Psych Flashcards
Define conversion disorder
Loss of sensory or motor function (neurological symptoms) without any neurological explanation
Often precipitated by acute life stressor
How long must the disturbance (nightmares, fear, reexperiencing traumatic event) last to receive a diagnosis of PTSD?
> 1 month
How long must the disturbance (nightmares, fear, reexperiencing traumatic event) last to receive a diagnosis of acute stress disorder?
3 days - 1 month
How long must anxiety last to receive a diagnosis of generalized anxiety disorder?
> 6 months
Define an adjustment disorder (including time frame) and compare to Generalized anxiety disorder
Adjustment disorder - emotional symptoms like anxiety and depression causing impairment following a significant psychosocial stressor (divorce, illness, etc.)
Lasts 6 months
What are defining characteristics of narcolepsy?
- Excessive daytime sleepiness (most common cause of this is OSA)
- Hallucinations - hypnagogic (before sleep) or hypnopompic (before awakening)
- Narcoleptic sleep episodes that start with REM
- Cataplexy - loss of all muscle tone following strong emotional stimulus (laughter, crying, etc.)
What causes narcolepsy?
Decreased hypocretin (orexin) production in lateral hypothalamus
Compare and contrast characteristics of delirium and dementia
Delirium
- Acute
- Consciousness impaired
- Fluctuating course
- Reversible
- Overall global impairment and changes in sensorium
- Abnormal EEG
Dementia
- Gradual
- Consciousness intact
- Progressive course
- Irreversible (usually, don’t forget about hypothyroidism and B12 deficiency in the elderly -> presents as dementia)
- Short term memory deficits, long term intact
- Normal EEG (usually)
Describe the following ego defense process: Acting out
Expressing unacceptable feelings and thoughts through actions
Describe the following ego defense process: Denial
Avoiding awareness of a painful reality
Describe the following ego defense process: Displacement
Transferring avoided ideas and feelings to a neutral person or object
Example: mother yells at child because her husband yelled at her
(Vs. projection - attributing unacceptable internal impulse to an external source, like a man who wants another woman suspects his wife is cheating on him)
Describe the following ego defense process: Dissociation
Temporary drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stress
Describe the following ego defense process: Fantasy
Substituting reality with imaginary scenarios
Describe the following ego defense process: Identification
Modeling behavior after another person who is more powerful (though not necessarily admired)
Example: abused child identifies with abuser
Describe the following ego defense process: Intellectualization
Using intellect to avoid uncomfortable feelings
Describe the following ego defense process: Somatization
Transforming emotional conflicts into physical symptoms
Describe the following ego defense process: Passive aggression
Expressing negativity and performing below what is expected as an indirect show of opposition
Describe the following ego defense process: Projection
Attributing unacceptable internal impulse to an external source
example: Man who wants another woman thinks his wife is cheating on him
(Vs. displacement)
Describe the following ego defense process: Fixation
Partially remaining at more childish level of development
Example: adults fixating on video games
(Vs. regression)
Describe the following ego defense process: Rationalization
Proclaiming logical reasons for actions actually performed for other reasons, usually to avoid self-blame
Describe the following ego defense process: Reaction formation
Replacing a warded-off idea or feeling by unconsciously placing emphasis on its opposite
Example: patient with thoughts of doing heroin again volunteers at narcotics anonymous
(Vs. sublimation)
Describe the following ego defense process: Regression
turning back maturational clock and going back to earlier modes of dealing with world
(Vs. fixation)
Describe the following ego defense process: Repression
Involuntarily withholding and idea or feeling from conscious awareness
(Vs. suppression)
Describe the following ego defense process: Splitting
Believing all people are either completely good or completely bad at different times due to intolerance of ambiguity
Common in borderline personality.
Describe the following ego defense process: Altruism
Alleviating negative feelings via unsolicited generosity
Describe the following ego defense process: Humor
Find amusement in anxiety-provoking or adverse situation
Describe the following ego defense process: Sublimation
Replacing unacceptable wish with a course of action that is similar to wish, but does not conflict with one’s values
Example: teenager’s aggression towards father gets redirected to perform well in sports
(Vs. reaction formation)
Describe the following ego defense process: Suppression
Intentionally withholding an idea or feeling from conscious awareness, temporarily
(Vs. repression)
What are the mature ego defenses?
Mnemonic: Mature adults wear a SASH
Sublimation
Altruism
Suppression
Humor
Describe dysthymia (including time frame)
Milder form of depression - also called persistent depressive disorder
Does not fulfill MDD criteria
> 2 years
What is pica and what is it commonly associated with?
Ingestion of non-food items (commonly ice)
Associated with iron-deficiency anemia (and can worsen anemia due to lack of nutritional value)
What is the most common cause of death in someone on PCP?
Trauma
What are indications of PCP intoxication?
Belligerence - violent behavior
Nystagmus - vertical and horizontal
Acute brain syndrome - constellation of symptoms including disorientation, poor judgment, memory loss
What are indications of Opioid withdrawal?
Dilated pupils (mydriasis) Piloerection Fever Yawning Lacrimation Stomach cramps, active bowel sounds Diarrhea
What are indications of Alcohol withdrawal?
Autonomic hyperactivity (tachycardia, tremors, anxiety, seizures) Delirium Tremens - life threatening 2-4 days after last drink, commonly in alcoholics postsurgery (not able to drink)
Can rarely get Alcoholic hallicinogenesis - 12-48 hours after last drink
What factor most increases someone’s risk of dying of suicide?
Access to firearms
What are the criteria for schizophrenia and how long must they be present to receive a diagnosis?
Delusions, Hallucinations, Disorganized speech, Disorganized or catatonic behavior, Negative symptoms
> 6 months
What is the time frame for a diagnosis of Brief Psychotic disorder
Less than 1 month
What is it called when a patient meets the criteria for schizophrenia but does not meet the time frame?
Schizophreniform disorder (1-6 months)
Define Schizoaffective disorder (including required time frame) and compare to mood disorder with psychotic symptoms
Psychotic symptoms with superimposed major depression or mania (>2 weeks)
There must be a period where psychosis occurs in the absence of mood symptoms, otherwise the diagnosis would be mood disorder with psychotic symptoms
What drug group makes up the majority of overdose-related deaths?
Opioid analgesics
What are the 3 clusters of personality disorders?
Cluster A - “Weird”
Cluster B - “Wild”
Cluster C - “Worried”
What are the Cluster A personality disorders?
Paranoid
Schizoid - distant, okay with social isolation
Schizotypal - super weird, magical thinking
What are the Cluster B personality disorders?
Antisocial - disregard for rights of others (conduct disorder if
What are the Cluster C personality disorders?
Avoidant - socially inhibited, but desire relationship with others
Obsessive compulsive
Dependent
What is a major concern with opioid intoxication?
Respiratory depression
Describe somatic symptom disorder
Various complaints in multiple organ systems
Associated with excessive, persistent thoughts and anxiety about symptoms
May have actual co-occurring medical illness
What is the proper management of somatic symptom disorder?
Schedule regular visits with same provider
Reassure of lack of illness
