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46 Cards in this Set
- Front
- Back
Psychosocial treatment
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the physician treats both the medical conditions and the psychosocial issues
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Neurobiological psychiatry
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organic brain dysfunction
psychopharmacology starts here |
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Psychoanalytical
-define |
Freud
- to find the ethiology of the problem - forces acting in people ID, ego, superego |
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psychoanalysis tx
- characteristics |
highly verbal
- 5 steps free assoc. - transference-working through-insight-termination -goal to resolve problems of childhood -intense and long therapy -pain/passion - 3-6 years |
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Psychoanalytical
- charac. of therapy |
tx to understand conflicts and defenses
- face to face - free association - supportive techniques - medication adjunct months to years |
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Behavioral therapy
- characteristics |
Stimulus-response-reinforcement
- important tool for psychiatry and education system - to eliminate disruptive behavior - classical conditioning -contingency contracting - token economies |
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Learning
-definition |
relatively permanent change in behavior as a result of experience
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difference bw FEAR and PHOBIA
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fear still has a degree of reationality.
- phobia, they become anxious and irrational over something |
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Cognitive therapy
- characteristics - type of patients |
- to identify and alter cognitive distortions
- non-psychotic depressed pt - could be from exogenous and endogenous causes - depressed pt are easiest to work with - bc depression and anxiety are learned - RET rational emotive therapy |
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Humanistic
- origin -characteristics - for which pt? |
- from existentialism
- here and now - hierarchy of needs - personal power - "disassociation" we should lead with our brains not with our emotions... - flexibility of thoughts |
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Supportive psychotx
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To maintain or reestablish the best basic level of functioning
- support intellectualization - therapist guide and mentor - meds - active approach - discussion to alternatives/homework |
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purpose of psychological and educational tests?
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- evaluate school children
- get more info not attained in interview - |
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psychometric tests
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measurement- a single unit
evaluation-collection and interpretation |
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standarization
- definition |
- the test administration and the scoring to be invariant over time..
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Validity
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the ability to test a measure what it intends to measure
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psychometric testing
- def. reliability |
measures a test consistency over time
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When do you ask for psychometric testing?
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for a differential diagnosis
- to consider medication - school based learning problems - neurological impairment - limits of activity - suicidal/homicidal |
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classification of tests
- 5 areas |
tests designed for
1- intelligence 2- education and achievement 3- perceptual motor abilities 4- adaptive behavior 5- personality |
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2 most common intelligence tests
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Stanford-Binet: for young children
Wechsler: intelligence scale for children (school children) |
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WISC -R
- purpose - results |
Wechsler Intelligence Scale for children revised.
- Assesses abilities VERBAL and PERFORMANCE - Information, vocabulary, similarities, arithmetic, comprehension, digit span, picture completion, picture arrangement, block design, object assembly, coding, mazes. Mean-100 SD- 15 67% children have a 85-115 IQ 95% 70-130 Q - Always consider the child cultural background |
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Educational achievement tests
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ITBS- Iowa test of basic skills for young kids
ITED for educational development- ideal to use in high school children They test language, arts, reading, study skills, arithmetic, social studies Disadvantage: group setting kids usually perform bad |
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Adaptive behavior testing
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Vineland adaptive behavior scale
Iowa-Conner teacher rating scales: helpful in ADHD evaluation |
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Perceptual motor skills
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- Draw a person test
- Bender Gestalt (copy a design) - Benton visual retention test (copy a design and recall it later) |
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Projective Tests
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- Unstructured and ambiguous stimuli
-idiographic -perceiving inkblots -also drawing pictures or telling stories based on presented picures |
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ROSCHACH test
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- most freq. used in clinics
- 5 color and 5 b&w inkblots - verbatim record of pt response, reaction, time and total time - free association phase then inquiry Ideal for assessment and association patterns - indication of interpersonal experiences, anxieties, fears, and drives. |
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Additional tests to rule out other disorders
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EEG, MRI< ST
to r/o seizures, autism, MR, tourettes, ADHD |
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TAT thematic appercetion test
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30 pics 1 bland card
- pt id's a hero and attributes to their own strives and conflicts |
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Draw a person test
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detail is correlated to IQ and development
In adults- draw a person aand a person of opposite sex - also tree-house-person Its an expression of the self in the environment |
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Integration test
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to report test behavior
-intellectual functioning -personality functioning -impulse control - manifest depression/guilt - interpersonal conflicts - self concept - affect - interferred diagnosis - progress form social recovery - motivation for change - strength and weakness - recommendations and summary |
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Physical examination
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refine the neuro exam and produce a quantifiable results
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Neurological soft signs
- how do you assess; tests - on PE? |
-graphestesia
- left-right discrimination - motor coordination - perceptual motor skills on PE look for congenital abnormalities maybe CT or MRI - high arched palate - low set ears - single palmar crease - unusal carrying angle - webbing - genitalia abnormalities - neuroectodermal abnormalities |
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Neuropsychological assessment
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to assess
- dementia - neurotoxic effects - effects of treatment - developmental disorders and learning disabilities |
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Character
- definition |
a persons distinctive mark or nature
- often used to signify personality traits that are shaped by developmental processes and life experiences. |
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personality ***************
"Rating scales" |
useful to detect a disorder w/o a lot of time
- they provide a rapid concise assessment of a specific area or psychotherapy - one single tool for a larger picture |
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Temperament
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- biological dispositions that color the personality
- usually conceptualized as simple non-motivated characteristics 50% genetics 50% environmental-home-growing up |
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Personality
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Theorist of personality
- Theodore Milton Ingrained, percasive, enduring and habitual ways of psychological functioning - attitudes, perceptions, habits and emotions -behaviors related to others |
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personality*****************
DSM IV personality traits |
- enduring patters of perceiving, relating to and thinking about the environment and oneself.
- exhibited in a wide range of contexts -More than a collection of traits: a mind process input: how d you do what you do? 1- people 2-places 3-activities 4-information 5-things is there balance? |
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Personality disorders
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Their study lead to a reduction in ambiguity bw health and illness
- are traits noxious to others? - have effects to doctor/pt relationship - stress of the illness induces emotional crises and behavioral regression - difficult to help the patients - principal diagnosis: clinical interview, collect info from family and other professionals |
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Personality disorder criteria
***************DSM IV |
an enduring pattern of inner experience that deviates markedly from the expectations of the culture
- 2 or more areas --congnition --affectivity --interpersonal functioning --impulse control the KEY is the enduring pattern - the patient is inflexible and pervasive - significant stress or impairment in social or occupational outlook - pattern is stable of long duration and can be traced back to adolescence or early adulthood. - no manifestation of other disorder, substance abuse, general medical condition - no prevalence data exists in personality disorders |
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personality clusters ************
A - weird B- wild C- worried D-DOES NOT EXIST only a-b-c |
A- odd eccentric, schizoid, schizotypical, paranoid
B- drama, emotional, histrionic, narcissistic, antisocial, borderline C- avoidant, dependent, OCD |
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etiology if personality disorders
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heredity 40-60%
- serotonin levels diff in CSF - smooth pursuit eye movements in patients w schizotypal personality - psychological factors - social factors |
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Cluster A personality disorder features
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--Paranoid
distrust suspicion overrx to anger susp disloyal, infidelity --SCHIZOID no enjoyment of social relations isolated, celibate, restricted --SCHIZOTYPAL paranoid, ideas of reference, odd beliefs, odd thought pattern, eccentric, lack of close friends. |
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cluster B personality disorder
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- antisocial: <15 y/o aggresion, >15 unlawful, lies, cons,
- border line: unstable and intense behaviors, fear of abandonment, - histrionic: demands attention, seductive, provocative, early suggestibility, false sense of intimacy, gullible. - narcissistic: grandiosity, fantasies of unlimited power, arrogance. |
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Cluster C personality disorder
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- Avoidant: fear, anxious, restricted
-dependent: cant make decisions - OCD; preoccupied w details, perfectionist, rigid, stubborn. |
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Treatment of personalty disoders
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help the patient achieve the highest level of functioning
- AXIS II diagnosis only (pervasive personality disorder) |
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Treatment modalities of personality disorders
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-SUPPORTIVE: help w/op challenging the patient
- COGNITIVE: to reduce specific behaviors. - PSYCHOPHARM: essential to reduce axis I. Lithium, SSRI, Lithium-manic SSRI clopiramine: OCD BDZ: conversion stimulants: PPD Buspirone: for anxiety antidepressants: BPD The key is diagnosis, many measures make the diagnosis |