Exam 3 Flashcards
What is a personality made up of (7)?
-Major traits
-Coping styles
-Values
-Interests
-Drives
-Ways of interacting in the social environment
-How we approach the world
What 5 dimensions is personality based on?
-Neuroticism
-Introversion/Extroversion
-Openness
-Agreeableness
-Conscientiousness
True or False: People with PDs always have obvious mental health symptoms like depression or anxiety
False
What are the signs of a PD (2)?
-Inability to function
-Inflexible traits
What are inflexible traits in a PD (2)?
-Chronic interpersonal problems
-Problems with sense of self
What are the DSM criteria for any PD (6)?
-Longstanding, pervasive, inflexible, extreme, and persistent patterns of thoughts, feelings, and behaviors
-Deviates from the expectations of the individual’s culture
-Onset in early adulthood
-Leads to distress or impairment
-Typically cause as much stress in other people as they do in themselves
-Extremely stable and chronic across time
Why are children not diagnosed with PDs (2)?
-Making sure there is enough evidence to prove there is a PD
-Ensuring that this behavior isn’t caused by age
What are the 3 clusters of PDs?
-Cluster A: Odd, eccentric
-Cluster B: Dramatic, emotional, erratic, unpredictable
-Cluster C: Anxious, fearful
Which “Cluster A” Disorder type involves patterns of distrust and suspicion causing other people’s motives to be interpreted as malevolent
Paranoid
Which “Cluster A” Disorder type involves a pervasive pattern of social and interpersonal deficits
Schizotypal
What types of symptoms may characterize a Schizotypal Disorder (at least 5)?
-Ideas of reference
-Odd beliefs or magical thinking
-Unusual perceptual experiences
-Odd thinking and speech
-Suspicious or paranoid ideation
-Inappropriate or constricted affect
-Behavior that is odd, eccentric, or peculiar
-Lack of close friends
-Excessive social anxiety that does not diminish with familiarity
Which “Cluster A” Disorder type involves detachment from social relationships, restricted range of emotional expression
Schizoid
What indicates a schizoid disorder (at least 4)?
-Neither desires nor enjoys close relationships
-Almost always chooses solitary activities
-Has little interest in sexual experiences
-Takes pleasure in few activities
-Lacks close friends
-Appears indifferent to praise or criticism
How can you differentiate paranoid and schizotypal disorders from schizophrenia?
Lack of psychosis
Which “Cluster B” PD is characterized by a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity
Borderline
Who is typically diagnosed with Borderline Personality Disorder?
People who identify as female
What is Borderline Personality Disorder indicated by (at least 5)?
-Frantic efforts to avoid real or imagined abandonment
-Pattern of unstable and intense relationships
-Identity disturbance
-Impulsivity
-Recurrent suicidal behavior or threats
-Affective instability
-Chronic feelings of emptiness
-Inappropriate, intense anger
-Transient, stress-related paranoid ideation
Which “Cluster B” PD is characterized by a pattern of excessive emotionality and attention seeking
Histrionic
What indicates Histrionic Personality Disorder (4)?
-Uncomfortable when not the center of attention
-Interaction with others is characterized by inappropriate sexual seduction
-Displays rapidly shifting and shallow emotions
-Uses physical appearance to attract attention to self
Which “Cluster B” PD is characterized by a pervasive pattern of grandiosity?
Narcissistic
Which “Cluster B” PD is characterized by a pervasive disregard for and violation of the rights of others?
Antisocial
What indicates Antisocial Personality Disorder (3 or more)?
-Failure to conform to social norms with no respect to lawful behaviors
-Deceitfulness
-Impulsivity
-Irritability and aggressiveness
-Disregard for safety of self or others
-Consistent irresponsibility
-Lack of remorse
Antisocial Personality Disorder is the only time what is a written rule?
The patient must be at least 18 years old
In order to be diagnosed with APD, the patient must show evidence of what childhood disorder before 15 years old?
Conduct Disorder
Which “Cluster C” disorder is characterized by a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation
Avoidant
Which “Cluster C” disorder is characterized by an excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation
Dependent
Which “Cluster C” disorder is characterized by a pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency
Obsessive-Compulsive
How is Obsessive-Compulsive Personality Disorder different from OCD?
The PD is slightly less severe
General Personality Disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture. Manifested in at least 2 of which areas?
-Cognition
-Affectivity
-Interpersonal functioning
-Impulse control
What is it called when a patient has a severe disturbance in eating behaviors, such as eating too little or eating too much
Eating Disorder
Which section does the DSM have Eating Disorders in? What are some other disorders in this category (3)?
“Feeding Disorders” - Pica (eating non-food substances for extended periods)
-Rumination Disorder (repeated regurgitation of foods)
-Avoidant/Restrictive Food Intake Disorder (failure to meet appropriate nutritional and/or energy need, typically stems from issues with the texture or appearance of food)
Eating Disorder that involves restriction of energy intake relative to requirements leading to significantly low body weight in the context of age, sex, developmental trajectory, and physical health
Anorexia Nervosa
What are the 2 subtypes of Anorexia Nervosa?
-Restricting: During the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behavior. Weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise
-Binge-eating/Purging: During the last 3 months, the individual has engaged in recurrent episodes of binge eating or purging behavior (self-induced vomiting or misuse of laxatives)
Eating Disorder that involves recurrent episodes of binge eating followed by purging
Bulimia
How are Anorexia Nervosa (binging-purging type) and Bulimia different?
Anorexia creates a significantly low body weight, Bulimia creates an average or above-average body weight
Which Eating Disorder involves recurrent episodes of overeating?
Binge Eating Disorder
How is Binge Eating Disorder different from the other two?
Normal or above average weight (unlike Anorexia Nervosa), No compensatory action involved (unlike Bulimia)
How does dopamine’s relation to feelings of pleasure and motivation relate to eating disorders?
-High levels in Anorexia
-Low levels in Bulimia
What is the primary goal of Eating Disorder treatment?
Monitor physical health of the patient and work to achieve a healthy weight
How does Allen suggest we tame diagnostic inflation (5)?
- Dismantle “Big Pharma”
- Tighten DSM criteria
- Take the DSM away from the American Psychiatric Association (APA)
- Insurance companies shouldn’t require a diagnosis
- Tame doctors (MDs)
What are paraphilic disorders?
Abnormality where sexual behaviors are harmful to self or others
What are sexual dysfunctions?
Abnormality where difficulties are distressing
Name the steps of the sexual response cycle (4)
Desire
Excitement
Orgasm
Resolution
What is something the clinician needs to determine before proceeding with assessment for a Sexual Disorder?
If the problem is stemming from insufficient sexual stimulation
What is the Sexual Disorder that involves recurrent sexual attraction to unusual objects or sexual activities?
Paraphilia
Paraphilia should only be diagnosed when?
When the patient causes marked distress/harm to self or others or involve non-consenting persons
Paraphilic Disorder may only be diagnosed when which 2 criteria are satisfied?
-Criteria A: Qualitative nature of the paraphilia
ex. Exposing genitalia to strangers
-Criteria B: Negative consequences of the paraphilia
ex. distress, impairment or harm
What is it called when there is incongruence between one’s experienced/expressed gender and assigned gender of at least 6 months duration?
Gender Dysphoria
What is the primary criticism of the DSM’s presentation of Gender Dysphoria?
The authors use binary language
What are some controversies involving childhood disorders (3)?
-Number of children diagnosed is increasing
-Number of childhood disorders is increasing
-Number of medications prescribed is increasing
Which Childhood Disorder involves deficits in intellectual functions (reasoning, planning) and deficits in adaptive functioning (independence)?
Intellectual Developmental Disorder
Which Childhood Disorder involves academic issues in a specific area of comprehension and achievement not due to intellectual disability or deficient educational opportunities
Specific Learning Disorders
Which Childhood Disorder includes combined Autistic disorder, Asperger’s disorder, pervasive developmental disorder not otherwise specified, and childhood disintegrative disorder
Autism Spectrum Disorder
What 2 categories is Autism Spectrum Disorder often broken into?
-Deficits in social communication
-Restricted, repetitive behavior patterns, interests, or activities manifested
What is theory of mind?
Understanding people’s perspectives, emotions, and beliefs
Which Childhood Disorder involves the acquisition of coordinated motor skills below that expected given the person’s chronological age?
Motor Disorders
Which Childhood Disorders are characterized by deficits in language, speech, and communication?
Communication Disorders
Which Childhood Disorder is characterized by hyperactivity/impulsivity and inattention that is extreme for the developmental period, persistent across situations, and associated with significant impairment?
ADHD
In the DSM criteria for ADHD, one or both of these traits have to be present
-6 or more manifestations of inattention eg, careless mistakes, not listening well, not following instructions, easily distracted, forgetful in daily activities
-6 or more manifestations of hyperactivity-impulsivity present, eg, fidgeting, running about inappropriately (in adults, restlessness), acting as if “driven by a motor,” interrupting or intruding, incessant talking
Childhood Disorder where problems are manifested in behaviors that violate the rights of others and/or violate rules or laws
Conduct Disorder
Childhood Disorder where child doesn’t quite meet criteria for CD, but still loses their temper, argues with adults, deliberately annoys others, blames others for their problems, and is angry (not physical like with CD)
Oppositional Defiant Disorder
Childhood Disorder, characterized by recurrent behavioral outbursts representing a failure to control aggressive impulses
Intermittent Explosive Disorder
What is the key to determining if a child has pyromania or kleptomania?
Tension before the action and relief afterwards
Childhood disorder that involves severe recurrent, frequent temper outbursts in response to common stressors
Disruptive Mood Dysregulation Disorder
Childhood Disorder where a child worries constantly that harm will befall their caregivers or themselves when they are away
Separation Anxiety Disorder
What is Selective Mutism Disorder?
Consistent failure to speak in specific social situations in which there is an expectation of speaking despite speaking in other situations
Childhood Disorder where the child exhibits a consistent pattern of inhibited, emotionally withdrawn behavior toward caregivers
Reactive Attachment Disorder
Childhood Disorder where the child approaches and interacts with unfamiliar adults
Disinhibited Social Engagement
What are the 2 main types of disorders elderly face?
-Neurocognitive Disorder - Deterioration of cognitive function
-Delirium - State of mental confusion
What are the cognitive domains (6)?
Complex Attention
Executive Function
Learning and Memory
Language
Perceptible Motor
Social Cognition
Late Life Disorder that is characterized by significant cognitive decline from a previous level of performance in 1 or more cognitive domains
Major Neurocognitive Disorder
What is delirium?
State of mental confusion with a very quick onset
Evidence the person committed an illegal act and behaved with criminal intent
Mens Rea (Guilty Mind)
-No dispute over guilt
-Not responsible for the crime because of mental illness
-Indefinite commitment to a forensic hospital (unit within a mental health hospital)
-Only released when no longer mentally ill
These are all characteristics of…
Not Guilty by Reason of insanity (NGRI)
-Found guilty and responsible for the crime
-Mental illness plays a role in sentencing
-Can be committed for treatment until no longer mentally ill, then sent to prison to serve the rest of the sentence
-Most are incarcerated and may or may not receive any psychiatric care
These are all characteristics of…
Guilty but Mentally Ill (GBMI)
True or False: An individual can be committed to a psychiatric hospital against their wishes if deemed a danger to self or others
True
When must confidentiality be broken (5)?
-The patient has filed a malpractice suit against the therapist
-Therapist is subpoenaed to appear in court
-Evidence of child or elder abuse
-Patient is trying to avoid arrest for a crime committed
-Patient/participant is a danger to self or others
Therapist’s duty to use reasonable care to protect third parties from dangers posed by clients
Duty to Warn
A professional role with a person at the same time as another role
Multiple Relationships
Personal, scientific, professional, legal, or financial interest may impair objectivity
Conflict of Interest
What are the rules for sexual intimacy with patients (3)?
-Do not engage in sexual intimacies with current patients
-Do not accept previous sexual partners as patients
-Cannot engage in sexual intimacies with former patients for at least 2 years after termination of therapy
Our patient’s problems and stories may impact us
Vicarious Traumatization
What does Allen mean when he says “Nature picks diversity; we pick standardization”? How does this relate to the DSM? What does he say is the solution (4)?
Diversity is a good thing but we tend to prefer everything and everyone to be the same. The DSM standardizes the boundaries of what “normal” emotion is.
Solutions:
-Identify roles to determine impairment
-Insurance companies should have less control over who is able to receive mental health care
-Big pharma needs to have some of their power taken away - direct marketing to patients which leads to more polypharmacy
-Multiple opinions
