PSYCH 500-503 Flashcards
In classical conditioning, what two things are paired together to produce a learned response?
Conditioned stimulus (e.g. bell) with an unconditioned stimulus (e.g. food)
Is the learned response in classical conditioning usually voluntary or involuntary?
Involuntary
What type of conditioning typically deals with voluntary responses?
Operant conditioning
In operant conditioning, how is a particular action elicited?
Either because it produces a punishment or a reward
What are the 4 types of operant conditioning?
- Positive reinforcement
- Negative reinforcement
- Punishment
- Extinction
What is the difference between positive reinforcement and negative reinforcement?
In positive reinforcement, the behavior brings about reward whereas in negative reinforcement, the behavior brings about removal of punishment (aversive stimulus).
What is punishment?
Repeated application of aversive stimulus to extinguish unwanted behavior
What is extinction?
Discontinuation of reinforcement (positive or negative) eventually eliminates behavior?
Does extinction occur in operant conditioning, classical conditioning, both, or neither?
Both
Patient starts to see psychiatrist as a parent figure. What is this an example of?
Transference - when patient projects feelings about formative or other important persons onto the physician
Patient reminds physician of younger sibling. What is this an example of?
Countertransference - when doctor projects feelings about formative or other important persons onto patient
What are ego defenses?
Unconscious mental processes used to resolve conflict and prevent undesirable feelings (e.g. anxiety, depression)
What are the two subcategories of ego defenses?
Mature and Immature
What are the 4 mature defenses?
Mnemnoic: Mature adults wear a SASH
- Altruism
- Humor
- Sublimation
- Suppression
What are the 13 immature defenses?
MNEMONIC: Immature idiots fail at speaking professionally, 4 real (4 R’s) dude (think dud3 - 3’D’s).
Identification Isolation (of affect) Fixation Acting Out Splitting Projection
4 Rationalization
Reaction formation
Regression
Repression
Dissociation
Denial
Displacement
What type of ego defense is a tantrum an example of?
Acting out - expressing unacceptable feelings and thoughts through actions
When a patient avoids emotional stress via a temporary, drastic change in personality, memory, consciousness, or motor behavior, what is this called? What can this progress to?
Dissociation
Extreme forms can result in dissociative identity disorder (multiple personality)
What is denial?
Avoiding the awareness of some painful reality
Which patients are especially prone to exhibit denial?
Newly diagnosed AIDS and cancer patients
A mother yells at her child because her husband yelled at her. What is this an example of?
Displacement - transferring avoided ideas and feelings to some neutral person or object
A man who wants another woman thinks his wife is cheating on him. What is this an example of?
Projection - attributing an unacceptable internal impulse to an external source
What is the difference between displacement and projection?
Displacement - expressing a feeling that was given to you onto someone or something else; i.e. a displaced reaction
Contrast this with projection - where the feelings you are projecting are your own feelings that arose organically (not really a reaction per se)
What is the difference between fixation and regression?
Fixation - partially REMAINING at a more childish level of develop
Regression - turning back the maturational clock and GOING BACK to earlier modes of dealing with the world
What is identification?
Modeling behavior after another person who is more powerful (though not necessarily admired)
What is it called when you separate feelings from ideas and events?
Isolation of affect
Define rationalization.
Proclaiming logical reasons for actions actually performed for other reasons, usually to avoid self-blame
A patient with libidinous thoughts enter a monastery. What is this an example of?
Reaction formation - replacing a warded-off idea or feeling by an unconsciously derived emphasis on its opposite.
What is the mature response version of reaction formation?
Sublimation
A patient does not recall a conflictual or traumatic experience. What is this an example of?
Repression - involuntary withholding an idea or feeling from conscious awareness
How does repression differ from suppression?
Repression is involuntary whereas suppression is an intentional withholding of an idea or feeling from conscious awareness
What immature defense is commonly seen in borderline personality disorder?
Splitting - believing that people are either all good or all bad at different times due to intolerance of ambiguity
What feeling is being alleviated in altruism? How?
Guilt by demonstrating unsolicited generosity toward others
What is humor?
Appreciating the amusing nature of an anxiety-provoking or adverse situation
In sublimation, what is an unacceptable wish replaced with?
A course of action that is similar to the wish but does not conflict with one’s value system
What are the 4 W’s of infant deprivation (of affection)?
- Weak - decreased muscle tone, weight loss, physical illness
- Wordless - poor language skills
- Wanting (socially) - poor socialization skills, anaclitic depression
- Wary - lack of basic trust
What is anaclitic depression?
Infant is withdrawn/unresponsive
After how much time can infant deprivation lead to irreversible changes?
> 6 months
What is the extreme consequence of infant deprivation?
Death
What do we look for in physical abuse in children?
Mnemonic: PHYSICAL
Pattern marks/bruising Healed fractures (spiral) Your mom (usually biological mother) Subdural hematomas "I" Problems (eye - retinal hemorrhage or detachment) Cigarette burns Abuse Lung cage (rib fractures)
80% of child abuse victims are under what age?
< 3
What are signs of sexual abuse in children?
- Genital, anal, or oral trauma
- STD’s
- UTI’s
Are the abusers in child sexual abuse typically known to the victim? What gender are they?
Typically males known to the victim
What age range does the peak incidence of child sexual abuse occur during?
9-12
What is the most common form of child maltreatment?
Child neglect - failure to provide a child with adequate food, shelter, supervision, education, and/or affection
What two things must be reported to local child protective services?
Child abuse and child neglect
What are some signs of child neglect?
Smelly, Small, Shy:
Poor hygiene, malnutrition/failure to thrive, withdrawal and/or impaired social/emotional development
What are the 3 types of amnesia?
- Retrograde
- Anterograde
- Dissociative
Contrast retrograde vs. anterograde amnesia.
Retrograde - can’t remember things BEFORE a CNS insult
Anterograde - can’t remember things AFTER a CNS insult (i.e. no new memories)
What causes Korsakoff amnesia and is it typically anterograde or retrograde amnesia?
Anterograde amnesia (although may also include some retrograde) that is caused by thiamine deficiency and the associated destruction of mammillary bodies
A patient comes in and exhibits confabulations. What condition are you suspicious of? What else would be notable on social history?
Korsakoff amnesia
Often associated with alcoholics
What does AO x 3 stand for and in what order are they typically lost?
Alert and oriented to person, place, time
Order of loss: time > place > person
A patient experiencing severe trauma or stress is unable to recall important personal information. What is this called?
Dissociative amnesia
What is dissociative fugue?
Abrupt travel or wandering during a period of dissociative amnesia, associated with traumatic circumstances
What are some causes of loss of orientation?
Mnemonic: LOST AO
Loss of electrolytes or fluid
hypOglycemia
Substances (drugs)
Trauma
Alcohol
Om nom noms (nutrient) deficiency
What characterizes pervasive developmental disorders?
Difficulties with language and failure to acquire or early loss of social skills
What are 2 pervasive developmental disorders?
- Autism spectrum disorder
2. Rett disorder
What is the only neurotransmitter imbalance in Alzheimer disease?
Decreased ACh
What is the only neurotransmitter imbalance in Schizophrenia?
Increased dopamine
Of the pervasive developmental disorders, which one is more common in boys and which one is more common in girls?
Autism - boys
Rett- girls
Why does Rett disorder almost exclusively affect girls?
An X-linked disorder that causes affected males to die in utero or shortly after birth
What the symptoms in Rett disorder?
Mnemonic: RETT
wRinging of hands
Etaxia
Talk less (loss of verbal abilities)
Time stops (loss of development)
+ intellectual disability
When does Rett disorder typically present?
Ages 1-4
What are symptoms characterizing autism spectrum disorder?
Mnemonic: AUTISM
Awkward (poor social interactions) Under 4 (typically diagnosed in early childhood) Twice (does things twice - repetitive/ritualized behaviors) Interests restricted Solitary (communication deficits) Mental retardation (intellectual deficits may OR may not accompany autism)
What are the neurotransmitter changes seen in anxiety?
Decreased: GABA, 5-HT
Increased: NE
What are the neurotransmitter changes seen in depression?
Decreased: NE
Increased: 5-HT, dopamine
What are the neurotransmitter changes seen in Huntington disease?
Decreased: GABA, ACh
Increased: dopamine
What are the neurotransmitter changes seen in Parkinson disease?
Decreased: dopamine
Increased: 5-HT, ACh
What is conduct disorder?
Repetitive and pervasive behavior violating the basic rights of others (e.g. physical aggression, destruction of property, theft)
What can conduct disorder progress to after age 18?
Antisocial personality disorder
Define attention-deficit hyperactivity disorder.
Limited attention span and poor impulse control characterized by hyperactivity and/or inattention in multiple settings
At what age is the typical onset of ADHD?
< 12
Is the intelligence of people with ADHD impaired?
Normal intelligence but often coexists with difficulties in school
Does ADHD typically continue into adulthood?
50% of cases
What are some of the treatments for ADHD?
Methylphenidate, amphetamines, atomoxetine, behavioral interventions (reinforcement, reward)
What neuroanatomic findings are associated with ADHD?
Decreased frontal lobe volume/metabolism
What is oppositional defiant disorder?
Enduring pattern of hostile, defiant behavior toward authority figures in the absence of serious violations of social norms
What characterizes Tourette syndrome?
Sudden, rapid, recurrent, nonrhythmic, stereotyped motor and vocal tics that persist for > 1 year
When is the onset of Tourette syndrome?
< 18
What is involuntary obscene speech called in Tourette and what is its incidence?
Coprolalia - found only in 10-20% of patients
How common is Tourette syndrome?
0.1 - 1.0% in the general population
What are two other disorders that Tourette is associated with?
OCD and ADHD
How do we treat Tourette?
Antipsychotics and behavioral therapy
What is separation anxiety disorder?
Overwhelming fear of separation from home or loss of attachment figure
How do we treat separation anxiety disorder?
SSRI’s and relaxation techniques/behavioral interventions
When is the typical onset of separation anxiety disorder?
7-9