Psychopathology Flashcards

Question

Paraphilic disorder treatment

Answer 1

CBT with group therapy, marital therapy or pharmacotherapy Cover sentization and orgasmic (masturbatory) conditioning

Answer 2

touching or rubbing someone that does not want this this can be acted on or by impairment due to fantasies or urges 6 months

Answer 3

cross dressing for sexual arousal 6 months

Answer 4

recurrent sexual urges and must have acted on them or experienced significant distress not to act on it with a child under age of 13. Person must be great than 16 years of age

Answer 5

recurrent and intense sex arrousal 6 months to a nonliving object or nongenital body part

Answer 6

1 or more for one day less than one month at least one delusions, hallucinations, or disorg speech 4 symptoms above and grossly disorganized or catatonic behavior

Answer 7

2/5 in active phase 1 month with at least 1 being delusions, hallucinations or disorganized speech 5 symptoms above and grossly disorganized or catatonic behavior and negative symptoms Must also be signs continuous for 6 months Prodromal and residual phase is 2 or more symptoms may be negative only

Answer 8

2/5 for one month to less than six months at least one being delusions, hallucinations, disorganized speech 5 symptoms above and grossly disorganized or catatonic behavior and negative symptoms

Answer 9

Parent 6% Bio Sib 9% Child of 1 parent w/schz 13% Dizygotic twin 17% Child w/2 parents 46% Monzygotic twin 48% Dopamine, glutame and serotonin

Answer 10

* Schizophrenia is high due to high levels of dopamine or hyperactivity of dopamine receptors * Positive symptoms due to dopamine hyperactivity subcortical regions (striatal area) * Negative symptoms due to hypo activity in cortical regions (prefrontal cortex)

Answer 11

lower than normal activity in prefrontal cortex contributes to negative symptoms

Answer 12

anxiety, ocd, 70-85% tobacco users

Answer 13

teens to early 30 peak early to mid 20 for female Psychotic symptoms decrease, neg&cog symptoms remain same Better prognosis for female acute, late onset and comorbid mood disorders

Answer 14

Familes response to member with schzophrenia or other mental disorder High expressed emotion-high criticism, hostility and over involvement with patient

Answer 15

* psychosocial interventions * antipsychotic drug * adjunctive medications * evidence-based include-community treatment * cbt for psychosis * cognitive remediation for schizophrenia, family psychoeducation, social skills training, supported employment and acceptance commitment

Answer 16

* 1 or more delusions for 1 month and overall functioning is not significantly impaired * erotomanic-believes another person is in love w/them * grandiose-believes they're great (unrecognized talent) * jealous-believes spouse or partner is unfaithful persecutory-being spied on, poisoned, conspired against

Answer 17

* MOOD--***6 months*** * mild form of acting out * less severe than Conduct disorder * 3 symptoms AVA has ODD * Angry/irritable mood * Vindictiveness * Argumentative * 30% more likely to become CD w/early onset * equal among boys and girls * higher with adolescent boys * ***parent management/family therapy, cognitive problem solving***

Answer 18

* 12 months 3 symptoms 1 sympt for 6 months * behavior violates the rights/social norms of others * 3 symptoms * Conduct D/O makes me SADD * serious violation of rules * aggression with animals/people * destruction of property * deceitful or stealing * Cannot be given over age 18 * emerges middle childhood to middle adolesence * * * *

Answer 19

* childhood onset at least 1sx (symptom) before 10 * adolescent onset no symptoms before 10 * Unspecified onset Unknown * * mild, moderate and severe is based on the # of conduct problems

Answer 20

* heriditary, ↓ serotonin, prenatal exposure to opiates, inadequate parenting * Life-Course persistent type- combo bio deficits, parenting and temperament * adolescent limited type-temporary and maturity gap between biological/sexual and social maturity

Answer 21

* family intervention * PMTO Parent mangaement training Oregon Model * parenting modifications, effective disciplinary strategies * Multisystemic treatment MST * mulitdetermined-get child w/family, school & combine cognitive, behavioral, family systems and case management *

Answer 22

* behavioral or verbal outburst unable to control aggressive behaviors/impulses * must be 6 years of age * not violent no damage to property or people * 2x weekly for 3 months * or with 3 outburst within/12 months * not premeditated or looking for tangible outcome * 6 YEARS OLD at least

Answer 23

* caffenine * cannabis * phencyclidine * inhalants * opioids * sedatives * hypnotics * anxiolytics * stimulants * tobacco * unknown

Answer 24

* 2 or more w/in 12 months except caffeine * cognitive, behavioral, physiological...person uses w/o reason * 4 sx (symptoms * lack of control, social challenges, risky use, pharmacological (tolerance/withdrawal) * # of sx indicates severity

Answer 25

* psychosocial intervention, group/family therapy, 12 step program and/or medication * *alcohol-*disulfiram or naltrexone * *opioid-*methadone, naltrexone * *nicotine-*replacement therapy * *tobacco-*antidepression, bupropion * *cocaine-*no fda medication approved for treatment * treatment is CBT, recovery based therapy, or psych social intervention

Answer 26

* addiction is a learned habit * relapse is after absence in high risk situation * relapse is worse when person does not have coping skills, self efficacy & ↑expectations * \*\*\* goal is to help client deal with ↑risk situations

Answer 27

* behaviors and psychological changes * WITH 1/6 * slurred speech * incoordination * unsteady gait * nystagmus (uncontrolled eye moment) * Δ memory/cognition stop coma

Answer 28

* ↓ 1\> cognitive domains interferes everyday activities * specifier Nonamnestic -confabulatory or amnestic-confabulatory AKA Korsafoff syndrome-thiamine deficiency & retrograde amnesia confabulation

Answer 29

2/8 w/in hours to days * autonomic hyperactivity * hand tremor * insomnia * nausea or vomiting * hallucinations, or illusions * anxiety * motor agitation (pacing, toe tapping) * genrelized tonic seizueres

Answer 30

* behavioral changes-initially euphoric followed by apathy or dysphoria and impaired judgment with PUPIL CONSTRICTION * 1/3 sx * drowsiness/coma * slurred speech * problems w/attention/memory

Answer 31

* 3/9 including dysphoric mood , nausea or vomiting * muscle aches, diarrhea, yawning * fever and insomnia

Answer 32

1/6 hypnotic or anxiolytic-slurred speech, incoordination, unsteady gait, nystagmus, impaired cognition, stupor or coma

Answer 33

2/8 hours to days after stopping the drug * ↓ of sedative, hypnotic, or anxiolytic use * autonomic hyperactivity, hand tremor, insomnia, nausea or vomiting, transient hallucinations or illusions, psychomotor agitations, anxiety, * GRAND MAL seizures

Answer 34

2/9 * ↑ tachycardic or bradycardic, pupil dilation * ↑↓decrease blood pressure, perspiration or chills, nausea or vomiting, weight loss, psychomotor agitation or retardation, respiratory depression or cardiac arrhythmia, seizures or coma * Stimulant drugs amphetamines, methamphetamines and cocaine

Answer 35

dysphoric mood and psychological 2/5 fatigue, vivid and unpleasant dreams, insomnia hypersomnia (excessive daytime sleeping), increased appetite, psychomotor agitation, retardation

Answer 36

* 4/7 within 24 hours of stopping/quitting * irritability, anger, anxiety, impaired concentration, ↑ increased appetite, restlessness, depressed mood, insomnia

Answer 37

* persistent, elevated/irritable mood, ↑ goal directed activity/energy for 1 week * includes 3 or more sx * ↑ self esteem-grandiosity * ↓need for sleep * flight of ideas * marked impairment in functoning * a need of hospitalization to avoid harm to self/or others * or psychotic features

Answer 38

* same as manic for at least 4 days, BUT the person has never met the criteria for a manic episode * ↑ expansive or irritable mood * increased activity or energy * 3 or more sx of mania 4 DAYS * NOT severe enough for marked hospitalization or marked impairment, do not have psychotic features

Answer 39

* 5 or more sx w/1 sx depressed mood or loss of pleasure * sx last 2 weeks & cause distress and/or significant impaired functioning

Answer 40

* requires at least 1 manic episode * cannot have been preseeded or followed by a major depressive or hypomanic episode

Answer 41

1 manic & 1 major depressive episode

Answer 42

requires hypomanic symptoms that have NEVER met criteria for mania and symptoms of depression that have NEVER met criteria for a MDD o can’t have more than 2 months without symptoms o Symptoms required for at least 2 years in adults and 1 year for kids

Answer 43

* heridity, NT and & brain abnormalities & circadian rhythm irregularities * Strong genetic component .67 to 1 mono twins, .2 di twins * Neurotransmitters- NE, Serotonin, Dopamine and Glutamate * brain-prefrontal, amygdala, hippocampus, basal ganglia * circadian rhythms-sleep-wake cycle, the release of hormones, appetite and core body temperature

Answer 44

* psychosocial and medication * psychosocial therapy + Rx is best, family therapy, psychoeducation, IPT, CBT, Interpersonal Social Rhythm Therapy (which is all about creating routines and circadian rhythms and resolving interpersonal problems), * Classic bipolarRx: lithium, atypical antipsychotics and antidepressants, valproate/carbamazepine

Answer 45

* Atypical Bipolar between ages 10-15 * -mixed mood states, rapid cycling, a lack of full recovery between episodes * at least 2 of the following ↑weight gain, ↑appetite, hypersomnia (excessive sleeping during day), leaden paralysis, interpersonal relationships sensitivity

Answer 46

* 5 or more sx for 2 weeks with at least 1sx being depressed mood or loss of interest in everything * ↓ REM latency (amount of time it takes to fall asleep) and ↑ REM density (frequency of eye movements that occurs during REM sleep)

Answer 47

* depressed mood 2 or more sx (poor appetite, or overeating, insomnia or hypersomnia, feelings of hopelessness) * 2 years for adults 1 year child & adolescents

Answer 48

o SEVERE, recurrent temper outbursts outside of developmental age o 3+ times a week o chronic irritability/angry mood o 12 months in 2 settings o At least 6 years old but not over 18 years old o Treatment: CBT, parent training, family therapy

Answer 49

* Peripartum-means symptoms occur during pregnancy or 4 weeks after delivery - symptoms include: anxiety (e.g. preoccupied with infant’s well-being), irritability, not being interested in the baby, guilt, suicidal ideation, sad mood and last for a short while * Post partum-lasts longer and symptoms includes sadness, difficulty with sleep, irritability, changes in appetite

Answer 50

* linked to ↓ serotonin↑ melatonin, crave carbs, irritability, hypersomnia, ↑ appetite, weight gain * tx-responds well to light therapy and exposure to bright light

Answer 51

* highest for 12-17 then 18-25 then 26-49 and then 50+

Answer 52

* HPA Axis involved,  cortisol, ↓ epinephrine/serotonin, * catecholamine hypothesis = low norepinephrine, Lewinsohn’s -*operant conditionin*g-reinforcement, b/c the person is on an “extinction schedule” for a really long time and not getting any reinforcement, * Social reinforcement theory-low rate of response due to lack of social reinforcement * *depression schemas/cognitive theory* (Beck) = negative beliefs about self/others/world, * Seligman’s *Learned Helplessness* – repeat negative life events that lead to hopelessness

Answer 53

* younger-genetic, life stress, cognitive limitations * more affective symptoms * older-chronic medical illness, medical illness ↓physical function and ↑ social loneliness more somatic symptoms * Americans and euro-Canadian express more psychological symptoms (depressed mood, loneliness, helplessness * other members non western, Chinese, latin, middle eastern and asian report somatic symptoms appetite, sleep disturbance, headaches, heart palpitations *

Answer 54

* 57% substance (alcohol most common) * 37% anxiety (generalized most common) * 31 % personality disorder (borderline most common) *

Answer 55

therapy and medication best antidepressants TCA SSRIS SNRI CBT IPT, Behavorial action therapy Problem solving acceptance and commitment therapy emotion focused therapy Similar in-person and telehealth results \*biblotherapy-effectiveness best established with major depressive patients

Answer 56

* 10th leading cause of death 1999-2017 * ↑ males ↓females * ↑ females aged 45-64 * ↑males over 75 * In order American Indians, whites, asian/pacific islanders, blacks, hispanic * American indians ↑ 15-24 years * Whites ↑ 45-64 & over 65-74 *

Answer 57

Goal of compulsions is to ↓ anxiety or distress is an attempt to prevent the undesirable event from happening

Answer 58

immediate exposure to most feared object or situation until the anxiety subsides (extinguished)

Answer 59

List of about 10 situations that cause anxiety from least to greatest. The client approaches the situation until the anxiety subsides

Answer 60

↑ males vs females in childhood ↑ females vs males in adulthood ↑ males comorbidity w/tic disorders

Answer 61

↓serotonin ↑ brain activity in the caudate nucleus, orbitofrontal cortex, cingulate gyrus, and thalamus.

Answer 62

* must have problem w/attention & awareness over short time hours and days * Δ's in severity * and 1 disturbance in cognition (memory or language impairment) * not due to a medical condition and psychological issues are specifically due to that impairment

Answer 63

* high fever, lack of food or electrolytes, renal or heptic failure, head injury and certain group medications * most common in elderly

Answer 64

* adequate lighting, noise reduction, minimize visitors, * Haloperidol, or other antipsychotics ↓agitations & symptoms

Answer 65

↓ in cognition acquired rather than developmental ↓1 or more cog domain (executive functioning, learning, memory, and social cognition) w/delivery & daily functioning

Answer 66

* modest ↓ in previously learned functioning * does not impact daily functioning

Answer 67

* 60 to 70 percent of all cases * meet mild or major (NCD) * insidious onset and gradual progression of impairment 1 or more cog domains * or 2 or more cog domain that interfere with daily functioning * meet criteria * not better explained

Answer 68

* Major NCD probable causative genetic mutations, family history, or testing if criteria not met the diagnosis of "possible Alzheimers * Mild NCD probable Alzheimers has evidence of causative genetic mutations, testing, or family history * Possible Alzheimers disease has NO EVIDENCE of genetic mutations but EVIDENCE of ↓ memory&learning, gradual ↓ cognition, no evidence of mixed etiology

Answer 69

Depression with cognitive symptoms

Answer 70

Pseudodementia VS Alzheimer * dont know wrong answers * abrupt onset insidious onset * responds well2 treatment minimus ordeals/cognitive problems

Answer 71

* ApoE4 variant chromosome 19 * ↓ACH & ↑Glutamate (both involved in learning and memory) * amyloid plaques neurofibrillary tangles first in the *temporal lobe (cortex, amygdala & hippocampus) as it progress moves to frontal and parietal lobes* * *locus ceruleus (part of brainstem) is affected first before signs are shown*

Answer 72

* 3 stages * gradual onset * slow decline in cognitive functioning * Early- 2-4 years anomia (hard time recalling names & objects), short term memory loss, * Middle-2-10 years (longest stage) ↑ anterograde &/or ↑retrograde amnesia, disorientation, anxiety, depression, delusions, wandering, repetitive behaviors, impaired speech, disruption of sleep patterns and daily activities * Late-1-3 years ↓IQ, disoriented. severe speech impairment, agitation, & aggression, incontinence, ↓ motor skills, cannot perform daily activiites

Answer 73

* cholinesterase & Memontine to ↓ reduce&stabilize memory loss and confusion * Cholinesterase inhibitors include DONEPEZIL & RIVASTIGMINE delay ACH breakdown * Memantine (NMDA receptor antagonist) regulates glutamate * antidepressants-depression & irritability * anxiolytic-anxiety, restlessness * antipsychotics-mania, psychosis

Answer 74

* person meets Major or Mild NCD criteria * abnormal protein * INSIDIOUS onset & GRADUAL progression * cognitive-attention, visuospatial & Executive F * cognition proceeds (before) motor issues * note in Parkinson's motor proceeds cognitive

Answer 75

* meets major or mild/minor NCD * symptoms include stroke, heart attack , ↓ attention & EF * acute onset, STEPWISE ↓ (significant plateaus)

Answer 76

* look at risk factors like hypertension * heart disease * diabetics * obesity * ↑ cholesterol * heavy cigarettes use

Answer 77

* mild or major NCD * damage to subcortical areas * forgetfulness, impaired attention, concentration * psychomotor retardation, clumsiness, dreamers, apathy, and social withdrawal

Answer 78

* think Creutzfeldt Jacob * INSIDIOUS onset and VERY RAPID * meets criteria for NCD w/n 6 months * confusion, disorientation, impaired memory & judgement, ataxia (impaired coordination), myoclonus (muscle jerk), chorea (involuntary movement, jerk) apathy, anxiety, mood swings * Sporadic CJD-most common, unknown etiology * Familial CJD-inherited * Acquired CJD-consuming infected meat-mad cow or blood transfusion

Answer 79

* symptoms 1 year * deviation of expectations, pervasive, inflexible * onset adolescence & early adulthood * stable over time, * leads to distress or impairment

Answer 80

1. odd or eccentric behaviors 1. paranoid, schizoid, schizotypal 2. dramatic, emotional, erratic 1. antisocial, borderline, histrionic and narcissistic 3. anxiety & fearful 1. avoidant, dependent, and OCD

Answer 81

↓ personality disorder can be diagnosed ↓18 ↑ 18 years of age or older for an antisocial personality

Answer 82

* distruss and suspiciousness 4 out of 7 4/7 1. believes others are harming, exploiting, deceiving 2. doubts of loyalty and trustworthiness 3. will not take to others 4. misinterprets remarks or events 5. believes being attacked & quick to attack 6. suspicious of partners fidelity 7. bears grudge

Answer 83

* D is for DETACHED from social relationships and DESIRES no sex/praise/pleasure/people, restricted emotions, flat affect, indifferent * 4/7

Answer 84

* P is for PECULIAR behavior/appearance * social/interpersonal deficits * odd interests and behavior * eccentric/odd/magical beliefs or thinking * if mom has schizophrenia more likely child will develop schizotypal * they want to have PALS, but hesitate to get close to people out of concern of being taken advantage of * may actually be okay being alone * ideas of reference * ↓closer friends or relatives of 1 degree * body illusion and/or unusual perception * 5/9

Answer 85

* disregard for & violation of others rights since BEFORE 15 years old * fail social norms regarding law * decitful * impulsive * disregard to safety or self or others * irresponsible * lack remorse * irritable and aggressive * \*\*\*\*must be 18 but have history before 15\*\*\* * want money or power

Answer 86

* cognitive behavioral group therapy may help to ↓ reoffense * contingency mangement

Answer 87

* instability of interpersonal relationships, self image, affection * 5/9 * avoid abandonment * unstable relationships (idealization to devaluation) * identity disturbance * impulsive and self-damaging * recurrent attempts of suicide * or self mutilization * effective instability * feelings of emptyness * intense anger * paranoid ideation or dissociate symptoms * * * *

Answer 88

* late adolescence w/most severe early adulthood * 75% no longer meet criteria by 40 years old

Answer 89

Linehans dialect behavioral therapy (DBT) * group skills training-emotional dysregulation, disastrous tolerance, relationship difference * individual therapy, maintain DBT skills * phone coaching for between therapy

Answer 90

emotional and attention-seeking * 5/8 * has to be center of attention * inappropriate sexual seduction or provation * the rapid shift in moods * uses looks to get attention * speech impressionistic and lacks details * exaggerated emotion * easily influenced * thinks relationships is more that it is

Answer 91

Histrionic- * exaggerated emotions & manipalitive * gain nurturance Antisocial- * antisocial & manipulative * gain power or material gratification

Answer 92

grandiosity, admiration, & lack empathy * 5/9 * grandiose self * fantasizes unlimited success power, beauty & love * unique & only important people n world understand them * entitlement * lack of empathy * envious of self or others * arrogant * admiration * interpersonally exploitative *

Answer 93

social inhibition, feelings of inadequacy, hypersensitive to (-) evaluation * 4/7 * avoids occupation activities * will not interact w/others unless knows will b liked * restraint in intimate relationships due to fear ridicule * worried about social rejection * feels inadequate * socially inept * reluctant to new activities fear of embarrassment

Answer 94

need to be taken care of very clingy * 5/8 * difficult make everyday decisions * needs others to assume reponsibilities * avoids dissagrements for fear of disapproval * does not like to do things alone * seeks nurturance & guidance & support seek new relationships quick * ↑ fears of being alone

Answer 95

order, perfection mental interpersonal * 4/8 * details and rues * devoted to work * inflexible moral and ethics or values * spends self and others * ridged and stubborn * perfection in tasks and task completion

Answer 96

* 2 SD below mean * deficits in intellectual, conceptional (reading, writing, math) social, and practical (adaptive) * vInelanD-assess adaptive functioning (also used in ASD, ADHD, TBI and dementia) * 25-50% cause is known of these 85% are due to prenatal factors (chromosome or genetic issues)

Answer 97

* most common cause Down Syndrome, followed by fragile X syndrome, most common preventable prenatal is Fetal alcohol syndrome

Answer 98

* deficits in social communication/interaction, restricted repetitive patterns/behaviors/interests/movement/use of objects/speech (e.g., pronoun reversal – say “me” instead of “I”, echolalia)/not good with routine changes * begins in early development (as early as 2 years old)

Answer 99

* Level 1-requiring support * Level 2-requiring substantial support * Level 3-requiring very substantial support

Answer 100

* abnormal cerebellum/amygdala/hippocampus, genetic and * ↑ serotonin, norepinephrine and dopamine * risk factors include * male gender * certain medical conditions fragile & Angelman * born before 2 weeks * advanced maternal age * exposure to certain environmental development

Answer 101

* Early Intensive Behavior Interventions (EIBI), * shaping and * discrimination training help with speech

Answer 102

* good prognosis 😊: if communicating by age 5, IQ \> 70 and symptoms happen later in development

Answer 103

**6 symptoms of inattention, and/or hyperactivity/impulsivity for 6 months o before age 12 in 2 settings o 17 years and older only need 5 symptoms from one of the categories o Females present more with symptoms of inattention**

Answer 104

* oppositional defiant * conduct disorder * anxiety * depressive disorder

Answer 105

* brain parts involved: Prefrontal cortex, Globus pallidus, Corpus callosum, Cerebellum, Caudate nucleus \*think Person Gotta Concentrate Concentrate Concentrate (PGCCC)\* * basal ganglia also involved, smoking during pregnancy, low birth weight, TBI, * abnormal levels of dopamine, serotonin and norepinephrine, genetic

Answer 106

4 executive neurocognitive functions * working memory * internalization of speech * self-regulation of affect * motivation and arousal * reconstitution-behavioral analysis and synthesis

Answer 107

* neurofeedback (EEG) more effective with inattention than hyperactivity, * parent/teacher intervention, * Rx (methylphenidate), * anamoxetine may be prescribed if people cannot tolerate the stimulant Rx, * BEST outcomes for therapy combined with Rx

Answer 108

* motor tics (i.e., eye blinking) between 4-7 years old and * vocal (i.e., echolalia) around 11 highly co-morbid with ADHD * peaks at 11-12 years age

Answer 109

* multiple motor + 1 vocal tic * at least 1 year before age of 18 * highly co-morbid with ADHD and OCD, Major Depressive D/o, Substance Use * usually begins around ages 5-7

Answer 110

* ↑ dopamine * ↓ caudate nucleus ( smaller)

Answer 111

* Haloperidol, behavior therapy, * CBIT (Cognitive Behavior Therapy for Tics) which includes psychoeducation, relaxation training and habit reversal, competing response * SSRIs, antihypertensive drugs (e.g., clonidine and guanfacine are the Rx of choice)

Answer 112

* deficits in language, speech communication * 1 or more of 7 1/7 symptoms * anxious about speaking due to abnormal fluency /timing speech * good predictor of recovery is severity of symptoms at age 8

Answer 113

* Habit reversal training – incorporates competing response with breathing – consists of awareness training, * social support

Answer 114

reading, writing, math: performance is typically 1.5 standard deviations below the mean * for at least 6 months * tend to have above average IQ’s and comorbid ADHD (20-30%) * delayed motor skills * ↑ unemployment/drop out of school/antisocial behavior

Answer 115

* genetic, * otitis media, * toxins

Answer 116

* *Tourettes-*multiple motor plus 1 vocal * *persistent (chronic) motor* or vocal tic- 1 motor or vocal for more than 1 year before age 18 * *provisional tic disorder*- 1 or more motor and/or vocal present for less than 1 year begins before 18

Answer 117

* no REactions, more REserved, withdrawn * opposite of disinhibited social engagement D/O * lack of seeking support or comfort * sx before age 5 must have a development age of 9 months or more * social and emotional disturbance at least 2 * limited social-emotional responsiveness * limited positive affect * unexplained irritability * sadness * or fearfulness * all with caregiver

Answer 118

poor care, neglect, frequent changes in caregiver (all of these examples are aka “pathogenic care” and lead to insecure attachment)

Answer 119

* no reservations * opposite of Reactie Attachment D/O * inappropriate interactions with unfamiliar adults * the developmental age of 9 months or greater * diagnosis requires history of extreme insufficient care believe responsible for sx * 2/4 sx * reduced or absent reticence approaching strangers * overly familiar behavior with strangers * diminished or absent checking w/adult caregivers after being separated from them * willingness to accompany a stranger with little or no hesitation

Answer 120

5 symptoms clusters \*DINAA, as in DINAAsaurs traumatize you\* for at least a month o Dissociative o Intrusive (re-experiencing memories/dreams/flashbacks) o Negative mood o Avoidance o Arousal (aggression, reckless behavior, sleep difficulty)

Answer 121

* ↓ medial prefrontal cortex and anterior cingulate cortex * ↓ volume in hippocampus * ↑ responsivity of amygdala to trauma stimuli * ↑ dopamine, norepinephrine, glutamate * ↓serotonin and GABA

Answer 122

* CBT and/or CPT (cognitive processing therapy-combines negative cognitions w/writing and reading detailed description of trauma), cognitive therapy, brief eclectic psychotherapy, EMDR and narrative * children and adolescence- trauma-focused cognitive behavioral therapy created for age 3-18 experience sex abuse and now used for a variety of trauma * SSRI's-fluoxetine, paroxetine, sertraline and SNRI venlafaxine

Answer 123

* detached, outside observer of thoughts/actions * sense of unreality/detachment with surroundings o may feel: dead, dream-like, lifeless, foggy

Answer 124

* requires actual or threatened death, severe injury or sex violation * must of 9 sx from any of 5 categories (intrusion, - mood, dissociative symptoms, avoidance, arousal) * must lasted 3 days to 1 month * cause significant distress or impairment

Answer 125

* inability to recall important personal information beyond forgetfulness * *dissociative fugue-*purposeful travel or purposeful wandering due to loss of memory * *localized amnesia*-most common inability to recall events during a certain time in life * *selective*-cannot recall some events that happened during a certain time in life * *generalized-*complete loss of memory for ones entire life * *systematized*-a loss of memory for specific category of information * *continuous-*inabiity to remember new events

Answer 126

* think soooooo many aches and pains) * excessive thoughts/emotions/behaviors related to symptoms or associated health concerns constantly worry about their health * may or may not have an actual health diagnosis * 6 months, have at least 1 somatic symptom concerned about * predominant pain can be used as a specifier if applicable (i.e., chronic pain dx)

Answer 127

aka hypochondriac * may or may not have mild somatic symptoms * *preoccupied with having or developing a serious illness* * excessive anxiety about health – tend to be preoccupied with acquiring a disease * often hyperaware of normal body signs and interpret as signs of a serious illness (e.g., I can feel my heart pounding in my chest = I must be dying * for at least 6 months

Answer 128

* ACT * CBT for chronic pain * Biofeedback

Answer 129

Functional neurological symptom disorder AKA Munchousens * FAKing for attention * must be distinguished from malingering * the factitious disorder requires the absence of obvious rewards * Imposed on self – induce physical/psychological symptoms to present to others as sick (e.g., ingesting raw meat to make you sick for attention; not for an external incentive) * Imposed on another (aka Factitious D/o by Proxy)– usually mother to child (Ex. mom makes the kid sick like Gypsy Rose Blanchard and the mom to her daughters in the show/book Sharp Objects)

Answer 130

* establish a strong rapport and provide supportive therapy to help manage symptoms, * family therapy can be helpful but not as effective

Answer 131

* think Money * malingering is differentiated from factitious disorder by the intentional reporting of symptoms for personal gain * intentionally create symptoms for an external reward (money, reduced sentence) * related to Antisocial Personality D/o * use forced-choice method to detect (using True/False items and malingerers will answer INCORRECTLY more than 50% of the time) -called Test of Memory and Malingering (TOMM)

Answer 132

* *feigned memory loss* onset and termination are sudden * people do not recall any events during this time * believe hints or clues will help them recall lost memories * *genuine memory loss*-beginning & end time are gradual and hazy * people will recall fragments of some events *

Answer 133

* Functional Neurological Symptom Disorder * 1 or more symptoms that involve a disturbance involuntary motor or sensory functioning that suggest serious neurological or other medical condition (paralysis, blindness, seizures, fainting) * Specifiers- symptom type acute or persistent and presence or absence of a psych stressor

Answer 134

a persistent problem with eating or eating-related behavior that alters consumption/absorption of food and impairs physical health or psychological function

Answer 135

eating nonnutritive/nonfood substance for at least ## Footnote ***1 month***

Answer 136

* restrict energy which leads to low body weight * must have * intense fear to gain weight or engage in behavior that interferes with weight gain * and * altered view of how one experiences their weight, self-evaluation, influenced by weight

Answer 137

* *restricting type*-3 months no binging or purging * person is restricting intake by diet/exercise * *binge-eating/purgin*g- 3 months person has engaged in binging/purging behaviors

Answer 138

* ↑ Serotonin, perfectionism, genetic * co-morbidity w * depression and or anxiety (OCD) * it is shown anxiety precedes anorexia * one of the most difficult disorders to treat * poorer prognosis than bulimia * recovery at 9 year follow up 31 percent compared to bulimia 68%

Answer 139

* goal is to restore person to healthy weight * ↑ motivation to participate in treatment * provide nutritional counseling * help person identify and ∆ beliefs/emotions * treat psychological conditions * enlist family support * help person identify strategies * ***CBT/IPT, Family Behavioral Therapy (FBT) and SSRI's to maintain weight gain***

Answer 140

* least 1x (time) a week for 3 months * many people within normal weight range * recurrent binge eating ***with lack of control*** * inappropriate compensatory behavior to prevent weight gain (e.g., self-induced vomiting, excessive exercise, laxatives)

Answer 141

* depression or anxiety preceeds disorder * severity is based on the average # binge episodes * most people are normal weight or overweight * ↓serotonin

Answer 142

* Nutritional rehabiiltation + CBT preferred * IPT-takes longer to produce results * nutritional counseling, * CBT/IPT, * SSRIs, imipramine and fluoxetine *

Answer 143

* most effective for people with bulima * Stage 1- engage patient in treatment/identify problem, establish self-monitoring, estab eating pattern * Step 2-brief transitional stage-involves review patients progress, identify problems & barriers * Stage 3-addressing patients' overall evaluation of shape and weight, explore origin. * Stage 4-help patient find other ways to keep progress and reduce stress

Answer 144

* Bulimia compared to Anorexia, bulimics are more stressed about having the disorder and are motivated to change * Autonomous (intrinsic) and Controlled (extrinsic) motivation it is found that ↑levels of autonomous motivation (but not controlled motivation) predicted greater reduction of overall symptoms and ↓risk of dropping treatment

Answer 145

o wet bed/clothes 2 or more times a week for 3 months o can be intentional/unintentional o must be at least 5 years old w=developmental level * specifier nocturnal (night) or diurnal (day)

Answer 146

* bell and pad (moisture alarm → this is the BEST Tx), * Rx = desmopressin – think of something heavy pressin’ on your bladder → when used by itself – but ↑ relapse in behavior when medication is discontinued

Answer 147

* sx's 3x's per week for 3 months * 1/3 * difficulty initiating sleep (sleep-onset) (2^{nd common)} * difficulty maintaining sleep (sleep maintenance) middle \*\*\*most common\*\* * early morning waking or unable to return 2 sleep (late insomnia)

Answer 148

* CBT-I- with stimulus control, * sleep restriction, * sleep hygiene education, * relaxation training

Answer 149

* sx's 3 times per week for 3 months * attacks of irrepressible need to sleep that causes daytime naps at least 3 times per week for 3 months * requires * cataplexy is required=loss of muscle tone, triggered by strong emotion * hypocretin deficiency--etiology * or a rapid eye movement 15 minutes or less

Answer 150

* 2 types * hypoGOgic hallucinations- going to sleep * hypnoPOMpic hallucinations-cheerleaders using pom-poms to Pump wake you up

Answer 151

* combination medication and behavior strategies * meds are used to improve alertness & ↓cataplexy * modafinil (armodafinil) ↑dopamine levels * amphetamines (methylphidate) ↑dopamine, increase serotonine, and NE a little * med cataplexy-antidepressant venlafaxine, fluoxetine, clomipramine. * sodium oxybate is useful for people who do not respond to other drugs (natural brain chemical taken to improve sleep)

Answer 152

* tends to occur in stages 3 and 4 of sleep in the 1st/3 (third) of sleep cycle * *sleep walking-*getting out of bed during sleep and may include sleep related eating, sexual behavior * *sleep terror* no-remembrance of what happened during a sleep terror o*sleep terror* abrupt arousal from sleep o starts with screaming, intense fear, increased heart rate, unresponsive to attempts to be awakened

Answer 153

* think Nightmare on Elm Street + REM sleep o REMember what happened during nightmares b/c they occur in REM sleep * when awakened person may be oriented and alert

Answer 154

* Concurrent sx of schizophrenia & major depressive or manic episode * Happening in and out of the illness * Presence of hallucinations for 2 or more weeks without mood symptoms

Answer 155

* immigrant adjust better to with a disorder than both us native-born same ethinicity and acculturated immigrants

Answer 156

* negative emotions * guilt * sense of personal failure

Answer 157

* apathy-does not care (opposite empathy) * dysphoria-unease or dissatisfaction w/life * euphoria-intense excitement * hypervigilance-constantly assessing threats (trauma)

Answer 158

* risky use * social impairment * pharmalogical (tolerance and withdrawal) * impaired control

Answer 159

* impacts positive sx more than - * blocking D2 or dopamaine receptors

Answer 160

* Anticholinergic-cant pee, cant see, cant poop, dry mouth and tachycardia * extrapyramidal- high potency (haloperidol & fluphenazine) parkinsonism resting tremor or rigidity, dystonia cant control muscles, akathisia (restless leg-aka cant be still), and tardive dyskinesia ( life-threatening) * neuroleptic malignant syndrome-rare but life-threatening, mind altering, autonmic dysfunction, high fever, combative