Exam 3 Flashcards

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1
Q

long-term pattern of INNER experience and OUTWARD behavior

A

Personality

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2
Q

characteristics of personality

A

consistent (traits)

flexible

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3
Q

disorder with a very rigid pattern of experience of behavior

A

personality disorder

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4
Q

characteristics of personality disorder

A

lacking flexible piece

always feel need to act and feel the same way constantly

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5
Q

DSM requirements for diagnosing personality disorder

A

Must cause impairment in social or occupational functioning, or personal distress

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6
Q

what was personality disorder formerly diagnoses in for DSM-IV

A

Axis II (not transient problems)

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7
Q

when do personality disorders typically start?

A

adolescence/early adulthood

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8
Q

Generally, person with personality disorder doesn’t see their personality issues as problematic. What do they tend to do?

A

Tend to externalize the problem

– its not about them but how the world is reacting to them; think their dysfunction is from others treating them poorly

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9
Q

Problems with DSM Categories for personality disorder

A

Criteria cannot always be observed directly
-PD is an inner experience
Diagnosis is based on self-report

Differ more in degree than in type of dysfunction

  • Can have same symptoms of other personality disorder
  • Diagnosis of a certain personality disorder is made by the different levels (mild, severe, etc.) of the symptoms

Criteria change in each DSM up until DSM-V

Often co-morbid with
“Axis I” disorder – depression, bipolar disorder, etc.

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10
Q

Cluster A?

A

Eccentric or odd behavior

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11
Q

cluster A PD has superficial similarity with what psychological disorder?

A

mild schizophrenia

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12
Q

cluster for Paranoid Personality Disorder

A

A

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13
Q

characteristics of Paranoid Personality Disorder

A

Strong suspicion or mistrust of others

Often avoid relationships

Do not see themselves as needing help
-Think its other people who have the problem

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14
Q

cluster A personality disorders more common in males or females?

A

males

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15
Q

cluster for schizoid personality disorder

A

A

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16
Q

what is schizoid PD characterized by

A

Pervasive indifference to others
-Avoid socialization with anybody; don’t value socialization

Lack desire for social relationships
-Indifference towards relationships

Diminished range of emotions and expressions
-Protective factor

Generally don’t seek treatment.
-Externalize dysfunction/stress/problems

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17
Q

cluster for schizotypal PD

A

A

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18
Q

what is schizotypal personality disorder characterized by

A

Odd (but not delusional) ways of thinking and perceiving, and behavioral eccentricities
-Disorganized and eccentric on how they talk about things

Most closely similar to schizophrenia

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19
Q

Most severe cluster A disorder?

A

schizotypal disorder

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20
Q

why do people with schizotypal disorder have a hard time dealing with it?

A

because want/value relationships but when they try to form relationships their behavior pushes others away

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21
Q

“dramatic” PD

A

cluster B

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22
Q

characteristics of cluster B PD

A

Extremely self-absorbed and prone to exaggerate importance of events

Immense difficulty maintaining close relationships

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23
Q

Most commonly diagnoses cluster?

A

B

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24
Q

histrionic PD cluster?

A

B

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25
Q

what is histrionic PD characterized by

A

excessive emotionality and attention-seeking behavior

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26
Q

what does someone with histrionic disorder seek treatment

A

Goal = please or seduce therapist

Seek treatment in order to get attention from the therapist

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27
Q

most common gender for histrionic PD

A

females

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28
Q

Grandiose, need much admiration, and little empathy for others

Convinced of own great success, power, or beauty
-Want people to confirm it

Exaggerate achievements and talents, often appear arrogant

Mostly in males

A

narcissistic PD

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29
Q

Persistently disregard and/or violate others’ rights for own gain

Likely to lie repeatedly, be reckless, and impulsive
-More likely to engage in criminal behavior – don’t see criminal activity as wrong since it might meet their needs

A

antisocial PD

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30
Q

cluster for antisocial PD

A

B

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31
Q

cluster for narcissistic PD

A

B

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32
Q

How old must someone be to be diagnosed with antisocial PD

A

18

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33
Q

pre diagnosis for antisocial PD

A

conduct disorder

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34
Q

Borderline personality disorder cluster?

A

B

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35
Q

characteristics of borderline personality disorder

A

Great instability in life

  • Major and sudden shifts in mood
  • Chronically unstable self-image

Shifts in attitudes towards others

  • Dichotomous thinking – idolize certain people or people they meet for first time, but if you do anything to violate idolization you become a horrible person to them
  • Either love or hate the person, no in between

Impulsivity

  • Do whatever there mood tells them to do
  • Reckless behavior
  • Self injury

Prone to bouts of anger;  can lead to physical aggression or self-harm

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36
Q

What are borderline personality disorder people born with?

A

strong emotional sensitivity

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37
Q

what is borderline PD linked to?

A

parental loss/abuse

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38
Q

who is borderline PD more common in?

A

women

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39
Q

What is the only PD with its own treatment

A

borderline PD

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40
Q

treatment for borderline PD

A

dialectical behavior therapy (DBT)

drug therapy can help with severe mood

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41
Q

what theory is dialectical behavior therapy based on?

A

mindfulness theory (idea of being focused on what is happening in the moment)

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42
Q

what needs to be incorporated when someone with borderline PD experiences an intense mood?

A

reasonable/rational mind

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43
Q

what is included in the DBT states of mind diagram?

A
reasonable mind
wise mind (middle)
emotional mind (borderline personality disorder)
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44
Q

what cluster are the anxious personality disorders

A

C

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45
Q

characteristics of cluster C?

A

anxious
fearful
depressed

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46
Q

cluster of avoidant personality disorder

A

C

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47
Q

PD:

Shy and socially uncomfortable but desire social contact

fear intimacy

Extremely sensitive to negative evaluation

Come to therapy seeking acceptance and affection

A

Avoidant personality disorder

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48
Q

most treatable cluster C personality disorder?

A

avoidant personality disorder

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49
Q

cluster of dependent personality disorder?

A

C

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50
Q

PD:

Pervasive, excessive need to be taken care of

  • Clingy, obedient, fear separation from loved ones
  • Rely on others so much  cannot make smallest decision for themselves

Many feel distressed, lonely, and sad

A

Dependent personality disorder

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51
Q

cluster for obsessive-compulsive PD

A

C

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52
Q

PD:

Enduring pattern of thinking, behavior characterized by perfectionism, inflexibility

Preoccupied with rules, excessively moralistic, judgmental

Unreasonably high standards (for self and others)

A

Obsessive-Compulsive Personality Disorder

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53
Q

Enduring pattern of thinking, behavior of obsessive compulsive PD is characterized by?

A

perfectionism and inflexibility

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54
Q

what gender more commonly has obsessive compulsive PD?

A

males

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55
Q

Eating disorders are on a _____

A

continuum

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56
Q

What refers to a range of unhealthy diet-related behaviors?

A

Eating disturbances and disordered eating

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57
Q

% of 10 year old girls afraid of being fat

A

80

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58
Q

Average onset of eating disorders dropped form 13-17 to what?

A

9-12

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59
Q

% of american college women engaging in disordered eating?

A

50%

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60
Q

how have eating disorders changed in males?

A

doubled in past decade

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61
Q

What has been the shift of focus in body size?

A

Shift in focus from body size to overall body health advocated by many healthy researchers

“healthy ideal” not “thin idea”

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62
Q

Main symptoms of anorexia nervosa?

A

Refusal to maintain 85%+ of normal body weight

Intense fear of becoming overweight

Distorted view of body weight and shape

Amenorrhea – menstruation stops

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63
Q

What are the two types of anorexia nervosa?

A

Restricting Type

Binge-eating/Purging Type

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64
Q

What culture is anorexia nervosa a problem in?

A

Euro-american

65
Q

What is anorexia associated with?

A

Depression, low self-esteem, anxiety

Insomnia/other sleep disturbances

Substance abuse

Obsessive-compulsive patterns and Perfectionism

66
Q

Medical complications of anorexia nervosa?

A

Caused by starvation:

Reduced bone density, dry skin, brittle nails

Low body temperature and blood pressure

Slow heart rate and poor circulation

Metabolic and electrolyte imbalance

Amenorrhea

Extreme cases: death

67
Q

Bulimia Nervosa?

A

Not necessarily under-normal weight – not restricting intake

Regularly engage in discrete periods of overeating

Followed by compensation activities for overeating and to avoid weight gain

68
Q

For someone with bulimia nervosa how often to compensatory behaviors occur?

A

2x per week for 3 months

69
Q

Types of bulimia nervosa?

A

Purging type

Non purging type

70
Q

what is the non purging type of bulimia nervosa?

A

excessive exercise

71
Q

What is bulimia nervosa associated with?

A

Emotional distress,
Personality Disorders,
seasonal-related depression

72
Q

Complications of bulimia?

A

Tooth decay
Gastric, rectal, and esophageal issues
Arrhythmia and cardiac arrest

73
Q

percentage of cases that occur in females for bulimia?

A

90-96%

74
Q

lifetime prevalence of bulimia nervosa?

A

1-2%

75
Q

NOS eating disorder?

A

NOS = not otherwise specified

Extreme disordered behavior but do not fit the criteria for anorexia or bulimia

76
Q

Examples of NOS?

A

AN but with some menstrual cycle or normal weight

Purging with out bingeing or lower frequency of purging

Binge Eating Disorder

77
Q

percentage of people in treatment programs diagnosed with NOS?

A

60%

78
Q

biological dimension of eating disorders?

A

Genetic factors
- hypothalamus development affected

Neurotransmitters
- serotonin production

79
Q

Is the hypothalamus over active or under active in anorexia?

A

under active (opposite for bulimia)

80
Q

How is neurotransmitter affected in people with anorexia?

A

serotonin excessively produced (opposite for bulimia)

81
Q

Psychological dimension of eating disorders?

A

Body dissatification/distortion

perfectionism

low self esteem

lack of control

82
Q

Social dimension of eating disorders

A

parental attitudes and behaviors

history of being teased about body

peer pressure with weight/eating

83
Q

Social cultural dimension of eating disorders

A

social comparison

media presenting distorted images

cultural definitions of beauty

84
Q

What kind of approach is necessary in treating anorexia?

A

team approach

85
Q

What kind of treatment is preferred in anorexia?

A

residential treatment

86
Q

Medication effective in anorexia treatment?

A

no, poor support

87
Q

Goals for anorexia treatment?

A

Restore healthy weight and treat physical complications

Enhance motivation for change through psychoeducation of nutrition

Psychotherapy for emotional disturbances with food

Family therapy

Relapse prevention

88
Q

what eating disorder is more likely to seek treatment?

A

bulimia

89
Q

Treatment for bulimia?

A

Anti-depressants

Often have problems like depression
Work on seratonin aspect – reduce pleasure response associated with food

Therapy: CBT or E/RP (65% stop binge-purge cycle)

(Eat –> not binge–>  eventually stop binge-purge behavior

90
Q

What kind of approach is most effective in bulimia treatment?

A

combined approach of anti depressant and cognitive/behavioral therapy

91
Q

Condition where someone is experiencing symptoms but is coming from a psychological condition not physiological

A

Somatoform disorder

92
Q

What often triggers a somatoform disorder?

A

traumatic event

93
Q

what are some somatoform disorders?

A

conversion disorder

hypochondriasis - (DSM-5 = anxiety disorder)

body dysmorphic disorder - (DSM-5 = OCD disorder)

pain disorder

somatization disorder

94
Q

What are some somatoform-like disorders?

A

malingering

factitious disorder

factitious disorder by proxy

95
Q

they physical symptoms of conversion disorder suggests what?

A

a neurological problem

96
Q

what triggers conversion disorder

A

severe stress

97
Q

common symptom of conversion disorder?

A

loss of limb movement

98
Q

1/3 of cases of people with conversion disorder don’t seem to care that they are experiencing the symptoms associated with the disorder.

What is this called?

A

La belle indifference

99
Q

who was conversion disorder common in

What symptoms did they experience

A

soldiers from World War I

loss eye sight

-had benefit of being discharged (secondary gain)

100
Q

Someone who has somatoform disorder may feel pain –> they get attention, etc –> this results in what for the person?

A

secondary gains

101
Q

What is PNES?

A

psychogenic non-epileptic seizures

type of conversion disorder

seizure like symptoms

102
Q

What makes the seizures in PNES different from epilepsy?

A

No abnormal brain activity while having PNES seizure
-No misfiring of electrical signals in brain

Presence of tears during seizures

Attacks occur when others are present, but not while sleeping or alone

103
Q

illness anxiety disorder (somatoform)

A

hypochondriasis

104
Q

somatoform disorder (changed to anxiety disorder in DSM-5) where person is preoccupied that normal sensations are symptoms of a serious disease

A

hypochondriasis

  • frequent visits to physicians
105
Q

excessive concern with real or imagine defects in appearance

frequent visits to plastic surgeon

A

body dysmorphic disorder

106
Q

What is the placement of body dysmorphic disorder (somatic) in DSM-5?

A

OCD

107
Q

bigorexia is known as

A

muscle dysmorphia

108
Q

physical pain caused by a psychological reaction (not physiological)

A

psychogenic pain

109
Q

what causes an increase in pain or those with pain disorder

A

psychosocial facts

incredible increase in pain under stress

110
Q

How might pain disorder be maintained?

A

by primary and secondary gains

111
Q

Primary gains for pain disorder?

A

Developed from a primary interaction to an internal experience they don’t want to experience (trauma, depression, etc.)

Pain is a distraction from the internal experience

112
Q

secondary gains for pain disorder?

A

Attention from environment, get out of doing things like having a responsibility due to pain

113
Q

what symptom must somatization disorder include?

A

Must include 4 recurrent, different pains/somatic complaints before age 30

  • 2 gastrointestinal (GI) symptoms
  • 1 sexual symptom
  • 1 pseudoneurological (PN) symptom
  • Brain problem (injury or misfiring)
114
Q

what do symptoms tend to be reported as with someone who has somatization disorder?

A

vague, unfounded or exaggerated

115
Q

somatoform-like disorder where someone fakes symptoms to gain medical attention

more obsessive/anxiety like

A

factitious disorder

116
Q

why is malingering (somatoform-like disorder) not a DSM disorder?

A

Behavior is motivated by external incentives only

117
Q

Injury deliberately and gradually inflicted upon another

Considered a form of abuse

Person is requiring someone else to take care of them

Person in the care is being injured or caused to be sick by their care taker

Care taker wants attention/reinforcement

A

Factiticious disorder by proxy

118
Q

who is the dependent and who is the proxy in factiticious disorder by proxy?

A

Care taker = proxy

Person in the care = dependant

119
Q

Example of a culture-bound somatoform disorder symptoms

A

Dhat

Fear loss of seminal fluid during:
Nocturnal emissions
Urination

Reflects Indian belief that loss of semen is a loss of physical/mental energy

120
Q

Sociocultural dimension of somatoform disorder?

A

cultural differences in rates and symptoms

differences in acceptance of medical vs. psych problems
-Higher incidences of somatoform in cultures that focus more on medical conditions vs psychological

121
Q

Social dimension of somatoform disorder?

A

Parental/peer modeling

122
Q

Biological dimension of somatoform disorder

A

Innate sensitivity to physiological reactions

History of illness or injury

123
Q

Psychological dimension of somatoform disorder?

A

psychodynamic

cognitive-behavioral

124
Q

Biological treatment for somatoform?

A

Medication

  • Show person that pain is not physiological in nature but psychologically caused
  • Or actually treat pain with medication if it helps
125
Q

behavioral treatment for somatoform disorder?

A

Address “sick role”/avoidance reinforcers

Issues with trauma –> trauma manifestation –> treat trauma

126
Q

cognitive treatment for somatoform disorder

A

Correct “cognitive distortion” or magnification of physical symptoms

Have to work with beliefs and motivation to change

127
Q

DSM symptoms for autism?

A

Impaired Social Interactions
E.g. poor nonverbal activity

Impaired Communication
-Delay in spoken language development

Restricted, Repetitive, & Stereotyped Behavior Patterns
-Stereotyped movements:
Repetitive, destructive behaviors (e.g. hand flapping)

Shows some signs “in early childhood” (before age 3)

Symptoms limit and impair daily functioning

128
Q

what is asperger’s

A

form of autism, but doesn’t display all the symptoms

trouble with social interactions

don’t have delay in language, deviance in behavior, or repetitiveness

129
Q

percentage of people with autism who remain severely disabled as adults and unable to lead independent lives

A

90%

130
Q

percentage of people with autism who has severe IDD

A

70%

131
Q

what is the IQ like for people with aspergers?

A

average or above

132
Q

how much more prevalent is autism in boys than girls?

A

4X

133
Q

why is autism more common in boys

A

genetic condition on Y chromosome

134
Q

racial, ethnic, social differences in people with autism?

A

no differences

135
Q

prevalence of people within autism spectrum?

A

1 in 68

rate has tripled in last 10 years

136
Q

Biological etiology of autism?

A

genetic factor

brain structure deficits

  • hippocampus under developed (memory center)
  • issues with cerebellum (balance)
  • amygdala over firing (emotional expression)

IDD also affect (intellectual developmental disability)

137
Q

Treatment for autism?

A

Early intervention

  • test genetic factors
  • social interaction test
  • behavior treatment
138
Q

Types of treatment for autism?

A

Behavioral therapy, communication training, stress management, parent training

  • Disorder prevents them to learn these things naturally
  • Comprehensive and intensive training
139
Q

DSM criteria for AD/HD

A

6 symptoms of :

  • Inattention AND/OR
  • Hyperactivity & Impulsivity
  • In order to be diagnosed need to have 6 symptoms
  • If have both symptoms (6 of each) = mixed type

AND
-Onset before age 12
-Impairment in at least 2 settings
-Impairment in social, academic or occupational function
-No other pervasive disorder
(AD/HD can look like anxiety; if someone has anxiety and displaying AD/HD symptoms, they do not have AD/HD)

140
Q

how does the prevalence of ADHD differ from younger people to older people

A

A lot less people age 40 (1:2000) have ADHD compared to school age children (1:25)

141
Q

pitfalls to the diagnosis of ADHD

A

DSM criteria also describes normal kids

no physical or lab markers

significant overlap with other disorders (anxiety)

Public awareness and misinformation (parents and confirmation bias)

142
Q

Keys to accurate diagnosis of ADHD

A

get a lot of history

standardized checklists/questionnaires

computer based testing

behaviorally observe interactions with others

look for slower developmental milestones (not all cases)

143
Q

what is the social aspect of ADHD

A

parenting skills/environment is never the cause but it can influence it

144
Q

genetic aspect of ADHD?

A

Overly active CNS
Agitated
Attention and memory centers under active

145
Q

Medication used for ADHD

A

stimulants

146
Q

what do stimulants do for ADHD

A

target CNS and activate it
- do so body sees as abnormal and responds by cutting production of processes activating CNS

activate attention and memory parts of brain
- originally under active

147
Q

therapy for ADHD?

A

behavior modification

need structured schedule and environments

148
Q

short term adverse effects of stimulants?

A

sleep disturbance
appetite suppression
tic

149
Q

problems of stimulants

A

misinformation

controlled substance

adverse effects

overprescribed

150
Q

what was the long term effect of stimulants on rats?

A

consequence in nuclear accumbent (translates motivation into action)

rats lacked drive as adults

growth/maturation affected

parts of brain dealing with attention, memory, energy, focus damaged

151
Q

diagnosis for conduct disorder

A

violation of age appropriate basic rights/societal norms, with presence of at least 3 of the following:

  1. aggression towards people/animals
  2. destruction of property
  3. deceitfulness or theft
  4. serious violation of rules
152
Q

percentage of kids who grow out of conduct disorder

A

70%

153
Q

excessive and inappropriate anxiety around separation from caregiver

A

separation anxiety disorder

154
Q

% of kids whose symptoms go away at adolescence for separation anxiety disorder

A

80-90%

155
Q

intellectual developmental disorder? (IDD)

A

deficits in intellectual functions, adaptive functioning, and onset during developmental period (not indicative of autism or other pervasive disorder)

156
Q

IQ of mild IDD

A

50-70

2 SD away

157
Q

IQ of moderate IDD

A

35-50

3 SD away

158
Q

IQ of severe IDD

A

20-35

4 or more SD away

159
Q

what areas of brain are affected for IDD

A

verbal and spatial