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abnormal psych

CD clinical description  Aggression to people and animals Destruction of property Deceitfulness or theft Serious violation of rules
CD same as ASPD?  Similarities: deceitfulness, unlawful behavior, violates basic rights of others, school/parental issues in CD and work/financial issues in ASPD, intellectually manipulative; ASPD is global ways of being vs. CD symptoms are very specific
Treatment of CD socio-cultural, child-focused treatment, prevention
socio-cultural family interventions, video-tape modeling, parent management training, foster care treatment, juvenile training centers
child-focused treatment problem-solving skills trainning, anger coping, simulant drugs
prevention try to change unfavorable social conditions, offer training opportunities etc
ADD have great difficulty attending to tasks or behave over actively and impulsively, appears before the start of school and correlated with poor school performance…Most commonly diagnosed childhood disorder currently
3 clinical features of ADHD inattention, hyperactivity, impulsivity
risk factors of ADHD o Genetic vulnerability passed on o Mother who smokes during pregnancy o Pre-frontal cortex doesn’t work as well which controls attention and behavior
causes of ADHD o Biological: abnormal activity of the neurotransmitter dopamine and abnormalities in the frontal-striatal (what?) region of the brain o Socio-cultural: high levels of stress and family dysfunction
ICD and DSM differences look at chart.
use of psychostimulants for ADHD o Ritalin doesn’t fix problem, not sure of long term effects o Treating ADHD reduces low self-esteem and lowers risk of other drug abuse
role of gender in diagnosis of ADHD o 2-9 more common among boyso Physical symptoms more visible in males, easier to diagnose boys w ADHD
aspergers o Less severe form of autistic disordero Impaired social interactionso Some stereotyped behavioro Little impairment in language or cognitive development
rett's disorder o Only seen in girls after age 1-2 years o Slowing of head growth, deteriorating motor skills, loss of social interest
childhood disintegrative disorder o Loss of previously acquired developmental skillso Impaired social interaction
diagnostic features of autism impaired social interaction, impaired social communication
echolalia repeating last part of what someone just said/asked),
behaviors o Routines (have to follow strict routine…everything has to be the same or get upset and throw a tantrum)o Stereotyped movements (head banging, hand flapping, high sensitivity to touch, pulling hair)o Preoccupation with parts of objects
savant being talented in certain areas…true savants rare but some elements can be seen (ex. Math)
theory of mind can put yourself in someone else’s shoes (not just because they don’t care, they just don’t understand)
etiology of autism psychological theories, prenatal/birth/neurological factors, genetic vulnerability
treatment of autism o Neuroleptics (Risperdal): used to target aggressiono Behavior modification (Lovaas) Reinforce behaviors, first by shaping them, breaking them down so they can be learned step by step and then rewarding each step clearly and consistently
DID ruleouts o Transvestic fetishismo Gender role experimentationo Perceived cultural advantages of other gendero Intersexuality
discuss GID in children sexist language, play on societal stereotypes, "preference vs. insistence"...more common diagnosis for boys, relies on children's introspection
sex-change story • Hormone treatments: when males take estrogen to have breast development and loss of body hair and change in fat distribution and females take testosterone
sexual reassignment • Sexual reassignment surgery: after 1-2 years of hormone therapy, man amputates penis and creates artificial vagina and face changes...women have bilateral mastectomy/hysterectomy…some cases create artificial penis
Discuss John/Joan case
Legal/ethical issues in ab. psych ethical regulations, civil vs. criminal commitment
ethical regulations for psych • Duty to warn and protect: imminent danger or specific intended victim• Confidentiality, privileged communication• Dual (multiple) relationships, boundary issues, client perpetuity
civil commitment vs. criminal commitment when people accused of crimes are judged to be mentally unstable and usually sent to mental institution
competency to stand trial those who are mentally unstable at the time of their trial are considered to be unable to understand the trial procedures and defend themselves in court.
NGRI if individuals are judged to be mentally unstable at time of crime they may plead this
M'Naughten rule has to be unable to know right from wrong at the time of the crime
irresistible impulse test a person who could not control actions at time of the crime is considered to be not guilty
durham test stated that not guilty if crime was a product of a mental disease/defect
GBMI have a mental illness at time of their crime, but illness was not fully related to or responsible for crime…go to jail but receive treatment needed
discuss issues raised by insanity defense3 criticisms...
positive symptoms of schiz delusions of 1. persecution, 2. grandeur 3. control 4. romance, 5. reference and hallucinations (auditory, visual, tactile, somatic, gustatory, olfactory
negative symptoms of schiz disorganized speech, disorganized behavioe, catatonic immobility or flexibility, inappropriate affect
subtypes of schiz paranoid type, catatonic type, disorganized type, undifferentiated type
type 1 schiz Mainly positive symptomsExcessive D2 receptors in prefrontal cortexDrug sensitivity Earlier onsetMore likely to remit
type 2 schiz Mainly negative symptoms and/or catatoniaLargely increased lateral ventricle size Drug resistance Later onset Progressive (increasing withdraw)
prodromal phase symptoms are not yet obvious, but persons are beginning to deteriorate. They may withdraw socially, speak vague or odd ways, develop strange ideas, or express little emotions
active phase symptoms become apparent. This phase may be triggered by stress in the person life.
residual phase they return to a prodromal-like level of functioning. The striking symptoms of the active phase lessen, but some negative symptoms, such as blunt emotions, may remain
diathesis-stress model • Clinical theorist agree that schizophrenia can probably be traced to a combination of biological, psychological, and sociocultural factors. BUT biological factors have been more precisely identified.
biological basis family genetics and brain dysfunction
family genetics 1. relatives of people iwth schiz 2. identical twins w disorder 3. relative of an adoptee vulnerable 4. genetic linkage and molecular biology
brain dysfunction 1. brain lesions, 2. biochemical imbalance
schiz etiology expressed emotion, double-blind hypothesis, social class
expressed emotion members frequently express criticism, disapproval, and hostility towards each other and intrude on one another’s privacy. People recovering from schizophrenia are considered more likely to relapses if their families rate high in expressed emotion.
double blind situation contradictory messages...child cannot avoid displeasing parents, schiz represents child's attempt to deal
social class Social causation: factors associated with low SES may contribute to development of schizophrenia.Social selection: people genetically predisposed to schizophrenia drift downwards in society
treatment psychosurgery, milieu therapy, token economy programs, antipsychotic medication
milieu A humanistic approach to institutional treatment based on the belief that institutions can help patients recover by creating a climate that promotes self-respect, responsible behavior, and meaningful activity
token economy programs A behavioral program in which a person’s desirable behaviors are reinforced systematically throughout the day by awarding of tokens that can be exchanged for goods and products.
presenile dementia means onset before age 65 but most often it occurs after the age of 65 (late onset)
amnestic phase hard to diagnose at this stage: failure of working memory/ short term memory new piece of information dyscalculia- inability to do simple math in head (ex. Tip, old skill with new situation) apraxia-hand-eye coordination\
confusion stage disorientation, dysphasia, agnosia, personal changes
dementia stage  total shutdown of biological functions withdrawal, poor judgment less awareness of limitations fully dependent on other people
early onset 1. genetic mutations, association w . Downs syndrome, increase production β-APP-beta-amyloid precursor protein
Created by: lkcoug10