Exam 3 Flashcards
(159 cards)
1
Q
long-term pattern of INNER experience and OUTWARD behavior
A
Personality
2
Q
characteristics of personality
A
consistent (traits)
flexible
3
Q
disorder with a very rigid pattern of experience of behavior
A
personality disorder
4
Q
characteristics of personality disorder
A
lacking flexible piece
always feel need to act and feel the same way constantly
5
Q
DSM requirements for diagnosing personality disorder
A
Must cause impairment in social or occupational functioning, or personal distress
6
Q
what was personality disorder formerly diagnoses in for DSM-IV
A
Axis II (not transient problems)
7
Q
when do personality disorders typically start?
A
adolescence/early adulthood
8
Q
Generally, person with personality disorder doesn’t see their personality issues as problematic. What do they tend to do?
A
Tend to externalize the problem
– its not about them but how the world is reacting to them; think their dysfunction is from others treating them poorly
9
Q
Problems with DSM Categories for personality disorder
A
Criteria cannot always be observed directly
-PD is an inner experience
Diagnosis is based on self-report
Differ more in degree than in type of dysfunction
- Can have same symptoms of other personality disorder
- Diagnosis of a certain personality disorder is made by the different levels (mild, severe, etc.) of the symptoms
Criteria change in each DSM up until DSM-V
Often co-morbid with
“Axis I” disorder – depression, bipolar disorder, etc.
10
Q
Cluster A?
A
Eccentric or odd behavior
11
Q
cluster A PD has superficial similarity with what psychological disorder?
A
mild schizophrenia
12
Q
cluster for Paranoid Personality Disorder
A
A
13
Q
characteristics of Paranoid Personality Disorder
A
Strong suspicion or mistrust of others
Often avoid relationships
Do not see themselves as needing help
-Think its other people who have the problem
14
Q
cluster A personality disorders more common in males or females?
A
males
15
Q
cluster for schizoid personality disorder
A
A
16
Q
what is schizoid PD characterized by
A
Pervasive indifference to others
-Avoid socialization with anybody; don’t value socialization
Lack desire for social relationships
-Indifference towards relationships
Diminished range of emotions and expressions
-Protective factor
Generally don’t seek treatment.
-Externalize dysfunction/stress/problems
17
Q
cluster for schizotypal PD
A
A
18
Q
what is schizotypal personality disorder characterized by
A
Odd (but not delusional) ways of thinking and perceiving, and behavioral eccentricities
-Disorganized and eccentric on how they talk about things
Most closely similar to schizophrenia
19
Q
Most severe cluster A disorder?
A
schizotypal disorder
20
Q
why do people with schizotypal disorder have a hard time dealing with it?
A
because want/value relationships but when they try to form relationships their behavior pushes others away
21
Q
“dramatic” PD
A
cluster B
22
Q
characteristics of cluster B PD
A
Extremely self-absorbed and prone to exaggerate importance of events
Immense difficulty maintaining close relationships
23
Q
Most commonly diagnoses cluster?
A
B
24
Q
histrionic PD cluster?
A
B
25
what is histrionic PD characterized by
excessive emotionality and attention-seeking behavior
26
what does someone with histrionic disorder seek treatment
Goal = please or seduce therapist
Seek treatment in order to get attention from the therapist
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most common gender for histrionic PD
females
28
Grandiose, need much admiration, and little empathy for others
Convinced of own great success, power, or beauty
-Want people to confirm it
Exaggerate achievements and talents, often appear arrogant
Mostly in males
narcissistic PD
29
Persistently disregard and/or violate others’ rights for own gain
Likely to lie repeatedly, be reckless, and impulsive
-More likely to engage in criminal behavior – don’t see criminal activity as wrong since it might meet their needs
antisocial PD
30
cluster for antisocial PD
B
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cluster for narcissistic PD
B
32
How old must someone be to be diagnosed with antisocial PD
18
33
pre diagnosis for antisocial PD
conduct disorder
34
Borderline personality disorder cluster?
B
35
characteristics of borderline personality disorder
Great instability in life
- Major and sudden shifts in mood
- Chronically unstable self-image
Shifts in attitudes towards others
- Dichotomous thinking – idolize certain people or people they meet for first time, but if you do anything to violate idolization you become a horrible person to them
- Either love or hate the person, no in between
Impulsivity
- Do whatever there mood tells them to do
- Reckless behavior
- Self injury
Prone to bouts of anger; can lead to physical aggression or self-harm
36
What are borderline personality disorder people born with?
strong emotional sensitivity
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what is borderline PD linked to?
parental loss/abuse
38
who is borderline PD more common in?
women
39
What is the only PD with its own treatment
borderline PD
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treatment for borderline PD
dialectical behavior therapy (DBT)
drug therapy can help with severe mood
41
what theory is dialectical behavior therapy based on?
mindfulness theory (idea of being focused on what is happening in the moment)
42
what needs to be incorporated when someone with borderline PD experiences an intense mood?
reasonable/rational mind
43
what is included in the DBT states of mind diagram?
```
reasonable mind
wise mind (middle)
emotional mind (borderline personality disorder)
```
44
what cluster are the anxious personality disorders
C
45
characteristics of cluster C?
anxious
fearful
depressed
46
cluster of avoidant personality disorder
C
47
PD:
Shy and socially uncomfortable but desire social contact
fear intimacy
Extremely sensitive to negative evaluation
Come to therapy seeking acceptance and affection
Avoidant personality disorder
48
most treatable cluster C personality disorder?
avoidant personality disorder
49
cluster of dependent personality disorder?
C
50
PD:
Pervasive, excessive need to be taken care of
- Clingy, obedient, fear separation from loved ones
- Rely on others so much cannot make smallest decision for themselves
Many feel distressed, lonely, and sad
Dependent personality disorder
51
cluster for obsessive-compulsive PD
C
52
PD:
Enduring pattern of thinking, behavior characterized by perfectionism, inflexibility
Preoccupied with rules, excessively moralistic, judgmental
Unreasonably high standards (for self and others)
Obsessive-Compulsive Personality Disorder
53
Enduring pattern of thinking, behavior of obsessive compulsive PD is characterized by?
perfectionism and inflexibility
54
what gender more commonly has obsessive compulsive PD?
males
55
Eating disorders are on a _____
continuum
56
What refers to a range of unhealthy diet-related behaviors?
Eating disturbances and disordered eating
57
% of 10 year old girls afraid of being fat
80
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Average onset of eating disorders dropped form 13-17 to what?
9-12
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% of american college women engaging in disordered eating?
50%
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how have eating disorders changed in males?
doubled in past decade
61
What has been the shift of focus in body size?
Shift in focus from body size to overall body health advocated by many healthy researchers
"healthy ideal" not "thin idea"
62
Main symptoms of anorexia nervosa?
Refusal to maintain 85%+ of normal body weight
Intense fear of becoming overweight
Distorted view of body weight and shape
Amenorrhea – menstruation stops
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What are the two types of anorexia nervosa?
Restricting Type
| Binge-eating/Purging Type
64
What culture is anorexia nervosa a problem in?
Euro-american
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What is anorexia associated with?
Depression, low self-esteem, anxiety
Insomnia/other sleep disturbances
Substance abuse
Obsessive-compulsive patterns and Perfectionism
66
Medical complications of anorexia nervosa?
Caused by starvation:
Reduced bone density, dry skin, brittle nails
Low body temperature and blood pressure
Slow heart rate and poor circulation
Metabolic and electrolyte imbalance
Amenorrhea
Extreme cases: death
67
Bulimia Nervosa?
Not necessarily under-normal weight – not restricting intake
Regularly engage in discrete periods of overeating
Followed by compensation activities for overeating and to avoid weight gain
68
For someone with bulimia nervosa how often to compensatory behaviors occur?
2x per week for 3 months
69
Types of bulimia nervosa?
Purging type
Non purging type
70
what is the non purging type of bulimia nervosa?
excessive exercise
71
What is bulimia nervosa associated with?
Emotional distress,
Personality Disorders,
seasonal-related depression
72
Complications of bulimia?
Tooth decay
Gastric, rectal, and esophageal issues
Arrhythmia and cardiac arrest
73
percentage of cases that occur in females for bulimia?
90-96%
74
lifetime prevalence of bulimia nervosa?
1-2%
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NOS eating disorder?
NOS = not otherwise specified
Extreme disordered behavior but do not fit the criteria for anorexia or bulimia
76
Examples of NOS?
AN but with some menstrual cycle or normal weight
Purging with out bingeing or lower frequency of purging
Binge Eating Disorder
77
percentage of people in treatment programs diagnosed with NOS?
60%
78
biological dimension of eating disorders?
Genetic factors
- hypothalamus development affected
Neurotransmitters
- serotonin production
79
Is the hypothalamus over active or under active in anorexia?
under active (opposite for bulimia)
80
How is neurotransmitter affected in people with anorexia?
serotonin excessively produced (opposite for bulimia)
81
Psychological dimension of eating disorders?
Body dissatification/distortion
perfectionism
low self esteem
lack of control
82
Social dimension of eating disorders
parental attitudes and behaviors
history of being teased about body
peer pressure with weight/eating
83
Social cultural dimension of eating disorders
social comparison
media presenting distorted images
cultural definitions of beauty
84
What kind of approach is necessary in treating anorexia?
team approach
85
What kind of treatment is preferred in anorexia?
residential treatment
86
Medication effective in anorexia treatment?
no, poor support
87
Goals for anorexia treatment?
Restore healthy weight and treat physical complications
Enhance motivation for change through psychoeducation of nutrition
Psychotherapy for emotional disturbances with food
Family therapy
Relapse prevention
88
what eating disorder is more likely to seek treatment?
bulimia
89
Treatment for bulimia?
Anti-depressants
Often have problems like depression
Work on seratonin aspect – reduce pleasure response associated with food
Therapy: CBT or E/RP (65% stop binge-purge cycle)
(Eat --> not binge--> eventually stop binge-purge behavior
90
What kind of approach is most effective in bulimia treatment?
combined approach of anti depressant and cognitive/behavioral therapy
91
Condition where someone is experiencing symptoms but is coming from a psychological condition not physiological
Somatoform disorder
92
What often triggers a somatoform disorder?
traumatic event
93
what are some somatoform disorders?
conversion disorder
hypochondriasis - (DSM-5 = anxiety disorder)
body dysmorphic disorder - (DSM-5 = OCD disorder)
pain disorder
somatization disorder
94
What are some somatoform-like disorders?
malingering
factitious disorder
factitious disorder by proxy
95
they physical symptoms of conversion disorder suggests what?
a neurological problem
96
what triggers conversion disorder
severe stress
97
common symptom of conversion disorder?
loss of limb movement
98
1/3 of cases of people with conversion disorder don't seem to care that they are experiencing the symptoms associated with the disorder.
What is this called?
La belle indifference
99
who was conversion disorder common in
What symptoms did they experience
soldiers from World War I
loss eye sight
-had benefit of being discharged (secondary gain)
100
Someone who has somatoform disorder may feel pain --> they get attention, etc --> this results in what for the person?
secondary gains
101
What is PNES?
psychogenic non-epileptic seizures
type of conversion disorder
seizure like symptoms
102
What makes the seizures in PNES different from epilepsy?
No abnormal brain activity while having PNES seizure
-No misfiring of electrical signals in brain
Presence of tears during seizures
Attacks occur when others are present, but not while sleeping or alone
103
illness anxiety disorder (somatoform)
hypochondriasis
104
somatoform disorder (changed to anxiety disorder in DSM-5) where person is preoccupied that normal sensations are symptoms of a serious disease
hypochondriasis
- frequent visits to physicians
105
excessive concern with real or imagine defects in appearance
frequent visits to plastic surgeon
body dysmorphic disorder
106
What is the placement of body dysmorphic disorder (somatic) in DSM-5?
OCD
107
bigorexia is known as
muscle dysmorphia
108
physical pain caused by a psychological reaction (not physiological)
psychogenic pain
109
what causes an increase in pain or those with pain disorder
psychosocial facts
incredible increase in pain under stress
110
How might pain disorder be maintained?
by primary and secondary gains
111
Primary gains for pain disorder?
Developed from a primary interaction to an internal experience they don’t want to experience (trauma, depression, etc.)
Pain is a distraction from the internal experience
112
secondary gains for pain disorder?
Attention from environment, get out of doing things like having a responsibility due to pain
113
what symptom must somatization disorder include?
Must include 4 recurrent, different pains/somatic complaints before age 30
- 2 gastrointestinal (GI) symptoms
- 1 sexual symptom
- 1 pseudoneurological (PN) symptom
- Brain problem (injury or misfiring)
114
what do symptoms tend to be reported as with someone who has somatization disorder?
vague, unfounded or exaggerated
115
somatoform-like disorder where someone fakes symptoms to gain medical attention
more obsessive/anxiety like
factitious disorder
116
why is malingering (somatoform-like disorder) not a DSM disorder?
Behavior is motivated by external incentives only
117
Injury deliberately and gradually inflicted upon another
Considered a form of abuse
Person is requiring someone else to take care of them
Person in the care is being injured or caused to be sick by their care taker
Care taker wants attention/reinforcement
Factiticious disorder by proxy
118
who is the dependent and who is the proxy in factiticious disorder by proxy?
Care taker = proxy
Person in the care = dependant
119
Example of a culture-bound somatoform disorder symptoms
Dhat
Fear loss of seminal fluid during:
Nocturnal emissions
Urination
Reflects Indian belief that loss of semen is a loss of physical/mental energy
120
Sociocultural dimension of somatoform disorder?
cultural differences in rates and symptoms
differences in acceptance of medical vs. psych problems
-Higher incidences of somatoform in cultures that focus more on medical conditions vs psychological
121
Social dimension of somatoform disorder?
Parental/peer modeling
122
Biological dimension of somatoform disorder
Innate sensitivity to physiological reactions
History of illness or injury
123
Psychological dimension of somatoform disorder?
psychodynamic
cognitive-behavioral
124
Biological treatment for somatoform?
Medication
- Show person that pain is not physiological in nature but psychologically caused
- Or actually treat pain with medication if it helps
125
behavioral treatment for somatoform disorder?
Address “sick role”/avoidance reinforcers
Issues with trauma --> trauma manifestation --> treat trauma
126
cognitive treatment for somatoform disorder
Correct “cognitive distortion” or magnification of physical symptoms
Have to work with beliefs and motivation to change
127
DSM symptoms for autism?
Impaired Social Interactions
E.g. poor nonverbal activity
Impaired Communication
-Delay in spoken language development
Restricted, Repetitive, & Stereotyped Behavior Patterns
-Stereotyped movements:
Repetitive, destructive behaviors (e.g. hand flapping)
Shows some signs “in early childhood” (before age 3)
Symptoms limit and impair daily functioning
128
what is asperger's
form of autism, but doesn't display all the symptoms
trouble with social interactions
don't have delay in language, deviance in behavior, or repetitiveness
129
percentage of people with autism who remain severely disabled as adults and unable to lead independent lives
90%
130
percentage of people with autism who has severe IDD
70%
131
what is the IQ like for people with aspergers?
average or above
132
how much more prevalent is autism in boys than girls?
4X
133
why is autism more common in boys
genetic condition on Y chromosome
134
racial, ethnic, social differences in people with autism?
no differences
135
prevalence of people within autism spectrum?
1 in 68
| rate has tripled in last 10 years
136
Biological etiology of autism?
genetic factor
brain structure deficits
- hippocampus under developed (memory center)
- issues with cerebellum (balance)
- amygdala over firing (emotional expression)
IDD also affect (intellectual developmental disability)
137
Treatment for autism?
Early intervention
- test genetic factors
- social interaction test
- behavior treatment
138
Types of treatment for autism?
Behavioral therapy, communication training, stress management, parent training
- Disorder prevents them to learn these things naturally
- Comprehensive and intensive training
139
DSM criteria for AD/HD
6 symptoms of :
- Inattention AND/OR
- Hyperactivity & Impulsivity
- In order to be diagnosed need to have 6 symptoms
- If have both symptoms (6 of each) = mixed type
AND
-Onset before age 12
-Impairment in at least 2 settings
-Impairment in social, academic or occupational function
-No other pervasive disorder
(AD/HD can look like anxiety; if someone has anxiety and displaying AD/HD symptoms, they do not have AD/HD)
140
how does the prevalence of ADHD differ from younger people to older people
A lot less people age 40 (1:2000) have ADHD compared to school age children (1:25)
141
pitfalls to the diagnosis of ADHD
DSM criteria also describes normal kids
no physical or lab markers
significant overlap with other disorders (anxiety)
Public awareness and misinformation (parents and confirmation bias)
142
Keys to accurate diagnosis of ADHD
get a lot of history
standardized checklists/questionnaires
computer based testing
behaviorally observe interactions with others
look for slower developmental milestones (not all cases)
143
what is the social aspect of ADHD
parenting skills/environment is never the cause but it can influence it
144
genetic aspect of ADHD?
Overly active CNS
Agitated
Attention and memory centers under active
145
Medication used for ADHD
stimulants
146
what do stimulants do for ADHD
target CNS and activate it
- do so body sees as abnormal and responds by cutting production of processes activating CNS
activate attention and memory parts of brain
- originally under active
147
therapy for ADHD?
behavior modification
need structured schedule and environments
148
short term adverse effects of stimulants?
sleep disturbance
appetite suppression
tic
149
problems of stimulants
misinformation
controlled substance
adverse effects
overprescribed
150
what was the long term effect of stimulants on rats?
consequence in nuclear accumbent (translates motivation into action)
rats lacked drive as adults
growth/maturation affected
parts of brain dealing with attention, memory, energy, focus damaged
151
diagnosis for conduct disorder
violation of age appropriate basic rights/societal norms, with presence of at least 3 of the following:
1. aggression towards people/animals
2. destruction of property
3. deceitfulness or theft
4. serious violation of rules
152
percentage of kids who grow out of conduct disorder
70%
153
excessive and inappropriate anxiety around separation from caregiver
separation anxiety disorder
154
% of kids whose symptoms go away at adolescence for separation anxiety disorder
80-90%
155
intellectual developmental disorder? (IDD)
deficits in intellectual functions, adaptive functioning, and onset during developmental period (not indicative of autism or other pervasive disorder)
156
IQ of mild IDD
50-70
2 SD away
157
IQ of moderate IDD
35-50
3 SD away
158
IQ of severe IDD
20-35
4 or more SD away
159
what areas of brain are affected for IDD
verbal and spatial
