Psychopathology Flashcards
Exam (100 cards)
1
Q
Intellectual disability
A
Deficits determined by assessment
Deficits in adaptive functioning
Onset during developmental period
2
Q
Level of severity
A
Mild, Moderate and Severe
3
Q
Most common chromosomal causes
A
Down’s syndrome
Fragile X syndrome
Fetal Alcohol syndrome
4
Q
Autism Spectrum Disorder (ASD)
A
Deficits in social communication
Restrictive or repetitive patterns
Deficits in adaptive functioning
5
Q
ASD Levels
A
Level 1 requires support
Level 2 requires substantial support
Level 3 requires very substantial support
6
Q
Prognosis Best
A
IQ over 70
Verbal before age 5
Absence of comorbid mental health issues
7
Q
Frequencies
A
4 X’s more in males
8
Q
Causes
A
Brain/neurotransmitter abnormalities
Structural abnormalities in cerebellum and amygdala
Lower than normal serotonin synthesis
9
Q
ADHD
A
Inattention and hyperactivity and impulsivity persisting 6 months onset before age 12 Diagnosis requires at least 6 symtoms 0ver 17 requires 5 symptoms 2X's more common in males
10
Q
ADHD brain abnormalities
A
Smaller than normal Prefrontal cortex Caudate nucleus Globus pallidus Corpus Callosum Cerebellum
11
Q
Tic Disorders
A
“sudden, rapid, recurrent, nonrhythmic motor movement or vocalization
12
Q
Tourette’s disorder
A
requires at least one vocal tic and multiple motor tics that may occur together or at different times, may wax and wane in frequency but have persisted for more than one year, and had an onset before 18 years of age
13
Q
Tourette’s linked to
A
has been linked to dopamine overactivity, a smaller-than-normal caudate nucleus, and heredity
14
Q
Treatment Tourette’s
A
Treatment may include an antipsychotic drug (e.g., haloperidol) and medication for comorbid conditions – e.g., serotonin for obsessive-compulsive symptoms and methylphenidate or clonidine for ADHD
15
Q
Communication Disorders
A
Stuttering
Disturbance in normal fluency and time patterning of speech.
16
Q
Specific Learning Disorder
A
Difficulties related to academic skills
5 to 15% have a specific learning disability
80% have reading disorder
dyslexia most common
17
Q
Brief Psychotic Disorder (BPD)
A
Symptoms for at least one day but less than a month.
18
Q
BPD Symptoms
A
Delusions, hallucinations or disorganized speech. Disorganized or catatonic behavior.
19
Q
Schizophreniform Disorder
A
Symptoms for one month and less than 6 months.
20
Q
Schizophreniform Disorder:symptoms
A
delusions, hallucinations or disorganized speech
or catatonic behavior and negative symptoms
avolition, alogia, anhedonia.
21
Q
Schizophrenia
A
Symptoms for at least on month and less than 6 months.
22
Q
Schizophrenia Symptoms
A
Delusions, hallucinations and disorganized speech for at least 6 months.
23
Q
Schizophrenia etiology
A
Genetic factors and neurotransmitter abnormalities.
24
Q
Schizophrenia concordance rates
A
Parent 6%
biological sibling 9%
Child with one parent with schizophrenia 13%
Dizygotic (fraternal twin) 17%
Child with two parents with Schizophrenia 48%
Monozygotic (identical twin) 48%
25
Schizophrenia neurotransmitters
dopamine, glutamate, and serotonin
Dopamine hypothesis of schizophrenia - high levels of dopamine or hyperactivity of dopamine receptors.
Positive symptoms due to dopamine hyperactivity in subcortical regions of the brain especially in striatal areas.
Negative symptoms due to dopamine hyperactivity in cortical regions especially the prefrontal cortex.
26
Schizophrenia Brain abnormalities
enlarged ventricles and hypofrontality
lower than normal activity in the prefrontal cortex
dysfunction in the temporal-limbic-frontal network causes the negative symptoms
27
Schizophrenia comorbidity
Anxiety disorders, obsessive compulsive disorder, tobacco use disorder
28
Onset, course and prognosis
Symptoms appear late teens and early 30's.
Peak onset is early to mid 20's for males
Late 20's for females.
Psychotic symptoms decrease with age
Negative symptoms and cognitive symptoms persist
Better prognosis=female gender, acute and late onset of symptoms, comorbid mood symptoms especially depressive symptoms.
Predominately positive symptoms
anosognosia lack of insight to ones disorder is associated with non adherence to treatment and elevated risk for relapse.
Families high in expressed emotion are at risk for relapse.
29
Treatment
Antipsychotic medications, adjunctive medications, CBT
family psychoeducation and other interventions, assertive community treatment, supported employment and social skills training.
30
Schizoaffective disorder
requires concurrent symptoms of schizophrenia and a major depressive or manic episode for most of the duration of the illness, but with the presence of delusions or hallucinations for two or more weeks without mood symptoms.
31
Delusional disorder
the person have one or more delusions for a duration of at least one month and (b) the person’s overall functioning has not been markedly impaired except for any direct effects of the delusion
32
Delusional disorder subtypes
grandiose (the person believes he/she has great but unrecognized talent or insight); (c) jealous (the person believes his/her spouse or partner is unfaithful); (d) persecutory (the person believes he/she is being conspired against, spied on, poisoned, or maliciously maligned); and (e) somatic (the person’s delusion involves bodily functions or sensations).
33
Bi-Polar I
One manic episode followed by or preceded by major depressive or hypomanic episodes
Manic episode for at least one week
Depressive episode for at least two weeks
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Bi-Polar II
One hypomanic and one depressive episode
Hypomanic must be at least a week.
Depressive episode for at least two weeks.
35
cyclothymic disorder
Periods of hypomania and depression that do not meet the criteria for hypmania or major depression.
36
Etilogy of Bi-Polar
heredity, neurotransmitter and brain abnormalities
strong genetic component
Identical twins .67 to .1
dizygotic twins .20
Neurotransmitters that have been linked to bipolar disorder include norepinephrine, serotonin, dopamine, and glutamate (Ayano, 2016), and structural and functional abnormalities have been found in several areas of the brain including the prefrontal cortex, amygdala, hippocampus, and basal ganglia
37
Treatment
pharmacotherapy may include lithium; valproate, carbamazepine, or other anticonvulsant drug; and/or a second-generation antipsychotic drug such as aripiprazole, olanzapine, or risperidone
38
Depressive Disorders
MDD 5 or more symptoms for at least two weeks.
one symptom being depressed mood and lost of interest and pleasure in most activities.
Persistent depressive disorder symptoms for at least two years in an adult and one year in a child.
disruptive mood dysregulation disorder 12 months with severe and recurrent temper outbursts
39
peripartum onset and with seasonal pattern
peripartum onset of symptoms during pregnancy
| seasonal pattern temporal relationship between mood episodes and time of year.
40
Childhood
Rates similar for boys and girls
Rates for females increases during adolescence
Higher rates for females persists into adulthood 1.5 to 3x's higher than males.
41
MDD etology
identical twins 50%
dizygotic twins 20%
has been kinked to lower-than-normal levels of norepinephrine and serotonin and increased levels of cortisol in the hypothalamic-pituitary-adrenocortical (HPA) axis
structural and functional abnormalities in the brain prefrontal cortex, cingulate cortex, hippocampus, amygdala, and thalamus.
42
Behavioral and cognitive explanations
1. Lewinsohn’s social reinforcement theory result of a low rate of response-contingent reinforcement for social behaviors due to a lack of reinforcement in the environment and/or poor social skills.
2. Seligman’s learned helplessness model links depression to repeated exposure to uncontrollable negative life events that results in a sense of helplessness, and a reformulated version stresses the role of a negative cognitive style that involves attributing negative life events to stable, internal, and global factors
3. Beck’s (1974) cognitive theory attributes depression to a negative cognitive triad that consists of negative thoughts about oneself, the world, and the future.
43
Age related and cultural factors
younger adults genetics and stressful events
older adults chronic medical illness
non-western culture report somatic symptoms
chinese emphasize somatic symptoms
Euro Canadians emphasize psychological symptoms
44
Treatment
tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), and other antidepressants.
cognitive-behavior therapy, interpersonal therapy, behavioral activation therapy, problem-solving therapy, acceptance and commitment therapy, and emotion focused therapy
45
Suicide
Suicide rate for males higher than females
Males 65 and older have the highest rates
Rates higher for American Indians and Alaskan Natives
46
Separation Anxiety
excessive fear or anxiety of being separated from attachment figures.
Symptoms must last 4 weeks for children and adolescents and 6 months for adults.
47
Treatment
CBT
| School getting child back to school ASAP
48
Specific phobia
Intense fear or anxiety about a specific object or situation.
Fear and anxiety must be out of proportion to the situation or object.
Onset in childhood with mean age is 10.
Mower's two factor theory classical and operant conditioning.
49
Specific phobia tx
Exposure and prevention
| in vivo more effective
50
Social anxiety disorder (Social Phobia)
Fear or anxiety reaction to at least one social situation.
Treatment is CBT
Exposure and response prevention
51
Panic Disorder
one attack followed by one month concern of an additional attack.
Treatment is CBT with interoceptive exposure with relaxation
antidepressants (e.g., imipramine) and benzodiazepines
have been found to be useful
52
Agoraphobia
Fear that escape will be difficult
| Treatment in vivo exposure and response prevention
53
GAD
Excessive anxiety or worry about multiple events
inability to control worrying
Treatment CBT
Antidepressants Buspar and benzodiazepines
54
OCD
Recurrent obsessions or compulsions that are time consuming
Lower levels of Seratonin
elevated activity in several areas of the brain including the caudate nucleus, orbitofrontal cortex, cingulate gyrus, and thalamus
Male earlier age of onset in childhood
Females higher rate in adulthood.
Treatment exposure and response prevention.
55
Body Dysmorphic Disorder
Preoccupation with perceived defect or flaw in personal appearance.
56
Treatment
```
pharmacotherapy and/or psychosocial interventions
tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), and other antidepressants
gnitive-behavior therapy, interpersonal therapy, behavioral activation therapy, problem-solving therapy, acceptance and commitment therapy, and emotion focused therapy
```
57
Suicide
```
Males 3.6x's more than females
Males 65 and older highest rate
Females 45-54
Females 55-64
Highest rates for American Indians and Alaskan Natives
```
58
Separation anxiety
Excessive fear and anxiety of being separated
4 weeks for children and adolescents
6 months adults
59
Specific Phobia
Fear or anxiety about a specific object or situation
| onset early childhood mean age 10
60
Theories
Mower's two factor theory phobic reactions due to operant and classical conditioning.
61
Treatment
exposure and response prevention
| in vivo exposure
62
Social anxiety
fear or anxiety about a social situation
tx: CBT
Exposure and response prevention
63
Panic Disorder
one attack followed by one month concern for another attack
medical conditions must be ruled out first
tx: CBT
Anti-depressants impramine benzos
64
Agorophobia
Fear of being outside the home
| tx: in vivo exposure response prevention
65
GAD
Anxiety or worries about multiple events
| tx: CBT with anti-depressants or anxiolytic buspirone (Buspar) or a benzodiazepines
66
OCD
recurrent obsessions or compulsions that are time consuming
Males have higher rate in childhood
Females higher rate in adulthood
linked to lower levels of serotonin and elevated activity in several areas of the brain including the caudate nucleus, orbitofrontal cortex, cingulate gyrus, and thalamus
TX; response prevention and with SSRI or clomipramine
67
Body Dysmorphic Disorder
preoccupation with a body defect or flaw
68
Reactive attachment disorder
Persistent pattern of inhibited and withdrawn behavior toward adult care givers.
must have history of extreme insufficient care.
onset before age 5
69
Disinhibited Social Engagement Disorder
inappropriate actions with unfamiliar adults
extreme insufficient care
developmental age of at least 9 months
70
PTSD
Symptoms lasted more than one month
tx-Adults CBT
Pharmacological tx: SSRIs fluoxetine (prozac), paroxetine (paxal), and sertraline (zoloft) and the SNRI venlafaxine (effexor).
71
Acute stress disorder
exposure to death or injury.
| 3 days to one month
72
Dissociative Amnesia
inability to recall important personal information
| often related to victimization or exposure to a traumatic event.
73
Depersonalization/Derealization Disorder
recurrent sense of unreality or detachment
74
Somatic Symptom Disorder
accompanied by excessive thoughts, emotions, or behaviors related to the symptom(s) or associated health concerns as indicated by the presence of at least one of the following: disproportionate or persistent thoughts about the seriousness of the symptoms
75
. Illness Anxiety Disorder
preoccupation with having a serious illness
| symptoms 6 mos
76
Conversion Disorder (Functional Neurological Symptom Disorder
disorder is characterized by one or more symptoms that involve a disturbance in voluntary motor or sensory functioning
77
Factitious Disorder
Individuals with factitious disorder imposed on self falsify or induce physical or psychological symptoms that are associated with a deception
Factitious disorder imposed on another has the same symptoms except that they’re induced in another person (often in a child by his/her mother).
Malingering involves an intentional production of physical or psychological symptoms to obtain a drug, financial compensation, or other external reward
78
Feeding and eating disorders
a persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning
79
Pica
persistent eating of non-nutritive, nonfood substances
80
Anorexia Nervosa (AN)
an intense fear of gaining weight or becoming fat or engage in behavior that interferes with weight
co-occurs with depression or an anxiety disorder
Anxiety precedes onset
81
AN TX
```
Restore person to health weight and address physical complications
Education about healthy nutrition
Change beliefs, attitudes and emotions
Family support
CBT
Family TX
```
82
Bulimia Nervosa (BN)
Binge Eating
compensatory behavior to prevent weight gain
Depression and anxiety.
83
BN TX
nutritional rehabilitation and counseling plus cognitive-behavior therapy or interpersonal therapy,
84
Elimination Disorders
enuresis 2 or more times per week for 3 months
tx moisture alarm
antidiuretic hormone desmopressin
85
Insomnia Disorder
Dissatisfaction with sleep quality
3 nights per week for 3 months
Tx stimulus control and sleep restriction.
86
Narcolepsy
irrepressible need to sleep
hypnagogic or hypnopompic hallucinations (vivid hallucinations just before falling asleep or just after awakening
tx: behavioral strategies and medication
87
Sexual dysfunction
disturbance in persons ability to respond sexually or experience sexual pleasure
88
Erectile Disorder
marked difficulty obtaining an erection during sexual activity, marked difficulty maintaining an erection until completion of sexual activity, marked decrease in erectile rigidity. Symptoms must have been present for at least six months and cause significant distress
89
ED treatment
behavioral techniques and pharmacotherapy.
sensate focus was developed by Masters and Johnson
Drugs used to treat erectile disorder include sildenafil citrate (Viagra), tadalafil (Cialis), and vardenafil (Levitra), which increase blood flow to the penis
90
Premature (Early) Ejaculation
persistent or recurrent pattern of ejaculation
| TX sensate focus and SSRI's
91
Genito-Pelvic Pain/Penetration Disorder
Recurrent problems with vaginal penetration during intercourse; marked vulvovaginal or pelvic pain during intercourse or penetration attempts
TX: relaxation training, sensate focus, a topical anesthetic, vaginal dilators, and Kegel exercises
92
Gender Dysphoria
incongruence between one’s assigned gender and one’s experienced or expressed gender
93
Paraphilic Disorders
paraphilia as involving “intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners”
TX: CBT, marital tx, grp tx and medications
94
Frotteuristic disorder
Touching or rubbing against a non-consenting adult.
95
Transvestic
Cross dressing for sexual arousal
96
Pedophilic Disorder
involves recurrent and intense sexual arousal for at least six months related to fantasies, urges, and/or behaviors involving sexual activity with a child or children 13 years of age or younger.
97
Fetishistic Disorder
sexual arousal to a non living object.
98
Oppositional Defiant Disorder
recurrent pattern of an angry/irritable mood, argumentative/defiant behavior, and/or vindictiveness
Symptoms 6 mos
more common in boys than girls
TX: parent management training, family therapy, cognitive problem-solving skills training, social skills training, and school-based programs
99
Conduct Disorder
requires a persistent pattern of behavior that violates the basic rights of others and/or age-appropriate social norms or rules
must be over 18
more common in males
linked to several factors including heredity, neuropsychological factors (e.g., low levels of serotonin), prenatal exposure to opiates or alcohol, and inadequate adolescence-limited type is a temporary and situational type of antisocial behavior that’s due to a “maturity gap practices
adolescence-limited type is a temporary and situational type of antisocial behavior that’s due to a “maturity gap”
TX: Family intervention
100
intermittment Explosive disorder
Behavioral outbursts due to failure to control aggressive impulses.
