Abnormal Psych Midterm 3
Imagine that your neighbor, who is being treated for schizophrenia, says that she has mostly negative symptoms of schizophrenia and is afraid of the extrapyramidal side effects of medication. She asks you what she should do. Based on current research, the BEST response is:
"Try atypical antipsychotics; they should work best."
A friend says, "My 70-year-old grandmother is in good physical health but has been diagnosed with depression. Should she even bother getting therapy? She is pretty old, after all." Based on current research, the BEST answer is:
"Yes, more than half of elderly patients show improvement with treatment."
what is the rate of acquittal via plea of insanity?
1 in 400 1% of cases plea and only 26% acquitted
effective community care features
1) coordination of services - MI substance abusers 2) short term hospitalization 3) partial hospitalization-day 4) supervised residencies 5) occupational training
what ratio of kids have a diagnosable psych disorder?
1/5 boys more common
what percentage of people with schizo display catatonia?
10%
what percentage of children have an anxiety disorder?
14-25% generally after age 7 more somatic symptoms
what percentage of the population is past age 65
14.5%
tardive dyskinesia
15% of typical antipsychotics patients after 6+ months 50+ yrs = 3-5x the risk 5% on an atypical (Clozapine is best)
students and bullying
20% frequent 50% at least once
what percentage of those who receive competency evaluations are found incompetent to stand trial?
20-25% of 60,000 conducted
Separation Anxiety Disorder
4% children school refusal common
what percentage of people with schizophrenia receive no care at all?
40-60% poor coordination and shortages
neurocognitive disorder prevalence
47 million worldwide with 4.6 million incidence 1-2% 65 years 50% those 85+
concordant trait rate of schizo in identical twins?
48%
Children must be at least _____ year(s) old to receive a diagnosis of enuresis.
5
late winter birth rate and schizophrenia
5-8% higher than other times of year
what percentage of all mental health services does the government currently fund?
63%
twins and antisocial PD
67% of twins also have
ADHD childhood stats
7% of all children 70% of them boys 60% continue into adulthood
what percentage of wrongful convictions are based on mistaken eyewitness testimony?
70%
how to treat childhood anxiety disorders
80% significant improvement with CBT and antidepressants
schizo breakdown Type 1 vs Type 2
80-85% positive dominated (Type 1) 10-20% negative dominated (Type 2)
how many deaths are attributable to alzheimers a year?
94,000
schizo care programs release rates?
98% in token economy 75% in milieu care 45% in custodial care
clang
A rhyme used by some persons with schizophrenia as a guide to forming thoughts and statements.
brain chemicals responsible for memory linked proteins
ACh, glutamate, RNA, Ca
what gene is responsible for late-onset?
ApoE-4 in 30% of people
hallucination reinterpretation and acceptance
CBT - 50% less rehospitalize coping, realizing they dont have power, etc.
catatonic rigidity
Fixed and sustained motoric position that is resistant to change.
average age of onset schizophrenia
M = 23 W = 28
Why are people who take medication for schizophrenia often given medication that helps control shaking and tremors?
Medication used to treat schizophrenia leads to Parkinson-like symptoms.
Regarding old age, stress, and illness, which of these statements is NOT true?
Most people over age 65 develop psychological disorders due to the stressors in their lives.
mentally disordered sex offenders
People categorized this way are found guilty of a crime and judged to be responsible but are committed to a mental health facility instead of prison came about in the 1940s but states have been dissolving them recently
Which statement about schizophrenia is true?
Psychosis is a key feature of schizophrenia, but it can also occur in other disorders.
Which statement BEST describes effective therapy for treating borderline personality disorder?
Research suggests that dialectical behavior therapy is the most effective.
Based on current research, which statement about the relationship between antipsychotic medications and side effects is NOT true?
The benefits of taking antipsychotic medications outweigh the costs of the side effects they produce.
In a token economy, if a person no longer receives tokens for saying his or her correct name when prompted, then what is likely to follow?
The person will eventually stop saying his or her correct name when prompted.
Which of the following is NOT a response to the increased clinical focus on the young?
The study of treatment of children has slowed down because enough has been conducted.
Which statement BEST reflects current research about the biological causes of autism spectrum disorder?
There are probably multiple biological causes.
What do Parkinson-like symptoms, neuroleptic malignant syndrome, and tardive dyskinesia have in common?
They all involve disruption of motor control.
How is an operant conditioning explanation of schizophrenia similar to an explanation that focuses on misinterpreting unusual sensations?
They both assume that symptoms are influenced by feedback from the environment.
Which statement is NOT generally true of those with antisocial personality disorder?
They care for no one's safety, except theirs and their children's.
what type of schizophrenia is more responsive to drug therapy?
Type 1
Oppositional Defiant Disorder
a childhood disorder in which children are repeatedly argumentative and defiant, angry and irritable, and in some cases, vindictive 10% prevalence more common in boys before puberty
schizophrenogenic mother
a cold, dominating, and rejecting parent who was thought to cause schizophrenia in her offspring
dialectical behavior therapy (DBT)
a form of therapy used to treat borderline personality disorder efforts to reduce self-harm and group session to build social skills draws from humanistic and psychodynamic approaches
milieu therapy
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 often improve compared to custodial care
American Law Institute Test
a legal test for insanity that holds people to be insane at the time they committed a crime if, because of a mental disorder, they did not know right from wrong or could not resist an uncontrollable impulse to act combined all 3 previous tests
M'Naghten Rule
a legal test for insanity that holds people to be insane at the time they committed a crime if, because of a mental disorder, they did not know the nature of the act or did not know right from wrong
Durham test (1954)
a legal test that holds people to be insane at the time they committed a crime if their act was a result of a mental disorder -- replaced soon after due to too much flexibility
Statistically speaking, which person is LEAST likely to develop alcohol use disorder?
a man in his 70s who lives in alone
schizoid personality disorder
a personality disorder characterized by persistent avoidance of social relationships and little expression of emotion prefer to be alone 3.1% prevalence M slightly more likely
The fact that Alzheimer's disease resembles Creutzfeldt-Jakob disease suggests that Alzheimer's may be caused by:
a virus
catatonic stupor
an immobile, expressionless, comalike state, non-responding
how many gene sites linked to schizo?
at least 281
most common hallucination in schizophrenia
auditory
anxious personality disorders
avoidant dependent obsessive-compulsive
delusions of reference
belief that common elements in the environment are directed toward the individual
delusions of control
belief that outside forces are controlling one's body or actions
The lack of multicultural research is of special concern with regard to:
borderline personality disorder
"I can't work with that client!" says your friend, the psychotherapist. "As soon as I show any empathy at all, it becomes almost impossible to challenge the client, and the client keeps calling me at all hours of the day." MOST likely, this is a client with:
borderline personality disorder.
An individual is extremely sad, can't sleep well, and experiences very low, and decreasing, self-esteem. These are features of depression among:
both the elderly and the young.
Phenylketonuria (PKU)
cannot break down the AA phenylalanine which leads to poison -> severe intellectual dysfunction
dependent personality disorder
clinging, obedient, fear separation, cannot make small decisions themselves, seldom disagree, dislike themselves, 1% prevalence
Pick's disease (frontotemporal dementia)
clinically similar to alzheimers
cognitive remediation for schizo
computer tasks intended to address attention, planning, and memory difficulties
A child is extremely aggressive. She is always fighting with her peers and is frequently very cruel to them. She never tells the truth. Her MOST likely diagnosis is:
conduct disorder.
what delusion is most common
delusions of persecution
psychopathology and schizophrenia
diathesis stress model 1)begins to unfold long before onset 2)HPA axis overactivity - brain inflammation 3)prevention
The _____ approach to personality disorders assumes that personality disorders should be classified by the severity of personality traits rather than by the presence or absence of specific traits. Correct!
dimensional
schizotypal personality disorder
discomfort in close relationships, odd thinking/perceiving, behaviorally eccentric anxiety around others = lonely 3.9% skewed towards men
A new disorder in the DSM-5 that is used to describe children with patterns of severe rage is called:
disruptive mood dysregulation disorder.
Cretzfeldt-Jakob disease (CJD)
due to prions as a result of a virus
According to psychodynamic theorists, an important factor in the development of avoidant personality disorder is:
early experiences of shame.
what is the preferred treatment for autism spectrum disorder
early intensive behavior-focused programs
gustatory hallucinations
experiencing tastes
smooth pursuit eye movements
eye movements made to track a moving object or to track a stationary object while the head is still diminished in schizo
Hallucinations
false sensory experiences
most effective therapies for schizophrenia
family and social family = family support of psychoeducational groups social = problem solving, decision making, social skills
If you and your family were receiving support, encouragement, and advice from other families with schizophrenic members, you would MOST likely be participating in:
family psychoeducational programs.
somatic hallucinations
feelings that something is happening inside the body, such as a snake crawling inside one's stomach
Phenothiazines
first gen antipsychotics antihistamines bind most strongly to D-2 receptors
Shy and anxious children who have mild to moderate degrees of intellectual dysfunction, language impairments, and behavioral problems are MOST likely to be diagnosed with:
fragile X syndrome.
narcissistic personality disorder
grandiose, need admiration, feel no empathy to others, think they deserve admiration and attention, exaggerate, arrogant, 6.2% adult (75% men) difficult to treat because of hubris
borderline personality disorder
great instability in mood and self-image, impulsive, emptiness, prone to aggression, suicide threats/attempts, violate relationship boundaries, abandonment anxiety self-mutilatory behavior 5.9% prevalence 3/4 W
A particular country has a nearly 3 percent prevalence for schizophrenia. That country:
has a higher-than-average schizophrenia prevalence.
families with expressed emotion
highly critical and hostile those from families with this trait who have schizo are 4x more likely to relapse
Which has NOT been used as a cognitive-behavioral treatment for Alzheimer's disease?
increasing the capacity of short-term memory by memorizing strings of random numbers
Avolition
lack of motivation
percentage of people with severe psychological disorders that have jobs in the competitive job market?
less than 20%
Psycosis
loss of contact with reality
type 2 attention processes
mental processes we control ex) reading
OCPD comorbidities
most likely major depressive, anxiety, or substance use NOT OCD
viral theory of schizophrenia
mothers more likely to be exposed to influenza during pregnancy 40% of schizos have antibodies to suspicious viruses
If a patient developed extrapyramidal side effects after taking antipsychotic medication for several months, you would expect to see the patient showing primarily _____ dysfunction.
motor
The millennial generation is thought to be extremely self-centered, often posting photos of themselves online for others to admire. If this is true, a sociocultural theorist would predict a larger-than-usual percentage of which kind of personality disorder among this generation?
narcissistic
Poverty of speech, blunted and flat affect, loss of volition, and social withdrawal are all _____ symptoms of schizophrenia.
negative
personality disorder trait specified (PDTS)
negative affectivity detachment antagonism disinhibition psychoticism
The five traits to be included in future revisions of the DSM-5 that utilize a dimensional approach in diagnosing personality disorders are:
negative affectivity, detachment, antagonism, disinhibition, psychoticism.
neologism
new word or expression
Big 5 Personality Traits
openness, conscientiousness, extraversion agreeableness, neuroticism
when does dependent personality disorder arise?
oral stage of development = lifelong need for nurturing
dopamine hypothesis of schizophrenia
overactivity of dopaminergic neurons
odd personality disorders
paranoid schizoid schizotypal
conduct disorder
patterns of behavior in which the rights of others or basic social rules are violated begins between 7 and 15 5-10% prevalence (75% boys)
Getting extremely upset if an object is moved to a different part of the room represents:
perseveration of sameness.
Abnormal beta-amyloid protein activity is to _____, as abnormal tau protein activity is to _____.
plaques; tangles
Alogia
poverty of speech
A person with schizophrenia who is experiencing alogia is displaying:
poverty of speech.
The cognitive-behavioral view of schizophrenia:
provides a partial explanation for the origins and symptoms of schizophrenia.
perservation
repeating things over and over
residual phase
return to a prodromal-like level of functioning 25% recover completely
downward drift theory
schizophrenia causes its sufferers to fall from a higher to a lower socioeconomic level or to remain poor because they are unable to function effectively
Fragile X Syndrome (Martin-Bell Syndrome)
second most common chromosomal cause of intellectual disability shy, anxious, mild intellectual dysfunction, language impairment
bodily illusions
sensing an external "force" or presence common in those with schizotypal PD
The brain changes that those with Alzheimer's disease experience are:
similar to those of most elderly people, but they happen to an excessive degree.
olfactory hallucinations
smelling odors
The duties of case managers are MOST similar to the duties of:
social therapists
Research has found that people with schizophrenia who received _____ were less likely to be readmitted to the hospital compared with those who received _____.
social therapy and antipsychotic medication; only social therapy or antipsychotic medication
MOST cases of mild intellectual disability seem to be related to:
sociocultural and psychological factors.
Which person would be diagnosed correctly with intellectual disability?
someone with an IQ of 69 having problems coping with life
Broca's area
speech production increased activity with auditory hallucinations
Autism Spectrum Disorder
symptoms typically appear before 3 years of age 1 in 2,000 and 80% cases boys 90% disabled into adulthood
"The client scores low on extroversion and agreeableness but high on neuroticism. Looks like schizoid personality disorder to me." The therapist being quoted is using what instrument to make the diagnosis?
the Big Five personality test
joint attention
the ability to focus on what another person is focused on those with autism experience a deficiency
mentalize
the ability to understand your own mental state and other people's lacking in BPD according to psychpath model
delusions of persecution
the belief that people are out to get you
If you went to a meeting of a group lobbying for better care for the mentally ill and made up primarily of family members of people with severe mental disorders, you would probably be attending:
the national alliance on mental illness
If you could "get inside the head" of a person experiencing auditory hallucinations, you would MOST likely find that:
the person actually produces nerve signals of sound in the brain.
Delia does not display all the full-blown schizophrenia symptoms anymore. Occasionally, a shadow of a symptom appears. She is a bit withdrawn and not entirely clear all the time, but she can marginally function in the world. This is an example of:
the residual phase of schizophrenia.
jail diversion
the term for when a disturbed individual is diverted from jail to the community for mental health care after committing a minor charge.
tactile hallucinations
tingling, burning, or electric-shock sensations
concordant trait
trait shared by both twins
disorganized attachment style
trauma/abuse results in attachments to others off of parent model = anxiety, emotionally unstable, inconsistent increases risk for BPD
The main contribution of Philippe Pinel to the care of those with severe mental illnesses was to:
treat patients with sympathy and kindness.
treatment length of time compared to prison sentence
twice as long on average
avoidant personality disorder
uncomfortable and inhibited in social settings, sensitive to negative eval, feel inadequate, few relationships, feel lonely/depressed similar to SAD but fear relationships not circumstances 2.4% prevalence shame early in life
Alzheimer's disease
2/3rds of neurocognitive disorders 5.4 million in the USA (triple by 2050) 11% of those 65+ have 2x prevalent in AA and Hispanic populations
MAOA gene
The gene responsible for the activity of the enzyme monoamine oxidase in the brain. The low-activity variant of the gene is closely associated with aggressive behavior.
Which is NOT a problem in the use of the DSM-5 to diagnose personality disorders?
The criteria are so restrictive that several categories rarely, if ever, are used.
Irresistible Impulse Test
a legal test for insanity that holds people to be insane at the time they committed a crime if they were driven to do so by an uncontrollable "fit of passion"
catatonia
a state of unresponsiveness to one's outside environment, usually including muscle rigidity, staring, and inability to communicate
Which of the following would provide the STRONGEST evidence that age-related health problems produce depression?
a study showing that depressive symptoms increase after age-related health problems occur
sheltered workshop
a supervised workplace for people who are not yet ready for competitive jobs
Jerry is a resident in a psychiatric ward. When he makes his bed, brushes his teeth, and sweeps the floor, he gets a plastic chip. He can exchange the plastic chips he has earned for extra privileges, such as additional TV time. This example illustrates the basic features of:
a token economy
not guilty by reason of insanity (NGRI)
a verdict stating that defendants are not guilty of committing a crime because they were insane at the time of the crime they are then committed
delusions of grandeur
belief that you enjoy greater power and influence than you do
self theorists schizo
believe the most basic human motive is to strengthen the self -> biological deficiencies causes schizos to develop fragmented self
genes responsible for early onset alzheimer's
beta-amyloid precursor protein (beta-APP) presenilin
schizophrenia outcomes developing vs developed nations?
better in developing nations
type 1 attention processes
beyond voluntary control ex) sudden sounds
BPD causes
biological: low serotonin biosocial: interal + external = lack of control devel. psychopath: early relationships important to biosocial perspective
Any biochemical, molecule, gene, or structural characteristic that accompanies a disease is called a(n):
biomarker
Statistically speaking, which of these individuals is at greatest risk for depression?
an older woman in a nursing home
Psychodynamic theorists explain obsessive-compulsive personality disorder as a fixation at the:
anal stage
If a child with autism spectrum disorder were being encouraged to engage in child-initiated interactions, the child would be:
asking about things that were of particular interest to him or her.
catatonic posturing
assuming awkward, bizarre positions for long periods of time
depression differences by sex in children
at 13: none at 16: 2x girls vs boys
During the mid-1900s, why were the most "difficult" patients transferred to the back wards of state hospitals, where they were often isolated, restrained, and punished?
because the priority of state hospitals shifted from treating people humanely to maintaining order
drugs with protective effects against alzheimers
estrogen and long term use of NSAIDs
indicators for more positive recovery of schizophrenia?
good premorbid functioning stress as trigger, abrupt onset, middle age development, early treatment
schizoid PD individual develop what skills very slowly?
language and motor skills
If you were trying to learn a new language and you could understand it better than you could speak it, you would be showing symptoms MOST like:
language disorder
A _____ of the elderly who use the Internet also use Facebook.
large percentage (60%)
sexually violent predator laws
laws allowing for the civil commitment of convicted violent sex offenders after they have served their prison sentence if it can be shown that they pose a continued threat
criminal commitment
legal procedure by which a person found not guilty of a crime by reason of insanity must be confined in a psychiatric hospital
What percentage of the population has dependent personality disorder?
less than 1%
antisocial PD biological cause
low Serotonin low bodily/brain arousal (sympathetic + HPA)
An individual diagnosed with schizoid personality disorder reports having a great deal of difficulty figuring out how others feel and as a child had difficulty developing adequate language skills. These findings would make the MOST sense to a theorist with which background?
cognitive-behavioral
Occasionally, you see or hear things. Your friends tell you it's your imagination, but eventually you come to think your friends are hiding something and you develop delusions of persecution to explain their behavior. This scenario is consistent with the:
cognitive-behavioral view.
If psychological and sociocultural explanations are to make the same kind of progress in understanding schizophrenia that biological explanations have, then they must: Correct!
come up with more precise theories that explain how psychological and sociocultural factors contribute to schizophrenia.
Recently, the dopamine hypothesis for schizophrenia has been challenged because it has been discovered that:
effective new drugs suggest abnormal neurotransmitter activity of serotonin, glutamate, and GABA, as well as dopamine.
Which is NOT a goal of parent-child interaction therapy?
encouraging parents to act consistently with their child
pronominal reversal
using you instead of I
levels of intellectual impairment by IQ
mild: 50-70. (80% of people) moderate: 35-49 (10%) severe: 20-34 (3-4%) profound: below 20 (1-2%)
Which problem related to substance abuse is more typical among the elderly than other age groups?
misuse of prescription drugs
Clozapine
more effective atypical
loose associations (derailment)
most common rapid shifts in thought
obsessive-compulsive personality disorder
preoccupation with order, perfection, and control, neglect leisure and friendships, afraid to make mistakes, rigid/stubborn, 7.9% prevalence white, educated, employed, men most likely (2x men) responds well to CBT and SSRIs
antisocial personality disorder
psycho/sociopaths disregards and violate others rights, impulsive, lie, aggressive, not safe must be 18+ 3.6% 4x M to W
The absence of parental love results in emotional detachment and the use of power to form relationships. This is most likely believed by _____ therapists.
psychodynamic
Constant criticism or ignoring of a child is considered:
psychological abuse.
catatonic excitement
purposeless and excessive motor activity
Tay-Sachs disease
recessive disorder that results in progressive loss of mental function, vision, and motor abilities over 2-4 years before death.
If you had a PET scan at a relatively young age to predict your likelihood of developing Alzheimer's, you would be most disturbed if you had:
reduced hippocampus activity.
Selective Mutism
1% children special friend to communicate precursor to SAD possible delays in development
Neuroleptic Malignant Syndrome
1% of patients (elderly) potentially fatal rigidity, fever, altered consciousness, improper autonomic function
how much does the government spend on funding for people with psych disorders?
152 billion
what percentage of people with alzheimers develop major depressive disorder?
17%
what percentage of schizotypal people suffer from major depressive disorder to bipolar disorder at some point?
2/3rds
what percentage of the elderly have a mental disorder? benefit from care? receive car?
20% 50% 20%
Schizophrenia and suicide
25% attempt 5% succeed they live 10-20 years less on average
what percent of federal money is spent on psych drugs?
28%
atypical antipsychotics
2nd gen antipsychotics bind D-2 less and more D1/D4 also serotonin, glutamate, GABA
what percentage of violent acts are committed by people with mental disorders?
3 percent
intellectual disability demographics
3% of people 3/5ths male mostly mild low IQ = below 70 and great difficulties in functioning must appear before age 18
what percentage of schoolchildren take methylphenidate
3% or 2.2 million
average time to death for alzheimers
3-8 years
what percentage of the prison population has antisocial personality disorder?
35%
childhood neglect increases your odds of developing BPD by
4
men under 30 are ___ times as likely as men over 60 to display a behavioral problem associated with excessive alcohol use
4
what degree of certainty is required to commit somebody to treatment?
75%
BPD and suicide
75% attempt 10% die from it
what states use what tests for pleas of insanity?
75% use M'Naghten 25% use ALIT Idaho, Kansas, Montana, Utah do not have
what percentage of kids with ADHD misbehave?
80%
what percentage of those acquitted by reason of insanity have schizophrenia or another form of psychosis?
80%
what percentage of those with antisocial PD display a substance abuse disorder?
80%
what percentage of those with conduct disorder displayed oppositional defiant disorder first? have ADHD?
80% 1/3
Which second-generation antipsychotic drug is the LEAST likely to cause tardive dyskinesia?
Clozapine
dramatic personality disorders
antisocial borderline histrionic narcissistic
A child with a diagnosis of developmental coordination disorder has difficulty with things like:
buttoning his shirt and dressing in general.
social breakdown syndrome
extreme withdrawal, anger, physical aggressiveness, and loss of interest in personal appearance and functioning resulting from institutionalization
histrionic personality disorder
extremely emotionally charged, center of attention, grandiose gestures, change opinions for attention, vain, sexual 1.8% prevalence
Delusions
false beliefs
Milieu therapy is to _____, as token economy is to _____.
humanism; behaviorism
Displaying emotions that are unsuited to the situation is called:
inappropriate affect
delirium
major disturbance in attention and orientation to the environment that make it hard to think in a clear/organized manner 1% over 55 14% over 85
corona radiata/longitudinal fasciculus
tied to attention
prodromal phase
time of mild signs or symptoms before onset
paranoid personality disorder
type of personality disorder characterized by extreme suspiciousness or mistrust of others shun close relationships cold/distant, suspicions not delusions 4.4% prevalence more in M
Chloropromazine
typical antipsychotic (neuroleptic) one of the first used
world schizophrenia prevalence rate
1%
Nations that pioneered normalization in the treatment of intellectual disability include:
Denmark and Sweden
what percentage of the homeless and the prison population has schizophrenia?
about 25% (140,000)
when is treatment for conduct disorder most effective?
before 13
delayed echolalia
A deferred repetition of someone else's speech
Agranulocytosis
A life-threatening drop in white blood cells. This condition is sometimes produced by the atypical antipsychotic drug clozapine 1-1.5% risk
Comorbidity describes a situation in which:
Comorbidity describes a situation in which:
Which statement about Alzheimer's disease is true?
It is currently incurable and difficult to treat.
Which statement about medication and schizophrenia is the LEAST accurate?
Medication is the only effective way to treat schizophrenia.
blunted affect
Significant reduction in the intensity of emotional expression. flat affect = no emotions
Anna shows no emotions when people tell her happy or sad stories and complains of hearing voices in her head telling her that the TV is spying on her. At times, she remains motionless in her chair for hours. When she does get out of her chair, she poses like the statue in the town square. Which of these represents a positive symptom of schizophrenia?
hearing voices in her head
Research evaluating the effectiveness of various approaches to treating postpartum psychosis is lacking. All of the following are potential reasons for this EXCEPT:
there are significant ethical concerns related to the various research models proposed to study treatment effectiveness.
