Higher Yield Flashcards
(91 cards)
1
Q
Acting out
A
immature
expressing unaceptable feelings and thoughts through actions
ex: spazzy face
2
Q
Dissociation
A
temporay drastic changes in personality, memory, consciousness, motor behaviour to avoid emotional stress
***can lead to Dissociative Identity Disorder
3
Q
Denial
A
Avoid awareness of painful reality
ex: ‘‘i dont have cancer’’
4
Q
displacement
A
takes things out on others
mom yells at kid bc kid yelled at her
5
Q
fixation
A
REMAIN at a childish level
men and sports….?
6
Q
identification
A
model behavoiur after someone more powerful, not necessarily admired
ex: abused child ids with abuser
7
Q
isolation of affect
A
separate feelings from ideas and events
ex: describe event in detail without emotion
8
Q
projection
A
blames someone else for their own bad impulse
ex: i suck at this so im gonna say you do instead
PARANOID PERSONALITY DISORDER
9
Q
rationalization
A
proclaiming logical reasons for action actaully performed for other reasons to avoide self blame
ex: lost the thing of value, says it doesnt matter
10
Q
reaction formation
A
replace issue with opposite
ex: sexy time to celebacy
11
Q
regression
A
15 year old becky
TURN BACK (versus fixation where stuck at) maturational clock to deal with conflict in childish way
ex: commonly seen in children….
12
Q
repression
A
INVOLUNTARY (vrs suprression - voluntary) withholing idea or feelign from consciou awareness
ex: dont rememebr bad thing
13
Q
splitting
A
believing extremes
BORDERLINE PERSONALITY DISORDER
ex: love him/hes perfect and hate him/hes everything horrible
14
Q
SASH
Alturism
A
alleviating guilting feelings with generosity
ex: stole something now gives to chairy
15
Q
SASH
humor
A
haah the step is in three months
16
Q
SASH
sublimation
A
replace unacceptable wish with a course fo action that is SIMILAR to the wish but doesnt not conflict with ones value systems (reaction formation –does the OPPOSITE)
17
Q
SASH
suppression
A
intentinal withholding of an idea of feeing from conscious awareness
ex: yep.
18
Q
Weak + Wordless + Wanting + Wary
A
effects of infant long term deprivation of affection (> 6 months) - decreased muscle tone, poor language skills, poor socilalization skills, lack of basic trust, anaclitic depression (infant withdrawn/unresponsive), weight loss, physical illness –> severe can result in death
19
Q
11 year old presents with inability to control impulses, limited attention span. In school his teachers complain that he acts with hyperactivity, impulsivity and inattention compared to the other children. His parents have similar complaints of this type of behaviour at home. IQ testing shows approriate values for age, but inability to pay attention for long periods of time has risk of having difficulties in school. Has a 1/2 risk that problem with continue into adulthood.
A
ATTENTION-DEFICIT HYPERACTIVITY DISORDER:
- before 12 years old, 50% continue into adulthood
- limited attention span and poor impulse control
- will present in multiple settings with a) hyperactivity, b) impulsivity, and/or c) inattention.
- NORMAL INTELLIGENCE, but usually coexists with difficulties in school
- **associated with fronal lobe volume decrease and metabolism
- **associated with Tourette Syndrome
20
Q
A 12 year old is brought to your office with complaints from his parents of repeatitive occurences of physical agression towards his/her siblings. He was foudn to be responsbile for the destruction of the school’s playground and was also found stealing from the cafeteria. When questioned, he/she showed no respect for the basic rights of others.
A
CONDUCT DISORDER
* repetitive and pervasive beaviour violating the basic rights of tohers a) stealing b) physical aggression c) destruction of property
after 18 –> ANTISOCIAL PERSONALITY DISORDER
21
Q
A hostile teenager with history of outwardly aggressive behaviour in the face of minimal criticism from teachers and parents is brought to your clinic. He/she has had many run ins with authority figures and has shown defiant behaviour consistently despite serious violatiosn of social norms
A
OPPOSITIONAL DEFIANT DISORDER
* enduring pattern of hostile, defiant behaviour toward authority figures in absence of seriosu violatiosn of social norms
22
Q
TOURETTE SYNDROME
A
- onset before 18
- sudden, rapid, recurrent, nonrhythmic, stereotyped motor and vocal tics
- coprolalia - involuntary obscence speech @ 10-20%
- must persist for over ONE YEAR
ASSOCIATED WITH ADHD and OCD
23
Q
A 7-9 year old child saying goodbye to his/her parents before heading to summer camp displays an overwhelming fear of separation from her home upon her departure. At camp, she complains of a stomach ache in hopes that she may return home. After assessement, it is foudn that these symptoms are mostlikely factitious.
A
SEPARATION ANXIETY DISORDER
- 7-9 years old
- overwhelming fear of separation from home or loss fo attachemtn figure
- may lead to factitious physical complaints to avoid going to or staying at school
24
Q
A young boy in early childhood presents with ritualized/repetitive behaviours and complaints frmo his parents that they have a hard time communicationg with him and that he has problems with social interactions at school. He appears to be of normal or not intelligence and had very restricted intesne interests.
A
AUTISM SPECTRUM DISORDER
- characterized by poor social interactions, communication deficits, repetitive/ritualized behaviours, restricted interests
- MUST present in early childhood
- may or may not have intellectual disability
- more common at BOYS
25
A young 1-4 yo girl presents with the loss of developmenta milestons previously achieved. She can no longer verbalize her wishes, shows ataxia on walking and stereotypicall wrings her hands
RETT SYNDROME
* X linked but almost always/exculsively seen in girls (males pass away in utero)
* becomes apparent at ages 1-4 yo
* regression cxzed by: a) loss of development, b) loss of verbal abilities, c) intellectual disability d) ataxia and e) stereotyped hang wrining
26
NT changes in ALZHEIMER DISEASE
decreased Ach
27
NT changes in anxiety
```
decreased GABA + decreased 5HT (all the inhibit GABAs and make you happy NTs)
increased NE (increased sympa)
```
28
NT changes in depression
decreased NE + decreased DA + decreased 5HT (decreased in all the make you happys - sympathetic rush gone, reward DA gone, 5HT in love gone)
29
NT changes in Huntington
decreased GABA + decreased Ach
increased DA
(all these changes will make the motor sytem activity increase HYPERKINESIA (los of stop)-- Ach normally inhibits DA - in pathophys lec notes)
30
NT changes in Parkinson
decreased DA
increased 5HT + increased Ach
(opposite of huntington - remember parkinson is HYPOKINESIA (loss of go) so NT should reflect decreased activity of motor systmes check)
31
what NT are opposite direction of change in Parkinson vrs Huntington
Ach increases in P and decreases in H
| DA increases in H and decreases in P
32
Inability to recall personal information after a severe trauma or stress
Dissociatve amnesia
33
Dissociative Fugue
abrupt travel or wandering during a period of dissociative amnesia associated with traumatic circumstances
34
Describe DELIRIUM
| *FA says: deliRIUM changes in sensoRIUM*
due to other illness, check for drogs
waxing and waning with acute onset and rapid decline in attention span and level of arousal.
* disorganized thinking, (visual) hallucinations, illusions, misperceptions, disturbance in sleep-wake cycle, cognitive dysfunction
* secondary to: CNS disease, infection, trauma, substance abuse/withdrawal, metabolic/electrolyte disturbances, hemorrhage, urinary/fecal retention) WATCH OUT IN STEM FOR ELDERLY PERSON WITH UTI/OTHER PATHOS - remember funny presentation of pain so sbe careful that you dont miss anything.
35
Describe DEMENTIA
| FA says: deMEMtia is characterized by MEMory loss
gradual decline in intellectual abilitys/cognition with no changes in consciousness
* cxzd by a) memory deficits, aphasia, apraxia, agnosia, loss of abstract thought, behavioural/personality changes, impared judgement
* can develop DELIRIUM (acute onset of loss in consciousness = hallucinations, disorganized thinking, decreased level fo arousal, misperceptions, s-w disturbances, cgo dysfucntion)
36
IRREVERSIBLE causese of dementia
dementia - cognition not consciousness
Alzheimer Disease, Lewy Body Dementia, Huntington dz, pick dz, cerebral infarcts, creutzfeldt-jakob dz, chronic substance abuse
37
REVERSIBLE causes of dementia
dementia - cognition not consciousness
| NPH, vita B12 def, hypothyroidism, neurosyphillis, HIV
38
family of disorders characterized by distorted perception of reality characterized by a) delusions, b) halluciations AND/OR c) disorganized thinking
**be careful becky**
PSYCHOSIS
| can occur @ medical illness, psychiatric illness or BOTH
39
Schizo-PHREN-ia
chronic with periods of psychosis, distubred behaviour and thought, decline in function for GREATER THAN 6 MONTHS; associated with INCREASED DA and decreased DA branching
DX: requires 2 or more
* delusions +ve symptoms
* hallusiciations, auditory +ve symptom
* disorganized speech with loss associations +ve symptom
* disorganized speech or catatonic behaviour +ve symptom
* flat affect, social withdrawal, lack of motivation, lack of speech, lack of thought -ve symptoms
40
Presentation of Schizo-PHREN-ia
1.5% lifetime prevalence
late teens to early twenties in males
late twenties to early thirties in females
increased risk of SUICIDE
41
Delusional Disorder
fixed, persistent, untrue belief system lasting LONGER THAN ONE MONTH - function is otherwise unimpaired
ex: person who thinks is married to a celebrity when they arent.
42
SIGECAPS and the deets
```
MAJOR DEPRESSIVE DISORDER
S - sleep disturbances
I - loss of interest/anhedonia
G - guilt or feelings of worthlesness
E - energy lose and fatigue
C - concentration problems
A - appetite/weight changes
P - psychomotor retardation or agitation
S - suicidal ideations
depressed mood
5/9 for more than 2 weeks episodes for 6-12 months
```
43
Maternal/Postpartum Blues
```
50-85%
depressed affect + tearfulness + fatuge
starts 2-3 days after delivery
usually resolves in 10 days
follow up for postpartum depression
```
44
Postpartum Depression
10-15%
depressed affect + anxiety + poor concentration
starts within 4 weeks after delivery
lasts 2 weeks to a year or more
45
Postpartum Psychosis
0.1-.02%
delusions + hallucinations + confusion + unusual behaviour + possibly homicidal/suicidal ideation or attempts
lasts for 4-6 weeks
46
''I have two or more distinct personalities or identities and Im a woman because this is more common in us. I could have an associated history of sexual abose, PTSD, depression, substance abuse, borderline personalitiy disorder and somatoform conditions"
Dissociative Identity Disorder
| Two face from batman
47
" I have persistent feelings of detachement or estrangemetn frmo my own body, thoughts, perceptions and actions to both my environment and my actions''
Depersonalization (disconnect from actions)/derealization (disconnect from environment) Disorder
48
DIG FAST for at least 1 week
manic episode: distinct period of abnormally and persistently elevated, expansive or irritable mood and abnormally and persisitently increased activity or energy that last AT LEAST ONE WEEK; often disturbing to the patient
D - distractibility
I - irresponsbility - seeks pelasure without regard to consequence/hedonistic
G - grandiosity - inflated self esteem
F - flight of ideas - racing thoughs
A - increased in goal directed activith and psychomotor agitation
S - decreased need for sleep
T - talkativeness or pressure speech
MARKED IMPAIRMENT
49
HYPOMANIA
like mainc except doesnt cause social or occupation functioning and doesnt requrie hospitalization
no psyhcotic features
LASTS AT LEAST 4 CONSECUTIVE DAYS
50
at least 1 manic episode DIGFAST with our without a hypomanic or depressive disorder with return to nomral inbetween episodes
Bipolar I
| HIGH SUICIDE RISK (schizo)
51
hypomanic AND a depressive disorder with return to normal inbetween episodes
Bipolar II
| HIGH SUICIDE RISK (schizo)
52
dysthymia and hypomania for at least two years
Cyclothymia
| milder form of bipolar
53
" I have inappropriate experiences of fear and worry that have a phsycial manifestation when the source of the fear or worry is either not real or insufficiecnt to account for said symptoms. The symptoms interfere with my daily life and i have a lifetime prevelance of 30% in women and 19% in men. What familly of disorders am I? "
Anxiety disorders
54
Descrieb PANIC DISORDER
DX: attack folowed by 1 monthf or more fo 1 or more i
i) persistent concern of additional attcks
ii) worry about consequences of the attack
iii) behavioural chang related to attacks
AND
recurrent panic attacks - preiods of intesne fear and discomfort peaking in 10 minutes with at least FOUR of:
PpANIiCcccSss
* palpitations
* paresthesias
* abdominal distress
* nausea
* intense fear of dying or losing control
* lIghtheadedness
* chest pain
* chills
* choking
* disConnectedness
* sweating
* shaking
* SOB
55
Specific phobia
fear that is excessive/unreasonable/interferes with normal functioning.
cue = presence or anticipation fo a specific object or stiuation
PERSON KNOWS FEAR IS EXCESSIVE
56
SAD
social anxiety disroder: exaggerated fear of embarrassment in social situations - public speaking and restrooms
57
Agoraphobia
exaggerated fear of open or enclosed placess - public transprotation, being in line or in crowds, leaving home alone.
58
GAD
AT LEAST 6 MONTHS of uncontrollable anxiety that is UNRELATED to a specific persion, situation, event.
= sleep disrutbance, fatigue, gi disturbance, difficulty concentration
59
Adjustment disorder
emotional symptoms causing impairment following an IDENTIFIABLE psychosocial stressor ie divorce, illness that lasts LESS THAN 6 MONTHS
60
OCD
obsessions: recurring intrusive thoughts, feelings, sensations that cause severe distress
compulsions: relived in part by performances of repetitive actiosn
associated with tourette's syndrome
61
BDD
preoccupation with minor or imagined defect in appearance leading to significant emotional distress or imparied funtioning
commonly seek cosmetic surgery repeatedly
62
PTSD
persistent reexperienceing of a previosu traumatic event
* nigthmares, flashbakcs, intense fear, helplessness or horror
* avoidance of stimuli
* persistently increased arousal
LASTS GREATER THAN 1 MONTH with onset of sxs anytime after the event that cause:
* significnat distress
* negative cognitive alterations
* and/or impaired functioning
63
Acute Stress Disorder
like PTSD but lasts 3 days to 1 month
64
Personality Disorders Clusters and lists pelase
CLUSTER A: weird, accusatory, aloof, awkward
* paranoid personality disorder
* schizoid personality disorder
* schizotypal personality disoder
odd or eccentric, inability to develop meaningful social relationships, NO PSYCHOSIS, genetic association with schizophrenia
```
CLUSTER B: wild, bad ot the bone
* antisocial personality disorder
* borderline personality disorder
* histrionic personality disorder
* narcissistic personality disorder
dramatic, emotional or erractic; genetic assocation with mood dirsoders and substance abuse
```
CLUSTER C: worried, cowardly, compulsive, clingy
* avoidant personality disorder
* obsessive-compulsive personality disorder
* dependent personality disorder
anciosu or fearful; fenetic association with anxiety disorders
65
Paranoid personality Disorder
Cluster A: weird, accusatory, aloof awkward, odd or eccentric, inability to develop meaningful social relationships. no psychosis, genetic association with SCHIZOPHRENIA
- -> pervasive distinct and suspiciousness
- -> PROJECTION is major defense mechanism
66
Schizoid Personality Disorder
Cluster A: weird, accusatory, aloof awkward, odd or eccentric, inability to develop meaningful social relationships. no psychosis, genetic association with SCHIZOPHRENIA
--> voluntary social withdrawal, limited emotional expression, content with social isolation (avoidant - fear of isolation)
67
Schizotypal Personality Disorder
Cluster A: weird, accusatory, aloof awkward, odd or eccentric, inability to develop meaningful social relationships. no psychosis, genetic association with SCHIZOPHRENIA
--> eccentric appearance, odd beliefs or magicla thinking, interpersonal awkwardness
68
Antisocial Personability Disorder
Cluster B: wild, bad to the bone, dramatic, emotional or erratic. genetic association with MOOD DISORDERS and SUBSTNACE ABUSE
- -> disregard for and violation of rights of others, criminality, impulsivity
- -> males> females
- -> must be over 18 yo and have a history of conduct disorder before the age of 15
69
Borderline Personality Disorder
Cluster B: wild, bad to the bone, dramatic, emotional or erratic. genetic association with MOOD DISORDERS and SUBSTANCE ABUSE
--> unstable mood and interpersonal relationships, impulsivness, self-mutilation, boredome, sense of emptiness
--> females > males
defense mechanism: SPLITTING
70
Histrionic Personality Disorder
Cluster B: wild, bad to the bone, dramatic, emotional or erratic. genetic association with MOOD DISORDERS and SUBSTANCE ABUSE
--> excessive emotionality and excitability, attention seeking, sexually provocative, overly concerned with appearance
71
Narcissistic Personality Disorder
Cluster B: wild, bad to the bone, dramatic, emotional or erratic. genetic association with MOOD DISORDERS and SUBSTANCE ABUSE
--> grandiosity, sense of entitlement, lacks empath and requires excessive admiration, often demands the ''best' and reacts to criticism in rage
72
Avoidant Personality Disorder
Cluster C: worried, cowardly, compulsive, clingy; anxious or fearful. genetic association with ANXIETY DISORDERS
--> hypersensitive to rejection, socially inhibitied, timid, feelings of inadequacy, desires relationships with otehrs (schizoid -- happy to be alone)
73
Obsessive-complusive Personality Disorder
Cluster C: worried, cowardly, compulsive, vlingy; anxious of fearful. genetic association with ANXIETY DISORDERS
- -> preoccupation with order, perfectionisn and control
- -> ego syntonic
- -> behaviour consistent with one's own beliefs and attitudes (versus OCD - causes stress)
74
Depedent Personality Disorder
Cluster C: worried, cowardly, compulsive, clingy; anxious or fearful. genetic assocation with ANXIETY DISORDERS
- -> submissive and clinging
- -> exevssive need to be taken of
- -> low self confidence
75
unexplained symptoms or compliants + no conscious attempt to deceive =
somatoform disorder
76
unexplaiend symptoms or complaints + conscious attempt to deceive + chief goal is psychological ie 1e gain
factitious disorder
77
unexplained symptoms or complaints + conscious attempt to deceive + cheif goal is external ie 2e gain
malingering
78
"I have physical symptoms with no identifiable physical cause that are produced and motivated by UNCONSCIOUS drives. I dont intentionally produce or feign my symptoms and Im most likely a women"
Somatic symptom and related disorders
79
A patient with a medical illness complains of one or more organ systems lasting for months to years. The patient also has excessive, persistent thoughts and anxiety about symptoms.
Somatic symptom disorder
80
"Uh oh, I've had a sudden loss of sensory or motor function (probably muteness, blindness, paralysis) after I had an acute stressor. Im pretty la belle indifference abotu the whole thing or maybe Im not. im probably an adolescent or young female"
Conversion disorder
81
"you've given me lots of medical evaulation and reassurance, but I still have a preoccupation wtih and fear of having a serious illness despite it all"
Illness anxiety disorder
82
"I partake in excessive dieting with or without purging and I have an intense fear of gaining weight, a distorted body image, and exercise excessively. My BMI is
Anorexia Nervosa
* fear of gaingin weight
* exercise, dieting, maybe purge
* BMI low
* osteoprosis and depression
83
"I binge eat and then do or do not purge. I use lasatives, diuretics or emetics as well as make myself vomit. My body weight is pretty normal but you might notice parotitis, enamle erosion, electrolyte distrbances, alklaosis, dorsla hand calluses fommy induced vomtiming ie a RUSSELL SIGN. I am also probably an adolescent girl"
Bulimia Nervosa
84
" I have a desire to live as the opposite sex, and will ofter go through surgery or hormone treatment to do so"
Transsexualism
85
Transvestism
paraphila, not gender dysphoria -- like to wear clothes of the opposite sex
86
"I have a strong and persistent cross gender identification that makes me persistently feel discomfort with my sex assigned at birth. I find this causes my significant distress and/or impaired functioning. People refer to me as TRANSGENDER"
Gender Dysphoria
87
I;m a kid who ''woke up'' terrified in the middle of the night but was unresponsive to your concern. Went back to bed and can't remember the episode in the morning"
Sleep terror disorder: episodes of screaming in middle of night. occurs in NON REM - no memory
88
Im a kid who woke up scared of a dream and could remember it in the mornign
Nightmares - ocur in REM = memory
89
nnnnNarco-LEP-see
caused by decreased OREXIN production in lateral hypothalamus --> disorder regulation of sleep-wake cycles and EXCESSIVE DAYTIME SLEEPINESS
associated features:
* hypnagogic - just before sleep
* hypnopompic - just before awakening hallucinations
* nocturnal and narcoleptic sleep episodes that start off with REM sleep
cataplexy - loss of all muscle tone following a strong emotional stimulus - laughter in some patients.
STRONG GENETIC COMPONENT
90
Substance Use Disorder
TWO or MORE within ONE YEAR:
* tolerance
* withdrawal
* substance taken in larger amounts or over longer time than desired
* persistent desire or unsuccessful attempts to cut down
* significant energy spent obtaining, using, recovering from substnace
* important social, occupational or recrreaitonal activires reduced bc of substance use
* continued used despite problems it causes
* craving
* recurrent use in physically dangerous situations
* failure to fulfill major obligations at work, school, home
* social, interpersonal conflicts related to substance use
91
Stages to overcoming substance addiction
PRECONTEMPLATION: not yet acknowldeging that there is a probolem
COMPTEMPLATION: acknowledging that there is a problem, but not yet ready or willing to make a change
PREPARATION/DETERMINATION: getting ready to change behaviour
ACTION/WILLPOWER: changing behaviours
MAINTENANCE : maintaining the changed behaviour
RELAPSE: returnign to old behaviours and abandonign ne changes
