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Abnormal Psych 4

QuestionAnswer
Loosening of associations Switching tenses, changing subject, incoherent speech
Types of delusions delusions of persecution(aliens, FBI), delusions of grandeur(believe they are god or have godlike powers), delusions of control(being controlled by external force), delusions of reference(being watched), somatic delusions(may believe they are a machine)
Disordered perception Schizophrenic symptom; hallucinations
Most to lease common senses of hallucination Auditory, visual, tactile, smell/tase
Acute Schizophrenia Currently in schizophrenic state
Disordered Attention Schizophrenic symptom; too much going on; can't attend to everything at once. Breakdown in the cognitive filter mechanism leads to a stimulus overload
Asarnow & MacCrimmon 1978 Span of Apprehension Task; detect if you saw a T or a F in the sequence of letters, normal controls had more correct detections that schizophrenics and the biggest differences start at 5 or more letters. Remitted schizophrenics similar to acute
Semantic Intrusion Strong association gets distracted; alternate meeting of a word introduces a new thought which causes the change of a subject
Phonetic Intrusion "clang" association; rhyming
Habit strength Intrusion Cliches used to answer questions
Catatonia Disordered motor behavior, bizarre movements
Catatotonic stupor Unresponsive, motionless, silent
Catatonic posturing and rigidity Waxy flexibility
Inappropriate affect Schizophrenia symptom; laugh when someone dies, cry during a comedy, etc.
Lack of insight Don't question delusions or hallucinations, 96% of schizophrenics
Paranoid Schizophrenia Systemized delusions, auditory delusions, no flat affect, later onset, better prognosis
DSM 5 Symptom Clusters (Schizophrenia) For two subtypes to differ, they should be different in many dimensions: symptom picture, course, etiology, response to treatment, prognosis
Type 1 Schizophrenia Positive symptoms, acute onset, fluctuating episodes, good premorbid functioning, better response to traditional neuroleptics
Type 2 Schizophrenia Negative Symptoms, gradual onset, chronic, poor premorbid functioning
Disturbance in brain chemicals (schizophrenia) Type 1, high dopamine levels
Structural brain changes (schizophrenia) Type 2, brain atrophy
Differential Diagnosis of Schizophrenia Different from MPD, bipolar disorder, schizotypal personality disorder,
Delusional Disorder Has non-bizarre delusions: things that could really happen. Other than delusions, functioning well. Erotomania type, jealous type, grandiose type
Erotomania type Delusion that someone is secretly in love with them (usually someone of higher status)
Jealous type Delusion that romantic partner is unfaithful
Grandiose type Delusion that they have a special talent, special purpose, or special relationship with god
Epidemiology Schizophrenia 1/100. more common in lower SES, age of onset for males is 23 and females is 28, gender ratio 1:1 in long run
Sociogenic hypothesis Low socioeconomic status causes non- adequate care during pregnancy, birth complications may lead to schizophrenia
Social drift hypothesis Drifts to a lower socioeconomic status due to schizophrenia
22% of schizophrenics Only have one episode
MZ twins and Schizophrenia 48%- suggests that schizophrenia is not only genetic
Gottesman & Bertelsen 1989 Children of twins and schizophrenia: If parent has schizophrenia- 16%, if parent's identical twin has schizophrenia- 16%
Dopamine hypothesis Dopamine overactivity in schizophrenia; penothiazines block dopamine receptor sites
Amphetamine Psychosis Amphetimes (ex:meth) raise dopamine levels causing resemblance of paranoid schizophrenia. Administer phenothiazines to treat amphetamine psychosis
Dopamine overactivity gender differences Receptors decline more rapidly with age in men than women, but before age 25, they start with more receptor sites
McGuire et. al 1993 Press button when you hear voices (while brain is being scanned), broca's area is active (speech production), listening part of the brain also active, no activity in the pre-frontal cortex. Explains auditory hallucinations
Dopamine theory more applicable to Positive Schizophrenia
Central Atrophy Negative schizophrenia; enlarged brain ventricles
Peripheral Atrophy Negative schizophrenia; fissures in brain are bigger because brain is fading away, smaller brain
Hypfrontality Schizophrenics brain; less frontal cortex may make type 2 schizophrenics unmotivated, unable to anticipate future, can't plan
Problems in neurotransmission treated by Traditional psychotics
Abnormalities in brain structure treated by Medication that targets serotonin
Thorazine Neuroleptic, phenothiazines
Clozapine Atypical antipsychotics, second generation
Phases of schizophrenia Premorbid, prodromal, active phase, residual phase
How many schizophrenics recover completely? 25%
More likely to recover from schizophrenia if... Sudden onset triggered by stress, later onset, good premorbid functioning, treatment during prodromal phase
Personality Disorders: dimensional vs. categorial Dimensional- how much of a characteristic rather than all black or white. DSM5 is categorical
Prevalence of Personality Disorders 10-13% of population, half have 2 or more personality disorders which supports a dimensional system
Comorbidity in Borderline Personality Disorder 50% also have major depression, 10% also have bipolar, 25% also have bulimia
Brain in Borderline Personality Disorder Smaller prefrontal lobes and underachieve prefrontal cortex; poor executive functions, planning, and self control. Smaller, but overactive amygdala
Serotonin in Borderline Personality Disorder Receptors are less sensitive.
Dialectical Behavior Therapy Lineman, 2006. Full acceptance, and change; skill building, problem solving, interpersonal skills, regulate emotions
Must be ____ for diagnosis of Antisocial Personality Disorder 18
Antisocial Personality Disorder "burnout" Around age 40, criminal activity and aggressive behavior declines, thought attitudes don't change (remain cold hearted)
Under-arousal Hypothesis Proneness to boredom, need for stimulation. Low arousal leads to sensation-seeking, high-risk taking behaviors
ADHD and arousal Hyperactivity is treated with a stimulant: those with ADHD are under-aroused, to they search for constant activity to become aroused, and stimulant raises arousal and decreases behavior. More likely to develop ASPD
Perseveration Schizophrenia- repeating the same phrase over and over again
Pathological Lying- Personality Disorders Narcissistic, antisocial, borderline
What percentage of children qualify for a diagnosis of oppositional defiant disorder? 10%
Alogia A decrease in speech or speech content; a symptom of schizophrenia. Also called poverty of speech (negative symptom
Phenothiazines A group of antihistamine drugs that became the first group of effective antipsychotic medications; neuroleptics
Atypical antipsychotic drugs A relatively new group of antipsychotic drugs whose biological action is different from that of thetional antipsychotic drugs. Also known as second-generation antipsychotic drugs
Expressed emotion The general level of criticism, disapproval, hostility, and intrusiveness expressed in a family. People recovering from schizophrenia are considered more likely to relapse if their families rate high
Milieu Therapy A humanistic approach to institutional treatment based on the premise that institutions can help patients recover by creating a climate that promotes self-respect, individual responsible behavior, and meaningful activity
Schizoid personality disorder A personality disorder in which a person persistently avoids social relationships and shows little emotional expression
Schizotypal personality disorder A personality disorder characterized by extreme discomfort in close relationships, odd forms of thinking and perceiving, and behavioral eccentricities (most severe of the "odd" disorders)
Antisocial personality disorder A personality disorder marked by a general pattern of disregard for and violation of other people’s rights
Borderline personality disorder A personality disorder characterized by repeated instability in interpersonal relationships, self-image, and mood and by impulsive behavior. Self-mutilation, black and white thinking.
Avoidant personality disorder A personality disorder characterized by consistent discomfort and restraint in social situations, overwhelming feelings of inadequacy, and extreme sensitivity to negative evaluation
Disruptive mood dysregulation disorder A childhood disorder marked by severe recurrent temper outbursts along with a persistent irritable or angry mood, initial diagnosis between 6-18 years of age
Oppositional defiant disorder A disorder in which children are repeatedly argumentative and defiant, angry and irritable, and, in some cases, vindictive
Conduct disorder A disorder in which a child repeatedly violates the basic rights of others and displays aggression physical cruelty to people or animals, the deliberate destruction of other people’s property, and the commission of various crimes
Cerebellum The area of the brain that coordinates movement in the body and perhaps helps control a person’s ability to shift attention rapidly
Psychosis A loss of contact with reality- 6 months or more=Schizophrenia
Downward drift theory Schizophrenics becoming unable to function properly leads to a low socioeconomic status
L-dopa Increases dopamine in those with Parkinson's disease- makes schizophrenics worse
Extrapyramidal Effects Severe shaking, bizarre grimaces, twisting of body... caused by neuroleptics (phenothiazines)
Odd personality cluster Paranoid, schizotypal, schizoid (behaviors similar to schizophrenia)
Dramatic personality cluster Antisocial, borderline, histrionic, narcissistic
Anxiety personality cluster Avoidant, dependent, obsessive-compulsive
Low serotonin activity in Antisocial personality disorder
% of children and adolescents that experience an anxiety disorder 14-25%
TADS Treatments for Adolescents with Depression Study; found that cognitive behavioral therapy is hardly better than a placebo, and antidepressants are the best
Medication less effective in addressing the negative symptoms of schizophrenia Traditional antipsychotics
The atypical antipsychotics (2nd generation) bind to the _____ receptors D-1, D-2, and D-4
OCD in childhood is more common in... Males
_____ of autistic children only say a few phrases in their life 20-50%
Preservation of sameness Extreme negative reactions to change
Hyper-reactivity Overstimulated, try to block stimulation
Hypo-reactivity Interested in/react to low stimulation
_____ of autistic children score in the intellectual disability range of intelligence 26-75%
Shah & Firth 1983 Autistics performed better than "normals" and those with intellectual ability on embedded figures task
_____ of autistic children show "islands of excellence" 10%
Islands of excellence Autistic "savants"- limited to non symbolic, rote tasks (drawing, musical performance, calendar calculator, prime numbers...)
Autism Epidemiology Rare, 4x more common in boys
MZ twins and Autism 60%
Autism treatment Lavaas (1987); start therapy around age 3, 40 hours per week for 2 years, parents trained to administer treatment as well, behavior oriented with rewards. Treatment gains were maintained.
Schizotypal personality disorder is often co morbid with Major depressive disorder
Epidemiology of Antisocial Personality Disorder 3.6% of population, increasing rates (especially amongst women), low SES, 4:1 M:F
Diathesis- Stress Environment Antisocial Personality Highest rates are among those with environmental and biological factors (36% of sons with a biological father and adoptive father convicted of crimes)
Treatment of ADHD Treated by methylphenidate, a stimulant (Ritalin). Best combined with behavioral therapy
Schizoaffective disorder Marked symptoms of both schizophrenia and a mood disorder
Obsessive Compulsive Personality Epidemiology White, educated, married, and employed people receive the diagnosis most often. Males are twice as likely
Created by: knuepril
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