Psychopathology Flashcards
Intellectual Disorders (Deficits)
1.Intellectual Functioning
2. Adaptive Functioning
Adaptive Functioning Categories for Intellectual Disorder
- Social
- Conceptual
- Practical
Autism Spectrum (Deficits/Primary sx)
1.Social communication
2.Social Interaction
3. Restrictive/Repetitive behavior, interest and activities
Risk factors to ASD
- Male
- Birth prior to 26 weeks gestation
- Older parents
- Prenatal exposure to toxins
AD/HD (onset before)
age 12
AD/HD (duration of sx)
6 months or more
AD/HD (# of sx needed for Adults & Children)
Adults 5
Children 6
must be at least 5 or 6 from one category
AD/HD treatment per age group
Preschool = primarily behavioral intervention
Elementary = medication & behavioral
Adolescents= medication, behavioral & instructional intervention
Adults= first line of defense is medication then CBT
symptoms of inattention, impulsivity, and hyperactivity decline to some degree with increasing age, with the persistence of the disorder depending more on continuing inattention than on continuing impulsivity and hyperactivity.
Tourette’s
1 vocal tic
2 or more motor tics
*more than 1 year since first sx
*sx present before 18 y.o.
Persistent motor or vocal tic disorder
1 or more motor or vocal tic
*more than 1 year since first sx
*sx present before 18 y.o.
Provisional tic disorder
1 or more motor or vocal tic
*less than a year of sx
*sx present before 18 y.o.
Typical age of onset for Tic disorders
4 to 6
Age of severity peak for tic disorder
10 to 12
Typical age of onset for Communication disorder
2 to 7
Brief psychotic disorder
- 1 or more sx
- 1 sx must be (Hallucinations, delusions or disorganized
speech - HDD)
-1 day to 1 month
Schizophreniform
- 2 or more sx
- 1 sx must be HDD
- 1 month & less than 6 months
Schizophrenia
- 2 or more sx
-1 sx must be HDD - Active phase (positive sx ) for at least 1 month
-Continuous signs for 6 months (prodromal or residual phase)
Better prognosis of schizophrenia
- Female
- Acute/Later onset of sx
- Precipitating event
- No family history of psychosis
- Family history of mood disorders
- Aware of sx
- Comorbid mood dx
- Predominantly positive sx
- Good premorbid adjustment
Mania
-elevated, expansive or irritable mood
-increased activity or energy
- sx present for 1 week or more
-impaired functioning
-hospitalization
-psychosis
Hypomania
-elevated, expansive or irritable mood
-increased activity or energy
- sx present for 4 days or less
Bipolar I
1 or more manic episodes
Bipolar II
1 hypomanic episode
1 depressive episode
cyclothymic disorder
-multiple subclinical hypomanic and depressive episodes
- 2 years for adults
-1 year for children/teens
-sx are not dormant for more than 2 months at a time
Classic Bipolar
-separation of manic and depressive episodes
-No rapid cycling
-Onset 15 -19 y.o.
Atypical Bipolar
-Mixed mood states
-Rapid cycling
-Low recovery between episodes
-Onset 10 - 15 y.o.
MDD
- Must have 5 symptoms
- Symptoms must be present for 2 weeks or more
- 1 of the symptoms must be either Dysphoric (low)
Mood or Anhedonia
DMDD
-12 months
-3 or more times a week
-outburst (verbal or behavioral)
-irritability/angry mood (most days)
-sx prior to 10 y.o.
-no dx before 6 y.o. or after 18 y.o.
Rehm’s- self control theory
*Theory of depression
- Self-monitoring
(only attending to negative events) - Self-evaluation
(attributing failures to oneself) - Self-reinforcement
(low rates of reinforcement and high rates of
punishment)
Recommended therapies for MDD
- Teens - IPT -A
- Adults - CBT or IPT & psychopharm
Separation Anxiety
3 symptoms
-distress from anticipating or expected separation
-reluctant to got to work or school
-somatic symptoms when separated
*Secure attachment is most common attachment style (children coming from nurturing and secure homes)
*typically occurs after a traumatic event
Children - 4 weeks
Adults - 6 months
*if child is refusing to go to school, getting them back is number 1 priority for treatment.
Specific Phobias
- Avoiding
- Enduring with distress
-6 months
Two Factor Theory (specific phobias)
- Object paired with anxiety response (classical conditioning)
- Avoidant of object to avoid anxiety (operant conditioning)
Panic Disorder
- Recurrent & unexpected episodes
- 1 episode followed by 1 month or more of concern or change in behavior.
-4 sx
Agoraphobia
*Must express fear of engage in 2 of 5 situations
1. Being on public transportation
2. Being in a crowd
3. Being in a confined area
4. Being in an open area
5. Alone when out of the house
Symptoms persist for 6 months of more
Primary fear:
1. escape will be difficult
2. help will be unavailable
Conduct Disorder
-12 months
-3 sx
-Aggression towards people or animals
-Destruction to property
-Deceitfulness/ theft
-Severe violation of rules
-Childhood onset (1 sx before 10 y.o.)
-Adolescent onset ( no sx before 10 y.o.)
GAD
-Multiple events or activities
-Occur most days than not
Unable to control worry
Worry about large number of events
More likely to have somatic symptoms
-6 months
-3 sx in adults
-1 sx in child
PTSD
- Symptoms present for 1 month or more
- Intrusive thoughts/memories
- Avoidance
- Change in arousal
- Negative cognition/mood
Acute Stress
- less than 1 month
-9 sx from any category
- Avoidance
- Change in arousal
- Dissociation
- Intrusive
- Negative cognition/mood
Localized Amnesia
loss of all memory related to a specific event
Sleep patterns associated with MDD
Takes longer to fall asleep
Shorter time for sleep onset of REM
Reduced time in stages 3 and 4
Spend more time in REM
Selective Amnesia
loss of some parts of the memory related to a specific event
Globalized Amniesia
complete loss of memory
Systematized Amniesia
loss of specific categories in a persons memory
Continuous Amniesia
loss of memory related to new events
Somatic Symptom Disorder
- 1 or more somatic symptoms
- 6 months
- 1 or more sx
-excessive thought and or emotions related to somatic symptoms
-excessive worry about sx
-high anxiety about health
-excessive time spent on health concerns
Illness Anxiety Disorder
-preoccupation with having or acquiring a severe illness
-no or mild somatic sx
-excessive anxiety about health
-seek or avoid health care
-6 months
Anorexia Nervosa
-Restriction of calories
-low body weight
-Fear of gaining weight
-disturbance in perception of body
-self-evaluation/ lack of insight
severity = BMI
Bulimia Nervosa
-Recurrent episodes of binge eating and purging
-Compensatory behavior prevent weigh gain
Must occur 1x a week (both binging and purging)
At least 3 months
Severity determined by number times per week
Binge Eating Disorder
-recurrent episodes
-eating abnormal amounts of food
-lack of control
-3 sx
-At least 1x a week
-At least 3 months
Insomnia
3 sx
3 or more times week
3 months
-overestimate sleep latency
-overestimate time awake at night
-underestimate total amount of sleep
Narcolepsy
- Symptoms occur at least 3 times a week
- Symptoms present for at least 3 months
Diagnostic features:
A. cataplexy (brought on by strong emotions)
B. hypocretin deficiency
C. REM latency 15 min or less
Associated symptoms:
1. Hypnogogic hallucinations (falling asleep)
2. Hypnopomic hallucinations (waking up)
ODD
*Symptoms must be present for 6 months or more
*4 or more symptoms must be present
*Child must demonstrate symptoms with 1 person other than a sibling.
- Angry or irritable mood
- Argumentative/defiant
- Vindictiveness
*earlier the age of onset, the more likely the child will be diagnosed with Conduct Disorder.
Better prognosis ASD
- IQ > 70
- Speech before 5 y.o.
- No other psychological diagnoses
Risk for ASD
-Male
-Born prior to 26 weeks
-Older parents
-Exposure to toxins in prenatal development
Risk for AD/HD
-Male
-Low birth weight
-premature birth
-prenatal smoking
-prenatal alcohol use & substance use
Revised Dopamine Hypothesis
*Schziophrenia
Negative symptoms:
dysfunction in the temporal limbic frontal network
Positive symptoms:
disinhibition due to dysfunction ing the TLFN causes and increase in dopamine in subcortical regions (striatum and basal ganglia).
Worse prognosis for schizophrenia
-lack of insight into diagnosis lead to non-adherence
-family who are high in expressive emotions (hostile or criticism)
Lewinsohn’s- Social Reinforcement Theory
*Theory of Depression
Low rate of response-contingency-reinforcement
Lack of reinforcement due to:
1. environment
2. poor social skills.
*reduces the likelihood of future positive reinforcement
Results: low self-esteem, isolation, pessimism.
Seligman’s - Learned Helplessness
(1974) - repeated exposure to uncontrollable negative life events, resulting in a sense of helplessness
(reformatted) - role of a negative cognitive style which attributes negative life events to stable internal and global factors.
(1989) - sense of hopelessness as the proximal and sufficient cause of depression.
Age and associated symptoms of depression
Children:
-separation anxiety
-irritability
-oppositional behavior
Adolescents:
-aggression
-anti-social behavior
Older Adults:
-feelings of hopelessness
-insomnia
-decreased appetite
-cognitive impairments
younger vs. older adults with depression
younger adults are more likely to express
-affect sx
-somatic sx
-cognitive sx
-anhedonia
Most common psychiatric disorder associated with coronary heart disease
MDD
Ketamine tx for MDD
Used for tx resistant depression and SI
*works by increasing glutamate
*nasal spray
Electroconvulsive therapy
*used to treat sever depression or when a quick treatment is needed.
-anterograde amnesia
-retrograde amnesia (typically more severe)
Risk factors for suicide in adolescents
A diagnosis of either:
- AD/HD
- SUD
- Conduct disorder
Risk for GAD
-Family history of anxiety disorders
-temperament dimensions of behavioral inhibition (strong reaction to novelty)
- Neuroticism
-Harm avoidance
-childhood trauma
-chronic illness
Non-REM sleep disorder
- Night terrors
- Sleep walking
-occur during stages 3 and 4 of sleep
Placebo vs. antidepressants effects on brain structure for treating MDD
Placebo
produces increased activity in the prefrontal cortex
Antidepressants
produce decreased activity in the prefrontal cortex
Dementia vs. Pseudo-dementia
Pseudo-dementia (Depression):
-Responds well to treatment
-Acute onset
-Exaggeration of cognitive symptoms
-Moderate memory loss
-Melancholia
-Anxiety
***Will say “I don’t know” when asked a question during an assessment.
Dementia:
-Insidious onset
-Denial of symptoms
-Apathy
*Will respond to questions incorrectly during a psychological assessment.
Risk for Alzheimer’s
1.Lower formal education
2.diabetes
3.depression
4.head injury
5.Down’s syndrome
Barkley - Theory for ADHD
Brain structures in those with ADHD causes a deficit in behavioral inhibition, affecting working memory. internalization of speech, affect regulation, motivation, arousal and reconstitution.
Non-Western countries vs. Western countries and Psychosis
Non-Western are:
1. More acute
2. Short corse of symptoms
3. Higher rates of remission
Immigrant Paradox
Immigrants to the U.S. have been shown to have better health outcomes than those who have lived here for many years or who are U.S. born.
Dutch protocol for gender dysphoria
- Children under 12 years of age, it recommends “watchful waiting” accompanied by support for children and their families.
- First signs of puberty, social transition and puberty-blocking drugs are started for children who are persistent in their gender dysphoria.
- Decide if they want to start cross-sex hormone therapy when they’re 16 years of age and undergo gender-affirming surgeries after they’re 18
The gender-affirmative model
*Most widely used for gender dysphoria
“a child of any age may be cognizant of their authentic identity and will benefit from a social transition at any stage of development”
Social transition is followed, as appropriate, by puberty blockers, cross-sex hormones, and surgeries; and, throughout the transition process, gender issues are addressed with youth and their families in a supportive and non-judgmental way.
A. gender variations are not disorders
B. gender presentations are diverse and vary across cultures
D. gender is not always binary and may be fluid
E. if present, a child’s psychological problems are often secondary to negative interpersonal and cultural reactions to the child (e.g., transphobia, homophobia, sexism).
Moffitts 2 types of Conduct Disorder
- Life-Course-Persistent Type
*Starts in early childhood
*Continues into adulthood
*Consistent across situations
(CAUSE: neuropsychological deficits temperament and cognitive abilities) and trauma) - Adolescent-Limited Type
*Temporary and situations
*Behaviors occur typically around peers
(CAUSE: “maturity gap” between the child’s biological maturity and social maturity. It is a way to attain maturity)
Outcomes for Adolescent limited type
Symptom go away by adulthood more often in ALT vs. LCPT
Outcomes for Life-Course-Persistent
Children are at higher risk of:
1.Criminal behavior
2. SUD
3. Conduct Disorder / Antisocial Personality Disorder in adulthood.
