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EPPP > Psychopathology/DSM > Flashcards

Psychopathology/DSM Flashcards

1
Q

Prevalence and Gender ratio of ID

A

1% of population (of these – 85% mild severity)

Male to female is 1.5:1

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2
Q

Language disorder (brief summary)

A

Difficulty acquiring and using language (comprehension or production)

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3
Q

Speech Sound disorder (brief summary)

A

Articulation (eg lisps)

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4
Q

What are the severity levels and specifiers for ASD?

A 
Level 1 (require support) 
Level 2 (require substantial support)
Level 3 (require very substantial support)
Specify with/without intellectual impairment and language impairment.
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5
Q

Prevalance and gender ratio for ASD

A

1%, male to female 4:1

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6
Q

Prevalence and gender ratio for ADHD

A

5% children and 2.5% adults

Males to females 2:1

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7
Q

Common associated features of ADHD

A

Low frustration tolerance, mood symptoms, social rejection/conflict.

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8
Q

Prevalence of SLD

A

5-15%

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9
Q

Differential between Tourette’s and other tic disorders

A

Tourettes has multiple motor and 1 or more vocal tics

Motor/Vocal tic disorders only have one type.

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10
Q

Differential tics vs stereopies

A

Stereotypies are consistent and rhythmic, Tics are variable and brief

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11
Q

Symptoms of Psychosis (5)

A 
Delusions, 
Hallucinations, 
Disorganized speech, 
Grossly disorganized or catatonic behavior, 
negative symptoms.
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11
Q

Brief Psychotic Disorder

A

At least one of: delusions, hallucinations, disorganized speech.
Duration 1 – 30 days

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12
Q

Schizophreniform disorder

A

At lest 2 symptoms (must include one of delusions, hallucinations, or disorganized speech)
Duration 1-6 months

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13
Q

Schizophrenia

A

“Active phase” at least one month with 2 symptoms, followed by a prodromal/residual phase with attenuated symptoms or negative symptoms lasting longer than 6 months

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14
Q

Neurotransmitters involved in psychosis

A

Dopamine, Glutamate, serotonin.

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15
Q

Dopamine hypothesis of schizophrenia:

A

Positive symptoms are caused by too much dopamine in subcortical striatal areas.
Negative symptoms are caused by not enough dopamine in prefrontal cortex.

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16
Q

Brain regions in schizophrenia

A

Enlarged ventricles, small cortex, small thalamus.
Underactive frontal lobe.
Temporal-limbic-frontal network and striatum (caudate nucleus, putamen, nucleus accumbens).

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17
Q

Common comorbidities of schizophrenia

A

Anxiety, OCD, tobacco use.

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17
Q

Prevalence and heritability of Schizophrenia

A

Lifetime prevalence around 0.5%.

Identical twins .5, sibs .1 concordance.

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18
Q

Onset and course of schizophrenia

A

Usually early 20s for males and late 20s for females.

Positive symptoms decrease with age, negative/cognitive persist

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19
Q

Prognostic factors in schizophrenia

A

Better prognosis: Female, late and acute onset, comorbid mood symptoms, mainly positive symptoms, precipitating stressor, good prior adjustment.

Worse prognosis: lack of insight, high expressed emotion families (criticism/hostility)

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20
Q

Treatment for schizophrenia

A

Antipsychotic drugs, CBT, cognitive remediation, family psychoed, social skills training, ACT, supported employment

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21
Q

Schizoaffective Disorder

A

Concurrent mood episode AND one month of 2 active symptoms, AND at least 2 weeks with delusions/hallucinations without mood symptoms.

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22
Q

Delusional Disorder

A

1+ delusions for at least one month without any other psychotic symptoms, and without overall impairment in functioning

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23
Q

Subtypes of delusion disorder:

A

Erotomanic (someone is in love with them), grandiose, jealous (spouse unfaithful), persecutory, somatic, unspecified

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24
Q

Treatment for delusions

A

Medication, CBT for delusions (forming alternative explanations and evaluating both, starting with less closely held aspects)
Family therapy

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25
Q

Characteristics of Mania

A 
Necessary: Elevated/Expansive/Irritable mood AND increased activity or energy for most of the day, nearly every day.
Other symptoms:
Inflated self-esteem/gradiosity
Decreased sleep
Pressured speech
Flight of ideas/racing thoughts
Distractibility
Increased activity (goal-directed or non-goal directed)
Excessive risky behavior
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26
Q

Manic Episode vs Hypomanic

A

Both have:
Elevated/Expansive/Irritable mood AND increased activity or energy for most of the day, nearly every day.

Manic: Hospitalization AND/OR At least 1 week of “severe marked impairment” AND/OR psychotic features

Hypomanic: At least 4 days, no psychosis, less impairment

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27
Q

Criteria for Bipolar 1

A

One manic episode

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28
Q

Criteria for Bipolar 2

A

One hypomanic and one major depressive episode

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29
Q

Cyclothymic disorder

A

Several hypomanic and depressive symptoms that don’t meet full criteria for an episode. Sx are present at least half the time (periods of remission shorter than 2 months).
Adults: at least 2 years, Children: At least 1 year

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30
Q

Typical onset for bipolar

A

Late teens to mid 20’s. BP1 is earlier. Often preceeded by a stressor.

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31
Q

Neurotransmitters involved in Bipolar

A

Norepinephrine, Serotonin, Dopamine, Glutamate

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32
Q

Brain regions involved in Bipolar

A

Prefrontal cortex, amygdala, hippocampus, basal ganglia

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33
Q

Therapies for Bipolar

A

Family focused therapy, CBT, psychoed, “interpersonal and social rhythm therapy”

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34
Q

Medications for Bipolar

A

Lithium for Classic BPD

Anticonvulsants and 2nd gen Antipsychotics for atypical features

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35
Q

Frequent comorbidities for bipolar:

A

ADHD, anxiety, Substance use, sleep disorders, eating disorders, disruptive disorders

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36
Q

Symptoms of depression (10)

A 
Depressed mood nearly every day (children: includes irritability)
Diminished interest/pleasure
Weight/appetite change
Sleep disturbance
Psychomotor agitation/retardation (observable by others)
Fatigue/loss of energy
Feel worthless/guilty
Can’t concentrate or indecisive
Thoughts of death/suicidal ideation
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37
Q

Depressive episode criteria

A

At least 5 symptoms (including mood or anhedonia) every day for 2 weeks

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38
Q

Depressive episode with anxious distress

A 
Depressive episode with 2 of: 
feeling keyed up/tense
Restlessness
Trouble concentrating due to worry
Fearful something awful will happen
Feel they may lose self-control
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39
Q

Mood episode with mixed features

A

A depressive, manic, or hypomanic episode with at least 3 features of the “opposite” type of episode.

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40
Q

Mood disorder with rapid cycling

A

At least 4 episodes per year, with either 2 months of remission in between or switch to episode of the opposite pole.

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41
Q

Depressive episode with atypical features

A

Depressive episode with positive mood reactivity (when positive events occur) and at least 2 of: increased eating/weight gain, hypersomnia, leaden feeling in limbs, long standing rejection sensitivity (causing impairment).

42
Q

Mood episode with psychotic features, mood-congruent or mood-incongruent

A

Delusions and/or hallucinations at any point during the episode.

43
Q

Mood episode with peripartum onset

A

During pregnancy or 4 weeks postpartum

44
Q

Mood episode with seasonal pattern

A

Majority of episodes occur in fall/winter, then remission.

45
Q

Prognosis for recovery from mood episode

A

80% begin to recover within 1 year.

Positive prognostic factors: shorter duration, lower severity, no psychosis, no anxiety.

46
Q

Age/gender pattern and course for major depressive disorder

A

Similar rates in childhood, in adolescence/adulthood more common in females.
Most common in adolescence and early adulthood.
Older adults describe less affective and more somatic/cognitive symptoms

47
Q

Neurotransmitters involved in depression

A

Low Serotonin and norepinephrine

48
Q

Brain regions involved in depression

A

HPA axis, prefrontal cortex, cingulate cortex, hippocampus, caudate nucleus, putamen, amygdala, thalamus

49
Q

Lewinsohn’s social reinforcement theory of depression

A

Depression is due to lack of reinforcement due to poor social skills, causing isolation and low self esteem, creating a vicious cycle

50
Q

Hopelessness theory of depression

A

Hopelessness is the cause of depression, which is caused by negative life events and negative cognitive style.

51
Q

Disruptive Mood dysregulation disorder

A

-Severe recurrent temper outbursts at least 3x per week AND
-Persistent irritability or anger observable by others
For over 1 year in two settings starting before age 10.
Diagnosis must be made between age 6 and 18.

52
Q

Persistent depressive disorder/Dysthymia

A

Depressed mood + 2 more symptoms, duration 2 years (adults) or 1 year (kids)

52
Q

Persistent depressive disorder/Dysthymia

A

Depressed mood + 2 more symptoms, duration 2 years (adults) or 1 year (kids)

53
Q

Premenstrual dysphoric disorder

A

During most cycles, 5 symptoms the week before menstruation, with improvement thereafter. Similar symptoms but not identical to depressive episode.

54
Q

Demographic Suicide predictors

A

Highest among whites, then indigenous. Elderly and 45-65 are the highest rates.
Male gender, living alone, family history of suicide.
History of suicide attempts, hospital discharge.

55
Q

Common medical conditions that can resemble/co-occur with depression

A

Huntington’s, Parkinson’s, stroke, brain injury, hypothyroidism, Cushing’s disease.

56
Q

What is the most common anxiety disorder under age 12?

A

Separation Anxiety

57
Q

5 specifiers for specific phobia (types)

A

Animal, natural environment, blood-injection-injury, situational, other

58
Q

Focus of social anxiety disorder

A

Fear of scrutiny by others – concern behavior will be embarrassing or lead to rejection.

59
Q

Agoraphobia

A

Fear of 2 or more situations (eg closed spaces, crowds, outside) due to concern that escape might be difficult or help unavailable when embarrassing symptoms occur)

60
Q

Prevalence and gender in OCD

A

About 1%. For males onset is earlier, but by adolescents females are more affected than males.

61
Q

Body Dysmorphic disorder

A

Preoccupation with 1+ perceived flaws in appearance, excessive repetitive behaviors or mental acts are performed.

62
Q

Common comorbidities for body dysmorphic

A

MDD, social anxiety, substance related

63
Q

Oppositional Defiant Disorder

A

Angry, argumentative, vindictive behavior for >6 months

Four symptoms across those three categories, at least twice per week

63
Q

Oppositional Defiant Disorder

A

Angry, argumentative, vindictive behavior for >6 months

Four symptoms across those three categories, at least twice per week

64
Q

Intermittent Explosive Disorder

A

Recurrent aggressive outbursts (physical or verbal) twice per week for 3 months (or 3 severe instance in a year). Age 6+

65
Q

Conduct disorder

A

Pattern of violation of rights of others or societal rules. 3 symptoms for 12 months.
Symptoms include aggression, destruction, deceitfulness/theft, serious rule violation.

66
Q

Common comorbidities with conduct disorder

A

ADHD, ODD, learning probs, mood/anxiety, bipolar, substance abuse.

67
Q

Prognosis and treatment of conduct disorder

A

Poorer prognosis with childhood onset.
Majority remit by adulthood, but others age into ASPD.
Tx: Parent training and MST

68
Q

Pyromania

A

2 or more intentional fires set, with affective arousal, fascination with fire, and pleasure/relief resulting from firesetting

69
Q

Kleptomania

A

Impulsive theft, with initial affective tension then relief/pleasure.

70
Q

Basic criteria for personality disorders

A 
Enduring pattern of experience/behavior that: deviates from expectations, 
is pervasive/inflexible, 
onset in adolescence/early adulthood, 
stable over time, 
impairment and distress.
Symptoms in at least 2 of:
Cognition
Affect
Interpersonal functioning
Impulse control
71
Q

Criteria for personality disorders under 18

A

Symptoms present for at least 1 year (except antisocial, never under 18)

72
Q

Cluster A personality disorders

A

Odd/eccentric presentation.

Paranoid, Schizoid, and Schizotypal.

73
Q

Cluster B personality disorders

A

Dramatic, Emotional, erratic behavior

Antisocial, borderline, histrionic, narcissistic

74
Q

Cluster C personality disorders

A

Anxious or fearful

Avoidant, Dependent, Obsessive-Compulsive

75
Q

Paranoid Personality Disorder

A

Distrustful/Suspicious of others, negative interpretation of others’ behavior and intentions. 4 symptoms.

76
Q

Schizoid Personality Disorder

A

Social detachment/indifference and restricted range of emotion (flat, cold). 4 symptoms.
Doesn’t desire/enjoy relationships or activities

77
Q

Schizotypal PD

A

Deficits in social functioning (including discomfort), and abnormal cogntions/perceptions/behavior. Psychotic symptoms as not as marked/persistent and in full blown psychosis. 5 symptoms
Eg ideas of reference, odd beliefs, inappropriate affect, paranoid fears

78
Q

Differentiate Schizoid from Schizotypal PD

A

Schizoid - asociality/flat affect

Schizotypal - social probs AND more positive sx.

78
Q

Differentiate Schizoid from Schizotypal PD

A

Schizoid - asociality/flat affect

Schizotypal - social probs AND more positive sx.

79
Q

Antisocial Personality Disorder

A

Pervasive disregard for rights of others since age 15. 3 symptoms,
eg Law-breaking/predatory behavior, impulsivity, disregard for safety of self/others, lack of remorse.

80
Q

Borderline PD

A

Unstable mood, relationships, self image, Plus impulsivity. 5 symptoms.
Eg. Try to avoid abandonment, splitting, unstable self image, recurrent self harm, emptiness, anger, stress-related paranoia or dissociation

81
Q

Histrionic PD

A

Excessive emotionality and attention seeking, 5 symptoms, eg:
Exaggerated/shallow emotion, promiscuity, easily influenced by others, considers relationships closer than they are

82
Q

Narcissistic PD

A

Grandiosity, need for admiration, lack of empathy. 5 symptoms
Eg fantasies of greatness, entitlement, exploitative, envious

83
Q

Narcissistic PD

A

Grandiosity, need for admiration, lack of empathy. 5 symptoms
Eg fantasies of greatness, entitlement, exploitative, envious

84
Q

Avoidant pd

A

Social inhibition, feelings of inadequacy, hypersensitivity. 4 symptoms
Eg avoids situations/relationships due to fear of negative evaluation, inhibited in new situations

85
Q

Dependent PD

A

Excessive need to be cared for – submissive/clingy, indecisive, fear of separation. 5 symptoms, eg:
Abandonment fears, difficulty expressing disagreement, excessive support seeking

86
Q

Obsessive Compulsive Personality Disorder

A

Preoccupation with order, perfectionism, control, resulting in inflexibility and inefficiency. 4 symptoms,
Eg rigid/stubborn, too detail focused, hoarding
“true” obsessions/compulsions are absent, though can be comorbid with OCD

87
Q

Reactive Attachment Disorder

A

Inhibited, withdrawn behavior toward caregiver (rarely seeks/responds to comfort)
Some mood symptoms, minimal social responsiveness.
History of neglect

88
Q

Disinhibited Social Engagement Disorder

A 
Indiscriminant attachment behavior – overly familiar, lack of checking back, no apprehension. 
Insufficient care (eg changing caregivers)
89
Q

Sources of trauma in PTSD

A

Direct experience, learning it occurred to a family member, repeated exposure to aversive details.
Must be physical threat (violence/integrity)

90
Q

4 characteristic symptoms of ptsd

A 
Must have symptoms in all categories:
Intrusive (eg re-experiencing)
Avoidance of associated stimuli
Negative change in thoughts/mood (e.g., can’t remember the event, distorted cognitions)
Increased arousal
91
Q

What are the evidence based interventions for PTSD?

A

Cognitive processing therapy, prolonged exposure, seeking safety (for comorbid substance use), EMDR.

92
Q

Describe psychological debriefing for ptsd

A

Intended as a brief preventative intervention for ptsd but it doesn’t work and might even be harmful.

93
Q

Acute Stress Disorder

A

Traumatic event, 9 ptsd symptoms (any category), lasts 3 days to 1 month

94
Q

Adjustment Disorder

A

Identified stressor, symptoms develop within 3 months and remit within 6 months.

94
Q

Adjustment Disorder

A

Identified stressor, emotional/behavioral problems develop within 3 months and remit within 6 months.

95
Q

Explain the distinctions between PTSD, Acute stress, adjustment

A

PTSD- can be onset any time, sx in all categories
Acute stress – sig trauma, lasts 3-30 days after trauma
Adjustment – stressor (less extreme), lasts up to 6 months

96
Q

Dissociative Identity Disorder

A

2+ distinct identities, including: discontinuity of sense of self, with alterations in behavior/experience.
Frequent gaps in recall.

97
Q

Common associated features with DID

A

Mood/anxiety, substance use, NSSI, seizures, flashbacks

98
Q

Dissociative Amnesia

A

Inability to recall important information , usually associated with trauma/stressful event.

99
Q

Dissociative Fugue

A

A feature/specifier for dissociative amnesia, during which the person travels/wanders during amnesia.

100
Q

Depersonalization/Derealization

A

Sense of unreality or detachment from oneself/surroundings

101
Q

Depersonalization/derealization disorder

A

Repeated/persistent episodes of depersonalization and/or derealization during which reality testing remains in tact.

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