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SD- Psych > Personality/Somatoform/Psychotic DO Lecture > Flashcards

Personality/Somatoform/Psychotic DO Lecture Flashcards

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1
Q

an enduring, repetitive pattern of perceiving, relating to, and thinking about the environment and oneself

A

Personality trait

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2
Q

a pervasive, inflexible, maladaptive manner by which the world is viewed, which originates in adolescence or earlier (some even cite from the first 2 years of life!), and alters how the patient views the world

A

Personality disorder

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3
Q

Dysfunctional characteristics of a person’s personality that are incongruent with social norms

A

Personality disorder

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4
Q

With this type of psychiatric diagnosis, there is conflict betwen the person and the world

*these pts are aware of their condition

ie..a depressed person realizes he/she is depressed

A

Ego-dystonic

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5
Q

With this type of personality disorder,
there is no conflict between the person and the way they view the world

*they rarely see difficulty with how they act and rarely seek help. they therefore tend to have maladaptive lives riddled with legal and psychosocial dysfunction

A

Ego-syntonic

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6
Q

Individuals with this type of personality disorder…

are “unaware” of their condition and ofteen feel perscuted by society as a result of this

A

Ego-syntonic

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7
Q

There are 10 personality disorders that are broken up into _____ clusters

*must have 5 of 9 traits to have disorder

A

three clusters! (A, B, C)

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8
Q

“weird, wacky, odd/eccentric”

Paranoid
Schizoid
Schizotypal

..what cluster?

A

Cluster A

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9
Q

“Dramatic, emotional, erratic, wild”

Antisocial
Borderline
Histrionic
Narcissistic

..what cluster?

A

Cluster B

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10
Q

“Anxious, fearful, worried”

Dependent
Obsessive-Compulsive
Avoidant

what cluster?

A

Cluster C

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11
Q

This disorder is marked by intense distrust due to assuming the motives of others are malicious

Because of the preoccupation with unjustified doubts, a person with this disorder may perceive even an innocuous interaction as a character assassination.

The result of this is extreme suspicion and strained interpersonal relationships and the ability to interact becomes stilted.

A

Paranoid

(part of Cluster A personality D/O)

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12
Q

Blunted affect (expressionless) associated with feelings of detachment

*desire relationships to be distant, often choose to be solitary

do NOT show much emotion, they are often perceived as emotionally cold

A

Schizoid

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13
Q

Think of the night watchman: Happy being alone, do not want friends and wont think anything of not having friends, seem emotionally cold

“Goes to work comes home goes to work comes home… same thing everyday”

A

Schizoid

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14
Q

Inability to interact with others due to discomfort, which arises from the actual act of having to interact (NOT due to negative self image)

*they may also demonstrate cognitive distortions, odd speaking patterns, and experience strange perceptual occurrences influencing their behavior

(magical thinkers, link to schizophrenia D/O)

A

Schizotypal

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15
Q

“GET FACT”

  • *G**rudges help for long periods of time
  • *E**xploitation expected (without a sufficient basis)
  • *T**rustworthiness of others doubted
  • *F**idelity of sexual partner question
  • *A**ttacks on character are perceived
  • *C**onfides in others rarely, if at all
  • *T**hreatening meanings read into events
A

Paranoid Personality Disorder

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16
Q

“SIR SAFE”

  • *S**olitary lifestyle
  • *I**ndifferent to praise or criticism
  • *R**elationships of no interest
  • *S**exual experiences not of interest
  • *A**ctivities not enjoyed
  • *F**riends lacking
  • *E**motionally cold and detached
A

Schizoid Personality Disorder

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17
Q

“UFO AIDER”

  • *U**nusual perceptions
  • *F**riendless except for family
  • *O**dd beliefs, thinking and speech
  • *A**ffect- inappropriate, constricted
  • *I**deas of reference
  • *D**oubts others- suspicious
  • *E**ccentric appearance/behavior
  • *R**eluctant in social situations, anxious
A

Schizotypal Personality D/O

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18
Q

Paranoid, Schizoid and Schizotypal are all what cluster of personality DOs?

A

Cluster A

(they are strange)

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19
Q

Antisocial
Borderline
Histrionic
Narcissistic

..what cluster of personality DOs?

A

Cluster B

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20
Q

pervasive pattern of disregard for and violation of the rights of others.

Very impulsive and show disregard for the safety and welfare of others and of themselves. They fail to conform to social norms, participate in unlawful activities, and lack remorse for those they have wronged.

MC= Men, Diagnosis @18y

A

Antisocial

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21
Q

instability in self-image and interpersonal relationships.

Impulsivity may lead to self-harm, such as drug abuse and promiscuous sex, and relationships are often polarized (black-white, love-hate) such that a pattern of extreme valuation-devaluation is expressed.
This can lead to efforts to avoid real or imagined abandonment and feelings of emptiness.

MC= Women; Cutting, 18

A

Borderline

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22
Q

What type of personality D/O….

Young woman who cuts herself or harms herself but is not trying to actually kill herself

*Commit acts for attention, not trying to kill self

A

Borderline

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23
Q

emotionality and attention seeking behavior is expressed, and are not happy unless they are the center of attention.

In order to gain attention, they often are swayed by fads, become overly trusting, and even may interact in inappropriately sexual manners.

Displays of emotion are often theatrical and overly dramatic, yet are superficial and can change immediately

A

Histrionic

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24
Q

prone to grandiose fantasies, with the need for admiration.

Generally lacking empathy, these people are arrogant and feel a sense of entitlement.

They expect others to acknowledge their supposed superiority and feel overly jealous when others receive praise.

A

Narcissist

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25
Q

Avoidant
Dependent
Obsessive-Compulsive

..what cluster of personality DOs?

A

Cluster C

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26
Q

They want friends, but do not know how to obtain them
*dysfunction in ability to act interpersonally due to discomfort.

They have self-inadequacy (compare to schizoid).
Because of their fear of shame, ridicule, or rejection, they choose to interact with others as little as they possibly can.

New activities are rarely attempted and new relationships are seldom formed.

MC in Women, related to abuse

A

Avoidant

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27
Q

excessively clingy and have a pervasive need to be cared for
They are prone to experience separation anxiety, and jump from relationship to relationship when one ends.

They have trouble making everyday decisions on their own, and they go out of their way to make sure others have responsibility to make major decisions.

MC in Women

A

Dependent

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28
Q

inflexible and rigid strive for perfection (“Type A Personality; “Anal-Retentive”);

rigidity is to the point that projects and tasks cannot be completed on time because they are not perfect enough.

The preoccupation with details, rules, lists, and organization can be very invasive to the point that it affects interpersonal functioning.

A

Obsessive-compulsive

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29
Q

Are there FDA approved medications to treat any personalty DOs?

A

NO

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30
Q

What is largely the mainstay of treatment for personality disorders?

A

Psychotherapy

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31
Q

relationship between psychological events and physical health has been recognized for a long time, but the precise nature of this relationship is unclear

A

Psychosomatic theory

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32
Q

Something internally (ie depression) causes something physical/externally to happen (ie migraine, diarrhea)

A

Psychosomatic problems

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33
Q

Mental disorders characterized by physical symptoms but without physical cause

symptoms NOT intentionally produced (unconscious)
More common in women

ie.. Somatic symptom D/O, Illness anxiety D/O, Conversion D/O

A

Somatoform disorders

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34
Q

Variety of complaints in one or more organ system(s) lasting for months to years

Associated wth excessive, peristent thoughts about symptoms
May co-occur with medical conditions

A

Somatic symptom disorder

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35
Q

Preoccupatin with and fear of having a serious medical illness despite medical evidence and reassurance to the contrary

**often have CHECKERBOARD abdomen from so many surgeries*

Need to make these ppl feel understood but also rationalize how insurance will only pay for so much

A

Illness anxiety disorder (hypochondriasis)

36
Q

Sudden loss of sensory or motor function (paralysis, blindness, mutism,etc) often following an acute stressor

patient is aware of but sometimes indifferent to the symptoms
**LA BELLE INDIFFERENCE

More common in females, young adults, adolescents

A

Conversion disorder

37
Q

A condition in which a person is unconcerned with symptoms caused by a conversion disorder

*inappropriate lack of emotion or concern

A

La Belle Indifference

38
Q

Presenting complaints may be: dramatic, multiple, peculiar
Can have extreme anxiety or profound lack of anxiety

History often vague and complex. multiple past work ups with inconclusive findings

Lab studies are often inconsistent with medical complaints

A

Diagnostic clues to somatoform disorders

39
Q

What is the difference between a somatoform D/O vs. malingering and factious D/O?

A

Somatoform= unconscious, NOT intentional

Malingering and factious disorder= CONSCIOUS! there is incentive for this person

40
Q

The intentional/conscious production of false or grossly exaggerated physical or psychological symptoms that is motivated by external incentives

A

Malingering

41
Q

“Faking” or exaggerated symptoms to obtain a specific secondary gain

*POOR compliance!

Complaints cease after gain

A

Malingering

42
Q

Involves the intentional/conscious production or feigning of physical or psychological illness based primary upond a desire to assume the sick role and get medical attention, not as a response to external incentives

*INVOLVES PRIMARY GAIN

A

Factitious disorder

43
Q

Which intentional/conscious decision to fake or exaggerate and illness is for primary gain?

which one is for secondary gain?

A

Primary gain= Factitious disorder (medical attention)

Secondary gain= Malingering (ie financial gain)

44
Q

Munchausen syndrome and Munchausen syndrome by proxy are examples of?

A

Factitious disorders

45
Q

Chronic factitious disorder with predominantly physical signs and symptoms, characterized by a history of multiple hospital stays and willingness to receive invasive procedures

A

Munchausen Syndrome

46
Q

When illness in a child or elderly patient is caused by the caregiver

Motivation is to assume the sick role by proxy

A

Munchausen syndrome by proxy

(this is a form of child/elder abuse*)

47
Q

Which 2 of the following are psychiatric disorders:

Malingering
Factitious Disorder
Somatization

A

Factitious and Somatization are psychiatric disorders

(Malingering is NOT)

48
Q

Which 2 of the following are deliberate and conscious decisions?

Malingering
Factitious Disorder
Somatization

A

Malingering
Factitious D/O

(Somatization is NOT deliberate)

49
Q

Syndrome characterized by gross impairments in the ability to assess reality, and behave coherently

A

Psychosis

50
Q

Defined if 1 or more of the following is present:

Hallucinations
Delusions
Disorganized speech
Disorganized behavior
Disorganized motor behavior
Negative symptoms

A

Psychosis

51
Q

Cognitive disorders, such as delirium and dementia
Mood disorders
Autistic disorder
Psychotic disorders

…all of these disorders incorporate _______

A

psychosis

52
Q

sensory impressions that occur without external stimulation of the relevant sensory organ

A

Hallucinations

53
Q

fixed, false beliefs even in the presence of evidence to the contrary. The beliefs are firmly held and do not waver.

A

delusions

54
Q

Diminished emotional expression and avolution are examples of..

A

negative symptoms

(seen with psychosis)

55
Q

Presenting complaints of auditory and/;or visual hallucinations, bizarre beliefs, unusual suspiciousness, change in social behavior, marked decrease in motivation or self-care, and peculiar behaviors or mannerisms

physical exam often unremarkable

A

Psychosis

56
Q

Mental status examination shows hallucinations, delusions, disorganized speech or behavior, peculiar psychomotor activity

A

Psychosis

57
Q

Disorder characterized by psychosis and disintegration of abilities to think logically and maintain normal social behavior

pts have both positive and negtive symptoms (plus other sxs)

A

Schizophrenia

58
Q

Examples of positive symptoms seen in schizophrenia

A

Hallucinations
Delusions

59
Q

Examples of negative symptoms seen in schizophrenia?

A
  • *Affectal blunting** (decreased intenstiy of emotional response)
  • *Avolition** (decreased motivation to do purposeful activities)
  • *Alogia** (lack of speech)
  • *Social withdrawal**
60
Q

Examples of disorganized sxs in schizophrenia?

A

Illogical/incoherent speech
Aimless or pecuilar motor behavior

61
Q

Examples of cognitive sxs in schizophrenia?

A

Impaired attention
Impaired ability to plan, organize, sequence activity
Impaired memory

62
Q

Depressed mood
Substance abuse
Sleep disturbances

A

Other symptoms associated with schizophrenia

63
Q

Delusions
Hallucinations
Disorganized speech
Grossly disorganized or catatonic behavior
Negative symptoms: decreased emotional expression, avolition

…how many of these are required for a schizophrenia dx?

A

2 or more

64
Q

Post morbid decline (ie..occupation, social, self care)
6+ month duration

A

Other requirements for a schizophrenia dx

65
Q

Serotonin and dopamine antagonists (SDAs), aka atypical antipsychotics, are first line treatment for?

A

Schizophrenia

(Clozapine is second line because it can cause agranulocytosis)

66
Q

Typical neuroleptic and antipsychotic meds with dopamine antagonist activity (haloperidol, chlorpromazine, thioridazine, loxapine, flupheazine)

are best for the management of _______ symptoms in schizophrenia

A

positive!

67
Q

Second generation antipsychotics or atypical neuroleptics with SDA activity (risperidone, paliperidone, asenapine, olanzapine, aripiprazole, ziprasidone, quetiapine)

are generally used in the treatment of _________ symptoms in schizophrenia

A

negative

68
Q

For a schizophrenia dx, the symptoms must last longer than…

A

6 months

69
Q

Schizophreniform disorder has virtually the same symptoms as schizophrenia but has a different timeline

what is the timeline for schizophreniform?

A

1 month to 6 months

70
Q

What is the timeline for brief psychotic disorder (which has pretty much the same symptoms as schizophrenia)

A

1 day to 1 month

71
Q

A disorder with baseline psychosis with inter-episode mood symptoms, with at least a 2 week period with the absence of mood symptoms and just psychotic symptoms

A

Schizoaffective disorder

72
Q

Baseline psychosis with mixed episodes of mood symptoms, with a 2 week period that is just psychotic symptoms

A

Schizoaffective disorder

73
Q

This disorder meets the criteria for major depressive episode, manic episode, or mixed episode, during which criteria for schizophrenia are also met

there is a mixture of psychotic and mood symptoms

**delusions or hallucinations lasting for 2 weeks without mood disorder symptoms help to differentiate***

A

Schizoaffective disorder

74
Q

Disorder involving delusions about plausible events, such as being persecuted, having a serious illness, or having a secret relationship with another person

often not overly bizarre
thought process generally organized

functioning is NOT markedly impaired

A

Delusional disorder

75
Q

Present to clinical attention when:

Anxiety overtakes them about their delusion
Discovery by a relative, friend or found upon medical examination
Threats or illegal activity related to delusion

A

Delusional disorder

76
Q
  • *Erotomanic** (belief another person is in love with the pt)
  • *Somatic** (delusions of a physical defect or medical condition)
  • *Jealous** (delusions of sexual partner’s infidelity)
  • *Persecutory** (delusion of mistreatment or persecution)
  • *Grandiose** (inflated self worth, power, knowledge)
A

Subtypes of Delusional Disorder

(tx= same as schizophrenia)

77
Q

Alcohol
Illicit drugs
Medications (anticholinergics, antidepressants, hallucinogens, psychostimulants)
CNS disease
Endocrinopathies
Vitamin deficiency
HIV/AIDS
SLE

..can all cause?

A

psychotic disorders

78
Q

Paranoid
Disorganized
Catatonic
Undifferentiated
Residual

A

Types of schizophrenia

79
Q

MC type of schizophrenia?

A

Paranoid schizophrenia

80
Q

Rare subtype of schizophrenia

Must have at least 2 of the following:
Extreme negativism or mutism
Motor immobility
Excess motor activity without purpose
Pecuilary voluntary movement (bizarre posture, “waxy flexibility”)
Echolalia
Echopraxia​

A

Catatonic schizophrenia

81
Q

Good pre-morbid functioning
Later age at onset
Acute onset
Obvious precipitating factors
Presence of positive symptoms

A

more favorable prognosis of schizophrenia

82
Q

3 phases of schizophrenia?

A
  1. prodromal phase
  2. psychotic phase
  3. residual phase
83
Q

Precedes first psychotic break by month or years

subtle behavioral changes, functional decline, social withdrawal, irritability

A

Prodromal phase of schizophrenia

84
Q

What phase of schizphrenia…

Delusions, hallucinations, disorganized speech, bizarre behavior, thoughts and content

A

Psychotic phase

85
Q

What phase of schizphrenia..

Occurs between psychotic episodes
Blunted affect, odd thinking/behavior and other negative symptoms

A

Residual phase

SD- Psych (7 decks)

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