Psych and cognitive disorders (ch 10) Flashcards
1
Q
what is echopraxia?
A
the meaningless imitation of another person’s movements.
2
Q
what is catatonia?
A
immobility or rigidity.
3
Q
what is stereotypy?
A
the repetition of fixed patterns of movement and speech (ex. echolalia).
4
Q
what is psychomotor agitation?
A
excessive motor and cognitive activity, usually nonproductive and in response to inner tension.
5
Q
what is hyperactivity?
A
restless, sometimes aggressive, or destructive activity, often associated with brain pathology.
6
Q
what is psychomotor retardation?
A
decreased or slowed motor and cognitive activity.
7
Q
what is aggression?
A
forceful, angry, or destructive speech or behavior
8
Q
what is akathisia?
A
the state of restlessness characterized by an urgent need for movement, usually as a side effect of medication.
9
Q
what is ataxia?
A
the irregularity or failure of muscle coordination upon movement.
10
Q
what is circumstantiality?
A
speech that is delayed in reaching the point and contains excessive/irrelevant details
11
Q
what is tangentiality?
A
the abrupt changing of focus to a loosely associated topic.
12
Q
what is perseveration?
A
a persistent focus on a previous topic or behavior after a new topic or behavior has been introduced
13
Q
what is flight of ideas?
A
rapid shifts in thoughts from one idea to another.
14
Q
what is thought blocking?
A
the interruption of a thought process before it is carried through to completion.
15
Q
what is loosening of associations?
A
a disorder of the logical progression of thoughts where seemingly unrelated and unconnected ideas shift from one subject to another.
16
Q
what are delusions?
A
false beliefs about external reality without an appropriate stimulus that cannot be explained by the individual’s intelligence or cultural background.
17
Q
what are compulsions?
A
a need to act on specific impulses to relieve associated anxiety.
18
Q
what are obsessions?
A
a persistent thought or feeling that cannot be eliminated by logical thought.
19
Q
what is concrete thinking?
A
characterized by actual things, events, and immediate experience; the inability to think abstractly.
20
Q
what is pressured speech?
A
rapid and increased in amount. may be difficult to understand and/or interrupt.
21
Q
what is poverty of speech?
A
limited in amount; i.e. one word answers to questions
22
Q
what is poverty of content?
A
speech that is adequate in amount but conveys little info due to vagueness, lack of specificity, and limited detail.
23
Q
what is nonspontaneous speech?
A
consist of responses that are given only when spoken to directly.
24
Q
what is stuttering?
A
repetition or prolongation of sounds or syllables.
25
what is perseveration?
continued, persistent repetition of a word or phrase, often in response to different stimuli or different questions.
26
what is expressive aphasia? (aka ______)
aka Broca's aphasia... a disturbance in which the individual knows what he wants to say, but cannot say it.
27
what is receptive aphasia? (aka______)
aka Wernicke's aphasia... an organic loss of the individual's ability to comprehend what has been said to him.
28
what is nominal aphasia?
inability to name objects
29
what is global aphasia?
involves all forms of aphasia
30
what are hallucinations?
false sensory perceptions that are not in response to an external stimulus. Often referred to clinically as "responding to internal stimuli."
31
what are illusions?
misperceptions or misinterpretations of real sensory events.
32
what is agnosia?
inability to understand and interpret significance of sensory input. Visual agnosia is the inability to recognize people and objects.
33
what is astereognosis?
inability to identify objects through touch
34
what is apraxia?
inability to carry out specific motor tasks in the absence of sensory or motor impairment.
35
what is adiadochokinesia?
inability to perform rapidly alternating movements.
36
what is depersonalization?
subjective sensation of unreality about oneself or the environment
37
what is derealization?
a subjective sense that the environment is unreal.
38
what is fugue?
a state of serious depersonalization, often involving travel or relocation, in which the individual takes on a new identity with amnesia for his old identity.
39
what is dissociative identity disorder?
the appearance that an individual has developed two or more distinct personalities.
40
dissociation involves...
the separation of a group of mental or behavioral processes from the rest of the person's psychic activity. May involve separating an idea from its emotional tone.
41
what is immediate memory?
ability to recall material within seconds or minutes, aka "short term memory"
42
what is recent memory?
the ability to recall events of the past few days
43
what is recent past memory?
the ability to recall events of the past few months.
44
what is remote memory?
ability to recall events of the distant past, aka "long term memory"
45
what is procedural memory?
automatic sequence of behavior such as conditioned responses.
46
what is declarative memory?
recall specific to consciously learned facts, such as school subjects.
47
what is semantic memory?
knowing the meaning of words and the ability to classify information
48
what is episodic memory
the knowledge of one's personal experiences
49
what is prospective memory?
the capacity to remember to carry out actions in the future, such as knowing you have appointments scheduled, to turn off the stove, and to pay bills on time. Prospective memory is clinically important, especially with regard to an individual's ability to live safely and independently.
50
what is amnesia?
an inability to recall past experiences or personal identity. May be caused by organic or emotional dysfunction. Retrograde amnesia is the inability to remember events that occurred prior to the precipitating event.
51
what is the difference between mood and affect?
```
mood= pervasive, sustained emotion
affect= observable expression of mood
```
52
Axis I diagnoses...
clinical disorders and other conditions that may be a focus of clinical attention
53
Axis II diagnoses...
includes personality disorders and mental retardation
54
Axis III diagnoses...
identifies general medical conditions
55
Axis IV lists...
psychosocial and environmental problems (problems with primary support group, social environment, education, occupational, housing, economic, health care access, interaction with legal system/crime, other psychosocial/enviro problems.
56
Axis V provides...
a global assessment of functioning (GAF) coded 0-100.
57
The GAF is based on clinicians' assessment of the person's psych, social, and occupational functioning on a proposed mental health continuum. Codes...
0= there is inadequate info upon which to make an assessment.
1-10= a person who has completed a serious suicide act or who presents a persistent danger to self or others. This danger can be physical harm or complete inability to care for self.
91-100= a person who functions at a superior level and has no mental health symptoms.
*Codes also include descriptions of functional impact of symptoms, occupational impairment, and social functioning.
58
Schizophrenia: must have two or more of these symptoms (for 6 months)...
```
delusions
hallucinations
disorganized speech
grossly disorganized or catatonic behavior (positive symptoms)
negative symptoms
```
59
Negative symptoms (what are they and name them)...
A loss or absence of function
- restricted emotion (flat affect)
- difficulty in experiencing pleasure (anhedonia)
- decreased thought and speech (alogia)
- lack of energy (anergia) and initiative, often misinterpreted as lack of motivation
- inability to relate to others
60
Schizophrenia paranoid type
- characterized by preoccupation with one or more delusions of persecution or grandeur
- auditory hallucinations are frequently present
- tend to exhibit fewer negative symptoms
61
Schizophrenia disorganized type
-marked regression demonstrating primitive, disinhibited, and disorganized behavior
62
Schizophrenia catatonic type
-severe disturbances in motor behavior involving stupor, negativism, rigidity, excitement, or posturing.
63
Schizophrenia undifferentiated type
-used to classify those patients who do not clearly fit into another category!
64
Schizophrenia residual type
-used when there is continued evidence of schizophrenic behavior in the absence of a complete set of diagnostic criteria.
65
Onset, prevalence, and prognosis of schizophrenia
- Onset: usually b/w early adolescence and mid-30's.
- Prevalence: 0.6-1.9%.
- Prognosis: recovery possible with effective intervention. 50% of cases have good outcome (complete recovery or independent satisfying life); 25% able to lead satisfying lives with ongoing support; 25% with poor prognosis- repeated hospitalizations, exacerbation, and major mood disorder episodes.
66
what is schizophreniform disorder?
the individual meets criteria for schizophrenia; however, episode lasts more than one month but less than required 6 months, so can't be diagnosed with schizophrenia
67
what is schizoaffective disorder?
person has uninterrupted period of illness during which, at some time, there is a major depressive episode, manic episode, or mixed episode concurrent with symptoms that meet symptoms for schizophrenia.
68
what is delusional disorder?
individual's predominant symptoms are non-bizarre delusions with the absence of other symptoms of schizophrenia.
69
what is brief psychotic disorder?
individual experience at least one day but less than one month with one or more symptoms of schizophrenia which result from severe psychosocial stress.
70
what are the traditional antipsychotic medications?
Thorazine, Prolixin, Haldol, and Navane. Long-acting injections of Haldol and Prolixin are available.
71
what are side effects and complications of traditional antipsychotic medications?
Side effects: dry mouth, blurry vision, photosensitivity, constipation, orthostatic hypotension, Parkinsonism, dystonias, akathisia (restless, anxiety provoking need for movement), and cardiovascular disorders.
Complications: neuroleptic malignant syndrome (autonomic emergency); tardive dyskinesia (neurological disorder with abnormal involuntary irregular movements; neuroleptic-induced Parkinsonism.
72
what are the atypical antipsychotic medications?
Clozaril, Risperdal, Zyprexa, Seroquel, Geodon, Sphris, Fanapt, Latuda, Symbyax, Invega, and Abilify.
73
Side effects of atypical antipsychotics vary. Complications of Clozaril include:
agranulocytosis (decrease in certain white blood cells- potentially fatal.)
74
Major depressive disorder
one ore more depressive episodes; may be single episode or recurrent.
75
Bipolar I disorder
one or more manic episodes; ma be combined with depressive episodes.
76
Bipolar II disorder
one or more major depressive episodes; must be at least one hypomanic episode; no history of a manic episode.
77
what is dysthymia?
at least two years of a depressed mood, most days, with depressive symptoms that are not severe enough to meet the criteria for a major depressive episode.
78
what is cyclothymic disorder?
characterized by at least to years with numerous periods of hypomanic and depressive symptoms that do not meet the criteria for a manic episode or a major depressive episode.
79
symptoms of manic episode (need 3+ for diagnosis)
- inflated self-esteem or grandiosity
- decreased need for sleep
- more talkative than usual or pressured speech
- flight of ideas or feeling that thoughts are racing
- distractibility
- increase in goal-directed activity or psychomotor agitation
- excessive involvement in pleasurable activities that have high potential for painful consequences
80
Major depressive episode... diagnostic criteria (need 5+ for diagnosis)
- depressed mood most of the day
- markedly diminished interest or pleasure
- weight loss/gain, increase/decrease appetite
- insomnia/hypersomnia
- psychomotor retardation/agitation
- fatigue, loss of energy
- feelings of worthlessness/guilt
- diminished ability to concentrate/make decisions
- recurrent thoughts of death/suicide (with or without a plan), suicide attempt.
81
what is a mixed episode?
criteria are met for both a manic episode and a major depressive episode for at least one week.
82
what is a hypomanic episode?
symptoms are the same as a manic episode, but are not severe enough (don't last long enough) to cause marked impairment in social/occupational function or to require hospitalization.
83
what is agoraphobia?
anxiety about being in places/situations from which escape may be difficult or embarrassing.
84
what is social phobia?
anxiety from certain types of social or performance situations leading to avoidance.
85
what is obsessive-compulsive disorder?
- obsessions: recurrent and persistent thoughts, images, or impulses that are disturbing, intrusive, and inappropriate.
- compulsions: repetitive behaviors that the person is driven to perform to reduce anxiety or prevent a dreaded event of situation.
- the obsessions and compulsions are tim-consuming and distressing despite the individual's awareness of their irrationality.
86
what is post-traumatic stress disorder?
the persistent re-experiencing (for more than a month) of an extremely traumatic event that produces symptoms of increased arousal. Results in avoidance of stimuli associated with the traumatic event.
87
what is acute stress disorder?
similar to PTSD, but it immediately follows the event. Symptoms do not persist beyond one month.
88
what is generalized anxiety disorder?
6 months of persistent and excessive unfocused anxiety and worry.
89
what is paranoid personality disorder?
person has long-standing suspiciousness and mistrust of people in general; refuses responsibility for own feelings and assigns responsibility to others; can often appear hostile, irritable, and angry.
90
what is schizoid personality disorder?
frequently diagnosed in individuals who display a lifelong pattern of social withdrawal; discomfort with human interaction and bland, constricted affect are noteworthy; often seen by others as eccentric, isolated, or lonely.
91
what is schizotypal personality disorder?
appear odd or strange in their thinking and behavior; magical thinking, peculiar ideas, ideas of reference, illusions, and derealization are part of the person's everyday world.
92
what is antisocial personality disorder?
continual antisocial or criminal acts, but not synonymous with criminality; an inability to conform to social norms that involve many aspects of the individual's adolescent and adult development; no regard for safety/feelings of others and lack remorse.
93
what is borderline personality disorder?
person experiences extraordinarily unstable affect, mood, behavior, relationships, and self-image; fear or real or imagined abandonment leads to frantic efforts to avoid it; recurrent self-destructive or self-mutilating behavior may be threatened or carried out; majority of patients have a history of trauma.
94
what is histrionic personality disorder?
colorful, dramatic, extroverted behavior in excitable, emotional person; inability to maintain deep, long-lasting attachments with accompanying flamboyant presentation is often characteristic.
95
what is narcissistic personality disorder?
a heightened sense of self-importance and a grandiose feeling that they are special in some way.
96
what is avoidant personality disorder?
extreme sensitivity to rejection, which may lead to a socially withdrawn life; but the person is not asocial... shows a great desire for companionship but considers himself inept or unworthy. Person needs unusually strong and repeated guarantees of uncritical acceptance; commonly referred to as having an inferiority complex.
97
what is dependent personality disorder?
people with this disorder subordinate their own needs to those of others and need others to assume responsibility for major areas in their lives; lack self-confidence; may experience discomfort when alone for more than a brief period.
98
what is obsessive compulsive personality disorder?
(NOT to be confused with OCD)
emotional constriction, orderliness, perseverance, stubbornness, and indecisiveness. Essential feature is a pervasive pattern of perfectionism and inflexibility.
99
what are personality disorders not otherwise specified (4 of them)
passive-aggressive
depressive
sadomasochistic
sadistic
100
diagnostic criteria for anorexia nervosa...
- refusal to maintain body weight at/above normal weight for age and height.
- intense fear of gaining weight or becoming fat, even though underweight.
- disturbance in the way in which one's body weight or shape is experienced (too much self-evaluation; denial of the seriousness of currently low body weight even when gravely ill).
- amenorrhea of at least 3 consecutive months
- food restrictive or binge/purge.
101
diagnostic criteria for bulimia nervosa...
- recurrent episodes of binge eating defined as lack of control over discrete periods of excessive eating of an abnormally large amount of food.
- recurrent, inappropriate compensatory behavior in order to prevent weight gain (vomiting, laxative, fasting, excessive exercise)
- binge/purge occurs on average at least 2x/week for 3 months
- self-evaluation is unduly influenced by body shape and weight
- the disturbance does not occur exclusively during episodes of anorexia nervosa.
102
what is oppositional defiant disorder?
negativistic, hostile, and defiant behaviors that result in functional impairment
103
what is conduct disorder?
disregard for the rights of thers leading to aggression toward people and animals, destruction of property, deceitfulness, theft, or serious violation of rules
104
what is disruptive behavior disorder NOS?
children who do not been criteria for Conduct Disorder or Oppositional Defiant Disorder; however they display significant functional impairment and conduct and oppositional behaviors are present.
105
diagnostic characteristics of autism...
- impaired social interaction and in most cases cognitive disabilities (poor eye contact, impaired attachment, anxiety with changes in routine; difficulty related to others; lack social seeking behaviors or awareness of others seeking interaction; decreased ability to infer feelings)
- difficulty with communication (lack of spoken language; if speech difficulty in initiating/engaging in conversation; stereotyped echolalia)
- repetitive stereotyped behaviors and movements in one+ of the following: ritualistic nonfunctional routines and preoccupation; rigid observance of nonfunctional routines; restrictive fixation on parts of a whole object.
- difficulty with sensory processing
106
diagnostic characteristics of Asperger's disorder...
- difficulty with social interaction
- restricted interests and behaviors
- characterized by clumsiness
- delayed developmental motor milestones
- differentiated from autism by adequate language and the level of social interaction/engagement in activities with others
107
what is Rett's syndrome?
progressive encephalopathy developing after 6 months-2 years of normal development.
108
diagnostic characteristics and sequelae of Rett's syndrome
- deterioration of language, receptive and expressive communication, and social skills at a six-month to one-year developmental level.
- motor deterioration characterized by loss of purposeful hand mvmnt with development of stereotypical mvmnts, like hand wringing, licking, biting, and slapping of fingers.
- muscle tone becomes hypotonic and then progresses to spasticity and then rigidity. (ataxic, uncoordinated, and stiff gate)
- muscle wasting
- breathing patterns become irregular, marked by hyperventilation, apnea, and holding of breath
- regression in cognition and praxis
- abnormal EEG and seizures common.
109
symptoms of Pervasive Developmental Disorder, Unspecified...
impairments in social interaction, communication, motor behavior, interests, and activities; however, can't be classified as indicative of a pervasive developmental disorder since not all diagnostic criteria are met.
110
characteristics of Reactive Attachment Disorder, Inhibited type...
- persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions.
- interactions are excessively inhibited, hypervigilant, or highly ambivalent and contradictory in nature.
111
characteristics of Reactive Attachment Disorder, Disinhibited type....
- indiscriminate sociability with inability to exhibit appropriate selective attachments.
- demonstrated by excessive familiarity with relative strangers or lack of selectivity.
112
behaviors of children with Reactive Attachment Disorder (RAD)
- high need to be in control
- frequent lying
- affectionate and overly related with strangers
- frequent episodes of hoarding or gorging on food without physical need
- denial of responsibility
- projecting blame for their actions on others.
113
There is no one standard tx for RAD in the literature. Some interventions that may be efficacious...
- nondirective play therapy
- sensory integrative therapy
- attachment therapy (somewhat controversial)
- psychotherapy combined with psychoeducation
114
diagnostic criteria for Attention-Deficit/Hyperactivity disorders include six or more symptoms in the inattention domain, hyperactivity-impulsivity domain, or both (for 6+ months). Symptoms are...
- inattention: lack of attention to detail, poor listening, limited follow-through, difficulty with organization, and avoidance of tasks that require sustained attention, tendency to lose things, distractibility, forgetfulness.
- hyperactivity: fidgeting, can't remain seated, inappropriate activity level for a situation, difficulty with quiet sedentary activities, frequent movement, excessive talking.
- impulsivity: answering questions before they're fully stated, difficulty with turn taking, interrupting the conversations/activities of others.
- vial-perceptual, auditory-perceptual, language, and/or cognitive problems may be present.
115
Impact of ADHD on function
- defensiveness to enviro stimuli, frequent irritability, aggressive behavior, emotional lability, and fluctuating/unpredictable performance.
- difficulty with delayed gratification in school/home.
- deficits in perceptual motor tasks with disorders in reading, math, written expression, and general coordination.
- disorders of memory, thinking, speech, and hearing.
- depression secondary to frustration and difficulty with learning
- if symptoms remain in adolescence/adulthood, prone to antisocial personality disorders and risk for substance-related disorders.
116
etiology of intellectual disorders...
- genetic conditions such as chromosomal abnormalities (Down syndrom, Fragile X, Prader-Willi Syndrome, and Klinefelter's syndrome)
- metabolic conditions such as phenylketonuria, hypothyroidism, and Tay-Sachs disease.
- prenatal infections like rubella, toxoplasmosis, AIDS
- maternal substance abuse
- perinatal factors like trauma and prematurity
- acquired conditions including inflections like encephalitis, meningitis.
- head trauma sustained in MVA, falls, child abuse
117
Focus of OT mental health evaluation
- determination of values, interests, desired occupational roles, and self-determined goals.
- identification of cognitive, perceptual, and psychosocial strengths/skills and ability to facilitate recovery
- identification of cognitive, perceptual, and psychosocial deficits/limitations and impact on function/lifestyle
- determination of functional problems associated with psychiatric symptoms (like safety awareness/judgment)
- tx history and ability/interest to engage in recovery
- identification of coping skills, stressors, and enviro/social supports
118
OT mental health intervention... focus during acute hospitalization
-management of all behaviors that threaten safety of patient and others
-stabilization of behavior to enable engagement in tx
-engagement in activities that are do-able to enable success and promote reality.
-engagement of patient in tx.
-development of relaxation/stress management skills to help decrease incidence/severity of symptoms
-development of skills needed to pursue desired occupational roles
-engagement in activities to improve communication skills and self-expression
gathering/sharing of ongoing assessment info with tx team
-assistance with discharge planning to support recovery
119
OT mental health intervention... focus during long-term hospitalization
- development/implementation of plan for self-determined goal achievement
- provision of normalizing enviro that enables participation in meaningful/desired occupational roles
- engagement of patient in tx process
- provision of graded activities to develop skills needed for all areas of occupation
- development of relaxation/stress management skills to help decrease incidence/severity of symptoms
- continuation of assessment to determine realistic and meaningful discharge goals
- development of skills/supports needed to pursue desired post-discharge occupational roles and participate in discharge environment
120
OT mental health intervention... focus in community settings
- provision of services that facilitate recovery and assit in maintenance of existing skills
- assistance with continued development of skills needed for community living, social participation, and pursuit of valued occupational roles.
- development of skills and supports to enable ongoing recovery (ex. NAMI)
- development of skills and provision of assistance (PRN) to obtain concrete practical resources to support community living (ex. SSI, affordable housing, food stamps)
- monitoring of patient for changing clinical, personal, and social needs.
