Assessment And Dx Flashcards
(331 cards)
1
Q
MMPI2 validity scale k
A
Measures guardedness and defensiveness
Serves as moderator variable— adjusts for defensiveness
2
Q
MMPI scale L
A
Naive attempt to present favorably
3
Q
MMPI F scale
A
Measures infrequently endorses items- used to assess overall distress and pathology, attempts to fake bad or random responding
4
Q
MMPI VRIN and TRIN
A
Response inconsistency or random responding
5
Q
Standard error of estimate
A
Direct rel with the SD of criterion
Indirect rel w validity (when validity is high, there should be little error in prediction and vice versa)
6
Q
Halo effect
A
Being influenced by only 1 attribute when evaluating so
Can be controlled by training, utilizing forced choice, and objective methods like the BARS
7
Q
Range of standard error of measurement
A
Index of Amt of error expected in obtained score for individuals d/t unreliability of the test
0 to SDx (test)
8
Q
Range of validity coefficient
A
-1 to 1
9
Q
Range of reliability coefficient
A
0 to 1
10
Q
Range of standard error of estimate
A
0 to SDy (criterion)
11
Q
selection ratio
A
of openings over # of applicants
12
Q
base rate
A
rate of successful hiring without test
13
Q
criterion validity
A
correlation between scores on the validity test and scores on the outcome measure of performance production
14
Q
what effects incremental validity
A
base rate, selection ratio, criterion validity
15
Q
concordance rates for twins with bipolar
A
75%
16
Q
adverse impact
A
percentage of minorities hired is less than 4/5 % of non-minorities. Can multiply hiring rate for non minorities by .8
17
Q
Reliability
A
Consistency.
Correlating the test with itself.
Do items measure what they’re supposed to measure?
Ex. .84 means 84% of variability in scores is due to score differences among examinees and 16% is due to measurement error
18
Q
Factors that affect reliability
A
- Test length- longer is better for rel
- Range of scores- unrestricted is best for rel
- Guessing - as probability of guessing right increases, rel decreases
19
Q
Content validity
A
Extent to which a measure represents all facets of a given construct
Ex depression scale may lack content validity if it only measures affect
20
Q
Construct validity
A
The degree to which a test measures what it claims to be measuring
Do all items measure the same construct?
21
Q
Criterion validity
A
Extent to which a measure is related to an outcome
Concurrent: compare measure in question and an outcome measured at the same time
Predictive: compares the measure in question with an outcome predicted at a later time
22
Q
item response theory
A
It is a theory of testing based on the relationship between individuals’ performances on a test item and the test takers’ levels of performance on an overall measure of the ability that item was designed to measure.
23
Q
criterion keying approach to constructing a personality inventory (i.e., MMPI)
A
discriminate among various criterion groups
24
Q
primary mental abilities test
A
multifaceted test of intelligence
25
Tourette's sx
1 or more vocal tic with motor tics.
duration of more than 1 yr
onset before age 18
pds of remission can last up to 3 mo
obsessions/compulsions (40-60%)
hyperactivity, impulsivity, (50%)
tx: antipsychotics: haldol &; pimozide (effective 80%)
excessive dopamine
treat hyperactive not with stimulant but with clonodine or desipramine (antidepressant)
26
anterograde amnesia
loss of ability to create new memories
27
retrograde amnesia
loss of memory of events that took place before amnesia
28
substance dependence
```
3sx in 12 mo:
tolerance
withdrawal
larger amounts/longer periods
keep using despite impairment
NOT cravings
```
29
nicotine dependence
3-4x more likely to have heart attack or stroke. 1-5 yrs after quitting, risk returns to normal. 65% who attempt to uit fail in 3 mo. only 7.5% achieve long term abstinence. 91% quit on their own.
30
amphetamine or cocaine withdrawal
dysphoric mood, fatigue, vivid/unpleasant dreams, insomnia/hypersomnia, increased appetite, psychomotor agitation/retardation
31
alcohol withdrawal
autonomic hyperactivity (sweat, tachycardia), hand tremor, insomnia, nausea/vomiting, transient illusions or hallucinations, anxiety, psychomotor agitation, grand mal seizures
32
treatments for depression
combined tx of meds and therapy is best for severe or recurring
combined not more effecvtive for mild or moderate cases
33
OCD
decrease in serotonin and oversensitivity in right caudate nucleus
increase in activity in orbitofrontal cortex, cingulate cortex and caudate nucleus
= in sexes in adult; kids earlier onset in males so boys are higher than girls
tx: exposure with response prevention; tricyclic clomipramine or SSRI (antidepressants associated with high risk of relapse so rarely used alone)
34
conversion disorder
physical sx with no medical explanation
NOT intentionally produced
primary gain: keep conflict out of consciousness; secondary gain: avoid unpleasant activity or support
35
malingering
physical sxs with no medical explanation but voluntarily produced with goal of gaining a reward
36
factitious disorder
intentionally produced or feigned physical or psychological sx with purpose to adopt sick role
tx: supportive therapy
37
Factors to consider when evaluating the appropriateness of a psychological test
1. examiner qualifications
2. examinee characteristics
3. test characteristics
38
test characteristics
1. reliability and validity
2. standardization
3. types of scores (norm-criterion or self-referenced)
39
standardization
1. scores collected at different times and places are comparable
2. has been administered under standard conditions to a representative sample for purpose of establishing norms
40
types of scores
1. norm referenced
2. criterion-referenced
3. self-referenced
41
norm referenced scores
permit comparisons between an examinees test performance and the performance of individuals in the norm group
e.g., percentile rank and standard scores
42
criterion-referenced scores
aka domain referenced scores and content referenced scores
permit interpreting an examinees test performance in terms of what the examinee can do or knows with regard to a clearly defined content domain. e.g., percent - may be compared to a cutoff percentage
43
self-referenced scores
provided by ipsative scales - can compare your scores in one domain to your scores in another domain
44
types of psychological assessment
1. behavioral assessment
2. dynamic assessment
3. computer-assisted assessment
45
behavioral assessment
focuses on overt and covert behaviors that occur in specific circumstances e.g., functional behavioral assessent
46
dynamic assessment
Vygotsky
interactive approach and deliberate deviation from standardized testing procedures to obtain additional info about the examinee and to determine if the examinee is likely to benefit from assistance or instruction
educational assessment and personality and social fxning
47
testing the limits
type of dynamic assessment
providing examinee with additional cues, suggestions, or feedback - done after standard administration of the test
48
types of dynamic assessment
1. testing the limits
2. graduated prompting
3. test-teach-retest
49
graduated prompting
giving a series of verbal prompts that are graduated in terms of difficulty level
50
test-teach-retest
following initial assessment with intervention designed to modify the examinee's performance and then re-assessing
51
computer-assisted assessment
used to administer, score, and interpret results
52
computer adaptive testing
tailors the test to an individual examinee
advantages: precision and efficiency
53
Actuarial (statistical) predictions
based on empirically validated relationships between test results and specific criteria
make use of a multiple regression equation or similar statistical technique
54
clinical predictions
based on intuition, experience, and knowledge
55
which is more accurate? actuarial v clinical predictions
actuarial
56
interviews can be used to obtain reliable and valid data from children as young as
6
57
techniques used to assess children
1. descriptive statements
2. reflection
3. labeled praise
4. avoid critical statements
5. open ended questions
58
2 goals when interviewing children
establish rapport and maintain child's cooperation
59
use of anatomically correct dolls to assess for child sexual abuse
children who have been abused are more likely to demonstrate sexual activity when presented with the dolls than nonabused children
do not cause children to act more suggestively
no widely accepted standards
no evidence that anatomical dolls are better than regular dolls
60
assessing members of culturally diverse populations
acculturation
racial/ethnic identity,
language proficiency
availability of appropriate norms
cultural equivalence of the content or construct measured
availability of alternatives that are more appropriate
61
guidelines for selecting, administering and interpreting assessment procedures for diverse populations
1. be clear about the purpose of the assessment
2. sensitive to test content
3. alternative methods when possible
4. ethnic norms
5. self-monitor their level of assessment expertise
62
racial/cultural differences between examinee and examiner
no consistent effect of a match or mismatch
rapport and examiner's attitude may be more critical to test performance
63
Spearman's two-factor theory
general intellectual factor (g). performance on any cognitive task depends on g plus one or more specific factors (s) unique to the task
64
Horn & Cattell's theory of intelligence
crystallized v fluid
65
Crystallized intelligence
acquired knowledge and skills, is affected by educational and cultural experiences, and includes reading and numerical skills and factual knowledge
66
Fluid intelligence
does not depend on specific instruction
is culture-free
enables an individual to solve novel problems and perceive relations and similarities
67
Three-stratum theory of intelligence
Carroll
Stratum III is g
stratum II consists of 8 broad abilities including fluid, crystallized, general memory and learning,
Stratum I consists of specific abilities that are each linked to one of the second stratum abilities . e.g., crystallized intelligence is linked to language development, comprehension, spelling, communication
68
Cattell-Horn-Carroll Theory
McGrew
developed on basis of empirical research
serves as framework for KABC-II and WJ IV
distinguishes bt 10 broad-stratum level abilities and over 70 narrow -stratum abilities that are each linked to one of the broad stratum abilities
g does not contribute to psychoeducational assessment practice
69
Convergent and Divergent Thinking
Guilford
structure-of-intellect model
distinguishes between convergent and divergent thinking
convergent: rational, logical reasoning and involves the use of logical judgement and consideration of facts to derive the correct solution
divergent: nonlogical processes and requires creativityy and flexibility to derive multiple solutions
70
Triarchic theory of intelligence
Sternberg
successful intelligence = ability to adapt to, modify, and choose environments that accomplish one's goals
3 abilities: analytical, creative, and practical
71
Gardener's multiple intelligences
```
8 types of cognitive ability:
linguistic
musical
logical-mathematical
spatial
bodily-kinesthetic
interpersonal
intrapersonal
naturalistic
```
not static- can be developed by exposure to appropriate learning experiences
72
Concordance rates for IQ scores:
| Identical twins reared together -
.85
73
Concordance rates for IQ scores:
| Identical twins reared apart-
.67
74
Concordance rates for IQ scores:
| Fraternal twins reared together-
.58
75
Concordance rates for IQ scores:
| Bio siblings reared together
.45
76
Concordance rates for IQ scores:
| Bio siblings reared apart
.24
77
Concordance rates for IQ scores:
| Bio parent and child (together)
.39
78
Concordance rates for IQ scores:
| Bio parent and child (apart)
.22
79
Concordance rates for IQ scores:
| adoptive parent and child
.18
80
Variability in intelligence due to genetic factors
between 32 and 64% in industrialized countries
81
Role of the environment on IQ scores
a. confluence model
| b. Flynn effect
82
Confluence model
children's IQ scores decreasing from the child that is born first to the child that is born last
83
Flynn effect
increase in IQ
d/t increases in fluid intelligence
not explained by genetics. d/t environmental factors
continues in US for individuals with IQs ranging from 70-109 but has reversed for individuals with IQs of 110 and above
84
IQ scores become consistent after age
7
85
crystallized intelligence increases until age
60
86
fluid intelligence peaks in ___ and then___
late adolescence
| declines
87
declines in fluid intelligence are attributed to
declines in working memory and processing speed
88
Seattle Longitudinal Study
combined cross-sectional and longitudinal design
(cross-sequential)
cross sectional design is more likely to find early age-related declines in IQ because it is more vulnerable to cohort effects
longitudinal design shows- intelligence remains stable or slightly increases over time until about age 60. only perceptual speed declined before 60
89
factors related to cognitive decline
1. many items and tasks emphasize speed of information processing
2. physical health - cardiovascular functioning - which impacts information processing speed and other cognitive functions
4. disuse - can be reversible
90
differences in intelligence d/t gender
no diff on avg. performance
differences are small and may be declining:
females do better on some measures of verbal ability, esp during school years, and are less likely to have a reading disability
males outperform females on measures of certain spatial and math skills - spatial skills showing the largest gender gap
differences d/t biology and also environment (opportunity)
91
differences in IQ d/t ethnicity and race
Whites outperform AA by one SD on IQ and achievement tests; gap has narrows somewhat since 70s
92
2 types of IQ test bias
1. slope bias
| 2. intercept bias
93
Slope bias
differential validity -- validity coefficients for a predictor differ for different groups
94
intercept bias
unfairness -- validity coefficients and criterion performance for different groups are the same but their mean scores on the predictor differ. so the predictor consistently over- or under- predicts performance on the criterion for members of one of the groups
95
Standford Binet (SB5) age range
2 - 85+
96
SB5 goals
1. general cognitive ability
2. psychoeductational evaluation
3. diagnosis of developmental disabilities
4. forensic career
5. neuropsych
6. early childhood assessment
97
development of the SB5
hierarchical g model
incorporates 5 cognitive factors from CHC model: fluid reasoning, knowledge, quantitative reasoning, visual-spatial processing, working memory
98
administration of the SB5
tailored to level of cognitive fxn thru routing and functional subtests
99
Scoring and interpretation of the SB5
subtest scores (M =10, SD =3 ) combined to obtain 4 composite scores (M= 100, SD = 15): FSIQ, Factor Index (FR, KN, QR, VS, WM), Domain (verbal, nonverbal), and abbreviated battery IQ
100
WAIS-IV age range
16-90:11
101
Wechsler's view of IQ
global ability comprised of numerous and interrelated functions that allow the individual to "act purposefully, think rationally, and deal effectively with environment"
102
goals of recent revision to WAIS
1. enhance user friendliness
2. increase test's clinical utility
3. improve psychometric properties - update norms, reduce item bias, and improve test's floor and ceiling (now 40-160)
103
WAIS IV indexes
WMI (digit span, arithmetic)
VCI (vocal, similarities, information)
PSI (symbol search, coding)
PRI (block design, MR, visual puzzles)
104
when to interpret WAIS IV with caution
when a diff of 1.5 SD or more between any 2 index scores bt any 2 subtest scores that comprise an index
105
when to obtain GAI on WAIS IV
minimize impact of WMI and PSI
106
composite score range on WAIS IV for:
| mild cognitive impairment
93+
107
composite score range on WAIS IV for:
| Alzheimer's (mild)
76-86
| PSI = 76
108
composite score range on WAIS IV for:
| MDD
95+
109
composite score range on WAIS IV for:
| ADHD
94+
| WMI and PSI lowest
110
composite score range on WAIS IV for:
| TBI
80-86
| PSI lowest
111
WISC-V age range
6-16:11
112
WISC-V domains
FSIQ, VCI, VSI, FR, WMI, PSI
113
WPPSI-IV age range
2:6-7:7
114
WPPSI-IV domains for children 2:6-3:11
FSIQ, Verbal Comp, VSI, and WMI
| ancillary: Vocab Acquisition, Nonverbal, and GA
115
WPPSI-IV domains for children 4+
FSIQ, Verbal comprehension, VSI, FR, WMI, PS
| ancillary: Vocal acquisition, nonverbal, cognitive proficiency, and GA
116
KABC-II age range
3-18:11
117
KABC-II goals
culture fair test by minimizing verbal instructions and responses
118
KABC-II scales
Simultaneous, Sequential, Planning, Learning, Knowledge
119
KABC-II Interpretation is based on
CHC model or Luria's neuropsychologist processing model (recommended when performance on measures of crystallized ability would be negatively impacted by a non-mainstream cultural background, language, or hearing impairment, autism, or other factor
120
KBIT -2 age range and domains
4-90+
| crystallized and nonverbal (fluid) ability
121
KAIT age range and domains
11-85+
| fluid, crystallized, and composite IQ
122
Cognitive Assessment System (CAS2) measures __ and is designed to assist with ___
cognitive processing abilities that are central to learning
Differential diagnosis, determining eligibility for special ed, instructional planning
123
CAS2 is based on ++++ model of intelligence, which ___
PASS
| distinguishes bt 4 cognitive functions- planning, attention, simultaneous processing, sequential processing
124
SIT-P-1 goal
obtain quick estimate of mental ability and identify children at risk for educational failure or who require more extensive testing
125
Slosson Intelligence Test-Revised 3rd Edition for Children and Adults (SIT-R3-1) : age range and goal
4- 65:11
screening test for crystallized (verbal) IQ
* may be used to test those with visual impairments
IQs between 36-164
126
Woodcock Johnson tests: ___; based on ___ theory of IQ
WJ-IV tests of cognitive abilities
WJ-IV tests of oral language
WJ-IV tests of Achievement
CHC
127
WJ-IV age range
2-80+
128
Denver Developmental Screening Test (Denver II)
brief assessment device for developmental delays
birth -6yo
4 domains: personal-social, fine motor adaptive, language, gross motor
developmental delay: fail on an item that 90% of children pass
an be administered by a para with only a few hours of training
129
Bayley (Bayley-III)
current developmental status of infants and toddlers ages 1-42 mo
subtests: cognitive, motor, language, social-emotional, and adaptive
130
Fagan Test of Infant Intelligence (FTII)
based on research indicating that measures of information processing administered during infancy are good predictors of IQ in childhood
assesses selective attention to novel stimuli - ability to abstract and retain information
score: amount of time spent looking at pictures of new vs. familiar faces
infants 3-12 mo
identify infants with cognitive impairments
131
ADA and assessment
any test administered to a job applicant with a disability must accurately measure the skills and abilities the test was designed to measure rather than reflect their disability
132
Columbia Mental Maturity Scale - Third Edition (CMMS)
test of general reasoning for children ages 3:6-9:11
no verbal responses or fine motor skills
92 cards - have to pick the drawing that does not belong
children with CP, brain damage, ID, speech impairments, hearing loss, limited English proficiency
133
Peabody Picture Vocabulary Test (PPVT-4)
measures receptive vocab - estimate of verbal intelligence
2:6-90+
ppl with motor or speech impairment
134
Haptic Intelligence Scale for the Adult Blind
16+ who are blind or partially sighted
tactile stimuli; 6 subtests: digit symbol, object assembly, block design, object completion, pattern board, bead arithmetic
135
Hiskey-Nebraska Test of Learning Aptitude
3-17:6
learning ability when you have hearing or language impairments
administered verbally or in pantomime
consists of 12 nonverbal subtests that measure broad range of IQ
136
culture fair tests
reduced cultural content
nonverbal format
may be just as culturally loaded; discrepancies in test performance may be d/t diff in test-taking motivation, interest, problem solving, cognitive styles, and attitudes toward standardized tests
137
culture fair tests - examples
CMMS, KABC-II, Leiter, Raven's Progressive Matrices
138
Leiter Internal Performance Scale-Third Edition (Leiter-3)
culture fair measure of cognitive abilities for individuals aged 3-75+
no verbal instruction
also useful for those with language problems or hearing impairment
match a set of response cards to corresponding illustrations
emphases: fluid intelligence and 4 domains: visualization, reasoning, memory, attention
139
Raven's Progressive Matrices:
nonverbal measures of g
culturally independent
used with indiv who are hearing/language impaired, or physical disability
solve problems involving abstract figures and designs by indicating which of several alternatives complete a matrix
140
most commonly used version of Raven's Progressive Matrices
Standard Progressive Matrices (SPM) - 60 matrices that require examinee to choose missing section from 6 alternatives
6+
141
shorter, easier version of Raven's Progressive Matrices
Colored Progressive Matrices (CPM)
| 5-11:0, older adults, and individuals with mental or physical impairments
142
Group Intelligence Tests for School and Industry
Kuhlmann-Anderson
Cognitive Abilities Test
Wonderlic Test
143
Kuhlmann-Anderson Test
grades K-12
evaluates school learning ability
Verbal, quantitative, and total scores
less dep on language than other individual and group IQ tests
144
Cognitive Abilities Test
reasoning abilities in 3 areas that are linked to academic success- verbal, quantitative, and nonverbal
K-12
used to predict school grades and determine eligibility in GAT
145
Wonderlic Personel Test (WPT-R)
12 min. test of cognitive abilities for adults
50 verbal, numerical, spatial items
used by employers for hiring decisions
146
Wonderlic Basic Skills Tests (WBST)
40 min test that assesses job related verbal and math skills and is used by educational institutions and employers to evaluate employability for entry level career position
147
Instructional Assessments
1. Curriculum Based measurement (CBM)
| 2. Performance Based Assessment (PBA)
148
Curriculum Based Measurement (CBM)
periodic assessment of school aged children with brief standardized and validated measures of basic academic skills e.g., Diagnostic Dynamic Indicators of Basic Literacy Skills (DIBELS)
149
Curriculum Based Measurement (CBM) v Curriculum Based Assessment (CBA)
some do not distinguish.
others say CBA= teacher made tests
150
Performance Based Assessment (PBA) aka; centerpiece of ____
Authentic assessment
Goals 2000 - proposed by Clinton admin
151
Performance Based Assessment (PBA)
observing and judging a student's skill in actually carrying out a physical activity (giving a speech)
+better for assessing kids from culturally and + linguistically diverse populations
- might be based on prior knowledge than what was learned
152
Tests for identifying learning disabilities
1. Illinois Test of Psycholinguistic Abilities (ITPA-3)
2. Wide-Range Achievement Test (WRAT4)
3. Wechsler Individual Achievement Test (WIAT-III)
153
Illinois Test of Psycholinguistic Abilities (ITPA-3)
age range: 5-12:11
evaluate a child's strengths and weaknesses in linguistic abilities, assist in dx of dyslexia and problems re: phonological coding, and track a child's progress
Based on Osgood's communication model
154
Wide Range Achievement Test (WRAT-4)
age range 5-94:11
rapid screening device for assessing reading, spelling and math skills
155
WIAT-III
age range 4-50:11
assesses 8 areas of achievement identified by the IDEA as important for identifying learning disabilities
156
Admission Tests
1. SAT
| 2. GRE
157
SAT best predictor of first year college GPA
writing subtest
best combo: SAT scores + high school GPA
less accurate for predicting college GPA for those scoring in the middle
related to SES and ethnicity
coaching produces avg. increase of 25-35 points for students whose skills are rusty of nonexistent
158
Aptitude Tests measure
potential for learning a specific skill but overlap with achievement tests
159
Aptitude Tests examples
1. Multiple Aptitude Test Batteries (poor differential validity)
2. Occupational Tests of Specific Aptitude (low predictive validity- better when predicting training program performance v on the job success)
160
Validity of interest inventories
good predictors of : occupational choice, satisfaction, and persistence
less valid than IQ tests for predicting academic and occupational success
better predictors when combined with measures of self-confidence, self-efficacy, and personality
161
Types of interest inventories
1. Strong Interest Inventory
2. Kuder Tests
3. Self-Directed Search
162
Holland's Theory of Career Choice emphasizes
the importance of matching a person's preferences to the characteristics of the job
163
Holland's 6 themes
RIASEC
```
Realistic
Investigative
Artistic
Social
Enterprising
Conventional
```
164
Holland's themes - Realistic
technical, physical, mechanical and outdoor (occupations- engineer, mechanic, etc.)
165
Holland's themes- Investigative
Preferences are scientific, mathematical, analytical (occupations - biologist, veterinarian, mathematician, professor)
166
Holland's themes- Artistic
music, art, writing, drama (occupations - artist, actor, musician, writer, interior designer, )
167
Holland's themes- Social
working with and helping others (occupations - teacher, psychologist, SW, nurse, minister, personnel manager)
168
Holland's themes - Enterprising
competition, management, sales, public speaking (occupations - sales manager, realtor, stockbroker, financial planner, buyer)
169
Holland's Themes - Conventional
structured, unambiguous activities that involve organizing data, attending to detail and following through on other's instructions (occupations - accountant, admin asst, actuary, technical writer, paralegal, banker)
170
Self-Directed Search based on
Holland's theory of career choice
171
Self-Directed Search (SDS) appropriate for___; provides ___
Hs students, college students, adults
compare 3 letter summary code (3 highest scores) to profiles that correspond to 1300 occupations, 750 postsecondary fields of study, 700 leisure activities
172
factors that Holland believed affect a person's readiness for career decision-making
1. congruence - degree of consistency between expressed interests and the summary code
2. Coherence - expressed interest belong to the same RIASEC categories
3. Consistency - similarity of the 2 strongest measured interests
4. Differntiation - distinctiveness of interests (high score on one, low on all others)
5. commonness - frequency that summary code appears in normative groups
173
Ways to construct a personality test
1. logical content method - reason and deductive logic
2. theoretical method- e.g., ayers-briggs type based on Jung's personality theory
3. Empirical Criterion Keying- e.g., MMPI
4. Factor Analysis - e.g., Cattell's 16 personality factor questionnaire and NEO personality inventory
174
MMPI-2 age range and reading level
18+
| at least 5,6,or 8 th grade
175
scoring and interpretation of MMPI-2
raw scores converted to T scores (mean of 50 and sd of 10)
| 65 + is clinically significant
176
Scores on the L, f, K scales assume V-shaped pattern
attempt to "fake good." common for child custody litigants
177
extremely elevated F scale with a high value on F-K
symptom exaggeration "fake bad"- linked to malingering
178
L and K are around 50; F is slightly elevated; clinical score profile is "saw toothed"
malingering
179
very elevated F and high scores T >65
random responding
180
L and K are below 50, and F and clinical scores on the right side of the profile (6-9) are very elevated
"true" to all items
181
"false" to all items
scores on all 3 validity scales and clinical scale scores on the left side (1-5) are elevated
182
MMPI2 most commonly used for
assessing personality and behavior through profile analysis.
not good for differntial diagnosis
183
neurotic triad of conversion V
1-2-3 code with scale 1 and 3 higher than 2
somatization of psychological problems, lack of insight, and chronic pain that has an organic basis
184
paranoid valley or psychotic v
6-7-8 with 6 and 8 higher than 7
delusions, hallucinations, disordered thought
185
one problem with standardization sample for MMPI-2
mostly college graduates
186
multicultural assessment of MMPI2
AA tend to score higher on F and scales 4, 8, 9 than Whites but some think this is not clinically significant
appropriate for use with diverse groups when SES, education, acculturation taken into account
187
Edwards Personal Preference Schedule (EPPS)
based on Murray's personality theory - distinguishes 15 basic needs
forced choice format:
1. controls for social desirability
2. permits comparison of relative strengths but not absolute strengths
188
Sixteen Personality Factor Questionnaire
based on Cattell
factor analysis
Can compare profile with profiles associated with certain groups (e..g, delinquents)
189
NEO Personality Inventory -3
Costa and McCrae
assess Big Five Personality traits - extraversion, agreeableness, conscientiousness, neuroticism, and openness to experience
190
original identification of Big 5 traits based on
theoretical lexical approach - all socially relevant traits are encoded in language
Allport
replicable across cultures with exception of openness and asians
E, A, and O lowest in East Asian nations; A and C highest in African nations
191
Myers-Briggs Type Indicator
Jung
4 bipolar dimensions: Introversion-Extraversion (I-E), Sensing-Intuition (S. N), Thinking-Feeling (T, F), Judging -Perceiving (J, P)
Forced choice items
often used for career counseling but validity has mixed results
192
Projective Tests share 3 characteristics
1. ambiguous and unstructured stimuli can elicit meaningful info (projective hypothesis)
2. less susceptible to faking
3. reveal unconscious, global aspects of personality
193
Rorschach age range and phases
ages 2+
1. free association - presents 10 cards in order, keeps track of what subject says
2. inquiry phase - examiner questions examinee about features of the inkblot
194
Scoring the Rorschach based on
1. location - whole or detail?
2. determinants - what determined the response? color?
3. form quality - how similar perception is to actual shape
4. content - human, animal, nature
5. popularity - how often a response is elicited
195
psychometric properties of Rorschach
originally: no good for clinical use; ok for research
| later tests show: better validity than we thought
196
Thematic Apperception Test (TAT)
Henry Murray's theory of needs
make up a story about each picture
little utility for assigning specific diagnoses; may be useful for gross diagnostic distinctions (schizophrenia v neurosis)
197
2 most common NP batteries
1. halstead-reitan
| 2. Luria-Nebraska
198
Halstead-Reitan (H-R) NP Battery
used to detect presence of brain damage and determine severity and possible location
15+
Halstead Impairment Index (HII) ranges from 0 to 1: 0 to .2 suggests normal fxn; 0.3 to 0.4 mild impairment; .5 to .7 moderate impairment; 0.8 to 1 severe impairment
199
Luria-Nebraska NP battery (LBNB)
11 content scales that assess various aspects of NP fxn: motor, visual spatial, memory, language
raw score 0 to 2; 0 = normal, 2 = brain injury
converted to T scores
children 8-12 and adults 13+
200
How is LBNB is different from HR
1. less time to administer
2. more standardized
3. provides complete coverage of deficits and more precise identification of brain damage
201
Individual NP tests
1. Bender Visual-Motor Gestalt Test
2. Benton Visual Retention Test
3. Beery-Buktenica Developmental test of Visual-Motor Integration
4. Wisconsin Card Sorting Test
5. Stroop Color-Word Association
6. Tower of London
7. Wechsler Memory Scale-IV
8. Mini Mental Status Exam
9. Glasgow Coma Scale
10. Rancho Scale of Cognitive Functioning Revised
202
Bender Visual Motor Gestalt Test (Bender-Gestalt II)
visual motor integration
3+
copy and recall phase
screening for brain damage; should use with other measures
school readiness in first graders, academic achievement, and emotional problems and learning disabilities
up to age 10- scores correlate with IQ
203
Benton Visual Retention Test (BVRT)
visual memory, visual perception, visual-motor skills to identify brain damage in 8+
204
Beery VMI
visual motor integration
ages 2 +
id deficits associated with neurological impairments or might lead to learning and behavior problems
205
Wisconsin Card Sorting Test (WCST)
ages 6:6 to 80:11
form abstract concepts and shift cognitive strategies in response to feedback
sensitive to frontal lobe damage; impaired performance is linked to alcoholism, autism, schizophrenia, depression, and malingering
206
Stroop
can you suppress a prepotent (habitual) response in favor of an unusual one
measures cognitive flexibility, selective attention, and response inhibition
sensitive to frontal lobe damage; poor performance associated with ADHD, mania, depression, and schizophrenia
207
Tower of London
measures attention, memory, and EF
frontal lobe damage, ADHD, autism, depression
208
Wechsler Memory Scale-IV
older adolescents and adults
Auditory memory, Visual memory, Visual working memory, Immediate memory, and Delayed memory
209
Mini Mental Status Exam (MMSE)
screening tool for cog impairment in older adults
sometimes used for dementia but should not be solely used for that purpose
Scores below 23/24 meaning cognitive impairment
relies heavily on verbal responses - use with caution for those with communication disorder, limited english, etc.
210
Glasgow Coma Scale
assess level of consciousness following brain injury
visual response (eye opening), best motor response, best verbal response
scores from 3-15; lower score indicating more severe brain injury. 3-8= unconscious state
211
Rancho Scale of Cognitive Functioning Revised
measure of cognitive recovery during first weeks to months following head injury
rate pt on 10 levels ranging from I- no response to 10= purposeful, appropriate: modified independent
212
Beck Depression Inventory (BDI-II)
21 items assessing mood, cognitive, behavioral, and physical aspects of depression
0-13= minimal; 14-19= mild; 20-28= moderate; 29-63= severe
213
Assessment for ADHD
1. broad-band scale to assess general behavioral and psych functioning
2. narrow-band scale to get detailed info on sx of ADHD
214
Assessment for Autism
CARS2, ABC, ADI-R
children with autism tend to find embedded figures faster than peers without the disorder on the Embedded Figures Test
215
Assessment of ID per IDEA
1. all disabled persons from infancy to 21 yo must be evaluated by a team of specialists
2. an IEP must be developed; least restrictive environment
3. assignment to special ed classes can not be made on basis of IQ only
216
Vineland
birth to 90 yo
| evaluate personal and social skills for those with ID, ASD, aDHD, brain injury, dementia
217
AAMR Adaptive Behavior Scales
assesses 5 areas: personal self-sufficiency, community self-sufficiency, personal-social responsibility, social adjustment, and personal adjustment
ABS school - 3-18:11 yo
ABS-Residential and Community - 18+
218
measuring malingering
validity scales on MMPI-2
symptom validity tests - less than 50% suggests deliberately choosing wrong answers
219
diagnostic uncertainty is indicated by
1) other specified disorder (clinician lists reason why symptoms don't meet criteria)
2) unspecified disorder (doesn't list reason)
3) provisional (not enough info to make dx)
220
level 1 cross cutting symptom measures assess
identifying areas that require additional evaluation (broad)
221
level 2 cross-cutting symptom measures assess
in-depth info. on specific domains to help guide diagnosis
222
assessment measures available in DSM or online
1) cross cutting symptom measures (in text)
2) disorder-specific severity measures (mostly online except for psychosis symptom severity measure in text)
3) World Health Org. Disability Assessment Schedule -2
4) Personality Inventories (online)
223
DSM tools to help with cultural formulation
1) outline for cultural formulation
2) cultural formulation interview
3) cultural concepts of distress
224
cultural concepts of distress
cultural syndromes
cultural idioms of distress
cultural explanations
225
cultural syndromes
clusters of symptoms that co-occur among individuals from a particular culture
226
cultural idioms of distress
used by members of different cultures to express distress and provide shared ways for talking
227
cultural explanations
explanatory models that members of a culture use to explain the meaning and causes of symptoms
228
Neurodevelopmental Disorders
```
ID
ASD
ADHD
LD
Tourette's
Behavioral Pediatrics
```
229
Intellectual Disability
1) deficits in intellectual functioning - confirmed by testing
2) deficits in adaptive functioning
3) onset during developmental period
4 stages of severity based on adaptive functioning
230
Course of Intellectual Disability
mild - may not be lifelong with intervention
231
Etiology of Intellectual Disability
30% d/t chromosomal changes and exposure to toxins during prenatal development (down syndrome)
30% etiology is unknown
15-20% to environmental factors and predisposing mental disorders
10% d/t pregnancy and perinatal problems
5% d/t acquired medical conditions during infancy (lead poisoning)
5% d/t heredity
#1 risk factor for etiology unknown = low birth weight
232
Childhood-onset fluency disorder
stuttering
disturbance in normal fluency and patterning of speech that is inappropriate for person's age
233
course/prognosis for childhood onset fluency disorder
begins between ages 2-7
worse when pressure to communicate
65-85% of children recover with severity of disfluency at age 8 being a good predictor of prognosis
234
treatment for childhood onset fluency disorder
reduce stress
relaxation for young children
older children and adults = habit reversal
235
ASD
1) deficits in social communication across multiple contexts
2) restricted, repetitive patterns of behavior, interests, and activities
3) sx during early developmental period
4) impairments
3 levels of severity: 1 requiring support; 2 requiring substantial support; 3 requiring very substantial support
236
associated features of ASD
language abnormalities
uneven cognitive profile
motor deficits
237
prognosis - ASD
1/3 with partial independence as adults
best prognosis: communicate verbally by age 5 or 6, IQ over 70, and later onset of symptoms
238
etiology ASD
1) unusually rapid head growth during first year
2) brain abnormalities in amygdala and cerebellum; serotonin, dopamine, and other neurotransmitters
3) genetic - rates higher for bio sibs
239
treatment - ASD
behavioral- shaping and discrimination training
240
ADHD
pattern of inattention and/or hyperactivity that has persisted for at least 6 mo., onset prior to age 12, is present in at least 2 settings, and interferes with functioning; must have 6 symptoms in a domain
sx fluctuate depending on setting
241
Associated features- ADHD
test lower on IQ tests even though IQ is generally average
exhibit academic difficulties
social problems
comorbidities: CD, LD, ODD, anxiety, MDD
adults - low self esteem, social problems, poorer health outcomes and lower educational and occupational achievement. at risk for bipolar, depression, anxiety, antisocial behavior, substance abuse
242
prevalence ADHD
5% children
| 2.5% adults
243
Gender and ADHD
children: 2:1 boys:girls
adults: 1.6:1
combined = more common for boys; inattentive = more common for girls
244
course/prognosis for ADHD
65-85% continue to meet dx criteria in adolescence
15% continue to meet as young adults; 60% meet in partial remission
gross motor activity in childhood declines; hyperactivity in adults looks like fidgeting, excessive talking, inner sense of restless
impulsivey in adults looks like patience, irritability, problems related to management of time and money, impulsive sexuality
inatention predominates symptom profile
245
etiology of ADHD
genetic component
lower than normal activity and smaller in size caudate nucleus, globes pallid us and prefrontal cortex
246
behavioral disinhibition hypothesis
core features of ADHD is inability to regulate behavior to fit situational demands
247
treatment of ADHD
methylphenidate (Ritlin) and other stimulants have beneficial effect on 75%
behavioral interventions
248
National Institute of Mental Health Multimodal Treatment Study of ADHD (MTA)
initially: medication alone and combined tx were best compared to behavioral intervention alone
longitudinal follow up: results above didn't persist and outcomes wre comparable to behavioral tx or community care
249
Specific LD
difficulties re: academic skills (Reading, writing, math)
1) at least 1 characteristic symptom that persists for at least 6 mo despite intervention
2) academic skills are substantially below those expected for age, interfere with performance or ADLs
3) begin during school age
250
associated features of LD
IQ is average to above
higher than normal rates of other problems - language delays, attention deficits, low self esteem
most frequent comorbidity: ADHD (20-30%)
also at higher risk for antisocial bx
251
course /prognosis for ADHD
continue through adolescence and adulthood esp when severe
| 1/3 of children with reading disorders have psychosocial problems as adults
252
gender and LD
2:1 -3:1 males:females
253
etiology of LD
cerebellar- vestibular dysfunction; incomplete dominance and other hemispheric abnormalities; exposure to toxins (lead), genetics
254
persistent (chronic) motor or vocal tic disorder
one or more motor OR vocal tics that have persisted for more than one year and began before age 18
255
provisional tic disorder
one or more motor and/or vocal tics that have been present for less than one year and began before age 18
256
treatment for medical procedures based on what theory
based on Meichenbaum's stress inoculation model
257
children ages __ have hardest time with hospitalizations
1-4
| d/t separation from family
258
risk of psychopathology is greatest for children with ___ medical condition
neurologic disorder (e.g., CP)
259
CNS irradiation and intrathecal chemotherapy are associated with
impaired neuro cognitive functioning and LDs
260
noncompliance in adolescence is often related to
concerns about peer acceptance, reduced conformity to rules, questioning of the credibility of health care provider, reduced parental supervision
261
delusions common in schizophrenia
persecutory
referential (passages from books are directed at you)
bizarre
262
most frequent hallucination
auditory
263
Delusional disorder
presence of 1 or more delusions that last at least 1 mo.
not marked impairments in functioning
a) erotomanic (someone in love with you)
b) grandiose
c) jealous
d) persecutory
e) somatic
264
Schizophrenia
at least 2 active phase sx (delusions, hallucinations, disorganized speech, disorganized behavior, negative symptoms) for at least 1 month
at least 1 symptom has to be delusion, hallucination, or disorganized speech
continuous signs for 6 mo.
265
associated features of schizophrenia
```
inappropriate affect
dysphoric mood
disturbed sleep
no interest in eating
anosognosia (poor insight into illness) - predictor of relapse
```
substance use disorder (esp tobacco)
NOT violent behavior
266
prevalence for schizophrenia
0.3 - 0.7%
| slightly lower for females
267
culture and schizophrenia
AA are often misdiagnosed d/t the fact they are more likely to experience hallucinations and delusions as symptoms of depression
developing countries: acute onset, shorter course, complete remission
268
course/prognosis for schizophrenia
peak onset for males: mid-20s
peak onset for females: late 20s
better prognosis is associated with good premorbid adjustment, acute and late onset, female gender, presence of a precipitating event, brief duration of active phase symptoms, insight into illness, family history of mood disorder, no family history of schizophrenia
269
etiology for schizophrenia
genetic component
brain abnormalities: enlarged ventricles, smaller hippocampus, amygdala, globes pallidus
lower activity in prefrontal cortex
Northern hemisphere - born in late winter or early spring (higher rate of infectious disease?)
270
dopamine hypothesis for schizophrenia
elevated levels of dopamine
271
differentiating schizophrenia from schizoaffective disorder, MDD, and bipolar with psychotic features
1) mood symptoms are brief relative to duration of the disorder
2) mood symptoms do not occur in active phase
3) do not meet full criteria for mood episode
272
schizoaffective disorder v schizophrenia
schizoaffective disorder: prominent mood(depression or manic) symptoms occur concurrently with psychotic symptoms but there is also a period of at least 2 weeks with only psychotic symptoms.
273
MDD and bipolar with psychotic features
psychotic sx only occur during mood disturbance
274
treatment for schizophrenia
traditional (first gen) antipsychotics: haloperidol and fluphenazine: treat mostly positive sx. down side: tardive dyskinesia
atypical (second geo) antipsychotics: clozapine and risperidone - treat positive and neg sx. less likely to cause TD
best when combined with CBT, education, social skills, supported employment
family based interventions are best when they target high levels of expressed emotion among family members -- linked to high relapse and rehospitalization
275
Schizophreniform
same as schizophrenia EXCEPT present for at least one month but less than 6 mo.; impairments may occur but not necessarily
276
Brief psychotic disorder
presence of at least one (delusions, hallucinations, disorganized speech, disorganized behavior)
one sx has to be delusions, hallucinations, or disorganized. speech
sx present for one day but less than 1 month
277
concordance rates for schizophrenia
bio sib - 10%
fraternal twin - 17%
identical twin - 48%
child of 2 parents with schizophrenia - 46%
278
Bipolar I
at least 1 manic episode (at least one week) with at least 3 sx: inflated self-esteem or grandiosity, decreased need for sleep, excessive talkativeness, flight of ideas
MAY include hypomania or depression
279
associated features of Bipolar I
anxiety and substance use
completed suicide is 15x more likely
280
prevalence of Bipolar I
12 mo. prev = 0.6%
| lifetime male: female = 1.1:1
281
course of Bipolar I
average age for first episode is 18 yo
| 90% who experience 1 episode have others
282
etiology of bipolar I
of psychiatric disorders, genetic factors have been most linked to bipolar disorders : twin studies show concordance rates from .67-1.0 for monozygotic twins
283
treatment for bipolar I
lithium in 60-90% of cases
for poor lithium compliance or response - try anti-seizure drug: carbamazepine or divalproex sodium
drugs best when combined with psychosocial intervention (CBT, Family focused treatment, and interpersonal and social rhythm therapy)
284
Bipolar II
1 hypomanic episode and 1 major depressive episode
hypomanic: lasts 4 days, not severe enough to cause impairment
MDD has to last 2 weeks
285
Cyclothmic Disorder
numerous periods of hypomanic symptoms that don't meet criteria for hypomanic episode; numerous periods of depressive symptoms that don't meet criteria for MDD
cause sig distress or impairment
2 years in adults or 1 year in children. can't be sx free for more than 2 mo.
286
Disruptive mood dysregulation disorder
1) severe recurrent temper outbursts
2) chronic, persistently irritable mood on most days
sx for at least 12 mo; at least 2 settings
between 6 and 18. age of onset must be before 10 yo
287
Major Depressive Disorder
at least 5 sx nearly every day for at least 2 weeks:
depressed mood, loss of interest, weight gain/loss or change in appetite, insomnia/hypersomnia, psychomotor agitation/retardation, fatigue or loss of energy, feeling worthless/guilty, poor concentration, SI
288
peripartum onset
MDD, BP I, BP II when onset is during pregnancy or within 4 weeks postpartum
anxiety and preoccupation with infant's well being
10-20% of women
only 0.1 to 0.2% develop postpartum psychosis
80% develop "baby blues" which is mild and transitory
289
associated features of MDD
40-60% with EEG abnormalities in sleep
60% with anxiety - poorer prognosis, increased risk for suicide
290
Prevalence of MDD
12 mo = 7%
18-29 yo 3x more likely than 60+
prior to puberty, rates are = for males and females; in early adolescence rate for females is 1.5 to 3 x rate for males
291
course of MDD
peak age of onset is mid 20s
| as number of episodes increases, risk of new episodes is related more to prior episodes than life stressor
292
etiology of MDD
strong genetic component = .50 for MZ twins and .20 for DZ twins
MDD and neuroticism
cortisol and shrinkage in hippocampus
293
catecholamine hypothesis
some forms of depression are due to deficiency in norepinephrine
294
indolamine hypothesis
result of low levels of serotonin
* now thought to be number and sensitivity of receptors, not neurotransmitter itself
295
Lewinsohn's behavioral theory of depression
based on operant conditioning
low rate of response-contingent reinforcement for social and other behaviors
296
treatment for MDD
tricyclics (TCAs)- classic "vegetative"
SSRIs- first line tx for moderate to severe; fewer side effects than TCAs
MAOIs- do not respond to TCAs or SSRIs or who have atypical sx
meds and therapy best together than alone; CBT associated with lower risk of relapse than drugs
297
Risk factors for suicide
Age: 45-54 for females; 75+ for males
Gender: 4x males as females commit suicide; females attempt 2-3x more
Race/ethnicity: highest for Whites except Indians ages 15-34
Marital Status: divorced, separated, widowed and then single
Previous Suicidal Thoughts and Behavior: 60-80% have made at least 1 previous attempt and about 80% give a warning
Early Warning Signs: self-harm, writing, talking about, making preparations
Life Stress: failure at work, rejection, living alone; adolescents -- rejection by boyfriend or girlfriend or argument with parent
Psychiatric Disorders: mood disorder 15-20% more likely , esp when combined with ADHD, conduct, or substance use (with depression- most likely to occur 3mo after depression sx get better)
Personality: hopelessness, perfectionism
Biology: low levels of serotonin
298
separation anxiety often manifests as
school refusal - esp during times of transition in school - MS and HS associated with social phobia
299
etiology of separation anxiety
warm, close families; often precipitated by major life stressor
300
treatment for separation anxiety
systematic desensitization or other behavioral intervention
| older children - cognitive therapy
301
Mower's two-factor theory
attributes phobias to avoidance conditioning - involves a combination of classical and operant conditioning
302
treatment for specific phobia
exposure with response prevention
303
etiology of social anxiety
behavioral inhibition
info processing bias - attend selectively to socially threatening situations and overestimate likelihood of negative outcomes
304
prevalence of panic disorders
2-3% for adolescents and adults
females 2x more likely than males
very unusual in children
305
treatment for panic disorder
CBT with exposure
306
agoraphobia v specific phobia v social anxiety
agoraphobia is fear of at least 2 situations compared to specific phobia - could be 1 situation
social anxiety - fear of being scrutinized by others
307
treatment for agoraphobia
in vivo exposure with response prevention
some evidence that intensive (starting with most feared sit) has better long term effects
308
of anxiety disorders __ is associated with highest comorbidity rates
GAD; 90%
309
RAD onset
evident before age 5, must have developmental age of at least 9 mo
310
disinhibited social engagement disorder
must have experienced extreme insufficient care
311
PTSD
1. exposure to trauma
2. 1 intrusive sx
3. avoidance
4. negative changes in mood and cognition
6. marked changes in arousal and reactivity associated with the event
sx for more than 1 mo
312
treatment for PTSD
CBT; can have SSRI to treat comorbid anxiety/dep but risk of relapse is high when drug is discontinued
Cognitive Incident stress debriefing (CISD) - may worsen syptoms
EMDR - works but likely d/t exposure
313
OCD v OCPD
OCPD - no obsessions or compulsions; preoccupation with orderliness, perfectionism, control
314
anorexia etiology
90% female
genetic contribution
higher serotonin
research on family factors is inconsistent
315
anorexia treatment
CBT
| family therapy; when EE is high, separated FT is best
316
treatment for BN
nutritional counseling and CBT
317
treatment for insomnia
CBT
| sleep hygiene, stimulus control, relaxation training, cognitive therapy
318
non-rapid eye movement sleep arousal disorders
episodes of incomplete awakening that occur during first third of major sleep episode, usually during stage 3 or 4 sleep with sleepwalking or sleep terror
319
Frotteuristic Disorder
intense sexual arousal from touching a non consenting adult
320
treatment for paraphilias
used to be in vivo aversion
now: CBT including covert sensitization or orgasmic reconditioning
321
diagnosis of substance use disorder can be applied to all drugs except
caffeine
322
Conger's tension-reduction hypothesis
alcohol reduces anxiety, fear, and other tension; addiction is result of negative reinforcement
323
Marlatt & Gordon - Relapse Prevention Therapy (RPT)
addictive behaviors are acquired - overlearned, maladaptive habit pattern
relapse is a mistake resulting from specific, external, and controllable factors
identify what increases risk for relapse - implement C and B strategies to prevent future lapses
324
predictive factors to quit smoking
```
male
35 +
college edu
smoke free home, smoke free at work
married or partenred
started smoking at a later age
low level of nicotine dependence
abstained for longer than 5 days in previous attempts to quit
```
325
smoking cessation intervention increases long term abstinence when
1) nicotine replacement therapy
2) multicomponent behavioral therapy
3) support and assistance from a clinician
326
Korsakoff Syndrome
anterograde and retrograde amnesia and confabulation - linked to thiamine deficiency
327
opioid withdrawal
dysphoric mood, nausea/vomitting, muscle aches, lacrimation or rhinorrhea, pupillary dilation, piloerection, sweating, diarrhea, yawning, fever, insomnia
328
tobacco withdrwal
iritability, anger, anxiety, impaired concentration, increased appetite, restlessness, depressed mood, insomnia
329
neurocognitive disorder d/t alzheimers
major or minor neurocognitive disorder
insidious onset of symptoms
gradual progression of impairment in one or more cognitive domains
accounts for 60-90% of dementia cases
330
course of alzheimer's
stage 1 (1-3 yrs): anterograde amnesia, wandering, indifference, irritability, sadness
stage 2 (2-10 yrs): retrograde amnesia, flat or labile mood, restlessness and agitation, delusions, fluent aphasia, can't translate idea into movement
stage 3 (8-12 yrs): severely deteriorated intellectual functioning, apathy, limb rigidity, urinary and fecal incontinence
331
course of BPD
most chronic and severe when YA
| 75% no longer meet all diagnostic criteria by age 40
