Final Exam Study Pt. 2 (most recent info)

Question 1

Describe substance-related disorders

Answer 1

Involve problems associated with using and abusing drugs that alter patterns of thinking, feeling, and behaving.

Include problems with the use of:

• depressants (alcohol, benzodiazepines)
• stimulants (amphetamines, nicotine, cocaine)
• opiates (heroin, codeine, morphine)
• hallucinogens (cannabis, LSD)

Question 2

Clinical description of substance-abuse related disorder

Answer 2

• cognitive, behavioral and physiological symptoms indicating the individual continues using the substance despite significant problems
  - impaired control over substance use
  - social impairment (e.g., impact on relationships, work, school)
  - risky use

Underlying change in brain circuits that may persist beyond detoxification
- tolerance and withdrawal

Question 3

Biological and psychological causes of substance abuse disorder

Answer 3

Biological dimensions

      - familial/genetic: twin and family studies indicate that certain people may be genetically vulnerable to drug abuse - neurobiological: drugs affect the reward or pleasure centres of the brain. 

Psychological dimensions

  - positive and negative reinforcement: people are positively reinforced for using drugs and negatively reinforced when the drugs remove unpleasant experiences such as pain or anxiety, or result in withdrawal symptoms. 
     - cognitive factors (e.g., expectations, cognitive implications of substance use)

Question 4

Social and cultural causes of substance abuse disorder

Answer 4

Social dimensions

- exposure to substance: family, friends,  media
 - social experiences

Cultural dimensions
- differences in what is “normal”/”abnormal” or acceptable/unacceptable behavior

Question 5

List some biological treatments for substance abuse disorder

Answer 5

Agonist substitution - provision of safe drug that is chemically similar to the abused drug (e.g., methadone)

Antagonist treatments - block or counteract the positive effects of psychoactive drugs (naloxone)

Aversive treatment - use of drugs that make ingestion of abused substance extremely unpleasant

Question 6

Psychosocial treatments for substance abuse disorder

Answer 6

Psychosocial

 - inpatient facilities
 - alcoholics anonymous (AA)
 - controlled use
 - relapse prevention

Harm reduction
- example of SISs for harm reduction and to minimize risk of overdose

Relapse prevention

- education
- reform of laws regarding drug possession and use
 - community-based interventions

Question 7

Describe Cluster A personality disorders and a short description of each

Answer 7

Cluster A are the odd/eccentric personality disorders

Paranoid - distrusting and suspicious interpretation of the motives of others

Schizoid - social detachment and restricted emotional expression

Schizotypal - social discomfort, cognitive distortions, behavioral eccentricities

Question 8

Describe Cluster B personality disorders and a short clinical description of each

Answer 8

Cluster B are the dramatic/erratic disorders.

Antisocial - disregard for and violation of the rights of others

Borderline - unstable relationships, self-image, affects and impulsivity

Histrionic - excessive emotionality and attention seeking

Narcissistic - grandiosity, need for admiration, lack of empathy

Question 9

Describe Cluster C personality disorders and give a short clinical description of each

Answer 9

Cluster C are the anxious/fearful personality disorders.

Avoidant - socially inhibited feelings of inadequacy, hypersensitivity to negative evaluation

Dependent - submissive behavior, need to be taken care of

Obsessive-compulsive - preoccupation with orderliness, perfectionism, and control

Question 10

Define delusions, hallucinations and psychosis.

Answer 10

Delusions - fixed beliefs that do not change in light of conflicting evidence; may include variety of themes:

• persecutory (belief that one is going to be harmed)
• referential (belief that certain gestures and comments are directed at oneself
• religious
• grandiose

Hallucinations - vivid and clear perception-like experiences that occur without an external stimulus

Psychosis - loss of touch with reality; involves delusions and/or hallucination

Question 11

Differentiate positive and negative symptoms

Answer 11

positive symptoms - ‘abnormal’ things that start happening, such as delusions and hallucinations

negative symptoms - ‘normal’ things that stop happening, such as lack of pleasure, trouble with speech, flattened affect

Question 12

Clinical description of schizophrenia

Answer 12

Two (or more) of the following, present for a significant portion of time during a 1-month period:

  - delusions
  - hallucinations
  - disorganized speech
  - disorganized or catatonic behavior
  - negative symptoms

Question 13

50-70% of people with schizophrenia experience positive symptoms (hallucinations, delusions, or both) (true/false)

Answer 13

True

Question 14

Both men and women are affected by schizophrenia at the same rate (true/false)

Answer 14

True

Question 15

Describe the development and onset of schizophrenia

Answer 15

Age of onset - greatest in early adulthood and declines with age for males, increases with age for females

Early brain damage during neurodevelopment may contribute to the development of schizophrenia

Relapse rates are very high when treatment is discontinued

Question 16

Genetic influences of schizophrenia

Answer 16

• multiple gene variances combine to produce vulnerability
• children of parents with schizophrenia likely to have it too

Gene-environment interaction: interaction with specific environmental pathogens and stimuli at crucial developmental stages

Question 17

Neurobiological influences in schizophrenia

Answer 17

Dopamine - clues to the role of dopamine in schizophrenia…

• neuroleptics (dopamine antagonists) effective in treating schizophrenia
• neuroleptics produce negative side effects
• L-dopa (agonist) can produce schizophrenia-like symptoms
• amphetamines, which activate dopamine, can worsen some symptoms in schizophrenia

Question 18

Neurobiological influences of negative symptoms

Answer 18

Hypofrontality (less active frontal lobe) associated with negative symptoms

Question 19

Psychological and Social influences of schizophrenia

Answer 19

Stress

  - retrospective and prospective approaches to examine impact of stress
  - note: extreme stress can produce psychotic-like symptoms in otherwise healthy persons
   - tendency for people with schizophrenia to be found in lower social classes

Question 20

Relapse in schizophrenia treatment appears to be triggered by

Answer 20

hostile and critical family environments characterized by high expressed emotion

Question 21

Biological treatments for schizophrenia

Answer 21

Neuroleptics (dopamine antagonists) reduce or eliminate delusions and hallucinations and are effective in 60-70% of people.

Newer antipsychotics have fewer side effects (like tardive dyskinesia which are involuntary movements of the tongue, face, mouth, or jaw

Transcranial magnetic stimulation (TMS) treatment for hallucinations. TMS also improves auditory hallucinations briefly.

Question 22

Psychosocial interventions for schizophrenia

Answer 22

Behavioral family therapy - must be ongoing if patients and families are to benefit from other

Support for improving medication compliance and self care

Multilevel treatments reduce relapses

Question 23

How the DSM-5 defines neurodevelopmental disorders

Answer 23

A group of conditions with onset in the developmental period. They are characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning.

Question 24

Clinical description of ADHD

Answer 24

Inattention (e.g. difficulty listening when spoken to, difficulty organizing tasks and activities, forgetful)

and/or

Hyperactivity-impulsivity (e.g., fidgets, difficulty waiting their turn)

May be combined presentation, predominantly inattentive, or predominantly hyperactive/impulsive

Question 25

Causes of ADHD

Answer 25

Hereditary factors; there are multiple genes responsible.

Inhibition of the dopamine transporter gene.

Exposure to lead, infections, or alcohol in utero.

Family members with ADHD more likely to have children with ADHD

Question 26

Biological treatment of ADHD

Answer 26

Medication
Aim: to reduce impulsivity and hyperactivity, and to improve attention
- typically, use of prescription of stimulant medication (i.e., Ritalin, Dexedrine)
- effects non long-term

Stimulant medication: increases dopamine levels in brain

Question 27

Psychological treatments for ADHD

Answer 27

Goal setting and reinforcement. Cognitive behavioral intervention for ADHD also appears to be helpful for adults with ADHD. Most clinicians focus on using a combination of treatment approaches.

Question 28

Clinical description of ASD

Answer 28

• persistent difficulties with social communication and social interaction across multiple contexts
• restricted, repetitive patterns of behavior, interests, or activities
• impairments present in early childhood
• effect/limit daily functioning

Question 29

Describe the social difficulties of those with ASD

Answer 29

• challenge with developing age-appropriate social relationships
• inability to engage in joint attention
• disinterest in social situations
• deficits in nonverbal communication
• lack of prosody

Question 30

Describe the restricted and repetitive patterns of ASD

Answer 30

Restricted, repetitive patterns of behavior, interests, or activities

  - stereotyped and ritualistic behaviors
   - rituals often complex
   - if rituals are interrupted or prevented, person has a severe emotional reaction or tantrum

Question 31

According to the DSM-5, there are three levels of severity in ASD

Answer 31

1. requiring support
2. requiring substantial support
3. requiring very substantial support

Question 32

Genetic influences of ASD

Answer 32

• genetic heritability
• families that have one child with ASD have about a 20% chance of having another child with the disorder
• children with ASD often have older parents (gene mutations may occur in sperm of fathers or ovum of mothers)

Question 33

Neurobiological and psychological/social influences of ASD

Answer 33

• fewer neurons in amygdala in adults. Larger amygdala in children with ASD which may contribute to fear and social withdrawal.
• lower levels of oxytocin in blood, contributing to children not being able to form attachments/social bonds

Parents of individuals with ASD may not differ substantially from parents of children without

Question 34

Treatment of ASD

Answer 34

Psychosocial treatments:
- behavioral focus: communication, socialization, living skills

Early Intensive Behavioral Intervention (EIBI)
This is a type of ABA for very young children with ASD, usually younger than 5 and often younger than 3. EIBI uses a highly structured teaching approach to build positive behaviors (such as social communication) and reduce unwanted behaviors (such as tantrums, aggression, and self-injury). EIBI takes place in a one-on-one adult-to-child environment under the supervision of a trained professional
- inclusive schooling

Medical intervention has not been successful.

Question 35

Describe neurocognitive disorders

Answer 35

a group of disorders in which the primary clinical deficit is cognitive function.

   - cognitive function deficits are not present at birth or early life.
   - decline from a previous level of cognitive functioning. 

Have consequences for behavior and personality (e.g., paranoia, agitation, aggression)

Question 36

Clinical description of major and mild neurocognitive disorder.

Answer 36

Major neurocognitive disorder

    - gradual deterioration of brain functioning
    - affects judgment, memory, language, other advance processes

Mild neurocognitive disorder
- early stages of cognitive decline

Question 37

Describe the initial stage symptoms of neurocognitive symptoms

Answer 37

Memory and visuospatial skills are affected. Agnosia may occur, the inability to recognize and name objects. Facial agnosia may occur, in which the person has the inability to recognize even familiar faces.

Question 38

Subtypes of neurocognitive disorders

Answer 38

Alzheimer’s disease, frontotemporal lobar degeneration, Lewy body disease, vascular disease, traumatic brain injury, substance-medication-induced, HIV infection, Prion disease, Parkinson’s disease, Huntington’s disease, other medical condition, multiple etiologist