Psych Flashcards
positive reinforcement
- positive stimulus increases a behavior
negative reinforcement
- removal of a negative stimulus increases a behavior
punishment
- averse stimulus stops a behavior
extinction
- removal of a positive stimulus stops a behavior
transference
- patient projects feelings about others onto physician (psychiatrist is seen as parent)
countertransference
- doctor projects feelings about important people onto patient (pt reminds them of a younger sibling)
acting out
immature defense, expressing unacceptable feelings and thoughts through actions
- ex: tantrums
dissociation
immature defense, temporary, drastic change in personality, memory, consciousness or motor behavior to avoid emotional stress
- extreme forms can result in dissociative identity disorder
denial
immature defense, avoid the awareness of some painful reality
- a common reaction in newly diagnosed AIDS/cancer patients
displacement
immature defense, transferring avoided ideas and feelings to some neutral person/object
- mother yells at child because her husband yelled at her, husband punches a wall because he is mad at wife
projection
immature defense, attributing an unacceptable internal impulse (or ones own feelings) to an external source (or others)
- man who wants another woman thinks his wife is cheating on him, kid whose parents are getting divorced thinks they are mad at him
fixation
- immature defense, partially remaining at a more childish level of development
- men fixating on sports games
regression
immature defense, turning back the maturational clock and going back to earlier modes of dealing with the world
- seen in children under stress such as illness, punishment, or birth of new sibling (previously toilet trained starts bed wetting)
identification
immature defense, modeling behavior after another who is more powerful (although not always admired)
- abused child identifies with abuser
isolation of affect
immature defense, separating feelings from ideas and events
- describing murder in graphic detail with no emotional response
fantasy
subtituting imaginary scenarios for reality
rationalization
immature defense, proclaiming logical reasons for action actually performed for other reasons, usually to avoid self blame
- after getting fired, saying the job wasnt important anyways
repression
immature defense, involuntary withholding an idea or feeling from conscious awareness
- not remembering a conflictual or traumatic experience, pressing bad thoughts into the unconscious
suppression
mature defense, intentional witholding of an idea or feeling from conscious awareness
- choosing not to worry about the big game until its time to play, choosing not to worry about your step 1 grade
altruism
mature defense, alleviating guilty feelings by unsolicited generosity towards others (avoiding negative feelings by helping others)
- mafia boss makes a large charitable donation, alcoholic stops drinking and volunteers
humor
mature defense, appreciating the amusing nature of an anxiety provoking or adverse situation
- ex: nervous medical student makes jokes about a test
sublimation
mature defense, replacing an unacceptable wish with a course of action that is similar to the wish but does not conflict with one’s value system
conduct disorder
- repetitive and pervasive d/o of violating basic human rights (physical aggression, vandalism)
- may go on to antisocial personality disorder
ODD
- enduring pattern of hostile, defiant behavior toward authority figures in the absence of serious violations of social norms
tourettes
need to have symptoms x 1 year, frequently coexists with OCD/ADHD
Rett disorder
X linked disorder seen almost exclusively in girls
- symptoms apparent age 1-4, including regression characterized by loss of development, loss of verbal abilities, intellectual disability, ataxia, and stereotyped hand wringing
delusional d/o
- fixed, persistent, untrue belief system lasting > 1 month
- functioning not otherwise impaired
keeping “schizo” straight
- < 1 month - brief psychotic d/p
- 1-6 months - schizophreniform
- > 6 months - schizophrenia
- 2 weeks of mood symptoms (must have 2 weeks with solo psychosis) - schizoaffective
mania
DIG FAST x 1 week
- distractability, irresponsibility, grandiosity, flight of ideas, increased goal-directed activity/psychomotor agitation, sleep req decreased, talkative/pressured speech
Bipolar d/o
Type I - 1 manic episode with or without a hypomanic or depressive episode
Type II - hypomanic and depressive episode
dysthymia
2 symptoms of depression x 2 years
post partum blues
depressed affect, tearfulness, and fatigue staring 2-3 days after delivery
- usually resolves within 10 days
post partum depression
- 10-15% incidence rate
- depression that starts within 4 weeks of delivery, lasts 2 weeks to a year or more
pathologic grief
- prolonged greif lasting > 6-12 months or grief that is delayed, inhibited or denied
- may experience depression, delusions or hallucinations
generalized anxiety disorder
uncontrollable anxiety for > 6 months unrelated to a specific person, situation or event
- associated with sleep disturbance, fatigue, GI disturbance of difficulty concentrating
adjustment d/o
emotional symptoms (anxiety, depression) causing impairment following an identifiable stressor for < 6 months
PTSD vs. acute stress disorder
acute stress is 3 days - 1 month, PTSD is more than 1 month
narcolepsy
- disordered regualtion of sleep wake cycles
- decreased orexin production in the lateral hypothalamus (hypocretin-1/orexin-A deficiency in the CSF)
- hyponogogic and hyponopompic hallucinations
- sleep starts with REM sleep (REM latency < 15 minutes)
- cataplexy or spontaneous facial movements without emotional triggers
- treat with daytime stimulants (amphetamines, modafinil) and nighttime sodium oxybate (GHB)
opioid intox and withdrawal
- intox: euphoria, CNS depression, decreased gag, pupillary constriction and seizures
- w/d: sweating, dilated pupils, piloerection, fever, rhinorrhea, yawning, nausea, stomach cramps, diarrhea
barbituates intox and withdrawal
- intox: resp depression
- w/d: delerium, life-threatening CV collapse
benzo intox and withdrawal
- intox: ataxia, minor resp depression
- w/d: sleep disturbance, depression, rebound anxiety, seizure, tremors, perceptual disturbances
amphetamine intox and withdrawal
- intox: euphoria, grandiosity, pupillary dilation, prolonged wakefulness and attention, HTN, tachycardia, anorexia, paranoia, fever
- w/d: anhedonia, increased appetite, hypersomnolence, existential crisis/severe depression
cocaine
- intox: impaired judgement, pupillary dilation, hallucinations, paranoid ideations, angina, sudden cardiac death
- w/d: hypersomnolence, malaise, severe psychological craving, depression/suicidality
nicotine
- intox: restlessness
- w/d: irritability, anxiety, craving
- treat withdrawal with buproprion/varenicline (competitive partial agonist of nicotinic Ach receptor that decreases symptoms of withdrawal and increase efficacy of nicotine)
