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Exam 3 Flashcards

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1
Q

3 christs of Ypsilanti

A

Milton Rockeach
* worked at a psych hospital where in 3 different units at the same time 3 men had the same delusion that they were jesus christ
* the 3 got into conflicts all the time
* Clyde resolved that the other 2 christs were dead (corpses with machines inside them that did the talking)
* joseph concluded that the other 2 christs were crazy and that research assistants were his allies
* leon thought other men were faking, crazy, wanted recognition, or were lesser gods

  • all 100% believed their delusions
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2
Q

positive symptoms of schizophrenia

A

delusions
hallucinations
command auditory hallucinations

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3
Q

delusions

A

false, fixed beliefs
disturbance in thought content
over 90% people with schizophrenia have delusions

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4
Q

common types of delusions

A

granduer
persecution
thought broadcasting
insertion/withdrawl
reference
control
somatic

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5
Q

delusions of grandeur

A

great power, knowledge, talent
*all 3 christs would have this
- less common

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6
Q

delusions of persecution

A

paranoid
* police are in on it
* more common

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7
Q

thought broadcasting

A

ones private thoughts are being broadcasted to others against your will

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8
Q

thought insertion/withdrawl

A

thoughts are being taken out of your brain without knowledge
thought that your roommate is stealing information from your brain while you’re sleeping so you stay up all night

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9
Q

delusions of reference

A

things in environment have a special meaning only intended for you

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10
Q

delusions of control

A

thoughts being controlled by external agents such as robots

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11
Q

somatic delusions

A

part of your body is diseased or altered or believing your intestines have been replaced by snakes

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12
Q

symptoms of schizophrenia exist in

A

three dimensions:
positive
negative
disorganized

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13
Q

positive symptoms aka

A

pathological excesses

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14
Q

hallucinations

A

positive symptom of schizo
false sensory experiences
experienced as real

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15
Q

most common hallucination

A

auditory

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16
Q

types of hallucinations

A

visual
gustatory (taste)
olfactory (smell)
tactile (touch) ** red flag

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17
Q

why is tactile (touch) symptom of hallucination a red flag for therapists

A

not very common and may be a red flag for malingering

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18
Q

do hallucinatory symptoms occur one by one or together

A

can all occur together

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19
Q

auditory hallucinations

A

often voices are known or of God/Devil
most people report hearing more than on voice
most of the time they utter rude, vulgar, critical comments

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20
Q

command auditory hallucinations

A

command or not command

  • command- voices tell person to do something - difficult to ignore and often telling the person to do something really bad to themselves or others
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21
Q

negative symptoms of schizophrenia aka

A

pathological deficits

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22
Q

negative symptoms of schizophrenia

A

alogia
avolition
restricted affect
anhedonia
social withdrawl

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23
Q

what is a poor prognostic sign of schizophrenia

A

preponderance - excess superiority

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24
Q

alogia

A

poverty of speech
* speak less often, use fewer words

(-) schizo

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25
Q

avolition

A

apathy, inability to initiate or persist in goal directed activities

  • appears as lazy when really they truly do have significant challenges doing a particular task
    *inability to start or complete paying bills even when urgent

(-) schizo

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26
Q

social withdrawl

A

when more psychotic, drawn deeper into social withdrawal which worsens dissociation from reality and makes delusions and hallucinations worse

(-) schizo

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27
Q

restricted affect

A

low emotional expression

(-) schizo

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28
Q

anhedonia

A

inability to feel pleasure

(-) schizo

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29
Q

disorganized symptoms of schizo

A

disorganized speech or behavior
thought disorder
catatonia
posturing
stereotyped movements
inappropriate affect

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30
Q

disorganized speech

A

disorganized symptom of schizo

does not make sense
* could reflect an underlying thought disorder
loose associations (lack of connection between ideas)
clanging (words that sound the same but dont make sense together)
perseveration (stuck on idea)
neologisms (new word)
malapropisms (mistaken use of word in place of similar sounding one)

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31
Q

disorganized behavior

A

disorganized symptom of schizo

poor/unusual hygiene, dress
catatonic stupor (can’t move or respond- stare into space)
posturing (hold specific position)
stereotyped movements (repetitive movements)
inappropriate affect (hysterically laughing in serious situation)

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32
Q

DSM Schizophrenia

A

two or more for one month:
- delusions
- hallucinations
-disorganized speech
-disorganized/catatonic behavior
- negative symptoms

continuous signs for 6 months to a degree that impairs social/occupational functioning

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33
Q

what % of population does schizophrenia affect

A

1%

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34
Q

are there differences in # of men vs women cases in schizophrenia

A

no

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35
Q

when is schizophrenia typically diagnosed

A

late adolescence or early adulthood

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36
Q

is schizophrenia progressive

A

no only debilitating

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37
Q

if a person has anosognosia, what is their diagnosis

A

anosognosia = lack of insight

  • important for understanding schizophrenia
  • a person with schizophrenia lacks insight into their mental health condition
  • not knowing you have schizophrenia and lacking insight into fact you may be hallucinating
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38
Q

is genetics a factor in developing schizo

A

yes significant genetic component
as the degree of genetic similarity increases in people so does the risk of schizophrenia

60-80% heritability
* identical twins have a greater genetic similarity so they have a higher chance of developing schizo if other has it

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39
Q

environmental factors: schizo

A

really early - prenatal and perinatal
viral infection
maternal stress
birth complications

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40
Q

infants born to mothers who had the fly in their third trimester have significantly elevated risks of

A

schizophrenia

  • this is because mothers antibodies for flu cross the placenta which may disrupt the development of the fetal brain
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41
Q

if a mother is stressed and has high cortisol, what is fetus at risk for developing

A

schizo because cortisol crosses placenta and has negative effects on devloping brain

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42
Q

if a baby is born in breach position or after prolonged labor or with umbilical cord wrapped around their neck what are they more at risk for developing

A

schizo due to lack of O2 to brain

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43
Q

neurodevelopmental perspective

A

the brain of someone with schizophrenia may be impacted early on in life
- maybe genetics or environmental factors
** but the symptoms do not reveal themselves until adolescence or early adulthood which coincides with a significant period of brain maturation in prefrontal cortex

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44
Q

dopamine hypothesis

A

schizophrenia results from excessive levels of dopamine activity
increased dopamine levels may be result of increase dopamine receptors on post-synaptic cell

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45
Q

how did the dopamine hypothesis come about

A

based on the action of thorazine which is a first generation antipscyhotic, which blocks dopamine receptors (D2 receptors)
blocking dopamine receptors = reduced hallucinations and delusions

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46
Q

first generation psychotics

A

thorazine
blocks dopamine receptor (D2 receptors) and reduces hallucinations and delusions (70%)

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47
Q

second generation antipsychotics

A

clorazil and risperdal
block D2 and other dopamine receptors and impact other NTs (Glutamate, GABA, serotonin)
70% much improved- mostly positive symptoms

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48
Q

what is the front line txt for schizo

A

second generation antipsychotics

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49
Q

side effects of second generation antipsychotics (clozaril and risperdal)

A

fewer extrapyramidal symptoms (EPS)
less tardive dyskinesia
weight gain and increased risk of diabetes, hypertension, and CHD

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50
Q

fewer extrapyramidal symptoms (EPS)

A

neurological disturbance: muscular rigidity, tremors, restless agitation, involuntary postures, Parkinsonism

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51
Q

Parkinsonism

A

difficult initiating motor movements, tremors (antipsychotic medications mimic antipsychotics)

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52
Q

less tardive dyskinesia (TD)

A

involuntary movements of :
the mouth (lip smaking, tongue thrusting)
eyes (rapid blinking)
fingers or limbs

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53
Q

what causes TD more: 1st or 2nd gen antipsychotics

A

1st generation

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54
Q

can TD be fixed

A

sometimes if caught early enough

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55
Q

when can a schizo stop taking meds

A

never

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56
Q

sociocultural perspective: schizo

A

clinical outcomes often better in non-western developing countries
Wusten and Lincoln

57
Q

Wusten & Lincoln 2021

A

participants from high income countries and collective low and middle income countries were randomly assigned to label vs no label condition
HIC had more stigmatizing attitudes than LAMIC
label = increased stigma in both HIC and LAMIC
association between label and stigma stronger than association between HIC and LAMIC

58
Q

deinstitutionalization

A

1963 community mental health act:

create community mental health centers
* had good intentions but poor funding for community mental health centers
problems for people with schizo and society

59
Q

revolving door

A

1963 community mental health act

schizos always in and out of hospitals/jails

60
Q

developmental psychopathology

A

understanding maladaptive behavior, emotion, and cognition in the context of normal development

  • not a simple downward translation- can’t take what we know about adult mental health and apply it to children
61
Q

masked depression

A

children don’t have the cognitive capacity to have depression so they misbehaved instead

62
Q

symptoms of depression in children vs adults

A

children show same depression symptoms as adults EXCEPT children can either be showing symptoms as depressed mood OR irritability (more common)

63
Q

disruptive mood dysregulation disorder

A

applying bipolar disorder to children/adolescents
new category for diagnosis of bipolar disorder
characterized by temper outbursts

64
Q

internalization vs externalization

A

internalization = depression/anxiety - expressing distress INWARDS

externalization = oppositional defiant disorder, conduct disorder (behavior disorders, expressing distress OUTWARDS, ADHD)

65
Q

ADHD : DSM

A

attention deficit/hyperactivity disorder
6 symptoms in either or both categories (inattention or hyperactivity/impulsivity) and must be present in more than one setting

inattention:
failure to attend to detail
doesnt follow instructions
difficulty organizing tasks
avoids tasks w attention/effort
difficulty sustaining attention
forgetful

hyperactivity/impulsivity :
fidgets of taps hands/feet
leaves seat
runs/climbs
talks excessively
blurts out answers/interrupting
difficult waiting turn

66
Q

ratio of male to female ADHD

A

2:1 male to female

67
Q

females are more likely to exhibit which category of ADHD symptoms

A

inattention

68
Q

ADHD has comorbidity with

A

ODD and CD

69
Q

treatment for ADHD

A

stimulants
ritalin or adderall

70
Q

behavioral disorders in children include

A

oppositional defiant disorder
conduct disorder

71
Q

oppositional defiant disorder (ODD)

A

more than one setting:

angry/irritable mood
argumentative
vindictive (seek revenge)

*likely to become CD if not treated

72
Q

conduct disorder : DSM

A

more than one setting:
- aggression toward people and/or animals
- destruction of property
- deceitfulness or theft
- violation of rules

73
Q

angry/irritable mood : ODD

A

loses temper
easily annoyed
often angry and resentful

74
Q

argumentative/defiant behavior : ODD

A

argues with authority figures
defies requests
deliberately annoys others
blames others for mistakes/misbehavior

75
Q

aggression to people or animals: conduct disorder

A

bullies, threatens, intimidates others
initiates physical fights
use of weapon
cruel to people
cruel to animals
forced sexual activity

76
Q

destruction of property: CD

A

destroys others’ property
fire setting

77
Q

deceitfulness or theft; CD

A

lies
breaking into house, building, car
stealing

*in more than one setting

78
Q

violation of rules : CD

A

breaks curfew
runs away
truancy

*in more than one setting

79
Q

if CD is not treated what does it become

A

antisocial personality disorder

80
Q

patterson’s coercive model of antisocial behavior

A

parent with antisocial behavior leads to poor parental discipline and/or child conduct problems

81
Q

parent management training

A

goal is to interrupt parenting strategies that sustain and escalate dysfunction
- set clear expectations
-follow through
- positive reinforcement
- time out (negative punishments)

82
Q

problem solving skills training

A

goal is to generate alternatives to interpreting and managing interpersonal situations
- modeling
-role playing
- corrective feedback
- may occur in context of play (often structured)

83
Q

play therapy

A

humanistic or psychodynamic
based on developmental idea that children lack capacity for abstract thought for using language as a primary means for expressing things such as thoughts and emotions
act out things they can’t express though words
play reveals feelings through:
- choice
- how toys are used
- themes: how we understand what they are doing

84
Q

Anorexia DSM

A

1) individual purposely takes in too little nourishment, resulting in body weight that is significantly low and below that of other people of similar age and gender
2) individual is very fearful of gaining weight, or repeatedly seeks to prevent weight gain despite low body weight
3) individual has distorted body perception; places inappropriate emphasis on weight or shape in judgements of self; fails to appreciate serious implications of her or his low weight

85
Q

medical consequences of anorexia

A

amenorrhea
dry skin, brittle hair & nails, lowered body temp
reduced bone density
lanugo - downy hair on limbs and cheeks
CV problems
high mortality rate

86
Q

typical behavior/dieting characteristics: anorexia

A
  • inflexible food variety
  • eat alone
  • eating rituals
  • consume low calorie foods/bevs to create false statiety
  • restrict after certain times of day
  • hide limited intake
  • preoccupied with food
87
Q

common thought distortions: anorexia

A

control/failure- “giving into hunger means im a failure”
minimizing ED- “having anorexia means im superior to others who cant show this degree of self restraint
eating habits - “chronic dieting is the only way to control my weight”
emotions- “being thin= being happy”

88
Q

biological influences: anorexia

A

evolution
genes
brain structure or chemistry

89
Q

psychological influences: anorexia

A

emotions
personality
learning
cognition

90
Q

socio-cultural influences

A

roles
expectations
socioeconomic status
definitions of normality and disorder

91
Q

bio influences anorexia: Keys Starvation Study

A

tested dietary restraint/starvation
objectors to the draft had to participate in studies
on avg each male lost 25% body weight
preoccupation with food
negative mood
food rituals
lack of dietary control (binged)

92
Q

biological factors ED: genetics

A

MZ with AN = 70% (23% BN)
DZ with AN= 20% (9% BN)

93
Q

bio factors ED: brain circuits

A

dysfunction in fear, OCD, and depressive circuits

94
Q

treatment for BN

A

SSRI
prozac

95
Q

Bulimia DSM

A

1) repeated binge eating episodes
2) repeated performance of compensatory behaviors (vomiting, exercise) to prevent weight gain
3) symptoms take place for at least 3 months
4) inappropriate influence of weight and shape on appraisal of oneself

96
Q

medical consequences BN

A

salivary gland enlargement (chubby cheeks)
eroding of dental enamel
tear esophagus
electrolyte imbalance= cardiac arrhythmia, kidney failure, seizures
intestinal damage and colon damage

97
Q

prevalence of ED

A

1-5%

98
Q

when do ED begin

A

adolescence/young adulthood

99
Q

comorbidity of ED

A

depression
anxiety
OCD
substance use disorders

100
Q

ED more common in

A

women (?)
people involved in activities or jobs that emphasize weight and appearance

101
Q

what % of women on college campuses suffer from an ED

A

40%

102
Q

psychological influences of EDs

A

cluster of personality characteristics and cognitive factors predict the development of ED:
- body dissatisfaction
- low self esteem
- perfectionism
- struggle for control
- self evaluation based on others

103
Q

diagnostic crossover in ED

A

mostly start with AN and end up with BN

104
Q

what is the #1 predictor of ED

A

body dissatisfaction

105
Q

sociocultural influences ED

A

family environment - focuses on thinness, dieting, perfection
enmeshed families
thin/muscular ideal

106
Q

enmeshed families

A

sociocultural perspective ED

families too involved in each others lives - codependency- young girls

107
Q

Sharma and Vidal

A

specific about social media and highly visible social media focusing on thin/muscular ideal

108
Q

Fairburns Integrative Model of ED

A

most commonly done in groups
diet to feel better
restrict food intake
binge
purge
low self esteem/negative affect
(repeat cycle)

diet to feel better about self
restrict food intake
low self esteem/negative affect

109
Q

txt: ED

A

CBT-E (enhanced)

110
Q

CBT-E

A

txt for ED (BN)
3 stages
transdiagnostic- most preferred txt for EDs

111
Q

stage 1 CBT-E

A

behavioral strategies to normalize and develop new eating patterns
- self monitoring
- three meals, 2 snack
- behavioral analysis and problem solving to generate alternatives to binges

112
Q

stage 2- CBT-E

A

cognitive interventions to challenge overconcern with weight/shape

113
Q

stage 3 CBT-E

A

relapse prevention
-abstinence violation effect

114
Q

CBT-E effectiveness for BN

A

rates of binge/purge reduced by 75%
50% recover
30% relapse
20% chronically impaired (chronically ED’d for future)

115
Q

txt for anorexia

A

inpatient
- controlled weight gain
- strict behavior therapy that makes rewards contingent on weight gain
- results in increased anxiety, depression, and distress

116
Q

effectiveness of txt for AN

A

limited effectiveness
- 10% die
- 40% underweight and chronically impaired
- 50% normal weight but still have problems with food, weight, depression/BN

117
Q

abstinence violation

A

tendency to continue to engage in prohibited behavior following violation of personal goal to abstain

118
Q

personality disorders

A

enduring pattern of maladaptive experiences in cognition, emotion, interpersonal functioning, and/or impulse control
onset in early childhood
ego-syntonic vs dystonic

119
Q

the number one factor that predicts outcome of therapy for EDs is

A

how long they have had ED before txt

120
Q

egosyntonic

A

people with personality disorder are not distressed by their symptoms or they are comfy with their situation
everyone else has the problem but not me

121
Q

borderline personality disorder DSM

A

pervasive patterns of instability or impulsivity, including 5 of the following:

  • fear of abandonment
  • unstable, intense relationships, alternating between idealization and devaluation
  • unstable sense of self
  • impulsive behavior in 2 areas
  • recurrent suicidal gestures or self mutilation
  • affective instability
  • inappropriate, intense anger
    transient paranoid ideation or dissociation
122
Q

txt for borderline personality disorder

A

DBT (dialectical behavior therapy)

123
Q

etiological theory : borderline personality disorder

A

strong emotional reactions (more active amygdala and trouble recruiting prefrontal cortex- impulse control)
lack of emotion regulation skills
invalidating early environment
lack stable sense of self
reliance on others (to supply them with sense of self and validate their existence)
resort to manipulation and impulsive actions

124
Q

DBT

A

dialectic = a deep contradiction
therapist an client must both radically accept who you are
radical self acceptance vs need to change
3 stages

125
Q

stage 1 : DBT

A

survival and basic functioning
behavioral skills in group context (mindfulness, distress tolerance, decrease suicidal behavior, call therapist prior to self injury, no calling within 24 hours after self injury , decrease behaviors that interfere with therapy)

126
Q

stage 2: DBT

A

reduce distress with past trauamas through exposure therapy

  • describe past abuse over and over until distress decreases
127
Q

stage 3: DBT

A

address long term issues - achieve career and interpersonal goals

128
Q

cluster B personality disorder DSM

A

antisocial
borderline
histrionic (attention seeking)
narcissistic

129
Q

common misconceptions about psychopathy

A

1) psychopathy = ASPD (antisocial)
2) psychopathy = violence
3) people with psychopathic personalities are fundamentally different from the rest of humanity
4) psychopathy = psychosis
5) people with psychopathic personalities = no emotion
6) psychopaths are born, not made
7) psychopathy is inalterable

130
Q

why is psychopathy NOT = ASPD

A

ASPD = observable behaviors

131
Q

ASPD DSM

A

lifelong pattern of disregarding the rights of others and at least 3 of following :

Failure to conform to social norms and laws
Deceitfulness
Impulsivity
Irritability and aggressiveness
Disregard for safety of self or others
Irresponsibility
Lack of remorse

132
Q

Hare (2003) characteristics of psychopathy

A

2 categories:

interpersonal-affective
- superficial charm/glib
-pathological lying
-manipulative/conning
- lack of guilt/respinsibilty
- shallow affect
-grandiose sense of self worth
- callousness/lack of empathy

antisocial
- need for stimulation
- parasitic lifestyle
-impulsivity/poor behavioral control
-irresponsibility
-juvenile deliquency/early behavioral problems
-criminal versatality
- promiscuous sexual behavior

133
Q

“The mask of Sanity”

A

first identified psychopathy
mask - psychopaths initially presented just like Ted Bundy
actions and attitudes changed over time and revealed more severe underlying patholog

134
Q

Duchenne smile

A

people high on psychopathy able to fake a real smile

135
Q

Brinke et al 2007

A

criminals scoring high in the PCL-R showed marked behavioral incongruence: more Duchenne smiles while also more angry language
- duplicitous style of communicating

136
Q

is psychopathy inherited

A

yes moderate (~50%)

137
Q

biological factors: psychopathy

A

neuroscience: reduced amygdala activity- poor at identifying fearful faces
-reduced physiological arousal

138
Q

environmental factors - psychopathy

A

history of abuse and parental jail time

139
Q

effectiveness of txt : psychopathy

A

successful psychopaths wont make it to therapy and even if they do, they wont be motivated to change and will try to calm the therapist

effectivess may depend on dependent variable- unlikely to make an impact on the underlying symptom of a psychopath

parent management and parent solving skills training (from childrens unit)

Abnormal Psych (2 decks)

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