Psych Exam 4

Front 1

How many times per night does the sleep cycle occur?

Back 1

4-5

Front 2

when does deep sleep occur and what is a person like if they are awakened during this time?

Back 2

Occurs in stages 3 and 4 during the first 1/3 of the night. If awoken, the person is confused and disoriented

Front 3

when does rem occur most

Back 3

the later parts of the night

Front 4

What happens during REM

Back 4

brain wave activity= awake activity
paralysis
eye movement

Front 5

what are parasomnias

Back 5

abnormal behaviors or physiological events during sleep

Front 6

Describe sleep walking

Back 6

aka somnambalism
20% of children, 4% of adults
DSM 4 requires the person actually gets out of bed
can last a few minuets to 1/2 and hour
occurs during sleep stages 3 and 4, during first 1/3 of night
no memory of event
heriditary

Front 7

What are sleep terrors?

Back 7

horric dreams typically a male child, 5% of children
"awakens" screaming in bed sweating high h.r.
not actually awake, difficult to wake up
more likley during stressful times

Front 8

What stage do sleep terrors occur in?

Back 8

stage 4

Front 9

What does a person experiance during a sleep terror?

Back 9

images not long drawn out dreams, doesn't remember

Front 10

What is the difference between nightmares and sleep terrors?

Back 10

Nightmares occur during REM and can be remembered, sleep terrors occur during stage 4 and the person cannot remember

Front 11

What is REM sleep behavior disorder? Damage in what brain area may be responsible for it

Back 11

muscles don't become paralysed during rem , person acts out dreams, 85% hurt themselves, 44% their bed partner, can be produced in cats by lesioning the pons (part of the brain stem)

Front 12

What are dysomnias?

Back 12

Abonormalities in the amount, time, or quality of sleep (TAQ)

Front 13

What is narcolepsy?

Back 13

Sudden sleep attacks, switch from wakefullness to REM, often occurs when excited, stay asleep for about 15 minutes, some sleep paralysis upon awakening

Front 14

what is cataplexy?

Back 14

sudden loss of muscle tone while awake

Front 15

what ussually preceeds a Dx of narcolepsy?

Back 15

excessive sleepiness, seem to be always tired

Front 16

What is the prevalence fo narcolepsy? Gender ratio? Age of onset?

Back 16

1:200, men=women, typically first seen in adolescence

Front 17

What is the casue of narcolepsy

Back 17

strong basis for genetic causes, low levels of the NT hypocretin which is produced by the hypothalamus

Front 18

How is narcolepsy treated?

Back 18

stimulant drugs such as modafinil (like an amphetamine) and napping

Front 19

What are the three categories of sexaul dysfunctions?

Back 19

Sexual desire disorder, sexual arousal disorder, orgasm disorders

Front 20

Describe the two sexual desire disorders

Back 20

hypoactive sexual desire- a mild form, a general lack of sexual desire
sexual adversion disorder- a severe disorder where sex is seen as disgusting

Front 21

What is sexual arousal disorder?

Back 21

the female form of sexual arousal dysfunction, can't achieve physical response and proper lubrication

Front 22

What is male erectile disorder

Back 22

aka impotence, 50% of men will have at least one episode at least once
failure to get or maintain an erection

Front 23

What are the characteristics of orgasm disorders

Back 23

delay or absensce of orgasm, inhibited male/ female orgasm, premature ejaculation

Front 24

What is dyspareunia?

Back 24

pain in genitals during or after sex, 3% of males, 14% of females

Front 25

What is vaginismus

Back 25

Vaginal muscles tighten and prevent penetration, mostly phsychological causes, learned fear response

Front 26

What are paraphilias

Back 26

achieveing sexual arousal through inappropriate/ unusual means
20 times more common in men

Front 27

What is fetishism

Back 27

need some physical object to achieve arousal (necessary for arousal)

Front 28

What is transvestic fetishism

Back 28

achievenig arousal by dressing as a memeber of the opposite sex, usually a heterosexual male

Front 29

What is pedophilia

Back 29

sexual arousal can only be achieved through children, (a molester can also achieve arousal with adults but not a pedophiliac)

Front 30

What is exhibitionism?

Back 30

Urge to expose onself to strangers to attempt to surprise or arouse the stranger and achieve arousal

Front 31

What is voyeurism

Back 31

Achieve arousal by watching others engaging in sex or getting undressed

Front 32

What is sexual sadism

Back 32

Achieve arousal by inflicting pain on others

Front 33

What is sexual masochism

Back 33

Achieve arousal by recieving pain or being humiliated

Front 34

What is frotteurism

Back 34

achieve arousal by rubbing up against a person, usually in a crowded place, fantasy of having a caring relationship

Front 35

What is Gender Identity disorder

Back 35

a mild form of gender disorders, dissatisfaction with gender

Front 36

What is transsexualism

Back 36

a severe form of gender identiy disorder, typically seen in adulthood, preocupation and disgust with gender

Front 37

What are the 3 DSM sxs of transsexualism

Back 37

strong and persisten cross gender identification (from childhood), persisten discomfort with sex (disgust with genitals etc.), significant distress or impairment

Front 38

What is the prevalence, gender ratio, age of onset, and course of transexualism?

Back 38

1/ 37,000 for males, 1/100,000 for females, 3:1 male to female (based on surgery but research is showing more equal distribution), most grow out of it by adolescene, very few children w/ GID become transsexuals but about 40% develop homosexual preferences

Front 39

How is GID different from gender non conformity

Back 39

nonconformity does not display the same preocupation and disgust that GID does

Front 40

How is GID different from transvestic fetishism

Back 40

both like to wear opposite clothes but most TF's are heterosexual and do not wish to change their anatomy

Front 41

What are the 4 steps of reassignment treatment

Back 41

Evaluation (rule out other mental disorders), hormone treatments, cross living, surgery

Front 42

How satisfied are pts after reassignment surgery

Back 42

female to male 97%, male to female 87%,
7% resulted in tragic outcomes (initial evaluation not good enought, psychotic episode, suicide)

Front 43

How do prenatal hormone imbalances effect GID

Back 43

prenatal exposure in female monkeys to androgens exhibited more male like behaviors, in humans if mother is given anodrogens or estrogen, the fetus displays those behaviors

Front 44

What are the psychological causes of GID?

Back 44

inappropriate sex role socialization, parents wanted child of the opposite sex, child identifies with other parent, parent mental diorders

Front 45

What are the sxs of schizo.

Back 45

disordred thought, content of thought, disordered perception, disordred attention, disordered motor behavior

Front 46

What are some examples of disordred thought in schizo

Back 46

loosening of associations, jumping words

Front 47

What are some examples of disordred content of thought?

Back 47

Delusions- unshakable false beliefs

Front 48

What delusions do schizo's experiance?

Back 48

delusions of: persecution, grandeur, control, reference, somatic delusions

Front 49

What are some examples of disordered perception?

Back 49

auditory and visual hallucinations (false sensory experiences)

Front 50

What are some examples of disordered attention

Back 50

breakdown of the filter mechanism, asarnow and maccrimmon letter recognition test- attention span, schiz are distracted by strong associations to words when weak association is called for

Front 51

What are the three types of intrusions that schizo's experiance

Back 51

semantic (alternate meaning of a word introduces a new thought), phonetic intrusion (words or ideas are associated because they rhyme), habit strength intrusion (associated words like cliche's or common sayings are put together)

Front 52

What are some examples of disordered motor behavior in Schizo?

Back 52

catatonic rigidity, waxy flexibility, catatonic stupor, catatonic excitement

Front 53

What are the affective sxs of schizo

Back 53

inappropriate affect, flat affect

Front 54

Describe lack of insight

Back 54

most popular sx of schizo. 97% show this
don't question the reality of delusions and hallucinations

Front 55

What are the subtypes of schizo?

Back 55

disorganized, paranoid, catatonic, undifferentiated

Front 56

What are the features of the disorganized subtype of schizophrenia?

Back 56

disorganized speech and behavior, delusions and hallucinations but not systematized, flat or inappropriate affect, poor pre morbid functioning, slow gradual deterioration, early onset, more chronic

Front 57

What are the features of the paranoid subtype of schizophrenia?

Back 57

delusions of persecutiong and grandiosity, systematized delusions, lack of insight, later onset, better prognosis

Front 58

What are the features of the catatonic subtype of schizophrenia

Back 58

somewhat more rare, can be prevented with medication, unusual motor activity, increasingly uncommon

Front 59

What are the features of the undifferentiated subtype of schizophrenia?

Back 59

mixed features, "garbage bag" category

Front 60

How should subtypes differ acording to the DSM

Back 60

symptom picture, course, etiology, response to tx, prognosis

Front 61

How does newer research categorize schizo?

Back 61

Positive negative distinction

Front 62

What are the features of positive subtype schizophrenia?

Back 62

presence of sxs, excessive behaviors, delusions, loose association, hallucinations

Front 63

What are the features of negative subtype schizophrenia?

Back 63

absence of sxs, behavior deficits, anhedonia (inability to experiance pleasure), avolition (loss of motivation), apathy, alogia (lack of speech)

Front 64

How do positive and negative subtype of schizophrenia differ in etiology? onset? premorbid functioning? course? response to neuroleptics? prognosis?

Back 64

positive: disturbance in brain chemicals esp high dopamine, acute "reactive" form, good prefunctioning, better response to drugs, better prognosis
negative: structural brain changes esp. atrophy, gradual process, poor prefunctioning, chronic course, poor response to neuroleptics but atypicals seen to work, poor prognosis

Front 65

How is schizophrenia different from Major depressive disorder?

Back 65

both can have hallucinations but MDDs can function better

Front 66

How is schizophrenia different from bipolar disorder

Back 66

both may have grandiose delusions but bipolar is dependent on mood

Front 67

How is schizophrenia different from schizotypal personality disorder

Back 67

the pd is a low grade, "sub clinical" version but these people are more suceptible to full out disorder

Front 68

How is schizophrenia different from delusional diorder

Back 68

delusional disorder has "nonbizzare" delusions and otherwise function well

Front 69

What are the 3 subtypes of delusional disorder?

Back 69

erotomanic, jealous, and grandiose

Front 70

What are the features of delusional disorder subtype erotomanic

Back 70

delusin that another person, usually of higher status is in love with them, leads to stalking behavoir

Front 71

What are the features of delusional disorder subtype grandiose

Back 71

delusions that they have special talents/ purpose/ relationship to god/ believe that they have a mission,

Front 72

what are the features of delusional disorder subtype jealous

Back 72

belief that romantic partner is having an affair w/ little evidence, follow partner and imagined lover

Front 73

What is the prevalence of schizophrenia?

Back 73

1/100, holds across countries

Front 74

What social class is most effected by schizo

Back 74

much more common in lower classes especially in large cities

Front 75

What two theories describe why schizophrenia is more common in lower classes

Back 75

sociogenic hypothesis- enviroment and social conditions cause higher likleyhood of birth complications and therefore schizophrenia

Social drift hypothesis- can become schizo in any class but after onset they become lower class (support- become lower class than fathers)

Front 76

What is the age of onset of schizophrenia

Back 76

differes for males and females, male age is significantly lower, even out in mid 40's (may be because men leave home ealier and lose support network)

Front 77

How does birth month affect schizophrenia

Back 77

more likley to be born in winter, reflects stillbirth rates, perhaps exposure to disease, if just high risk 9% get it but if high risk , born in large city, and born during winter 23%

Front 78

What are the four courses of schizophrenia

Back 78

1. one episode -22%
2. episodes and regressions, no sxs during regression -35%
3. episodes and regression, some sxs during regression 8%
4. episodes and regressions, sxs during regeressions get progresivly worse as they continue through cycle -35%

Front 79

how do genetics relate to schizo?

Back 79

higher risk in blood relatives but it could be just the enviroment but adoption studies prove genetic basis, high rates among identical twins (48%)

Front 80

WHat is the dopamine hypothesis and how is it supported

Back 80

schizophrenia is caused by dopamine overactivity supported by response (2/3) to phenothiazines which block dopamine receptors, reaction of amphetamine psychosis to phenotiazines, amphetamines given to a schizo make sxs worse

Front 81

How does the dopamine theory explain the gender difference in schizophrenia

Back 81

dopamine receptor sites deteriorate more rapidly with age in males- earlier onset

Front 82

how does dopamine theory explain auditory hallucinations

Back 82

when aud hall. is heard there is activity in broca's area (making speech) and verniki's area (hearing), no activity in forebrain- not planning out what they say -external voice, dopamine overactivity could generate interanl speech

Front 83

Which subtype is dopamine theory more applicable? Why?

Back 83

positive- show florid delusions and hallucinations, these sxs most amenable to phenotiazines

Front 84

What biological origens might negative subtype schizophrenia have?

Back 84

brain structure abnormalities-
enlarged ventricles (central atrophy), atrophy of outer cortex (peripheral atrophy)
hypofrontality- reduced brain vol. in forebrain and reduced activity

Front 85

Overall, what are the biological causes of positive and negative subtypes of schizo?

Back 85

positive- problems in neurotransmission
negative- abnormalities in brain structure

Front 86

What types of disease could cause schziophrenia

Back 86

prenatal disease that effects neural migration, the guide cells get sticky and the neurons get tangleded. higher rates among mothers who had bad flu 5-7 mo. through pregnancy, expect to see signs of schizo in early childhood (motor devl. etc)

Front 87

Does being raised by a schizo increase changes of schizo

Back 87

no, stress is not a causal factor, poor genes and a poor family enviroment raise rates, adoption studies support this

Front 88

How does the family effect schizo relapse

Back 88

higher relapse in familes with high negative expressed emotion (criticism, hostility, emotional overinvolvement), highest relapse among those who had spent a lot of time with NEE family and not on drug Tx

Front 89

What are some Txs for schizo

Back 89

psychosurgery, drug therapy, psychotherapy, family therapy

Front 90

What is a prefrontal lobotomy

Back 90

a procedure previously used to tx schizo drill hole in skull and separate frotal lobe from rest of the brain

Front 91

What is a transorbital lobotomy

Back 91

"ice pick" through eye socket, destroy prefrontal tissue

Front 92

What are the typical drugs used to Tx schzio and what are the side effects

Back 92

neuroleptics (phenothiazines, thorazine), act as dopamine antagonsit and blocks receptors
side effects
mild: dry mouth, blurred vision, wt. gain, sensitivity to light, agitation
severe: tardive dyskinesia

Front 93

what is tardive dyskinesia

Back 93

person has involuntary movements esp. facial twitching and body shrugging

Front 94

When is CBT effective to Tx schizo

Back 94

when used in combination with drugs, used mostly to educate pt and combat other complications

Front 95

What is milieu therapy

Back 95

a Tx for schizophrenia, stimulating enviroment, pts have rights and control their government, somewhat helpful

Front 96

What is the token economy system

Back 96

earn tokens for appropriate behavior, helps behavior but not functioning, may just be imitating good behavior to get what they want

Front 97

What is social skills training

Back 97

teach social skills, behave better on ward but doesn' help much outside

Front 98

What is the purpose of family therapy?

Back 98

teach coping skills, lower negative expressed emotion, raise positive emotion, results: lower sx over time, lower relapse rates

Front 99

How do atypical drugs work and how are they different from phenothiazines?

Back 99

reduce serononin and dopamine activity (different b/c phenos only tx dopamine), reduce likleyhood of TD but other side effects, increased likelyhood of agranulocytosis (white blood cell loss)- need to monitor WBC counts

Front 100

What are the disorders first diagnosed in childhood?

Back 100

mental retardation, learning disorders, communication disorders, pervasive developmental disorders, ADHD, feeding and eating disorders, tic disorders, elimination disorders, separation anxiety, "adult" disorders can also effect children

Front 101

What is the general prevalence of mental disorders among children

Back 101

about 1/5 of children will experiance a significant learning or emotional problem

Front 102

What are the four sxs categories of autistic disorder

Back 102

social interactions, speech and language, ritualistic behavior patterens, intellectual capabilities

Front 103

What are the features of autistic aloneness, a feature of impaired social interactions?

Back 103

don't smile, aversion to being held, avoid eye contact, tend to be aloof or distant as adults

Front 104

How is speech impaired among autistic children

Back 104

delayed and abnormal from the start, between 20 and 50% remain nearly speechless their whole lives, high pitched speech, echolalia (repetition of speech that is heard), literal rather than figurative understanding of language, pronoun reversal

Front 105

What are some features of the ritualistic behavior patterns of autism

Back 105

extreme negative reaction to change, compulsive attachment to objects (but don't understand symbolic meaning), ritualistic motor behaviors- self stimulation (facination with body, rocking, spinning), self injourios (head banging, biting, motive is to simulate no to hurt themselves)

Front 106

Describe the intellecutal capabilities of autistic people

Back 106

75% score in mentally retarded range, uneven intellectual performance strong in visual, spacial tasks (shah and firth shape test)

Front 107

How are autistics capable of savant activities

Back 107

limited to nonsymbolic tasks (drawing, music, calendar calc, prime #'s etc) lack of abstract thought allows intense concentration on physical features, not bored by repitition

Front 108

What is the prevalence, gender ratio, and social class of autism

Back 108

prevalence 1/200- 1/600, 4x more common in boys, even amongst social classes

Front 109

WHat is the course of autism? what are predictors of poor prognosis?

Back 109

2/3 can't function independently as adults, 10% are borderline normal, IQ less than 60 and impaired language after 5 are predictors of poor prognosis

Front 110

How is autism different from childhood schizo?

Back 110

both are rare but autistics have an ealier age of onset, no delusions or hallucinations, more limited speech, less social attachment

Front 111

What is the psychodynamic explanation for autism

Back 111

"refrigerator parents" cold, uninterested parents but there is NO evidence for this

Front 112

What is the twin concordance for autism? Other genetic factors?

Back 112

identical 60%, fraternal 10%, "normal" family members often have impaired language or cognitive deficits

Front 113

What are some neurological abnormalities in autistics sugesstive of brain damage?

Back 113

slow brain wave activity, high prevalence of epileptic seizures, prenatal difficulties or birth complications (born with rubella but vaccine doesn't cause it), cerebellum shrinkage (impair motor coordination, sensory motor integration, pay attention to only one stimulus at a time), large brain size (doesn't undergo "prunning")