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69 Cards in this Set
- Front
- Back
brain damage (especially left hemisphere damage) is suggested when
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Verbal IQ is significantly lower than Performance IQ.
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Prader-Willi
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-caused by chromosomal deletion (part of a chromsome is missing)
- obesity and MR |
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Heredity is responsible for MR in ____ % of cases?
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5%
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___% of MR cases have an unknown cause?
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30-40%
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Most common known cause of MR?
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early alterations in embryonic development
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PKU
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-rare recessive gene syndrome
-detected by blood test at birth -if untx, irreversible mod to profound MR -unable to metabolize phenyl found in high protein foods |
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Down syndrome
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-extra chromosome (trisomoy 21)
-causes 10-30% of mod to sev MR cases -high risk for alzheimer's -often have heart lesions, repiratory defects, intestinal defects, cataracts |
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Learning Disabilities
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-IQs usu in ave to above ave range
-Most frequent comorbid disorder is ADHD (20-30% have) -high risk for antisocial beh -1/3 of ppl w/reading d/os have psychosocial problems as adults |
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stuttering
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-usu begins b/n ages 2-7
-3 times more common in males -60% of cases remit by age 16 -tx: elim stress in home, lowered demands overall, habit reversal (breathing, social supp, awareness training) |
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autism
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-some evidence prior to age 3
-impairments in social interaction (2), communication (1), restricted/repetitive behs, interests (1) -1/2 remain mute throughout lives -if speech, may be abnorm in prosody, echolalia -up to 70% have IQs in MR range -1/3 achieve partial independence as adults |
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best outcome for autism
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-verbal communication by 5 or 6
-IQ over 70 -later onset |
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shaping and discrimination training
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most effective tx for autism
-improves communication skills |
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Rett's
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-only in females
-follows normal dev for 5 mos or more -head growth deceleration -loss of purposeful hand skills -stereotyped hand mvts -limited coordination of gait or trunk mvts -loss of interest in soc environ -impaired language dev |
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childhood disintegration d/o
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regression in at least 2 areas of funct after at least 2 yrs of normal dev
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asperger's
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do better on verbal tasks versus non-verbal
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ADHD
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-onset prior to 7
-IQ ave or above ave (but test lower on IQ) -almost all have academic probs -25-30% have LDs -30-90% have conduct disorder -In kids, 4-9X more common in boys (more equal for inattentive type) -adults, rates for adhd equal In early adolescence, overactivity declines but conduct probs increase -60% have sx as adults (more divorce, job probs, accidents, sub ab, aspd) |
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Ritalin
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effective in 75% of cases
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Conduct D/O
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childhood onset: sx prior to age 10, more aggressiveness, higher risk for ASPD and/or sub ab
Adolescent onset: sx at 10 or later |
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pica
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-sx for at least 1 month without aversion to food
-usu begins between 12 and 24 months |
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Tourette's
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-@ least 1 vocal tic and multiple motor tics
-prior to 18 -Most common assoc sx: obessions and compulsions -hyperactivity, impulsivity also common -antipsychotics (haldol & pimozide) effective in 80% of cases -tourette's due to high dopamine -psychostimulants increase tics, so ADHD sx treated with clonidine or desipramine |
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tourette's
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-obsessive sx tx with SSRIs
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enuresis
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-night alarm (bell & pad or moisture alarm) effective in 80% of cases but 1/3 relapse in 6mos
-Imipramine and Desmopressin also used - st effects good, lt effects poor |
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separation anxiety
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-onset before 18
-lasts at least 4 weeks -usu from close warm families -freqently precip by major life stress -school refusal: 5-7 when begins sch 11-12 when changes sch 14 or older -school refusal during adolescence usu sign of dep or something else |
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irradiation and chemo for Leukemia
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-assoc w/ deficits in neurocog fx and higher rates of LDs
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Delirium
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requires:
-disturbance in consciousness -change in cognition (memory disorientation, lang) OR -perceptual abnormalities (halluc, illusions) |
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depression vs dementia
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depression: impaired recall, but good recognition; procedural memory is affected
Dementia: deficits in both recall and recognition, deficits in declarative memory |
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procedural memory
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-know-how memory
-memory storage of skills and procedures |
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declarative memory
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-memory for facts
-broken down into semantic and episodic memory -episodic: memory for past and personally experienced events) -Semantic: knowledge for the meaning of words and how to apply them. |
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Dementia of Alz type
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-highest cause of dementia
-accounts for 65% of cases |
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Alzheimer's Stage 1 (1 to 3 yrs)
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-anterograde amnesia, esp for declarative memory
-visuospatial deficits (wandering) -indifference -irritability -sadness |
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Alzheimer's Stage 2 (2 to 10 yrs)
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-retrograde amnesia
-flat or labilie mood -restlessness/agitation -delusions -ideomotor apraxia (difficulty translating an idea into movement) |
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Alzheimer's Stage 3 (8 to 12 yrs)
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-severely impaired IQ fx
-apathy -limb rigidity -incontinence |
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Alzheimer's: duration from onset to death is?
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8 to 10 yrs
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Alzheimer's more common in
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-women
-those with lower levels of educ -late onset (after 65) more common than early |
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Etiology of Alzheimer's
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--early onset assoc with abnormalities on chrom 21
--late onset assoc with abnormalities on chrom 19 --aluminum deposits in brain --poor immune system --low ACH |
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tourettes is due to
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excessive dopamine
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vascular dementia
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-cog impairment AND neurological signs
-stepwise fluct course -if due to stroke, most improvements in 1st six months and physical sx improve quicker than cog |
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dementia due to Parkinsons
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-bradykinesia (slowness of movement)
-rigidity -resting tremor -masklike facial expression -pill rolling -loss of coordination & balance -akathesia (cruel restlessness) |
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Parkinson's
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-50% develop depression
--20-60% dev dementia -assoc with loss of dopamine producing cells and Lewy bodies in Substantia Nigra -L-Dopa helps by increasing dopamine |
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Huntington's
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-sx appear b/n 30 and 40
-cog, affective, motor sx -affective sx first -early motor signs: fidgeting and clumsiness - later, athetosis (slow, writhing movements) and chorea (invol jerky movements) |
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alcohol withdrawal
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autonomic hyperactivity
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Korsakoff's
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Anterograde and retrograde amnesia, BUT ANTEROGRADE MORE SEVERE and retrograde memory is more affected for recent vs remote memories
-due to thiamine deficiency -often preceded by Wernicke's |
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Alcohol-induced sleep disorder
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when due to intox: sleepy then restless
when due to withdrawal: disruption in sleep continuity and vivid dreams |
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alogia (neg symptom)
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poverty of thought and speech
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avolition
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restricted initiation of goal-directed behavior
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anosognosia
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poor insight into illness
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Schizophrenia
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-prevalence higher for males
-onset earlier for males -over time, positive sx decrease, negative sx increase Best prognosis: good premorbid fx, acute onset, late onset, female, precipitating event, brief duration of active phase sx, insight, fam hx of mood d/o, no fam hx of schiz |
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concordance rates for Schiz:
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Gen pop: 1%
Fraternal twin: 17% Identical Twin: 48% Child (both parents schiz): 46% |
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Most common structural abnormality in schiz
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ENLARGED VENTRICLES
Functional abnormalities: hypofrontality which is assoc with negative sx |
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Dopamine Hypothesis
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-too much dopamine in Schiz (trad antipsychotics block dopamine)
-modified to: ELEVATED Seratonin and Norepinephrine and low GABA and Glutamate |
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Schizophreniform D/O
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-less than six months of sx
-impaired soc/occup fx not required -2/3rds eventually dev schiz |
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Manic episode
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1 week or longer
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Hypomanic episode
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-At least 4 days
-Not marked impairment -absence of psychosis -often increase in creativity, efficiency |
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Mixed Episode
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-At least one week
-rapid altering sx of manic and depressive episodes -either poor functioning or psychosis |
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Postpartum Depression
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-10-20% of women experience sx severe enough to warrant MDD after birth
-1/500 to 1/1000 develop depressive psychosis that may involve delusions re the newborn |
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Gender and Depression
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-rates equal in children
-rate twice as high for women in adolescence and adulthood |
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depression in children
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-irritability, social withdrawal, and somatic sx
-preadolescents (esp boys) may exhibit aggressiveness and destructiveness |
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Duration of Depression
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-Untreated, sx usu last 6 months
-20-30% of cases, some sx remain for months to years -50% of cases, person experiences more than 1 episode |
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Catecholamine Hypothesis
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dep related to low norepinephrine
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idolamine hypothesis
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dep related to low seratonin
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Bipolar I
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-One or more Manic OR Mixed Episodes
-May or May not have had depressive episodes -Equally common in males and females |
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Bipolar II
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-At least one depressive episode and one hypomanic episode
-Never had Manic or Mixed Episode -More common in men |
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Genetic Factors most consistently linked to which disorder?
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Bipolar Disorder
-Identical Twins: 65% -Fraternal Twins: 14% |
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Lithium
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effective in 60-90% of classic bipolar cases
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Cyclothymic Disorder
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-fluctuating hypomanic sx and numerous periods of depressive symptoms
-Depressive sx not severe enough for MDD -Hypomanic sx not severe enough for Manic Episode -Duration: 2 yrs in adults, 1 yr in kids |
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suicide risk increases dramatically in adolescents if they have:
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conduct disorder, substance abuse, or ADHD
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MOst effective meds for atypical depression
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SSRIs and MAOIs
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GAD and comorbidity
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-GAD has the highest comorbidity rates of all anx d/os
-80% have at least one other anx or mood disorder |
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Panic D/O
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-mustr have at least 2 unexpected attacks (with one being followed by 1 month of concern over having another, worry re: implications of another, or beh changes due to attack)
-33-50% have agoraphobia -of the anxiety disorders, GAD most likely to occur with Panic -Panic more common in women -75% of agoraphobics are women -60-70% respond to in vivo exposure with response prevention |