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86 Cards in this Set

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describe successful resolution and pathology of the oral stage.
resolution confers the capacity to give and receive and rely on others with a sense of trust. Pathology is extreme dependance on others for self esteem
the freudian anal stage overlaps with what erikson stage?
initiative versus guilt
pathology of the anal stage?
anal retentive or anal expressive
what is the resolution of the phallic stage?
includes identity and curiosity as a sexual person with confidence and without embarrassment
an excess of inner control during which of freud's stages can lead to premature closing of personality development with predominant obsessive character traits
failure to resolve adolescent issues in the genital phase results in what according to Erikson?
identity diffusion
what is the first stage of piagets developmental theory and what is the final aspect that leads to progression?
sensorimotor, realization of object permanence
what three ways of thinking are characteristic of the preoperational stage of piaget?
phenomenalistic causality (2 things happen back to back, so one must cause the other), animistic thinking (give physical events and objects a life), and semiotic function (ability to represent an event or object as a conceptual schema)
what are important characteristics of the concrete operations stage?
limited logic, concept of reversibility, concept of conservation
seperation anxiety is characteristic of what developmental stage?
sensorimotor
what are the ages and gists of the trust vs. mistrust stage?
birth to 1 year. Trust that they have needs that someone (mom) will take care of. Conflict is learning that they must not bite or nipple will leave…
what are the ages for autonomy vs. shame and doubt?
1 to 3 years
what are the ages for initiative vs. guilt and what stage of freud's theory does it link too?
3 to 5 years, phallic stage
what is the age for industry vs inferiority and what freudian stage does it correspond with?
6-11, latency
what are the ages for and gist of the identity vs. role diffusion stage?
11-end of adolescence, struggle to develop ego identitywhat is the
what is the age for intimacy vs isolation?
21 to 40
what are the ages and gists of the generativity vs stagnation phase?
45 to 60, teach something to leave on to the next generation
what is the age for integrity vs. despair?
65+
this is the process by which a stimulus that previously did not elicit a response comes to illicit a response in a reflex like fashion after it has been paired for one or more trials with a stimulus that already elicits that response.
classical conditioning (Pavlov)
the basic principle behind operant conditioning is what?
consequences of a response increase or decrease the likelihood that the response will occur again (organism is active whereas in classical conditioning it was passive)
a test is reliable if the test results are what?
reproducable with simillar situations
a test is valid if it what?
measures what it is really supposed to measure
what are the tests that may be done in a structured clinical interview?
structured clinical interview for DSM-IV, rorschach, mini international neuropsychiatric inventory, miller forensic assessment of symptoms test, structured interview of reported symptoms
what is a very reliable and valid test for depression?
hamilton depression rating scale
what is the name of a common self report test that measures the patient's current emotional state and enduring personality characteristics?
minnesota multiphasic personality inventory - 2 (MMPI)
how is the personalit assessment inventory different than the MMPI?
shorter, easier reading level, no item overlap in terms of scales (one answer indicates one meaning not many), designed on DSM criteria
Describe the MCMI-II test.
T/F, seperates axis I from axis II, need to watch validity
this test has a list of 21 items and 4 answers for each ranging from I'm so happy I can't stand it to I'm so sad I could not be happy.
Beck Depression Inventory - 2
weschsler scales are what kind of evaluations and test what specefic aspects?
neuropsychological evaluation, tests memory and intelligence
what are the mental status exam components
appearance, attitude, behavior, speech, mood, affect, thought processes, thought content, (the following are the cognitive aspects of the mental status exam) orientation, memory, concentration, executive functioning, abstraction, fund of knowledge, judgement and insight, impulsivity/reliability
this type of affect is characterized by a significant reduction in the intensity of emotional expression.
blunted
this type of affect is characterized by an absence or near absence of any signs of affective expression
flat
this type of affect is characterized by a mild reduction in the range and intensity of emotional expression as in restraining tears
restricted or constricted
this type of affect is characterized by an abnormal variability in affect with repeated, rapid, and abrupt shifts in affective expression.
labile
a blocking thought process usually indicates what?
interuption bu internal stimuli like a hallucination
what is a confabulation?
unconsciously filling memory gaps by imagined, untrue experiences that are believed by the patient yet there is no basis in fact
this is characterized by an inability to carry out specefic tasks like ADL's due to cognitive disturbances
apraxia
what are some agnosias?
anososnosia (don't know they are ill), somatopagnosia (do not know a body part is there, like neglect in stroke), and prosopagnosia (faces)
loss of ADL's due to cognition is due to damage in what area of brain?
frontal lobe
differentiate between delirium and dementia.
delirium consists of visual and tactile hallucinations, poor attention/concentration, changing sensorium (consciousness), and disorientation to time and place while dementia is characterized by progressive global memory loss, agnosia, apraxia, and visual/spatial defects
what is pseudodementia?
patient is depressed so cognition changes, fix the depression and the cognition will be fixed.
what are four signs of psychosis?
usually oriented and cognitively intact, bizarre delusions and auditory hallucinations, disorder of thought process, concrete interpretations of proverbs/simillarities/differences
describe the 5 axes of DSM
1 is clinical disorders, 2 is personality DO and MR, 3 is general medical conditions, 4 ispsychosocial and environmental factors, and 5 is global assesment of functioning
define psychosomatic medicine.
studies the interplay of psycological and social phenomena with physiologic functions (normal or pathological) in the development, course, and outcome of all diseases; it advocates the biopsychosocial approach to patient care
what are the problems patients present with that merits psychiatric consultation?
psychiatric presentations of medical conditions, pschiatric complications of medical conditions or treatments, psychiatric reactions to medical conditions, medical complications of psychiatric conditions or treatments, co morbid medical and psychiatric conditions
death by MI from CV disease is more common when patients are…
depressed
what physiological aspects of a depressed person contribute to CV dz deaths?
increased sympathetic tone, decreased parasympathetic tone, and often have premature ventricular depolarizations
treatment with what type of anti depressant can have CV effects?
tricyclics (orthostatic hypotension) and SSRI's (inhibit metabolism of certain beta blockers and class IA antiarryhythmic agents)
what are some coping responses to being sick?
minimization and denial, avoidance, hyperattention and somatic preoccupation, refusal to accept limits, capitulation or surrender, seeking other sources of knoweledge, and alternative health care
what are the defense mechanisms for sick that are detrimental? Healthy?
denial, regression, self-blame. Humor, altruism, delay self gratification
what are reactions to illness by the various personality types?
dependent - need to be cared for. Passive aggressive - asks for help and does not follow advices. Compulsive - becomes too controlling for fear of loss of control. Histrionic - dramatic, etc. Narcissistic - perfect self image is threatened. Paranoid - blames it on the doctor. schizoid - more withdrawn and anxious.
what psychiatric problems are common in renal dialysis patients?
depression and suicide, sexual problems.
what psychiatric problems are common in surgery patients?
unrealistic expectations, depression, denial… improved out come with knowing what to expect
psychiatric problems in ppl with aids?
anxiety, hopelessness, and fear of abandonment
what are the illnesses associated with psychosomatic factors?
asthma, cancer, CAD, DM, hypertension, migraines, pruritis and tension headache
what are the four ways that personality manifests (note 2 or more must be abnormal for a personality disorder)?
cognition, affectivity, interpersonal functioning, and impulse control
what are the three cluster A personality disorders and what characterizes them?
they all appear odd or eccentric. Paranoid, schizoid and schizotypal
differentiate between schizoid and schizotypal.
schizoids keep to themselves but if you approach them gently they will respond while schizotypals are almost schizophrenic…
what are the cluster B personality disorders and what characterizes them?
appears dramatic, emotional or erratic. Antisocial, borderline, histrionic, and narcissitic
what are the cluster C pesonality disorders and what traits unify them?
avoidant, dependent, obsessive compulsive, and unknown personality disorders. These ppl are anxious and fearful
characterize the workaholic.
perceives with thought first, is logical, responsible, and organized. 75% are male. Horizontal lines on forehead
describe the persister.
judges first, evaluates with opinions. Dedicated, observant, conscientious. Mainly male, 10% of US. Furrows between eyes and piercing eyes
describe the reactor.
feels first, is compassionate, sensitive, and warm. Most are women, half moon over eyes, nails, make up and hair styles are very important
describe the dreamer.
reflective, imaginative, calm. Mainly female, smooth face few lines even with age
describe the rebel.
reacts to ppl and things with likes and dislikes, spontaneous, creative, and playful, mainly female, smile lines around eyes and mouth, twinkles in the eyes
describe the promoter
action oriented, adaptable, persuasive, charming, mainly male, ruddy complexion, only 5% of US, most are in prison
distinguish between bipolar type I, type II, and cyclothymia.
type I is mania or mixed mania and major depressive episodes, type II is hypomania and major depressive episodes, cyclothymia is hypomania and depressive symptoms
what mood disorder may have 2/3 of pts with hallucinations?
bipolar type I
what are pharmacological treatments for bipolar disorder?
lithium, divalproex sodium, carbamazepine, atypical antipsychotic medications, ECT or vagal nerve stimulators, adjunctive medications, novel drugs
in child/adolescent bipolar disorders, what may preced manic episodes?
ADHD
these bipolar patients have a very poor prognosis, have manic episodes multiple times a year, and may need three mood stabalizers
rapid cyclers
what is bereavement?
loss of something in life that causes depression symptoms, and may become depression if lasts over 2 months are symptoms are severe
what illnesses have an increased rate of association with major depression?
stroke, parkinson's, AIDS or HIV infection
what axis and clinical signs are for MR?
axis II, IQ below 70 and impaired adaptive function
what are the three learning disorders?
reading, math, and written expression
what are characteristics of autistic disorders?
problems with social interaction, impairment in communication, repetitive and stereotypal behavior.
describe asperger's disorder.
little professors, cannot interact with their peers however, they are normal usually in language and cognition
describe Rett's disorder.
only in girls, normal early development, @ 5-6 mo's head circumference growth diminishes, stereotypical hand movements, no cognitive development past the first year
describe childhood disintegrative disorder.
normal development first two years, then loss of previously acquired skills.
what is encopresis and enuresis?
encopresis is inappropriate defecation and enuresis is inappropriate urination, usually see a ped, not a shrink
what age do you need to see ADHD symptoms for a diagnosis?
7
what percentage of school aged children have ADHD? Boys vs girls?
3-5%, boys more than girls (3:1), may be under-diagnosed in girls
ADHD is usually co morbid with what other disorders?
depression, tics and tourettes, conduct disorder, substance abuse, and learning disability
what are the outcomes for adults who had ADHD as children?
most have continued problems, more wrecks, sex, drugs, and diseases.
what can lead to sociopathology in children?
conduct disorder
what are treatments for ADHD?
stimulants, antidepressants, and some alpha adrenergic stimulators