PSYCH 500-503 Flashcards by Daniel Zheng

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)

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Is the learned response in classical conditioning usually voluntary or involuntary?

Involuntary

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What type of conditioning typically deals with voluntary responses?

Operant conditioning

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In operant conditioning, how is a particular action elicited?

Either because it produces a punishment or a reward

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What are the 4 types of operant conditioning?

Positive reinforcement
Negative reinforcement
Punishment
Extinction

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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).

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What is punishment?

Repeated application of aversive stimulus to extinguish unwanted behavior

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What is extinction?

Discontinuation of reinforcement (positive or negative) eventually eliminates behavior?

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Does extinction occur in operant conditioning, classical conditioning, both, or neither?

Both

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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

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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

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What are ego defenses?

Unconscious mental processes used to resolve conflict and prevent undesirable feelings (e.g. anxiety, depression)

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What are the two subcategories of ego defenses?

Mature and Immature

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What are the 4 mature defenses?

Mnemnoic: Mature adults wear a SASH

Altruism
Humor
Sublimation
Suppression

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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

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What type of ego defense is a tantrum an example of?

Acting out - expressing unacceptable feelings and thoughts through actions

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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)

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What is denial?

Avoiding the awareness of some painful reality

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Which patients are especially prone to exhibit denial?

Newly diagnosed AIDS and cancer patients

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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

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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

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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)

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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

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What is identification?

Modeling behavior after another person who is more powerful (though not necessarily admired)

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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)?

1. Weak - decreased muscle tone, weight loss, physical illness 2. Wordless - poor language skills 3. Wanting (socially) - poor socialization skills, anaclitic depression 4. 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?

1. Genital, anal, or oral trauma 2. STD's 3. 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?

1. Retrograde 2. Anterograde 3. 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?

1. 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