Exam 3

Question 1

Psychotic disorders distinction

Answer 1

out of touch with reality

Question 2

Schizophrenia prevalence

Answer 2

early adulthood
prevalence is similar across the globe (probably biological)
1% US population, 0.7% across the globe

early 20’s for men, late 20’s for women

Question 3

Schizophrenia Delusions (thought patterns)

Answer 3

Positive symptom
delusions = false beliefs (irrational, nor strongly held or socially acceptable, deeply embedded and strongly held) obscured thought content, maladaptive, not always distressing to patient
thought broadcasting = believes their thoughts can be read by others against their will
thought insertion = believes own thoughts had been implanted be something else
thought withdrawal = believe their thoughts have been taken from them

Question 4

Negative Schiz symptoms

Answer 4

reduction of regular functioning
lack of emotional expression–flat affect
lack of eye contact, gesturing, intonation, volition (decrease in motivated and self-initiated activities, engagement)
diminished speech output
anhedonia–no pleasure with activities
asociality–no interest in socializing

Question 5

Types of Schiz delusions

Answer 5

persecutory = belief they will be harmed, harassed, targeted
referential = random cues gestured specifically directed at person, feel they are being singled out, special meaning
grandiose = believes they are somebody famous, or have wealth, talents, fame
erotomanic = believes other person is in love with them 
Nihilistic = catastrophe will occur
Somatic = preoccupation with health, odd and unlikely, bizarre

Question 6

Schiz hallucinations

Answer 6

positive symptom
false sensory perceptions, VERY clear for patients
auditory = hearing voices or something else, voices seem distinct from patient’s thoughts, most common hallucination in schiz

Question 7

Schizophrenia phases

Answer 7

late adolescence, realy adulthood (brain needs to be fully developed)
Prodromal phase–signs symptoms start to appear, gradual deterioration, no hallucinations or delusions, patient cant take care of self
Acute phase–delusions, hallucinations, illogical thinking, obvious symptoms, psychotic
residual phase–odd thoughts and behaviors, but not acute psychosis

Question 8

Psychodynamic theory of Schiz

Answer 8

ego overwhelmed by sexual impulsive drives form id
id threatens the ego–regression to oral stage
treatment frm this theory is ineffective

Question 9

behavioral theory of schiz

Answer 9

patient learns how to and models bizarre behaviors

Question 10

family theories for schiz

Answer 10

schizophrengenic mother–cold, aloof, overprotective parenting lowers kids SE, impairs independence
increased risk if father is not active/present to counteract mother’s
this theory has been debunked, but stress within family is probably a factor

Question 11

biological theory of schiz

Answer 11

concordance rates–MZ have higher risk of developing than DZ
closer genetic relationship–higher likelihood
biochemistr–DA hypothesis–either overabundance of DA or oversensitivity to DA–medications reduce DA to reduce positive symptoms
viral infections in mother during pregnancy may increase risk (evidence shows that mothers pregnant during flu season during first trimester may have higher risk–not sound evidence thought
structural–size of ventricles–too large so brain tissue is less, PFC smaller,
brain circuitry–PFC to limbic system connection is impaired

Question 12

diathesis stress model of schizophrenia

Answer 12

genetic risk of developing X stress factors

protective factors may reduce likelihood of disorder or severity of symptoms (IQ, personality)

Question 13

Treatment for schiz

Answer 13

antipsychotic meds (block DA receptors)--side effect tardive dyskinesia--involuntary chewing, lip smacking, puckering lip, trunk limb movements, hand tremors, eye blinking (long term use)
newer meds have reduced risk or severity

learning-based–operant conditioning to selectively reinforce good behaviors, token economy = give small rewards to trade in for larger reward, social skills training–inhibit problematic behaviors and teach social skills

psychosocial rehab–support systems for patient to be functional, individualized for severity and medication, targets social and occupational skills (work, communication, cognitive), reducing psychotic break, can be consistently provided

family intervention-help family members understand diagnosis, needs of patient, how to support patient, reducing stress, increase communication

Question 14

Brief psychotic disorder

Answer 14

psychotic symptoms for a month or less

follows major stressor

Question 15

Schizophrenophorm disorder

Answer 15

psychotic symptoms for 1-6 months

Question 16

Delusional disorder

Answer 16

recurrent delusional beliefs, usually persucatory

Question 17

Schizoaffective disorder

Answer 17

features of schiz and severe mood disorder

Question 18

Erotomania

Answer 18

delusion that you are loved by someone (usually) but you are not

Question 19

Personality Disorders Definition

Answer 19

An enduring pattern of inner experience and behavior that:
different from expectations of culture, person is inflexible, low insight into their issues, disorders affect every aspect of person’s life, disorder usually isn’t diagnosed until early adulthood sine usually don’t develop fully, disorder is stable over time, person doesn’t want to change disorder because they don’t see the problems

Question 20

3 clusters of personality disorders

Answer 20

A. odd or eccentric (schizoid)
B. dramatic, emotional erratic (antisocial, borderline, narcissistic)
C. anxious, fearful (avoidant, dependent, obsessive-compulsive)

Question 21

Paranoid Personality Disorder

Answer 21

Cluster A
pervasive distrust, suspicious of others, thinks others mean harm

characteristics: suspect that others are exploiting, harming, or deceiving them, feeling they are injured by others, secretive/cold/lack emotional feelings, doubtful of others, no one can be trusted, disbelieving of others who are trustworthy, don’t expect others to help, do not confide n others and do not have close friends, look for hidden meanings and make misinterpreted assumptions, hold major grudges, hostile toward insults, counterattack and react with anger, super jealous, major lack of trust and need to control others, may have psychotic episodes

Question 22

Schizoid Personality Disorder

Answer 22

Cluster A
EMOTIONALLY COLD AND DETACHED
detachment form social relationships, lack desire of intimacy, don’t want to develop close relationships, prefer to spend time alone, almost always choose to be on their own, may affect their job, do not have intimate relationships, little pleasure from activities, indifferent to what others think of them, seem oblivious to social cues, don’t reciprocate emotionally, rarely experience strong emotions, can’t express anger, appear cold/aloof, do not have cognitive or perceptual distortions, are not suspicious of others

Question 23

Schizotypal Personality Disorder

Answer 23

Cluster A
ODD ECCENTRIC UNUSUAL(THOUGHT PATTERNS AND ACTIONS)
pervasive pattern of social and interpersonal deficits
discomfort with relationships, cognitive or perceptual distortions
ideas of reference–incorrect interpretations of events–assuming they have specific meaning when they don’t, but not as severe as delusions
odd beliefs or magical thinking, superstitious of paranormal phenomenon, feel they have special powers to sense things before they happen
alterations in perceptions, thinking someone is calling their name (but not out of touch with reality)
odd thinking and speech–vague, overly abstract or concrete
ideation–suspicious or paranoid
difficulty of affect
odd, eccentric mannerisms–unkempt dress, not put together
usually do not have close relationships, less desire for intimacy, highly anxious in social situations with unfamiliar people, usually do not socialize because they realize they are different, socialize when thy have to, but would rather keep to themselves

Question 24

Antisocial Personality Disorder

Answer 24

Cluster B
Anti = against society
lack of regard for others and their rights, begins in childhood or early adolescence, persists into adulthood, diagnosis usually isn’t made until late adolescence
“sociopathy, psychopathy, sociopath”
failure to follow norms, repeated illegal behavior (destruction of property), disregard for wishes rights or feelings of others
deceitful, manipulative of others to gain, repeatedly lie
pattern of impulsivity, do not plan ahead, do not think about consequences
sudden changes in jobs, residence, relationships
highly irritable and aggressive–physical fights, assault, child abuse
disregard for own safety and for others–road rage DWI, substance use, neglect to care for others they are responsible for
consistently and extremely irresponsible with everything and are indifferent to how their behavior affects others
lack of empathy–callous, cynical, lack or remorse
tend to come in contact with criminal justice system, but even people in power can have this disorder because they appear charming

Question 25

Borderline Personality Disorder

Answer 25

Cluster B instability of relationships, self-image, affect presents in early adulthood frantic efforts to avoid real or impaired abandonment--if perceive they will be left/rejected, have profound changes in self-image, thought processes, affect severe abandonment fears even for realistic separations intolerance of being alone and need to be surrounded by others do not have strong sense of self-identity identity based on interactions and relationships with others unstable and intense relationships demand to spend a lot of time with another, share super personal info with another person early on idealize others then switch to devalue them when change of relationship sudden and dramatic shifts in how they view others identity disturbance--persistent and unstable self-image and sense of self, shifting goals, values, work life, sudden changes in opinions and plans, changes in friends, impulsive--high likelihood to be self-damaging (gambling, drive recklessly, risky sex, suicidal behavior or threats with purpose of manipulating others to keep them engaged in relationship completed suicide 8-10% unstable affect, irritability, anxiety, low mood, shifting last a few days, anger, panic chronic feelings of emptiness because no sense of self--easily bored, finding new things to do, uncontrollable anger sometimes usually when other appears uncaring, paranoia or dissociation along with fear of abandonment

Question 26

Histrionic Personality Disorder

Answer 26

Cluster B emotionality and attention seeking behavior--need to be center of attention sexually provocative, bur don't actually become emotionally intimate rapid shifts in emotion, but emotion is shallow, nothing is deep appearance is attention grabbing, provocative, noticeable, need to impress others with appearance, spend money on clothes, fish for compliments, do not take criticism well for appearance impressionistic speech, express dramatic strong opinions, vague reasons though, lack info facts, details to support drama, theatric, embarrass others with public display easily influenced by other opinions, overly trusting because need attention perceive relationships as more intimate than they are

Question 27

Narcissistic Personality Disorder

Answer 27

Cluster B super grandiosity, need for admiration, lack of empathy for others, self esteem is vulnerable, vulnerable to "injury" (not experiencing self or being seen as others as grandiose) self esteem--very sensitive to criticism, feel defeated, react with rage, counterattack other, seek reassurance high sense of self-importance, inflate accomplishments, boastful, pretentions preoccupies with success power brilliance love, privilege, right for admiration, compare self with famous others, believe they are superior special and unique and expect others to see them the same way SE is mirrored by idealized value of people they associate with--need the best of the best, believe needs are special, and need more than others how they feel about self is fragile, so need admiration from others, have high expectations of others sense of entitlement--more important than everyone else exploitation of others, expect to be given what they want/need LACK OF EMPATHY--DIFFICULTY RECOGNIZING OTHERS HAVE NEEDS OF THEIR OWN lack of interest in others, envious of others, expect others to be envious of them haughty, arrogant

Question 28

Avoidant Personality Disorder

Answer 28

Cluster C social inhibition, feelings of inadequacy, hypersensitive to emotions avoid interpersonal contact because fear of criticism, disapproval, rejection avoid making friends unless being absolutely sure they will be accepted need to be guaranteed they wont get any criticism appear to be restrained, withholding preoccupied with rejection--low thresholds for detecting these, always alert shy, quiet long for active social life, but too fearful not good socially, because low SE, believe they are inept, reluctant to take risks or engage in new activities, fear embarrassment

Question 29

Dependent Personality Disorder

Answer 29

Cluster C excessive need to be taken care of, clingy, submissive pessimism, self-doubt, minimize assets and abilities, criticism is proof of worthlessness need advice and reassurance depend on single person to make decisions for them--usually parent or spouse--live, job, friends difficulty expressing disagreement toward other they are dependent on--dot want to upset them can't act independently, initiate projects, need for nurturance or support, will submit to unreasonable demands uncomfortable and helpless when alone--will urgently seek another relationship if they lose one

Question 30

Obsessive-Compulsive Personality Disorder

Answer 30

Cluster C personality--affects every aspect of life preoccupied with order, perfectionism, mental control painstaking attention to rules, schedules, lists, instructions--activity is lost in details take up time with these behaviors perfectionism causes distress so involved with every detail that can't complete the work can't prioritize, delegate excessive devotion to work, don't engage in leisure or relationships workaholic excessive conscientiousness rules, morality, ethics, rigid morals highly self-critical when make a mistake hoarding behaviors--stingy, miserly, believe spending money is wrong rigidity, stubbornness

Question 31

Freud perspective of Personality Disorders

Answer 31

Freud--oedipal complex (test of ego), lacking ego and superego

Question 32

Learning Perspective on personality disorders

Answer 32

maladaptive behaviors, behavior modification early childhood experiences shape this environmental factors lead to maladaptive habits--to disorders look into individual's history to find environmental factors that developed into behaviors

Question 33

Family perspectives on personality disorders

Answer 33

family relationships

Question 34

Bio perspectives of personality disorders

Answer 34

genetic factors potentially causal--anti, narc, paranoid, borderline brain abnormalities--borderline and antisocial--may be PFC abnormalities because emotion and impulsivity antisocial--lack of emotional responsiveness, reactivity lowered, possibly may need greater amounts of stimulation, which may be a reason for exaggerated craving for stimulation drug therapy is not effective, SSRI's may be a little helpful for controlling anger

Question 35

sociocultural perspectives on personality disorders

Answer 35

social conditions and problems may contribute to development of disorders rates of disorders more predominant in lower SES

Question 36

Impulse control disorders

Answer 36

failure to control impulses, temptations, or drives | harm to self and others

Question 37

Kelptomania Disorder

Answer 37

compulsive stealing

Question 38

Intermittent explosive disorder

Answer 38

impulsive uncontrollable aggression

Question 39

Pyromania

Answer 39

compulsive fire setting

Question 40

Childhood Depression

Answer 40

irritability, hopelessness, low SE/self-confidence, insomnia, poor sleep, appetite, distorted thinking

Question 41

Childhood Anxiety Disorders--Separation Anxiety Disorders

Answer 41

Separated form primary caregiver--more anxiety than expected persistent, developmentally inappropriate significant distress, recurrent distress, persistent worry to caregivers, reluctance to go out, refusal to sleep away from home and caregiver

Question 42

Neurodevelopmental Disorders

Answer 42

group of disorders that onset in childhood, mostly before grade school or symptoms present when child starts school, deficits that cause impairments

Question 43

Intellectual disability

Answer 43

deficits in intellectual functioning AND adaptive (need both) intellectual = IQ test, score must be 2SD below mean adaptive = observing child, people who know child well fill out checklists about child's adaptiveness and independence, sociocultural expectations deficits in adaptive--usually needs ongoing support, communication, social participation, home, school, community can be mild-moderate-severe-profound earlier diagnosis/intervention--better

Question 44

Causes of intellectual disabilities

Answer 44

biological, impoverished environment (nutrition), psychosocial, chromosomal, diseases, fetal alcohol syndrome Down syndrome--extra chromosome on 21st pair, heightened risk for IQ disability Fragile X syndrome--genetic mutation on gene on X chromosome--can lead to mild--> sever IQ disability Phenylketonuria (PKU)--preventable, genetic, recessive gene prevents metabolizing of amino acid phenylalanine, builds up in brain and causes functioning impairment--pregnant mom can avoid amino acid so it doesn't build up (diet soda) child is tested to see if they have it when they are born so you can avoid consuming the amino acid (damages CNS) FAS--cells in brain migrate to wrong place lead--child consumes leads to IQ problems severe nutritional deficits infections--rubella, meningitis, teratogens

Question 45

Interventions for intellectual disabilities

Answer 45

school system--least restrictive environment, don't separate kids with intellectual disabilities from other kids (case by case) educational, vocational (work skills), psychological, social, practical

Question 46

Autism Spectrum Disorder prevalence

Answer 46

spectrum for severity persistent deficits in social communication and interaction across multiple contexts 2% of children, risk increases in older fathers, diagnosis usually around 6 yrs

Question 47

Theoretical perspectives on ASD

Answer 47

detached/cold parents (now discredited) Lovass (1979)--first to suggest sensory/perceptual issues now we know brain/neurological abnormalities, but still unclear possibly infections are involved NOT caused by vaccines

Question 48

ASD interventions

Answer 48

intensive, structured, very individualized | operant conditioning--using reinforcements (Lovass)

Question 49

Specific learning disorders

Answer 49

difficulty mastering keystone academic skills testing--IQ show how well child should be performing typically a specific area reading, writing, math, executive functioning achievement tests--if 1.5SD below for specific area, and IQ is average, then learning disorder impairment in reading--dyslexia impairment in written expression--spelling, grammar, clarity math--understanding numbers, terms, simple math, times tables, reasoning EF--problem solving, judgement, coordination

Question 50

Communication disorders

Answer 50

Language disorder--difficulty acquiring and using language, reduced vocab, sentence structures, Speech sound disorder--producing speech sounds so difficulty communicating Childhood inset fluency disorder--stuttering, causes anxiety, makes it worse, an be treated social pragmatic communication disorder--taking turns, understanding social rules of verbal and nonverbal, rephrasing, greeting, sharing info, not changing communication or adjust to context or listener, following rules of social communication

Question 51

Attention Deficit Hyperactivity Disorder

Answer 51

inattention, hyperactivity, impulsivity = interferes/decrease quality with functioning or development must have several symptoms before 12yrs and need to be in 2 or more settings (school AND home) inattention = wandering off task, no persistence, focus, disorganization, no close attention, careless mistakes, avoiding tasks that require focus, lose, misplace things hyperactivity = inappropriate excessive motor activity, talking excessively, interrupt impulsivity = "hasty actions" occur in moment, immediate gratification

Question 52

3 Types of ADHD

Answer 52

Predominantly inattentive type Predominantly hyperactive or impussive type combined type

Question 53

Bio perspective of ADHD

Answer 53

genetic contribution = higher concordance in identical twins, may run in families brain dysfunction = PFC

Question 54

Interventions for ADHD

Answer 54

stimulant medications (Ritalin, Adderall) = work because they activate PFC , used during school, but not summer because side effects behavior modification/operant conditioning, skills training CBT--get child to stop and think before acting

Question 55

Oppositional Defiant Disorder

Answer 55

excessive pattern of angry/irritable mood, argumentative defiant behavior, vindictiveness last at least 6 months irritable--temper, easily annoyed, edgy defiant--argue with authority, actively defy moods, deliberately annoy others vindictiveness--spiteful usually not distressing for patient but is for others

Question 56

Conduct Disorder

Answer 56

Young antisocial personality disorder (not all CD kids move on to ASPD) repetitive--violates rights of others and social norms typically bullies, initiate fights, aggressive toward others, physically cruel to others, stealing, force sexual activity, destruction of property (fires), deceitfulness, lying to obtain goods, stealing, violations of rules

Question 57

Theories for Oppositional defiant and conduct disorders

Answer 57

"difficult child" temperament--personality characteristics, not easily soothe, highly reactive innate unresolved child-parent conflict overly strict parenting psychodynamic--anal stage fixation

Question 58

Intervention for conduct and oppositional defiant dosirders

Answer 58

parenting training programs | behavior modification and learning good parenting skills

Question 59

Enuresis

Answer 59

no control over bladder urinate in bed or on clothes--involuntary or intentional 2x/wk for 3 months (at least 5yrs od)

Question 60

Encopresis

Answer 60

repeated passages of feces in inappropriate places | 1x/mo for 3 months (at least 4yrs)

Question 61

Neurocognitive disorders

Answer 61

not psychologically based--physical or medical causes change in brain-->cognitive change in prior level of functioning

Question 62

Delirium

Answer 62

disturbance in attention and awareness often times reversible develops short period of time typically most recent memory is impaired, awareness of where they are, what day, perceptual disturbance, maybe hallucinations causes: head trauma, metabolic disorders, drug abuse, fluid imbalance, stroke, CNS disorders, Vitamin B deficiency need to rule out prior neurocognitive disorder

Question 63

Major Neurocognitive Disorders

Answer 63

profound/significant decline in cognitive functioning multiple potential causes may be reversible interferes with person's independent functioning problems with executive functioning, learning, memory

Question 64

Mild neurocognitive disorder

Answer 64

mild or moderate cognitive deficits don't interfere with independence, person usually uses compensatory means for issues mild diagnosis allows for early intervention for neuro problems

Question 65

Neurocognitive Disorder due to Alzheimer's Disease

Answer 65

impairment in memory and deterioration in other cognitive (word-finding, forgetfulness, getting lost, judgment, subtle personality changes) subtle onset and gradual/steady progression sometimes hallucination very late on causes--neurofibrillary tangles (in neurons) and amyloid plaques

Question 66

Vascular neurocognitive disorder

Answer 66

2nd leading cause caused by stroke or cerebrovascular accident (blood clot) typically occurs suddenly and rapid decline left side of brain--aphasia symptoms, severity, recovery varies

Question 67

Fronto-Temporal Neurocognitive Disorder

Answer 67

``` deterioration of tissue in frontal and temporal lobes memory loss (not as severe as Alz) and inappropriate social functioning` ```

Question 68

Neurocognitive Disorder due to Traumatic Brian Injury (TBI)

Answer 68

must have evidence of brain injury deficits vary with site of injury better recovery when younger amnesia, loss of consciousness, seizure activity

Question 69

Substance-Medication-Induced Neurocognitive Disorder

Answer 69

caused by use of substance or medication Korsakoff's syndrome--chronic alcohol use, loss of LTM due to vitamin D deficiency Wernicke's disorder--alcohol use, vitamin B1 deficiency, confusion, balance

Question 70

NCD with Lewy Bodies

Answer 70

``` Lewy Bodies--abnormal protein buildups in nuclei of brain cells super profound cognitive decline usually subtle onset problems with attention and alertness visual hallucinations, rigidity ```

Question 71

NCD due to Parkinson's

Answer 71

``` deterioration of substantia nigra--DA tremors, shaking, rigid muscles, walking problems, lack of control flat affect, no emotional expression NCD with progresion of disease L-DOPA medication increases DA ```

Question 72

NCD due to Huntingtons

Answer 72

inherited degenerative Choreiform movements--involuntary/jerky movements cognitive impairment, executive functioning first, subtle onset cognitive onset usually before motor

Question 73

NCD due to HIV

Answer 73

impaired executive functioning, slow processing speed, difficulty with demanding attentional tasks, new learning

Question 74

NCD due to Prion

Answer 74

Prions are abnormal pathogenic agents that are transmissible prions cause molecules that become infected and lead to neurodegeneration--prions kill neurons mad cow disease

Question 75

Schizophrenia categories of symptoms

Answer 75

must have 2 or more for at least 6 mo--delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms impairment, persistent symptoms and disruption, rule out medical conditions or drugs

Question 76

Schizophrenia Language Problems

Answer 76

illogical thought processes derailment--switching topics, lose associations--associate things that don't make sense tangentiality--answer something completely differently, incoherence--speaks in incoherent way "word salad")

Question 77

Schizophrenia Physical behavior

Answer 77

grossly disorganized or catatonic behavior--varied catatonia--reduction in reactivity to enviro stim, unresponsive or unusual posture without movement, frozen stereotyped movements--unnecessary repetitive movements excessive motor behavior

Question 78

Hans Kohut perspective of personality diorder

Answer 78

cohesive sense of self: NPD--façade to cover deep feelings of inadequacy, pathological narcissism--lack of parental support healthy narcissism is present in childhood but becomes a problem into adulthood

Question 79

Otto Kernberg perspective of personality disorders

Answer 79

Otto Kernberg--BPD--failure to develop sense of unity in self-image, lack of ability to develop strong sense of identity, cant synthesize positive and negative views of self and others

Question 80

Margaret Mahler perspective of personality disorders

Answer 80

BPD--may develop from difficulties of separation of child from mother figure, cant differentiate own identity from mother's

Question 81

ASD social symptoms

Answer 81

social-emotional reciprocity--difficult to go back and forth, don't initiate, lack of emotion, sharing nonverbal communication behaviors--eye contact, gestures, facial expressions, body orientation, intonation of speech, flat tone, joint attention developing, maintaining, understanding relationships--adjust behaviors to suit contexts, imaginative play, no interest in peers, making friends autism usually "utterly alone"

Question 82

ASD physical and intellectual symptoms

Answer 82

restricted repetitive patterns of behaviors--stereotyped repetitive motor movements, echolalia (stereotyped speech) sameness--inflexible, changes cause distress, rigid thinking highly restricted fixated interests--abnormal intensity hypo or hyper-reactivity to sensory input (usually hyper) savant syndrome--may have one skill that is outstanding