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NB3 (last of MS1) > lecture 3+4+DLA > Flashcards

lecture 3+4+DLA Flashcards

1
Q

Body dysmorphic disorder (BDD)

A

Preoccupation with a perceived flaw in physical appearance (the flaw is minimal or non-observable)

Repetitive behaviors or mental acts are performed in response to the appearance concerns

cannot be associated with eating disorder
must cause functional impairment
can even be delusional (absent insight add on)

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2
Q

Hoarding Disorder (HD)

A

Accumulation of possessions in living areas that compromises their intended use

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3
Q

Excoriation Disorder

A

Recurrent unwanted skin picking causing lesions

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4
Q

Trichotillomania

A

Recurrent unwanted pulling out of one’s hair

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5
Q

causes of somatic disorders

A

it is multi factorial

  1. physiological
    overactivity of certain brain areas
    amplify perception of pain
  2. cognitive bias
    over attentiveness about somatic symptoms
    negative thoughts about somatic symptoms
  3. behavioral consequences
    conform to a sick role
    get reinforced to play the sick role
  4. psychological
    transfer psychological stress into physical symptoms
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6
Q

treatment for those with somatic disorders

A

CBT

reduce stress
reduce excessive attention to body 
correct cognitive distortions
reinforce non-sick role 
address emotional stress
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7
Q

factitious disorder

A

diagnosis is often overlooked:

A person fakes/induces (feigns) physical or
psychological symptoms, in self or others, in the
absence of obvious “external” rewards.. but no secondary rewards

unexplained persistent symptoms
dramatic presentation
insistence on treatment
grid abdomen

the goal is to stop further medical treatment that is not needed, when diagnosed

report ‘by proxy’ cases to CPS ( imposed on another)

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8
Q

obsessive compulsive disorder (OCD)

A

recurrent obsessions and compulsions
are time consuming and disruptive
symptoms not explained by another disorder

obsession: intrusive thoughts and urges that lead to distress
compulsions: repetitive behaviors that are done to lower distress

can have an ‘absent insight’ add on

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9
Q

contributing factors to OCD

A

Cortico-striato-thalamo-cortical (CSTC) circuit overactivity

serotonin deficiency

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10
Q

treatment for those with OCD

A
  1. behavioral therapy (exposure and response prevention)
  2. medication
    SSRI’s (fluoxetine)
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11
Q

treatment for refractory OCD

A

neuro surgery :

lesion:
anterior cingulate gyrus
anterior limb of the internal capsule

deep brain simulation:
electrical stimulation of specific brain areas (subthalamus)

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12
Q

somatic symptoms disorder (SSD)

A

more than one disruptive somatic symptom

at least one indicator of excessive thoughts or behaviors (such as a lot of anxiety about the symptom)

The diagnosis of SSD focuses on the abnormal behaviors/thoughts/feelings in response to the distressing somatic symptom.

can still have a medical explanation for the symptom but still have SSD

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13
Q

illness anxiety disorder (IAD)

A

preoccupation with having or acquiring a serious illness

Patient performs excessive health-related behaviors
or shows maladaptive avoidance

somatic symptoms are not present, if they are they are mild.

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14
Q

SSD VS IAD

A

In IAD the patient does not have any distressing physical complaints, but worries about their health

SSD has a physical complaint with excessiveness

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15
Q

Delusional Disorder (DD), Somatic Type

A

A Schizophrenia Spectrum disorder characterized by a persistent fixed, false belief about body/health

In DD, the belief is held with delusional intensity (100% certainty); In SSD and IAD, the belief is less strongly believed

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16
Q

conversion disorder

A

altered voluntary motor or sensory function

Evidence of incompatibility between the symptom and neurological conditions

many subtypes:
ex: speech issue or abnormal movement

17
Q

factitious disorder vs malingering

A

malingering:

A person fakes/induces (feigns) physical or
psychological symptoms in self/others for “external”
rewards (such as missing work)

a secondary gain (external reward)

FD is a primary gain, with no external reward

18
Q

posttraumatic stress disorder (PTSD) symptoms

A

exposure to a traumatic stressor
can be directly involved, witnessed, or learning about an event.

must have 1+ symptoms of each of the four categories:

  1. intrusive symptoms
    (dreams, feeling of event reoccurring, distress when being reminded of event)
  2. avoidance symptoms
    avoids things that remind them of event (can be a place, thought, conversation)
  3. negative mood and cognition
    (negative beliefs, negative emotional states, no positive emotion, low interest, detachment)
  4. alterations in arousal and reactivity
    (sleep issues, irritable, reckless behavior, lack of concentration, large startle response)
19
Q

PTSD diagnosis

A

must last for longer than 1 month

usually begin within 3 months of the trauma, but can happen at any time

there are more vulnerable populations:
usually young adults, but can be anyone
those who have sudden life-threating medical issues can have PTSD

20
Q

acute stress disorder (ASD)

A

exposure to a traumatic stressor

9+ PTSD-like symptoms must develop from the four PTSD symptom categories or an additional category: Dissociative Symptoms (can remember or dissociation)

duration of disorder is 3 days to 1 month after the exposure

21
Q

PTSD VS ASD

A

ASD: symptoms start and resolve within 30 days

PTSD: symptoms last more than 30 days

22
Q

Adjustment Disorder Diagnosis

A

Significant and disproportional emotional/behavioral symptoms in direct response to a stressor

acute onset, brief duration, can be psychosocial or traumatic ex: divorce

Adjustment Disorder diagnosed ONLY if there is a causal stressor AND no other disorder explains the symptoms

subtypes:
Ex: depression, anxiety, disturbance of conduct

23
Q

Reactive Attachment Disorder (RAD) Diagnosis

A

child does not have a secure, healthy emotional bond with a caregiver

  1. pattern of inhibited, withdrawn behavior
    (child doesn’t seek comfort)
  2. at least 2 persistent social/emotional disturbances
    limited positive affect, unexplained sadness, minimal social effort
  3. at least 1 extreme insufficient childcare
    persistent lack of needs / changing of caregivers a lot
  4. Insufficient childcare precedes withdrawn behavior
24
Q

Disinhibited Social Engagement Disorder (DSED)

A

very similar to RAD, but the child will approach and interact with unfamiliar adults in more than two ways

willingness to go off with a stranger
want to venture away even in unfamiliar settings
Age and culturally inappropriate verbal or physical behavior

25
Q

PTSD and ASD etiology

A

hyperesponsive amygdala (more fear)

under-response of the prefrontal cortex (failure to inhibit fear)

reduced volume and dysfunction of the hippocampus

26
Q

RAD and DSED Etiology

A

a direct result of pathogenic care in early childhood

social emotional neglect / changes in caregiver

27
Q

PTSD and ASD treatment

A

psychotherapy
supportive therapy to express feelings
behavioral therapy to address behavior

medication:
antidepressants
anxiolytics

28
Q

treatment or adjustment disorder

A

psychotherapy to learn coping mechanisms
involvement in support groups

severe!!!!!
psychotropics
hospitalization

29
Q

Dissociative Amnesia

A

memory loss for autobiographical information not caused by another disorder

localized: total loss of memory during a specific time period
selective: limited recall of memories during a time period
generalized: loss of personal memory up till triggering event

30
Q

fugue

A

Purposeful travel or bewildered wandering associated
with amnesia for identity or other autobiographical information

features:
brief (hours to days)
rarely recurs
spontaneous termination of amnesia

31
Q

is the dissociative amnesia biological or psychological

A

biological:
anterograde memory loss
difficult learning new info

psychological:
learns new info well
retrograde memory loss

32
Q

Dissociative Identity Disorder

A

Disruption of individual identity characterized by 2+ distinct personality states (the primary and an alter)

Inability to recall personal information
frequent memory gaps in primary while an alter takes control

33
Q

Depersonalization/Derealization Disorder

A

Depersonalization: Experiences of unreality, detachment or being an outside observer of one’s thoughts, feelings, sensations, body or actions

Derealization: Experiences of unreality or detachment with respect to surroundings (e.g., objects and/or environment seem unreal or dreamlike)

reality testing remains intact (they know it is a misperception)

function impairment due to symptoms 
not due to medical condition
34
Q

Dissociative Disorders Etiology

A

currently not known

a last ditch effort to respond to an overwhelming environment

35
Q

DID etiology

A

known to have smaller hippocampus, amygdala, parietal structures, and frontal structures

associated symptoms:
dissociation
neurotic defense mechanisms

36
Q

Dissociative Disorders Treatment

A

Usually psychotherapy supported by a strong therapeutic alliance

Hypnosis may be used to help recover memories

Memory retrieval may trigger grief, rage, shame, guilt,
depression and inner turmoil

NB3 (last of MS1) (11 decks)

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