superduperpyschopathology Flashcards
1
Q
A
2
Q
What are the criteria for delusional disorder?
A
- 1 or more delusions that have occurred for greater than one
month? - No marked impairment in functioning except for effects of
delusion.
3
Q
A poor prognosis for people with schizophrenia is least associated with which of the following?
A. female gender
B. anosognosia
C. early age of onset
D. predominantly negative symptoms
A
a. female gender
4
Q
The most likely diagnosis for a client who had auditory hallucinations and disorganized speech for five weeks and odd behaviors and anhedonia for an additional seven months is:
A. major depressive disorder with psychotic features.
B. schizophreniform disorder.
C. schizoaffective disorder.
D. schizophrenia.
A
d. schizophrenia
the key part of his question is seven months, as schizophreniform is 1 month to 6 months, and there is no mood component.
5
Q
A person who abuses an amphetamine or other ________-enhancing drug may develop symptoms similar to those associated with schizophrenia.
A. ACh
B. dopamine
C. serotonin
D. GABA
A
b. dopamine
Drugs that amp you up get you dopamine.
Dopamine hyperactivity in the subcortical regions has been associated with positive symptoms.
6
Q
A high level of expressed emotion by family members toward patients with schizophrenia has been linked to:
A. caregiver burnout.
B. substance use by the patient.
C. a better prognosis.
D. an increased risk for relapse.
A
d. an increased risk of relapse
Basically, expressed emotion means high-emotion shitheads who are not sympathetic.
7
Q
As reported by I. I. Gottesman (1991), the concordance rate for schizophrenia is about ___% for monozygotic twins and ____% for dizygotic twins.
A. 50; 30
B. 50; 25
C. 48; 24
D. 48; 17
A
d. 48; 17
The key point is that there is a large discrepancy
8
Q
A reformulated version of the dopamine hypothesis proposes that the negative symptoms of schizophrenia are due to:
A. dopamine hyperactivity in certain subcortical areas.
B. dopamine hypoactivity in certain subcortical areas.
C. dopamine hyperactivity in certain cortical areas.
D. dopamine hypoactivity in certain cortical areas.
A
d. dopamine hypoactivity in certain cortical regions.
this is tricky remember it’s hyper in subcortical for positive symptoms
its hypo for negative in cortical
9
Q
A person whose biological mother and father have both received a diagnosis of schizophrenia is about _____ times more likely to receive the same diagnosis as a person whose only biological relative with schizophrenia is his or her non-twin sibling.
A. 50
B. 16
C. 5
D. 2
A
c. 5
10
Q
Which of the following is considered the most effective antipsychotic drug for treatment-resistant schizophrenia?
A. haloperidol
B. chlorpromazine
C. clozapine
D. risperidone
A
c. clozapine
It is the first-line drug of choice
11
Q
Schizoaffective disorder is likely to be the appropriate diagnosis for a client if her psychotic symptoms have:— Tell me also about the diagnosis
A. always occurred with concurrent mood symptoms.
B. occurred concurrently with mood symptoms except for a period of at least two weeks when her psychotic symptoms were absent.
C. occurred concurrently with mood symptoms except for a period of at least two weeks when her mood symptoms were absent.
D. occurred concurrently with mood symptoms except for a period of at least one month when her mood symptoms were absent.
A
c. occurred concurrently with mood symptoms except for a period of at least two weeks when her mood symptoms were absent.
Schizoaffective disorder is characterized by 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.
so basically, it’s like schizophrenia
-symptoms occur concurrently for more than a month
-duration greater than six months
-5 symptoms
1. hallucinations 2. delusions 3. grossly disorganized speech of behaviour 4. catatonic behaviour 5. negative symptoms.
must have 2, one must be in the top 3
plus a major manic depressive episode occurring concurrently
-but there must be a period of at least two weeks where you have no mood, but you get delusions or hallucinations.
12
Q
What are the diagnosis criteria for psychosis?
A
must have at least one of the following for a period greater than one day but less than a month
1. delusions
2. hallucinations
3 grossly disorganized speech or behaviour
4. catatonic behavior
13
Q
What are the diagnosis criteria for schizophreniform
A
Must have two of the following, and one must fall in the top 3
-must occur for a period greater than one month and duration less than six months.
1. delusions
2. hallucinations
3 grossly disorganized speech or behaviour
4. catatonic behavior
5. negative symptoms
14
Q
What is the diagnosis for schizophrenia
A
Must have two of the following, and one must fall in the top 3
-must occur for over one month and duration greater than six months.
1. delusions
2. hallucinations
3 grossly disorganized speech or behaviour
4. catatonic behavior
5. negative symptoms
15
Q
What is the best prognosis for schizophrenia
A
- female
- late onset
- comorbid mood symptoms
- positive symptoms
- insight
- other factors
16
Q
What is the diagnosis for intellectual disability, and how is it done?
A
- clinical assessment and testing
- Two or more standard deviations from the norm.
17
Q
In terms of cause, what is the primary cause in 85 percent of known cases. for ID
A
pre-natal in particular
Fragile X and downs syndromes
18
Q
ASD diagnosis?
A
- deficits in social communication
- deficits in social interaction
- restrictive or repetitive behaviours.
19
Q
ASD best prognosis?
A
- functional language by 5
- lack of comorbidity
3 IQ greater than 70
20
Q
ADHD, tell me about the diagnosis.
A
- six or more symptoms of inattentive or hyperactivity
- onset before the age of 12
- across more than 2 contexts
- can be inattentive, hyper, or combined.
21
Q
ADHD tell me about treatment?
A
For the preschool, littles we have parent training and behavioural intervention
for middle school, you have meds and behavioural intervention
for adults, you have meds and CBT
22
Q
ADHD: what is the greatest risk for adulthood?
A
Substance abuse?
23
Q
tic disorder: diagnosis
A
one or more motor or vocal tic
-before age of 18
-persistent greater than a year
-provisional less than a year
24
Q
tics onset
A
4-6
Peaks 10-12
25
Tourettes diagnosis
At least one vocal tic and multiple motor tics.
26
The DSM-5 diagnosis of ADHD requires an onset of symptoms before ____ years of age.
A. 7
B. 9
C. 12
D. 15
c. 12
27
Neuroimaging studies have linked ADHD to a:
A. larger-than-normal entorhinal cortex.
B. smaller-than-normal entorhinal cortex.
C. larger-than-normal prefrontal cortex.
D. smaller-than-normal prefrontal cortex.
D. smaller-than-normal prefrontal cortex.
28
For a DSM-5-TR diagnosis of Tourette’s disorder, the client must have which of the following?
A. at least one motor tic and one vocal tic.
B. at least one motor tic and multiple vocal tics.
C. multiple motor tics and at least one vocal tic.
D. multiple motor tics and multiple vocal tics.
C. multiple motor tics and at least one vocal tic.
29
When assigning a DSM-5-TR diagnosis of intellectual disability to a child, the level of severity of the disorder is determined by considering the child’s:
A. adaptive functioning.
B. socioemotional functioning.
C. full-scale IQ score.
D. adaptive functioning and full-scale IQ score.
A. adaptive functioning.
30
The most common comorbid disorder for specific learning disorder is:
A. major depressive disorder.
B. ADHD.
C. social anxiety disorder.
D. oppositional defiant disorder.
B. ADHD.
unless its psychosis or a biggy the answer is probably ADHD
31
Which of the following is most associated with a better prognosis for autism spectrum disorder?
A. an IQ over 55
B. a sudden onset of symptoms
C. functional language skills by age five
D. brief duration of active-phase symptoms
C. functional language skills by age five
32
The most effective intervention for children with childhood-onset fluency disorder is likely to be which of the following?
A. overcorrection
B. habit reversal training
C. stimulus control
D. stress inoculation training
B. habit reversal training
33
ASD: what is the deal from a brain perspective
1. accelerated brain growth
2. too much serotonin flooding the brain.
34
ADHD, what are the neurotransmitters associated
1. dopamine
2. norepinephrine
35
ADHD's most common comorbidity
ODD
36
communication disorder diagnosis, treatment
Deficits in language, speech, and communication. Included in this category is childhood-onset fluency disorder (stuttering)
-habit reversal
37
LD diagnosis
at least six months
reading, writing, math, most common dyslexia
38
all personality disorders must have a duration of greater than a year what is the one that can't be diagnosed until 18 years of age.
anti-personality disorders
39
Cluster A(odd or eccentric) personality disorders include
1. paranoid
2 schizoid
3. schizotypal
40
Cluster B(dramatic, emotional, erratic) include
1. antisocial
2. borderline
3. histrionic
4. narcissistic
41
Cluster C (anxiety, fear) includes
1. avoidant
2. dependent
3. obsessive-compulsive
42
Paranoid personality disorder describe?
A pattern of distrust and suspiciousness
involves interpreting the motives of others as malevolent by four of seven symptoms:
-others are exploiting, harming, or deceiving him/her; is preoccupied -unjustified doubts about the loyalty and trustworthiness of others; is -reluctant to confide in others;
-reads demeaning content into benign remarks or events; -persistently bears grudges; perceives attacks on his/her character -quick to react with anger or a counterattack
-suspicious without justification about the fidelity of his/her spouse or sexual partner.
43
Schizoid personality disorder describe?
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 confidants other than first-degree relatives, -appears to be indifferent to praise or criticism
-emotionally cold or detached or has a flat affect.
-social they don't care
44
45
Schizotypal Personality Disorder describe?
-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 at least five of nine symptoms.
-they feel weird around others, but no desire to do anything
46
A person with __________ personality disorder is most likely to say she’d like to have friends but doesn’t spend time with people because she thinks she’s “not as good as other people” and fears that they’ll criticize and reject her.
A. avoidant
B. schizoid
C. borderline
D. histrionic
a. avoidant
47
Emotion dysregulation has been identified by Linehan (1993) as a cause of which of the following personality disorders?
A. histrionic
B. borderline
C. antisocial
D. dependent
b. borderline
48
The DSM-5 diagnosis of antisocial personality disorder cannot be assigned to a person who is less than _____ years of age.
A. 12
B. 15
C. 18
D. 21
c. 18
49
Which of the following is the most likely DSM-5 diagnosis when a young man says he prefers being alone, doesn’t have any close friends, isn’t bothered by the negative things his co-workers sometimes say about him, and thinks he’s “pretty stable” because he rarely experiences strong positive or negative feelings when he’s around other people?
A. schizoid
B. schizotypal
C. paranoid
D. avoidant
a. schizoid
50
A client is frequently late for therapy sessions and often avoids answering the therapist’s questions during sessions. A practitioner of dialectical behavior therapy would describe these behaviors as:
A. psychological reactance.
B. therapy-interfering behaviors.
C. emotional resistance.
D. a dialectical impasse.
b. therapy interfering behaviors
51
Which of the following best describes obsessive-compulsive personality disorder and obsessive-compulsive disorder?
A. Both disorders involve obsessions and compulsions, but they’re more pervasive in obsessive-compulsive disorder.
B. Both disorders involve obsessions and compulsions, but they’re of a longer duration in obsessive-compulsive personality disorder.
C. Only obsessive-compulsive personality disorder involves mood-incongruent obsessions.
D. Only obsessive-compulsive disorder involves true obsessions and compulsions.
D. Only obsessive-compulsive disorder involves true obsessions and compulsions.
52
Except for antisocial personality disorder at what age, and what is the rule for diagnosis
under 18 if symptoms have been present for over 1 year.
53
Briefly describe borderline personality disorder
pervasive pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity as indicated by at least five of nine symptoms:
Engages in frantic efforts to avoid abandonment, has a pattern of unstable and intense interpersonal relationships that involve fluctuations between idealization and devaluation,
has an identity disturbance that involves a persistent instability in sense of self, is impulsive in at least two areas that are potentially self-damaging, has made recurrent suicide threats or gestures or engages in self-mutilating behavior, exhibits affective instability, experiences chronic feelings of emptiness, exhibits inappropriate intense anger, has transient stress-related paranoid ideation or severe dissociative symptoms.
54
What is the treatment for borderline?
Dialectical behavior therapy (DBT), which is a type of cognitive-behavior therapy. It’s based on the assumption that borderline personality disorder is due to emotion dysregulation, which is the result of a combination of biological and environmental factors.
55
What is histrionic personality disorder
Think needy, overly emotional Karen's who are superficial attention whores, who crave nurturance.
56
What is a narcissistic personality disorder?
pervasive pattern of grandiosity, a need for admiration, and a lack of empathy as indicated by at least five of nine symptoms: has a grandiose sense of self-importance; is preoccupied with fantasies of unlimited success, power, beauty, and love; believes he/she is unique and can be understood only by special or high-status people; requires excessive admiration; has a sense of entitlement; is interpersonally exploitative; lacks empathy; is often envious of others or believes others are envious of him/her; exhibits arrogant behaviors and attitudes.
57
What is avoidant personality disorder?
Think scared and unworthy.
social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation with at least four of seven symptoms: avoids occupational activities that involve interpersonal contact due to fear of criticism, disapproval, or rejection; is unwilling to get involved with people unless certain of being liked; shows restraint in intimate relationships due to fear of being ridiculed; is preoccupied with concerns about being criticized or rejected in social situations; is inhibited in new relationships because of feelings of inadequacy; views self as socially inept, unappealing, or inferior to others; is usually reluctant to engage in new activities because they may be embarrassing.
58
What is dependent personality disorder?
Think scared of being alone, can't do it on my own
Pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and a fear of separation as indicated by at least five of eight symptoms: has difficulty making everyday decisions without advice and reassurance from others, needs others to assume responsibility for most areas of his/her life, avoids disagreeing with others due to fear of losing support or approval, has difficulty doing things alone, goes to excessive lengths to obtain nurturance and support, feels uncomfortable or helpless when alone, urgently seeks another relationship for care and support when a close relationship ends, is unrealistically preoccupied with fears of being left to care for him/herself.
59
What is obsessive personality disorder?
Think of a rules and routines freak
A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control that severely limits flexibility, openness, and efficiency as indicated by at least four of eight symptoms: is preoccupied with details, rules, and schedules so the major point of an activity is lost; shows perfectionism that interferes with task completion; is excessively devoted to work and productivity to the exclusion of leisure activities and friendships; is overly conscientious, scrupulous, and inflexible about morality, ethics, or values; is unable to discard worn-out or worthless objects even when they don’t have sentimental value; is reluctant to delegate work to others unless they’ll do it his/her way; adopts a miserly spending style toward self and others; shows rigidity and stubbornness.
60
Erectile disorder diagnosis?
Occurs for six months or more, 75% of the time.
61
Treatment for erectile dysfunction?
Sensate focus, which is a gradual exposure therapy to reduce anxiety.
62
Premature ejaculation treatment?
Sensate focus plus a SSRI or serotonin
diagnosis is Occurs for six months or more, 75% of the time.
63
Genito-Pelvic Pain/Penetration Disorder diagnosis?
Diagnosis Occurs for six months or more, and hurts being penetrated.
64
Genito-Pelvic Pain/Penetration Disorder Treatment?
Exercise, sensate focus
65
Female Orgasmic Disorder Treatment?
CBT, sensate, masturbation
66
Gender dysphoria: two models of care?
The dutch protocol blockers at 16 surgery at 18
the gender affirmation model which means if it's 6 months of age then go for it.
67
In terms of gender affirmation care, who does better?
well, the bullshit non-current evidence of APA says that it's better aftercare and males do better.
68
Paraphillic disorder treatment?
CBT and covert reconditioning(adverse reconditioning) and orgasmic reconditioning.
69
Tell me all about paraphillic disorders.
Doing fucked up shit that gets you off.
1. Frotteuristic Disorder: rubbing up against non-consenting people
2. Transvestic Disorder: cross-dressing to get off.
3. Pedophilic Disorder: getting off on kids being 13 or under, and you have to be 16 or older.
4. Fetishistic Disorder: sex doll, couch.
5. Exhibitionistic Disorder: exposing oneself to non-consenting.
70
Diagnosis for ODD?
1. angry/irritable
2. argumentative/defiant
3. vindictive
4 loses temper, angry, resentful, annoys others, blames others.
Greater than six months, 4 or more characteristics and in 30 percent of cases of conduct disorder, more males.
71
Diagnosis for Conduct disorder?
At least 3 characteristics in 12 months, and one symptom in the past six months-violates rights of others and social norms
1. aggression to people and animals
2. destruction of property
3. deceitfulness or theft
4. serious violation of rules
-3 subtypes
1. child and adolescent under 10 and level mild/moderate and severe.
72
Diagnosis for Intermittent explosive disorder?
-recurrent behavioural outbursts due to failure to control aggressive impulses
one of the following
1. verbal or physical aggression twice weekly for three months, no damage
2. three outbursts in 12 months that have caused damage
-must be non-proportional
must be six or older.
73
Etiology conduct disorder?
-multiple biological and environmental factors
e.g. neurotransmitters, prenatal exposure to drugs, and bad parenting.
1. serotonin and dopamine are linked to increased aggression, reduced sensitivity to punishment, and increased risk-taking behaviours.
-cortisol and cardio response do not go up during stress.
-poorer coordination between emotional and physical
-
74
Moffit describes types of antisocial behaviour in relation to CD. What are they?
1. life-course persistent type--which begins in childhood, think environmental and biological.
2. adolescence type--- which is temporary and due to maturity gap.
75
List the treatment types for conduct disorder that are parent-focused and describe them.
1. Parent-focussed interventions--age 2-18, teach better parenting.
2. kazdins parent management training operant conditioning reinforcing the right thing it's best when combined with PSST
3. parent-child interaction therapy- (2-7) modify parent-child interactions and teach positive parent interactions.
76
Describe child-focused intervention for Conduct disorder?
1. child-focussed(problem-solving skills training)---problem-solving
skills, allows them to understand and feel, and problem-solve
77
Describe family-focused intervention for conduct disorder?
functional family therapy
age 11-18
has an externalizing behaviour disorder and/or substance use problem or is at high risk for delinquency.
multidimensional family therapy
age 11-21
has a substance use disorder and comorbid internalizing or externalizing symptoms and/or delinquency.
78
Does scared straight work?
Nope it actually makes things worse
79
Why would one have multisystemic interventions for conduct disorder?
It's for those 12-18 at imminent risk for out-of-home placement due to antisocial behaviors, substance use problems, and/or serious psychiatric problems.
-problematic behaviours are the result of multiple risk factors at individual, family, peer, school, and community levels and interventions must be provided at all levels.
-equally effective for all types.
80
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
D. covert sensitization and orgasmic reconditioning
81
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.
B. rubbing up against a nonconsenting person.
82
Which of the following is most likely to be an effective pharmacological treatment for premature ejaculation?
A. an MAOI
B. an SSRI
C. a beta-blocker
D. an anti-seizure medication
B. an SSRI
83
Which of the following is considered to be the first-line treatment for female orgasmic disorder?
A. sensate focus
B. start-stop technique
C. orgasmic reconditioning
D. directed masturbation
D. directed masturbation
84
To assign a DSM-5-TR diagnosis of pedophilic disorder to a client, the client must be at least _____ years old.
A. 20
B. 18
C. 16
D. 14
C. 16
85
The development of sensate focus by Masters and Johnson (1970) was based on their assumption that most sexual problems are related to:
A. performance anxiety.
B. communication deficits.
C. dissatisfaction with sexual partners.
D. exposure to sexual trauma.
A. performance anxiety.
86
What is PICA and diagnosis?
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.
87
What is anorexia nervosa and diagnosis?
This disorder involves a restriction of energy intake that causes a significantly low body weight for the person’s age, sex, developmental trajectory, and physical health.
1. an intense fear of gaining weight or becoming fat or engage in behavior that interferes with weight gain
2. fucked up perspective on their weight, health, etc.
-measure by severity, in remission, or partial
-comorbidity, depression, anxiety, ocd
-can be binge-eating/purging, or starving.
88
What is bulimia nervous diagnosis?
-recurrent episodes of binge eating that are accompanied by a sense of a lack of control, inappropriate compensatory behavior to prevent weight gain (e.g., self-induced vomiting, excessive exercise), and self-evaluation that’s excessively influenced by body shape and weight. For the diagnosis, binge eating and compensatory behavior must occur at least once a week for three months or more.
****usually in normal weight range unlike anorexia nervosa
89
What is enuresis?
which involves repeated voiding of urine into the bed or clothing, with urination either occurring two or more times a week for at least three consecutive months or causing significant distress or impaired functioning.
90
treatment for enuresis?
-bed wetting alarm
-aniduretic hormone desmopressin
91
Diagnosis for insomia disorder?
-dissatisfaction with sleep quality or quantity that’s associated with one or more of three symptoms: difficulty initiating sleep; difficulty maintaining sleep; early-morning awakening with an inability to return to sleep. For the diagnosis, the sleep disturbance must occur at least three nights a week, have been present for at least three months,
92
Diagnosis for narcolepsy?
-an irrepressible need to sleep that causes sleep or daytime naps at least three times a week for three months or more. The diagnosis requires episodes of cataplexy (loss of muscle tone), hypocretin deficiency, or a rapid eye movement latency of 15 minutes or less as determined by nocturnal sleep polysomnography.
93
Diagnosis for non-rapid movement sleep arousal disorders?
include sleepwalking and sleep terrors, which involve recurrent episodes of incomplete awakening from sleep that usually occur during Stage 3 or 4 sleep in the first third of a major sleep period.
94
What is nightmare disorder?
Repeated occurrences of extended, extremely dysphoric, and well-remembered dreams that usually involve efforts to avoid threats to survival, security, or physical integrity. Nightmares usually occur during rapid eye movement (REM) sleep in the second half of a major sleep period.
95
tell me about treatment for anorexia nervousa?
1. get to a healthy weight and address health concerns.
2. get them into treatment
3. identify goals.
4 identify problems
5. CBTE
6. family support
7. address relapse
******not motivated to change
drugs that help include
antipsychotic olanzapine for getting weight
SSRT fluoxetine weight maintenance.
96
treatment for bullimia nervousa
similar to anorexia
1. FBT outpatient
2. CBTE
3. fluoxetine
CBT and SSRI (fluoxetine is the best)
in person is better than telepsychology for treatment outcomes
97
treatment for Sleep disorder?
multi-component cognitive-behavioral intervention that incorporates stimulus control or sleep restriction with sleep-hygiene education, relaxation training, and/or cognitive therapy
98
Treatment for binge eating?
CBTE is the best
meds work but CBTE is the best and combining them don't help
meds include fluoxetine, paroxetine, setraline.
99
treatment for narcolepsy?
1. good sleep habits, taking daytime naps, and staying active.
2. meds that increase dopamine levels and serotonin (amphetamines and other psychostimulants)
100
The presence of which of the following is required for a DSM-5-TR diagnosis of anorexia nervosa?
A. an apparent lack of interest in eating and food
B. recurrent episodes of binge-eating and purging
C. an intense fear of gaining weight or becoming fat
D. extreme sensitivity to the sensory characteristics of food
C. an intense fear of gaining weight or becoming fat
101
When the retrospective subjective reports of people with insomnia disorder about their sleep are compared to objective measures, the subjective reports tend to:
A. underestimate their sleep latency and overestimate total time they sleep each night.
B. underestimate their sleep latency and total time they sleep each night.
C. overestimate their sleep latency and underestimate total time they sleep each night.
D. overestimate their sleep latency and total time they sleep each night.
C. overestimate their sleep latency and underestimate total time they sleep each night.
102
For a DSM-5-TR diagnosis of bulimia nervosa, a person must exhibit characteristic symptoms for at least:
A. three weeks.
B. three months.
C. six weeks.
D. six months.
B. three months.
103
The treatment of insomnia disorder ordinarily includes which of the following?
A. positive practice or sleep restriction
B. positive practice or habit reversal training
C. stimulus control or overcorrection
D. stimulus control or sleep restriction
D. stimulus control or sleep restriction
104
Hypnopompic hallucinations are vivid dreams that occur:
A. immediately before an episode of REM sleep.
B. immediately after an episode of REM sleep.
C. just after awakening from sleep.
D. just before falling asleep.
C. just after awakening from sleep.
105
Sleepwalking and sleep terrors usually occur:
A. during Stage 1 or 2 sleep in the middle of a major sleep period.
B. during Stage 3 or 4 sleep in the first third of a major sleep period.
C. during REM sleep in the middle of a major sleep period.
D. during REM sleep in the first third of a major sleep period.
B. during Stage 3 or 4 sleep in the first third of a major sleep period.
106
When assigning a DSM-5 diagnosis of conduct disorder, severity is determined by considering which of the following?
A. number of conduct problems
B. number of conduct problems and severity of harm to others
C. degree of guilt and empathy
D. number of conduct problems and degree of guilt and empathy
B. number of conduct problems and severity of harm to others
107
According to Moffitt (1993), which of the following explains the adolescence-limited type of antisocial behavior?
A. a maturity gap
B. developmental delays
C. an adverse child-rearing environment
D. adolescent egocentrism
A. a maturity gap
108
The symptoms of oppositional defiant disorder are grouped in DSM-5 into three categories that include all of the following except:
A. argumentative/defiant behavior.
B. vindictiveness.
C. deceitfulness/dishonesty.
D. angry/irritable mood.
C. deceitfulness/dishonesty.
109
A pattern of emotional dysregulation is characteristic of:
A. oppositional defiant disorder and conduct disorder.
B. oppositional defiant disorder.
C. conduct disorder.
D. neither oppositional defiant disorder nor conduct disorder.
B. oppositional defiant disorder.
110
The DSM-5 diagnosis of conduct disorder requires the presence of at least three characteristic symptoms during the last _____ months and at least one symptom in the last _____ months.
A. 6; 3
B. 12; 3
C. 12; 6
D. 18; 6
C. 12; 6
111
Your new client’s aggressive behaviors seem to meet the diagnostic criteria for intermittent explosive disorder. To assign this diagnosis to the client, he must be at least _____ years old.
A. four
B. six
C. nine
D. twelve
B. six
112
Which of the following therapies is based on Bronfenbrenner’s ecological model and is for adolescents 12 to 18 years of age who are at imminent risk for out-of-home placement due to antisocial behaviors, substance use problems, and/or serious psychiatric problems?
A. multidimensional family therapy
B. multisystemic therapy
C. parent-child interaction therapy
D. functional family therapy
B. multisystemic therapy
113
What are the criteria for separation anxiety disorder?
3 of 8 symptoms
4 weeks for a child
6 months for an adult
-inappropriate and excessive fear or anxiety about being separated from attachment figures
-often develops after a stressful event.
114
treatment of separation anxiety and co-morbidity's
-school refusal
-CBT and parent training, which is best when combined together.
115
Social anxiety disorder diagnosis-treatment?
Fear or anxiety reaction to at least one social situation in which the person may be exposed to scrutiny by others.
-at least six months
-CBT the best no difference between it and telepsychology.
-cognitive restructuring and exposure
CBT and SSRI first line of defence
-
116
What is a panic disorder?
-Recurrent unexpected panic attacks with at least one attack being followed by one month or more of persistent concern about additional attacks or their consequences and/or a significant maladaptive change in behavior related to the attack.
-four of 13 symptoms: e.g., heart palpitations, sweating, nausea or abdominal distress, dizziness, fear of losing control or “going crazy,” fear of dying, paresthesia, derealization or depersonalization(surreal feeling).
117
Treatment for panic disorder?
-CBT introceptive exposure----deliberately exposing the person to the physical symptoms associated with panic attacks by, for example, having the person run in place, spin in a circle, or breathe through a straw.
-antidepressants work but have a high relapse rate when used alone.
118
Agoraphobia diagnosis?
-fear or anxiety that occurs in at least two of five situations: using public transportation, being in open spaces, being in enclosed spaces, standing in line or being in a crowd, and being outside the home alone
-six or more months
-fear is based upon the idea that if trouble comes, there is no way to get help or help would be unavailable.
119
Describe some therapy ways to deal with fear.
-In vivo exposure: Directly facing a feared object, situation or activity in real life. For example, someone with a fear of snakes might be instructed to handle a snake, or someone with social anxiety might be instructed to give a speech in front of an audience. (can be grades or non-graded_
-Imaginal exposure: Vividly imagining the feared object, situation or activity. For example, someone with Posttraumatic Stress Disorder might be asked to recall and describe his or her traumatic experience in order to reduce feelings of fear.
-Virtual reality exposure: In some cases, virtual reality technology can be used when in vivo exposure is not practical. For example, someone with a fear of flying might take a virtual flight in the psychologist's office, using equipment that provides the sights, sounds and smells of an airplane.
-Interoceptive exposure: Deliberately bringing on physical sensations that are harmless, yet feared. For example, someone with Panic Disorder might be instructed to run in place in order to make his or her heart speed up, and therefore learn that this sensation is not dangerous.
120
Diagnosis for specific phobia?
-Intense fear of or anxiety about a specific object or situation accompanied by avoiding the object or situation or enduring it with intense distress.
-six or more months
-onset usually 10 twice as common in girls than boys
-
121
Explain Mowrers two-factor theory regarding phobias
-it's based upon classical and operant conditioning.
122
What is the gold standard for the treatment of phobia's
exposure and response prevention
123
Which therapy for phobia's is the best.
-Graded vs non graded(flooding) flooding may be better but client's are more comfortable with graded.
-vr is the same as real
-in vivo is better than introceptive.
-Applied tension can be really helpful in terms of fainters.
124
What is the diagnosis for GAD?
-Excessive anxiety and worry about multiple events or activities that occur on most days for at least six months.-three of the symptoms.
125
What is going on in the brain for GAD?
Reduced connectivity between regions of the prefrontal cortex and anterior cingulate cortex and the amygdala
126
Treatment for GAD
CBT and SSRI
combined treatment best, CBT, SSRI, Motivational interviewing
127
OCD diagnosis?
-Current obsessions and/or compulsions that are time-consuming (consume more than one hour each day) and/or cause significant distress or impaired functioning:
-90% have and anxiety or depression co-morbidity.
128
OCD treatment?
CBT exposure therapy relapse prevention, in combination with an SSRI
129
OCD-neurotransmitter?
-lower level of serotonin elevated levels in the caudate nucleus, orbitofrontal cortex.
130
Body dysmorphic disorder diagnosis?
-a preoccupation with a perceived defect or flaw in physical appearance that’s not observable or appears to be minor to other people.
131
The DSM-5 diagnosis of agoraphobia requires:
A. a duration of symptoms for at least 12 months.
B. a history of at least one expected or unexpected panic attack.
C. marked fear or anxiety in at least two different situations.
D. a fear of being negatively evaluated.
C. marked fear or anxiety in at least two different situations.
132
The most common comorbid psychiatric disorder for obsessive-compulsive disorder is:
A. a depressive or bipolar disorder.
B. an anxiety disorder.
C. a substance use disorder.
D. an impulse control disorder.
B. an anxiety disorder.
133
A DSM-5-TR diagnosis of separation anxiety requires a duration of symptoms of at least __________ for children and adolescents and __________ for adults.
A. 2 weeks; one month
B. 4 weeks; three months
C. 4 weeks; six months
D. 6 weeks; four months
C. 4 weeks; six months
134
Interoceptive exposure involves:
A. exposing the individual to bodily sensations associated with a panic attack.
B. exposing the individual in virtual reality to stimuli that elicit a panic attack.
C. having the individual use applied relaxation during exposure to stimuli that elicit a panic attack.
D. having the individual use applied tension during exposure to stimuli that elicit a panic attack.
A. exposing the individual to bodily sensations associated with a panic attack.
135
Bill has just received a diagnosis of specific phobia, blood-injection-injury type. The most effective treatment for Bill is likely to be exposure and response prevention and:
A. a beta-blocker.
B. an anxiolytic.
C. applied relaxation.
D. applied tension.
D. applied tension.
136
The treatment-of-choice for obsessive-compulsive disorder (OCD) is which of the following?
A. systematic desensitization
B. exposure and applied relaxation
C. exposure and response prevention
D. covert desensitization
C. exposure and response prevention
137
Data from the Global Burden of Disease study indicate that which of the following is the most common mental disorder worldwide?
A. anxiety disorders
B. alcohol use disorder
C. schizophrenia
D. depression
A. anxiety disorders
138
Research comparing the effectiveness of guided internet-delivered cognitive behavior therapy (iCBT) and face-to-face cognitive behavior therapy (CBT) as a treatment for adults with social anxiety disorder has found that:
A. guided iCBT is significantly more effective than face-to-face CBT in terms of symptom reduction.
B. face-to-face CBT is significantly more effective than iCBT in terms of symptom reduction.
C. guided iCBT and face-to-face CBT are essentially equivalent in terms of symptom reduction.
D. guided iCBT and face-to-face CBT are essentially equivalent in terms of symptom reduction only for adults with mild symptoms.
C. guided iCBT and face-to-face CBT are essentially equivalent in terms of symptom reduction.
139
As described in the DSM-5-TR, the symptoms of a panic attack include all of the following except:
A. exaggerated startle reaction.
B. heart palpitations or an accelerated heart rate.
C. derealization or depersonalization.
D. fear of losing control.
A. exaggerated startle reaction.
140
Which of the following would be most helpful for confirming that the correct DSM-5-TR diagnosis for a client is agoraphobia?
A. The client’s anxiety occurs in situations that remind him of the traumatic event that preceded the onset of his symptoms.
B. The client’s anxiety occurs only in unfamiliar situations or with unfamiliar people.
C. The client’s anxiety is related to a fear of being negatively evaluated by others.
D. The client’s anxiety is related to a fear of being unable to get help if he develops panic-like symptoms.
D. The client’s anxiety is related to a fear of being unable to get help if he develops panic-like symptoms.
141
Delirium what is it and diagnosis?
think delirious
(A) a disturbance in attention and awareness that develops over a short period of time (often hours to a few days), represents a change from baseline attention and awareness and tends to fluctuate in severity over the course of the day plus
(b) at least one additional disturbance in cognition (e.g., a memory or language impairment).
142
What type of drugs may reduce delirium?
antipsychotics such as halperidol
143
What is a major and mild neurocognitive disorder?
-Cognitive dysfunction that’s acquired rather than developmental.
-a significant decline from a previous level of functioning in one or more cognitive domains
144
Alzheimer's disease account for what percentage of NCD?
60-80 percent
145
Diagnosis for Alzeimer's?
1. meets criteria for NCD
2. insidious onset and gradual decline, 1 cognitive domain for mild, 2 for major.
3. related to a causative genetic mutation.
4. often related to chromosomal mutation.
146
Prevalence rate for Alzheimer's?
1. women higher than men
2. blacks, Hispanics, and whites.
147
Causes of Alzheimer's?
linked to chromosomal, neurotransmitter, and brain abnormalities
148
Neurotransmitter associated with Alzheimer's?
Reduced acetylcholine (ACh) and excessive glutamate are both known to be involved in learning and memory.
149
Brain abnormalities with Alzeimer's?
Amyloid plaques and neurofibrillary tangles, which disrupt cell-to-cell communication
150
What sense loss is associated with Alzeimer's?
Rapid deterioration in the sense of smell during a period of normal cognition predicts the subsequent development of mild cognitive impairment or Alzheimer’s disease, with greater olfactory loss associated with greater cognitive impairment.
151
List the treatment for Alzheimer's?
-Cholinesterase inhibitors and memantine are used to reduce or stabilize memory loss, confusion, and other cognitive symptoms.
-Cholinesterase inhibitors include donepezil and rivastigmine and delay the breakdown of ACh, while memantine is an NMDA receptor antagonist and regulates glutamate activity.
-CBT
-atidepressants to reduce depression and anxiety
-antipsychotics to reduce aggression.
-
152
Neurocognitive Disorder with Lewy Bodies?
its due to build up of protein in lewy bodies.
153
What is the difference between NCD due to lewy bodies and alzheimer's?
In LEWY the prominent early cognitive symptoms are deficits in complex attention and visuospatial and executive functions
In Alzheimer's, the prominent early cognitive symptoms are deficits in learning and memory.
154
Vascular neurognitive disorder are consistent with what?
stroke or other cerebrovascular event or by a prominent decline in complex attention and executive functioning; and there’s evidence of cerebrovascular disease from the individual’s history, a physical exam, or neuroimaging
155
Neurocognitive Disorder due to HIV Infection: diagnosis?
Neurocognitive Disorder due to HIV Infection:
-damage to subcortical areas of the brain and include forgetfulness, impaired attention and concentration, cognitive slowing, psychomotor retardation, clumsiness, tremors, apathy, and social withdrawal.
156
neurocognitive disorder due to Prion disease diagnosis?
The criteria for major or mild NCD, symptoms have an insidious onset followed (in most cases) by a very rapid progression of impairment, and symptoms include motor features associated with prion disease, or there’s biomarker evidence of the disease (e.g., characteristic lesions on an MRI). The most common type is Creutzfeldt-Jakob disease (CJD)
157
Frontotemporal Neurocognitive Disorder onset?
earliest onset prior to 65.
-however, does not have significant impact on learning, memory, or perceptual motor functioning.
different variants.
behavior, language,
158
Identifying the temporal sequence of the onset of motor and cognitive symptoms is most useful for distinguishing between NCD due to Parkinson’s disease and:
A. NCD due to HIV infection.
B. NCD with Lewy bodies.
C. NCD due to prion disease.
D. vascular NCD.
B. NCD with Lewy bodies.
159
The DSM-5 requires the presence of which of the following for a diagnosis of delirium?
A. disorientation to time and place
B. impaired attention and awareness
C. a perceptual disturbance
D. impaired memory
B. impaired attention and awareness
160
Beth, a 68-year-old retired physician exhibits impaired attention and judgment, seems disoriented, and has short-term memory loss that she doesn’t seem to be aware of. Her husband tells you that she “just hasn’t seemed the same” for the past year or so and that the changes he’s noticed have occurred gradually. Beth’s symptoms are most suggestive of which of the following?
A. major depressive disorder (pseudodementia)
B. persistent depressive disorder
C. neurocognitive disorder due to Alzheimer’s disease
D. neurocognitive disorder due to Prion’s disease
C. neurocognitive disorder due to Alzheimer’s disease
161
Early memory loss associated with NCD due to Alzheimer’s disease has been linked to lower-than-normal levels of which of the following in the hippocampus, cortex, and basal forebrain?
A. epinephrine
B. norepinephrine
C. GABA
D. ACh
D. ACh
162
Which of the following is not one of the DSM-5 diagnostic criteria for the behavioral variant of frontotemporal neurocognitive disorder?
A. dietary changes
B. loss of empathy
C. ataxia
D. apathy
c. ataxia, which means
condition that affects muscle coordination and can cause clumsy movements, balance problems, speech difficulties and more
163
Research has found that, on the Revised NEO Personality Inventory, people with Alzheimer’s disease often obtain:
A. high scores on neuroticism and conscientiousness.
B. low scores on neuroticism and conscientiousness.
C. high scores on neuroticism and low scores on conscientiousness.
D. low scores on neuroticism and high scores on conscientiousness.
C. high scores on neuroticism and low scores on conscientiousness.
164
Neurocognitive disorders that are due to prion disease most often have a:
A. very rapid progression of impairment.
B. gradual and steady progression of impairment.
C. stepwise progression of impairment.
D. fluctuating course with plateaus of impairment.
A. very rapid progression of impairment.
165
reactive attachment disorder diagnosis?
(a) a persistent pattern of inhibited and emotionally withdrawn behavior toward adult caregivers as demonstrated by a lack of seeking or responding to comfort when distressed
(b) persistent social and emotional disturbances that include at least two of the following: minimal social and emotional responsiveness to others; limited positive affect; unexplained irritability, sadness, or fearfulness when interacting with adult caregivers.
history of extreme insufficient care that is believed to be responsible for the person’s symptoms
-onset of symptoms must have been before 5 years of age, and the person must have a developmental age of at least nine months.
166
Disinhibited Social Engagement Disorder diagnosis?
-persistent pattern of behavior that’s characterized by inappropriate interactions with unfamiliar adults as demonstrated by at least two of four symptoms:
reduced or absent reticence in approaching or interacting with strangers, overly familiar behavior with strangers, diminished or absent checking with adult caregivers after being separated from them, willingness to accompany a stranger with little or no hesitation.
167
PTSD diagnosis?
-symptoms greater than one month
-distress or impaired functioning
-due to exposure
4 types, avoidance, intrussion-intrusive thoughts, negative changes in mood or cognition, alterations in arousal and activity.
168
What brain abnormalities have been linked with PTSD?
-Hyperactive amygdala and anterior cingulate cortex
-hypoactive ventromedial prefrontal cortex, and a reduced volume of the hippocampus
-reduced activity in the ventromedial prefrontal that reduces inhibitory top-down control of the amygdala, resulting in an exaggerated fear response
-
169
What neurotransmitters have been associated with PTSD?
Increased levels and activity of dopamine, norepinephrine, and glutamate and decreased levels and activity of serotonin and GABA (Sherin & Nemeroff, 2011).
170
Treatment for PTSD?
CBT, exposure therapy, EMDR, ART
171
What are the treatment outcomes for PTSD for telepsychology and in-person?
Relatively the same. but the therapeutic alliance is unknown.
172
What are the drugs recommended for PTSD?
SRIs fluoxetine, paroxetine, and sertraline and the SNRI venlafaxine.
173
acute stress disorder diagnosis?
-exposure to actual or threatened death, severe injury, or sexual violation.
-The person must also have at least nine symptoms from any of five categories (intrusion, negative mood, dissociative symptoms, avoidance, arousal), and symptoms must have lasted for three days to one month and cause significant distress or impaired functioning.
174
prolonged grief disorder diagnosis?
exposure to actual or threatened death, severe injury, or sexual violation. The person must also have at least nine symptoms from any of five categories (intrusion, negative mood, dissociative symptoms, avoidance, arousal), and symptoms must have lasted for three days to one month and cause significant distress or impaired functioning.
175
Dissociative amnesia diagnosis?
nability to recall important personal information that cannot be attributed to ordinary forgetfulness and causes significant distress or impaired functioning.
types:
-selective
-sytematized
-continuous
176
somatic symptom disorder diagnosis?
Excessive thoughts, emotions, or behaviors related to the symptom(s) or associated health concerns as indicated by the presence of at least one of the following: -disproportionate or persistent thoughts about the seriousness of the symptoms, a persistently high level of anxiety about health or symptoms, excessive time and energy spent on health concerns or symptoms. Specifiers are used to indicate if symptoms are mild, moderate, or severe, involve predominant pain, and are persistent (are severe, have caused marked impairment, and have lasted more than six months).e severe, have caused marked impairment, and have lasted more than six months).
-physical symptoms
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Illness Anxiety Disorder:
a preoccupation with having a serious illness with no or mild somatic symptoms, excessive anxiety about health, and either excessive health-related behaviors or avoidance of health care. Symptoms must be present for at least six months, although the nature of the symptoms may vary over time.
-no physical symptoms
178
Functional Neurological Symptom Disorder (Conversion Disorder):
This disorder is characterized by one or more symptoms that involve a disturbance in voluntary motor or sensory functioning (e.g., paralysis, blindness).
-
179
Factitious Disorder diagnosis?
-factitious disorder imposed on self and factitious disorder imposed on another. Individuals with factitious disorder imposed on self falsify or induce physical or psychological symptoms that are associated with a deception (e.g., ingestion of a drug to produce abnormal lab results). They present themselves to others as being ill or impaired and engage in the deception even when there’s no obvious external reward for doing so. Factitious disorder imposed on another has the same symptoms except that they’re induced in another person (often in a child by his/her mother).
180
What is malingering?
consciously faking for a reason of externalized reward, test of memory malingering will indicate as real memory loss is cloudy, and they think clues can help malingering will not.
181
To assign a DSM-5-TR diagnosis of posttraumatic stress disorder (PTSD), symptoms must have a duration of more than:
A. seven days for adults and adolescents and 14 days for children.
B. 14 days for adults, adolescents, and children.
C. one month for adults and adolescents and two months for children.
D. one month for adults, adolescents, and children.
D. one month for adults, adolescents, and children.
182
Which of the following is likely to be the least effective treatment for an adult with posttraumatic stress disorder (PTSD)?
A. cognitive behavioral therapy
B. psychological debriefing
C. cognitive processing therapy
D. prolonged exposure therapy
B. psychological debriefing
183
A DSM-5-TR diagnosis of somatic symptom disorder requires the presence of one or more somatic symptoms that are:
A. accompanied by excessive thoughts, feelings, or behaviors related to the symptoms.
B. being intentionally produced, faked, or exaggerated in terms of severity.
C. related to exposure to a traumatic event.
D. incompatible with any known medical condition.
A. accompanied by excessive thoughts, feelings, or behaviors related to the symptoms.
184
A six-year-old child of divorced parents experiences abdominal pain, vomiting, and diarrhea whenever she stays with her mother but has no symptoms when she stays with her father or other relative. This situation is most suggestive of:
A. functional neurological symptom disorder.
B. malingering.
C. factitious disorder.
D. somatic symptom disorder.
C. factitious disorder.
185
Neuroimaging studies have linked PTSD to:
A. decreased activity in the ventromedial prefrontal cortex and amygdala
B. increased activity in the ventromedial prefrontal cortex and amygdala
C. decreased activity in the ventromedial prefrontal cortex and increased activity in the amygdala
D. increased activity in the ventromedial prefrontal cortex and decreased activity in the amygdala.
C. decreased activity in the ventromedial prefrontal cortex and increased activity in the amygdala
186
Peter Lewinsohn’s model of depression is based on the principles of:
A. operant conditioning.
B. classical conditioning.
C. systems theory.
D. psychodynamic theory.
A. operant conditioning.
187
Barton, a 20-year-old college sophomore, has come to therapy at the urging of his parents who are concerned about recent changes in his behavior. Barton tells you that, in the last six months, he’s experienced several periods in which he feels tired all the time despite sleeping more than usual, has trouble concentrating while reading for his classes and studying for exams, has low energy, and has no appetite. He says that each of the times he’s felt this way lasted for two or three weeks. The presence of which of the following will confirm a diagnosis of major depressive disorder for Barton?
A. recurrent suicidal ideation with a specific plan
B. a loss of interest or pleasure in most activities
C. feelings of guilt about past failures
D. slowed speech and thinking
B. a loss of interest or pleasure in most activities
188
Which of the following best describes the likely effects of electroconvulsive therapy (ECT) on memory when it is used as a treatment for severe depression?
A. Anterograde amnesia caused by ECT will be more persistent than retrograde amnesia.
B. Retrograde amnesia caused by ECT will be more persistent than anterograde amnesia.
C. ECT will produce transient anterograde amnesia but will not cause retrograde amnesia.
D. ECT will produce transient retrograde amnesia but will not cause anterograde amnesi
B. Retrograde amnesia caused by ECT will be more persistent than anterograde amnesia.
189
Which of the following symptoms is least useful for distinguishing bipolar disorder from ADHD in children and adolescents?
A. irritability
B. decreased need for sleep
C. hypersexuality
D. flight of ideas
A. irritability
190
Your new client, a 29-year-old physician’s assistant, describes experiencing alternating periods of hypomania that do not meet the criteria for a hypomanic episode and periods of depression that do not meet the criteria for a major depressive episode. To assign the diagnosis of cyclothymic disorder, the client must have experienced these symptoms for at least:
A. 6 months.
B. 1 year.
C. 18 months.
D. 2 years.
D. 2 years.
191
Ketamine has been found most useful for treating:
A. manic episodes.
B. atypical depression.
C. major depressive disorder with seasonal pattern.
D. treatment-resistant depression.
D. treatment-resistant depression.
192
Which of the following best describes rates of depression for males and females?
A. The rates of depression for females are twice as high as the rates for males in childhood, adolescence, and adulthood.
B. The rates of depression for males are twice as high as the rates for females in childhood, but the rates for females are higher in adolescence and adulthood.
C. The rates of depression for males and females are similar during childhood but the rates for females are higher in adolescence and adulthood.
D. The rates of depression for males and females are similar during childhood, but the rates for males are higher in adolescence and adulthood.
C. The rates of depression for males and females are similar during childhood but the rates for females are higher in adolescence and adulthood.
193
A higher-than-normal level of melatonin has been linked to which of the following?
A. bipolar I disorder
B. bipolar II disorder
C. major depressive disorder with seasonal pattern
D. major depressive disorder with peripartum onset
C. major depressive disorder with seasonal pattern
194
As a treatment for major depressive disorder, _______ has the highest response and remission rates and fastest time to remission.
A. CBT
B. rTMS
C. ECT
D. SSRI
C. ECT
195
Research has found that the experience of depression is associated with:
A. hyperactivity in the ventromedial prefrontal cortex and dorsolateral prefrontal cortex.
B. hyperactivity in the ventromedial prefrontal cortex and hypoactivity in the dorsolateral prefrontal cortex.
C. hypoactivity in the ventromedial prefrontal cortex and hyperactivity in the dorsolateral prefrontal cortex.
D. hypoactivity in the ventromedial prefrontal cortex and dorsolateral prefrontal cortex.
B. hyperactivity in the ventromedial prefrontal cortex and hypoactivity in the dorsolateral prefrontal cortex
196
What is a manic episode?
It is abnormally and persistently elevated, expansive, or irritable mood and increased activity or energy for at least one week.
It includes three or more characteristic symptoms.
1. inflated self-esteem or grandiosity
2. decreased need for sleep
3. flight of ideas
4. marked impairment in functioning
5. a need for hospitalization to avoid harm to self or others
6. and/or the presence of psychotic features
197
what is a hypomanic episode?
-It's less severe than manic.
-no psychotic features, or possible harm or hospitalization
three or more symptoms.
-at least 4 days.
1. inflated self-esteem or grandiosity
2. decreased need for sleep
3. flight of ideas
4. marked impairment in functioning
198
What is the diagnosis for major depressive disorder?
The diagnosis of major depressive disorder requires five or more symptoms of a major depressive episode for at least two weeks.
-with at least one symptom being depressed mood or loss of interest or pleasure in most or all activities.
symptoms
1. depressed mood most of the day, nearly every day, sad, hopeless, in children and adolescents, it can be an irritable mood.
2. marked diminished interest or pleasure in most or all activities.
3. significant weight loss, or gain
4. insomnia or hypersomnia(excessive sleeping)
5. psychomotor agitation or retardation
6. fatigue or energy loss
7. feelings of worthlessness or excessive guilt.
8. diminished ability to think
9. recurrent thoughts of death, suicidal ideations.
199
What is the diagnosis of persistent depressive disorder?
-Requires a depressed mood with two or more characteristic symptoms (e.g., poor appetite or overeating, insomnia or hypersomnia, feelings of hopelessness) for at least two years in adults or one year in children and adolescents.
3. significant weight loss or gain
4. insomnia or hypersomnia(excessive sleeping)
6. fatigue or energy loss
7. feelings of worthlessness or excessive guilt.
8. diminished ability to think
9. feelings of hopelessness.
200
bipolar considers what episodes?
manic
hypomanic
depressive
201
What is disruptive mood dysregulation disorder diagnosis?
-disruptive mood dysregulation disorder requires the presence for at least 12 months (a) severe and recurrent temper outbursts that are verbal and/or behavioural, are grossly out of proportion to the situation or provocation, and occur three or more times each week; and
(b) a persistently irritable or angry mood that is observable to others most of the day and nearly every day between outbursts.
202
Diagnosis of Bipoloar I?
bipolar I disorder requires at least one manic episode that may or may not have been preceded or followed by one or more major depressive or hypomanic episodes.
203
Bipolar II diagnosis?
bipolar II disorder requires at least one hypomanic episode and at least one major depressive episode.
204
Cyclothymic disorder diagnosis?
Cyclothymic disorder requires numerous periods of hypomanic symptoms that do not meet the criteria for a hypomanic episode and numerous periods of depressive symptoms that do not meet the criteria for a major depressive episode.
-The minimum duration of symptoms for cyclothymic disorder is two years for adults -or one year for children and adolescents.
205
suicide rate in order from race, gender, age?
males(75) much higher than females(45)
-race ---native, white, hispanics, blacks, asians,
overall whites-45-54
others-25-34
asians 85+
206
bipolar and adhd explain in terms of differential diagnosis?
Lots of overlap so look at what does not overlap.
AGE 7-16 elation, grandiosity, flight of ideas/racing thoughts, decreased need for sleep, and hypersexuality
AGE adults. manic episodes are typically characterized by a euphoric, elevated, or irritable mood; increased self-esteem or grandiosity; distractibility caused by thought acceleration; and a decreased need for sleep, usually without physical discomfort
207
Etiology or cause of bipolar disorder?
-Bipolar disorder has been linked to heredity, neurotransmitter and brain abnormalities.
-strong heredity twins studies have .67-1 for mono and .2 for dizygotic
-neurotransmitters include norepinephrine, serotonin, dopamine, and glutamate
-abnormalities have been found in several areas of the brain, including the prefrontal cortex, amygdala, hippocampus, and basal ganglia.
208
What is the treatment for bipolar disorder?
-psychosocial interventions and pharmacotherapy
-(such as psychoeducation, interpersonal and social rhythm therapy, CBT, family focussed therapy)
------Lithium prescribed drug of choice
-anticonvulsants and anti-psychotics most effective for atypical BPD
-(atypical being, weight gain, increase in appetite, hypersomnia, leaden paralysis, interpersonal rejection sensitivity)
209
What are the rates of depression e.g. male, female?
male vs female childhood the same
-adolescent females increase.
-in adulthood, females increase even more.
(why you ask) hormones in puberty tighten females, but deaden males.
210
What are the risk factors for major depressive disorder
AGE
CULTURE?
AGE
-in younger adult depression is linked to genetics, life events, problems, cognition
-they also refer to affective (mood)
-in older adults it has been linked to illness, social isolation, decreased physical functioning.
-they refer to somatic symptoms, cognition, loss of interest in activities.
CULTURE
Western it's psychological.
Non-western, it's somatic.
211
Major Depressive disorder co-morbidity?
1. substance abuse (alcohol)
2. anxiety disorder
3. personality disorder
4. sleep disorder
5. linked to heart disease, Parkinsons
212
Etiology or cause of major depressive disorder?
Heredity; neurotransmitter, hormone, and brain abnormalities; and cognitive and behavioural factors.
--some heredity as indicated in twin studies a .3-.5 vs .2 to .3 correlation not crazy high.
---Neurotransmitters, low levels of serotonin, dopamine, and norepinephrine.
---hyperactivity in the hypothalamic-pituitary-adrenal axis-hypersecretion of cortisol
---high levels of activity in the ventromedial prefrontal cortex (vmPFC) and abnormally low levels of activity in the dorsolateral prefrontal cortex (dlPFC)
213
Models to explain the etiology of major depressive disorder?
-----Lewinsohn’s social reinforcement theory
states that depression is caused by removing positive reinforcement from the environment. Certain events, such as losing your job, induce depression because they reduce positive reinforcement from others (e.g., being around people who like you).
-----Seligman’s learned helplessness model
According to Seligman’s learned helplessness theory, depression occurs when a person learns that their attempts to escape negative situations make no difference.
------Beck’s cognitive theory
(Beck's triad, schema's and faulty thinking)
214
Treatment of Major depressive disorder?
-no difference between psychotherapy and pharmacology.
-however they are better when combined together.
children----no evidence to support or recommend
Youth----CBT or IPTA (interpersonal therapy for adolescents)
(fluoxetine is the drug of choice)
Adults---drugs are SSRI or SNRI and/or psychotherapy
(therapies include CBT, Mindfullness based, interpersonal therapy, behavioral therapy, and psychodynamic)
---OLDER adults CBT or IPT, and second-gen anti-depressant.
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St. John's wort for depression; what is that all about?
-It is a herbal supplement that has been shown to be similar to SSRI for mild to moderate depression.
-
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ketamine for depression what is that all about?
Ketamine has been found to be effective as a fast-acting treatment for treatment-resistant depression (TRD) and suicidal ideation.
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Electroconvulsive therapy (ECT) for depression: what is that all about?
Has been shown to have a high success rate when used to treat severe depression but is ordinarily used only when other treatments have not been effective or when the severity of symptoms requires a quick treatment response (e.g., when the individual is at high risk for suicide).
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What does ECT therapy for depression do to memory?
That it causes both anterograde amnesia (an inability to form new memories after ECT) and retrograde amnesia (an inability to recall events that occurred before ECT)
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What is Repetitive transcranial magnetic stimulation (rTMS) for depression?
It uses a magnetic field to stimulate the left dorsolateral prefrontal cortex. Not as good as ECT but does not cause problems.
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Compare telepsychology to in-person for depression?
It's the same.
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What are common specifiers for depression?
1. peripartum onset--during pregnancy or the four weeks after delivery
---treatment CBT, setrolin but you have to be careful
2. seasonal pattern--symptoms include hypersomnia, overeating, weight gain, and a craving for carbohydrates. linked to a lower-than-normal level of serotonin and a higher-than-normal level of melatonin.
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Substance use disorder diagnosis?
a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems.
-2 or more characteristics within a 12 month period.
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Which commonly used substance drug is not included as a disorder?
Caffeine.
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What is a substance-induced disorder?
These disorders include
1.substance intoxication
2. substance withdrawal
3. substance/medication-induced mental disorders (e.g., substance-induced depressive disorder, anxiety disorder, major neurocognitive disorder, withdrawal delirium).
In addition, hallucinogen-induced disorders include hallucinogen persisting perceptual disorder.
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What is alcohol intoxication?
-problematic behavioral and psychological changes (e.g., inappropriate sexual or aggressive behavior, mood lability, impaired judgment)
-with at least 1 of 6 symptoms:
- slurred speech, incoordination, unsteady gait, nystagmus, impaired attention or memory, stupor or coma.
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Alcohol withdrawal symptoms?
two of eight symptoms that develop within several hours to a few days following cessation or reduction of heavy and prolonged alcohol use:
1. autonomic hyperactivity
2. hand tremor
3. insomnia
4. nausea or vomiting
5. transient hallucinations or illusions
6. anxiety
7. psychomotor agitation--unintentional and purposeless motions and restlessness,
8. generalized tonic-clonic seizures. (grand mal seizures).
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Alcohol-Induced Major Neurocognitive Disorder diagnosis?
significant decline in one or more cognitive domains that interferes with independence in everyday
-Korsakoff syndrome, which has been linked to a thiamine deficiency and involves anterograde and retrograde amnesia and confabulation.
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What are the signs of opioid intoxication?
-initial euphoria followed by apathy or dysphoria and impaired judgment) plus pupillary constriction and the development of at least one of three symptoms during or shortly after opioid use: drowsiness or coma, slurred speech, impaired attention or memo
-can occur with or without hallucinations.
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Opiod withdrawl symptoms?
dysphoric mood, nausea or vomiting, muscle aches, diarrhea, yawning, fever, insomnia.
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signs of stimulant intoxication?
-Euphoria or affective blunting, hypervigilance, interpersonal sensitivity, anxiety or anger, impaired judgment)
-and the development of at least two of nine symptoms during or shortly after stimulant use: tachycardia or bradycardia, pupillary dilation, elevated or lowered blood pressure, perspiration or chills, nausea or vomiting, weight loss, psychomotor agitation or retardation, respiratory depression or cardiac arrhythmia, seizures or coma.
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Signs of stimulant withdrawl?
dysphoric mood and at least two of five physiological changes that develop within a few hours to several days after cessation of prolonged stimulant use:
-fatigue, vivid and unpleasant dreams, insomnia or hypersomnia, increased appetite, psychomotor agitation or retardation.
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Signs of tobacco withdrawl?
four of seven symptoms that develop within 24 hours of abrupt cessation or reduction of the use of tobacco: irritability, anger or anxiety, impaired concentration, increased appetite, restlessness, depressed mood.
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What is Hallucinogen Persisting Perception Disorder?
-reexperiencing at least one of the perceptual symptoms that were experienced while intoxicated with LSD or other hallucinogen, with symptoms causing significant distress or impairment
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What is the general treatment model for substance-related disorders?
-treatment ordinarily includes individual, family, and/or group interventions and medication.
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What therapies are commonly used for substance-related disorders?
-cognitive behavioral therapy, motivational interviewing, contingency management, family behavior therapy, the community reinforcement approach, personalized normative feedback, text messages, relapse prevention therapy, and 12-step facilitation
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What therapeutic approach is best for substance-abuse-related disorders?
Combined e..g therapy and meds.
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What is Community Reinforcement Approach (CRA), or CRAFT for substance-abuse-related disorders?
based on the principles of operant conditioning and “helps people arrange their lifestyles so that healthy, drugfree living becomes rewarding and thereby competes with alcohol and drug use”
-The program works with a significant other to help influence the addict into making positive rewarding changes.
-the f is the involving of family
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Voucher-Based Reinforcement Therapy (VBRT): what is it?
-Giving patients vouchers that can be exchanged for goods and services in the community when they achieve treatment goals.
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How is voucher therapy compared to VBRT in terms of efficacy?
VBRT better in the short run less in the long rund
CBT better in the long run and less in the short run.
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What is Personalized Normative Feedback (PNF) therapy for substance abuse?
-perceptions of the prevalence of a given behavior influence one’s own behavior
-providing clients with information that allows them to compare the frequency of their own behavior and their perceived frequency for a typical person in their peer group to the actual average frequency for people in their peer group
-originally for alcohol use.
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text messaging efficacy for substance abuse?
Alone it's similar but it's better combined.
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Relapse prevention therapy what is it?
-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).
-uses CBT to form new learned habits
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What were the finding of project Match for substance abuse?
-compared the effectiveness of cognitive behavioral coping skills therapy, motivational enhancement therapy, and twelve-step facilitation.
-match the characteristics for treatment to characteristics of patients
12 step does a little better.
244
Whittaker et al.’s (2019) meta-analysis of research evaluating the effectiveness of text messaging as an intervention for smoking cessation found that, in terms of quit rates, text messaging alone was:
A. significantly more effective than other smoking cessation interventions alone (e.g., brief smoking cessation counseling).
B. about the same in terms of effectiveness as other smoking cessation interventions alone (e.g., brief smoking cessation counseling).
C. significantly less effective than other smoking cessation interventions alone (e.g., brief smoking cessation counseling).
D. significantly less effective than both minimal smoking cessation support alone (e.g., general health advice provided by a clinician) and other smoking cessation interventions alone (e.g., brief smoking cessation counseling).
B. about the same in terms of effectiveness as other smoking cessation interventions alone (e.g., brief smoking cessation counseling).
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Practitioners of which of the following interventions work with a family member of a person with a substance use disorder because the person with the disorder refuses to enter treatment?
A. CRA
B. CRAFT
C. VBRT
D. FFT
B. CRAFT
246
A cigarette smoker decides to quit “cold turkey.” Her withdrawal symptoms will most likely include which of the following?
A. autonomic hyperactivity, psychomotor agitation, and insomnia
B. lower blood pressure, cardiac arrhythmias, and confusion
C. irritability, impaired concentration, and insomnia
D. insomnia or hypersomnia, increased appetite, and psychomotor retardation
C. irritability, impaired concentration, and insomnia
247
As described by Marlatt & Gordon (1985), lapses following a period of abstinence are precipitated by which of the following?
A. high-risk situations
B. chronic stress
C. denial
D. lack of impulse control
A. high-risk situations
248
Symptoms of opioid withdrawal include which of the following?
A. nausea or vomiting, diarrhea, and fever
B. autonomic hyperactivity, hand tremor, and anxiety
C. irritability, impaired concentration, and increased appetite
D. pupillary dilation, nausea or vomiting, and weight loss
A. nausea or vomiting, diarrhea, and fever
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Personalized normative feedback (PNF) involves:
A. helping clients distinguish between prescriptive and proscriptive norms for a behavior.
B. helping clients identify how their personal norms for a behavior affect their behavior.
C. having clients compare the frequency of their own behavior to their perceived frequency of members of their peer group.
D. having clients compare the frequency of their own behavior and perceived norm for the behavior to the actual norm for that behavior.
D. having clients compare the frequency of their own behavior and perceived norm for the behavior to the actual norm for that behavior.
250
The amnestic-confabulatory type of alcohol-induced major neurocognitive disorder has been linked to a:
A. higher-than-normal cortisol level.
B. niacin deficiency.
C. blood dyscrasia.
D. thiamine deficiency.
D. thiamine deficiency.
