Module 6 compiled Flashcards
Ultimate purpose of classification of mental disorders
Improve treatment and prevention efforts
Four Domains of Practice Affected by Classification
Standard Frame of Reference
Diagnostic Standards and Instruments for Research
Teaching of Psychiatry
Communication of users of services
One of the Three Principal Functions Of Medical Classification which involves assigning a common name to a group of phenomena
Denomination
One of the Three Principal Functions Of Medical Classification which involves enriching category information with relevant descriptive features
Qualification (Demographics, Epidemiology, Prognosis)
One of the Three Principal Functions Of Medical Classification which involves the expected outcome and response to treatment
Prediction
Symptoms, pathology, pathophysiology, etiology are known; conjunction of etiology and pathology
Disease
Exact etiology and mechanism not known; Conjunction of syndrome with clinical course
Disorder
A set of signs and symptoms that occur at greater than chance frequency
Syndrome
Caveat of present classification where there is ambiguity of concretism
Reification Fallacy
In every disorder in Psychiatry, there must be a biological basis
Biological Basis of Classification
Disease is defined without having to attribute them to a theory
Atheoretical Classification
A kind of validity in classification where symptoms chosen as a criteria are consistently associated with the disorder
Construct Validity
A kind of validity in classification which includes the extent to which a diagnosis is able to predict the course of disorder and the likely treatments
Predictive Validity
A kind of validity in classification which includes the extent to which a diagnosis reflect what experts in a field think
Content Validity
It is a degree to which a measurement is consistent
Reliability
The two widely used classifications in Psychiatry at present
International Classification of Diseases (ICD) 10th Ed.
Diagnostic and Statistical Manual (DSM) 5th Ed.
Classification produced by the global health agency of UN; covers all health conditions; global, multidisciplinary, multilingual development; approved by the World Health Assembly
ICD
Classification produced by national professional association and covers only mental disorders; for (US) psychiatrists; dominated by US, Anglophone perspective; approved by APA assembly
DSM
ICD edition with first separate section in on Mental Disorders
ICD 6
T or F: One limitation of ICD is that there is no explicit agreement of mental disorder
True
T or F: In international use of ICD, there no need for universalism and diversity
False (there is a need instead)
Diagnosis made in a condition meeting symptomatic requirements of simple schizophrenia but the duration is less than 1 month and can be reclassified as schizophrenia if symptoms persists longer
Acute schizophrenia-like psychotic disorder
T or F: Loss interest in work, social activities, and personal appearance and hygiene together with generalized anxiety and mild degrees of depression and preoccupation are in the prodromal phase of schizophrenia that preceded the onset of psychotic symptoms by weeks or even months.
True
Schizophrenia should be diagnosed in the presence of overt brain disease or during states of drug intoxication or withdrawal.
False (should not be)
The diagnosis of schizophrenia should be made in the presence of extensive depressive or manic symptoms unless it is clear that schizophrenic symptoms antedated the affective disturbance.
False (should not be)
Year of 1st DSM edition
1952
Corresponding ICD of DSM II
ICD 8
DSM that is psychoanalytic in orientation; contained in 3 broad categories;Psychoses, Neuroses, Character Disorder
DSM I and II
DSM that started to use empirical data to determine disorders and has specific diagnostic criteria
DSM III
Referring to behaviors, values, and feelings that are in harmony with or acceptable to the needs and goals of the ego, or consistent with one’s ideal self-image
Egosyntonic
Refers to thoughts and behaviors (e.g., dreams, impulses, compulsions, desires, etc.) that are in conflict, or dissonant, with the needs and goals of the ego, or, further, in conflict with a person’s ideal self-image
Egodystonic
In this edition of DSM, Acute Stress Disorder, PTSD, Bipolar II Disorder, Asperger’s Disorder were added while Cluttering, Passive-Aggressive Personality Disorder were deleted
DSM IV
(DSM II) Neurosis that is characterized by anxious over-concern extending to panic and frequently associated with somatic symptoms
Anxiety Neurosis
T or F: (DSM II) Anxiety neurosis may not occur in many circumstances and is restricted to specific situations or objects.
False (may occur and is not restricted; the definition suits Phobic Neurosis)
T or F: (DSM II) In contrast to anxiety neurosis, normal apprehension or fear occurs in realistically dangerous situations.
True
(DSM 5) Generalized Anxiety Disorder characterized by excessive anxiety and worry occurring more days than not for at least 6 months about a number of events or activities.
True
Latest DSM is DSM V
False (DSM 5)
Feature of DSM 5 where it describes the manifestations of mental disorders and rarely accounts etiology
Descriptive Approach
Feature of DSM 5 where specific diagnostic criteria are provided for each specific mental disorder
Diagnostic Criteria
Feature of DSM 5 where each disorder is systematically described in terms of associated features such as specific age, culture, etc,
Systematic Description
Diagnosis based on 5 axes is discontinued in DSM 5.
True
One limitation of DSM is that the validity criteria remain elusive.
True
Formed in 199, it serves as conduit for the exchange of information and ideas from research to clinical practice on mood and anxiety disorders
Canadian Network for Mood and Anxiety Treatments (CANMAT)
A drug is any substance (including food and water) which when taken into the body, alters the body’s function either physically and/or psychologically.
False (excluding food and water)
Alcohol and caffeine (especially in commercial drinks) are considered as drugs.
True
It is the repeated non therapeutic use of any drug in doses or schedules which produce significant risk of adverse effects to users or others. It requires a pattern of pathological use that led to impairment. There’s no withdrawal.
Substance Abuse
It is the heart of drug use and may cause medical, financial, legal, social, psychological, and family problems.
Adverse effects
A condition in which the use of drugs has become a central part in the person’s life. There is tolerance and withdrawal.
Substance Depedence
Increased amounts of substances are needed to achieve the desired effect or there is diminished effect with regular use of the same dose.
Tolerance
This occurs when a substance specific syndrome follows abstinence from a substance previously used on a regular basis.
Withdrawal
The most neglected health problem and the most untreatable illness today.
Alcoholism
T or F:People are much less likely to abuse drugs which are readily available to them.
False (more likely)
T orF: Modeling and social reinforcement may make a new user accept the use of drugs.
True
The major cause of compulsive drug use
Pharmacologic Reinforcement
Risk takers seem more likely to become abusers than those who cautiously refrain from chancy and risky activities.
True
Males outnumber women in substance abuse.
True
Psychostimulant which is found in decongestant
Ephedrine
Psychostimulant used in treatment of ADHD
Methylphenidate
T orF: Psychostimulants increase concentration of monoamine transmitters (dopamine, noradrenaline, serotonin) in synaptic cleft.
True
Normal duration of effect of Methamphetamine
3-6 hours
Normal duration of effect of MDMA (ecstacy)
6 hours
Plant part that is being used in Cannabis is the leaves.
False (buds)
Concentrated form of Cannabis
Hashish oil
Active compound in Cannabis
Delta 9-THC
T or F: Withdrawal symptoms to Cannabis are gradual because of its water solubility.
False (lipid solubility)
Syndrome in Cannabis abuse where patient became so contented he/she no longer wants to change
Amotivational Syndrome
Effect of Cannabis occurs within minutes
True
What are the six levels of insight?
- Complete denial of illness
- Slight awareness but there is also denying
- Awareness but blaming it on others
- Awareness but does not know about the illness/condition
- Intellectual insight
- True emotional insight
This refers to the ability to ability to control expression of aggressive, hostile, fearful, guilty, affectionate or sexual impulses in situations when the expression would be maladaptive.
Impulse Control
T or F: In testing judgment, the test situation must have standard goal actions since the tester himself may have poor judgment.
T
T or F: Preoccupations are usually abnormal especially when these are obsessional in nature.
F, most preoccupations are normal
This refers to the ability to shift back and forth between general concepts and specific examples.
Abstract Thought
The ff is an example of what type of abnormality of thought process?
Dr: Ano dason ang natabo?
Px: Te subo mo kag ginbubo ko ang kabo amo to natabo
Clang Associations
This refers to hallucinations one feels inside his/her body; bodily functions that are usually not detectable.
Coenesthetic hallucinations
What are the characteristics of a normal thought process
Linear, organized,
goal-directed
Looseness of association is an abnormality in thought process that is common in which conditions?
Psychosis, schizophrenia
T or F: Paranoid patients must be reassured via touch to establish trust and make them feel secure.
F
Differentiate speech from language.
Speech is the physical production of oral communication, while language refers to cognitive function of generating and expressing thoughts in oral speech, sign language, writing or other means.
What are the elements of affect?
Quality, quantity, range, appropriateness, congruence
In marital and relationship history, how is cyclothymics defined?
Very turbulent
T or F: The MSE provides a cross-sectional perspective.
T
T or F: Cyclothymic are known to have very turbulent relationship history.
T
How is blending assessed in a psychiatric interview?
Through checking the Duration of Utterance (DOU), the Reaction Time Latency (RTL), and the Degree of Interruptions
Differentiate empathy from identification.
Empathy - maintaining one‘s own perspective
Identification - proceeding to feel the emotional state of the px
What are the three keywords in a psychiatric interview?
Engagement, blending, empathy
T or F: The first five minutes of the psychiatric interview should consist of establishing rapport using closed-ended questions.
F
Suicidal thoughts are particularly common in which type of psychiatric disorders?
Mood disorderst
T or F: The psychiatric history gives a longitudinal view of the px
T
The psychiatric history must focus on the relationships between which factors?
The occurrence of symptoms and life events and feelings
What is lethality history?
Suicide, violence and homicidal history
T or F: It is better to avoid asking “what” questions. Instead, “why” questions should be asked so the px can explain his/her point of view better.
F
A total score of 3 in the CAGE Questionnaire is indicative of…
High suspicion for alcholism
Hyperthyroidism can mimic which psychiatric disorder?
Anxiety disorder
Why is it important to ask for past surgeries?
This is to evaluate the patient’s reactions and coping
Thumb sucking disappears at which age?
2-3 y.o.
When does bedwetting become a disorder
At >5y.o.
Middle childhood illness, surgery, and trauma need to be evaluated at which age range especially?
3-6 y.o.
Different ways of looking at mental illnesses or mental disorder
Paradigm
Most popular among paradigm models
Biological Model
This model assumes that all symptoms are rooted at some dysfunctions of the brain
Biological Model
In the biological model the clinician is concerned with what?
Etiology Pathogenesis s/sx ddx treatment & prognosis
In the biological model the attitude of the clinician is respectful, but he keeps his distance. Why is this so?
To maintain objectivity, detachment fosters objectivity. The clinician is less interested in the personality of the px.
This model presumes that the mind funcitons (no physical structures) because it has structures which interact each other
Psychodynamic model
T or F. in the psychodynamic model, the mind is located outside the brain and it is not equal to the brain.
False, it believes that the mind is located IN the brain, BUT does not necessarily mean that the mind is equal to the brain
In the psychodynamic model why is it that the psychiatrist would like to know your past as much as he can?
To determine your character because it will be the vulnerabilities in this character that will explain what you are having
what is the focus of the sociocultural model
It centers on the social system (px and his human/societal environment)
The treatment in the sociocultural model would consist of:
Reorganizing the patient’s relation to the social system, or reorganizing the system itself
This model believes that behaviors can be learned
Behavioral model
How does the behavioral model explain why problematic behaviors are maintained?
These behaviors are maintained because they lead to positive effects or because they avoid deleterious ones
The conditions that precede the behavior may be modified by:
Desensitization
Reciprocal inhibition
Conditioed avoidance
How did Freud describe what is sexual?
Anything that is pleasurable is sexual. Even if you are just sitting there feeling pleasure that is not related to your genitals, that is sexual
Psychoanalysis designed 2 theories to understand the human mind, what are these theories?
TOpograhic model
Structural model
The topographic model states that the mind is made up of 3 areas:
Conscious
Preconscious/Subconscious
Unconscious
What is the small area that is at the end of the circle (circle=mind) that freud talks about?
The conscious
Part of the mind that contains everything that is in your awareness at this present time
Conscious
T or F:The unconscious area contains those things that are not in your consciousness now but can be brought back to consciousness either by you being provided with a clue or by you trying to remember what that thing is.
False it is the preconscious area
T or F: Some or most of the things that we have studied for the exam goes to the unconscious.
It depends on you. Basta the unconscious contains the things that you could not remember easily even if you put attention to them and even if you are given clues as to their existence. Cry ka na lang
According to the topographic model, how does anxiety happen?
It happens when the mind is unable to put fears, unacceptable sexual desires etc in the unconscious
According to the jack in the box effect, the force that keeps jack (our memory) from escaping from the box is our mind. This form of defense mechanism is called
Repression
T or F. In therapy, to be more objective, the details to an event is what you want to remember and not the feelings associated to it
F: it is not the details but the feelings associated to it
Why is the structural model also known as the tripartite model
because aside from the conscious, preconscious and subconscious, the mind is made up of three structures which interact with each other (either form conflicting or harmonious relationships with each other): ID, EGO, AND SUPEREGO
refer to a reservoir of unorganized instinctual drives
ID
Only structure present at birth
ID
During blackouts, the generator is turned on and provides light for a particular house. But it is hidden and placed in a location not accessible to other people. The people only see the lights and electrical appliances that were turned on. They also know that the house has a working generator. But they do not see the generator.
In this analogy which one is the ID and the which is the ego?
(The Id is the generator which fuels; we are not aware of its presence. The lights and appliances are the Ego; what we often see and observe in ourselves are Ego functions.)
What are the source of instinctive and driving forces of id
Pleasure
Destruction
What is the pleasure principle that the id works on
It is the thought of wanting something and trying to get that something no matter what the cost
executive organ of psyche”; controls motility, perception, contact with reality, delay and modulation of drive expression
Ego
What does the ego do to the id and superego
It mediates the desires of the id and demands of the superego
The ego spans all 3 topographic dimensions
What comprises the conscious and preconscious?; unconscious?
Conscious and preconscious: logical and abstract thinking; verbal expression
Unconscious: defense mechanisms
What is the reality principle that the ego works on
Postponing pleasure for a far greater one
What are the funcitons of the ego
- Control and regulation of drives and instincts
- Reality testing
- Judgment
- Affect regulation
- Thought process
- Objective relations
- Defense Mechanisms
- Synthetic Function
- Autonomous Ego function
T or F: Instincts are Ego functions
F: Instincts are ID fxns
T or F: Reality testing involves mediation btn the internal world and external world
T
Reality with the outside world can be divided into 3 aspects what are these
Sense of reality
Reality testing
Adaptation to reality
Capacity to anticipate consequences of our actions and make decisions
Judgement
Ability to maintain or increase positive feelings and a sense of well-being, while minimizing or regulating stress feelings and defensive states
Affect regulation
Ability to have logical, coherent, and abstract thoughts
Thought process
Are mental processes, usually unconscious, that we resort to in order for us to be relieved of anxiety in our daily lives
Defense mechanism
The capacity of the ego to lead the ID and superego in doing something
Synthetic Function
Moral arm of the psyche
Superego
One Monday morning while you are riding a jeep you paid 1000 pesos because that was the only money you have and you have no change. You are the first passenger of this jeep and as soon as the driver got your money he started to become hysterical and scolds you until you are near your destination 1 hour after. These thoughts came to your mind:
a. Bun-on ko na lang ni ang gago ya kagina pa ni mo.
b. Indi ko sya pag bun-on kay sala ina bisan kagina pa sya wala untat pangakig
c. Indi ko sya pag bun-on subong, karon lang.
d. Iya na lang 1000 ko mautang na lang ko kay Betita kay damo kita nya sa dream cake What were the structures involved in these thoughts?
a. Id
b. Superego
c. Ego
d. Ambot ano ni ya
prescribes (tells you that what you do is good or bad) what is best. “You should be like this
Ego Ideal
The part of the superego that includes the rules and standards for good behaviors.
Ego ideal
