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437- Psychiatric > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

schizo- positive s/s

A

change in behavior/thoughts
ex. delusions, hallucinations

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2
Q

schizo- phase 1-premorbid

A

poor peer relationships/school performance
shy
first noticed by family

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3
Q

schizo- phase 2- prodromal

A

cognitive impairment, OCD, social withdrawal

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4
Q

schizo- phase 3- schizophrenia

A

full blown psychosis
delusion, hallucinations, dec functioning

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5
Q

schizo- phase 4- residual

A

flat affect
no s/s of active psychotic phase

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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withdrawn, social isolation, risk for suicide (anhedonia) (can’t experience pleasure)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

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7
Q

schizophrenia

A

inability to differentiate btw what’s real and what’s not real
affects speech, affects, motor mvmnts

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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

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9
Q

depression and bipolar

A

bipolar disorder misdiagnosed as depression

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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)

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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)

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12
Q

depression- endocrine disturbances

A

HPA- excessive cortisol (inc neurotoxicity and reduced neurogenesis)
HPTA- dec TSH= blunts circadian rhythm

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13
Q

depression- physiological predisposing factors

A

med side effects, electrolyte disturbance, hormonal disorder, nutritional deficiencies

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14
Q

depression- childhood depression-

A

disruptive mood dysregulation disorder
hard to diagnose w/ changing hormones
onset <10 yrs

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15
Q

depression- adolescence

A

2nd leading cause death for 15-24 yrs old

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16
Q

depression- senescence (elderly)

A

males >85 yrs have 4x national rate

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17
Q

depression- postpartum

A

1-2/1000 have severe depression
50-85% have “the blues”
10-20% have moderate depression

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18
Q

psychoanalytical theory- depression

A

S. Freud
loss is internalized and becomes directed against the ego
(loss of connection)

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19
Q

learning theory- depression

A

Seligman
learned helplessness
depressed bc feel helpless

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20
Q

object loss- depression

A

renee spitz
loss of signif other during first 6mo of life
(attachment theory)

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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

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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

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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

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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

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25
Q

premenstrual dysphoric disorder

A

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

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26
Q

substance-induced depressive disorder

A

can be assoc with withdrawal of seizure and HTN meds

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27
Q

childhood depression criteria- s/s based on age

A

<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

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28
Q

childhood depression- trtmnt

A

precipitated by loss
therapy- alleviate sx and strengthen coping skills
parental/family therapy

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29
Q

adolescent depression- diagnosis/ trtmnt

A

beh change that lasts for several weeks
results from perception of abandonment (parents or peers)

trtmnt- supportive psychosocial intervene
SSRI

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30
Q

consideration w/ ssri and kids/ adolescents

A

inc risk of suicidality

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31
Q

senescence- depression trtmnt

A

antidepressant meds, electroconvulsive therapy, psychosocial therapy

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32
Q

postpartum depresion- trt/ s/s

A

trt- antidep, psychosocial therapy

s/s- fatigue, dec appetite, sleep disturbances, concern abt inability to care for infant

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33
Q

transient depression

A

s/s not impair functioning
tired, self blame, crying

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34
Q

mild depression

A

usually assoc. w/ grieving
affective- anger, anxiety
behavioral- tearful
cognitive- preoccupied w/ loss
physiological- anorexia, insomnia

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35
Q

moderate depression

A

affective- helpless
behavioral- limited verbalization, slowed movements
cognitive- difficulty concentrating/ critical thinking
physiol- ha, sleep disturbance

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36
Q

severe depression

A

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

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37
Q

depression disorders trtmnt

A

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)

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38
Q

depression disorders- meds

A

SSRI
SNRI
MAOI
Tricyclics
ketamine nasal spray

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39
Q

SSRI

A

ae- dry mouth, dec libido
do not take w/ MAOI- SS
nsaids, warfarin inc lvls
work 4-8 wks

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40
Q

SNRI

A

dry mouth, dec libido
withdrawal s/s
MAOI, haldol, lithium, tramadol, nsaids, warfarin contraindicated - SS
work 4-8 wks

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41
Q

Noraderenergic -dopaminergic antidepr

A

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

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42
Q

heterocyclics

A

ex. trazadone
ae- urinary retention, priapism
instant onset- works for sleep aid
MAOI contraind
full effect 3-4 wks

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43
Q

tricyclics

A

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

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44
Q

MAOI

A

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

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45
Q

bipolar def

A

mood swings from profound depression to extreme mania
can have delusions and hallucinations
s/s can reflect seasonal pattern

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46
Q

hypomania- bipolar

A

period of abnormal and persistent elevated or irritable mood lasting 4 days
no impaired functioning
no psychotic s/s

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47
Q

bipolar epidemiology

A

presents in ages 20-30

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48
Q

bipolar 1- timeline

A

lows at least 2 wks, extreme highs at least 1 wk
or need for hospitalization
can last 3-6mo

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49
Q

bipolar 2- def

A

bouts of MDD w/ episodic hypomania
NOT meet criteria for full manic episode
lows just as low as BP1 but manic episodes are milder

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50
Q

cyclothymic disorder- criteria

A

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

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51
Q

bipolar- biologic theories

A

has genetic component
GABA disregu
inc noradrenergic activity
ion channel abnormal
kindling (inc severity of responses w/ recurrent exposure to triggers)

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52
Q

bipolar- childhood

A

inc comorbid w/ ADHD
adhd meds can exacerbate mania

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53
Q

bipolar childhood- trtmnt

A

lithium, divalproex, atypical antipsychotics
carbamzaepine

family psychoeducation about disorder
communication training
problem-solving skills

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54
Q

bipolar- mania meds

A

lithium
anitconvulsants (mood stabilizer)
cardiogenic drugs for vascular effect
histmine blockers for tension
antipsychotics

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55
Q

bipolar- depressive phase meds

A

mood stabilizers
SSRI (with care!!! can trigger mania)

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56
Q

lithium contraindications

A

nsaids and etoh
need to maintain consistent blood volume lvls

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57
Q

lithium range

A

0.5-1.2 mEq/L
draw a trough 12 hrs post dose
toxicity dependant upon each person

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58
Q

lithium ae

A

polyuria, polydipsia, wt gain, sexual dysfunction

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59
Q

lithium lab tests

A

TSH, PTH, UA, CBC, EKG, Na, Ca, phosphorus

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60
Q

lithium toxicity

A

ae- n/v, tremor, seizures
trtmnt- IV fluids, whole bowel irrigation

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61
Q

SILENT- lithium

A

syndrome of irrev lithium effectuated neurotoxcicity
truncal ataxia, scanning speech, incoord

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62
Q

lithium- pt ed

A

notify dr if diarrhea or vomiting occur
check lvls every 1 to 2 months
maintain consistent diet
don’t skimp on dietary sodium intake

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63
Q

anticonvulsants (mood stabilizer) pt ed

A

do not discont abruptly
report rash, brusing, sore throat, fever, malaise, dark urine
avoid use of etoh

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64
Q

Ca channel blocker pt ed

A

take if GI upset occurs
orthostatic hypotension
blurred vision, dizziness, drowsiness

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65
Q

antipsychotics pt ed

A

use sunscreen
orthostatic hypotension
avoid etoh
report- sore throat, persistent n/v, ha, rapid hr, change in urination, yellow skin, muscular incoordination

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66
Q

suicide-def

A

BEHAVIOR (not diagnosis or disorder)
15x inc in ppl w/ bipolar or depression vs normal pop

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67
Q

suicide risk factors- marital, age, religion, socioeconomic and ethnicity

A

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

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68
Q

suicide r/factors- other

A

substance abuse, mood disorder
(schizo, personality disorder, anxiety, trauma)
insomnia, etoh abuse, psychosis w/ command hallucinations
fam hx of suicide
chronic disease
LGBTQ

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69
Q

physical dependence v psychological dependence

A

physical- need for inc amnts to produce same effects
psychological- desire to repeat use of a particular drug for pleasure

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70
Q

substance-induced disorder- subst. intoxication

A

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

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71
Q

substance-induced- withdrawal

A

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

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72
Q

substance abuse- personality factors

A

low self-esteem
freq depression
inability to relax/defer gratification
inability to communicate

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73
Q

phases of alcoholism

A

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

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74
Q

alcoholic myopathy

A

from vitamin B (thiamine) deficiency
acute- sudden onset muscle pain, weakness, reddish tinge to urine
chronic- graduate wasting of muscles

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75
Q

Wernicke’s encephalopathy

A

most severe form of thiamine deficiency in alcoholics

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76
Q

ae of alcohol abuse

A

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)

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77
Q

ae of alcohol abuse

A

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)

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78
Q

alcohol and preg- ae

A

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

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79
Q

etoh withdrawal s/s

A

tremors, irritability, seizures, hallucinations, delirium
autonomic act is worst in the first 5 days

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80
Q

alcohol assessment tools

A

drug hx and assessment
CIWA clincial institute w/drawal assessment of etoh scale
cage questionnaire

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81
Q

ciwa

A

mild, mod or severe
q3h
bp,hr,rr
clonidine for high bp

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82
Q

cage

A

cut
annoyed
guilty
eye-opener (drink first thing in the morning)

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83
Q

barbiturates, nonbarbit hypnotics, antianxiety and club drugs- priority assessment

A

CNS depression
respiratory rate
hr
bp
(all are dec)

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84
Q

sedative/ hypnotic affects on the body

A

respir depression
hypotension
jaundice
dec body temp
rebound insomnia

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85
Q

intoxication vs withdrawal of hypnotics

A

intox- can be aggressive or comatose
w/drawal- can be fatal

86
Q

stimulant affects on the body

A

tremor, inc motor activity
inc bp, hr, arrhythmias (inc contracitlity= inc 02 requirements)
pneumonia- relaxes bronchial smooth music
GI- anorexia

87
Q

stimulant intoxication

A

euphoria, impaired judgement, confusion

88
Q

stimulant w/drawal

A

DO NOT die
n/v, muscle pain, fatigue, irritability

89
Q

inhalant- trtmnt

A

supportive care
most common in 12-17 yrs old

90
Q

inhalant affects on the body

A

CNS depressant, ataxia, tremor, encephalopathy, parkinsons
dyspnea
renal failure

91
Q

inhalant intoxication

A

during or shortly after use
ataxia, dizziness, hypoactive reflexes, blurred vision, slurred speech

92
Q

opioid intox

A

last several hrs- depends on half life of drug
euphoria, followed by agitation and apathy
respiratory depression

93
Q

opioid withdrawal- shrt v long acting

A

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
Q

opioid withdrawal- s/s

A

n/v, muscle aches, pupil dilation, sweating, yawning, fever, abdominal cramping

95
Q

hallucinogen intoxication

A

dec thermoregulation
metabolic brain injury
depersonalization, tachydardia, synesthesia (experience one sense through another)
formication (bugs on skin)
can be assaultive

96
Q

cannabis- intox v withdrawal

A

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
Q

substance abuse management

A

coping skills
nutrition
problem solving
relaxation skills (deep breathing)

98
Q

substance abuse at work- clues

A

high absenteeism, discrepancies in documentation

99
Q

gambling- trtmnt

A

first ID underlying cause (mental illness)
CBT, psychoanalysis, gamblers anonomys
meds- SSRIs, clomipramine (tricyclic antidep for OCD), lithium (mood stabil )carbamazepine (anticonv), naltrexone

100
Q

codependecy steps

A

survival- let go of denial
reidentification- accountibility
core issues- recog things beyond indiv control
reintegration- get power back

101
Q

meds for alcoholism

A

disulfiram (antabuse) IM
causes sevre illness, flusing, n/v and dizziness if used w/ etoh
naltrexone IM
SSRIs

102
Q

meds for substance intoxication and withdrawal

A

benzodiazepines (lower brain act.) (seizures, anxiety etc)
anticonvul
multivitmains
thiamine (etoh)

103
Q

meds for opioid abuse

A

naloxone, naltrexone (prevents relapse)
methadone (opioid agonist that reduces s/s of withdrawal)
buprenorphine (partial opioid agonist)

104
Q

meds for stimulant abuse

A

antidep
tranquilizers
anticonvulsants

105
Q

WRAP model

A

6 steps
develops safety plan at DC
wellness recovery action plan

106
Q

s/s/ of thiamine deficiency

A

ataxia, peripher neuropathy

107
Q

benzodiazepine withdrawal s/s

A

anxiety, tremors, tachycardia

108
Q

anxiety def

A

emotional response to anticipation of danger
not the same as stress! (stress leads to the disorder)
stimulus is unidentifiable

109
Q

mild anxiety

A

inc sensory stimulation

110
Q

moderate anxiety

A

nervous, difficulty concentrating
still able to utilize coping skills

111
Q

severe anxiety

A

inc vital signs, restless, irritable, angry

112
Q

panic anxiety

A

enlarge pupils, focused on defense

113
Q

anxiety- epidemiology

A

most common disorder
inc in women
minority children and children with low SES at risk
dysregulated family orientation

114
Q

panic disorder

A

recurrent panic attacks
onset unpredictable
impending doom

115
Q

s/s panic attack

A

sweating, SOB, chest pain, dizziness, numbness, fear of losing control (going crazy

116
Q

panic attack- trtmnt

A

safety number one priority
use anxiolytics
benzodiaz, buspirone (take 4x day)
SSRI
Clonidine, propranolol

117
Q

agoraphobia

A

fear of being in situations where can’t escape easily
ex. cinema, crowds, traveling in public transportation

118
Q

causes of anxiety- medical v substance

A

medical- CHF, MI, low BG, asthma, seizures
substance intoxication or withdrawal- all (incl caffeine)

119
Q

OCD- obsessions v compulsions

A

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
Q

OCD trtmnt-meds

A

meds- 2nd line
SSRI, tricylic antidep, SSRI+ atypical antipsycho, SSRI+ lithium

121
Q

hoarding trtmnt

A

difficult, relapse high
assoc. w/ unorganized thoughts, perfectionsim, depression

122
Q

OCD- psychoanalytic theory

A

Freud
egos are underdeveloped (anxiety and fraught with guilt)

123
Q

OCD- learning theory

A

conditioned response to traumatic event
produce actions that lead to less resistance

124
Q

OCD and serotonin

A

possible dec

125
Q

OCD trtmtn

A

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
Q

anxiety meds- action

A

block serotonin, norephinephrine
potentiate GABA
depress lvls CNS

127
Q

anxiety meds- ae

A

lethargy, orthostatic hypoten, n/v, inc CNS effects

128
Q

buspirone

A

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
Q

anxiety meds- shrt v long term

A

“am”s- short term/acute
bridge meds

Chronic trtmnt- SSRI/ Busiprone

130
Q

antianxiety and caffeine

A

dec serum drug lvls
r/f dependence w/ benzos (Xanaxz)

131
Q

pattern of abuse

A

cyclical
abusers were abused as children

132
Q

abuse predisposing factors

A

toxic stress
alt in norepinep, serotonin and dopamine
alterations in neurophysical and neurocognitive dis

133
Q

abuse- psychodynamic theory

A

Freud
underdev ego
poor self concept
unmet needs for satisfaction

violence gives power to person and inc self esteem

134
Q

abuse- learning theory

A

children learn how to behave by imitating role models
more likely to abuse if physically disip as. achild

135
Q

abuse- societal influences

A

american cult
violence means of solving problems

136
Q

intimate partner violence- def

A

battering
pattern of coercive control founded on violence of threat of violence

137
Q

IPV- predisposing victim factors

A

women (affects all age, race, relgion, cult and socioecon)
low self-esteem
inadeq support systems
abusive childhood

138
Q

IPV abuser profile

A

low self-esteem
limited coping
severe stress rxns
views spouse as personal possession
controls through intimidation

139
Q

cycle of battering- phases

A

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
Q

child abuse- emotional

A

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
Q

child abuse- beh indicators of neglect

A

freq absent from school
begs/steals
lacks medical care
consist dirty
abuses drugs/alcohol

142
Q

child abuse- sexual indicators

A

nightmares
bedwetting
sudden change in app
attaches quickly to strangers
suddenly refuses. to particip in physical activities

143
Q

child abuse general influences

A

substance abuse inc risk for neglect/abuse
numerous stresses
poverty
social isolation
lack of knowledge abt child care needs

144
Q

child incest characteristics

A

lack. trust
low self esteem
poor sense of id
absence of pleasure w/ sexual act

145
Q

child incest- complications (at r/f)

A

PTSD
sexual dysfunc
depression, anxiety
eating dis
substance dis
alteration in response to intimacy

146
Q

rape epidemiology

A

any age
16-34 yrs
single women
attacked near own neighborhoods
degree of resistance by women depends on if abuser has a weapon

147
Q

rape response patterns

A

expressed or controlled

148
Q

rape reactions

A

compounded reaction (ass. w/ mental illness and substance abuse, suicide)
silent (don’t tell anyone)

149
Q

rape- long term v short term goals

A

long-dev coping skills
short- guide through initial shock
provide shelter, promote reassurance of safety

150
Q

crisis intervention

A

focus of initial interview and follow-up w the client who has been sexually assaulted is alone

151
Q

PTSD epidemiology

A

more common in women
10% of ppl that have traumatic event will develop

152
Q

PTSD v adjustment disorder

A

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
Q

PTSD def

A

rxn to extreme trauma
s/s- reexperi traumatic event
sustained high lvl anxiety
intrustive thoughts
amnesia
substance abuse
guilt
anger/aggression

154
Q

PTSD onset

A

can by delayed yrs after event
s/s must be present for 1+ mo, sign interference w/ social, occupational functioning

155
Q

factors for dev PTSD

A

duration, severity, exposure, or location

156
Q

acute stress disorder

A

s/s do not last more than 1 mo

157
Q

trauma disorder trtmnt

A

cognitive therapy
prolonged exposure ther
group/family therapy
eye mvmnt desensitization and reprocessing (don’t use if seizures or suicidal)
SSRI

158
Q

adjustment disorder trtmnt

A

goal to reduce triggers, relieve s/s
regular therapy
crisis intervention
SSRI
self-help groups

159
Q

trauma informed care

A

safety, trustworthiness/ transparency, peer support

160
Q

trauma response- beh

A

reckless, freq seeking attention, reverting to younger beh, fighting when critized, resisting change

161
Q

trauma response- emotional/physical

A

nightmares, sensitive to stimuli, fear of separation, dec trust, emotional swings, unexplained medical problems

162
Q

trauma response- psychological

A

confusing safe v dangerous
trouble focusing
diffic imagining future

163
Q

personality disorders trtmnt

A

no curative
only supportive

164
Q

predisposing factors- personality disorder

A

established psychiatric and medical disorders
s/s of personality dis manifest from

165
Q

cluster A- odd, eccentric (unconventional)

A

paranoid, schizoid, schizotypal

trtmnt- exposure therapy- guided
exposed to normalcy

166
Q

cluster B- dramatic, impulsive, self-destructive

A

antisocial (socipath)
borderline
histrionic
narcissistic

are aware of own actions
trt w/ CBT, group therapy, Dialectal Behavior T (mindfulness, meditation)

167
Q

cluster c- anxious, avoidant, dependent

A

avoidant, dependent, obsessive-compulsive (anxiety dis)

Trt w/ group therapy (learn from like-minded others) in moderation, CBT (restructuring thinking patterns), exposure therapy

168
Q

paranoid personality dis

A

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
Q

schizoid personality dis def

A

profound defect in the ability to form personal relationships
do not respond in emotional way
can be misinterpreted for autsim

170
Q

schizoid personality dis– clincial

A

emotionally cold, avoids ppl, aloof, no close friends
inapprop serious

171
Q

schizoid personality dis- predisp factors

A

epigenetics
childhood cold, unempathetic, lack nuture

172
Q

schizoid personality dis– clincial

A

emotionally cold, avoids ppl, aloof, no close friends
inapprop seriouss

173
Q

schizotypal disorder

A

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
Q

schizotypal disorder- clinical

A

medication not trt s/s- only alters LOC
bizarre speech pattern, demonstrate psychoic s/s
bland affect

175
Q

schizotypal disorder- pre d

A

family dynamics (indifference, impassivity, formality)
causes discomfort w/ affection/closeness

176
Q

antisocial def

A

manipulative beh w/NO REMORSE
disregards rights of others
rules don’t apply (law, jobs, relationships)
see themselves as victims

177
Q

antisocial- development

A

onset 3-4yrs old- impairment in fear conditioning
1% in pop
16% in jail
clinically overdiagnosed

178
Q

antisocial- behaviors

A

exploitation/manipu for peronsal gain
unable to delay gratification
reckless
gaslighting

179
Q

antisocial- predisposing f

A

possible genetic factors
hx of severe physical abuse
removal from home
inconsistent parental discipline
extreme poverty
ADHD, conduct disorder as a child

180
Q

borderline personality disorder-def

A

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
Q

borderline personality disorder- beh

A

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
Q

borderline personality disorder- predi f

A

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
Q

histrionic personality dis def-

A

more common in women
2-3%
extroverted, emotional, dramatic
don’t usually engage in self harm

184
Q

histrionic- clincial

A

ex. dennis rodman
attention seeking
seductive
self-dramatizing
very distractable
easily influenced by others (rely on reactions)

185
Q

narcissistic def

A

exagg sense of self worth
no empathy
rules do not apply to them

186
Q

narcissistic- behaviors

A

exploit others to fulfill own desires
grandiose, cheerful, optimistic
fragile self-esteem
can be triggered by criticism

187
Q

narcissistic- predis p

A

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
Q

avoidant personality- def

A

extreme sensitivity to rejection
avoid social situations
social withdrawal
1%

189
Q

avoidant- clinical

A

want connection- are often lonely
timid
self doubt

190
Q

avoidant- pre disp

A

no clear cause
parental rejection, reinforced by peers

191
Q

dependent personality- def

A

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
Q

dependent personality- pre di

A

hereditary, nurture from one exclusive source (mom)
singular attachment as an infant

193
Q

OC personality disorder- def

A

inflexibility, rigid, rank conscious
must be done a certain way
common in oldest child
men
relatively common

194
Q

ocd v ocpd

A

ocd= aware that actions are irrational but repeat to relieve discomfort

ocpd- unaware, optimize utility vs pleasure

195
Q

oc personality disorder- pre d

A

overcontrolled by parents
lack positive reinforcement for good beh
freq punishment for undesirable beh

196
Q

general trtmnt- mood disorders

A

interpersonal psychotherapy
psychoanalytical pscyhother
cbt
dialectical beh therapy
psychopharmacology
* antisocial disorder- therapy does not work

197
Q

somatic s disorders- def

A

disorders w/ no pathological reason
common in women, less educated ppl, rural areas

198
Q

dissociative disorders- def

A

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
Q

somatic s disorder

A

mult dis w/ no explanation
anxiety, depression, drug abuse, dependence and suicide common

200
Q

illness anxiety dis

A

somatic
fear of having serious dis
OCD traits accompany
frm past experi w/ physical illness (family, friends etc)

201
Q

conversion dis

A

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
Q

factitious dis

A

somatic
intentional pretending of physical/psych s/s
make self sick for attention
“Munchausen syndrome

203
Q

somatic dis- family dynamics

A

child can pretend to become ill
shifts focus to child and not fighting parents
brings stability

204
Q

somatic dis- learning theory

A

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
Q

dissociative amnesia

A

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
Q

dissociative fugue

A

sudden need to travel away from home w/ inabil to recall past

207
Q

dissociative identity disorder

A

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
Q

depersonalization derealization disorder

A

tempor change
ureality reelings
detachment from environment
obsering oneself from outside body

209
Q

depersonal v derealization

A

deperson- can’t feel sensations (altered perception of self)
derealization- can’t process event is happening (altered percep of environ)

210
Q

dissociative amnesia- psychodynamic theory

A

repression
invol blocking of unpleasant feelings

437- Psychiatric (3 decks)

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