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88 Cards in this Set

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Criteria for autism
6 symptoms: 2+ in Category 1 = soc interaction,
1+ in Category 2 = communication,
1+ in Category 3 = stereotyped behavior,
PRIOR to 3 yrs = abnormal soc interaction, soc language or imaginative play
Phenlketonuria (PKU)
Rare recessive gene syndrome, unable to metabolize amino acid phenylalanine in high-protein foods.
Produces mental retardation, impaired motor & language dev & erratic behaviors.
Down Syndrome
"trisomy 21" due to extra chromosome.
Cause of 10-30% of all cases of mod to severe retardation.
Differential for mental retardation
borderline intellectual functioning IQ = 71-84.

BUT could be retardation if IQ < 75 PLUS deficits in adaptive functioning.
Types of learning disorders (3)
Reading, Mathematics Disorder, Written Expression.
Types of communication disorders (4)
Expressive Language Disorder, Mixed Receptive-Expressive Language Disorder, Phonological Disorder, and Stuttering
Types of pervasive developmental disorders (4)
Autistic Disorder,
Rett's Disorder,
Childhood Disintegrative Disorder, and
Asperger's Disorder.
Gender differences in rates of autism
4 - 5 times more common in males
treatment for autism
shaping & discrimination training (Lovaas, 1960s)
Rett's Disorder
Characteristic pattern of symptoms FOLLOWING 5+ MONTHS OF NORMAL DEVELOPMENT lasting for 5 months +
head growth deceleration, loss of purposeful hand skills, stereotypical hand movements, impairments in gait, loss of interest in social environment, impaired language development, psychomotor retardation.
Childhood Disintegrative Disorder
developmental regression in 2 areas of development, FOLLOWING 2+ YEARS OF NORMAL DEVELOPMENT
Asperger's Disorder
Severe impairment in social interactions, restricted behaviors / interests, normal intelligence, good verbal skills with NO DELAYS IN LANGUAGE, COGNITIVE SKILLS etc.
Indicator for favorable prognosis in Autism
verbal communication by age 5 or 6, Qu = 70+, later onset symptoms.
ADHD very common with comorbid ___________
conduct disorder
ADHD: Gender ratio
2 - 9 times more common in boys.

More equal gender ratio with Inattentive Type.

More equal gender ratio in adults.
ADHD: distinguishing characteristic
Fluctuation of symptoms in different settings.

Sx more likely in situations that are: familiar, highly repetitive, highly structured with no regular feedback.
ADHD: behavioral disinhibition hypothesis
Inability to regulate behavior to fit situational demands.

Hypothesis supported by fluctuation of sx in diff settings.
Ritalin
CNS stimulant methylphenidate
Attention-Deficit and Disruptive Behavior Disorders (3)
ADHD, Conduct Disorder, and Oppositional Defiant Disorder
Conduct Disorder
Pattern of behaviors that violate rights of others and/or age-appropriate social rules.

Childhood-onset type (<10 yrs) Adolescent-onset type (>10 yrs) life-course persistent type
Adolescence-limited type
Oppositional Defiant Disorder
pattern of negativistic, defiant, and hostile behaviors toward authority figures
Other Disorders of Infancy, Childhood, or Adolescence
Separation Anxiety Disorder, Selective Mutism,
Reactive Attachment Disorder,and Stereotypic Movement Disorder.
Separation Anxiety Disorder
< 18 yrs, 4+ weeks 3 characteristic behaviors.

DIFF DIAG - school refusal (can be a sign of depression during adolescence)
Reactive Attachment Disorder
Developmentally inappropriate social relatedness, onset <5 yrs , there must be evidence of pathogenic care.
Delirium: diagnosis
1. disturbance in consciousness 2. change in cognition and/or perceptual abnormalities.
Delirium: high risk groups (5)
1. Elderly people with decreased cerebral reserve due to dementia.
2. stroke
3. HIV
4. postcardiotomy patients
5. burn patients
6. people with drug dependence experiencing withdrawal
Dementia: diagnosis
multiple cognitive deficits that include:
1. some memory impairment
2. aphasia, apreaxia, agnosis, and/or impaired executive functioning
aphasia
Deterioration in language functioning:
difficulty naming people and objects, and
difficulty understanding written and spoken language.
apraxia
difficulty executing motor actions e.g. unable to dress
agnosia
Inability to recognize and identify familiar objects and people.
executive functioning
Abstract thinking,
trouble shooting,
initiating behaviors,
monitoring behavior, and stopping complex behaviors.
Dementia: differentials
1. age-related cognitive declines
2. mental retardation (< 18 yrs) 3. major depressive disorder
Alzheimer's: stages
Stage 1 (1-3 yrs) anterograde amnesia, wandering, irritability, sadness.

Stage 2 (2-10 yrs) retrograde amnesia, flat mood, agitation, delusions.

Stage 3 (8-12 yrs) severely deteriorated intellectual functioning, limb rigidity, incontinence.
Dementia: Types (e.g. Dementia Due to…)
1. Dementia of the Alzheimer's Type
2. Vascular Dementia
3. Dementia Due to HIV Disease
4. Dementia Due to Parkinson's Disease
5. Dementia Due to Huntington's Disease
Dementia: % caused by Alzheimer's Type
65%
Dementia Alzheimer's Type: possible causes
1. genetics (chromosome 21)
2. aluminum deposits in brain tissues
3. malfunctioning immune system
4. low level ACh
Vascular Dementia: risk factors
1. hypertension
2. diabetes
3. cigarette smoking
4. atrial fibrillation
Vascular Dementia
caused by arteriosclerosis or other cerebrovascular disease

course is stepwise & fluctuating
Dementia Due to Parkinson's Disease
1. Bradykinesia
2. rigidity resting tremor
3. mask like expression
4. loss of coordination
bradykinesia
Extreme slowness of movement
akathesis
Inability to sit still
Dementia Due to Huntington's Disease
30 - 40 yrs sx fall into 3 categories: affective, cognitive , and motor.

Often starts with depression, irritability, apathy.
apathy
absence of feeling or enthusiasm
Marlatt & Gordon re: Substance Dependence
relapse prevention program dealing with high risk situations
Substance Dependence
3 symptoms in 12 months
Substance Abuse
1 symptom in 12 months
Substance-Induced Disorders (5)
1. Alcohol Intoxication
2. Alcohol Withdrawal
3. Alcohol Withdrawal Delirium
4. Alcohol-Induced Dementia
5. Alcohol-Induced Persistic Amnestic Disorder (Wernicke-Korsakoff Syndrome
Wernicke-Korsakoff Syndrome
Alcohol-Induced Persisting Amnestic Disorder

retrograde & anterograde amnesia, confabulation, abnormal eye movements.

Due to thiamine deficiency.
Schizophrenia
disturbance for 6+ months

1+ month of >2 active-phase symptoms
Schizophrenia: Active phase symptoms
a. delusions
b. hallucinations
c. disorganized speech
d. grossly disorganized behavior
e. negative symptoms
Schizophrenia: age of onset
Men: 18 - 25 yrs

Women: 25 - 35 yrs
Schizophrenia: Concordance rate of biological sibling
10%
Schizophrenia: Biological theories
a. enlarged ventricles
b. dopamine hypothesis (elevated)
c. elevated norepinephrine & serotonin
Schizophrenia: Treatment
Antipsychotic medication

Side effect = tardive dyskinesia (TD)

Atypical antipsychotics (e.g. clozapine) dec chances of TD & reduces neg. symptoms
Delusional Disorder
1+ month of 1+ nonbizarre delusion

psychosocial functioning not markedly impaired
Delusional Disorder subtypes (7)
1. erotomanic
2. grandiose
3. jealous
4. persecutory
5. somatic
6. mixed
7. unspecified
Brief Psychotic Disorder
Same active symptoms of schizophrenia BUT for 1-30 days.

Often follows overwhelming stressor.
Manic Episode
1+ week elevated mood, plus
3 symptoms marked impairment and/or hospitalization.
Hypomanic Episode
4+ days elevated mood, plus
3 symptoms

NO marked impairment or hospitalization
Depression: Biological theories
1. Catecholamine hypothesis deficiency in norepinephrine
2. Indolamine hypothesis deficiency in serotonin
3. permissive theory serotonin interacts with other neurotransmitters to produce depression
4. elevated levels of cortisol (stress hormone)
Depression: Pharmacological tx
TCAs = classic depression with vegetative symptoms, acute onset & short duration of sx.

SSRIs = melancholic depression, fewer side effects than TCAs or MAOIs.

MAOIs = TCAs & SSRIs don't work, atypical depressions.
Dysthymic Disorder
A. 2+ yrs depressed mood (adults)
1+ yr depressed mood (children)
B. <2 months symptom-free
C. no depression episode in first 2 yrs of disturbance
Bipolar I Disorder
1+ manic or mixed episodes

without hx major dep episode
Bipolar II Disorder
1+ major dep episode
AND 1+ Hypomanic episode

NEVER had manic or mixed episode
Cyclothymic Disorder
2+ years fluctuating hypomanic sx and depressive sx

note: 1 yr for kids
Panic Disorder: Pharmacotherapy
imipramine (TCA)
SSRIs
PTSD: characteristic symptoms
A. reexperiencing of trauma
B. avoidance of stimuli associated with trauma
C. symptoms of increased arousal
delayed onset PTSD
Onset of sx occur after 3 months of event
Acute Stress Disorder
PTSD sx BUT duration is 2 days to 4 weeks
Somatoform Disorders: main characteristic
A. physical symptoms suggesting a medical disorder

B. NOT intentionally produced
Somatoform Disorder: Types (6)
a. somatization disorder
b. conversion disorder
c. pain disorder
d. hypochondriasis
e. BDD
f. undifferentiated somatoform disorder
Somatization Disorder
A. recurrent multiple somatic complaints for several yrs
B. 4 pain sx
C. 2 gastrointestinal sx
D. 1 sexual sx
E. 1 pseudoneurological sx

onset <30 yrs age
Conversion Disorder
Sx that suggest a serious neurological or medical condition
Conversion Disorder: Etiological mechanisms (2)
1. primary gain keeping inner conflict out of consciousness

2. secondary gain avoiding unpleasant activity or obtaining support
Conversion Disorder: differential diagnosis
1. Factitious Disorder
2. Malingering
Factitious Disorder
intentional sx to fulfill a need for a sick role
Malingering
intentional sx to obtain external reward
Munchausen's Syndrome by Proxy
A factitious disorder where sx in child intentionally caused by his parent(s)

sx absent in parent's absence
Dissociative Disorder: Types (4)
1. dissociative amnesia
2. dissociative fugue
3. dissociative identity disorder
4. depersonalization disorder
Dyspareunia
genital pain associated with sexual intercourse
Vaginismus
involuntary spasms of vaginal muscle, interfering with intercourse
Paraphilia
intense recurrent sexual urges, fantasies or behaviors involving nonhuman objects, suffering, children or other nonconsenting partners
Dyssomnias vs. Parasomnias
Dys - disturbances in sleep amount, quality or timing

Paras - behavioral or physiological abnormalities, where focus is event, not sleep quality
Anorexia Nervosa: subtypes (2)
1. restricting type
2. binge-eating/purging type
Bulimia Nervosa
a. compensatory behavior twice a week
b. for 3 months or longer

NORMAL weight range
Personality Disorders: Cluster A (3)
a. Paranoid
b. Schizoid
c. Schizotypal
Personality Disorders: Cluster B (4)
a. Antisocial
b. Borderline
c. Histrionic
d. Narcissistic
Personality Disorders: Cluster C (3)
a. Avoidant
b. Dependent
c. Obsessive-Compulsive