Severe and Enduring

Question 1

What are the two categories of paranoia in older adults?

Answer 1

Bad me

Poor me

Question 2

Who talks about bad me and poor me?

Answer 2

Chadwick

Question 3

To what kind of self-esteem is ‘bad me’ related?

Answer 3

Low self-esteem

Question 4

To what kind of self-esteem is ‘poor me’ related?

Answer 4

Variable self-esteem/that derived from the opinions of others

Question 5

What is Knight’s Model of Ageing/

Answer 5

Ageing is circled by:
Maturity
Cohort
Specific challenge
Context

Question 6

How might older evaluate their lives and change accordingly?

Answer 6

Selection, optimisation, compensation

Continuity vs. Accommodation

Question 7

What kind of schizophrenia is onset after 60 years?

Answer 7

Very late onset

Question 8

By what is very late onset schizophrenia categorised?

Answer 8

Hallucinations more florid - visual and auditory

Question 9

What MUST you check for if older adults present with hallucinations/paranoia?

Answer 9

Sensory decline

Question 10

Who’s model is quite helpful when considering stage of life in older adults?

Answer 10

Erikson’s

Question 11

What does macular degeneration result in?

Answer 11

Loss of clarity in focal part of vision

Question 12

List 3 (of 6) themes in very late onset schizophrenia/paraphrenia.

Answer 12

Underlying feeling of insignificance and vulnerability
Mistrust of younger people
Social comparison with younger people
Bitterness
Uncertainty (need to be certain)
Life review and identity (loss)

Question 13

What kinds of themes are prevalent in delusional beliefs in older adults?

Answer 13

Persecutory with high conviction

Question 14

To what are delusional beliefs usually restricted in older adults?

Answer 14

A particular setting (e.g. neighbours)

Question 15

What is critical to do when formulating older adults with psychotic-type symptoms?

Answer 15

Integrate ageing issues and potential for life review

Question 16

What is the most likely intervention for very late onset schizophrenia?

Answer 16

CBT and family work

Question 17

How much research is there into efficacy of treatment for VLOS?

Answer 17

Very little.

Question 18

What seem to be the key underlying issues in very late onset schizophrenia?

Answer 18

Identity and ego integrity

Question 19

What is psychosis sometimes seen as in older adults?

Answer 19

A prodrome of dementia (but it’s probably not)

Question 20

What is the nature of ‘organic’ psychoses?

Answer 20

Visual hallucinations more prevalent than auditory

In Lewy Bodies Dementia, hallucinations are not upsetting

Question 21

By what is Charles-Bonnet Syndrome characterised?

Answer 21

Vivid complex hallucinations linked with visual impairments/damage to optic pathways

Question 22

Who proposes that there are 2 forms of personality disorder in later life?

Answer 22

Zarit and Zarit

Question 23

What are the two forms of PD in later life proposed by Zarit and Zarit?

Answer 23

That which has been masked life long

That which is linked to severe depression/anxiety (not true PD)

Question 24

Which forms of PD are most prevalent in later life?

Answer 24

Clusters A and C

odd/eccentric and anxious/fearful

Question 25

List 4 differences in PD in later life.

Answer 25

Splitting of caregivers Low ability to engage in age appropriate tasks Less reckless - more self-neglect More prone to somatic symptoms (Mistrusting and critical Hopeless resignation Demanding and fearful of institutionalisation)

Question 26

What are Young's Early Maladaptive Schema?

Answer 26

Dependence/Incompetence Abandonment/Instability Subjugation/Self Sacrifice

Question 27

What are the three elements to Linehan's biosocial model of BPD?

Answer 27

Stronger emotions and more sensitive Affective dysregulation Developmental history of invalidation

Question 28

Who adapted Linehan's biosocial model of BPD?

Answer 28

Lynch et al. (2007)

Question 29

Outline the biosocial model (in a nutshell)

Answer 29

Negative affect Inflexible coping Reinforced and/or Aversive feedback from environment

Question 30

What are opposing constructs?

Answer 30

Two constructs that are opposite and that the middle ground needs to be found.

Question 31

What is the ultimate compromise in therapy?

Answer 31

Accepting and validating vs change

Question 32

How does Lynch (2007) adapt reasonable and emotional mind?

Answer 32

fixed and fresh mind

Question 33

How does Lynch (2007) adapt wise mind?

Answer 33

Fluid mind.

Question 34

What are the main differences in Lynch et al. (2007)'s model and Linehan's model?

Answer 34

Much more skills driven