Week 4 - Psych Flashcards
(23 cards)
Somatoform disorders
--MUPS (medically unexplained physical symptoms),, not consciously produced or faked,, Alexithymia= difficulty expressing emotions verbally Somatization disorder (somatic symptom disorder) Conversion disroder (functional neurologic symptom disorder) Pain disorder (eliminated) Hypochondriasis (illness anxiety disorder) Body dysmorphic disorder (now a OCD variant)
Somatization disorder (somatic symptom disorder)
multiple recurring physical complaints before 30yo
4 pain, 2 GI, 1 sexual, 1 neuro complaint
1+ somatic symptom, excessive thoughts, high anxiety about health, persistent more than 6mo
describe selves as sickly but look fine
stress can cause physical illness
Tx= cbt
Conversion disorder (functional neurological symptom disorder)
1+ sx affecting voluntary motor or sensory sx, suggesting neurological disorder
often proceeded by acute stressor
1/3rd have true neuro illness
‘la belle indefference’
full recovery is expected, PT and OT
good prognosis: onset after stressor, prompt tx
poor prognosis: delayed tx, sx of seizure or tremor
Pain disorder (eliminated)
pain caused by psychological factors,, disproportionate
good prognosis: resolution of litigation
Hypochondriasis (illness anxiety disorder)
preoccupation with fear of serious illness not of delusional intensity lasts more than 6mo somatic sx usually not present high level of anxiety tx= cbt
Body dysmorphic disorder (now OCD anxiety)
pervasive feeling of ugliness despite normal appearance
repetitive/compulsive behaviors
tx= SSRI, (NOT surgery)
Factious disorder
deception syndrome, intentional exaggerates sx of illness motivation is to assume sick role external incentives are absent Munchausen syndrome= severe and chronic, pseudologia fantastica (dramatic) Ganser's syndrome= approximate answers they tend to praise then punish
Malingering
deception syndrome, intentional
motivated by external incentives (drugs, litigation, money, avoid work/jail)
Intimate partner violence
assaultive behavior that functions to dominate, control, or punish another in an intimate, peer, relationship.
physical, sexual, property destruction, psychological battering /terrorism
violence in past year= 25%, injury= 15%
violence lifetime= 39%, injury= 25%
over half done by spouse or lover
there is a transgenerational correlation
facial and head injuries are suspicious
battered women are hospitalized more
PTSD= 61%, depression= 50%, suicidality= 20%
alcohol abuse
impact= $8.1 billion/yr
kids do witness it, and it affects their risk for many health outcomes (via catecholamines, HPA, immune response, proinflam cytokines, sleep disruption
How to help a patient with intimate partner violence
SOS Doc
Support - “im sorry, nobody deserves that”
Safety - are you safe at home, kids safe?
Options - shelters, legal, police, etc
Strengths - validate pts strengths/care
Document - use direct quotes
Continuity - encourage follow-up
Sexual violence statistics
1 in 3 girls and 1 in 6 boys will be assaulted by age 18, 93% by someone they trust
86% are female, 14% male
39% occur between 11-15yo
92% have no injuries
for males- mostly strangers, opposite for females
Types of stress
positive= short, good, useful stress tolerable= normal stress after family member death or something pretty bad toxic= super bad stuff, long duration, permanent changes
Communication disorders
Language= reduced vocab, limited sentences, impairment in discourse,, across modalities
Speech sound= difficulty in speech sound production
Childhood onset fluency= stuttering
Social communication= difficulty in social use of verbal and nonverbal communication
Unspecified communication=
Autism spectrum disorder (ASD)
need all 3:
-deficits in socail-emotional reciprocity
-deficits in nonverbal communicative behavior
-deficits in developing, maintaining, understanding relationships
Also: stereotypes or repetitive motor movement, ritualized patterns, fixated interests
Hyper or hypo-reactivity to sensory input
levels of severity: 3 is worst, 1 is best
Diagnosis= MCHAT (18-24mo)
Attention deficit Hyperactivity disorder (ADHD)
persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning
before age 12, several settings
can have subtypes, predom inattentive or hyperactive,, mild-severe
Specific learning disorder
trouble with one or more subjects or academic skills
Motor-developmental coordination disorder
acquisition and execution of coordinated motor skills is substantially below expected
Motor-stereotypic movement disorder
repetitive, driven, purposeless motor behavior
Tic disorders
Tourette’s= both motor and vocal tics, over 1 year, before 18yo
Persistent motor or vocal tic disorder= one or more motor OR vocal tic (not both), over 1 year
Provisional tic disorder= present less than 1yr
Motor milestones (-2yr)
months = gross motor 1 = holds head 4 = sits with support 6 = sits and plays 12 = walks (also associates vocalizations with communication) 18 = runs, jumps 24 = stairs (uses words to communicate)
Adolescent and older stages of devo
Adolescence= identity vs role confusion
young adult= intimacy vs isolation
middle adult= generativity vs stagnation
Traumatic brain injury (TBI)
alteration in brain function or pathology caused by external force
open or closed
mechanism= axonal stretch (diffuse axonal injury)
stretch of less than 5%= temporary ionic fluxes
5-10%= reversible cytoskeletal damage
15-20%= secondary axotomy
more than 20% = primary axotomy
Ca influx, K efflux, excitotoxicity cascade
low blood flow after injury= mismatch, makes recovery less effective
Loss of Conciousness= predicts mortality
Post traumatic amnesia= predict morbidity
MILD traumatic brain injury
at least one: -loss of consciousness -loss of memory -alteration in mental state -focal neuro deficit BUT does not exceed: -LOC more than 30min -initial glascow coma scale of 13-15 -PTA more than 24hrs
usually recover sx within one week, physiology takes longer
small subset have persistent sx
