age
16-34 yrs
single women
attacked near own neighborhoods
degree of resistance by women depends on if abuser has a weapon
147
rape response patterns
expressed or controlled
148
rape reactions
compounded reaction (ass. w/ mental illness and substance abuse, suicide)
silent (don't tell anyone)
149
rape- long term v short term goals
long-dev coping skills
short- guide through initial shock
provide shelter, promote reassurance of safety
150
crisis intervention
focus of initial interview and follow-up w the client who has been sexually assaulted is alone
151
PTSD epidemiology
more common in women
10% of ppl that have traumatic event will develop
152
PTSD v adjustment disorder
adjustmnt- difficul w/ stress rxns to less extreme events
common
usually dev depression
s/s occur w/in 3 mo and last no longer than 6 mo
153
PTSD def
rxn to extreme trauma
s/s- reexperi traumatic event
sustained high lvl anxiety
intrustive thoughts
amnesia
substance abuse
guilt
anger/aggression
154
PTSD onset
can by delayed yrs after event
s/s must be present for 1+ mo, sign interference w/ social, occupational functioning
155
factors for dev PTSD
duration, severity, exposure, or location
156
acute stress disorder
s/s do not last more than 1 mo
157
trauma disorder trtmnt
cognitive therapy
prolonged exposure ther
group/family therapy
eye mvmnt desensitization and reprocessing (don't use if seizures or suicidal)
SSRI
158
adjustment disorder trtmnt
goal to reduce triggers, relieve s/s
regular therapy
crisis intervention
SSRI
self-help groups
159
trauma informed care
safety, trustworthiness/ transparency, peer support
160
trauma response- beh
reckless, freq seeking attention, reverting to younger beh, fighting when critized, resisting change
161
trauma response- emotional/physical
nightmares, sensitive to stimuli, fear of separation, dec trust, emotional swings, unexplained medical problems
162
trauma response- psychological
confusing safe v dangerous
trouble focusing
diffic imagining future
163
personality disorders trtmnt
no curative
only supportive
164
predisposing factors- personality disorder
established psychiatric and medical disorders
s/s of personality dis manifest from
165
cluster A- odd, eccentric (unconventional)
paranoid, schizoid, schizotypal
trtmnt- exposure therapy- guided
exposed to normalcy
166
cluster B- dramatic, impulsive, self-destructive
antisocial (socipath)
borderline
histrionic
narcissistic
are aware of own actions
trt w/ CBT, group therapy, Dialectal Behavior T (mindfulness, meditation)
167
cluster c- anxious, avoidant, dependent
avoidant, dependent, obsessive-compulsive (anxiety dis)
Trt w/ group therapy (learn from like-minded others) in moderation, CBT (restructuring thinking patterns), exposure therapy
168
paranoid personality dis
can be seen in schizo and PTSD
more common in en
mimic PTSD- less hyperarousal
trusts no one
magnifies/distorts environment
does not accept responsibility for own beh
attributes shortcomings to others
insens/oversen to ppl's feelings
169
schizoid personality dis def
profound defect in the ability to form personal relationships
do not respond in emotional way
can be misinterpreted for autsim
170
schizoid personality dis-- clincial
emotionally cold, avoids ppl, aloof, no close friends
inapprop serious
171
schizoid personality dis- predisp factors
epigenetics
childhood cold, unempathetic, lack nuture
172
schizoid personality dis-- clincial
emotionally cold, avoids ppl, aloof, no close friends
inapprop seriouss
173
schizotypal disorder
same as schizoid but have more concerning positive s/s
graver
magical thinking, illusion, depersonalization, withdrawal
same as schizo but no negative s/s
174
schizotypal disorder- clinical
medication not trt s/s- only alters LOC
bizarre speech pattern, demonstrate psychoic s/s
bland affect
175
schizotypal disorder- pre d
family dynamics (indifference, impassivity, formality)
causes discomfort w/ affection/closeness
176
antisocial def
manipulative beh w/NO REMORSE
disregards rights of others
rules don't apply (law, jobs, relationships)
see themselves as victims
177
antisocial- development
onset 3-4yrs old- impairment in fear conditioning
1% in pop
16% in jail
clinically overdiagnosed
178
antisocial- behaviors
exploitation/manipu for peronsal gain
unable to delay gratification
reckless
gaslighting
179
antisocial- predisposing f
possible genetic factors
hx of severe physical abuse
removal from home
inconsistent parental discipline
extreme poverty
ADHD, conduct disorder as a child
180
borderline personality disorder-def
intense, chaotic relationships w/ affective instability
rapid change in beh from one extreme to another
impulsive
response to learned beh/emotional response to trauma/neglect when little
181
borderline personality disorder- beh
threaten self harm- only way they know how to get needs met
unstable self image
overly concerned w/ abandonment- don't like to be alone
fall btw border of neuroses (very anxious) and psychoses (visual/auditory hallucinations)
depression, clinging,
splitting
182
borderline personality disorder- predi f
biochem- serotonergic defect- trt w/ ssri
genetic- assoc. w/ depression, learned beh from trauma (neglect, parents emotionally unstable)
psychosocial- truma/abuse
16-24 mo old child fails to reach task of autonomy (rapprochement phase)- don't complete tasks by themselves
183
histrionic personality dis def-
more common in women
2-3%
extroverted, emotional, dramatic
don't usually engage in self harm
184
histrionic- clincial
ex. dennis rodman
attention seeking
seductive
self-dramatizing
very distractable
easily influenced by others (rely on reactions)
185
narcissistic def
exagg sense of self worth
no empathy
rules do not apply to them
186
narcissistic- behaviors
exploit others to fulfill own desires
grandiose, cheerful, optimistic
fragile self-esteem
can be triggered by criticism
187
narcissistic- predis p
dependency needs responded to w/ neglect/criticism as kids
parents narcissistic themselves
parents have no limits, or give in to child to avoid conflict
188
avoidant personality- def
extreme sensitivity to rejection
avoid social situations
social withdrawal
1%
189
avoidant- clinical
want connection- are often lonely
timid
self doubt
190
avoidant- pre disp
no clear cause
parental rejection, reinforced by peers
191
dependent personality- def
rely on others for emotional support/sense of self
common in the youngest and midlife crisis
lack self-confidence (stooped posutre, small voice)
passive and submissive roles in relationships
overly generous
192
dependent personality- pre di
hereditary, nurture from one exclusive source (mom)
singular attachment as an infant
193
OC personality disorder- def
inflexibility, rigid, rank conscious
must be done a certain way
common in oldest child
men
relatively common
194
ocd v ocpd
ocd= aware that actions are irrational but repeat to relieve discomfort
ocpd- unaware, optimize utility vs pleasure
195
oc personality disorder- pre d
overcontrolled by parents
lack positive reinforcement for good beh
freq punishment for undesirable beh
196
general trtmnt- mood disorders
interpersonal psychotherapy
psychoanalytical pscyhother
cbt
dialectical beh therapy
psychopharmacology
* antisocial disorder- therapy does not work
197
somatic s disorders- def
disorders w/ no pathological reason
common in women, less educated ppl, rural areas
198
dissociative disorders- def
disruption in integrated fun of consciousness, memory and identity
very rare
no medication
person is on autopilot- don't remember daydreams
brief periods common in young adults w/ lots of stress (brain not fully dev)
form of survival star. for child in traumatic environment
199
somatic s disorder
mult dis w/ no explanation
anxiety, depression, drug abuse, dependence and suicide common
200
illness anxiety dis
somatic
fear of having serious dis
OCD traits accompany
frm past experi w/ physical illness (family, friends etc)
201
conversion dis
somatic
precip by stress
timing unpredictable (1 yr v 30 yrs onset)
usually effect lower half of body
mimic s/s of neurologic dis
202
factitious dis
somatic
intentional pretending of physical/psych s/s
make self sick for attention
"Munchausen syndrome
203
somatic dis- family dynamics
child can pretend to become ill
shifts focus to child and not fighting parents
brings stability
204
somatic dis- learning theory
somatic complaints reinforced
person uses to get out of responsibilities (primary)
shift focus to themselves (secondary gain)
relieve conflict - shift focus to person (tertiary)
205
dissociative amnesia
onset follows severe stress
can't remember events even though conscious
localized (all incidents for specific amnt time), selective (certain incidents), generalized (all events during the lifetime)
206
dissociative fugue
sudden need to travel away from home w/ inabil to recall past
207
dissociative identity disorder
2+ personalities w/in 1 person
transition btw personalities is sudden, precip by stress
beh bizarre, contradict true self
trtmnt- hypnosis
integration therapy (inc predictability of actions)
208
depersonalization derealization disorder
tempor change
ureality reelings
detachment from environment
obsering oneself from outside body
209
depersonal v derealization
deperson- can't feel sensations (altered perception of self)
derealization- can't process event is happening (altered percep of environ)
210
dissociative amnesia- psychodynamic theory
repression
invol blocking of unpleasant feelings
