Impulse Control, neurocognitive d/o, gender and sex offenders Flashcards
(40 cards)
What are the impulse control and conduct d/o’s?
- Oppositional defiant d/o
- Intermittent Explosive d/o - Conduct d/o
- Disorders of Aggression
Diagnostic criteria for oppositional defiant d/o?
Pattern of angry/irritable mood, argumentative/defiant behavior or vendictivness > 6 mo
With 4 of:
- often looses temper
- touch and easily annoyed
- angry and resentful
- argues w authority figures
- defies or refuses to comply w authority/rules
- deliberately annoys others
- blames others for own mistakes
- spiteful/vindictive 2x in 6 mo
Severity levels for ODD?
Mild - one setting
Moderate - two settings
Severe - three or more settings
Settings: (school, home, peers)
Ddx for ODD?
- Conduct d/o (more sever that ODD)
- ADHD (often comorbid)
- Intermittent explosive d/o (violence toward people)
What is intermittent explosive d/o?
Failure to control aggressive impulses
Manifested by either:
- minor (2x week x 3 mo)
- severe (3x in 12 mo)
Minor vs severe intermittent explosive actions?
Minor
- verbal aggression
- physical aggression toward property, animals, or people
Severe
- damage/destruction and physical assault
Describe the aggression for intermittent explosive d/o
Aggression is:
- out of proportion
- not premeditated
- caused marked distress to the individual
What is conduct d/o?
Repetitive and persistent pattern of behavior in which the basic rights of others or social norms/rules are violated As manifested by at least 3x in 12 mo - aggression toward people/animals - destruction of property - deceitfulness/theft - serious violation of rules
Doesnt meet the criteria for antisocial personality d/o
With disorders of aggression ___
Aggression and violence are symptoms rather than disease and most frequently are not necessarily associated w an underlying medical condition
Tx for disorders of aggression?
Psychological - slow, non-threatening , calm
Pharm
- acute
- antipsychotics (TOC)
- benzos (for mild aggression)
- long term
- brain lesion - carbamazepine and valproic acid
- intermittent outburst - lithium, SSRI
- intellectual disabled - buspirone
Physical
- actual restraints
- threat of restraint (multiple big people in room)
What are neurocognitive d/o?
Transient or permanent brain dysfunction w alterations in awareness or attention
Classification of neurocognitive d/o?
Primary - brain d/o
Secondary - manifestation of gen d/o
Clinical findings of neurocognitive d/o?
Pobs w:
- orientation
- attention span
- memory
- judgment
- emotional liability
- initiative
- impulse control
- reason
- confabulation
- hallucinations
- delusions
Essentials of diagnosis for neurocognitive d/o?
- Transient or permanent brain dysfunction w alterations in awareness or attention
- cognitive impairment to varying degrees
- impaired recall/memory and trouble w attention, perceptual processing and psychotic ideation
- emotional d/o freq: depression, anxiety, irritability
- behavioral d/o: impulse control, sexual, attention deficits, exhibitionism
With neurocognitive d/o you must determine?
If its:
- primary brain d/o
- 2/2 some general d/o
What is dementia?
- chronicity and deterioration of selective mental functions
Dementia pts can be id’d by?
Their tendency to complain about memory problems rather than cover them up
If a dementia pt says they cant do something?
You should press them, they often can when encouraged to
What is depression induced dementia?
Reversible dementia - fix the depression and viola!
What type of dementia do geriatrics usually have?
Progressive dementia
What is delirium?
Transient global d/o of attention
Delirium pts often have?
- clouding of consciousness
- mental status fluctuates
- marked deficit of short term memory and recall
- anxiety
- irritability
- inability to retain info
What is sundowning?
When they are good during the day and bad at night
What is terminal delirium?
End of life delirium
