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Flashcards in Behavioral Deck (100):
1

What is APGAR?

A - appearance (color)
P - pulse
G - grimace (reflex irritability)
A - Activity (muscle tone)
R - Respiration

Used to predict likelihood of immediate survival (of neonates)
Normal = 8-9

2

Post Partum Major Depression occurs in ___ of new mothers, within ___ of child birth, and can persist ___

10%
1 month
1 year

3

Criterion for premature and very premature birth

Premature: 37 Weeks
Very premature: 32 Weeks

4

4 Necessary infant reflexes necessary for survival

1. Rooting: touch cheek --> turn toward nipple
2. Palmar Grasp: grip any object put in palm
3. Moro: limb extended when child is startled
4. Babinski: dorsiflexion of toes when sole is stroked

5

3 Spheres of Development:

-Motor
-Social
-Verbal/Cognitive

6

How does development tend to occur (progress)? From ___ to ___

-Cephalad to caudal
-Central to peripheral
-From self to others
-From understanding to expressing

7

Stranger anxiety starts at ___

9 months

8

Social smile starts at ___

12 weeks

9

Separation anxiety starts at age ___
But ____always comes first
Separation Anxiety Disorder Starts at age ___

Late in first year
Object permanence comes first
7 years: school phobia/refusal

10

Babinski reflex disappears at ___

1 year

11

What milestone at age 2?

Say "No!"
Terrible Twos

12

Gender identify by age ___

3 years

13

Play progression:
Cooperative by age ___

Solitary --> parallel --> associative --> cooperative
4 years

14

Year 6 Milestones

-"Superego"
-Morality
-Empathy
-Lying is wrong
-Finality of death

15

Rett's Disorder Characteristics:

-4 Years of normal functioning
-Hand wringing
-Breathing problems
-Intellectual impairment
-Ataxia
-Motor and social declines,
-X-linked

16

Universality of death by age ___
Morality by age ___

9 years
12 years

17

Body image and popularity ideas by age ___

15 years

18

3 Predisposing factors for teen pregnancy

1. Depression
2. Poor school achievement
3. Divorced parents

19

Selective Mutisum usually starts at age ___

6 years

20

Phonological vs Articulation disorders

Phonological: leaves out or misplaces speech sounds

Articulation: unable to make necessary motor movements for accurate speech. ex: lisp

21

Separation Anxiety Disorder Characteristics

-School phobia or refusal
-Starts at 7 years/stressful life event/anxious family

22

Autism Spectrum Disorder Findings:

-Seen before age 3
-No finger pointing (theory of mind)
-Larger head circumference (overgrowth during first year)
-More common in boys

23

5 Stages of Dying:

Denial
Anger
Bargaining
Depression
Acceptance

24

Bereavement (normal grief) vs. Complicated Bereavement (abnormal)

-Both have initial shock and denial
-Both include sadness and crying
-Abnormal involves suicidal thinking or hallucinations

25

Schizophrenia definition:

"Split Mind"
Behavior vs. thought content divergence

26

Hallmark symptom of schizophrenia:

Psychosis: impairment in reality testing

27

List 12 Symptoms of Psychosis

1. Illusion
2. Hallucination
3. Ideas of reference
4. Delusions
5. Loss of ego boundaries
6. Alogia
7. Echolalia
8. Thought Blocking
9. Neologisms
10. Circumstantiality
11. Tangentiality
12. Loose associations

28

Difference between Illusion vs Hallucinations

Illusion: misinterpretation of real external stimuli

Hallucinations: sensory perceptions not generated by external stimuli

29

What is false conviction that one is subject of attention by other people?

Ideas of reference

30

Delusions:
Most common type?

-False beliefs
-Not correctable by logic or reason
-Delusions of persecution most common

31

Loss of ego boundaries:

Not knowing where one's mind and body end and those of others begin

32

Alogia:

-Lack informative content in speech
-Mute or speaks few words

33

"I'm very sure I've got the cure and I'm not pure"

Echolalia:
-Repeating statements of others
-Associating words by their sounds, not meanings

34

"I have to take my....."
Often because of ___

Thought blocking

hallucinations

35

"I'm fatigloo"

Neologisms

36

Circumstantiality vs Tangentiality

Circumstantiality: responds to questions, but presenting voluminous details

Tangentiality: beginning logically, getting further from the point, fail to answer question

37

"I drive a brown car. So i like brown snickers and the sun is really nice today."

Loose associations
-Loss of logical meaning
-No linked associations
-Illogically jumps from one subject to another

38

Differentiate Schizophrenia vs Medical Delirium

Schizophrenia= no clounding of consciousness: alert, oriented

39

Schizophrenia DSM-5 Criteria

A. Characteristic Symptoms (2+)
B. Social/Occupational dysfunction: at least 1 of work, interpersonal, self care
C. Duration: at least 6 months w/ 1 month of symptoms
D. Schizoaffective and Mood Disorder exclusion
E. Substance/general medical condition exclusion

40

5 Schizophrenia characteristic symptoms:

1. Delusions
2. Hallucinations
3. Grossly disorganized or catatonic behavior
4. Negative symptoms
5. Disorganized speech

41

3 Phases of Schizophrenia:

1. Prodromal: prior to 1st psychotic break
2. Psychogic/Active: loss of touch w/ reality
3. Residual: period between psychotic episodes, in touch w/ reality, but doesn't behave normally

42

Schizophrenia age of onset in men vs women

Men: 15-25
Women 25-35

43

Enlargement of what brain structure(s) in Schizophrenia?

Lateral and third ventricle

44

Brain density change in what brain structure(s) in Schizophrenia?

Lower density --> smaller
Hippocampus, amygdala, parahippocampal gyrus

45

What happens in frontal lobe in Schizophrenia?

Hypofrontality: decreased use of glucose

46

Dopamine Hypothesis of Schizophrenia:
Glutamate Hypothesis of Schizophrenia

-Excessive DA activity in MESOLIMBIC tract
-Hypoactivity of NDMA receptor in brain

47

2 Neuronal Pathways in Schizophrenia (positive/negative symptoms)

Positive: Glu-GABA-Glu-DA
Pathology: high DA in mesolimbic

Negative: Glu-GABA-Glu-GABA-DA
Pathology: low DA in mesocortical

48

Brief Psychotic Disorder

Schizophrenia symptoms
1-29 days **LESS than 1 month**

49

Schizophreniform Disorder

1-6 Months of Schizophrenia symptoms

50

Schizoaffective Disorder

Schizophrenia + mania and/or depression

51

All effective antipsychotics for Schizophrenia block ___ receptors in ___ DA pathway

D2
mesolimbic

52

DSM-5 Criteria for Neurodevelopmental Disorder

New name for ADHD
-Start before age 12
-Symptoms in multiple (2+) settings
-Must cause social disability
-6+/9 Symptoms (inattention or hyperactive/impulsive)
-6 Months

53

Versions of ADHD

-Combined
-Inattentive
-Hyperactive/impulsive
-Other specified, or unspecified

54

2 neurotransmitter genes most commonly associated w/ ADHD

Dopamine system
Noradrinergic system

55

ADHD __ symptoms tend to persist greater than ___ symptoms

Inattentive > hyperactivity/impulsivity

56

High dopamine/noradrinergic activity leads to ___
Very high leads to ___

Hypervigilant

Very high --> Psychosis

57

Low dopamine/noradrinergic activity leads to ___
Very low leads to ___

ADHD

Very low --> Schizophrenia (-) symptoms

58

In ADHD brains, selective pruning happens (earlier/later)

Later

59

3 Nonaddictive ADHD Drugs:
Side effects?

Atomoxetine (NRI)
Guanfancine ER a2 agonist
Clonidine ER a2 agonist

Less efficacy than stimulants
Often sedating
May lower BP

60

Class of ADHD drugs that has greatest efficacy is ___
Adverse effects?

Stimulant class

Risk of addiction
Too much --> paranoia
Stunt growth, weight loss (low appetite)

61

1st line ADHD treatment for preschool, children and adolescents, and adults

Preschool: behavioral therapy

Children and adolescents: Slow release Methylphenidate (MPH)

Adults: Nonaddictive (Atomoxetine, Modafinil, Ganfacine ER, Clonidine ER)

62

a2 Agonist mechanism of action for ADHD

Norepi a2 receptor: increase signal strength --> increase signal to noise ratio -->make glutamate function more efficient

63

Most common co-occuring disorder with ADHD:

Anxiety

64

Functional MRI finding in ADHD

Hypoactive Anterior Cingulate

65

3 Spheres of functioning:

1. Social
2. Academic
3. Occupational

66

Personality traits are [immutable/circumstantial/modifiable] risk for suicide

Immutable

67

Risk traid for suicide includes

Ideation
Intention
Plan

68

What religions are at increased risk for suicide?

-Jewish or protestant
-Highest in protestant

69

Highest risk demographic for suicide:

Middle aged
White/Caucasian
Male

70

Top 3 leading causes of death for adolescents 15-19

1. Accidents
2. Homocide
3. Suicide

71

Age and gender pattern for suicide risk

-Increases substantially after 55
-Decrease for old women
-Increase for old men
-Men ALWAYS higher risk than women

72

Top suicide method in US vs. elsewhere

US: firearms
Elsewhere: hanging

73

[Short/long] allele for serotonin transporter gene (SERT) associated with increased MDD and suicide risk

Short allele (ss) -->highest risk

Long allele (l/l) --> protective

74

Antidepressents [raise/lower] risk of suicide for what group of people?

Raise
24 or younger

75

Why increased suicide risk initially after being put on antidepressants?

-Increased energy and clear thinking improve before lifting of depressed mood --> More energy to act on suicidal thoughts

76

Greatest predictor of suicide risk:

Past violence

77

DSM-5 Major Depressive Disorder Criteria:

1. 5+/9 Symptoms during 2-week period (at least 1 is depressed mood or loss of interest/pleasure)
2. Symptoms cause distress or impairment in functioning
3. Not attributable to physiological effects

78

SIG E CAPS

Sleep disturbance
Interest/pleasure reduction
Guilt, worthlessness
Energy loss, fatigue
Concentration/attention impairment
Appetite changes
Psychomotor symptoms
Suicide Ideation

79

How to differentiate normal sadness vs. depression?

S.W.A.G
Have at least one of the following in depression:
Suicidality
Weight loss
Anhedonia
Guilt

80

Atypical Depression likely findings:

-Weight gain, hypersomnia
-Leaden paraysis, carb cravings, rejection sensitivity

81

Medical conditions that mimic depression:

-Hypothyroidism -->tired
-Cushing's
-Anemia -->tired
-Vitamin deficiency (B12, Folate)
-Obstructive sleep apnea --> poor brain perfusion at night

82

2 Biological Theories of Depression:

-Monoamine deficinecy
-Monoamine receptor excess

-Reality= combination of both

83

(Genetic/Environmental) factors more important in depression

Environmental

84

Functional Neuroanatomy in MDD:

-Hypoactive dorsolateral prefontral cortex
-Hyperactive amygdala

85

Gender difference in MDD

-Lifetime prevalence: women > men
-Women more likely to seek help

86

2 Common comorbidities of MDD:

-Substance abuse
-Generalized anxiety

87

3 Frontline treatment classes of MDD:

SSRI
SNRI
NDRI

Less severe side effects than MAOIs and TCAs

88

Increasing cortisol in brain does what to make depression more likely?

Decrease brain neurotrophic factors

89

What is Delay of Reinforcement Gradient?

-Individuals w/ ADHD are MORE sensitive to IMMEDIATE reinforcement
-LESS sensitive to DISTAL reinforcement
-Compared to normally developing individuals

90

Oppositional Defiant Disorder (ODD) Criteria:
How to define severity?

-4+ Symptoms (3 groups: Angry/Irritable, Argumentative/Defiant, Vindictive) for 6+ Months
-Negative Impact
-Not during course of other disease (psychotic, depressive)
-Severity based on number of settings (1, 2, 3+)

91

Conduct Disorder (CD) Criteria:

Violate norms or rights of others
-3+ symptoms for 12+ months (agression, destruction, deceit/theft, violate rules)
-Functional impairment
-If 18+, criteria not met for Antisocial personality disorder

92

Limited prosocial emotions is:

Specific manifestation of Conduct Disorder
-2+ findings for 12+ months in multiple relationship/ssettings
Symptoms:
1. no remorse/guilt
2. no empathy
3. unconcerned about performance
4. shallow/deficient affect

93

Development impairment characteristics of Autism (4)

1. No babble or coo by 12 months
2. No gesture (point, wave, grasp) by 12 months
3. Doesn't say single words by 16 months or 2-word phrases by 24 months
4. Loss of language or social skills at any age

94

Asperger's Syndrom is Autism with high ___

IQ

95

Diagnosis of Autism based on:

-Autism Diagnostic Interview-R (ADI-R)
- Observation (home, school, video analysis)

96

3 Criteria for Intellectual Disability Diagnosis:

1. IQ

97

Academic level achievement in Mild vs Moderate ID:

Mild: 6th grade, minimal supervision

Moderate: 2nd grade, under supervision

98

Examples of "essential" vs "associated" feature of Autism:

Essential: repetitive behavior, flapping, body rocking

Associated: self-injury, aggression, pica

99

3 Diagnostic criteria for Pica

1. >1 month eating non-nutritive substancces
2. Eating is inappropriate for developmental level
3. eating is not culturally sanctioned

100

Medication use in Autism

~27% of children take >1 med

Increase use of meds with age

CAM treatment decreases w/ age