Final Flashcards
4Ds
Deviance
Distress
Dysfunctional
Dangerous
What are the major components of the MSE
Appearance Motor Speech Affect Thought content Thought process Perception Intellect Insight
MINI mental status exam
Orientation Short term memory Concentration Arithmetic ability Language Praxis-learning
Scoring of the MMSE
Traditional score threshold is >23
21-25 inconclusive
26 highly likely
Stanford Binet intelligence test
Average IQ 100 SD 15.
<70 disability
>130 intellectually gifted
Deviation intelligent quotient
IQ
Wechsler adult intelligence scale (WAIS-4)
Adult intelligence
Avg 100 SD 15
Personality tests
MN multiphasic personality inventory (MMPI) Beck depression inventory (BDI) Projective tests (emotional functioning) -Rorschach ink blot -thematic apperception test (TAT)
Neuropsychological testing
Uses behavioral measures to asses skills and abilities to brain function
Cognitive skills
MRI
Diagnose disease that affect nerve fibers that make up the white matter
Proton magnetic resonance spectroscopy (MRS)
Metabolic activity of neurons
Areas of brain damage
FMRI
How people react to stimuli in time
Diffusion tensor imagining (DTI)
Investigate abnormalities in white matter of brain adn neural pathways
Biological perspective and TX
Disturbances due to neurotransmitters imbalanced
Psychotherapy meds/surgery
Electroconvulsive therapy
Psychodynamic perspective and TX
Freud
Defense mechanisms
Psychodynamic therapy —self awareness
Behavioral perspective and TX
Due to faulty learning experiences
Classical conditioning pavlov-automatic responses
Operant conditioning-skinner-voluntary behaviors
Counterconditioning-systematic desensitization
Contingency management-token economy
Modeling
Cognitive perspective and TX
Product of disturbed thought
Cognitive restructuring
Cog. Behavioral therapy
Acceptance and commitment therapy
Humanistic perspective and TX
People are motivated to strive for meaning in live
Person-centered (Rogers)
Self-actualization (Maslow)
Unconditional positive regard
Motivational interviewing
Person centered theory
Rogers
Individuals uniqueness
Self actual inaction theory
Hierarchy of needs Physiological Safety Love/belonging Esteem Self-actualization
Maslow
Positive psychology
Seligman
Potential for growth and change
Agoraphobia
Intense anxiety triggered by real/anticipated exposure to situations which they may not be bale to get help or escape
- public transportation
- enclosed space
- open space
- outside of home alone
- lines or a crowd
TX for agoraphobia
Benzodiazepines SSRI SNRI Relaxation training Panic control therapy
Ddx for anxiety disorder
Cardiovascular problem Arrhythmia Endocrine disorder MI PE Neurologic conditions
OCD MC in who?
Mc in young males and adult women
TX for OCD
Clomipramine
Satiation therapy
Thought stopping
BDD TX
Obsession about appearance
SSRI
CBT
Trichotillomania
Pull out one’s own hair
Excoriation disorder MC in?
Picking at ones own skin 3/4 female
TX for BDD and trichotillomania
Habit reversal training—learn new response to compete with habit
Stimulus control
TX for PTSD
SSRI
Virtual reality therapy
Eye movement desensitization reprocessing (EMDR)
Dysphoria
Intense sad mood
How common is depression
6-10% have current depression
2x as common in weomen
Secrets of depression 7
Common Missed Easy to diagnose when looking Severe Recurrent Costly Highly treatable
Patient health questionnaire
Depression
Depressive disorders
Major depressive disorder
Dysthymic disorder
Disruptive mood dysregulation disorder
Premenstrual dysphoric disorder
Major depressive disorder
At least 2 weeks of depressed mood or loss of interest nearly all day
+4 s/s
Subtypes of major depression
Psychotic: plus delusions/hallucinations
Seasonal
Atypical
Postpartum
Persistent depressive disorder (dysthymia)
C depression of less intensity
3 symptoms for 2 years +
Disruptive mood dysregulation disorder (DMDD)
In children with irritability and outbursts that are developmentally inappropriate and 3x/wk+
Bipolar 1 vs bipolar 2
1: one of more manic episodes and possibility of major depressive
2: one or more depressive episodes and at least one hypomanic episode
Cyclothymic disorder( subtype of bipolar)
S/s more chronic and less severe
Meet criteria for hypomanic episode. Numerous depressive periods and NEVER meet criteria for major depressive
Lasts at least 2 years
Treatment for bipolar s
SSRI, SNRI, TCA, MAOI
Lithium
ECT
Deep brain stimulation
Behavioral activation
CBT
Women vs men and suicide
Women: more attempts, less lethal succeed less often
Men: fewer attempts, more lethal, succeed more
One of the top 3 causes of death in young adults and teens
Suicide
5 components to suicide risk
Ideation Intent Plan Access to lethal means History of past attempts
What is schizophrenia classified as
A spectrum disorder
Neologisms
Make up new words and think people understand them and know them.
Bleuler’s for A’s
Association: thought disorder
Affect: emotional disturbance
Ambivalence: can’t follow through
Autism: withdrawal from relating
In regards to schizophrenia
Psychotic disorder s/s
Delusion
Hallucinatin
Disorganized speech
Catatonic/disorganized behavior
Schizophrenia or disorder
S/s of schizophrenia but 1-6months
Schizoaffective disorder
Schizophrenia with co-occurring with major affective disorder such as major depressive or bipolar
Delusional disorder
Only s/s are delusions for at least one month
Treatment for schizophrenia/psychotic disorders
Neurileptics (antipsychotic)
Thorazine and hallow
Extrapyramidal symptoms (rigid muscles, tremors, struggling, restless) Tardive dyskinesia (involuntary movements of the mouth, arms and trunk of the body)
CBT
cognitive training
Personality disorders
Pattern that is pervasive and inflexible. Manifests in 2/4: Cognition Affect Interpersonal functioning Impulse control
Paranoid personality disorder
Always on guard and impossible to trust others. Project blame on others
Schizoid personality disorder
Alone No desire to love Insensitive to others feelings Perceived as cold Find situations that involved minimal interaction
Schizotypal personality disorder
Odd beliefs, behavior, appearance, ideas, etc.
Antisocial personality disorder
Disregard for society moral/legal standards Psychopathy!!!!!! Lack remorse Poor judgment Incapacity for love Lack of emotional response Impulsive Never nervous Unreliable, untruthful and insincere
Borderline personality disorder
Poor impulse control and instability in mood
Avoid abandonment, intense unstable relationships, impulsive, etc
Histrionic personality disorder
Exaggerated emotional reactions approaching theatrical in everyday behavior
Love center of attention
Narcissistic personality disorder
Inflated sense of self-importance and lack of sensativity to others around
Entitlement
Grandiose narcissism
Think of self entireled in inflated way
Vulnerable narcissism
Internally weak sense of self, sad when someone important betrays them
Avoidant personality disorder
Fearful and extremely sensitive to Disapproval Rejection Criticism Ashamed/embarrassed
Depended PD
Strongly drawn to others=Cliny
Unable to make decisions
OCPD
Perfectionism
Worrying, indecisive, and behaviorally rigidity
TX for PD
Best to CBT
Echolalia
Autism
Reptivition of vocal noises made by someone else
Autistic savants
Develop very narrow and specifically focused interests
Dementia affects
3-11% of those older than 65
Mnemonic fo causes of dementia
Drugs Endocrine Metabolic/mechanical Epilepsy Nutrition/NS Tumor/trauma Infection Arterial
Risk factors for Alzheimer’s
Genetics
Smoker
Obese
Lack of exercise
Somatoform disorders
Caused by the mind and reflected by the body
Somatic symptom disorder (somatization)
Illness anxiety disorder (hypochondriasis)
Conversion disorder
Factisious disorder
Somatic symptom disorder
Somatization aka
Psychological distress displaced in form of physical symptoms and spend great deal of time researching them and seeking treatment for them
Clues to somatization
Thick chart syndrome Change in utilization with increasing unexplained complaints Vague confusing bizarre s/s Resistance to inquiry Physicians heart sink response
Illness anxiety disorder
Hypochondriasis
Conversion disorder
Aka conversion hysteria
NS s/s that cannot be explained
Blindness, weakness, paralysis etc
Factitious disorders
Fake s/s due to internal need to maintain sick role—munchausen’s syndrome
Falsifying s.s for primary (internal motivations) gain
Malingering: Falsifying s.s for secondary (external motivations) gain. Ex: time off
TX of somatic symptom and related disorders
SSRI
CBT
Hypnotherapy
Interpersonal therapy
