Psych 405 Exam #4
integrative explanation for borderline personality disorder
#1 biosocial: internal forces (difficulty identifying emotions, skills deficit, neurotransmitters) and external forces (kid can't interpret emotions and parents teach them to ignore their intense feelings) - similar to Hilde Bruch, comorbid with eating disorders #2 developmental psychopathology: internal and external forces intersect and early parent-child relationships are influential. Early trauma and abuse, inattentive parents who are uncaring and dismissive leads to a disorganized attachment style - flawed capacity for health relationships - positive factors can counter this
Failure to treat patients
#1. poor coordination of services #2. shortage of services
explanation for obsessive compulsive personality disorder
- Freud: anal retentive, fixated on anal stage - strong of control and independence with parents - CB: illogical thinking, dichotomous thinking leads to rigidity and perfectionism
causes of conduct disorder
- genetic and biological factors, some tied to anti-social personality disorder - drug use, poverty, trauma, violent peers or community - troubled parent-child relationship - inadequate parenting, family conflict, marital conflict, family hostility, parents leaving - no supervison - interactions between all of these
biological cause of autism
- genetics (sibling prevalence is 10-205, identical twins is 60%) - prenatal difficulties and birth complications (mom had rubella, Hg and Pb exposure, alcohol and drugs use, labor and delivery issues) - abnormal cerebellum (controls attention shift, flawed interconnectivity in circuits) - NO AUTISM CIRCUIT FOUND - MMR vax: NO
brain structures in schizophrenia
- large ventricles - reduction in brain volume (neg symptoms) - enlarged ventricles - small hippocampus, amygdala, and thalamus - reduced activity in prefrontal cortex (many behaviors disrupted by schizophrenia are governed by this area
explanations for schizoid personality disorder
- object relations theorists: unsatisfied need for human contact - abusive, unaccepting parents, - CB: deficiency in thinking
explanations for dependent personality disorder
- psychodynamic: similar to depression, unresolved conflict in oral stage lead to lifelong need for nurturance - object relations: early parental loss, abandonment fear - over controlling and overprotective parents - CB: parents unintentionally rewarded kids clinginess and "loyal" behavior and punish independence, maladaptive assumptions, and dichotomous thinking
Neurleptic Malignant Syndrome
1%, common in elderly people, severe and potentially fatal muscle rigidity, fever, improper functioning of ANS - immediately taken off anti-psychotics and treated
3 phases of schizophrenia
1. Prodromal 2. Active 3. Residual
institutional care today
1. medical hospitals with psychiatric floor 2. adult residential treatment center 3. VA * many white females receive inpatient care
what are the two distinct sub circuits for schizophrenia
1. substantia nigra and striatum dysfunction= positive symptoms 2. hippocampus and amygdala dysfunction= negative symptoms
how many children and adolescents experience a psychological disorder?
1/5. Boys with disorders is greater than girls with disorder even though most adult disorders are more common among women.
treatment for childhood anxiety disorders
2/3 go untreated, psychodynamic, CBT, family, and group therapy or helpful - CBT: best with meds, 80% improvement - parallel adult treatment but tailored to the child'c cognitive abilities - psychotropic drugs and psychotherapy also used - anti-depressants can be pretty helpful
institutional care in the past
20th century, people were institutionalized and many were not responsive to treatment. just given food, shelter, and clothing - neglect and abuse - Pinel moral treatment= mental hospitals not asylums
schizophrenia and suicide
25% attempt and 5% die - high risk, patients should receive suicide risk assessment in treatment - high risk of physical illness too (live 10-20 years less than general population)
severe intellectual disability
3-4%; IQ 20-34; age 2 or 3 deficits during infancy, neurons dysfunction and risk for brain seizure disorder - mainly biological
mass murders
4+ people in same location at the same time - US happens every 2 weeks - 75% feature a lone killer - 67% use guns - 96% performed by males - anger, resentment, persecution, desire for revenge
total inmates with mental disorders
55%; 67% female, more white
treatment for ADHD
80% of people get treatment, usually drugs, CBT, or both (both is best because it requires a lower dose of meds) - monkey on meds: keeps them on task but does not change how they perform
conduct disorder
A disorder in which a person regularly violates the rights of others and breaks social rules and displays significant aggression - cruel, steal, run away, arson, shoplifting, armed robbery - severe cases continue into adulthood sometimes as personality disorder, may lead to rape and homicide - onset: 7-15 years old - 5-10% of children - earlier onset= poor outcome - 1/3 comorbid with ADHD - may start with oppositional defiant disorder
Oppositional Defiant Disorder
A disorder in which children are repeatedly argumentative and defiant, angry and irritable, and, in some cases, vindictive. - 11% of children - boys>girl before puberty - boys=girls after puberty
Agranulocytosis
A life-threatening drop in white blood cells. This condition is sometimes produced by the atypical antipsychotic drug clozapine.
Supported Employment
A method of integrating people with disabilities who cannot work independently into competitive employment. Includes the use of a job coach who helps the person with disabilities train for and succeed on the job.
dependent personality disorder
A personality disorder characterized by a pattern of clinging and obedience, fear of separation, and an ongoing need to be taken care of. - can't make decisions - difficulty with separation (key) - fear rejection, feel distressed, dislike themselves - high risk for depression, anxiety, and eating disorders - men=women - <1% of the population
clang
A rhyme used by some persons with schizophrenia as a guide to forming thoughts and statements.
ABCs of psychological functioning
Affect - range, intensity, and changeability of emotions and emotional responsiveness Behavior - ability to control impulses and interactions with others Cognition - perceptions and interpretations of events, other people, and oneself
lack of responsiveness and social reciprocity
Aloofness, lack of interest in others, and inability to share attention with others
post partum psychosis
Andrea Yates killed her children -1-2 in 1000 - triggered by shift in hormone levels - lose touch with reality - antipsychotic drugs and psychotherapy - people who are bipolar or have MDD are vulnerable
Diagnosing Schizophrenia
Be in active phase for at least 1 month. Must have deterioration in work, social relations and self care. The DSM requires that the person exhibit a deterioration of daily activities along with at least two of the following symptoms: (at least one has to be delusions or hallucinations or disorganized speech) - Hallucinations - Delusions or thought disorders - Incoherent speech - Grossly disorganized behavior - Loss of normal emotional responses and social behaviors
inappropriate affect
Display of emotions that are unsuited to the situation; a symptom of schizophrenia.
treatment for paranoid personality disorder
Few seek professional help on their own - distrust, rebel against therapists - object relations: focus on patient's wish for satisfying relationships - CBT: anxiety reduction techniques, improving interpersonal problem solving skills, develop realistic interpretations - drugs: limited help
Marijuana and Psychosis
Increased THC levels may trigger psychosis - highest in people with a biological predisposition, but still high in those without one - early weed use doubles risk - THC increases dopamine efflux - anandamide in schizophrenics
occupational training and support
Paid employment provides income, independence, self-respect, and the stimulation of working with others
childhood problems and intellectual disabilities
Pb, Hg, nitrares, X-Ray, injury, pesticides
schizoaffective disorder
Psychotic disorder featuring symptoms of both schizophrenia and major mood disorder.
schizophreniform disorder
Psychotic disorder involving the symptoms of schizophrenia but lasting less than 6 months.
Methylphenidate
Ritalin, stimulant drugs used to treat ADHD, commonly used
half way houses
Short-term group living facilities for individuals making the transition from an institution (mental hospital, prison, etc.) to independent living - don't require hospitalization but cannot Iive alone - paraprofessionals - milieu therapy, mutual support, responsibility, government - help adjust to community life
state hospitals
State-run public mental institutions in the United States. - overcrowding, low funding, shift from providing care to keeping order - restraints, isolation, punishment, chronic wards - many patients here were schizophrenic
expressed emotion
The general level of criticism, disapproval, and hostility expressed in a family. People recovering from schizophrenia are considered more likely to relapse if their families rate high in expressed emotion.
Disruptive Mood Dysregulation Disorder (DMDD)
a childhood disorder marked by severe recurrent temper outbursts along with a persistent irritable or angry mood - introduction decreased the diagnosis of Bipolar disorder in children - outbursts for 1 year at least 3x a week in different settings - 6-18 years old
case managers
a community therapist who offers a full range of services for people with schizophrenia or other severe disorders, including therapy, advice, medication, guidance, and protection of patients' rights
separation anxiety disorder
a disorder marked by excessive anxiety, even panic, whenever the person is separated from home, a parent, or another attachment figure - 4% of all children - reluctant to go places they might be separated from their parent - worry parent will die, they will get kidnapped - school refusal and more girls than boys
Autism Spectrum Disorder
a disorder marked by extreme unresponsiveness to others, severe communication deficits, highly repetitive and rigid behaviors, interests and activities (Leo Kanner) - onset: before 3 years old - 1 in 60 - 80% boys - 90% remain impaired - difficulty holding a job, performing household tasks, living alone - problems with closeness and empathy - key: lack of responsiveness and social reciprocity
ADHD
a disorder marked by the inability to focus attention, or overactive and impulsive behavior, or both - beyond what is developmentally normal - onset: before child starts school - 1/2 have learning/communication problems, perform poorly in school and have a hard time interacting with others - 80% misbehave - 7-10% of population - 70% boys - increased risk if parent has ADHD - difficult to assess and observe in different settings, often use reports form parents and teachers - over-diagnosed
formal thought disorder
a disturbance in the production and organization of thought - confusion: communication becomes difficult - often positive symptoms (loose associations, neologisms, perseveration, clang)
token economy
a form of behavior therapy in which clients are given "tokens" for desired behaviors, which they can later trade for rewards - operant conditioning - reduced psychotic behaviors - limitations: uncontrolled studies, increase in staff attention may cause improvement or change in setting, unethical? imitation rather than behavior change? - hard transition to society
dialectical behavior therapy (DBT)
a form of therapy used to treat borderline personality disorder, suicidal intent, and other psychological problems - goal: develop more realistic sense of self, impulse control, correct disordered thinking and tolerate thinking - Marsha Linehan - mindfulness, HW, coping skills, education, goal setting, decrease self harm, decrease therapy interfering behavior, decrease escape behaviors, increase behavioral skills - more likely to stay in therapy
antisocial personality disorder
a general pattern of disregard for and violation of other people's rights (psychopath & sociopath) - linked to substance use (80%) and criminal behavior - must be 18 years old to receive a diagnosis - lie repeatedly, don't work consistently - impulsive, aggressive - reckless, self centered - lack moral conscience - men > women (4:1) - 35% of people in prison have this disorder - risk focused explanation - people with conduct disorder and ADHD have increased risk - crimes and violence typically decrease with age
Phenylketonuria
a genetic disorder in which the essential digestive enzyme phenylalanine hydroxylase is missing. converts it to a poison - 1 in 14,000
Phenothiazines
a group of antihistamine drugs that became the first group of effective antipsychotic medications - produce muscle tremors identical to Parkinson's who have low dopamine levels - bind to dopamine receptors as dopamine antagonist - D1, D2, D3, D4, D5
milieu therapy
a humanistic approach to institutional treatment based on the belief that institutions can help patients recover by creating a climate that promotes self-respect, responsible behavior, and meaningful activity - patients deteriorate because they cannot exercise independence, responsibility and positive self regard - Maxwell Jones - group interactions - improves schizophrenics and leave hospital at higher rates
augmentative communication system
a method for enhancing the communication skills of people with autism spectrum disorder, intellectual disability, or cerebral palsy by teaching them to point to pictures, symbols, letters, or words on a communication board or computer
National Alliance on Mental Illness (NAMI)
a national self-help group that supports the belief that major mental disorders are brain diseases that are of genetic origin and biological in nature and are diagnosable and treatable with medications
catatonia
a pattern of extreme psychomotor symptoms, found in some forms of schizophrenia, which may include catatonic stupor, rigidity, or posturing - 10% of schizophrenics experience this
schizoid personality disorder
a personality disorder characterized by persistent avoidance of social relationships and little expression of emotion. lack close ties and genuinely prefer to be alone - loner, lack of interest in intimacy - many live by themselves, have jobs with little contact - unaffected by praise of criticism - cold, humorless, dull, unable to give or receive love - men>women (slightly) - 4.9% of the population - slight increase in family members of schizophrenics, but weakest in the cluster
obsessive-compulsive personality disorder
a personality disorder characterized by preoccupation with orderliness, perfection, and control. Person loses flexibility, openness and efficiency - unreasonably high standards for self - reluctant to make decisions - rigid, stubborn morals, ethics and values - men > women (2:1) - more common in people who are educated, married, and employed - more likely to suffer from MDD, anxiety or substance use than OCD
paranoid personality disorder
a personality disorder marked by a pattern of distrust and suspiciousness of others and their motives. Believe everyone will harm them - shun close relationships - sensitive to criticism - often choose anger as a role play response - always feel threatened, targeted - cold, distant - 4.4% of US adults - critical of others - men>women (3:1)
Aftercare
a program of post-hospitalization care and treatment in the community during the day
Schizophrenia
a psychotic disorder in which personal, social, and occupational functioning deteriorate as a result of strange perceptions, unusual emotions, and motor abnormalities. Symptoms occur for 6 or more months. Patient may have previously functioned well or acceptingly - Emil Kraeplin
Psychosis
a state in which a person loses contact with reality in key ways - may be substance induced or caused by a brain injury, but most appear with schizophrenia
state school
a state-supported institution for people with intellectual disability - basic care, neglect, abusr
sheltered workshop
a supervised workplace for people who are not yet ready for competitive jobs
community mental health centers
a treatment facility that provides medication, psychotherapy, and emergency care for psychological problems and coordinates treatment in the community
brain explanations for auditory hallucinations
abnormal activity of auditory cortex, failure to recognize internal generated speech as own, cross activation with auditory areas causing thoughts to get voices - abnormal attention to subvocal stream
psychodynamic factors for antisocial personality disorder
absence of parental love, lack of basic trust leads to child becoming emotionally distant - childhood stress, family violence, parental conflict
Kar-XT
acetylcholine, cholinergic effects, reduction in psychotic symptoms, no current side effects
prescribing first generation anti-psychotics
add additional drugs (synergistic) rather than increasing the dose - stop the drug and try a different one - prescribe lowest effective dose and reduce dose over time - reduce positive symptoms, not negative
classical conditioning and enuresis
alarm treatment, bell and battery test, dry bed training
Psychopaths
all psychopaths have antisocial personality disorder, but not all people with antisocial personality disorder or psychopaths - 1940s: lack of empathy, arrogant, superficial, charming
adderal
amphetamine uses to treat ADHD, increasing prescriptions, drug of choice for adults with ADHD
Special Education
an approach to educating children with intellectual disability in which they are grouped together and given a separate, specially designed education
personality disorder
an enduring, rigid behavior of inner experience and outward behavior that repeatedly impairs a person's sense of self, emotional experiences, goals, capacity for empathy, and or capacity for intimacy - personality traits are extreme and dysfunctional more so than others in their culture - narcissism, grandiosity, insensitivity - symptoms last for years - onset: adolescence, early adulthood - difficult to treat - life time prevalence: 11% - impacts and complicates the recovery from other comorbid disorders
bullies
anti-social, low empathy, poor at school, more likely to bring weapons, drop out, drink, and use drugs
"anxious" personality disorder
anxious, fearful behavior similar to anxiety and depression disorders but no clear links. better treatment outcomes for this cluster
Avolition
apathy, feeling drained of energy and of interest in normal goals and unable to start or follow through on a course of action - common in people who have had schizophrenia for years - ambivalence
concerns about ADHD treatment
applicable to minorities? long term effects? children misdiagnosed and prescribed meds, mild tremors, tics, growth interference, psychosis, heart problems, addictive
play therapy
approach to treating childhood disorders that helps children express their conflicts and feelings indirectly by drawing, playing with toys, and making up stories
NOTE: personality disorders in general
are more common in less educated, never married or separated individuals with suicidal behavior. Obsessive compulsive personality disorder is the opposite.
dopamine hypothesis of schizophrenia
argue that schizophrenia results from excessive activity of dopamine - amphetamines producing psychosis is evidence - Parkinson's patients treated with dopamine may develop schizophrenic symptoms
misinterpretation and schizophrenia
as an individual attempts to understand unusual experiences, more features of the disorder emerge - "rational path to madness" - process of drawing incorrect/bizarre conclusions (delusions) may be helped by cognitive bias that schizophrenics jump to conclusions
catatonic posturing
assuming awkward, bizarre positions for long periods of time
Echolalia
automatic and immediate repetition of what others say
theory of mind
awareness that people base their behaviors on own beliefs, intentions and mental states
ideas of reference
beliefs that unrelated events pertain to them in some important way
self theorists and schizophrenia
believe most basic motive is to strengthen the wholeness of self - biological deficiencies cause people with schizophrenia to develop fragmented self
delusions of grandeur
believe selves to be great inventors, religious saviors, and empowered people
delusions of control
believe their feelings, thoughts, and actions are being controlled by other people
Type 1 attention process
beyond voluntary control, focus attention on unexpected things that occur in the surrounding
adoption and schizophrenia
biological relatives of adoptees with schizophrenia are more likely than adopted relatives to develop schizophrenia
narcissistic personality disorder
broad pattern of grandiosity, need for admiration, and lack of empathy - con - cold indifference, humiliation and pessimism - 75% men - 6.3 % of the population - feel partners who will bolster their status that they can show off
DSM-5 distinguishing characteristic for conduct disorder
callous and unemotional behavior
Mentallization
capacity to understand one's own mental state and those of other people
explanation for histrionic personality disorder
cases of hysteria - psychodynamic: cold parent, kid feels unloved, afraid of abandonment - CBT: lack of substance, very self focused and emotional, feel hopeless, can't care for self - cultural norms and expectations (exaggeration of femininity) --> less in Asia because they discourage sexualization, more in hispanic populations
DSM-5 Personality Disorders
categorical approach, problem is either present or absent, either displayed or not displayed, person isn't troubled by traits outside the disorder - lacks reliability and validity - challenged with dimensional approach
second generation antipsychotics
challenge the dopamine hypothesis, more effective than phenothiazines. - bind D1 and D2 and also receptors for serotonin, glutamate, and GABA - not just dopamine - glutamate: up and coming, low levels post mortem in schizophrenics
covert-destructive pattern
characterized by secretive destructive behaviors such as violating other people's property, breaking and entering, and setting fires
problem solving skills training
child focused, modeling, role play, systematic rewards to teach constrictive thinking and positive social behaviors
juvenile delinquents
children between 8-18 that break the law - more common for black youths - black: more likely to receive punishment - white: more likely to receive treatment - boys>girl - girls: more likely to be sexual offenders, drugs, and running away - boys: more likely to be drugs and destruction of property - >1/2 are repeat offender
coping power program
children with conduct problems participate in group sessions that teach them to manage their anger more effectively, view situations in perspective, solve problems, become aware of their emotions, build social skills, set goals, and handle peer pressure - reduce aggression and prevent substance use
current explanation for hallucinations
circuit of cortical and subcortical structures
dimensional approach
classify disorders by degree, not specific traits, on a continuum
explanation for narcissistic personality disorder
cold rejecting parents - object relations: grandiosity to feel self fulfilled and self sufficient without the need for warm relationships - neglect, abuse, loss of parents - high shame and rejection scores - CB: people treated too positively, doting parents, over value self worth
psychodynamic explanation of schizophrenia
cold, unnurturing parents set schizophrenia in motion - Frieda Fromm-Reichmann - mother uses child to meet her own needs and confuses the child - Freud: regression to primitive ego state when people encounter the harsh world
Multisystematic Therapy (MST)
combination of interventions used in school, social lives, and community. Increase the time children spend with positive role models, not delinquents
Metabolic disorders
common cause is 2 recessive genes
worry
common experience in children; nervous, confused, depressed
childhood anxiety disorders
common if the parent reacts events with a high level of stress or anxiety or if they are overprotective. - divorced parent, ill parent, and separation increase risk - anxious temperament - experienced by 25% of all children - dominated by behavioral and somatic symptoms rather than cognitive symptoms - child tends to focus on specific objects or events - usually triggered by immediate situations or surroundings
community approach to schizophrenia
community mental health act, patients were to receive a range of mental health services in communities (outpatient, inpatient, emergency care, preventative care, after care)
substance use and mental disorder
complex. may precede disorder and exacerbate or may follow disorder, form of self medicating - cocaine and amphetamines exacerbate psychosis, intensify schizophrenic symptoms - greater problem - treatment is difficult because many facilities only treat one disorder and many are rejected from programs - many find themselves in jail, or homeless
pronominal reversal
confusion of pronouns
avoidant personality disorder
consistent discomfort and restraint in social situations, overwhelming feelings of inadequacy, and extreme sensitivity to negative evaluation - give people no opportunity to reject or accept them - dread criticism, disapproval and rejection - feel unappealing, inferior - similar to social anxiety disorder = dear of humiliation and low confidence - different from social anxiety disorder in that SAD fear circumstances and PD fears social relationships - 2% of adults - men = women
patterns of attention and perception in schizophrenia
deficiency in smooth-pursuit eye movements, many develop years before the onset of the disorder and may contribute to further memory impairment
effects of bullying
depression, anxiety, low self esteem, substance use disorder, sleep issues, somatic problems, anti-social behavior, suicidal thinking and attempts, phobias
nature vs nurture in schizophrenia
detangling the two is futile. licking and grooming rats gets passed on to offspring - some genes are turned on and off, does not reveal what is inherited
treatment for schizotypal personality disorder
difficult, help the patient reconnect with the world, recognize limits of thinking and power - increase social contact - ease loneliness - CB: ignore inappropriate thoughts after evaluation - drugs help reduce thought problems
emotional abuse
discipline, rejection, ridicule, isolation, often accompanies physical abuse
selective mutism
disorder marked by the failure to speak in certain social situations when speech is expected despite the ability to speak in other situations - 1% of all children - early version of social anxiety disorder - some have delays in communication and language skills - some are misclassified as having an intellectual disability
Type 2 Schizophrenia
dominated by negative symptoms - 15-20% of cases
overt-nondestructive pattern
dominated by openly offensive but nonconfrontational behaviors such as lying
Type 1 Schizophrenia
dominated by positive symptoms - 80-85% of cases - people seem to be better adjusted before, have later onset of symptoms, and are more likely to show improvement especially with meds
"dramatic" personality disorders
dramatic, emotional, erratic - more commonly diagnosed - antisocial, borderline, histrionic, narcisisti
MICA —mentally ill chemical abuser
dual diagnosis, people who have severe mental and substance use disorders. More distress and poorer treatment outcome- 20-50% of schizophrenics also have another disorder. Treatment is often undermined bu the patients hiding their substance abuse - more common among young men, uneducated, poor, act out, have more ER visits and more arrests - higher relapse rate - 10-20% homeless
explanation for avoidant personality disorder
early trauma, conditioned fear, upsetting beliefs, biochemical abnormalities - not directly tied to anxiety disorder - psychodynamic: shame, insecurity, early bowel/bladder accidents - CBT: harsh criticism and rejection in early childhood , think people will always judge them negatively - social skills deficit - biological: over-aroused, react hyper-sensitively to stimuli
neurodevelopmental disorders
emerge at birth or develop very early in childhood. effect behavior, memory, concentration, and ability to learn - significant impact throughout a person's life
sociocultural view of narcissistic personality disorder
eras of narcissism in society correspond - young, materialistic, self centered people with short attention spans - competitive western culture encourages this - US: highest narcissism scores
social withdrawal
experienced by many people with schizophrenia, attend only to own ideas or thoughts - ideas are illogical, so further withdrawn - breakdown of social skills - do not recognize others' emotions accurately
schizotypal personality disorder
extreme discomfort in close relationships, odd patterns of thinking and perceiving, behavioral eccentricities - seek isolation, lonely - more severe, most linked to schizophrenia - disturbed ideas of reference and bodily illusions - believe they have special abilities, magic powers - bad attention span, aimless and un-attentive - men > women - 2/3 comorbid with depression
social breakdown syndrome
extreme withdrawal, anger, physical aggressiveness, and loss of interest in personal appearance and functioning - made it impossible for people to return to society even if they overcame their original symptoms
delusions
false beliefs
hallucinations
false sensory experiences
sociocultural causes of autism
family dysfunction - refrigerator parents (cold, intelligent) - no evidence
family dysfunction and schizophrenia
family stress, parents of people with schizophrenia often display more conflict, have difficulty communicating with each other and are more critical and over involved with their children
fathers age and schizophrenia
father late 40s-50s and older, increased likelihood of offspring developing schizophrenia - more genetic mutations in sperm
explanations for borderline personality disorder
fear of abandonment, early parental relationships - object relations: lack of parental acceptance leads to low self esteem, increased dependence, neglect, rejection, and verbal abuse - biological predisposition: 35% identical twins and close relatives are 5x more likely - low serotonin= impulsivity and aggression - hyperactive amygdala and underachieve hippocampus and prefrontal cortex - poor interconnectivity - as culture loses value and stability, people have identity problems and feel empty, anxious, fear abandonment, and lack belonging - link to sexual abuse
waxy flexibility
feature of catatonic schizophrenia in which people rigidly maintain the body position or posture in which they are placed by others
somatic hallucinations
feel as if something is happening inside the body, such as a snake crawling inside one's stomach
1940s and schizophrenia
first anti-histamines developed to combat allergies, discover phenothiazines calm people who are about to undergo surgery - chlorpromazine, calming effects (thorazine) - Henri Laborit
course of schizophrenia
first appear in late teens to mid 30s, 25% recover completely but the majority remain in the residual phase
1960s, 70s, 80s, and schizophrenia
first generation anti-psychotic drugs, others are second generation
neuroleptic drugs
first generation anti-psychotics so called because they often produce undesired effects similar to the symptoms of neurological disorders - block excessive activity of dopamine
gustatory hallucinations
food or drink tastes strange on a regular basis
treatment foster care for conduct disorder
foster home in the community, receive family therapy with foster and biological parents, meetings, treatment
developmental psychopathology and schizophrenia
genetic predisposition, life stress, difficult family interactions, negative environmental factors - diathesis stress relationship - HPA axis: dysfunction of schizophrenia related circuit leads to repeated overreactions of HPA in the face of stress -->people are sensitive to stressors --> leads to dysfunctional immune system, because more inflammation - schizophrenics produce high proflammatory cytokines - multifinality
Cause of ADHD
genetic predisposition, type 2 attention process does not override type 1, breakdown in balance of type 1 and 2, abnormal dopamine and abnormalities in frontal striatal
cyberbullying
girls are 50% more likely to experience it, social media - 60-90% of people have witnessed it on social media
Schizophrenics who functioned better before diagnosis
good premorbid functioning=fuller recovery - people whose initial disorder is triggered by stress, it abrupt, and develops during middle age, and receive early treatment often have better treatment outcome - early treatment= better
anxiety, depression, and disruptive disorders
have adult counterparts
Treatment for autism spectrum disorder
help adapt to the environment, cannot reverse the disorder
antipsyhotic drugs
help correct grossly confused or distorted thinking - phenothiazines - don't treat negative symptoms
parent management training and ADHD
help parents deal with children
amphetamines psychosis
high doses of amphetamines--> high dopamines--> psychosis
multicultural factors and schizophrenia
higher prevalence in African Americans (are they more prone to develop it or do they develop it because they are more likely to be poor?) - Hispanics also higher than whites - indicates correlation with low SES - people in developing countries recover more often, quicker, and more completely
adults with ADHD
higher substance use, insomnia, risky sexual behavior, driving accidents and job changes
MAOA gene
human warrior gene. when this gene is present and combined with maltreatment in childhood, an individual is at a higher risk for conduct disorder
delusions
ideas that people believe but have no basis in fact. may consider them enlightening or confusing. single delusion that dominates life or many delusions
revision of dopamine hypothesis
imbalance of dopamine function - high dopamine in the subcortical and midbrain results in positive symptoms - decreases in dopamine in the cortical regions and frontal result in negative symptoms
coordination of services
important for those with substance use and mental disorder (MICA)
childhood disorders and COVID-19
increase in the number of kids who feel edgy, annoyed, worried, sad, apathetic, negative. This is dangerous because kids don't have the same coping skills as adults and have poorer emotion recognition
relational aggression
individual is socially isolated and primarily performs social misdeeds such as slandering others, spreading rumored, manipulating friendships - girls>boys
overt-destructive pattern
individuals display openly aggressive and confrontational behaviors
covert-nondestructive pattern
individuals secretly commit nonaggressive behaviors, such as being truant from school
treatment for antisocial personality disorder
ineffective because the individual does not want to change, lacks conscience, and has no respect for the therapists or therapy - victim awareness, anger management, decrease impulsivity and increase empathy - better to interfere early with intense and prolonged treatment
borderline personality disorder
instability in interpersonal relationships, self-image, shift in mood, as well as impulsivity - unstable relationships, feeling is often not mutual and fear of abandonment - shift in sexual orientation - depressive, anxious and irritable states in conflict with the surrounding environment - feel empty, harm to others and self - 75% women - 85% comorbid with depression and ED - 70% attempt suicide, drugs therapy is unwise - dramatic identity shift - 6% of adults
Normalization
institution and common residences for people with ID should provide living conditions and opportunities like the rest of society
Mainstreaming
integrating students with disabilities or special needs into the overall educational program
profound intellectual disability
intellectual disability in which IQ scores fall below 20 or 25, very noticeable at birth, infancy, can't walk , talk or feed self
mild intellectual disability
intellectual disability in which IQ scores fall in the range of 50 or 55 to 70. benefit from schooling, support themselves, need assistance when under stress - improves with age, unskilled or semi skilled jobs - sociocultural and psychological factors: poor, unstimulating environment biological: malnourishment
moderate intellectual disability
intellectual disability in which IQ scores range from 35 or 40 to 50 or 55, 10% go ID, early diagnosis, clear deficits, need supervision - mainly biological
stress and family dysfunction in ADHD
interferes with the development of the Type 2 processes - symptoms and diagnosis may produce further symptoms - viewed negatively by peers, teachers, parents
tardive dyskinesia
involuntary movements of the facial muscles, tongue, and limbs; a possible neurotoxic side effect of long-term use of antipsychotic drugs that target certain dopamine receptors - 15% of patients, greater risk if over 50 years old - mild case: usually one symptom - severe case: rocking back and forth, irregular breathing - difficult to eliminate. Early detection is elusive because symptoms are close to psychotics symptoms - D2 receptor - receptor sensitivity: the brain compensates for the lack of dopamine by increasing the number of receptors
hallucination reinterpretation and acceptance
journey into schizophrenia takes place when people attempt to make sense of strange sensations and conclude incorrectly that they're from external sources - change how people react to hallucinations - interpret in more accurate way - helps patients feel in control and reduce delusional ideas
prevention and conduct disorder
key! change unfavorable social conditions before conduct disorder develops - educate and involve family - greatest hope for reducing disorder
psychological causes of autism
lack of theory of mind, mind blindness, deficiency in joint attention (no shared experiences)
Schizophrenia stats
large emotional and financial cost, 1 in 100 people, 20 million people worldwide, 3.2 million people in the US, more common among low socioeconomic status (NOTE: does schizophrenia cause this decline or does this environment cause schizophrenia?) - lifetime prevalence: 1% - 20% have good outcomes - 40% PTSD
short-term hospitalization
lasts a few weeks rather than months after medication and therapy fail
new wave behavioral therapists
lessen the impact of hallucinations and delusions on person - ACT - mindfulness - patients often feel less disturbed after CBT and even shed their diagnosis - decrease hospitalization by 50%
restricted affect
life flat and blunted affect, may reflect an inability to express emotions (show less facial expressions when presented with emotional clips) even though they report feeling emotions - Schizophrenics experience emotions internally and grapple with anxiety/depression
DSM-5 checklist for personalisty disorder
long term patterns leading to dysfunction in 2 areas - cognition, emotions, social interactions, and impulsivity - distress, impairment
prenatal causes of intellectual disabilities
low iodine (cretinism), fetal alcohol syndrome, syphilis, anorexia
Major depressive disorder (child)
low rates in young people because children lack the cognitive skills that help produce clinical depression - children don't really feel "hopeless" - may be triggered by negative life events (loss), major changes, rejection or abuse - irritability, stomach aches, disinterest in toys and games - more common among teens (relationships, bodily changes) - leading cause of suicide in this age group (1 in 6 think about it) - 2 % children, 8% adolescents
bullying
major problem in the minds of the young - 20% report it frequently - 50% have experienced it more than once - leads to humiliation, anxiety, dislike for school, and dissatisfaction
neologism
making up new words
the dark triad
malicious traits that work together to produce offensive behavior - high score in these= risk for personality disorder that is high functioning - self absorbed, creates problems for others, seek power, status, social dominance, reward, thrills - men>women - white > minorities - CEOs> - have high salaries, negotiate, and have leadership positions #1 narcissism #2 psychopathy #3 machiavellianism (undermine others)
family therapy and schizophrenia
many patients live with their families. Family stress, pressures and family reactions can impact a patient and their recovery. - patients that feel positive toward their family have a better recovery - expressed emotion = high relapse rate - therapy helps family develop more realistic expectations and become more tolerant and less guilt ridden - when combined with drug therapy, helps tension, decreases relapse rate and hospital admissions
Viral problems and schizophrenia
may result from exposure to influenza in utero - presence of microglia (brain immune cells) in schizophrenics - large number of schizophrenics are born during late winter when there is more exposure to virus - poor nutrition, birth complications, immune reactions, and toxins may cause schizophrenia
Typical treatment of schizophrenia
medication, often linked to health problems, compromised lifestyle, hope and frustration - anti-psyhotic drugs - 36% do not get adequate care - label of schizophrenia assigned to people with psychosis but this is wrong, some of these people may be bipolar or have MDD
Gender and Schizophrenia
men=women, onset for men=23; onset for women= 28 - women have milder form with fewer hospital visits, less social withdrawal, more opportunities to develop socially because onset it later - women socialized at younger age (sociocultural) - estrogen: protective effect on the brain
Type 2 attention process
mental activities we control, involve effortless focus of attention
multicultural factors and ADHD
minorities are less likely to be assessed and diagnosed, less likely to be treated with stimulants or a combination - economic factors (poor less likely to get help) - viewed as low IQ, poor parenting, substance use, violence
CB factors in antisocial personality disorder
modeling, imitation fro antisocial parents or relatives - operant conditioning as parents reward kid's aggressive behavior - hold attitudes that trivialize other people's needs - cancer recognize another's point of view
shortage of services for schizophrenia
money and resources are devoted to those with less disabling problems, economic reasons, money put elsewhere (drugs), state and local governments, minorities more likely to get diagnosed and have the least resources. - poverty - transportation - discrimination - bad insurance
treatment for conduct disorder
more effective when children are less than 13 years old - no treatment alone is successful - family factors are important
treatment for histrionic personality disorder
more likely to seek treatment on their own - therapist needs to remain objective, maintain strict boundaries - CB: get better problem solving skills and change the belief that they are helpless - recognizes excessive dependency, find inner satisfaction, cope - drugs to relieve depression
loose associations (derailment)
most common formal thought disorder, rapidly shift from one topic to another, believing that their incoherent statements make sense
Parkinson's symptoms
most common when taking anti-psychotics, resemble Parkinson's, tremors, muscle rigidity, shakes, slow shuffling. - result of medication induced reduction of dopamine in striatum (movement and posture) - can be reversed with anti-Parkinson's drugs
delusions of persecution
most common, believe that they are being plotted against, spied on, slandered, threatened, attacked, etc.
auditory hallucinations
most common, hear sounds and voices that seem to come from outside their head. Voice may speak directly to person, giving commands or warnings of danger or the voice is overheard
catatonic excitement
move excitedly, sometimes wildly waving their arms and legs
Deinstitutionalization
moving people with psychological or developmental disabilities from highly structured institutions to home- or community-based settings - revolving door pattern for schizophrenics
psychomotor symptoms
moving slowly, awkward movements, odd gestures, repeated grimaces, ritualistic/magical purpose to movements
assertive community treatment
multidisciplinary team of clinicians which takes full responsibility for care of a fixed caseload of persons with severe mental illness. - meds, therapy, residential guidance - avoid homelessness, fewer hospitalizations
flat affect
no emotion, face still, monotonous, poor eye contact
gender and MDD
no gender differences between 13 years old, but by 16 years old, girls are 2x more likely than boys to have MDD - hormonal changes, rumination - more female stressors, girls more emotionally invested in relationships - social media - body dissatisfaction
NOTE: Schizophrenia perspective
no matter how compelling the biological evidence is, a strictly biological approach is a big mistake
prodromal phase
no obvious symptoms, deterioration has started (social withdrawal, speak in vague/odd ways, and develop strange ideas and express little emotion
Explanations of Paranoid Personality Disorder
no research support - psychodynamic: demanding parents, rigid dads, rejecting moms, lack of love, mistreatment - CB: broad maladaptive assumptions - Biological: genetic
child abuse
non-accidental use of excessive physical or psychological force by an adult on a child - 5-16% of kids in the US - 1 in 10 are aa subject of severe violence, usually parents who were abused themselves as children - more common among the poor - immediate and long term psychological effects - anxiety, bed wetting, depression, behavioral problems, lack of social acceptance, increased arrests, impulsivity and alcohol use,, suicide risk and unemployment - 1/3 of those abused grow up to be abusive, neglectful and inadequate parents
juvenile training centers
not much success, often strengthen delinquent behavior - more black delinquents end up here
schizophrenia spectrum disorders
number of schizophrenia like disorders in DSM-5
which personality disorder is the most common?
obsessive compulsive has the highest prevalence rate (7.9%)
hypopompic hallucinations
occur when person is waking up
10 personality disorder, 3 cluster
odd cluster (A): paranoid, schizoid, schizotypal dramatic cluster (B): antisocial, borderline, histrionic, narcissistic anxiety cluster (C): avoidant, dependent, obsessive compulsive
olfactory hallucinations
odors that no one else smells, such as the smell of poison or smoke
treatment for narcissistic personality disorder
on of the most difficult to treat because the client can't acknowledge weaknesses or incorporate feedback. try to manipulate the therapist - often consult therapist for other disorders like depression - psychodynamic: recognize and work through insecurities and defenses - CB: redirect client's focus onto opinions of others, increase ability to empathize and take criticism - no clear success
Big 5 Personality Traits
openness, conscientiousness, extraversion, agreeableness, neuroticism - suggested for personality disorder diagnosis
Cognitive-behavioral explanation of schizophrenia
operant conditioning and misinterpretation - difficulties focusing on stimuli (poor at dual attention test)
hyperreacticity
overstimulated
parents and stress
parents underestimate the levels of stress their children feel
positive symptoms of schizophrenia
pathological excesses or bizarre additions to a person's behaviors. - delusions - disorganized thinking and speech - heightened perceptions - hallucination - inappropriate affect
histrionic personality disorder
pattern of excessive emotionality and attention seeking, need approval and praise - vain, self centered, demanding - theatrical gestures, constantly changing to impress people and get attention - need approval and praise - provocative, seduction - manipulation and suicide attempts - gender bias toward women - 2% of adults
auditory hallucinations: whats actually happening
people actually produce nerve signals of sounds in the brain and hear them, then believe external sources are responsible - high blood flow in Broca's area (speech) - high activity in auditory cortex enables people to hear sounds
blunted affect
people display less anger, sadness, joy and other feelings, some show no emotion at all
treatment for obsessive compulsive personality disorder
people don't think anything is wrong with them, not likely to seek treatment - therapist has to win over client - psychodynamic: recognize, experience, and accept underlying feelings and insecurities, take a risk, accept personal limitations -CB: change dichotomous thinking - SSRI: good response
treatment for avoidant personality disorder
people looking for acceptance and affection - hard to keep them in treatment because they start to avoid it and distrust the therapist - gain trust of client - CB: change distressing beliefs and improve self image - exposure, skills training, anti-anxieties and anti-depressants
treatment for dependent personality disorder
place all responsibility for treatment on clinician, need to help client act responsible - group, family and separate therapy - psychodynamic: transference on therapist - CBT: take control of life, challenge assumptions - drugs when comorbid with depression - group therapy works pretty well like avoidant personality disorder
Pseudocommando Mass Murderer
planned, in a public setting during the day, killer expects to be killed and has advanced weaponry
3 categories of symptoms for schizophrenia
positive (excess thought, emotion, behavior), negative (deficit of thought, emotion, behavior), and psychomotor (unusual movement, gestures) - also have other issues with memory, attention, and cognitive functioning
Genes and Schizophrenia
possible gene defects on chromosome 1.2.6.8.10.13.15.18.20.22 and X Chromosome - more than 100 genes linked - polygenic disorder: caused by a combination of gene defects
Alogia
poverty of speech, a reduction in speech or speech content - say little or say a lot with no meaning
biological factors of antisocial personality disorder
predisposition and genes - 67% identical twins - low serotonin - abnormalities in areas that help people follow rules, display symptoms and judgement and empathy - low brain/body arousal to stress or warnings - less anxiety, goes with sensation seeking behavior - poor connectivity: low reaction to stress by SNS and HPA axis
attention circuit and ADHD
prefrontal cortex, anterior cingulate, striatum; dysfunctional circuit, faulty interconnectivity - abnormal dopamine levels - type 2 doesn't override 1
schizophrenia related brain circuit
prefrontal cortex, hippocampus, amygdala, thalamus, striatum, substantia nigra - some structures hyperactive, some underactive - excessive interconnectivity or diminished interconnectivity - 2 distinct sub circuits?
lobotomy & Egas Moniz
prefrontal leukotomy destroyed nerve fibers to stop abnormal thinking - trans-orbital lobotomy: needle in the brain through the eye socket - thought to be miracle cure in the 40s-50s - left people subdued, withdrawn, and stuporous - inventors: professional ambition led to them moving quickly and applying the procedure - fatality rate: 1.5-6% - seizures, weight gain, loss of motor, paralysis, poor intellectual and emotional responsiveness
day centers or day hospitals
program that offers hospital like treatment during the day only - Moscow 1933
Brief Psyhotic Disorder
psychosis for days or months from extreme stress
treatment for borderline personality disorder
psychotherapy to some degree but it is hard to find a balance between empathy and challenging the client - patient often violates therapist-patient boundaries, hard to establish a relationship - transference focused psychotherapy: success, supportive posture, create sympathetic setting
treatment for schizoid personality disorder
rarely enter treatment unless going for something else (i.e alcoholism) - CB: help patient have positive emotions and social interactions - list of emotions, social skills, exposure, role playing
2nd generation antipsychotics
received at fewer dopamine receptors (D2) and more D1, D4, and serotonin receptors (clozapine, risperidone, ariprizole) - as effective or more effective than first generation - reduce positive and negative symptoms - fewer extra-pyramidal symptoms - lower rate of tardive dyskinesia - used to treat other disorders too - only modest change in quality of life - side effects: weight gain, sissiness, metabolic problems, sex dysfunction, high blood sugar, CVD
stimulant drugs and conduct disorder
reduce aggressive behavior, especially if symptoms include impulsivity and over-reactivity
anti-bullying programs
reduce bullying 25%, increased supervision, consequences, policies, cooperation among staff, parents and professionals, identify the risk factors
effectiveness of anti-psychotics
reduce symptoms in 70% of people and most effective for schizophrenia. - improvement within weeks to 6 months - symptoms return if patient stops taking them - first generation: reduces positive symptoms and have a better recovery - many patients dislike the effects (intended or unintended) and refuse to take them
VMAT2
reduced tardive dyskinesia, plays a role in the storage and release of dopamine - inhibits transporter and reduced the amount of dopamine released
Perseveration
repeat words and statements
enuresis
repeated bed wetting or wetting one's clothes - 5 years and older - triggered by stressful events - prevalence decreases with age - boys > girls (2:1) - most correct without treatment but treatment can speed up the process - many have a close relative with it - anxiety is underlying conflict - disturbed family interactions - poor toilet training
bullying definition
repeated infliction of force, threats, or coercion in order to intimidate, hurt or dominate the behavior of another less powerful person - physical, verbal, relational, social - 2/3 occurs at school, 1/3 in the classroom infront of a teacher
multicultural factors of personality disorder
research neglect. - Borderline PD is 75% women, is it because of the trauma women are subjected to? - experiences are pre-requisites - forms of PTSD? - reaction to social inequalities?
residual phase
return to prodromal like functioning, may retain some negative symptoms like blunted emotion but less striking symptoms
catatonic rigidity
rigid, upright posture for hours and resist efforts to be moved
anti-depressants and teenagers
risk of suicide, black box warning, overall reduced suicide behavior
downward drift theory
schizophrenia causes its sufferers to fall from a higher to a lower socioeconomic level or to remain poor because they are unable to function effectively
Fragile X Syndrome
second most common chromosomal disorder, 1 in 6,000, shy anxious - mild to moderate intellectual disability
autogenic mass murder
self generated, kill people indiscriminately to fulfill a personal agenda
bodily illusions
sensing an external "force" or presence
Folie a deux
shared delusions, 2 or more people share a delusion or hallucination (i.e slender man)
explanations for schizotypal personality disorder
similar to schizophrenia, family conflict, disorders in parents, defects in attention and short term memory, poor backwards masking - high levels of dopamine - enlarged ventricles - small temporal lobe - loss of gray matter - linked to mood disorder (2/3 comorbid)
"odd" personality disorders
similar to the behavior of schizophrenics, often leaves the person isolates and many qualify for a diagnosis of schizophrenia
Psychopathy vs. Sociopathy
sociopathy: behavior results from social conflicts psychopathy: psychological, biological, genetic, environmental roots
Encopresis
soiling, repeatedly defecate in clothing. Less common than enuresis, less researched - involuntary, seldom at night - 4 years and older - 1.5-4% - social problems, shame embarrassment - boys > girls - try to hide it, constipation, stress, improper toilet training - most effective treatment is CBT and medical approach to stimulate the bowel regularly and detect a full bowel
operant conditioning and schizophrenia
some people are not reinforced for their attention to social cues so they stop attending to them and focus on irrelevant clues. Bizarre responses are then rewarded with attention so they are repeated. - circumstantial support - patients can learn social skills and verbal behaviors of clinicians ignore weird behavior and reward normal behavior. - partial explanation
genetic factors of schizophrenia
some people seem to be genetically predisposed to schizophrenia, shown by twin studies (48% concordance) - develop later when faced with stress - schizophrenia and brain abnormalities are more common in relatives of people with the disorder - prenatal problems prevalence increases 3x in people who have family members with schizophrenia
catatonic stupor
stop responding to their environment, remaining motionless and silent for long stretches of time
schizophrenics in state hospitals
straight jackets, hand cuffs, hopelessness, lobotomy - no improvement and developed additional symptoms
child adolescence multimodal study (AMS)
study that compares CBT alone, anti-depressants alone, both, and placebo. Found that both CBT and anti-depressants had the most favorable outcome for treating childhood anxiety disorders - 80% improved
active phase
symptoms become apparent, sometimes triggers by stress or trauma
negative symptoms
symptoms of schizophrenia that are marked by deficits in functioning, such as apathy, lack of emotion, and slowed speech and movement, social withdrawal, flat affect
variety in schizophrenia
symptoms, triggers, causes and responsiveness vary greatly!
CBT and autism
teach new skills and appropriate behaviors, speech, reduce negative dysfunction - modeling - operant conditioning - behavior focused is preferred - individualized education program (IEP) - communication training: signing, etc
delusions of reference
the belief that common elements in the environment are directed toward the individual. Attach special and personal meaning to actions of others or various objects and events
hallucinations
the experiencing of sights, sounds, or other perceptions in the absence of external stimuli - cam be normal - differ form illusions, dreams, imagery, pseudo hallucinations
Down Syndrome
the most common chromosomal abnormality, causing intellectual disability, susceptibility to heart disease, and other health problems; and distinctive physical characteristics, such as slanted eyes and stocky build - IQ 30-55 - age early, neurological decline - trisomy 21 - risk increases with geriatric pregnancy
social labeling
the term "schizophrenic" is assigned to those that fail to conform by society - label may be a self fulfilling prophecy
child-centered therapy (humanistic)
therapists listen, reflect, and show empathy and give unconditional positive regard
parent-child interaction therapy
therapists teach parents to work with their child positively, to set appropriate limits, to act consistently, to be fair in their discipline decisions, and to establish more appropriate expectations regarding the child - kid can be as young as 2 - video monitoring
schizophrenia causes major disturbances in.......
thought, emotion, behavior, disrupted interpersonal relationships
tactile hallucinations
tingling, burning, or electric-shock sensations
CBT (ADHD)
treat and manage specific behaviors - operant conditioning - token economy program - school intervention
parent management training
treatment approach combining family and CB interventions to improve family functioning and help the parent deal with the child with conduct disorder
Coordinated specialty care (CSC)
treatment approach that for people with mental disorders, clinicians provide interventions ranging from therapy and practical advice to medical monitoring, housing guidance, and vocational counseling - people need to address social and personal difficulties - team of specialists, provided to people in early development of schizophrenia - helps keep people out of hospitals
cognitive remediation and schizophrenia
treatment that focuses on cognitive impairments that often characterize people with schizophrenia (attention, memory, planning issues) - uses a information processing center on the computer - moderate improvement
Schizophrogenic mother
type of mother, cold, domineering, and uninterested in the needs of children. cause schizophrenia in children
hyporeactivity
under stimulated
personality disorder trait specified (PDTS)
undergoing study for possible inclusion on the DSM-5 - impairment in functioning as a result of one or more very problematic traits
Personality
unique ways of thinking, behaving, feelings - traits: predictable
motor movements
unusual, jump, flap, twist, rock, walk in toes, lunging, banging head
extrapyramidal effects
unwanted movements, such as severe shaking, bizarre-looking grimaces, twisting of the body, and extreme restlessness, sometimes produced by conventional antipsychotic drugs
rigid, repetitive behaviors
upset easily, resist efforts to be change, tantrums - perseveration of sameness - like routine, attached to objects
elimination disorders
urinate or defecate in clothes, bed, floor, not from illness after the age where children are expected to control this
children and bipolar disorder
used to be considered an adult disorder. Kids who are angry, aggressive, and explosive are often diagnosed as bipolar. - irritability, rage, aggression primarily looked at - children not even experiencing mania or mood swings of adult bipolar disorder - over applied - over prescription of medication
avatars
used to help clients overcome their psychological problems - virtual reality - patient fights back against their avatar that resembles their delusions - decreases intensity of auditory hallucinations - confronting hallucinations can help
ECT and schizophrenia
used to induce seizures as a protective effect, thought epileptics were less likely to develop schizophrenia. Wrong!
sexual abuse
using a child to fulfill adult sexual desires - 20% of women and 9% of men - equal among SES, race and ethnicity
elimination disorders
usually disappear or radically change form by adulthood
immigrants and schizophrenia
usually higher than natives, but also over diagnosed in immigrant populations - stressors tied to immigration - more discrimination, more likely to develop schizophrenia
visual hallucinations
vague perceptions of colors or clouds, or distinct visions of people or objects
communication problems in autism spectrum disorder
various forms, hard time understanding people, using language, rigid, receptive speech pattern, no eye contact, echolalia, pronomial reversal
intellectual disability
vary, display general intellectual functioning that is well below average, poor adaptive behavior - 1 in 100 - more male - person learns very slowly, attention, memory, and planning deficits - IQ below 70
hypnagogic hallucinations
vivid sensory phenomena that occur during the onset of sleep - geometric faces, patterns, landscapes
psychotherapy and schizophrenia
win trust and build a relationship with the patient - Frieda Fromm Reichmann - trust, emotional bonding, relieve thought and perceptual disturbances
