Psych Flashcards
Schizophrenia Positive symptoms
Disorganized thinking
Delusions
Hallucinations
Behavior
Disorganized thinking
formal thought disorder
Neologisms, Tangentiality, Derailment, Loosening of associations (word salad), Private word usage (neologism),
Perseveration, Nonsequitors, Poverty of speech (Alogia)
Delusions
Fixed false beliefs, not open to counter-example and not consistent with those of a culture or subculture or religion:
Paranoid/persecutory; Ideas of reference; External locus of control; Thought broadcasting; Thought insertion or withdrawal; Jealousy, Guilt; Grandiosity, Religious delusions; Somatic delusions
Hallucinations
Perceptual experience in the absence of stimuli, does not include hallucinations falling asleep (hypnogognic) or awakening, (hypnopompic) which are normal experiences.
Auditory; Visual; Olfactory; Somatic/tactile
Formication (infestation by bugs);Gustatory
Behavior
Bizarre dress, appearance; Catatonia; Motor abnormalities; Poor impulse control ;Anger, agitation; Stereotypies
Schizophrenia negative symptoms
diminished emotional expression
avolition
Diminished emotional expression
Decreased expression of emotion Inappropriate affect Blunting of affect/mood Isolation or dissociation of affect Incongruent affect
Avolition
Decreased self initiated activity asociality
Decreased drive
Loss of willed intentions
Anticipatory or consumatory anhedonia
Schizoaffective disorder
For cases with > 2 weeks of psychosis w/o a mood syndrome and have experienced mood episodes for at least half of the total duration of their psychotic disorder from its onset.
Kraepelin
distinguished manic depressive insanity from dementia praecox based on the course of illnes’
Alzheimer
discovery of a neuropathological anatomy for a mental illness.
(Nissl Stain)
Bipolar I disorder
has episodes of Mania
Bipolar II disorder
No mania, just hypomania
Cyclothymic disorder
> 50% of time too high or too low
dysthymic/hypomanic
Bipolar disorders virtually always includes
Depressive Disorders
Major depressive disorder
Dysthymic disorder
Depressive disorder NOS
Ego defenses (defense mechanism)
Unconscious and automatic mental processes everyone utilizes to prevent undesirable feelings (ex. Anger, depression, sadness) in response to both internal and external stressors and emotional conflict
= Coping mechanisms
Ego functioning
Methods of anxiety and affect tolerance (i.e. defense mechanisms)
Insight into mood, behavior, thoughts
Management of relationships
Sense of identity, history and place in the world
Reality testing
Splitting
less adaptive (immature)
difficult or impossible for a person to tolerate the idea that anything bad exists in someone - or oneself - that they view as good, they unconsciously keep good and bad separate
immature defenses
Acting out Denial Dissociation Fixation Passive aggression Projection Regression Splitting
Repression
idea that the bad or unacceptable thought or feeling is kept unconscious
more adaptive defenses
Displacement Identification Isolation of affect Rationalization Reaction formation Repression
most adaptive defenses
Altruism
Humor
Sublimation
Suppression
psychotherapy always occurs
within a set framework, by a trained professional, in order to improve the patient’s mental and emotional health
anatomical OCD
-Increased metabolism in the caudate nucleus in the basal ganglia is reversed by Cognitive Behavioral Therapy
anatomical BPD
-After Transference Focused Psychotherapy, brain function at level of amygdala and orbital prefrontal cortex is changed in patients with negative affect.
psychodynamic psychotherapy purpose
attempting to help make unconscious processes conscious
psychodynamic psychotherapy techniques
clarification confrontation interpretation free association transference countertransference
psychodynamic psychotherapy indications
- Depression
- Anxiety disorders
- Personality Disorders (especially Cluster B)
- No DSM5 Pathology (Problems with “work, love, or play”)
goals of supportive psychotherapy
- Reduce symptoms
- Maintain self-esteem
- Maximize adaptive capacities
techniques of supportive psychotherapy
- Empathy, conversational style (alliance building)
- Reassurance, normalizing (esteem building)
- Advice, teaching, anticipatory guidance, behavioral techniques (skills building and anxiety reduction)
indications of supportive psychotherapy
Almost all major mental illnesses including psychosis
Recent traumas or crises
CBT purpose
Therapist works with patient to identify automatic thoughts, learns adaptive responses
CBT indications
Panic Disorder: evaluation and testing of catastrophic thinking
GAD: realistic evaluation of danger
OCD: exposure and response prevention
Phobias: cognitive work, guided exposure, systematic desensitization, relaxation techniques
Depression, PTSD, substance abuse, sleep disorders
types of manualized psychotherapies
Dialectical Behavioral Therapy
Transference Focused Psychotherapy
Interpersonal Therapy
indication of Dialectical Behavioral Therapy
BPD, but also used with major mental illnesses in inpatient settings
DBT techniques/process
Skills to manage affect
Avoidance of self-destructive behavior
Teaching skills for more effective interpersonal interactions
Treatment contracts
Creation of a validating environment (acceptance by therapist and group)
Homework assignments
types of stage theories
psychodynamic
cognitive
Psychodynamic theory
Behavior is a surface characteristic that represents symbolically the deep inner workings of the mind – the unconscious
Freud’s theory
Believed that people move through psychosexual stages (biological urges) for the adult personality to be formed
Erikson’s theory
Believed people develop in psychosocial stages throughout life
difference in Freud vs. Erikson
Erikson- involved social and environmental factors, continued after puberty
Cognitive theory
Stress conscious thoughts and how the brain processes information
• Children actively construct their own cognitive worlds
AAO of Cognitive theory
assimilation
accommodation
organization
Piaget’s
stages of cognitive development
sensorimotor
pre-operational
concrete operations
formal operations
Kohlberg’s
moral development
preconventional
conventional
postconventional
tasks of infancy
• Motor control
• Establishment of routines
– Day-Night, Sleep-Wake rhythms – Regulate crying
• Development of Emotions
• Attachment
– Attunement, object constancy
• Self-other differentiation – Consciousness
Ability to roll over
3 months
Sitting without support
7 months
Crawling
9-10 months
Walking
13 monoths
up and down stairs
18 months
Facial recognition
6 wks-2 months
laughing in response to games
7-9 months
social smiling
1-2 months
social referencing
using another person’s response to an ambiguous situation as a guide for one’s own response
temperament definition
Inborn patterns of responding to the environment
Chess and Thomas
easy children
difficult children
slow to warm-up childrem
goodness of fit
How well parents and the environment fit or adjust to the temperament of the child
inhibited children- anatomical differences
All inhibited subjects showed a significant activation of the amygdala
babies begin to recognize their parents and respond preferentially to them
2-3 months
selective attachments form and fear of strangers develop
6-8 months
attachment types
- Securely Attached
- Insecurely Attached – Resistant/Ambivalent – Avoidant
- Disorganized/Disoriented
tasks of the toddler years
autonomy and independence improved motor control language self regulation cooperative and pretend play empathy and standards gender identity
– Brain reaches 4/5 of eventual size
– Daytime bladder control and bowel control
age 2-3
– Run easily
– Throw with accuracy – Running jumps
age 5
– Pour milk
– Button clothes
– Begin to attend to their own toileting
age 3
– Cut with scissors – Copy letters
age 4
telegraphic sentences
18 months
full sentences
age 3
self recognition
18-20 months
self-conscious (moral) emotions
– Pride, guilt, shame, embarrassment
– Use of personal pronouns – I, mine
effortful control
– Following rules
– Constraining emotional outbursts
– Planning long term strategy
parenting behavior
emotionality
control
parenting styles
authoritative
authoritarian
permissive
indifferent
boys issues
Boys
Autism
ADHD
Conduct Disorder Language problems Learning disabilities OCD (early onset) Tics/Tourette’s
girls issues
Depression
Shyness/social anxiety
Eating disorders Panic disorder
cause of autism
multiple etiologies
No single cause, no single cure
No biological marker
No evidence of parenting defects or emotionally induced autism
hallmarks of autism: social communication and social interaction
Deficits in social-emotional reciprocity,
Deficits in nonverbal communicative behaviors
Deficits in developing, maintaining, and understanding relationships,
hallmarks of autism: restrictive, repetitive, stereotyped patterns of behavior
Stereotyped or repetitive motor movements, use of objects, or speech
Insistence on sameness,
Highly restricted, fixated interests
Hyper- or hypo-reactivity to sensory input
Shared major feature of Social communication disorder and ASD
A persistent difficulty with verbal and nonverbal communication that cannot be explained by low cognitive ability
associated symptoms of autism
Intellectual Disability (most common coexisting disorder) Epilepsy
Developmental Syndromes Metabolic Disorders (e.g., PKU)
ADHD
Obsessive/Compulsive Disorder
Depression&Anxiety
Other psychiatric disorders
key predictors of autism
at 18 months
Lack of pretend play
Lack of proto-declarative pointing Lack of social interest
Lack of joint attention
weak central coherence theory
Tendency to focus on details rather than the meaningful whole
autism MRI
5-10% above normal- enlarged brain
may be related to decreased pruning
fMRI of autism
Hypoactivation of the fusiform gyrus during face perception tasks.
Amygdala dysfunction
hallmarks of ID
*Impairments in Adaptive Functioning
Effective coping with common life demands
Ability to meet standards of independence
recognition of mild ID- when?
often indistinguishable from other children until school age
moderate ID- highest level of educational ability
Unlikely to progress beyond the 2nd grade academically
profound ID
Considerable impairments in sensorimotor functioning; very limited understanding of speech
Dependent for all aspects of living
selective mutism
Consistent failure to speak in specific social situations (in which there is an expectation for speaking, e.g., at school) despite speaking in other situations
treatment for anxiety disorder
Psychotherapy
— Psychoeducation , Cognitive/Behavior therapy
Medication
