Psych 12 Flashcards
What is the distinguishing feature between dissociative amnesia and other conditions resulting in memory loss
Procedural memory is preserved
How do you distinguish binge-purge anorexia from bulimia
In anorexia patients have significantly low body weight vs. bulimia where patients have normal body weight
Define binge eating
Excessive food intake within a 2 hour period accompanied by a sense of loss of control
Time frame of bulimia
Binge eating and compensatory behaviors occur at least once a week for 3 months
Tx of anorexia
SSRI do not work
CBT, family therapy, supervised eating group
Tx of Bulimia
Fluoxetine is only FDA approved
Binge-eating disorder vs. Bulimia
Patients with binge-eating disorder suffer from distress over their binge eating by do not try to control their weight by purging or restricting
Time frame of binge eating disorder
Binge eating occurs at least once a week for 3 months
What are the sleep stages
To remember EEG waves THINK: BATS Dream Big ♣ Awake (eyes open) • Beta waves ♣ Awake (eyes closed) • Alpha waves • Meditating ♣ Non-REM N1 • Theta waves • Light sleep ♣ Non-REM N2 • Sleep spindles and K complexes • Bruxism (teeth grinding) ♣ Non-REM N3 • Delta waves (lowest frequency) • Deepest sleep • Sleep-walking, night terrors, bed wetting ♣ REM sleep • Beta waves • Loss of motor tone • Dreaming
What are types of insomnia disorder
- Difficulty initiating sleep
- Frequent nocturnal awakenings
- Early morning awakenings
- Waking up feeling fatigued and unrefreshed
Tx of insomnia
CBT is first-line
Benzos, Non-benzo hypnotics, Trazodone, amitriptyline, Doxepin
DSM criteria and time frame for hypersomnolence disorder
o Excessive sleepiness despite at least 7 hours of sleep, with at least one of the following:
♣ Recurrent periods of sleep within the same day
♣ Prolonged, nonrestorative sleep > 9 hours
♣ Difficulty being fully awake after awakening
o Occurs at least 3 times per week for at least 3 months
Tx of hypersomnolence disorder
Modafinil or stimulants
Amphetamine-like antidepressants such as atomoxetine are second line
Time frame for narcolepsy
o Recurrent lapses into sleep or naps
♣ Minimum 3x per week for 3 months
What is it called when you have hallucinations when going to sleep and when waking from sleep
HypnaGogic = Going to sleep
HyponopoMic = waking froM sleep
What substance can be used to test for narcolepsy
Low CSF levels of hypocretin
What is cataplexy
Brief loss of muscle tone precipitated by strong emotion (e.g. laughter excitement)
Tx of cataplexy
Sodium oxybate (drug of choice)
TCAs, SSRI/SNRI
What is Delayed sleep phase disorder
o Chronic or recurrent delay in sleep onset and awakening times with preserved quality and duration of sleep
What is advanced sleep phase disorder
o Normal duration and quality of sleep with sleep onset and awakening times earlier than desired
What part of the brain coordinates circadian rhythm
Suprachiasmic nucleus in the hypothalamus
What disorders occur in Non-REM sleep
Sleepwalking, sleep terrors, nightmare disorder
Describe a sleep terror episode
o Recurrent episodes of sudden terror arousals
o Difficult to arouse during an episode
o After episode, patients usually return to sleep without awakening
o Dreams are not remembered
Describe nightmare disorder
o Recurrent frightening dreams that occur during the second half of the sleep episode
o Terminate in awakening with vivid recall
What is REM sleep behavior disorder
- Repeated arousals during sleep associated with vocalization or complex motor behavior (dream enacting behaviors) occurring during REM
- Characterized by lack of muscle atonia during REM sleep
Tx of REM sleep behavior disorder
o Discontinue causative medication
o Clonazepam
o Melatonin
What is Restless leg syndrome
• Urge to move legs accompanied by unpleasant sensation in the legs, characterized by relief with movement, aggravation with inactivity, and only occurring or worsening in the evening
Tx of restless leg syndrome
o Dopamine agonists and benzos are first line
Appearance of Prader Willi patients
o Obese, small stature, almond-shaped eyes
Presentation of fetal alcohol syndrome
o Growth retardation
o CNS involvement (structural, neurologic, functional)
o Facial dysmorphology (smooth philtrum, short palpebral fissures, thin vermillion border)
What is language disorder
• Difficulty acquiring and using language due to expressive and/or receptive impairment
What is speech sound disorder
• Difficult producing articulate, intelligible speech
What is social communication disorder
- Challenges with the social use of verbal and nonverbal communication
- If restricted/repetitive behaviors, activities, or interest also present, diagnose autism spectrum disorder
Symptoms of ADHD
• Two symptom domains: inattentiveness and hyperactivity/impulsivity
• At least 6 inattentive symptoms
o Fails to give close attention to details or makes carless mistakes
o Difficult sustaining attention
o Does not appear to listen
o Struggles to follow through on instruction
o Difficulty with organization
o Avoids or dislikes a lot of thinking
o Loses things
o Easily distracted
o Forgetful in daily activities
And/or
• At least 6 hyperactive symptoms o Fidgets or squirms o Difficulty remaining seated o Restless o Difficulty engaging in activities quietly o Acts as if driven by a motor o Talks excessively o Blurts out answer before question complete o Difficulty waiting or taking turns o Interrupts or intrudes upon others
Time frame for ADHD
• Symptoms > 6 months and present in two or more settings
DSM Criteria for Autism spectrum disorder
♣ Problems with social interaction and communication
• Impaired social/emotional reciprocity (cannot hold convos)
• Deficits in nonverbal communication (decreased eye contact)
• Interpersonal/relational challenges
♣ Restricted, repetitive patterns of behavior, interests, and activities
• Intense, peculiar interests
• Inflexible adherence to rituals
• Stereotyped, repetitive motor mannerisms (hand flapping)
• Hyper/hyporeactivity to sensory input
Diagnostic criteria for Tourette disorder
o Multiple motor tics and at least one vocal tic for > 1 year
• Vs. Chronic tic disorder
o Either motor or verbal tics (but not both) for > 1 year
Recurrent defecation into inappropriate places
Encopresis
Effects of Dopamine and Serotonin on sexual function
Dopamine enhances libido
Serotonin inhibits sexual function
Medications used to treat erectile dysfunction
Phosphodiesterase inhibitors (Sildenafil) - still requires stimulation to reach erection
Alprostadil (injected into corpora cavernosa or transurethral) acts locally and produces an erection without stimulation
Medications used to treat premature ejaculation
SSRI and TCAs
Medications used to treat male hypoactive sexual desire disorder/female sexual interest/arousal disorder
Testosterone
• Sexual fantasies/urges/behaviors involving sexual acts with prepubescent children (<13 y/o)
Pedophilic disorder
• Sexual arousal from touching or rubbing against a nonconsenting person
Fortteuristic disorder
• Sexual arousal from observing unsuspecting nude, or disrobing individuals
Voyeuristic disorder
• Sexual arousal from exposure of one’s genitals to an unsuspecting person
Exhibitionistic disorder
• Sexual arousal from exposure of one’s genitals to an unsuspecting person
Sexual masochism disorder
• Sexual arousal from the physical or psychological suffering of another person
Sexual sadism disorder
• Sexual arousal from either the use of nonliving objects or nongenital body parts
Fetishistic disorder
Transvestic disorder
Sexual arousal from crossdressing
