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Flashcards in Advanced Abnormal Psychology Deck (61):
1

Abnormal behavior is a __ within an individual that is associated with __ in functioning and a response that is __.

Psychological dysfunction;
Distress or impairment
Not typical or culturally expected

2

A breakdown in cognitive, emotional or behavioral functioning

Psychological dysfunction

3

The most widely accepted definition of abnormal behavior in DSM-5 describes __, __, or __ dysfunctions that are unexpected in their __ context and associated with present __ and __ in functioning, or increased risk of __, __, __ or __.

Behavioral, psychological; biological;
Cultural;
Distress; impairment;
Suffering; death; pain; impairment

4

The patient may have only some features or symptoms of the disorder (a minimum number) and still meet criteria for the disorder because his or her set of symptoms is close to the __, or the typical profile.

Prototype

5

__ is the scientific study of psychological disorders; it adopts scientific methods to learn more about the nature of psychological disorders, their causes and their treatments which describes a __ model

Psychopathology; Scientist-Practitioner

6

The scientist-practitioner model elaborates the three fundamental functions of mental health professionals. Identify them.

1. Consumer of science (use the most current diagnostic and treatment procedures to enhance the practice)
2. Evaluator of science (evaluate own assessment or treatment procedures to see whether they work)
3. Creator of science (conduct research and produce new information)

7

Identify the three major categories that make up the study and discussion of psychological disorders; these are the main focus of psychopathology

1. Clinical description
2. Causation / Etiology
3. Treatment and outcome

8

A clinical description is the unique combination of behaviors, thoughts and feelings that make up a specific disorder. Importantly, it specifies what makes the disorder different from normal behavior or from other disorders.
Identify the important information indicated under the clinical description of a psychological disorder.

Prevalence
Incidence
Sex ratio
Typical age of onset
Course (chronic/episodic/time-limited)
Onset (acute/insidious)
Prognosis
Patient's age

9

The study of changes in abnormal behavior is __; the study of abnormal behavior across the entire age span is referred to as __

Developmental Psychopathology; Life-span Developmental Psychopathology

10

Syphilis, a medical condition, was believed to be related to __, a psychological disorder marked by psychotic symptoms. __ was discovered to cure syphilis. This discovery is a pivotal event in the assumption that causes and cures for psychological disorders may be traced to biological origins.

General Paresis; Malaria/Penicillin

11

Made a lasting contribution in the area of diagnosis and classification of mental disorders; many of his descriptions of schizophrenic disorder are still useful today

Emil Kraepelin

12

Community health movement at the end of 19th century which aimed to reduce the population of mental hospitals by releasing patients into their communities

Deinstitutionalization

13

Treating institutionalized patients as normally as possible in a setting the encouraged and reinforced normal social interaction

Moral Therapy
Originated with Philippe Pinel and Jean-Baptiste Pussin (France); William Tuke (England); Benjamin Rush (US)

14

Moral therapy worked best when the number of patients in an institution was 200 or fewer. After the Civil War, patient loads in hospitals greatly increased and moral therapy declined. In response, Dorothea Dix began the __ and campaigned for humane treatment in institutions.

Mental Hygiene Movement

15

__ is regarded as the father of hypnosis but was labeled a charlatan; __ used and legitimized hypnosis with psychological disorders; __ came to study with the former then teamed up with __, who used hypnosis in conjunction with free association

Mesmer; Charcot; Freud; Breuer

16

In the 1990s, two developments came together and shed light on the nature of psychopathology as we know today

1. Sophistication of scientific tools and methodology
2. Realization that no one influence ever occurs in isolation
The only currently valid model of psychopathology is multidimensional and integrative.

17

Identify the time of publication of the Diagnostic and Statistical Manual of Mental Disorders

DSM-I (1952)
DSM-II (1968)
DSM-III (1980); III-R (1987)
DSM-IV (1994); IV-R (2000)
DSM-V (2013)

18

__ is a degenerative brain disease that appears in early to middle age and traced to a genetic defect that causes deterioration in a specific area of the basal ganglia; __ is a genetic disorder that causes intellectual disability

Huntington's disease; Phenylketonuria (PKU)

19

Each normal human cell has __ pairs of chromosomes, of which all the pairs (excluding the last one) provide programs or directions of the development of the __ and __; while the last pair determines an individual's __.

23; body and brain; sex

20

Two models depicting the interaction of genes and environment have received the most attention. The __ model shows that individuals may have a genetic endowment to increase the probability that they will experience stressful life events and therefore trigger a vulnerability; the __ model states that people inherit a vulnerability to express certain traits or behaviors that may be activated under certain stress conditions

Gene-Environment Correlation (or Reciprocal Gene-Environment);
Diathesis-Stress

21

Identify major neurotransmitters related to psychopathology

Norepinephrine (related to panic states)
Serotonin (regulate behavior, moods and thought processes)
Dopamine (more general effect, switch that turns on various brain circuits)
Gamma-aminobutyric acid (major inhibitory NT; reduce overall arousal)
Glutamate (major excitatory NT)

22

Differentiate emotion, mood and affect

Emotion is an action tendency and usually short-lived, temporary states occurring in response to an external event; it is composed of behavioral, physiological and cognitive components.
Mood is a more persistent period of affect or emotionality.
Affect is a momentary emotional tone that accompanies what we say or do.

23

Identify various relevant dimensions whose interaction must be considered to arrive at a multidimensional integrative approach to the causes of psychological disorders

Genetic contributions
Role of the nervous system
Behavioral and cognitive processes
Emotional influences
Social and interpersonal influences
Developmental factors

24

In considering a multidimensional integrative approach to psychopathology, it is important to remember the principle of __, which reminds us that we must consider the various paths to a particular outcome, not just the result.

Equifinality

25

__ is the systematic evaluation and measurement of psychological, biological and social factors in an individual with a possible psychological disorder; __ is the process of determining that those factors meet all criteria for a specific psychological disorder

Clinical assessment; Diagnosis

26

Methods of classification include __, __ and __ approaches. The DSM-5 is based on a __ approach in which certain essential characteristics are identified but certain "nonessential" variations do not necessarily change the classification.

Classical categorical; Dimensional; Prototypical;
Prototypical

27

DSM-5 defined mental disorder as a __ characterized by clinically significant disturbance in an individual's __, __, or __ that reflects a __ in the psychological, biological or developmental processes underlying mental functioning. Mental disorders are usually associated with significant __ or __ in social, occupational, or other important activities. Socially __ behavior and conflicts that are primarily between the individual and society should result from a __ in the individual.

Syndrome; Cognition; Emotion regulation; Behavior; Dysfunction; Distress; Disability; Deviant; Dysfunction

28

Differentiate anxiety, fear, panic and panic attack

Anxiety is a negative mood state characterized by bodily symptoms of physical tension and by apprehension about the future.
Fear is an immediate alarm reaction to danger characterized by strong escapist action tendencies.
Panic is a sudden overwhelming reaction, often with no apparent cause of alarm.
Panic attack is an abrupt experience of intense fear or acute discomfort, accompanied by physical symptoms (can be expected and unexpected).

29

(a) The areas of the brain most often associated with anxiety is the __; (b) The most common additional diagnosis for all anxiety disorders was __ (50%); (c) Suicide is most strongly associated with __ and __,

(a) Limbic system
(b) Major depression
(c) Panic disorder and PTSD

30

Diagnostic criteria for Generalized Anxiety Disorder

Threshold Duration: 6 months
1.Excessive anxiety and worry more days than not about a number of events
2. Difficulty in controlling the worry
3. Anxiety and worry associated with the ff (3 for adults, 1 for children): a. Restlessness; b. Easily fatigued; c. Difficulty concentrating; d. Irritability; e. Muscle tension; f. Sleep disturbance
+ Clinically significant distress or impairment
+ Not due to direct physiological effects of a substance or general medical condition
+ Not better explained by another mental disorder

31

Diagnostic criteria for Panic Attack (Specifier)

NOTE: This is not a mental disorder; specifier used in conjunction with other mental disorders.
1. An abrupt surge of intense fear or intense discomfort that reaches a peak within minutes during which the ff. occur (min. 4):
a. Palpitations, pounding heart or accelerated heart rate;
b. Sweating;
c. Trembling/shaking;
d. Shortness of breath/smothering;
e. Choking feelings;
f. Chest pain/discomfort;
g. Nausea/abdominal distress;
h. Dizziness/light-headedness;
i. Chills/heat sensations;
j. Numbness/tingling (paresthesia);
k. Derealization/depersonalization;
l. Fear of losing control;
m. Fear of dying

32

Diagnostic criteria for Panic Disorder

1. Recurrent unexpected panic attacks
2. (In at least one month after at least one attack), either or both:
a. Persistent concern or worry about additional panic attacks or their consequences; or
b. Significant maladaptive change in behavior related to the attacks
+ Not due to direct physiological effects of a substance or general medical condition
+ Not better explained by another mental disorder

33

Diagnostic criteria for Agoraphobia

Threshold duration: 6 months
1. Marked fear or anxiety about the ff. (at least 2): a. public transportation, b. open spaces, c. enclosed places, d. standing in line or being in a crowd, e. being outside the home alone.
2. Fears or avoids these situations due to thoughts of difficulty escaping or getting help when panic-like symptoms arise
3. Agoraphobic situations almost always provoke fear or anxiety
4. Agoraphobic situations are actively avoided, require presence of companion or endured with intense fear or anxiety
5. Fear or anxiety is out of proportion to actual danger and to the sociocultural context
+ Clinically significant distress or impairment
+ If another medical condition is present, fear, anxiety or avoidance is clearly excessive
+ Not better explained by another mental disorder

34

Diagnostic criteria for Specific Phobia

Threshold duration: 6 months
1. Marked fear or anxiety about a specific object or situation
2. Phobic object or situation almost always provokes immediate fear or anxiety
3. Phobic object or situation is actively avoided or endured with intense fear or anxiety
4. Fear or anxiety is out of proportion to actual danger and to sociocultural context
+Clinically significant distress or impairment
+ Not better explained by another mental disorder
(Specify type: Animal / Natural environment / Blood-injection-injury / Situational / Other)

35

Diagnostic criteria for Separation Anxiety Disorder

Threshold Duration: 1 month in children/adolescents; 6 months in adults
1. Developmentally inappropriate and excessive fear/anxiety concerning separation from attached person through persistent/excessive (min. 3):
a. Distress when separated from home or major attachment figures
b. Worry about losing these figures or possible harm to them
c. Worry about experiencing untoward event on oneself that causes separation
d. Refusal to go out because of fear of separation
e. Fear about being alone or without major attachment figures
f. Refusal to sleep away from home or without being near a major attachment figure
g. Nightmares involving theme of separation
h. Complaints of physical symptoms when separation occurs/anticipated
+Clinically significant distress or impairment
+ Not better explained by another mental disorder

36

Diagnostic criteria of Social Anxiety Disorder (or Social Phobia)

Threshold Duration: 6 months
1. Marked fear or anxiety of at least one social situation with exposure to possible scrutiny
2. Fears of acting in a way or showing anxiety that will be negatively evaluated
3. Social situation almost always provoke fear or anxiety
4. Social situation is avoided or endured with intense fear or anxiety
5. Fear or anxiety is out of proportion to actual threat and to sociocultural context
+ Clinically significant distress or impairment
+ Not due to direct physiological effects of a substance or general medical condition
+ Not better explained by another mental disorder
+ If another medical condition is present, fear, anxiety or avoidance is unrelated or excessive
Specify if: Performance only

37

Diagnostic criteria of Selective Mutism

Threshold Duration: 1 month
1. Consistent failure to speak in specific social situations despite speaking in other situations
2. Interferes with educational or occupational achievement or social communication
3. Failure to speak is not attributable to a lack of knowledge/comfort with spoken language
4. Not better explained by a communication disorder and does not occur exclusively during the course of autism spectrum disorder, schizophrenia or another psychotic disorder

38

Identify the classification of Anxiety Disorders

Generalized Anxiety Disorder (5.7%)
Panic Disorder (4.7%) / Panic Attack (Specifier)
Agoraphobia
Specific Phobia (12.5%)
Social Anxiety Disorder (Social Phobia) (12.1%)
Separation Anxiety Disorder*
Selective Mutism*
Substance/Medication-Induced Anxiety Disorder
Anxiety Disorder Due to Another Medical Condition
Other Specified Anxiety Disorder
Unspecified Anxiety Disorder

39

Diagnostic criteria of Posttraumatic Stress Disorder

Threshold Duration: 1 month AFTER traumatic event
1. Exposure to actual or threatened death, serious injury or sexual violence (at least one way)
2. Presence of at least one intrusion symptom associated with traumatic event: a. recurrent distressing memories; b. recurring dreams; c. dissociative reactions/flashbacks; d. intense psychological distress to cues; e. marked physiological reactions to cues
3. Persistent avoidance of associated stimuli (at least one way): a. avoidance of memories/thoughts/feelings; b. avoidance of external reminders
4. Negative alterations in associated cognitions and moods (at least two ways)
5. Marked alterations in arousal and reactivity (at least two ways): a. irritable behavior; b. reckless/self-destructive behavior; c. hypervigilance; d. exaggerated startled response; e. problems concentrating; f. sleep disturbance
+ Clinically significant distress or impairment
+ Not due to direct physiological effects of a substance or general medical condition
Specify if:
With delayed expression (>6 months after event)
With Dissociative Symptoms (1. Depersonalization or 2. Derealization)

40

Diagnostic criteria of Acute Stress Disorder

Threshold Duration: 3 days to 1 month AFTER traumatic event
1. Exposure to actual or threatened death, serious injury or sexual violence (at least one way)
2. At least nine of the ff. symptoms:
a. recurrent distressing memories
b. recurrent distressing dreams
c. dissociative reactions/flashbacks
d. intense psychological distress or physiological reactions to related cues
e. persistent inability to experience positive emotions
f. altered sense of reality (derealization)
g. inability to remember important aspect of event
h. avoidance of related memories/thoughts/feelings
i. avoidance of external reminders
j. sleep disturbance
k. irritable behavior
l. hypervigilance
m. concentration problems
n. exaggerated startle response
+ Clinically significant distress or impairment
+ Not due to direct physiological effects of a substance or general medical condition
+ Not better explained by brief psychotic disorder

41

Diagnostic criteria of Adjustment Disorders

Threshold Duration: Within 3 months of onset of stressor
1. Clinically significant emotional or behavioral symptoms in response to stressor through the ff. (at least one): a. marked distress that is out of proportion to severity of stressor; b. impairment of functioning
+ Not better explained by another mental disorder or exacerbation of preexisting mental disorder
+ Not normal bereavement
+ Once stressor is terminated, symptoms do not persist for more than an additional 6 months
Specify whether:
With depressed mood
With anxiety
With mixed anxiety and depressed mood
With disturbance of conduct
With mixed disturbance of emotions and conduct
Unspecified

42

Diagnostic criteria of Reactive Attachment Disorder

Threshold Age: Development age of 9 months; Less than 5 years
1. Consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers by the ff. (at least one): a. rarely seeks comfort when distressed; b. rarely responds to comfort when distressed
2. Persistent social and emotional disturbance by the ff. (at least two): a. minimal responsiveness to others; b. limited positive affect; c. episodes of unexplained irritability/ sadness/ fearfulness
3. Pattern of extremes of insufficient care by the ff. (at least one): a. social neglect or deprivation; b. repeated changes of primary caregivers; c. rearing in unusual settings
+ Disturbances in Criterion 1 began following Criterion 3
+ Not met for autism spectrum disorder
Specify if:
Persistent (more than 1 year)
Severity: Severe (all symptoms at high levels)

43

Diagnostic criteria of Disinhibited Social Engagement Disorder

Threshold Age: Development age of 9 months
1. Pattern of behavior in which child actively approaches and interacts with unfamiliar adults (at least two ways) (behaviors should include socially disinhibited behavior and not limited to impulsivity)
2. Pattern of extremes of insufficient care by the ff. (at least one): a. social neglect or deprivation; b. repeated changes of primary caregivers; c. rearing in unusual settings
+ Disturbances in Criterion 1 began following Criterion 2
Specify if:
Persistent (more than 1 year)
Severity: Severe (all symptoms at high levels)

44

Identify classification of Trauma- and Stressor-Related Disorders

Posttraumatic Stress Disorder (6.8%)
Acute Stress Disorder
Adjustment Disorders
Reactive Attachment Disorder
Disinhibited Social Engagement Disorder
Other Specified Trauma- and Stressor-Related Disorder
Unspecified Trauma- and Stressor-Related Disorder

45

Diagnostic criteria of Obsessive-Compulsive Disorder

1. Presence of obsessions and/or compulsions
2. Time-consuming or cause clinically significant distress or impairment
+ Not due to direct physiological effects of a substance or general medical condition
+ Not better explained by another mental disorder
Specify if:
With good or fair insight
With poor insight
With absent insight/delusional beliefs
Tic-related

46

Diagnostic criteria of Body Dysmorphic Disorder

1. Preoccupation with one or more defects/flaws in physical appearance that are not observable or appear slight to others
2. Repetitive behaviors or mental acts at some point during course of disorder
+ Clinically significant distress or impairment
+ Not better explained by concerns with body fat or weight meeting criteria for an eating disorder
Specify if:
With good or fair insight
With poor insight
With absent insight/delusional beliefs
With muscle dysmorphia

47

Diagnostic criteria of Hoarding Disorder

1. Persistent difficulty discarding or parting with possessions regardless of actual value, due to perceived need to save the items and to associated distress
2. Accumulation of possessions that compromises intended use of living areas
+ Clinically significant distress or impairment
+ Not attributable to another medical condition
+ Not better explained by another mental disorder
Specify if:
With excessive acquisition (not needed or no available space)
With good or fair insight
With poor insight
With absent insight/delusional beliefs

48

Diagnostic criteria of Trichotillomania (Hair-Pulling Disorder)

1. Recurrent pulling out of one's hair resulting in hair loss
2. Repeated attempts to decrease or stop hair pulling
+ Clinically significant distress or impairment
+ Not attributable to another medical condition
+ Not better explained by another mental disorder

49

Diagnostic criteria of Excoriation (Skin-Picking Disorder)

1. Recurrent skin picking resulting in skin lesions
2. Repeated attempts to decrease or stop skin picking
+ Clinically significant distress or impairment
+ Not attributable to physiological effects of a substance or another medical condition
+ Not better explained by another mental disorder

50

Identify classification of Obsessive-Compulsive and Related Disorders

Obsessive-Compulsive Disorder (1.6%-2.3%)
Body Dysmorphic Disorder
Hoarding Disorder (2%-5%)
Trichotillomania (Hair-Pulling Disorder)
Excoriation (Skin-Picking Disorder)
Substance/Medication-Induced Obsessive-Compulsive and Related Disorder
Obsessive-Compulsive and Related Disorder Due to Another Medical Condition
Other Specified Obsessive-Compulsive and Related Disorder
Unspecified Obsessive-Compulsive and Related Disorder

51

Diagnostic criteria of Somatic Symptom Disorder

Threshold Duration: > 6 months
1. At least one somatic symptom that is distressing and/or disruptive in daily life
2. Excessive thoughts/feelings/behaviors related to somatic symptom or associated health concerns through the ff. (at least one): a. disproportionate to seriousness of symptom; b. high level of health-related anxiety; c. excessive time and energy devoted
Specify if:
With predominant pain
Persistent (severe symptoms, marked impairment, long duration)
Severity: Mild; Moderate; Severe

52

Diagnostic criteria of Illness Anxiety Disorder (Hypochondriasis)

Threshold Duration: > 6 months
1. Preoccupation with having OR acquiring serious illness
2. Somatic symptoms are not present OR if present, only mild OR if medical condition present or high risk of developing it, preoccupation is excessive or disproportionate
3. High level of health-related anxiety and easily alarmed about personal health status
4. Performs excessive health-related behaviors (care-seeking) OR maladaptive avoidance (care-avoidance)
+ Not better explained by another mental disorder
Specify whether:
Care-seeking type
Care-avoidance type

53

Diagnostic criteria of Psychological Factors Affecting Other Medical Conditions

1. Present medical symptom or condition
2. Physiological/behavioral factors adversely affect of medical condition through the ff. (at least one):
a. exacerbation of or delayed recovery from medical condition
b. interfere with treatment, such as poor adherence
c. additional health risks
d. precipitate or exacerbate medical symptoms or necessitate medical attention
+ Not better explained by another mental disorder
Specify severity:
Mild (increased medical risk)
Moderate (aggravated underlying medical condition)
Severe (medical hospitalization or ER visit)
Extreme (severe, life-threatening risk)

54

Diagnostic criteria of Conversion Disorder (Functional Neurological Symptom Disorder)

1. At least one symptom of altered voluntary motor or sensory function
2. Incompatibility between symptom and recognized neurological/medical conditions through clinical findings
+ Not better explained by another medical or mental disorder
+ Clinically significant distress or impairment in functioning OR warrants medical evaluation

55

Diagnostic criteria of Factitious Disorders

1. Falsification of physical/psychological signs or symptoms OR induction of injury or disease, associated with identified deception
2. Presentation of oneself to others as ill, impaired or injured
3. Deceptive behavior evident even in the absence of obvious external rewards
+ Not better explained by another mental disorder
Specify if:
Single episode
Recurrent episodes

56

Identify classification of Somatic Symptom and Related Disorders

Somatic Symptom Disorder
Illness Anxiety Disorder (Hypochondriasis)
Psychological Factors Affecting Other Medical Conditions
Conversion Disorder (Functional Neurological Symptom Disorder)
Factitious Disorders
Other Specified Somatic Symptom and Related Disorder
Unspecified Somatic Symptom and Related Disorder

57

Diagnostic criteria of Depersonalization-Derealization Disorder

1. Persistent or recurrent experiences of:
a. depersonalization (unreality, detachment or being an outside observer with respect to one's thoughts, feelings, sensation, body or actions AND/OR
b. derealization (unreality or detachment with respect to surroundings)
2. Reality testing remains intact during depersonalization or derealization experience
+ Clinically significant distress or impairment
+ Not attributable to physiological effects of substance or another medical condition
+ Not better explained by another mental disorder

58

Diagnostic criteria of Dissociative Amnesia

1. Inability to recall important autobiographical information usually of a traumatic or stressful nature (localized/selective amnesia for specific event or generalized amnesia for identity and life history)
+ Clinically significant distress or impairment
+ Not attributable to physiological effects of substance or another neurological / medical condition
+ Not better explained by another mental disorder
Specify if:
With dissociative fugue

59

Diagnostic criteria of Dissociative Identity Disorder

1. Disruption of identity by at least two distinct personality states with marked discontinuity in sense of self, related alterations in affect, behavior, consciousness, memory, perception, cognition and/or sensory-motor functioning as observed by others or reported by individual
2. Recurrent gaps in recall of everyday events, important personal information and/or traumatic events but NOT ordinary forgetting
+ Clinically significant distress or impairment
+ Not part of accepted cultural or religious practice
+ Not attributable to physiological effects of substance or another medical condition

60

Identify classification of Dissociative Disorders

Depersonalization/Derealization Disorder
Dissociative Amnesia
Dissociative Identity Disorder
Other Specified Dissociative Disorder (e.g. dissociative trance)
Unspecified Dissociative Disorder

61

Diagnostic criteria for Disruptive Mood Dysregulation

Threshold Duration: > 1 year
1. Severe recurrent temper outbursts manifested verbally and/or behaviorally that are grossly out of proportion to situation or provocation
2. Temper outbursts are inconsistent with developmental level
3. Temper outbursts occur, on average, 3 or more per week
4. Persistently irritable or angry mood between temper outbursts most of the day, nearly every day and observable by others
(to be contd)