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45 Cards in this Set

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Types of Dyslexia
Surface dyslexia – reads without comprehension due to an inability to read words that are irregularly spelled (e.g. light, sword)
• Deep dyslexia – several reading errors including semantic paralexia = substitution of words with similar meanings (e.g. cold for hot)
• Pure Alexia – “word blindness” an inability to read words, even if they were just written by the person.
• Literal Alexia – can read whole words, but not individual letters
Phonological Alexia - be unable to read (pronounce) pseudo-words
Alzheimer's type dementia - Eitology
*Abnormalities on Chromosome 21 - early-onset familial type
*Abnormalities on Chromosome 19 - Later-onset type
*low level of ACh
*Aluminium deposits in brain tissues
Treatment for Alzheimer type dementia
Combo of group therapy (esp therapy that emphasizes reality orientation and reminiscence) ;
antidepressant drugs;
behavioral techniques ;
Antipsychotic drugs to reduce agitation;
environmental manipulation

Most effective when family members are included.
Vascular Dementia
*Cognitive impairments and Focal neurological signs.
*Stepwise and fluctuating pattern with evidence of a cerebrovascular disease.
*Risk factors - cigarette smoking, hypertension, diabetes
Dementia due to HIV
*forgetfulness, impaired attention, slowed mental processes.
*Problem solving difficulties and concentration, apathy and social withdrawal, tremor and clumsiness and saccadic eye movements.
*Subcortical dementia
Dementia due to Parkinson's disease
*Bradykinesia
*Pill rolling
*Tremor at resting
*Akathesia (Cruel restlessness)
*Loss of coordination
*Mask like face expression
*Psychiatric symptoms precede these in minority of patients.
Parkinson's disease
Loss of dopamine producing cells in the substantia niagra
L-Dopa helps alleviate symptoms
More recent treatment - injection of human fetal cells.
Huntington's disease
*Fatal
*Causes degeneration of GABA secreting cells in the substantia niagra, basal ganglia and cortex.
*PPl are aware of their deficits +loss of impulse control = increased risk for suicide
Huntington's disease
Symptoms - affective, cognitive and motor
*Affective - appear first - depression, irritability and apathy
*Cognitive deterioration - forgetfulness and eventually leads to dementia
*Motor - Athetosis (slow writing movements), Chorea (involuntary rapid, jerky movements)
Alcohol-induced Persisting Amnestic Disorder (Korsakoff syndrome)
*Anterograde amnesia - most severe esp for declarative memories
*Retrograde Amnesia - affects recent long term memories
*Confabulation

Due to thaimine deficiency (affects the thalamus)
Wernicke's Syndrome
*Ataxia
*Abnormal eye movements
*Confusion

Co occurrence of both is called Wernicke-Korsakoff syndrome
Alochol Intoxication
*Maladaptive behavioral and psychological changes,
*Slurred speech
*Incoordination
*Unsteady gait
*Impairedattention or memory(esp anterograde amnesia)
Alcoholo Withdrawal
*Autonomic hyperactivity
*Illusions and hallucinations
*Anxiety
*Hand tremors
*Psychomotor agitation
*nausea and vomiting
*Grand mal seizures
Amphetamine or Cocaine Intoxication
*Euphoria, anxiety, hyperactivity, confusion, grandiosity, anger, paranoind ideation, auditory hallucinations
*Tachycardia
*Weight loss
*elevated or lowered blood pressure
*Dialated pupils
*Psychomotor agitation
*Seizures
Amphetamine or Cocaine Withdrawal
8Dysphoric mood
*fatigue
*unpleasant dreams
*insomnia or hypersomnia
*increased appetite
"Crash"
Withdrawal following an intense high-dose use causes crash
*intense lassitude and depression
Caffeine Intoxication
*restlessness, nervousness, excitement, insomnia, flushed face - at low doses
*muscle twitching, rambling thoughts and speech, cardia arrhythmias and psychomotor agitation - at high doses
Schizophrenia - Concordance rates
Biological sibling - 10%
Identical twins - 48%
Fraternal twics- 17%
Child with both parents schizophrenic -46%
Structural brain abnormalities associated with Schizophrenia
*Smaller than normal hippocampus, amygdala and globus pallidus
*Enlarged ventricles
Functional brain abnormalities associated with schizophrenia
*hypofrontality - associated with negative symptoms.
*Lower than normal activity in the prefrontal cortex (measured by cerebreal blood flow and glucose metabolism)
Dopamine Hypothesis
*elevated levels of dopamine
*Oversensitive dopamine receptors
Research shows in addition to dopamine hyp -
*elevated levels of norepinephrine and serotonin and low levels of GABA receptors in some schizophrenic patients.
Schizophrenia - Tx - PHARMACOTHERAPY
*Traditional antipsychotics - positive symptoms but more side effects (tardive dyskinesia)
*Atypical antipsychotics - Negative symptoms, less side effects but atleast two to four weeks to take effect.
Shcizophrenia - Tx - PHARMACOTHERAPY + PSYCHOSOCIAL INTERVENTIONS
*Family interventions are very useful when they target high levels of Expressed emotion among family members
- High EE characterized by open criticism and hostility toward the patient or overprotection, symbiotic relationships.
*Social skills training
*Supported employment
Schizophreniform disorder
identical to schizophrenia but
*disturbance is present for atleast one month, but less than six months
*impaired social or occupational functioning (mite occur) is not required.
*2/3rd ppl with this diagnosis ultimately receive a diagnosis of Schizophrenia or Schizophreniform disorder
Brief Psychotic Disorder
Presence of
*hallucniations,
*delusions
*disorganized speech, behavior
*grossly disorganized/ catatonic behavior
for atleast one day but less than one month

Return to premorbid functioning

Usually involves an overwhelming stressor
Manic episode
*One week period or longer
*prevailing mood is abnormally and persistently elevated, expansive or irritable
*atleast three of the following
psychomotor agitation
flight of ideas
decreased need for sleep
grandiosity
restlessness
distractibility

if mood is only irritable, then four symptoms are required (versus three)
Hypomanic episode
*atleast four days of elevated mood irritability, expansive mood
*three of the symptoms associated with manic episode
Mixed episode
*lasts for one week
*rapidly alternating symptoms of manic and major depressive episodes.
Bipolar 1
*one or more manic or mixed episode with or without a Hx of one or more Major depressive episode
*subtype will depend on the most recent episode
*equally common in males and females
Bipolar 2
*atleast one majo dep episode and one hypomanic episode
*never had a manic or mixed episode
*more common in females
*avg age is 20yrs
Bipolar Tx
*Lithium - treatment of choice - effective in 60 - 90 % of cases
*reduces manic symptoms, and also manages the mood swings
*Lithium compliance is a frequent problem
*Good results with combined pharmacotherapy and psychotherapy
Suicide
*60 - 80 % of ppl have had prev attempts
*25-44 - most common for attempts
10- 19 - greatest increase in suicide rates
*4 - 5 times as many males COMMIT suicide as females
females ATTEMPT suicide abt 3 times more often than males.
*Whites - greatest for all age grps
Native americans - greatest for adolescence
*Divorced, separated and widowed > single > married
*Hoplessness - best predictor
*Life stress
*Early warning signs
*comorbid disorders
*low levels of serotonnin and 5 H1AA
Post Concussional Disorder
Impaired memory and attention
headaches
irritability
fatigue

for atleast three months
Premature Ejaculation - Tx
Sensate focus
SSRI (dapoxetine)
Start and squeeze technique
Tx for paraphilias
In vivo aversion therapy- but this has only short term effects.
More recently, trend has been to use covert sensitization (aversive conditioning in imagination), stiation therapy, and teaching of alternative desirable behaviors.
Primary Insomnia
difficulty initiating or maintaining sleep, or no restorative sleep for atleast one month
Primary Hypersomnia
Excessive sleepiness for atleast one month as evidenced by either prolonged sleep episodes or daytime sleep episodes that occur almost daily.

recurrent- if the sleep episodes occur for 3 days , several times a year for atleast 2 yrs

Males > females
Narcolepsy
Irrestible attacks of refreshing sleep that occurs daily over atleast 3 months

presence of
cataplexy (bilateral loss of muscle tone)
recurrent intrusions of elements of REM sleep in to the transition between sleep and wakefulness, seen by hypnogogic hallucinations or sleep paralysis at the beginning or end of sleep episodes.
Dyssomnias
abnormalities in amount, quality, or timing of sleep

Primary Insomnia

Primary Hypersomnia

Narcolepsy

Breathing related sleep disorder

Circadian rhythm sleep disorder
Parasomnias
abnormal behavioral or physiological events occurring in association with sleep, specific sleep stages or sleep-wake transitions.

Nightmare disorder ~ dream anxiety disorder

Sleep terror disorder

Sleepwalking disorder
Nightmare disorder
repeated awakenings from the major sleep period with detailed recall of extremely frightening dreams, usually involving threats to survival, self-esteem.

generally occur duing second half of sleep.

on awakening, person becomes immediately oriented and alert
Sleep Terror disorder
recurrent episodes of abrupt awkening from sleep, usually occurring during the first third of the major sleep episode and beginning with a panicky scream

intense fear and signs of autonomic arousal like tachycardia, rapid breathing

reltive unresponsiveness to efforts of others to comfort the person during the episode

no detailed dream is recalled

amnesia for the entire episode
Sleepwalking disorder
repeated episodes of rising from bed during sleep and walking about usually occurring during the first third of the majoe sleep cycle

person has a blank staring face, relatively unresponsive to efforts of others to communicate with him, awakened only with great difficulty

amnesia for the episode

after awakening , no impairment in mental activity or behavior , but short period of confusion
Epilepsy
best treated with biofeedback and individual psychotherapy (anxiety and depression).

Most common kind is Tonic-Clonic (formerly Grand-Mal)