Doechii Flashcards
(144 cards)
1
Q
Bipolar and related disorders
A
• Bipolar I
• Bipolar II
• Cyclothymic
• Substance/medication induced
2
Q
Bipolar disorder is a mental illness that causes unusual and extreme shifts in mood, marked by episodes of
A
Mania and depression
3
Q
• Showing Intense happiness or sliness
• Having a very short temper or soeming extremely intable
Taking very fast or having racing thoughts
• Having an inflated sense of ability, knowledge, and powel
• Doing reckless things that show poor judgment
A
Mania
4
Q
• Feeling very sad or hopeless
Feeling lonely or isolating from others
• Eating too much or too lite
Having little energy and no interest in usual actuties
• Sleeping too much
A
Depression
5
Q
A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting al least 1 week and present most of the day, nearly every day
A
Manic episode
6
Q
distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day.
A
Hypomanic episode
The episode is not severe enough to cause marked impsirment in social or ossupa-tional functioning or to necessitate hospitalization.
7
Q
Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, or hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
2 wks
A
Major depressive episodes
8
Q
Criteria have been met for at least one manic episode (Criteria A-D under “Manic Ep-isode” above).
A
Bipolar I disorder
9
Q
Criteria have been met for at least one hypomanic episode (Criteria A-F under “Hypo-manic Episode” above) and at least one major depressive episode (Criteria A-C under
“Major Depressive Episode” above).
A
Bipolar II Disorder
10
Q
Bipolar II ave age of onset
A
Mid 20s
11
Q
Chronic, fluctuating, mood disturbance involving numerous periods of hypomanic symptoms and periods of depressive symptoms that are distinct from each other
A
Cyclothymic Disorder
12
Q
For at least 2 years (at least 1 year in children and adolescents) there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode.
A
Cyclothymic disorder
13
Q
Children with persistent irritability and frequent episodes of extreme behavioral dyscontrol
• Severe recurrent temper outburst manifested verbally and/or behaviorally that is out of proportion in intensity or duration to the situation
• Persistently irritable or angry most of the day, nearly everyday
• For at least 12 mos
A
Disruptive Mood Dysregulation Disorder
14
Q
Age of onset
Disruptive mood dysregulation
A
10 y/o
15
Q
Disruptive Mood Dysregulation Disorder in adolescent and adulthood
A
Unipolar depressive disorder or anxiety disorder
16
Q
Disruptive Mood Dysregulation Disorder
Functional consequence
A
• Marked disruption in relationships and school performance
• Low frustration tolerance
17
Q
Depressed mood for at least 2 yrs
A
Dysthymia
During the 2-year period (1 year for children or adolescents) of the disturbance, the individual has never been without the symptoms in Criteria A and B for more than 2 months
18
Q
• Life event most associated with development of depression:
A
• Losing a parent before age 11
19
Q
• Environmental stressor most often associated with onset of depressive episode:
A
Loss of spouse
20
Q
Classic view of depression:
1. Disturbances in infant-mother relationship during oral phase predispose to depression
2. Linked to real or imagined object loss
3. Introjection of the departed object is a defense mechanism invoked to deal with the distress related with loss
4. Because the lost object is regarded with a mixture or love and hate, feelings of anger are directed toward inner self
A
Freud, expanded by Karl Abraham:
21
Q
aware of discrepancy between extraordinarily high ideals and inability to meet goals
A
Edward Bibring
22
Q
many depressed people have lived their lives for someone else rather (principle ideal, institution) than for themselves. Depression sets in when patients realize that the person or ideal for which they have been living is never going to respond in a manner that will meet their expectations.
A
Silvano Ariety
23
Q
developing self has specific needs that must be met by parents to give the child a positive sense of self-esteem and self-cohesion. When others do not meet these needs, there is a massive loss of self-esteem that presents as depression.
A
Heinz Kohut
24
Q
believed that damaged early attachments and traumatic separation in childhood predispose to depression. Adult losses are said to revive the traumatic childhood loss and so precipitate adult depressive episodes.
A
John bowbly
25
Psychodynamic factors in mania
• Defense against underlying depression
• May also result from a tyrannical superego, which cannot tolerate self-criticism
• Ego is overwhelmed by pleasurable or feared impulses
26
Depression results from specific cognitive distortions present in susceptible person
Cognitive Theory
27
cognitive triad of depression who
Aaron Beck
28
cognitive triad of depression
View about self - negative
Future - expectation of suffering and failure
Environment - hostile and demanding
29
Connects depressive phenomena to the experience of uncontrollable events
Learned helplessness
30
Internal causal explanations are thought to produce a loss of self-esteem after adverse external events
• Tx: improvement of depression is contingent on the patient's learning a sense of control and mastery of the environment
Learned helplessness
31
Mood stabilizers, anti-depressants and anti-psychotics
Pharmacotherapy
32
alleviate depressive episodes and prevent their recurrence by helping the patient identify and test negative cognitions; develop alternative, flexible and positive ways of thinking and rehearse new cognitive and behavioral responses
Cognitive therapy
33
focus on patient's current interpersonal problems
• Current interpersonal problems likely to have roots in early dysfunctional relationships and
Current interper
likely to be involved in precipitating or perpetuating the current episode
interpersonal therapy
34
effect change in personality structure or character
Psychoanalytically oriented psychotherapy
35
Excessive fear and anxiety and related behavioral disturbances
Anxiety disorders
36
• Diffuse, unpleasant, vague sense of apprehension, often accompanied by autonomic symptoms and restlessness
• Alerting signal that warns of impending danger and enables us to take measures to deal with threat
Normal anxiety
37
2 components of adaptive anxiety
1. Awareness of physiological sensation
2. Awareness of being nervous or frightened
38
Signal of danger in the unconscious
• Result of psychic conflict between unconscious sexual or aggressive wishes and corresponding threats from the superego or reality
• Treatment: not eliminate but to increase tolerance
Psychoanalytic theory
39
Developmental issues
Disintegration anxiety
Persecutors anciety
Castration anxiety
Superego anxiety
40
• Fear that self will fragment because others are not responding with needed affirmation and validation
Disintegration anxiety
41
• Self is being invaded and annihilated by an outside malevolent force
Persecutors anxiety
42
Oedipal phase in boys in which a parental figure (usu father) may damage the boy's genitals or cause bodily harm
Castration anxiety
43
Guilt feelings about not living up to internalized standards derived from parents
Superego anxiety
44
• Or learning theory of anxiety
• Conditioned response to a specific environmental stimulus thus developing mistrust
Behavioral theories
45
• No specifically identifiable stimulus
• Person experience feelings of living in a purposeless universe
• Anxiety is their response to perceived void in existence and meaning
Existential theories
46
abrupt surge of intense fear or intense discomfort that reaches a peak within minutes,
Panic attack
47
Recurrent unexpected panic attacks.
Panic disorder
48
At least one of the attacks has been followed by 1 month (or more) of one or both of the following:
1. Persistent concern or worry about additional panic attacks or their consequences (o.g., losing control, having a heart attack, "going crazy").
2. A significant maladaptive change in behavior related to the attacks (e.g., behaviors designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations).
Panic disorder
49
instruction on false beliefs and information about panic attacks
Cognitive psychotherapy
50
positive and negative reinforcements; relaxation techniques
Behavior therapy
51
increase the development of insight into psychological conflicts
Insight oriented psychotherapy
52
use of psychodynamic concepts promoting adaptive coping
Supportive psychotherapy
53
Marked fear or anxiety triggered by real or anticipated exposure to:
• Using public transportation
• Being in open spaces
• Being in enclosed spaces
• Standing in line or being in a crowd
• Being outside of home alone
• Escape might be difficult or help might not be available in the event of development of symptoms
Agoraphobia
54
Excessive anxiety and worry at least 6 mo
Generalized anxiety disorder
55
• Represented by intrusive thoughts, rituals, preoccupations and compulsions
• Cause severe distress
• Time consuming and interfere significantly with patient's routine, occupational functioning, social activities and relationships
• Patient may try to resist but unbearable anxiety builds up
Obsessive Compulsive Disorder
56
1. Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.
2. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action
Obsessions
57
1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
2. The behaviors or mental acts are aimed at preventing or reducing anxiety or dis-tress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.
Compulsions
58
The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impalment in social, occupational, or other important areas off functioning:
Obsessive Compulsive Disorder
59
Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.
The preoccupation causes clinically significant distress or impairment in social, occu-pational, or other important areas of functioning.
Body dysmorphic disorder
60
training in decision making and categorizing
Cognitive behavioral therapy
61
exposure and habituation
Exposure and response prevention therapy
62
At least 9 mos of age
• Characterized by a pattern of markedly disturbed and developmentally inappropriate attachment behaviors, in which a child rarely or minimally turns preferentially to an attachment figure for comfort, support, protection, and nurturance
Reactive attachment disorder
63
Essential feature of reactive attachment disorder
absent or grossly underdeveloped attachment between the child and putative caregiving adults
64
When distressed:
• Show no consistent effort to obtain comfort, support, nurturance, or protection from caregivers
• Do not respond more than minimally to com forting efforts of caregivers
• Absence of expected comfort seeking and response to comforting behaviors
• Diminished or absent expression of positive emotions during routine interactions with caregiver
• Display episodes of negative emotions of fear, sadness, or irritability
Reactive attachment disorder
65
A. A consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregiv-ers, manifested by both of the following:
1. The child rarely or minimally seeks comfort when distressed.
2. The child rarely or minimally responds to comfort when distressed.
Reactive attachment disorder
66
B. A persistent social and emotional disturbance characterized by at least two of the following:
1. Minimal social and emotional responsiveness to others.
2. Limited positive affect.
3. Episodes of unexplained irritability, sadness, or fearfulness that are evident even during nonthreatening interactions with adult caregivers.
Reactive attachment disorder
67
Reactive attachment disorder
The child has experienced a patter of extremes of insufficient care as evidenced by at least one of the following:
I Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults.
2. Repeated changes of primary caregivers that limit opportunities to form stable attachments (e.g., frequent changes in foster care).
3. Rearing in unusual settings that severely limit opportunities to form selective attachments (e.g., institutions with high child-to-caregiver ratios).
68
Essential feature: pattern of behavior that is culturally inappropriate, overly familiar behavior with relative strangers
• Has experienced a pattern of extremes of insufficient care
• At least 9 mos of
Disinhibited social engagement disorder
69
Exposure to actual or threatened death, serious injury, or sexual violence
Posttraumatic stress disorder
70
Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s),
Posttraumatic stress disorder
71
Persistent avoidance of stimuli associated with the traumatic events), beginning after the traumatic events) occurred,
Posttraumatic stress disorder
72
Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic events) occurred,
Posttraumatic stress disorder
73
Marked alterations in arousal and reactivity associated with the traumatic events), beginning or worsening after the traumatic events) occurred,
Posttraumatic stress disorder
74
modify painful negative emotions
Cognitive processing therapy
75
repeated imaging of trauma in safe controlled environment
Prolonged exposure therapy
76
exposure to milder levels of stress and help them manage
Stress inoculation
77
PTSD Duration
1mo
78
Acute stress disorder symptoms
Intrusion
Negative
Dissociative
Avoidance
Arousal
79
Acute stress disorder time
3 days to 1 mo
80
Presence of emotional or behavioral symptoms in response to an identifiable stressor
• Examples of stressors
• Romantic relationship breakup
• Marked business difficulties
• Marital problems
Adjustment disorder
81
Adjustment disorder
Within 3 mo
82
The development of emotional or behavioral symptoms in response to an identifiable stressors) occurring within 3 months of the onset of the stressor(s).
Adjustment disorder
Once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional 6 months.
83
84
Characterized by disruption of and / or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control and behavior
Dissociative
Disorders
85
symptoms:
• Unbidden intrusions into awareness and behavior, with accompanying loss of continuity in subjective experience
• Inability to access information or to control mental functions
• Aftermath of trauma
Dissociative disorders
86
Clinically significant persistent or recurrent depersonalization and / or
derealization
• Intact reality testing
Depersonalization/Derealization Disorder
87
Inability to recall autobiographical information that is inconsistent with normal forgetting
• Should be successfully stored in memory
• Ordinarily would be readily remembered
Dissociative Amnesia
88
unable to remember an event or period of time (most common)
Localized amnesia
89
unable to remember a specific aspect of an event or some events within a period of time
Selective amnesia
90
complete loss of identity and life history
Generalized amnesia
91
Presence of 2 or more distinct personality states or an experience of possession
• Recurrent episodes of amnesia
Dissociative Identity Disorder
• Multiple personality disorder
92
Person experiences:
• Recurrent, inexplicable intrusions into conscious functioning and sense of self
• Alterations in sense of self (attitude, preferences)
• Odd changes of perception
• Intermittent functional neurologic symptoms
Dissociative Identity Disorder
93
Prominence of somatic symptoms associated with significant distress and impairment
Somatic Symptom and Related Disorders
94
A. One or more somatic symptoms that are distressing or result in significant disruption of daily life.
B. Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns
Somatic symptom disorder
95
A. Preoccupation with having or acquiring a serious illness.
B. Somatic symptoms are not present or, if present, are only mild in intensity. If another medical condition is present or there is a high risk for developing a medical condition (e.g., strong family history is present), the preoccupation is clearly excessive or dispro-portionate.
C. There is a high level of anxiety about health, and the individual is easily alarmed about personal health status.
D. The individual performs excessive health-related behaviors (e.g., repeatedly checks his or her body for signs of illness) or exhibits maladaptive avoidance (e.g., avoids doctor appointments and hospitals).
Illness preoccupation has been present for at least 6 months,
Illness anxiety disorder
96
One or more symptoms of altered voluntary motor or sensory function.
B. Clinical findings provide evidence of incompatibility between the symptom and recognized neurological or medical conditions.
Conversion Disorder
(Functional Neurological Symptom Disorder)
97
eating of nonnutritive, nonfood substances on a persistent basis over at least 1 month
Pica
98
repeated regurgitation of food occurring after eating over a period of at least 1 month
Rumination disorder
99
avoidance or restriction of food intake manifested by clinically significant failure to meet requirements for nutrition or insufficient energy intake through oral route
• Weight loss, failure to gain weight
• Nutritional deficiency
• Dependence on enteral feeding or oral supplements
• Marked interference with psychosocial functioning
• Avoidant/restrictive food intake disorder
100
1. Persistent energy intake restriction
2. Intense fear of gaining weight or of becoming fat
Persistent behavior that interferes with weight gain
4. Disturbance in self perceived weight or shape
Anorexia nervosa
101
1. Recurrent episodes of binge eating
2. Recurrent inappropriate compensatory behaviors to prevent weight gain
3. Self evaluation that is unduly influenced by body shape and weight
Bulimia nervosa
102
recurrent episodes of binge eating, that must occur, on average, at least once per week for 3 months with no compensatory behavior
Binge-eating disorder
103
Inappropriate elimination of urine or feces
• Usually first diagnosed in childhood or adolescence
• Self limited and eventually remit
Elimination disorder
104
repeated voiding in inappropriate places; at least 5 years of age
Enuresis
105
repeated passage of feces in inappropriate places; at least 4 years of age
Encopresis
106
Problems with quality, timing and amount of sleep
• Significant daytime distress and impairment in function
Sleep wake disorder
107
Restorative, homeostatic function and appears to be crucial for normal thermoregulation and energy conservation
Sleep
108
• Prolonged period can lead to ego disorganization, hallucinations and delusions
• Irritability, lethargy
Sleep deprivation
109
debilitated appearance, skin lesions, increased food intake, weight loss, increased energy expenditure, decreased body temp and death
Rats
110
Heterogenous group of disorder that are typically characterized by clinically significant disturbance in person's ability to respond sexually or to experience sexual pleasure
Sexual dysfunction
111
distress that accompany the incongruence between one's experienced or expressed gender and assigned gender
Gender dysphoria
112
• Problems in self control of emotions and behaviors
• Behaviors that violate the rights of others (aggression, destruction of property) and/or has conflict with societal norms or authority figures
• More common in males
Disruptive, Impulse Control and Conduct
Disorders
113
The disturbance in behavior is associated with distress in the individual or others in his or her immediate social context (e.g., family, peer group, work colleagues), or it impacts negatively on social, educational, occupational, or other important areas of functioning.
Oppositional defiant disorder
114
A patter of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following cate-gories, and exhibited during interaction with at least one individual who is not a sibling.
Oppositional defiant disorder
115
Recurrent behavioral outbursts representing a failure to control aggressive impulses
Intermittent explosive disorder
116
C. The recurrent aggressive outbursts are not premeditated (i.e., they are impulsive and/ or anger-based) and are not committed to achieve some tangible objective (e.g., money, power, intimidation).
D. The recurrent aggressive outbursts cause either marked distress in the individual or Impairment in occupational or interpersonal functioning, or are associated with financial or legal consequences.
E. Chronological age is at least 6 vears (or equivalent developmental level).
Intermittent explosive disorder
117
repetitive and persistent patter of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of at least three of the following 15 criteria in the past 12 months from any of the categories below, with at least one criterion present in the past 6 months:
Conduct disorder
118
A. Deliberate and purposeful fire setting on more than one occasion.
B. Tension or affective arousal before the act.
C. Fascination with, interest in, curiosity about, or attraction to fire and its situational contexts (e.g., paraphernalia, uses, consequences).
D. Pleasure, gratification, or relief when setting fires or when witnessing or participating in their aftermath.
E. The fire setting is not done for monetary gain, as an expression of sociopolitical ideol-ogy, to conceal criminal activity, to express anger or vengeance, to improve one's living circumstances, in response to a delusion or hallucination, or as a result of impaired judgment (e.g., in major neurocognitive disorder, intellectual disability [intellectual developmental disorder], substance intoxication).
F. The fire setting is not better explained by conduct disorder, a manic episode, or antisocial personality disorder.
Pyromania
119
Recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value.
B. Increasing sense of tension immediately before committing the theft.
C. Pleasure, gratification, or relief at the time of committing the theft.
D. The stealing is not committed to express anger or vengeance and is not in response to a delusion or a hallucination.
E. The stealing is not better explained by conduct disorder, a manic episode, or antisocial personality disorder.
Kleptomania
120
Cluster of cognitive, behavioral and physiological symptoms indicating the individual continues using substance despite significant substance related problems
• Underlying change in brain circuits that may persist beyond detoxification
• Relapses
• Intense craving
Substance related and addictive disorders
121
substance seeking activities, related evidence of pathological use patterns are emphasized
Behavioral dependence
122
physiological effects of substance use
Physical dependence
123
• Continuous or intermittent craving for the substance to avoid a dysphoric state
Psychological dependence
124
reversible syndrome caused by a specific substance that affects one or more of the following mental functions: memory, orientation, mood, judgement, and behavioral, social or occupational functioning
Intoxication
125
substance specific syndrome that occurs after stopping or reducing the amount of drug that has been used over a prolonged period; characterized by physiological signs and symptoms in addition to psychological changes
Withdrawal
126
Characterized by acute decline in both level of consciousness and cognition with particular impairment in attention
• May be life threatening but potentially reversible
• Involve perceptual disturbance, abnormal psychomotor activity and impaired sleep cycle
Delirium
127
Progressive cognitive impairment in setting of clear consciousness
• Significant impairment in social and occupational functioning
Dementia
128
4 types
Alzheimers
Dementia of lewy body
Vascular dementia
Frontotemporal dementia
129
deposition of neurofibrillary tangles and presence of senile plaques
Alzheimers disease
130
multiple infarct dementia
Vascular dementia
131
preponderance of atrophy in the frontotemporal regions; presence of pick bodies
Frontotemporal dementia
132
Cluster a pd
Schizotypal
• Schizoid
• Paranoid
• Odd, aloof features
133
Cluster b pd
Narcissistic
• Borderline
• Antisocial
• Histrionic
• Dramatic, impulsive and erratic
134
Cluster c pd
OC
• Dependent
• Avoidant
• Anxious and fearful features
135
pattern of distrust and suspiciousness
Paranoid pd
136
pattern of detachment from social relationships and restricted range of emotional expression
Schizoid pd
137
pattern of acute discomfort in close relationships, cognitive or perceptual distortions and eccentricities of behavior
Schizotypal pd
138
pattern of disregard for, violation of, the rights of others
Antisocial pd
139
pattern of instability in interpersonal relationships, self image and affects, and marked impulsivity
Borderline pd
140
pattern of excessive emotionality and attention seeking
Histrionic pd
141
pattern of grandiosity, need for admiration and lack of empathy
Narcissistic pd
142
pattern of social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation
Avoiding pd
143
pattern of submissive and clinging behavior related to an excessive need to be taken care
Dependent pd
144
pattern of preoccupation with orderliness, perfectionism and control
Oc pd
