Psychopathology Prepjet

Question 1

ASD Risk Factors

Answer 1

risk factors for ASD include male gender, family history of ASD, certain medical conditions (e.g., fragile X and Angelman syndromes), birth before 26 weeks of gestation, advanced parental age, and exposure to certain environmental toxins during prenatal development (Gialloreti et al., 2019). Note that, despite extensive research, a link between ASD and childhood vaccinations has not been established (e.g., Hviid et al., 2019).

Question 2

ASD Protective Factors

Answer 2

Prognosis for this disorder is best when the person has an IQ over 70, functional language skills by age five, and an absence of comorbid mental health problems

Question 3

Research on ASD

Answer 3

Studies have linked ASD to structural abnormalities in the cerebellum and amygdala and a lower-than-normal level of serotonin synthesis that contributes to abnormal brain development (Boucher, 2009; Wenzel, 2017). The studies have also linked ASD to higher-than-normal blood levels of serotonin, but the relationship between increased levels of serotonin in the blood and decreased serotonin synthesis in the brain is not well understood (e.g., Yang, Tan, & Du, 2014). Family, twin, and adoption studies support a genetic etiology (e.g., Vierck & Silverman, 2011).

Question 4

ADHD and statistics of male to female

Answer 4

ADHD is twice as common in males than females during childhood but the gender difference decreases somewhat in adulthood when the ratio of males to females is about 1.6:1. Up 80% of school-age children with ADHD continue to meet the diagnostic criteria for the disorder in adolescence, and up to 30% continue to do so into adulthood

Question 5

ADHD comorbidity statistics in children

Answer 5

most studies have found oppositional defiant disorder to be the most common comorbid disorder followed by, in order, conduct disorder, an anxiety disorder, and a depressive disorder

Question 6

ADHD and brain abnormalities in adult

Answer 6

Structural neuroimaging studies have found that overall brain volume and the volumes of the caudate nucleus, putamen, nucleus accumbens, amygdala, and hippocampus are smaller in people with ADHD

children and adolescents with this disorder have delayed cortical maturation (especially in the prefrontal cortex), while adults have reduced cortical thickness.

Question 7

ADHD and brain abnormalities in children

Answer 7

children and adolescents with this disorder have delayed cortical maturation (especially in the prefrontal cortex), while adults have reduced cortical thickness. Functional neuroimaging studies have identified hyper- or hypoactivation in several brain networks. For example, these studies have found that children with ADHD often exhibit hypoactivation in the frontoparietal network, which consists of the dorsolateral and anterior prefrontal cortex, anterior cingulate cortex, lateral cerebellum, caudate nucleus, and inferior parietal lobe

Question 8

What does a diagnosis of Tourettes include?

Answer 8

The diagnosis of Tourette’s disorder requires at least one vocal tic and multiple motor tics that may occur together or at different times, may wax and wane in frequency but have persisted for more than one year, and had an onset before 18 years of age.

Question 9

Tourettes d/o and neurotransmitter and treatment?

Answer 9

Tourette’s disorder has been linked to dopamine overactivity, a smaller-than-normal caudate nucleus, and heredity. Treatment may include an antipsychotic drug (e.g., haloperidol) and medication for comorbid conditions – e.g., serotonin for obsessive-compulsive symptoms and methylphenidate or clonidine for ADHD. Behavioral treatments include comprehensive behavioral intervention for tics (CBIT), which consists of psychoeducation, social support, and habit reversal, competing response, and relaxation training

Question 10

Age of onset for Communication Disorder (stuttering) and recovery

Answer 10

The onset is usually between two and seven years of age. Sixty-five to 85% of children recover from dysfluency, with the severity of symptoms at age eight being a good predictor of persistence or recovery. The treatment-of-choice is habit reversal training which incorporates several strategies including competing response training that, for this disorder, is regulated breathing.

Question 11

Learning d/o

Answer 11

diagnosis of this disorder requires difficulties related to academic skills as indicated by the presence of at least one of six symptoms that last for at least six months despite the use of interventions that address difficulties: inaccurate or slow and effortful word reading; difficulty understanding the meaning of what is read; difficulties with spelling; difficulties with written expression; difficulties mastering number sense, number facts, or calculation; and difficulties with mathematical reasoning.

Question 12

Prevalence of Learning Disorder

Answer 12

About 5 to 15 percent of school-age children have a specific learning disability and approximately 80% of these children have a reading disorder (American Psychiatric Association, 2018). Of the reading disorders, dyslexia is the most common type; of the types of dyslexia, dysphonic dyslexia is most common.

Question 13

Brief Psychotic Disorder: what’s the timeline for the required diagnosis?

Answer 13

diagnosis of brief psychotic disorder requires the presence of one or more of four characteristic symptoms for at least one day but less than one month, with at least one symptom being delusions, hallucinations, or disorganized speech.

Question 14

Schizophreniform and the time for the diagnosis?

Answer 14

diagnosis requires the presence of at least two of five characteristic symptoms for at least one month but less than six months, with at least one symptom being delusions, hallucinations, or disorganized speech.

Question 15

Schizophrenia Diagnosis?

Answer 15

The diagnosis of schizophrenia requires the presence of an active phase that lasts for at least one month and includes at least two of five characteristic symptoms, with at least one symptom being delusions, hallucinations, or disorganized speech. (The other two characteristic symptoms are grossly disorganized or catatonic behavior and negative symptoms). There must also be continuous signs of the disorder for at least six months that may include prodromal and/or residual phases in addition to the required active phase. Prodromal and residual phases consist of two or more characteristic symptoms in an attenuated form or negative symptoms only.

Question 16

Concordance rate for Schizophrenia?

Answer 16

Relationship to Person with Schizophrenia

Concordance Rate

Parent

6%

Biological sibling

9%

Child of one parent with schizophrenia

13%

Dizygotic (fraternal) twin

17%

Child of two parents with schizophrenia

46%

Monozygotic (identical) twin

48%

Question 17

Schizophrenia and the neurotransmitters involved in it (DOPAMINE HYPOSTHESIS)?

Answer 17

ccording to the original dopamine hypothesis, schizophrenia is due to high levels of dopamine or hyperactivity of dopamine receptors. Evidence for this hypothesis is provided by research showing that amphetamines increase dopamine activity and produce schizophrenia-like symptoms, while drugs that decrease dopamine activity reduce or eliminate these symptoms. A revised version of the dopamine hypothesis (Kuepper, Skinbjerg, & Abi-Dargham, 2012) predicts that the positive symptoms of schizophrenia are due to dopamine hyperactivity in subcortical regions of the brain (especially in striatal areas), while the negative symptoms are due to dopamine hypoactivity in cortical regions (especially in the prefrontal cortex).

Question 18

Brain abnormalities in Schizophrenia

Answer 18

Brain abnormalities associated with schizophrenia include enlarged ventricles and hypofrontality, which refers to lower-than-normal activity in the prefrontal cortex and is believed to contribute to the disorder’s negative and cognitive symptoms

Question 19

Better prognosis for Schizophrenia include:

Answer 19

A better prognosis for schizophrenia is associated with female gender, an acute and late onset of symptoms, comorbid mood symptoms (especially depressive symptoms), predominantly positive symptoms, precipitating factors, a family history of a mood disorder, and good premorbid adjustment.

Question 20

Worse prognosis for Schizophrenia include:

Answer 20

anosognosia (a lack of insight into or awareness of one’s disorder) is associated with non-adherence to treatment and an elevated risk for relapse. Patients whose family members are high in expressed emotion are also at increased risk for relapse. Expressed emotion refers to the emotional response of family members to a patient with schizophrenia or other mental disorder, and families high in expressed emotion are characterized by high levels of criticism and hostility toward and emotional overinvolvement with the patient

Question 21

Schizophrenia across countries and prognosis:

Answer 21

The research has identified variations in the onset, course, and prognosis of schizophrenia across countries. For example, there’s evidence that patients living in non-Western developing countries are more likely than those living in Western industrialized countries to experience an acute onset of symptoms, a shorter course, and a higher rate of remission (e.g., Hopper & Wanderling, 2000). The studies have also found that an “immigrant paradox” applies to schizophrenia, alcohol use disorder, and a number of other psychiatric disorders. It occurs when “newly arrived immigrants have better health outcomes than much more acculturated immigrants (with longer US residence) or even US born natives of the same ethnicity”

Question 22

Dx for Schizoaffective:

Answer 22

The diagnosis of schizoaffective disorder requires concurrent symptoms of schizophrenia and a major depressive or manic episode for most of the duration of the illness, but with the presence of delusions or hallucinations for two or more weeks without mood symptoms

Question 23

Delusional Disorder

Answer 23

This diagnosis requires that (a) the person have one or more delusions for a duration of at least one month and (b) the person’s overall functioning has not been markedly impaired except for any direct effects of the delusion. The DSM-5 distinguishes between the following subtypes: (a) erotomanic (the person believes that another person is in love with him/her); (b) grandiose (the person believes he/she has great but unrecognized talent or insight); (c) jealous (the person believes his/her spouse or partner is unfaithful); (d) persecutory (the person believes he/she is being conspired against, spied on, poisoned, or maliciously maligned); and (e) somatic (the person’s delusion involves bodily functions or sensations)

Question 24

Heredity for BIPOLAR disorder

Answer 24

twin studies report concordance rates of .67 to 1.0 for monozygotic twins and about .20 for dizygotic twins (Dubovsky, Davies, & Dubovsky, 2003).

Question 25

Seasonal Affective Disorder is due to what and how is it treated?

Answer 25

seasonal affective disorder (SAD), and its symptoms include hypersomnia, overeating, weight gain, and a craving for carbohydrates. It’s been linked to a lower-than-normal level of serotonin and a higher-than-normal level of melatonin, which is a hormone that plays an essential role in the sleep-wake cycle. SAD is often responsive to phototherapy which involves exposure to bright light that suppresses the production of melatonin

Question 26

Whats the prevalence rate for depression between male and female (child and as adults)?

Answer 26

During childhood, the rates of depression are similar for boys and girls; however, the rate for females increases in early adolescence while the rate for males remains fairly stable. Explanations for this gender difference incorporate the impact of biological and psychological factors. For example, there’s evidence that the increase of hormonal levels at puberty sensitizes females but desensitizes males to the stress of negative life events (Allen, Barrett, Sheeber, & Davis, 2006). The higher rate for females persists into adulthood, with female adolescents and adults having a rate that is 1.5 to 3 times higher than the rate for male adolescents and adults.

Question 27

Whats the etiology of depression?

Answer 27

twin studies have found that the concordance rate for unipolar depression is about .50 for monozygotic twins and .20 for dizygotic twins

Question 28

What parts to the brain is associated with depression?

Answer 28

Major depressive disorder has also been linked to lower-than-normal levels of norepinephrine and serotonin and increased levels of cortisol in the hypothalamic-pituitary-adrenocortical (HPA) axis, which plays an important role in the body’s reaction to stress

Question 29

Describe Lewinsohns social reinforcement theory:

Answer 29

Lewinsohn’s (1974) social reinforcement theory describes depression as the result of a low rate of response-contingent reinforcement for social behaviors due to a lack of reinforcement in the environment and/or poor social skills. This results in social isolation, low self-esteem, pessimism, and other characteristics of depression that, in turn, further decrease the likelihood of positive reinforcement in the future

Question 30

Describe Seligman’s Learned helplessness model:

Answer 30

Seligman’s (1974) original version of the learned helplessness model links depression to repeated exposure to uncontrollable negative life events that results in a sense of helplessness, and a reformulated version stresses the role of a negative cognitive style that involves attributing negative life events to stable, internal, and global factors. The most recent revision of the model (referred to as hopelessness theory) describes a sense of hopelessness as the proximal and sufficient cause of depression which, in turn, is the result of exposure to negative events and a negative cognitive style (Abramson, Metalsky, & Alloy, 1989).

Question 31

Describe Beck’s cognitive theory on depression:

Answer 31

Beck’s (1974) cognitive theory attributes depression to a negative cognitive triad that consists of negative thoughts about oneself, the world, and the future.

Question 32

Cultural Factors to Depression

Answer 32

With regard to cultural background, members of some Latino, Mediterranean, Middle Eastern, Asian, and other non-Western cultures report a larger number of somatic symptoms than members of Western cultures who report a larger number of psychological symptoms. For example, Ryder and his colleagues (2008) compared Chinese and Euro-Canadian outpatients and found that the Chinese patients were more likely to emphasize somatic symptoms (e.g., appetite and sleep disturbances, headaches, heart palpitations), while Euro-Canadian patients were more likely to emphasize psychological symptoms (e.g., depressed mood, loneliness, hopelessness).

Question 33

Age differences in depression

Answer 33

With regard to age, older adults are less likely than younger adults to refer to affective symptoms and more likely to refer to somatic symptoms, cognitive changes, and a loss of interest in usual activities (e.g., Fiske, Wetherell, & Gatz, 2009).

Question 34

Suicide rate for ethnicity

Answer 34

With regard to race/ethnicity, the suicide rate in 2017 was highest for American Indians/Alaska Natives followed by, in order, Whites, Asian/Pacific Islanders, Blacks, and Hispanics. Finally, American Indians/Alaska Natives had the highest rates of suicide among individuals ages 15 to 24 and 25 to 44, while Whites had the highest rates among individuals ages 45 to 64 and 65 to 74 (Brooks, 2019; Curtin & Hedegaard, 2018).

Question 35

Specific Phobia data for girls vs boys

Answer 35

Specific phobia is about twice as common in girls than boys, although the rates differ somewhat for different phobic stimuli. Its onset is usually in childhood, with the mean age of onset being about 10 years of age

Question 36

Describe specific phobia using Mowrer’s two factor theory

Answer 36

Mowrer’s (1947) two-factor theory is one explanation for the development of specific phobias. It attributes phobic reactions to a combination of classical and operant conditioning: Classical conditioning occurs when a previously neutral (non-anxiety arousing) object or event becomes a conditioned stimulus and elicits a conditioned response of anxiety after being paired with an unconditioned stimulus that naturally elicits anxiety. Operant conditioning then occurs when the person learns that avoiding the conditioned stimulus allows him/her to avoid experiencing anxiety. In other words, the person’s avoidance behavior is negatively reinforced. As a result, the conditioned response is not extinguished because the person never has opportunities to experience the conditioned stimulus without the unconditioned stimulus.

Question 37

Evidence for invivo versus imaginal exposure

Answer 37

There’s evidence that in vivo exposure is more effective than exposure in imagination, that therapist-led exposure is more effective than self-directed exposure, and that virtual reality exposure may be as effective as in vivo exposure, especially for fear of heights (acrophobia) and fear of flying

Question 38

OCD Prevalence rates

Answer 38

Males have an earlier age of onset of this disorder than females do and, consequently, have a slightly higher prevalence rate than females in childhood, while females have a slightly higher prevalence rate than males in adulthood. In addition, males more likely than females to have a comorbid tic disorder.

Question 39

What the treatment choice for OCD?

Answer 39

Exposure and response (ritual) prevention is the treatment-of-choice and may be combined with cognitive restructuring and/or an SSRI or the tricyclic clomipramine. There’s some evidence that combining exposure and response prevention with an SSRI or clomipramine is more effective than either treatment used alone (Dougherty, Rauch, & Jenike, 2015).

Question 40

PTSD has been linked to several brain abnormalities

Answer 40

Neuroimaging studies have linked it to decreased activity in the medial prefrontal cortex and anterior cingulate cortex, reduced volume of and activity in the hippocampus, and increased responsivity of the amygdala to trauma-related stimuli (Shin, Rauch, & Pitman, 2006). There’s also evidence of abnormalities in several neurotransmitters including increased levels and activity of dopamine, norepinephrine, and glutamate and decreased levels and activity of serotonin and GABA (Sherin & Nemeroff, 2011).

Question 41

Study on telehealth for PTSD:

Answer 41

Most studies evaluating the use of telepsychology for treating PTSD have found it to be comparable to face-to-face interventions in terms of effectiveness. For example, in their systematic review of studies evaluating telepsychology for veterans with PTSD, Turgoose, Ashwick, and Murphy (2018) found that trauma-focused therapies (e.g., exposure therapy, behavioral activation) delivered via telepsychology or in-person were similar in terms of the reduction of PTSD symptoms, attendance and dropout rates, client satisfaction, and therapist fidelity to treatment protocols. However, the studies included in their review did not provide entirely consistent results with regard to the therapeutic alliance: While therapists providing telepsychology said they didn’t have trouble developing rapport with clients, some reported barriers to developing a therapeutic alliance, such as the inability to detect nonverbal communications.

Question 42

Differentiating malingering versus factitious disorder

Answer 42

According to the DSM-5, “malingering is differentiated from factitious disorder by the intentional reporting of symptoms for personal gain … [while] the diagnosis of factitious disorder requires the absence of obvious rewards” (p. 326).

Question 43

How to test for malingering

Answer 43

The forced-choice method has been found useful for detecting malingering and involves presenting the person with test items that require him/her to choose the correct answer from two or more alternatives. The use of this method is based on the assumption that people who are malingering will answer items incorrectly at a higher rate than would be expected by chance alone. For instance, when each item has two alternative answers (e.g., true or false), malingering is suggested when the person answers more than 50% of the items incorrectly.

Question 44

How long does PICA need to last until diagnosed?

Answer 44

Pica involves persistent eating of non-nutritive, nonfood substances (e.g., paper, paint, coffee grounds) for at least one month that’s inappropriate for the person’s developmental level and is not a culturally or socially acceptable practice. Pica can occur at any age, but it’s most common among children and has an elevated rate among pregnant women.

Question 45

Anorexia Nervosa co-occurs with what disorders?

Answer 45

Anorexia nervosa often co-occurs with depression or an anxiety disorder (especially obsessive-compulsive disorder), and there’s evidence that anxiety often precedes the onset of anorexia (Kaye, Bulik, Thornton, Barbarich, & Masters, 2004). Medical complications are usually the direct result of malnutrition and extreme weight loss, affect nearly all of the major organ systems, and can lead to death (Mehler & Brown, 2015).

Question 46

Why is Anorexia nervosa one of the most difficult d/o to treat?

Answer 46

It’s also one of the most difficult disorders to treat because people with this disorder often deny they have an eating problem and resist treatment.

Question 47

SSRI’s and weight restoration in AN?

Answer 47

Although SSRIs have not been found effective for weight restoration, they may be helpful for maintaining weight gain after weight restoration (American Psychiatric Association, 2006).

Question 48

What co occurs with Bulimia Nervosa?

Answer 48

Like anorexia nervosa, bulimia nervosa frequently co-occurs with depression or anxiety, with anxiety sometimes preceding the eating disorder. Most people with this disorder are within the normal weight range or overweight, and medical complications are usually the result of compensatory behavior. For example, purging can cause dental erosion, caries, and other dental problems; gastroesophageal reflux, and dehydration, which causes an electrolyte imbalance that can result in heart arrhythmias and death (Mehler & Rylander, 2015).

Question 49

Most effective treatment for Bulimia nervosa?

Answer 49

The enhanced version of cognitive behavior therapy (CBT-E) has been found to be the most effective version of CBT for patients with bulimia. It’s a transdiagnostic intervention for eating disorders that’s based on the assumption that these disorders share the same core psychopathology – i.e., excessive value given to physical appearance and weight.

Question 50

Compared to anorexia, individual w/ BN how do they differ in terms of motivation?

Answer 50

Finally, compared to individuals with anorexia, those with bulimia are more distressed by their symptoms and tend to be more motivated to change their eating behaviors. The benefits of motivation – and, more specifically, autonomous motivation – on treatment outcomes for individuals with bulimia and other eating disorders has been confirmed by several studies. For example, Sansfacon, Gauvin, Fletcher, and Cottier (2018) compared the effects of autonomous (intrinsic) and controlled (extrinsic) motivation for reducing symptoms in adults who had received a diagnosis of bulimia nervosa, anorexia nervosa, or other specified feeding or eating disorder. They found that higher levels of autonomous motivation (but not controlled motivation) predicted a greater reduction in overall symptoms and a lower risk for dropping out of treatment.

Question 51

Most common method of treating Enuresis?

Answer 51

The most common treatment for nocturnal enuresis is the moisture alarm (also known as the bell-and-pad), which causes a bell to ring when a child begins to urinate while sleeping. The antidiuretic hormone desmopressin used alone also reduces or stops bedwetting in many cases, but it’s associated with a high risk for relapse when it’s discontinued (Houts, 2010).

Question 52

Premature ejaculation in men is involved with which neurotransmitter?

Answer 52

There’s evidence that a low level of serotonin contributes to this disorder, and research has confirmed that an SSRI taken daily (especially paroxetine) can delay ejaculation for some men (Waldinger & Olivier, 2004).

Question 53

What is the Gender Affirmative Model?

Answer 53

The gender-affirmative model has become the most widely accepted approach and is based on the assumption that “a child of any age may be cognizant of their authentic identity and will benefit from a social transition at any stage of development” (Ehrensaft, 2017, p. 60). 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. This model also assumes that (a) gender variations are not disorders; (b) gender presentations are diverse and vary across cultures; (c) gender is not always binary and may be fluid; and (d) if present, a child’s psychological problems are often secondary to negative interpersonal and cultural reactions to the child (e.g., transphobia, homophobia, sexism).

Question 54

Research on gender confirmation surgery

Answer 54

Research on the outcomes of gender confirmation surgery (also known as gender-affirming surgery) has generally found that it’s associated with a decrease in gender dysphoria, improved self-satisfaction, and a low incidence of regret. There’s also evidence that transgender male patients have somewhat more positive outcomes than transgender female patients do (Lawrence, 2017). Factors that have been linked to positive outcomes include careful diagnostic screening of individuals seeking surgery, psychological stability, adequate social support, and a lack of surgical complications (Lawrence & Zucker, 2014).

Question 55

Treating Paraphilic disorders

Answer 55

Behavioral strategies are based on classical conditioning and include covert sensitization and orgasmic (masturbatory) reconditioning. Covert sensitization is a form of aversive counterconditioning that’s conducted in imagination and replaces the sexual arousal elicited by the paraphilic object or behavior with fear or other undesirable response. Orgasmic reconditioning involves instructing the person to switch while masturbating from fantasizing about the paraphilic object or behavior to fantasizing about a more appropriate object or behavior.

Question 56

A young man who has just received a diagnosis of frotteuristic disorder is sexually aroused when he fantasizes about:
A. dressing in woman’s clothing.
B. rubbing up against a nonconsenting person.
C. a non-genital body part.
D. watching other people having sex.

Answer 56

Answer B is correct. Frotteuristic disorder involves recurrent and intense sexual arousal from touching or rubbing against a nonconsenting adult as manifested in fantasies, urges, and/or behaviors.

Question 57

The treatment for a young man who has just received a diagnosis of a paraphilic disorder is most likely to include which of the following?
A. overcorrection and habit reversal training
B. habit reversal training and covert sensitization
C. orgasmic reconditioning and systematic desensitization
D. covert sensitization and orgasmic reconditioning

Answer 57

Answer D is correct. Behavioral interventions for paraphilic disorders are based on classical conditioning and include covert sensitization and orgasmic reconditioning.

Question 58

To assign a DSM-5 diagnosis of pedophilic disorder to a client, the client must be at least \_\_\_\_\_ years old.
A. 20
B. 18
C. 16
D. 14

Answer 58

Answer C is correct. For the diagnosis of pedophilic disorder, the person must be 16 years of age or older and at least five years older than the children he responds to with sexual arousal.

Question 59

Data for Oppositional Defiant Disorder in children and adolescents.

Answer 59

In young children, ODD is more common in boys than girls but, in older children and adolescents, it occurs about equally often in boys and girls. About 30% of children who have a diagnosis of ODD eventually receive a diagnosis of conduct disorder, with an early age of onset of symptoms being associated with a higher risk for conduct disorder (Connor, 2002).

Question 60

Moffit and description of conduct disorder

Answer 60

Moffitt’s description of the outcomes of life-course persistent and adolescent-limited types of conduct disorder are consistent with the DSM-5’s description of the course of the disorder. According to the DSM-5, for most individuals, conduct disorder remits by adulthood, and this is especially true for those whose symptoms have an onset in adolescence. In contrast, individuals whose symptoms begin in childhood have a worse prognosis and “an increased risk of criminal behavior, conduct disorder, and substance-related disorders in adulthood” (APA, 2013, p. 473).

Question 61

Treatment of Conduct Disorder, which one is the most EFFECTIVE?? *

Answer 61

Interventions for conduct disorder are most effective when they include a family intervention. For example, Patterson, Reid, and Dishion (1992) have developed the parent management training Oregon model (PMTO) that teaches parents effective behavior modification techniques and how to monitor their children’s behaviors and use effective disciplinary strategies. An alternative is multisystemic treatment (MST), which views antisocial behavior as being multidetermined; targets the child or adolescent and his/her family, school, and community; and combines cognitive, behavioral, family systems, and case-management techniques (Borduin et al., 1995).

Question 62

Treatment of conduct disorder and using the SCARED STRAIGHT intervention:

Answer 62

Note that research investigating the effectiveness of Scared Straight programs as a prevention or intervention for conduct disorder have found that they tend to have harmful effects, with participation in these programs increasing the likelihood that juvenile offenders and at-risk juveniles will engage in criminal behaviors in the future. The studies have also found that confrontational “rap sessions” and nonconfrontational (educational) approaches have similar negative effects and that these programs may have even worse outcomes for seriously delinquent juveniles (Petrosino, Turpin-Petrosino, Hollis-Peel, & Lavenberg, 2014).

Question 63

Most Effective treatment for Substance Use Disorder

Answer 63

Studies comparing the effectiveness of various treatments have often found that combined treatments are most effective. For example, research on interventions for tobacco use disorder has found that therapy (especially therapies that include problem-solving skills training and social support) and medication (especially nicotine nasal spray and the nicotine receptor partial agonist varenicline) are each effective when used alone, but that interventions that combine therapy and medication are most effective (Fiore et al., 2008).

Question 64

Treatment for Cocaine Use Disorder

Answer 64

Note that no pharmacological treatment has been approved by the FDA for cocaine (stimulant) use disorder and that treatment ordinarily involves cognitive behavior therapy, recovery-focused behavior therapy, or other psychosocial intervention (Department of Veterans Affairs and Department of Defense, 2015).

Question 65

Treatment for relapse prevention and learned habit pattern?

Answer 65

One of the best-known approaches to relapse prevention is Marlatt and Gordon’s (1985; Larimer, Palmer, & Marlatt, 1999) relapse prevention therapy (RPT), which is a cognitive-behavioral approach. It describes substance addiction as a “learned habit pattern” and views lapses following a period of abstinence as being precipitated by a high-risk situation (e.g., a negative emotional state, interpersonal conflict, social pressure). It also proposes that a lapse is most likely to turn into a full-blown relapse when the person has poor coping skills, low self-efficacy, and high expectations about the positive effects of alcohol and responds to the lapse with an “abstinence violation effect” – i.e., with negative emotions, guilt, and a sense of personal failure. RPT utilizes cognitive and behavioral strategies that enable clients to recognize and deal more effectively with high-risk situations. Strategies include training in coping skills, enhancing self-efficacy, challenging myths about the positive outcomes of substance use, cognitive restructuring to view lapses as mistakes rather than the result of personal failure, and altering lifestyle factors that increase exposure or reduce resistance to high-risk situations.

Question 66

What did PROJECT MATCH find regarding substance use treatment?

Answer 66

Project MATCH, a multisite clinical trial, compared the effectiveness of cognitive behavioral coping skills therapy, motivational enhancement therapy, and twelve-step facilitation for clients who had received a DSM-III-R diagnosis of alcohol dependence or abuse. It also evaluated the client-treatment matching hypothesis, which predicts that client outcomes can be improved by matching clients with certain characteristics to treatments most appropriate for those characteristics. Clients were randomly assigned to one of the three treatments, and clients in each group were categorized in terms of several characteristics (e.g., alcohol involvement, psychiatric severity, anger, and social support for drinking versus abstinence). Results indicated that, at one-year and three-year follow-ups, all three treatments had produced significant reductions in drinking, with twelve-step facilitation having a slight advantage over the other two treatments. The results also provided some support for the matching hypothesis. For example, at the three-year follow-up, clients whose social networks were supportive of drinking benefited most from twelve-step facilitation, while clients who were high in anger benefited most from motivational enhancement therapy (Project MATCH Research Group, 1997, 1998).

Question 67

Core features of Mild/Major Neurocognitive disorder?

Answer 67

The core feature of major and mild neurocognitive disorder (NCD) is cognitive dysfunction that’s acquired rather than developmental

Question 68

Differences between “pseudodementia and Alzheimers”

Answer 68

The term “pseudodementia” is sometimes used to describe depression that has prominent cognitive symptoms. Unlike people with Alzheimer’s disease, people with pseudodementia usually respond well to treatment, and they have an abrupt onset of symptoms, exaggerate their cognitive problems, have moderate memory loss and symptoms of melancholia and anxiety, and often say “I don’t know in response” to assessment questions. In contrast, those with Alzheimer’s disease have an insidious onset of symptoms, minimize or deny their cognitive problems, have severe memory impairment, and symptoms of apathy and avolition, and often respond to assessment questions with wrong answers (Ahmed & Takeshita, 1997; Taylor, 1999).

Question 69

Etiology of Alzherimer’s and neurotransmitters

Answer 69

Alzheimer’s disease has been linked to chromosomal, neurotransmitter, and brain abnormalities (Turkington & Mitchell, 2010). Several genetic variants have been identified as risk factors, including the ApoE4 variant on chromosome 19. Neurotransmitter abnormalities include reduced acetylcholine (ACh) and excessive glutamate, which are both known to be involved in learning and memory.

Amyloid plaques and neurofibrillary tangles are first evident in medial temporal lobe structures (which include the entorhinal cortex, amygdala, and hippocampus) and, as the disease progresses, they appear in the frontal and parietal lobes and eventually throughout the cortex. There’s also evidence that the locus coeruleus (an area in the brain stem) is the first area of the brain to be affected by Alzheimer’s disease and shows abnormalities before the appearance of symptoms (Mather & Harley, 2016). Note that neuronal loss in the locus coeruleus has also been linked to neurocognitive disorder with Lewy bodies and neurocognitive disorder due to Parkinson’s disease (Brunnstrom, Friberg, Lindberg, & Englund, 2011).

Question 70

3 stages of alzheimers

Answer 70

The early stage lasts for about two to four years and involves anterograde amnesia, personality changes and mood disturbances, impaired attention and judgment, and anomia (difficulty recalling names of familiar people and objects). Next is the middle stage which lasts for two to 10 years. Its symptoms include increasing anterograde and retrograde amnesia, disorientation to time and place, anxiety or depression, delusions, wandering and pacing, compulsive and repetitive behaviors, impaired speech, disruption in sleep patterns, and problems with normal daily activities. Finally, the late stage usually lasts for one to three years and involves severely deteriorated intellectual functioning, severe disorientation, apathy, severely impaired speech, agitation and aggression, urinary and fecal incontinence, loss of basic motor skills, abnormal reflexes, and inability to perform basic activities of daily life.

Question 71

Differences between NCD with Lewey bodies and NCD due to Alzherimers

Answer 71

Note that one difference between NCD with Lewy bodies and NCD due to Alzheimer’s disease is that, in the former, the prominent early cognitive symptoms are deficits in complex attention and visuospatial and executive functions while, in the latter, the prominent early cognitive symptoms are deficits in learning and memory. Also, the main difference between NCD with Lewy bodies and NCD due to Parkinson’s disease is the sequence of the onset of motor and cognitive symptoms: Motor symptoms precede cognitive symptoms in NCD due to Parkinson’s disease, while cognitive symptoms precede (or, in some cases, are concurrent with) motor symptoms in NCD with Lewy bodies.

Question 72

Clusters for the personality disorders

Answer 72

Cluster A disorders involve odd or eccentric behaviors and include paranoid, schizoid, and schizotypal personality disorders. Cluster B disorders involve dramatic, emotional, or erratic behaviors and include antisocial, borderline, histrionic, and narcissistic personality disorders. Cluster C disorders involve anxiety and fearfulness and include avoidant, dependent, and obsessive-compulsive personality disorders.

Question 73

Shizoid personality versus Shizotypal Personality Disorder. Please distinguish….

Answer 73

Schizoid Personality Disorder: This disorder involves a pervasive pattern of detachment from social relationships and a restricted range of emotional expression in interpersonal settings with at least four of seven symptoms: doesn’t desire or enjoy close relationships, almost always chooses solitary activities, has little or no interest in sexual relationships, takes pleasure in few activities, lacks close friends or confidents other than first-degree relatives, appears to be indifferent to praise or criticism, is emotionally cold or detached or has flat affect.

Schizotypal Personality Disorder: A diagnosis of schizotypal personality disorder requires a pervasive pattern of social and interpersonal deficits involving acute discomfort with and reduced capacity for close relationships, distortions in cognition and perception, and eccentricities in behavior as indicated by least five of nine symptoms: exhibits ideas of reference, has odd beliefs or magical thinking that influence behavior, has bodily illusions and other unusual perceptions, exhibits odd thinking and speech, is suspicious or has paranoid ideation, has inappropriate or constricted affect, has peculiarities in behavior and appearance, lacks close friends or confidents other than first-degree relatives, has excessive social anxiety that doesn’t diminish with familiarity.