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MCAT ALL > Psychological disorders > Flashcards

Psychological disorders Flashcards

1
Q

Schizophrenia

A

A psychotic disorder. Must have one or more of the following: delusions, hallucinations, disorganized thought, disorganized behavior, catatonia, and negative symptoms.

> than 6 month presentation of two or more symptoms which must include:
delusions, hallucinations, or disorganized speech.

Symptoms divided into Positive and Negative symptoms.

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2
Q

Positive Symptoms

A

Behaviors, thoughts, or feelings added to normal behavior.

Delusions, Hallucinations, Disorganized Thought, disorganized behavior, and catatonic behavior.

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3
Q

Delusions

A

False beliefs discordant with reality and not shared by others in the individual’s culture that are maintained in spite of strong evidence to the contrary. Common delusions: persecution & grandeur.

Delusions of reference–involve the belief that common elements in the environment are directed toward the individual (TV is talking to him).

Delusion of persecution–belief that people are out to get him.

Delusion of grandeur–belief that the person is remarkable in some significant way.

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4
Q

Thought Delusions

A

Thought Broadcasting–belief that one’s thoughts are broadcast to the external world.

Thought Insertion–the belief that thoughts are being inserted into one’s head.

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5
Q

Hallucinations

A

Perceptions that are not due to external stimuli, but have a compelling sense of reality.

Most common are auditory.

Visual and Tactile are less common–can be associated with drug use.

Olfactory and Gustatory are least common–can be associated with seizure.

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6
Q

Disorganized Thought

A

Characterized by loosening of associations – speech topics shift in such a way that one is not able to follow the train of thought.

Word salad–completely incomprehensible speech

Neologisms–words “invented” (usually by schizophrenics).

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7
Q

Disorganized Behaviors

A

Inability to carry out daily living activities.

Catatonia–a rigid posture, useless and bizarre movements.

Echolalia–repeating another’s words

Echopraxia–imitating another’s actions

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8
Q

Negative Symptoms

A

Disturbance of affect & avolition

Affective symptoms:
blunting–reduced affect
flat affect–virtually no emotion
inappropriate affect–affect is discordant with context

Avolition–decreased engagement in purposeful, goal directed activities.

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9
Q

Prodromal Phase

A

Clear deterioration prior to onset of schizophrenia. During prodromal phase: social withdrawal, role functioning impairment, peculiar behavior, inappropriate affect, and unusual experiences.

If the onset is slow, the prognosis is particularly bad.
If the onset is rapid, the prognosis is better.

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10
Q

Major Depressive Disorder

A

-At least one major depressive episode.

Five of the following symptoms: SIG E. CAPS

Depressed Mood
Anhedonia
Appetite Disturbances
Weight Change
Sleep Disturbances
Decreased Energy
Feelings of Worthlessness
Difficulty Concentrating
Psychomotor Retardation
Thoughts of Suicide

Must have: depressed mood or anhedonia

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11
Q

Dysthymia

A

A depressed mood that is not severe enough to meet the criteria of MDD, more days than not for at least two years.

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12
Q

Seasonal Affective Disorder (SAD)

A

A major depressive episode with seasonal onset (winter months). Not a freestanding diagnosis in the DSM-V.

Often treated with bright light therapy.

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13
Q

Bipolar Disorder

A

Mood disorder characterized by depression and mania.

Explanation for bipolar disorder. Monoamine or Catecholamine Theory of Depression–states that too much norepinephrine and serotonin leads to mania, too little leads to depression.

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14
Q

Manic Episode

A 
Elevated mood for at least one week.: DIG FAST
Three of the following symptoms:
Increased Distractibility
Less Need for Sleep
Grandiosity
Racing Thoughts
Increased goal related activity
Agitation
Pressured Speech
High-Risk Behavior
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15
Q

Bipolar I, Bipolar II, & Cyclothymia

A

Bipolar I–manic episode, with or without depression, may have psychotic features.

Bipolar II–hypomania with MDE, no psychotic features.

Cyclothymia–combination of hypomanic episodes and dysthymia–not severe enough to qualify as MDE.

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16
Q

Specific Phobias

A

An irrational fear of something that results in a compelling desire to avoid it. The most common type of anxiety disorder

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17
Q

Social Anxiety Disorder

A

Characterized by anxiety due to social situations. Persistent fear of social or performance situations that may result in embarrassment.

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18
Q

Agoraphobia

A

Anxiety characterized by a fear of being unable to escape from a place or situation.

Uncomfortable leaving their homes.

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19
Q

Panic Disorder

A

Consists of repeated panic attacks.

Symptoms of a panic attack:
fear, sweating, trembling, hyperventilation, a sense of unreality.

Suddenly struck with a sense of impending doom
Frequently accompanied by agoraphobia.

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20
Q

Obsessive-Compulsive Disorder (OCD)

A

Characterized by obsessions (persistent intrusive thoughts) and compulsions (repetitive tasks).

Obsessions raise the individual’s stress level, compulsions relieve this stress.

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21
Q

Body Dysmorphic Disorder

A

A person has an unrealistic negative evaluation of his of her personal appearance and attractiveness, usually directed at a certain body part.

22
Q

Dissociative Disorders

A

The person avoids stress by escaping from his identity, but has an otherwise intact sense of reality.

Disorders include: Dissociative amnesia, DID, depersonalization/derealization

23
Q

Dissociative Amnesia

A

Inability to recall past experiences. Like regular amnesia, but not neurological in origin.

Often linked to trauma.

Dissociative Fugue–sudden, unexpected move or purposeless wandering away from one’s daily activities and home (associated with confusion and amnesia)

24
Q

Dissociative Identity Disorder (DID)

A

When two or more personalities recurrently take control of a person’s behavior. Components of identity fail to integrate.

Most cases involve a history of severe abuse.

Debated within the medical community.

25
Q

Depersonalization / Derealization

A

Individuals feel detached from their own mind and body (depersonalization) or from their surroundings (derealization).

Presents with a feeling of automation.

Out of body experience is an example of depersonalization.

Derealization is often describing the world as a dream-like state.

Person does NOT show symptoms of psychosis

26
Q

Somatic Disorders

A

Marked by somatic (bodily) symptoms that cause significant stress or impairment.

Somatic Symptom Disorder
Illness Anxiety Disorder
Conversion Disorder

27
Q

Somatic Symptom Disorder

A

Individuals have at least one symptom, which may or may not be linked to an underlying medical condition. Express a disproportionate amount of concern about its seriousness, and have elevated levels of anxiety.

28
Q

Illness Anxiety Disorder (formerly hypochondriasis)

A

One is consumed by thoughts of having or developing a serious medical condition.

29
Q

Conversion Disorder

A

Characterized by unexplained symptoms affecting voluntary motor or sensory functions. Usually begin after a traumatic event. Examples: paralysis or blindness without evidence of neurological damage.

la belle indifference–a person may be surprisingly unconcerned with the symptom.

30
Q

Personality Disorder

A

A pattern of behavior that is inflexible and maladaptive causing distress or impaired functioning in at least two of the following areas: cognition, emotions, interpersonal functioning, or impulse control.

Considered to be ego-syntonic.

Three Clusters: A, B, & C

31
Q

Cluster A

A

Odd or eccentric.

Paranoid PD
Schizotypal PD
Schizoid PD

32
Q

Paranoid PD

A

–pervasive distrust of others.

33
Q

Schizotypal PD–

A

a pattern of odd or eccentric thinking. Ideas of reference (similar but not as extreme as delusions of reference). Magical thinking (superstitious/ belief in clairvoyance)

34
Q

Schizoid PD

A

–pervasive pattern of detachment from social relationships and restricted range of emotional expression. Little desire for social interaction.

35
Q

Cluster B

A

Marked by behavior that is labeled as dramatic, emotional, or erratic by others.

Antisocial PD
Borderline PD
Histrionic PD
Narcissistic PD

36
Q

Antisocial PD

A

–a pattern of disregard for and violation of the rights of others. Include illegal acts, deceitfulness, aggression, and lack of remorse.

37
Q

Borderline PD

A

–Pervasive instability in interpersonal bx, mood, and self-image. Relationships are intense and unstable. Intense fear of abandonment. May use splitting–they view others as all good or all bad.

Suicide attempts.

38
Q

Histrionic PD

A

–constant attention-seeking bx. Wear colorful clothing, extremely extraverted, sexual.

39
Q

Narcissistic PD

A

–one has a grandiose sense of self-importance, uniqueness, preoccupation with fantasies of success, need for constant admiration and attention. Entitlement. Very fragile self-esteem. Can turn to rage if challenged.

40
Q

Cluster C

A

Marked by behavior that is labeled as anxious or fearful.

Avoidant PD
Dependent PD
Obsessive-Compulsive PD

41
Q

Avoidant PD

A

–extreme shyness, fear of rejection. See themselves as socially inept, are often socially isolated. Tend to stay in same jobs, situations, relationships–despite wanting to change.

42
Q

Dependent PD

A

–characterized by a continuous need for reassurance. Tend to remain dependent on one specific person–to take action and make decisions.

43
Q

Obsessive-Compulsive PD

A

–perfectionistic and inflexible. Likes rules and order. May include: inability to discard worn objects, lack of desire for change, excessive stubbornness, lack of a sense of humor, maintenance of careful routines.

44
Q

Biological Basis: Depression

A

Several markers associated with depression:

  • Abnormally high glucose metabolism in the amygdala.
  • Hippocampal atrophy after a long duration of illness.
  • Abnormally high levels of glucocorticoids (cortisol)
  • Decreased norepinephrine
  • Decreased serotonin
  • Decreased dopamine
45
Q

Biological Basis:

Schizophrenia

A

Genetic Causes, inherited. First degree relatives are ten times more likely to develop the disorder.

Highly associated with excess dopamine in the brain Many medications used to treat schizophrenia block dopamine receptors.

Trauma at birth (hypoxemia–low oxygen), marijuana use in adolescence.

46
Q

Biological Basis: Bipolar d/o

A

Exists a set of biological and genetic factors:

  • Higher risk if parent has d/o
  • Higher risk for person with MS
  • Increased serotonin
  • Increased norepinephrine
47
Q

Alzheimer’s Disease

A

a type of dementia characterized by gradual memory loss, disorientation to time and place, problems with abstract thought, and a tendency to misplace things. Later–associated with changes in mood or behavior, changes in personality, difficulty with procedural memory, poor judgement, and loss of initiative.

Common in patients < 65 yrs old.
Women greater risk than men.
Family hx. is a risk factor.
Lower risk associated with higher levels of education.

48
Q

Genetic Components to Alzheimer’s Disease

A
  • Mutations in the presenilin gene
  • Mutations on the apolipoprotein E gene
  • Beta amyloid precursor protein gene is known to contribute to alzheimer’s disease.
49
Q

Markers of Alzheimer’s

A
  • Diffuse atrophy of the brain on the CT or MRI
  • Flattened sulci in the cerebral cortex
  • Enlarged cerebral ventricles
  • Deficient blood flow in the parietal lobes, which is correlated with cognitive decline
  • Reduction in levels of acetylcholine
  • Reduction in choline acetyltransferase (ChAT), the enzyme that produces acetylcholine
  • Reduce metabolism in temporal and parietal lobes
  • Senile plaques of Beta-amyloid
  • Neurofibrillary tangles of hyperphosphorylated tau protein
50
Q

Parkinson’s Disease

A

Biological Basis is decreased dopamine production in the substantia nigra–a layer of cells in the brain that functions to produce dopamine to permit proper functioning of the basal ganglia

Several symptoms:
Bradykinesia–slowness in movements
Pill-Rolling Tremor–flexing and extending fingers while moving the thumb back and forth, as if rolling something in the fingers.
Resting Tremor–a tremor that appears when muscles are not being used.
Mask-Like Faces–a static facial expression
Cogwheel Rigidity–muscle tension that intermittently halts movement as an examiner attempts to manipulate the limb.
Shuffling Gait

The condition can be partially managed with L-DOPA, a precursor that is converted to dopamine once in the brain, replacing dopamine lost due to Parkinson’s.

51
Q

Which hormone and neurotransmitter concentrations are elevated in depression? Which ones are reduced?

A

Elevated: Cortisol is increased

Reduced: Norepinephrine, serotonin, and dopamine.

52
Q

What is a genetic factor that increases the risk of alzheimer’s?

A

Mutations in presenilin genes, and beta amyloid precursor gene.

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