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Flashcards in Exam II Deck (64):
1

Substance Abuse

(DRINK) Dangerous use of substance, Role Impairment (missing work..), No respect for the law, Keeps drinking/using in spite problems

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Substance Dependence:

TWO 6 PACK = Tolerance, Withdraw, Occupational, social, or recreational activities given up, 6, Persistent desire to drink, Amount taken in larger, Continued use despite problems, Keep using lots of time spend getting/recovering/using

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Diagnosis for SZ

Delusions, Hallucinations, Disorganized Speech, Catatonic behavior, Negative Symptoms, Impairment in Social/Occupational functioning, Duration = continuous signs for at least 6 months

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Schizophreniform Disorder

active SZ symptoms lasting 1-6 months then goes away

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Schizoaffective Disorder

Active SZ symptoms + recurrent major depression or bipolar disorder

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Delusional Disorder

Nonbizarre delusions lasting more than 1 month; no other significant impairment

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Major Depressive Episode

Five or more of the following during a 2 week period: Depressed mood most of the day, every day
o Depressed Mood
o Anhedonia: diminished interest or pleasure in all activities
o Significant change in appetite and/or weight (gain or loss)
o Sleep disturbance (hypersomnia (excessive sleep) or insomnia)
o Psychomotor agitation (antsy, fidgety) or retardation (slowed movements, speech…)
o Fatigue/loss of energy
o Feelings of worthlessness or inappropriate guilt
o Decreased concentration or increased indecisiveness
o Recurrent thoughts of death

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Dysthymia

Depressed most of the day, everyday for at least 2 years, and at least two of the following, can’t have no symptoms for more than 2 months in 2 years time
o Appetite disturbance
o Sleep disturbance
o Low energy/Fatigue
o Low Self-Esteem
o Poor concentration/Indecisiveness
o Feelings of hopelessness

9

Bipolar Disorder (Manic Depression)

Manic Episode: At least 1 week of persistently elevates, expansive or irritable mood, including more than or equal to 5 of the following (enough to cause marked impairment in functioning and/or hospitalization):
o Inflated self-esteem or grandiosity
o Decreased need for sleep
o Pressured speech (talking really fast)
o Racing thoughts
o Distractibility
o Increase in goal-directed activity or psychomotor agitation
o Excessive involvement in high-risk pleasure activities

10

Prevalence of SZ

0.5-2% of population is effected, most prevalent in homeless population ~200,000, women develop the disorder later have milder symptoms and have more favorable course than men do, possibly less severe in developing countries…, MZ twins 48% DZ twins 17%, people born in spring months

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Biological Etiology of SZ

• Genetic: very strong evidence for hereditary factors
• MZ twins concordance rate = 48%
• DZ twins concordance rate = 17%
• Possibly one set of genes for (+) symptoms; another set of genes for (–) symptoms

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Abnormalities of Brain Structure for SZ

• Enlarged ventricles (fluid-filled cavities); reduced volume, and neuron density in frontal cortex, and other brain abnormalities linked to cognitive and emotional deficits (neurocognitive disorder)
• Brain may not be fully developing in the right ways

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Neurochemical Etiology of SZ

• Excess of dopamine; serotonin, GABA, and Glutamate may also play roles [for (-) symptoms]
• Increased DA receptors in Mesolimbic pathway (VTA & NA), DA is in these places, not everywhere, is great for reducing (+) symptoms

14

Neurodevelopmental Hypothesis for SZ

• Disruptions in normal maturation process of the brain before or at birth
Evidence:
• Nazi blockade of food in Netherlands, women who were in their 2nd trimester during this time = bump in babies that had SZ
• Influenza epidemic in Finland – 2nd trimester get flu = increase in SZ babies

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o Birth Complications & Prenatal Viral Exposure for SZ

• Particularly those involving loss of oxygen that could damage brain
• More likely to have SZ when born during the Spring (esp. in boys, and left handed)

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Etiology of Stress in SZ

• Plays a key role in triggering SZ break
• Relationships, work, academic, abuse, financial, etc

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Genetic Factors for Dysthymia

• Multiple abnormalities strongly implicated
• Serotonin transporter gene abnormalities

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o Substance

Any natural or synthetic product that changes perception, thoughts, behaviors, etc

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o Substance Intoxication

experience of significant maladaptive behavioral and psychological symptoms (violent…)

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o Substance Withdrawal

experience of physiological and behavioral symptoms due to the cessation or reduction of substance use

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Substance Abuse

Maladaptive pattern leading to at most a month in 12 months causing impairment or distress (DRINK)

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Substance Dependance

Maladaptive pattern leading to 3 or more of the TWO 6 PACK

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o Tolerance

how much they need to get high/drunk increases

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o Binge drinking

drinking 5 or more drinks within a couple of hours

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delirium tremens (DTs)

withdrawal symptoms that occur in the third stage and are auditory, visual, and tactile hallucinations

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o Long term effects of Alcohol Abuse

low-grade hypertension, increased risk for heart disease, alcohol-induced persisting amnesic disorder (permanent cognitive disorder), Wernicke’s encephalopathy (mental confusion, disorientation), and Alcohol-induced dementia

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o Benzodiazepines

Xanax, valium) sedatives for treatment of anxiety and insomnia

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o Cocaine

euphoria, heightened self-esteem, alertness, energy, creativity, grandiosity, impulsiveness, hyper sexuality

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o Amphetamines

produce perceptual illusions, stimulant, euphoria, alertness, paranoia, movement seems distorted

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o Nicotine

resembles flight or flight response, CNS, PNS, bad withdrawal

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o Opioids

relives pain, euphoria, drowsiness

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o Hallucinogens

overflow of sensory, “bummers” anxiety, paranoia, loss of control, psychosis

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o PCP

euphoria, dullness, lack of concern, weakness, involuntary movements

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o Cannabis (Weed)

“high” feeling, relaxation, dizzy, sleepy, dreamy

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o Ecstasy

heightened energy, restlessness, social inhibition decrease

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o Positive Symptoms of SZ

• Delusions, Hallucinations, Disorganized thought or speech, Disorganized or catatonic behavior

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Negative Symptoms of SZ

Affective Flattening (Blunted Affect), Alogia, Avolition

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Delusions

• Beliefs that are not rooted in reality

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Hallucinations

• Unreal perceptual experiences

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Flat/Blunted Affect

• Severe reduction or complete absence of emotional (affective) responses to the environment

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Loosening Associations

• Jumps from topic to topic with out a lot of transitions

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Tangential Thinking

• Bring up something from “left field” (derailing)
o Word Salad:

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Word Salad

• Real words but not used correctly in order to make a sentence

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Neologisms

• Use made up words in real sentences in place of another word

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Alogia

• Severe reduction or complete absence of speech

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Avolition

• Inability to persist at common goal-oriented task at work/school/home

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Tardive Dyskinesia

involuntary jutting of tongue, facial grimacing, lip smacking, result of nerve damage that affects cranial nerves

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Akinesia

slowed motor activity

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Akathesis

increased agitation

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Depression with Melancholic features

physiological symptoms of depression are particularly prominent

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Depression with Psychotic features

people experience delusions, hallucinations, during major depressive episode

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Depression with Atypical features

Positive mood reactions to some events, significant weight gain or increase in appetite, hypersomnia, heavy or laden feelings in arms or legs, long-standing pattern of sensitivity to interpersonal rejection

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Depression with postpartum onset

This diagnosis is given to women when the onset of a
major depressive episode occurs within 4 weeks of delivery of a child

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Bipolar Disorder with Postpartum Depression

(rare) mania postpartum
o Postpartum Blues: emotional liability (unstable and quickly shifting moods), frequent crying, irritability, and fatigue.
Most stop after 2 weeks of birth

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Depression with Seasonal Pattern (SAD)

have a history of at least 2 years of experiencing and fully recovering from major depressive episodes. They become depressed when the daylight hours are short and recover when the daylight hours are long.

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Bipolar Disorder with Seasonal Pattern

develop mild forms of mania or have full
manic episodes during the summer months

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Premenstrual Dysphoric Disorder

women who frequently have significant increase in distress symptoms prior to menstruation

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Rapid Cycling in Bipolar Disorder

4 or more cycles in 1 year

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Egotistic suicide

committed by people who feel alientated from others, empty of social contacts, and alone in an unsupportive world

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Anomic Suicide

committed by people who experience severe disorientation because of a major change in their relationship to society (loosing job after 20yrs)

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Altruistic suicide

committed by people who believe that taking their life will benefit society

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Synergy

compounded effect resulting from a drug combination... antagonistic when drugs are canceled out, or additive.
i.e. taking alcohol and barbiturates is lethal

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Physiological Dependence

When a drug has been used fr some time alters the user's physiological functions in such a way as to necessitate continued use to prevent withdrawal symptoms

64

Habituation

Dependence on a drug because of a strong desire to replicate the psychological state
i.e. relief from depression