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Abnormal Psychology > Unit 3 (Final Exam) > Flashcards

Unit 3 (Final Exam) Flashcards

Chapters 12-14

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1
Q

positive symptoms of schizophrenia

A
  • excesses of thought, emotion, and behavior
  • includes delusions, hallucinations, disorganized thoughts/speech, heightened perceptions, inappropriate affect
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2
Q

delusions (schizophrenia)

A

delusions of persecution, delusions of reference, grandiose delusions

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3
Q

hallucinations (schizophrenia)

A
  • auditory most common, visual, tactile, smell, and taste very rare
  • PET scans show heightened activity in corresponding part of the brain during hallucination
  • people who are hallucinating seem to hear sounds produced by their own brains, but the brainss cannot recognize the sounds are actually coming from within
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4
Q

disorganized speech (schizophrenia)

A
  • loose association: derailment
  • neologisms: made-up words
  • preservation: patients repeat their words and statements again and again
  • clang: use of rhyme to think or express themselves, sound-alike associations
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5
Q

heightened perceptions (schizophrenia)

A

feeling that one’s senses are being flooded by sights and sounds, making it impossible to attend to anything important

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6
Q

inappropriate affect (schizophrenia)

A

emotional response doesn’t “fit” the situation

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7
Q

negative symptoms of schizophrenia

A
  • deficits of thoughts, emotion, and behavior
  • included affective flattening, alogia, avolition, anhedonia
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8
Q

affective flattening (blunted affect) (schizophrenia)

A

severe reduction or complete absence of effective (emotional) response to the environment

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9
Q

alogia (schizophrenia)

A

severe reduction or complete absence of speech

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10
Q

avolition (schizophrenia))

A

inability to persist at common, goal-oriented tasks

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11
Q

anhedonia (schizophrenia)

A

loss of pleasure in everything, indifference, social withdrawal

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12
Q

psychomotor symptoms of schizophrenia

A
  • unusual movements or gestures
  • includes awkward movements, repeated grimaces, odd gestures, catatonia
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13
Q

catatonia (schizophrenia)

A

pattern of extreme psychomotor symptoms which may include catatonic stupor, rigidity, or posturing

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14
Q

core symptoms of schizophrenia (per DSM-5 criteria)

A

at least two of the following for a period of at least a month
- delusions
- hallucinations
- disorganized speech
- grossly disorganized or catatonic behavior
- negative symptoms

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15
Q

social/occupational function of schizophrenia (per DSM-5 criteria)

A

significant impairment in work, academic performance, interpersonal relationships, and/or self-care

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16
Q

duration of schizophrenia (per DSM-5 criteria)

A

continuous signs of disturbance for at least 6 months; at least 1 month of this period must include core symptoms

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17
Q

multilevel diagnosis of schizophrenia

A

involves analysis of symptoms, functioning, and duration, along with elimination/ruling out of other causes

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18
Q

course of schizophrenia

A
  • from childhood past adolescence/young adulthood
  • premorbid phase: cognitive motor or social deficits
  • prodromal phase: brief/attenuated positive symptoms and/or functional decline, ends in first psychotic episode
  • psychotic phase: florid positive symptoms
  • stable phase: negative symptoms, cognitive/social deficits, functional decline
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19
Q

onset and prevalence of schizophrenia

A
  • about 0.2-1.5% of the world
  • often develops in early adulthood but can emerge whenever
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20
Q

gender differences of schizophrenia

A
  • affects males and females about equally
  • females tend to have a better long-term prognosis
  • onset differes
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21
Q

do genetics play a role in schizophrenia?

A

strong genetic component

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22
Q

pre-DSM-5 subtypes of schizophrenia

A
  • paranoid
  • disorganized
  • catatonic
  • undifferentiated (i.e.other)
  • residual (i.e. left over)
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23
Q

schizophrenia is chronic

A
  • most suffer with moderate-to-severe lifetime impairment
  • life expectancy is slightly less than average
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24
Q

paranoid schizophrenia

A
  • intact cognitive skills and affect
  • do not show disorganized behavior
  • hallucinations and delusions (Grandeur or persecution)
  • best prognosis of all types of schizophrenia
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25
Q

disorganized schizophrenia

A
  • marked disruption in speech and behavior
  • flat or inappropriate affect
  • hallucinations and delusions (tend to be fragmented)
  • develops early, tends to be chronic, lacks remissions
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26
Q

catatonic schizophrenia

A
  • show unusual motor response and odd mannerisms
  • examples include echolalia and echopraxia
  • “waxy flexibility”
  • tends to be severe and quite rare
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27
Q

undifferentiated schizophrenia

A
  • wastebasket category
  • major symptoms of schizophrenia
  • fail to meet criteria for another type
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28
Q

residual schizophrenia

A
  • one past episode of schizophrenia
  • continue to display less extreme residual symptoms
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29
Q

Type I schizophrenia

A

primarily positive symptoms, responds to drug therapy, better prognosis

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30
Q

Type II schizophrenia

A

primarily negative symptoms, often not responsive to drugs, prognosis poorer, but some newer drugs do seem more helpful for negative symptoms

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31
Q

schizophreniform disorder

A

schizophrenic symptoms for one to six months

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32
Q

schizoaffective disorder

A
  • symptoms of schizophrenia together with depression and/or mania
  • both disorders are independent of one another
  • at least 2 weeks only schizophrenic symptoms
  • prognosis is similar for people with schizophrenia
  • people do not tend to get better on their own
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33
Q

delusional disorder

A
  • delusions, but not bizarre ones
  • types include erotomanic, grandiose, jealous, persecutory
  • lack other positive and negative symptoms
  • extremely rare
  • better prognosis than schizophrenia
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34
Q

brief psychotic disorder

A
  • one or more positive symptoms of schizophrenia for less than 1 month
  • usually precipitated by extreme stress or trauma
  • tends to remit on its own
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35
Q

family studies of schizophrenia

A
  • inherit a tendency for schizophrenia
  • do not inherit specific forms of schizophrenia
  • risk increases with genetic relatedness
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36
Q

twin studies of schizophrenia

A
  • monozygotic twins: 48% risk
  • fraternal (dizygotic) twins: risk drops to 17%
  • adoption studies: risk remains high
  • cases where a biological parent has schizophrenia
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37
Q

genetic research for schizophrenia

A
  • risk increases with genetic relatedness
  • risk is transmitted independently of diagnosis
  • strong genetic component does not explain everything
  • likely polygenic
  • smooth-persuit eye movement
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38
Q

how can birth complications and prenatal viral exposure lead to schizophrenia?

A
  • particularly those involving loss of oxygen that could damage the brain
  • effects of perinatal hypoxia interact with genetic vulnerability
  • prenatal viral exposure (second-trimester flu)
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39
Q

neural differences in schizophrenics

A
  • pre-/perinatal insult: genetic and epigenetic factors impair electric, rhythmic activity and lead to the malformation of cortical circuits
  • reorganization of cortical networks confers vulnerability: increase in high-frequency oscillations fn long-range synchrony during late adolescence is associated with a transient destabilization of network functions
  • large-scale disintegration of network activity leads to emergence of psychosis
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40
Q

dopamine hypothesis for schizophrenia

A
  • excess dopamine in the brain is associated with schizophrenia
  • drugs that increase dopamine result in schizophrenic-like behavior
  • drugs that decrease dopamine reduce schizophrenic-like behavior
  • problems: not everyone not all symptoms respond, and timing of response is delayed
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41
Q

new biological theories for schizophrenia

A
  • excess dopamine activity in mesolimbic system
  • unusually low dopamine activity in prefrontal area of the brain
  • other neurotransmitters may be important (serotonin, glutamate, GABA)
  • likely that imbalances in levels or receptors for dopamine and interactions with other neurotransmitters
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42
Q

brain structure in relation to schizophrenia

A
  • enlarged ventricles, often associated with negative symptoms
  • gray matter reductions
  • less suppression of the default network than non-schizophrenic people
43
Q

psychological factors of schizophrenia

A
  • Freud: overwhelming rejection leads to regression, cant’ distinguish reality
  • “schizophrenic” mothers
  • communication deviance in family may cause stress for at-risk children
  • families with high expressed emotion are over involved and over protective, at the same time critical and hostile
44
Q

role of stress in schizophrenia

A
  • may activate underlying vulnerability
  • may also increase risk of relapse
  • concept of “social (downward) drift”
  • unlikely single stress reaction will lead to schizophrenia
45
Q
A
46
Q

behavioral perspective of schizophrenia

A
  • suggest cause is faulty operant conditioning, especially in attention and social responses
  • not widely accepted, but behavioral techniques for treatment are effective (token economies)
47
Q

cognitive perspective of schizophrenia

A
  • focus on attention problems, probably key issue in schizophrenia
  • cognitions and social response based on attention problems leads to withdrawal from outside and elaboration of the inner world
48
Q

early treatments for schizophrenia

A
  • insulin coma therapy
  • electroconvulsive therapy
  • prefrontal lobotomies
  • “warehousing” common
  • 1950s introduced phenothiazines (Thorazine
49
Q

biological treatment for schizophrenia

A
  • neuroleptics: block D1 and D2 dopamine receptors; extrapyramidal side effects; more effective for positive symptoms
  • “atypical” antipsychotics: clozapine, abilify, seroquel, risperdal; more effective and fewer side effects; “first line” treatment; also treat negative symptoms
50
Q

cognitive-behavioral therapy for schizophrenia

A
  • help patient change how they view and react to their hallucinatory experiences
  • new-wave: therapy helps clients to accept their streams of problematic thoughts, gain a greater sense of control, become more functional, and move forward in life
51
Q

family therapy for schizophrenia

A
  • over 50% live with family members; creates significant family stress, are at greater risk for relapse when living with relative who display high levels of expressed emotion
  • attempts to address such issues, create more realistic expectations, and provide psychoeducation about the disorder
  • may also involve family support groups and family psychoeducation programs
52
Q

social therapy for schizophrenia

A
  • addresses social and personal difficulties in the clients’ lives
  • includes practical advice, problem solving, decision making, social skills training, medication management, employment counseling, financial assistance, and housing
  • reduced hospitalization
53
Q

attention-deficit/hyperactivity disorder (ADHD)

A

marked by the inability to focus attention, or by overactive and impulsive behavior, or both

54
Q

overview of ADHD

A
  • “dis-inhibition” disorder, the normal facility to inhibit one’s behavior or actions are disabled by the frontal lobe’s sluggishness to respond
  • once the individual considers their behavior, there is usually some recognition of the inappropriateness of it
  • impaired executive functioning unified understanding of ADHD (includes working memory, internalization of self-directed speech, emotional control)
55
Q

DSM-5 symptom criteria for ADHD

A
  • essence of “attention deficit”: inattention to details, careless work, poor sustained attention to tasks, etc
  • hyperactivity and impulsivity: fidgetiness and squirming, difficulty being quiet when expected, always on the go, etc
56
Q

genetic factors contributing to ADHD

A
  • immaturity of the brain (frontal lobes, caudate nucleus, and corpus callosum)
  • dopamine is primary neurotransmitter involved
  • genetic predisposition
  • prenatal and birth complications (maternal alcohol, low birth weight, exposure to lead)
57
Q

how may families cause ADHD?

A
  • associated with frequent disruptions and parents with control problems
  • child abuse and neglect, brain injuries, chaotic family life
  • chicken-and-egg problem with difficult behavior and response from others
58
Q

treatment for ADHD

A

behavioral, pharmacological, and combined drug, behavioral, and family treatment associated with best results

59
Q

behavioral treatment for ADHD

A
  • reinforcing attentive, goal-directed, prosocial behaviors
  • extinguishing undesired behaviors
  • training parents and family therapy
  • challenges: very labor intensive, require high levels of consistency to effect change over time, behavioral modification is in competition with neurochemistry
60
Q

parent management training for ADHD

A
  • establish effective contingencies
  • use clear and direct commands
  • differential attention (reinforce target behaviors)
  • contingent reinforcement (positive consequences)
  • response cost (negative consequences)
  • time out
61
Q

collaborative and proactive solutions for ADHD

A
  • define the problem
  • ask the child about their perception of the problem in the broadest terms and at length
  • clarify the child’s concerns
  • clarify parent concerns
  • invite the child to collaborate on a solution that meets both the child’s and parents’ goals
  • assess and review collaboration as needed
62
Q

medication treatment for ADHD

A
  • most common is stimulant drugs like Ritalin
  • stimulate the sluggish functioning of the frontal lobes that are responsible for “executive functioning” such as planning and inhibition
  • some blood pressure meds, tricyclic antidepressants, mood stabilizers, anti-psychotics
63
Q

conduct disorder

A

behaviors that violate the basic rights of others and the norms for social behavior

64
Q

oppositional defiant disorder

A
  • argumentativeness, negativity, irritability, defiance, but behavior is not as severe as in conduct disorder
  • often result of inconsistent response to a child’s behaviors
  • frequently comorbid with ADHD
65
Q

autism spectrum disorder

A

marked by substantial unresponsiveness to others, significant communication deficits, and highly repetitive and rigid behaviors, interests, and activities

66
Q

autism defined

A
  • a complex brain disorder that inhibits a person’s ability to communicate and develop social relationships
  • often accompanied by extreme behavioral challenges
  • affects four times as many boys as girls
  • persistent deficits in social communication and social interaction across multiple contexts
67
Q

diagnostic criteria for autism

A
  • qualitative impairment in social communication and social interaction
  • not just being shy or being anxious
  • stereotypic behaviors, rigidity, restricted interests, hyper-hypo reactive to sensory stimuli
  • levels 1-3 increasing in severity
68
Q

diagnostic tests for autism

A
  • autism diagnostic interview-revised
  • prelinguistic autism diagnostic observation schedule
  • childhood autism rating scale
  • autism behavior checklist
  • autism diagnostic observation schedule
  • the higher the functioning the individual, the harder to ascertain their being autistic using tests
69
Q

diagnosis for autism

A
  • can be diagnosed as early as 1 year and is commonly diagnosed by age
  • diagnosis is based on specific observations of the developmental milestones (social and language) as well as of stereotypic behaviors
70
Q

autism spectrum disorder

A
  • matter of degree
  • language: from no functional language to complete reciprocal communication skills
  • stereotypes: severe (including self injury) to very mild self absorbed sensory stimulation
  • social relationships: from an inability to even notice another person in a room to good eye contact and interest in social reciprocity
71
Q

comorbid diagnoses: autism and…

A
  • intellectual disability
  • seizure disorders
  • genetic disorders (including fragile X)
  • other: phobias, OCD, ADHD, anxiety disorders, depression
72
Q

high-functioning autism

A
  • formerly known as “Asperger’s disorder”
  • mild autism
  • still a spectrum disorder
  • there can be a large disparity between intellectual and adaptive skills
73
Q

theories on the increasing incidence of autism

A
  • decrease in childhood mortality
  • diagnosis shifting: would previously be diagnoses as “childhood schizophrenia”
  • no research supports thimerosal, the mercury compound used in many childhood immunizations
73
Q

concordance studies on autism

A
  • 90% for identical twins
  • 35 times more likely for a sibling to have autism
  • assuming 1:91, the incidence is 0.01
  • 4 times as likely in boys than in girls
  • significant genetic component
74
Q

treatment strategies for autism

A
  • medication used to treat many behavioral symptoms
  • applied behavioral analysis: science of behavioral modification; painstaking objective observation, cataloging, and analysis of behavior; strong focus on positive reinforcement of appropriate behaviors; applies principles of operant and respondent conditioning to change behavior of social significance
  • parent management training
  • collaborative proactive solutions
  • commonalities to successful behavioral and educational success
75
Q

personality

A
  • long-standing patterns of thought, behavior, and emotions
  • big five: openness to experience, conscientiousness, extroversion, agreeableness, neuroticism
76
Q

personality disorders

A
  • an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture
  • pattern is inflexible, stable, and generally begins in adolescence
  • appears when individuals find themselves in situations that are beyond their ability to cope
77
Q

biopsychosocial model of personality disorders

A

biological predisposition to a difficult temperament –> parenting that is harsh, critical, or unsupportive or is alternatively overprotective and indulgent –> behavioral and emotional dysregulation; maladaptive beliefs about the self –> negative reactions from peers and adults –> worsening of temperamental difficulties in controlling emotions and behaviors

78
Q

prevalence of personality disorders

A
  • 0.5-2.5% of the general population
  • higher in inpatient and outpatient settings
79
Q

comorbidities of personality disorders

A
  • often seen in people who also meet criteria for anxiety, mood, and substance use disorders
  • those with one personality disorder are very likely to have another
  • high co-occurrence of disorders occurs within each cluster
80
Q

“odd” personality disorders (DSM-5 cluster A)

A
  • people typically have odd or eccentric behaviors, including extreme suspiciousness, social withdrawal, and peculiar ways of thinking and perceiving things
  • paranoid, schizoid, schizotypal
81
Q

schizoid personality disorder

A
  • chronic lack of interest in and avoidance of interpersonal relationships, emotional coldness toward others
  • limited range of emotions
  • causes unclear
  • preference for social isolation resembles autism (genuinely want to be alone)
82
Q

paranoid personality disorder

A
  • chronic and pervasive mistrust and suspicion of other people that is unwarranted and maladaptive
  • biological and psychological causes unclear
  • early learning: world is a dangerous place
83
Q

“dramatic” personality disorders (DSM-5 cluster B)

A
  • clients experience behaviors that are so dramatic, emotional, pr erratic that it is almost impossible for them to have relationships that are truly giving and satisfying
  • includes borderline, antisocial, histrionic, and narcissistic
84
Q

schizotypal personality disorder

A
  • chronic pattern of inhibited or inappropriate emotion and social behavior, aberrant cognitions, disorganized speech
  • magical thinking, ideas of reference, and illusions
  • most are socially isolate, highly suspicious
  • many meet criteria for major depression
  • causes: potentially phenotype of a schizophrenia genotype, more generalized brain deficits
85
Q

antisocial personality disorder

A
  • pervasive pattern of criminal, impulsive, callous, or ruthless behavior
  • disregard for right of others
  • no respect for social norms
  • one of the most common personality disorders and one of the most difficult to treat
86
Q

diagnostic criteria for ASPD

A

must be at least 18 and showed signs of conduct disorder before age 15
- noncompliance with social norms
- violates rights of others
- irresponsible, impulsive, and deceitful
- careless disregard for safety or self or others
- no regret for hurting or mistreating others
- failure to behave responsibly in spheres of work or finances
- lack of remorse

87
Q

ASPD overlap with psychopathy/sociopathy

A
  • about 10-25% have psychopathy, involving emotional detachment, lack of empathy, impulsive behavior and callousness, with apparently no conscience
  • Cleckley (1941/1988): the mask of sanity
88
Q

relationship between ASPD and early behavioral problems

A
  • early histories of behavioral problems
  • families often have inconsistent parental discipline and support
  • families often have histories of criminal and violent behavior
89
Q

theories of ASPD

A
  • genetic predisposition
  • deficits in brain structure and functioning
  • low levels of arousability
  • harsh and inconsistent parenting
  • physical abuse
  • two key factors: fearlessness and low cortical arousal
90
Q

treatment for ASPD

A
  • few seek treatment on their own
  • poor prognosis
  • emphasis is placed on prevention and rehabilitation
  • often incarceration is the only viable alternative
91
Q

borderline personality disorder

A
  • rapidly shifting and unstable mood, self-concept, and interpersonal relationships
  • impulsive
  • display pronounced, wide ranging, unstable and impulsive patterns in relationships, sense of self, and emotions
92
Q

diagnosis of BPD

A

at least 5 symptoms
- desperate efforts to avoid perceived abandonment
- fluctuations between idealizing and integrating family, friends, and coworkers
- highly changeable self concept
- self-damaging displays of impulsivity
- significant fluctuations in moods and emotions
- repeated self-mutilating or suicidal acts or gestures
- long-term sense of emptiness
- experiences of extreme and often uncomfortable anger
- periodic, short-term paranoid ideas or dissociation during times of stress

93
Q

treatment for BPD

A
  • issues in therapy: developing a therapeutic alliance, transference and countertransference, change is slow and hard won
  • antidepressant medications: some short-term relief
  • dialectical behavior therapy: comprehensive treatment approach that includes both individual therapy and group therapy sessions (treatment of choice)
  • synthesizing acceptance and change
94
Q

histrionic personality disorder

A
  • rapidly shifting moods, unstable relationships, and intense need for attention and approval; dramatic, seductive behavior
  • thinking and emotions are perceived as shallow
  • impulsive and need to be center of attention
95
Q

narcissistic personality disorder

A
  • grandiose thoughts and feelings of one’s own worth; obliviousness to others’ needs
  • exaggerated/unreasonable sense of self-importance
  • preoccupation with receiving positive attention
  • lack sensitivity and compassion for other people
  • sensitive to criticism, envious, and arrogant
96
Q

avoidant personality disorder

A
  • characterized by consistent discomfort and restraint in social situations, overwhelming feelings of inadequacy, and extreme sensitivity to negative evaluation
  • highly avoidant of interpersonal relationships
  • similar to social anxiety disorder
96
Q

“anxious” personality disorders (DSM-5 cluster C)

A
  • patterns of anxious and fearful behavior
  • extremely concerned about being criticized or abandoned by others and thus have dysfunctional relationships with them
  • includes avoidant, dependent, obsessive-compulsive personality disorders
97
Q

dependent personality disorder

A
  • characterized by pattern of clinging and obedience, fear of separation, and an ongoing need to be taken care of
  • reliance on others to make major life decisions
  • unreasonable fear of abandonment
  • clingy and submissive in interpersonal relationships
98
Q

problems with DSM-5 diagnostic system for personality disorders

A
  • diagnostic overlap and reliability
  • gender and ethnic/racial biases in construction and application
  • dimensional approach would be better
99
Q

obsessive-compulsive personality disorder

A
  • marked by such an intense focus on orderliness, perfectionism, and control that the person loses flexibility, openness, and efficiency
  • highly perfectionistic, orderly, and emotionally shallow
  • excessive and rigid fixation on doing things the right way
100
Q

five-factor model of personality

A
  • trait models attempt to analyze personality into its basic dimensions
  • maintain that personality can be described adequately with the five higher-order traits identified
  • agreeableness, conscientiousness (constraint), openness to experience, extraversion (positive emotionality), neuroticism (negative emotionality)
101
Q

interpersonal circumplex model

A
  • psychological model for conceptualizing, organizing, and assessing interpersonal motives, dispositions, and interactions
  • dominance, nurturance, submissiveness, cold-heartedness

Abnormal Psychology (3 decks)

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