FOCUSED STUDY 3 Flashcards
Total Quality Management is continuous improvement through __
ongoing changes
Total Quality Management includes:
__, management commitment to __, __ involvement, __ satisfaction, & data-driven __
teams, management commitment to quality, employee involvement, teams, customer satisfaction, data-driven decision making
Voucher-based reinforcement therapy (VBRT) is most effective for__ while CBT is most effective for__
promoting initial abstinence; relapse prevention
ASD has low serotonin levels in the __ & high levels in the __
low brain levels & high blood levels
APP is linked to __ & early onset __
Down syndrome Trisomy 21; Alzheimer
ADHD ppl have smaller than normal __, __, & __
caudate nucleus, putamen, & amygdala
St. John’s wort is not different from SSRI but has a __ rate of adverse events
lower
__ is best assessed using video EEG
PNES
CRAFT helps loved ones adopt a “__” from the identified patient
“loving detachment”
olanzapine might help w/ ___, while fluoxetine might help w/ ___ for anorexia
fostering initial weight gain; weight management
70-85% of dx __ have comorbid tobacco use
schizophrenia
Tx for schizophrenia includes __ tx, __, FGAs + SGAs, + __ to treat comorbidities
multimodal tx, psychosocial tx; additional meds to treat comorbidities
CBTp is a tx for schizophrenia & includes cognitive __, ACT, assertive __ tx, family psychoed, ___ self-management training, ___ skills, supported ___ services
remediation;community; illness; social; employee
SGA __ is most effective for treatment-resistant schizophrenia, which is 2 antipsychotic attempts for __wks each
Clozapine; 6 weeks
___ is a team-based program targeting high risk or early stage schizophrenia, includes ___ & ___ based on CBTp
NAVIGATE; family psychoed & individual resiliency training
bipolar disorder is linked to heredity, __ abnormalities, & irregular __
neurotransmitter/brain; circadian rhythm
__ is linked to coronary heart disease, stroke, diabetes, Parkinson’s
depression
abnormalities in the prefrontal cortex, amygdala, hippocampus, & basal ganglia are linked to __ disorder
bipolar
ppl w/ depression have abnormalities in the __ brain region due to early life stress w/ hypersecretion of cortisol
hypothalamic-pituitary-adrenal (HPA) axis
___ activity in the ventromedial prefrontal cortex [vmPEC] & ___ activity in the dorsolateral prefrontal cortex [dlPFC]) are characteristics of depression
high; low
Depression Concordance rates –
* MZ twins __ for unipolar depression
* DZ twins __ for unipolar depression
* MZ female twins __
* MZ male twins __
* DZ female twins __
* DZ male twins __
Concordance rates –
* MZ twins 50% for unipolar depression
* DZ twins 20% for unipolar depression
* MZ female twins 50%
* MZ male twins 40%
* DZ female twins 34%
* DZ male twins 28%
GAD is linked to reduced connectivity between the __ cortex & anterior __ cortex & __ leading to weak top-down control of amygdala activity
prefrontal cortex & anterior cingulate cortex & amygdala leading to weak top-down control of amygdala activity
MDD can be bidirectional in causality of myocardial infarction aka __
heart attacks
the best tx for kids w/ MDD is __
there is insufficient evidence to recommend a specific tx
best tx for teens w/ MDD includes __, __, & __ but there is insufficient evidence to recommend one tx over another
- CBT
- IPT-A for adolescents (IPT-A)
- fluoxetine/Prozac
best tx for adults w/ MDD is a combination of __ or __ plus __
strong recommendation for combined tx of CBT or IPT plus second-gen antidepressant (Prozac)
__% of children who have dx of ODD eventually receive a dx of conduct disorder
30%
psychosocial interventions are 1st line tx for __
conduct disorder
MCBT, IPT, behavior, psychodynamic, & supportive therapy are useful in treating MDD in __ (age group), but are not the strongest recommended tx
adults w/ MDD
either group-CBT or a combo of IPT & second-gen antidepressant are the best tx for MDD in __ (age group)
older adults w/ MDD
there is insufficient evidence for bibliotherapy or life review therapy for tx __ in older adults
MDD
symptoms of ___ depression include hypersomnia, overeating eating, weight gain, craving carbs
seasonal pattern or SAD
SAD includes ___ serotonin levels & __ melatonin; tx includes __
low serotonin levels; high melatonin ; phototherapy (light exposure)
ECT for MDD has an SE of anterograde (resolves w/i __) & retrograde amnesia (resolves w/i __)
2wks; weeks to months
remission rates for ECT is __,
IPT/CBT is __
& antidepressants is __
ECT w/i 1-3wks; IPT/CBT 6-10wks, antidepressants 4-12wks.
Child-Focused Intervention Problem-Solving Skills Training (PSST) is for kids & teens & is used to treat __ & __
conduct disorder or ODD
rTMS is a noninvasive technique using magnetic fields to stimulate the ___ cortex
noninvasive technique using magnetic fields to stimulate the left dorsolateral prefrontal cortex
persistent reluctance to go to school, work, places away from home & repeated complaints of physical symptoms when separated are characteristic of __ dx
separation anxiety
CBT + psychoed, exposure + relaxation techniques + cognitive restricting are used to treat ___ disorder & for best outcomes, CBT is combined w/ __
separation anxiety disorder; parent training
if school refusal is part of separation anxiety disorder, initial tx goal is school attendance, to avoid __, academic failure, & other __
avoid social isolation; other secondary impairments
Specific phobias are 2x more common in __ than __
girls than boys
specific phobia onset usually in childhood or by age __
10
first line of tx for Social Anxiety is __ & __
CBT + antidepressants (SSRI + SNRI)
Internet driven CBT is found to be equally effective for adults as face-to-face for treating __
Social Anxiety
school-based CBT is found to be effective for children/adolescents for treating __
Social Anxiety
CBT is used to treat Panic Disorder, as well as Panic Control Treatment, which is a __ exposure
interoceptive exposure
Antidepressants, like TCA imipramine & Benzos are used to treat __, but there is a high relapse rates when meds are the only tx
Panic Disorder
OCD patients have ___ serotonin, elevated activity in the __, __ cortex, cingulate gyrus, & the thalamus
low serotonin; caudate nucleus; orbitofrontal
Combining exposure & response pervention with a SSRI or TCA clomipramine is the most effective for treating severe symptoms of __ dx
OCD
25-50% of cases of ___ have an unknown cause
Intellectual Developmental Disabilities
80-85% of Intellectual Developmental Disabilities are linked to ___ (chromosomal or genetic causes)
Prenatal Factors
5-10% of Intellectual Developmental Disabilities are linked to __ (asphyxia) & __ factors
perinatal factors (asphyxia); postnatal factors
the most common chromosomal causes of an Intellectual Developmental Disabilities are __ then __
Down’s syndrome; then fragile X syndrome
the most common preventable prenatal cause of an Intellectual Developmental Disabilities is ___
fetal alcohol syndrome
abnormalities in the cerebellum, __, & amygdala are linked to ASD
corpus callosum
an IQ score over __, functional language skills by __, & absences of comorbid mental health problems make a good prognosis for ASD
70; 5y/o
ASD kids 3-4y/o reacted __ to familiar & novel objects but reacted __ to novel & familiar faces
differently; similarly
difficulty recognizing face, voice, & body is characteristic of __ dx
ASD
a dx of ASD in males is __x more likely than females
4x
ASD children have accelerated brain growth starting at __ & plateus by __ (grade level) w/ a larger head circumference + brain volume & weight during that time
6mos; preschool
birth prior to 26wk is a risk factor for __
ASD
concordance rates of MZ twins 69-95% & DZ twins 0-24% are for ___ dx
ASD
tx goal for ASD is to minimize __ & maximize __
core symptoms; independence
ADHD is linked to abnormalities in the __ cortex, cerebellum, __, striatum, & __
prefrontal cortex; amygdala; thalamus
ADHD is linked to impaired __ information processing
temporal information processing
Children w/ ___ dx have reduced total brain volume, smaller prefrontal cortex, striatum, corpus callosum, & cerebellum with reduced activity in these areas
ADHD
low birth weight, premature birth, & maternal smoking/alcohol use during pregnancy are risk factors for ___ disorder
ADHD
ADHD is of the most heritable psychiatric disorders, __% across twin studies:
MZ twins ___%
DZ twins ___%
76% across twin studies
MZ twins 71%
DZ twins 41%
parent training in behavioral management (PTBM) is the most recommended for __ disorder
ADHD
Parent- and teacher-administered behavioral intervention for preschoolers & Parent-child interaction therapy (PCIT) are tx for __ disorder
ADHD
ADHD tx includes a combo of meds & behavior interventions at home/school for __ (school grades)
elementary/middle-school
to treat ADHD, a combo of meds & behavioral/instructional interventions is best for ___ (age group)
teens
for adult ADHD, the first line of tx is __ with CBT for support
medication
ADHD dx in childhood is linked to an increase risk of ___ in teens & adults, whether or not they were medicated for ADHD
substance use
high dopamine & a small caudate nucleus is characteristic of __ disorder
Tourettes
Haloperidol antipsychotic, is used to treat Alzheimer’s & __
Tourette’s
CBIT is CBT for tic interventions, & includes __, __ support, habit reversal, competing response, & relaxation training
psychoed; social support;
Provisional Tic Disorder dx has __ vocal tic &/or __ motor tics for __ than 1 year w/ an onset of before __y/o
1+; 1+; less than 1 year; before 18y/o
__ disorder usually starts 4-6y/o w/ severity peaking at 10-12y/o
provisional tic disorder
Persistent Chronic Motor or Vocal Tic dx includes ___ vocal tic & __ motor tics persisting for __, w/ an onset before __y/o.
1+; 1+; 1yr+; 18y/o
Childhood Onset Fluency Disorder (stuttering) is a disturbance in normal ___ & ___ patterning in speech, that persists over time & has an onset of age __y/o, w/ 65-85% of kids recovering by __y/o
fluency & time; 2-7y/o; 8y/o
habit reversal, competing response, & regulating breathing are tx for __ disorder
childhood onset fluency disorder
dx criteria for a specific learning disability: __ skills must be lower than age-appropraite, interefere w/ school/work or ___ w/ an onset during __ years
academic skills; ADLs; school-aged years
5-15% of school-aged children have ___ dx w/ 80% having __ disorder, most commonly ___ dyslexia
Specific Learning Disability; reading disorder; dysphonic dyslexia
dysphonic dyslexia is the struggle to connect __ to __
struggle to connect sounds to letters