Health, Distress, and Impairment Test 3 Flashcards
1
Q
What are the Severity ratings based on # of symptoms?
A
Mild= 2-3
Moderate= 4 to 5
Severe= 6 or more
2
Q
What are the 5 General Categories?
A
- Depressants (alcohol, sedative hypnotic, anxioylic)
- Stimulants (cocaine, amphetamines, caffeine, tabacco)
- Opioids (heroin, opium, oxy)
- Hallucinogens (cannabis)
- Other (inhalants, steroids, ketamine)
3
Q
Tolerance
A
reduction in the effect of a drug as a result of repeated use requires greater quantities to achieve the same effect
4
Q
Withdrawal
A
negative physical and psychological effects occur when stopping taking or reducing substance amount
5
Q
What are the Levels of Substance Involvement?
A
Use, Intoxication, Abuse, Dependence/Addiction
6
Q
Physiological Dependence
A
experience tolerance and withdrawal
7
Q
What are Depressants
A
behavioral sedation and can induce relaxation
8
Q
Examples of Depressants?
A
Alcohol, sedative, hypnotic and anxiolytic drugs
9
Q
What occurs in the body with an Increase in Tolerance?
A
Changes in liver enzymes: efficient metabolism
CNS: changes in the number and sensitivity of GABA and glutamate receptors
10
Q
What is GABA?
A
neurotransmitter that blocks impulses between nerve cells in the brain.
11
Q
What is the function of Glutamate receptors?
A
mediate fast excitatory synaptic transmission in the central nervous system
12
Q
What are some Withdrawal Symptoms?
A
Anxiety, depression, agitation, insomnia, weak, muscle tremors, increased pulse/blood pressure
13
Q
Delirium Tremens
A
disorientation, confusion, visual hallucinations, memory problems
14
Q
Pro-typical heavy drinking
A
young adult male, not married, financially well-off
15
Q
Comorbidity
A
When one illness it accomponied by another: mood and anxiety disorders; personality disorders
16
Q
What are gender differences in Alcohol use?
A
Men have a variable pattern and women start later in life following a stressful event and they are less likely to binge
17
Q
What are the Short Term effects of Alcohol?
A
Biphasic effect: initial stimulant (increased sociability as alcohol levels rise), followed by depressant (negative emotions as alcohol declines)
18
Q
What are the Short Term Alcohol effects on Neurotransmitters?
A
GABA: increased; may reduce tension /anxiety
Serotonin: increased; pleasurable effects and cravings
Dopamine: increased; pleasurable effects
Glutamate: inhibited; slurred speech and memory loss
19
Q
What are the Long Term effects of Alcohol?
A
Severe malnutrition, B vitamin deficiency (Korsakoff’s liver syndrome), damaged endocrine glands and pancreas, heart failure, hypertension, reduces immune function (cancer)
20
Q
What happens to the brain when there is a prolonged heavy use of alcohol?
A
destruction of grey matter near temporal lobes
21
Q
Where do Stimulants act?
A
Brain and sympathetic Nervous System
22
Q
What are examples of stimulants?
A
cocaine, caffeine, amphetamines
23
Q
How do stimulants effect us?
A
Increases alertness and motor activity
24
Q
What are the effects of Cocaine?
A
reduces pain and increases dopamine
25
What are the effects of Amphetamines?
Increases dopamine and norepinephrine
26
What are the effects of Caffeine?
Activates noradrenaline neurons and seems to affect the local release of dopamine and adenosine
27
What are examples of Opioids?
morphine, heroin, codeine, oxy, and fentanyl
28
What is the function of Heroin?
pain relief, induces sleep
29
What are the effects of Heroin?
euphoria, drowsiness, daydream state, lack of coordination
30
What is Methadone?
an opioid medication used to treat severe pain and opioid addiction
31
What is Demerol/pethidine?
an opioid pain-relief medicine
32
What feeling is immediate after Herion injection?
warm suffusing ecstasy
33
When can withdrawal symptoms be felt after injecting Heroin?
8 to 20 hours
34
What Heroin withdrawal symptoms are felt after 8-20 hours?
influenza symptoms, muscle pains, sneezes, sweats
35
What Heroin withdrawal symptoms are felt after 36 hours?
More severe, uncontrollable muscle twitching, cramps, chills, increased heart rate/blood pressure, vomiting
36
How long are Heroin withdrawal symptoms felt?
72 hours
37
What is Fentanyl?
Potent opioid used for treating severe pain
38
What counteracts effects of opioids?
Naloxone by blocking the effects of opioids
39
What are the effects of Hallucinogens?
hallucinations, expansions of consciousness, loss of boundaries, sense of detachment, feeling magically in control
40
What are examples of Hallucinogens?
Mescaline, psilocybin (shrooms) , PCP (angel dust), LSD, cannabis
41
Are their withdrawal symptoms for Hallucinogens?
No evidence of any
42
What would more likely cause a bad trip?
Anxiety which then causes a panic attack
43
How does Cannabis effect individuals?
If used heavy in teenage years it contributes to psychological problems in adulthood
44
What are the effects of Inhalants?
Feelings of euphoria and psychic numbing, dizziness, slurred speech, effects are similar to alcohol and damages the CNS
45
What are examples of Inhalants?
glue, correction fluid, spray paint, gasoline, aerosol sprays, nitrous oxide
46
What may be a stepping stone in alcohol/drug use disorders?
Inhalants
47
What are Causes of Addiction?
Biological/genetic, Psychological, Social, Cultural influences
48
What are the effects of Neurobiological influences in Addiction?
Positively reinforcing- work on internal reward centre dopamine and opioid neurons in mid-brain
Negatively reinforcing- alcohol reduces anxiety (GABA system)
49
What are the effects of Psychological Influences in Addiction?
Positive and negative reinforcement
Opponent process theory (when an emotion is expressed another is suppressed)
Role of expectancy effects
50
What are Social Influences in Addiction?
Media, family, peers
Parents and the family appear critical (role of siblings)
Self efficacy: combats peer pressure
51
What are the Biological Treatments of Substance-Related Disorders?
1. Agonist Substitution
2. Antagonistic Treatment
3. Aversive Treatment
52
What is Agonist Substitution?
Safe drug with a similar chemical composition as the abused drug e.g methadone for heroin addiction and nicotine gum or patch
53
What is Antagonistic Treatment?
used to block addictive drugs from activating the brain's receptors e.g Naltrexone
54
What is Aversive Treatment?
Drugs that make the injection of abused substances extremely unpleasant e.g. Antabuse makes the person feel ill
55
What are Psychosocial Treatments of Addiction?
debate over controlled use vs. complete abstinence
Alcoholics Anonymous and related groups: abstinence and disease model
Harm reduction and controlled- SIS: Safe Injection Sites
56
What makes personality disorders different from other psychological disorders studied thus far?
Ways of relating and thinking and predispositions are inflexible causing distress and impairment
57
What is the Dimensional View of Personality Disorders?
views various personality features along several continuous dimensions and allows a clinician to assess the severity of a condition and does not imply a concrete threshold between “normality” and a disorder
58
What is Categorical View of Personality Disorders?
assumes each personality disorder is a separate and distinct category; i.e., separate from other personality disorders, and distinct from "normal" personalities, either you have it or you don't.
59
What is Cluster A?
Odd or eccentric characteristics (paranoid, schizoid, schizotypal)
60
What are the Clinical Features of Paranoid Personality Disorder?
pervasive and unjustified mistrust and suspicion
61
What is PPD is comorbid with?
schizotypal, borderline and avoidant PD
62
What are the Psychological speculations on PPD?
parenting that emphases
i) not making mistakes
ii) the child is different from other people
63
How does PPD differ from Schizophrenia?
Visual and auditory hallucinations are not present
64
How does PPD differ from Delusional Disorder?
Full blown delusions are not present and less impairment in social and occupational functioning
65
What is the Treatment for Paranoid PD?
focus on development of trust, counter negativistic thinking
66
What are the Clinical Features of Schizoid Personality Disorder?
Pervasive pattern of detachment from social relationships
Very limited range of emotions in interpersonal situations
Do not have unusual thought processes
Most socially isolated and may be highly suspicious of others
Magical thinking (clairvoyant or telepathic)
Ideas of reference (everyone in the cafeteria is talking about him/her)
Illusions are common (presence of a person, NOT actual person)
67
Schizoid Personality Disorder is comorbid with?
schizotypal, avoidant and paranoid PD
68
What is the Psychoanalytic explanation for Schizoid PD?
unaccepting/abusive parents
69
What Criteria does Schizoid PD usually meet?
MDD (major depressive disorder)
70
What is the difference between Schizophrenia and Schizoid PD?
Schizophrenia includes hallucinations and delusions. Schizotypal personality disorder does not and it usually co-occurs with personality disorders.
71
Etiology (causes) of Schizotypal PD
A phenotype of a schizophrenia genotype and Left hemisphere (learning and memory deficits) and more generalized brain deficits
72
What is the Schizophrenia Genotype?
programmed to disrupt the migration of neuronal cells in the developing cortex during the second trimester, resulting in impaired embryogenesis.
73
What is a Phenotype?
Determined by a person genetic makeup and environmental factors
74
When having Schizoid PD what is at a high risk at developing?
Schizophrenia
75
What is the difference between Schizotypal and Schizoid PD?
Schizotypal personality disorder tends to cause discomfort in relationships, distorted thoughts and beliefs, and odd behavior. Schizoid personality disorder tends to cause a detachment from relationships and limited emotional expression.
76
What is the Treatment for Schizotypal PD?
focus on developing skills/empathy and treating comorbid depression and some respond to antipsychotic medication at low doses
77
What is the Treatment for Schizoid PD?
focus on developing skills/empathy
78
What is the prognosis for personality disorders?
Poor
79
What is Cluster B?
Dramatic, emotional, erratic (antisocial, borderline, historic, narcissistic)
80
What are the Clinical Features of Antisocial Personality Disorder?
unusual emotional responses, impulsive rages
Failure to comply with norms and violations of the rights of others
irresponsible, impulsive, and deceitful
Lack a conscience, empathy and remorse
81
Antisocial Personality Disorder vs. Conduct Disorder
Conduct disorder occurs under the age of 18 and Antisocial PD happens above the age of 18
82
Etiology of Antisocial Personality Disorder
Many come from families with inconsistent parental discipline and support
Families often have histories of criminal and violent behaviour
83
What are the Neurobiological Contributions of Antisocial Personality Disorder?
Underarousal Hypothesis: low levels of cortical arousal primary cause of antisocial/risk taking behaviours
Fearlessness Hypothesis: fail to respond with fear to danger
cues
84
What is the Treatment for Antisocial Personality Disorder?
Treatment shouldn't be sought and ways of prevention include programs for at risk children, and teaching empathy
85
What are the Clinical Features of Borderline Personality Disorder?
Unstable moods and relationships, impulsive, fear of abandonment, poor self image, self harm
86
What is Borderline Personality Disorder Comorbid with?
depression, bipolar disorder, bulimia
87
Etiology of Borderline Personality Disorder
Runs in family, shares familial connection to mood disorders, early trauma/abuse, neglect, childhood sexual/physical abuse
88
What is the Treatment for Borderline Personality Disorder?
Dialectical Behaviour Therapy (DBT) which is the most promising approach as it teaches people to accept their thoughts, feelings and behaviours, and the techniques to change them
89
What is the paradoxical stance of therapist
Accept BPD patients as they are (Person-centred)
Help patients to change (CBT approach)
90
What are the Clinical Features of Histrionic Personality Disorder?
dramatic, sensational and sexually provocative, impulsive and need to be centre of attention (good or bad), shallow, more common in females
91
Etiology of Histrionic Personality Disorder
caused by unloving parents , crave attention as adults
92
What Psychodynamic influence occurred to cause Histrionic Personality Disorder?
cold and controlling parents- child feels unloved and abandoned
93
What is the Treatment for Histrionic Personality Disorder?
Long-term psychological therapy because there is usually no place for medicines in its treatment
94
What are the Clinical Features of Narcissistic Personality Disorder?
Exaggerated sense of self-importance, obsessed with receiving positive attention/entitlement, highly sensitive to criticism, little empathy for others, envious and arrogant
95
Etiology of Narcissistic Personality Disorder
failure to receive “empathic mirroring” in childhood, only scored same with psychopathy on disagreeableness, therefore not same construct as psychopathy
96
What is the Treatment for Narcissistic Personality Disorder?
Psychotherapy (Talk therapy)
97
What is Cluster C?
Fearful and anxious (avoidant, obsessive-compulsive, dependent)
98
What are the Clinical Features of Avoidant Personality Disorder?
sensitive, avoidant of interpersonal relationships, interpersonally anxious and fear of rejection
99
Psychosocial Etiology of Avoidant Personality Disorder
individuals born with a difficult temperament and as a result parents are more rejecting or don't provide enough uncritical love described parents as:
i) more rejecting
ii) more guilt engendering
iii) less affectionate than the control group of subjects
100
Biological Etiology of Avoidant Personality Disorder
higher levels of behavioural inhibition
(heritable temp. factor = avoidance response to unfamiliar situations)
101
What is the Treatment for Avoidant Personality Disorder?
Cognitive Behavioural and Psychodynamic Therapy
102
What are the Clinical Features of Dependent Personality Disorder?
Excessive reliance on others for decisions, fear of abandonment, clingy and submissive in interpersonal relationships
103
Etiology of Dependent Personality Disorder
Unknown, but may be linked to attachment style
104
What is the Treatment for Dependent Personality Disorder
Clients appear to be ideal/model clients because of their need to please and eagerness to give responsibility of their problems to the therapist but progress in therapy is typically slow
105
What are the Clinical Features of Obsessive Compulsive Personality Disorder?
excessive fixation on doing things the right way, perfectionistic, orderly, emotionally shallow
106
Are obsession and compulsions present in Obsessive Compulsive Personality Disorder?
Not typically present cause its extremely rare
107
Etiology of Obsessive Compulsive Personality Disorder
Largely Unknown
108
What is the Treatment for Obsessive Compulsive Personality Disorder?
Address fears related to the need for orderliness, target rumination, procrastination and feelings of inadequacy
109
What is Schizophreniform Disorder?
Has symptoms of schizophrenia between 1 and 6 months then disappears with treatment or unknown reasons
110
What is Brief Psychotic Disorder?
Has one or more positive symptoms, persist at least 1 day but less than a month
111
What is Schizoaffective Disorder?
Has symptoms of a mood disorder and schizophrenia
Prognosis similar to schizophrenia
Presence of hallucinations or delusions for 2 weeks with no symptoms occurring
112
What is Delusional Disorder?
persistent belief that is contrary to reality
113
The 5 mistaken belief Subtypes that people with Delusional Disorder hold are
1. Erotomanic: higher status and thinks person loves them
2. Grandiose: inflated worth, power, knowledge identity to a famous person
3. Jealous: a sexual partner is unfaithful
4. Persecutory: they or someone close is being malevolently treated
5. Somatic: they are afflicted with a medical defect or condition
114
What is Attenuated Psychosis Syndrome?
Display some positive symptoms of schizophrenia, have insight regrading the bizarre symptoms, high risk of developing schizophrenia
115
What is the DSM-V Schizophrenia Diagnostic Criteria?
Criterion A: one of the following symptoms must be present:
- delusions/delusional ideas
- hallucinations
- Disorganized speech
Criterion B: impairment
Criterion C: frequency and duration
Criterion D: rule of schizoaffective, depressive or bipolar with psychotic features
Criterion E: exclusion (substance use)
116
What is the Clinical Description for Schizophrenia
Major disturbance in thought, emotion and behaviour, Disordered thinking
Faulty perception, Bizarre disturbances of motor activity
Socially withdrawn, Delusions and hallucinations
117
What are the POSITIVE Symptoms of Schizophrenia?
The presence of too much of a behaviour that is NOT apparent in most people which consists of hallucinations and delusions
118
What are the NEGATIVE Symptoms of Schizophrenia?
The absence of a behaviour that SHOULD be evident in most people like alogia (speech issues)
119
Examples of Negative Symptoms of Schizophrenia
Avolition: lack of energy, seeming inability to persist at activities (hygiene, work)
Anhedonia: inability to experience pleasure
Flat Affect: no stimulus can elicit an amotional response; flat, toneless voice
Asociality: impaired social relationships
Alogia: poverty in th eamount or content of speech
120
What are the Disorganized Symptoms of Schizophrenia?
Erratic behaviours that affect speech, motor function, and emotional reactions and don't fit into positive-negative scheme
121
Examples of Disorganized Symptoms
1. Different types of motor abilities (immobility, holding a stance)
2. Inappropriate affect (emotions are out of context)
3. Disorganized Speech (problems in organizing ideas and speaking so one can understand)
122
Tangentiality
tendency to speak about topics unrelated to the main topic of discussion
123
Loose association/derailment
vague and confusing speech, in which the individual will frequently jump from one idea to an unrelated one
124
Clang
using similar-sounding words together, even though they don't make sense
125
Neologism
new words or phrases are invented
126
Perseveration
when someone “gets stuck” on a topic or an idea
127
Incoherence
respond to questions with unrelated answers, say illogical things, or shift topics frequently (word salad)
128
What is Cotards Syndrome?
Person believes that a part of their body has changed in some impossible way
129
What is Capgras Syndrome?
Someone they know has been replaced by a double
130
Delusions of control or thought broadcasting
one's thought is projected and perceived by others (thinks everyone is reading their mind)
131
Delusions of Grandeur
believe that they are wonderful, successful, more important than others
132
Delusions of Reference
Thinks everything they see or hear is about them
133
What are Biological Treatments of Schizophrenia?
Antipsychotic Medication because it reduces/eliminate positive symptoms but parkinson-like effects are common
134
What are Psychosocial Interventions for Schizophrenia?
High Expressed Emotion: criticism, hostility, and emotioal over involvment
Associated with higher relapse for people with schizophrenia
Low Expressed Emotion: warmth, positive regard
