Week 3 and 4 Flashcards
1
Q
Somatic Symptom Disorders
A
- replaces somatization disorder, hypchondriasis, pain disorder, undifferentiated somatic disorder
- emphasis on ‘maladaptive thoughts, feelings and behaviors’ not just somatic symptoms
2
Q
Somatic Symptoms Disorders
A
- illness anxiety disorder
- BDD moved to OC and related disorders chapter
- no longer a requirement for conversion disorder to have a psychologically-related stressor
3
Q
Feeding and Eating Disorders
A
- Feeding ds (PICA, ruminination disorders) combined with eating disorders
- avoidant/restrictive food intake->feeding disorder
- limited binge/purge numbers for bluimia
- binge eating disorder
4
Q
Sleep Wake Disorder
A
- insomnia disorder
- narcolepsy versus hypersomnolence
- breathing related sleep disorder to obstructive versus central form
- circadian rhythm sleep disorders
- REM sleep behavior disorder and restless legs syndrome are independent
5
Q
Sexual Dysfunctions
A
- sexual desire and arousal disorder are combined
- 6 months duration to dx
- vaginismus and dyspareunia combined to genito-pelvic pain/penetration disorder
6
Q
Gender Dysphoria
A
- cross-gender identification and aversion toward one’s gender have been merged
- post-transition specifier is added
7
Q
Disruptive, Impulse Control and Conduct Disorder
A
-unifies disorders of difficult, disruptive, impulsive or antisocial behavior: oppositional defiant disorder, conduct disorder, intermittent explosive disorder, antisocial personality disorder, pyromani, kleptomania
8
Q
Neurocognitive Disorders
A
Dementia
9
Q
Paraphilic Disorders
A
-psychosexual disorders characterized by sexual fantasies, feelings, or activites involving a nonhuman object, a nonconsenting partner (child) or pain/humiliation of oneself or one’s partner
10
Q
Other Disorders
A
conditions of clinical importance that may be a focus of dx and tx but are not mental disorders
- medication induced movement disorders
- conditions distress pt. and family
11
Q
Psychiatric Interview
A
-identifying information, hx of illness, psychiatric ROS/psychiatric hx, medical hx, personal birth and developmental hx, family psych hx, social and chemical use hx, exam via SCID, mental status, other formal testing
12
Q
Mental Status Exam Indicated In
A
pts. with brain lesions (tumors, trauma, CVA), cerebral dysfunction, all psych pts., and pts. with vague complaints (memory, concentration, declining interests, various physical complaints without organic etiology)
13
Q
Depression in what brain area
A
frontal and temporal tumors, hydrocephalus or cotrical atrophy
14
Q
Mental Status Exam Components
A
-includes all of the observations made during an interview and the formal cognitive testing or mini mental state exam
15
Q
MSE Observational Data
A
-presentation, motor behavior and affect, cognitive status, thought, mood
16
Q
MSE Presentation
A
- level of consciousness (Glasgow)
- general appearance
- attitude
- eye contact
17
Q
MSE Motor Behavior and Affect
A
- Motor: akinesia, involuntary movements
- Affect: facial expression, gestures, speech characteristics, pressure, volume, etc.
18
Q
MSE Cognitive Status
A
- attention/alertness: digit span, number of trials to learn 4 words
- concentration and vigilance: serial subtraction, letter cancellation tasks etc
- orientation x 3
- speech and language: fluency and comprehension of spoken/written
19
Q
MSE Language
A
- repetition, naming and reading
- writing, spelling
20
Q
MSE Memory
A
- verbal memory, visual memory
- constructional ability: reproducing figures from memory, copying figures/constructing blocks or token designs
- calculations
- reasoning
21
Q
MSE Thought
A
- process, coherence, goal directedness
- content: hallucinations, delusions, preoccupations or obsessional thoughts, suicide/homicidal
- insight: nature of illness and awareness of factors that affect the course of the illness
22
Q
MSE Mood
A
- relation to affect and congruence with thought content
- variability
- hopelessness/suicidality
- anger/agression
- guardedness
23
Q
ADHD
A
NE and DA
24
Q
Basal Ganglia
A
-selection of appropriate behavior, voluntary motorl control and emotional functions
25
Orbital Frontal Cortex
impulsive, blurts out, don't wait
| -OFC->bottom of caudate->thalamus->OFC
26
ADHD cerebellum
-smaller in these kids
27
SSRI
can treat ADHD
28
when to dx ADHD
up to age 12, not before age 5
29
Dx ADHD
6 or more of 18 dx criteria
30
MMSE (mini mental status exam) or folstein
30 points: orientation x3 for 10, language reading (1), writing (1), naming (2), comprehension (3), repetition (1), registration (3), recall (3), attention/simple calculations (5), constructional praxis (1)
31
MMSE Cutoff Number
23 points
32
MMSE Normal Range
27-30
33
MMSE mild cognitive impairment
11-20
34
MMSE Severe
0-10
35
Office Screening for Depression
- hamilton rating scale for depression
- patient health questionaire
- geriatric depression scale
36
Office Screening for Anxiety
- hamilton rating scale for anxiety
| - patient health questionaire
37
Office Screening for Alcohol Use
Alcohol use disorder identification test (audit)
38
Screening for ADHD and Childhood Behavior Problems
SNAP-IV rating scale
| -90 questions to be answered by classroom teachers, contains items to screen for ADHD and oppositional defiant disorder
39
Nominal Measurement
- least precise of the measures, simply assigns numbers or labels to id categories to which individuals belong
- can count, no other math to this
40
Ordinal Measurement
- measures arrange or sort individuals in a series ranging from highest to lowest according to an observed characteristic (can't say how much difference b/w)
- no arithmetical functions to apply
41
Interval Measurement
- gives numbers for both order and differences b/w are meaningful
- ie class exams, can complete elementary mathematical operations (add and subtract)
42
Ratio Scales
gives numbers for which all arithmetical operation can be used; this is a true zero point (height, weight, volume, etc)
43
Diathesis/Stress
goal is to stop the cascade in young people
44
Comorbidity
It is the norm, when you ID a young person with one psych problem, they likely have others
45
Conduct Disorder
repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated
46
3 or More Criteria for Conduct Disorder
-aggression to ppl and animals, destruction of property, deceitfulness or theft, serious violations of rules
47
Aggression to Ppl and Animals
-bullies, threatens or intimidates others, often initiates physical fights, used a weapon to cause harm, physically cruel to ppl or animals, stolen while confronting a victim, forced sexual acts
48
Destruction of Property
-deliberately fire setting, deliberately destroyed others' property
49
Deceitfulness or Theft
-breaking in, lies to obtain goods or favors, stolen items of nontrivial value
50
Serious violation of the Rules
stays out at night, run away from home overnight at least twice, often truant from school before age 13
51
Similar Etiology in ODD and CD in Infancy
tmperamentally hyper-reactive, irritable, difficult to soothe, slow to adapt to new circumstances
52
Similar Etiology in ODD and CD in Families-Highly Stressed
Marital discord, parental psychopathology (parent pre-occupied with own problems), socioeconomic disadvantage
53
Similar Etiology in ODD and CD in Parenting
-inconsistent limit setting (bad behavior, all behavior, is generally ignored with sporadic, unpredictable repetitive cycles of rxn to the behavior involving coercive harsh punishment)
54
Percent of People with CD to go on to have antisocial personality disorder
25-40%
55
Percent of kids with ODD to CD
25%
56
Treatment of ODD
kids under 12, tx is provided primarily through the parents, replace coercive discipline with more effective child-rearing techniques
57
Multisystemic Family Therapy
-home based model, low case load, time limited to 3-5 months, team based of 3-4 practitioners, available 24 hours a day, appointments at family convenience, daily contact via face or phone
58
Substance Use Disorders in Adolescents
-a maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by 2 or 3 sx in a 12 month
59
Predictors of SUD in Adolescence
impulsivity, aggression, sensation seeking, low levels of harm avoidance, inability to delay gratification, low achievement motivation, psychopathology, especially conduct disorder
60
Diathesis
predisposing biology, including genetic factors=vulnerability to a disorder
61
Protective Factors of GxE
mitigate or provide a buffer against the effects of major stressors
62
CRAFFT
- car by someone high/drunk
- substances to Relax
- substances Alone
- Family/Friend say you have a problem
- Forget things (black out)
- Trouble
63
Addiction Tx is
-a linear process, think akin to chronic illness management
64
Reliability
consistency of predictive statements over time
65
Validity
'truthfulness', reflects the degree of accuracy of predictive statements
66
Most Common IQ Test for Adults
Wechsler Adult (or children) Intelligence Scale, individual, provide standardized scores, comprehensive and expensive to use
67
Most Common IQ Test for Pre-school
McCarthy Scales and Wechsler Preschool and Primary Scale of Intelligence
68
Most Common IQ Test for Infants
Bayley Scales of Infant and Toddler Development
69
Mean IQ
100
| --1SD is 85, -2SD is 70, +1SD is 115, +2SD is 130
70
Memory Tests
- Rey-Osterreich Figure and the Rey Auditory verbal learning test
- California verbal learning test
71
Halstead-Reitan Neuorpsychological Test Battery
Contains 10 subtests that examine a variety of brain functions
-abstract reasoning, kinesthetic and sensorimotor ability, attention, auditory perception, sensory-perceptual ability, language
72
Luria-Nebraska Neuorpsychological Test Battery
- 269 items in a number of categories (motor, rhythm, receptive speech, reading, etc)
- high reliability (some false positives in elderly)
73
Anomic Aphasia
Pt. has word finding difficulties and struggles to find the right words for speaking and writing
74
Causes of Aphasia
AD, Pick's, PD, coricobasalganglionic degeneration, diffuse lewy body ds, or nonspecific degneration
75
Rey Auditory Verbal Learning Test (RAVLT)
15 words read aloud at rate of 1/sec, pt. repeat all words pt can remember in any order, 5 times repeated and then on additional 15 set with only one attempt at recall
76
Global Burden of Disease
2004 60% increase in suicide over the past 50 years
77
1998-2010 increase in anti-depressant
400% increase, 25% of women take an anti-depressant
78
Taking Anti-depressants for more than 10 years
14% of Americans
79
Suicide Rate under 18
2nd leading cause of death
80
Suicide Rate
12 per 100,000
- highest risk for white males over the age 85
- NA youth at highest risk
81
Major Depressive
-persistent sadness and loss of interest in activities plus others on the list to dx too
82
Persistent Depressive Disorder
Depressed mood for at least 2 years plus two of the following
83
Bipolar Disorder
Major depressive episode plus severe changes in mood to either extreme irritability, or overly silly and elated
84
Bipolar 1
Mania 7 days
85
Bipolar 2
Hypomania 4 days
86
Disruptive Mood Dysregulation Disorder
To distinguish children with milder mood dysregulation from childhood-onset bipolar disorder
87
Tx for Adolescents with Depression
dx of major depression, to 4 groups of meds, CBT, both or placebo and combined was best with 71% response rate, identical for meds and CBT (but quicker response with meds)
88
Predisposing to Suicide in Youth
fill in
89
Precipitating Factors for Suicide
fill in
90
Interviewing for Suicide
-be direct, be available/interested, don't be sworn to secrecy, take action
91
Postpartum Depression in Adolescent Mothers
Over half have depression in ages 15-19 (rather than waiting until their 20s)
92
Anxiety
apprehension and fear, can be concrete or imagined, scientific research and clinical demonstrates that it is amenable to behavioral and pharmaco-therapy
93
Panic Disorder and Attack
-intense fear with physical sx (heart rate etc) that occur repeatedly and unexpectedly, 1.5%, 4x > in women, onset late teens to early 30s, less in older adults
94
social phobia
an intense fear of becoming humiliated in social situations, specifically of embarrassing yourself in front of other people; 3 to 13% prevalence
95
Specific Phobia
marked and persistent fear that is excessive or unreasonable, that is caused by the presence of a stimulus, more in women, 5-12%, age of onset varies
96
Acrophobia
fear of heights
97
Nosophobia
fear of being sick
98
Thanatophobia
fear of death
99
Pogonophobia
fear of beards
100
Melanophobia
fear of dark or black people
101
Arachibutryrophobia
fear of pb sticking to roof of mouth
102
Obsessive Compulsive Disorder
obsessions that are unwanted, recurrent, distubing thoughts, impulses, images which the person cannot suppress and which can cause overwhelming anxiety
103
Compulsions
repetitive, ritualized behaviors that the person feels driven to perform to alleviate the anxiety of the obsessions
104
OCD Epidemiology
life prevalence 2-3%, one year prevalence 1.5%-2.1%, often not treated until adulthood
105
Disinhibited Social Engagement Disorder
overly familiar (unknown kids will come up and hug you) kids don't have consistent care giver
106
Adjustment Disorder
array of stress response syndromes occurring after exposure to a distressing event
107
Acute Stress Disorder
need a qualifying traumatic event experience directly, witnessed or experienced indirectly (3 days-1 month)
108
PTSD
person has experienced an event that is outside the range of usual human experience
109
PTSD primary feature
significant rxn to a serious traumatic event that involves actual or threatedened death, serious injury or sexual violation
110
PTSD Sx
intrusive sx, avoidance of reminders, negative alterations in cognition and mood, alterations of arousal and reactivity
111
PTSD recurring exposure
applies to first responders
112
Evaluation of PTSD
15 minutes-1 hour in office
113
DREAMS
detachment, reexperiencing the event, event had emotional effects, avoidance, month in duration, sympathetic hyperactivity or hypervigilance
114
NT during a Traumatic Event
NE (mobilizing fear/flightresponse/etc), 5HT (self defense, rage and attenuation of fear)
115
Critical Incident Stress Debriefing
Critical Incident Stress Debriefing in the first 72 hours, forestall emergence of disabling sx, short term psychosocial interventions
116
PTSD Prevalence
7.8%, women 10%, men 5%
117
Percent of PTSD with comorbidity
80%: anxiety, affective disorder, substance use disorders, somatization, psychosis; women with PTSD 4.1xF or 6.9M more likely to get major depression (also more likely to develop mania)
118
PTSD suicide attempts
20%
119
Exposure Therapy
education on common rxns to trauma, breathing and retraining; goal is to recall event without anxiety or panic
120
Cognitive therapy
separating intrusive thoughts from the associated anxiety
121
Stress inoculation training
Variant of exposure training teaches client to relax; helps the client relax when thinking about traumatic event exposure by providing client a script
122
Treatment Goals in PTSD
decondition anxiety and re-establish feeling of integrity and or control; at least 50% show improvement with therapy
123
Avoidance Behavior reinforced by
reduction in anxiety
124
SSRI's
sertraline (zoloft), paroxetine (paxil), escitalorpram (lexapro), fluvoxamine (luvox), fluextine (prozac)-serotonin
125
Tricyclic Antidepressants
clomiprimine (anafranil), doxepin (sinequan), nortriptyline (aventyl), amitriptyline (elavil), maprotiline (ludiomil), desipramine (norpramin)-5HT and NE
126
Taijin kyofusho (TKS)
Korean and Japanese cultures, individuals are concerned about being observed and then avoid a variety of social situations (concerned about doing something, or presenting an appearance, that will offend or embarrass the other person, compared to oneself in SAD)
127
Four Subtypes
the fear of blushing, the fear of a deformed body, the fear of eye to eye contact, the fear of one's own foul body odor
128
Dx for Male Hypoactive Sexual Desire Disorder
Persistently or recurrently deficient sexual/erotic thoughts or fantasies and desire for sexual activity; judgement of deficiency
