Comlex Psychiatry
IQ for severe ID
20-35
what percent of autism become semiindependent adults
30%
IQ for moderate ID
35-50
IQ for mild ID
50-69
symptoms for ADHD last at least_____ and occur before _____
6 months, 12 years olf
Mild ID has academic skills of what grade
6th grade
ID is present in ______% of ASD
75%
intellectual disability age of onset
< 18
IQ for profound ID
< 20
what has the following symptoms: short attention span constant fidgeting inability to sit through cartoons/meals inability to wait in lines no quiet/still in class disobedience shunning by peers fighting poor academic performance carelessness poor relationships with siblings
ADHD
family history in ADHD:
ADHD mood/anxiety substance abuse antisocial personality disorder
Autism spectrum disorders cause
CNS damage due to known/unknown factors
defense mechanisms, judgement, relationship to reality, object relationships, developed shortly after birth
Ego
ddx for autism
ID hearing impairment environmental deprivation selective mutism Rett syndrome
diagnostic tests for ADHD
IQ and structured symptom rating scales for teachers and parents
diagnostic tests for learning disorders
IQ testing and academic achievement tests
equation for IQ: IQ=
IQ= MA/CA x 100
type of ID where person attains academic skills to 6th grade level, lives independently or with supervision, problems with impulse control/self esteem, associated conduct disorder, ADHD
Mild ID 50-69
physical findings in autism
^ incidence abnormal EEGs seizures abnormal brain morphology
autism spectrum disorders definition
a group of disorders characterized by problems with social interaction, behavior, and language
what is blocking
a temporary block in thinking "i have known him for years but can never seem to remember his name"
communciation symptoms in autism
absent or bizzarre use of speech
behavioral or emotional outburst
acting out
ADHD differential
age appropriate behavior response to environmental problem ID ASD mood disorder
diagnostic tests for ID
amniocentesis
reaction formation:
an unacceptable impulse is transformed into its opposite, results in formation of character traits
in the mental status exam, the general description of the patient includes:
appearance behavior attitude toward examiner
autism predictors of poor outcome
associated ID failure to develop useful speech
what is projection
attributing your own wishes, thoughts, or feelings on to someone else
age onset for ASD
before 3
what does Stanford Binet measure
child IQ
this question asks for specific information without allowing options in answering
closed ended question "are you hearing voices"
ID is measured by IQ tests < 70 and must be accompanied by
concurrent impairment in adapting to demands of school, work, social, and other environments
persistent violantions over 6 months in 4 ares of : aggression, property, destruction, deceit/theft, rules
conduct disorder
interviewing technique where you point something out to the patient
confrontation "you seem very upset today"
used to avoid becoming aware of some painful aspect of reality
denial
an emotion or drive is shifted to another that resembles the original aspect
displacement
what is splitting off of the brain from conscious awareness
dissociation
medical conditions associated with ASD
encephalitis maternal rubella PKU tuberous sclerosis fragile X perinatal anoxia
learning disorder differential
environmental deprivation hearing/vision impairment ID
risk factors for ID
errors of metabolism chomosomal abnormalities intrauterine infections intrauterine toxins postnatal exposure to toxins/malnutrition poor prenatal care post natal metal exposure trauma socialdeprivation
physical exam for ID shows
evidence of underlying disorder or injury
what is it called when
external objects are divided into all good or all bad
what is splitting
external objects are divided into all good or all bad
this type of interviewing technique helps the patient continue by providing verbal and nonverbal cues
facilitation "yes, please continue"
autism tx
family counseling special ed antipsychs for agitation/destructive behavior
what is introjection
features of the external world are taken and made part of the self
permits the expression of feelings and thoughts without personal discomfort
humor
what component of ADHD diminishes with adulthood
hyperactivity
excessive use of intellectual processes to avoid affective expression or experience
intellectualization
features of the external world are taken and made part of the self
introjection
what is separation of an idea from the affect that accompanies it
isolation
social symptoms in autism
lack of peer relationships, no nonverbal social cues
risk factors for learning disorders
lead poisoning FAS
interviewing technique in which you provide the answer in the question
leading "are the voices telling you to hurt yourself"
learning disorder:
learning achievement in specific areas that is substantially below expectations, given the patient's age, intelligence, sensory abilities, educational experience
what has the following symptoms: 5% of school age children onset in elementary school perceptual motor problems conduct disorder, oppositional defiant, ADHD poor self esteem and social immaturity school failure/behavioral disturbance
learning disorder
ID ddx:
learning/communication disorders sensory impairment autism spectrum disorder borderline intellectual functioning (IQ 70-100) environmental deprivation
male or females have ADHD
males 2:1 in children and 6:1 in adults
more males or females with autism
males 5:1
intellectual disability used to be called
mental retardation
in conjunction with the history, the ________ is the best way to make an accurate diagnosis
mental status exam
pharmacotherapy for ADHD
methylphenidate/dextroamphetamine atomoxetine andidepressants clonidine
attains skills of second grader, can manage ADLs, work in shltered workshops, live in homes, problems with social norms
moderate ID 35-50
what is difference between mood and affect
mood: emotions perceived by patient (depressed/angry) affect: patient's present emotional responsiveness (flat)
to measure personality, _______ tests use simple stimuli, do not need much clinical experience
objective
the Minnesota Multiphasic Personality Inventory (MMPI) is a
objective personality test
learning disorders can persist into adulthood and interfere with
occupational function
this type of question allows the patient to speak in his own words as much as possible
open ended question "can you describe your pain"
problems in ADHD on physical exam
perceptual: motor problems and poor coordination
tx for ID
primary prevention (genetic counseling) prenatal care safe environments' tx medical conditions special ed behavioral guidance
attributing your own wishes, thoughts, or feelings on to someone else
projection
to measure personality, _______ tests use ambiguous stimuli, need clinical experience, are not diagnostic
projective
rational explanations are used to justify unacceptable attitudes, beliefs, or behaviors
rationalization
what defense mechanism results in formation of character traits
reaction formation
what is it called when an unacceptable impulse is transformed into its opposite
reaction formation
most common learning disorder
reading
types of learning disorders
reading, math, written expression
return to an earlier stage of development
regression
what is the most immature defense mechanism
regression
behavioral symptoms in autism
repetitive activities mannerisms ritual
an idea or feeling is witheld from consciousness, unconscious forgetting
repression
repression vs suppression
repression: unconscious forgetting suppression: conscious forgetting
example of projective personality tests:
rorschach (inkblot) thematic apperception (tat) sentence completion tests family drawings
common associated problems with ADHD
self esteem mood lability conduct disorder learning disorders clumsiness communication drug abuse school failure physical trauma from impulsivity
isolation
separation of an idea from the affect that accompanies it
little or no speech, limited abilities to manage self-care, require highly supervised care setting
severe/profound ID
2 most important dives (instincts) that make up the Id
sex & aggression
when is the Ego developed
shortly after birth
psychic derivatives are converted into bodily symptoms
somatization
tx for learning disorders
special education counseling patients and families
impulse gratification has been achieved, but the aim or object has been changed from unacceptable to acceptable; allows instincts to be channeled. most mature of all defenses.
sublimation
what is the most mature of the defenses
sublimation
conscience, empathy, and morality are formed during latency period, right vs. wrong
superego
which defense mechanism is conscious
suppression
what is the only conscious defense mechanism:
suppressioon
ADHD tx
tx symptoms structure at home/ environment sensory modalities reinforcementstimulants atomoxetine (non stimulant) antidepressants clonidine
acting out the reverse of an unacceptable behavior, consists of an act
undoing
name of adults IQ test
wechsler adult intelligence scale revised (WAIS-R)
what is the name of the childrens IQ test
wechsler intelligence scale for children revised (WISC-R), stanford binet