psych unit 3

Disruptive Mood Dysregulation Disorder

checklist- 1. For at least a year, individual repeatedly displays severe outbursts of temper that are extremely out of proportion to triggering situations and different from ones displayed by most other people of his or her age. 2. The outbursts occur at least three times per week and are present in at least two settings (home, school, with peers). 3. Individual repeatedly displays irritable or angry mood between the outbursts. 4. Individual receives initial diagnosis between 6 and 18 years of age. -A childhood version of bipolar disorder? -"Children with patterns of severe rage" -Struggle to regulate emotions -"Big emotions" -Frequent temper tantrums -Chronic irritability in between tantrums

female sexual interest/arousal disorder covers both arousal and desire

combined because research indicated it is difficult to distinguish between the two, often co-occur

sexual functioning

(normal) William Masters and Virginia Johnson, late 1950's, Studied sexual response in the lab

homosexuality in the DSM

- DSM & DSM II included homosexuality as diagnosis -gay activists protested at APA conventions in 1970,71 -APA voted to remove homosexuality from DSMII in 1974 -DSM-III retained "ego-dystonic homosexuality" 1980 -this was removed in DSM-III-R in 1987

disc. of antipsychotic drugs

- discovered in the 1950s when researchers developed antihistamine drugs for allergies -Antihistamines (phenothiazines) used to calm patients about to undergo surgery -Chlorpromazine tested on patients with psychosis and symptom reduction -In 1954, chlorpromazine (Thorazine) was approved for sale in the US -Effectiveness of antipsychotic drugs -Symptoms reduce in about 65 percent of patients diagnosed with schizophrenia -More effective than any other approach used alone -In most cases, the drugs produce the maximum level of improvement within the first six months of treatment -Positive symptoms of schizophrenia are reduced more completely, or at least more quickly, than negative symptoms

Children's Mental Health

-"Mental health in childhood means reaching developmental and emotional milestones and learning healthy social skills and how to cope when there are problems" (CDC). -Positive quality of life, high functioning at home, school, and in the community.

conduct disorder

-"Repeatedly violate the basic rights of others." -Physical aggression, cruel to people or animals, stealing or lying. -More severe than ODD children with conduct disorder often go on to become involved with the criminal justice system -5 to 10% of kids are diagnosed with CD -Begins between ages 7 to 15 -75% of children diagnosed with CD are male -linked to genetic and biological factors -tied to drug abuse, poverty, traumatic events, and exposure to violent peers or community violence -tied to troubled parent-child relationships, inadequate parenting, family conflict, marital conflict, and family hostility

Issues Affecting the Mental Health of the Elderly

-10 to 20 percent of elderly people live with their children or other relatives, usually because of increasing health problems -about 4 percent of the entire elderly population live in nursing homes (1.5 million people), around 13 percent of people 85 years and older eventually wind up being placed in such facilities

Anxiety Disorders

-14 to 25% of all children experience an anxiety disorder -around two-thirds of anxious children go untreated -Different symptoms from adults -More behavioral and somatic symptoms -Sleep difficulty -Stomach pain -Irritability -Imaginary concerns (monsters, ghosts) -More immediate focused rather than future focused -Separation Anxiety Disorder -Children have difficulty being away from major attachment figures -School refusal -Begins during preschool years -4% of children experience separation anxiety disorder -Selective Mutism -Failure to speak in certain social situations. -May be talkative at home but mute in school settings. -1% of children experience selective mutism -This may be an early form of social anxiety disorder

institutional care in the past for schizophrenia

-1793: Move from asylums toward large mental hospitals -Because patients failed to respond to traditional therapies, the primary goals of the hospitals were to restrain them and give them food, shelter, and clothing. -The move toward institutionalization began in 1793 with the practice of "moral treatment." -By the end of the nineteenth century, several factors led to a reversal of the moral treatment movement: -Money and staff shortages -Declining recovery rates -Overcrowding -Emergence of prejudice -By the early years of the twentieth century, the moral treatment movement had ground to a halt; long term hospitalization became the rule once again.

financial and emotional costs of schizophrenia

-25 percent attempt suicide; 5 percent die -Increased risk of physical illness -occurs in all socioeconomic status groups, but more frequently in lower-SES groups (downward drift theory)

genetic causes of alzheimers

-Abnormal activity by the beta-amyloid protein, key to the repeated formation of plaques -Abnormal activity by another protein, tau, is key to the excessive formation of tangles -early-onset alzheimer's: abnormalities in the genes responsible for the production of two proteins—the beta-amyloid precursor protein (beta-APP) and the presenilin protein -- some families transmit mutations -late-onset alzheimer's: typically do not run in families and are often called sporadic Alzheimer's disease.- late-onset form of the disease appears to result from a combination of genetic, environmental, and lifestyle factors -About 30 percent of the population inherit the form called ApoE-4, may be vulnerable to Alzheimer's

multicultural factors and ADHD

-African American and Hispanic American children with significant attention and activity problems are less likely than white American children with similar symptoms to be assessed for ADHD receive a diagnosis of ADHD undergo treatment for it -children from racial minorities are less likely than white American children to receive the promising (but more expensive) long-acting stimulant drugs that have bee developed in recent years

sociocultural view of schizophrenia - multicultural factors

-African Americans are more likely than non Hispanic white Americans to receive this diagnosis -As many as 2.1 percent of African Americans receive a diagnosis of schizophrenia, compared with 1.4 percent of white Americans -48 percent of those with a diagnosis of schizophrenia are African American, although only 16 percent of the state population is African American -More prone to disorder (?) -Biased diagnoses by White clinicians -Misread cultural differences as symptoms -Economic hardship effects -Key country to country differences -Stable prevalence- around 1 percent in countries across the world -Varied course and outcomes: Schizophrenics from developing countries fare better than those from developed countries -Genetic differences among populations(?) -Psychosocial environments: More family and social support?

childhood problems for ID

-After birth, particularly up to age 6, certain injuries and accidents can affect intellectual functioning and intellectual disability -lead poisoning, from eating lead-based paints or inhaling high levels of automobile fumes -certain infections, such as meningitis and encephalitis, can lead to intellectual disability if they are not diagnosed and treated in time

care-giving and neuro diseases

-Almost 90 percent of all people with Alzheimer's disease are cared for by their relatives -One of the most frequent reasons for the institutionalization: overwhelmed caregivers can no longer cope with the difficulties of keeping them at home

developmental psychopathology view of schizophrenia

-Applies an integrative and developmental framework -Individual's genetic predisposition is implemented by a dysfunctional brain circuit -May eventually lead to schizophrenia if, over the course of the person's development, he or she experiences significant life stressors, difficult family interactions, and/or other negative environmental factors -This is similar to the diathesis stress model , but there are two modifications or refinements 1. Disorder begins long before the actual onset of schizophrenia symptoms -Cognitive, perceptual, and attentional problems earlier in their lives -More socially isolated, disobedient, and disagreeable, and display motor disturbances during childhood -Those early problems result largely from the inherited predisposition, but, may also be due to repeated experiences of childhood stress, family dysfunction, and/or difficult social interactions 2. Dysfunctional brain circuit may lead to schizophrenia through disruption of the hypothalamic pituitary adrenal (HPA) axis

Moderate, Severe, and Profound ID

-Approximately 10 percent of those with intellectual disability function at a level of moderate ID -typically receive their diagnosis earlier in life than do individuals with mild ID -typically demonstrate basic motor and communication deficits during infancy -signs of neurological dysfunction and have an increased risk for brain seizure disorder -Around 1 to 2 percent of all people with intellectual disability function at a level of profound ID (IQ below 20) -very noticeable at birth or early infancy. With training, people with profound ID may learn or improve basic skills such as walking, some talking, and feeding themselves

Oppositional Defiant Disorder

-Argumentative, defiant, vindictive, angry, resentful -Frequently argue with adults, ignore rules, deliberately annoy others -10% of children are diagnosed with ODD -80% of those who develop CD first showed symptoms of ODD.

intellectual disability prev.

-As many as 3 of every 100 people meet the criteria for this diagnosis -four levels of intellectual developmental disorder have been distinguished: mild (IQ 50-70), moderate (IQ 35-49), severe (IQ 20-34), and profound (IQ below 20). -Around 30 percent or more have a psychological disorder other than intellectual disability

anxiety disorders in later life

-At any given time, as many as 11 percent of elderly individuals in the United States experience at least one of the anxiety disorders -generalized anxiety disorder is particularly common, affecting up to 7 percent of all elderly people -people over 85 years of age report higher rates of anxiety than those between 65 and 84 years

treatment for pedophilic disorder

-Aversion therapy -Masturbatory satiation -Orgasmic reorientation -Cognitive-behavioural therapy -Antiandrogen drugs -Relapse-prevention training (as in substance use disorder, identify trigger, learn strategies to avoid or cope)

prevalence by type

-Avoidant 1 2% -Histrionic 2% -Borderline 2 3% -Dependent 0.5% -Narcissistic .5 1% -OCPD 2% -Paranoid 2% -Antisocial 1 4% -Schizoid 1%? -Schizotypical 1%

Parent Management Training

-Behavioral therapy for externalizing disorders -Caregiver involvement required -Change/improve their response to, and supervision of, child' s behavior -Therapist may also work with the child -Teach problem solving skills and skills for dealing with angry feelings -However, therapist child work isn' t most important "ingredient" **Behavior Therapy with the caregiver is the key to kids with behavior problems getting better**

treatments for schizotypal personality disorder

-Behavioral: Help the client reconnect to the world and recognize thinking limits -Cognitive behavioral: Recognize unusual thoughts and magical predictions; speech lessons, social skills training, appropriate dress and manners recognition -Biological: Some patients benefit from low dose anti-psychotic drugs

Three Broad Categories

-Internalizing : "feelings or emotional" problems -Depression, anxiety, somatization, posttraumatic stress (anxiety response to trauma) -Externalizing : acting out" Problems -Fighting, rule breaking, not listening, anger outbursts; ADHD, ODD, Conduct Disorder -Other Disorders -Delays in the development of multiple basic functions including socialization and communication; Autism, Intellectual Disability

dysfunctional brain structures and circuitry of schizophrenia

-Brain circuit structures function and interconnect in problematic ways that are collectively unique to this disorder -Brain scans have shown repeatedly that the circuits of schizophrenic and non schizophrenic individuals differ significantly whether study participants are at rest, performing cognitive tasks, or experiencing hallucinations. -enlarged ventricles (display more negative symptoms and fewer positive ones, patients who have enlarged ventricles tend to be more poorly adjusted socially before the onset of schizophrenia, to have more cognitive disturbances, and to respond less well to conventional antipsychotic drugs)

Schizotypal Personality Disorder (Cluster A)

-Characterized by a range of interpersonal problems, marked by extreme discomfort in close relationships, odd (even bizarre) ways of thinking, and behavioral eccentricities -Individuals believe unrelated events pertain to them in important ways; bodily illusions -Demonstrate difficulty keeping attention focused; conversation is typically digressive and vague, loose associations -Affects 3.9 percent of adults; slightly more males than females

Paranoid Personality Disorder (Cluster A)

-Characterized by deep distrust and suspicion of others -Limited close relationships; cold and distant affect -Excessive trust in own ideas and abilities; critical of weakness and fault in others -Experienced by about 4.4 percent of U.S. adults; more common in men than in women

schizoid personality (cluster a)

-Characterized by persistent avoidance of social relationships; little demonstration of emotions -Individual focuses primarily on self and is generally unaffected by praise or criticism -Often seen as flat, cold, humorless, and dull. -Preference for being alone; weak social skills -Lack of intimacy interest; often marital or family problems -Present in 3.1 percent of U.S. adults; slightly more common in men than in women

biological causes of Intellectual disability

-Chromosomal Causes The most common of the chromosomal disorders that lead to intellectual disability is Down syndrome, named after Langdon Down -occurs in fewer than 1 of every 1,000 live births, but the rate increases significantly when the mother's age is over 35 -older expectant mothers are now encouraged to undergo amniocentesis (testing of the amniotic fluid that surrounds the fetus) -(94 percent of cases) is trisomy 21, in which the person has three free-floating 21st chromosomes instead of two -IQ from 35 to 55 -Fragile X syndrome is the second most common chromosomal cause of intellectual disability -generally display mild to moderate degrees of intellectual dysfunctioning, language impairments, and in some cases, behavioral problems -shy and anxious

positive symptoms of schizophrenia - thought disorder symptoms (disorganized thinking and speech) also more

-Circumstantiality: speech filled with unnecessary, tedious, and inconsequential detail, leading to rambling descriptions of events or responses to questions. For example, "Although this morning when I woke up I felt as though today I would think of an example of this, but it didn't turn out to be a productive day"

positive symptoms of schizophrenia - thought disorder symptoms (disorganized thinking and speech) more same

-Clanging or rhymes: refers to a mode of speech characterized by association of words based upon sound rather than concepts. -For example, this may include compulsive rhyming or alliteration without apparent logical connection between words. How are you? "Well, hell, it's well to tell."

Cluster A Personality Disorders

-Cluster A of the personality disorders in DSM 5 include those disorders characterized by eccentric behavior. -show characteristics that might lead others to view them as slightly odd, unusual, or peculiar.

Dramatic Personality Disorders (cluster b)

-Cluster of dramatic personality disorders includes -Antisocial personality disorder -Borderline personality disorder -Histrionic personality disorder -Narcissistic personality disorder -Dramatic, emotional, or erratic problems make it almost impossible to establish relationships -Disorder causes are not well understood; treatments are ineffective to moderately effective

Cognitive behavioral therapies for schizophrenia

-Cognitive remediation -Focuses on difficulties in attention, planning, and memory -Provides increasingly more complex computer tasks until planning and social awareness tasks are reached -Provides moderate improvement -Improvements in attention, planning, memory, and problem solving surpass those with other interventions -Hallucination reinterpretation and acceptance -Based on idea that hallucinations are the result of biologically triggered internal sensations that get misinterpreted as from an external source -Therapists help change how clients view and react to their hallucinations 1. Education about the biological causes of hallucinations. 2. help clients learn to identify which kinds of events and situations trigger the voices in their heads. 3. Challenge clients' inaccurate ideas about the power of their hallucinations , such as the idea that the voices are all powerful and uncontrollable and must be obeyed. (also have the clients put such notions to the test. What happens, for example, if the clients resist following the orders from their hallucinatory voices) 4. Teach clients to reattribute and more accurately interpret their hallucinations. (Clients may, for example, adopt and apply alternative conclusions such as "It's not a real voice, it's my illness.") 5. Teach clients techniques for coping with their unpleasant sensations (breathing and relaxation techniques, positive self statements, distraction strategies) -Virtual avatar to address hallucinations -New wave cognitive behavioral therapies -Posit that hallucinations should be accepted rather than misinterpreted or overreacted to -Help clients accept their streams of problematic thoughts & gain a greater sense of control, become more functional, and move forward in life -Often produce helpful results

depression in later life

-Depression is one of the most common mental health problems of older adults -as many as 20 percent of people become depressed at some point during old age; rate is highest in older women -older depressed people with high blood pressure are almost three times as likely to suffer a stroke as older non-depressed people with the same condition -elderly people are also more likely to commit suicide than young people, and often their suicides are related to depression; among the elderly it is more than 16 per 100,000

Attention Deficit/Hyperactivity Disorder

-Difficulty attending to tasks, overactivity, impulsivity, or both -Inattentive type -Disorganized -Dislikes/avoid mentally effortful work -Loses items -Easily distracted -Hyperactive impulsive type -Fidgety -Talks excessively -Interrupts -Inappropriately wanders, runs, climbs -Unable to wait turn -Combined type -7% of children are diagnosed with ADHD; 70% boys -60 percent of affected children continue to have ADHD as adults -Almost 80 percent of all children and adolescents with ADHD receive treatment -Type 1 v. Type 2 Attention Processes -Type 1 : Beyond voluntary control focus on unexpected things -Type 2 : Effortful focus controlled attention -Imbalance between Type 1 & Type 2 attentional processes -Attention Circuit -Dysfunctional attention circuit, marked by poor connectivity (communication) -Abnormal dopamine activity

types of externalizing disorders

-Disruptive Mood Dysregulation Disorder -Oppositional Defiant Disorder (ODD) -Conduct Disorder (CD) -Attention Deficit/Hyperactivity Disorder (ADHD) Other: Autism Spectrum Disorder

psychotherapy treatment for schizophrenia

-Early psychotherapy treatment was rare before antipsychotic drugs emerged-- (relieve thought and perceptual disturbances, learn about their disorder, participate actively in therapy think more clearly about themselves and their relationships, make changes in their behavior, and cope with stressors in their lives.) -Today psychotherapy is more successful in schizophrenia treatment with Cognitive behavioral therapies Sociocultural interventions: Family therapy and social therapy

community approach fails if not truly applied

-Effective community programs can help people with schizophrenia recover -But, it appears that community treatment fails, in that, -Fewer than half of all people who need them receive appropriate community mental health services -Approximately 40 to 60 percent of all people, in any given year, with schizophrenia and other severe mental disorders receive no treatment at all -Two contributing factors -Poor coordination of services -Shortage of services -Solutions -Community therapists as case managers -Shortage of services -An inadequate number of community programs are available to people with schizophrenia -failure to provide adequate services for people with severe disorders in available community programs -Economic reasons for services shortage -Less funding for people with severe disorders -Program funding often falls to local governments and nonprofit organizations -Consequences of inadequate community treatment -Many people with schizophrenia or other severe mental disorders receive no or inadequate treatment -Premature discharge; inadequate follow up treatment -Housing settings vary -Many people with schizophrenia become homeless -jails and prisons

psychotic disorders in later life

-Elderly people have a higher rate of psychotic symptoms than younger people -schizophrenia is less common in older people than in younger ones -uncommon for new cases of schizophrenia to emerge in late life -antipsychotic drugs may pose more dangers (cognitive impairment, stroke, seizures) - metabolism changes in older people -delusional disorder increases in the elderly population (rare in most age groups—around 2 of every 1,000 persons)

Externalizing Disorders

-Externalizing disorders consist of problems that are based on "under controlled" symptoms -Serious conduct problems such as fighting, stealing, assaulting, threatening, and other behaviors -Serious difficulties in regulating their behaviors and emotional expressions. -What we think of when we think of "problem" children -Easier to notice -Raises more parent/teacher concern

community approach to schizophrenia

-Features of effective community care -Coordinated services -Community mental health centers provide medications, psychotherapy, and inpatient emergency care -Coordination of services is especially important for mentally ill chemical abusers (MICAs) -Short term hospitalization -If treatment on an outpatient basis is unsuccessful, patients may be transferred to short term hospital programs -After being hospitalized for up to a few weeks, patients are released to aftercare programs for follow up in the community -Features of effective community care -Partial hospitalization -if the patient needs fall between full hospitalization and outpatient care, day center programs may be effective -Programs provide daily supervised activities and programs to improve social skills -Semihospital (residential crisis center) houses or other structures in the community provide 24 hour nursing care for patients with severe mental disorders -Supervised residences -Halfway houses (or group homes) provide shelter and supervision for those patients who are unable to live alone or with their families, but who do not require hospitalization -Staff are usually paraprofessionals -Houses are run with a milieu therapy philosophy -Mutual support -Responsibility -self government -Programs help persons with schizophrenia adjust to community life and avoid rehospitalization

Other antipsychotic drugs later discovered

-First generation antipsychotic drugs (neuroleptic drugs) vs. -Second generation antipsychotic drugs -At least as effective, often more effective, than first generation agents -Reduce positive symptoms -Cause fewer extrapyramidal symptoms and less tardive dyskinesia -May cause weight gain, dizziness, and significant elevations in blood sugar -Prescribing first generation antipsychotic drugs -No improvement -Up the dosage -Current practice -Prescribe the lowest effective dose -Gradually reduce or stop the medication weeks or months after the patient begins functioning normally

lobotomy

-First performed in 1935 -Leucotomy: Two holes were drilled in either side of the skull, and an instrument resembling an icepick was inserted into the brain tissue to cut or destroy nerve -Lobotomy: A needle was inserted through the eye socket and then rotated to destroy tissue Dr. Egas Moniz one of the founders of modern psychosurgery, having developed the surgical procedure leucotomy known better today as lobotomy for which he became the first Portuguese national to receive a Nobel Prize in 1949 (shared with Walter Rudolf Hess). -Between 1945 and 1965 50,000 lobotomies performed in US alone -He retired after former pt. shot him in back, turning him into a paraplegic -With the discovery of thorazine and other drugs known as neuroleptics (essentially a chemical lobotomy, but at least could be reversed somewhat), lobotomies fell out of favor -Lobotomy is rarely, if ever, performed today , and if it is, "it's a much more elegant procedure," Lerner said. "You're not going in with an ice pick and monkeying around." The removal of specific brain areas (psychosurgery) is only used to treat patients for whom all other treatments have failed.

positive symptoms of schizophrenia - thought disorder symptoms (disorganized thinking and speech) cont

-Flight of ideas: speech is intelligible, marked by a fast pace and rapid acceleration, and often characterized with abrupt changes of topic, has the quality of a speaker ready to burst forth with a spew of sentences.

schizophrenia checklist

-For 1 month, individual displays two or more of the following symptoms much of the time: Delusions Hallucinations Disorganized speech Very abnormal motor activity, including catatonia Negative symptoms -At least one of the individual's symptoms must be delusions, hallucinations, or disorganized speech -Social/occupational dysfunction: Individual functions much more poorly in various life spheres than was the case prior to the symptoms -Duration: Beyond this 1 month of intense symptomology, individual continues to display some degree of impaired functioning for at least 5 additional months -Rule out schizoaffective and psychotic mood disorder -Not attributable to substance or general medical condition -Not a manifestation of a pervasive developmental disorder

psychodynamic views of schizophrenia

-Freud (1924, 1915, 1914) believed that schizophrenia develops from two psychological processes: (1) regression to a pre-ego stage (primary narcissism, only recognize their own needs) and (2) efforts to reestablish ego control -Frieda Fromm Reichmann expanded on Freud's suggestion that cold or un-nurturing parents plant the seeds of schizophrenia in their child -The theory of schizophrenogenic mothers proposed that mothers of people with schizophrenia were cold, domineering, and uninterested in their children's needs ; these mothers appeared self sacrificing, but were really using their child to meet their own needs -This combination of overprotective and rejecting behavior set the stage for the later development of the disorder -Little research support: The majority of schizophrenics do not appear to have mothers who fit the schizophrenogenic description.

Treatment for Externalizing Disorders Young Kids The Incredible Years (IY) Program

-How it works : -Parenting groups that use videos and role plays to teach parents how to decrease problem behaviors, increase positive behaviors and child self esteem. -Supplemental child group (Dinosaur School) to teach emotions, social skills, and coping skills -Who' s involved : -Primarily groups of parents/caregivers -Sometimes kids Other treatments: Helping the Noncompliant Child (HNC), Parent Child Interaction Therapy (PCIT), Triple P Positive Parenting Program

Treatment for Externalizing Disorders Older Kids Functional Family Therapy (FFT)

-How it works : Increases motivation between child, caregiver, & family to solve problems, teaches specific skills to deal with conflict or communication problems. -Who' s involved : Entire family -Multisystemic Therapy (MST) -How it works : Ecological program that strategically targets known risk factors across a youth' s 'ecology', including family, peers, community and school. -Who' s involved : Parents are the primary focus of the intervention, although some work may be done directly with the youth based on individual need.

Treatment for Depression Older kids: Behavioral Activation (BA) for Adolescents

-How it works : Short term, individual therapy. The focus is on increasing rewarding experiences as a strategy for directly targeting depressive symptoms. -Who' s involved : Youth focused with some caregiver sessions to help them support their adolescent -Other treatments: CBT, Interpersonal Psychotherapy for Adolescents (IPT A) BA Goal Setting -Scheduling and goal setting -Effective goals are SMART -Specific -Measurable -Appealing -Realistic -Time Bound -Taking mini steps

institutional care for schizophrenia - Milieu and token econ.

-In the 1950s, two new institutional approaches emerged -Milieu therapy (Maxwell Jones) -Institutions cannot help patients unless they create a social climate that promotes productive activity, self respect, and individual responsibility -Residents live in a therapeutic community of respect, support, and openness, which resembles daily life outside the hospital -Many leave the hospital at higher rates than patients receiving traditional custodial care; some need sheltered aftercare -Often combined with other community programs -Token economy - -Systematic use of operant conditioning techniques to change patient behaviors -Patients are rewarded with tokens for acceptable behavior; not rewarded for unacceptable behavior -Immediate rewards are tokens that can later be exchanged for food, cigarettes, privileges, and other desirable objects -Token economies reduce psychotic and related behaviors --Limitations -Uncontrolled studies; instead of patients being randomly assigned to groups, a whole ward will participate in the program -ethical and legal concerns about controlling rewards related to basic needs -question whether change involves thoughts/perceptions or just imitation of normal behavior -Transfer to real world rewards may be difficult

positive symptoms of schizophrenia - thought disorder symptoms (disorganized thinking and speech) more

-Incoherence: speech is incomprehensible or lacking in meaning and structure, such as saying, "The sheep on the roof twelve is New Jersey," when asked one's name.

biological view of schizophrenia

-Inheritance and brain activity play key roles in the development of schizophrenia -Principles of a diathesis stress approach , genetic researchers believe that some people inherit a biological predisposition to schizophrenia. -This disposition/disorder triggered by later exposure to extreme stress. -This theory has been supported by family pedigree studies and by genetic linkage studies and molecular biology. -Family pedigree studies have repeatedly found that schizophrenia is more common among relatives of people with the disorder. The more closely related they are to the person with schizophrenia, the greater their likelihood for developing the disorder: -General population: 1 percent -Second degree relatives: 3 percent -First degree relatives: 10 percent -Factors other than genetics may explain these findings. -Twins have received particular research attention. -Studies of identical twins have found that if one twin develops the disorder, there is a 48 percent chance that the other twin will do so as well. -If the twins are fraternal, the second twin has a 17 percent chance of developing the disorder, -Factors other than genetics may explain these findings. -Biological relatives of adoptees with schizophrenia are more likely than their adoptive relatives to develop schizophrenia. --If both members of a pair of twins have a particular trait, they are said to be concordant for that trait Family Links: -People who are biologically related to someone with schizophrenia have a heightened risk of developing the disorder during their lifetimes. -The closer the biological relationship (that is, the more similar the genetic makeup), the greater the risk of developing the disorder.

community approach cont

-Research indicates that clients in effective community programs make more improvements than those in other kinds of treatments or poor community programs -Worldwide, well coordinated community treatment is seen as a crucial solution to the problem of severe mental dysfunction

Internalizing Disorders

-Internalizing disorders consist of problems that are based on "over controlled" symptoms -Control or regulation of emotional and cognitive state ——"the way we think about how we feel" -Problems/symptoms are typically developed and maintained within the child. -Understanding has lagged -Harder to detect -Less problematic for parents

types of internalizing disorders

-Internalizing disorders: -Anxiety -Depression -Prevalence of these disorders is increasing over time -Rates of children aged 6 to 17 years "ever having been diagnosed with either anxiety or depression" -5.4% in 2003 -8% in 2007 -8.4% in 2011 2012.

Chronic Traumatic Encephalopathy(CTE)

-It is a progressive degenerative disease of the brain found in athletes and others with a history of repetitive brain trauma. -Multiple concussions trigger progressive degeneration of the brain tissue, including the build-up of an abnormal protein called tau. -Essentially CTE is a building up of tau, an abnormal protein that strangles brain cells in areas that control memory, emotion, and other functions -Formerly known as "punch drunk" thought to be found only in boxers who have taken repetitive hits to the head.

downward drift theory (schizophrenia)

-Leading theorists argue that the stress of poverty causes the disorder. OR -Other theorists argue that the disorder causes victims from higher social levels to fall to lower social levels and remain at lower levels the "downward drift"

negative symptoms of schizophrenia - avolitional

-Loss of volition (motivation or directedness) -Feeling drained of energy and interest in normal goals -Inability to start or follow through on a course of action -Ambivalence: Conflicted feelings about most things

current use of insanity tests

-M'Naghten test is now is used in all cases tried in federal courts and in about half of the state courts -The more liberal ALI standard is still used in the remaining state courts, except in Idaho, Kansas, Montana, and Utah, which have more or less done away with the insanity plea altogether

Major Depressive Disorder

-MDD for young kids maybe triggered by negative life events -Behavioral and somatic symptoms -Stomach aches -Headaches -Disinterest in play -Irritability -Around 2% of children and 8% of adolescents are currently experiencing a major depressive disorder -20% of adolescents experience at least 1 depressive episode during teen years. -Younger children may lack cognitive skills that lead to development and maintenance of depression, thus low prevalence -Gender differences -No difference in the rates of depression in boys and girls before age 13 -By age 16 girls are more than 2x as likely than boys to be depressed -Hormonal changes, stressors, societal values and norms.

Treatment for Externalizing Disorders

-Many psychotherapies for externalizing disorders are grounded in behavioral principles -Problems: Rule breaking, anger outbursts, not obeying, aggression -Principle: Behavior is reinforced by the environment/people; solution requires changing the response in the environment Medication -Stimulants for ADHD -Best studied and among the most effective psychiatric medication for children and adolescents -May lead to growth suppression and sleep issues

cognitive view of schizophrenia

-Misinterpreting unusual sensations -Biological factors produce strange and unreal sensations when they have hallucinations and related experiences -Further features of the disorder emerge due to a faulty interpretation and misunderstanding of symptoms -For example: -Man experiences auditory hallucinations -Approaches his friends for help; they deny the reality of his experience -Concludes that they are trying to hide the truth from him -Begins to reject all feedback and starts feeling persecuted -Zimbardo (1976): "rational path to madness". -Little direct, clear research support for this view

treatment for enuresis

-Most cases of enuresis correct themselves without treatment -bell-and-battery technique, a bell and a battery are wired to a pad consisting of two metallic foil sheets, and the entire apparatus is placed under the child at bedtime. A single drop of urine sets off the bell, awakening the child as soon as he or she starts to wet. the bell (unconditioned stimulus) paired with the sensation of a full bladder (conditioned stimulus) produces the response of waking. Eventually, a full bladder alone awakens the child. -dry-bed training, in which children receive training in cleanliness and retention control, are awakened periodically during the night, practice going to the bathroom, and are appropriately rewarded.

Medication

-Not recommended as primary or only treatment -Child should also be in therapy -Antidepressants (SSRIs) shown to be effective and relatively safe -FDA black box warning for suicidal ideation -Other medications have less support (e.g., mood stabilizers, atypical antipsychotics)

Categorical approach: DSM 5 identifies ten personality disorders , which are organized into three categories (clusters)

-Odd or eccentric behavior: Paranoid, schizoid, and schizotypal personality disorders -Dramatic, emotional, or erratic behavior: Antisocial , borderline, narcissistic, and histrionic personality disorders -Anxious or fearful behavior: Avoidant, dependent, and obsessive-compulsive personality disorders

olg age and stress

-Old age is usually defined the years past age 65 -around 43 million people in the United States are "old," -13.6 percent of the total population - 70 million elderly people in the US by the 2030, more than 20 percent of population -Older women outnumber older men by almost 3 to 2 -About half of adults over 65 have two or three chronic illnesses, and 15 percent have four or more

Odd Personality Disorders (cluster a)

-Paranoid personality disorder -Schizoid personality disorder -Schizotypal personality disorder -Behaviors include extreme suspiciousness, social withdrawal, and peculiar ways of thinking and perceiving things- leave the person isolated. -display behaviors similar to, but not as extensive as, schizophrenia -Some clinicians believe these disorders are related to schizophrenia, and so call them "schizophrenia spectrum disorders." -Few people with these disorders seek treatment; treatment success is limited -Clinicians have learned much about the symptoms of odd personality disorders, but little about their causes or how to treat them.

negative symptoms of schizophrenia - deficits, missing part of speech quality

-Pathological deficits -Poverty of speech (alogia): -Reduction of quantity of speech or speech content -May also say quite a bit but convey little meaning

positive symptoms of schizophrenia - thought disorder symptoms (disorganized thinking and speech) more also same

-Perseveration : is not clanging, but clinging to the same idea, word, phrase, or sound repeatedly. "I must stop writing. I must stop writing. I have to finish this. I must stop writing. I have to finish this writing. I must stop" would be an example.

Personality cont.

-Personality: uniquely expressed characteristics that influence behaviors, emotions, thoughts, and interactions -Personality traits: Particular, predictable, flexible characteristics -Personality disorder: An enduring, rigid pattern of inner experience and outward behavior that leads to significant problems and psychological pain for self and others

Biological perspective of schizophrenia - genetics

-Possible defects on chromosomes 1, 2, 6, 8, 10, 13, 15, 18, 20, and 22 and on the X chromosome, each of which may help predispose a person to develop this disorder -The number of specific gene sites linked to schizophrenia is no fewer than 281 to date -These varied findings may indicate: -Some of these gene sites do contribute to the disorder and some do not -Different types of schizophrenia are linked to different genes. -These varied findings may indicate that schizophrenia is a polygenic disorder, caused by a combination of gene defects -Research has pointed to two kinds of biological abnormalities that could conceivably be inherited: Biochemical abnormalities Dysfunctional brain circuitry.

Autism Spectrum Disorder - treatment

-Problems: Deficits in social communication and social interaction. Restricted repetitive behaviors, interests, and activities. -Principle: Reinforce behavior related to more adaptive ways of responding to situations. -Applied Behavioral Analysis (ABA) -Social skills -Communication skills -Fine and gross motor skills -augmentative communication systems, such as "communication boards" or computers that use pictures, symbols, or written words to represent objects or needs

explanations of enuresis

-Psychodynamic theorists explain it as a symptom of broader anxiety and underlying conflicts. -family theorists point to disturbed family interactions -Behaviorists view the problem as the result of improper, unrealistic, or coercive toilet training -biological theorists suspect that children with this disorder often have a small bladder capacity or weak bladder muscles.

theoretical explanations of paranoid personality disorder (cluster a)

-Psychodynamic: Linked to patterns of early interactions with demanding parents -Cognitive behavioral: Tied to broad maladaptive assumptions such as "People are evil and will attack you if given the chance" are to blame -Biological: Genetic causes -Little systematic research -People with paranoid personality disorder do not typically see themselves as needing help. -Few come to treatment willingly. -Those who are in treatment often distrust and rebel against their therapists. -has limited effectiveness and moves slowly

treatments for paranoid personality disorder

-Psychodynamic: Object relations therapists try to see past the patient's anger and work on the underlying wish for a satisfying relationship -Self therapists psychodynamic clinicians who focus on the need for a healthy and unified self—try to help clients reestablish self cohesion -Behavioral: Anxiety reduction and interpersonal problem solving improvement. Try to help clients control anxiety and improve interpersonal skills. -Cognitive: Cognitive therapists also try to restructure clients' maladaptive assumptions and interpretations. Development of more realistic interpretations of words and actions of others -Biological: Antipsychotic drug therapy -Drug therapy is of limited help.

treatments for schizoid personality disorder

-Psychodynamic: Object relations therapists; self therapists -Behavioral: Social skills education; role playing, exposure techniques; group therapy -Cognitive: focuses on thinking about emotions. -Cognitive behavioral therapists have sometimes been able to help people experience more positive emotions and satisfying social interactions. -Presenting and evoking memories of pleasurable experiences -Group therapy is apparently useful, as it offers a safe environment for social contact. -Biological: Drug therapy provides limited help -Drug therapy is of little benefit.

theoretical explanations of schizoid personality disorder

-Psychodynamic: Rooted in unsatisfied need for human contact; unaccepting and/or abusive parents; objects relations theory links schizoid personality disorder to an unsatisfied need for human contact. -Cognitive behavioral: Tied to deficiencies in thinking; inability to pick up emotional cues; language and motor skills delays. Their thoughts tend to be vague and empty, and they have trouble scanning the environment for accurate perceptions. -Their extreme social withdrawal prevents most people from entering therapy unless some other disorder makes treatment necessary. - patients are likely to remain emotionally distant from the therapist, seem not to care about treatment, and make limited progress.

theoretical explanations of BPD

-Psychodynamic: early parental relationships (objects relations theory- lack of early acceptance or abuse/neglect by parents) -- some research support -Biological: genetic predisposition, lower brain serotonin activity, abnormal brain structure/circuit activity and anatomy -sociocultural: impact of rapidly changing cultures may fuel a sense of instability -biosocial: combination of internal and external forces- children have intrinsic difficulty identifying and controlling emotions, parent teach them to ignore their feelings -developmental psychotpathology: childhood traumas and dysfunctional parental attachments lead to flawed capacity for healthy relationships, positive factors can counter -- mentalization deficits

common terminology- diversity in transgender identity

-ftm: female to male -mtf: male to female -genderqueer/nonbinary: identifying as neither man nor woman -assigned male/female at birth: referring to biological sex when born

course of schizophrenia

-Schizophrenia usually first appears between the late teens and mid thirties Three phases -Prodromal: Beginning of deterioration; mild symptoms (may withdrawal socially, speak in vague or odd ways, express little emotion) -Active: Symptoms become apparent (sometimes triggered by stress or trauma) -Residual: Return to prodromal like levels Each phase of the disorder may last for days or years A fuller recovery from the disorder is more likely in people: -With good premorbid functioning -Whose disorder was triggered by stress -With abrupt onset -With later onset (during middle age) -Who receive early treatment -(25%) One fourth of patients fully recover; three fourths continue to have residual problems.

biochemical changed in brain and alzheimer's

-Several chemicals: acetylcholine, glutamate, RNA (ribonucleic acid), and calcium— production of the memory-linked proteins -if any chemicals are disturbed, the proper production of proteins may be prevented and memories interrupted -blocking activity of glutamate, animal researchers have prevented the operation of short-term memory -blocking cellular production of RNA or of calcium, interrupted the formation of long-term memories

negative symptoms - restricted affect

-Show less emotion than most people -Avoidance of eye contact -Immobile, expressionless face -Blunted affect -Flat affect

theoretical explanations for schizotypal personality disorder

-Similar factors are at work in schizotypal personality disorder and schizophrenia and related disorders -Symptoms linked to family conflicts and to psychological disorders in parents -Schizotypal personality disorder is linked to some of the same biological factors found in schizophrenia, such as high activity of the dopamine, enlarged brain ventricles, smaller temporal lobes, and loss of gray matter -Links to mood disorders, especially depression, have been found-- More than half of people with schizotypal personality disorder also suffer from major depressive disorder at some point in their lives

positive symptoms of schizophrenia - inappropriate affect

-Situationally unsuitable -May sometimes be an emotional response to other disorder features -any range of emotion that does not fit the content of the situation -may laugh when describing serious events -may have explainable mood shifts -may become angry in positive situations -may be inappropriately intense -might be caused by internal stimuli (hallucinations) --investigators found more blood flow in Broca's area while patients were having auditory hallucinations

psychomotor symptoms of schizophrenia

-Slow, awkward movements, repeated grimaces, and odd gestures that have a private purpose -Movements seem to have a magical quality -catatonia; includes repetitive or purposeless over-activity, resistance to passive movement -catatonic stupor; stop responding to their environment, remain motionless and silent for long stretches of time -catatonic rigidity; maintain rigid, upright posture for hours and resist efforts to be moved -catatonic posturing; assuming awkward, bizarre positions for long periods -catatonic excitement; move excitedly sometimes waving arms and legs -Experienced by about 10 percent of people with schizophrenia

Autism Spectrum Disorder (other)

-Social challenges -Responsiveness -Social reciprocity -Aloofness -Difficulty sharing attention -Communication challenges -Difficulty developing or understanding speech -Difficulty understanding/interpreting nonverbal behaviors -Echolalia - repeating what is said rather than generating a new response -Pronominal Reversal - mixing self pronouns (i am hungry but say you are hungry) -Rigid and repetitive behaviors -Rituals and become upset with deviations from routine/normalcy -Rigid or unusual motor movements: jumping, flapping, twisting -Self stimulatory behaviors -Deficits in social communication and social interaction -Restricted repetitive behaviors, interests, and activities. -Typically appear before age 3 -as many as 1 in 68 children display this pattern -80% of all cases occur in boys -90% of children remain significantly impaired into adulthood **It is a SPECTRUM there is A LOT of variability in symptoms and presentation**

sociocultural views of schizophrenia - social labeling

-Social labeling: some features are influenced by the diagnosis itself -Self fulfilling prophecy -Society labels people who fail to conform to certain norms of behavior -Once assigned, the label becomes a self fulfilling prophecy -Other people treat you like you're schizophrenic -dangers of social labeling demonstrated in the famous Rosenhan's (1973) "pseudo patient" study: "Sane in Insane Places"

Autism Spectrum Disorder - theorized causes

-Sociocultural -Cold, rejecting parents? (not supported by research) -Psychological -"Theory of mind"; An awareness that other people base their behaviors on their own beliefs and mental states -"mind-blindness" -Biological -Genetic factor (twin studies) -Prenatal difficulties or birth complications -Differences in brain structures; one line of research has pointed to the cerebellum -Vaccines? -Prevalence studies across the globe have suggested the MMR vaccine does not relate to ASD

mild ID - intellectual dis.

-Some 80 to 85 percent of all people with intellectual disability fall into the category of mild ID -individuals can benefit from schooling and can support themselves as adults -Research has linked mild ID mainly to sociocultural and psychological causes, particularly poor and unstimulating environments during a child's early years, inadequate parent-child interactions, and insufficient learning experiences

treatment for antisocial personality disorder

-Some cognitive therapists try to guide clients with antisocial personality disorder to think about moral issues and about the needs of other people -tried to create a therapeutic community, a structured environment that teaches responsibility toward others -clinicians have also used psychotropic medications, particularly atypical antipsychotic drugs, some report that these drugs help reduce certain features of the disorder

psychosis (schizophrenia)

-State in which a person loses contact with reality in key ways -Most commonly appears as schizophrenia

Definitions of Personality

-Sum total of all typical ways of acting, feeling, and thinking that makes a person different from all others -The unique pattern of psychological and behavioral characteristics that distinguishes each of us from everyone else. -Personality characteristics are relatively stable and enduring, often developed in childhood and affect the way we think, act, feel and behave. -Individual personality patterns are both consistent and stable and unique and distinctive

Psychopathy Measurement

-The Psychopathic Personality Inventory was the first tool to be created, and is based on the work of Cleckley, who was the first to study -The simplest tool for measuring psychopathy, however, is Hare's Psychopathy Checklist -Hare's model argues that psychopathy has four dimensions: 1. Interpersonal ; for example, cunning, conniving, manipulative/charismatic, pathological lying, glib/superficial, grandiose self worth 2. Affective ; for example, callousness/lack of empathy, failure to accept responsibility, lack of remorse or guilt, shallow affect (shallow emotion) 3. Lifestyle ; for example, impulsive, irresponsible, parasitic, lack of realistic goals, stimulation seeking 4. Antisocial ; for example, early behavioral problems, juvenile delinquency, poor behavioral control, persistent rule breaking, criminal versatility.

Checklist: Personality Disorder

-The individual displays a long term, rigid , and wide ranging pattern of inner experience and behavior that leads to dysfunction in at least two of the following realms -Cognition (ways of perceiving and interpreting self, other people, and events) -Emotion (the range, intensity, lability, and appropriateness of emotional response) -Social interactions (interpersonal functioning) -Impulsivity (impulse control) -The individual's pattern is significantly different from that usually found in their culture -The individual experiences significant distress and/or impairment in functioning -Symptoms last for years -Among the most difficult psychological disorders to treat -Affect around 15 percent of the U.S. population at some point in life -Comorbidity with other mental disorders is common

Treatment of Schizophrenia

-Today's treatment picture varies dramatically for patients, families, caregivers, and communities -The treatment outlook is superior to that of past years -Severe mental disorders are still very difficult to treat; only 40 percent of people with schizophrenia receive adequate care

Side effects of antipsychotics

-Unwanted effects of first generation antipsychotic drugs: Extrapyramidal effects -Parkinsonian and related symptoms: Result of medication induced reductions of dopamine activity in striatum -Muscle tremor and rigidity -Bizarre movements of the face, neck, tongue, and back -Great restlessness, agitation, and discomfort in the limbs -In most cases, the symptoms can be reversed if an anti Parkinsonian drug is taken along with the antipsychotic agent. -Sometimes the dosage must be decreased or the medication must be halted altogether. -Neuroleptic malignant syndrome : Potentially fatal reaction, particularly in the elderly -Symptoms include muscle rigidity, fever, altered consciousness, and improper functioning of the autonomic nervous system. -As soon as the syndrome is recognized, drug use is discontinued and each symptom is treated medically. -Individuals may also be given dopamine enhancing drugs -Tardive dyskinesia : Symptoms similar to psychotic symptoms and often overlooked; difficult to eliminate -writhing or tic like involuntary movements, usually of the mouth, lips, tongue, legs, or body

Other Neurocognitive Disorders

-Vascular neurocognitive disorder, for example, follows a cerebrovascular accident, or stroke -Frontotemporal neurocognitive disorder, also known as Pick's disease, is a rare disorder that affects the frontal and temporal lobes (similar to alzheimer's, re autuposy) -Neurocognitive disorder due to prion disease, also called Creutzfeldt- Jakob disease, has symptoms that include spasms of the body (slow-acting virus) -Neurocognitive disorder due to Huntington's disease is an inherited progressive disease in which memory problems, along with personality changes and mood difficulties, worsen over time (children of those w have 50% chance of developing) -Parkinson's disease, slowly progressive neurological disorder marked by tremors, rigidity, and unsteadiness, can result in neurocognitive disorder due to Parkinson's disease, particularly in older people or those whose cases are advanced. -other neurocognitive disorders may be caused by HIV infections, traumatic brain injury, substance abuse, or various medical conditions such as meningitis or advanced syphilis.

biological cont.

-Viral problems -Exposure to viruses before birth triggers a passed on immune response that interrupts fetal brain development -Evidence -Animal model investigations -Circumstantial evidence for this theory comes from the unusually large numbers of people with schizophrenia who were born during the late winter months -Consistent with explanations that point to viral infections and immune system reactions, -Microglia are brain immune cells that provide a first line of defense against brain infections and inflammation. -Microglia are especially active in the brains of people with schizophrenia.

gender dysphoria

-a condition listed in the DSM-5 in which people whose gender at birth is contrary to the one they identify with resulting in impairment and distress -replaces "gender identity disorder" -ICD and other organizations have removed transgender/gender dysphoria from mental diagnosis -may be eliminated in next revision

irresistible impulse test

-adopted in the late 19th century, first used in Ohio in 1834 -A legal test for insanity that holds people to be insane at the time they committed a crime if they were driven to do so by an uncontrollable "fit of passion."

pedophilia and child sexual abuse

-adults sexually abuse for a variety of reasons, not always motivated by underlying sexual interest -emerging evidence that many individuals with pedophilic interest do not abuse children -DSM-5 originally described pedophilia as a type of "sexual orientation" but later revised due to concerns of legitimizing sexual abuse -many researchers believe the term is more accurate

R. D. Laing's View of schizophrenia

-combined sociocultural principles -schizophrenia is actually a constructive process in which people try to cure themselves of the confusion and unhappiness caused by their social environment. -human beings must be in touch with their true selves in order to give meaning to their lives. -Other people's expectations, demands, and standards require us to develop a false self rather than a true one -research simply has not addressed the issue. Laing's ideas do not lend themselves to empirical research

subtypes of HPD (theodore millon identified)

-appeasing: including dependent and compulsive features, personality traits of seeks to placate, mend, patch up, smooth over troubles; knack for settling differences, moderating tempers by yielding, compromising, conceding; sacrifices self for commendation -vivacious: the seductiveness of the histrionic mixed with the energy typical of hypomania, some narcissistic features can also be present; personality traits of vigorous, charming, bubbly, brisk, spirited, flippant, impulsive; seeks momentary cheerfulness and playful adventures; animated, energetic, ebullient -tempestuous: including negativistic features; personality traits of impulsive, out of control; moody complaints, sulking; precipitous emotion, stormy, impassioned, easily wrought-up, periodically inflamed, turbulent -disingenuous: including antisocial features; personality traits of underhanded , double-dealing, scheming, contriving, plotting, crafty, false-hearted, egocentric, insincere, deceitful, calculating, guileful -theatrical: variant of "pure" pattern; personality traits of affected, mannered, put-on; postures are striking, eye-catching, graphic; markets self-appearance; is synthesized, stagy; simulated desirable/dramatic poses -infantile:including borderline features; personality traits of labile, high-strung, volatile emotions; childlike hysteria and nascent pouting; demanding, overwrought; fastens and clutches to another; is overly attached, stays fused to and clinging

criminal behavior

-approximately two-thirds of defendants who are acquitted of a crime by reason of insanity qualify for a diagnosis of schizophrenia, both in North America and Europe -less than 1 of every 400 defendants in the United States is found not guilty by reason of insanity

diagnosis of alzheimer's after death

-as excessive senile plaques and neurofibrillary tangles -Senile plaques are sphere-shaped deposits of a small molecule known as the beta-amyloid protein that form in the spaces between cells in the hippocampus, cerebral cortex, and certain other brain regions, as well as in some nearby blood vessels; exceptionally high in people with Alzheimer's -Neurofibrillary tangles, twisted protein fibers found within the cells of the hippocampus and certain other brain areas; also found in large numbers

biological view of where fetishes come from

-associated with sensation seeking personality -s&m activities release endorphins

cognitive behavioral - treatment for paraphilias

-aversion therapy: pair paraphilic interest with a noxious stimulus -covert sensitization: like aversion therapy, but noxious stimulus is imagines -masturbatory satiation: masturbate to orgasm with desired object, continue masturbating fantasizing about undesired object for 1 hour to get bored of object

Cluster C personality disorders - anxious

-avoidant personality disorder -dependent personality disorder -obsessive-compulsive personality disorder -typically display anxious and fearful behavior -limited research

compare npd to ocd

-both have perfectionist qualities, and the belief that only they can do things right -however, people with OCD are more self-criticizing, while people with NPD think they are perfect

Other Explanations of Alzheimer's Disease

-certain substances found in nature may act as toxins, damage the brain; high levels of zinc, lead -Interpreting shinbone levels of lead as indicators of the person's lifetime exposures to lead: higher a person's lifetime lead exposure, the more poorly performed on memory and language tests. -autoimmune theory: changes in aging brain cells may trigger an autoimmune response (mistaken attack by the immune system against itself ) -viral theory: Alzheimer's disease resembles Creutzfeldt-Jakob disease, another type of neurocognitive disorder that is known to be caused by a slow-acting virus, some researchers propose that a similar virus may cause

gender transition

-changed in gender expression: changing name, pronouns, clothing, often coincides with 'social transition' -changes in hormonal sex: hormone replacement therapy -hair removal -surgical interventions: top surgery, subcutaneous mastectomy for ftm -bottom surgery, phalloplasty, penectomy, etc -includes many providers: psychologists, psychiatrists, doctors, surgeons -many clinics specialize in gender transition/care -increasing question of role of psychologists as 'gatekeepers' of gender transition care

Avoidant Personality Disorder (Cluster C)

-characterized by consistent discomfort and restraint in social situations, overwhelming feelings of inadequacy, and extreme sensitivity to negative evaluation --social avoidant personality disorder= fear of close social relationships --social anxiety disorder= fear of social circumstances --the two may reflect core psychopathology; should be combined -at least 2% of adults have avoidant personality disorder, men as frequently as women

obsessive-compulsive personality disorder

-characterized by intense focus on orderliness, perfectionism, and control and resulting in loss of flexibility, openness and efficiency -unreasonably high standards for self and others and fearing a mistake, may be afraid to make decisions -tendency to be rigid and stubborn -difficulty expressing affection; relationships are often stiff and superficial -as many as 7.9% of the adult population affected; men are twice as likely as women -people with the personality disorder are more likely to suffer with mdd, anxiety disorder, or substance use disorder than form obsessive-compulsive disorder

Cognitive and behavioral treatments for neuro diseases

-cognitive activities, including computer- based cognitive stimulation programs, may help prevent or delay the onset of Alzheimer's disease -physical exercise helps improve cognitive functioning -changing everyday patient behaviors that are stressful for the family, such as wandering at night, loss of bladder control, demands for attention, and inadequate personal care -behavioral therapists use a combination of role-playing exercises, modeling, and practice to teach family members how and when to use reinforcement in order to shape more positive behaviors.

Treatment of HPD

-cognitive theorists: focus on lack of substance and extreme suggestibility found in people with this --general assumption of helplessness to care for self, so individuals seek out other who will meet their needs --try to change their patients' belief that they are helpless and to help them develop better, more deliberate ways of thinking and solving problems -sociocultural/mulitcultural theorists: disorder caused in part by norms/expectations --diagnosed more often in Hispanic american and Latin american and more often in Asian culture -vain, dramatic, and selfish behavior may be an exaggeration of femininity as culture once defined it

brain structure and alzheimer's

-damage to or improper functioning of one or more of these brain areas -short-term memory is prefrontal cortex -structures in transforming short-term memory to long-term memory are the temporal lobes (hippocampus and amygdala) and the diencephalon (mammillary bodies, thalamus, hypothalamus)

sociocultural approaches to neuro diseases

-day-care facilities: providing treatment programs and activities for outpatients during the day, return home at night. -assisted-living facilities

positive symptoms of schizophrenia - delusions

-delusions: ideas that they believe wholeheartedly but that have no basis in fact, person may have a single delusion or many -delusions of persecution: believes they are being stalked, spied upon, obstructed, poisoned, conspired against or harassed by other individuals or an organization -delusions of reference: A neutral event is believed to have a special and personal meaning. -delusions of grandeur: believes they are much greater or more influential than they really are; e.g. believe themselves to be great inventors, religious saviors, or other specially empowered persons. -delusions of control: False belief that another person, group of people, or external force controls one's general thoughts, feelings, impulses, or behavior.

BPD and comorbid disorders

-depression 71% -anorexia 40% -bulimia 33% -alcohol abuse 24% -substance abuse 8% -antisocial 22% -avoidant 21%

subtypes of NPD (millon)

-described in DSM as homogeneous, no sub-types -unprincipled narcissist, including antisocial features -amorous narcissist. including histrionic features -compensatory narcissist, including negativism and avoidant featurs -elitist narcissist, variant of pure pattern -normal narcissist, absent of traits of the other four -fanatic narcissist, including paranoid features -hedonistic narcissist, mix of initial four subtypes -malignant narcissist, including antisocial, sadistic, and paranoid features

Treatments for neurocognitive disorders, alzheimer's - drugs

-drugs for Alzheimer's patients designed to affect acetylcholine and glutamate (important roles in memory)--drugs include tacrine (Cognex), donepezil (Aricept), rivastigmine (Exelon), galantamine (Reminyl), and memantine (Namenda). -vitamin E

NPD Comorbidity

-dysthymic or major depressive disorder -hypomanic moods -anorexia nervosa -substance-related disorders (esp cocaine) -other personality disorders such as histrionic, borderline. antisocial, and paranoid

Disorders of Excitement

-erectile disorder -female sexual interest/arousal disorder

compulsive sexual behavior

-excessive sexual urges, feelings, and behaviors that are distressing and cause impairment -also known as, sex addiction, hypersexuality, out of control sexual behavior -hypersexual disorder proposed for DSM-5 ; excluded due to lack of research compulsive sexual behavior disorder included in ICD-11

Sex therapy techniques - kegels

-exercises to strengthen pelvic floor muscles, same muscles that starts and stops urine flow -beneficial for men and women -increase sexual pleasure and control, decrease pain

transvestic fetishism

-fantasies, urges, or behaviors involving dressing in clothes of the opposite sex to achieve sexual arousal -this behavior causes significant stress or impairment -most commonly hetero men who are aroused by wearing women clothing, makeup, jewelry -not the same as transgender identity -cause possibly behavioral principles of operant conditioning

pedohilic disorder

-fantasies, urges, or behaviors involving sexual activity with prepubescent child -also must be distressed or causing harm due to these desires -may also include child pornography -more common in men; evidence suggest two-thirds of victims are girls -may be attracted to prepubescent children (classic type), early pubescent children (hebephilic type), or both (pedohebephilic type) -Studies have found that most men with pedophilic disorder also display at least one additional psychological disorder -may be related to biochemical or brain structure abnormalities such as irregular patterns of activity in the amygdala or in the frontal areas of the brain, little research

prenatal and birth related causes

-fetal alcohol syndrome A group of problems in a child, including lower intellectual functioning, low birth weight, and irregularities in the hands and face, that result from excessive alcohol intake by the mother during pregnancy. -Birth complications also can lead to problems in intellectual functioning

treatment for paraphilias

-find positive outlets for sexual interests -more complicated for pedophilia, voyeursim, etc -supreme court case ruled "simulated" child pornography is legal under freedom of speech -no research on whether indulging the interest part way will create slippery slope -removing stigma around sexual interest can remove the distress -some practitioners administer drugs called antiandrogens that lower testosterone (may disrupt normal sexual behavior) , SSRIs

Sex therapy techniques - mindfulness techniques

-focus on immediate experience, pleasure -learn to cope with anxieties/pressures can include self-exploration, guided masturbation -useful for problems with orgasm, sexual anxiety, with self or partner

treatment for paraphilias- relapse prevention

-for paraphilias that lead to sexual offending -based on cognitive behavioral treatment for substance abuse -identify triggering situations -address cognitive distortions -some evidence for success among sex offenders

theoretical perspective of obsessive-compulsive personality disorder

-freudian: overly harsh toilet training during anal stage; anal retentive and fixated -cognitive-behavioral: illogical thinking processes

other verdicts

-guilty but mentally ill: A verdict stating that defendants are guilty of committing a crime but are also suffering from a mental illness that should be treated during their imprisonment. -mentally disordered sex offenders: convicted of criminal offense and are thus judged to be responsible for their actions -mental incompetence: A state of mental instability that leaves defendants unable to understand the legal charges and proceedings they are facing and unable to prepare an adequate defense with their attorney.

biological causes of erectile disorder

-hormonal issues -vascular, neurological, or other physical health issues -effects of medication and substance abuse -can be assessed nocturnal penile tumescence (NPT): men normally have several erections during REM sleep, lack of these erections can indicate physiological cause

Biological causes for disorders of desire

-hormones: in both men and women, high levels of prolactin, low levels of testosterone, and/ or high or low levels of estrogen have been linked to low sex drive -may be linked to excessive activity of serotonin and dopamine -chronic illness -medication side effects: birth control pills, pain medication, some psychotropic drugs (SSRIs) -alcohol and other drugs

Psychodynamic therapy - treatment for paraphilias

-identify defense mechanism causing the paraphilia -no evidence for its effectiveness

treatment for disorders of desire

-in addition to sex therapy -affectual awareness; patients visualize sexual scenes in order to discover any feelings of anxiety, vulnerability, and other negative emotions they have concerning sex

Dependent Personality Disorder (Cluster C)

-individuals have a pervasive, excessive need to be cared for -clinging and obedient; fear separation from loved ones; distressed, lonely, sad, and prone to self-dislike -reliance on others so the smallest decision cannot be made -difficulty with separation is central feature -affects fewer than 1% of population; equal occurance in male and females

Sex therapy techniques - sensate focus/nondemand pleasuring

-instruct couple in intimate touching exercise: no toughing genitals, no sex, focus on what feels good, communicate with partner -why it works: changes sexual script, takes pressure off 'performance', refocuses attention on pleasure and intimacy used to treat: erectile dysfunction, delayed/lack of orgasm, premature ejaculation, sexual pain/anxiety

frotteuristic disorder

-intense fantasies, urges, or behaviors involving touching and rubbing against a nonconsenting person -typically in crowded public place -almost always male, the person fantasizes during the act that he is having a caring relationship with the victim -usually begins in the teen years or earlier -acts generally decrease and may disappear after 25

paraphilic disorders

-intense sexual urges, fantasies, or behaviors involving objects or situations outside the usual sexual norms -can include sexual behaviors/urges/fantasies about: objects or non genital body parts, children, non consenting adults, experience of suffering or humiliation -cause significant distress for the individual or violating the rights of others

fetish disorder

-intense sexual urges, sexually arousing fantasies, or behavior that involves the use of a nonliving or nongenital body part, often to the exclusion of all other stimuli -fetishistic disorder involves fetishes that lead to severe impairment or distress most common: feet, bodily fluids, hair, body hair, underwear, diapers, leather. satin, fabrics, full body costumes, balloons

Enuresis

-is repeated involuntary (or in some cases intentional) bed-wetting or wetting of one's clothes -Children must be at least 5 years of age to receive this diagnosis -may be triggered by stressful events, such as a hospitalization, entrance into school, or family problems. In some cases physical or psychological abuse -10 percent meet the criteria for enuresis; in contrast, 3 to 5 percent of 10-year-olds and 1 percent of 15-year-olds have enuresis

positive symptoms of schizophrenia - formal thought disorder symptoms (disorganized thinking and speech)

-loose associations or derailment: cognitive disruption characterized by an illogical, unfocused, or vague train of thought. (example, when asked how one is feeling, the person might reply, "Healthy, wealthy, and wise. Three wise men run the bank, you know; they have the wealth of nations.")

delirium

-major disturbance in attention and orientation to the environment -difficulty concentrating and thinking in an organized way, leading to misinterpretations, illusions, and sometimes hallucinations -typically develops over a short period of time, usually hours or days -may occur in any age group, including children, but is most common in elderly people -Fewer than 0.5 percent of the nonelderly population experience delirium, 1 percent of people over 55 and 14 percent of those over 85 -Fever, certain diseases and infections, poor nutrition, head injuries, strokes, and stress, subtance intoxication (including the trauma of surgery) may all cause delirium -can often be easy to correct—by treating the underlying infection, for example, or changing the patient's drug prescription

Disorders of Desire

-male hypoactive sexual desire disorder -female sexual interest/arousal disorder

sexual masochism disorder and sexual sadism disorder

-masochism: arousal from being humiliated, beaten, bound, or otherwise made to suffer, have fantasies of being forced into sexual acts against their will, but only those who are very distressed or impaired by the fantasies receive this diagnosis. -sadism: arousal from inflicting psychological or physical suffering on another -disorder involves significant distress, impairment, violating others rights, or engaging in unsafe behaviors -biological studies have found signs of possible brain and hormonal abnormalities in people with sexual sadism

neurocognitive disorder

-may also undergo personality changes and their symptoms may worsen steadily -44 million people with neurocognitive disorders around the world, with 4.6 million new cases emerging each year -cases is expected to reach 135 million by 2050 unless a cure is found -Among people 65 years of age, prevalence is 1 to 2 percent, increasing to as much as 50 percent in ages over 85 -Alzheimer's disease is the most common type of neurocognitive disorder, accounting for around two-thirds of all cases

medical/physical interventions - physical

-medical procedures to reduce pain in genitals -botox injections for vaginal muscles -surgical implants for erectile issues -vacuum erection device-directed masturbation training (female orgasmic disorder)

Metabolic Causes of intellectual disabilities

-metabolic disorders that affect intelligence and development are typically caused by the pairing of two defective recessive genes, one from each parent -most common metabolic disorder to cause intellectual disability is phenylketonuria (PKU), which strikes 1 of every 14,000 children -cannot break down the amino acid phenylalanine -Tay-Sachs disease, another metabolic disorder resulting from a pairing of recessive genes -progressively lose their mental functioning, vision, and motor ability over the course of two to four years, and eventually die -One of every 30 persons of Eastern European Jewish ancestry carries the recessive gene responsible for this disorder -1 of every 900 Jewish couples is at risk for having a child with Tay-Sachs disease.

compare npd to aspd

-ndp is not characteristically impulsive -npd is not an aggressive disorder -npd individuals not purposefully deceitful -npd requires more admiration from others -npd individuals may lack the conduct disorder from childhood or criminal behavior in adulthood

positive symptoms of schizophrenia - thought disorder symptoms (disorganized thinking and speech) more cont

-neologisms: the inventions of new words or distortion of existing ones, often to match some self perceived meaning. -Describing the " wretchedivism " of your tetramatic " lifestyle would be an example.

compare npd to hpd

-npd has excessive pride in achievements -npd has a lack of emotional display -npd has a lack of concern for others' sensitivities

compared npd to bpd

-npd has stable self-image -npd has a lack of self-destructiveness, impulsivity and fear of abandonment

treatment for NPD

-one of the most difficult personality patterns to treat -difficult because most people with NPD will not seek treatment -usually directed by others to begin therapy -people with NPD fear that therapy will expose their weakness -individuals may try to manipulate therapists to support their sense of superiority - psychodynamic: recognize and work through basic insecurities and defenses -cognitive-behavioral: focus on self-centered thinking and redirection -no major approaches have much success

cognitive- behavioral view of schizophrenia

-operant conditioning and misinterpretations -Operant conditioning explanations focus on reinforcement -Not reinforced for their attention to social cues and, as a result, they stop attending to those cues and focus instead on irrelevant cues (e.g., room lighting) -Their responses become increasingly bizarre yet are rewarded with attention and, therefore, are likely to be repeated -Circumstantial support; more recently viewed as a partial explanation

problems with paraphilic disorders

-origin of these diagnoses is more moral than scientific -early DSM diagnoses viewed any deviation from "coitus" as a disorder -reviewed by many as relics from another era -homosexuality

psychological causes of erectile disorder

-other psychological disorders (anxiety, depression, etc) -90% of men with severe depression experience some degree of ED -(cognitive-behavioral theory x masters and johnson) performance anxiety & spectator role: anxious about ability to "perform" during sex, pulls attention away from in the moment pleasurable sensations

psychological causes of disorders of desire

-other psychological problems: anxiety, depression, anger, etc -fear and anxiety response to sex (traumatic experience, sex-negative beliefs and attitudes

treatment for obsessive-compulsive personality disorder

-people do not usually think theres something wrong with them -unlikely to seek treatment unless also suffering from another disorder, most frequently anxiety or depression -individuals often respond well to psychodynamic or cognitive therapy -clinicians report success with SSRIs

clinical picture of schizophrenia - positive, negative, psycho-motor symptoms

-person could have positive, negative, or both types of symptoms -the symptoms, triggers, and course of schizophrenia vary greatly -some clinicians have argued that schizophrenia is actually a group of distinct disorders that share common features

Disorders of Orgasm

-premature ejaculation -delayed ejaculation -female orgasmic disorder

disorders of cognition

-problems in memory and related cognitive processes can occur without biological processes as dissociative disorders -more likely, cognitive problems have organic roots -leading such disorders among the elderly are delirium, major neurocognitive disorder, and mild neurocognitive disorder

positive symptoms of schizophrenia - heightened perceptions and hallucinations

-problems of perception and attention: People may feel that their senses are being flooded by sights and sounds, making it impossible to attend to anything important. -Hallucinations: Sensory perceptions that occur in the absence of external stimuli. -Most common are auditory -seem to be spoken directly to, or overheard by, the hallucinator -Hallucinations can involve any of the other senses: tactile (tingling, burning, electric shock sensations), somatic (feel like something is happening inside the body), visual, gustatory (taste), or olfactory (smell).

orgasm gap

-problems with reaching orgasm much more common in women (21%), then men (10%) -10% of women report never having an orgasm, another 9% report infrequent orgasm

Explanations of Antisocial Personality Disorder

-psychodynamic theorists propose that this one begins with an absence of parental love during infancy, leading to a lack of basic trust -behavioral theorists have suggested that antisocial symptoms may be learned through modeling, or imitation -cognitive view says that people with antisocial personality disorder hold attitudes that trivialize the importance of other people's needs -biological factors: lower serotonin activity, deficient functioning in their frontal lobes, particularly in the prefrontal cortex, low brain and bodily arousal, such as slow autonomic arousal and slow EEG waves

sociocultural view of schizophrenia - family dysfuntion

-schizophrenia is linked to family stress -Parents of people with the disorder often 1. Display more conflict 2. Have greater difficulty communicating 3. Are more critical of and overinvolved with their children than other parents -some families are high in "expressed emotion" family members frequently express criticism and hostility and intrude on each other's privacy -People with schizophrenia are often difficult to live with, so dysfunctional families are maybe a consequence, rather than a cause , of the disorder

theoretical explanations of NPD

-psychodynamic: cold, rejecting parents --lack of healthy, empathetic attachments with primary caregivers --the child begins to feel unwanted and unconnected to others --unconscious belief that oneself is "flawed in a way that makes the person fundamentally unacceptable to others" thus focus on grandiose self-presentation; self-sufficiency to compensate and replace warm relationships --Freud thought that it is common in everyone because at some point "all human infants pass through a phase of primary narcissism in which they assume they are the center of their universe. the phase ends when the baby is forced by the realities of life to recognize that it does not control its parents but in fact entirely dependent on them -cognitive behavioral: excessive amounts of pampering --may develop when people are treated too positively rather than too negatively in early life; overvalue self-worth --excessive admiration that is never balanced with realistic feedback --valued by parents as a mean to regulate their own self-esteem -sociocultural theorists: see link between narcissistic personality disorder and eras of narcissism in society -mass media's preoccupation with "lifestyles of rich and famous" rather than with ordinary or average people --social approval of open displays of money, status, or accomplishments rather than modesty and self-restraint --growth of large corps and gov bureaucracies that favor a managerial style based on "impression management" rather than objective measurements of performance --social trends that encourage parents to be self-centered and to resent their children's legitimate needs -weakening of institutions that traditionally helped children to see themselves as members of a community rather than as isolated individuals (churches, social)

treatments for BPD

-psychodynamic: relational psychoanalytic therapy, dialectical behavior therapy -biological: antidepressant, anti-bipolar, anti-anxiety, or anti-psychotic drugs as adjuncts to psychotherapy -no meds shown to be effective for BPD -meds is for comorbid disorders not for BPD symptoms -sedatives should not be used for more than a week -anti-psychotics can have short term benefits- cognitive-perceptual, anger, mood lability

treatment for dependent personality disorder

-psychodynamic: transference of dependency needs -cognitive-behavioral: often combines interventions --behavioral: assertiveness training to cope --cognitive: challenge and change incompetence and helplessness assumptions -biological: anti-depressant drug therapy, when disorder is comorbid with depression -groups therapy format

theoretical explanations of HPD

-psychodynamic: unhealthy relationships with cold, controlling parents in childhood; feelings of being unloved and fear of abandonment; dramatic crisis invented for protection -cognitive-behavioral: lack of substance and extreme suggestibility tied to self-focused and emotional behavior; search for others to meet needs related to sense of helplessness -sociocultural/multicultural: partially influenced by cultural norms and expectations

theoretical perspectives of dependent disorder

-psychodynamic; similar to depression --freudian: unresolved conflicts during oral stage -object relations theory: early parental loss or rejection prevents normal attachment and separation -other psychodynamic: over involvement or overprotection -behavioral: unintentional clinging and loyal behavior rewarded by dependent parents -cognitive: maladaptive behaviors --inadequate and helpless to deal with the world --need to find a person to provide protection

Double Bind Theory (Schizophrenia)

-psychological explanation which can be classified as a sociocultural explanation -bateson suggested that schizophrenia is best understood as a wider problem occurring within the family -it is not an inborn mental disorder but instead is a learned confusion in thinking -schizophrenia can be attributed to the exposure to, and participation in dysfunctional communication patterns in the family -double blind communication is where a pair of messages are mutually contradictory -family members of individuals with schizophrenia communicate in a destructively ambiguous manner (say I love you in a hateful way) -bateson argued child's ability to respond is incapacitated by the contradictions, prolonged exposure to these interactions prevents the development of a coherent construction of reality -this manifests as schizophrenic symptoms, e.g. flattened affect, delusions, hallucinations, incoherent thinking and speaking as well as paranoia -largely discredited -Except research shows that high expressed emotion (families high in criticism and hostility and intrude on each other's privacy) is tied to relapse -Individuals who are trying to recover from schizophrenia are almost four times as likely to relapse if they live with such a family

law and mental health

-psychology in law; clinical practitioners and researchers operate within the legal system -law in psychology: legislative and judicial systems act upon the clinical field, regulating certain aspects of mental health care. (ex. courts force ppl to enter treatment) -intersections between mental health field and legal and judicial systems are referred to as forensic psychology--may perform such varied activities as testifying in trials, researching the reliability of eyewitness testimony, or helping police profile the personality of a serial killer on the loose

Can Personality Change Over Time?

-relatively stable particularly as we age -Age 30 being a typical point at which personality stops changing as much -However, it is possible to modify personality -Therapy -Maturation -substance use and/or medication

cognitive-behavioral view of where fetishes come from

-result of classical or operant conditioning -treat with aversion therapy, covert sensitization (imagine pleasurable object and repeatedly pair with imagined aversive stimulus until object is no longer desired) -masturbatory satiation (Plaud, 2007; Wright & Hatcher, 2006), client masturbates to orgasm while fantasizing about a sexually appropriate object, then switches to fantasizing in detail about fetishistic objects while masturbating again and continues the fetishistic fantasy for an hour. The procedure is meant to produce a feeling of boredom, which in turn becomes linked to the fetishistic object. -orgasmic reorientation, which teaches individuals to respond to more appropriate sources of sexual stimulation

Psychodynamic view of where fetishes come from

-result of subconscious conflict or childhood trauma -often symbolic meaning to fetish -defense mechanisms that help people avoid anxiety produced by normal sexual contact -little success

biological views- new research

-schizophrenia-related circuit may be two distinct sub-circuits whose various structures sometimes overlap -dysfunction by one sub-circuit (includes the substantia nigra and striatum) might be more responsible for cases of schizophrenia that are characterized by positive symptoms such as hallucinations or delusions -dysfunction by other sub circuit (hippocampus and amygdala) might be responsible for cases of schizophrenia that are dominated by negative symptoms like flat affect and poverty of speech -abnormal neurotransmitter activity is now seen as part of broader circuit dysfunction that can propel people towards schizophrenia

sex therapy

-short-term (15-20 sessions) and instructive therapy to address sexual dysfunction -focus may include: sexuality education, relationship dysfunction; increasing positive, effective communication, challenging problematic sexual script, education about sexuality

sociocultural causes of disorders of desire

-societal attitudes/norms/fears around sex -pressure to "perform around men being 'virile'" -situational pressures, divorce, death in the family, job difficulties

other NPD characteristics

-some make suicide attempts, often to manipulate others -haunted by criticism -low threshold for humiliation -severely impaired relationships -low functioning due to a fear of defeat -common among normal teens and does not usually lead to adult narcisssim similar to histrionic, antisocial, and borderline except for: GRANDIOSITY

Durham test (1954 case)

-soon replaced by most courts -A legal test for insanity that holds people to be insane at the time they committed a crime if their act was the result of a mental disorder or defect

Interventions for ID

-state schools; overcrowded institutions provided basic care, but residents were neglected, often abused, and isolated from society -During the 1960s and 1970s, the public became more aware of these sorry conditions and, as part of the broader deinstitutionalization movement -reforms have led to the creation of small institutions and other community residences

sociocultural causes of erectile disorder

-stress from lost jobs, finances, marital , relationship patterns

substance abuse in later life

-the prevalence of such patterns decline after age 65 -3 to 7 percent of older people, particularly men, have alcohol use disorder in a given year -alcohol problems among older people admitted to general and mental hospitals range from 15 percent to 49 percent, and estimates of alcohol-related problems among patients in nursing homes range from 10 percent to 20 percent -alcohol use disorder is treated with interventions as detoxification, Antabuse, Alcoholics Anonymous (AA), and cognitive-behavioral therapy -A leading substance problem in the elderly is the misuse of prescription drugs (mostly intentional) -antipsychotic drugs are currently being given to almost 30 percent of the total nursing home population in the US, despite the fact that many of the residents do not display psychotic functioning (sedate and manage patients)

theoretical perspectives of avoidant personality

-theorists often assume avoidant personality disorder has the same causes as anxiety disorder; no clear research ties the two together -psychodynamic: focus on shame and insecurity traced to childhood experiences -cognitive-behavioral: harsh criticism in early childhood leads to expected rejection; failure to develop effective social skills

Treatment for avoidant personality disorder

-therapy often sought for acceptance and affection -the therapist gains the individuals trust and tends to treat the disorder in the same way as social phobia and anxiety -cognitive-behavioral: group therapy provides practice in social interactions -anti-anxiety and anti-depressant drugs are sometimes useful; symptoms return when meds stopped

exhibitionistic disorder

-urges to expose genitals in a public setting -sexual contact is rarely initiated or desired -usually begins before age 18 and is most common in males -often upsetting or traumatic for victims -public nudity typically against the law -In a survey of 2,800 men, 4.3 percent of them reported that they perform exhibitionistic behavior

voyeuristic disorder

-urges to view or photo/video others without their knowledge/consent -typically when they are undressing or having sex -may include masturbation -usually begins before the age of 15 and tends to persist -risk of discovery often adds to excitement -class c felony -psychodynamic clinicians propose people are seeking by their actions to gain power over others, possibly because they feel inadequate or are sexually or socially shy

more characteristics of HPD

-usually high-functioning, both socially and professionally -good social skills, despite tending to use them to manipulate others into making them the center of attention -may affect a person's social and/or romantic relationships, as well as their ability to cope with losses or failures -may seek treatment for clinical depression when romantic or other relationships end -fail to see their own personal situation realistically, instead dramatizing and exaggerating their difficulties -may go through frequent job changes, easily bored and may prefer withdrawing from frustration -tend to crave novelty and excitement, placing themselves in risky situations

etiology of pedophilic disorder

-vast majority of research has been on sex offender population -creates bias: non-offenders likely look much different -no convincing evidence for a particular origin -offenders typically have lower-than average intelligence - similar to the experience of LGB sexual orientations -some may have been sexually abused as children -commonly co-occurs with other mental disorders

where do fetishes come from?

-very little research on this, no evidence that they arise from trauma or are a sign of psychopathology -those with specific fetishes or transvestic, masochistic, or sadistic sexual interests often report first knowledge of interest in childhood/adolescence

disorders of sexual pain- vaginismus

-very painful involuntary contractions of the muscles of the outer third of the vagina -estimates are that it occurs in fewer than 1% of all women -most clinicians agree with the cognitive-behavioral theory that vaginismus is a learned fear response

positive symptoms of schizophrenia - thought disorder symptoms (disorganized thinking and speech) even more

-word salad: is a jumble of random words that have no meaning, though because they may be arranged in phrases, they sound as if they are conveying meaning. The words may or may not be grammatically correct. An example is "Sheep furiously color greens truths speaking."

Disorders of desire - female: sexual interest/arousal disorder symptoms

1. for at least 6 months, individual usually displays reduced or no sexual interest and arousal, characterized by the reduction or absence of at least three of the following: sexual interest, sexual thought or fantasies, sexual initiation or receptiveness, excitement or pleasure during sex, responsiveness to sexual cues, genital or non genital sensations during sex 2. individual experiences significant distress 38% of women worldwide

Intellectual Disability

1. Individual displays deficient intellectual functioning in areas such as reasoning, problem-solving, planning, abstract thinking, judgment, academic learning, and learning from experience. The deficits are reflected by clinical assessment and intelligence tests. 2. Individual displays deficient adaptive functioning in at least one area of daily life, such as communication, social involvement, or personal independence, across home, school, work, or community settings. The limitations extend beyond those displayed by most other persons of his or her age and necessitate ongoing support at school, work, or independent living. 3. The deficits begin during the developmental period (before the age of 18).

mild neurocognitive disorder checklist

1. Individual displays modest decline in at least one of the following areas of cognitive function: Memory and learning, Attention, Perceptual-motor skills, Planning and decision-making, Language ability, Social awareness. 2. Cognitive deficits do not interfere with the individual's everyday independence.

major neurocognitive disorder checklist

1. Individual displays substantial decline in at least one of the following areas of cognitive function: Memory and learning, Attention, Perceptual-motor skills, Planning and decision-making, Language ability, Social awareness. 2. Cognitive deficits interfere with the individual's everyday independence.

neurocognitive disorder due to alzheimer's disease

1. Individual displays the features of major or mild neurocognitive disorder. 2. Memory impairment is a prominent feature. 3. Genetic indications or family history of Alzheimer disease underscore diagnosis, but are not essential to diagnosis. 4. Symptoms are not due to other types of disorders or medical problems. -Around 5 million people in the US currently have this disease, expected to triple by 2050 -sometimes appears in middle age (early onset), but in the vast majority of cases it occurs after the age of 65 (late onset) -prevalence increases markedly among people in their late 70s and early 80s -named after Alois Alzheimer, the German physician who formally identified it in 1907 -may survive for as many as 20 years, the time between onset and death is typically 8 to 10 years -Alzheimer's disease is currently responsible for close to 84,000 deaths each year in the US; 6th leading cause of death in the country, third leading cause among the elderly

delirium checklist

1. Over the course of hours or a few days, individual experiences fast-moving and fluctuating disturbances in attention and orientation to the environment. 2. Individual also displays significant cognitive disturbance.

disorders of sexual pain - genito-pelvic pain/penetration disorder

1. for at least 6 mo, individual repeatedly experiences at least one: difficulty having vaginal penetration intercourse, significant vaginal or pelvic pain, significant fear that vaginal penetration will cause pain, significant tensing of the pelvic muscles during penetration 2. significant distress -can be diagnosed in men and women; more common in women -pain could have variety of causes: anxiety around sexual activity, trauma, expectations -cognitive behavioral; learned fear response set off by women expectation that intercourse will be painful -pelvic pain without contractions; dyspareunia, more than 14% of women, usually physical cause (childbirth)

Cleckley's "The Mask of Sanity" 16 Psychopathy Traits

1. Superficial charm and good intelligence: more often than not the typical psychopath makes a distinctly positive impression on first meeting. He seems to embody the concept of a well adjusted happy person. He does not seem to be artificially exerting himself like one who is covering up or who wants to sell you a bill of goods. He looks like the real thing. 2. Absence of delusions and other signs of irrational thinking: excellent logical reasoning is maintained and in theory the patient can foresee the consequences of injudicious or anti social acts, outline good plans and criticize their former mistake 3. Absence of nervousness or psychoneurotic manifestations : they seem immune to nervousness or anxiety. They show extraordinary poise and a smooth sense of well being. No fear. 4. Unreliability: although they give an early impression of being a thoroughly reliable person, it will soon be found that on many occasions he shows no sense of responsibility at all, no matter how urgent the circumstances. However, they are capable of exhibiting spurts of responsible behavior. So its impossible to predict their unreliability. 5. Untruthfulness & insincerity : they can lie under any circumstances with the utmost comfort. Often they lie with no good reason. Simply to practice skill at lying. 6. Lack of remorse & shame : usually they deny all responsibility and directly accuse others as responsible. No matter how outlandish their misdeeds , they never exhibit any real embarrassment or guilt. 7. Inadequately motivated antisocial behavior : they will commit theft, forgery, adultery, fraud for astonishingly small stakes. 8. Poor judgement and failure to learn by experience: punishment, no matter how distasteful has no effect in changing the behavior of a psychopath. 9. Pathologic egocentricity and an incapacity for love: probing will always reveal an extreme self centeredness that is apparently unmodifiable and all but complete. 11. Specific loss of insight : cannot see himself as others see 10. General poverty in major affective reactions : though they display appropriate emotional reactions, all such expressions lack depth and sincerity. 12. Unresponsiveness in general interpersonal relations : i.e. They don't exhibit real trust or appreciation. 13. Fantastic and uninviting behavior with drink and sometimes without : includes vulgarity, domineering, rudeness, petty bickering, buffoonish quasi mauling of women. For psychopaths these behaviors emerge after only a few drinks. Other examples include: sitting under a porch striking matches all night or urinating from the window of a building on to passerbys on the street below. 14. Suicide rarely carried out : no sign of genuine suicide attempts. 15. Sex life is impersonal, trivial, and poorly integrated 16. Failure to follow any life plan

Disorders of Desire - male: hypoactive sexual desire disorder symptoms

1. for at least 6 months, individual repeatedly experiences few or no sexual thoughts, fantasies, or desires 2. individual experiences significant distress about this 18% of men worldwide have this disorder

disorders of excitement- men: erectile disorder symptoms

1. for at least 6 months, individual usually finds it very difficult to obtain an erection, maintain an erection, and/or achieve past levels of erectile rigidity during sex 2. individual experiences significant distress Occurs in abt 25% of male population, most are over 50 (7% under 40)

sexual dysfunction

30% of men and 45% of women around the world suffer form dysfunction during their lives

M'Naghten test or rule (England 1843)

A legal test for insanity that holds people to be insane at the time they committed a crime if, because of a mental disorder, they did not know the nature of the act or did not know right from wrong.

American Law Institute Test (1955)

A legal test for insanity that holds people to be insane at the time they committed a crime if, because of a mental disorder, they did not know right from wrong or could not resist an uncontrollable impulse to act. -criticized for being too liberal

borderline personality disorder (dramatic, cluster b)

A personality disorder characterized by repeated instability in interpersonal relationships, self-image, and mood and by impulsive behavior. -many engage in self-injurious or self-mutilation behaviors, such as cutting or burning themselves -Studies suggest that around 75 percent of people with borderline personality disorder attempt suicide at least once; as many as 10 percent actually commit suicide -found in 5.9% of US adults: 75 percent are women

Histrionic personality disorder checklist

A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five or more of the following: -is uncomfortable in situations in which they are not the center of attention -interaction with others is often characterized by inappropriate sexually seductive or provocative behavior -displays rapidly shifting and shallow expression of emotions -consistently uses physical appearance to draw attention to self -has a style of speech that is excessively impressionistic and lacking in detail -shows self-dramatization, theatricality, and exaggerated expression of emotion -is suggestible: easily influenced by others or circumstances -considers relationships to be more intimate than they actually are

APD Diagnosis

Antisocial personality disorder (psychopaths, sociopaths) -A. Disregard for and violation of others rights since age 15, as indicated by one of the seven sub features: -Failure to obey laws and norms by engaging in behavior which results in criminal arrest, or would warrant criminal arrest -Lying, deception, and manipulation, for profit or self amusement, -Impulsive behavior -Irritability and aggression, manifested as frequently assaults others, or engages in fighting -Blatantly disregards safety of self and others, -A pattern of irresponsibility and -Lack of remorse for actions -B. The person is at least age 18, -C. Conduct disorder was present by history before age 15 -D. and the antisocial behavior does not occur in the context of schizophrenia or bipolar disorder -Found in 3.6 percent of U.S. adults, four times more common in men than in women -Higher rate of alcoholism, substance use disorder, or childhood conduct disorder and ADHD

Mnemonic for Antisocial PD

C cannot follow law O obligations ignored R remorselessness R recklessness U underhandedness P planning deficit T temper

Coping Cat Program manualized CBT for child anxiety

Child treatment focuses on: -Changing irrational/unhelpful thoughts (something bad is going to happen") -Teaching coping skills to calm down (e.g., relaxation) -Gradually facing or confronting fears (exposure) -Caregiver treatment focuses on: -Reinforcing skills taught child, supervise homework' (e.g., exposure, coping practice)

Treatment for Internalizing Disorders

Cognitive Behavioral Therapy -Emphasizes the connection between thoughts, feelings and behaviors -Identifying and labeling emotions -Behavioral component - activation, facing fears -Cognitive component - recognizing unhealthy thoughts -Mainly individual treatment with the child or adolescent -Caregiver involvement helpful to: -Increase understanding/awareness of child internal distress -Support child in adopting new thoughts and using new skills for handling

negative symptoms of schizophrenia

Deficits in normal thought, emotions, or behaviors -poverty of speech -blunted and flat affect -loss of volition -social withdrawal

biochemical abnormalities of schizophrenia

Dopamine hypothesis -Certain neurons using dopamine fire too often and transmit too many messages -Messages from dopamine sending neurons to dopamine receptors neurons, particularly to the D2 receptors, may transmit too easily -This theory is based on the effectiveness of anti-psychotic medications problems with dopamine hypothesis -new types of anti-psychotic drugs are more effective and bind to D1 receptors and to serotonin receptors -theorists claim that excessive dopamine activity contributes primarily to the positive symptoms, which respond well to conventional anti-psychotic drugs that bind to d-2 receptors -schizophrenia may be related to abnormal activity or interactions of both dopamine and other neurotransmitters, rather than abnormal dopamine activity alone -studies suggest that negative symptoms may be related to abnormal brain structure and circuitry rather than dopamine over activity -Studies suggest that a dysfunctional brain circuit may lead to schizophrenia. -This circuit includes the prefrontal cortex, hippocampus, amygdala, thalamus, striatum, and substantia nigra , among other structures.

paraphilic disorders in the DSM-5

Involving "atypical" sexual desire -fetishistic disorder -transvestic disorder -sexual masochism disorder -sexual sadism disorder Involving non-consenting others -exhibitionistic disorder -voyeuristic disorder -frotteuristic disorder -pedophilic disorder

The late 1800s - mid 1900s: long term hospitalization became the rule once again

Overcrowding and understaffing created dramatic changes -Mental hospitals warehoused inmates and provided minimal care -Shift to earlier treatment using restraints, isolation, and punishment -"Back wards" - hide the patient -Straitjackets, and handcuffs -Most common pattern of decline was social breakdown syndrome: extreme withdrawal, anger, physical aggressiveness, and loss of interest in personal appearance and functioning -Lobotomy

positive symptoms of schizophrenia - added onto what would be the normal range of behavior

Pathological excesses or bizarre additions to normal thoughts, emotions, or behaviors: delusions, disorganized thinking, and speech, heightened perceptions and hallucinations, and inappropriate affect

Schizophrenia

Psychotic disorder in which personal, social, and occupational functioning deteriorate as a result of unusual perceptions, odd thoughts, disturbed emotions, and motor abnormalities -1 of 100 experience schizophrenia during lifetime -24 million worldwide; 2.5 million in the United States -Equally distributed between men and women -Average age at onset: 23 for men; 28 for women

CBT for Trauma related Anxiety Trauma focused CBT (TF CBT)

Similar to CBT: -Changing irrational/unhelpful trauma related thoughts (" I am in danger", "It was my fault") -Teaching coping skills to calm down (e.g., relaxation) -Caregivers reinforce new thinking and supporting use of skills to cope with anxieties and fears -Trauma focus: -Gradually facing or confronting fears (exposure): -Remembering trauma on purpose in safe environment -Facing reminders in the real world that are not really dangerous -Putting experience into perspective

Geropsychology

The field of psychology concerned with the mental health of elderly people. -4 percent of clinicians work primarily with elderly persons

Personality Disorders cont.

This categorical approach, assumes that: -Problematic personality traits are either present or absent -A personality disorder is either displayed or not -A person who suffers from a personality disorder may not be markedly troubled by personality traits outside of that disorder These assumptions are frequently contradicted in clinical practice -The symptoms of the personality disorders overlap so much that it can be difficult to distinguish one disorder from another -In addition, diagnosticians sometimes determine that particular individuals have more than one personality disorder -The frequent lack of agreement between clinicians and diagnosticians has raised concerns about the validity (accuracy) and reliability (consistency) of these categories. -Diagnoses of such disorders can easily be overdone

Trait vs. State

Trait -Distinguishing characteristics or qualities possessed by the individual -Consistent patterns of thoughts, feelings and actions State -Temporary behavioral tendency -How one responds in a particular situation -Behavioral signatures: intraindividual situation behavior patterns that are characteristic, distinctive patterns of behavioral variability in response to certain features of situations

criminal commitment

When people accused of crimes are judged to be mentally unstable, they are usually sent to a mental institution for treatment

Encopresis

a childhood disorder characterized by repeated defecating in inappropriate places, such as one's clothing -starts at the age of 4 or older, and affects about 1.5 to 3 percent of all children -much more common in boys than in girls. -may stem from stress, biological factors such as constipation, improper toilet training, or a combination of these factors -The most common and successful treatments for encopresis are behavioral and medical approaches or a combination of the two

Anosognosia

a deficit of self-awareness; a condition in which a person with a disability is unaware of its existence

transgender

a gender identity or performance that does not fit with cultural norms related to one's assigned sex at birth

Histrionic Personality Disorder (dramatic, Cluster B)

a personality disorder characterized by a pattern of excessive emotions and attention seeking, including inappropriately seductive behavior and an excessive need for approval, usually beginning in early adulthood -lively, dramatic, vivacious, enthusiastic, and flirtatious -affects 4 times as many women as men -2-3% in the general population, 10-15% in inpatient and outpatient mental health institutions

NPD Checklist

a pervasive pattern of grandiosity (in fantasy or behavior), a constant need for admiration, and a lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by the presence of at least 5 of the following: -a grandiose sense of self-importance; exaggerates achievements and talents, expects to be recognized as superior -a preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love -a belief that they are special and unique and can only be understood by, or should associate with, other high-status people or institutions -a need for excessive admiration: fragile self-esteem, fishing for compliments -a sense of entitlement: unreasonable expectations of especially favorable treatment or automatic compliance with their expectations -inter-personally exploitative behavior: takes advantage of others to achieve their own ends --lack of sensitivity to the needs and wants of others --expecting far too much out of other people --forming relationships that simply enhance their self-esteem --being greedy with material resources -lack of empathy: unwilling to recognize or identify with the feelings and needs of others -envy of others of a belief that others are envious of them -demonstration of arrogant and haughty behaviors or attitudes --criticizing the words of others --snobby attitudes, name calling

borderline personality disorder checklist

a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: -frantic efforts to avoid real or imaged abandonment -a pattern of unstable and intense interpersonal relationships characterized by altering between extremes of idealization and devaluation -impulsivity in at least two areas that are potentially self-damaging (eg. spending, sex, substance abuse, reckless driving, binge-eating) -recurrent suicidal behavior due to marked reactivity of moon (eg, intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days) -chronic feelings of emptiness -inappropriate, intense anger or difficulty controlling anger (eg, frequent displays of temper, constant anger, recurrent physical fights) -transient, stress-related paranoid ideation or severe dissociative symptoms

splitting in BPD

alternating between extremes of idealization and devaluation -failure in a person's thinking to bring together the dichotomy of both positive and negative qualities of the self and others into a cohesive and realistic whole (common defense mechanism) -allows them to readily discard things they have assigned as "bad" and to embrace things they consider "good", even if those things are risky or harmful -difficulty holding opposing thoughts; a person who experiences splitting is unable to weight positive and negative attributes of a person or event or recognize that good and bad attributes can be true at the same time -frame people or events in terms that are absolute with no middle ground for discussion -can sometimes shift back and forth from one moment to the next -often seen to be overly dramatic or overwrought, especially when declaring that things have either "completely fallen apart"-- can be exhausting to those around them -intensely emotional and defensive dynamic -- it can become highly contagious in the workplace, often become "high-conflict" people because they increase conflicts around themselves instead of resolving them -"staff splitting" is a phenomenon in which professionals treating borderline patients begin arguing and fighting about a patient (treatment plant, behavior), and the responsibility is attributed to the patient

criminal responsibility

because people act out of free will, they are accountable for their actions when they violate the law -"Free will" •The law assumes that individuals have free will •Human behavior is the product of free will•Each person has the capacity to make choices and freely act on them •Therefore, people are generally responsible for their actions•Thus, punishment is deemed a just consequence for criminal behavior

Disorders of orgasm- men

delayed ejaculation: many of the same causes as erectile dysfunction, esp performance anxiety premature ejaculation: 30% of men experience at some point, effected by youth, lack of experience recognizing/controlling sexual arousal

Kaplan's Sexual Response Cycle

desire, excitement, orgasm, resolution -Males: ejaculation, Females: physical contractions; also sometimes ejaculation). physiological sexual arousal -males: erection, females: vasocongestion and lubrication

Sexual Disorders in the DSM

disorders of orgasm - premature ejaculation, delayed ejaculation, female orgasmic disorder disorders of excitement- erectile disorder (ED), female sexual interest/arousal disorder disorders of desire- male hypo-active sexual desire disorder, female sexual interest/arousal disorder disorders of sexual pain - genito-pelvic pain/penetration disorders, vaginismus: involuntary contractions of the muscles of the vagina, dyspareunia: severe vaginal or pelvic pain

Response cycle and DSM categories reflect sexual script

disorders of orgasm, disorders of excitement, disorders of desire

Disorders of orgasm- women

female orgasmic disorders: many of the same causes as interest/arousal disorder -25% of women have this to some degree

neurodevelopmental disorders

group of disabilities in the functioning of the brain that emerge at birth or during very early childhood and affect the individual's behavior, memory, concentration, and/or ability to learn -ADHD -Autism -Intellectual disability

Goldwater rule

informal name given to section 7 in the APA principles of medical ethics, which states that it is unethical for psychiatrists to give a professional opinion about public figures whom they have not examined in person, and from whom they have not obtained consent to discuss their mental health in public statements -named after former US Senator and 1964 presidential candidate Barry Goldwater

sexual scripts

initiation, foreplay, penetration, male ejaculation, sometimes females, resolution Issues: sociocultural perspective: places emphasis on heterosexual norms, man's pleasure, reproductive sex, rigid adherence to sexual scripts can cause performance problems (women passive recipients, focus on achieving orgasm or completing the sexual act), sex therapy usually involves challenging scripts.

civil commitment

legal process by which a person can be forced to undergo mental health treatment. -Civil commitment laws vary from state to state•Family members often begin the proceedings -Few guidelines have been offered by the Supreme Court -Minimum standard of proof required (1979): Must be "clear and convincing"proof of illness and of meeting the state's criteria for commitment -Civil commitment has been criticized on several grounds: -It is difficult to assess dangerousness -The legal definitions of "mental illness"and "dangerousness"are vague -Civil commitment has questionable therapeutic value -On the basis of these and other arguments, some clinicians argue that involuntary commitment should be abolished -Others advocate finding a more systematic way to evaluate dangerousness

Erectile disorder treatment

medications -Viagra: introduces in 1998, since then: Cialis, Levitra, Stendra -widespread prescription and recreational use -side effects: flushing, stuffy/runny nose -double standard in sexual dysfunction treatments: no female viagra, more quickly adopted by insurance than bc -penile implant -penis pump -direct injections

Medical/physical interventions - medical

medications: -ed medication (Viagra, tadalafil, vardenafil- effective in 75% of men) -medications to increase female sexual arousal (addy, vyleesi) have not shown as much success -evaluate if current medication cause sexual side effects -SSRI to reduce sexual arousal (premature ejaculation) -no current evidence for "aphrodisiac" (substance to increase sexual desire)

Narcissistic personality disorder (dramatic, cluster b)

narcissus is the origin of the term narcissism, a fixation with oneself and one's own appearance or public perception -in Greek myth, narcissus was a hunter who was known for his beauty and who loved everything beautiful -Narcissus was proud, in that he disdained those who loved him, causing some to commit suicide to prove their unrelenting devotion to his striking beauty

gender identity

one's subjective experience of gender

mnemonic for borderline pd

p- paranoid idea r- relationship instability a- angry outbursts, affective instability, abandonment fears i- impulsive behavior, identity disturbance s- suicidal behavior e- emptiness

negative symptom - social withdrawal

seems also to lead to a breakdown of social skills, including ability to recognize other people's needs and emotions accurately

cisgender

term used when gender identity and/or expression aligns with the sex assigned at birth

Gender

the socially constructed roles and characteristics by which a culture defines categories related to sex - men, women, third gender, nonbinary

"Determinism"

the view that human behavior is determined by biological, psychological, and social forces. •Assumptions about free will and determinism collide in the insanity defense •In the U.S. law, insanity is an exception to criminal responsibility. •The legally insane are assumed not to be acting out of free will.

terms that are generally not used anymore

transsexual- referring to transgender individuals who have undergone physical procedures transvestite- refers to individuals who are aroused by crossdressing

Type 1 and Type II schizophrenia

type I are thought to be dominated by positive symptoms, such as delusions, hallucinations, and certain formal thought disorders (generally seem to have been better adjusted prior to the disorder, to have later onset of symptoms, and to be more likely to show improvement, especially when treated with medications) --positive symptoms of Type I schizophrenia may be linked more closely to biochemical abnormalities in the brain type II have more negative symptoms, such as restricted affect, poverty of speech, and loss of volition --negative symptoms of Type II schizophrenia may be tied largely to structural abnormalities in the brain.

other differential diagnoses

when compared to schizotypal or paranoid PD -NPD is not socially withdrawn and suspicious (unless there is fear or defeat or criticism) when compared to manic/hypomanic episodes -both have grandiose characteristics, but npd does not have rapid mood change or impaired functioning -symptoms not result of substance abuse

sex

whether a person is classified as male or female based on anatomical or chromosomal criteria -anatomical sex: penis and testes /vulva and vagina -hormonal sex: relative levels of androgens and estrogen -chromosomal sex: XY vs. XX