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What differentiates Personality Disorders from Axis I disorders?
Axis I has major mental disorders
Axis II is personality disorders and mental retardation.

Designed so consideration can be given to prevailing personality patterns, which may be less obvious than Axis I disorders
What is the age of onset and course of most personality disorders?
Age: unknown exactly.
Exception: Antisocial PD needs to have a diagnosis of Conduct Disorder before the age of 18.

Course: Maladaptive ways of perceiving, thinking about, and relating to the world in childhood seem to develop these disorders later.
What are the “clusters”? Why do we have them?
Cluster A:Paranoid, Schizoid, Schizotypical

Cluster B: Antisocial, Borderline, Histronic, Narcissistic

Cluster C: Avoidant, Dependent, Obsessive-Compulsive

The clusters group similar personality disorders.
What are the characteristics of each cluster?
Cluster A: Odd, eccentric

Cluster B: dramatic, emotional, erratic

Cluster C: often include anxiety and/or fearfulness
What are the major symptoms of Paranoid PD?
Need 4+:
bears grudges, reluctant to confide in others, believe people don't have your best interest at heart, misinterpret reality, tend to be hostile in order to protect themself.
What are the major symptoms of Schizoid PD?
4+
Doesn't enjoy close relationships, chooses solitary activities, never had interest in sex, little pleasure in activities, lack close friends, indifferent to praise/criticism, emotionally closed, detached or flattened.
*LACK (not loss) of pleasure and are distressing to family/friends
What are the major symptoms of Schizotypal PD?
5+
ideas of reference, odd beliefs/magical thinking, bodily illusions, odd thinking or speech, suspicious/paranoid ideas, inappropriate/constricted affects, odd behavior, lack of friends, excessive social anxiety (even with familiar people)
*VERY superstitious, belief that conversations or gestures of others have special meaning or personal significance (woman watching Letterman thought he was communicating his love to her).
Which Axis I disorder is Schizotypal PD most similar to? Why do we think this?
Schizotypal PD is similar to Schizophrenia because of their oddities in thinking, talking and other behaviors.
What are the major symptoms of Antisocial PD?
MUST MEET CRITERIA FOR CONDUCT DISORDER!
3+
Fail to conform to society with respect to laws (repeatedly perform acts that are grounds for arrest), deceitful (lying, use aliases, con others), impulsivity, irritable/aggressive (many fights), disregard safety of self/others, irresponsible
*LACK REMORSE
*Most studied PD
*Most validated (for sure a personality disorder)
How are conduct disorder and Antisocial PD related?
Conduct disorder is permissive for Antisocial PD
Conduct disorder: Aggressive behavior before the age of 10
Both disorders have a disregard for the law, social norms, and the safety of self and others.
What are the major symptoms of Borderline PD?
5+
Frantic efforts to avoid real/imagined abandonment, history of unstable/intense relationships (extreme love and/or hate), identity disturbance (unstable self-image), impulsivity in at least 2 areas that are self-damaging, suicidal/self-mutilating behavior, affective instability, chronic feelings of emptiness, difficulty controlling anger, transient stress-related paranoid ideation or severe dissociative symptoms.
*Pervasive pattern of instability of interpersonal relationships, self-image and affect.
What are the major symptoms of Histrionic PD?
5+
Uncomfortable when person isn't the center of attention, interaction is inappropriate with sexual seduction or provacation, rapidly shifting and shallow expression of emotions, uses physical appearance to draw attention to self, excessively impressionistic style of speech (lacks detail), self-dramatization, theatrically, exaggerates emotions, suggestible, considers relationships to be more intimate than they actually are.
*"DRAMA QUEEN", seek compliments
What are the major symptoms of Narcissistic PD?
5+
Grandiose sense of self-importance, preoccupied with future perfect life, person is "special", only associates with special or high-status people, requires excessive admiration, sense of entitlement, takes advantage of others, lacks empathy, often envious of others or believe others envy them, shows arrogant, haughty behaviors or attitudes.
*Prone to violence, even homicide, if achievements go unrecognized.
*Common in sex offenders and domestic abusers
What are the major symptoms of Avoidant PD?
4+
Avoid jobs with much interpersonal contact because of criticism, disapproval, or rejection, unwilling to work with people unless certain they'll be liked, restraint in intimate relationships b/c of fear of shame/ridicule, preoccupied with being rejected/criticized in social situations, inhibited in new interpersonal situations (feel inadequate), view self as socially inept, personally unappealing, or inferior, reluctant to take personal risks or engage in new activities.
*Similar to social phobia but more generalized and life-long.
*Few close relationships, but unlike Schizoid, WANT the relationships.
What differentiates Avoidant PD from social phobia?
Some investigators believe that avoidant PD may simply be a more severe manifestation of generalized social phobia.
There have been findings of generalized social phobia w/o avoidant PD but few cases of avoidant PD w/o gen. social phobia.
What are the major symptoms of Dependent PD?
5+
Difficulty making everyday decisions w/o advice f/ others, needs others to assume responsibility for major areas of their life, difficulty expressing disagreement with others, fear loss of support/approval, difficulty initiating projects on their own (lack of self-confidence), excessive lengths to obtain nurturance/support f/ others- volunteer to do unpleasant things (Cleaning office bathroom), uncomfortable/helpless when alone, urgently seek relationships for care/support
*RISK ending up in abusive relationships
*Submissive, clingy, low self-esteem, feel inadequate, need others to make decisions for them not just give advice.
What are the major symptoms of Obsessive-Compulsive PD?
4+
Preoccupied with details, rules, lists, order, organization or schedules to extent that point of activity is lost, perfectionism interferes with task completion, excessively devoted to work, excludes leisure and friends, overconscientious, scrupulous, inflexible with morality, ethics, values. Unable to discard worn-out and worthless objects (no sentimental value), reluctant to delegate tasks unless others do it their way, hoards money for future catastrophes, rigid and stubborn.
*Sacrifice flexibility, openness and efficiency for order, perfection and control.
*Risk factor for OCPD is a type A personality
What differentiates OCPD from OCD?
OCPD lacks true obsessions and compulsions characteristic of OCD.
Which personality disorders may include transient, psychotic-like symptoms? What differentiates these personality disorders from the psychotic disorders?
?
Which personality disorders have major gender differences in prevalence rates? What may account for this?
Cluster A (paranoid, schizoid, schizotypical) tends to be more males.
Antisocial PD is more male dominated due to the aggressive nature of the PD.
Borderline PD is 3:1 females, possibly caused by females being more sensitive and emotional.
What differentiates Schizoid PD from Avoidant PD? Borderline PD from Antisocial PD? Histrionic PD from Narcissistic PD?
Schizoid PD is indifferent to other people whereas Avoidant wants friends but can't handle interpersonal contact.

Borderline PD is unstable and possibly harmful to themselves, Antisocial PD disregards safety for themselves as well as others.

Histrionic PD people seek attention for the sake of being the center of attention, Narcissistic people seek attention AND praise for their ego.
Why are personality disorders difficult to treat? How are they treated?
Difficult to treat because most people with psychopathic and antisocial personalities identify their personality disorder as themselves. They have to change their whole inner-thinking and self-identity (DIFFICULT!). Most PD's are not distressing to person and therefore they will refuse treatment.
Cognitive-Behavioral (the most effective treatment): increasing self-control, critical thinking and social perspective, and victim awareness. Teach anger-management, change antisocial attitudes, and cure drug addiction.
What are the major symptoms of Schizophrenia?
1) Hallucinations (false sensory perceptions)
2) Delusions- fixed, false belief
(need only one of the above to qualify. Need two or more of the following.)
3) Disorganized speech (tangential)
4) Disorganized/catatonic behavior
5) Negative symptoms
What distinguishes Schizophrenia from the other psychotic disorders?
A significant loss of contact with reality, referred to as psychosis.
What are the different types of delusions?
Religious: related to religion
Grandiose: exaggerated sense of self
Persecutory: person is being chased, watched, or persecuted
Bizarre: something the person's culture would view as implausible
Thought insertion: thoughts are being inserted into person's head
Thought withdrawal: thoughts are being taken out of person's head
Thought broadcast: thoughts are being broadcasted
Control: person is being controlled by something/someone else
Somatic: things happening to body
Nihilistic: person believes s/he is dead or doesn't exist
Reference: neutral stimuli have special meaning to the person
What are the different types of hallucinations? Which type is the most common?
Auditory: hear something that's not there ***MOST COMMON!
Tactile: feel something that's not there
Visual: see something that's not there (usually from substance abuse or brain damage)
Olfactory/Gustatory: Smell/taste something not there
Somatic: feels like something is going on inside the body
What are the different types of disorganized speech?
Loose associations: speech goes from one place to another, little association in between
Incoherence: lacks clarity, intelligibility, relevance
Tangential: start to answer, don't get there
Frequent derailment: off track, lose track often
Clang: speech follows sounds
Neologisms: made up words
Circumlocution: talk around issue
What are the different subtypes of Schizophrenia? What are their symptoms?
Paranoid Schizo: preoccupation with one or more delusions or hallucinations (content doesn't matter)
NO disorganized speech/behavior, catatonic, flat.

Disorganized Schizo: prominent: disorganized speech/behavior, not catatonic

Catatonic Schizo: 2+ catatonic symptoms. Immobility, stupor, rigor, etc.
What are the gender differences in Schizophrenia?
The genders are equal, though onsets differ:
Men: late teens to 20s
Women: mid 20s to mid 30s
What does the course/outcome look like in Schizophrenia?
Onset is acute or gradual
Often 3 phases:
1) Prodromal: beginning of deterioration, mild symptoms, no delusions/hallucinations
2) Active: symptoms are increasingly apparent, meet criteria for schizo
3) Residual: return to prodromal levels, mild symptoms, impairment of funct., no delusions/halluc.

Only ~15% fully recover, ~85% continue to have residual and/or active symptoms. ~10% commit suicide.
What are some of the risk factors for Schizophrenia?
Born in winter or early spring
Family history of Schizo
What do we know about the heritability of Schizophrenia?
Risk of Schizo increases with relatedness to someone with Schizo:

6% if you have child with schiz
10% full sibling
13% parent
42% monozygotic twin
50% both parents
What are some signs of better prognosis in Schizophrenia?
Severity of negative symptoms
Good premorbid functioning
Acute onset
Later age onset and being female (b/c of later onset)
Mood disturbances
Family history of Mood Disturbance
Anti-psych meds and compliance with meds
no family history of schiz
Insight (realize you're sick)
What are the major symptoms of Schizophreniform?
Same criteria for A, D, and E of Schiz
B: An episode of the disorder (including prodromal, active and residual) lasts at least one month but less than six months.

**SAME AS SCHIZ, JUST SHORTER!
What are the major symptoms of Brief Psychotic Disorder?
A: Presence of ONE OR MORE of the following: delusions, hallucinations, disorganized speech, catatonic behavior.
B: Duration: one day to one month. with eventual full return to premorbid levels of functioning
What are the major symptoms of Schizoaffective Disorder?
A: Periods of psychosis (uninterrupted) mixed with mood symptoms.
B: During same period of illness, have had delusions/hallucinations at least 2 weeks in absence of prominent mood symptoms.
*D*: Symptoms that meet criteria for a mood disorder for a substantial portion of the duration of the illness.
What differentiates Schizoaffective Disorder from a Mood Disorder with Psychotic Features?
SA has 2 weeks with no mood disorders
What are the major symptoms of Delusional Disorder?
A: Nonbizarre delusion lasting at least one month.
B: Criterion A for Schizo has never been met (tactile/olfactory are exceptions to this)
C: Behavioral funct is not markedly impaired, behavior is not obviously odd or bizarre
D: If mood episodes are concurrent with delusions, total duration has been brief relative to duration of the delusional periods.
Delusions
Fixed, false belief. Often bizarre (implausible)
Hallucinations
False sensory perceptions, most commonly auditory.

Positive symptom of Schizo
Disorganized Speech
Speech that is hard to follow and that impairs communication

Positive symptom of schizo
Disorganized Behavior
Grossly disorganized behavior such as:
Child-like silliness
Unpredictable or inappropriate behavior
Unpredictable agitation
Markedly disheveled appearance
Dressing in unusual manner
Clearly inappropriate sexual behavior

Positive symptom of schizo
Catatonic Behavior
Stupor, rigidity, or posturing (don't move)
Negativism (resistant to movement)
Waxy flexibility or catalepsy (limbs remain where placed)
Purposeless, unstimulated movement
Prominent mannerisms or grimacing

Positive symptoms
Negative Affect
Flat affect
No emotional expression in speech
Restricted fluency of thought and speech

Negative symptoms
Neologisms
Made up words (disorganized speech)
Expressed emotion
Type of negative communication involving excessive criticism and emotional over-involvement directed at a patient by family members.
Why do we include cognitive disorders in the DSM-IV-TR? Why should mental health professionals be able to recognize them?
Cognitive disorders are known to have an organic (biological) basis. Therefore psychotherapy professionals should be able to recognize symptoms that must be treated by a medical professional.
What are the major symptoms of Delirium?
A: Disturbance of consciousness
B: Change in cognition
C: Short periods of time (hours to days), fluctuations through day
D: Caused by direct physiological consequences of a GMC and/or substance
What are some of the causes of Delirium?
Psychoactive substances of abuse
Medications other than above
Infections, esp. in brain
Toxins, shock, surgery, head injury
Who is at risk for Delirium? Why?
The elderly and children.
The elderly because of brain changes caused by normal aging that lead to "reduced brain reserve" and especially after surgery.
Children are at high risk because their brains are not yet fully developed.
What are the major symptoms of Dementia?
Development of multiple cognitive defects manifested by both:
1) Memory impairment (retrograde or anterograde)
2) One or more of the following cognitive disturbances:
a) aphasia- language disturbances
b) agnosia- fail to identify objects
c) apraxia- unable to do motor tasks
d) loss of executive function- planning, organizing, etc.
What are some of the causes of Dementia?
Alzheimers (70% of dementias)
Vascular lesions in the brain (low blood flow to brain)
HIV
head trauma
Parkinson's Disease
Huntington's Disease
Pick's Disease
Creutzfeldt-Jakob Disease
What distinguishes Delirium from Dementia?
Delirium is episodic or chronic whereas dementia is a slow and steady decline in cognitive impairment.
What do we know about Alzheimer’s?
Alzheimer's typically develops after age 60, seems to be caused by plaques and neurofibrillary tangles on the brain
What are the differences between early-onset and late-onset Alzheimer’s?
Early onset: prior to age 60
Late onset: at age 60 or later
What do we not know about Alzheimer’s?
We do not know how to cure Alzheimer's and are not positive what causes the degeneration of brain functioning.
How does Vascular dementia occur?
Damage to specific parts of the brain, often:
1) Stroke: interrupts blood flow to brain, leads to lack of O2, sections of brain may die
2) Aneurism: rupture of blood vessel, blood floods brain, pushes against skull. Abrupt, sudden onset of sympt. w/ fast decline; some normal funct.
What is the difference between Vascular Dementia and Dementia due to Alzheimer’s
Vascular dementia happens quickly and damages specific parts of the brain, possibly leaving some functioning normal. Ex: anuerism.
Dementia due to AD happens gradually and can cripple all cognitive functioning.
What is amnestic syndrome?
Development of memory impairment (inability to learn new info or to recall previously learned info, usually after a few min.)
What should mental health professionals know about caregivers of patients with cognitive disorders?
Caregivers need support too. They must deal with the "social death" of their loved one before the physical death as well as:
Financial burdens
Chronic stress
High risk for depression
What are the consequences of damage to the frontal lobes? Parietal lobes? Occipital lobes? Temporal lobes?
Frontal Lobe - "higher cognitive functions" including behavior and emotions.
Parietal- visuo-spatial abilities, ability to understand spoken and/or written language.
Occipital- visual information
Temporal- smell, sound, short-term memory.
What did the case of Phineas Gage contribute to abnormal psychology?
*Disruptions to the brain can cause changes in a person's personality so much that they don't seem like the same person anymore.
*Different parts of the brain control different emotions and parts of our personality. Not all brain injuries result in the same symptoms.
Anterograde amnesia
The inability to store effectively in memory events that happen during variable periods of time after the trauma.
Retrograde amnesia
An inability to recall events immediately preceding the injury.
Confabulation
Filling in of memory gaps with false and often irrelevant details.
Procedural memory
Procedural memory is the long-term memory of skills and procedures, or "how to" knowledge (procedural knowledge).

It is considered a form of implicit memory.

Why someone may not have to learn how to walk, eat, dress again after a major head injury.
Why do the childhood disorders have such a short history?
Childhood Disorders not studied until the 20th century.
Children were thought of as "miniature adults" and were diagnosed as downward extensions of adult-oriented diagnoses.
Why are childhood disorders difficult to diagnose?
Because behavior that would be seen as abnormal in an adult may be normal for children. Depends on their developmental learning stage.
What are the major symptoms of Mental Retardation?
A: Significantly subaverage intellectual functioning (equal to or below 70 IQ points)
B: concurrent deficits or impairments in present adaptive funct. in at least 2 areas: communication, self-care, work, home living, social/interpersonal skills, academia, leisure, health and safety.
C: Onset before age 18
What are the different levels of Mental Retardation?
Mild: IQ 50-55 to 70
Moderate: IQ 35-40 to 50-55
Severe: IQ 20-25 to 35-40
Profound: IQ <20-25
How are genes related to mental retardation?
Mild mental retardation runs in families. Mental retardation is attributed to both genetic and environmental factors.
What are the general characteristics mild mental retardation?
Mild: 85%, "Educable", skills up to 6th grade level, some social/vocational skills, adequate independent living, may need some supervision.
What are the general characteristics of moderate mental retardation?
Moderate: 10%, "Trainable", up to 2nd grade level skills, vocational training, unskilled/semi-skilled occupations
What are the general characteristics severe mental retardation?
3-4%, may learn to talk, trained self-care, limited extent of acedemia (alphabet), closely supervised- no occupations suitable
What are the general characteristics profound mental retardation?
1-2%,need a highly structured environment, constant supervision and individual caregivers. Can complete some simple tasks under close supervision
What are different treatment methods for Autism?
Intense behavior modifications have:
Eliminated echonia, self-mutilation and self-stimulation
Increased verbaliztions, playing with others and attending to others
What are the major symptoms of Rett’s Disorder?
A: all of the following:
1) Apparently normal prenatal and perinatal development
2) Apparently normal psychomotor development first 5 mo.
3) Normal head circumference at birth.
B: Onset of all the following after the period of normal development:
1)Deceleration of head growth 5-48 mo.
2) Loss of previously acquired hand skills and social engagement
3) Appearance of poor gait/trunk movements
What are the major symptoms of Childhood Disintegrative Disorder?
A: Apparently normal development first 2 years,
B: Clinically significant loss of previously acquired skills, between ages 2 and 10
2+ loss of following:
Expressive or receptive language
social skills or adaptive behavior
bowel or bladder control
play
motor skills
C: 2+ impairments in social interaction, communication, repetitive behaviors.
What are the subtypes of ADHD?
Inattention ADHD
Hyperactivity ADHD
What are the learning disorders? What are the signs of learning disorders?
Learning disorder refers to retardation, disorder, or delayed development manifested in language, speech, mathematical, or motor skills. Not due to a physical or neurological defect. Most common and studied is dyslexia.

Signs: apparent disparity between expected academic achievement level and actual performance in one or more school subjects. Do not necessarily have obvious crippling emotional problems, motivation cooperation, etc.
What are the pervasive developmental disorders?
Autistic Disorder
Rett's Disorder
Childhood Disintegrative Disorder
Asberger's Disorder
What are the major symptoms of Autism?
There are 3 groups of symptoms.
Group 1: Qualitative impairment in social interaction. (Ex: failure to develop peer relationships)
Group 2: Qualitative impairments in communication. (Ex: Delay or lack of development of spoken language)
Group 3: Restricted repetitive and stereotyped patterns of behavior interest and activities. (Ex: Preoccupations are abnormal in intensity or focus)
**Must have 6 or more items from 1,2 & 3 with at least 2 from group 1 and at least one from groups 2 & 3.
What environmental factors affect people with Autism?
?
What are the major symptoms of Asberger’s?
A and B are the same as Autism:
A: Qualitative impairment in social interaction
B: Significant distress or impaired functioning in social interaction, social communication and/OR symbolic or imaginative play
*C: No clinically significant delays in language or cognitive development
How are Autism and Asberger’s related?
Both have trouble with social interaction and social communication.

Difference: Children with Asberger's do not have a delay in language or cognitive development
What are the major symptoms of ADHD?
6+ symptoms of inattention (maladaptive and inconsistent with developmental level): fail to give close attention to detail, careless mistakes, difficulty sustaining attention in tasks or play activities, often not paying attention.
OR
6+ symptoms of hyperactivity: often fidget, leave classrooms when expected to sit, run/climb excessively, difficulty playing/engaging, talk excessively, interrupt, difficulty waiting turn
How is ADHD treated?
Behavioral: increased structure and appropriate behaviors.

Pharmacological:
Stimulants (Ritalin) are a dopamine reuptake inhibitor. (over-prescribed?)
Nonstimulants (Strattera) norepinephrine reuptake inhibitor.
What is the course of ADHD? Do people outgrow ADHD? Do people have ADHD as adults? If so, what does ADHD look like in adolescence and adulthood?
Course: Over half of cases remit in late adolescence or early adulthood.

Adults can have ADHD and it manifests by feelings of inner restlessness.
What are the major symptoms of Conduct Disorder?
A: violate basic rights of others or major age-appropriate societal norms or rules.
3+ criteria in past 12 mo. or 1 in past 6 mo.:
Aggression to people or animals (initiate physical fights)
Destruction of Property (fire setting)
Deceitful/theft (break into house)
Serious violation of rules (run away from home)
B: Impaired functioning
C: Must be under 18 years old
What are the differences between early and late onset Conduct Disorder?
Early onset: less than 10 years old
Late onset: 10-18 years old
What differentiates Antisocial PD from Conduct Disorder?
Conduct disorder is permissive for Antisocial PD but someone can have conduct disorder without having antisocial PD. Conduct disorder criteria must be met before the age of 18.
What are the major symptoms of Oppositional Defiant Disorder?
A: pattern of negative, hostile, and defiant behavior lasting 6+ months. 4+ symptoms: lose temper, argue with adults, actively defy, often angry/resentful, spiteful.

Usually before the age of 8, usually boys. Can lead to conduct disorder
What differentiates Conduct Disorder from Oppositional Defiant Disorder?
Children with ODD are not violating the basic rights of others or societal norms or rules but are just very angry and defiant.
What are the major symptoms of Separation Anxiety Disorders?
A: Developmentally inappropriate and excessive anxiety concerning separation from home or from attached individuals (parents, siblings). 3+ symptoms:
Excessive distress when separated, worry about losing/harm befalling loved ones, reluctance/refusal to go to school/else where, nightmares, complains of physical symptoms.
B: 4 week min. duration
C: Onset before age 18
D. Clinically significant distress/dysfunction
Who is likely to have Separation Anxiety Disorder? What are the risk factors?
More common in females from pre-school to adolescents.
Risk factors include stressful/traumatic event. Associated with immaturity and low self-confidence.
How does depression differ in children and adults?
Depression in children uses the same diagnostic criteria as adults but there is thought to be differences in hormonal levels and responses to treatment.
Adults are more likely to get help. Depression in children can be "misdiagnosed" by parents.
What are tics? Describe the subjective experience of having a tic.
Tics are persistent, intermittent muscle twitches or spasms, usually limited to a localized muscle group. Ex: blinking, twitching the mouth, licking the lips, shrugging the shoulders, twisting the neck, clearing the throat, blowing the nose, etc.)

Some tics are preceded by an urge or sensation that seems to be relieved by execution of the tic.
When are signs of each childhood disorder usually apparent?
Childhood disorders are most easily seen when a major developmental plateau for their age has not been met

**Not in text, this is what I came up with!!
What are the important factors in treating childhood disorders?
Children are unable to seek assistance themselves, so their parents need to do it for them.
Some children are at risk for developing problems just because of where they are being raised.
Parents need be taken care of through the treatment just as much as the kids do.
Parents may need to be used as "change agents".
Down Syndrome
A condition that creates irreversible limitations on survivability, intellectual achievement, and competence in managing life tasks.
Genetically caused by three 21 chromosomes (trisomy of chromosome 21)
Dyslexia
Problems in word recognition and reading comprehension, often markedly deficient in spelling as well.
Will routinely omit, add, and distort words. Reading is typically painfully slow and halting.
Encorpresis
a symptom disorder of children who have not learned appropriate toileting for bowel movements after age 4.
Less common than enuresis.
About 1/3 of encorpretic children are also enuretic.
Enuresis
the habitual involuntary discharge of urine, usually at night, after the age of expected continence (age 5).
Tourette’s Syndrome
An extreme tic disorder involving multiple motor and vocal patterns.
Selective Mutism
Condition that involves the persistent failure to speak in social situations and interferes with educational or social adjustment.
Coprolalia
A verbal tic in which an individual utters obscenities aloud.

AKA Tourette's Syndrome
Tourettes
What is the difference between psychologists and psychiatrists? How do they differ in their approach to treatment?
A psychiatrist is a medical doctor who specializes in the diagnosis and treatment of mental disorders.
A psychologist treats patients without prescribing drugs.

Difference in approach?
What is the importance of the therapeutic relationship? What are important elements of the therapeutic relationship?
A therapeutic relationship will have a large impact on the outcome of the patient's mental health.
Important elements:
Personal characteristics: trust, empathy, etc.
Motivation to change (patient)
Level of expertise (therapist)
Experience (therapist)
How can you measure success/progress in therapy?
1. Assess change (therapist's impression as well as client's self-report and family and friend's input)
2. Objectify and Quantify change (compare pre- and post-treatment scores, measure change in select behaviors, etc)
What is an evidence-based treatment?
Treatments that have empirical data that can prove their success rates.
When should psychotropic medications be used in the treatment of a mental illness?
?
What is the difference between the typical and atypical antipsychotics?
Atypical antipsychotics (2nd Generation) treat both positive and negative symptoms of schizophrenia.
Typical antipsychotics work mainly on the positive symptoms.
What are SSRIs? What are they used to treat? Why are they so popular?
ANTIDEPRESSANTS! (Selective serotonin re-uptake inhibitors.)
Treat panic disorder, social phobia, GAD, OCD, bulimia, and Cluster B PD's
Popular because the have dramatic effects (3-5 weeks) with fewer side effects than Tricyclics.
What are benzodiazapines? What are they used to treat? What are the disadvantages to using them?
ANTI-ANXIETY DRUGS!
Treat: anxiety, insomnia,
Disadvantages: highly addictive, high relapse
What is ECT? When is it used? Why?
Electroconvulsive Therapy.
Used for:
Severely depressed pregnant women, depressed elderly patients, severely depressed/suicidal patients who don't respond to other treatments, patients with manic disorders who don't respond to other treatments.
*Still not sure how it works, but virtually every neurotransmitter is impacted and it has effective results.
What is the basic theory behind behavior therapy?
Increased awareness of our actions will make us more able to change and fine-tune them.
What are the arguments for and against behavior therapy?
For: quick, low cost, clear methods, proven effects. Best with anxiety disorders.

Against: ?
What is the basic theory behind cognitive/cognitive-behavior therapy?
Problems result from biased processing of external events or internal stimuli leading to cognitive errors.
Can be corrected by identifying automatic thoughts and logical errors and correcting them.
What are the arguments for and against cognitive/cognitive-behavior therapy?
For: Comparable to medication in reducing symptoms (better at preventing relapse), clients can gather info about self and challenge their beliefs.
What is client-centered therapy?
(Carl Rogers)
Resolve incongruence-- help clients accept and be themselves.
Restatement of client's description of life difficulties (Kelly buying a puppy story).
What are the arguments for and against client-centered therapy?
For: creates a climate of acceptance. Self-concept becomes congruent with actual experiences.
Against: lack of agreed-upon therapeutic procedures and vagueness.
Rarely used in US today-- popular in Europe.
Generally speaking, what is the basic idea of psychodynamic therapy?
Uncover repressed memories, thoughts, fears and conflicts and help individuals come to terms with them in light of the realities of adult life.
What are the arguments for and against psychodynamic therapies?
Pros: May help come to terms with things that have happened in the past.

Cons: time-consuming, expensive, questionable approach, neglects immediate problems.
What is eclecticism? Why would someone practice eclecticism?
Combining therapies
Transference
When a patient reacts to a therapist like the therapist is a person in the patient's life (like their mother).
Counter-Transference
When a therapist reacts to a patient like the patient is someone else in the therapist's life, like how the therapist would react to their mom.
Efficacy
In a situation where treatment is tested under ideal conditions (usually a controlled clinical trial) efficacy is how well a given treatment improves clinical outcome compared to a control or comparison condition.
Free-association
When a patient says whatever comes into his or her mind, regardless of how personal, painful or seemingly irrelevant it may be.
Part of Freudian psychology.
Exercise used to uncover repressed memories.
Half-life
Time taken for the level of an active drug or medication in the body to be reduced to 50% of the original level.
In vivo exposure
Exposure therapy-- using REAL objects to desensitize patient.

Opposite of Imaginal exposure (using imaginary techniques-- drawings, models, etc.)
Manualized therapy
Standardization of psychosocial treatments (as in development of manual) to fit the randomized clinical paradigm.
Modeling
When the client learns new skills by imitating another person, such as a parent or therapist, who preforms the behavior to be acquired.

Autistic children!
Systematic Desensitization
Exposure therapy.
GRADUAL exposure to anxiety-provoking stimuli.
Resistance
An unwillingness or inability to talk about certain thoughts, motives or experiences.

Ex: purposely skirting an issue.
Response Shaping
Using positive reinforcement to establish (gradually) a response that is actively resisted or is not initially in an individual's behavioral repertoire.

Example: TOKEN ECONOMY (used in highly structured areas. Tokens can be traded for prizes/rewards).