Psych 2 Flashcards
DSM criteria of specific phobia/social anxiety disorder
- Persistent, excessive fear elicited by a specific situation or object which is out of proportion to actual danger/threat
- Exposure to situation triggers an immediate fear response
- Situation of object avoided or tolerated with intense anxiety
- Sx cause significant social or occupational dysfunction
Tx of specific phobia
CBT
Tx of social anxiety disorder
CBT = Tx of choice
SSRI = 1st line medication if needed
Benzos PRN, Beta blocker
DSM criteria of selective mutism
- Consistent failure to speak in select social situations despite speech ability in other scenarios
- Mutism not due to language difficulty or communication disorder
- Symptoms cause significant impairement
Time frame for selective mutism diagnosis
> 1 month
THINK: You SELECT a single (1) choice
Time frame for specific phobia/social anxiety diagnosis
> 6 month
Tx of selective mutism
CBT, family therapy
SSRI for anxiety
Time frame of separation anxiety in children/adolescents and in adults
> 4 weeks in children/adolescent
> 6 weeks in adults
Tx of separation anxiety
CBT, family therapy
SSRI as possible adjunct
Somatic sx associated with GAD
Fatigue, muscle tension
Time frame for diagnosis of GAD
> 6 months
DSM criteria for GAD
- Excessive anxiety/worry about various daily events/activities >6 months
- Difficulty controlling the worry
- Associated >3 sx: restlessness, fatigue, impaired concentration, irritability, muscle tension, insomnia
Median age of onset of GAD
30 y/o
But sx of worry begin in childhood
Tx of GAD
Most effective tx is psychotherapy + pharacotherapy
CBT, SSRI/SNRI, short-term benzo, uncommonly TCA or MAOI
What are obsessions?
Recurrent, intrusive, undesired, anxiety-provoking thoughts, images, or urges that the patient attempts to suppress, ignore or neutralize by some other thought or action
What are compulsions?
Repetitive behaviors or mental rituals performed in attempt to relieve obsessive anxiety
Average age of onset of OCD
20 y/o
Tx of OCD
Psychopharmacology and CBT (exposure and response prevention)
SSRI, Clomipramine (TCA), atypical antipsychotics
DSM criteria for body dysmorphic disorder
- Preoccupation with one or more perceived defects of flaws in physical appearance that are not observable by or appear slight to others
- Repetitive behaviors or mental acts are performed in response to appearance concerns
- Causes significant distress or impairment in functioning
Tx of body dysmorphic disorder
SSRI and/or CBT
Time frame (onset and duration) of PTSD
Can occur immediately after trauma or have delayed expression
Symptoms last > 1 month
Time frame (onset and duration) of Acute Stress Disorder
Trauma occurred < 1 month ago
Symptoms last < 1 month
Symptoms of PTSD
Recurrent intrusions (nightmares, flashbacks), distress at exposure to cues relating to trauma, avoidance of triggers, dissociative amnesia, negative feelings of self/others/world, self-blame, hypervigilance, exaggerated startle response, irritability/angry outburts, impaired concentration, insomnia
Pharmacologic tx of PTSD
- SSRI/SRI
- Prazosin (a1 antagonist) = nightmares and hypervigilance
- Atypical antipsychotics
Psychotherapy tx of PTSD
Specialized CBT, supportive and psychodynamic therapy
Diagnostic criteria of adjustment disorder
- Emotional or behavioral sx within 3 months in response to an identifiable stressful life even
- Sx are not of normal bereavement
- Sx resolve within 6 months after stressor has terminated
Subtypes of adjustment disorder
Depressed mood, anxiety, mixed anxiety and depression, disturbance of conduct (such as aggression), or mixed disturbance of conduct and emotions
Tx of adjustment disorder
Supportive psychotherapy, group therapy, occasional pharmacotherapy
What do you call irrational beliefs that one is being persecuted
Delusions of persecution/paranoid delusions
What do you call belief that cues in the external environment are uniquely related to the individual (i.e. TV characters talking directly to me)
Ideas of reference
What do you call belief that one’s thoughts can be heard by others
Thought broadcasting
What do you call belief that others thoughts are being placed in one’s head
Though insertion
What do you call belief that on has special powers beyond those of a normal person
Delusions of grandeur
What do you call belief that one is guilty or responsible for something (e.g. I am responsible for all world wars)
Delusions of guilt
What do you all belief that on is infected with a disease or has a certain illness
Somatic delusions
Ddx of psychosis
- Psychotic disorder due to medical condition
- Substance/medication-induced
- Delirium/dementia
- Bipolar disorder
- Major depression with psychotic features
- Brief psychotic disorder
- Schizophrenia
- Schizophreniform disorder
- Schizoaffective disorder
- Delusional disorder
Describe delusion vs. illusion vs. hallucination
Delusion = false belief
Illusion = misinterpretation of an external stimulus
Hallucination = perception in the absence of external stimulus
CNS diseases that can cause psychosis
Cerebrovascular disease, multiple sclerosis, neoplasm, Alzheimers, Parkinson’s, Huntingtons, tertiary syphilis, epilepsy (temporal lobe), encephalitis, prion disease, AIDS
Endocrinopathies that can cause psychosis
Addison’s, Cushings, hyper/hypothyroidism, hyper/hypocalcemia, hypopituitarism
Time frame of schizophrenia-like disorders
Brief psychotic disorder < 1 month
Schizophreniform disorder between 1 and 6 months
Schizophrenia > 6 months
DSM for schizophrenia
2 or more of the following for at least one month:
- 1. Delusions
- 2. Hallucinations
- 3. Disorganized speech
- 4. Grossly disorganized or catatonic behavior
- 5. Negative ssx
At least one myst be 1, 2, or 3
Duration > 6 months
Positive sx of schizophrenia
Hallucinations, delusions, bizarre behavior, disorganized speech
Negative sx of schizophrenia
Flat or blunted affect, anhedonia, apathy, alogia, and lack of interest in socialization
Cognitive sx of schizophrenia
Impairments in attention, executive function, and working memory
1st phase of schizophrenia
Prodromal = decline in functioning that precedes the first psychotic episode
2nd phase of schizophrenia
Psychotic = perceptual disturbances, delusions, and disordered thought process/content
3rd phase of shizophrenia
Residual = occurs following an episode of active psychosis. Mild hallucinations or delusions, social withdrawal, and negative sx
Age of presentation of schizophrenia
Men = mid-20s
Women = late 20s
Neurotransmitter associated with schizophrenia
Increased dopamine activity
Tx of schizophrenia
1st generation (typical) antipsychotics = Haloperidol, Chlorpromazine, Fluphenazine
2nd generation (atypical) antipsychotics = Aripiprazole, Clozapine, Olanzapine, Quetiapine, Risperidone)
Behavioral therapy
