Psych 1 Flashcards by Giselle McIntyre

Difference between mood and affect

Mood = Internal subjective feeling (i.e. how patient feels, typically in quotes)

Affect = Interviewer’s experience of a patient

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Label:

Baseline is slightly shifted downwards and range of variation is less than full range

Restricted range

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Label: Baseline shifted down significantly with almost no variation in affect of expression

Flat

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Label:

When affect of the eyes does not match affect of the mouth
Can also be defined as the range between restricted and flat

Blunted

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Label:

When patient’s subjective mood does not match the interviewer’s observed affect of the patient

Mood incongruent

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Label:

Baseline shifted upwards but range of variation is less than full range

Bright

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Label:

Baseline shifted upwards significantly with almost no variation in range

Euphoric

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Label:

Baseline shifted slightly upwards with normal amount of variation
Between euphoric and bright

Expansive/Elevated

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Label:

When a patient is just all over the place with really large variation (crying one second and super happy the next)

Labile

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Words used to describe normal thought process

intact, logical, linear,

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Word used to describe thought process: patient has lots of side thoughts, but eventually make their way back to the original though

Circumstantial

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Word used to describe thought process: mind bounces around from idea to idea; the ideas are related to each other but the patient never gets back to the original thought; continuous side-tracking

Tangential

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Word used to describe thought process: mind going around in a loop, coming back to the same thing over and over

Rumination

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Word used to describe thought process: code for psychosis; the thoughts are connected to the thought before but it is hard to see the association and to follow the thought process

Loose

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Describe name/time frame of PTSD disorder that refers to PTSD before time frame that allows it to be classified as PTSD

Acute stress disorder = lasts > 3 days and < 1 month

PTSD = lasts > 1 month

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Diagnostic requirements of schizophrenia

Diagnosis of schizophrenia – requires at least 2 of the following, with at least one from 1-3:

Delusions
Hallucinations
Disorganized speech
Disorganized or catatonic behavior
Negative symptoms (affective flattening, avolition, anhedonia, asociality, alogia)

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Names of the 3 different disorders on the spectrum of schizophrenia based on time period

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Brief psychotic disorder > 1 day and < 1 month
Schizophreniform disorder > 1 month and < 6 months
Schizophrenia > 6 months

What is schizoaffective disorder

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Mood episodes and active symptoms of schizophrenia occurring at the same time + at least 2 week lifetime history of delusions or hallucinations in the absence of prominent mood symptoms
Aka normal schizo sometimes and schizo + mood at other times

Describe schizoid vs. schizotypal personality disorder

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Schizoid distant, detached, unemotional, and prefer to be alone
Schizotypal magical thinking, eccentric, odd beliefs, interpersonal awkwardness

Components of mania

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DIG FAST:
♣	D – Distractibility
♣	I – Insomnia / impulsive behavior 
♣	G – Grandiosity
♣	F – Flight of ideas (e.g. racing thoughts)
♣	A – Activity / Agitation
♣	S – Speech pressured
♣	T – Thoughtlessness

Differentiate between Bipolar I and Bipolar II

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Bipolar I = 1 manic episode +/- a hypomanic or depressive episode
Bipolar II = Hypomanic episode + major depressive episode

Diagnosis of Major Depressive Disorder

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Must be present for at least 2 weeks
Must include at least 5/9 of SIG E CAPS symptoms (MUST include either depressed mood or anhedonia)
• Depressed mood
• S – Sleep disturbance (hyper/insomnia)
• I – Loss of Interest (anhedonia)
• G – Guilt or feelings of worthlessness
• E – Energy loss / fatigue
• C – Concentration problems
• A – Appetite / weight change
• P – Psychomotor retardation or agitation
• S – Suicidal ideations
l

Average IQ score

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85-115

Components of the mental status exam

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General
Behavior
Motor
-
Mood
Affect
-
Thought process
Thought content
Associations
-
Speech
Language
-
Cognition
Fund of knowledge
Memory
Orientation
Concentration
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Insight 
Judgment

Describe Behavior vs. Motor in the MSE

Behavior: - Level of cooperation (e.g. cooperative, superficially cooperative) Motor: - Movements (increased/decreased) - Agitation (e.g. pacing, tapping, fidgeting) – referring to movement; does not refer to affect

Describe Affect in the MSE

Interviewer's experience of a patient Full range, restricted, blunted, flat, incongruent, bright, elevated, euphoric

Describe thought process vs. thought content in the MSE

Thought Process: - Rate, organization, goal orientation Thought Content: - Obsessions, delusions (e.g. paranoia), hallucinations, suicidal/homicidal ideation - E.g. Delusions of grandeur, delusions of reference, paranoia, delusional parasitosis,

Describe associations in the MSE

ow thoughts are linked together (e.g. intact, logical, loose, circumstantial, tangential)

Describe Speech vs. Language in the MSE

Speech: - Rate, rhythm, volume, tone, articulation, spontaneity, interruptible vs. pressured - Decreased spontaneity = one word answers - Pressured = difficult/impossible to interrupt; nothing to do with the rate of speech - Think: formation of sounds; the mechanical part Language - Symbolic understanding and use of words/vocabulary - Normal = grossly intact, expected vocabulary for age (for kids) - Stilted/Pedantic language = using vocabulary inappropriate to the conversation

Describe Insight vs. Judgement in the MSE

Insight - Understanding of current state (e.g. intact, good, fair, poor, absent) - Ability to understand their mental illness Judgment - Ability to make decisions (good, fair, poor, impaired, very impaired) - Can have great insight but impaired judgment (e.g. heroin users)

Describe Cognition in the MSE

♣ Ability to understand things ♣ Normal = intact ♣ Serial 7s = test cognition and attention

Describe Fund of Knowledge in the MSE

♣ Expected knowledge compared to peer group (e.g. average for age) ♣ Normal = aware of current events; intact ♣ E.g. person could be oriented (knows month) but have poor fund of knowledge (not know the president)

Describe Orientation in the MSE

Person, place, time, and situation (oriented x4)

What is the most common form of psychopathology

Anxiety disorders

Pharmacotherapy used in anxiety disorders

SSRI/SNRI = first line - Benzodiazepine - Non-addicting anxiolytics (diphenhydramine, hydroxyzine) - Buspirone (5HT partial agonist) - Beta blockers (control autonomic symptoms: palpitations, tachycardia, sweating, with panic attacks or performance anxiety) - TCA and MAOIs if first line SSRI not effective

Symptoms of panic attack

Dizziness, disconnectedness, depersonalization, palpitations, paresthesias, abd distress, numbness, nausea, intense fear of dying, chills, chest pain, sweating, shaking, SOB

DSM-5 criteria of panic disorder

- Recurrent, UNEXPECTED panic attack without an identifiable trigger - One or more panic attacks followed by > 1 month of continuous worry or avoidance behaviors - Not caused by substance, other mental disorder, or medical condition

Treatment of Panic disorder

Pharmacotherapy and CBT - SSRI = first line - TCA if SSRI not effective - Benzos PRN

DSM criteria of agoraphobia

AKA Mom from Shameless - Intense fear/anxiety about >2 situations due to concern of difficulty escaping or obtaining help in case of panic or other humiliating symptoms - Fear/anxiety is out of proportion to the potential danger posed - Symptoms cause significant social or occupational dysfunction - Symptoms last > 6 months

Treatment of agoraphobia

CBT and SSRI (for panic symptoms)

Psych 1 Flashcards

(40 cards)