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105 Cards in this Set
- Front
- Back
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What are the overriding characteristics of personality disorders?
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1. self-aggrandisement
2. diminshed capacity for understanding and respecting the needs and rights of others 3. mistrust/distrust of others 4. emotional instability 5. manipulation and exploitation of others 6. blaming others 7. limited capacity for give and take |
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General Diagnostic Markers of PD
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1. difficulty in personal relationships across settings and people
2. personality traits that are inflexible and rigid 3. personality traits/behaviors that are maladaptive |
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The person does not recognize his traits as undesirable, problematic, or maladaptive
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Ego-syntonic
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This person views his traits as undesirable, but despite efforts cannot change them
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Ego-dystonic
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In personality disorders, the earlier the onset...
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the more pervasive and chronic the pattern
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_____ typically increases symptoms of PD's and decreases self control or increases their impulsiveness.
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Stress
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______ amplifies personality disorder and decreases self control/increases impulsiveness.
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Substance abuse
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When are crises most problematic in PD?
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young adulthood
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PDs that remit or mellow with age
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antisocial and borderline
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PDs that worsen with age
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OCD and schizotypal
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Borderline personality disorder is associated with...
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mood disorders, substance abuse disorders
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Schizotypal PD is associated with...
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schizophrenia
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OCD is associated with...
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family history
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PDs rarely require hospitalization unless their condition is complicated by...
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1. substance abuse
2. mood disorder 3. major life stressor that results in suicidal, assaultive or homicidal behavior |
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What PD treatment has the best outcome?
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long term psychotherapy...even though its still poor
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Cluster A PD
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schizotypal
schizoid paranoid |
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Cluster B PDs
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histrionic
narcissistic antisocial borderline |
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Cluster C PDs
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avoidant
dependent obsessive compulsive |
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Paranoid PD presents with 4 of these 7
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1. suspects without basis that people are exploiting, harming or deceiving him
2. preoccupied with unjustified doubts about loyalty of friends 3. reluctant to confide in others 4. reads benign comments as demeaning or threatening 5. persistently bears grudges 6. perceives attack on character and is quick to anger 7. has recurrent suspicions of infidelity of partner |
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Whats the main difference between Schizoid and Schizotypal?
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Schizotypal have a fear of people and relationships whereas schizoid just have no interest in relationships
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Schizoid PD has 4 of these 7
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1. no desire for close relationships
2. always chooses solitary activities 3. little/no interest in sex 4. takes pleasure in few/no activities 5. lacks close friends 6. appears indifferent to praise or criticism of others 7. shows emotional coldness, detachment or flattened affect |
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Schizotypal PD has 5 of these 9
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1. ideas of reference
2. odd beliefs or magical thinking 3. unusual perceptual thinking 4. odd thinking and speech 5. suspicious or paranoid ideation 6. inappropriate or constricted affect 7. behavior or appearance that is odd, eccentric, or peculiar 8. lack of close friends 9. excessive social anxiety associated with paranoid fears |
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Pattern of disregard for and the violation of the rights of others occurring since the age of 15
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Antisocial PD
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Pervasive pattern of instability of interpersonal relationships, self image and affect, marked impulsivity beginning by early adulthood and present in a variety of contexts
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Borderline PD
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A pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts
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Histrionic PD
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A pervasive pattern of grandiosity, need for admiration, and lack of empathy, beginning in early adulthood and present in a variety of contexts
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Narcissistic PD
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A pervasive patten of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Begins in early adulthood
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Avoidant PD
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A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation. Begins in early adulthood
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Dependent PD
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A pervasive pattern or preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency.
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Obsessive Compulsive Personality Disorder
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Criteria for Anorexia
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1. Refusal to maintain body weight-usually 85% of expected
2. intense fear of gaining weight even though underweight 3. Disturbance in the way she experiences her body shape or weight, or denial of the seriousness 4. amoenorrhea |
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What is the onset for anorexia?
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teens to early adults
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What is the sex ratio for anorexia?
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90-95% are female
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Onset of anorexia often follows...
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a new life situation in which the person feels inadequate or unable to cope
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When do anorexics come to medical attention?
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usually die to amenorrhea, edema, constipation, abdominal pain or requests for diet pills or diuretics
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What % of anorexics recover completely?
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40%
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What is the 10 year mortality rate for anorexia?
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5-10%
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What is the 20 year mortality rate for anorexia?
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20%
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Which anorexics have a better prognosis?
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younger onset patients and those with restricting type
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In anorexics, lifetime prevalence of ____ is 25%
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OCD
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In anorexia is cortisol high or low?
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high
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What are some indicators of favorable prognosis in anorexia?
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1. good premorbid level of psychosocial adjustment
2. early age of onset 3. less extreme weight loss 4. less denial of illness 5. restrictive subtype |
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What are indicators of unfavorable prognosis in anorexia?
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1. poor premorbid level of psychosocial adjustment
2. low SES 3. extreme weight loss 4. greater level of denial 5. presence of bulimia, purging behavior |
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Major depression is associated with anorexia ____% of the time.
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60%
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Anxiety disorders are associated with anorexia ___% of the time
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20%
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Personality disorders are associated with anorexia ___% of the time
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40%
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What meds can be used in moderate to severe cases of anorexia?
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imipramine and desipramine
SSRI's -the book says they have no role in anorexia- |
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_____ or ______ is associated with bulimia is 75% of cases.
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major depression or anxiety
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When does bulimia begin?
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adolescence or young adulthood
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Bulimia onset often follows...
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change in living situation or relationship
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What two methods of assessment are employed in evaluating kids?
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1. obtaining information from collateral sources.
2. observation |
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Most common behavior disorder diagnosed in kids and teens
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ADHD
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3 groups of ADHD symptoms
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inattention
impulsiveness hyperactivity |
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Who gets ADHD?
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males 3:1
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Hallmark of ADHD
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variability of symptoms from time to time and in different situations
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What 2 disorders are often associated with ADHD?
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oppositional defiant disorder
conduct disorder |
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Children with coexisting ADHD and conduct disorders tend to have...
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1. earlier age of onset
2. exhibit a greater total number of antisocial behaviors 3. display more physical aggression |
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What % of ADHD persists into adulthood?
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60-70%
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25% of ADHD kids go on to be adults with ____.
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antisocial personality disorder
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Girls with ADHD have a _______ than do boys with ADHD.
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stronger family history
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Psychiatric disorders that aggregate with ADHD
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mood disorder
learning disorder substance abuse antisocial personality disorder |
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______ is associated with novelty seeking behavior
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Dopamine D receptor
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Most common complaint in referrals to child and adolscent clinics and hospitals
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conduct disorders
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Conduct disorder is associated with...
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chaotic/dysfunctional families
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________ is a strong factor is the development of conduct disorder in males.
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having an anti-social mother
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_____ and ____ often precede the development of conduct disorder.
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ADHD and ODD
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Among children, the strongest predictors for conduct disorder include:
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drug use
stealing truancy lying low educational achievement |
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Conduct disorder involves at least 3 of the 4:
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1. aggression to people or animals
2. destruction of property 3. deceitfulness and theft 4. serious violation rules |
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Who gets tourette's?
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males 3:1
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Tourette's is highly familial and comorbid with...
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OCD
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Some kids get Tourette's after...
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infection with Group A beta-hemolytic strep-PANDAS
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Treatment of Tourettes
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alpha adrenergic drugs like clonidine or guanfacine.
Haldol, pimozide and atypical antipsychotics can be used when others fail |
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Nocturnal enuresis is largely a consequence of...
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delayed maturation of bladder control mechanism
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___% of enueretic kids have a 1st degree relative with a history of enuresis
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75%
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Nocturnal enuresis in kids under 7 should be treated with...
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patience
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Encopresis is often a sign of...
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severe emotional/psychological disturbance
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3 groups who have encopresis
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1. kids who haven't been systematically toilet trained-MR
2. Secondary to psychiatric disorders-ODD, ADHD, Conduct disorder, Phobia 3. Chronic, severe constipation, megacolon |
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In schizophrenia, ______ are more common in children than adults.
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visual hallucinations
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Prior to puberty, depression is more common in...
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boys
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Mania in young children may appear similar to...
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ADHD
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In childhood mood disorders, _____ may be more pronounced.
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irritability
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Who gets autism?
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boys 3-4:1
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70% with autism show evidence of ______
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mental retardation
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____% with autism have seizure disorders
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25%
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when a person echoes back what another has said
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echolalia
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Deceleration of head growth between 5 and 48 months, loss of hand skills, social engagement, poor coordination and impaired language
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Rett's disorder
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severe and sustained impairment in social interaction and development of restricted and repetitive patterns of behaviors, interests, and activities
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Asperger's
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clinically significant loss os previously acquired skills before the age of 10
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Childhood Disintegrative Disorder
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Mild Mental Retardation
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50-55 to70
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Moderate MR
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35-40 to 50-55
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SevereMR
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20-25 to 35-40
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Profound MR
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<20-25
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Most common chromosomal cause of MR
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Down's
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Most common inheritable cause of MR
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Fragile X
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What is the PLISSIT model
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sex therapy:
P-give permission to discuss sexual concerns LI-clinician provides limited information SS-clinician makes specific suggestions IT-patients who don't respond are referred for intensive therapy |
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Hallmark of Hypoactive Sexual Desire Disorder
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baseline of sexual desire (libido) remains significantly low
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Most common cause of orgasm disorders
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SSRIs
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_______ have the highest rate of recidivism
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Males who molest young males
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The best treatment for pedipohilia
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protection of potential vicitms ie jail-ie keepin Dr H in business
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Psychiatric emergencies respresent...
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life threatening situations
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Psychiatric urgencies represent...
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wants and demands
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What is the most likely form of psychiatric emergency?
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suicide attempts
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The most important decision in evaluation of psychotic patients is...
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differentiate between mental disorders due to medical, neurological and toxic causes
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Clinical features highly suggestive of delirium include...
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1. Clouding of consciousness
2. age over 40 3. no previous psychiatric history 4. disorientation 5. abnormal vital signs 6. visual hallucinations and illusions |
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______ is the mainstay of evaluation and treatment in psychiatric emergencies.
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verbal intervention
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What can you use for rapid tranquilization?
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lorazepam combined with haldol or thiothixene-most patients respond in 1-3 doses
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