Exam 3 Flashcards
The term, “Insanity” is used in what context?
Mental Disorder – Psychological Term
Insanity – Legal Term
Know the types of insanity pleas
o Not guilty by reason of insanity (NGRI)- Not guilty of crime, Indefinite commitment to a forensic hospital, Released when no longer mentally ill
o Guilty but mentally ill (GBMI)- Found guilty and responsible for the crime , Can be committed for treatment until “No longer mentally ill”, then sent to prison for remainder of sentence, Most are incarcerated and may or may not receive any psychiatric care
Is the insanity plea commonly used? Is it effective?
o Pleaded in fewer than 1% of cases, Rarely successful (26%)
Understand competency to stand trial
o Person has mental illness at time of trial, Accused must be able to participate in his or her defense, Determination of competency is made before individual is tried, Most receive treatment and then are returned to court, If medication can produce rationality, trial can be held, Even if discontinuation of drug would render defendant incompetent
Understand CA Involuntary Commitment Law (5150)
o A Person is: A danger to oneself, A danger to others; OR Gravely disabled (inability to obtain food, clothing, and/or shelter, due to mental illness). Requires documentation by police officer or clinician
Understand Confidentiality and exceptions to confidentiality
o Requires therapists to keep information from clients private, unless a release of information is provided., This includes the fact that the client is seeing the therapist.
o Duty to warn
o Duty to report child/dependent adult/elder abuse
o Suicidal/homicidal
o Legal subpoena (but don’t disclose more than needed)
What are dual relationships and what is therapists responsibility regarding them?
o Therapists refrain from entering into a multiple relationship if it could reasonably be expected to impair the psychologist’s objectivity, competence or effectiveness
o Therapists do not enter into sexual relationships with clients, students, supervisees, research assistants, research participants, family members of clients, etc.
Define Obsessions
Recurrent thoughts, urges, or images
o Intrusive and unwanted
o The individual attempts to suppress or neutralize them with another thought or action (sometimes compulsions)
Most common obsessions:
o Contamination o Aggressive impulses o sexual impulses o symmetry/order o doubt
Define Compulsions
o Repetitive behaviors or mental acts that must be performed in response to an obsession or rule
o Aimed at reducing anxiety or preventing a calamity
o Behaviors are not connected realistically to what they are trying to prevent or are clearly excessive
o Short Definition: Impulse to repeat certain behaviors or mental acts to avoid distress
Common Examples of compulsions:
o Washing and cleaning, o checking o Counting o Touching o Mental
Define Obsessive Compulsive Disorder
o Presence of obsessions, compulsions, or both
o The obsessions or compulsions are time consuming (e.g. 1 hr per day) or cause clinically significant distress or impairment in functioning
o Recognition that obsessions or compulsions are unreasonable (not for children)
Understand the maintenance of OCD as explained in lecture
o Association of certain objects/ideas with fear
o Develop obsessions to process and suppress fear
o Perform compulsions in order to help reduce the fear
o Compulsions began randomly, then become associated with anxiety
Define Body Dysmorphic Disorder
o Preoccupied with a real or imagined defect in appearance – excessive.
o Person’s concern is excessive
o Engage in compulsive behaviors
o Checking, comparing, seeking reassurance, or trying to change their appearance
o High levels of shame, anxiety, and depression
o Not due to symptoms of an eating disorder
o Can have serious effect on functioning – in some, inability to work.
Understand the maintenance of Body Dysmorphic Disorder as explained in lecture.
o Biased attention to detail
o Self-objectification and more value on physical appearance
o Focus on specific “defective” features rather than overall appearance
What is often misunderstood about people’s self-evaluation in BDD?
.Often misunderstood – People with BDD often “lack a normative self-enhancing bias” Show more accurate self-evaluation.
Define Hoarding Disorder
o Perceived need to save the items, and distress about to discarding regardless of value.
o Accumulation of possessions clutters living areas and substantially compromises their intended use.
o If no cluttering, it is due to third party intervention (e.g. family)
o 66% are unaware of severity of problem
Define Trichotillomania. What do people typically feel before and during pulling. What emotions can trigger the behavior?
o Recurrent pulling out of one’s hair, and repeated attempts to stop.
o Causes loss of hair and significant distress/impairment.
o A feeling of tension prior to pulling or when trying to resist the behavior.
o Pleasure, gratification, or relief while engaging in the behavior.
o Can be triggered by stress but also other emotions such as boredom.
o Average age of onset is 11.
o Female to male ratio is 10:1
Define Excoriation Disorder
o Recurrent skin picking resulting in lesions
o Repeated attempts to stop
o Causes distress or impairment
o Most common among women between the ages of 30 and 45
o New disorder in the DSM-5
Understand Exposure Plus Response Prevention (ERP) for treating OCD
o Exposure
o Not perform compulsions.
o Results in the extinction of the conditioned response (the anxiety)
What term was the pre-curser to PTSD? When was the term introduced?
Shell shock, Charles Myers, WWI
When did PTSD did become a disorder? Veterans of what war supported this?
1980 PTSD established as a diagnosis in the DSM 3 as a result of a political movement supported by Vietnam Veterans, the Women’s Movement and other cultural groups.
What is Posttraumatic Stress as defined in lecture.
Traumatic Stress
o Extreme form of stress – from overwhelming incident(s).
o Fight, flight, freeze and submit responses.
Posttraumatic Stress
o Traumatic Stress that is ongoing.
o Not relieved by a nervous system response at the time
o Or later by natural or therapeutic means.
What is trauma as an event? (As defined in lecture)
o Distressing situations - overwhelming, creating sense of powerlessness.
o Often threatens life, safety and sense of security.
o Trauma as a Response
o Symptoms that are considered “normal” reactions to trauma.
o Subjective response to an event
o Common symptoms: Shock, denial, and feelings of overwhelm.
o Sometimes symptoms can be ongoing for a long time.
Know PTSD Criteria A: Event
o DSM Criteria A: Exposure to real or threatened death, serious injury, or sexual violence
o Exposure can be: Directly experiencing it. Witnessing it, in person, occurring to others. Learning that it happened to a close family/friend. Experiencing extreme exposure to details of the events (e.g. police exposed to child abuse)
o Know the PTSD intrusion symptoms
