• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/166

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

166 Cards in this Set

  • Front
  • Back
What is meant by the "disease model?"
behavior is simply a sx of underlying pathology
What factors influence classical conditioning?
1) CS-US order
2) Number of CS-US pairings
3) Time b/w CS, US, and UR
4) Consistency of pairing
What is stimulus generalization? What kind of conditioning do we see it in?
subject responds to stimuli similar to the CS w/ a CR. Seen in classical conditioning.
What is extinction? What is spontaneous recovery?
Extinction of a classically conditioned response) is the decay of the CS-CR bond if the CS is no longer followed by the US. Spontaneous recovery is when following extinction, the CR reappears if the CS is presented following a short delay
What is stimulus discrimination? What is a discriminatory stimulus?
Stimulus discrimination: organism learns to discriminate b/w similar stimuli, responding only to the CS.

Discriminatory stimulus: certain stimuli (or antecedents) in the environment may serve as a signal to the organism that if a previously reinforced behavior is performed, it will again be reinforced. e.g., time of day on playground, or mom vs. dad coming home from work
What is psychoneuroimmunology? Who pioneered it? Give example.
classical conditioning of an immune response, the work of Robert Ader.

CS: saccharine flavored water
US: effects of cyclophosphamide, an immunosuppressive drug
CR/UR: Immunosuppression

also, anticipatory nausea in chemo pts, treatment of alx airway diseases
What is interoceptive conditioning?
classical conditioning involving an internal gland or organ. E.g. insulin effects, bell and pad treatment for nocturnal enuresis:

CS: Sensation of full bladder
US: alarm
UR/CR: awakening and tightening muscles
What are the DSM-IV criteria for substance dependence?
3 or more of the following:
-Tolerance
-Withdrawal
-Substance taken for a longer time or greater amount than intended
-Desire or efforts to reduce or control use
-Much time spent in activities to obtain the substance
-Social, recreational, or occupational activities given up or reduced
-Use continued despite knowing that psychological or physical problems are worsened by it

Note: while tolerance and withdrawal aren't essential for this diagnosis, if either is present, then the pt. is physically dependent on the drug
What are "drug opposite effects?"
tolerance responses, or homeostatic physiological responses which tend to be counter, or opposed to, the direct effects of the drugs
What is conditioned tolerance?

What is conditioned withdrawal?
conditioned tolerane: classical conditioning of the tolerance response. The response is anticipatory b/c it occurs in response to environmental CSs that alert the organism that the drug is coming. Homeostatic.

Conditioned withdrawal: drug opposite responses are subject to classical conditioning, but the sx are milder.
What is conditioned euphoria?
direct effects of the drug may become conditioned to environmental stimuli. e.g., the opiate dependent user experiences drug-like physiological changes and euphoric-like feelings.

These conditioned responses make drug use more likely in the presence of such CSs

Treatment programs use extinction: expose user to environmental CSs w/o the US (drug).
What are the anxiety disorders?
Phobia, Panic Disorder, Generalized anxiety disorder, post-traumatic stress disorder, acute stress disorder.
What is a phobia? What is the criteria for specific phobia? What provides the basis for phobias?
fear and avoidance of objects or situations that do not present any real danger

Criteria:
-excessive, unreasonable, persistent fear triggered by objects or situations
-exposure to the trigger leads to intense anxiety
-person recognizes that the fear is unrealistic
-object/situation is avoided or endured w/ intense anxiety



the basis is conditioned fear
What is panic disorder?
recurrent panic attacks involving a sudden onset of physiological sx, such as dizziness, rapid heart rate, and trembling, accompanied by terror and feelings of impending doom; sometimes accompanied by agoraphobia, a fear of being in public places
What is Generalized Anxiety Disorder?
Persistent, uncontrollable worry, often a/b minor things
What is PTSD? What are the criteria?
aftermath of a traumatic experience in which the person experiences increased arousal, avoidance of stimuli associated w/ the event, and anxiety caused by recalling the event

Criteria:
-exposure to a traumatic event causing extreme fear
-the event is re-experienced
-the person avoids stimuli associated w/ the trauma and has a numbing of responsiveness
-hyperarousal sx such as an exaggerated startle response
-duration of sx is more than one month

classical conditioning accounts for the continuing anxiety in the presence of environmental CSs associated w/ the trauma, operant conditioning plays a role in the avoidance behavior seen.
What is acute stress disorder?
sx are the same as those of PTSD but last for FOUR WEEKS OR LESS.
What is: Claustrophobia? Agoraphobia? Acrophobia?
fear of enclosed spaces
fear of public places
fear of heights
What is another way of acquiring a phobia other than through classical conditioning?
vicarious learning or verbal report
How are phobias maintained?
Avoidance behavior results in avoidance of anxiety - operant conditioning (negative reinforcement)
What is social phobia?

What treatment approaches are taken?
persistent, irrational fear of behaving in an embarrassing manner in a social situation

-fears concerning excessive sweating/blushing common
-Prevalence: 11% men, 15% women

Behavioral approaches e.g. systematic desensitization are good. Purely cognitive approaches are good for social phobia but not for specific phobia.
What are the treatment approaches for PTSD?
exposure (imaginal and/or in vivo) to potentiate extinction.

critical incident stress debriefing (CISD), though social support may be superior to this

distancing from traumatic memories

eye movement desensitization and reprocessing (EMDR): pt. recalls traumatic experience while following movement of therapist's fingers.
What is resiliency?
ability of people to be okay and not develop PTSD in response to trauma.
As a physician, how would you use conditioning to ensure a better pt. outcome?
foster a sense of expectancy, hope, and optimism in your pts.
What is a paraphilia?
a sexual disorder in which sexual arousal occurs primarily in the context of inappropriate objects, situations, or individuals

occur more commonly in males
What are the criteria for fetishism?
-sexually arousing fantasies, urges, or behaviors involving the use of nonliving objects, occurring over a period of at least six months
-results in marked distress or impairment in social or occupational functioning
-the sexually arousing objects are not limited to articles of female clothing or devices to provide tactile genital stimulation

typical: underwear, feet, shoes, rubber, latex, fur, leather
Criteria for voyeurism?
recurrent, intense, sexually arousing fantasies, urges, or behaviors involving the observation of unsuspecting others who are naked or engaged in sexual activity
-over a period of at least 6 months
-person has acted on these urges, or the urges and fantasies cause marked distress or interpersonal problems

*risk is important
Criteria for exhibitionism?
-recurrent, intense, sexually arousing fantasies, urges, or behaviors involving showing one's genitals to an unsuspecting stranger
-person has acted on these urges, or the urges and fantasies cause marked distress or interpersonal problems

*desire is to shock or embarrass the observer
What is frotteurism?
a paraphilia involving non-consensual rubbing against other people to achieve sexual arousal
What is the operant conditioning model?
aka instrumental conditioning, a type of learning in which behavior is either increased or decreased as a function of its consequences
Define positive reinforcement
a stimulus (consequence) which is applied following a behavior results in the strengthening of that behavior, making it more likely to be repeated
When is positive reinforcement a bad thing?
in the case of the somaticizing patient, a doctor's attention reinforces unnecessary patient visits to the clinic
Define negative reinforcement
behavior is strengthened by a consequence involving termination, withdrawal, or avoidance of an aversive stimulance (aka avoidance learning)
What are three properties of reinforcement and punishment affecting the effectiveness?
1) Immediacy
2) Consistency
3) Contingencies made clear
What is two-factor theory?
refers to the roles played by both classical and operant conditioning in the acquisition and maintenance of phobias. Classical conditioning is instrumental in acquisition while operant conditioning plays a role in maintenance.
What are the criteria for OCD?
-obsessions: recurrent and persistent thoughts, impulses, and images that cause anxiety
-the obsessions are not simply excessive worry a/b real-life problems
-the person attempts to ignore, suppress, or neutralize such thoughts or impulses
-thoughts or impulses are normally recognized as irrational
-compulsions: repetitive behaviors or mental acts that hte person feels driven to perform in response to an obsession, or to rules that must be applied rigidly
-such behaviors/mental acts are aimed at preventing or reducing distress or preventing some dreaded event; however, these actions are not connected in a realistic way with what they are designed to prevent or neutralize, or are clearly excessive
The compulsive behavioral rituals characterizing OCD are considered what?
avoidance behaviors because they reduce anxiety (negative reinforcement), making them more likely to be repeated
What are the most common obsessions clinically in OCD patients?
fears of contamination, fears of expressing some sexual or aggressive impulse, and hypochondriacal fears
What is the definition of a true compulsion?

Give examples of behaviors commonly mistaken for true compulsions
True compulsions are performed in response to an obsession and they are not engaged in with pleasure.

non-true compulsive behaviors include compulsive gambling, eating, sexual activity, drinking, etc.
Define punishment, positive punishment, and negative punishment
Punishment (general): refers to the situation in which the consequence which follows a behavior weakens that behavior, making it less likely it will be repeated.

Positive Punishment: application of an aversive stimulus contingent upon behavior.

Negative Punishment: removal of a pleasant or desirable stimulus contingent upon behavior.
Name the disadvantages of punishment, particularly physical
-May engender resentment and violence towards others
-models violence as a means of coping w/ frustration
-teaches only what NOT to do
-undesirable side effects, e.g. fearfulness
-ay actually be positively reinforcing
What is extinction? What is the post-extinction burst?
Extinction occurs when reinforcement is consistently withheld following a learned behavior which has previously been reinforced, resulting in weakening and eventual elimination of that behavior.

The extinction burst is when the subject's brain says, "what's happening; this can't be true" in response to reinforcement being withheld, so the behavior increases for a time before stopping.
What is the difference between primary and secondary reinforcers and punishers?
primary reinforcers and punishers are "naturally" reinforcing/punishing. Secondary (or conditioned) reinforcers/punishers involve learning (e.g., applause).
Between continuous reinforcement and intermittent reinforcement, which one causes behaviors to be learned more quickly? Which one makes behaviors more resistant to extinction?
Continuous: behaviors learned more quickly, extinguished more quicly

Intermittent: behaviors learned more slowly, but resistant to extinction.
What is shaping?
creating new behaviors through positive reinforcement of successive approximations of the desired behavior
What are the steps in a behavioral assessment?
A. Describing the problem behavior
B. Identifying environmental antecedents and consequences
C. Selecting an appropriate behavioral treatment intervention
D. Evaluating treatment outcome
What is the reversal design?
ABAB - allows you to hypothesize that your intervention helped.

A: establish baseline, e.g. how often does the child bang his head against the wall
B: Introduce treatment, e.g. apply electrical shock
A: Reversal, e.g. stop electric shock and observe behavior increasing again
B: treatment, e.g. reinstitute B, behavior decreases again.
What is systematic desensitization? How is it carried out?
pairs relaxation with anxiety-provoking CS in order to weaken and eventually eliminate the CR. Relaxation is antagonistic to anxiety, or reciprocally inhibiting.

It is carried out by pairing relaxation with a hierarchy of least to most disturbing anxiety-eliciting scenes
Are cognitive approaches effective for phobias?
Generally, no, because the phobic fear is already recognized as irrational. However, it has some use for treatment of social phobias
What are the criteria for male erectile disorder?
-persistent inability to attain or maintain an erection adequate for completion of sexual activity
-causes marked distress or interpersonal problems
-not d/t another axis I disorder or the direct physiological effects of a drug or a general medical illness
What is sensate focus?
counterconditioning - pairing stimuli in the sexual situation w/ relaxation and pleasure. Useful in behavioral sex therapy.
What is aversion therapy?
a behavioral technique in which a CS previously associated w/ pleasure is paired w/ a US which naturally elicits an unpleasant reponse, such as shock, or a nausea-producing drug. As a result, the CS tends to become assocaited w/ the unpleasant effects of the US.

Useful in the treatment of pedophilia
What are the criteria for pedophilia?
-sexually arousing fantasies, urges, or behaviors involving sexual contact w/ a prepubescent child over a period of at least six months
-person has acted on these urges, or the urges and fantasies cause marked distress or interpersonal problems
-person is at least 16 y/o and 5 yrs older than the child
What is the prevalence of sexual abuse?
19% of women and 8-9% of men report that they have been sexually abused as children
Name the impulse-control disorders. What are they?
failure to resist an impulse, drive, or temptation to perform an act that is harmful to self or others

Intermittent explosive disorder
kleptomania
pyromania
pathological gambling
trichotillomania
What are the criteria for kleptomania?
-recurrent failure to resist impulses to steal objects not needed for personal use or for monetary value
-increasing sense of tension immediately before committing the theft
-pleasure, gratification, or relief at the time of committing the theft
-the stealing is not committed to express anger or vengeance, and is not the result of a delusion or hallucination
-the stealing is not better accounted fro by conduct disorder, a manic episode, or antisocial personality disorder
Define exposure (in vivo or imaginal)
a treatment technique similar to systematic desensitization (gradual exposure to anxiety-provoking stimulus), except there is no training in an incompatible response (relaxation)
Define flooding (in vivo or imaginal)
abrupt, prolonged and full-intensity exposure to the anxiety-provoking stimulus
Define exposure and ritual prevention. What is it used for?
pt. is exposed to the anxiety provoking stimulus, but then not permitted to perform the ritualistic, compulsive avoidance behaviors which serve to lessen the anxiety associated w/ this stimulus

first line treatment for OCD
What is the first line treatment approach for OCD?
Exposure and ritual prevention
What is contingency management?
involves manipulating environmental consequences, using reinforcement and punishment, in order to modify a behavior
What is biofeedback?
Monitoring some physiological response related to anxiety. The change itself is reinforcing; e.g. heart rate represented by beeping, reward is when beeping slows
Time out is an example of what?
negative punishment
What is operant extinction?
withholding reinforcement following a previously reinforced behavior in order to eliminate that behavior
What are contingency contracts?
therapeutic understanding, usually involving a family or couple, and the behavioral therapist. Contingencies relating to certain desirable and undesirable behaviors are made explicit and agreed to by all parties
What are token economies?
operant-based management systems commonly employed in residential treatment facilities, prisons, etc. They involve the use of secondary, or conditioned, reinforcers to encourage desirable behaviors.
What is the purely cognitive approach? How do we refer to cognitive treatment approaches?
emphasizes the importance of cognitions in determining our behavior. Emphasizes that it is our interpretation of events that determines our behavior as opposed to the event itself.

Referred to as cognitive restructuring
What is Ellis' Rational-Emotive Therapy?
troublesome emotional states (e.g. anxiety and depression) stem primarily from our beliefs and interpretations of events, not the events themselves. The therapist can identify, challenge, and modify irrational, distorted ways of viewing the self and the world.

A: event
B: belief/interpretation
C: emotion
What is catastrophizing?
attributing dire and disastrous meaning to certain life outcomes
What is Beck's cognitive therapy?
Depression is the result of negative views of self, events, and the future. These negative views constitute a "self-schema," or basically, a template or filter through which all events are viewed.
What is Albert Bandura's Social Learning Theory?
Take home message: much human social behavior is learned through observing others - modeling or vicarious learning
What is Marsha Linehan's Dialectical Behavioral Therapy?
encourages acceptance and change simultaneously. Says for pt to accept themselves as they are, not a they want to be, and commit to taking responsibility to change.

Uses mindfulness to become aware of and tolerate destructive emotions w/o acting on them

Encourages a moment-by-moment examination of the sequence of emotions, thoughts, sensations, and interactions that typically precede destructive behavior
What is dialectical behavioral therapy primarily used for?
helpful for pts w/ borderline personality disorder. Also,
-suicidal pts
-severely depressed adolescents
-chronic eating disorders
-drug-dependent patients
-chronic px disorders
What is mindfulness-based stress reduction (MGSR)?
stress reduction/px management approach based primarily on the practice of mindfulness meditation (being fully attentive and aware withing the present moment), and yoga.
What are the multiple factors that cause illness in human beings?
biological, psychological, and social factors
What is the role of psychology in health and illness?
psychological factors are the consequences of illness, but also contribute to its etiology and course
What is the focus of behavioral medicine/health psychology?
modification of lifestyle behaviors involving designing interventions which take biopsychosocial determinants into account
What is the leading preventable cause of death in the U.S.?
tobacco use -- it's responsible for 1 in every 5 deaths
What is the prevalence of smoking? What percentage of smokers would like to quit?
23.5% of Americans smoke, ~70% would like to quit
What proportion of smokers regret starting by age 18?
2/3
What proportion of smokers try to stop smoking each year? How many are successful w/o outside help?
1/3, 10%
What percentage of smokers see a physician each year?
70%
How does a physician's advice influence smoking cessation rates?
A physician's advice to stop smoking increases cessation rates by 30%. Counseling doubles this.
Smoking is a learned behavior, but how should the physician view it?
As a chronic disease requiring a long-term treatment strategy
What two treatment approaches have strong evidence of efficacy for smoking cessation?
pharmacotherapy and counseling, primarily cognitive-behavioral approaches

a combination of both of these approaches results in the highest rates of smoking cessation
What are the five steps to the typical treatment approach to smoking?
1) Determining the patient's readiness to quit
2) Assessing the pt's level of physical dependence on nicotine
3) Addressing the psychological and social determinants of smoking in the patient's life
4) Designing a comprehensive intervention strategy
5) Preventing relapse
What are three models for conceptualizing the behavioral change process (step one: readiness to change, of smoking cessation steps)
1) The "stages of change model"
2) The "Health belief model"
3) The construct of "health locus of control"
Name the steps of the "stages of change" model of part 1 (Readiness to change) of smoking cessation
1) Precontemplation
2) Contemplation
3) Preparation
4) Action
5) Maintenance
What is the precontemplation stage (of the stages of change model of part one of the smoking cessation model)
the person is not yet considering the possibility of change.
What is the health care provider's task given a patient in the precontemplation stage?
to educate the patient and raise doubt, increasing the patient's awareness of the risks of the behavior and the advantages of change
What is the contemplation stage (of the stages of change model)?
the person is now considering taking action. Ambivalence has been introduced and reasons for and against changing are considered. There is awareness of pros and cons
What frequently pushes a person to go from the precontemplation to the contemplation stage? What doesn't?
Does: convincing, personal, and timely information
Doesn't: coercion or advice
What is the role of the health care provider with a patient in the contemplation stage (of the stages of change model)?
to tip the balance in favor of change by emphasizing benefits of quitting, risks of continuing to smoke.

Also, to strengthen the patient's sense of SELF-EFFICACY
Define "self-efficacy"
a person's confidence that s/he can successfully modify a behavior
What is the preparation stage (of the stages of change model?)
the person intends to take action in the near future. There is a window of opportunity and the pt has a plan of action.
What is the physician's role for a patient in the preparation stage?
to explore realistic treatment options, encourage realistic goals, help the pt set a quit date, support and encourage (especially small initial steps), and refer pt to action-oriented programs
What is the action stage of the stages of change model?
the person has made specific overt modifications in lifestyle (e.g. they quit smoking)
What is the physician's role for a patient in the preparation stage?
to help the patient identify those situations in which there is increased risk of returning to smoking, to provide reinforcement for having begun, and to continue to promote confidence and self-efficacy
Define action in the context of smoking cessation
total abstinence, not reduction of the number of cigarettes smoked or switching to lower tar cigarettes
What is the maintenance stage in the stages of change model?
it involves being able to successfully avoid any temptations to return to the behavior in question. Pt anticipates situations in which a relapse could occur and prepares coping strategies in advance
What is the physician/therapist's role for a pt in the maintenance stage?
help the pt develop effective coping strategies designed to prevent relapse
What is regression? What is relapse?
Regression occurs when individuals revert to an earlier stage of change.

Relapse is one form of regression involving moving from action or maintenance to an earlier stage. Most ppl who relapse regress to contemplation or preparation, rarely precontemplation.
What is the health belief model?
Another model to predict the likelihood of health-related behavior change

Hierarchy:
Susceptibility to illness
Severity
Costs
Benefits
Cues to action
Health motivation
Perceived Control
What is the health locus of control?
another model used to predict health behaviors. Centers on whether an individual has an internal or external locus of control. Measures evaluate whether an individual regards their health as:

-Controlled by them
-Not controllable by them
-under the control of powerful others

Individuals with an internal locus of control are more likely to change their behavior
What are the withdrawal sx characterized by discontinuation of tobacco use?
Irritability
Anger
Impatience
Restlessness
Difficulty concentrating
Insomnia
Increased appetite
Anxiety
Depression
When are sx of nicotine withdrawal first experienced?

When are sx most pronounced?
a few hours after the last cigarette.

sx are most pronounced 2-3 days later
What is bupropion (zyban)?
a sustained release antidepressant w/ dopaminergic and noradrenergic activity. Used to help w/ smoking cessation
What is varenicline (Chantix)?
a partial agonist that eases smoking withdrawal by stimulating nicotine receptors and blocking them if the subject takes up smoking again. Has recently been associated w/ serious psychological side effects (suicidal behavior) so it was banned among pilots and air traffic controllers in May '08
How does NRT effect rates of smoking cessation?
Nicotine replacement therapy doubles long-term rates of smoking cessation and relieves withdrawal sx and craving. Bupropion has similar effects.
What is nicotine fading?
Having the patient gradually reduce the # of cigarettes smoked per day and/o switching to a lower nicotine cigarette
What diagnostic tool is used to assess the patient's level of physical dependence on nicotine and determine the appropriateness of NRT intervention?
the Fagerstrom Questionnaire of Nicotine Dependence (FTQ), a 6-item questionnaire the smoker should complete
On the FQT questionnarie, what are some indicators of physical dependence on smoking?
smoking first thing in the morning and enjoying that cigarette more than any of the others, and smoking more in the mornings than later in the day. This is b/c physical dependence on nicotine leads to withdrawal sx during sleeping hours
When are NRTs NOT recommended?
-few withdrawal sx
-relapse >2 weeks
-low FQT score
How is smoking negatively reinforced?
since cigarettes are often used to help handle stress and negative emotions, such as anxiety, anger, and depression, smoking behavior is negatively reinforced since it alleviates these states
What are some cognitive behavioral treatment approaches used in the development of coping skills when quitting smoking?
-stress management training
-assertiveness training
-relaxation training
-aversion therapy
-relapse prevention
What is relapse prevention?
refers to the general treatment approach aimed at helping the patient identify situations in which return to use of the substance is probable. Patient is then assisted in developing adequate coping skills for these situations
What is the abstinence violation effect? (AVE). In light of this, what should the therapist do?
refers to the feelings of guilt, self-blame, and loss of confidence that often occur when the abstinent patient slips

the therapist works to avoid full-blown relapse
What is psychodynamic theory?
literally, "forces within the mind." Posits that psychopathology results from unconscious conflict within the mind. Paradigm comes from Freud
When is intrapsychic conflict first experienced? What does it represent? How does it factor into personality development?
Intrapsychic conflict is initially experienced in early childhood. It represent the clash b/w biological drives of individuals and the limitations society poses on the satisfaction of such drives. How this conflict is resolved determines later personality development and whether or not psychopathology develops
What did Freud consider to be the most important determinants of our behavior?
Unconscious motivation - true motivations are biologically based drives that generally are socially unacceptable, so they are excluded from conscious awareness by active repressive forces
What is psychopathology?
occurs when hidden drives intrude into voluntary behavior in the form of sx.

examples: phobias, panic attacks, somatic sx
What are Freud's three principle parts of the mind?
The Id: source of all the energy needed to run the psyche, comprised of biological urges. Collective life energy is referred to as the libido

The Ego: the part of the psyche tasked w/ satisfying the id in a realistic manner, but in accordance w/ the dictates of the superego.

The Superego: the conscience, representing the internalized beliefs, values, and roles of one's culture, family, and religion.
What are the somatoform disorders?
Pain disorder, body dysmorphic disorder, hypochondriasis, conversion disorder, and somatization disorder
What are the criteria for conversion disorder? When do conversion sx tend to occur?
-One or more sx affecting voluntary motor or sensory functioning that suggest a neurological or medical condition
-sx appear in the context of conflict or stress
-sx are not intentionally produced or feigned, and are not the result of a medical condition or substance

sx tend to come out in stressful situations with abrupt onset to excuse the individual from some unpleasant activity or to gain attention
What is "la belle indifference?"
literally, the beautiful indifference. When patients w/ conversion disorder sometimes demonstrate a lack of concern regarding their sx (e.g. not really being so upset that they suddenly went blind).
A patient comes in to your office complaining of loss of sensitivity in the hand and wrist. Your colleague, a third year from Harvard SOM, diagnoses the patient with carpal tunnel syndrome, but you know better. What does this patient really have and why?
The anesthesia is clearly psychogenic in origin, since no combination of nerves serve the area in question. The patient has glove anesthesia indicative of conversion disorder.
patients suffering from conversion disorder often also suffer from what other comorbid syndromes?
anxiety and depression
What are personality disorders? When do they appear? What axis are they?
personality disorders involve chronic, excessively rigid and entrenched patterns of behavior which are highly resistant to change. They are first observed in early childhood and adolescence. They are Axis II of DSM-IV
What characterizes the cluster A personality disorders? What are the cluster A personality disorders?
Odd or eccentric behavior. Paranoid, schizoid, and schizotypal
What characterizes the cluster B personality disorders? What are the cluster B personality disorders?
Dramatic, emotional, or erratic behavior

Antisocial, Borderline, Histrionic, and Narcissistic
What characterizes the cluster C personality disorders? What are they?
Avoidant, dependent, and obsessive-compulsive
What is paranoid personality disorder?
tense, guarded, suspicious, holds grudges
What is schizoid personality disorder?
socially isolated, with restricted emotional expression, does not desire close interpersonal relationships
What is schizotypal personality disorder?
peculiarities of thought, appearance, and behavior that are disconcerting to others; emotionally detached and isolated
What is histrionic personality disorder?
seductive behavior, needs immediate gratification and constant reassurance, rapidly changing moods, shallow emotions
What is narcissistic personality disorder?
Self-absorbed, expects special treatment and adulation, envious of attention to others
What is borderline personality disorder?
cannot stand to be alone, intense, unstable moods, and personal relationships, chronic anger, drug and alcohol abuse, sexual promiscuity, self-harm gestures
what is antisocial personality disorder?
manipulative, exploitive, dishonest, disloyal, lacking in guilt, habitually breaks social rules, childhood history of such behavior, often in trouble w/ the law.

NOT a person who avoids social situations

psychopathology: no conscience, no anxiety when committing a bad act
What is the major difference between avoidant personality disorder and schizoid personality disorder?
Schizoid is happy, avoidant is afraid and upset
What is avoidant personality disorder?
easily hurt and embarrassed, few close friends, sticks to routines to avoid new and possibly stressful situations
What is dependent personality disorder?
wants others to make decisions, needs constant advice and reassurance, fears being abandoned
What is obsessive compulsive personality disorder?
perfectionistic, overconscientious, and orderly. indecisive, preoccupied with details, stiff, unable to express affection.
What are the criteria for obsessive-compulsive personality disorder?
-preoccupation w/ rules and details to the extent that the major point of an activity is lost
-extreme perfectionism to the degree that projects are seldom completed
-excessive devotion to work to the exclusion of leisure and friendships
-inflexibility about morals
-** Difficulty discarding worthless items
-reluctance to delegate unless others conform to one's standards
-**miserliness
-** rigidity and stubbornness
What is meant by ego-syntonic symptoms?
Pt. thinks there way is the only way, and they're not wrong. Prognosis for treatment is poor for these types of pts
What is an anal-retentive personality? Explain
obsessive-compulsive personality type. Such individuals became fixated in the anal stage of development (1.5 to 4 y/o) when issues of control and autonomy are particularly important in the child's development

this personality type is typically referred to as "control freak"
What is the psychodynamic explanation for obsessive compulsive personality disorder?
a fear of loss of control, which is handled by overcompensation.
What is the goal of psychoanalysis? What were Freud's two main methods?
to gain insight into how intrapsychic conflicts adversely influence the patient's life in the present. Freud used free association and dream analysis, though others used hypnosis"
What happens to the patient in free association?
the therapy makes the ego relax enough that the patient "slips," though their resistance immediately goes back up.

Hence the term, Freudian slip
What is dream analysis?
The material in dreams is extremely threatening and it usually cannot be allowed into consciousness in its original form, so it is repressed, altered, and disguised in symbols.

Dream analysis holds that in sleep, ego defenses are relaxed, allowing normally repressed material to enter the sleeper's consciousness, satisfying the repressed urge or conflict
What is the deterministic view of human nature? What is the pessimistic view of human nature?
Deterministic: tension reduction is the highest goal

Pessimistic: even religion and humor have unflattering bases
What is the definition of psychological testing?
a sample of an individual's behavior obtained under standardized conditions
What is the definition of reliability? What are some measures of reliability?
addresses the issue of how consistent a test is.

measures include the test-retest method, the alternate forms method, measures of internal consistency (e.g. split half method correlates b/w the two halves of a test), and interscorer reliability
What is validity? What are two types?
Validity addresses the extent to which a test measures what it was designed to measure and well it does so.

Content validity: are items representative of a certain domain (common teacher-written tests)

Criterion-related validity: do test results correlate significantly with a direct and independent measure of what the test is designed to assess? Two types:
-Predictive validity: how well test results correlate w/ what the test is designed to predict (e.g. MCAT and med school GPA)
-Concurrent validity: same as predictive except criterion is measured concurrently. Used in diagnostic tests (e.g. HAM-D)
What do IQ tests measure?
general abilities such as abstract thinking, problem solving, attention, memory, perceptual-motor skills, handling new situations, learning from the environment, and insight
What do aptitude tests measure?
assess specific abilities which might be relevant to certain vocational and academic pursuits
What do personality tests measure?
assess relatively enduring behavioral traits, beliefs, attitudes, and values that characterize an individual's behavior across situations and over time
When would you administer a neuropsychological battery test and why?
after head trauma or neurological damage. It tells what behavioral/personality deficits are apparent and helps clinician to infer where the brain damage is.
What is a vocational/interest inventory?
examines to what extent the test-taker's interests match those of individuals in selected vocational fields.
What is the MMPI-2 test for? Is it objective or subjective?
Assessmen of global functioning. Often seen in hospital settings where it is helpful in identifying individuals who are prone to develop physical sx in response to stress and conflict

objective
What test is used to provide a measure of the Type A pattern of behavior? What characterizes a Type A personality?
The Jenkins Activity Survey.

Competitiveness, Sense of time urgency, and hostility/cynicism.
What do the L, F, and K validity scales on the MMPI-2 mean?
L = faking good
F = faking bad
K = defensiveness, avoiding their problems
What are the criteria for hypochondriasis? When does it typically begin?
-preoccupation with fears of having, or the idea that one has, a serious disease based on the person's misinterpretation of bodily sx
-the preoccupation persists despite apropriate medical evaluation and reassurance
-the belief is not delusional, or only related to appearance
-the duration of the disturbance is at least 6 months

begins in early adulthood and runs a chronic course
What is the gold standard of depression rating scales?
the Hamilton Psychiatric Rating Scale for Depression (HAM-D). Good reliability and validity in measuring response to treatment
What is the Beck Depression inventory?
A self-report inventory based on Beck's theory of depression (i.e. depression results from distorted beliefs involving negative views self, world, and future.
What are projective personality tests? What are they designed to assess?
they involve ambiguous test stimuli and primarily subjective scoring. Reliability tends to be lower and it is more difficult to demonstrate validity

designed to assess unocnscious motivation and areas of intrapsychic conflict

bypass conscious resistance using symbolic representation
Give two examples of Projective Personality tests
1) The Rorschach test

2) The thematic apperception test (TAT)