Ch. 9 Personality Disorders
88. Which of the following is widely used in treating individuals with schizotypal personality disorder who are experiencing significant distress?
A. Antidepressants
63. _____ therapies have proven most helpful for people with avoidant personality disorder.
A. Cognitive and behavior
1. _____ determines all the ways we have of acting, thinking, believing, and feeling that make each of us unique.
A. Personality
4. The DSM-5 approach to diagnosing personality disorders differs from its approach to other types of disorders in that it explicitly incorporates a _____ perspective into the diagnosis.
A. continuum
49. Aaron Pincus and Mark Lukowitzky maintained that narcissists can be both:
A. grandiose and vulnerable.
10. In the DSM-5, _____ is a negative characteristic of the disinhibition dimension.
A. impulsivity
41. The results of drug treatment studies for borderline personality disorder have been:
A. mixed.
12. If an individual does not meet the criteria for any of the DSM-5 personality disorders but still has significant difficulties in his or her sense of self and relationships together with pathological personality traits, a clinician may give a diagnosis of:
A. personality disorder—trait specified.
82. Individuals with schizotypal personality disorder tend to rate higher than do people with other personality disorders on the dimension of:
A. psychoticism.
73. A criterion for a diagnosis of _____ personality disorder is a distorted self-concept.
A. schizotypal
A.B.C.
A= Activating experience, B=beliefs & C= consequences.
Albert Ellis
ABC chain of events leading from faulty cognitions to dysfunctional emotions.
Magical Thinking
Others might know their thoughts
Maslow's Hierarchy of needs
Our most basic needs like food, shelter & companionship, have to be met in order to reach higher fulfillment & self-actualization.
Examples of cognitive errors are:
Over-generalization -negatives apply to all situations. Emotional Reasoning: it must be true because I feel it.
Aspects of Genetic Contribution to mood disorders are
PCLO gene that plays a role in synaptic transmission.
A person diagnosed with ________ personality disorder is usually distrusting and suspicious, interprets others motives as malevolent and is always on the look out for evidence confirming their suspicions.
Paranoid
Cluster A's
Paranoid Personality Disorder, Schizoid Personality Disorder, and Schizotypal Personality Disorder
What are thought to be features related to the development of borderline personality disorder?
Parental psychopathology, childhood neglect, childhood physical or sexual abuse
Describe some of the major controversies regarding AD/HD in the field of mental health.-
Parents are the ones filtering the behavior through their own views so it can be arbitrary. Also, many children are being diagnosed according to school standards & expectations which is a lot of sitting & listening. Are they being labeled & medicated in order to fit into that environment ? Also, different individuals diagnose according to different methods of assessment.
Psychological and social influences of Antisocial Personality Disorder. How can Early life influence if an individual develops antisocial personality disorder?
Parents of those with antisocial personality disorder are likely to be overburdened, lack parenting skills & themselves exhibit antisocial behaviors
Parasympathetic system
Part of the Peripheral/Autonomic System which is in the spinal cord that slows the heart down, stimulates digestion, secretion. liver, bladder & kidneys & is important for sexual arousal. The Rest or Digest response. Supplies nerve impulses to the thorax, abdomen, and pelvic regions.
According to SAMHSA the following tend to have lower usage of illicit drugs:
People living in rural areas, Southerners, people who are employed & college graduates.
Because of the variable nature of bipolar disorder, additional treatments may be necessary.
People with psychotic symptoms may need anti-psychotic medication, rapid cycling may need an anticonvulsant medication & depressive episodes may need antidepressant medication.
What is obsessive compulsive personality disorder?
People with this disorder are rigid, perfectionists, have their self esteem attached to work, are concerned with order
Cluster A: Paranoid Personality Disorder- Pervasive & unjustified mistrust & suspicion. Bears grudges, doubts loyalty & looks for hidden meaning.
Perceives others as exploiting them. May be related to Schizophrenia & possible early learning that the world is a dangerous place. Key *They misconstrue events, but the events are actually happening as opposed to hallucinogenic or delusions.*
People with OPCD *are not looking for approval from their work accomplishments, & throw themselves into work to the exclusion of social relationships.*
Perfectionism makes it difficult to complete a task because there's always a flaw & their works never good enough to meet unrealistic standards. These high standards make them very critical of others.
1844, American Psychiatric Association was developed in the scientific approach.
APA writes all the DSM's.
Who is most likely to be diagnosed with a personality disorder?
Ada, aged 30, a woman with a lifelong interpersonal difficulties
What are the prevalence rates for Neurocognitive Disorders dementia?
Affects 5% of people 65 to 74 years old.
Depressants
Alcohol and others
Diathesis stress model is emphasized as ADHD is influenced by environmental factors too.- Children who consumed sodium benzoate, a preservative, & AFCA, artificial food coloring, demonstrated increased hyperactivity.
Also, environmental toxins such as pesticide exposure from sources like fruits & vegetables, the air or farming/agricultural communities, was associated with hyperactivity & more severe symptoms.
DSM-5 classes of MND
Alzheimer's, vascular disease, MND due to substance use, Parkinson's, MND NOS
Describe epidemiology and the diagnostic criteria of obsessive‑compulsive disorder.
An obsession is a recurrent & persistent thought, urge or image that the individual experiences as intrusive & unwanted.
The third dimension of the DSM5 Personality Dimensions model is _______, which is anchored on the positive end by characteristics such as honesty, appropriate modesty, and concern for others, and at the negative end by characteristics such as deceitfulness, grandiosity, and callousness.
Antagonism
What DSM5 Personality Dimensions best describes Carl? He is deceitful, grandiose, and callous.
Antagonism
Which of the following is a personality disorder recognized by the DSM-5?
Antisocial personality disorder
Cluster C
Anxious fearful cluster
SSRI's
Are the Most commonly used med as they have a lower side effect rate, & you can't OD on them; not because they work better.
Which of the following antidepressants has proven most useful in the treatment of borderline personality disorder?
Aripiprazole
The medications that have been proven most useful in the treatment of borderline personality disorder besides the mood stabilizers are the....
Atypical antipsychotics
What classes of drugs are used to treat schizotypal personality disorder?
Atypical antipsychotics, neuroleptics, anti-depressants
Characteristic feelings associated with panic attack can include respiratory distress, shortness of breath, hyperventilation, & feelings of choking;
Autonomic disturbances such as sweating, stomach distress, shaking or trembling & heart palpitations. & sensory abnormalities like dizziness, numbness or tingling. One might feel like they are going crazy or losing control.
What are features of detachment in the DSM5 Personality Dimensions?
Avoidance of intimacy, withdrawal, restricted affect
6. The DSM-5 incorporates a continuum based functional assessment tool know as the Levels of Personality Functioning Scale for diagnosing a personality disorder. This scale evaluates functional impairment ranging from 0 to _____.
B. 4
44. Individuals with narcissistic personality disorder tend to seek _____.
B. admiration
65. Individuals with obsessive-compulsive personality disorder tend to be highly:
B. perfectionistic.
Discuss the theories (biopsychosocial) and common treatments for post‑traumatic stress disorder.
Because it's an external event there are no biological causality. But, they lead to changes in the brain to the hippocampus make it primed to possible danger in the future.
behavioral activation
Behavioral therapy for depression in which the clinician helps the client identify activities associated with positive mood.
Deterministic genes-
Beta-amyloid precursor gene
New to DSM-5.
Binge eating disorder
Factors that affect how quickly BAC rises and falls
Body mass. The dosage has to be bigger for a larger person. Food slows the absorption into the bloodstream.
Jen, a second-year medical student, attempted suicide at least 10 times before entering therapy. Her attempts to hurt herself usually followed arguments with her husband about getting a divorce. Which of the following diagnoses is Jen most likely to receive from her therapist?
Borderline personality disorder
Schizoaffective disorder: One who meets the diagnostic criteria for schizophrenia i.e. have delusions &/or hallucinations and meet criteria for deppressive or bipolar too.
Both disorders are independent of one another. Psychotic symptoms occur independent of mood disorder. Prognosis is similar for people with schizophrenia. Such persons do not tend to get better on their own.
What is the difference in prevalence rates between boys and girls?-
Boys outnumber girls 3 to 1.
SSRI's are the only FDA approved medications for people with PTSD.
But they don't work best alone. -Best when combined with exposure; in vivo or imaginal with relaxation & cognitive restructuring. --Watching movies, Telling their story, talking about it over & over & having errors in thinking challenged by therapist.
26. A nationwide study suggests that approximately _____ percent of the population could be diagnosed with borderline personality disorder.
C. 6
76. Which personality disorder is characterized by an unstable or disorganized identity and is accompanied with odd beliefs, perceptions, and self-presentations?
C. Schizotypal personality disorder
50. Which of the following is understood as a subtype of a narcissist?
C. Vulnerable narcissist
16. Borderline personality disorder is characterized by hypersensitivity to _____.
C. abandonment
74. All of the following are personality traits associated with schizotypal personality disorder in the DSM-5 EXCEPT:
C. antagonism.
55. People with avoidant personality disorder:
C. are prone to shame.
9. In the DSM-5, the psychoticism dimension includes:
C. eccentricity.
28. According to Linehan, people diagnosed with borderline personality disorder:
C. have deficits in emotional regulation.
13. The DSM-5's approach to personality disorders is a _____ model.
C. hybrid
70. Cognitive theories suggest that people with _____ personality disorder harbor beliefs such as, "Flaws, defects, or mistakes are intolerable."
C. obsessive-compulsive
80. Teresa seems emotionally detached. Most people think that she is a snob. Teresa likes activities where she can be alone. She views relationships with others as unrewarding, messy, and intrusive. She has very few friends outside of her first-degree relatives. Teresa is most likely to be diagnosed with:
C. schizoid personality disorder.
60. People with avoidant personality disorder:
C. tend to have more severe and generalized anxiety about social situations than people with social anxiety disorder.
91. The crucial component of cognitive therapy with clients diagnosed with schizotypal personality disorder is:.
C.) teaching them to look for objective evidence for their thoughts in the environment and to disregard bizarre thoughts.
Discuss the various cognitively based treatment methods that help change behavior.
CBT cognitive behavioral therapy & Cognitive restructuring.
Stimulants
Caffeine and Nicotine
What two models of personality disorder are found in DSM5?
Categorical, dimensional
What are the divisions of the nervous system associated with the anxiety response?
Central Nervous system includes the brain & spinal cord aka the Peripheral nervous system.
How are D1, D2, and NMDA receptor sites related to symptoms of schizophrenia?
Changes in NMDA receptors, which are GABA receptors, play a role by helping to promote new learning in the brain by helping build new synapses.
What may explain why child abuse could contribute to the deficits seen in people diagnosed with borderline personality disorder?
Changes in brain structures such as the hippocampus and amygdala
Multiple genes are involved in Alzheimer's disease (from slides/lecture)-
Chromosomes 21, 19, 14, 12 & 1.
Cognitive Treatment of Mood Disorders include
Clinicians begin with a careful assessment of the frequency, quality, and range of activities and social interactions, focusing on sources of positive and negative reinforcement.
Discuss common pharmacological interventions for depressive and bipolar disorders.
Clinicians prescribe antidepressants from 4 major categories of selective serotonin reuptake inhibitors aka SSRI's.
IPSRT is Interpersonal & social rhythm therapy - a biopsychosocial approach to treating bipolar disorder that proposes that relapse can result from stressful life events & problems in personal relationships.
Clinicians work with clients to pay careful attention to the regularity of daily routines & the extent to which positive & negative life events influence daily routines. The goal is to increase stability in social rhythms.
2nd Generation Atypical antipsychotics operate on both serotonin & dopamine neurotransmitters a.k.a. serotonin-dopamine antagonists.
Clozapine/Clozaril had lethal side effects b/c it caused agranulocytosis affecting the white blood cells. Now safer atypicals are: Risperdal, olanzapine & quetiapine, but they cause weight gain, cholesterol, insulin resistance leading to diabetes & heart disease.
Opiates
Cocaine, morphine and Heroin;
A _______ therapist, treating someone with narcissistic personality disorder, would help clients develop more realistic expectations of their abilities to be more sensitive to the needs of others.
Cognitive
CBT
Cognitive Behavioral therapy is a treatment method in which clinicians focus on changing both maladaptive thoughts & maladaptive behaviors by challenging their thoughts & using homework to help the client identify recognize when their unrealistic perspectives, thoughts or expectations are contributing to dysfunctional emotions.
Psychosocial Treatments
Cognitive behavioral therapy, CBT. -Addresses cognitive errors in thinking. -Also includes behavioral components.
Describe the various theories that explain how cognition affects behavior.
Cognitive perspective focuses on the way that peoples thoughts affect their emotions.
A compulsion is the repetitive behavior or mental act performed according to rigid rules that the person feels driven to carry out.
Compulsions do not need to be paired with obsessions.
Time released medications which decrease abuse potential are-
Concerta, Adderall XR, Metadate CD.
and structured interviews
Consists of a standardized series of questions with predetermined wording & order. Adults, specifically focus on that person. Child, focuses on the primary care provider about the child.
22 year old Ana from Ethiopia has eccentric beliefs that her ancestors are haunting her. The diagnosis of schizotypal personality disorder may not be made, however because Ana's beliefs could be part of her _______ beliefs.
Cultural
14. The DSM-IV included _____ separate personality disorders.
D. 10
46. A nationwide study in the United States found about _____ percent of men could be diagnosed with narcissistic personality disorder.
D. 8
43. Under the DSM-5 criteria, which of the following pathological personality traits is associated with narcissistic personality disorder?
D. Antagonism
77. Which of the following characterizes schizotypal personality disorder?
D. Bizarre or idiosyncratic worldviews
53. Which of the following statements is true about the treatment of narcissistic personality disorder?
D. Cognitive techniques help these clients develop more realistic expectations of their abilities and more sensitivity to the needs of others.
35. Which of the following psychotherapies for borderline personality disorder focuses on helping clients gain a more realistic and positive sense of self, learn adaptive skills for solving problems and regulating emotions, and correct dichotomous thinking?
D. Dialectical behavior therapy
52. Which of the following personality disorders is more likely to endorse beliefs such as "I don't have to be bound by rules that apply to other people"?
D. Narcissistic personality disorder
67. Under the DSM-5 criteria, which of the following pathological personality traits is associated with obsessive-compulsive personality disorder?
D. Negative affectivity
72. Which of the following is widely used in treatment for obsessive-compulsive personality disorder?
D. Relaxation techniques
38. _____ uses the relationship between patient and therapist to help patients develop a more realistic and healthy understanding of themselves and their interpersonal relationships.
D. Transference-focused therapy
59. Avoidant personality disorder is:
D. associated with rejection in early life of a child.
22. All of the following are pathological personality traits associated with borderline personality disorder in the DSM-5 EXCEPT:
D. detachment.
25. In dialectical behavior therapy, clients with borderline personality disorder may learn how to control their _____ behaviors by monitoring situations most likely to lead to such behaviors and learning alternative ways to handle those situations.
D. impulsive
31. The process of splitting, whereby individuals with borderline personality disorder see themselves and other people as either all good or all bad, was theorized in the _____ school of thought.
D. psychoanalytic
21. All of the following are personality traits associated with borderline personality disorder in the DSM-5 EXCEPT:
D. psychoticism.
81. Reggie is uninteresting, dull, and humorless. He is aloof and reclusive, rarely responds to people saying "Good morning" or "Hello" to him, and often doesn't understand jokes. His self-concept is distorted, and he has difficulty understanding others' motives. If Reggie were diagnosed with a personality disorder, it would most likely be:
D. schizotypal personality disorder.
Schizophrenia is related to loss of connectivity caused by changes in neural pathways. There are at least 19 genes identified.
D2 receptors, serotonin, glutamate & GABA, an inhibitory neurotransmitter are involved. NMDA receptors help promote new learning by helping to build synapses; alterations in them may be related to changes in neurons that make them less capable of memory & learning.
Describe the three personality disorder clusters.
DSM 5 Clusters are: A. odd or eccentric cluster. B, Dramatic, emotional & erratic cluster. & C, Fearful or anxious cluster. Within the cluster the disorders share similar features.
The term ________ is a personality dimension that captures the extent to which people are appropriately outgoing and trusting of others, or tend to be withdrawn, avoidant, and untrusting.
Detachment
What is a psychotic disorder?
Diagnosis includes Hallucinations, delusions, disorganized speech and grossly disorganized or catatonic behavior.
The first step in the DSM 5 in diagnosing personality disorders is to use a ________ based on the five factor model.
Dimensional approach
Rewards and punishment shape development.
Discuss the various treatment methods under the behavioral perspective e.g. counterconditioning, token economy, etc. and examples of these treatments. Consequences are a key component.
When people have fundamental deficits in who they are as people and in their ability to relate to others, they may be diagnosed with a personality _______.
Disorder
Examples of defense mechanisms
Displacement: punching bag. Repression: past abuse stuffed into the unconscious. Denial: Failed exam grade. Regression: Thumb sucking.
Cluster B
Dramatic emotional cluster
Cluster B, Borderline personality disorder; What are the key clinical features e.g. symptoms, relationship to self-harm, suicidality, etc?
Dramatic emotional shifts, unstable moods, dysphoria, impulsivity, fear of abandonment, very poor self-image. Unstable intense relationships; Enmeshed.
Hallucinogens
Ecstasy and Marijuana
Opioids, natural & synthetic substances with narcotic effect producing euphoria.
Effects of opioids: ~Activate body's enkephalins & endorphins. ~low doses induce euphoria, drowsiness & slowed breathing.
Delusional disorders, There are five types of delusional disorder:
Erotomaniac. Grandiose, jealous, persecutory, & somatic.
Effects of Marijuana are
Euphoria, heightened awareness, relaxation, well-being, analgesic effects, dizziness, increased appetite, calm & relaxed.
Identify and describe the positive symptoms of schizophrenia.
Excess of normal experience or behavior. Exaggeration or distortion of normal thoughts, emotions, and behavior. Positive does not mean good; it means excessive.
placebo
Experimental results caused by expectations alone; any effect on behavior, like their condition improves, caused by the administration of an inert substance or condition, which is assumed to be an active agent.
Describe the characteristics of people who are at higher risk of committing and attempting suicide.
Exposure to life stresses. Distorted cognitive processes. And a genetic predisposition. Men who lose their job,
Outline the basics of the assessment and treatment of suicidality.
Expressing explicitly or inferred intent to die.
Avoidant personality disorder Clinical description-
Extreme sensitivity to the opinions of others, fearful of rejection, criticism or judgment so they avoid anxiety.
Inattentive Symptoms are six or more of the following for at least 6 months in a manner that is maladaptive & inconsistent with developmental level.
Fails to give close attention to details or makes careless mistakes. Difficulty sustaining attention in tasks & or play.
Causes of Narcissim-
Failure to learn empathy as a child, fixation at early stage of development & Sociological view is that they're a product of the "me" generation.
Theories developed based on the sociocultural perspective are
Family perspective & social discrimination.
Mood disorders: Familial & Genetic influences
Family/twin studies, -Rate of diagnosis is 2 to 4 times higher in relatives of probands. -Identical twins are 2 to 3 times more likely to develop disorder than fraternal twins. -Heritability increases with severity.
Psychomotor agitation or lethargic (retardation) observable by others.
Fatigue or loss of energy. Feelings of worthlessness or excessive or inappropriate guilt.
Hyperactive symptoms are-
Fidgets, squirms, leaves seat, runs about or climbs excessively, has difficulty playing or engaging in leisure activities quietly, "on the go", "driven", talks excessively, blurts out answers, interrupts, & has difficulty waiting turn.
Positive psychology provides a framework with The Buffering hypothesis of suicidality which describes 3 aspects of resilience.
First, resilience is separate from risk. You may be high risk, but if you are high on resilience you're unlikely to do it.
Which of the following statements is true about schizotypal personality disorder?
For a person to be given a diagnosis of schizotypal personality disorder, his or her odd or eccentric thoughts cannot be part of cultural beliefs.
Females are twice as likely to have major depression in the US.
Gender imbalance disappears after age 65.
What are strategies that might be used in cognitive treatment of narcissistic personality disorder?
Generating more realistic expectations, becoming more sensitive to others' needs, challenging dysfunctional thinking
Identify what research tells us about how biological, neuro-biological, and genetics factors influence Autism.-
Genetic: families with 1 child have a 20% risk of having a 2nd with autism. There is a significant genetic role.
The subtype of the _______ narcissist copes with difficulties in self esteem by viewing himself as superior and unique, and engaging in fantasies that involve him in famous or powerful situations.
Grandiose
What are features of narcissistic personality disorder?
Have a belief that they are superior, have a strong sense of entitlement, have a belief that they are exceptional
What is typical of a person with a diagnosis of obsessive compulsive personality disorder?
Have difficulty tolerating others, high standards for self and others, extremely perfectionistic
Rob has been diagnosed with narcissistic personality disorder and has been described as a vulnerable narcissist. Which of the following likely apply to him? (Select all that apply.)
He engages in grandiose fantasy. He is hypersensitive to rejection. He experiences difficulties in self-esteem.
Rob has been diagnosed with narcissistic personality disorder and has been described as a vulnerable narcissist. What is most likely to happen to him?
He experiences difficulties in self esteem, he is hypersensitive to rejection, he engages in grandiose fantasy
Rob has been diagnosed with narcissistic personality disorder and has been described as a vulnerable narcissist. What is likely to happen to him?
He exposures difficulties in self esteem, he engages in grandiose fantasy, he is hypersensitive to rejection
Cyrus has been diagnosed with narcissistic personality disorder. What are descriptors of his behavior.
He is arrogant, he craves attention
Eugene has been diagnosed with schizotypal personality disorder. His therapist intends to focus on...
Helping Eugene focus on objective evidence for his thoughts, helping Eugene increase social contacts, assisting Eugene in social skills training, group therapy for Eugene
Alicia has been diagnosed with a personality disorder. She has rapidly shifting emotions, unstable relationships, and is constantly seeking the attention of others. She does not engage in self destructive behaviors, does not display angry outbursts to those close to her, nor does she particularly feel empty inside. Her best diagnosis would be ______ personality disorder.
Histrionic
Dr. G: A person can receive a diagnosis of MDD if that person has experienced at least 1 major depressive episode.
However, most people diagnosed with MDD experience more than 1 major depressive episode i.e. recurrent.
The DSM 5 approach to personality disorders is described as a ______ model because it combines dimensional with categorical.
Hybrid
-Education & work history,
"What type of work do you do? What is your educational background?
Tangentiality
"going off on a tangent"
Typical antipsychotics like Mellaril and Thorazine have serious undesirable consequences e.g. extrapyramidal symptoms which are motor disorders like rigid muscles, tremors, shuffling, restlessness & spasms affecting posture.
& Tardive dyskinesia which is: involuntary movements of mouth, arms & trunk of body.
*Not always problematic, but is one of the most commonly occurring groups of mental illnesses.*
(Yerkes & Dodson, 1908) LPR = 28.8%. 12 month Prevalence Rate = 18.1%
M'Naghten rule
*"right-wrong" test* used to determine whether or not a defendant should be held responsible for a crime; *insanity defense originated from this*
Anxiety is Characterized by *physical tension.*
*Sympathetic* nervous system arousal/activation. Often characterized by *avoidance*.
It's something that keeps evolving; 2013 DSM 5, the assumption is that you can use it to diagnose patients as it provides reliability.
*it is a disease, or illness based medical model.* Dr. G
Other medications with limited efficacy are-
Imipramine & clonidine & beta blockers.
Apraxia- Think X rated, naked, can't dress
Impaired motor functioning; automatic skills like dressing or driving.
Which of the following are components of treatment for schizoid personality disorder? (Select all that apply.)
Improved awareness of emotions Improvement in social skills
What are characteristics that fit the negative end of the personality trait referred to as disinhibition in the DSM5 Personality Dimensions model?
Impulsive and irresponsible
What are features of the core personality trait that is referred to in the DSM 5 as disinhibition?
Impulsivity, risk taking
Ch 5 NEURODEVELOPMENTAL DISORDERS
- Disorders commonly diagnosed in childhood. Focused on developmentally related earlier in life.
Describe what is encompassed in the mental status exam and the purpose of the mental status exam.
-Appearance, -Attitudes, -Behavior., -Mood & affect. -Speech. -Thought processes . -Content of thought. -Perception. -Cognition. -Insight. -Judgment.
Causes: Psychological and social dimensions: What were past perceptions of the cause of Autism e.g. bad parenting?-
In the 50's the explanation was the "refrigerator mother" who was cold, detached & uncaring who made her child autistic by not attaching to them because they "didn't want them". Now we understand it's much more biologically based.
Alcohol Use: Facts & Statistics
In the US: - Most adults consider themselves light drinkers or abstainers.
Learned Helplessness & a depressive attributional style; how people explain events. Certain types of beliefs
-Internal attributions; when things go wrong it's my fault. -Stable attributions; "I mess up all the time". -Global attribution, "I mess up at everything & everywhere". Relationships, work, parenting, life.
Cognitive restructuring helps the client view the feared situation more rationally by challenging their irrational beliefs about the fear.
In thought stopping the individual learns to stop anxiety-provoking thoughts by mentally shouting "Stop"! each time the anxiety producing thought comes to mind.
Nature of disorganized affect is:
Inappropriate emotional behavior.
Attention deficit/hyperactivity disorder- clinical features of AD/HD-
Inattention, overactivity & impulsivity
What are the subtypes of AD/HD?- DSM5 symptom types-
Inattentive type, Hyperactive-Impulsive type, Combined, & NOS
Indicate how a Cultural Formulation is constructed.
Includes the clinician's assessment of the client's degree of identification with their culture.
Major Depressive Disorder Prevalence rates are: 80% experience average of 4 in lifetime; recurrent episodes. 16% Lifetime prevalence rate 20% are women & 13% men.
-mean onset is 32 years. -Incidence is getting higher. Severe, with or without psychotic features--> differential diagnosis. Postpartum or seasonal pattern.
What are the components of treatment of paranoid personality disorder?
Increasing self efficacy, respect
-Cultural supports available to the client.
...
-Culture of origins beliefs about psychological disorder.
...
-DSM-5 is the latest version, 2013, of the diagnostic system developed by the American Psychiatric Association. Contains latest in research & theory on psychological disorders. Typically used in mental health settings.
...
-Diagnostic & Statistical Manual DSM & Internal Classification of Diseases ICD systems that WHO uses.
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Ch 13 Neurocognitive Disorders
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Ch 14 Personality Disorders.
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Chapter 12: Substance Use Disorders
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Chapter 7: Depressive and Bipolar Disorders
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Chapter 8: Anxiety, Obsessive Compulsive, & Posttraumatic Stress Disorders
...
Chapter Four
...
Chapter Three
...
Chapter Two
...
Define the concepts of standardization, reliability, and validity and be able to identify examples of each
...
Dependence of the mother during pregnancy & malnutrition in early life may also be risk factors.
...
Dependence runs in families showing a role in genetics.
...
Dependent Variable-is what's being measured.
...
Describe the nature of a psychoactive substance.
...
Describe the overall goals of psychological assessment.
...
Describe the relationship between dopamine levels, schizophrenia, and Parkinson's disease
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Describe the symptoms of a manic episode, the types of bipolar disorder, epidemiology (prevalence rate as well as incidence), and course of bipolar disorder (how many days and to what extent).
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Describe the various conditioning theories of behavior, including classical and operant conditioning.
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Distinguish between the terms of substance use,
...
Don't have to memorize these, just remember it's pretty much all day, every day for at least 6 months.
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Legal impairment is .08%.
...
e.g. analgesics like codeine, hydrocodone, oxycontin etc.
...
intoxication
...
According to twin studies,the heritability of dependent personality disorder is estimated to be ______.
.81
What are the prevalence rates of Autism in the US?-
1% LPR.
Schizophrenia is a disorder of development that arises in the years of adolescence or early adulthood due to early alterations in genetic control of the brain maturation.
Individuals with schizophrenia may have genetic vulnerability, which becomes evident when they are exposed to certain risks during brain development. These risks occur during prenatal period in the form of viral infections, malnutrition, or exposure to toxins.
33% to 64% have
Intellectual Disability aka retardation
Agoraphobia
Intense anxiety triggered by the real or anticipated exposure to situation in which they may be unable to get help should they become incapacitated. - they are not fearful of being in public situations themselves, but the possibility that they can't get help or escape if they have panic symptoms.
Which of the following are core features of personality? (Select all that apply.)
Interpersonal relationships Sense of self Meaning and purpose in life
unstructured interview
Involves a series of open-ended questions inquiring about what kind of symptoms the client is experiencing.
What characteristics fit the negative end of the personality trait referred to as disinhibition in the DSM 5 Personality Dimensions model?
Irresponsible and impulsive
What characteristics fit the negative end of the personality trait referred to as disinhibition in the DSM5 Personality Dimensions model?
Irresponsible, impulsive
Symptoms must persist at least 6 months for agoraphobia
It also must cause considerable stress & not be due to another psychological or medical disorder.
Indicate the symptoms used in the diagnosis of generalized anxiety disorder.
It does not have a particular focus, rather, a feeling of anxiousness most of the time even though they can't necessarily say why.
Explain the importance and emphasis of the sociocultural perspective and the theories developed based on it.
It emphasized the way that people, social institutions, & social forces influence people in the world around them.
Which is true of the DSM-5 clustering system for personality disorders?
It is recognized as being limited and not consistently validated.
Specific phobias have fear or anxiety that is marked & intense & people with them go to great lengths to avoid the object or situation.
It must be present for at least 6 months to be diagnosed.
Strattera is a ____ Non-stimulant medication
It's a SNRI; Norepenepherine uptake inhibitor.
It's moving toward dimensional where they look at the range of personality traits like agreeable, anxious vs. stable/, introverted or extroverted, etc..
It's a more in depth evaluation but it's a lot of work, *so we still have the categorical approach for now.*
Consider such approaches as learned helplessness
Learned Helplessness is lack of perceived control over life events. -A worldview that gives a person a vulnerability to depression.
OCD has a lifetime prevalence rate of
1.6%. 12 month prevalence rate is 1%.
What percent of people with diagnoses of borderline personality disorder die by suicide?
10%
Autistic disorder; clinical description- The DSM 4 had 3 main categories of social deficits, emotional deficits & restricted behaviors. The DSM 5 has
2 which are Social/Emotional deficits & behaviors.
incidence of dementia
23 out of 1000 new cases in people ages 75-79 (or 2.3%); rates seem to double with every five years after age 75
specialized inpatient treatment centers
24 hour, inpatient, Intense supervision without hospital care.
Symptoms usually present around____years old.- KEY* Look at the child compared to other children.
3 or 4 years
Binge drinking is ingesting large amounts of alcohol in a short amount of time.
3 strong beers for men & 2 large glasses of wine for women every day or most days of the week is considered binge drinking.
The KEY point is that- these established patterns of symptoms of ASD are displayed by
36 months/3 years old. It's very rare to develop normally then back track developmentally. Disinterest in others will be apparent early.
Anxiety & stress Disorders are more commonly diagnosed on *women*
36% Lifetime Prevalence Rate in women and 25% LPR in men
Hippocrates
4 important body fluids that influenced physical & mental health leading to 4 personality dispositions. To treat a psychological disorder would require draining the body of excess fluid/bleeding the patient. 1st scientific approach.
Anorexia
4-20% mortality rate estimates. 23 times higher suicide rate (Harris and Barraclough, 1997).
Twin Studies of Schizophrenia- identical twins have ___% risk, fraternal have ____% risk.
48% for identical & 17% for fraternal twins. Adoption studies show risk remains high.
Fathers aged 40 & up were ___ times more likely than fathers under 30 to have a child with ASD.
5
Over 20% to 40% of people 85 years & older; there is a dramatic increase & rates seem to double with every
5 years of age after 75.
The prevalence rate of borderline personality disorder in the US among adults is about ______%.
5.9
What are the prevalence rates of AD/HD?-
5.9% worldwide. in 2011, it was 11% CDC. 3% to 7% of School aged children.
Among people with any form of specific phobia
50% have a fear of animals or a fear of heights.
Approximately 3 million Americans are alcohol dependent.
58 million Americans, 23%, report binge drinking in the past month.
The prevalence rate of borderline personality disorder in the United States among adults is about _____ percent.
6
A nationwide study suggests that approximately _____ of the population could be diagnosed with.
6 percent
Alzheimer's Onset is usually- ___ but can happen as early as 45 years old.
60 to 70's
A nationwide study in the United States found about _____ percent of men could be diagnosed with narcissistic personality disorder.
8
Average survival time is about- ___ after diagnosis.
8 years
Tardive dyskinesia,
Lip smacking and tongue protruding,Involuntary movements; trunk movements
The Average age of onset of major depressive disorder is 32.
Looking at a 12 month prevalence, 18 to 29 year olds are 200% as likely as adults 60 & older to have experienced this disorder.
Psychological considerations:
Low sense of personal control and self-confidence.
Dependent personality disorder, Clinical description-
Main characteristic is that they're extremely passive & tend to cling to other people, to the point of being unable to make any decisions or to take independent actions.
Hare developed the Psychopathy Checklist-Revised. The two factors at the core of psychopathic personality & antisocial lifestyle are: glibness & superficial charm.
May also include a grandiose sense of self-worth, pathological lying, lack of empathy, remorse or guilt & unwillingness to accept responsibility for their actions. Need constant stimulation.
Symptoms of a manic episode
A Manic Episode is defined by increased activity or energy, lasting at least 1 week & present most of the day, nearly every day, during which there is an abnormally and persistently elevated, expansive, or irritable mood.
The events that can cause acute stress disorder may lead to the longer-lasting disorder known as PTSD.
A PTSD diagnosis will be given when a person experiences acute stress disorder symptoms for more than 1 month after the event.
Which of the following features are typical of individuals with narcissistic personality disorder? (Select all that apply.)
A belief that they are superior A strong sense of entitlement A belief that they are exceptional
Persistent Depressive Disorder aka Dysthymia
A depressive disorder involving chronic depression of less intensity than major depressive disorders. Persists for at least 2 years, 1 year for children under 18, & has a more limited set of symptoms than major depressive disorder.
Motivational Interviewing
A directive client-centered style for eliciting a behavior change by helping clients explore and resolve ambivalence.
psychosurgery
A form of brain surgery, the purpose of which is to reduce psychological disturbances.
Associality
A is the Absence of sociality; refers to a lack of interest in social relationships, including an inability to empathize and form close relationships with others.
A prominent feature of those diagnosed with borderline personality disorder is greater ______ variability.
Mood
Marijuana
Most commonly used "illegal" drug in the US; estimated at 1 in 5 between the age of 18 & 25, 21.5%
Stimulants
Most widely consumed class of drugs
Discuss how a clinician determines the best approach to treatment.
Must be made on the choie of the most appropriate theoretical perspective or combination of perspectives.
Brief psychotic disorder; one of 4 symptoms of psychosis i.e. delusions, hallucinations, disorganized speech & grossly disorganized or catatonic behavior for more than a day, but recover in less than a month.
Must take into account: cultural background, if there's been a recent stressor such as flood, death, auto accident or if its been within 4 weeks of giving birth.
A person with a diagnosis of ______ personality disorder views problems they have as the result of weaknesses or flaws of others.
Narcissistic
A person with a diagnosis of ________ personality disorder may appear to think of themselves as better than others but this grandiosity may mask an underlying vulnerability in their sense of self.
Narcissistic
Which of the following personality disorders is more likely to endorse beliefs such as "I don't have to be bound by rules that apply to other people"?
Narcissistic personality disorder
One of the DSM5 trait dimensions is _______ affectivity. This trait dimension is similar to the Big Five concept of neuroticism in that it is a continuum with clam on one end and emotional liability on the other.
Negative
A fundamental trait dimension describing the extent to which people are even tempered and calm versus emotionally labile and over reactive to stress is described in the DSM 5 as...
Negative affectivity
What biological factors contribute to the development of Alzheimer's disease? ___ tangles which keep axons together fray, decay & fall apart so neurons can't be nourished & ____ plaques.
Neurofibrillary tangles & Amyoloid plaques.
Which of the following classes of drugs are used to treat schizotypal personality disorder? (Select all that apply.)
Neuroleptics Antidepressants Atypical antipsychotics
Incidence
New Development of a condition in a population in a period of time.
What are features of schizotypal personality disorder?
No clear motivation, distortions in person's sense of self, eccentric ideas and unusual beliefs, difficulty in establishing relationships
______ personality disorder is the most prevalent personality disorder in the US population with about 8% of the population meeting the criteria for a diagnosis.
Obsessive compulsive
A person diagnosed with which disorder defines their sense of self and self worth in terms of their work productivity?
Obsessive compulsive personality disorder
Cluster "A" Personality Disorders are:
Odd or eccentric
Cluster A
Odd, eccentric cluster
Unconditional Positive Regard
A method in client-centered therapy in which the clinician gives total acceptance of what the client says, does & feels.
expressed emotion
A pattern of interactions that includes emotional over-involvement, critical comments, and hostility directed toward a patient by family members
Prevalence and Causes of Schizophrenia
Onset and prevalence of schizophrenia worldwide about 1% of population. Often develops in Early adulthood i.e. early 20s but can emerge at any time in the lifespan.
Individuals with narcissistic personality disorder tend to seek _____.
admiration
Women are 60% more likely than men to experience
an anxiety disorder in their lifetime.
One specific of borderline personality disorder according to a psychological perspective is that there is...
an inability to regulate emotions
Under the DSM-5 criteria, which of the following pathological personality traits is associated with narcissistic personality disorder?
antagonism
OCPD is a disturbance of personality, not a disturbance involving
anxiety or out-of control behaviors like OCD.- People with OCPD are unproductive & their pursuit of perfection becomes self-defeating.
Anxiolytic's are
anxiety reducing e.g. benzodiazepines.
role of susceptibility genes (Alzheimer's)
apolipoprotein (apoE) E2, E3, E4 defects
Jealous type of delusional disorder
are certain that their romantic partner is unfaithful to them.
People with obsessive-compulsive personality disorder:
are often workaholics who see little need for leisure activities.
The medications that have been proven most useful in the treatment of borderline personality disorder are mood stabilizers and _____.
atypical antipsychotics
What features are descriptors for the core personality dimension in the DSM5 of detachment?
avoidant, withdrawn, untrusting
What are results of mentalization based treatment of people with borderline personality disorder?
better functioning, less medication, less suicide
Neuro implies-
biological according to etiology, which is the cause, set of causes, or manner of causation of a disease or condition.
Psychosocial Contributions to ADHD include:- Early environmental stressors e.g.
birth complications. Children with ADHD are viewed negatively by others & receive negative feedback from peers & adults, are associated with stressful, chaotic family environments which contribute to more behaviors & there is a Mood disorder comorbidity.
Cognitive-behavioral therapy seems well suited for
both adolescents & adult offenders.
Some of the functions served by these genes involve serotonin, glutamate,GABA and dopamine. These genetic abnormalities could also affect
brain development, synaptic transmission, immune functioning, and the manufacturing of important neurotransmitters of important proteins involved in neurotransmission.
legal/ethical issues (in professional practice)
breach of confidentiality, multiple relationships, duty to warn, civil commitment, criminal commitment (insanity, competency)
A psychotic disorder is a broad term for some type of
break or disconnect with reality. Most common form of hallucination is visual.
-Caucasian Americans have highest use
but Native Americans are diagnosed most with alcohol dependency.
Persistent depressive disorder aka Dysthymia is chronic, for at least 2 years,
but less severe where the individual does not experience a major depressive episode.
CBT
can also be effective intervention with Bipolar clients.
Amyloid Plaques-
cell death due to plaques attaching to the outside of the neuron
4 major dimensions to the symptoms of OCD are
checking compulsions, need for symmetry & order, obsessions about cleanliness & hoarding.
privileged communication
clinician may not disclose any information about the client in a court of law without the client's permission
A fifth category of specific phobias includes miscellaneous stimuli or situations like
clowns or hypochondria.
STEPPS is a _____ therapy treatment for borderline personality disorder.
cognitive
Cognitive
cognitive perspective is based on the idea that people's thoughts lead to their emotions:
The Treatment approach method that shows the greatest effectiveness for PTSD is:
cognitive-behavioral
The most effective psychological treatment for PTSD is
cognitive-behavioral therapy combines some type of exposure, in vivo or imaginal, with relaxation & cognitive restructuring.
A large scale analysis of studies on interpersonal therapy showed that
compared to CBT & medications, interpersonal therapy was significantly more effective.
DSM-5 cognitive disorder change
considered neurocognitive disorders but went from "organic mental" to "cognitive" in previous editions
Loose associations
conversation in unrelated directions.
Treatment & Prevention- Resistant to insight or behavioral interventions. The most effective interventions are those that are less focused on developing empathy & conscience or personality. Instead, effective treatment should:
convince participants that they are responsible for their own behavior & develop more prosocial ways to satisfy their needs by using their strengths.
Alzheimer's facts
costs associated with the disease are $140 billion/yr; US prevalence is 5 million; onset usually in 60's or 70's; prevalence estimated to be 14 million by year 2050
Some researchers believe that one thing that social anxiety disorder and avoidant personality disorder have in common is self ______.
criticism
antagonists antipsychotics e.g. Haldol, Thorazine that ___ dopamine called , tend to ____ schizophrenic symptoms, .
decrease
role of deterministic genes (Alzheimer's)
defects in presenillin (PS1 and PS2) genes cause the brain to age prematurely and most early-onset cases occur with these mutations; beta-amyloid precursor gene (leads to development of amyloid plaques)
three classes of cognitive disorders
delirium, dementia, amnestic
Schizophrenia and dopamine:
delusions, hallucinations, and positive symptoms are caused by too much dopamine.
Which of the following is NOT recognized by the DSM-5 as a distinct personality disorder?
dependent personality disorder
Cyclothymic disorder
describes periods of hypomania with brief periods of depression that are not as extensive or long-lasting as seen in full depressive episodes. A person with this is never without symptoms for more than 2 months at a time.
The term ____ is a personality dimension that captures the extent to which people are appropriately outgoing and trusting of others or withdrawn, avoidant and untrusting.
detachment
criminal commitment
detainment in a mental health facility when accused of commiting a crime to determine fitness to stand trial; person may be found guilty or not guilty by reason of insanity
personality
determines how one feels, interacts with others, and perceives events
Claudius Galen
developed a system of medical knowledge based on anatomical studies.
Aphasia- Think "phase/phrase"
difficulty with language; expressing or understanding.
The alternative model for diagnosing personality disorders appearing in the DSM-5 utilizes a _______ approach.
dimensional
The five-factor model of personality is a _____.
dimensional approach
Control group
does not receive
People with schizotypal personality disorder tend to show dysregulation of _____ in the brain.
dopamine
Sedatives are calming
e.g. barbituates which are central nervous system depressants from mild sedation to anesthesia.
Deterioration is slow during the-
early 1st phase & 3rd phase
Alzheimer's treatment
early is best; most attempt to slow progression and treat symptoms
chromosome 14 is associated with-
early onset Alzheimer's.
Describe various biological, psychosocial, and preventative treatments for Alzheimer's dementia.- __ treatment is best;
early; most attempt to slow progression and treat symptoms.
Behavioral work with a client
education & homework are important. Begin with assessment, then focus on areas of positive & negative reinforcement. Help them make changes in their environments & teach them necessary social skills. Encourage them to increase involvement in activities that they find positively rewarding.
Discuss the ways in which the clinician rules out via differential diagnosis.
eliminate the possibility that the client is experiencing a different disorder or perhaps an additional disorder. testing against other possibilities. Differential diagnosis involves the ruling out of alternative diagnoses
commitment
emergency procedure for involuntary psychiatric hospitalization
Kendra's Law
enacted by NY state in 1999 to allow for involuntary outpatient commitment (assisted outpatient treatment) of potentially dangerous individuals with untreated mental disorders, after a girl was pushed in front of a subway train by a stranger with untreated schizophrenia
Durham rule
expansion of insanity defense, began in 1950's; person is not responsible for a criminal offense if the act was due to a psychological disorder or defect i.e. they *know right from wrong but may be impaired/unable to stop themselves due to mental illness*
OCD diagnosis is given to individuals who experience either obsessions or compulsions to such an extent that they find it difficult to conduct their daily activities &
experience significant distress or impairment in their occupational or social functioning.
Impairment in communication- e.g.
eye contact, body language, gestures & lack of facial expressions.
agnosia
failure to recognize objects
True or false: More men than women are diagnosed with avoidant personality disorder.
false
Erotomaniac delusional disorder
falsely believe that another person is in love with them.
Psychological explanations of Avoidant personality disorder include:
fear of attachment in relationships reflecting hypersensitivity to rejection due to extreme parental criticism in childhood which lead to a core belief that they are flawed & unworthy of other people's regard.
There are Many ___ psychopathic women.
fewer
The diagnosis of antisocial behavior has its origins in the work of Hervey Cleckley, "The Mask of Sanity" which was the
first scientific attempt to list & categorize the behaviors of the "psychopathic " personality.- The most effective interventions are those that convince participants that they are responsible for their own behavior.
dialectical behavior therapy
focuses on: gaining more realistic and positive sense of self learning adaptive skills for solving problems and regulating emotions correcting dichotomous thinking
Cognitive restructuring
fundamental techniques of cognitive behavioral therapy in which clients learn to reframe negative ideas into more positive ideas.
Schizophrenia prognosis-
generally chronic; most suffer with moderate to severe lifetime impairment; life expectancy is slightly less than average. Females tend to have a better long-term prognosis.
Polygenic influence-
genes DRD4 & DAT1 associated with dopamine are influenced by methylphenidate & DRD5 genes have been implicated.
Neurobiological differences between healthy people and those with diagnoses of borderline personality disorder could be due to ____ factors.
genetic
Explain the various theories that explain basic concepts in genetics, such as genes, chromosomes, genotype, and phenotype.
genotype is the genetic make up, phenotype is the external representation; what it looks like.
Aaron Pincus and Mark Lukowitzky maintained that narcissists can be both:
grandiose and vulnerable
Theorists have identified borderline personality disorder as...
having fundamental deficits in emotional regulation
Cyrus has been diagnosed with narcissistic personality disorder. What are likely descriptors of his behavior?
he craves attention, he is arrogant
Most common symptoms reported with panic attack are:
heart pounding or palpitations & dizziness.
Genetic contributions,
heritability; ADHD runs in families.
People more likely to experience PTSD following exposure to a trauma are found to have
high level of neuroticism, negativity, affectivity, prior psychological symptoms & a history of child abuse.
What are goals of cognitive therapy in treating someone with a diagnosis of histrionic personality disorder?
identifying irrational beliefs, helping formulate goals that do not rely on the approval of others
Cognitive slippage
illogical and incoherent speech.
A substance use disorder is diagnosed by assessing the individual in 4 categories:
impaired control, social impairment, risky use & pharmacological changes. They then count the number of symptoms & use this # to assign a severity rating from mild to severe.
What are components of treatment for schizoid personality disorder?
improved awareness of emotions, improvement in social skills
Proband
in behavior genetic studies, probands are family members who have a disorder, and the relatives of the index cases are examined for concordance.
grave disability
in danger of harm to self due to inability to care for basic needs as a result of a mental illness
Insanity Defense Reform Act 1984
in response to Hinckley case; added criterion of "severe disturbance" meaning that people with personality disorders could not use this; also, the defense must now prove that a person fits the legal definition (previously they just had to provide reasonable doubt that defendant was sane)
High levels of dopamine and serotonin:
increase psychotic symptoms
What are components of treatment of paranoid personality disorder?
increasing self efficacy, respect
The mood disturbance must be accompanied by at least three additional symptoms from a list that includes:
inflated self-esteem or grandiosity, decreased need for sleep, pressure of speech, flight of ideas, distractibility, increased involvement in goal-directed activities or psychomotor agitation, and excessive involvement in pleasurable activities with a high potential for painful consequences.
Alzheimer's progression
insidious onset with gradual progression, starts as "sundowner syndrome"; deterioration is slow during the early and later stages but rapid in the middle; avg survival time is about 8 yrs
Obsessive-compulsive personality disorder Clinical description-
intense perfectionism & inflexibility manifested in worrying, indecisiveness & behavioral rigidity. They define their self worth in terms of their work productivity.
Negative Consequence
is Taking something away. Think minus. e.g. Time Out is the loss of access to positive reinforcers.
Cognitive Triad
is a negative view of the self, the world, and the future.
Positive Consequence
is adding something.
Active chemical in Marijuana
is tetrahydrocannabinol THC.
What are true of metallization based treatment for borderline personality disorder?
it is psychodynamically oriented, it attempts to help patients appreciate alternative points of view
parkinson's disease and dopamine:
lack of dopamine leads to diminished control of nerve movement leading to tremors.
insanity
lack of moral responsibility for committing criminal acts; *legal term used to describe state of mind during the time a crime was committed; diagnosis of a disorder is NOT the same*
Anhedonia
lack of pleasure, or indifference.
What are general principles that lead to therapeutic success in the treatment of borderline personality disorder?
learn appropriate assertiveness skills, monitor self disparaging thoughts, monitor black and white evaluations of others
People who had traumatic experiences that had negative coping styles were most susceptible to
learned helplessness & predisposed to developing depression.
cognitive disorders affect...
learning, memory, consciousness; most develop later in life
civil commitment
legal declaration of mental illness; person can be forced into tx involuntarily; laws and definitions of mental illness vary by state; gov't authority over this is held by police and state
right to treatment
legal right to receive appropriate care upon entering a psychiatric hospital
insanity defense (NGRI)
legal statement that a client should not be held responsible for a crime due to diminished mental capacity and lack of self-control (at time of the crime); client is sent to a treatment facility instead of prison; doesn't exist in Idaho
Punishment
less likely to occur.
Research on anorexia nervosa genetics in humans has identified abnormalities involving serotonin and dopamine receptor genes that are concentrated in the
limbic system, may play a role in altering emotion regulation in individuals with anorexia nervosa.
Affective flattening
little expressed emotion.
Women are 70% more likely than men to experience
major depressive disorder at some point in life.
dementia
marked by broad cognitive deterioration
Compulsions involve the repetition of a specific behavior such as washing & cleaning, counting, putting items in order, checking or requesting assurance or,
mental rituals such as counting.
(Alzheimer's) risk factors
metabolic syndrome, obesity, lack of exercise, smoking, diabetes, lack of brain exercises, unhealthy diet
Deterioration is rapid during the-
middle 2nd stage.
Narcissistic personality disorder
mixed
Borderline personality disorder is _____.
more commonly diagnosed in people of color
Alzheimer's neurobiological findings
neurofibrillary tangles and amyloid plaques found on autopsy; brains tend to atrophy; multiple genes involved
Called borderline because it borders between ____ which is in touch with reality & ___ which is out of touch with reality.
neurotic & psychosis.
Medications increase compliance & decrease negative behaviors.- Benefits are ____ when stopped.
not lasting
Cognitive theories suggest that people with _____ personality disorder harbor beliefs such as "Flaws, defects, or mistakes are intolerable."
obsessive-compulsive
Development: Describe how schizophrenia tends to develop over time.
often develops in early adulthood but can emerge at any time; affects females and males about equally.
One of either of these: ~Depressed mood most of the day.
or Markedly diminished interest or pleasure in all or most daily activities aka Anhedonia.
A major risk factor is depression & alcohol use.
over 90% of suicides are associated with a psychological disorder.
Ellen is convinced that her husband is having an affair with a co-worker. Her suspicion is reinforced when the co-worker calls him. Ellen is also quite certain that her own boss is out to get her because she notices that he scowls when he talks to her. Which of the following personality disorders might be Ellen's diagnosis?
paranoid
narcissistic personality disorder
pattern of behavior characterized by an exaggerated sense of self-importance, lack of empathy for others, and an excessive need for admiration
obsessive-compulsive personality disorder
pattern of behavior characterized by excessive concern with perfection and having things a certain way along with rigid beliefs and control over oneself and one's environment
antisocial personality disorder
pattern of disregard for and violation of the rights of others
paranoid personality disorder
pattern of pervasive distrust and suspiciousness of others
guardian ad litem
person appointed by the court to make decisions for or represent a person who is legally incapable of doing so in a civil legal proceeding
What are features of borderline personality disorder?
poor sense of self, alternately idealizing and despising others, worry about abandonment
Flooding, in vivo flooding, imaginal flooding & graduated exposure.
positive reinforcement is implicit in all behavioral techniques.
Neuroimaging research has found abnormalities in the ____ cortex of the brain in patients with borderline personality disorder.
prefrontal
Individuals with Bipolar disorder have difficulties in attention, memory & executive function consistent with abnormalities in the
primary visual cortex, the frontal lobes, the temporal lobes & the cingulate cortex. Think Bi = 2 lobes & 2 cortex's.
ALI (American Law Institute) guidelines
propose that people are not responsible for their criminal behavior if they are unable to appreciate the wrongfulness of their behavior due to a mental disorder
Over the long run clients benefit more from psychotherapy rather than
psycho pharmacological interventions.
Dr. Fraser says that narcissism results from a failure to develop a realistically positive view of the self in childhood. Dr. Fraser is reflecting the _____.
psychodynamic perspective
Binge-eating-purging subtype
purge after eating small amounts of food where they are successfully losing weight.
guilty but mentally ill (GBMI)
result of insanity defense reform act; allows for both treatment and punishment
Cultural factors are-
risk for certain conditions vary by ethnicity & class.
Cheryl has a boyfriend but, when she talks about him, she talks as if he were an object. There is no emotional expression and no pleasure from their interactions. If Cheryl were to be diagnosed with a personality disorder, it would most likely be _____.
schizoid personality disorder
Family studies have shown that paranoid personality disorder is more common in the families of people with diagnoses of _____.
schizophrenia
Teresa seems emotionally detached. Most people think that she is a snob. Teresa likes activities where she can be alone. She views relationships with others as unrewarding, messy, and intrusive. She has very few friends outside of her first-degree relatives. Teresa is most likely to be diagnosed with:
schizotypical personality disorder
People diagnosed with avoidant personality disorder:
shun interactions if there is a possibility of being criticized
Symptoms for Persistent Depressive Disorder or Dysthymia are
sleep & appetite disturbances, low energy, low self-esteem, difficulty concentrating & making decisions, & feelings of hopelessness.
Hypnotic's are
sleep inducing.
Catatonia
spectrum. Removed from DSM 5.
parens patriae
state's authority to protect those who are unable to protect themselves
What are features of avoidant personality disorder?
staying away from social encounters, oversensitivity to criticism, feeling socially inferior
Schizophrenia Genetic influences-
strong genetic component; children inherit a tendency for schizophrenia, *Not* types of schizophrenia.
substituted judgment
subjective analysis of what the client would decide if he/she were cognitively capable of making the decision
Developmental influences e.g. maturation hypothesis
suggests that older individuals are better able to manage their high-risk tendencies.
Sundowner syndrome-
symptoms are more apparent & intense as the day goes on due to fatigue.
schizotypal personality disorder
symptoms similar to those of schizophrenia but in milder form a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior
The crucial component of cognitive therapy with clients diagnosed with schizotypal personality disorder is:
teaching them to look for objective evidence for their thoughts in the environment and to disregard bizarre thoughts.
delirium
temporary confusion and disorientation
Systematic desensitization is an effective behavioral method for treating specific phobia
the client learns to substitute relaxation for fear through a series of graduated steps & forms the basis for 4 types of behavioral treatments involving exposure therapy.
People with alcohol use disorder develop problematic beliefs about alcohol early in life through reinforcement & observational learning according to
the expectancy model.
Some people also experience changes in polarity from high to low or vice-versa within a single week, or even within a single day
the full symptom profile that defines distinct, separate episodes may not be present; e.g. the person may not have a decreased need for sleep, making such "ultra-rapid" cycling a more controversial phenomenon.
treatment group
the group that gets the treatment or drug.
lifetime prevalence rate for specific phobia is 12.5%
the highest prevalence rates of specific phobias involve fear of natural situation, particularly heights estimated between 3.1 & 5.3%.
Brain structure: What are lateral ventricles?
the lateral ventricles are cavities in the brain that contain cerebrospinal fluid.
Substance-related disorders reflect patterns of use, abuse, intoxication & withdrawal.
the line demarcating substance use from abuse is difficult to draw. - The DSM5 combines abuse & dependence into a single dimensional rating. Individuals receive a diagnosis based on meeting only 2 criteria: withdrawal & tolerance.
*2 major divisions of the peripheral system in the spinal cord are:
the somatic which is under voluntary control like deliberate breathing. & Autonomic which is outside our voluntary control & even awareness e.g. heart rate & breathing. Think "Auto-pilot".
psychodynamics
theoretical orientation that emphasises unconscious determinants of behavior.
Which of the following is true in terms of gender differences in obsessive-compulsive disorder?
there are no gender differences
With generalized anxiety disorder there is no particular situation that is identified as the root of the anxiety;
they just find it very difficult to control their worrying.
EMDR, aka Eye Movement Desensitization Reprocessing has clients
think about the traumatic memory while focusing on rapid movement of something from left to right for 10 to 12 eye movements.
What is the treatment for borderline personality disorder that uses the client clinician relationship as the framework for helping clients achieve greater understanding of their unconscious feelings and motives?
transference focused psychotherapy
major part of ethics code
trust and maintaining confidentiality; most counselors/psychologists get into trouble due to issues with confidentiality
Cognitive-behavioral view is that people with specific phobias have overactive alarm systems to danger & they perceive things as dangerous because they misinterpret stimuli as being
uncontrollable, unpredictable, dangerous or disgusting & is correlated with feelings of vulnerability.
A cognitive approach to treating narcissistic personality disorder is focusing on...
unrealistic positive assumptions
Which of the following symptoms is characteristic of borderline personality disorder?
unstable relationships
transference-focused therapy
uses the relationship between patient and therapist to help patients develop a more realistic and healthier understanding of themselves and their interpersonal relationships
determination of competence to stand trial
~60k evals completed annually and it is essential for legal processes/trial; person must have an understanding of legal charges and ability to assist in own defense (consult with attorney, give info, etc); ethical issues arise when a person goes to trial without being evaluated. Burden of proof is on the defense
The concept of _______ includes a self identity, how we relate to other people, and our sense of meaning and purpose in life.
Personality
epigenesis
Process through which the environment causes them to turn off or on.
Most effective approach is to:
Provide reassurance, and help develop realistic view of themselves and of others
Singmond Freud in early 1900's developed
Psychoanalysis.
Part of the _______ perspective is the belief that insecure attachment of a child plays an important role in the development of BPD.
Psychoanalytic
Alzheimer's medications include-
Razadyne, Aricept, Exelon;
Alzheimer's meds
Razadyne, Aricept, Exelon; Cognex is rarely prescribed due to safety concerns
What are additional psychological/social factors that influence autism?-
Reinforcement, Motivation/Carrot, develop sound making skills, baby steps e.g. starting with the alphabet sounds then reinforcing, shaping behavior by breaking it down into more component skills. The idea is to intervene early to achieve the best success.
Describe the theories (biopsychosocial) and common treatments for generalized anxiety disorder.
Researchers believe that people with generalized anxiety disorder experience their symptoms due to disturbances in GABA, serotonergic & noradrenergic systems. Support for the biological genetic vulnerability of the inherited an underlying neurotic personality style.
DSM-5 subtypes of anorexia:
Restricted, & Binge-eating-purging
Describe the difficulties surrounding identifying abnormal behavior. What criteria do psychologists use to help them distinguish between normality and abnormality?
Results from underlying disturbances, psychological, biological or developmental. Impairment/disability, Distress, Dysfunction, Outside of Cultural norms/deviance/infrequency.
The difference between SNRI's & Tricyclic medications are
SNRI's increase activity or activate latent suicidal tendencies, like putting gas in a car. They're a good match for those with a lethargic depression. Tricyclic's are possible to OD on so a suicidal person has a means to commit suicide if they have the desire.
Biological; Medical and drug treatments for anorexia and bulimia.:
SSRI's can provide some benefit for bingeing/purging behavior. working to get Anorexics at normal weight. Are not efficacious in the long-term.
A person diagnosed with ______ personality disorder demonstrates a restricted range of emotional expression in interpersonal interactions and a pervasive pattern of detachment.
Schizoid
People with a diagnosis of _______ personality disorder show symptoms similar to schizophrenia but in milder form.
Schizotypal
The disorganized symptoms are:
Severe and excess speech, behavior, and emotion.
Self-dangerous, self-mutilation, & suicidal gestures to cope with distress, sexual acting out, radical emotional shifts.
Splitting i.e. labeling things as all good or bad.
Paranoia
Suspiciousness
C. Identify and describe the negative symptoms of schizophrenia.
The absence or insufficiency of normal behavior; a deficit.
Ideas of reference
The belief that random events are related to them
What symptoms are more typical for women diagnosed with borderline personality disorder?
They have higher rates of mood and anxiety disorders, they have higher rates of eating disorders
Assessment of suicidality:
Thinking about ending one's life, developing a plan to non-fatal suicidal behavior aka a suicide attempt, to the actual ending of one's life.
Second, we can view both risk & resilience as bipolar dimensions: you can be high on one, both or neither.
Third, resilience is a psychological construct such as the belief that you have the ability to overcome adversity.
Second, therapist & client collaborate in formulating a treatment plan that focuses on the primary problem; usually inadequate social skills.
Third, the therapist carries out the treatment plan using a combination of encouraging self-exploration, providing support, educating the client & providing feedback on their ineffective social skills. This therapy focuses on the here & now.
When do personality disorders tend to develop during the lifespan?-
Thought to begin in childhood & run a chronic course.
Treatments of Avoidant Personality Disorder-
Treatment is similar to that used for Schizoid personality disorder & targets include social skills & anxiety.
Pharmacological meds for depressive and bipolar disorders
Treatment of Mood Disorders include Tricyclic Medications which have a 3 ring chemical structure. Widely used to Block re-uptake of (Primarily) norepinephrine, serotonin & other neurotransmitters.
Primary explanations of specific phobias rely on biological & psychological perspectives.
Treatment sometimes involves partners & family because Specific phobias in an individual can impact those who are close to that person.
Family members 4 to 5 times higher risk.
Twin studies and bulimia; 23% in identical twins vs. 9% in fraternal twins
-Taking a Tylenol when you have a headache.
Tylenol has been taken to remove or take away the headache. -E.g. using candy as "an obnoxious child suppressant." when screaming stops when they get the candy.
What are features of psychoticism?
Unusual beliefs, eccentricity, odd perceptions
Describe the purpose of using multiple theories as the basis for understanding and treating abnormal behavior.
Using multiple theories such as Humanistic, Biological, Psychodynamic, socio-cultural & Behavioral gives a Broad range of tools & techniques to assess, treat & diagnose.
antisocial personality disorder borderline personality disorder histrionic personality disorder narcissistic personality disorder
What are the 4 labels under Cluster B?
avoidant personality disorder dependent personality disorder obsessive-compulsive personality disorder
What are the three labels in Cluster C?
paranoid personality disorder schizoid personality disorder schizotypal personality disorder
What are the three labels of disorders under Cluster A?
Anxious-fearful personalities people with these disorders are extremely concerned about being criticized or abandoned by others and thus have dysfunctional relationships with others
What is Cluster C considered?
· Indicate the characteristic features and epidemiology of specific phobias.
a Phobia is an irrational fear associated with a particular object or situation.
Restrictive affect,
a narrowing of the range of outward expression of emotions.
An active is
a placebo that has the same side effects or administration effects as the procedure or drug under investigation so participant can't determine if they're getting the treatment or not.
Differential Diagnosis
a process of systematically ruling out alternative diagnosis.
day treatment programs
a structured program in a community treatment facility that provides activities similar to those provided in a psychiatric hospital.
During what time period is a person with a diagnosis of borderline personality disorder most at risk from suicide?
a year or two after the diagnosis
Describe the BAC and the various effects of Blood Alcohol Content on mood and behavior.
...
Describe the case study method.
...
Describe the differences between inattentive and hyperactive/impulsive symptoms.
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Families and relapse
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Identify and describe the disorganized symptoms of schizophrenia.
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Identify the basic physiological and neurological effects of psychoactive substances covered in class, such as alcohol and other depressants, stimulants, opiates, and marijuana.
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Independent Variable-what's changed or manipulated.
...
Indicate how measures of brain structure and function are used in assessment, including the EEG, CAT scan or CT scan, MRI, functional MRI, PET scan, SPECT, MRS, and fMRI.
...
Describe the essential elements of the scientific research method in abnormal psychology.
Hypothesis is a question or statement, Test/conduct experiment, analyze results, Revise if necessary, Purpose Theory.
structure of personality
id=pleasure, ego= mental powers of judgement, memory, perception, and decision making, enabling the individual to adapt to the realities of the external world. Superego=the conscience and the ego ideal; it incorporates societal prohibitions and exerts control over the seeking of instinctual gratification.
What are features of negative affectivity in the DSM5 Personality Dimensions?
over reactive to stress, emotionally labile
Tyler's clinician has made a diagnosis and must now create a picture of how the disorder may have evolved and what factors might influence his psychological status. Which of the following is the best description of this process?
Case Formulation
Discuss the correlational method and define negative and positive correlations. Be able to identify correlations in an example and distinguish them from experiments.
Correlation; research design that examines the extent to which two variables are associated. -Statistic represented as +1 & -1.
What are exceptions to the diagnostic criteria for personality disorder?
Criteria are not met if behaviors are the result of drug use, criteria are not met if behaviors are the result of a physical cause
What is the prevalence rate of schizophrenia in the US?
Estimated lifetime prevalence is about 5% and the prevalence at any one time is about 3%.
What are descriptors for Cluster B personality disorders in the DSM 5?
Emotional, dramatic
histrionic personality disorder
pervasive pattern of attention-seeking behavior and excessive emotions, including seductiveness
borderline personality disorder
pervasive pattern of unstable self-image, emotions, and interpersonal relationships along with marked impulsitivity
DSM 5 now encompasses all these different disorders under Autism Spectrum Disorder classified in a
range from mild to severe & Asperger's was eliminated.
What are aspects of cognitive behavioral treatments for dependent personality disorder?
relaxation training, exposure, homework assignments
Biological treatment
the most effective anti anxiety medications for panic disorder & agoraphobia are benzodiazepines, which increase the availability of GABA, an inhibitory neurotransmitter that they become dependent on or can abuse.
The 4 categories of specific phobias are:
the natural environment, animals, blood-injection injury & particular situations like driving, flying or claustrophobia.
1841 Dorothea Dix started the Humanitarian approach
when she opened institutions & got more funding for mental health patients.
Describe how clinicians use multiple sources of information about a client in putting together comprehensive assessment.
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Describe how intelligence is assessed through tests such as the Stanford-Binet Intelligence Test and the Wechsler Intelligence Scales.
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Describe the main concepts of Freud's theory, including the structure of personality, psychodynamics, defense mechanisms, and his approach to treatment of psychological disorders. Be able to identify examples of these concepts.
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Describe the various objective and self-report assessment methods and the scales used by clinicians.
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Describe various aspects of behavioral assessment, including identifying target behavior, types of observation, behavioral self-report, behavioral interviewing, and self-monitoring. Be able to identify examples of each o type of behavioral assessment
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Discuss biological, neurological, and psychological (e.g. behavioral, opponent-process, cognitive, etc.) theories of substance dependence.
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Discuss the various theories (biopsychosocial) and primary treatments for specific phobias.
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Emil Kraepelin was the 1st person to develop a classification system for mental disorders. He proposed that disorders could be identified by their patterns of symptoms.
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Environmental contributions to development are unclear.
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Experiments, Hypotheses, observational approach collecting empirical data, Minimize the effects of bias & categorizing/systematically logging data.
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Explain the characteristic features and epidemiology of panic disorder and agoraphobia.
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Explain the concepts of projective and objective personality testing.
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Explain the experimental method and describe the concepts of independent and dependent variables, placebos, treatment and control groups, double-blind techniques. Be able to identify examples of these concepts if given an example of an experiment.
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Explain the various modalities of treatment, including individual psychotherapy, family therapy, group therapy, and milieu therapy.
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Explain the various types of neuropsychological tests to assess different functioning of individuals.
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Family perspective- it is assumed that abnormality is caused by disturbances in the pattern of interactions and relationships within the family.
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Freud, Pavlov, Watson, Skinner, Aaron Beck, Albert Banduras & Albert Ellis were all practiced the Scientific approach.
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From the sociocultural perspective, stressors within the family, community & culture are factors that lead the person to develop alcohol use disorder.
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Further describe the following key features/diagnostic criteria of autism spectrum disorder:
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Genome-wide association studies, GWAS -Genetic method in which researchers scan the entire genome of individuals who are not related, to find the associated genetic variations with a particular disease.
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How do family studies, twin studies, adoption studies, offspring of twin studies, help us understand the genetics of schizophrenia?
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Indicate how the single-subject study is conducted and how the multiple baseline technique is used in this type of research.
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Indicate the major models of genetic transmission of inherited traits and diseases, as well as the diathesis-stress model.
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Indicate the prevalence of substance abuse disorders in the U.S. population.
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It's a dimensional model -meeting 1 to 2 mild, 3 to 6 moderate, 6 or more would be severe.
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Nature of disorganized speech is:
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Negative correlation -opposite directions; A finding that two factors vary systematically in opposite directions, one increasing as the other decreases.
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Other psychotic disorders: What are the clinical features of each disorder?
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Outline the cognitive and behavioral perspectives of the nature and treatment of mood disorders.
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Outline the forms of biologically based treatments, including psychotherapeutic medication, psychosurgery, and electroconvulsive therapy
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Positive correlation-A correlation where as one variable increases, the other also increases, or as one decreases so does the other. Both variables move in the same direction.
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Psychological and social influences of Schizophrenia
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Reinforcement means the behavior is more likely to occur.
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Review major DSM-5 changes in substance use disorder terminology
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SSRI's + CBT is promising (Walch et. al., 1997).
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Substance Use vs Substance Abuse:
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Summarize biological and psychological/psychosocial treatment approaches to alcohol dependence.
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Summarize the demographic patterns of alcohol use and prevalence rates of alcohol use disorders.
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The types of bipolar disorder are:
...
Theories & treatment of OCD
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There are 4 genes involved in Alzheimer's Disease according to learnsmart
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These include: -
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Treatment
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Treatment of ADHD:
...
Treatment of Schizophrenia
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Uses of IQ tests -Overall cognitive evaluation. -Diagnosis of learning disabilities. Determination of giftedness. -Prediction of future academic achievement diagnosis of neurological & psychiatric disorders . -Evaluation of the potential of employees.
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What are the influences such as gender role norms on prevalence rates?
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What is expressed emotion and how is it related to schizophrenia?
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What role may stress play in the onset and course of schizophrenia?
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What they're missing is fear, they become aroused for different reasons. They don't have anxiety or fear of getting caught.
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What's the difference between substance use and substance use disorder?
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The DSM5 Levels of Functioning Scale allows clinicians to evaluate clients in terms of sense of self and interpersonal relationships on a scale from...
0-4
What is the overall prevalence rate of personality disorders?
0.5% to 2.5% of the general population, most often seen in inpatient settings. Insidious onset & high co-morbidity rates.
Major depressive episode Criteria
For most of the time during a 2 week period, a person experiences at least 5 of the following symptoms, & at least 1 of the first 2 symptoms must be present. - Also, during this 2 week period, most of these symptoms must be present nearly every day:
Positive psychology proposes that people can grow through the experience of trauma.
if the client can find positive interpretations of their experiences they can develop particularly beneficial persona traits of optimism & openness to new experiences.
The evidence for the heritability of schizoid personality disorder is ____.
indirect
Psychodynamic treatment of dependent personality disorder is likely to involve...
insight into early caregiver experience, interpreting transference
Set up a schedule of rewards in behavioral therapy; pair the activity with a desirable reward.
instruction, modeling, coaching, role playing, & rehearsal & perhaps working in a real world setting.
Bipolar I disorder
involves periods of severe mood episodes from full manic episodes to depressive disorder. Age of onset is 18. 1% prevalence rate.
Reliability
is The degree to which clinicians provide diagnoses consistently across individuals who have a particular set of symptoms. Consistent conclusions.
Conditioned fear reaction
is a classical conditioning perspective which the individual associates unpleasant bodily sensations with memories of the las panic attack, causing a full-blown panic attack to develop even before measurable biological changes have occurred.
Freudian psychoanalytic approach to Narcissism-
is a failure to progress beyond early, highly self focused stages of psychosexual development. It's the adults expression of childhood insecurity & need for attention.
Bipolar II disorder
is a milder form of mood elevation, involving milder episodes of hypomania that alternate with periods of severe depression that last about 4 days . Age of onset is 22 years. Tends to be chronic.
Alogia
is a relative absence of speech because of mental defect, confusion or aphasia. Poverty of speech, without meaning, because the person has difficulty mentally formulating their thoughts. Hence, Think "Alone".
Rapid-cycling bipolar disorder
is characterized by four or more mood episodes that occur within a 12-month period. Episodes must last for some minimum number of days in order to be considered distinct episodes.
Family history studies suggest that histrionic personality disorder clusters in families along with all of the following except...
narcissistic personality disorder.
Tolerance
need more of the substance to have the same effect. Both people will have the exact same BAC, one person can just experience it as fine while the other feels totally drunk. What does affect BAC is how quickly you drink, not tolerance.
Under the DSM-5 criteria, which of the following pathological personality traits is associated with obsessive-compulsive personality disorder?
negative affectivity
People with obsessive-personality disorder have a slightly greater history of physical ____ than people with no disorder.
neglect
Treatments for Borderline Personality Disorder are:
pharmacological; antidepressants & mood stabilizers which provide short-term relief. DBT, Dialectical Behavior Therapy is the most promising treatment which is a combination of behavior & cognitive/psychological therapy.
consequences of determination of incompetence
results in commitment with limitations and client loses decision-making authority; must be re-evaluated periodically; people used to be placed in tx, never re-evaluated and just forgotten about
Cognex is rarely prescribed due to
safety concerns
Reggie is uninteresting, dull, and humorless. He is aloof and reclusive, rarely responds to people saying "Good morning" or "Hello" to him, and often doesn't understand jokes. If Reggie were diagnosed with a personality disorder, it would most likely be:
schizotypical personality disorder
People with schizotypal personality disorder are more likely than orders to have unusual beliefs about the:
significance of random events.
Alcohols predictable effects are:
slight to high euphoria, slurred speech, impairment in judgement, motor skills like reaction time & body balance & coordination, impairment in thought processes, decreased inhibition, memory loss, confusion & stupor.
3rd stage-
slower, but has typically major declines in memory & needs quite a bit of care.
It may be that ______ anxiety disorder is a less severe form of avoidant personality disorder.
social
The term parasuicide describes
suicidal gestures
The term parasuicide describes _____.
suicidal gestures
May be highly or totally insensitive to aspects of environment- e.g.
tactile, texture, smell, lighting or temperature.
Substance use disorder is a cluster of cognitive, behavioral & physiological symptoms indicating that
the individual uses a substance despite significant substance-related problems.
Caffeine can have
tolerance, dependence & withdrawal. Excessive doses people can experience psychosis & hallucinations that are similar to side effects of amphetamines & hallucinations.
Which of the following is a treatment for borderline personality disorder that uses the client-clinician relationship as the framework for helping clients achieve greater understanding of their unconscious feelings and motives?
transference-focused psychotherapy
least restrictive alternative
treatment settings that provides the fewest constraints on the client's freedom
True or false: One recommended treatment for schizoid personality disorder is to use role playing and homework assignments to try out new social skills with other people.
true
What are goals of psychodynamic treatment for histrionic personality disorder?
uncovering repressed emotion, helping express emotion appropriately
multiple role relationships
unethical relationships that increase conflict of interest occurring when a psychologist has a professional role with a client and also has another role with that person that could impair objectivity, competence, etc or risk exploitation/harm of the client (e.g. family member, colleague, student)
facts about insanity defense
used in less than 1% of criminal cases and only about 25% of those are successful; people spend more time in mental hospitals than in jail; public views it as a legal loophole and 50% of states moved to abolish it after John Hinckley Jr was found not guilty
Overall prevalence rates have risen dramatically since 1970s.
70% of "severe" cases are young, middle/upper class women....
-Drug/Alcohol use & current medication.
-Behavior observations.
-Physical/mental health history, "Have you been in counseling before?"
...
-The more data we have from multiple assessments the more accurate the diagnosis is.
...
-Ways in which the culture interprets particular events.
...
-number of new cases.
...
criteria for civil commitment
1) has a mental illness and needs treatment; 2) dangerous to self or others; 3) gravely disabled; a person must meet 1 AND 2 or 3
The DSM-IV included _____ separate personality disorders.
10
People receive a diagnosis of recurrent major depressive disorder if they have had
2 or more major depressive episodes with an interval of at least 2 consecutive months without meeting the criteria for a major depressive episode.
By 9 years old
20% of girls report attempting to lose weight and by age 14 years old 40% were trying to lose weight.
Obsessive-compulsive personality disorder is the most prevalent personality disorder in the U.S. population with about _____ percent of the population meeting criteria for a diagnosis.
8
68. People with obsessive-compulsive personality disorder:
B. are often workaholics who see little need for leisure activities.
The STEPPS program is designed for people with _______ personality disorder that combines cognitive and behavioral techniques.
Borderline
drug dependence: antisocial personality disorder has a co-morbidity rate of _% for alcohol and __% for nicotine
27% for alcohol & 59% for nicotine.
Overall genetic contributions appear to be considerably higher for Bipolar
60% vs MDD which is 30 to 40%
19. Jen, a second-year college student, attempted suicide at least 10 times before entering therapy. Her attempts to hurt herself usually followed arguments with her husband about getting a divorce. Which of the following diagnoses is Jen most likely to receive from her therapist?
A. Borderline personality disorder
24. One theory as to why _____ are more likely to receive a diagnosis of borderline personality disorder is that stress is more common among this group.
A. Latinos
8. Which of the following is NOT a personality disorder recognized by the DSM-5?
A. Multiple personality disorder
18. Gina has been diagnosed with borderline personality disorder. Which of the following would best describe Gina's mood?
A. Unstable
42. Individuals with narcissistic personality disorder are characterized by _____.
A. arrogance
Explain the main concepts of the person-centered approach of Rogers
An approach based on the belief that people are innately good and that the potential for self-improvement lies within the individual. A well adjusted person's self image should be congruent with the persons experiences. A mismatch between self-image & reality leads to a blocking of an individuals potential to live up to their full capacity.
40. Which of the following antidepressants has proven most useful in the treatment of borderline personality disorder?
B. Aripiprazole
69. People with obsessive-compulsive personality disorder:
B. are often experienced by others as stubborn and stingy.
A person diagnosed with _______ personality disorder might idealize someone at one time and then condemn them at a later time.
Borderline
A person with a diagnosis of ________ personality disorder may feel emptiness which leads them to cling to new acquaintances or therapists.
Borderline
Cutting, burning, and other self mutilating gestures is considered common in someone with a diagnosis of ______ personality disorder.
Borderline
Metallization based treatment is used for _______ personality disorder.
Borderline
Poor self concept and impulsivity combine in _______ personality disorder to create that the DSM refers to as a disinhibition and this leads to self mutilating behaviors such as cutting or burning one's self.
Borderline
86. Which of the following statements is true about schizotypal personality disorder?
C. For a person to be given a diagnosis of schizotypal personality disorder, his or her odd or eccentric thoughts cannot be part of cultural beliefs.
45. Which of the following statements is true about narcissistic personality disorder?
C. People with this disorder are preoccupied with fantasies of power and success.
ASD includes Persistent deficits in social communication & social interaction across multiple contexts, as manifested by:
Deficits in social emotional reciprocity, nonverbal communicative behaviors, & Deficits in developing, maintaining & understanding relationships.
Perfectionistic attitudes toward self, others, & or social.
Distorted body image; primarily anorexia. Obsessive compulsive features. Preoccupation with food. Mood intolerance.
Indicate the diagnostic characteristics of a major depressive episode, types of depression, epidemiology, and course of major depressive disorder and persistent disorder.
Dr. G: In order to be diagnosed with a major depressive episode, a person must experience 5 or more depressive symptoms most of the day, every day, for at least 2 weeks.
"Psychopaths or Sociopaths" Cleckley, "The Mask of Sanity" set criteria as characterized by a lack of regard for society's moral or legal standards & a highly impulsive & risky lifestyle; lacking the capacity for regret over their actions & do not learn from experience.
Extreme egocentricity & incapacity for love. Absence of nervousness, unreliable, & unable to respond to emotionality.
Differentiate between fear and anxiety.
Fear is the emotional response to real or perceived threats. Anxiety is a sense of dread about what might happen to you; it is future oriented & global. Lifetime prevalence for all anxiety disorders peaks between 30 & 44.
Abby's therapist and Abby have developed a hierarchy of social situations that range from not very threatening to very threatening. The therapist's strategy is to start with the least threatening and work up to assist Abby in not being so sensitive to rejection, to improve Abby's sense of unworthiness and to assist her in having more relationships with others. This is a description of _______ _______ to treat Abby's diagnosis of avoidant personality disorder.
Graduated exposure
Narcissistic personality disorder, Cluster B; Clinical description
Grandiosity, lack of empathy, love of power, success & beauty, preoccupation with receiving attention & requires admiration; highly envious & arrogant. Rely on others excessively to confirm their worth.
What are the characteristic symptoms, course, stages, and features of Alzheimer's Disease?-
Insidious onset, gradual progression
What is a personality disorder? An ingrained pattern of relating to other people, situations & events with a rigid & maladaptive pattern of inner experience & behavior, dating back to adolescence or early adulthood.
It's a personality disorder when personality traits become problematic. Part of the problem is the rigidity or flexibility of the problematic traits that cause distress to the individual.
-Over 50% of the US greater than 12 years report drinking alcohol.
Men drink more than women. Men's use is likely to go down with children & women's is more likely to go up.
Causes of Avoidant Personality Disorder-
Numerous have been proposed. Difficult temperament & early rejection. Extreme shame of shyness and perceived flaws, extreme fear of being ridiculed
_______ personality disorder is the most prevalent personality disorder in the US population with about 8% of the population meeting the criteria for a diagnosis.
Obsessive compulsive
Karl is having problems at work. His boss is increasingly frustrated with his lack of timeliness in getting projects done but Karl tells him that the reason he is slow is that he is perfect. What personality disorder is a possibility for Karl?
Obsessive compulsive personality disorder
Often does not seem to listen when spoken to directly. Often does not follow through on instruction & fails to finish schoolwork, chores, etc.
Often Has difficulty organizing tasks, often avoids/dislikes tasks that involve sustained mental effort. Often loses things, easily distracted & forgetful in daily activities.
Schizophreniform disorder
Onset of at least 2 schizophrenic symptoms between 1 month & up to 6 months; Associated with good premorbid functioning.
Classical Conditioning
Pavlov's Dogs. unconditioned stimulus which leads to an unlearned response. The food produced saliva. -Pair the U.S. with a neutral stimulus. The bell with the food. -The bell becomes the conditioned stimulus which leads to a conditioned response.
Describe the spiritual approach which regarded abnormal behavior as the product of possession by evil or demonic spirits.
Regard psychological disorders as the product of possession by evil or demonic spirits; Trephining, Exorcism, Treatments recommended by church.
Spectrum of negative symptoms include:
Restrictive affect, Avolition, Associality, Alogia, Anhedonia, & Affective flattening.
Which of the following is true about schizotypal personality disorder?
Schizotypal personality disorder is much more common in the first-degree relatives of people with schizophrenia than in the relatives of other psychiatric patients.
The DSM-5 does NOT recognize _____ as distinct personality disorder.
histrionic personality disorder
schizoid personality disorder
display a pervasive pattern of detachment from social relationships and restricted range of emotion
High doses of opioids can result in death.
Withdrawal symptoms can be lasting & severe.
They worry a lot, apprehensively expecting the worst to happen to them.
Symptoms for generalized anxiety disorder include restlessness, sleep disturbances, easily fatigued, irritability, muscle tension & trouble concentrating to the point of the mind going blank.
Hippocampus which is the structure involved in short-term memory seems to function abnormally.
The volume isn't different, but the shape is. They also have deficits in frontal lobe functioning which make them less able to inhibit aggression.
The Dependent person Feels despondent & abandoned when alone, preoccupied with fear that close ones will leave them.
They Seek approval & are shattered by criticism. Extreme dependence; always in a relationship to fill the void. Unusually high levels of agreeableness, overly docile, self-sacrificing & clinging.
Like Schizoid, The Avoidant Personality looks similar with no friends, no relationship & no romance But:
They Want it, they're just too afraid.* They are inter-personally anxious & fearful of rejection in contrast to the person with PPD & have a chronic sense of inadequacy.
Key feature of Avoidant Personality Disorder-
They are *Highly avoidant of most interpersonal relationships.
genetics account for ...
about half of Alzheimer's cases
The Peripheral Nervous system connects the
organs to the brain via the spinal cord.
Key* difference of OCD & OCPD is that Obsessive Compulsive Personalities do not experience
obsessions & compulsions. OCPD refers to rigidly compulsive personality tendency & obsessive concern with perfectionism e.g. fixated on certain routines.
In the DSM-5, _____ is a negative characteristic of the detachment dimension.
withdrawal
While there are Therapeutic effects to Tricyclic's
you can overdose so they're not good to give to clients with suicidal ideation.
Describe both versions of:
...
Describe genetic factors associated with substance abuse/dependence.
...
-Current social situation,
"Tell me about your family, support system"
-the consequences of a behavior produce changes in the probability of the behavior's recurrence. A behavior followed by a rewarding consequence is more likely to recur, whereas a behavior followed by a punishing stimulus is less likely to recur.
...
25% of college age women and 20% of college age men engage in restrictive eating disorder.
...
A major controversy over vaccinations is that, specifically, the MMR contains mercury which potentially predisposes children to it.
...
Alzheimer's Disease- Broad range of cognitive deficits, memory impairments plus-
...
Autism Spectrum Disorder
...
Biological considerations:
...
Bipolar disorders equally affect males & females.
...
Briefly describe various psychological, social, and cultural factors that influence the progression of Alzheimer's disease.
...
Chromosomes
...
Clarify the nature of the sociocultural and interpersonal perspective of mood disorders & include:
...
Clinicians may use thought stopping to help clients reduce obsessional thinking, as in exposure to situations that provoke compulsive rituals or obsessions.
...
Common Developmental Disorders
...
DSM 4 was categorical with Axis 1 seen as less chronic or problematic & Axis 2 more problematic like mental retardation.
...
DSM 5 is no longer Multiaxial, classification system that categorizes & summarizes relevant information about an individuals physical & psychological function, like the DSM 4 was.
...
DSM 5 now categorizes Substance use & Substance dependence like the DSM 4; it rates it from mild to severe. -Reviews criteria & based on that makes a determination of mild to severe use & dependence.
...
Defense mechanisms: Tactics that keep unacceptable thoughts, instincts, and feelings out of conscious awareness and thus protect the ego against anxiety.
...
Define and distinguish between prevalence from incidence
...
Define reliability and validity as they apply to diagnosis and classification of psychological disorders.
...
Cluster C Personality Disorders; Think Scaredy Cat:
Fearful or anxious behaviors i.e. avoidant, dependent, & obsessive-compulsive personality disorders.
What percent of people with diagnoses of borderline personality disorder die by suicide?
10
How does the DSM-5 describe personality disorders?-
11 distinct categories grouped into 3 clusters based on shared characteristics.
From 2005-2008 antidepressant use went up 400%
11% of Americans take antidepressants. Whites use most. Women are 2.5% higher than men.
Interpersonal therapy IPT.
12 to 16 weeks with 3 broad phases: First assess the magnitude & nature of the individual's depression using quantitative (numbers) measures.
Benjamin Rush
1745-1813 Founder of American Psychiatry. Advocated for mental health patients to have own wards, OT, & not to be showcased by curious onlookers.
67% of Prisoners of war are diagnosed with PTSD
19% in those who weren't afraid of being harmed or killed. 45% in those Female assault victims who did fear being harmed or killed.
personality trait
aspect of personality that is stable across time and across many situations
DSM 5 saw major changes in definition & categorization of anxiety disorders. OCD is categorized with body dysmorphic disorder, hoarding disorder, trichotillomania aka hair pulling, & skin-picking.
Acute & PTSD moved into their own category of "Trauma & Stressor-Related Disorders." & Agoraphobia became a separate disorder.
32. Psychoanalytic theory suggests that the instability in emotions and interpersonal relationships seen in people with borderline personality disorder is due to:
B. splitting.
34. Drug treatments for people with borderline personality disorders have focused on reducing:
B. symptoms of anxiety and depression.
· Describe the features of acute stress disorder and differentiate between acute stress disorder and posttraumatic stress disorder.
Acute stress disorder is an anxiety disorder that develops after a traumatic event & lasts for up to 1 month with symptoms such as depersonalization, numbing, dissociative amnesia, intense anxiety, hypervigilance & impairment of everyday functioning.
Who of the following is most likely to be diagnosed with a personality disorder?
Ada, aged 30, a woman with lifelong interpersonal difficulties
Each one of these drinks will raise your BAC by .02%.
BAC goes down .015% per hour.
The incidence of the diagnosis of schizotypal personality disorder is ____.
higher in men
The highest suicide rates by age are 45 to 54 years old.
75 to 84 have the next highest rates. White men are much more likely than non-white men to commit suicide.
Research Design.
A method to test hypotheses. - Experimental or treatment group. - Control group. - Random Assignment.
Which of the following are correct in regard to the prognosis for a person with a diagnosis of borderline personality disorder? (Select all that apply.)
A minority of those considered to be in remission relapse. Symptoms usually improve over time.
Specifically, monoamine oxidase A is an enzyme coded by the MAOA gene.
A mutation in this gene results in insufficient amounts of monoamine oxidase in the nervous system which results in abnormally high levels of dopamine, serotonin & norepinephrine which are linked to greater impulsivity
Panic Attacks
A period of intense fear & physical discomfort accompanied by the feeling that one is being overwhelmed & is about to lose control. Feeling like you're going to die or my heart is going to explode.
Key to Major Depressive Disorder*
A person must have at least 1 Major Depressive Episode to be diagnosed with Major Depressive Disorder. It involves acute, but time-limited periods of depressive symptoms that are called major depressive episodes.
6 months or longer is Chronic PTST.
PTSD & related disorders such as depression can last for many years.
The term ______ describes suicidal gestures that are frequently made by a person with a diagnosis of borderline personality disorder.
Parasuicidal
Single case experimental design
A type of case study in which a single subject is used as his or her own control switching between alternating on off phases of the baseline condition. - AKA ABAB designs.
37. STEPPS is a _____ therapy treatment for borderline personality disorder.
B. cognitive
62. Cognitive theorists suggest that people with avoidant personality disorder:
B. develop dysfunctional beliefs about being worthless as a result of rejection by important others early in life.
85. Roger believes he has a special ability. He believes he can read the thoughts of other people and transfer his own thoughts into their mind. There are times when he believes that certain random events and circumstances are directly related to him. On some occasions, he becomes very suspicious of the people around him. Which of the following personality disorders best describes Roger's behavior?
B. Schizotypal personality disorder
75. As with avoidant personality disorder, which of the following is characterized by withdrawal from social situations?
A. Schizotypal personality disorder
64. _____ are sometimes used to reduce the social anxiety of people with avoidant personality disorder.
A. Serotonin reuptake inhibitors
90. Which of the following is true about schizotypal personality disorder?
B. Schizotypal personality disorder is much more common in the first-degree relatives of people with schizophrenia than in the relatives of other psychiatric patients.
57. Twin studies have shown that _____ plays a role in avoidant personality disorder.
B. genetics
36. _____ is a group intervention for people with borderline personality disorder that combines cognitive techniques challenging irrational and maladaptive cognitions and behavioral techniques addressing self-management and problem solving.
A. Systems training for emotional predictability and problem solving (STEPPS)
schizophrenogenic mother.
According to an obsolete, unsupported theory, a cold, dominating, and rejecting parent who was thought to cause schizophrenia in her offspring.
Behavioral perspective of the Nature of mood disorders are:
According to the Behaviorist point of view, the lack of positive reinforcement elicits the symptoms of low self-esteem, guilt & pessimism.
23. Cognitively, people with borderline personality disorder are _____ negative emotional stimuli in the environment.
B. hyperattentive to
61. Janice's friend invited her to a five-star restaurant. Janice became nervous when she saw the various pieces of silverware placed on the table. She felt that others were scrutinizing her every move and watching to see if she used the cutlery properly. Overwhelmed with anxiety, Janice left the restaurant without eating dinner. Janice would most likely be diagnosed with:
A. avoidant personality disorder.
71. People with obsessive-compulsive personality disorder tend to have slightly greater histories of _____ than people with no personality disorder.
A. physical neglect
29. Psychoanalytic theorists, particularly those in the object relations school, suggest that people with borderline personality disorder have:
A. poorly differentiated views of themselves compared to others.
What are the prevalence rates for Neurocognitive Disorder due to Alzheimer's Disease?-
About 5 million Americans & many more worldwide; likely to double by 2050 up to 4 million.
akinesia; think knee
Absence or loss of control over voluntary muscle movements
A couple more divisions we can look at within the Autonomic division are the flight or fight system when the sympathetic nervous system is kicked in & Parasympathetic system..
Adrenaline. Heart rate increases. sustained energy. & pupils dilate to see better.
Which of the following is one of the interpersonal categories on the levels of function scale for diagnosing personality disorders?
Agreeableness
Which of the following brain areas have been identified as smaller through neuroimaging in people with diagnoses of borderline personality disorder?
Amygdala and hippocampus
Discuss the various theories, biopsychosocial, and treatments for panic disorder and agoraphobia.
Anxiety sensitivity theory is when people who develop panic disorder have heightened responsiveness to the presence of carbon dioxide in the blood. Hence, they are more likely to panic due to the sensation that they are suffocating.
Susceptibility genes-
ApoE4 gene
Describe the general characteristics of anxiety symptoms
Apprehensive, tense, and uneasy about the prospect of something terrible happening
3. A(n) _____ trait is a complex pattern of behavior, thought, and feeling that is stable across time and across many situations.
B. personality
The term _________ describes suicidal gestures that are frequently made by a person with a diagnosis of borderline personality disorder.
Parasuicidal
A job involving working alone and independently would probably appeal to someone with a diagnosis of _______ personality disorder.
Avoidant
The cognitive theory of ________ personality disorder is that a person with this diagnosis has developed dysfunctional beliefs about being worthless as a result of rejection by important others early in life.
Avoidant
Shelley's roommate wonders why she never accepts any social invitations. The roommate has also noticed that Shelley is sensitive to rejection and often interprets innocent remarks as ridicule. The roommate knows Shelley has recently seen a psychologist and has been diagnosed with...
Avoidant personality disorder
47. A nationwide study in the United States found that about _____ percent of women could be diagnosed with narcissistic personality disorder.
B. 5
15. Although the DSM-5 uses a continuum-based approach to diagnosing personality disorders, it also includes _____ separate personality disorders.
B. 6
89. Which of the following groups is most likely to be diagnosed with schizotypal personality disorder?
B. African Americans
58. Under the DSM-5 criteria, which of the following pathological personality traits is associated with avoidant personality disorder?
B. Detachment
39. _____ is based on the argument that people with borderline personality disorder have fundamental difficulty understanding the mental states of themselves and others because of traumatic experiences in childhood and poor attachment to their caregivers.
B. Mentalization-based treatment
78. _____ shown by people with schizotypal personality disorder set them apart from people with other personality disorders.
B. Oddities in cognition
33. Studies show that people with borderline personality disorder have greater activation of the _____, which may contribute to the difficulty they have in regulating their moods.
B. amygdala
5. Under the DSM-5 approach, the first step in diagnosing a personality disorder is determining:
B. an individual's level of functioning.
Certain types of alcohol will raise your alcohol level. Based on the standard drinks you can quantify how much your concentration will be raised:
Beer- 12 oz. Wine- 4 oz. Liquor- 1.25 oz. 80 proof or 40%.
BPD Has a 6% suicide rate & they are unique as they are the most likely to seek treatment & engage in it.
Best treatment for BPD is Dialectical Behavior Therapy which is a merging between behavior & cognitive/ psychological therapy; with treatment many achieve remission.
CBT for Bulimia: Education about physiological effects of Binge Eating & Purging.
Binge eating and purging and dieting. Scheduling/eating regular/manageable meals and snacks throughout the day. Minimizing time alone during the early stages. Challenging / altering dysfunctional beliefs surrounding body image, eating, weight. Distress tolerance skill development.
endophenotype
Biobehavioral abnormalities that are linked to genetic and neurobiological causes of mental illness.
Biopsychosocial perspective is particularly appropriate for understanding why people commit suicide.
Biological theories emphasize the genetic & physiological contributions that also contribute to the causes of mood disorders.
Types of bipolar disorders:
Bipolar disorder is a lifelong illness. Episodes of mania and depression eventually can occur again, if you don't get treatment. Many people sometimes continue to have symptoms, even after getting treatment for their bipolar disorder.
Emily has been hospitalized and diagnosed with a personality disorder. Her sister tells the clinician that Emily spends all her time pestering family members and is moody demanding and reckless. She talks continuously about not knowing what to do in her life. When Emily is interviewed, she tells the clinician that she feels empty all the time. What disorder is Emily most likely to be diagnosed with?
Borderline personality disorder
27. According to research, which of the following groups is more likely to be diagnosed with borderline personality disorder?
C. Latinos
84. Which of the following is NOT a category of odd cognition seen in individuals with schizotypal personality disorder?
C. Narcissism
51. Cognitive theorists have argued that some people with narcissistic personality disorder:
C. develop the belief that they are unique or exceptional as a defense against rejection.
83. As children, people who develop schizotypal personality disorder are:
C. hypersensitive to criticism.
48. Psychodynamically oriented theorists suggest that the symptoms of narcissistic personality disorder are:
C. maladaptive strategies for managing emotions and self-views.
56. People diagnosed with avoidant personality disorder:
C. shun interactions if there is a possibility of being criticized.
79. People with schizotypal personality disorder are more likely than others to have unusual beliefs about the:
C. significance of random events.
92. Individuals diagnosed with borderline personality disorder are: .
C. somewhat more often from lower socioeconomic classes.
Cluster A Schizotypal Personality Disorder; Think Kramer: Behavior & dress is odd & unusual, socially isolated & highly suspicious, magical thinking, Illusions or unusual perceptual experiences which are not quite hallucinations.
Causes of Schizotypal are a phenotype of schizophrenia genotype, possibly transmitted genetically. Treatment options include developing social skills, medical treatment e.g. anti-psychotics; treatment prognosis is generally poor & Schizotypal are at a much higher risk of developing Schizophrenia.
Ch 6 SCHIZOPHRENIA SPECTRUM DISORDERS
Clinical Description, Symptoms, and Subtypes
Treatment Of Narcissistic Personality Disorder- There's little evidence that treatment is effective. Psychodynamic approach-
Clinician uses empathy to support client's search for recognition & admiration, guiding them towards a more realistic appreciation that No one is flawless leading to them becoming less grandiose & self-centered.
Indicate how a Case Formulation is constructed.
Clinicians analysis of the factors that might have influenced the clients current psychological status. This is when they're getting background information. What you get at the beginning of each chapter, the case reports.
Which of the following statements is true about the treatment of narcissistic personality disorder?
Cognitive techniques help these clients develop more realistic expectations of their abilities and more sensitivity to the needs of others.
Psychotherapeutic methods are preferred treatments:
Cognitive-behavioral therapy (CBT). Interpersonal psychotherapy (IPT). Family-based therapy (FBT).
Explain the biological perspective of mood disorders, including approaches to theory and treatment that focus on genetics and biochemical abnormalities.
Consider such aspects as genetic contributions to depressive and bipolar disorders and the neurological factors that influence these disorders.
L-Dopa is the precursor to the neurotransmitters dopamine, norepinepherine aka noradrenaline & epinephrine/adrenaline collectively know as catecholamines.
Conventional, or typical, antipsychotics help raise dopamine levels by blocking the dopamine receptors in the Central Nervous System & reduce positive symptoms but not negative symptoms.
20. Which of the following statements about borderline personality disorder is NOT true?
D. About 30 percent of persons diagnosed with borderline personality disorder experience hallucinations.
17. Which of the following symptoms is characteristic of borderline personality disorder?
D. Unstable relationships
7. All of the following are personality dimensions recognized in the DSM-5 EXCEPT:
D. creativity.
66. Compared to individuals with obsessive-compulsive disorder, those with obsessive-compulsive personality disorder tend to have:
D. more general concerns with order.
54. Narcissistic personality disorder is most associated with a history of _____ in childhood.
D. neglect
2. When an individual fails to develop a sense of self-identity and a capacity for interpersonal functioning that are adaptive in the individual's relationships, he or she may be diagnosed with a(n) _____ disorder.
D. personality
30. Jennifer has been diagnosed with borderline personality disorder. Her therapist noticed that she sees things as either "all good" or "all bad." This process is called _____.
D. splitting
11. In the DSM-5, _____ is a negative characteristic of the detachment dimension.
D. withdrawal
What is the DSM 5 Clinical description of Antisocial personality disorder?
DSM 5 Requires that there be a pervasive pattern of 3 out of 7 possible behaviors including:- failure to conform to social norms, deceitfulness, impulsivity, aggressiveness, disregard for safety of self or others, irresponsibility & lack of remorse.
5 Types of Depression are:
Depressive Disorder, Dysphoria, Major Depressive Disorder, Major Depressive Episode, & Persistent Depressive Disorder aka Dysthymia.
Restricted affect, suspiciousness, withdrawal and avoidance of intimacy are all features of ________ in the DSM5 Personality Dimensions.
Detachment
Elsa's therapist decides that Elsa's symptoms do not meet the diagnostic requirements for any of the personality disorders identified in the DSM, yet Elsa clearly has a personality disorder. What does the therapist do?
Diagnoses Elsa with Personality Disorder Trait Specified
______ behavior therapy (DBT) was developed by Marsha Linehan for use with people diagnosed with BPD.
Dialectical
Biopsychosocial treatment is
highly recommended because they're superior to medication or behavioral treatments alone.
Which of the following are features of schizotypal personality disorder? (Select all that apply.)
Difficulty in establishing relationships Social isolation Restricted range of emotions
While the DSM 5 continues to use the categorical scheme for understanding personality disorder, it also offers an alternative model for diagnosing personality disorders that incorporates a _______ or continuum perspective.
Dimensional
The DSM 5 includes two models of personality disorder:
Dimensional and categorical
Epidemiology of Major Depressive episode, incidence & distribution, is 16.6% of the adult population.
Each year 6.7% of the adult population receives a diagnosis of major depressive disorder. 30.4% of these cases are severe.
Psychosocial factors do not cause MND directly but they may influence onset & course.- Some Psychosocial factors are
Educational attainment, coping skills & social support.
Caffeine use Disorders
Effects of caffeine: Used by over 90% of Americans, The Gentle stimulant. It's found in tea, coffee, cola, energy drinks & cocoa products. Small doses elevate mood & reduce fatigue.
Cluster B Personality Disorders- Think a "B movie; Bad Drama"
Emotional, overly dramatic, & erratic or unpredictable attitudes & behaviors cluster. I.e. antisocial, borderline, histrionic & narcissistic personality disorders.
Agnosia- Think "nose" for face
Failure to recognize objects; facial, can't remember children or spouse or objects like stop signs.
The cognitive-behavioral perspective proposes that maladaptive thought patterns contribute to the development & maintenance of OCD symptoms like startle reactivity.
For people with OCD experiences become transformed to disturbing images, which they then try to suppress or counteract with compulsive rituals.
Freud's approach to treatment of psychological disorders
Free association, hypnosis & talking.
Neurotransmitters that play roles in activation and inhibition are: Norepinephrine, serotonin, & GABA.
GABA prevents anxiety and stress-related messages from reaching the motor centers of the brain by occupying their receptor sites; Central Nervous system. GABA can be taken to calm the body like tranquilizers, but without the fear of addiction.
Biological perspective of mood disorders:
General biological vulnerability to stress.
Genome-wide linkage study
Genetic method in which researchers study the families of people with specific psychological traits or disorders.
Boys are more likely to present at hyperactive & impulsive.-
Girls are more likely to present as inattentive. This is important because you're much more likely to notice the crazy, hence, diagnosed more for boys.
Neuro-biological influences e.g. response modulation hypothesis is when they're unable to pay attention to secondary cues to switch or modulate their attention. They pay attention only to the trials in which they will receive a reward & do not learn from trials in which they incur punishment.
Hence, they focus only on what they can get from a situation e.g. money, power, etc. & not consider that if they pursue these rewards that punishment might result. They focus only on their own pleasure but not on the pain that they may cause the people that they hurt.
Restricted behavior, interests, and activities: 2 of the following-
Hypo/hyper-reactivity to sensory input or unusual interest in sensory aspects of environment. Insistence on sameness. Strict adherence to routine or ritual. Highly restricted, fixated interests that are abnormal in intensity or focus & may have a persistent preoccupation with parts of objects.
Neuroimaging research has found abnormalities in the ________ cortex, the area of the brains of people with borderline personality disorder.
Prefrontal
Interventions based on the resilience model would address
assessing & then strengthening the individual's feelings of personal control & perceived abilities to handle stress.
What are characteristics of borderline personality disorder?
Impulsive behaviors, identity disturbances, feelings of emptiness, frantic efforts to avoid abandonment
SSRI's is the most effective biological treatment.
In extreme cases people may be treated with psychiatric neurosurgery.
3 or more of the following symptoms have persisted for at least 1 week to be diagnosed a Manic episode:
Inflated self-esteem, decreased need for sleep, pressured speech or talkative, racing thoughts, distract ability, increased goals, excessive high risk pleasurable activities e.g. spending, sex & high potential for harmful consequences; impulsive.
Distinguish the treatment sites of psychiatric hospitals
Inpatient; Milieu therapy is a treatment modality that is specific to psychiatric hospitals and is based on the premise that the environment is a major component of the treatment. Can be court ordered or voluntarily admitted.
And some of these to total 5 symptoms out of 9 present for at least 2 weeks: Significant unintended weight loss or unusual increase or decrease in appetite.
Insomnia or hypersomnia.
People diagnosed with Persistent Depressive Disorder or Dysthymia *are Never free of their symptoms for longer than 2 months*!
Prevalence is 2.5% of Adult population & peaks in 45 to 59 year olds.
DSM5 requires all of the following symptoms to be present on some level:
Intrusions or flashbacks, dissociation, detachment, or numbing, avoidance, either emotional or physical, Hyper-viligance, irritability or easily startled, sleep problems like nightmares.
Outline the history of the development of DSM and the assumptions underlying the DSM-5.
It started with Scientific method (see ch 1) & Emil Kraepelin.
Parent management training is effective consistently.-
It's ok to take medication breaks during the Summer or times when the child might not need it. Taper off slowly to avoid withdrawal symptoms.
Psychosocial can be cognitive, behavioral or humanistic.- Think PSR
It's short term, goal oriented, reward & discipline to improve a child's behavior. Managing their environment, clear expectations & rules at the child's developmental level.
Mind of a Murderer Clip- Kenneth Bianchi, killed women in LA with his cousin Angelo every 3 to 4 weeks for a year.
Known as the Hillside Stranglers. He Moved to WA, more women were found which lead police to him.
33% to 64% of children with ASD also met criteria for Intellectual Disability.
Language ability & IQ are related to prognosis; the earlier we can intervene the better indicator of prognosis.
14% of people taking Antidepressants have taken them for more than 10 years. 23% of women between 40 & 59 years old take Anti Depressants.
Less than a third of people taking AD's have seen a Doctor in the last year.
Cognitive and Cognitive-Behavioral Approaches:
Lewinsohn's model maintained that depressed people have a low rate of "response contingent positive reinforcement behaviors." Lack of positive reinforcement elicits the symptoms of low self-esteem, guilt & pessimism.
Behavioral interventions: Describe various behavioral interventions for AD/HD.-
Reinforcement programs, Parent training helping to build positive behaviors, psycho-education, school interventions & Combined biopsychosocial treatments.
Treatment for pervasive developmental disorders & treatments for Autistic Disorders. The Lovaas behavioral perspective is the most relevant to treatment. This is based on early interventions
Lovaas treatment is based on behavioral perspectives & uses operant conditioning. Consists of ignoring aggressive behaviors, use time outs for disruption and positive reinforcement when they engage in appropriate behavior. Lovaas treatment takes a lot of time and commitment on the parents and clinicians
The 4 major categories are: serotonin SSRI's, norepinephrine reuptake inhibitors or SNRI's, tricyclic antidepressants & monoamine oxidase inhibitors which are aka MAOI's.
MAOI's blocks the enzyme that breaks down serotonin & norepinephrine; they require strict dietary restrictions from beer, red wine & cheese bc they contain tyramine.
Which of the following do therapists using dialectical behavior therapy focus on in the treatment of borderline personality disorder? (Select all that apply.)
Monitoring self-disparaging thoughts Monitoring black-and-white evaluations of others Learning appropriate assertiveness skills
Negative attitudes by 3 years old.
More than 50% of 6 to 8 year old females surveyed wish they were thinner.
Lifetime prevalence of Panic attack is between 3 to 5%; 75% are female. Early onset for panic disorders are 15 to 40 years old.
Must happen more than once & client must be fearful of another attack for at least a month or maladaptive behaviors to avoid another attack.
Beck's cognitive theory,
Negative cognitive coping styles. -Depressed persons engage in *cognitive errors*. -Tendency to interpret life events negatively.
Beck's Cognitive Theory- Think "I'm a loser baby.."
Negative cognitive coping styles. -Depressed persons engage in cognitive errors & have a tendency to interpret life events negatively.
Biological treatment for Schizophrenia is antipsychotic medication a.k.a. neuroleptics meaning "to seize the nerve" & has Two categories: Typical or 1st generation conventional antipsychotics, & atypical 2nd generation antipsychotics.
Neuroleptics sedate & reduce psychotic symptoms. The 1st med used was Thorazine/chlorpromaizne developed by Paul Charpentier. Hadol also acts on dopamine associated with positive symptoms.
chromosome 14
associated with early onset Alzheimer's
Obsessive-compulsive PD are also Overly moralistic & stick to overly conscientious standards that almost anyone would find difficult to meet. Perceived as rigid & stubborn. Things have to be "Just so" or they're miserable.
Perseveration; going over & over something they've done looking for flaws. Negative affect.-
according to the DSM 5 The nature of personality disorders are enduring & relatively stable predispositions.
Persistent pattern of emotions, cognitions & behavior that result in enduring emotional distress for the person affected & or for others.
Which of the following are diagnostic criteria for a personality disorder in the DSM-5? (Select all that apply.)
Personality deviates markedly from cultural expectations. Personality is inflexible and nonadaptive. Personality functioning is stable over time.
Cluster "A"; Schizoid Personality Disorder- Think avoid the Noid
Pervasive pattern of detachment from social relationships i.e. not interested in having friends. Key feature *they are not interested in romantic or sexual relationships & have a very limited range of emotions.*
Difficulties with Executive functioning- i.e.
Planning, organizing, sequencing, abstracting information. Agitation, confusion or combativeness. Negative impact on social & occupational functioning.
Neuroimaging research has found abnormalities in the ______ cortex, the area of the brains of people with borderline personality disorder.
Prefrontal
Restricted patterns of behavior, interests & activities.- Previously a ____ of conditions that are now a ___ grouped along a dimension of severity.
Previously a group of conditions that are now a single grouped along a dimension of severity.
Describe the types of clinicians who provide psychological treatment.
Psychiatrists (MD only 1 that can prescribe meds), Psychologists (could be a Professor), clinician (Practicing/working with client), clinical psychologist.
Psychodynamic Approaches:
Psychoanalytic explanations of bipolar disorders propose that manic episodes are defensive responses through which individuals stave off feelings of inadequacy, loss, and helplessness.
What psychological perspective has the belief that early childhood experiences, specifically those that involve trauma or neglect and insecure attachment of the child play and important role in the development of BPD?
Psychodynamic
Sydney has a high number of unusual beliefs and people consider him to be quite eccentric. Which of the core personality dimensions of the DSM5 best describes Sydney?
Psychoticism
3 Central DSM 4 features of autism were -
Qualitative impairment of social interaction, problems in communication & restricted patterns of behavior, interests & activities; & had a whole group of disorders called PDD.
chromosome 19
associated with late onset Alzheimer's
AREAS COVERED IN A CLINICAL INTERVIEW
Reason for referral, "What brought you in today?"
Difficulty maintaining concentration or making decisions.
Recurrent thoughts of death or having suicidal thoughts, plans or attempts.
Lifestyle factors are-
metabolic syndrome, obesity, lack of exercise, smoking, diabetes, lack of brain exercises, unhealthy diet.
What prenatal influences are related to later develop of schizophrenia e.g. exposure to a viral infection?
Researchers have identified at least 19 possible genes dispersed over chromosomes 1,2,9,5,6,8,11,13,14,19, and 22.
Which of the following are symptoms present in obsessive compulsive personality disorder?
Rigid attention to rules, perfectionism and attention to detail, self esteem that is based on work and productivity
Family studies
Risk increases with genetic relatedness; i.e. higher numbers of shared genes.
Biological interventions: What medications are primarily used to treat AD/HD?
Ritalin aka methylphenidate, Dexedrine, Adderall aka dextroamphetimine & Vyvanse.
For this reason, clinicians prefer to prescribe
SSRI's or SNRI's because they're not addictive like the benzodiazepines are.
Cheryl has a boyfriend but when she talks about him, she talks about him as if he were an object. There is no emotional expression and no pleasure from their interactions. If Cheryl were to be diagnosed with a personality disorder, it would most likely be...
Schizoid personality disorder
other treatment sites
School or Work Employee Assistance Programs.
Describe how the scientific approach looks for causes that we can objectively measure, such as biological alterations, faulty learning processes, or emotional stressors.
Scientific approach
Illusions
Seeing people in wallpaper patterns
Maslow's self-actualization theory.
Self actualized people are able to create an accurate self-perception & enjoy every day tasks.
_____ are sometimes used to reduce the social anxiety of people with avoidant personality disorder.
Serotonin reuptake inhibitors
Amanda is controlling and rigid in her relationship with her husband, is a workaholic, and is perfectionistic. She was recently diagnosed with obsessive compulsive personality disorder. What other qualities might Amanda have that fits with this diagnosis?
She is rigid, she is concerned with order
Which of the following are features of histrionic personality disorder? (Select all that apply.)
Shifting emotions Unstable relationships
Describe the key features/characteristics of Autism Spectrum Disorder.-
Significant impairments with social interactions & for some, communication.
What are components of DBT?
Skills in expressing feelings in a mature manner, skills in expressing needs, assertiveness training
operant conditioning
Skinner's Operant Conditioning came from Thorndike's Law of Effect:
Neuro-biological contributions to ADHD- think "streamlined"
Smaller brain volume by 3% to 4%. Smaller Cortical volume by as much as 9% which is the lining around the brain, & inactivity or impairment in functioning of the frontal cortex.
Avoidant Personality Disorder is a more severe form of
Social Anxiety Disorder along the continuum. The link between social anxiety disorder & avoidant personality disorder is that both involve excessive self criticism.
Psychological theories focus on distorted cognitive process & extreme feelings of hopelessness that characterized suicide victims.
Sociocultural perspective suggest that there are contributions relating to an individual's religious beliefs & values as well as to the degree to which the individual is exposed to stresses.
NATURE OF ANXIETY
The relationship between arousal & performance: your maximum performance is optimally aroused right in between under-aroused or hyper arousal.
Epigenetics
The science that attempts to identify the ways that the environment influences genes to produce phenotypes.
They don't learn to avoid getting hurt. They're opportunists. Psychopaths are everywhere.
The skills that they have often serve them well.
Psychopaths & learning- Psychopaths show deficits in
avoidance Learning. Psychopaths fail to develop fear to punishment. They don't show conditioned emotional responses.
The biological basis for OCD may be abnormalities in the basal ganglia.
The symptoms are contributed to by failure of the prefrontal cortex to inhibit unwanted thoughts, images or urges.
The symptoms are not attributable to a medical condition or use of a substance.
The symptoms cause significant distress or impairment.
What is the dopamine hypothesis? Chlorpromazine blocked dopamine receptors giving rise to the dopamine hypothesis.
The theory that drugs that raise dopamine levels cause schizophrenia. This theory has been found to be too simplistic. Drugs that increase dopamine, aka agonists, cause schizophrenic-like symptoms, e.g. amphetamines and L-Dopa;
The cognitive theory of _____ personality disorder is that a person with this diagnosis has developed dysfunctional beliefs about being worthless as a result of rejection by important others early in life.
avoidant
Psychological perspective people with PTSD have a biased information processing style that, due to the trauma they experienced, causes their attention to be biased toward potentially threatening cues.
They feel more under threat & more likely to avoid perceived threatening situations.
What best describes a person with a diagnosis of schizotypal personality disorder?
They have basic contact with reality
1963 legislation began community mental health legislation act.
They provided ½ way houses to rehabilitate people. The Humanitarian approach; by the 1970's there was such an overflow of patients as there wasn't enough funding or planning for this de-institutional movement.
Impairment in social interactions- making friends, sharing imaginative play, absence of interest in peers. Lack of interest in sharing relationships.
They're interested in objects & spending time by themselves.
Which of the following is a treatment for borderline personality disorder that uses the client clinician relationship as the framework for helping clients achieve greater understanding of their unconscious feelings and motives?
Transference focused psychotherapy
electroconvulsive therapy
The application of electrical shock to the head for the purpose of inducing therapeutically beneficial seizures.
Describe treatments based on the humanistic perspective.
The belief that human motivation is based on an inherent tendency to strive for self-fulfillment & meaning in life. Unconditional positive regard, & Motivational interviewing.
privileged communication exceptions
child abuse or neglect, child custody cases, when someone/group is in danger (duty to warn), and for trials when a defendant is using mental disability as a defense
outpatient treatment
Voluntarily or Court ordered establishments that you visit & leave; Support groups, community mental health center (CMHC). outpatient clinic that provides psychological services on a sliding fee scale to serve individuals who live within a certain geographic area. AA meetings.
apraxia
motor function impairment
Psychoactive drugs are chemical substances that affect the brain functioning, causing changes in behavior, mood and consciousness.
While these drugs can be used therapeutically to treat both physical and psychological disorders, they are also used recreationally to alter mood, perceptions and consciousness.
-It is a Scientifically based Classification system but has introduced gradients of disorders moving toward a dimensional system.
The current DSM5 assumes that there is a recognizable distinction between normality & abnormality. One of the issues of diagnoses in general is that by labeling a collection of behaviors as constituting a "disease" manual use can raise the tendency to stigmatize those whose behaviors falls outside the norm
The term _______ is used in the psychological profession to describe the way that people with a diagnosis of borderline personality disorder relate to others. This means that their preoccupation with feelings of love for the object of their desire and attention can easily turn to extreme rage and hatred when the love objects rejects them.
Splitting
Validity
The extent & frequency with which a test, diagnosis, or rating accurately & distinctly characterizes a person's psychological status. -A "real clinical phenomena".
All of the following are personA nationwide study in the United States found about _____ percent of men could be diagnosed with narcissistic personality disorder. ality traits associated with schizotypal personality disorder in the DSM-5 EXCEPT:
antagonism
Substance intoxication show's signs of significant impairment.
The extent of substance intoxication depends on the specific drug, how rapidly it acts & the duration of its effects. Efficient absorption of intravenous or smokable drugs into the bloodstream is likely to lead to a more intense kind of intoxication than pills.
personality disorder
enduring patterns of thinking, feeling, and behaving markedly interfere with an individual's ability to function adaptively in the world and relate to others
Describe how the humanitarian explanations view psychological disorders as the result of cruelty, stress, or poor living conditions.
The idea of moral treatment took hold the notion that people could develop self control over their behaviors if they had a quiet and restful environment.
Which of the following brain areas have been identified through neuroimaging as smaller in people with diagnoses of borderline personality disorder? (Select all that apply.)
hippocampus amygdala
psychotherapeutic medication
Somatic treatments that are intended to reduce the individual's symptoms by altering the levels of neurotransmitters that researchers believe are involved in the disorder. E.g. SSRI's.
These alterations, in turn, may be related to changes in neurons that make them less capable of supporting memory and learning .
Symptoms of schizophrenia related to increased excitation, decreased inhibition, and altered cognitive functioning would thus correspond with these neurotransmitters.
duty to warn laws originated from this case
Tarasoff vs. Regents of Univ. of CA; although police were told about the death threats, the victim had no knowledge she was in danger and the man making the threats denied them when questioned by police and then shot and stabbed the victim
Parkinsonian symptoms
The most common extrapyramidal effects; reactions that closely resemble the features of Parkinson's disease, including muscle tremors and muscle rigidy
Sedative, Hypnotic & anxiolytic Substance use Disorders:
The nature of drugs in this class:
Opioids
The nature of opiates & opioids are exclusively for the treatment of pain legally.
Describe the relationship between ventricle size and schizophrenia. The brain of individuals with schizophrenia have enlarged ventricles & cortical atrophy i.e. wasting away of the brain tissue & loss of brain volume in the prefrontal lobes
The prefrontal lobes are the area of the brain responsible for planning and inhibiting thoughts and behaviors. Throughout the condition, the brain starts thinning in the temporal lobes which process auditory information & frontal lobes.
What are accurate descriptions of the cognitive processes of people diagnosed with borderline personality disorder?
Their memories are more negatively valence, they have negatively biased interpretations of situations, they are hyper attentive to negative emotional stimulation
What are necessary criteria for diagnosing a person with a personality disorder according to the DSM 5?
Their symptoms must not be due to substance use, they must show significant difficulties in identity, they must have pathological personality traits, they must show significant difficulties in interpersonal functioning
Which of the following are necessary criteria for diagnosing a person with a personality disorder according to the DSM-5? (Select all that apply.)
Their symptoms must not be due to substance use. They must show significant difficulties in identity. They must have pathological personality traits. They must show significant difficulties in interpersonal functioning.
Dr. Honts' lecture on psychopathy- Psychopathy is a spectrum some are highly functional, creative, impulsive & have a lack of remorse which can attract successful jobs. On the other side of the spectrum is the killer & sexual deviant.
Their thoughts are not deranged or suffering from hallucinations.- They know what they're doing.
Describe theories for the causality of AD/HD.-
There are Genetic & Polygenic influences, Neurobiological contributions, Environmental factors & Psychosocial contributions to ADHD.
The Behavioral approach for specific phobias emphasizes the conditioning that occurs when the individual learns to associate unpleasant physical sensations to a certain kind of stimulus or situation.
There may also be developmental aspects to specific phobias where young children fear things they can see & as they get older the fear becomes more abstract.
Causes of Borderline Personality Disorder
There's Genetic risk, & correlational risk with early trauma & abuse. Women are much more likely to be diagnosed because they're much more likely to experience abuse.
People with substance use disorders can neglect obligations a work, commitments to home & family, begin to take risks that are dangerous & put others in jeopardy, & legal problems can arise.
These disturbances also frequently involve interpersonal problems due to the fact that abuse & dependence create strains on relationships with family, friends & coworkers.
What is true of people high in vulnerable narcissism?
They are more sensitive to rejection, they are more likely to feel shame, they are hypersensitive to rejection
The third dimension of the DSM-5 personality dimensions model is _____, which is anchored on the positive end by characteristics such as honesty, appropriate modesty, and concern for others, and at the negative end by characteristics such as deceitfulness, grandiosity, and callousness.
antagonism
Biological perspective associate specific phobias with abnormalities in the anterior insular cortex & focus on symptom management with
anti-anxiety medications such as benzodiazepines; but only when the specific phobia interferes with the individual's ability to carry on everyday activities.
Neurobiological influences on Schizophrenia
enlarged ventricles and reduced tissue volume, cortical atrophy, attention/working memory impairment; en utero factors: exposure to *viral* infections, high doses of marijuana, asphyxia aka birth complications.
clinical interview
Unstructured Interview: Involves a series of open-ended questions inquiring about what kind of symptoms the client is experiencing.
Psychosocial interventions for schizophrenia are: Behavioral approaches, community care programs, Independent living skills programs, & Behavioral family therapy.
Vocational rehabilitation is used to help persons with schizophrenia gain and maintain employment, and may include hands-on job coaches.
Caleb's therapist describes him as being hypersensitive to criticism and rejection, and a person who engages in grandiose fantasies to quell his sense of shame. Most likely, Caleb is a....
Vulnerable narcissist
Which of the following is understood as a subtype of a narcissist?
Vulnerable narcissist
Openness vs. closedness to experience Conscientiousness vs. undependability Extraversion vs. introversion Agreeableness vs. antagonism Negative emotionality vs. emotional stability
What are the big 5 personality factors?
The odd-eccentric personalities people with these disorders have symptoms similar to those of people with schizo, including inappropriate or flat affect, odd thought and speech patterns, and paranoia. People with these disorders maintain their grasp on reality, however
What is Cluster A considered?
Dramatic-emotional personalities people with these disorders tend to be manipulative, volatile, and uncaring in social relationships. they are prone to impulsive, sometimes violent behaviors that show little regard for their own safety or the safety or needs of others
What is Cluster B considered?
Multiple baseline method
When it's unethical to remove treatment, as in suicide cases, the methods or treatments are applied in AB fashion to determine & measure effectiveness.
Schizophrenia is in remission
When symptoms lo longer interfere with the behavior an individual.
Can AD/HD symptoms continue into adulthood?-
Yes, the DSM 5 is the first to include criteria for adults.
halfway houses
a community treatment facility designed for deinstitutionalized clients leaving a hospital who are not yet ready for independent living.
Nature of disorganized behavior Includes
a variety of unusual behaviors.
Genetic influences- psychopathy & antisocial behavior with heritability estimates
as high as 80% with genes related to serotonin & dopamine.
DSM5 referres to it as a "substance use disorder" from mild to moderate as opposed to
addiction which has a more negative connotation.
Approximately 25% of people who have DSM5 panic disorder with agoraphobia syndrome would meet diagnostic criteria for
agoraphobia alone.
Avolition
aka apathy; is lack of initiation and persistence. Think A is for Absence of "Volition"
The abnormal processing of emotions in people with anorexia nervosa may also be related to variations in
another gene that relates to neuroticism, depressive mood, and selective processing of emotional stimuli. Such abnormalities may be at the core of altered nonconscious emotion-related disturbances that influence
Behavioral Activation BA.
behaviorist method for depression, the clinician helps the client identify activities associated with positive mood. Client keeps records & sets goals that gradually increase the frequency & duration of these activities.
Grandiose type of delusional disorder
believe that god communicates with them.
Persecutory type of delusional disorder
believe that someone or someone close to them is treating them in a malevolent manner.
Somatic type of delusional disorder
believe that they have a medical condition.
Sedative Hypnotics like Ambien
help relax or sleep. Mixing alcohol with them can depress the body to the point that they stop breathing & die.
irresistible impulse defense
came to light in the famous case of Lorena Bobbitt who claimed to be temporarily insane due to years of mental and physical abuse by her husband
2nd stage;
can be combative & aggressive based on their symptoms- Much more rapid decline; More frightening experiences, nothing's familiar, lost, can't read signs aka agnosia. Memory lapse where they can't remember basic information like address.
dementia (major neurocognitive disorder) onset and prevalence
can occur at any age but more common in elderly, affects 5% of those ages 65-74 and over 20-40% ages 85 and older
Survivor syndrome is
chronic depression, anxiety & difficulties in interpersonal relationships.
Distinguish the concept of a client from that of a patient as the individual who is the focus of psychological treatment.
client is active & patient is passive receptor of treatment.
Idaho-specific guidelines (regarding incompetence)
client is held in tx facility, jail, residential facility; treatment plan to restore competence, re-evaluate every 3-6 months for a specific time limit e.g. 18 months; if incompetency continues: the case may be dismissed or client can be held through max. sentence of crime
The Scientific Approach to psychological disorders proposed behavior models that included explanations of abnormality.
cultural factors play a role in determining what's normal or abnormal. Cultural factors also play a role in understanding expression of symptoms & how the client seeks support; sex, ethnic groups, class, etc. & express differently when affected by these factors.
2.5 million children take Medications which reduces symptoms of impulsivity & hyperactivity & improves attention in 70% of cases.- These medications do not help with
depression or learning.
Biopsychosocial Perspective to PTSD involves regions of the brain in responding to
fearful or threatening situations. Perhaps what determines whether an individual with a propensity toward developing an anxiety disorder is the unique combination represented in that person's life by the confluence of genetics, brain functioning, life experiences & social context.
Norepinephrine
is the activating neurotransmitter that results in such effects that increased heart rate & blood flow, attention, etc.
Anxiety can be beneficial & helpful
it's adaptive in the respect that it can keep you on your toes; a motivational factor to study & be organized.
aphasia
language difficulty (problems speaking/articulating or understanding language)
3 major stages: 1st is- gradual not clear & overt. e.g.
lapses, frequent confusion & memory lapses, usual tasks become more difficult due to memory lapses, dizzy spells. Slight Speech difference. Nothing too alarming, temporary.
Chromosome 19 is associated with-
late onset Alzheimer's.
Restricted subtype
limit calorie intake via diet and fasting e.g. eat less and less,
In addition, with PTSD, there are negative changes in cognition including
loss of memory for the event, excessive self-blame, distancing from others, & inability to experience positive emotions.
An individual can live in a highly stressful environment which is high risk, but feel that they can cope successfully which is high resilience.
low resilience occurs with high levels of perfectionism & hopelessness. Also, the ability to solve problems, high self-esteem, confidence, & general feeling of social support buffer suicide risk.
Schizophrenia prodromal stage has 1 to 2 years of unusual behaviors, e.g.
magical thinking, paranoia, restricted affect, prior to full onset. About 85% of people go through a prodromal stage.
amnestic disorders
memory dysfunctions (amnesia)
Alzheimer's central features
memory impairment, aphasia, apraxia, agnosia, confusion, combativeness, difficulties planning and organizing
being Male or Female.
men have a higher level of enzymes that allow them to process alcohol quicker.
What are diagnostic criteria for a personality disorder in the DSM5?
personality deviates markedly from cultural expectations, personality is inflexible and non adaptive, personality functioning is stable over time
five-factor model
perspective that everyone's personality is organized along 5 broad personality traits or factors
dependent personality disorder
pervasive pattern of behavior marked by a deep-seeded belief that one can not care for oneself
avoidant personality disorder
pervasive pattern of social inhibition, low self-esteem, and severe anxiety in social situations
This process of splitting, whereby individuals with borderline personality disorder see themselves and other people as either all good or all bad, was theorized in the _____ school of thought.
psychoanalytic
A ______-oriented theorist views the origins of the narcissistic personality disorder as residing in the fact that people with it do not develop a realistic or positive view of themselves in childhood, so they rely on praise and domination of others for their self-esteem in adulthood.
psychodynamic
what does the HIPAA ethics code say about fees for services?
psychologist must inform clients about fees they charge prior to beginning services and reach an agreement regarding billing arrangements; clinician can also barter with clients (accept goods or services instead of money) if it isn't considered/indicated or exploitative
This process of splitting, whereby individuals with borderline personality disorder see themselves and other people as either all good or all bad, was theorized in the _____ school of thought.
psyhoanalytic
duty to warn
responibility of a clinician to break confidentiality in order to warn a person(s) in danger; victim(s) must be identifiable, threats must be specific, imminent and serious ie. have potential to cause physical harm/death, and person making threat has intent and ability to carry out threat
Alcohol Anonymous is a 12 step program based on
the premise that alcoholism is a disease.
Diathesis-model
the proposal that people are born with a predisposition or diathesis that places them at risk for developing a psychological disorder if exposed to certain extremely stressful life experiences.
Prevalence
the ratio or number of people who have ever had the disease or disorder over a given amount of time shown as percentage. Existing plus new cases.
Schizotypal personality disorder is usually treated with...
the same medications that are used in schizophrenia
Histrionic personality disorder Clinical description: Clinicians diagnose histrionic personality disorder in those who show extreme pleasure as the center of attention and behave in whatever way necessary in order to make that happen. They are excessively concerned with
their physical appearance, often trying to draw attention to themselves in such extreme ways that their behavior seems ludicrous. They are highly influenced by others and lack analytic ability, and see the world in broad, impressionistic terms.
metallization based treatment
theorizes that childhood trauma and attachment difficulties have made it difficult for these patients to understand the mental states of themselves and others
Neurotransmitter systems: Serotonin & its relation to other neurotransmitters;
there is a Permissive hypothesis is that serotonin may not be only a serotonin issue. Serotonin helps us regulate dopamine & norepinephrine, so if your serotonin levels are low all other neurotransmitters may be thrown off. it's indirect.
What are similarities shared by people with diagnosis of schizotypal personality disorder and people with diagnoses of schizophrenia?
there is a dysregulation in dopamine, they are cognitive deficits
What are true in terms of the DSM5 personality component of psychoticism?
there traits are rare, traits involve unusual beliefs, traits involve eccentricity
Case Study - observation technique in which one person, or a small group of individuals, is studied in depth in the hope of revealing universal principles.
they lack control to make generalizable assumptions about the conditions to a larger population.
