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112 Cards in this Set
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What is a personality disorder? |
Persistent pattern of emotions, cognitions and behavior that results in enduring emotional distress for the person affected and/or for others and may cause difficulties with work and relationships. |
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What are the 2 models of personality disorders? |
1) Categorical model - either have it or you don't 2) Diemensional model - categorize diagnosis and rate on series of personality dimensions. This has 3 advantages: retain more info about the individual, More flexibility, avoid decisions about placing someone in a category |
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What is the five factor model? |
rated on a series of personality dimensions and a combination of 5 components that describes why people are so different. The dimensions are extraversion, agreeableness, conscientiousness, neuroticism, and openness to experience |
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What are the 3 clusters for personality disorders? |
a - odd, eccentric b - dramatic, emotional, erratic c - anxious and fearful |
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At what ages do borderline personality and antisocial personality disorders start to dissipate? |
B: 30's A: 40's |
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What types of traits are shown in men and women with personality disorders? |
Men - aggressive traits Women - emotional traits |
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What is Paranoid Personality Disorder? |
Cluster A personality disorder involving pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent. It is characterized as unjustified distrust, hard time forming close relationships, hostility towards others, and mistaken assumptions about others, but no hallucinations like schizophrenia |
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What are some causes of Paranoid Personality Disorder? |
Genetics, some relationship to schizophrenia, trauma in childhood, schemas of the world |
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What are treatment options for Paranoid Personality Disorder? |
These individuals aren't trusting, so they are unlikely to seek help and not develop trust for therapist. Cognitive therapy and cognitive restructuring is an option, however there is no confirmed demonstrations that any form of treatment is helpful |
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What is schizoid personality disorder? |
Cluster A personality disorder featuring a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions. They don't enjoy close relationships, restricted range of emotional expression and have social deficiencies |
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What are some causes/treatments of schizoid personality disorder? |
Inherited traits (childhood shyness), childhood abuse/neglect, and the contribution of low dopamine. They can be taught relationships and empathy, as well as social skills training |
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What is schizotypal personality disorder? |
Cluster a personality disorder involving a pervasive pattern of interpersonal deficits featuring acute discomfort with, and reduced capacity for, close relationships, as well as by cognitive/perceptual distortions and eccentricities of behavior. It is on a continuum with schizophrenia, and includes psychotic-like symptoms, social deficits and cognitive impairments/paranoia. It can include "magical thinking". |
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What are some causes of schizotypal personality disorder? |
- One phenotype of schizophrenia's genotype (environment and biology plays role in how strong this shows) - risk for developing schizophrenia later on - Genetic component - higher in families with schizophrenia - Damage in left hemisphere - Generalize brain abnormalities |
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What are some treatments for schizotypal personality disorder? |
- Comorbid with MDD so difficult to treat (30-50%) - Modest results at best - Teach social skills and accepting their lifestyle - Schizophrenia meds only show a mild improvement |
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What is Antisocial Personality disorder? |
Cluster B persoanlity disorder involving a pervasive pattern of disregard for/ violation of the rights of others. Similar to the non-DSM-label psychopathy, but with a greater emphasis on overt behavior rather than personality traits. It is the most dramatic, manipulative and selfish personality disorder, characterized by lack of guilt, regret, conscience and empathy as well as violating the rights of others |
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What is psychopathy? |
Non-DSM category similar to ASPD, but with less emphasis on overt behavior. Indicators include superficial charm, lack of remorse and other personality characteristics. The diagnostic criteria for ASPD tends to be more liberal. |
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What is the Checkley Criteria? |
16 characteristics describing psychopathic personality including unreliability, lack of remorse/shame and untruthfulness/insincerity |
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What is Hare's List? |
20 item checklist to serve as an assessment tool; revised psychopathy checklist. High scores indicate psychopathy |
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What is the biggest factor in the role of whether or not a psychopath becomes a criminal? |
IQ (it may be a factor) |
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What is conduct disorder? |
Similar to ASPD but for children; engage in behaviors that violate societies' norms and have 2 types: Childhood onset type (1 or more criterion seen before the age of 10) and adolescent onset type (Absence of any criteria characteristic prior to age 10). Important to the diagnosis is psychoticism - high impulsitivity and low empathy |
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What are some neurobiological influences in ASPD? |
- Underarousal hypothesis: low levels of cortisol arousal means negative affect/poor performance. Primary cause of antisocial/risk taking behavior. This goes along with the cortical immaturity hypothesis (cerebral cortex is at a relatively primative stage of development; childlike or impulsive) - Fearlessness hypothesis: Higher threshold for experiencing fear; this gives rise to symptoms. Essentially, it is hard to associate certain cues with punishment/danger - Genetic contribution: seen in many men which means it is likely found on the X chromosome (all genes show) - MAOA enzyme: if neurotransmitters build up, they may be prone to violence |
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What are the 3 major brain systems influencing learning/emotional behavior? |
1) Behavioral Inhibition System (BIS) - stops/slows down when facing impending punishment and is located in septal-hippocampal area of the brain involving noradrenergic and serotonergic neurotransmitter systems 2) The Reward System (REW) - Approach behavior (to positive rewards) in the Mesolimbic area of the brain with with dopaminergic NT system 3) Fight-Flight System (FFS) |
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What are some psych/social dimensions of Antisocial Personality Disorder? |
- Failure to abandon an unattainable goal - Parents giving into kids (maintain behaviors) - Stress (traumatic events, childhood trauma) |
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What are some treatment options for ASPD? |
- Poor prognosis with few success stories - Incarceration - Teach as kids - Parent training, improve family relations, reduce association with bad peers - Prevention programs |
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What is Borderline Personality disorder? |
Cluster B personality disorder involving a pervasive pattern of instability of interpersonal relationships, self-image, affects and control over impulses. Some characteristics include turbulent relationships, fearing abandonment, lack of control over emotions, suicidal/self-mutilative behaviors and comorbidity with other disorders |
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what are some causes of Borderline Personality Disorder? |
- Familial and linked to other disorders (mood disorders) - Early Trauma (abuse) - might explain why more prevalent in women - Similar to PTSD - rapid cultural changes (immigrants) |
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What are Treatment options of Borderline Personality Disorder? |
- Complicated due to comorbidity - Medications have positive results (including lithium); atypical antipsychotic quetiapine - DBT: cope with suicidal stressors (including inpatient) - Couples therapy if person is in a relationship - Treatment similar to PTSD |
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What is Histronic Personality Disorder? |
Cluster B Personality Disorder involving a pervasive pattern of excessive emotionality and attention seeking. Characterized by exaggerated emotions, vain, self-centered and needing praise |
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What are some causes/treatment options of Histronic Personality Disorder? |
- Potential relationship with PTSD? - Little success with treatment - Modify attention-getting behavior - Focus on interpersonal relationships |
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What is Narcissistic Personality Disorder? |
Cluster B Personality Disorder involving a pervasive pattern of grandiosity, in fantasy/behavior, need for administration and lack of empathy. There is an unreasonable sense of self-importance |
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What are some causes/treatments of narcissistic personality disorder? |
- Empathetic "mirroring" by parents in development - "Me generation" - Treatment limited in success - Cognitive Therapy and coping strategies - Learn empathy |
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What is avoidant personality disorder? |
Cluster C Personaity Disorder featuring a pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to criticism. Characteristics include interpersonally anxious, fear rejection and pessimism about the future |
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What are some causes of Avoidant Personality disorder? |
- People born with a difficult temperment may be rejected by their parents; this can turn into low self-esteem which persists into adulthood - Limited support - Similarities to Social Anxiety Disorder (behavioral inhibition) |
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What are some treatment options for Avoidant Personality Disorder? |
- Behavioral intervention techniques - Similar treatment to Social Anxiety Disorder - exposure to the feared situations - Even moderate improvement is encouraging |
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What is Dependent Personality Disorder? |
Cluster C Personality Disorder characterized by a person's pervasive and excessive need to be taken care of, a condition that leads to submissive and clinging behavior and fears of separation. Characterized by agreeing so someone won't be rejected and clinging to relationships |
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What are some causes/treatments of Dependent Personality Disorder? |
- Neglect/death/rejection of caregiver cause fears of abandonment - Genetic influences in personality traits - Hard to treat due to the submissive nature (must gain confidence) |
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What is Obsessive-Compulsive Personality Disorder? |
Cluster C Personality Disorder featuring a pervasive pattern of preoccupation with orderliness, perfectionism and mental/interpersonal control at the expense of flexibility, openness and efficiency |
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What are some causes/treatments of Obsessive-Complusive Personality Disorder? |
- Weak genetic contribution - Predisposed to favorite structure - Parental reinforcement of conformity/neatness - CBT for perfectionism |
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What is the attachment theory? |
- Nature of child/caregiver bond is crucial for development and regulation of children's emotional experiences and behavior - 3 types: Anxious-ambivalent, avoidant or disorganized - Personality Disorders are related to various manifestations of insecure attachment |
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What is the most common personality disorder in psychiatric settings? |
Borderline Personality Disorder |
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What is schizophrenia? |
Devastating psychotic disorder that may involve characteristic disturbances in thinking (delusions), perception (hallucinations), speech, emotions and behavior |
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What are catatonia, hebephrenia and paranoia? |
c: Alternating immobility and excited agitation h: silly and immature emotionality p: delusions of grandeur or persecution |
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Discuss Kraepelin's contributions to schizophrenia |
- Thought of dementia praecox, which combined symptoms thought to be separate disorders - Distinguished dementia praecox from bipolar illness (noted the different symptoms) - Discussed onset and poor outcomes of schizophrenia |
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What is Dementia Praecox? |
Latin term meaning "pre mature loss of mind", an early label for what is now called schizophrenia, emphasizing the disorder's frequent appearance during adolescence |
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Who coined the term schizophrenia? |
Eugen Bleuer (he also looked at the universal underlying problem) |
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What are Positive Symptoms? |
More overt systems, such as delusions/hallucinations, displayed by some people with schizophrenia |
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How do you diagnose schizophrenia? |
Must have 2 or more symptoms lasting from 3 categories (positive, negative or disorganized symptoms) persisting for more than 1 month |
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What is a delusion? |
Psychotic symptom involving disorder of thought content and the presence of strong beliefs that are misrepresentations of reality. A common delusion is feeling like people are "out to get me". It is potentially information that is not integrated, and delusions may serve the purpose for those upset by changes taking place within themselves |
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What are hallucinations? |
Psychotic symptom of a perceptual disturbance in which things are seen or heard or otherwise sensed although they aren't real/present. Auditory are the most common types. They are usually experiences when the person is unoccupied or restricted from sensory input |
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What are the two theories behind auditory hallucinations? |
1 - Listening to their own voice and thinking it is someone else (can't tell difference) 2 - Abnormal activation of the primary auditory cortex |
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what are negative symptoms? |
Less outgoing symptoms, such as flat affect and poverty of speech, displayed by some people with schizophrenia |
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What are the examples of negative symptoms? |
- Avolition: inability to initiate and persist in activities - Alogia: Relative absence of speech - Anhedonia: Presumed lack of pleasure experienced - Flat Affect: Apparently emotionless demeanor (including toneless speech and vacant gaze) when a reaction would be expected - Asociality: severe deficits in social relationships (few friendships, little interest in socializing, poor social skills). The best indicator is chronic cognitive impairment - processing info may contribute to social skills |
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What are disorganized symptoms? |
Erratic behaviors that affects speech, motor behavior and emotional reactions |
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What is disorganized speech? |
Style of talking often seen in people with schizophrenia that involves incoherence and a lack of typical logical patterns, such as going off on a tangent, loose associations and derailment |
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What is inappropriate affect? |
Laughing/crying at improper times and bizarre behaviors |
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What is schizophreniform disorder? |
Psychotic disorder involving the symptoms of schizophrenia but lasting less than 6 months. The first symptom appears within the first 4 weeks of noticeable change in usual behavior. Confusion occurs at the peak of the episode |
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What is schizoaffective disorder? |
Psychotic disorder featuring symptoms of both schizophrenia and major mood disorder. The prognosis is the same as schizophrenia and delusions/hallucinations for 2 or more weeks in absence of mood symptoms |
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What is delusion disorder? |
Persistent belief that is contrary to reality in the absence of other characteristics of schizophrenia. It is not the result of organic factor/ severe psychosis. There are 5 subtypes. |
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What are the 5 subtypes of delusion disorder? |
Erotomaniac: High status/unsuspecting person is in love with them and they engage in pursuit Grandoise: inflated worth, power, knowledge Jealous: Partner is unfaithful Persecutory: he/she/someone close is being mistreated in some way Somatic: Afflicted by physical defeat/general medical condition |
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What is shared psychotic disorder (foile a deux)? |
An individual develops delusions simply as a result of a close relationship with a delusional individual. it is rare and they tend to fare better than schizo patients. |
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What is substance-induced psychotic disorder? |
Psychosis is caused by ingestion of meds, psychoactive drugs, toxins |
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What is psychotic disorder due to another medical condition? |
Condition characterized by hallucinations and delusions and that is the direct result of another physiological disorder such as stroke or brain tumor |
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What is Brief Psychosis disorder? |
Psychotic disturbance involving delusions, hallucinations, or disorganizational speech, but lasting less than one month; often occurs in reaction to a stressor |
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What is attenuated psychosis syndrome? |
Disorder involving the onset of psychotic symptoms such as hallucinations and delusions which puts a person at high risk for schizo; designated for further study in the DSM-5 |
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What are some statistics for schizophrenia? |
- generally chronic, hard time functioning in society - equal for men and women - slightly less than average life expectancy |
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What is the development pattern for schizophrenia? |
- signs generally seen by early childhood - Brain damage in developmental period - may lie dormant until later in development - Earlier damage occurs, more time to compensate for it |
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What is the genetic influence in schizophrenia? |
- Responsible for making some individuals vulnerable - No single gene is responsible, rather multiple variances produce vulnerability - severity of parent's disorder influenced likeliness in child - The schizo you inform may be manifesting different from your parents - Risk of schizo varies with how many genes an individual shares with someone with the disorder |
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What are some problems with brain structure in schizophrenia patients? |
- Size of ventricles: abnormally large third and lateral ventricle indicates adjacent part of brain has not developed fully or atrophied, allowing ventricles to become larger, though this is not seen in everyone - Frontal Lobe: less active (hypofrontality) which is associated with negative symptoms; major dopamine pathway - Prefrontal Cortex: Same cortical regions, subcortical circuits involving thalamus/stratum |
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Discuss the theory of viral infection for schizophrenia |
- Virus-like disease - prenatal exposure to influenza - 2nd trimester developmental problems - Fingerprint ridges are the marker of prenatal brain damage |
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Discuss some psychological and social influences on schizophrenia |
- Stress: certain stressors such as urban living or combat. Stress must use a prospective approach to measuring so that it is not misleading - Family and relapse: schizophrenogenic (cold, dominating and rejecting parent who was thought to cause schizo in their offspring) and double bind (conflicting messages caused schizo to develop) theories are no longer supported. Expressed emotion is now supported |
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What is Expressed Emotion (EE)? |
The hostility, criticism, and overinvolvement demonstrated by some families toward a family member with a psychological disorder; this can lead to the person's relapse. High EE = intrusive negative attitude |
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What are some biological interventions for schizophrenia? |
- 1950's saw a breakthrough in medications - Drugs are not effective on everyone but the newer ones seem to work better - Relapse occurs mostly because patients refuses to take meds due to cost, negative relationship with doctor and poor social support - Terrible side effects from meds such as tardive dyskinsia |
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What is Transcranial Magnetic Stimulation (TMS)? |
It deals with hallucinations. Stimulate brain area with hallucinations and it seems to improve auditory hallucinations |
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What are some psychosocial interventions for schizophrenia? |
- Token economy: Social learning behavior system in which individuals earn items they can exchange for desired rewards by displaying appropriate behaviors - Support in community and halt institutionalization - Independent living skills programs - Differences across cultures to approaching this |
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What are some preventions for schizophrenia? |
- Treat at-risk kids - Increase attention treatment for people in early stages |
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What is the Dopamine Hypothesis? |
- Schizo caused by an overactive dopamine system - Dopamine antagonist drugs - Drugs that increase dopamine results in schizophrenic-like behavior is normal and worsening of psychotic symptoms in patients with schizophrenia - There is some evidence against this hypothesis; not everyone is helped by these drugs and are more helpful in positive symptom relief over negative symptoms
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what is Delirium? |
Rapid-onset reduced clarity of consciousness and cognition, with confusion, disorientation and deficits in memory and language. USually found in older adults, people undergoing medical procedures, cancer and AIDS patients. It usually subsides quickly and usually people make a full recovery. It can be caused by intoxications, withdrawl, head injury, certain drugs and brain trauma |
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What are some treatment options and prevention measures for delirium? |
- Rapid treatment has better long term outcomes - Antipsychotic medication - Psychosocial intervention - Proper medical care/drug monitoring needed to prevent |
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What is Major Neurocognitive Disorder? |
Gradual deterioration of brain functioning that affects memory, judgment, language and other advanced cognitive processes |
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What is Mild Neurocognitive Disorder? |
New DSM-5; created to focus on the early stages on cognitive decline |
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What is Agnosia/Facial Agnosia? |
A: Inability to recognize or name objects F: Inability to recognize even familiar faces |
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What are the classes of Neurocognitive Disorder? |
- Alzheimer's - Vascular injury - Frontotemporal degeneration - TBI - Lewy body disease - Parkinson's - HIV Infection - Substance use - Huntington's Disease - Prion Disease - Another medical condition |
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What is Alzheimer's Disease? |
The strange disease of the cerebral cortex that causes and atypical form of senile dementia discovered in 1906. |
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What is a Neurocognitive Disorder due to Alzheimer's Disease? |
Condition resulting from a disease condition resulting from a disease that most often develops in adults 50 and over; characterized by multiple cognitive deficits that develop gradually and steadily. There is impairment in memory, orientation, judgment and reasoning. Forget things such as events and lose objects. Only an autopsy can FULLY diagnose, but doctors are usually able to by examining the brain. Use a mini mental state examination to assess language and memory problems. Rapid deterioration happens int he middle stages. |
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What is Asphasia? What is Apraxia? |
Asp: Difficulties with language APR: Impaired motor functioning |
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What is the Cerebral reserve hypothesis? |
The more synapses a person develops through life, the more neuronal death must take place before the signs of neurocognitive disorder are obvious |
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What is Vascular Neurocognitive Disorder? |
Progressive brain disorder involving loss of cognitive functioning, caused by a blockage of blood flow to the brain, that appears concurrently with other neurological signs and symptoms. There is a decline in speed of information processing and executive functioning. It has a lower incidence than Alzheimer's, it is more prevalent in men and is the result of a stroke |
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What is Frontotemporal neurocognitive disorder? |
Condition that damages the frontal/temporal regions of the brain; behavior or language is negatively affected. It declines in appropriate behavior and language |
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What is Pick's Disease? |
Very rare neurological disorder that results in presenile (early onset) dementia |
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What is a TBI? |
Brain damage caused by a blow to the head or other trauma that injures the brain and results in diminished neurocognitive capacity |
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What is neurocognitive disorder due to TBI? |
Condition resulting from jarring of the brain caused by a blow to the head or other impact; symptoms (executive function, lack of memory or learning) persist for at least a week after the initial trauma |
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What is NCD due to Lewy body disease? |
Neurological impairment that affects people with Lewy Body disease, in which protein deposits damage brain cells and gradually cause motor impairments and loss of alertness. Includes vivid visual hallucinations and motor impairment |
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What is NCD due to Parkinson's Disease? |
Disorder characterized by progressive decline in motor movements; results from damage to dopamine pathways |
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What is Parkinson's Disease? |
Degenerative brain disorder principally affecting motor performance (tremors, stooped posture) associated with reduction in dopamine |
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What is NCD due to HIV? |
less common type of neurocognitive disorder that affects people who have HIV; may lead to impaired thinking in advanced stages. Results in cognitive slowness, impaired attention and forgetfulness |
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What is Huntington's Disease? |
Genetic disorder marked by involuntary limb movements and progressing towards dementia |
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What one chromosome has a deficit on it for Huntington's Disease? |
Chromosome 4 |
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What is NCD due to prion disease? |
Rare progressive neurodegenerative disorder caused by prions, proteins that can reproduce themselves and cause damage to brain cells. There is no DNA or RNA that can be destroyed by chemotherapy and radiation, and no known treatment. It is not contageous |
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What is Creutzfeldt-Jakob disease? |
Extremely rare condition that causes dementia |
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What is substance/Medication-induced NCD? |
Memory impairment and 1 of: aphasia, apraxia, agnosia, executive functioning disturbance |
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What are some biological causes of Alzheimer's? |
- Smoking deceases risk; however this may just be due to the fact that smokers do not live as long - neurofibrillary tangles and amyloid plaques in the brian - We cannot yet observe all changes in the brain, which is why we need to use autopsy's - Genes linked on chromosomes 21,19,14,12,1 |
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What is deterministic? What is suseptibility? |
D: Genes that lead to nearly a 100% chance of developing the associated disorder S: Increase risk in developing genes but is more related to the general public |
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What does Amyloid Beta Protein do? |
- It is a buildup due to Amyloid Precursor Protein (APP) - May be responsible for an early onset of NCD - E4 protein is responsible (apolipoprotein E) - Gene-environment interaction with E4 and environment |
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What are some biological treatments for Neurocognitive Disorders? |
- some aren't currently treatable - GDNF may someday be able to reduce/reverse progression of degenerative brain diseases - Stem cell transplants - Drugs: target amyloid plaques in the brain and SSRIs for symptoms |
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What are some psychosocial treatments for Neurocognitive Disorders? |
- Memory Wallets: Write info on the cards - Cognitive stimulation to delay onset - Instructions and support for caregiver |
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What are some prevention measures for NCD? |
- Control blood pressure - Do not smoke - Active/physical life |
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What are the two types of explicit memory? What do they do? |
Episodic: Memory from one's autobiographical past (My dog) - recolection and familiarity Semantic: Common knowledge for everyone (The capital of Canada) - generic and personal |
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Which part of the brain is focused on episodic memory? |
Medial temporal lobes |
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Which part of the brain is focused on semantic memory? |
lateral and anterior temporal lobes |
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What are some characteristics of amnesia? |
- Cognitive functions relatively preserved except for memory - Affects more long term memory and explicit memory |
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What is means end problem solving? |
Measure of real-life problem solving, typically used in clinical setting. Requires one to conceptualize means of moving towards a goal |
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What are the 3 types of means? |
1) Relevant - a step or action that gets the individual closer to achieving his/her goal 2) Irrelevant - A step or action that may be directed towards a specific goal but that is not effective within the context of the story 3) No means - doesn't provide steps to achieve a goal |
