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What are the defining criteria of childhood onset obsessive compulsive disorder?

Compulsions start 1 to 2 years before the obsessions.
Washing, checking, ordering rituals
High comorbidity rate..tic d/o, depression, ADHD
Family loading for OCD
High frequency of hoarding ob/comp

1

What are the criteria for acute stress disorder?

Symptoms occur within 1month of stressor

Sx resolve by 1 month....last 2 days to 1month

At least 3 dissociative sx

2

What is the diagnostic criteria for conversion disorder?

1 sx or deficit in motor or sensory fx such as paralysis, seizure, blind
May be due to primary gain, decrease anxiety or keep it ucs, or to secondary gain, avoid st, get support

Often conflict or stressful even shortly before onset. No physical cause.
Tx--hypnosis, narcosis, dramatic placebo

3

What are the dx criteria for somatization disorder?

Multiple physical sx
Before age 30
At least 4 pain sx
2 GI sx, 1 sexual sx,
1 pseudo neurological sx

Also called briquets syndrome

4

How is malingering different than factitious disorder?

Malingering is not a mental disorder. It is a deliberate production of symptoms motivated by external incentives (miss work, $). It is under the pts control.

Factitious..behaviors can be deliberate but not necessarily controlled.

5

What are the types of focal seizures and how do they differ?

Partial (focal) seizure--uncontrollable twitching, part of body jerks and can increase.

Complex partial seizure (psychomotor or temporal lobe seizures) impaired consciousness. Stare blankly. Drunk acting.

Simple partial seizures-(Jacksonian)
One side of the body uncontrollable. No problem w consciousness. Tonic clinic may follow.

6

What are the types of bilateral seizures?

No local onset

General tonic clonic (grand mal)
Convulsions, ucs, rigidity. May go 1 hr. deep sleep when done

Generalized absence of seizures (petit mal)-- very brief loss of cs, few or no other sx, no deep sleep

7

What are the differences between tension and migraine headaches? Include info on treatment.

Tension headaches--pain both sides, tight band around the head
Use EMG biofeedback to decrease tension or relaxation training

Migraine- pain on one side, nausea and GI sx, aura before
Caused by dilation and spasms of blood vessels.
Tx- thermal hand warming and biofeedback. Relaxation training and biofeedback equally effective. Often combine them and it is more effective then either alone and better than self monitoring.

8

What is Selye's theory of general adaptation syndrome to stress?

ARE

Alarm--pituitary adrenal system mobilizes sympathetic nervous system

Resistance--defenses stabilized , sx disappear , energy depleted

Exhaustion--depleted

9

Flooding is used to treat what disorders?

Exposure to feared stimuli with response prevention is effective with agoraphobia, specific phobias, obsessive compulsive do, and PTSD.

10

What is systematic desensitization and who does it treat?

Gradual exposure to feared stimuli with relaxation strategies is highly effective with specific phobias.

11

Erickson's stages of development

Year 1. Trust vs mistrust (oral).
Year 2 autonomy vs shame/doubt (anal)
3 to 6. Initiative vs guilt (phallic)
6 to 12 industry vs inferiority...competence occurs
Corresponds to freuds latency phase.

12 to 18 yrs identity vs role confusion

18 to 35 yrs Early adulthood.. intimacy vs isolation..capacity to form intimate relationships

35 to 60. Middle adulthood...generativity vs stagnation...capacity to care and give to next generation.

60 plus . Late adulthood...Integrity vs despair..wisdom occurs

12

How do ericksons stages correspond to freuds?

Oral
Anal....1 to 3. Autonomy v shame/
Doubt
Phallic. 3 to 6. Initiative v guilt
Latency 6 to 12. Industry v inferiority
Genital 12 to 18. Identity v role
confusion

13

What is rehms self control theory?

It is a theory of depression which integrates cognitive and behavioral models. Depression is viewed as a result if negative self evaluations, lack of self reinforcement, and high rates of self punishment.

Tx-- self monitoring, self evaluating, self control skills, modify dysfx thoughts and behaviors

14

What problem use aversive conditioning?
1. PTSD
2. Sexual dysfx
3. Delusional do
4. Smoking

4. Smoking.

Aversive used for addictive behaviors. Aversive stimulus (shock) Repeatedly paired with conditioned stimulus (smoking). Hoped ucr of pain will become cr, replacing pleasure.

Problems with aversive conditioning..hi relapse rate, lack of generalization, and ethical concerns.

15

Night terrors remit:
1. Early childhood
2. Middle childhood
3. Adolescence
4. Adulthood

3. Occur 3 to 12 years. Peak age is 3.5 years.

1 to 6 percent have it.

Equally affected

16

What is the treatment of choice for a specific phobia?

Flooding

Then in vivo modeling...gradual interactions with feared object. Exposed and observes coping.

17

Howard found in his meta analysis of outcome by the end if 6 months of treatment what percent of pts are improved?
1. 25
2. 50
3. 75
4. 90

3. 75 percent by 6 mo

50 percent after 8 sessions

18

What predicts adjustment following a traumatic event?

Family history of mental illness, social support, and manner of processing stressful stimuli.

Debriefing has not shown to prevent PTSD and factors such as permit if fx, or training of debriefer have not been shown to matter.

19

Which theorist believed maladaptive behavior results from ppls attempts to make up for perceived or real disabilities as children?
1. Freud
2. Adler
3. Horney
4. Jung

Adler...inferiority complex. Children experience a sense if inadequacy based on real and perceived limitations. To overcome and achieve mastery, they develop. Lifestyle that is either adaptive or maladaptive. Adler examines the lifestyle..mistaken goals and faulty assumptions are discovered and ideally modified to be more constructive. Individual psychology.

21

What is an early indicator of therapy outcome?

Therapeutic alliance.

22

What are the steps in psychoanalysis?

Confrontation
Clarification
Interpretation
Working through


Proven sequence

23

From psychoanalytic pt of view, anxiety occurs when:
A. Defense mechanisms have not properly modulated intrapsychic excitation.
B. person has difficulty coping
C. Experiences emotions that have previously been repressed
D. Facing difficult life transition.

A

24

What psychodynamic theorist is linked to introversion/extroversion?

Which is linked to STEP etc?

1. Jung



2. Adler

25

How did Jung describe the ucs?

Analytic therapy. Ucs made cs
He divided the ucs into two.

Personal/individual ucs..contains repressed material.

Collective ucs...archetypes; transpersonal (for all peeps)

Trait theorist...intro/extroversion
4 archetypes: self, shadow, anima, animus

26

What is associated with Adler?

Individual therapy
Inferiority complexes as kids motivate us to power, superiority
Masculine protest
Style of life...tx replaced broken style
STEP...used with parents, schools etc...
Rejected id concept

27

Who are the neofreudians and what were their theories?

Focus on society and culture
Less emphasis on drives

Horney..parent behaviors cause anxiety. Move to, away, against. Healthy integrate all

Sullivan. Relationship importance through the Lifespan. Cognitive sequentially occurs...
Prototaxic
Parataxic
Syntaxic

Fromm..societal structures and dynamics. 5 character styles.
Productive only one realize true nature.

28

Describe the sequential cognitive modes Sullivan put forth. Which is the cause of neurotic behavior?

Prototaxic...b4 language symbols
Discrete momentary states. First months of life. Schizophrenic experience.
Parataxic...private, autistic symbols w causal connections w events not related..serve developing self and reduce anxiety.
Distortion here cause neurotic behavior
Syntaxic..symbols w shared meaning, logical.. End yr 1. Underlies language acquisition.

29

Who are the ego analysts and what separates their theory?

Anna Freud, rappaport, Hartman

Ego defensive fx..resolution of conflict
Ego autonomous fx..adaptive no conflict fx like learning, memory, speech

Healthy behavior cs
Pathology..ego loses autonomy id

More emphasis present, less transference, re parent , build adaptive fx

30

Who are the object relation theorists and what is important to them?

Mahler, winnocott, Klein, kohit, kernberg, fiarbairn

Object introject, self or other,

3 rd yr...psychological birth of the infant.
Splitting

Kohut..self psych. Narcissism and grandiose self

Tx ---re parenting facilitates reintegration of the ego.