Eppp Abnormal Psychology

Front 1

Axis I - V

Back 1

I Clinical
II Personality/MR
III Medical
IV Psychosocial/Environmental
V GAF

Front 2

MR Criteria

Back 2

IQ less than or equal to 70
Impaired adaptive functioning
Onset before 18

Front 3

Degrees of MR

Back 3

Mild: 50-55 to 70
Moderate: 34-40 to 50-55
Severe: 20-25 to 35-40
Profound: < 20-25

As adults, individuals with Moderate MR can contribute to their own support by performing unskilled or semi-skilled tasks under supervision -- in sheltered workshops or in the competitive job market. They constitute 10% of the mentally retarded population, they are unlikely to progress beyond the second grade level in academic skills, and they can talk or learn to communicate during the preschool years.

Front 4

Etiology

Back 4

5% - Heredity
30% - Early alt in embroyonic dev
10% - Pregancy and perinatal problems
5% - General med problems
15-20% - Environmental factors
30-40% Unknown

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PKU

Back 5

Inability to metabolize PKU, which causes MR if untreated/improper diet.

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DS/Trisomy 21

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5th finger
Large protruding tongue
Heart lesions
Respirator and intestinal defects
Risk for AD

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Borderline IQ

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IQ of 71-84
MR; 71-75 with poor adaptive functioning

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LD

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20-30% of children w/ LD have ADHD
Greater risk of antisocial beh
More males

Front 9

Comm DIs

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Exp, Exp-Rec, Phono, Stuttering (stress reduction)

Front 10

PDD

Back 10

Impairments in:
1. Comm
2. Social Int
3. Stereotyped Beh

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Autism

Back 11

Prior to 3
1. Comm
2. Social Int
3. Stereotyped Beh
70% have MR
Atrophic cerebellum and enlarged ventricles

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Rett's

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Normal until 5+ months
Deceleration of head growth
Loss of motor
Language impairment
Less social interest
ONLY IN FEMALES

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Childhood Disintegrative Disorder

Back 13

After 2 normal years, regression in 2 areas.

Front 14

Asperger's

Back 14

Social imp & restriced interests w/o comm diff

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ADHD

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Onset before 7
Duration of 6 months
Lower IQ, yet ave/high ave
25-30; 50% have LD
30-90% have Conduct Dis
Inattentive = equal gender
Hyper = more males
60% of children cont as adults w/ CONDUCT PROBLEMS being a good predictor of issues.

Front 16

ADHD and Beh Disinhibition Hypothesis

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Core ADHD feature is the inability to regulate behavior to fit situational demands.

Front 17

ADHD Treatment

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Methylphenidate (Ritalin)
Atomoxetine (Strattera; non stimulant)
Classroom management
Parental involvement

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Conduct Disorder

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W/in the past 12 months:
1. Agg to people or animals
2. Destruction of property
3. Deceitfulness or theft
4. Violation of rules

Front 19

CD

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Childhood onset = prior to 10
Adolescent onset = after 10

Front 20

Moffitt's CD Types

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Life-course-persistent
Adolescence-limited

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CD Treatment

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Target preadolescents + family intervention

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Pica

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12-24 months

Front 23

Tourette's Disorder Treatment

Back 23

Antipsychotics = Haloperidol and pimozide (80% effective)

Front 24

Enuresis

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Clinical after 5 years of age
Night alarm

Front 25

Separation Anxiety

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Lasts 4 weeks
Onset before 18

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RAD

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Inappropriate social relatedness before 5.
Parental neglect or family chaos
Inhibited and Disinhibited

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Behavioral Pediatrics (Pediatric Psy)

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In response to increased mental disorders in children w/ medical conditions.

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Behavioral Ped Recommendations

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Disclose asap
Cog-Beh anxiety reduction for med procedures
Allow family to visit often
Reduced compliance
School adjustment

Front 29

Delirium

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Disturbance in consciousness
Change in cog and/or perceptual abnormalities

Front 30

Dementia

Back 30

Memory + 1
Pseudodementia = intact rec w/ poor procedual memory.

Front 31

AD

Back 31

Course until death = 8-10 years
> Females

Front 32

HIV Dementia

Back 32

Motor slowness, absence of aphasia, severe dep/anx.

Front 33

Substance Dependence

Back 33

12 months of 3 criteria:
Tolerance
Withdrawal
Larger amounts
Can't stop
Time spent
Impacts activities
Continued use despite issues

Front 34

Substance Dependence Treatment

Back 34

Covert sensitization
Aversion therapy
Social skills training
Stress management
AA

Front 35

Most common precipitant of relapse...

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...anxiety, frustration, and depression.

Front 36

Marlatt & Gordon (1985)

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Dep is an "overlearned habit pattern" w/ a "abstinence violation effect" that invokes anxiety and self-blame.

Decrease relapse when relapse is blamed on external factors.

Marlatt's model of substance dependence holds that addicts learn to associate substance use with relief of self-criticism and guilt through a variety of cues and reinforcers, such as advertisements depicting people feeling cheerful when drinking and social occasions in which a carefree attitude is reinforced. In other words, there are a variety of cues and mediators that serve to encourage and reinforce use. Contrary to the person's expectations, however, excessive substance use only exacerbates problems, such as interpersonal or work-related problems. This leads to more self-criticism and guilt, which the person again attempts to relieve by using. In other words, substance use is self-reinforcing -- it is the cause of and the expected solution to the same problems. And it is "over-learned" in that, due to the multiplicity of its antecedents, it becomes a strongly ingrained behavior.

According to Marlatt, a slip is likely to lead to a full-blown relapse when the person makes dispositional attributions for it, such as when the person blames him or herself. Relapse prevention involves teaching the person to make non-dispositional attributions, such as blaming the situation or the nature of the disease.

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Relapse Prevention Program

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Id environmental cues and coping with them.

Front 38

Nicotine Dependence

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Only 7.5% quit long term
91% of them do it alone
Treatment:
Nicotine replacement
Beh therapy
Clinical support

Front 39

Substance Abuse

Back 39

1 criteria in the last 12 months:
Impacts life
Use of sub
Recurrent legal issues
Continued use despite issues

Front 40

ETOH withdrawal

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Autonomic hyperactivity (e.g., sweating tachycardia), tremor, insomnia, nausea, hall, anxiety, seizures.

Front 41

Schizophrenia

Back 41

6 months or more w/ 2 or more:
Delusions
Hall
Dis Speech
Disorganized or catatonic beh
Neg symptoms

Front 42

Schizophrenia Subtypes

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Paranoid - most fav prognosis
Catatoic
Disorganized
Undifferentiated
Residual

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Type I & II Schizophrenia (Crow; 1985)

Back 43

Type I = Positive symptoms; responds well to antipsychotics; neurotransmitter based
Type II = Negative symptoms; poor premorbid functioning; brain structure based

Front 44

Schizophrenia Prevalence

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Males>Females
Male onset (18-25)
Female onset (25-35)
A-A>Majority
Patients from developing countries more often exhibit an acute onset of symptoms, a shorter clinical course, and a complete remission of symptoms.

Front 45

Etiology

Back 45

Gen pop = .5%-1.5%
Concordance rate
Bio sib = 10%
Fraternal twin = 17%
Identical twin = 48%
Child (both parents schiz) = 46%

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Dopamine Hypothesis

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Schizo is the result of elevated dopamine.

Front 47

Antipsychotics

Back 47

Reduce positive symptoms
Tardive dyskenesia

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Atypical Antipsychotic

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Clozapine = less likely to cause TD and help neg symptoms

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Expressive Emotion

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High EE is associated with relapse

Front 50

Schizophreniform Disorder

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1 month, but less than 6 for impairment
2/3 convert to Schizo

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Delusional Disorder

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"Nonbizarre"
Poisioned
Betrayed
Followed

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Delusional Subtypes

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Erotomanic
Grandiose
Jealous
Persecutory
Somatic

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Brief Psychotic Disorder

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1 day, but less than 1 month

Front 54

MDE

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2 weeks
5 criteria

Front 55

Manic Episode

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1 week or longer
3 criteria
Hosp, impairment, psychotic

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Hypomanic

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4 days
3 symptoms of manic
increased productivity, increased efficiency, and increased creativity

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Mixed Episode

Back 57

1 week

Front 58

MDD

Back 58

10-20% after childbirth
2x more likely for females than males beginning in adolescence
Onset = mid 20's
W/ psychotic features (higest suicide rate)

A rapid onset of REM sleep
Decreased percentage of slow wave sleep
Increased REM sleep

No prior history of depression but rapid REM onset have an increased risk of developing depression

Front 59

MDD Course

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May last 6 months or longer, but usually w/ remission
20-30% w/ residual
50% remission rate

Front 60

Catecholamind Hypothesis

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Depression = low norepinephirne levels

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Indolamine Hypothesis

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Depression = low dopamine levels

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Antidepressants

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1. Tricyclics (TCA's) - "classic" depression w/ vegative symptoms
2. SSRI - fewer SE/melancholic dep
3. Monoamine oxidase inhibitors (MAOI's) - phobia

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Dysthymic Disorder

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Chronic low grade depression over 2 years for adults and 1 year for children.
No symptom free periods

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Bipolar I

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Manic is focus

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Bipolar II

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Depression w/ Hypomania (no mania)

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Bipolar Demographics

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BP I = M/F
BP II F>M
Onset in early 20's

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BP Genitic Links

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65% Mono twins
14% Di twins

Front 68

Cyclothymic Disorder

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Hypomania and depressive symptoms
Dep must be at least 2 years in adults and 1 year in children

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Suicide

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60-80% who complete have made previous attempts
80% warning signs
Attempts 24-44
Complete 65+
Highest for Whites
Divorce, separation, widowed
Hopelessness
Socially-prescribed perfectionism
Life stress
3 months after MDD improves
Low serotonin

Front 70

Panic Disorder

Back 70

2+ PA's w/in 1 month

Front 71

Panic Disorder Demographics

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Females > Males
Onset adolescence - mid 30's

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Treatment for PA

Back 72

Flooding (60-70% effective)
Drugs alone have a high relapse rate (30-70%)

Front 73

Types of Specific Phobia

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Animal
Natural Environment
Situational - flying, elevators, bridges; most common
Blood-Injection-Injury
Other

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Social Phobia

Back 74

Fear of social performance or sit that may cause embarrassment or humiliation as the result of scrutiny or evaluation by others.

Front 75

OCD

Back 75

Males=Females
Ave onset is earlier in males (@ 6 more males)
Low serotonin
Due to hyperactive right caudate
Treated with tricyclic/SSRI and exposure/prevention

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PTSD

Back 76

Experience and react to stress
Symptoms last > 1 month
Treatment = Cog-Beh, exposure, anx man w/ SSRI

Front 77

Acute Stress Disorder

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Onset w/in 4 weeks and last for 2-3 weeks
Emotional detachment
Derealization
Diss amnesia

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GAD

Back 78

6 months
3 criteria:
Keyed up
Easily fatigued
Diff concentrating
Irritability
Muscle tension
Sleep distrubance

Treated with Cog-Beh SSRI or anxiolytic

Front 79

Somatization Disorder

Back 79

Prior to age 30 and persist for several years
4 pain
2 gastrointestinal
1 sexual
1 pseudoneurological

Research indicates that 61% of Somatization Disorder patients have one or more co-occurring personality disorders. The next most frequent co-diagnoses are Major Depression (55%), Generalized Anxiety Disorder (34%), and panic disorder (26%).

Front 80

Conversion Disorder

Back 80

Voluntary motor or sensory functioning that suggests a serious condition. Symptoms reduce under hypnosis or amytal interview.
Primary gain = psychological conflict remains intact
Secondary gain = avoid activity or gain support

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Fictitious Disorder

Back 81

Intentional feigning to be in a "sick role"

Internal reward (Malngering is external reward)

Front 82

Dissociative Amnesia Subtypes

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1. Localized - all events; specific time
2. Selective - some events; specific time
3. Generalized - entire life
4. Continuous
5. Systematized - category specific

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Dissociative Fugue

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Travel

Front 84

Depersonalization Disorder

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"Out of body"

Front 85

Dyspareunia

Back 85

Genital pain w/ intercourse

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Vaginismus

Back 86

Involuntary spasms that interferes w/ intercourse

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Paraphilias

Back 87

Intense sexual urge or fantasy involving obj, suffering/humiliation, or children

Front 88

Gender Id Dis

Back 88

Discomfort w/ sex and desire to be the opp.

Front 89

Dyssomnia

Back 89

Disturbance in amount, quality, and timing of sleep

Front 90

Parasomnias

Back 90

Beh or psychiological abn during sleep

Front 91

Bulimia

Back 91

Binging and compensation 2x/week for 3 months
Genetic
Low levels of opioid beta-endorphins, serotonin, and norepinephrine

Front 92

Paranoid Personality Disorder

Back 92

Distrust
4 criteria

Front 93

Schizoid PD

Back 93

Lack of interpersonal relationships
4 criteria

Front 94

Schizotypal PD

Back 94

Low social and odd behaviors
5+ criteria

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Antisocial PD

Back 95

Must be 18
Conduct disorder by 15
3 criteria

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Borderline PD

Back 96

5 characteristics
Treated w/ Dialectical Behavior Therapy

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Histrionic PD

Back 97

Attention-seeking
5 criteria

Front 98

Narcissistic PD

Back 98

Grandiosity
Lack of empathy
Need for admiration
5 criteria

Front 99

Avoidant PD

Back 99

Social ingibition
Feelings of inadequacy
Hypersensitivity to neg eval
4 criteria

Front 100

Dependent PD

Back 100

Excessive need to be taken care of which leads to submissive, clinging beh, and fear of separation.
5 Criteria

Front 101

OC PD

Back 101

Order!
4 criteria