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Psychiatry Flashcards

1
Q

Delirium-DSM 5

A

A. Disturbance in attention and awareness

B. Disturbance develops over a short period of time, represents a change from baseline, and tends to fluctuate in severity over the course of a day

C. Additional disturbance in cognition (memory deficit, disorientation, language, visuospatial ability/perception).

D. Does not occur in the context of a severely reduced level of arousal (coma)

E. Evidence of physiological consequence as the cause

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2
Q

Causes of Delirium

A
  1. Substance Abuse
  2. Substance Withdrawal
  3. Medication-Induced
  4. Due to another medical condition
  5. Due to multiple etiologies
    • Nutritional deficiencies
    • Anemias
    • Electrolyte imbalance
    • Low ACh (Anticholinergics)
    • High DA (Opioids)
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3
Q

Clinical Findings in Delirium

A
  1. Acute onset
  2. Inattention
  3. Disorientation
  4. Fluctuation of mental status
  5. Memory impairment
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4
Q

Pathophysiology of Delirium

A
  1. Inflammation (pro-inflammatory cytokines)
  2. Stress Rxn
    • High coritsol
    • Sleep deprivation
  3. Neuronal injury
    • Disrupts BBB
  4. Neurotransmission abnormalities
    1. Decreased ACh
    2. Increased DA
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5
Q

Precipitating Factors of Delirium

A
  1. Medications: Anticholinergics/Opioids
  2. Hypoxia
  3. Hypoglycemia
  4. Hyperthermia/Fever
  5. Infection
  6. Metabolic Abnormalities
  7. Hypoalbuminemia (early sign)
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6
Q

Factors to reduce frequency of delirium

A
  1. Orientation protocol (write day/date/location/ID in sight)
  2. Noise reduction
  3. Visual aids
  4. Hearing aids
  5. Hydration
  6. Early mobilization
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7
Q

Drug Treatments for Delirium

A
  1. Benzodiazepines IF caused by withdrawal of ETOH or Benzodiazepines
  2. Pro-cholinergic drugs (AChE Inhibitors)
  3. DA antagonists (antipsychotics)
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8
Q

Major vs Minor neurocognitive disorder

A

Major: Substancial cognitive decline that interferes with independent living

Minor: Modest changes in cognition that do not yet interfere with independent living

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9
Q

Examples of major neurocognitive Disorders

A
  1. Alzheimer’s
  2. Vascular disease
  3. Prion Disease
  4. Parkinson’s
  5. Huntington’s
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10
Q

Changes in the brain in Alzheimer’s patients

A
  1. Amyloid plaques (beta amyloid peptides)
  2. Neurofibrillary tangles (tau protein)
  3. Loss of connections/cell death
  4. Loss of ACh
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11
Q

Symptoms of Alzheimer’s

A
  1. Memory loss***
  2. Loss of recognition
  3. language problems
  4. Anterograde amnesia
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12
Q

Drugs that treat alzheimer’s

A
  1. AChE inhibitors (inhibit ACh breakdown)
  2. NMDA antagonists
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13
Q

Risk Factors for Alzheimer’s

A
  1. Age
  2. Genetics for early-onset (chromosomes 1, 14, 21)
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14
Q

Most common cause of amnestic disorder

A

Alcohol abuse with chronic thiamine (B-1) deficiency

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15
Q

Symptoms of Wernicke’s Encephalopathy

A
  1. Ophthalmoplegia
  2. Ataxia
  3. Mental confusion
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16
Q

Symptoms of Korsakoff’s psychosis

A
  1. Amnesia (retrograde or anterograde)
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17
Q

What are the six cognitive domains in neurocognitive disorders?

A
  1. Attention
  2. Executivefunction
  3. Learning and memory
  4. Language
  5. Perceptual motor
  6. Social-cognition
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18
Q

Difference between Hallucination and Illusion

A
  1. Hallucination: seeing something that isn’t there (any of the 5 senses)
  2. Illusion: seeing something that is there but thinking that it is something else (see a rope but think it is a snake)
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19
Q

Mood vs Affect

A
  • Mood: emotional attitude that is relatively sustained, self-reported
  • Affect: the way the patient conveys their emotional state as perceived by others (how a patient “appears”)
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20
Q

Tegmentum: origin of which neurotransmitter?

A

Dopamine

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21
Q

Raphe nucleus: origin of which neurotransmitter?

A

Serotonin

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22
Q

Locus Ceruleus: origin of which neurotransmitter?

A

Norepinephrine

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23
Q

Tuberomammiliary nucleus: origin of which neurotransmitter?

A

Histamine

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24
Q

Nucelus Basalis of Meynert: origin of which neurotransmitter?

A

ACh

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25
Q

Neurotransmitter mediating executive function, motivation,interpersonal and emotional behavior

A

Glutamate

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26
Q

Function of DA

A

Attention

Pleasure

Motivation

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27
Q

Function of NE

A

Energy

Alertness

Concentration

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28
Q

What part of the brain atrophies in depression?

A

Hippocampus

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29
Q

What are the changes in DA transmission in Schizophrenia?

A
  • Decreased in prefrontal cortex
    • Due to excess stimulation of serotonin receptors on presynaptic neuron
  • Increased in Mesolimbic cortex
    • Inhibition of serotonin receptors on presynaptic neuron
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30
Q

Results of Glutamate Hypoactivity in the brain in Schizophrenia

A
  1. Decrease DA downstream
    • if glutamate neuron directly connected to DA neuron
    • Prefrontal cortex in Schizophrenics
    • leads to negative symptoms (mood and cognitive)
  2. Increase in DA downstream
    • connected to DA neuron through a GABA interneuron
    • Mesolimbic system in Schizophrenics
    • Leads to psychotic symptoms
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31
Q

Pavlovian conditioning definition

A

Pairing of stimuli

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32
Q

Operant conditioning definition

A

Positive reinforcement vs negative reinforcement where behavior can control its own consequences

Unpredictable schedule of reinforcement works best

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33
Q

Behavioral therapy moto

A

work on observable behaviors, feelings to follow

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34
Q

Types of behavioral therapy

  1. Relaxation training
  2. Exposure
  3. Flooding
  4. Behavioral Activation
A
  1. muscle relaxation to achieve control over feelings of tension and relaxation
  2. imaginary or in vivo; gradual exposure to more and more fearful things; systematic desensitization
  3. Constant exposure to most feared thing; Not used
  4. Re-Engage person in social activities
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35
Q

What is a cognitive schema?

A

How you have learned to think

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36
Q

What is the cognitive triad and in what disorder is it mostly found?

A
  1. Negative view of self
  2. Negative view of future
  3. Negative interpretation of experience

Found in depression

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37
Q

What is arbitrary inference?

A

Drawing an erroneous conclusion from an experience

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38
Q

What is Selective abstraction?

A

Taking a detail out of context and using it to denigrate the entire experience

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39
Q

What is overgeneralization?

A

Making general conclusions about overall experiences and relationships based on a single instance

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40
Q

What is magnification and minimization?

A

Altering the significance of specific events in a way that is structured by negative interpretations

Ex: a good grade explained by the test being easy but a bad grade being attributed to being a terrible student who will never succeed in life

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41
Q

What is personalization?

A

Interpreting events as reflecting on the patient when they have no relation to him or her

Ex: a frown from a grouchy traffic policeman is seen as recognition of the patient’s overall lack of skill as a driver and general worthlessness

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42
Q

What is Dichotomous thinking?

A

Seeing things in an all-or-nothing way

Ex: An A- student gets a B in a course and concludes that it proves that they are a terrible student

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43
Q

What is free association?

A

In psychoanalytic therapy, spontaneous, uncensored verbalization by the patient of whatever comes to mind.

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44
Q

What is Transference?

A

In psychoanalytic therapy, feeling something toward the analyst that stems from a feeling toward someone else/an experience in life.

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45
Q

What is Couter-transference?

A

In psychoanalytic therapy, the transference/emotional reaction by the analyst of previous experience and feelings onto the patient

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46
Q

What is transference neurosis?

A

In psychoanalytic therapy, fully developed transference of the role of someone in the patient’s life to the analyst

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47
Q

What is projection?

A

A defense mechanism in which the feelings one feels toward another is viewed as being felt by the other person towards oneself.

Ex: I have negative feelings toward you but think you don’t like me

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48
Q

What is Splitting?

A

A defense mechanism in which the self or others are viewed as all good or all bad, with failure to integrate the good and bad qualities into a cohesive image.

The person alternatively idealizes and devalues the same person.

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49
Q

What is dissociation?

A

A defense mechanism consisting of an altered state of consciousness; separation of an idea from its emotional significance

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50
Q

What is Reaction formation?

A

A defense mechanism in which a person adopts affects, ideas, and behaviors that are opposites of impulses harbored either conscously or unconsciously.

Ex: excessive moral zeal may be a reaction to strong but repressed asocial impulses.

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51
Q

What is intellectualization?

A

A defense mechanism in which the person engages in excessive abstract thinking to avoid confrontation with conflicts or disturbing feelings.

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52
Q

What is sublimation?

A

A defense mechanism by which instinctual drives, consciously unacceptable, are diverted into personally and socially acceptable channels.

Ex: feeling agression toward someone so you beat them at a game rather than physically

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53
Q

Focus of insight-oriented psychotherapy

A

interpersonal relations in the present and intellectual understanding

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54
Q

Focus of interpersonal therapy

A

ID and work on problem areas that ma affect self esteem and interactions

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55
Q

Characteristics of Atypical Depression

A
  1. Mood reactivity
  2. Leaden paralysis (arms and legs)
  3. Weight Gain, Excessive sleep
  4. Treat w/MAOIs
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56
Q

Characteristics of Melancholic Depression

A
  1. Guilt
  2. Terminal insomnia
  3. Anorexia
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57
Q

Characteristics of SAD

A

Depressed mood coincides with particular seasons

Spring-onset: more sever, higher risk of suicide

Fall-onset: rull remission in the summer months

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58
Q

Characteristics of Persistent Depressive Disorder

A
  1. Longer duration and persistance (2 years)
  2. Less severe symptoms
    • 2 symptoms of depression persist for 2 years
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59
Q

Characteristics of Psychotic Depression

A
  1. Mood-congruent delusions

More common in bipolar psychosis than unipolar

Treat with antidepressant + antipsychotic

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60
Q

Causes of Depression

A
  1. Genetics
  2. Neurobiology
    • Decreased DA
    • Increased Serotonin
    • Prefrontal Cortex, Amygdala, and Hippocampus involved
  3. Psychosocial
    • at first stimulated by large stressors but later by progressively small stressors or none at all
61
Q

Disorder that is often a comorbidity with depression

62
Q

Symptom domains of Bipolar Disorder

A
  1. Manic (like stimulants)
  2. Dysphoric
  3. Psychotic
    • Delusions
    • Hallucinations
  4. Cognitive
    • Racing thoughts
    • distractibility
    • Disorganization
63
Q

Predictors of suicide (in bipolar patients)

A
  1. Lack of sleep
  2. Anxiety
64
Q

Bipolar I vs Bipolar II

A

Bipolar I: full manic episodes followed by depressive episodes

Bipolar II: at least one hypomanic episode followed by depressive episodes

65
Q

Frequent comorbidity with Bipolar II

66
Q

Characteristics of Cyclothymic disorder

A
  1. Cycles of mild depression followed by hypomania
    • manias are not socially or professionally incapacitating

Mildest form of bipolar

67
Q

Symptoms of Major Depression

A

Depressed Mood

Interest

Weight

Sleep

Motor activity

Energy

Guilt

Concentration

Suicide

“Depression Is Worth Studiously Memorizing Extremely Grueling Criteria, Sorry”

68
Q

What is the difference between delusions and hallucinations?

A

Delusions: beliefs

Hallucinations: perceptual distortions

69
Q

Characteristics of psychosis

A
  1. Loss of reality testing
  2. Delusions or hallucinations w/o insight into their pathological nature
  3. Impaired social/personal functioning
    • Social withdrawal
70
Q

Causes of Schizophrenia

A
  1. Genetic**
  2. Environment
    • cannabis use
    • Maternal malnourishment/depression during pregnancy
  3. Neurodegeneration
    • Gray matter loss
    • dendritic spine reduction
71
Q

Prodromal symptoms of schizophrenia

A
  1. Paranoia***
    • Including ideas of reference
  2. Perceptual distortions***
  3. Social withdrawal
  4. Lack of appropriate affect
  5. Unusual ideas/beliefs
  6. Crippling Anxiety
72
Q

Types of delusions in Schizophrenia

A

These are Positive signs

  1. Fixed, false beliefs
  2. Paranoid type
  3. Grandiose type
  4. Delusions of reference
  5. Thought insertion (believe thoughts are not their own and are being broadcast in their mind)
  6. Thought broadcasting (believe thoughts are being broadcast for others to hear
  7. LACK OF INSIGHT
73
Q

Neurobiology of delusions

A

Hippocampus retrieves old, irrelevant memories and the amygdala adds emotion

74
Q

Types of hallucinations in schizophrenia

A

These are positive signs

  1. Outer-space auditory hallucinations (heard outside head)
  2. Inner-space auditory (heard inside head)
  3. Elementary (indistinct sounds

Unpleasant, difficult to control, distressing and disruptive

75
Q

Neurobiology of hallucinations

A

overinterpreting spontaneous sensory activity that is commonly ignored in healthy brains

76
Q

Neurobiology of auditory hallucinations

A

Failure of corollary discharge (responsible for distinguishing self-generated from externally generated perceptions) to alert temporal lobes that these thoughts are self-generated

77
Q

Types of thought processing/speech in schizophrenia

A

Positive Symptoms

  1. Tangential (respond to question in round-about manner or not at all)
  2. Circumstantial (delayed in reaching goal idea; tangents, tedious details)
  3. Flight of ideas (rapid, continousflow of speech with abrupt changes in topic; associations, distractions, word play
  4. Derailing (Disjointed with many changes in topic)
  5. Paucity of speech (scarcity, answer in two-word responses)
  6. Increased response latency
78
Q

Negative symptoms in schizophrenia

A
  1. Flat/Blunted Affect
  2. Lack of initiative/motivation
  3. Anhedonia
  4. Social withdrawal
79
Q

Neurobiology of negative symptoms

A

Hypoglutamatergic state

  • Glutamate directly connected to DA neuron, causing decreased DA in prefrontal cortex (mesocortical)
80
Q

Neurobiology of Positive symptoms

A

Hypoglutamatergic State

  • Glutamate neuron connected to GABA interneuron then DA neuron
  • Increased DA in mesolimbic system
81
Q

Function of Atypical antipsychotics

A
  1. Block D2 receptors in the mesolimbic system (where there is too much)
  2. Block serotonin receptors in the prefrontal cortex (where there isn’t enough DA)
    • DA release inhibited by serotonin
82
Q

What are MUPS

A

Medically explained physical symptoms that are distressing/disrupt daily life

83
Q

Characteristics and treatment of Somatic Symptom Disorder

A
  1. Somatic symptoms disrupt daily life
  2. Excessive thoughts/feelings/behavior focused on symptoms
  3. State of being symptomatic is persistent

Treatment: brief, scheduled visits

84
Q

Characteristics and treatment of Illness Anxiety Disorder

A
  1. Preoccupation with having/acquiring a serous illness
  2. Symptoms not present or mild
  3. excessive health-related behaviors (checking)
  4. Distress that they have an illness (focus not on symptoms)

Treatment:

  1. Frequent scheduled appointments
  2. Cognitive behavioral therapy
  3. SSRIs (anti-obsessional effects)
85
Q

Characteristics and Treatment of Conversion Disorder

A

Characteristics:

  1. Altered voluntary motor or sensory function (paralysis/pseudoseizures)
  2. Not compatible with recognized disease

Treatment

  1. “face-saving” treatment and symptoms remit spontaneously in 2 weeks
86
Q

Psychodynamic interpretation of Conversion Disorder

A

Achieves a primary goal steming from unconscious conflicts (aggression, sexuality)

Ex: aggression makes man want to shoot wife’s lover but dominant hand and arm become paralyzed

Secondary gain: benefits from the “sick role”

87
Q

Characteristics of Malingering

A

Characteristics:

  1. Intentional production of false/exaggerated symptoms
  2. Motivated by external incentives (avoid military duty/criminal prosecution)

Confrontation is correct response

88
Q

Characteristics and Treatment of Separation Anxiety Disorder

A
  1. Fear of being separated from places/people to whom one has strong emotional attachment
  2. Worry of losing that person/being separated from that person by being kidnapped, ect.
  3. School Phobia is one form

Treatment: SSRI and cognitive behavioral therapy

89
Q

Characteristics and Treatment of Selective Mutism

A

Characteristics:

  1. Absence of expressive verbal speech in select situations

Treatment: SSRI and behavioral therapy

90
Q

Characteristics and Treatment of Social Anxiety Disorder

A

Characteristics

  1. Fear of scrutiny
  2. Avoidance and fear of social situations
  3. Physical symptoms of anxiety (autonomic arousal)

Treatment:

  1. SSRI/MAOI/BZD
  2. Beta blockers
  3. Behavioral desensitization
91
Q

Characteristics and treatment of Panic Disorder

A

Characteristics:

  1. abrupt episodes with autonomic arousal
  2. Chest pain or discomfort
  3. Shortness of breath
  4. Parasthesias
  5. Derealization or depersonalization
  6. Episodes followed by persistent worry or maladaptive change in behavior to avoid attack

Treatment:

  1. SSRI/MAOI/TCA/BZD
  2. Cognitive behavior therapy
92
Q

Pathophysiology of Panic Disorder

A
  1. lactate metabolism abnormality
  2. GABA abnormality
  3. Locus Coeruleus abnormality (NE)
93
Q

Characteristics and Treatment of Agoraphobia

A

Characteristics: fear of

  1. public transportation
  2. enclosed spaces
  3. crowds
  4. Being away from security of home base

Treatment: Behavioral therapy

94
Q

Characteristics and Treatment of Generalized Anxiety Disorder

A

Characteristics:

  1. Anxiety
  2. Restlessness
  3. Fatigue
  4. Sleep disturbance
  5. Unrealistic fear

Treatment: SSRI/MAOI/BZD/TCAs and cognitive behavioral therapy

95
Q

What is excoriation?

A

An OCD syndrome characterized by skin picking

96
Q

What is Trichotillomania?

A

An OCD disorder characterized by hair pulling

97
Q

What is PANDAS?

A

Pediatric Auto-immune Neurologic Disorder from Streptococcal infection

Causes an OCD-type disorder in children

Causes Tourette’s Syndrome

98
Q

The following tests are used to test what?

  1. WISC-IV
  2. Bender-Gestalt
  3. Iowa test
  4. Draw a person test
A
  1. IQ
  2. Perceptual-Motor skills
  3. Educational achievement to detect learning disabilities
  4. Perceptual-Motor skills
99
Q

What is speech sound disorder?

A

A language disorder involving problems with certain sounds (ex: “r”s or “w”s)

100
Q

What is Child-onset fluency disorder?

A

Stuttering

Usually grows out of it

101
Q

What is social communication disorder?

A

Problems with communication, including:

  1. Failure to change communication style with environment
  2. Trouble taking turns in conversation
  3. Poor ability to make inferences
102
Q

Characteristics of Autism

A
  1. Deficits in social-emotional reciprocity
  2. Deficits in non-verbal communication
    • No eye contact
    • No gesturing while talking
  3. Restricted repetitive patterns of behavior (need a set schedule)
  4. Devoid of novelty-seeking
103
Q

Characteristics of ADHD

A
  1. Inattentive
    • Short attention
    • Misses details
    • Disorganized
  2. Hyperactivity/impulsivity
    • Fidgets
    • Talks excessively

Highly Inheritable

104
Q

Characteristics of Tourette’s Disorder

A

Vocal and motor tics before age 18

Can be caused by PANDAS

105
Q

Characteristics of Anorexia nervosa

A
  1. Significantly low body weight (<17 kg/m2)
  2. Fear of gaining weight or becoming fat
  3. Disturbance in the way weight or shape is experienced
  4. Lack of insight into the problem (denial)
    • Symptoms are ego-systonic (consistent with patient’s ideals)
106
Q

Acute and Chronic Medical Complications of Anorexia Nervosa

A

Acute

  1. Electrolyte abnormalities (low K)
  2. Refeeding hypophosphatemia
  3. Cardiac abnormalities (Low bp, arrythmia)

Chronic

  1. Cognitive impairment
  2. Changes in brain volume
  3. Cardiac arrythmias
  4. Osteoporosis
  5. Amenorrhea
107
Q

Types of Anorexia Nervosa

A
  1. Restricting Type: primarily through diet, fasting, and excessive exercise
  2. Binge-eating/purging type
    • Differentiate from bulemia by low weight
108
Q

Characteristics of Bulemia Nervosa

A
  1. Eating a larger amount of food than what most would eat (feel lack of control over eating)
  2. Compensatory behaviors in order to prevent weight gain
  3. Self-evaluation largely based on body shape/weight
  4. Normal/above normal weight
  5. Symptoms are ego-dystonic (in conflict with self image)
109
Q

What is a russell sign? With which disorders is it associated?

A

A sore on the finger/knuckle due to contact with gastric acid from inducing vomiting

110
Q

Acute and Chronic Medical Complications of Bulimia Nervosa

A

Acute

  1. Electrolyte abnormalities (low K lvls)
  2. Increased serum amylase
  3. Low plasma insulin, low glucose

Chronic

  1. Mallory-Weiss tears of esophagus
  2. Fatty Liver
  3. Arrhythmias
  4. Hypothermia
  5. Amenorrhea
111
Q

Treatment: Anorexia vs Bulimia

A

Anorexia

  1. Focus on restoring weight
  2. Calcium/Vit D supplement
  3. Estrogen/Progesterone replacement

Bulimia

  1. Focus on metabolic balance
  2. SSRIs (Not Bupropion due to reduced seizure threshold)

Both: Psychoeducation!

112
Q

Characteristics of Hypersomnolence Disorder

A
  1. Excessive sleepiness despite main sleep period lasting at least 7 hours
  2. Includes one of the following:
    • Recurrent periods of sleep or lapses into sleep within the same day
    • Prolonged main sleep of more than 9 hours per day that is unrefreshing
    • Difficulty being fully awake after abrupt awakening
113
Q

Characteristics of Narcolepsy

A
  1. Recurrent episodes of an irrepressible need to sleep
  2. Decreased sleep and REM latency
  3. May have cataplexy
114
Q

Characteristics of Parasomnias

A
  1. Incomplete awakening from sleep
  2. Either Sleepwalking or Sleep Terrors
115
Q

Aspects of Personality Disorders

A

ABC’s

  1. Affect
  2. Behavior
    • interpersonal and impulse control
  3. Cognition
    • Ways of perceiving and interpreting self and others
116
Q

What disease-types are in each cluster of Personality Disorder?

Cluster A

Cluster B

Cluster C

A
  1. Cluster A: Odd (Psychosis)
    • Schizoid, Schizotypal, Paranoid
  2. Cluster B: Dramatic (Affective)
    • Antisocial, Borderline, Histrionic, Narcissistic
  3. Cluster C: Anxious
    • Avoidant, Dependent, OCpD
117
Q

Characteristics of Paranoid Personality Disorder and Primary Defense

A

Characteristics:

  1. Suspicious
  2. Mistrustful
  3. Preoccupied with being exploited or betrayed by others

Projection is primary defense

118
Q

Characteristics of Schizoid Personality Disorder

A

Characteristics:

  1. Defect in ability to form personal relationships
    • Due to lack of interest
  2. Indifferent, aloof
  3. Unresponsive to feelings expressed by others
119
Q

Characteristics of Schizotypal Personality Disorder

A

Characteristics:

  1. Idiosyncratic speech patterns
  2. eccentric beliefs
  3. paranoid tendencies
  4. withdrawn from society

Like schizophrenia but person has never had a psychotic break

120
Q

Characteristics of Antisocial Personality Disorder

A

Characteristics

  1. Socially irresponsible
  2. Deception/manipulation of others for personal gain
  3. Lacks remorse
  4. Fails to abide by the law
121
Q

Characteristics of Borderline Personality Disorder and Major defense

A
  1. Intense and chaotic relationships
  2. Fluctuating and extreme attitudes toward others
  3. Self-destructive behaviors in response to abandonment

Major defense: Splitting

122
Q

Characteristics of Histrionic Personality Disorder

A
  1. Attention-seeking
  2. seductive
  3. exhibitionistic
  4. shallow emotions
123
Q

Characteristics of Narcissistic Personality Disorder

A
  1. Egocentric
  2. Crave admiring attention and praise
    • need external validation all the time
  3. Feel “entitled” to special rights/attention/privileges
124
Q

Characteristics of Avoidant Personality Disorder

A
  1. Introverted
  2. Low self-esteem
  3. Social awkwardness
  4. Self-conscious
  5. Fears of being embarrassed or acting foolish

**Wants to socialize, but is afraid

Differs from Schizoid b/c wants social interaction

similar to social anxiety disorder, but is long-term

125
Q

Characteristics of Dependent Personality Disorder

A
  1. Excessive reliance on others
  2. permit others to make important decisions
126
Q

Characteristics of Obsessive-Compulsive Personality Disorder and Defenses

A

Characteristics

  1. Perfectionistic
  2. Emotionally distant
  3. Driven/competitive

Defenses:

  1. reaction formation
  2. intellectualization
127
Q

Most common cause of sexual disorder

A

Psychological:

Psych disorder

Stress

Relationship conflicts

Abuse/trauma

128
Q

Drugs that cause sexual dysfunction

A
  1. Antipsychotics
  2. SSRIs
  3. MAOIs
  4. TCAs
  5. Alcohol
  6. Opioids
  7. Antihistamines
129
Q

Hormones/Neurotransmitters that increase sexual desire

A
  1. increased DA
  2. increased testosterone
130
Q

Hormones/Neurotransmitters that decrease sexual desire

A

Elevated:

  1. Serotonin
  2. Prolactin
  3. Cortisol
  4. Progesterone
131
Q

Components of Dual Sex Therapy

A

Components:

  • Dyad as the object of therapy
  • Sexual problems reflect other areas of disharmony in relationship
  • Goal: improve sexual and nonsexual areas

Techniques:

  • sensate focus exercise: focus on heightening sensory awareness of touch, sight, sound, and smell
  • Squeeze technique: for premature ejaculation
132
Q

Drug therapies for ED

A
  1. Phosphodiesterase 5 inhibitor (enhances NO)
  2. Prostaglandin E (vasodilation)
133
Q

Drug therapy for premature ejaculation

134
Q

Drug therapy to increase sex drive

A
  1. Increased androgens
135
Q

Characteristics of Paraphilic Disorder

A
  1. Inability to resist an impulse for sexual act
  2. Deviance
  3. Cause harm to others
136
Q

Drug therapy to reduce sex drive (ex: in paraphilic disorder)

A

Antiandrogens

SSRIs

137
Q

Behavioral treatment of Paraphilic disorder

A
  1. Masturbation satiation (with own deviant fantasies)
  2. Covert sensitization (replace patient’s fantasies with unpleasant ones)
  3. Masturbatory conditioning (paried with non-deviant fantasies)
  4. Cognitive-behavior therapy (correct cognitive distortions, including minimizations, excuses, justification)
138
Q

Quadrad of PTSD symptoms

A
  1. Intrusive thoughts
  2. Avoidant behaviors
  3. Negative cognitions and mood
  4. Hyperarousal
139
Q

Treatment of PTSD

A
  1. Re-establish circadian rhythms
  2. Relieve nightmares
  3. Dialectic behavioral psychotherapy
  4. SSRIs
140
Q

Characteristics of Substance Use Disorder

A
  • Tolerance
  • Withdrawal
  • Use more than intended
  • Craving
  • Unsuccessful efforts to cut down
  • Spends excessive time in acquisition
  • Activities given up because of use
  • Uses despite negative effects
141
Q

Stages of Changes in Overcoming Addiction

A
  1. Precontemplation: not acknowledging that there is a problem
  2. Contemplation: Acknowledgement but not ready to change
  3. Preparation/Determination: Getting ready to change
  4. Action/Willpower: Changing behaviors
  5. Maintenance: Staying clean
  6. Relapse
142
Q

Major Withdrawal symptom of Depressants

A

Seizure

(not in opioids)

143
Q

Major Withdrawal symptom of Alcohol

A

Delirium Tremens (hallucinations, Increased HR and BP, Confusion)

144
Q

Sensitive indicator for alcohol in lab tests

A

GGT (Gamma-glutamyltransferase)

145
Q

Detox drug used for alcohol

A

Benzodiazepines

146
Q

Drug used to treat overdose of Opioids

147
Q

Drug used for Detox in Opioid

A

Methadone (prevent symptoms)

Suboxone (naltrexone + buprenorphine)

148
Q

PCP intoxication key symptoms

A
  1. Belligerence
  2. Assaultiveness

ICM II (12 decks)

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