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48 Cards in this Set
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Anaclitic depression
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Depression in an infant attributable to continued separation from a caregiver.
Can result in failure to thrive. Infant becomes withdrawn and unresponsive |
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Oppositional defiant disorder
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child is noncompliant in absence of criminality
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Separation anxiety disorder
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fear of loss of attachment figure, leading to factitious physical complaints to avoid going to school.
common onset 7-8 years of age. |
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Rett's disorder
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X-linked disorder seen only in girls (affected males die in utero), characterized by loss of development and mental retardation appearing at age 4.
Stereotyped hand-wringing |
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Childhood disintegrative disorder
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marked regression in multiple areas of functioning after at least 2 years of apparently normal development.
Significant loss of expressive or receptive language, social skills, or adaptive behavior, bowel or bladder control, play or motor skills. Onset age 2-10 years old. |
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Long-term deprivation of affection
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1. Poor muscle tone
2. Poor language skills 3. Poor socialization skills 4. Lack of basic trust 5. Anaclitic depression 6. Weight loss 7. Physical illness 4 W's - weak, wordless, wanting, wary irreversible after 6 months, can result in infant death |
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Neurotransmitter change with anxiety
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Inc NE
Dec GABA Dec serotonin |
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Neurotransmitter change with Depression
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Dec NE
Dec 5-HT |
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Neurotransmitter change with Alzheimer's dementia
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Dec ACh
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Neurotransmitter change with Huntington's disease
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Dec GABA
Dec ACh |
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Neurotransmitter change with Schizophrenia
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Dec dopamine
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Neurotransmitter change with Parkinson's disease
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Dec dopamine
Inc ACh |
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Anosognosia
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lack of awareness that one is ill
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Autotopagnosia
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inability to locate one's own body parts
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Depersonalization
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body seems unreal or dissociated
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Dissociative fugue
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Abrupt change in geographic location with inability to recall past, confusion about personal identity or assumption of a new identity. Leads to distress or impairment
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Sleep patterns of depressed patients
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Dec slow-wave sleep
Dec REM latency Inc REM early in sleep cycle Inc total REM sleep Repeated nighttime awakenings Early-morning awakenings |
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Risk factors for suicide completion
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Male
Age - teenage or elderly Depression Previous attempt Ethanol or drug use Loss of rational thinking Sickness Organized plan No spouse Social support lacking SAD PERSONS |
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Adjustment disorder
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Emotional symptoms (anxiety, depression) causing impairment following an identifiable psychosocial stressor (divorce, moving) and lasting less than 6 months
If > 6 months - generalized anxiety disorder w/ no relation to event |
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Post-traumatic Stress Disorder
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Persistant reexperiencing of a previous traumatic event as nightmares and flashbacks.
Response involves intense fear, helpless, horror, leading to avoidance of stimuli and persistently elevated arousal. Disturbances last > 1 month anc causes distress or social/occupational impairment. Often follows acute stress disorder, which lasts 2-4 weeks. |
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Factitious disorder
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Consciously creates symptoms in order to assume "sick role" and to get medical attention (primary gain)
Munchausen's syndrome - chronic history of multiple hospital admissions and willingness to receive invasive procedures Munchausen's syndrome by proxy - seen when illness in a child is caused by the parent- child abuse |
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Pseudocyesis
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False belief of being pregnant associated with objective physical signs of pregnancy
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Personality disorder
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When the patterns of perceiving, relating to and thinking about the world become maladaptive.
Causing impairment in social or occupational functioing or subjective distress. Person not aware of problem. Disorderd patterns stable by early adulthood, not diagnosed in children |
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Cluster A personality disorders
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Odd or eccentric, cannot develop meaningful social relationships.
No psychosis; genetic assoc w/ schizophrenia Types: 1. Paranoid - distrust and suspiciousness; projection main defense mechanism. 2. Schizoid - voluntary social withdrawl, limited emotional expression, content w/ social isolation, unlike avoidant 3. Schizotypal - interpersonal awkwardness, odd beliefs or magical thinking, eccentric apperance |
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Cluster B personality disorders
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Dramatic, emotional, or erratic.
Genetic association w/ mood disorders and substance abuse. Types: 1. Antisocial - disregard for violation of righst of others, criminality; males > females; conduct disorder if < 18 years 2. Borderline - unstable mood and interpersonal relationships, impulsivenss, sense of emptiness; females> males; splitting a major defense mechanism. 3. Histrionic - excessive emotionality, attention seeking, sexually provocative, overly concerned with appearance 4. Narcissistic - grandiosity, sense of entitlement; may react to criticism with rage; may demand top physician, best health care |
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Cluster C personality disorders
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Anxious or fearful
Genetic association with anxiety disorders. Types - 1. Avoidant - sensitive to rejection, socially inhibited, timid, feelings of inadequacy 2. Obsessive-compulsive - preoccupation with order, perfectionism and control 3. Dependent - submissive and clinging, excessive need to be taken care of, low self-confidence Worried. |
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Alcohol
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Intoxication
Disinhibition, emotional lability, slurred speech, ataxia, coma, blackouts. Serum g-glutamyltransferase GGT - sensitive indicator of alcohol use |
Withdrawl
Tremor, tachycardia, hypertension, malaise, nausea, seizures, delirium tremens, tremulousness, agitation, hallucinations |
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Opioids
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Intoxication
CNS depression, nausea, vomiting, constipation, pupillary constriction (pinpoint pupils), seizures (overdose is life threatening) |
Withdrawl
Anxiety, insomnia, anorexia, sweating, dilated pupils, piloerection, fever, rhinorrhea, nausea, stomach cramps, diarrhea, flulike symptoms, yawning |
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Amphetamines
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Intoxication
Psychomotor agitation, impaired judgement, pupillary dilation, HTN, tachycardia, euphoria, prolonged wakefullness and attention, cardiac arrhythmias, delusions, hallucinations, fever |
Withdrawl
Post-use "crash" including depression, lethargy, HA, stomach cramps, hunger, hypersomnolence |
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Cocaine
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Intoxication
Euphoria, psychomotor agitation, impaired judgment, tachycardia, pupillary dilation, HTN, hallucinations, including tactile, paranoid ideations, angina, sudden cardiac death |
Withdrawl
Post-use "crash" including severe depression and suicidality, hypersomnolence, fatigue, malaise, sever psychological craving |
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PCP
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Intoxication
Belligerence, impuslivenss, fever, psychomotor agitation, vertical and horizontal nystagmus, tachycardia, ataxia, homicidality, psychosis, delirium |
Withdrawl
Recurrence of intoxication symptoms due to reabsorption in GI tract, sudden onset of severe, random, homicidal violence |
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LSD
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Intoxication
Marked anxiety or depression, delusions, visual hallucinations, flashbacks, pupillary dilation |
Withdrawl
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Marijuana
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Intoxication
Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgement, social withdrawl, inc appetite, dry mouth , hallucinations |
Withdrawl
Can be detected in urine up to 1 month after last use |
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Barbituates
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Intoxication
Low safety margin, respiratory depression |
Withdrawl
Anxiety, seizures, delirium, life-threatening cardiovascular collapse |
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Benzodiazepines
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Intoxication
Greater safety marjing, Amnesia, ataxia, somnolence, minor respiratory depression. Additive effects w/ alcohol |
Withdrawl
Rebound anxiety, seizures, tremor, insomnia |
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Caffeine
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Intoxication
Restlessness, insomnia, inc diuresis, muscle twitching, cardiac arrhythmias |
Withdrawl
Headache, lethargy, depression, weight gain |
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Nicotine
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Intoxication
Restlessness, insomnia, anxiety, arrhythmias |
Withdrawl
Irritability, HA, anxiety, weight gain, craving |
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Heroin addiction
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At risk for hepatitis, abscesses, overdose, hemorrhoids, AIDS, right-sided endocarditis
Naloxone and naltrexone competitively inhibit opiods and are used in cases of overdose Methadone - long-acting oral opiate is used for heroin detoxification or long-term maintenance |
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Dissociation
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Termporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stress.
Extreme forms can result in multiple personalities - dissociative identity disorder. |
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Displacement
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Process whereby avoided ideas and feelings are transferred to some neutral person or object
e.g. mother yells at child because she is angry at her husband |
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Identification
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Modeling behavior after another person who is more powerful, though not necessarily more admired.
Abused child becomes an abuser |
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Isolation
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Separation of feelings from ideas and evens.
Describing a murder in graphic detail w/ no emotional response |
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Projection
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An unacceptable internal impulse is attributed to an external source.
A man who wants another woman thinks his wife is cheating on him. |
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Reaction formation
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Process whereby a warded-off idea or feeling is replaced by an unconsciously derived emphasis on it's opposite.
A patient w/ libidinous thoughts enters a monastery. |
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Splitting
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Belief that people are either all good or all bad.
A patient says that all nurses are cold and insensitive but that the doctors are warm and friendly. |
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Altruism
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Guilty feelings alleviated by unsolicited generosity toward others.
Mafia boss makes a large donation to charity. Mature ego defense. |
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Sublimation
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Process whereby one replaces an unacceptable wish with a course of action that is similar to the wish but does not conflict with ones' value system.
Aggressive impulses used to succeed in business ventures. Mature ego defense. |
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Suppression
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Voluntary (unlike repression) whiholding of an idea or feeling from conscious awareness.
Mature ego defense. |
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