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EPPP Study > Disorders > Flashcards

Disorders Flashcards

1
Q

What are the goals of compulsions

A

to reduce anxiety or prevent an undesirable situation from happening. Often excessive and not connected in a realistic way to the goal.

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2
Q

Mean age of onset for specific phobia is

A

10 years old

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3
Q

Most common comorbid disorders with OCD

A

Anxiety disorders followed by depressive or bipolar disorder, impulse control disorder, and substance use disorder

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4
Q

How long must sxs last for a diagnosis of Separation Anxiety Disorder for children & adolescents and for adults

A

at least 4 weeks in children and adolescents, at least 6 months in adults

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5
Q

Most prevalent mental disorders worldwide

A

Anxiety Disorders

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6
Q

_____% of people with OCD have co-morbid disorders

A

90

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7
Q

Specifiers for specific phobia include

A

Animal, natural environment (lighting, heights), blood-injection-injury (seeing blood, having invasive medical procedure), situational (bridges, elevators), other (vomiting, choking, catching illness)

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8
Q

Why is combining in vivo exposure with relaxation or cognitive techniques not really effective in significantly improving outcomes for treatment of Agoraphobia

A

Because the person needs to be exposed and learn to tolerate high levels of fear or anxiety

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9
Q

Lower than normal levels of _______ and elevated activity in _______ ______ ___________ and _________ are linked to OCD

A

Serotonin; caudate nucleus, orbitofrontal cortex, cingulate gyrus, and thalamus

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10
Q

Deliberately exposing a person to physical sxs associated with panic attacks including having the person run, spin in circle, breath through a straw

A

interoceptive exposure to treat panic attacks

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11
Q

Used as a treatment for blood-infection-injury phobias

A

Applied tension—repeatedly tensing and relaxing the body’s large muscle groups to increase pressure and prevent fainting

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12
Q

Mowrer’s 2 Factor Theory explains that the development of phobias is a combination of

A

Classical conditioning and Operant conditioning

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13
Q

What are treatments for Phobias

A

Exposure and Response Prevention, flooding, graded/graduated exposure

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14
Q

Repetitive bxs or mental acts that a person feels the drive to perform. Rigid rules typically apply

A

Compulsions

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15
Q

Preoccupation with a perceived defect or flaw in physical appearance which isn’t observable or appears minor to others

A

Body Dysmorphic Disorder

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16
Q

Sxs of Agoraphobia must be persistent for at least __________ months

A

6

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17
Q

First line treatment for Social Anxiety are

A

CBT and Antidepressants (SSRI and SNRI)

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18
Q

Hyperthyroidism, cardiac arrhythmia, and other conditions should be ruled out before diagnosing this disorder

A

Panic Disorder

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19
Q

___________ have earlier age of onset for OCD and slightly higher prevalence rates in childhood

A

males

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20
Q

3 reasons why a person fears or avoids situations when they have agoraphobia

A

fear that escape will be difficult, that help with be unavailable, fear that it will be embarrassing

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21
Q

Combined ERP and __________ is most effective in circumstances when issues are severe, to help with comorbid sxs, and when treatments haven’t been effective individually

A

SSRI

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22
Q

Fear or anxiety reactions to at least one social situation in which someone could be exposed to scrutiny

A

Social Anxiety

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23
Q

Recurrent, unexpected panic attacks with at least one attack being followed by at least _________ month(s) of persistent concern about having an additional attack or maladaptive change in bx related to the attack

A

1 Month (Panic Disorder)

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24
Q

_________ Conditioning is when a previously neutral object/event becomes a conditioned stimulus and elicits a conditioned response after being paired with an unconditioned stimulus

A

Classical conditioning

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25
Q

A sxs of this disorder is Delusion of Reference. What is the Disorder and what are delusions of reference?

A

Body Dysmorphic Disorder; believing others are mocking or taking special notice of physical appearance

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26
Q

Effectiveness of treatment (CBT) for Separation Anxiety Disorder in children is increased by what other intervention

A

Parent training

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27
Q

Recurrent and persistent thoughts, urges, or images that are intrusive or unwanted

A

obsessions

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28
Q

Developmentally inappropriate and excessive fear or anxiety about being away from attachment figures

A

Separation Anxiety Disorder

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29
Q

Specific Phobia is twice as common for ______

A

girls

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30
Q

________ Conditioning to described the development of a specific phobia and happens when a person learns that avoiding conditioned stimulus allows them to avoid anxiety. So, person’s avoidance bx is negatively reinforced and the conditioned response is not extinguished because the person never has the opportunity to experience the conditioned stimulus without the unconditioned stimulus

A

Operant Conditioning

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31
Q

Marked fear of anxiety that occurs in at least 2/5 situations:
using public transit
being in open spaces
being in enclosed spaces
standing in line or being in a crowd
being outside the home alone

A

Agoraphobia

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32
Q

2 Types of Exposure

A

In vivo and Imaginal (in vivo may be more effective than imaginal and therapist led exposure may be more effective than client led).

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33
Q

Person may perform repetitive bxs such as mirror checking and skin picking with this disorder

A

Body Dysmorphic Disorder

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34
Q

_________ have slightly higher prevalence rates of OCD in adulthood

A

Females

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35
Q

____________ and ______________ have been found useful for alleviating panic attacks but are associated with high relapse rates when used alone

A

Antidepressants and benzidiazepines

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36
Q

Criteria for Specific Phobia

A

Fear/Anxiety must be out of proportion to actual danger, must be persistent (usually lasting at least 6 months), must cause significant distress or impairment

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37
Q

First line treatment for Agoraphobia

A

Exposure and Response Prevention

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38
Q

Intense fear or anxiety about a specific object or situation accompanied by avoiding it or enduring it with intense distress

A

Specific Phobia

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39
Q

Virtual reality exposures may be as effective as in vivo exposures especially for what types of phobias

A

acrophobia-fear of heights and fear of flying

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40
Q

Preferred treatment for Separation Anxiety Disorder

A

CBT including psychoeducation, exposure, relaxation techniques and cognitive restructuring

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41
Q

First line treatment for OCD

A

Exposure and response prevention

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42
Q

Fear or anxiety related to social anxiety must be excessive for the threat or situation, cause significant distress, and avoidance must be persistent for at least how long

A

6 months

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43
Q

Persistent eating of non-nutritive, non-food substances

A

Pica

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44
Q

How long must sxs persist for a diagnosis of Pica

A

1 month

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45
Q

Pica is most common among which populations

A

kids and pregnant women

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46
Q

What must be present for a diagnosis of Anorexia Nervosa

A

-Intense fear of gaining weight/becoming fat or engaging in bxs that interfere with weight gain
-Self-evaluations are unduly influenced by weight/shape and lack of awareness about the seriousness of low weight

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47
Q

Specifiers for type of Anorexia

A

restricting or binge eating/purging types

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48
Q

Severity of Anorexia is determined by what

A

BMI

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49
Q

Anorexia often co-occurs with what other diagnoses

A

Depression and Anxiety. Anxiety often precedes Anorexia

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50
Q

Why is Anorexia difficult to treat

A

Denial of problem and resistance to change

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51
Q

In the short term, the prognosis for Anorexia tends to be _________ than the prognosis for Bulimia. But this changes in the long term.

A

poorer; over time the prognosis becomes similar to Bulimia

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52
Q

Research supported treatments for Anorexia include

A

CBT for anorexia
CBT-E (enhanced CBT)
FBT (family based treatment)
Pharmacology

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53
Q

Outpatient treatment for Anorexia and Bulimia that includes parents.

A

FBT (Family Based Treatment)

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54
Q

What is a post hospitalization intervention that’s based on the assumption that shape and weight concerns engender dietary restriction and extreme methods of weight control. It uses behavioral strategies to establish regular eating patters and eliminate body checking. It uses cognitive strategies to identify and replace problematic thinking and enhance motivation.

A

CBT for Anorexia

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55
Q

Transdiagnostic treatment that proposes eating disorders share same core psychopathology—excessive value given to physical appearance and weight. It’s personalized, flexible, and focusus on the factors that are maintaining patient’s sxs.

A

CBT-E (Enhanced CBT)

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56
Q

What are compensatory bxs related to Bulimia?

A

vomiting, excessive exercise (things done to prevent weight gain)

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57
Q

There are inconsistent findings about the use of pharmacotherapy to treat Anorexia. Still, some say the antipsychotic drug Olanzapine and the SSRI Fluoxetine are useful for what?

A

Olanzapine: fostering initial weight gain; Fluoxetine: improving weight maintenance

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58
Q

For a diagnosis of Bulimia, binge eating and compensatory bx must occur at least ___ times per week for at least _____ months

A

1 x/week for at at least 3 months

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59
Q

Severity of Bulimia is based on what?

A

The average number of episodes of inappropriate compensatory bx per week

60
Q

Bulimia frequently is comorbid what what disorders

A

Depression and/or Anxiety ; Anxiety frequently precedes the dx

61
Q

Recurrent episodes of bing eating that are accompanied by a sense of lack of control, inappropriate compensatory behavior to prevent weight gain, and self-evaluation that’s excessively influenced by body shape and weight

A

Bulimia Nervosa

62
Q

Most people with this disorder are within the normal weight range, overweight or obese

A

Binge Eating Disorder

63
Q

Purging can cause

A

dental erosion and gastroesophageal reflux, dehydration, heart arrhythmias, and death

64
Q

Research supported treatments for Bulimia include

A

CBT*
CBT-E*
IPT (interpersonal therapy)
FBT (Family Based Treatment)
* = preferred treatment (takes less time than IPT)

65
Q

Family Based Treatment for this eating disorder tends to be more collaborative because clients are more motivated to change and see their sxs and ego-dystonic

A

Bulimia

66
Q

Which drug treatment has been found effective for alleviating comorbid Depression and for reducing binge eating and purging in patients without Depression

A

SSRI (especially fluoxetine)

67
Q

When is comes to Bulimia, some research has found that combined treatment (medication and CBT) is more effective than medication alone. Other studies have found that combined treatment (CBT and medication) is no more effective than _________ alone

A

CBT is found to be very effective, even without medication

68
Q

Most effective version of CBT for patients with Bulimia

A

CBT-E

69
Q

What are the 4 stages of CBT-E

A

Stage 1: engaging patients in treatment and developing formulation of what is maintaining problem (bxs, feelings, thoughts, events, etc.)
Stage 2: reviewing progress, identifying new problems, and updating formulation
Stage 3: identifying triggers and addressing patient’s over-evaluation of shape and weight. Addressing perfectionism, low self-esteem, and interpersonal problems
Stage 4: reducing relapse and identifying ways to maintain progress

70
Q

As far as treatment for Bulimia, does telepsychology and in person treatment yield same results?

A

Yes. However, those in face to face treatment abstained from purging slightly more and had greater reduction in eating -disordered cognitions than those doing telepsychology

71
Q

Who is more distressed by their sxs, those with Anorexia or those with Bulimia?

A

Those with Bulimia are more distressed by sxs and have more autonomous (intrinsic) motivation to reduce sxs which predicts a greater reduction in sxs

72
Q

What is the diagnostic criteria for Binge-Eating Disorder/ Sxs of Binge Eating Disorder?

A

Requires recurrent episodes of bing eating that involves eating an amount of food that is larger than what most people would eat during similar period of time and a lack of control over eating during episodes. Also, other sxs including eating more rapidly than usual, eating until uncomfortably full, eating large amounts when not feeling hungry, feeling alone due to embarrassment about bing eating, feeling disgusted, depressed, or very guilty about binge eating

73
Q

Binge eating episodes must occur on average at least ____ times per week and at least _____ months

A

1 x week ; 3 months

74
Q

Severity (mild, moderate, severe, extreme) for Binge Eating Disorder is determined by what?

A

Number of binge episodes per week

75
Q

Binge Eating is how many more times common in women than men?

A

2-3 x more common in women

76
Q

People with this disorder tend to be of normal weight, overweight, or obese

A

Binge Eating Disorder

77
Q

Who tends to have a better response to treatment, those with Bulimia or those with Binge Eating Disorder?

A

Those with Binge Eating Disorder because they do not engage in compensatory behaviors

78
Q

Evidenced based treatments of Binge Eating Disorder are

A

CBT-E
IPT (interpersonal therapy)
Some studies have found CBT-E to be more effective

79
Q

True of False: Medication alone is less effective than CBT and Medication to treat Binge Eating Disorder?

A

True

80
Q

Repeated voiding of urine into the bed or clothing

A

Enuresis

81
Q

For a diagnosis of Enuresis, must urinate in bed or clothes at least _____ times per week for at least _____ consecutive months

A

Must pee in bed/clothes at least 2 times per week for at least 3 consecutive months

82
Q

For a diagnosis of the Elimination Disorder Enuresis, the person must be at least _____ years old or at the equivalent developmental level

A

5 years old

83
Q

Specifiers for the Elimination Disorder Enuresis include what?

A

Nocturnal only, Diurnal only, or Nocturnal an Diurnal

84
Q

What is the most common treatment for Enuresis?

A

Moisture alarm (Bell and pad)

85
Q

What are the 3 sleep problems that can effect someone with Insomnia?

A
  1. Difficulty initiating sleep (sleep onset-initial)
  2. Difficulty maintaining sleep (sleep maintenance-middle)
  3. Early morning awakening with an inability to return to sleep (late insomnia)
86
Q

For a dx of Insomnia, sleep disturbance must offur at least _____ nights a week and be present for at least _____ months

A

Must occur at least 3 nights a week for 3 months

87
Q

Most common single type of insomnia?

A

Sleep maintenance- involves frequent or extended waking up during the night

Of note, combination of all three types is the most common form of insomnia

88
Q

Subjective Reports by those with insomnia vs Objective Measured reports (polysomnography) of those with insomnia tend to show what?

A

People with insomnia tend to overestimate how long it took them to fall asleep, tend to overestimate time awake during the night, and tend to underestimate total amount of sleep

89
Q

Non-pharmacological treatment of choice for insomnia is what?

A

Multi-component cognitive behavioral intervention that incorporates stimulus control, sleep restriction with sleep hygiene, relaxation training, and/or cognitive therapy
-stimulus control: strengthening the bedroom and bed for sleep cues
-sleep restriction: restricting the time allotted for sleep each night so time spent in bed matches sleep requirements

90
Q

Repeated occurrences of extended, extremely dysphoric, and well-remembered dreams that involve efforts to avoid threats to survival, security, or physical integrity

A

Nightmare Disorder

91
Q

When does Nightmare disorder typically occur?

A

During REM sleep in the second half of a major sleep period

92
Q

Sleep walking and Sleep terrors are what kind of sleep disorders?

A

Non-Rapid Eye Movement Sleep Disorders

93
Q

Sleepwalking and Sleep terrors usually occur during which stage of sleep

A

Stage 3 or 4 in the first third of a major sleep period

94
Q

An abrupt arousal from sleep that usually starts with a panicky scream and accompanied by intense fear and autonomic arousal (tachycardia and rapid breathing)

A

Sleep terror

95
Q

During these sleep disorders, the person is unresponsive to attempts to awakening them and they tend to have little memory of what happened during sleeping

A

Sleepwalking and Sleep Terrors

96
Q

Sleep walking and Sleep terrors usually occur most often for who?

A

Children

97
Q

Attacks of irrepressible need to sleep

A

Narcolepsy

98
Q

People with Narcolepsy have to fall asleep or have daytime naps at least _____ times per week for at least _____ months

A

3 x per week for at least 3 months

99
Q

Hypnagogic hallucinations

A

vivid hallucinations just before falling asleep

100
Q

Hypnopompic hallucinations

A

vivid hallucinations just after awakening

101
Q

People with these sleep disorder tend to have vivid hallucinations just before falling asleep or just after awakening from sleep

A

Narcolepsy; hypnagogic and hypnopompic hallucinations

102
Q

In Narcolepsy, this symptom is often triggered by strong emotion so people with this disorder attempt to control their emotions to avoid sleep episodes

A

Cataplexy (loss of muscle tone)

103
Q

Persistent pattern of inhibited & emotionally withdrawn bx toward adult caregivers as demonstrated by lack of seeking or responding to comfort when distressed and persistent social and emotional disturbances that include 2 of the following:
-minimal social and emotional -responsiveness to others
-limited positive affect
-unexplained irritability, sadness, or fearfulness when interacting with adult caregivers

A

Reactive Attachment Disorder

104
Q

For a diagnosis of Reactive Attachment Disorder there must be a hx of what?

A

There must be a history of extreme insufficient care that is believed to be responsible for the person’s symptoms;

105
Q

For a dx of Reactive Attachment Disorder the onset of symptoms must be before what age and the person should have a developmental age of at least what age?

A

Before 5 years old; Developmental age of at least 9 months.

106
Q

This disorder involves a persistent pattern of behavior that’s characterized by inappropriate interactions with unfamiliar adults

A

Disinhibited Social Engagement Disorder

107
Q

Sxs of this diagnosis include:
-reduced or absent reticence in approaching or interacting with strangers
-overly familiar behavior with strangers
-diminished or absent checking with adult caregivers after being separated from them
-willingness to accompany a stranger with little or no hesitation

A

Disinhibited Social Engagement Disorder

108
Q

Diagnosis of Disinhibited Social Engagement Disorder requires a hx of what?

A

History of extreme insufficient care that’s believed to be responsible for their sxs

109
Q

You must have a developmental age of ____ for a Reactive Attachment Disorder and Disinhibited Social Engagement Disorder

A

9 months

110
Q

For a diagnosis of PTSD, sxs must last for more than how long?

A

More than one month

111
Q

Diagnostic criteria for PTSD includes

A

Cause significant distress and impaired functioning and be due to exposure to actual or threatened death, serious injury, or sexual violence;
Symptoms include 4 types:
-Intrusion (recurrent, distressing memories of the event)
-Persistent avoidance of stimuli associated with the traumatic event
-Negative changes in mood or cognition
-Alterations in arousal and reactivity

112
Q

Brain abnormalities associated with PTSD

A
  • hyperactive amygdala
  • hyperactive anterior cingulate cortex
  • hypoactive ventromedial prefrontal cortex
  • reduced volume of the hippocampus
113
Q

PTSD is associated with what neurotransmitter activity

A

increased dopamine, norepinephrine, and glutamate; decreased levels of serotonin and GABA

114
Q

Recommended treatments for PTSD

A

CBT
CPT (Cognitive Processing Therapy)
Cognitive Therapy
Prolonged Exposure
Conditional Recommendations for:
brief eclectic therapy
EMDR
narrative exposure therapy

115
Q

This treatment for PTSD combines challenging negative cognitions and writing and reading detailed description of the trauma

A

Cognitive Processing Therapy (CPT)

116
Q

Effects of single-session psychological debriefing and group psychological debriefing

A

Found to be ineffective and may worsen symptoms

117
Q

Telepsychology and in person treatment for PTSD are found to be of different effectiveness in what way?

A

Some therapists reported barriers to developing therapeutic alliance; comparable in attendance, drop out rates, and client satisfaction.

118
Q

Pharmacological treatments with conditional support for PTSD

A

SSRI (fluoxetine, paroxetine, sertraline) ; SNRI (venlafaxine)

119
Q

For Acute Stress Disorder, sxs must persist for how long?

A

Between 3 days and 1 month

120
Q

Acute Stress Disorder requires what?

A

Exposure to actual or threatened death, severe injury, or sexual violation. Must have at least 9 sxs from 5 categories (intrusion, negative mood, dissociative ss, avoidance, arousal)

121
Q

This disorder requires the death of a person close to the bereaved person (the patient) some time ago

A

Prolonged Grief Disorder

122
Q

For a diagnosis of Prolonged Grief Disorder, how long ago must the person have died for adults? How long ago for children?

A

12 months ago for adults; 6 months ago for children

123
Q

These disorders involve a disruption of and/or discontinuity in normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior

A

Dissociative Disorders

124
Q

Inability to recall ALL events that occurred during a circumscribed period of time

A

localized amnesia (most common)

125
Q

Inability to recall SOME events that occurred during a circumscribed period of time

A

selective amnesia

126
Q

Complete loss of memory for one’s entire life

A

Generalized amnesia

127
Q

Loss of memory for a specific category of information

A

Systematized

128
Q

Inability to remember new events as they happen

A

Continuous

129
Q

Purposeful travel or purposeless wandering that associated with loss of memory

A

Dissociative fugue specifier

130
Q

Disorder involves an inability to recall important personal information that cannot be attributed to ordinary forgetfulness and causes significant distress or impaired functioning; often related to victimization or exposure to a traumatic event

A

Dissociative Amnesia

131
Q

Sense of unreality, detachment, or being an outside observer of one’s thoughts, actions, etc

A

Depersonalization

132
Q

Sense of unreality or detachment with regard to one’s surroundings

A

Derealization

133
Q

A diagnosis of this disorder requires persistent or recurrent episodes of unreality and detachment accompanied by intact reality testing and significant distress or impaired functioning

A

Depersonalization/Derealization Disorder

134
Q

Disorder involves a preoccupation with a serious illness with no or mild somatic symptoms, excessive anxiety about health, and either excessive health-realted behaviors or avoidance of healthcare

A

Illness Anxiety Disorder

135
Q

For a dx of illness anxiety, sxs must be present for how long?

A

at least 6 months, though the nature of the symptoms may vary over time

136
Q

This disorder involves one or more somatic sxs that are distressing or cause significant disruption to daily life. Sxs are associated with excessive concerns about health including: disproportionate thoughts about seriousness of sxs, persistently high levels of anxiety about health, excessive time and energy spent on health concerns

A

Somatic Symptom Disorder

137
Q

For a diagnosis of Somatic Symptom Disorder, sxs must be present for how long?

A

At least 6 months

137
Q

Functional Neurological Symptom Disorder is also referred to or called

A

Conversion Disorder

138
Q

For this disorder, one or more sxs must involve a disturbance in voluntary motor or sensory functioning (paralysis, blindness, etc) that is incompatible with any known neurological or medical condition and causes significant distress or impaired functioning

A

Functional Neurological Symptom Disorder (Conversion Disorder)

139
Q

This disorder can involve Psychogenic Non-Epileptic Seizures (PNES) in which the EEG patterns don’t correspond with the normal seizure like activity

A

Functional Neurological Symptom Disorder (Conversion Disorder)

140
Q

This disorder can involve self or other imposed sxs that falsify or induce physical or psychological symptoms that are associated with deception (but no obvious external reward for doing so)

A

Factitious Disorder

141
Q

What distinguishes Factitious Disorder from malingering?

A

Malingering involves deception due to trying to obtain drugs, financial compensation, or another external reward. Factitious Disorder involves deception, but without an obvious reward

142
Q

Malingering should be suspected when…

A

A personal seeks a medical evaluation for legal reasons, there’s a marked discrepancy between person’s sxs and objective findings, the person is uncooperative with evaluation or treatment, and/or the person has antisocial personality disorder

143
Q

The forced choice method is used for what

A

to help detect malingering. It involves presenting the person with test items that require the person to choose the correct answer from 2 or more alternatives. Malingering is suggested when the person answers more than 50% of items incorrectly (more than what would happen by chance alone)

144
Q
A

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