Abnormal Psych 4
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| Loosening of associations | Switching tenses, changing subject, incoherent speech
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| 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)
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| Disordered perception | Schizophrenic symptom; hallucinations
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| Most to lease common senses of hallucination | Auditory, visual, tactile, smell/tase
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| Acute Schizophrenia | Currently in schizophrenic state
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| 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
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| 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
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| Semantic Intrusion | Strong association gets distracted; alternate meeting of a word introduces a new thought which causes the change of a subject
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| Phonetic Intrusion | "clang" association; rhyming
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| Habit strength Intrusion | Cliches used to answer questions
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| Catatonia | Disordered motor behavior, bizarre movements
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| Catatotonic stupor | Unresponsive, motionless, silent
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| Catatonic posturing and rigidity | Waxy flexibility
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| Inappropriate affect | Schizophrenia symptom; laugh when someone dies, cry during a comedy, etc.
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| Lack of insight | Don't question delusions or hallucinations, 96% of schizophrenics
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| Paranoid Schizophrenia | Systemized delusions, auditory delusions, no flat affect, later onset, better prognosis
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| 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
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| Type 1 Schizophrenia | Positive symptoms, acute onset, fluctuating episodes, good premorbid functioning, better response to traditional neuroleptics
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| Type 2 Schizophrenia | Negative Symptoms, gradual onset, chronic, poor premorbid functioning
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| Disturbance in brain chemicals (schizophrenia) | Type 1, high dopamine levels
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| Structural brain changes (schizophrenia) | Type 2, brain atrophy
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| Differential Diagnosis of Schizophrenia | Different from MPD, bipolar disorder, schizotypal personality disorder,
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| Delusional Disorder | Has non-bizarre delusions: things that could really happen. Other than delusions, functioning well. Erotomania type, jealous type, grandiose type
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| Erotomania type | Delusion that someone is secretly in love with them (usually someone of higher status)
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| Jealous type | Delusion that romantic partner is unfaithful
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| Grandiose type | Delusion that they have a special talent, special purpose, or special relationship with god
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| 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
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| Sociogenic hypothesis | Low socioeconomic status causes non- adequate care during pregnancy, birth complications may lead to schizophrenia
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| Social drift hypothesis | Drifts to a lower socioeconomic status due to schizophrenia
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| 22% of schizophrenics | Only have one episode
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| MZ twins and Schizophrenia | 48%- suggests that schizophrenia is not only genetic
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| Gottesman & Bertelsen 1989 | Children of twins and schizophrenia: If parent has schizophrenia- 16%, if parent's identical twin has schizophrenia- 16%
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| Dopamine hypothesis | Dopamine overactivity in schizophrenia; penothiazines block dopamine receptor sites
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| Amphetamine Psychosis | Amphetimes (ex:meth) raise dopamine levels causing resemblance of paranoid schizophrenia. Administer phenothiazines to treat amphetamine psychosis
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| Dopamine overactivity gender differences | Receptors decline more rapidly with age in men than women, but before age 25, they start with more receptor sites
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| 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
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| Dopamine theory more applicable to | Positive Schizophrenia
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| Central Atrophy | Negative schizophrenia; enlarged brain ventricles
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| Peripheral Atrophy | Negative schizophrenia; fissures in brain are bigger because brain is fading away, smaller brain
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| Hypfrontality | Schizophrenics brain; less frontal cortex may make type 2 schizophrenics unmotivated, unable to anticipate future, can't plan
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| Problems in neurotransmission treated by | Traditional psychotics
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| Abnormalities in brain structure treated by | Medication that targets serotonin
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| Thorazine | Neuroleptic, phenothiazines
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| Clozapine | Atypical antipsychotics, second generation
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| Phases of schizophrenia | Premorbid, prodromal, active phase, residual phase
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| How many schizophrenics recover completely? | 25%
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| More likely to recover from schizophrenia if... | Sudden onset triggered by stress, later onset, good premorbid functioning, treatment during prodromal phase
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| Personality Disorders: dimensional vs. categorial | Dimensional- how much of a characteristic rather than all black or white. DSM5 is categorical
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| Prevalence of Personality Disorders | 10-13% of population, half have 2 or more personality disorders which supports a dimensional system
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| Comorbidity in Borderline Personality Disorder | 50% also have major depression, 10% also have bipolar, 25% also have bulimia
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| Brain in Borderline Personality Disorder | Smaller prefrontal lobes and underachieve prefrontal cortex; poor executive functions, planning, and self control.
Smaller, but overactive amygdala
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| Serotonin in Borderline Personality Disorder | Receptors are less sensitive.
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| Dialectical Behavior Therapy | Lineman, 2006. Full acceptance, and change; skill building, problem solving, interpersonal skills, regulate emotions
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| Must be ____ for diagnosis of Antisocial Personality Disorder | 18
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| Antisocial Personality Disorder "burnout" | Around age 40, criminal activity and aggressive behavior declines, thought attitudes don't change (remain cold hearted)
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| Under-arousal Hypothesis | Proneness to boredom, need for stimulation. Low arousal leads to sensation-seeking, high-risk taking behaviors
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| 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
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| Perseveration | Schizophrenia- repeating the same phrase over and over again
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| Pathological Lying- Personality Disorders | Narcissistic, antisocial, borderline
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| What percentage of children qualify for a diagnosis of oppositional defiant disorder? | 10%
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| Alogia | A decrease in speech or speech content; a symptom of schizophrenia. Also called poverty of speech (negative symptom
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| Phenothiazines | A group of antihistamine drugs that became the first group of effective antipsychotic medications; neuroleptics
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| 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
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| 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
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| 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
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| Schizoid personality disorder | A personality disorder in which a person persistently avoids social relationships and shows little emotional expression
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| 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)
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| Antisocial personality disorder | A personality disorder marked by a general pattern of disregard for and violation of other people’s rights
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| 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.
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| 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
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| 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
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| Oppositional defiant disorder | A disorder in which children are repeatedly argumentative and defiant, angry and irritable, and, in some cases, vindictive
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| 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
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| Cerebellum | The area of the brain that coordinates movement in the body and perhaps helps control a person’s ability to shift attention rapidly
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| Psychosis | A loss of contact with reality- 6 months or more=Schizophrenia
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| Downward drift theory | Schizophrenics becoming unable to function properly leads to a low socioeconomic status
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| L-dopa | Increases dopamine in those with Parkinson's disease- makes schizophrenics worse
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| Extrapyramidal Effects | Severe shaking, bizarre grimaces, twisting of body... caused by neuroleptics (phenothiazines)
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| Odd personality cluster | Paranoid, schizotypal, schizoid (behaviors similar to schizophrenia)
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| Dramatic personality cluster | Antisocial, borderline, histrionic, narcissistic
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| Anxiety personality cluster | Avoidant, dependent, obsessive-compulsive
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| Low serotonin activity in | Antisocial personality disorder
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| % of children and adolescents that experience an anxiety disorder | 14-25%
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| TADS | Treatments for Adolescents with Depression Study; found that cognitive behavioral therapy is hardly better than a placebo, and antidepressants are the best
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| Medication less effective in addressing the negative symptoms of schizophrenia | Traditional antipsychotics
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| The atypical antipsychotics (2nd generation) bind to the _____ receptors | D-1, D-2, and D-4
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| OCD in childhood is more common in... | Males
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| _____ of autistic children only say a few phrases in their life | 20-50%
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| Preservation of sameness | Extreme negative reactions to change
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| Hyper-reactivity | Overstimulated, try to block stimulation
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| Hypo-reactivity | Interested in/react to low stimulation
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| _____ of autistic children score in the intellectual disability range of intelligence | 26-75%
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| Shah & Firth 1983 | Autistics performed better than "normals" and those with intellectual ability on embedded figures task
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| _____ of autistic children show "islands of excellence" | 10%
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| Islands of excellence | Autistic "savants"- limited to non symbolic, rote tasks (drawing, musical performance, calendar calculator, prime numbers...)
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| Autism Epidemiology | Rare, 4x more common in boys
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| MZ twins and Autism | 60%
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| 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.
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| Schizotypal personality disorder is often co morbid with | Major depressive disorder
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| Epidemiology of Antisocial Personality Disorder | 3.6% of population, increasing rates (especially amongst women), low SES, 4:1 M:F
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| 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)
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| Treatment of ADHD | Treated by methylphenidate, a stimulant (Ritalin). Best combined with behavioral therapy
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| Schizoaffective disorder | Marked symptoms of both schizophrenia and a mood disorder
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| Obsessive Compulsive Personality Epidemiology | White, educated, married, and employed people receive the diagnosis most often. Males are twice as likely
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