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104 Cards in this Set

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GAF
Threshold for crisis (suicidal ideation)
<45
Mental Retardation-IQ scores
1) mild
2) moderate
3) severe
4) profound
1) 50-55 to 70
2) 35-40 to 50-55
3) 20-25 to 35-40
4) below 20-25
Mental Retardation
Grade levels associated with:
1) mild
2) moderate
1) 6th grade
2) 2nd grade
Mental Retardation
3 diagnostic criteria
1) significantly subaverage intellectual fx (below 70)
2) impairment in adaptive fx in at least TWO areas
3) onset prior to age 18
Mental Retardation-Etiology
1) what percentage is due to heredity?
2) alterations in embryonic development (Down's)?
3) pregnancy or perinatal problems?
4) environmental factors?
1) 5%
2) 30%
3) 5%
4) 15-20%
Mental Retardation
1) 10-30% of all cases of moderate to severe is caused by ___
2) Phenylketonuria (PKU) can be prevented by?
3) if not prevented, causes what level of MR?
1) Down's Syndrome
2) diet low in phenylalanine
3) moderate to profound
Borderline Intellectual Fx
What is the IQ range?
71-84
Learning Disorders
Achievement "substantially below" IQ is defined as how much?
2 or more SD
LD
1) most frequent comorbid d/o
2) what % of children w/ LD also have this comorbid d/o?
1) ADHD
2) 20-25%
Dyslexia -- what kind?
1) substitution of similar menaing words
2) cluster of reading disorders (one MUST be ___)
3) unable to read words JUST written by individual
1) semantic paralexia
2) deep dyslexia (one must be semantic paralexia)
3) alexia (pure alexia)
Stuttering
1) begins between age __ & __
2) __x more common in boys
3) __% remit spontaneously, usually by age ___
1) 2 & 7
2) 3
3) 60%, 16
Stuttering -- tx
1) best tx for younger children
2) best tx for older children
1) reduce psychological stress at home
2) regulated breathing method
Autism
1) dx requires at least # sxs
2) from 3 categories
3) onset must be ___
1) 6
2) social interaction (2 sxs), communication (1 sx), repetitive or stereotyped behaviors (1 sx)
3) before age 3
Autism
1) __% remain mute
2) __x more common in males
3) prognosis is better or worse than schizophrenia?
4) __% achieve PARTIAL independence
1) 50%
2) 4-5 times
3) worse
4) 33% (1/3)
Autism
Best outcome is predicted by:
1) speaking by age ___
2) IQ > ___
3) onset?
1) 5-6
2) 70
3) late onset
Autism
Brain structure abnormalities
-Name 2 types
1) reduced cerebellum
2) enlarged ventricles
Autism
EEG findings?
40-65% have abnormal EEGs
20-35% have epilepsy
Autism
abnormal levels of which neurotransmitters?
1) norephinephrine
2) serotonin (high)
3) dopamine (high)
Autism
__x higher among siblings
50-100 times
Rett's
1) pattern of sxs following a period of normal development for __ months or more
2) females or males?
1) 5
2) females only
Childhood Disintegrative d/o
pattern of developmental regression in at least __ areas following at least __ years of normal development
2, 2
ADHD
1) onset
2) duration
3) # settings
4) # sxs
1) prior to age 7
2) 6 mths
3) 2
4) 6 sxs of inattention OR hyperactivity-impulsivity
ADHD - subtypes
Based on # of sxs, when are these subtypes dx?
1) pred. inattentive
2) pred. hyper-imp
3) combined
1) 6 or more of inatt, less than 6 of h-i
2) 6 or more of h-i, less than 6 of inatt
3) 6 or more of inatt AND 6 or more of h-i
ADHD
1) Academic problems are worst for which subtype(s)?
2) Peer rejection problems are worst for which?
1) pred. inattentive or combined
2) pred. h-i or combined
ADHD alone (pure ADHD) vs. ADHD + Conduct D/O
1) which has MORE cognitive problems?
2) which has MORE academic problems?
1) and 2)
ADHD alone has more cognitive AND academic problems
ADHD
1) __x more common in boys
2) more equal gender ration for which subtype
1) 2-9 times
2) pred. inattentive
ADHD
1) __% continue to have sxs as adults
2) prognosis is poorest for those with:
a) co-dx of ____
b) low/high? IQ
c) parents with ___
1) 60%
2)
a) conduct d/o
b) low
c) severe mental d/o
ADHD-brain abnormalities
1) lower activity in which two regions
2) malfx in which hemisphere
3) brain structure - smaller than normal ___(3 structures)
1) frontal cortex AND basal ganglia
2) right
3) caudate nucleus, globus pallidus, prefrontal cortex
ADHD
1) Barkley's hypothesis to explain core feature of ADHD
2) hypothesis states that core feature is an inability to regulate one's behavior to fit ______
3) person with ADHD has trouble decreasing/increasing? level of activity to appropriate levels
1) behavioral disinhibition hypothesis (aka: regulatory hypothesis)
2) situtation demands
3) BOTH decreasing and increasing
ADHD-medications
1) stimulants are effective in __% of cases
2) BUT low doses lead to ___, while high doses lead to ___
3) this difference means the effect of stimulants are ___
4) Are meds associated with long-term improvements?
1) 75%
2) improved attention; decreased hyperactivity
3) dose dependent
4) no
ADHD-meds
1) stimulants can increase likelihood of what complications (name 2)
2) therefore, stimulants are contraindicated for children with family history of ___
1) tics and OCD sxs
2) Tic Disorder
ADHD-meds
1) which stimulant is most likely to lead to OCD sxs?
2) besides stimulants, what other classes of meds are used to tx ADHD? (2 types)
3) which drug is sometimes combined with stimulants when not effective alone?
1) dextroamphetamine (more than methylphenidate)
2) a) tricyclic antidepressants (e.g., imipramine, desiprmaine)
b) antihypertensives (e.g., clonidine)
3) clonidine
Conduct Disorder
1) # sxs
2) duration
3) 2 subtypes - based on what criteria are they determined?
1) at least 3 sxs
2) during past 12 months
3) childhood-onset (prior to age 10), adolescent-onset (age 10 or later)
Conduct Disorder
1) Moffit describes 2 types
2) to what are each attributed
a) "life-course-persistent" type (begins early) - attributed to neurological impairment, difficult temperament, adverse environment
b) "adolescence-limited" type - temporary form, "maturity gap"
Oppositional Defiant Disorder
rates for males and females is complex -- describe
before puberty, higher in males
after puberty, males and females are equal
Pica
1) sxs must be present for how long?
2) onset usually when?
3) frequently associated with what other dx?
1) one month
2) 12-24 mths
3) MR
Tics
1) imitating someone's movements
2) repeating socially-undesirable words
3) repeating one's own sounds and words
1) echokinesis
2) coprolalia
3) palilalia
Tourette's-dx criteria
1) presence of # tics
2) duration
3) onset
1) one vocal, multiple motor
2) at least one year
3) prior to age 18
Tourette's
1) most common associated sxs (2)
2) common dx in biological relatives
3) what type of outside problem is common?
1) Obsessions and compulsions(40-60%) and ADHD (50%)
2) OCD
3) school problems
Tourette's - tx
1) what class of drugs
2) effective in __% of cases
3) hypothesis on what causes Tourette's (based on drug efficacy)
1) antipsychotics (haloperidol, pimozide)
2) 80%
3) too much dopamine
Enuresis - dx criteria
1) occurs how frequently
2) for how long
3) diagnosed only if child is what age (minimum)
1) 2x/wk
2) 3 mths
3) age 5 or older
Encopresis
1) minimum age

2) are enuresis and encopresis involuntary only?
1) age 4

2) no, can be intentional
enuresis - tx
1) most common tx (2 names)
2) effective in __% of cases
3) which drug is most commonly used to tx
4) effective for __% of cases
5) do these treatments have good long-term effects
1) night alarm (bell&pad)
2) 80%
3) imipramine
4) 85%
5) no, 1/3 relapse afer night alarm, and most relapse after stopping drug
Separation Anxiety Disorder
1) duration
2) onset
3) # behaviors
1) 4 weeks
2) before age 18
3) 3 behaviors
tx for school refusal
intervention should include an immediate return to school
Reactive Attachement Disorder
1) inappropriate social relatedness in ___ settings
2) onset
3) REQUIRES evidence of ___
4) 2 subtypes
1) most
2) prior to age 5
3) pathogenic care (neglect or frequent caregiver change that prevented attachment)
4) inhibited type, disinhibited type
Random questions:
1) most common cause of mental retardation
2) lead poisoning is most associated with which d/o
3) autism is current considered a (genetic, biogenic, or psychosocial) d/o
4) which has greater long-term effects for enuresis -- bell & pad or imipramine?
1) prenatal factors (not perinatal)
2) pica
3) biogenic
4) bell & pad
Delirium - tx
1) what class of drugs are often used
2) what class is contraindicated
1) antipsychotics
2) sedatives - masks sxs
Dementia
1) AD accounts for __% of cases
2) drug tx for AD - what does it do in the brain?
1) 50-65%
2) prevents breakdown of ACh
Dementia due to HIV
early signs
forgetfulness, impaired attn, slowed mental processes, hand clumsiness
Parkinson's
1) what is the name of the restlessness associated with it ("cruel restlessness")
2) what neurotransmitter is associated
1) akathesia
2) low dopamine
Huntington's
1) what sxs appear first
2) slow, writing movements
3) involuntary rapid, jerky movements
4) what neurotransmitter is involved
5) besides motor and affective sxs, what other type of sx is associated
3)
1) affective
2) athetosis
3) chorea
4) degeneration of GABA cells
5) cognitive - starts with forgetfulness, progresses to dementia
Substance-related d/o
1) which one is not associated with dependence
2) which is the only one associated with Persisting Perception d/o
1) caffeine
2) hallucinogen
Substance Dependence
1) # sxs
2) how long?
3) is tolerance and withdrawal required for dx
1) at least 3
2) ANY TIME during 12 month period
3) NO
Marlatt and Gordon
1) dependence is what type of pattern?
2) potential for future relapse is reduced if relapse is viewed as resulting from _, _, _ factors
3) relapse prevention focuses on what types of triggers (internal/external)
1) overlearned habit pattern
2) specific, external, controllable
3) external
Substance abuse
1) # sxs
2) how long
3) associated with all classes of substances except __ and __
1) one
2) during 12 month period
3) nicotine and caffeine
Steele & Joseph model of ETOH
1) what is it called
2) ETOH creates a ___ that restricts attn to most salient aspect of situation
3) a person who has used ETOH will be most anxious when ___
1) attention-allocation model
2) myopia
3) when focusing on anxiety-producing task
ETOH
1) long-term ETOH impairs what cognitive fx
2) __% of alcoholics develop Wernicke-Korsakoff's
1) visual-spatial fx
2) 1%
ETOH
1) signs of withdrawal
2) signs of ETHO withdrawal delirium
1) sweating, tachycardia, tremor, insomnia, anxiety, seizure
2) DT - disturbance in consciousness, hallucination/delusions
Amphetamine/Cocaine
1) signs of intoxication
2) signs of withdrawal
1) dilated pupils, tachycardia, muscular weakness nausea/vomitting, weight loss, agitation, seizure
2) dysphoria, fatigue, bad dreams, sleep disturbance, increased appetite (also "crash" involves depression)
Delusions
what is the difference btwn delusions in Schizophrenia vs. Delusional d/o
in Schizophrenia, delusions are NOT limited
in Delusional D/O, delusions are limited, encapsulated, and non-bizarre
Schizophrenia
1) duration (complex)
2) # active-phase sxs required
3) what else is required
1) continuous disturbance of 6 months or more, including at least 1 months of 2 or more active-phase sxs
2) 2 (delusions, hallucination, disorganized speech, grossly disorganized or catatonic behavior, or negative sxs)
3) impairment in one or more areas of fx
Negative sxs
1) poverty of thought and speech
2) restricted initiation of goal-directed behavior
3) loss of interest or pleasure
1) alogia
2) avolition
3) anhedonia
Schizophrenia
1) 5 subtypes
2) which has the most favorable prognosis
3) which has the strongest familial link
paranoid
disorganized
catatonic
undifferentiated
residual (not currently exhibiting prominent positive sxs but has had such sxs in past and continues to show negative and/or attenuated positive sxs)
2) paranoid
3) paranoid
Schizophrenia
1) common co-dx
2) is there evidence that they are more violent or aggressive?
3) onset? is it different for men and women?
4) is sx pattern different for men and women?
5) higher rate of dx in any racial/ethnic group?
1) substance dependence
2) no
3) yes -- earlier for men
men (18-25), women (25-35)
4) yes
men - more negative sxs
women - more affective and positive sxs
5) yes, African-American
Schizophrenia
1) incidence rate in general adult population
2) biological siblings
3) fraternal twins
4) identical twins
5) child (both parents schizophrenic)
6) risk for identical twins is __times greater than for fraternal twins
7) finding associated with what researcher?
1) .5% - 1.5%
2) 10%
3) 17%
4) 48%
5) 46%
6) 2 1/2
7) Gottesman
Schizophrenia
1) brain abnormalities (3)
2) which is more common in males
1) a) enlarged ventricles
b) neocortical atrophy
c) smaller hippocampus, amygdala, and globus pallidus
2) enlarged ventricles
Schizophrenia
1) associated with lower activity in which part of brain
2) this is associated with positive/negative? sxs
1) prefrontal cortex (hypofrontality)
2) negative
Schizophrenia
1) What is the dopamine hypothesis
(it has been modified due to findings of involvement of other neurotransmitters)
1) too much dopamine leads to schizophrenia
Schizophrenia
what other neurotransmitters are involved (besides dopamine)
elevated norephinephrine and serotonin
low level of GABA and glutamate
Schizophrenia
In the northern hemisphere, it is associated with births in which 2 seasons
winter and spring
Schizophrenia
1) relapse is associated with high/low? expressed emotion
2) this means emotional over/under? involvement
3) and high/low critical comments
4) mediated by what variable?
5) in what way?
1) high
2) over
3) high
4) race/ethnicity
5) Mexican-Am families - LACK of emotional involvement leads to relapse; in Anglo families, critical comments leads
Schizoaffective disorder
-mood sxs occur concurrently with psychotic sxs but...
there is a period of __ during which ___
2 weeks
ONLY psychotic sxs are present
(for Mood D/O with psychotic features, there is NO period of only psychotic features)
Schizophreniform
1) disturbance is present for ___
2) does it require impairment of fx?
3) what fraction of those with schizophreniform eventually go on to have dx of schizophrenia or schizoaffective
1) at least 1 mth but less than 6 mths
2) no
3) 2/3
Delusional D/O
1) presence of __ delusions for ____ (duration)
2) quality of delusions
4) is fx impaired?
3) 7 subtypes
1) one or more; at least one month
2) non-bizarre, plausible
3)overall psychosocial fx NOT markedly impaired
4) erotomanic (believe someone is in love with individual), grandiose, jealous (unfaithful), persecutory, somatic, mixed, unspecified (event/person has special significance for individual)
Brief psychotic disorder
1) duration
2) eventual return to full/partial? fx
3) does it require a precipitating event
1) 1 day - < 1 month
2) full
3) often has a precipitating event but does not require one
Differential - duration
1) brief psychotic d/o
2) schizophreniform
3) schizophrenia
1) 1 day - < 1 mth
2) 1 mth - < 6 mths
3) > 6 mths
Adjustment Disorders
1) onset within __ mths of stressor
2) sxs remit within __ mths after termination of stressor
3) but dx can be assigned when sxs persist longer when __
1) 3 mths
2) 6 mths
3) the stressor is chronic or has enduring consequences
Somatization Disorder
1) onset
2) duration
3) complaints must include __
1) before age 30
2) several yrs
3) 4 pain sxs
2 GI sxs
1 sexual sx
1 pseudoneuro sx
Conversion Disorder
1) why are sxs judged to be due to psych factors
2) what is a key factor in successful tx
3) what are the 2 mechanisms that explain
4) what is REQUIRED for the dx
1) intiation or exacerbation of sxs preceded by stressor
2) suggestion
3) primary gain -- sx keeps internal conflict out of conscious awareness
secondary gain -- avoid unpleasant activity or obtain support
4) evidence that psychological factors are involved
how is factitious disorder different from conversion disorder
in factitious disorder, sxs are voluntarily produced or feigned

in conversion disorder, sxs may be related to primary or secondary gain, they are NOT produced intentionally
Hypochondriasis
1) definition
2) what is it based on
1) unrealistic preoccupation with serious illness
2) misinterpretation of bodily sxs
Undifferentiated Somatoform Disorder
1) # sxs
2) duration
3) common sxs
1) one or more physical complaint
2) at least 6 mths
3) fatigue, loss of appetite, stomach pains
How is factitious disorder different from malingering
factitious disorder -- sxs intentionally produced or feigned for purpose of fulfilling intrapsychic need to adopt sick role

malingering -- goal is to obtain external reward
what is the assessment of choice for malingering
forced-choice methodology

malingerer will do worse than chance alone
bulimia
1) 2 MAJOR requirements
2) duration
1) a) recurrent episodes of binge eating
b) inapprop compensatory beh

2) at least 2 times per week for 3 mths
Major Depressive episode
1) duration

Manic episode
2) duration
3) requires __ and/or __ and/or __
1) 2 wks

2) one week
3) sig imp in fx
and/or hospitalization
and/or psychotic sxs
hypomanic episode
1) duration
2) does it cause fx impairment
3) does it require hospitalization
4) does it incl psychotic sxs
1) 4 days
2-4) No (only required by manic or mixed episode)
mixed episode
1) duration
2) what else is required
1) one week
2) sig imp in fx
and/or hospitalization
and/or psychotic sxs
(like manic episode)
Major Depressive Disorder
1) # episodes req for dx
2) % of cases who have more than one episode

3) what is double depression
4) what is masked depression
1) one or more
2) 50%

3) MDD and Dysthymic D/O
4) physical sxs predominate
1) % of women with baby blues
2) % with postpartum depression
1) 70%
2) 10-20%
what is:
1) catecholamine hypothesis
2) indolamine hypothesis
3) permissive theory
4) cortisol theory
depression due to:
1) low norep
2) low serotonin
3) low serotonin PLUS others (norep, dop)
4) high levels of cortisol
what is best tx for:
1) mild to moderate depression
2) severe depression
combined tx (meds + thearpy) is effective
BUT
it may be no more effective than either alone
2) combined tx
dysthymic disorder
1) duration for adults
2) duration for child/adol
1) 2 yrs
2) 1 yr

NO period of over 2 mths without sxs
Bipolar I disorder
1) regardless of subtype, ALL must include h/o __

Bipolar II
2) must have h/o __ with NO h/o __
1) at least one FULL manic or mixed episode (1 week)

2) major depressive episode (2 wks) PLUS hypomanic episode (for 4 days)
NO h/o manic or mixed episode
what is the gender ratio for:
1) bipolar I
2) bipolar II
1) equally common in males and females

2) more common in females
bipolar
1) first line of tx
2) effective in __% of cases
3) 2nd line of tx
1) lithium
2) 60-90%
3) anti-seizure drugs (carbamazepine, divalproex sodium)
cyclothymic disorder
1) duration for adults
2) duration for child/adol
3) characterized by presence of ___
1) 2 yrs
2) 1 yr
3) fluctuating hypomanic sxs and numerous periods of depressive sxs (no h/o major depression)
suicide
1) males commit __x more often than females
2) females attempt __x more often than males

3) about __% give warning of their intentions
1) 4-5
2) 3

3) 80%
Three psychological disorders most commonly associated with suicide in order
1) depression
2) alcoholism
3) schizophrenia
OCD
1) is it necc to have Ob AND comp
2) does it req recongition that beh is excessive or unreasonable
3) gender ratio in adults and child/adol
4) associated with what neurotransmitter
5) assoc w/ what brain part
1) no
2) yes
3) adults - male and female are about equal
child/adol - male > female
4) low serotonin
5) OVERactive caudate nucleus
PTSD
1) duration
2) best tx
1) sxs must be present for at least one month
2) combine exposure (in vivo or imaginal) with stress inoculation or anxiety mgmt training
acute stress disorder
1) onset
2) duration
1) within 4 weeks of trauma
2) 2 days - <4 wks
GAD
1) duration
2) best tx
1) 6 mths
2) CBT