Sheet2-表格 1 Flashcards
What are evidence of sexual abuse in children?
genital/anal trauma, STDs, UTIs
What are the 5 components of the APGAR score at birth?
- A= Apperance (color)
- P= Pulse
- G= Grimace (reflex irritability)
- A= Activity (muscle tone)
- R= Respiration
What are the 7 effects of long-term deprivation of a!ection?
- Weak
- Wordless
- Wanting (socially)
- Wary (lack trust)
- Weight loss
- anaclitic depression
- physical illness
[Hint: 5 W’s and 2 more]
What are the development milestones at about 3 years old in preschool?
- group play
- rides tricycle
- copies line or circle drawing
What are the development milestones at about 4 years old in preschool?
- cooperative play
- simple drawings (stick figure)
- hops on 1 foot
What are the developmental milestones at about 12-14 months old in infancy?
NAME?
What are the developmental milestones at about 15 months old in infancy?
- walking
- few words
- separation anxiety
What are the developmental milestones at about 3 months old in an infant?
- holds head up
- social smile
- Moro reflex disappears
What are the developmental milestones at about 4-5 months old in an infant?
- rolls on back
- sits when propped
What are the developmental milestones at about 7-9 months old in infancy?
- stranger anxiety
- sits alone
- orients to voice
What are the developmental milestones during adolescence?
- abstract reasoning (formal operations)
- formation of personality
What are the developmental milestones during the schoolage years (6-11y/o)?
- development of conscience (superego)
- same-sex friends
- identification with same-sex parent
What are the Kubler-Ross dying stages?
Denial-Anger-Barganing-Grieving-Acceptance, don’t occur necessarily in this order [Hint: Death Arrives Brining Grave Adjustments]
What are the risks of low birth weight?
assoc. w/ gtr. Incidence of physical and emotional problems. Complications include:
- infections
- respiratory distress syndrome
- necrotizing entercolitis
- persistent fetal circulation
What can cause regression to younger behavior in children?
Stress:
- physical illness
- punishment
- birth of new sibling
- tiredness
What causes low birth weight?
prematurity or intrauterine growth retardation
What is anaclitic depression?
depression in an infant owing to continued separation from caregiver–can result in failure to thrive. Infant becomes withdrawn and unresponsive
What is grief?
normal bereavement characterized by shock, denial, guilt, and somatic symptoms, Typically lasts 6mo. to 1yr.
What is pathologic grief?
includes excessively intense or prolonged grief or grief that’s delayed, inhibited, or denied
What is the result of severe long-term deprivation of affection?
death
When can a child parallel play?
Toddler, 24-48 months old
When does a child achieve core gender identity?
Toddler, 24-36 months old
When does a child achieve object permanence?
Toddler, 12-24 months old
When does a child achieve rapprochement?
Toddler, 18-24 months old
When does a child become toilet trained?
Preschool, 30-36 months old
When is adolescence for boys and for girls?
Boys: 13 years old
Girls: 11 years old
Who is usually the abuser in physical abuse in children?
female primary caregiver
Who is usually the abuser in sexual abuse in children?
known to victim, usually male
Case-control studies are often?
Retrospective (case control)
Characteristics of a normal statistical distribution?
Gaussian = Bell Shaped (mean=median=mode )
Country with highest divorce rate
U.S.
Define a bimodal distribution
Peaks on either side of the median
Define a Meta-analysis
Pooling data from several studies to achieve greater statistical power
Define a negative skew
Asymmetry with the tail on the left
mean<mode
Define a positive skew
Asymmetry with the tail on the right
mean>median>mode
Define Accuracy
The trueness of test measurements
Define Alternate Hypothesis
Hypothesis that there is some difference
Define Coeffcient of Determination
r^2 (Correlation coefficient squared)
Define Correlation coeffcient (r )
Always between -1 and 1. Absolute value indicates the strength of correlation.
Define Negative Predictive Value
Number of true negatives / number that tested neg. for disease
Define Positive Predictive Value
“Number of true positives / number that tested pos. for disease or the prob. Of
having a condition, given a pos. test”
Define Precision
“The consistency of a test (reliability), absence of random error”
Define Primary Disease Prevention
“Prevent occurrence, e.g., vaccination”
Define Relative Risk
Disease risk in exposed group / disease risk in unexposed group; a/a+b / c/c+d
Define Reliability
Reproducibility of a test; repeat measurements are the same
Define Secondary Disease Prevention
“Early detection of disease, e.g., Pap smear”
Define SEM
Standard Error of the Mean; standard deviation / square root of n (sample size)
Define sensitivity
Number of true positives / all people with disease
Define specificity
Number of true negatives / number of all people w/o the disease
Define Tertiary Disease Prevention
“Reduce disability form disease, e.g. insulin for diabetics”
Define the Power of a study
Probability of rejecting a null hypothesis when it is false
Define Validity
Whether a test truly measures what it purports to measure; the appropriateness of a test
Do divorcees remarry frequently?
Yes
How do disease prevalence and positive predictive value relate?
Higher prevalence = Higher Positive Predictive Value
How do prevalence and incidence relate to disease length?
P>I for chronic diseases; P=I for acute diseases
How do SEM and Standard Deviation relate?
SD > SEM; as n increases,
SEM decreases
How do you measure the ‘power’ of a study or the probability that the study will see a difference if one exists?
1-beta
How does alpha relate to the Type I error?
“It is the probability of making a Type I error, is equal to p (p is usually < 0.05)”
How does beta relate to the Type II error?
Beta is the probability of making a Type II error
How many people >65
35,000,000 (approx. 13%)
“If the 95% confidence interval for OR of RR includes 1, what does this mean?”
That the study is inconclusive
In what age group will the greatest population increase be seen in?
Those >85
Increasing sample size will affect the Power of a study how?
By increasing the Power
Is divorce related to industrialization?
No
Is HIV positivity a reportable disease?
No
Marriages at high risk
Teenage marriages, Mixed religions, Low socio-economic status
Memory aid for Medicare/Medicaid
MedicarE=Elderly;
MedicaiD=Destitute
Preventive services needed for Alcoholism
Influenza, pneumococcal immunizations; TB test
Preventive services needed for Diabetes
Eye, foot exams; Urine test
Preventive services needed for Drug Abuse
HIV, TB tests; hepatitis immunization
Preventive services needed for High-risk sexual behavior
HIV, Hep B, syphilis, gonorrhea, chlamydia tests
“Preventive services needed for Homeless, Refugee, or Immigrant”
TB test
Preventive services needed for Obesity
Blood glucose test
Random error yields poor?
Precision
Relative Risk is used for what kind of study?
Cohort
Systematic error yields poor?
Accuracy
U.S. population in 2000
300,000,000
“Unlike specificity and sensitivity, what are
predictive values dependent on?”
Prevalence of disease in the population
What are risk factors for suicide?
White, male, alone, prior attempts, presence and lethality of plan, medical illness, alcohol or drug use, on 3 or more prescription meds.
What are the leading causes of death in AGE 1-14?
Injuries, cancer, congenital anomalies, homicide, heart disease
What are the leading causes of death in AGE 15-24?
Injuries, homicide, suicide, cancer, heart disease
What are the leading causes of death in AGE 25-64?
Cancer, heart disease, injuries, stroke, suicide
What are the leading causes of death in AGE 65+?
Heart disease, cancer, stroke, COPD, pneumonia
What are the leading causes of death in INFANTS?
Congenital anomalies, SIDS, short gestation, respiratory distress syndrome, maternal complications during pregnancy
What are the most common surgeries?
Dilation and curettage, hysterectomy, tonsillectomy, sterilization, hernia repair, oophorectomy, cesarean
section, cholecystectomy
What are the reportable diseases?
AIDS, chickenpox, gonorrhea, hepatitis A and B, measles, mumps, rubella, salmonella, shigella, syphilis, and tuberculosis
What does a t-test check?
The difference between two means (Mr. T is mean)
What does an ANOVA analyze?
Variance of 3 or more variables (Analysis of Variance)
What does SAD PERSONS represent?
Sex (male), Age, Depression, Previous attempt, Ethanol, Rational thought, Sickness, Organized plan, No spouse, Social support lacking
What factors influence the Power of a study?
1) The total # of endpoints experienced by a population;
2) Difference in compliance between treatment groups
What is a case-control study?
Observational study. Sample chosen based on presence or absence of disease. Info collected about risk factors.
What is a Clinical trial?
Experimental study. Compares benefit of 2 or more treatments.
What is a Cohort study?
Observational study. Sample chosen based on presence or absence of Risk Factors. Subjects followed over time for disease development. (Framingham study)
What is a memory key for suicide risk factors?
SAD PERSONS
What is a Null Hypothesis?
“Hypothesis of no difference, e.g., no assoc. between disease and risk factor”
What is a pitfall of Meta-analysis?
Cannot overcome limitations of individual studies or bias in study selection
What is a Type I error (alpha)?
Stating that an effect of difference exists when one really does not
What is a Type II error (beta)
Stating that there is not an effect or difference when actually there is
What is an Odds Ratio used for?
Approximates relative risk when prevalence is not too high; OR = ad/bc
What is Chi-Square test used for?
To check differences between 2 or more percentages or proportions of categorical
outcomes
What is desirable for confirmatory tests?
High specificity
What is desirable for screening tests?
High sensitivity is desirable for a screening test
What is incidence?
Number of new cases in a population per unit time
What is Medicaid?
Fed. And State assistance for those on welfare or who are indigent
What is Medicare Part A?
Hospital related
What is Medicare Part B?
Supplemental
What is Medicare?
Fed. Program for the Elderly
What is prevalence?
Total number of cases in a population at a given time (incidence x disease duration)
What is the False Negative Ratio?
1-sensitivity
What is the False Positive Ratio?
1-specificity
What is the highest quality study?
Clinical Trial
What is the p value?
The probability of making a Type I error.
What percent of medical costs will those >35 incur?
30%
What type of studies are Odds Ratios used for?
Retrospective (case control)
When do divorces peak?
During the 2nd to 3rd year.
Which sex has the most surgeries?
Females
Are intelligence tests objective or projective tests?
Objective
Define acting out.
Unacceptable feelings and thoughts are expressed through actions
Define altruism.
Guilty feelings alleviated by unsolicited generosity toward others
Define classical conditioning.
Learning in which a natural response is elicited by a conditioned stimulus that previously was presented in conjunction with an unconditioned stimulus
Define denial.
Avoidance of awareness of some painful reality
Define displacement.
Process whereby avoided ideas and feelings are transferred to some neutral person or object
Define dissociation.
“Temporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emotional
stress”
Define ego defenses.
automatic and unconscious reactions to phychological stress
Define fixation.
Partially remaining at a more childish level of development
Define humor.
Appreciating the amusing nature of an anxiety-provoking or adverse situation
Define identification.
Modeling behavior after another person
Define isolation.
Separation of feelings from ideas and events
Define operant conditioning.
Learning in which a particular action is elicited because it produces a reward
Define projection.
An unacceptable internal impulse that is attributed to an external source
Define rationalization.
“Proclaiming logical reasons for actions actually performed for other reasons, usually to avoid self-blame”
Define reaction formation.
Process whereby a warded-off idea or feeling is replaced by an (unconsciously derived) emphasis on its opposite
Define regression.
Turning back the maturational clock and going
back to earlier modes of dealing with the world
Define repression.
Involuntary withholding of an idea or feeling from conscious awareness.
Define sublimation.
Process whereby one replaces an unacceptable wish with a course of action that is similar to the wish but does not conflict with one’s value system.
Define suppression.
Voluntary (unlike other defenses) withholding of an idea of feeling from conscious awareness
Give an example of classical conditioning.
Pavlov’s dogs (ringing of a bell provoked salivation in dogs)
Give an example of continuous reinforcement
schedule.
A person gets upset when a vending machine doesn’t work
Give an example of negative reinforcement of opperative conditioining.
a mouse presses a button to avoid shock (do not confuse with punishment)
Give an example of positive reinforcement of opperative conditioning.
a mouse presses a button to get food
Give an example of preconscious topography.
remembering your phone number
Give an example of variable ratio reinforcement schedules.
A person continuing to play a slot machine at a casino
Is IQ testing more highly correlated with genetics or school achievement?
School achievement
Name 4 characteristics of psychoanalysis.
“-costly-lengthy-intensive-places great demands on the patient”
What are Freud’s three structures of the mind
“-Id-Superego-Ego”
What are the four factors in hopelessness?
- Sense of Impotence (powerlessness)
- Sense of Guilt
- Sense of Anger
- Sense of loss/Deprivation leading to depression
(Mnemonic IGAD!)
What are the immature ego defenses? (12)
Acting out, Disassociation, Denial, Displacement, Fixation, Identification, Isolation, Projection, Rationalization, Reaction formation, Regression, Repression
What are the MATURE ego defenses? (4)
- Sublimation
- Altruism
- Suppression
- Humor
(Mneumonic: Mature women wear a SASH)
What are the two most famous forms of intelligence testing?
Stanford-Binet and Wechsler
What are two factors with which IQ scores are
correlated?
Genetics and school achievement
What is an example of acting out?
Temper tantrums
What is an example of altruism?
Mafia boss makes large donation to charity
What is an example of denial.
A common reaction in newly diagnosed AIDS and cancer patients
What is an example of displacement?
Mother yells at child because she is angry at her husband
What is an example of dissociation?
Extreme forms can result in multiple personalities (dissociative identity
disorder).
What is an example of fixation?
Men fixating on sports games
What is an example of humor?
Nervous medical student jokes about the boards
What is an example of identification?
Abused child becomes an abuser
What is an example of isolation?
Describing murder in graphic detail with no emotional response
What is an example of projection?
A man who wants another woman thinks his wife is cheating on him
What is an example of rationalization?
Saying the job was not important anyway, after getting fired
What is an example of reaction formation?
A patient with libidinous thoughts enters a monastery
What is an example of regression?
Seen in children under stress (eg., bedwetting) and in patients on dialysis (eg., crying)
What is an example of sublimation?
Aggressive impulses used to succeed in business ventures
What is an example of suppression?
Choosing not to think about the USMLE until the week of the exam
What is negative reinforcement?
the removal of an aversive stimulus so as to increase behavior
What is positive reinforcement?
the desired reward which produces an action
What is the basic mechanism underlying all ego defenses?
Repression
What is the central goal of Freudian psychoanalysis?
To make the patient aware of what is hidden in his/her unconscious
What is the IQ criteria for diagnosis of mental
retardation?
IQ lower than 70 (or 2 standard deviations below the mean)
What is the topographical term used in psychoanalysis to describe what you are not
aware of?
Unconscious
What is the topographical term used in psychoanalysis used to describe what you are able to make conscious with
e!ort?
Preconscious
What is the topographical term used in psychoanalysis used to describe what you are aware of?
Conscious
What number is defined as the mean for standard IQ testing?
100 (with a standard deviation of 15)
What term first described by Freud is used to refer to repressed sexual feelings of a child for the opposite-sex parent, accompanied by rivalry with same-sex parent?
Oedipus complex
What term is used to describe the form of insight therapy developed by Freud which is often used for changing chronic personality problems?
Psychoanalysis
What thought structures is the Ego responsible for?
Bridge and mediator between the unconscious mind and the world (Think-Deals with conflict)
What thought structures is the Id responsible for? (3 things)
- Primal urges
- sex
- agression
(Think-‘I want it’)
What thought structures is the Superego responsible for? (2 things)
- Moral values
- conscience
(Think-‘You know you can’t have it’)
What type of behavior requires a continuous
reinforcement schedule?
behavior which shows the most rapid extinction when not rewarded
What type of behavior requires a variable ratio
reinforcement schedule?
behavior which shows the slowest extinction when not rewarded
Which is the conditioned (learned) stimulus in Pavlov’s experiment?
ringing bell
Which is the natural response in Pavlov’s experiment?
salivation
Which is the unconditioned stimulus in Pavlov’s experiment?
food
