Psych Flashcards
What is classical conditioning?
Learning in which a natural response is elicited by a conditioned stimulus that used to be paired with an unconditioned stimulus (involuntary)
What is operant conditioning? Positive reinforcement? Neg rein? Punishment? Extinction?
Particular action is elicited b/c it produces a punishment or a reward (voluntary responses)
Pos: Desired reward produces action
Neg: Target behavior is followed by removal of aversive stimulus
Punishment: aversive stimulus extinguishes unwanted behavior
Extinction: discontinuation of reinforcement eventually eliminates behavior. Can occur in operant or classical conditioning
What is transference? What is countertransference?
Patient projects feelings about formative or important persons onto physician
Doctor projects feelings about formative or other important persons onto patient
What are ego defenses? What are the mature ego defenses?
Unconscious mental processes used to resolve conflict and prevent undesirable feelings
Mature adults wear a SASH
Sublimation, altruism, suppression, humor
Describe acting out, denial, displacement, dissociation, fixation, identification, isolation of affect, passive aggression, projection, rationalization, reaction formation, regression, repression, splitting, altruism, humor, sublimation, suppression.
AO: expressing unaccetable feelings and thoughts through actions (tantrums)
Denial: Avoiding the awareness of some erality
Displacement: Transferring avoided ideas and feelings to a neutral person or object
Dissociation: Temporary, drastic change in personality, memory, or consciousness, or motor behavior to avoid emotional stress
Fixation: Partinally remaining at a mre childish level of development (video games)
Identificiation: Modeling behavior after another person that is more powerful (though maybe terrible and hated)
isolation: Separating feelings from ideas and events
Passive agg: Expressing negative and performing below what is expected as an indirect show of opposition
Projection: Attributing an unacceptable internal impulse to an external source
Rationalization: Proclaiming logical reasons for actions actually performed for other reasons to avoid blame
Reaction formation: Replacing a warded off idea r feeling by an emphasis on the opposite
REgression: Turning back the maturational clock and going to earlier modes of dealing with the world
Repression: Involuntarily withholding an idea or feeling frm conscious awareness
Splitting: People are either alll good or all bad at different times due to intolerance of ambiguity
Altruism: Alleviating negative feelings via unsolicited generosity
Humor: Appreciating the amusing nature of an anxiety provoking or adverse situation
Sublimation: Replacing an unacceptable wish with a course of action that is similar to the wish but does not conflict with ones value system
Suppression: Intentionally withholding an idea or feeling from conscious awareness; temporary
What does long term deprivation of affection in infants result in? 4W’s? What length of time can lead to irreversible changes? Whats the ultimate consequence?
Failure to thrive
Poor language/socialization skills
Lack of basic trust
Anaclitic depression (infant withdrawn/unresponsive)
Weak, wordless, wanting, wary
> 6 months
Eventually can lead to death
Compare and contrast physical and sexual child abuse concerning evidence present? Abuser? epid ?
PHYSICAL
Spiral fractures (or multiple fractures at different stages of healing) Burns (cigarette, buttocks/thighs) Subdural hematomas Posterior rib fractures Retinal detachment Children avoid eye contact
Biological mother
40% of deaths in children < 1 year old
SEXUAL
Genital, anal, or oral trauma
STDs
UTIs
Known to victim, usually male
9-12 years old
What is considered child neglect? Evidence? What must be done?
Failure to provide a child with adequate food, shelter, supervision, education, and/or affection
Poor hygiene malnutrition withdrawal impaired social/emotional development failure to thrive
CPS
What is the onset of ADHD? Basic symptms? How is it characterized? What is normal? Prognosis? Associated brain abnormalities? Treatment?
Onset before 12.
Limited attention span and poor impulse control
Hyperactivity
Impulsivity
and/or inattention in multiple settings
Normal intelligence
50% continue into adulthood
Decr. frontal lobe volume/metabolism
Stimulants (methylphenidate)
maybe CBT
Atomoxetine in some individuals
What is conduct disorder? Association? Treatment?
Repetitive and pervasive behavior violating the basic rights of others.
At age 18, will likely meet criteria for Antisocial PD
CBT
What is oppositional defiant disorder? Treatment?
Enduring pattern of hostile, defiant behavior toward authority figures in absence of seirous violations of social norms
CBT
What is separation anxiety disorder? age of onset? Signs? Treatment?
7-9 years
Overwhelming fear of separation from home or loss of attachement figure
Fictitious physical complaints to avoid going to or staying at school
CBT, play therapy, family therapy
Onset of Tourette syndrome? How is it characterized (lenght of time)? What is coprolalia? Commonality in tourettes? Assocations? Treatment? For intractable tics?
Before age 18
Sudden, rapid, recurrent, nonrhythmic, stereotyped motor and vocal tics that persist for > 1 year
Involuntary obscene speech (10-20%)
OCD, ADHD
Psychoeducation
behavioral therapy
Low-dose high potency antipsychotics (fluphenazine, pimozide)
Tetrabenazine
Clonidine
How are pervasive developmental disorders characterized? How is Autism spectrum disorder characterized (age)? What is intellect like? Epid?
Difficulties with language and failure to acquire or early loss of social skills
Poor social interactions
communication deficits
repetititive/ritualized behaviors
restricted interests
Early childhood***
May or may not have intellectual disability
Savants rare
More common in boys
What is epid of Rett syndrome? Why? Genetics? Age of onset? Presentatin?
Girls (boys die early)
x-linked
1-4
regression characterized by loss of development, loss of verbal abilities, intellectual disability, ataxia, sterotyped hand-wringing
What are the NT changes in Alz: Anx: Dep: Hunt: Park: Schizophrenia:
Alz: Decr ACh, incr. glut. Anx: incr. NE, decr. GABA, decr. 5-HT Dep: Decr. 5-HT, decr. DA, decr. NE Hunt: Decr. GABA, decr. ACh, incr. DA Park: Decr. DA, incr. ACh Schizophrenia: Incr. DA
What is orientation? What are some common causes of loss of orientation? Order of loss?
Ability to know
Identity (last)
location (2nd)
time (1st)
Alcohol drugs fluid/electrolyte imbalances head trauma hypoglycemia infection nutritional defic.
What is Retrograde amnesia? Anterograde amnesia? What is Korsakoff amnesia like? What is dissociative amnesia like? What might accompany it?
Retro: Can’t remember things that occurred before a CNS insult
Antero: Can’t remember things that occurred after a CNS insult
Korsakoff: Anterograde > Retrograde. Confabulations
Dissociative amnesia: Inability to recall important personal info, usually subsequent to severe trauma or stress. Dissociative fugue (abrupt travel or wandering)
What is delirium? How is it characterized? Causes? EEG finding? An approach for management? Treatment?
Waxing and waning level of consciousness with acute onset
Rapid decr. in attention span and level of arousal
Disorgranized thinking hallucinations (visual) Illusions Misperceptions Disturbance in sleep wak cycle Cognitive dysfunction
Secndary to other illness (CNA disease, infection, trauma, substance abuse/withdrawal, metabolic/electrolyte disturbances, hemorrhage, urainary/fecal retention)
Medications (anticholinergics), especially in elderly
Reversible
Abnormal EEG
Identifying and addressing underlying condition
Haloperidol as need
Benzos for EtOH withdrawal
T-A-DA approach=Tolerate, anticipate, don’t agitate
What is dementia? How is it characterized? What can it lead to? Irreversible causes? Reversible causes? Epid? EEG finding?
Decr. in intellectual function w/o affecting level of consc.
Memory deficits, apraxia, aphasia, agnosia, loss of abstract thought, beh/pers changes, impaired judgment
Can develop delirium (Alz w/ pneumonia)
Irreversible: Alz, Lewy Body Dementia, Huntington, Pick disease, cerebral infarct, Creutzfeldt-Jakob, chronic substance abuse
Reversible: Hypothyroidism, depression, vit. b12 defic, normal pressure hydrocephalus
Incr. incidence w/ age
EEG normal
What is psychosis? In which patients does it occur? What are hallucinations? What are delusions? What is disorganized speech?
A distorted perception of reality characterized by delusions, hallucinations, and/or disorganized thinking
Pts. with medical illness, psych illness, or both
Hallucinations: perceptions in the absence of ext stim
Delusions: Unique, false beliefs about oneself or others that persist despite facts
Disord speech: Words and ideas are strung together based on sounds, puns, or loose associations
What are visual hallucinations more commonly a feature of? Auditory? When does olfactory hallucinations occur? What due gustatory hallucinations occur? Tactile? What are hypnagogic halluc? When are they seen? What are hypnopompic halluc? When are they seen?
Vis: Medical illness
Aud: Psych illness
Olfactor: Aura of psychomotor epilepsy and in brain tumors
Gust: Rare, epilepsy
Tactile: alcohol withdrawal, cocaine use
Hypnagogic: Going to sleep, sometimes in narcolepsy
Hypnapompic: Waking up, sometimes in narc.
What is shizophrenia? Brain changes? What does the diagnosis require? Etiologies? Epid? Age of onset? Risks? Treatment?
Chronic mental disorder with periods of psychosis, disturbed behavior and thought, and decline in functioning.
Incr. DA, decr Dendritic branching
2 or more of the following symptoms for > 6 months
Delusions Hallucinations disorganized speech (loose associations) Disorganized or catatonic behavior negative symptoms-flat affect, social withdrawal, lack of motivation, lack of speech or thought
Genetics and environment
Frequent cannabis use in teens
Lifetime prevalence 1.5% (males=females, white=black)
Presents earlier in men (late teens to early 20s vs. late 20s to early 30s)
Incr. risk of suicide
Atypical antipsychotics (risperidone) are first line
What is a brief psychotic disorder? What is schizophreniform disorder? What is shizoaffective disorder? Length of time for each?
Lasting < 1 month, usually stress related
lasting 1-6 months
lasting > 2 weeks: psychotic symptoms superimposd with major depression or mania (or both). Psychosis present w/ and without affective symptoms. Affect only present w/ psyhotic symptoms.
