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90 Cards in this Set
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- Back
- 3rd side (hint)
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For antisocial personality disorder, how long does the person need to have been showing symptoms in order to be diagnosed?
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Since at least 15 years old.
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HOWEVER: Cannot be diagnosed until age 18.
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What are the <i>symptoms</i> for antisocial personality disorder (Criteria A)
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1) Not following laws (repeatedly performing acts that are grounds for arrest)
2) Deceitfulness (e.g. repeated lying or conning others) 3) Impulsivity or failure to plan ahead 4) Irritability and aggressiveness, shown by repeated fights or assaults 5) Reckless disregard for the safety of self or others 6) Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations 7) Lack of remorse, as indicated by being indifferent or rationalizing hurting others |
Generally speaking, disregarding rights of others. Dangerous, physically and psychologically.
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What are criteria B, C, D for antisocial personality disorder?
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B) Must be at least 18, C) have had indicators of conduct disorder before age 18, D) not show symptoms only during episodes of another disorder (Schizophrenia or Bipolar disorder in particular)
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What are the clinical characteristics of antisocial personality disorder?
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-Lack of empathy
-Inflated sense of self/arrogance -No remorse -Shallow, superficial relationships -can be somewhat grandiose -<b>Charming</b> -Want to connect to people <i>to exploit them</i> |
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Why do people with antisocial personality disorder want to make connections with people, vs borderline or other personality disorders?
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to EXPLOIT them. borderline is for attentions.
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What is the oldest and most researched personality disorder?
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Antisocial personality disorder
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started with phrenology
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True/False: It is easy to form a therapeutic relationship with individuals with antisocial personality disorder.
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FALSE: it is very difficult
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What percent of inmates meet criteria for antisocial personality disorder?
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47-50%
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What is the most commonly used assessment for antisocial personality behavior? What are the two factors measured in it?
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Hare psychopathy checklist (revised) [PCL-R]
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Factor 1: aggressive narcissism
Factor 2: socially deviant lifestyle |
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What are some questions/things to assess when a client might have antisocial personality disorder?
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Is there conning & manipulativeness? Pathological lying? Lack of concern for feelings and suffering of one's victims? Do they have a parasitic lifestyle (e.g. financially dependent on others)? Do they have a wide range of criminal behaviors?
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What is criteria A of Borderline Personality Disorder?
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A pervasive pattern of instability of interpersonal relationships, self, image, and affects and marked impulsivity beginning by early adulthood and present in a variety of contexts as indicated by <b>5 or more</b> symptoms.
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What are the symptoms of criteria A of Borderline Personality Disorder?
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1) Frantic efforts to avoid real or imagined abandonment.
2) A pattern of unstable & intense interpersonal relationships characterized by alternating between extremes of idealization & devaluation 3) Identity disturbance: markedly and persistently unstable self-image or sense of self 4) Impulsivity in at least two areas that are potentially self damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating) 5) Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior 6) Affective instability due to a marked reactivity of mood 7) Chronic feelings of emptiness 8) inappropriate, intense anger or difficulty controlling anger 9) Transient, stress related paranoid ideation or sever dissociative symptoms |
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What is the most common personality disorder seen in <i>clinical</i> settings?
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Borderline Personality Disorder
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What are frequent comorbid diagnoses with borderline personality disorder>
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Major depressive disorder, Bipolar disorder, substance use disorders, eating disorders, PTSD
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What % of people with childhood sexual abuse develop borderline personality disorder?
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Up to 75%
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What three things show instability in borderline personality disorder?
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Self-image (unstable sense of self, emptiness)
Affect (extreme reactions, emotional deregulation) Relationships (frantic efforts to avoid abandonment, idealization & devaluation) |
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What are the hallmarks of Borderline Personality Disorder?
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Instability, self-injurious behavior, Impulsivity, Dissociative states
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Treatment for Borderline Personality Disorder?
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Dialectical Behavioral Therapy (DBT)
(sort of like a cross between CBT & mindfulness) |
Theory: Those with Borderline Personality Disorder have high emotional sensitivity, but are raised in environments that are not validating of their emotional experience.
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DBT goals:
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-increase interpersonal effectiveness
-tolerate distress -decrease therapy disrupting behaviors such as suicidal behaviors accept where they are while also accepting the need for change |
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How is DBT best administered?
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Individually AND in groups
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What does "psychotic" mean?
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Defined as a loss or decrease in reality testing.
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What times can someone have psychotic symptoms?
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Medical conditions (delirium, substance induced)
Mood disorders (bipolar in mania, severe depression) Personality disorders (schizotypal, paranoid) Psychotic disorders |
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What are the two types of psychotic symptoms?
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Positive and Negativve psychotic symptoms
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What are positive psychotic symptoms? Give some examples.
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The ADDITION of something to normal perception.
"Excess or distortion of normal functions." |
examples: hallucinations, delusions, disorganized speech, bizarre or disorganized behavior.
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What are negative psychotic symptoms? Give some examples.
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The SUBTRACTION of something from normal functioning.
"Decrease or loss of normal functions." |
examples: flattened affect/restricted affect, alogia (reduction in speech), avolition (lack of goal-directed behavior)
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Define delusions:
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Erroneous beliefs that involve a misinterpretation of perceptions or experience.
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What are the subtypes of delusions?
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Persecution/Paranoia
Reference Control Grandiose Jealous Erotomanic Somatic |
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What are Persecution/Paranoia delusions?
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Person believes he/she is being threatened or mistreated by others. Often think they are being tricked, tormented, and believes that others are watching them, <b>intend to harm them</b>, or know private things about them.
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What are Reference delusions?
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Belief that certain (real) actions in the environment are directed at or meant for them-for example,
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What are Control delusions?
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Belief that one's thoughts or behaviors are being controlled by external forces (e.g. thought control or thought insertion)
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What are Grandiose delusions?
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Belief that the person is extraordinarily important or has extraordinary power, knowledge or ability. Often religious related.
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What are Jealous delusions?
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centers on the suspected unfaithfulness of a spouse or partner
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What are Erotomanic delusions?
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When a person believes that a movie star or someone famous (often whom they have never met but to whom they have written frequently) is in love with them.
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What are Somatic delusions?
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Belief focuses on a physical abnormality or disorder; believe they have some illness or physical condition.
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What are Bizarre and Non-bizarre delusions?
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Bizarre: clearly implausible, not understandable, and does not come from ordinary life experiences.
Non-bizarre: could possibly happen |
bizarre ex. someone removed all my internal organs but I have no scar.
non-bizarre ex. the police are watching me. |
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What are the subtypes of hallucinations?
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Auditory
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What are Auditory hallucinations?
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hearing things, usually voices. Voices are perceived as distinct from the person's own thoughts. Can involve 2 or more voices.
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Most common type of hallucination.
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What are Visual hallucinations?
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Seeing things that aren't there
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Need to occur while the person is FULLY AWAKE. 2nd most common type of hallucination.
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What are Olfactory hallucinations?
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Smelling things that aren't there.
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What are Tactile hallucinations?
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Feeling things that aren't there.
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What are characteristics of Disorganized Thinking/Speech?
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Person speaks with derailment/loose associations, it slips off track.
Tangentiality-answers to questions may be only slightly related, begin talking about one thing, end with another. Incoherence/Word salad-speech is so disorganized that it makes no sense. |
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What are characteristics of disorganized behavior?
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silly/inappropriate affect
unpredictable aggression or agitation disheveled or odd appearance poor hygiene clearly inappropriate behavior |
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What are characteristics of catatonic behavior?
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decrease in reactivity to the environment
could also be purposeless, unstimulated excessive motor activity. |
in DSM 5, catatonia is its own thing.
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What is affective flattening?
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Person's face appears immobile and unresponsive with poor eye contact and reduced body language.
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What is Alogia?
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No speech, or if they do speak, very little speech, or it takes a long time.
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What is Avolition?
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Inability to initiate and persist in goal directed activities. Person is like a "bump on a log" and is not bothered by it.
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Is it harder to treat positive or negative symptoms of psychotic disorders?
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Negative symptoms.
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What are the 3 phases of psychotic illness?
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Prodromal: mild or sub-threshold symptoms
Acute: Symptoms out of control, make it difficult to function Post-Acute/Residual/Recovery: after treatment or after stressful event goes away. commonly shows mood disturbance. May show some symptoms but not to same extent as before. |
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What is criteria A of schizophrenia?
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2 or more symptoms present for at least 1 month:
1) delusions 2) hallucinations 3) disorganized speech 4) grossly disorganized or catatonic behavior 5) negative symptoms |
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How long does a person need to show symptoms of schizophrenia to be diagnosed?
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6 months of <i>some</i> symptoms, at least 1 month with 2 or more symptoms from criteria A
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What are the specifiers of schizophrenia? When should they be used?
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First episode, currently in acute episode.
First episode, currently in partial remission First episode, currently in full remission Continuous: Symptoms fulfilling diagnostic criteria the majority of the time. With Catatonia Unspecified |
Should be used after a 1 year duration of the disorder.
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What makes Schizophreniform disorder different from Schizophrenia?
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Same symptoms, but lasts at least 1 month, but LESS THAN 6 MONTHS. Kinda like "pre-schizophrenia"
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What differentiates Brief Psychotic Disorder from Schizophrenia?
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Person only needs ONE symptom for AT LEAST ONE DAY but LESS THAN ONE MONTH. They also have a full return to "normal" functioning.
Kinda like an "adjustment disorder version" of schizophrenia because it can involve a stressor (specifier) |
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What differentiates Delusional Disorder from Schizophrenia and Schizoaffective Disorder?
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Person has one or more DELUSIONS for >= 1 month. Do not meet full criteria for Schizophrenia.
<b>Functioning not markedly impaired.</b> <i>If</i> hallucinations are present, they are only present as related to the delusion. |
If there are manic or depressive periods, they are brief.
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What is criteria A of Schizoaffective Disorder?
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An uninterrupted period of illness during which there is a major mood episode CONCURRENT with symptoms that meet criterion A of schizophrenia.
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What is criteria B of Schizoaffective Disorder?
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Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode at some time during the course of the illness
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What is criteria C of Schizoaffective Disorder?
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Symptoms that meet criteria for a mood episode are present for the majority of the total duration of the active and residual periods of the illness. (most of the time)
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Difference between Schizoaffective Disorder and Mood Disorders?
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In Schizoaffective disorder, psychotic symptoms are present ALL the time. People with mood disorders only exhibit psychotic symptoms during a mood episode.
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What are the specifiers for Schizoaffective Disorder?
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Bipolar type: if person displays manic episodes
Depressive type: if person only has major depressive episodes |
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When is "Other Specified Schizophrenia Spectrum and Other Psychotic Disorder" used, versus when is "Unspecified Schizophrenia Spectrum and Other Psychotic Disorder (Psychosis, NOS)" used?
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When you specify WHY they don't meet criteria for anything else.
The second one, when you DON'T or CAN'T say why they don't meet criteria. |
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Are there gender differences in schizophrenia? If yes, what are they?
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Yes-men tend to show symptoms earlier (early 20s to mid 20s) than women (late 20s).
Earlier onset = worse prognosis |
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What is the course of Schizophrenia?
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Chronic course, symptoms wax and wane. 50% are permanently and severely disabled.
Make up 14-50% of homeless population. |
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What is Anosognosia?
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Unawareness of your deficits. Shown sometimes in schizophrenic individuals. Related to higher relapse rates, and increased # of involuntary hospitalizations.
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What is the suicide risk in individuals with schizophrenia?
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20% attempt, 5-6% complete.
Higher risk for young men, comorbid substance use, post-hospitalization. |
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What is the most common psychotic disorder diagnosis?
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Schizophrenia.
Schizoaffective disorder is diagnosed 1/3 as often. |
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Why does stress increase relapse rates of schizophrenia?
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Stress --> increased cortisol production --> increases dopamine activity --> increase positive symptoms
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What are the 3 types of treatment for Schizophrenia?
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Biological- NUMBER ONE CHOICE OF TREATMENT is antipsychotic medication (e.g. haldol [very old], seroquel, risperdal, abilify, zyprexa)
Psychological-CBT Psychosocial-social skills training |
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What are some side effects of antipsychotic medicines?
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Tardive dyskinesia (involuntary movement of jaws, e.g. tongue smacking)
weight gain, sedation (zyprexa) Increased risk of type 2 diabetes (zyprexa) Agranulocytosis (decreased white blood cells-clozaril) |
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What is involved in CBT for Schizophrenia?
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teaching coping skills for managing stressors, teaching clients to reason out delusions, helping people to plan goals
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What percentage of people with borderline personality disorder commit suicide?
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10%
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What is criteria A of Anorexia?
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Restriction of energy intake leading to a significantly low body weight (a weight that is less than minimally normal or, for children and adolescents, less than minimally expected)
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What is criteria B of Anorexia?
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<b>Intense fear</b> of gaining weight or becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
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What are the two types of anorexia? Describe them.
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1) Restrictive-dieting, fasting, excessive exercise.
2) Binge-eating/purging type-excessive use of laxatives, vomiting. |
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How to be in partial remission from anorexia?
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Criteria A (low body weight) not met for a "considerable period of time," criteria B or C still met
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How to be in full remission from anorexia?
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previously met all criteria, now do not, have not for a "considerable time"
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How is severity of Anorexia determined?
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BMI
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What is the Female:Male ratio for anorexia?
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10:1
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What is the mortality rate of anorexia?
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10% +, due to starvation, suicide, electrolyte imbalance
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What is criteria A of bulimia?
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Recurrent episodes of binge eating
AND A sense of <b>lack of control</b> over eating during the episode |
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Define binge eating.
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(1) Eating, in a discrete period of time an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
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What is criteria B of bulimia?
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Recurrent inappropriate compensatory behavior in
order to prevent weight gain (i.e., purging) |
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How often do disordered eating behaviors need to be present for a diagnosis of bulimia?
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at least once a week for 3 months
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How is severity of Bulimia specified?
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By number of compensatory behaviors (purging) per week.
Mild=1-3 Moderate=4-7 Severe=8-13 Extreme=14+ |
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Cycle of bulimia?
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Binge --> Physical discomfort + emotional distress --> Compensation-->Return of Hunger-->Restriction-->Food intake-->“Failure” interpretation-->Binge
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Which disorder are people more likely to seek treatment-anorexia, or bulimia?
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Bulimia
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What is criteria A of binge eating disorder?
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Recurrent episodes of binge eating.
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What is criteria B of binge eating disorder?
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The binge-eating episodes are associated with three (or more) of the following:
1. Eating much more rapidly than normal. 2. Eating until feeling uncomfortably full 3. Eating large amounts of food when not feeling physically hungry. 4. Eating alone because of feeling embarrassed by how much one is eating. 5. Feeling disgusted with oneself, depressed, or very guilty afterward. |
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How long do binge eating episodes occur for a diagnosis of binge eating disorder?
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At least once a week for 3 months. (same as bulimia)
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What is criteria C of binge eating disorder?
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Marked distress regarding binge eating.
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First line of treatment for anorexia?
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Get them back to a healthy weight. Treat body before mind.
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