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Abnormal Psych > Midterm > Flashcards

Midterm Flashcards

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1
Q

What is abnormal?

A

Not a diagnosis

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2
Q

Nosology

A

The systematic classification of diseases

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3
Q

Disease

A

a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment.

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4
Q

Does the definition of disease leave room for interpretation?

A

Yes! Tons!

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5
Q

What 2 things are needed to use DSM for determining a diagnosis?

A

Clinical training and experience

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6
Q

Type 1 Error

A

Rejecting the Null Hypothesis (“false positive”)

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7
Q

Type 2 Error

A

Non-rejection of Null Hypothesis (“false negative”)

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8
Q

Examples of Type 1 & 2 errors

A

Type I error includes “This person is X,” when they are not. Type II error includes “This person is not X,” when they are.

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9
Q

What does diagnostic criteria incorporate?

A

gender, developmental stages, culture, and case context.

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10
Q

Does the DSM capture every disorder?

A

“…the range of genetic/environmental interactions over the course of human development affecting cognitive, emotional and behavioral function is virtually limitless. As a result, it is impossible to capture the full range of psychopathology in the categorical diagnostic categories that we are now using.” (DSM, pg. 19)

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11
Q

Common features of depressive disorders

A

the presence of sad, empty, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual’s capacity to function.

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12
Q

Major Depressive Disorder

A

5 of the 9 criteria are met during the same 2-week period, at least one symptom is either (1) depressed mood or (2) anhedonia (inability to feel pleasure.)

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13
Q

Anhedonia

A

inability to feel pleasure

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14
Q

9 Criteria of Major Depressive Disorder

A

(SIG-E-CAPS)
Sleep (Too little or too much sleep) (A lot of time depressed people sleep a lot and never feel rested)
Interest (No longer having interest in things they were once interested in)
Guilt (“I don’t deserve to be alive, I don’t deserve to be happy”)
Energy
Cognition/Concentration
Appetite (Some people eat a lot, some people stop eating)
Psychomotor (They don’t have the ability/energy to get around, they bump into things, etc)
Suicidality (“I just want to fall asleep and never wake up again”)

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15
Q

What does major depressive disorder require

A

A major depressive episode

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16
Q

What if someone is grieving (Major depressive disorder)?

A

There’s a grief clause. Related to time

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17
Q

What is: Disruptive Mood Dysregulation Disorder

A

“temper” due to depression (Ex: Children being irritable on the playground, depression for children on the inside manifests as irritability on the outside)
(THIS IS A DEPRESSED YOUTH WHO DUE TO DEPRESSION ARE ACTING IRRITABLE, DEVELOPMENTALLY INCONGRUENT)

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18
Q

Criteria for Disruptive Mood Dysregulation Disorder

A

Outbursts 3 or more times a week, and irritable mood “most of every day”
-Symptoms present for at least 12 months, with no more than 3 months without symptoms
This diagnosis is not made before 6 years old or after 18 years old. (Someone over 18 probably has a different, more appropriate diagnosis.)

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19
Q

Persistent Depressive Disorder (dysthymia)

A

2-year presence of depressive symptoms, or 1 year in children/adolescents (18 and under). (*if there is mania, it is probably not this)

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20
Q

Other Specified Depressive Disorder

A

Symptoms do not meet full criteria for other depressive disorder, but cause functional impairment

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21
Q

When would you diagnose ‘other specified depressive disorder’?

A

Diagnosis is meant to indicate the ‘specific’ reason for the diagnosis, despite the absence of full criteria for another existing disorder

22
Q

Unspecified Depressive Disorder

A

Characteristically depressive symptoms do not meet criteria for other existing depressive disorder, but cause functional impairment, and clinician chooses not to specify the reasons that the other criteria are not met

23
Q

Why would you diagnose ‘unspecified depressive disorder”?

A

Unspecified doesn’t mean there’s no reason, it means you choose not to specify reason
(Ex: transgender woman on her parents’ insurance who is not out, does not want this on her medical records)

24
Q

Differential Considerations for depressive disorders

A
  • Substance Use
  • Other Medical Conditions
  • Developmental/age-related
25
Q

Separation Anxiety Disorder

A

-”Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached…”

26
Q

Criteria for Separation Anxiety Disorder

A
  • 3 of 8 diagnostic criteria are met
  • 4 weeks in children, 6 months or more in adults (On test, Likely a CHILD, but know the difference)
  • ”Persistent reluctance or refusal” clause to indicate pattern, not anomaly
27
Q

8 DSM Criteria for Separation Anxiety Disorder

A
  1. Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures.
  2. Persistent and excessive worry about losing major attachment figures or about possible harm to them, such as illness, injury, disasters, or death.
  3. Persistent and excessive worry about experiencing an untoward event (e.g., getting lost, being kidnapped, having an accident, becoming ill) that causes separation from a major attachment figure.
  4. Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere because of fear of separation.
  5. Persistent and excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings.
  6. Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure.
  7. Repeated nightmares involving the theme of separation.
  8. Repeated complaints of physical symptoms (e.g., headaches, stomachaches, nausea, vomiting) when separation from major attachment figures occurs or is anticipated.
28
Q

Selective Mutism

A

”Consistent failure to speak in specific social situations in which there is an expectation for speaking despite speaking in other situations.”
(Probably, almost always, a CHILD)
(If they never speak, there might be other diagnoses like autism, vocal cord issue, etc. So for this diagnosis, they have to speak in other situations)
(Can’t be due to lack of language, lack of competency)
(A lot of times, it’s trauma related)

29
Q

Duration of Selective Mutism symptoms

A

Duration at least 1 month and symptoms are not attributable to lack of knowledge or comfort with the language in that situation

30
Q

Specific Phobia

A

-”Marked fear or anxiety about a specific object or situation.”
‘-Stimulus “almost always” provoking “immediate fear or anxiety.”
-Avoidance or endurance with same disproportionate fear or anxiety
-Lasting 6 months or more
-Specifiers (e.g. Animal, Blood-injection-injury, Situational)

((It’s hard to form a phobia, and it’s hard to get rid of them
Very few things have meaning unless you ascribe meaning to them
Not trauma related (someone who is afraid of driving after a car accident is NOT a phobia, likely ptsd) ))

31
Q

Social Anxiety Disorder (Social Phobia)

A

-”Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others.” (Criteria A)
SCRUTINY is an important identifier
-”The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated.” (Criteria B)
-Can be fear of performing and negative evaluation, and/or fear that the anxiety itself will cause embarrassment, ridicule, humiliation, etc.
(Be cautious this is not just an ordinary facet of life)

32
Q

Time frame for Social Anxiety Disorder

A

-The fear, anxiety, or avoidance is persistent, typically lasting 6 months or
more.

33
Q

Are there any differentials for social anxiety disorder?

A

Yes, many!

34
Q

Panic Disorder Criteria

A

”Recurrent unexpected panic attacks.” (Criteria A)
AND
At least one of the attacks has been followed by ONE MONTH or more of one
or both of the following:
1. Persistent concern or worry about additional panic attacks or their
Consequences (Fear of having more panic attacks)
2. A significant maladaptive change in behavior related to the attacks
(e.g. avoiding their likelihood) (Ex: if they had a panic attack in a grocery store, they avoid the grocery store)

35
Q

Criteria for a ‘panic attack’ (just familiarity)

A
  1. Palpitations, pounding heart, or accelerated heart rate.
  2. Sweating.
  3. Trembling or shaking.
  4. Sensations of shortness of breath or smothering.
  5. Feelings of choking.
  6. Chest pain or discomfort.
  7. Nausea or abdominal distress.
  8. Feeling dizzy, unsteady, light-headed, or faint.
  9. Chills or heat sensations.
  10. Paresthesias (numbness or tingling sensations).
  11. Derealization (feelings of unreality) or depersonalization (being detached from one-
    self) .
  12. Fear of losing control or “going crazy.”
  13. Fear of dying.
36
Q

Some extras about panic disorder

A

(Most people who have had a panic attack will be afraid of having another. This has to last for a month or more for it to be panic disorder)
(Theory: When we panic, our body is reacting to something, and our mind does not have a narrative that fits the bill. There’s no congruence to the physiological reaction. This is a feedback loop that causes a panic attack.)
(Grounding exercises help with panic attacks. Sometimes people are not available for that because they are freaking out too much, but if they can, it’s helpful)
(There doesn’t seem to be an evolutionary reason why people have panic attacks. Some people never have a panic attack)
(Everyone has at least a little anxiety)

37
Q

Agoraphobia Criteria

A
  • ”Marked fear or anxiety about two (or more) of the following 5 situations:”
    1. Using public transportation
    2. Being in open spaces (like in the middle of an open field, or on the 50 yard line of a football stadium) (Afraid that they’ll need help and no one will be able to get to them)
    3. Being in enclosed spaces (like in the Indiana Jones ride at Disney, or in the middle of stadium seating. You’re in a group, there’s fear of being able to get out) (different than claustrophobia, which is tight spaces like a coffin)
    4. Standing in line or being in a crowd
    5. Being outside of the home alone
38
Q

Agoraphobia fear is based on…

A

-The fear is based on thoughts that the individual may not be able to
escape, or that help may be unavailable in the event of panic-like
symptoms, including embarrassment

39
Q

What does agoraphobia provoke?

A

Fear and avoidance, The fear usually stems from a sense of danger. Fear and anxiety out of proportion with the situation

40
Q

What feels like a good solution for agoraphobic people?

A

Being home alone feels like a good solution to this for agoraphobic people, so they don’t leave the home a lot

41
Q

Generalized Anxiety Disorder

A

A: ”Excessive anxiety and worry, occurring more days than not for at least 6
months, about a number of events or activities.”
B: -”The individual finds it difficult to control the worry.”
C: 3 or more of the 6 symptoms that help define ‘worry.’
Restlessness or feeling keyed up or on edge.
Being easily fatigued.
Difficulty concentrating or mind going blank.
Irritability.
Muscle tension.
Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying
sleep).

42
Q

Is it important to use differential criteria for GAD?

A

-It is very important to use differential criteria for GAD; there are many alternative possibilities, although GAD is fairly common (2.9% adult 12-month prevalence, 9% lifetime morbid risk).

43
Q

Other Specified Anxiety Disorder

A

When an individual does not meet the full criteria for another diagnosis, but experiences clinically significant distress or impairment due to anxiety.

44
Q

Unspecified Anxiety Disorder

A

Individual does not meet full criteria for another anxiety disorder, but clinician chooses not to specify reasons that individual’s anxiety is present, and causes clinically significant distress or impairment.

45
Q

Bipolar I

A

Presence of one manic episode, and the occurrence of the mania and major depressive episode(s) is not better explained by another disorder
(You only need to have had ONE MANIC EPISODE in your life)
(*You do not need evidence of a depressive episode for this diagnosis)

46
Q

Criteria for a manic episode

A

7 days or a 5150

During this period of mood disturbance and increased energy or activity, 3 or more of the following symptoms are present to a significant degree and represent a noticeable change from usual behavior:

  1. Inflated self-esteem or grandiosity
  2. Decreased need for sleep
  3. More talkative than usual, or pressured speech
  4. Flight of ideas or subjective experience of racing thoughts
  5. Distractibility (reported or observed)
  6. Increase in goal-directed activity
  7. Excessive involvement in activities that have a high potential for painful consequences
47
Q

Bipolar 2

A
  • Presence of one hypomanic episode and one major depressive episode, and symptoms are not better explained by another disorder
  • Individual cannot have had a manic episode, or else they would receive a Bipolar I diagnosis
48
Q

Hypomania

A

the exact same seven descriptors as Manic, but NOT SEVERE ENOUGH to necessitate hospitalization.
4 Straight Days
-Notice nearly identical list for manic symptoms, but shorter required
duration

49
Q

Cyclothymic Disorder

A
  • For at least 2 years (1 year in minors), there have been numerous periods with hypomanic symptoms that do not meet criteria for hypomania, and numerous periods with depressive symptoms that do not meet the criteria for major depression
  • Episodes must have been present for half of the time (during the 2 years), and never without symptoms for longer than 2 months at a time
  • Criteria for Bipolar I or II have never been met
  • Not better explained by another disorder
50
Q

If a client has had at least one manic episode, what do we rule out?

A

major depressive disorder and cyclothymic disorder

Abnormal Psych (2 decks)

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