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Social Behavioral > Week 3 and 4 > Flashcards

Week 3 and 4 Flashcards

1
Q

Somatic Symptom Disorders

A
  • replaces somatization disorder, hypchondriasis, pain disorder, undifferentiated somatic disorder
  • emphasis on ‘maladaptive thoughts, feelings and behaviors’ not just somatic symptoms
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2
Q

Somatic Symptoms Disorders

A
  • illness anxiety disorder
  • BDD moved to OC and related disorders chapter
  • no longer a requirement for conversion disorder to have a psychologically-related stressor
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3
Q

Feeding and Eating Disorders

A
  • Feeding ds (PICA, ruminination disorders) combined with eating disorders
  • avoidant/restrictive food intake->feeding disorder
  • limited binge/purge numbers for bluimia
  • binge eating disorder
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4
Q

Sleep Wake Disorder

A
  • insomnia disorder
  • narcolepsy versus hypersomnolence
  • breathing related sleep disorder to obstructive versus central form
  • circadian rhythm sleep disorders
  • REM sleep behavior disorder and restless legs syndrome are independent
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5
Q

Sexual Dysfunctions

A
  • sexual desire and arousal disorder are combined
  • 6 months duration to dx
  • vaginismus and dyspareunia combined to genito-pelvic pain/penetration disorder
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6
Q

Gender Dysphoria

A
  • cross-gender identification and aversion toward one’s gender have been merged
  • post-transition specifier is added
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7
Q

Disruptive, Impulse Control and Conduct Disorder

A

-unifies disorders of difficult, disruptive, impulsive or antisocial behavior: oppositional defiant disorder, conduct disorder, intermittent explosive disorder, antisocial personality disorder, pyromani, kleptomania

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8
Q

Neurocognitive Disorders

A

Dementia

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9
Q

Paraphilic Disorders

A

-psychosexual disorders characterized by sexual fantasies, feelings, or activites involving a nonhuman object, a nonconsenting partner (child) or pain/humiliation of oneself or one’s partner

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10
Q

Other Disorders

A

conditions of clinical importance that may be a focus of dx and tx but are not mental disorders

  • medication induced movement disorders
  • conditions distress pt. and family
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11
Q

Psychiatric Interview

A

-identifying information, hx of illness, psychiatric ROS/psychiatric hx, medical hx, personal birth and developmental hx, family psych hx, social and chemical use hx, exam via SCID, mental status, other formal testing

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12
Q

Mental Status Exam Indicated In

A

pts. with brain lesions (tumors, trauma, CVA), cerebral dysfunction, all psych pts., and pts. with vague complaints (memory, concentration, declining interests, various physical complaints without organic etiology)

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13
Q

Depression in what brain area

A

frontal and temporal tumors, hydrocephalus or cotrical atrophy

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14
Q

Mental Status Exam Components

A

-includes all of the observations made during an interview and the formal cognitive testing or mini mental state exam

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15
Q

MSE Observational Data

A

-presentation, motor behavior and affect, cognitive status, thought, mood

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16
Q

MSE Presentation

A
  • level of consciousness (Glasgow)
  • general appearance
  • attitude
  • eye contact
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17
Q

MSE Motor Behavior and Affect

A
  • Motor: akinesia, involuntary movements

- Affect: facial expression, gestures, speech characteristics, pressure, volume, etc.

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18
Q

MSE Cognitive Status

A
  • attention/alertness: digit span, number of trials to learn 4 words
  • concentration and vigilance: serial subtraction, letter cancellation tasks etc
  • orientation x 3
  • speech and language: fluency and comprehension of spoken/written
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19
Q

MSE Language

A
  • repetition, naming and reading

- writing, spelling

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20
Q

MSE Memory

A
  • verbal memory, visual memory
  • constructional ability: reproducing figures from memory, copying figures/constructing blocks or token designs
  • calculations
  • reasoning
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21
Q

MSE Thought

A
  • process, coherence, goal directedness
  • content: hallucinations, delusions, preoccupations or obsessional thoughts, suicide/homicidal
  • insight: nature of illness and awareness of factors that affect the course of the illness
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22
Q

MSE Mood

A
  • relation to affect and congruence with thought content
  • variability
  • hopelessness/suicidality
  • anger/agression
  • guardedness
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23
Q

ADHD

A

NE and DA

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24
Q

Basal Ganglia

A

-selection of appropriate behavior, voluntary motorl control and emotional functions

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25
Q

Orbital Frontal Cortex

A

impulsive, blurts out, don’t wait

-OFC->bottom of caudate->thalamus->OFC

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26
Q

ADHD cerebellum

A

-smaller in these kids

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27
Q

SSRI

A

can treat ADHD

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28
Q

when to dx ADHD

A

up to age 12, not before age 5

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29
Q

Dx ADHD

A

6 or more of 18 dx criteria

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30
Q

MMSE (mini mental status exam) or folstein

A

30 points: orientation x3 for 10, language reading (1), writing (1), naming (2), comprehension (3), repetition (1), registration (3), recall (3), attention/simple calculations (5), constructional praxis (1)

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31
Q

MMSE Cutoff Number

A

23 points

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32
Q

MMSE Normal Range

A

27-30

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33
Q

MMSE mild cognitive impairment

A

11-20

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34
Q

MMSE Severe

A

0-10

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35
Q

Office Screening for Depression

A
  • hamilton rating scale for depression
  • patient health questionaire
  • geriatric depression scale
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36
Q

Office Screening for Anxiety

A
  • hamilton rating scale for anxiety

- patient health questionaire

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37
Q

Office Screening for Alcohol Use

A

Alcohol use disorder identification test (audit)

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38
Q

Screening for ADHD and Childhood Behavior Problems

A

SNAP-IV rating scale

-90 questions to be answered by classroom teachers, contains items to screen for ADHD and oppositional defiant disorder

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39
Q

Nominal Measurement

A
  • least precise of the measures, simply assigns numbers or labels to id categories to which individuals belong
    • can count, no other math to this
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40
Q

Ordinal Measurement

A
  • measures arrange or sort individuals in a series ranging from highest to lowest according to an observed characteristic (can’t say how much difference b/w)
  • no arithmetical functions to apply
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41
Q

Interval Measurement

A
  • gives numbers for both order and differences b/w are meaningful
  • ie class exams, can complete elementary mathematical operations (add and subtract)
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42
Q

Ratio Scales

A

gives numbers for which all arithmetical operation can be used; this is a true zero point (height, weight, volume, etc)

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43
Q

Diathesis/Stress

A

goal is to stop the cascade in young people

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44
Q

Comorbidity

A

It is the norm, when you ID a young person with one psych problem, they likely have others

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45
Q

Conduct Disorder

A

repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated

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46
Q

3 or More Criteria for Conduct Disorder

A

-aggression to ppl and animals, destruction of property, deceitfulness or theft, serious violations of rules

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47
Q

Aggression to Ppl and Animals

A

-bullies, threatens or intimidates others, often initiates physical fights, used a weapon to cause harm, physically cruel to ppl or animals, stolen while confronting a victim, forced sexual acts

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48
Q

Destruction of Property

A

-deliberately fire setting, deliberately destroyed others’ property

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49
Q

Deceitfulness or Theft

A

-breaking in, lies to obtain goods or favors, stolen items of nontrivial value

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50
Q

Serious violation of the Rules

A

stays out at night, run away from home overnight at least twice, often truant from school before age 13

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51
Q

Similar Etiology in ODD and CD in Infancy

A

tmperamentally hyper-reactive, irritable, difficult to soothe, slow to adapt to new circumstances

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52
Q

Similar Etiology in ODD and CD in Families-Highly Stressed

A

Marital discord, parental psychopathology (parent pre-occupied with own problems), socioeconomic disadvantage

53
Q

Similar Etiology in ODD and CD in Parenting

A

-inconsistent limit setting (bad behavior, all behavior, is generally ignored with sporadic, unpredictable repetitive cycles of rxn to the behavior involving coercive harsh punishment)

54
Q

Percent of People with CD to go on to have antisocial personality disorder

A

25-40%

55
Q

Percent of kids with ODD to CD

A

25%

56
Q

Treatment of ODD

A

kids under 12, tx is provided primarily through the parents, replace coercive discipline with more effective child-rearing techniques

57
Q

Multisystemic Family Therapy

A

-home based model, low case load, time limited to 3-5 months, team based of 3-4 practitioners, available 24 hours a day, appointments at family convenience, daily contact via face or phone

58
Q

Substance Use Disorders in Adolescents

A

-a maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by 2 or 3 sx in a 12 month

59
Q

Predictors of SUD in Adolescence

A

impulsivity, aggression, sensation seeking, low levels of harm avoidance, inability to delay gratification, low achievement motivation, psychopathology, especially conduct disorder

60
Q

Diathesis

A

predisposing biology, including genetic factors=vulnerability to a disorder

61
Q

Protective Factors of GxE

A

mitigate or provide a buffer against the effects of major stressors

62
Q

CRAFFT

A
  • car by someone high/drunk
  • substances to Relax
  • substances Alone
  • Family/Friend say you have a problem
  • Forget things (black out)
  • Trouble
63
Q

Addiction Tx is

A

-a linear process, think akin to chronic illness management

64
Q

Reliability

A

consistency of predictive statements over time

65
Q

Validity

A

‘truthfulness’, reflects the degree of accuracy of predictive statements

66
Q

Most Common IQ Test for Adults

A

Wechsler Adult (or children) Intelligence Scale, individual, provide standardized scores, comprehensive and expensive to use

67
Q

Most Common IQ Test for Pre-school

A

McCarthy Scales and Wechsler Preschool and Primary Scale of Intelligence

68
Q

Most Common IQ Test for Infants

A

Bayley Scales of Infant and Toddler Development

69
Q

Mean IQ

A

100

–1SD is 85, -2SD is 70, +1SD is 115, +2SD is 130

70
Q

Memory Tests

A
  • Rey-Osterreich Figure and the Rey Auditory verbal learning test
  • California verbal learning test
71
Q

Halstead-Reitan Neuorpsychological Test Battery

A

Contains 10 subtests that examine a variety of brain functions
-abstract reasoning, kinesthetic and sensorimotor ability, attention, auditory perception, sensory-perceptual ability, language

72
Q

Luria-Nebraska Neuorpsychological Test Battery

A
  • 269 items in a number of categories (motor, rhythm, receptive speech, reading, etc)
  • high reliability (some false positives in elderly)
73
Q

Anomic Aphasia

A

Pt. has word finding difficulties and struggles to find the right words for speaking and writing

74
Q

Causes of Aphasia

A

AD, Pick’s, PD, coricobasalganglionic degeneration, diffuse lewy body ds, or nonspecific degneration

75
Q

Rey Auditory Verbal Learning Test (RAVLT)

A

15 words read aloud at rate of 1/sec, pt. repeat all words pt can remember in any order, 5 times repeated and then on additional 15 set with only one attempt at recall

76
Q

Global Burden of Disease

A

2004 60% increase in suicide over the past 50 years

77
Q

1998-2010 increase in anti-depressant

A

400% increase, 25% of women take an anti-depressant

78
Q

Taking Anti-depressants for more than 10 years

A

14% of Americans

79
Q

Suicide Rate under 18

A

2nd leading cause of death

80
Q

Suicide Rate

A

12 per 100,000

  • highest risk for white males over the age 85
  • NA youth at highest risk
81
Q

Major Depressive

A

-persistent sadness and loss of interest in activities plus others on the list to dx too

82
Q

Persistent Depressive Disorder

A

Depressed mood for at least 2 years plus two of the following

83
Q

Bipolar Disorder

A

Major depressive episode plus severe changes in mood to either extreme irritability, or overly silly and elated

84
Q

Bipolar 1

A

Mania 7 days

85
Q

Bipolar 2

A

Hypomania 4 days

86
Q

Disruptive Mood Dysregulation Disorder

A

To distinguish children with milder mood dysregulation from childhood-onset bipolar disorder

87
Q

Tx for Adolescents with Depression

A

dx of major depression, to 4 groups of meds, CBT, both or placebo and combined was best with 71% response rate, identical for meds and CBT (but quicker response with meds)

88
Q

Predisposing to Suicide in Youth

A

fill in

89
Q

Precipitating Factors for Suicide

A

fill in

90
Q

Interviewing for Suicide

A

-be direct, be available/interested, don’t be sworn to secrecy, take action

91
Q

Postpartum Depression in Adolescent Mothers

A

Over half have depression in ages 15-19 (rather than waiting until their 20s)

92
Q

Anxiety

A

apprehension and fear, can be concrete or imagined, scientific research and clinical demonstrates that it is amenable to behavioral and pharmaco-therapy

93
Q

Panic Disorder and Attack

A

-intense fear with physical sx (heart rate etc) that occur repeatedly and unexpectedly, 1.5%, 4x > in women, onset late teens to early 30s, less in older adults

94
Q

social phobia

A

an intense fear of becoming humiliated in social situations, specifically of embarrassing yourself in front of other people; 3 to 13% prevalence

95
Q

Specific Phobia

A

marked and persistent fear that is excessive or unreasonable, that is caused by the presence of a stimulus, more in women, 5-12%, age of onset varies

96
Q

Acrophobia

A

fear of heights

97
Q

Nosophobia

A

fear of being sick

98
Q

Thanatophobia

A

fear of death

99
Q

Pogonophobia

A

fear of beards

100
Q

Melanophobia

A

fear of dark or black people

101
Q

Arachibutryrophobia

A

fear of pb sticking to roof of mouth

102
Q

Obsessive Compulsive Disorder

A

obsessions that are unwanted, recurrent, distubing thoughts, impulses, images which the person cannot suppress and which can cause overwhelming anxiety

103
Q

Compulsions

A

repetitive, ritualized behaviors that the person feels driven to perform to alleviate the anxiety of the obsessions

104
Q

OCD Epidemiology

A

life prevalence 2-3%, one year prevalence 1.5%-2.1%, often not treated until adulthood

105
Q

Disinhibited Social Engagement Disorder

A

overly familiar (unknown kids will come up and hug you) kids don’t have consistent care giver

106
Q

Adjustment Disorder

A

array of stress response syndromes occurring after exposure to a distressing event

107
Q

Acute Stress Disorder

A

need a qualifying traumatic event experience directly, witnessed or experienced indirectly (3 days-1 month)

108
Q

PTSD

A

person has experienced an event that is outside the range of usual human experience

109
Q

PTSD primary feature

A

significant rxn to a serious traumatic event that involves actual or threatedened death, serious injury or sexual violation

110
Q

PTSD Sx

A

intrusive sx, avoidance of reminders, negative alterations in cognition and mood, alterations of arousal and reactivity

111
Q

PTSD recurring exposure

A

applies to first responders

112
Q

Evaluation of PTSD

A

15 minutes-1 hour in office

113
Q

DREAMS

A

detachment, reexperiencing the event, event had emotional effects, avoidance, month in duration, sympathetic hyperactivity or hypervigilance

114
Q

NT during a Traumatic Event

A

NE (mobilizing fear/flightresponse/etc), 5HT (self defense, rage and attenuation of fear)

115
Q

Critical Incident Stress Debriefing

A

Critical Incident Stress Debriefing in the first 72 hours, forestall emergence of disabling sx, short term psychosocial interventions

116
Q

PTSD Prevalence

A

7.8%, women 10%, men 5%

117
Q

Percent of PTSD with comorbidity

A

80%: anxiety, affective disorder, substance use disorders, somatization, psychosis; women with PTSD 4.1xF or 6.9M more likely to get major depression (also more likely to develop mania)

118
Q

PTSD suicide attempts

A

20%

119
Q

Exposure Therapy

A

education on common rxns to trauma, breathing and retraining; goal is to recall event without anxiety or panic

120
Q

Cognitive therapy

A

separating intrusive thoughts from the associated anxiety

121
Q

Stress inoculation training

A

Variant of exposure training teaches client to relax; helps the client relax when thinking about traumatic event exposure by providing client a script

122
Q

Treatment Goals in PTSD

A

decondition anxiety and re-establish feeling of integrity and or control; at least 50% show improvement with therapy

123
Q

Avoidance Behavior reinforced by

A

reduction in anxiety

124
Q

SSRI’s

A

sertraline (zoloft), paroxetine (paxil), escitalorpram (lexapro), fluvoxamine (luvox), fluextine (prozac)-serotonin

125
Q

Tricyclic Antidepressants

A

clomiprimine (anafranil), doxepin (sinequan), nortriptyline (aventyl), amitriptyline (elavil), maprotiline (ludiomil), desipramine (norpramin)-5HT and NE

126
Q

Taijin kyofusho (TKS)

A

Korean and Japanese cultures, individuals are concerned about being observed and then avoid a variety of social situations (concerned about doing something, or presenting an appearance, that will offend or embarrass the other person, compared to oneself in SAD)

127
Q

Four Subtypes

A

the fear of blushing, the fear of a deformed body, the fear of eye to eye contact, the fear of one’s own foul body odor

128
Q

Dx for Male Hypoactive Sexual Desire Disorder

A

Persistently or recurrently deficient sexual/erotic thoughts or fantasies and desire for sexual activity; judgement of deficiency

Social Behavioral (2 decks)

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