Psychopathology

Question 1

Personality disorders are enduring patterns that manifest in 2 or more areas of _______

Answer 1

1. cognition2. affectivity3. interpersonal functioning4. impulse control

Question 2

Disorder is a harmful dysfunction wherein harmful is a value based on societal norms and dysfunction is scientific term referring to the failure of mental mechanism. Who wrote this?

Answer 2

Wakefield, 1992

Question 3

What are important elements of a mental status exam?

Answer 3

1.appearance 2. Attitude 3. behavior4. Speech and language 5. Mood6. Affect 7. Thought processes 8. thought content 9. orientation 10. Memory11. Attention/concentration 12. Judgment/insight13. Impulse control/Frustration tolerance

Question 4

A GAF score of 51-60 represents

Answer 4

moderate symptoms and moderate difficulty functioning

Question 5

What is the essential feature of BPD (borderline personality disorder)?

Answer 5

a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts

Question 6

Grove et al.’s (2000) meta-analysis of clinical vs. actuarial judgment found which to be superior?

Answer 6

Actuarial judgment. Mechanical prediction techniques were equal or superior to clinical prediction methods. (Clinical interviews, when included, resulted in even worse clinical judgments).

Question 7

What are the four broad dimensions of personality disorders suggested by Widiger & Samuel (2005)

Answer 7

1 Emotional Dysregulation, 2 Dissocial Behavior,3 Inhibitedness, 4 Compulsivity

Question 8

Widiger & Trull’s (2007) critiques of categorical model?

Answer 8

-does not account for severity-heterogenity means same disorder but very diff. presentations-Inadequate scientific basis for 16 major diagnostic classes-lacks developmental perspective

Question 9

What model is proposed to serve a dimensional approach to diagnosis?

Answer 9

Costa & McCrae’s Five-Factor Model

Question 10

What are Krueger et al.’s (2005) issues w/ categorical diagnostic systems?

Answer 10

1 comorbidity/co-occurrence,2 excessive NOS diagnoses, 3 arbitrary cutoffs between normal/abnormal

Question 11

What are some difficulties with moving from a categorical to dimensional model?

Answer 11

1 longer compatible with medical model2 No longer can use EST designed for specific disorders3 Incompatible w/ current 3rd party billing4 Huge change in language, thought

Question 12

Categorical diagnostic systems often present dilemmas, due to?

Answer 12

comorbidity, boundary distinctions (Widiger & Samuel, 2005)

Question 13

What is the multicultural critique of diagnostic systems?

Answer 13

They might not be valid across cultural perspectives (Widiger & Sankis, 2000)

Question 14

When should one not use the DSM?

Answer 14

i)Legal issues: criminal insanity, child custody, competence for trialii)Cross cultures: use for diagnosing personality disorders or psychosis iii)Presenting concern donäó»t warrant diagnosisiv)When symptoms donäó»t adequately fit current diagnostic systemv)When diagnostic label may result in undue harm to the individual and the individual is unable to consent to such diagnostic assessmentvi)When inadequate information is obtained to make an accurate diagnosisvii)Inadequate training viii)Make causality statements about behavior äóñ ix)Should not be used to determine eligibility for entrance into jobs, programs of study etc.

Question 15

What are advantages of a dimensional diagnostic system?

Answer 15

• broader range of maladaptive personality functioning along a single dimension (E.g. introversion vs. extraversion)-Traits organized within a hierarchy: e.g. Five-Factor Model of Personality (Costa & McCrae, 1999)-more valid and internally consistent way

Question 16

What are some difficulties of moving into a dimensional diagnostic system?

Answer 16

-incompatible with medical model-incompatible with diagnosis specific ESTäó»s-incompatible with 3rd party billing (insurance)-change in language, use, thought of pathology -requires more research to demonstrate advantages over current system as well as to

Question 17

A large genetic study out of New Zeeland found that genetic factors, along with severe maltreatment played a strong role in the development of what?

Answer 17

Becoming antisocial (Caspi et al., 2002)

Question 18

What are some factors of depression?

Answer 18

-Gender/being a woman (Nolen-Hoeksema (2001)-Negative life events (Kendler et al., 2004)-disruption of close relationships (Weissman et al., 1999)-attitudes and beliefs (Beck, 1991; Comer, 2006; Evans et al., 2005; Nolen-Hoeksema, 2004)-brain neurotransmi

Question 19

Essential feature of BPD is a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts. This is indicated by 5 or more of the following

Answer 19

NAME?

Question 20

What are some things likely observed in sessions working with a person with BPD?

Answer 20

• idealized me as a caregiver in first several sessions (DSM, p. 707)Switched quickly from idealizing me to devaluing me, -Talked about expecting rejection and abandonment, like other therapists-Expressed sudden sudden shifts in personality.Impulsivityäó

Question 21

What are some “bottom up” factors that influence SWB (subjective well-being)?

Answer 21

(Diener, 1999)-Wealthy, healthy, religious, married, and attractive = happy -age likely unrelated (Horley & Lavery, 1995)-women more depression (Eaton & Kessler, 1981)-goal-setting, job morale, job satisfaction, education = happier-in total, external, objective, and demographic factors account for less than 15% of variance in SWB (Argyle, 1999)

Question 22

What are some top-down factors that influence SWB?

Answer 22

-active coping, positive illusions, downward social comparison = happy-Personality = biggest/most consistent influence-genetics (Tellegen, 1988)-extraversion = happy, neuroticism = unhappy (Watson & Clark, 1997)-downward social comparison = happy (Lyubomi

Question 23

What are some differences between East and West in SWB?

Answer 23

(Diener, Oishi, & Lucas, 2003)a)high SWB (in western cultures) have self-serving biases: Overly positive self-evaluations, exaggerated perceptions of control and mastery, unrealistic optimism about the futureb) Eastern cultures, high SWB is associated with acceptance from others, emphasis on the importance of interdependence, not achieving too much difference from oneäó»s peer group.

Question 24

Therapists consistently underestimate clients’ ____________

Answer 24

suicidality (Firestone, 2013)

Question 25

What are predictors of suicide?

Answer 25

(Pope & Vasquez, 1991)a.Isolation, living alone, loss of support: Fewer social supports associated with greater overall ideationb.Depressive disorder: 60-70% more likely to be at suicide riskc.Family History: Family hx of suicide contributes a twofold increase in risk of suicide, even when controlling for family psychiatric hx, which is also a predictord.Alcoholism e.dysregulated impulse controlf.intense psychological pain g.Suicidal ideationh.Prior suicide attempts i.Lethal methodsj.Hopelessness, cognitive rigidityk.Stress/stressful events l.Anger/aggression

Question 26

What is the Firestone Assessment of Self-Destructive Thoughts? (FAST)

Answer 26

(Firestone & Firestone, 1996)i.Extreme self-hatred: “You don’t deserve to live.”ii.Personalized hopelessness: “Nothing matters anymore. “iii.Pushing away friends and family: “What’s wrong with you? “iv.Isolation: “Just be by yourself. v.Thoughts of not belonging: “You don’t fit in anywhere.”vi.Thoughts of being a burden to others:

Question 27

those who self harm are _____ times more likely to commit suicide than general public

Answer 27

100x (Owens, Horrocks, & House, 2002)

Question 28

What are three types of self-harmers?

Answer 28

i.Compulsive: OCD type, self-harm serves to manage intrusive thoughts (anxiety-based)ii.Impulsive, episode-based: no pre-planning, impulsive response to environment, may not identify as äóìself-harmeräóiii.Impulsive repetitive: any time there is a stressor they respond w/ self-harm

Question 29

What are specific steps to take with a suicidal client?

Answer 29

(1)Team up with the client to formulate a personal set of warning signs (not sleeping, feeling agitated, critical inner voice), that help client recognize suicidal state(2)Work with clients to remove dangerous items (3) develop a complete safety plan. (4) identify support who they can call if they start to feel bad(5)Make yourself available for the client to call(6)Inform of professional help that is available 24/7(7)Provide National Suicide Prevention Lifeline(8)safety plan: copy for the client, copy for file(9)Obtain a commitment to treatment from the client, what you will do and what they will do to create a life worth living.

Question 30

Are medications effective?

Answer 30

A review by Lictenberg, Goodyear, & Genther (2008) details the benefits of medication: evidence suggests psychotropic medications are necessary component in treatment for severe forms of chronic disorders, such as bipolar (Kennedy et al, 2004) and psychotic disorders (Gaudiano, 2005)1. meta-analyses conclude equivalent efficacy for drug and therapy interventions for depression and anxiety2. therapy appears to have additive effects for maintenance and relapse prevention for depression, anxiety, and eating disorders