Exam 3 Flashcards
pervasive pattern of criminal, impulsive callous, or ruthless behavior; disregard for rights of others; no respect for social norms. Fred- the bowler with the parrot.
Antisocial PD
rapidly shifting and unstable mood, self-concept, and interpersonal relationships; impulsive. Example: girl who dated rocker guy and wore all rocker clothes, dated a country guy and wore all country clothes, etc.
Borderline PD
Grandiose thoughts and feelings of one’s own worth; obliviousness to others’ needs. Sense of entitlement.
Narcissistic PD
Rapidly shifting moods, unstable relationships, and intense need for attention and approval; dramatic, seductive, behavior. More stable sense of self. Shallow emotions.
Histrionic PD
Anxious, fearful - cluster
Cluster C
pervasive anxiety, a sense of inadequacy, and a fear of being criticized, which leads to the avoidance of social interactions and nervousness.
Avoidant PD
pervasive selflessness, need to be cared for, fear of rejection, leading to total dependence on and submission to others. Example: guy would beat women, and she eventually left him and paid for divorce lawyers and gave him the house.
Dependent PD
chronic pattern of inhibited or inappropriate emotion and social behavior, aberrant cognitions, disorganized speech. They want to connect with people but they’re just awkward. Don’t understand social norms.
Schizotypal PD
Dramatic, erratic
Cluster B
chronic lack of interest in and avoidance of interpersonal relationships; emotional coldness toward others.
Schizoid PD
chronic, pervasive mistrust and suspicion of other people that is unwarranted and maladaptive.
Paranoid PD
Odd, eccentric
Cluster A
complex pattern of behaviors, thoughts, and feeling; stable across time and across many situations.
personality
rigid way of living lives, pervasive rigidity in one’s activities and interpersonal relationships, including emotional construction, extreme perfectionism, and anxiety about even minor disruptions in one’s routine.
Obsessive- Compulsive PD
Most common PD?
antisocial PD and borderline PD
FUMES?
F: fearless U: unresponsive to pain M: muscular/mesomorphic E: empathy deficient S: Stimulation seeking
What is a substance (as it pertains to ‘substance use disorder’)?
A substance is any natural or synthesized product that has psychoactive effects- it changes thoughts, perceptions, emotions, and behaviors.
What is meant by substance
intoxication?
Substance intoxication: behavioral and psychological changes that occur as a result of the physiological effects of a substance on the central nervous system. Must be maladaptive or significantly distressing.
What constitutes binge drinking?
five or more drinks with a couple hours for men, four or more drinks in a couple hours for women.
What are delirium tremens (DTs)?
Withdrawal from alcohol. Auditory, visual, or tactile hallucinations occur during withdrawal. Agitation, less sleep, bizarre terrifying delusions, fever, irregular heartbeat. 10% result in death.
11% of people with severe alcohol abuse experience seizures or DTs.
Which group of substances has the most lethal withdrawal symptoms (discussed in class and [MW])?
Any type of depressant: alcohol, meth, heroin, inhalants, etc.
What are synergy?
compounded effect from using a drug combination. Example: lethal potential when small amounts of alcohol and barbiturates are taken together. being cross-faded. combining substances to get a stronger effect.
What are the different DEA classes?
I: high abuse potential, no accepted medical use. (LSD, heroin)
II: high abuse potential with severe physical and psychological dependence (amphetamines, codeine, opium, morphine)
III: medium abuse potential with low to moderate physical dependence and high psychological dependence (compounds containing codeine, narcotic analgesics, steroids)
IV: low abuse potential with limited physical and psychological dependence (Benzos, non-narcotic pain meds)
V: lowest abuse potential (preparations w/ low narcotic levels)
Which substances have the highest (highest abuse
potential) DEA class [MW]?
Schedule 1 and 2.
Know the case of Betty Ford from [MW], along with the different treatment techniques described, and aspects of good alcoholism-prevention programs.
Addicted to prescription drugs and alcohol. Opened a clinic to help people with similar addictions. She developed tolerance and addiction due to prescription to pain meds.
What are the different clusters of personality disorders and which Personality Disorders fit in which clusters
Cluster A: Odd-eccentric (paranoid, schizoid, schizotypal)
Cluster B: Dramatic, emotional, erratic (histrionic, narcissistic, antisocial, borderline)
Cluster C: Anxious, fearful (avoidant, dependent, obsessive-compulsive, passive-aggressive)
What are the five dimensions of the Five Factor Model of Personality (AKA: “The Big Five”)?
Negative emotionality vs emotional stability, extraversion vs. introversion, openness vs. closedness to one’s own experience, agreeableness vs. antagonism, conscientiousness vs. undependability
OCEAN: openness, conscientiousness, extroversion, agreeableness, neuroticism
What is psychopathy? How is it different from Antisocial Personality Disorder?
Psychopath: superficial charm, grandiose sense of self-worth, need for stimulation, pathological lying, cunning, manipulativeness, lack of remorse. They hide their true colors/personality.
ASPD: recognized in the DSM-5. criminal. poor impulse control, no concern for consequences. They don’t care for how people think of them.
What percent of people with ASPD abuse alcohol and other substances?
80%
What are the concordance rates of ASPD is monozygotic twins and dizygotic twins?
50% in monozygotic, and 20% or lower in dizygotic
What are some of the different problems with the current DSM (categorical) conceptualization of personality disorders?
Psychopathy and sociopathy is not defined. The 10 separate PD have a lot of overlap in diagnostic criteria. Least research, subjective, and hard to diagnose.
What is the alternative DSM-5 model of personality disorders
(discussed in [N])? In what way is it considered a hybrid model?
- LEVEL OF FUNCTIONING. Characterizes personality disorders in terms of impairments. In personality and functioning and pathological traits.
The first step is diagnosing individuals level of functioning on a scale. 0-4 scale. - healthy adaptive functioning
- required for diagnosis of PD.
- extreme impairment.
- determining if the individual has any pathological personality traits: neuroticism, detachment.
- Determining meets criteria for any of the six disorders.
Know the cases of Hilde and Theodore Kaczynski from [MW]
Hilde: histrionic.
Ted Kaczynski: Schizoid.
According to [MW], what are the two main factors of psychopathy?
- effective cognitive instability
2. behavioral social deviance
Understand the various factors that contribute to the development of psychopathy, as described
in [MW]
Pg. 201-203 in MW. Biological disruption, inconsistent parenting, family history, low SES, characteristics of a FUME child.
What are positive and negative symptoms of schizophrenia?
Positive (added): delusions, hallucinations, disorganized thoughts and speech, disorganized or cataonic behavior
(all start with an A) Negative (subtracted): affectiive flattening, avolition, alogia
Be able to identify the different types of delusios
Delusions: (beliefs that are not rooted in reality)
- Persecutory (belief that someone is out to get somebody/you)
- Grandiose (beliefs that I am bigger better faster, etc than I actually am)
- Reference (special messages from the tv, radio, etc)
- Thought insertion (somebody is putting thoughts in my head and I can put them in your head too)
- Thought withdrawal (somebody can pull thoughts out of my head, cant remember that thing)
- Thought broadcasting (there is speakers on my head and its broadcasting out what I am thinking)
- Somatic delusion (false belief that something is going on in your body)
What are prodromal and residual symptoms of Schizophrenia?
Prodromal: mild symptoms prior to psychotic phase
What is the prognosis for people with Schizophrenia in the U.S.?
1-2% will be diagnosed. 50-80% of people will be rehospitalized. 10 year less life expectancy. 10-15% suicide rate. Women have better prognosis then men, because we develop later in life.
Why do people with Schizophrenia in developing countries tend to have a better prognosis?
Tend to have better prognosis because of stronger sense of community.
What is tardive dyskinesia? Akinesia? Akathesis?
Tardive Dy: or jaw. People with the disorder may involuntarily smack their lips, make sucking sounds, stick out their tongue, puff their cheeks, or make other bizarre movements over and over again.
Akinesia: slow motored activity, monotonous speech, and an expressionless face.
Akathesis: agitation that causes people to pace and be unable to sit still. Occasional effect of anti psychotic drugs.
What is expressed emotion?
Families high in expressed emotion are over-involved with one another, overprotective of the family member with schizophrenia, and voice self-sacrificing attitudes toward the family member while at the same time being critical, hostile, and resentful toward him or her.
How is expressed emotion related to relapse in people with Schizophrenia?
Related to relapse: family member will overwhelm ability to cope.
Example: guy w/ schizophrenia who did family session therapy and wound back up in hospital
What are phenothiazines or neuroleptics?
Phenothiazine and neuroleptics block the reuptake of dopamine, reducing the functional level in the brain.
What is the mesolimbic pathway and how is it
related to schizophrenia?
Mesolimbic pathway is a subcortical part of the brain involved in the processing of salience and reward. It is related to schizophrenia because there may be an excess of dopamine activity in this pathway which may lead to hallucinations and delusions to deficits in motivation. Might explain cognitive negative and positive symptoms of schizophrenia.
Understand the four models used by traditional healers use (e.g., structural model, social
support model, persuasive model and clinical model)
- Structural: Reintegrating these levels through a change of diet or environment, the prescription of herbal medicine or rituals.
- Social support model: Symptoms arise from conflictual social relationships
Healing involves mobilizing a patient’s kin to suppot him or her through the crisis and reintegrating the patient into a positive social support network - Persuasive model: Conflict resolution model: Suggests that rituals can transform the meaning of symptoms for patients, diminishing their pain
- Clinical model: Faith the patient has in the traditional healer to provide a cure for the symptoms if sufficient
Which medications primarily treat the positive symptoms of Schizophrenia?
Phenothiazines: Chlorpromazine (thorazine), trifluoperazine, thioridazine, fluphenazine, perphenazine. Calm agitation and reduce hallucinations and delusions
traditional.
Which medications treat both the positive and negative symptoms of Schizophrenia?
atypical treats both symptoms.
What are the different subgroups of Delusional Disorder?
Erotomanic type: the central theme of the delusion is that another person is in love with the individual
Grandoise type: The central theme of the delusion if the conviction of having some great talent or insight or having made an important discovery
Jealous Type: Delusion is that one’s spouse of lover is unfaithful
Persecutory type: Delusion is the belief that one is being conspired against, cheated spied on, poisoned or drugged, maliciously maligned, harassed, or obstructed in the pursuit of long-term goals
Somatic Type: Delusion involves bodily functions or sensations
Mixed type: No one delusional theme predominates
Unspecified type: The dominant delusional belief cannot be clearly determined or is not described in specific types
What is the prodromal pruning theory? Pg. 85
possible cause for the development of Schizophrenia. It is based on the well-known observation that as humans move from adolescence to adulthood, they go through a process where the brain initiates an intense form of biological “spring cleaning.”
According to [MW], what are some premorbid factors that are associated with the later
development of schizophrenia?
A history of prenatal disruption, birth problems or infections
Slowed reaction times in perception
Early signs of development and/or central nervous system dysfunction
Low birth weight
Rejection by peers
According to [MW], what factors indicate a more positive prognosis for people with Schizophrenia?
Sexual marital status: married, stable sexual-social adjustment
The degree to which negative symptoms are absent
A family history of affective rather than schizophrenic disorder
Presence of an affective response in the acute stage of the disorder
onset later than childhood
higher socioeconomic status
short length of stay in hospital
premorbid competence in interpersonal relationships
Know the cases of Sally, Daniel Paul Schreber and John Nash, Jr. from [MW]
Sally: Schizophrenia. Had waxy flexibility.
Daniel Paul Schreber: Paranoid Schizophrenia. Evaluated by freud.
John Nash: schizophrenia. a beautiful mind.
Flat or blunted affect?
Affective Flattening/Restriction (or blunted affect)
- severe reduction or complete absence of affect - can experience anhedonia (loss of ability to experience pleasure)
Loosening of
associations/Derailment?
person is talking about topic one and move to topic 3,4,5,6 fast but with topic connection
Tangential thinking?
jump from topic to topic without any connection to the topics
Word salad?
take real words but you throw them together in an order that does not make sense
Neologisms?
Person starts making up words
Catatonia?
state of immobility for hours
Waxy
Flexibility?
decreased response to stimuli, and tendency to remain in posture for hours.
Alogia?
Poverty of speech, severe reduction or complete absence of speech
Avolition?
Inability to persist at common, goal-oriented tasks at work, school or home- example: picking up of cigarettes example in the psych ward.
Anhedonia?
Loss of ability to experience pleasure
negative symptoms-
affect flattening, alogia, avolition
Withdrawal:
Set of physiological and behavioral symptoms that result when people who have been using substances heavily for prolonged periods of time stop or greatly reduce their use. Requires significant distress or impairment in a person’s every day functioning.
Substance abuse:
When a person’s recurrent use of substance results in significant harmful consequences of four categories:
1. fail to fulfill important obligations at work, school, or home.
2. Must repeatedly use the substance in situations in which it is physically hazardous to do so.
3. Individual must have repeated legal problems as a result of substance use.
4. Individual continues to use despite repeated social or legal problems bc of use.
DSM-5 says they must show one of these problems for more than a year/12-month period.
Tolerance:
experiencing diminished effects from the same dose of a substance and need more and more of it to achieve intoxication.
Substance dependence:
closest to what people call “drug addiction”.
Physical symptom: Characterized by physical symptoms of withdrawal when
the substance is discontinued
Psychological: Characterized by psychological withdrawal symptoms
example: Cravings, irritability, insomnia, depression, etc.
Substance use disorder:
difficult to distinguish between dependent and abuse.
DSM-5 criteria:
impaired control (impaired centre control), the continued use of substances despite negative social, occupational, and health consequences (social impairment) , (risky use), as well as evidence of tolerance or withdrawal (pharmacological criteria). To be diagnosed: most show two or more symptoms for more than a year.
physiological dependence:
what happens when a user becomes physiologically dependent on a substance so that they do no withdraw. example: heroin, nicotine, caffeine.
habituation:
dependence on a drug bc of strong desire to replicate the physiological state produced by drug. Example: oral needs and relief of depression.
substance use disorder:
A problematic pattern of substance use leading to clinically significant impairment or distress, as manifested by > 2 of the following, occurring within a 12-month period:
DSM-5 criteria for substance use disorder:
impaired control, social impairment, risky use, pharmacological criteria
Treatment for alcohol addiction:
Detoxification: period of detox
Medication: naltrexone, reduces need of alcohol. buspirone, non benzo anti anxiety drug- controls cravings. also SSRI’s for depression.
Family therapy:
Aversion Therapy: help control specific probs unique to client
Relapse prevention coping skills: CBT approach to maintain sobriety
Psychotherapy: learning to cope with negative effects
Self-help group: AA
Antabuse: its a drug that causes severe nausea if alcohol is consumed.
alcoholism-prevention programs:
harm reduction model: if you use it, do it safely
Keepin it REAL: refuse, explain, avoid, leave
Modeling: modeling good alcohol behavior to kids
hallucinations
Hallucinations (unreal perceptual experiences)
tactile (feeling),
somatic (feeling things inside of them)
olfactory (smelling things) (not based in reality)
Most common hallucinations:
auditory and visual
Pleasure pathway:
Ventral Tegmental Area > Nucleus Accumbens > Frontal Cortex
Dopamine is a major neurotransmitter
Drugs flood the circuit with Dopamine > Euphoric effects
Brain is wired to repeat behaviors that cause pleasure/reward
Louis Wain had what disorder and painted what?
Schizophrenia. Cats.
Schizophrenia is NOT what?
Split personality
A severe form of psychosis—the inability to
tell the difference between the real and the
unreal
schizophrenia
How much of national health budget is spent on schizophrenia?
Up to 3% of national health budgets
0.5–2% of the general population affected
beliefs that are not rooted in reality:
delusions
unreal perceptual experiences
hallucinations
Poverty of speech:
alogia
DSM-5 Criteria for Schizophrenia:
A. Two or more of the following present significantly during
a 1-month (acute) period
1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms—affective flattening, alogia, or
avolition
B. Social/occupational functioning: significant impairment in work, academic performance, interpersonal
relationships, and/or self-care
C. Duration: continuous signs of disturbance for at least 6
months including 1 month with symptoms that meet
Criterion A
impaired control:
- Amount taken is often larger or over longer periods than intended
- Craving, or a strong desire or urge to use substance.
- Persistent desire for drug or unsuccessful efforts to cut down or control
use - Lots of time is spent in activities necessary to obtain, use, or recover
from a substance’s effects.
social impairment:
- Recurrent substance use results in a failure to fulfill major role obligations at work, school, or home
- Continued substance use despite having social or interpersonal problems caused (or exacerbated by) the effects of substance.
- Important social, occupational, or recreational activities are given up or reduced because of substance use.
risky use:
- Recurrent substance use in situations in which it is physically hazardous.
- Substance use is continued despite knowledge of a physical or psychological problem that is likely to have been caused or exacerbated by substance.
Pharmacological criteria:
- Tolerance (either need more to obtain the desired effect or
decreased effect when using the same amount)
11.Withdrawal or use to avoid withdrawal
Substance use disorder and the DSM-5:
impaired control, social impairment, risky use, pharmacological criteria
Rip my heart out, I’m going to get you back. You either love me or you hate me.
Borderline
Mike who slit his wrists and about friend in college.
Borderline
If you wrong me, I’ll take you down with me.
Histrionic
Pervasive rigidity in one’s activities &
interpersonal relationships, including
emotional construction, extreme
perfectionism, and anxiety about even
minor disruptions in one’s routine. OCD x a million.
Obsessive compulsive PD
substance intoxication is influenced by:
¤ Substance type ¤ How much is taken and when ¤ Tolerance ¤ Context ¤ Expectations
