Exam 3 - Additional Reading Review Questions Flashcards

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1
Q

RITALIN GONE WRONG

A
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2
Q

What concerns does the author have about use of stimulant drugs in children? Do these drugs work?

A
  • The author discusses how attention-deficit drugs only increases concentration in the short term (helps you focus in class) , but do not have the same benefits long-term. In children, these drugs don’t improve school performance or behavioral issues in the long-term because you build tolerance and your brain adapts to it.
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3
Q

What is the diabetes metaphor for ADHD? Is there evidence to support it?

A
  • The diabetes metaphor for ADHD is that ADHD is a brain problem of genetic origin and can be treated with a simple solution. For example, insulin is used to treat Type 1 diabetes and attention-deficit drugs can be used to treat ADHD.
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4
Q

Is there evidence for a paradoxical effect of stimulant drugs? Explain.

A

No there is no evidence! While some researchers tried to argue that the brains of children with attention problems differ, it was revealed that ALL children respond to stimulant drugs in the same way. For all children, stimulants enhance the ability to concentrate on boring things, but DO NOT improve broader learning abilities in the long-term.

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5
Q

How do the long-term effects of these medications differ from the short-term effects?

A
  • While attention-deficit meditation can have some short-term effects on academic performance and concentration, there is NO EVIDENCE of any long-term benefit of attention-deficit medication on academic performance, peer relationships or behavior problems.
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6
Q

What types of factors are proposed by the author as contributing to attention difficulties in children?

A

The author says poverty can make a child more vulnerable to behavior problems. Also, family stresses like domestic violence, lack of social support from friends or relatives, chaotic living situations, etc.

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7
Q

A NATION OF KIDS ON SPEED

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8
Q

Explain the author’s general concerns and the evidence he presents for these concerns.

A
  • The author’s concern is that we are overprescribing kids with stimulants. And this can lead to widespread dependence and addiction.
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9
Q

According to this reading, is there evidence that stimulant use in children with ADHD reduces the risk of
later substance abuse? Explain.

A

No there is no evidence that stimulants have a protective effect on future substance abuse. In fact, ADHD itself predisposes children to later substance abuse.

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10
Q

PSYCHIATRISTS REACH OUT TO TEENS OF COLOR

A
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11
Q

Describe the general pattern of racial biases in diagnosis presented in this article.

A

This article presents several racial biases in diagnosis.
- The general pattern was that Black and other children of color were more likely to receive a harsher diagnosis than their white counterparts. For example, black and other children of color are more likely to be diagnosed with a disruptive behavioral disorder, while white patients are frequently diagnosed with internalized disorders (anxiety or depression) even when presenting similar symptoms.

  • These discrepancies can be caused by the fact that black patients are more likely to have faced trauma that lead to their “aggressive behavior”. Also, some behaviors in the black community that may be seen as acceptable, a clinician can find threatening. Lastly, it might not be a part of a black person’s culture to express sadness.
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12
Q

Why are these types of
misdiagnoses concerning in terms of outcomes for children?

A
  • These misdiagnoses are concerning because it can lead to wrong care, improper medication, school detention or misperception by a justice system that is inclined to view adolescents labeled hostile as inherently threatening.
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13
Q

A THEORY THAT RAISES QUESTIONS

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14
Q

What’s the main point of this article? In other words, what do the flu and flu vaccines have to do with
schizophrenia?

A

In this article, it discusses the link between maternal infections (ex: the flu) and an increased risk of schizophrenia. Therefore, it is suggested for pregnant women to get the flu shot to protect them from getting the flu.

INTERESTING NOTE: Is that the flu vaccine can also set off an immune response, but its not to the same degree as getting the flu. Not a perfect solution!

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15
Q

How might maternal flu lead to schizophrenia in offspring? In other words, what is the proposed
mechanism here?

A

Maternal flu might lead to schizophrenia in offspring because the flu (especially if the mother gets it during her first or second trimester) results in an immune reaction and higher levels of influenza antibodies, which have been found to make developing schizophrenia more likely.

  • Also, the flu and other infections activate an immune system protein (interleukin 6) which puts the offspring at an increased risk of schizophrenia.
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16
Q

What types of methodologies have linked maternal flu to schizophrenia in offspring?

A

1) One study where blood samples of mothers were studied showed that the mothers with the higher levels of influenza antibodies in their first or second trimester were more likely to have children who develop schizophrenia.

2) Researchers also found that an immune system protein (interleukin-6) was activated when mothers had the flu, which increased risk of schizophrenia in their children.

3) Pregnant rodents given flu infections seem more likely to have offspring with signs of schizophrenia, then when the effect of these flu antibodies were blocked.

17
Q

How could these findings offer an alternative explanation (i.e., non-genetic) for the concordance rates for
schizophrenia found in monozygotic vs. dizygotic twins?

A

While it is widely believed that the higher concordance rates for monozygotic twins vs. dizygotic twins is because of genetics. It can also be argued that monozygotic twins have a higher concordance rate bc they are more likely to share maternal cytokines bc most monozygotic twins share the same placenta compared to dizygotic twins (none of them share the same placenta).

18
Q

NEW WAY TO TREAT PEOPLE AFTER FIRST SCHIZOPHRENIA EPISODE

A
19
Q

What are the components of this “new” type of treatment?

A

This “new” type of treatment is called coordinated speciality care.
- This approach includes psychotherapy, medication, supported employment and education, help for families of the mentally ill person, and case management.
-> This approach is more expensive and labor-intensive but it has great results (patients have a greater quality of life and decrease in their symptoms)

20
Q

DOCTORS GAVE HER ANTIPSYCHOTICS

A
21
Q

This article describes how antipsychotics (both first and second generation) have been a disappointment to practitioners and patients. Why? What are their downfalls?

A
  • Both first and second generation antipsychotics have TERRIBLE side effects. They can cause a lot of weight gain, tiredness, and involuntary movements (tardive dyskinesia). And to make matters worse, these medications don’t seem to be very beneficial (so ppl are just having these severe side effects for no reason!)
  • Also, the treatments we have now are not much different from the first psychotic drug. Therefore, our treatments are not evolving with the time.
  • Also, these current methods have a singular focus on reducing symptoms and just checking things off a list, not necessarily treating patients a s human beings.
22
Q

NINE-YEAR OLD PSYCHOPATH

A
23
Q

What are some risks associated with labeling a young child as a psychopath?

A
  • When you are a young child, your brain is still developing and normal behavior at those ages can be misinterpreted as psychopathic.
  • There is a big social cost of branding a child as a psychopath. This label will follow them forever and they (and their family) will be treated differently. No one sympathizes with a psychopath.
24
Q

How do these callous-unemotional children seem different from those with ADHD or CD?

A
  • Callous-unemotional children differ from those CD bc they have a cold-predatory conduct (in addition to the violent/impulsive behaviors)
  • They also differ from children with ADHD because they are not sensitive to punishment (they don’t feel bad when they do something wrong or hurt someone)
25
Q

Describe the findings regarding cold-blooded behaviors and the brain.

A
  • Recent studies have shown significant anatomical differences in the brains of adolescent children who appear to be a psychopath.
  • So researchers believe that attacking the problem as early as possible can help callous-unemotional children bc their capacity for empathy might weakly exist
26
Q

Why might treating these children with Ritalin be dangerous?

A
  • Treating callous-unemotional children with Ritalin can be dangerous bc ritalin (typically used for ADHD) can suppress their impulsive behavior and might enable them to plan crueler acts of violence and manipulation (since they can concentrate better)
27
Q

WHEN IS YOUR CHILD A PSYCHOPATH

A
28
Q

What two possible “neural abnormalities” associated with psychopathy are described in this article?

A

1) Psychopaths tend to struggle with processing/feeling emotions because they have smaller or underactive amygdalas.

2) Also, hey have overactive reward systems (they are more sensitive to anything that delivers excitement).

29
Q

Describe the treatment approach at Mendota.

A
  • Decompression is a main facet at Mendota. This is the idea that the young boys who have been living in a state of chaos will learn how to not resort to violence (after awhile they will get tired).
  • Also, they use a reward system! At Mendota, they can earn points to join “clubs” where they have privileges such as candy, baseball cards, pizza, or a chance to play their Xbox.
30
Q

RACE AND HEALING

A
31
Q

Based on this reading, what advice would you give to mental health practitioners (especially White mental
health practitioners) about approaching topics related to racism with their client?

A
  • I would advise White mental health practitioners to not avoid talking about race with their clients just bc it feels uncomfortable.
  • Why you shouldn’t just come out and say “So how’s your racial trauma?”, you should facilitate a no-judgment free and trustworthy zone between you and your client, to allow the conversation to come up naturally.
  • Also, educate yourself so when this topic is brought up, you can talk about it in a productive manner. Don’t say things like, “I don’t see color”. While you might mean well this can invalidate your patient’s feelings.
32
Q

OVERSELLING OF THERAPY

A
33
Q

One of Jacobson’s arguments is that therapists should be more like physicians in terms of how they present treatment options. Explain this

A

Jacobson argues that therapists present patients with all available treatment options and also outline their costs and benefits!

34
Q

Explain the difference between clinical and statistical significance. Why is this difference relevant to
research evaluating whether psychotherapy is effective?

A

Clinical Significance: the extent to which clients feel that therapy has helped whatever they initially came in for (ex: you came in with depression but now you fall within a normal range on measures of depression.)

Statistical Significance: it tells you that the treatment was significant but it does not tell you how different. How did it actually impact the patient?

  • Knowing the difference is important when evaluating psychotherapy bc there are findings that show psychotherapy to be statistically significant but in reality sometimes the clinical significance is very small so the treatment barely helped the patient.
35
Q

Does experience/training have an impact on the effectiveness of therapists? Explain.

A

No experience/training DOES NOT impact the effectiveness of therapists!

  • This is because a lot of experienced therapists are no longer reading scientific literature, in order to strengthen their skills as therapists!