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68 Cards in this Set

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What are the 2 key states in mood disorders? What criteria must be met for each?
depression: depressed mood most of the day nearly every day; decreased interest in pleasurable activities; weight loss/gain; insomnia/hypersomnia; psychomotor agitation/retardation; fatigue; feel worthless; difficulty concentrating; recurrent thoughts of suicide

mania: grandiosity; decreased need for sleep; excessively talkative (pressured speech); flight of ideas; distractible; excessive involvement in pleasurable acitivities
What is hypomania? What are the criteria?
moderate mania; same symptoms as mania but at a lower level of intensity, no poor judgment, very productive
What are some examples of normal depression?
grief, postpartum depression
What are the criteria for Cyclothymic DO?
cycle between hypomania and depression; symptoms at least 2 yrs in adults, 1 yr in children/adolescents
What are the criteria for Dysthymic D/O?
usually begins in childhood/adolescence; mild to moderate symptoms of depression; never without symptoms more than 2 mos.; 2 yrs adults, 1 yr children/adolescents
What are the criteria for Major Depression?
severe symptoms of depression lasting at least 2 wks; sometimes briefly appear to be psychotic
What are the criteria for Bipolar I & Bipolar II (in general!)?
Bipolar I - at least one manic episode; Bipolar II - at least 1 hypomanic episode
What are the criteria for Schizoaffective D/O?
primarily symptoms of mood d/o, but occasionally full-blown psychotic for about 2 wks
What are some sociocultural factors related to depression (e.g., gender, stress)?
women more at risk than men; diathesis-stress model
What is the psychoanalytic explanation for depression?
anger turned on the self
What is the learning explanation for depression? How does it differ from the psychoanalytic explanation?
reduced reinforcement due to separation/loss; differs based on reinforcement rather than anger issue
What is the cognitive explanation for depression?
talk ourselves into it with negative self-talk, pessimistic outlook, etc.
What is learned helplessness?
Seligman - when your actions repeatedly have no impact on the events in your life, you give up
What is the genetic explanation for depression? the biochemical (i.e., neurotransmitters)?
concordance rates (MZ = 40%, DZ = 11%); deficiency in neurotransmitter levels
What are the 3 types of antidepressants?
SSRI, tricyclic, MAOI
What is used if medication is ineffective in the treatment of depression?
What medication is used to treat Bipolar D/O? How does it work?
Lithium or Depakote; controls manic end of symptoms
How do most people who experience suicidal ideation typically feel?
What is highly correlated with suicide?
What is alcohol-induced myopia?
restricted thought processes - near sighted, can't see anything in the future
What are the 3 categories of suicide according to Durkheim? Define each.
Egoistic - feel lost, without identity; isolated
Altruistic - want to further group goals; give up life for a higher cause
Anomic - dramatic imbalance in relationships with society; dramatic change in society leads to inability to cope with new status
What do we know about children and adolescents who commit suicide? college students? elderly?
children/adolescents: usually do it at home when someone is nearby
college students - tend to be older than the average student (about 4 yrs), more males, foreign students, foreign language/literature majors; higher GPAs
elderly - depression (spouse and friends dying, health, income, etc.)
How do friends and family react to suicide according to Kubler-Ross?
Denial - withdraw, close off feelings
Anger - experience grief, blame self, how could you
Acceptance - let go, regrets
What issue was debated regarding suicide? Any resolution?
right to die; no
25) What is the primary symptom of schizophrenia?
disruption of thought processes
Be familiar with the history of schizophrenia--Kraepelin, Bleuler.
Kraepelin - dementia praecox ("insanity at an early age," believed it was a biological cause)
Bleuler - schizophrenia ("split mind," person has gone to an inner world)
What is the incidence of schizophrenia in the U.S.?
What are the DSM-IV criteria for schizophrenia?
Criterion A (at least 2 symptoms, at least 2 mos in current phase)

delusions (firmly held false beliefs)

grandeur (famous/powerful)
control (others trying to control you)
thought broadcasting (others hear your thoughts)
persecution (others plotting against you, want to kill you)
reference (everything that happens is related to you)
thought withdrawal (others removing thoughts from your mind)

hallucinations - auditory, visual, tactile, olfactory, gustatory
disorganized speech - derailment, neologisms
disorganized behavior - catatonic
negative symptoms

flat affect - little/no emotion
anhedonia - inability to feel pleasure
avolition - lack of motivation
alogia - lack of meaningful speech

Criterion B - social/occupational dysfunction
Criterion C - duration of symptoms at least 6 months total
What are some of the problems in defining schizophrenia?
criteria more exact now, so those diagnosed before 1980 may have a different diagnosis
inability to verify hallucinations
Laing - mythical construct (symptoms exist but what we call schizophrenia is really several different d/o's
What are the most common subtypes of schizophrenia?
paranoid & undifferentiated
What are the criteria for Paranoid Schizophrenia?
1+ delusions; frequent hallucinations (auditory); delusions of grandeur and persecution; gradual onset
What are the criteria for Disorganized Schizophrenia?
all symptoms in Criterion A are prominent; severe disorganization; delusions usually sexual, religious, or persecutory; become infantile (baby talk); silly smile; anal stage; obscene behavior
What are the criteria for Catatonic Schizophrenia?
A least 2 of the following:

motoric immobility(stupor), excessive motor activity, extreme negativism/mutism; peculiar movements; echolalia/echophraxia

waxy flexibility, sudden onset, primary symptom is motor disturbance, can be violent, aware of things while in stupor
What are the criteria for Undifferentiated Schizophrenia?
"wastebasket;" don't clearly fit one of the other 3 types
What are the criteria for Residual Schizophrenia?
recovered, but still showing some mild symptoms
What are the criteria for Schizophreniform D/O?
@ least 1 months of symptoms but < 6 mos
What is the Rule of Thirds?
1/3 have episode, hospitalized, discharged, never experience recurrence
1/3 repeatedly hospitalized
1/3 institutionalized
What do twin studies tell us about schizophrenia?
MZ = 28%, DZ = 6%
What do adoption studies tell us about schizophrenia?
moderate genetic effect; children of schizophrenic mothers may be schizophrenic, antisocial, incarcerated, MR
What is the dopamine hypothesis?
too much dopamine
What have CAT scans and MRI's hypothesized about the cause of schizophrenia?
enlarged ventricles
What tends to occur in the families of children who later become schizophrenics?
double bind communication
What is Pervasive Developmental D/O?
not psychotic; language, social relationships, attention, perception, and affect all severely affected; not developmental delay
What are the criteria for Autism?
CRITERIA: usually onset by 2.5 y.o.; 4-5x more likely in boys; aloof, no interest in others; restricted used of speech (echolalia), ritualistic behavior, stereotyped/repetitive behavior (spinning, hand flapping, head banging); attach to odd objects; need sameness; 75% MR
Autism? Possible causes?
CAUSES: Psychoanalytic--deviant parent-child interactions (Kanner--cold, unresponsive parent); CHICKEN & EGG

Family & Genetic Studies--2-9% of their sibs are autistic (100-200x > general population). Concordance rates--->MZ = 80-90%, DZ = 10%.; mothers who were "emotional refrigerators" (Kanner)

CNS Impairment--fragile X chromosome, tuberous sclerosis (congenital disease associated w/ brain tumors), NF, PKU, intrauterine rubella.

Biological--enlarged ventricles, but no clearly identifiable cause of the syndrome

Cognitive--perceptual deficits limit them to processing only one stimulus at a time
Autism Treatment?
TREATMENT: Drugs (Haldol, Fenfluramine), Behavior Modification for targeted behaviors
What are splinter skills? an autistic savant?
unusual talents (calendar, math, music, puzzles); an autistic with splinter skills
What are the 3 other forms of P.D.D. now identified in DSM-IV?
Rett's D/O, Childhood Disintegrative D/O, Asperger's D/O
What is the prognosis for autism?
poor generally speaking, better if they have good verbal skills
What is the problem in diagnosing other childhood disorders?
Requires clinician judgment; determining what is and is not age appropriate
What are the 3 types of ADHD? Criteria?
Hyperactive-Impulsive: high motor activity, short attention span, distractible, impulsive, no self-control
Inattentive: distractible, can't sustain attention, inattentive to detail, difficulty completing tasks, sluggish/daydream
Hyperactive-Impulsive, Inattentive, Combined
When might we not notice a child is ADHD?
one-on-one, novel situation
How prevalent is ADHD? gender differences?
3-6%, boys 3-9x more likely than girls
What happens over time in ADHD?
symptoms diminish beginning in adolescence
What causes ADHD?
NOT food additives!; probably multiple factors related to the central nervous system
How might ADHD be treated?
Ritalin/Cylert/Adderol/Strattera; behavior modification
What are the criteria for Oppositional Defiant D/O?
negativistic, argumentative, hostile, lose temper, defy rules, defy authority
What are the criteria for Conduct D/O?
aggressive/antisocial behavior (fighting, sexually promiscuous, assault, rape, truancy, vengeful, lie, steal, set fires, vandalism, homicide, torture animals
What is the best treatment for Conduct D/O? Why doesn't punishment work?
best treatment = remove from home plus social skills and problem solving training, parent management training
punishment doesn't work because it only intensifies the behavior (intermittent schedule of reinforcement in action)
What are the criteria for Depression in childhood? causes? treatment?
same as adult except aggressive rather than depressed; same causes and treatment
What are the criteria for Anorexia Nervosa? typical onset? types? complications?
criteria = @ least 15% below normal weight for height & age, excessive fear of gaining weight, distorted body image, miss 3 or more menstrual periods
typical onset = 12-18 y.o.
types = Restricting Type, Binge Eating/Purging Type
complications = cardiac arrhythmia, hypotension, damaged heart, anemia, cracked skin, hair loss, bowel/intestinal obstruction, menstrual irregularity (amenorrhea), osteoporosis, 5-8% die
What are the criteria for Bulimia Nervosa? complications? accompanying feelings?
binge eating @ least 2x/wk for 3 mos, purge, fear weight gain but normal weight
COMPLICATIONS: puffy face, eroded tooth enamel, mouth ulcers, cavities, esophagitis, tears in throat, small red dots under eyes, laxative dependence
What is the treatment for Anorexia Nervosa and Bulimia Nervosa?
Anorexia - hospital to gain weight, behavior therapy reinforcing weight gain, cognitive behavioral therapy for new coping strategies, family therapy
Bulimia - psychotherapy & antidepressants
What are the criteria for Mental Retardation?
IQ < 70; difficulties with adaptive functioning; < 18 y.o.
What are the 4 levels of M.R.? associated terms & IQ ranges?
Mild - Educable (50-70)
Moderate - Trainable (35-50)
Severe - Dependent (20-35)
Profound - Life Support (< 20)
What is an idiot savant?
MR person with splinter skills
What are the potential causes of M.R.?
Down Syndrome, sensory & social deprivation, inadequate education
What are the Specific Developmental D/Os (learning disabilities)? What are the criteria? treatment?
Reading, Mathematics, Written Expression
IQ at least 15 points higher than achievement test
build on areas of strength for study skills/learning