Abnormal Psych Last Test

Front 1

Delusions

Back 1

 Persecution: people against you (most common)
 Grandeur: you are someone famous
 Reference: assigning personal meanings to meaningless events

Front 2

Avolition

Back 2

lack of motivation to initiate and continue activities

Front 3

Alogia

Back 3

poverty of speech

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Anhedonia

Back 4

no pleasure in previously pleasurable activities

Front 5

Affective Flattening

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Lack of emotion: diminished or empty

Front 6

Loose associations

Back 6

not attached to any one thought (part of Disorganized Symptoms)

Front 7

Neologism

Back 7

made up words that have meaning only to them (part of Disorganized Symptoms)

Front 8

Primary Schizophrenia Criteria

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o Delusions
o Hallucinations
o Negative symptoms
o Disorganized speech – evidence of disorganized thoughts
o Disorganized or catatonic behavior
o Prominent symptoms present for 1 month with prodomal/residual symptoms for 6+ months

Front 9

Prodromal phase

Back 9

clear deterioration from previous levels of functioning

Front 10

2 ways of entering Prodromal Phase

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Process Schizophrenia and Reactive (acute) Schizophrenia

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Process Schizophrenia

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 Slow deterioration
 Greater diathesis
 Poorer prognosis

Front 12

Reactive (acute) schizophrenia

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 Rapid decline
 Trauma/stress
 Better prognosis

Front 13

Active phase

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 Florid symptoms
 Positive symptoms—delusions and hallucinations
 Stress may bring it on/worsen symptoms

Front 14

Prodromal Phase Criteria

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o Impairment in social and role functioning
o Peculiar behavior
o Neglect hygiene
o Unusual ideas
o “not themselves”
o Negative symptoms predominate

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o Residual stage

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 Negative symptoms predominate
 Behavior similar to prodromal phase

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o Over time, span of time between active and residual phases _________ and symptoms worsen

Back 16

decreases

Front 17

Phases

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Prodromal and Active/Residual

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Subtypes of Schizophrenia

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Paranoid
Disorganized
Catatonic
Undifferentiated
Residual Type

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Paranoid

Back 19

o Preoccupation with one or more delusion(s) or frequent hallucinations
o Intact cognitive functioning and affect (not as much disorganized/negative symptoms)
o Without prominent negative symptoms
 Disorganized speech, disorganized/catatonic behavior, flat/inappropriate affect
o Best prognosis of all types
o Danger lies in acting on paranoia

Front 20

Disorganized

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o Marked disruption in speech and behavior
o Flat or inappropriate affect
o Hallucinations and delusions tend to be fragmented
o Develops early, chronic, few remissions
o Worst prognosis

Front 21

Catatonic

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o Motor involvement—usual and odd
o Echolalia (echoing)
o Waxy flexibility
 Like a manikin, leave hand, limbs in place
o Excitability
o Immobility
 People assume position and keep it
o Negativism
o Severe and quite rare
o Examples in video

Front 22

Undifferentiated

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o Waste basket category (everyone else)
o Multiple symptoms

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Residual Type

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o After an episode of schizophrenia
o Continue to have less extreme symptoms
 Odd beliefs, unusual perceptual experiences

Front 24

Onset is in the

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late adolescence to early 20s

Front 25

________ percent make one suicide attempt

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20-40%

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_______ percent smoke

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80-90%

Front 27

better prognosis

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o Relatively normal childhood; no family history
o Female
o Brief duration of active phase
o Older age at onset
o Acute onset (reactive vs process)
o Good premorbid functioning
o Paranoid symptoms present
o Good initial response to medication

Front 28

______ percent family genetics likelihood

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40%

Front 29

Drugs that increase Dopamine

Back 29

L-Dopa
Increase Schizo like behavior

Front 30

Drugs that decrease Dopamine

Back 30

neuroleptics
Decrease Schizo like behavior

Front 31

Neurobiological Theories

Back 31

• Enlarged ventricles
• Decreased grey matter concentration
• Hypofrontality – less active frontal lobes
• Prenatal factors (viral infections)

Front 32

_____ percent of adults have PDs

Back 32

4-15%

Front 33

• Paranoid PD:

Back 33

Pervasive Pattern of Suspiciousness of others such that their motives are interpreted as malevolent

Front 34

Schizophrenia Tx (in addition to meds)

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Behavioral
Cognitive Behavioral
Family Therapy

Front 35

Behavioral (schizo)

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o Social skills training helps, token economies to motivate
o Coping w/stress: ex: relaxation programs
o Supported

Front 36

CBT (schizo)

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o Examine alternative explanations for delusions & hallucinations—give control over symptoms
o Insight necessary
o New application but some support

Front 37

Family Therapy (schizo)

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o Psychoeducation—teaching family what to expect
o Reduce expressed emotion in family (EE)
o Supportive skills
o Problem-solving skills
o Supported

Front 38

Neuroleptics

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Decrease positive symptoms; not as good with negative symptoms
-side effects: Extrapyramidal and parkinson's like side effects; tardive dyskinesia

Front 39

tardive dyskinesia

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• Uncontrollable repetitive grimacing, tongue movement, or other parts of the body
• Sometimes permanent

Front 40

Schizo non compliance with meds rate ______ percent

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20%

Front 41

Hogarty's Schizo release from hospital study

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o Percentage of relapse in 1 year
 1) meds only—40%
 2)meds and social skills training—20%
 3)meds and family therapy—20%
o In 2 years relapse rates similar for groups.
 Delays, but doesn’t prevent

Front 42

Paranoid Dx Criteria

Back 42

 Suspect others are exploiting, harming, or deceiving them
 Preoccupied with doubts about loyalty of friends/associates
 Reluctant to confide for fear info will be used against them
 Reads threatening or demanding meanings into benign comments
 Bears grudges and unforgiving
 Perceives attacks, quick to react angrily
 Unjustified recurrent suspicions about fidelity of spouse or sexual partner
 Tend to be critical of others

Front 43

Paranoid PD defense mechanism

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projection: placing own unacceptable feelings onto others

Front 44

Paranoid Tx

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Therapy not successful because no trust

Front 45

• Schizoid PD

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o Pattern of detachment from social relationships and a restricted range of emotions

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Schizoid PD Dx Criteria

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 Don’t desire/enjoy close relationships—not because depressed or anxious
 Usually chooses solitary activities
 Little interest in sexual experiences with another person
 Takes pleasure in few if any activities
 Lack of close friends/confidants other than family
 Appears indifferent to praise/criticism
 Shows emotional detachment and coldness

Front 47

Schizoid PD Tx

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not usually seen in clinical settings, little data

Front 48

• Schizotypal PD

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o Pattern of interpersonal deficits marked by acute discomfort with, and reduced capacity for close relationships as well as cognitive and perceptual distortions and eccentrics of behavior

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Schizotypal PD Dx

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 Ideals of reference: belief that coincidental and meaningless events have special meaning for them
 Odd beliefs and magical thinking (ESP, elevation, etc)
 Unusual perceptual experiences (similar to hallucinations)
 Odd thinking and speech (ex: vague, circumstancial, over-elaborated)
 Suspiciousness and paranoid ideation
 Inappropriate and constricted affect
 Behavior or appearance is odd, eccentric, or peculiar
 Lack of close friends/confidants other than family because of oddness
 Excessive social anxiety related to suspiciousness or self doubt

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Schizotypal PD more common in families with:

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Schizophrenia

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Schizotypal tx

Back 51

one study used antipsychotic meds, community support, and social skills training to reduce the symptoms or delay development of schizophrenia

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 Lykken

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—worked with people with psychopathy
• They learn to obtain rewards as quickly as others, but learn to avoid shock (punishment, anxiety) much more slowly
(APD studies)

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 Schacter and Latane—

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psychopath and nonpsychopath prisoners. Focused on learning avoidance of shock under conditions of placebo (baseline) and adrenaline (hi arousal) injections
• People with APD perform and learn better with adrenaline

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 Yerkes-Dodson Law

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• There is a curvilinear relationship between arousal and performance
o (inverse U-shaped graph with Performance on the y axis and arousal on the x axis)
o The U shape of the graph goes from sleep, boredom, mild alertness, optimum, stress, anxiety, and panic.

Front 55

• Borderline PD

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o Pattern of instability of interpersonal relationships, self image and marked impulsivity
 Shifting pattern of ego identity; don’t think about consequences

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Histronic PD

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o Pattern of excessive emotionality and attention seeking

Front 57

Histronic PD Dx

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 Uncomfortable when not center of attention
 Often sexually seductive/provocative
 Rapidly shifting, shallow emotions
 Use appearance to draw attention to self
 Speech is lacking in depth (superficial)
 Dramatic, theatrical, and exaggerated expressions of emotion
 Suggestible, easily influenced
• May suggestible to things therapist wants them to do/be—may pretend they are to them
 Considers relationships more important than they are

Front 58

Avoidant PD

Back 58

o Pattern of social inhibition, feelings of inadequacy and hypersensitivity to criticism

Front 59

Avoidant

Back 59

 Avoids occupations with personal contact
 Doesn’t get involved unless sure of being liked
 Fears being rejected
 Views self as socially inept, unappealing
 Won’t try new things that could be embarrassing

Front 60

Dependent PD

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o Need to be taken care of. Submissive and clinging, fears separation

Front 61

Dependent contd

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 Difficulty making decisions without advice and reassurance
 Needs others to assume responsibility for most major areas of his/her life
 Often doesn’t disagree with others for fear of loss of approval
 Doesn’t initiate due to lack of self confidence
 Goes out of way to obtain support from others
 Uncomfortable /helpless feeling when left alone
 Urgently seeks another relationship when one ends

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Obsessive-Compulsive PD

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o Preoccupied with orderliness, perfectionism, and mental and personal control at the expense of flexibility, openness, and efficiency

Front 63

OCPD contd

Back 63

 Into rules, details, organization, and schedule so much that the main point is missed
 Perfectionism interferes with task completion
 Workaholic versus rounded family and friend life
 Overly conscientious or moralistic
 Can’t discard worn out or worthless objects even if no value (hoarder)
 Reluctant to delegate – micromanagers
 Miserly in spending largely out of fear of future catastrophe
 Rigid and stubborn

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Difference btwn OCD and OCPD

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• Compulsions aren’t to remove tension—is more global in the PD

Front 65

Bronfenbrenner’s Ecological Model

Back 65

Microsystem
Mesosystem
exosystem

Front 66

ODD

Back 66

pattern of negativistic, hostile, and defiant behavior lasting at least 6 months with four or more symptoms:
-loses temper
-argues with adults
-refuses to comply with rules or request
-deliberately annoys people
-blames others for mistakes/behavior
-touchy/easily annoyed
-angry and resentful
-spiteful and vindictive

Front 67

CD

Back 67

Diagnosis for children/adolescents with more severe aggression and antisocial behavior, inflicting pain on others, interfering with others' basic rights, or committing acts of vandalism

Front 68

____ percent develop APD after having CD

Back 68

25-40%