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207 Cards in this Set
- Front
- Back
Substance abuse (p. 128)
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Disinhibition, emotional lability, slurred speech, ataxia, coma, and blackouts are symptoms of which drug?
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Alcohol
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CNS depression, nausea and vomiting, constipation, pupillary constriction, and seizures are the signs of which drug?
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Opioids
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Psychomotor agitation, impaired judgement, pupillary dilation, hypertension, tachycardia, euphoria, prolonged wakefullness and attention, cardiac arrhythmias, delusions, hallucianations, and fever are side effects of which drug?
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Amphetamines
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Euphoria, psychomotor agitation, impaired judgment, tachycardia, pupillary dilation, hypertension, hallucinations, paranoid ideations, angina, and sudden cardiac death are symptoms of which drug?
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Cocaine
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Belligerance, impulsiveness, fever, psychomotor agitation, vertical and horizontal nystagmus, tachycardia, ataxia, homocidality, psychosis, and delerium are side effects of which drug?
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PCP
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Anxiety, depression, del.usions, visual hallucinations, flashbacks, and pupil dilation are side effects of which drug?
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LSD
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Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgement, social withdrawl, increased appetite, dry mouth, and hallucinations are symptoms of which drug?
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Marijuana
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Low safety margin and respiratory depression are characteristics of which drug?
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Barbiturates
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Amnesia, ataxia, somnolesence, minor respiratory effects, and addictictive effects with alcohol are the characteristics of which drug?
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Benzodiazepines
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Restlessness, insomnia, increased diuresis, muscle twitching, cardiac arrhythmias are the side effects of which drug?
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Caffeine
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Restlessness, anxiety, insomnia, and arrhytmias are the side effects of whicch drug?
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C2
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A craving for cheetos and the desire to watch "old school" are the side effects of which drug?
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marijuana
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What are the symptoms of alcohol withdrawl?
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Tremor, tachycardia, hypertension, malaise, nausea, seizures, DTs, agitation, hallucinations
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What are the symptoms of opioid withdrawl?
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anxiety, insomnia, anorexia, sweating, dilated pupils, piloerection, fever, rhinorrhea, nausea, stomach cramps, diarrhea, and yawning
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What are the symptoms of amphetamine withdrawl?
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Post use crash of depression, lethargy, headache, stomach cramps, hunger, hypersomnolence
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What are the symptoms of cocaine withdrawl
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Post use crash of suicidality, hypersomnolence, fatigue, malaise, severe craving
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What are the symptoms of PCP withdrawl
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Recurrance of symptoms due to reabsorption, with sudden onsets of severe random violence
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What are the side effects of barbiturate withdrawl?
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Anxiety, seizures, delerium, life threatening CV collapse.
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What are the side effects of benzodiazepine withdrawl?
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Rebound anxieety, seizures, tremor, insomnia.
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What are the side effects of caffeine withdrawl?
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Headache, lethargy, depression, weight gain
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What are the side effects of nicotine withdrawl?
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Irritabilty, headache, anxiety, weight gain, craving, tachycardia?
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When do DT's occur?
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2-5 days after last drink
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What is the treatment for DTs?
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Benzodiazepines
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What is the sequence of symptoms experienced in DT's?
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Autonomic hyperactivity --> psychotic symptoms --> confusion
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What is a competetive inhibitor of heroin?
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Naloxone
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What diagnoses are associated with heroin addiction?
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hepatitis, abscesses, overdose, hemorrhoids, AIDS, right sided endocarditis.
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What drug is used for long term maintinence or heroin detox?
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methadone
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Delerium & Dementia (p. 129)
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What are the symptoms of delerium?
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Decreased attention span and arousal, disorganized thinking, hallucinations, illusions, misperceptions, disturbance in sleep-wake cycle, cognitive dysfunction
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What is the pattern of onset of delerium?
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Rapid onset, waxing and waning.
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What class of drugs is associated with delerium?
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anticholinergics
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What are the symptoms of dementia?
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Multiple cognitive deficits- memory, aphasia, apraxia, agnosia, loss of abstract thought, behavioral or personality changes, impaired judgement.
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What are the differences between delerium and dementia?
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Dementia: alert patient, gradual onset.
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Dementia may mimic what other illness in the elderly?
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Depression
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Major depression (p. 129)
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What are the two main characteristics of major depression?
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Depressed mood, anhedonia
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What are the nine symptoms of depression?
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Sleep disturbances, loss of interest, guilt, loss of energy, loss of concentration, change in appetite, psychomotor retardation, suicidal ideations, depressed mood (SIG E CAPS)
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How many of those symptoms do you need and for how long?
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5 symptoms for 2 weeks.
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What is the definition of recurrant major depressive disorder?
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2 or more episodes with 2 month symptom free interval
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What is the lifetime prevalence of major depression in men?
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5-12%
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What is the lifetime prevalence of major depression in women?
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10-25%
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How long must a mild depressive episode last to be called dysthymia?
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2 years.
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ECT is painful, true or false?
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FALSE
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What are the side effects of ECT?
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due to anesthesia, disorientation, anterograde and retrograde amnesia
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Manic episodes (p. 130)
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How long must abnormally elevated mood be present for to be called a manic episode?
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1 week
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What are the symptoms of a manic episode?
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Distractability, insomnia, grandiosity, flight of ideas, increase in goal directed activity or psychomotor agitation, pressured speech, thoughtlessness (DIG FAST)
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How many of those symptoms must be present to be considered a manic episode?
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3
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True or false: A hypomanic episode does not cause marked impairment in social or occupational function?
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TRUE
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What is the drug of choice for bipolar disorder?
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lithium
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How many manic episodes does it take to define bipolar disorder?
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1
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How many hypomanic episodes does it take to define bipolar disorder?
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1
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What type of bipolar disorder involves hypomanic episodes?
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Type II
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How long must a milder form of bipolar disorder last to be called cyclothymic disorder?
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2 years.
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Munchausen's (p. 130)
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Is munchausen's syndrome involve conscious or unconscious motivation?
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Unconscious.
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Somatoform disorders (p. 130)
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What are the characteristics of conversion?
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Symptoms suggest motor or sensory neurologic or physical disorder, but physical exam and tests are negative
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True or false, somatoform disorders are more common in women?
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TRUE
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What is a prolonged pain that is not explained by an illness?
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Somatoform pain disorder
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What is the misinterpretation of normal physical findings leading to a persistent fear of serious illness in spite of medical reassurance?
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Hypochondriasis
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What are the characteristics of somatization disorder?
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A variety of complaints involving multiple organ systems
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What is the disorder where a patient believes their own anatomy is malformed?
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body dysmorphic disorder
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What is the false belief of being pregnant associated with objective physical signs of pregnancy?
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pseudocyesis
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What is primary gain?
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What a symptom does for a patient's internal psychic economy
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What is secondary gain?
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What a symptom gets a patient (sympathy or attention)
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What is tertiary gain?
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What the caretaker gets.
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Panic disorder (p. 131)
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How long does it take a panic attack to peak?
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10 minutes
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What are the symptoms of panic attack?
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palpitations, abdominal distress, nausea, increased perspiration, chest pain, chills, and choking (PANIC)
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How many of those must be present to call it a panic disorder?
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4
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What psychiatric disorder has a high prevalence during the step 1 exam?
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panic disorder
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Phobia (p. 131)
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What is a phobia?
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Excessive or unreasonable fear cued by presence or anticipation of a specific object or entity.
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True or false: a patient has insight into their own phobia
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TRUE
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Gamophobia is fear of what?
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marriage
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Algophobia is fear of what?
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pain
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Acrophobia is fear of what?
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heights
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Agoraphobia is fear of what?
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open places
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PTSD (p. 131)
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What are the symptoms of PTSD?
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Traumatic event is persistently reexperienced, a person persistently avoids stimuli associated with the traums, and experiences persistent increased arousal
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How long must the symptoms last to be called PTSD?
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1 month
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PTSD often follows which disorder?
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Acute stress disorder
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Other anxiety disorders (p.131)
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What is adjustment disorder
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Emotional symptoms including anxiety or depression causing impairment following a psychosocial stressor, lasting less than 6 months
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True or false: general anxiety is related to a specific person, situation, or event?
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FALSE
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What are the symptoms of generalized anxiety disorder?
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GI symptoms, fatigue, and difficulty concentrating
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Personality (p.131)
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What is a personality trait?
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an enduring pattern of perceiving, relating to, and thinking about the environment and oneself.
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True or false: a personality disorder does not cause impairment of social or occupational functioning?
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FALSE
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True or false: a patient with a personality disorder is aware of their problem
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FALSE
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What are the cluster A personality disorders?
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Paranoid, schizoid, schizotypal (Weird)
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What are the cluster B personality disorders?
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Antisocial, borderline, histrionic, narcissistic (Wild)
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What are the cluster C personality disorders?
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Avoidant, obsessive compulsive, dependant (Worried)
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What cluster has a genetic association with anxiety disorders?
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C (worried)
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What cluster has a genetic association with mood disorders?
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B (Wild)
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What cluster has a genetic association with schizophrenia?
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A (weird)
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What are the characteristics of paranoid personality disorder?
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Distrust, suspiciousness, and projection as a defense mechanism
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What personality disorder involves limited emotional expression and voluntary social withdrawl?
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Schizoid
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What personality disorder involves interpersonal awkwardness, odd thought patterns and appearance?
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Schizotypal
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What personality disorder involves a disregard for others, crimality, and conduct disorders?
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Antisocial
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What personality disorder involves unstable mood and behavior, impulsiveness, emptiness, and occurs more often in women?
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Borderline
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What personality disorder involves excessive emotionality, somatization, attention seeking, and sexually provocative?
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Histrionic
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What PD involves grandiosity, a sense of entitlement?
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Narcissistic
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What PD is sensitive to rejection, socially inhibited, timid, and has feelings of inadequacy?
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Avoidant
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What PD is preoccupied with order, perfectionism, and control?
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Obsessive-compulsive
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What PD is submissive and clinging, excessively needs to be taken care of, and has low self confidence?
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Dependant
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Childhood disorders (p. 133)
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What disorder is characterized by repetitive behaviors, unusual abilities, and below normal intelligence?
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Autism
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What is the treatment for autism?
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Communication skill and social skill training
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What is the name of a mild form of autism?
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Aspberger syndrome?
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True or false: Children with aspberger's syndrome has normal intelligence and lack social or cognitive defects?
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TRUE
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What is the only X-linked childhood personality disorder?
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Rett disorder
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Rett syndrome starts at which age?
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4
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What are the symptoms fo rett disorder?
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Loss of development, and mental retardation?
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Why does Rett disorder appear only in women?
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Male fetuses die in utero.
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True or false: Children with ADHD have normal intelligence
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TRUE
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What is the treatment for ADHD
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Methyphenidate (ritalin)
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What is the name given to continued behavior violating social norms?
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Conduct disorder
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What is oppositional defiant disorder?
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A noncompliant child in the absence of criminality
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What is the age of onset of tourette's syndrome?
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Before 18
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What is the treatment for tourette's syndrome?
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Haloperidol
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What is the name given to a fear of loss of attachment figure leading to factitious physical complaints?
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Seperation anxiety disorder
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What is the typical age for seperation anxiety disorder?
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7 or 8
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Eating disorders (p.133)
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What are the symptoms of anorexia nervosa?
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Excessive dieting, body image distortion, increase in exercise. Sever weight loss, amenorrhea, anemia, and electrolyte disturbances.
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What are the symptoms of bulimia nervosa?
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Binge eating followed by self-induced vomiting or use of laxatives. Parotitis, enamel erosion, increase in amylase, and esophageal varices from vomiting
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True or false: Bulimia nervosa involves normal body weight?
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TRUE
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Hallucination vs. illusion vs. delusion (p.133)
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What is a hallucination?
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A perception in the absence of actual external stimuli.
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What is an illusion?
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A misinterpretation fo actual external stimuli
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What is a delusion?
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A false belief that is not shared with other members of culture or subculture, which is firmly maintained in spite of evidence to the contrary
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True or false: A delusion is a disorder in the content of thought?
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TRUE
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True or false: A loose association is a disorder in the form ot thought?
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TRUE
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Hallucinations (p. 133)
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True or false: Visual hallucinations are rare in schizophrenia?
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FALSE
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What type of hallucination occurs as an aura of psychomotor epilepsy?
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Olfactory
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What type of hallucination is rarest?
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Gustatory
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What type of hallucination is common in DT's and in cocaine abusers?
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Tactile
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What type of hallucination occurs while going to sleep?
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Hypnagogic
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What type of hallucination occurs while waking from sleep?
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Hypnopompic
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Schizophrenia
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p.134
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periods of psychosis and disturbed behavior last how long?
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6 months
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4 positive symptoms?
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hallucinations, delusions, strange behavior, loose associations
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4 negative symptoms?
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flat affect, social withdrawal, thought blocking, lack of motivation
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4 A's (described by Bleuler) + 1
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1.ambivalence (uncertainty), 2. autism (self-preoccupation and lack of communication), 3. affect (blunted), 4. associations (loose), 5. auditory (hallucinations)
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5 subtypes
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disorganized, catatonic, paranoid, undifferentiated, residual
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etiology
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genetic factors > environmental factors
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lifetime prevalence
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1.5%; males>females; blacks>whites
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different presentation in men and women
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presents earlier and more often in men
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schizophrenia + mood disorder = ?
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schizoaffective disorder
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Structural theory of the mind
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C2
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how many structures?
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Freud had 3
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primal urges, sex, aggression - things you want
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Id
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moral values, conscience - you know you can't have it
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Superego
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bridge and mediator between unconscious mind and external world - conflict mediator
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Ego
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Topographic theory of the mind
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p.134
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*also 3
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Name the components of this theory
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CPU - Conscious, Preconscious, Unconscious
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Conscious
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what you're aware of
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Preconscious
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what you are able to make conscious with effort (like phone number or SSN)
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Unconscious
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what you are not aware of (what you don't know you don't know)
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the central goal of Freudian psychoanalysis
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to make the patient aware of what is hidden in his/her unconscious
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Oedipus complex
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p.134
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define oedipus complex
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repressed sexual feelings of a child for the opposite sex parent, accompanied by rivalry with same-sex parent - described by Freud
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Ego defenses
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p.135
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Your --- has many ---, or automatic and unconscious reactions to psychological stress.
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ego defenses
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Name the mature ego defenses
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Mature women wear a SASH: Sublimation, Altruism, Suppression, Humor
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using ---, one replaces an unacceptable wish with a course of action similar but not conflicting with one's values
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sublimation
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--- is unsolicited generosity toward others that alleviates guilty feelings
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altruism
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unlike other defenses, this is a voluntary withholding of an idea or feeling from conscious awareness
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suppression
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one uses ---, or appreciates the amusing nature to alleviate anxiety-provoking or adverse situations
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humor
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Acting out, dissociation, denial, displacement, fixation, identification, isolation, projection, rationalization, reaction formation, regression, repression, splitting are all ---.
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immature
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the three D's of immaturity
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Dissociation, Denial, Displacement
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by --- --- or throwing a tantrum, unacceptable feelings and thoughts are expressed through actions
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acting out
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the extreme forms of these temporary, drastic changes in personality memory, consciousness, or motor behavior can result in multiple personalities, or --- --- ---.
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dissociation; dissociative identity disorder
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this is a common reaction in which one avoids awareness of some painful reality
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denial
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a mother might transfer avoided anger at her husband by yelling at her child
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displacement
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partially remaining at a more childish level of development, like men's fascination with sports games
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fixation
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victim of child abuse becomes abuser
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identification
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separation of feelings from ideas and events like describing murder in graphic detail with no emotional response
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isolation
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when a man who wants another woman thinks his wife is cheating on him, he is ---.
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projecting
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when one wants to avoid self-blame, one might say a job wasn't important anyway after not getting it
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rationalization
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this is described by someone with libidinous thoughts enters a monastery
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reaction formation
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--- occurs when one turns back the maturational clock, going back to earlier modes of dealing with the world - like children in stress who wet the bed
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regression
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involuntary withholding of an idea or feeling from conscious awareness
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repression
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belief that people are either good or bad
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splitting
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Transference and countertransference
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p.136
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sometimes a patient projects feelings stemming from personal life onto his or her physician, and sometimes the physician projects feelings stemming from personal life onto the patient
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transference and countertransference, respectively
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Classical conditioning
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p.136
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salivation (a natural response) is elicited by a bell (a --- stimulus) that has been associated with food (a natural stimulus), not necessarily a reward
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conditioned, or learned
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Operant conditioning
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p.136
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a particular action is elicited because it produces a ---.
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reward
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an action (pressing a button) is produced because, for example, a mouse wants food
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positive reinforcement
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an action (pressing a button) is produced because, for example, a med student wants to avoid shock
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negative reinforcement - NOT punishment
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Reinforcement schedules
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p.136
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pattern of reinforcement determines what?
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how quickly a behavior is learned and extinguished if not rewarded
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how quickly is a behavior on a continuous schedule (i.e., vending machine use) extinguished when not rewarded?
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most rapidly
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what schedule shows the slowest extinction when not rewarded?
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variable ratio (gambling)
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Intelligence testing
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p.136
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How does the Stanford-Binet test calculate IQ?
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mental age/chronological age * 100
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How does the Wechsler Adult Intelligence Scale calculate intelligence?
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11 subtests - 6 verbal, 5 performance
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What is the mean IQ?
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100, standard deviation = 15
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what are the IQ values for profound, severe, and moderate to mild mental retardation?
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<20, <40, and <70 (or two standard deviations below the mean)
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What determines IQ scores - based on correlation?
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most highly correlated with school achievement, also correlated with genetic factors
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Are intelligence tests objective or projective?
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objective
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