Abnormal Exam 3

theoretical perspectives of ADHD

We know that ADHD tends to run in families, which is suggestive of a genetic contribution. But more direct evidence comes from findings of a higher concordance rate for the disorder among monozygotic (MZ) twins than among DZ (dizygotic) twins Rapidly accumulating evidence from brain-imaging studies of children with ADHD shows dysfunctions in parts of the brain, especially the prefrontal cortex, that regulate attention and impulsive behavior

thought disorder

a disturbance in thinking characterized by the breakdown of logical associations between thoughts Unless we are engaged in daydreaming or purposefully letting our thoughts wander, our thoughts tend to be tightly knit together. The connections (or associations) between our thoughts tend to be logical and coherent.

expressed expressions

a pattern of responding to the schizophrenic family member in hostile, critical, and unsupportive ways Schizophrenia patients from high EE families stand a higher risk of relapsing than those with low EE (more supportive) families High EE relatives typically show less empathy, tolerance, and flexibility than low EE relatives

communication deviance

a pattern of unclear, vague, disruptive, or fragmented communication that is often found among parents and family members of schizophrenia patients. CD is speech that is hard to follow and from which it is difficult to extract any shared meaning. High CD parents often have difficulty focusing on what their children are saying. Evidence shows that parents of schizophrenia patients tend to have higher levels of CD Mixed messages: parents are telling you two different things which makes it difficult to understand actually what they are saying

childhood onset fluency disorder

(also referred to as stuttering) is a disturbance in the ability to speak fluently

neurodevelopmental disorders

-Autism spectrum disorder -Intellectual disability -Specific learning disorder -Communication disorders -Attention-deficit hyperactivity disorder

symptoms of antisocial personality

-Failure to conform to social norms -Irresponsibility -Aimlessness and lack of long term goals or plans -Impulsive behavior -Outright lawlessness -Violence -Chronic unemployment -Marital problems -Lack of remorse -Substance abuse or alcoholism -Disregard for others

symptoms of borderline personality disorder

-Frantic attempts to avoid abandonment -Pattern of intense, unstable relationships -Identity disturbance -Impulsivity in self-damaging areas -Recurrent suicidal or self-harming behavior -Marked mood reactivity -Chronic feelings of emptiness -Difficulty controlling anger -Paranoia or dissociation may be present

symptoms of narcissistic personality disorder

-Grandiose sense of self-importance -Preoccupied with fantasies of success, love, etc. -Believes he or she is "special" and should only associate with other "high status" people -Requires excessive admiration -Sense of entitlement -Interpersonally exploitative -Lacks empathy -Envious of others or believes self to be envied -Arrogant or haughty attitude or behaviors

ADHD: Inattention Symptoms

-Makes careless mistakes -Difficulty sustaining attention during tasks -Does not appear to be listening -Fails to finish tasks he or she has started -Trouble organizing self or activities -Avoids tasks that require mental effort -Loses necessary items -Easily distracted -Forgetful

symptoms of obsessive compulsive personality disorder

-Overly preoccupied with details, order, etc. -Perfectionism interferes with task completion -Devoted to work to the exclusion of leisure (not because of economic necessity) -Inflexible about matters of ethics or morality -Unable to throw away useless objects -Reluctant to delegate tasks to others -Hoards money for anticipated catastrophes -Generally shows rigidity and stubbornness

symptoms of paranoid personality disorder

-Suspects, with no justification, that others are exploiting, harming, or deceiving him or her -Preoccupied with doubts about friends' loyalty -Reluctant to confide in others because of fear that this information will be used maliciously -Reads hidden meaning into benign events -Persistently bears grudges -Frequently perceives attacks on his or her character and reacts swiftly with anger -Excessively suspicious about partner's fidelity

symptoms of histrionic personality disorder

-Uncomfortable when not center of attention -Displays inappropriately provocative behavior -Shifting, shallow emotional expression -Sense of self is focused on physical appearance -Shallow, impressionistic manner of speaking -Theatrical and exaggerated behavior -Easily suggestible -Thinks relationships are unrealistically intimate

symptoms of schizotypal personality disorders

-delusions of reference -strange or "magical" thinking -abnormal perceptual experiences -paranoia (could cause social anxiety) -inappropriate or flat affect -inappropriate appearance -lack of close friends

Otto Kernberg

1975; a leading psychodynamic theorist, views borderline personality in terms of a failure in early childhood to develop a sense of constancy and unity in one's image of oneself and others. From this perspective, borderline individuals cannot synthesize contradictory (positive and negative) elements of themselves and others into complete, stable wholes. Rather than viewing important people in their lives as sometimes loving and sometimes rejecting, they shift back and forth between pure idealization and utter hatred.

Attention-deficit hyperactivity disorder (ADHD)

A behavior disorder characterized by excessive motor activity and inability to focus one's attention ADHD affects between 7% and 9% of school-age children, or some 2 million American youngsters total ADHD is divided into three subtypes: a predominantly inattentive type a predominantly hyperactive or impulsive type a combination type characterized by high levels of both inattention and hyperactivity-impulsivity The disorder is usually first diagnosed during elementary school, when problems with attention or hyperactivity-impulsivity make it difficult for the child to adjust to school. Symptoms, which can vary in intensity from mild to severe depending on the child, must be present prior to age 12 and occur in multiple contents (e.g., at home, at school, or during time with friends).

impulse control disorders

A category of psychological disorders characterized by failure to control impulses, temptations, or drives, resulting in harm to oneself or others. Impulse-control disorders in DSM-5 are grouped in a broader category of disruptive, impulse-control, and conduct disorders that also includes conduct disorder and oppositional defiant disorder. Other impulse control problems, such as compulsive Internet use and compulsive shopping, are presently under consideration for inclusion in the diagnostic manual.

schizophrenia

A chronic psychotic disorder characterized by disturbed behavior, thinking, emotions, and perceptions. Acute episodes of schizophrenia are characterized by delusions, hallucinations, illogical thinking, incoherent speech, and bizarre behavior. Between acute episodes, people with schizophrenia may still be unable to think clearly, may speak in a flat tone, may have difficulty perceiving emotions in other people's facial expressions, and may show little if any facial expressions of emotions themselves.

down syndrome

A condition caused by the presence of an extra chromosome on the 21st pair and characterized by intellectual disability and various physical anomalies. Down syndrome occurs in about 1 in 800 births. It usually occurs when the 21st pair of chromosomes in either the egg or the sperm fails to divide normally, resulting in an extra chromosome.

Alzheimer's Disease

A degenerative brain disease that leads to progressive and irreversible dementia, characterized by memory loss and deterioration of other cognitive functions, including judgment and ability to reason. The risks of AD increase dramatically with advancing age The disease affects about 1 in 8 people age 65 or older and more than 1 in 3 people over the age of 85; more prevalent in women

vascular neurocognitive disorder

A form of major or mild neurocognitive disorder resulting from cerebrovascular events (strokes) affecting the brain The symptoms of vascular neurocognitive disorder are similar to those of dementia of the Alzheimer's type, including impaired memory and language ability, agitation and emotional instability, and loss of ability to care for one's own basic needs; However, AD is characterized by an insidious onset and a gradual decline of mental functioning, whereas vascular dementia typically occurs abruptly and follows a stepwise course of deterioration involving rapid declines in cognitive functioning that are believed to reflect the effects of additional strokes.

intellectual disability

A generalized delay or impairment in the development of intellectual and adaptive abilities. The course of intellectual disability is variable. Many children with intellectual disability improve over time, especially if they receive support, guidance, and enriched educational opportunities. Those who are reared in impoverished environments may fail to improve or may deteriorate further. mental retardation; deficits in conceptual (reading writing), social, and practical aspects

Phenylketonuria (PKU)

A genetic disorder that prevents the metabolization of phenylpyruvic acid, leading to intellectual disability unless the diet is strictly controlled. It is caused by a recessive gene that prevents the child from metabolizing the amino acid phenylalanine, which is found in many foods. a genetic disorder that occurs in 1 in 10,000 to 15,000 births; can be tested for in an amniocentesis

insanity defense

A legal defense in which a defendant in a criminal case pleads not guilty on the basis of insanity. In the aftermath of the Hinckley verdict, the federal government and many states changed their statutes to shift the burden of proof to the defense to prove insanity. Even the American Psychiatric Association went on record as stating that psychiatric expert witnesses should not be called on to render opinions about whether defendants can control their behavior.

dependent personality disorder

A personality disorder characterized by an excessive need to be taken care of by others. Dependent personality disorder is linked to other psychological disorders, including mood disorders and social phobia, as well as to physical problems such as hypertension, cardiovascular disorder, and gastrointestinal disorders like ulcers and colitis There also appears to be a link between dependent personality and what psychodynamic theorists refer to as "oral" behavior problems, such as smoking, eating disorders, and alcoholism

antisocial personality disorder

A personality disorder characterized by antisocial and irresponsible behavior and lack of remorse for misdeeds. People with antisocial personalities often violate the rights of others, disregard social norms and conventions, and, in some cases, break the law. People with antisocial personalities also tend to be impulsive and fail to live up to their commitments to others

avoidant personality disorder

A personality disorder characterized by avoidance of social relationships due to fears of rejection. They may have few close relationships outside their immediate families. They also tend to avoid group occupational or recreational activities for fear of rejection. They prefer to lunch alone at their desks. Avoidant personality disorder, which appears to be equally common in men and women, is believed to affect about 2.4% of the general population

schizotypal personality disorder

A personality disorder characterized by eccentricities of thought and behavior. This disorder is similar to schizophrenia and may share some genetic underpinnings; however, it is usually milder than schizophrenia and neurological dysfunction is less pronounced. It also does not follow an episodic course, as in schizophrenia. Schizotypal personality disorder may be slightly more common in males than in females and is believed to affect about 4.6% of the general population higher rates of the disorder among African Americans than among Caucasians or Hispanic Americans

histrionic personality disorder

A personality disorder characterized by excessive emotionality and an overwhelming need to be the center of attention. People with histrionic personality disorder tend to be dramatic and emotional, but their emotions seem shallow, exaggerated, and volatile. The disorder was formerly called hysterical personality.

obsessive compulsive personality disorder

A personality disorder characterized by excessive orderliness, perfectionism, rigidity, difficulty coping with ambiguity, difficulty expressing feelings, and meticulousness in work habits. People with obsessive- compulsive personality disorder are so preoccupied with the need for perfection that they cannot complete work on time. Their efforts inevitably fall short of their expectations, so they redo their work. Estimates of the prevalence of the disorder vary from 2.1% to 7.9% of the population

narcissistic personality disorder

A personality disorder characterized by inflated or grandiose sense of themselves and an extreme need for admiration. They expect others to notice their special qualities, even when their accomplishments are ordinary, and they enjoy basking in the light of adulation. They are self-absorbed and lack empathy for others. They tend to be preoccupied with fantasies of success and power, ideal love, or recognition for brilliance or beauty Interpersonal relationships are invariably strained by the demands that people with narcissistic personality impose on others and by their lack of empathy with, and concern for, other people. They seek the company of flatterers and, although they are often superficially charming and friendly, their interest in people is one-sided: They seek people who will serve their interests and nourish their sense of self-importance. They have feelings of entitlement that lead them to exploit others.

paranoid personality disorder

A personality disorder characterized by pervasive suspiciousness—the tendency to interpret other people's behavior as deliberately threatening or demeaning. People who have paranoid personality disorder tend to be overly sensitive to criticism, whether real or imagined. Clinicians need to weigh cultural and sociopolitical factors when arriving at a diagnosis of paranoid personality disorder.

major neurocognitive disorder

A profound decline or deterioration in mental functioning characterized by significant impairment of memory, thinking processes, attention, judgment, and by specific cognitive deficits. There are many causes of dementia, including brain diseases, such as Alzheimer's disease (AD) and Pick's disease, and infections or disorders that affect the functioning of the brain, such as meningitis, HIV infection, and encephalitis. In some cases, the dementia can be halted or reversed, especially when it is caused by certain types of tumors, seizures, metabolic disturbances, and treatable infections, or when it results from depression or substance abuse. aphasias (speech) , apraxias (movement) , agnosias (recognizing), executive functioning disturbances

Parkinson's disease

A progressive disease characterized by uncontrollable shaking or tremors, rigidity, disturbances in posture (leaning forward), and lack of control over body movements. Parkinson's disease affects between half a million and one million people in the United States, including the former heavyweight champion Muhammad Ali and the actor Michael J. Fox. The disease affects men and women about equally and most often strikes between the ages of 50 and 69. Dementia occurs in perhaps 80% of Parkinson's patients over the course of the illness.

conduct disorder

A psychological disorder in childhood and adolescence characterized by disruptive, antisocial behavior. Whereas children with ADHD seem literally incapable of controlling their behavior, children with conduct disorder purposefully engage in patterns of antisocial behavior that violate social norms and the rights of others. Whereas children with ADHD throw temper tantrums, children diagnosed as conduct disordered are intentionally aggressive and cruel.

oppositional defiant disorder

A psychological disorder in childhood and adolescence characterized by excessive oppositionality or tendencies to refuse requests from parents and others. Children with ODD tend to be negativistic or oppositional. They defy authority by arguing with parents and teachers and refusing to follow requests or directives.

brief psychotic disorder

A psychotic disorder lasting from a day to a month that often follows exposure to a major stressor

schizophreniform disorder

A psychotic disorder lasting less than 6 months in duration, with features that resemble schizophrenia.

erotomania

A rare delusional disorder in which the individual believes that he or she is loved by someone, usually someone famous or of high social status

cerebrovascular accident

A stroke or brain damage resulting in a disruption in its blood supply, usually as a result of a blood clot that becomes lodged in an artery that services the brain and obstructs circulation

Korsakoff's syndrome

A syndrome associated with chronic alcoholism that is characterized by irreversible memory loss due to brain damage, resulting from deficiency of vitamin B1 (thiamine). People with Korsakoff's syndrome have major gaps in their memory of past experiences and significant difficulty learning new information. They sometimes become grossly disoriented and confused, and require custodial care.

kleptomania

A type of impulse control disorder characterized by repeated acts of compulsive stealing. The stolen objects are typically of little value or use to the person. The person may give them away, return them secretly, discard them, or just keep them hidden at home. In most cases, people with kleptomania can easily afford the items they steal.

pyromania

A type of impulse-control disorder characterized by repeated acts of compulsive fire setting in response to irresistible urges. Pyromania is considered a rare disorder, which may help explain why it remains so poorly understood. People with pyromania feel a sense of release or psychological relief when setting fires and perhaps feelings of empowerment as the result of prompting firefighters to rush to the scene of the blaze.

intermittent explosive disorder

A type of impulse-control disorder characterized by repeated episodes of impulsive, uncontrollable aggression in which people strike out at others or destroy property People with IED have episodes of violent rage in which they suddenly lose control and hit or try to hit other people or smash objects. People with IED typically experience a state of tension before their violent outbursts and a sense of relief afterwards. Typically, people with IED attempt to justify their behavior, but they also feel genuine remorse or regret because of the harm their behavior causes.

schizoaffective disorder

A type of psychotic disorder in which individuals experience both severe mood disturbance and features associated with schizophrenia

Lewy bodies

Abnormal protein deposits that form within the nucleus of cells in parts of the brain, disrupting brain processes that control memory and motor control. It accounts for about 10% of dementias in older adults and has features of both AD and Parkinson's; very common The distinguishing features of the disorder, in addition to profound cognitive decline, is the appearance of fluctuating alertness and attention, marked by frequent periods of drowsiness and staring into space, as well as recurrent visual hallucinations, rigid body movements, and stiff muscles typical of Parkinson's disease; depression

negative symptoms of schizophrenia

Affect the person's ability to function in daily life and include such features as lack of emotions or emotional expression, loss of motivation, loss of pleasure in normally pleasant activities, social withdrawal or isolation, and limited output of speech

symptoms of conduct disorder

Aggression toward people or animals -Bullying -Physical fights -Use of a weapon -Cruelty to others or animals -Stealing -Sexual assault Property destruction -Arson -Vandalism Deceitfulness or theft -Breaking and entering -"Conning" others -Shoplifting or forgery (indirect theft) Serious rule violations -Staying out too late -Runs away from home -Truant from school

antisocial behavior and criminality

Although it is the case that antisocial personality disorder is associated with an increased risk of criminality, not all criminals have antisocial personalities nor do all people with antisocial personality disorder become criminals Many people with antisocial personality disorders are law abiding and successful in their careers, even though they may treat others in a callous and insensitive manner.

hyperactivity

An abnormal behavior pattern characterized by difficulty in maintaining attention and extreme restlessness

theoretical perspectives on autism

An early and now discredited belief held that the autistic child's aloofness was a reaction to parents who were cold and detached—"emotional refrigerators" who lacked the ability to establish warm relationships with their children. (discredited theory) Psychologist O. Ivar Lovaas suggests that children with autism have perceptual deficits that limit them to processing only one stimulus at a time. As a result, they are slow to learn by means of classical conditioning (association of stimuli) brain abnormalities, mix of genetics and enviroment

families theories with schizophrenia

An early, but since discredited theory, focused on the role of the schizophrenogenic mother In what some feminists view as historic psychiatric sexism, the schizophrenogenic mother was described as cold, aloof, overprotective, and domineering. She was characterized as stripping her children of self-esteem, stifling their independence, and forcing them into dependency on her. Children reared by such mothers were believed to be at special risk for developing schizophrenia if their fathers were passive and failed to counteract the mother's pathogenic influences.

splitting

An inability to reconcile the positive and negative aspects of the self and others, resulting in sudden shifts between positive and negative feelings. People with BPD may cling desperately to others whom they first idealize, but then shift abruptly to utter contempt when they perceive the other as rejecting them or failing to meet their emotional needs. individuals with BPD often have very troubled relationships with their family and others

huntington's disease

An inherited degenerative disease that is characterized by jerking and twisting movements, mental deterioration, and unstable moods. Seems to be related to a mutation on a particular gene. The most prominent physical symptoms of the disease are involuntary, jerky movements of the face (grimaces), neck, limbs, and trunk. These twitches are termed choreiform, which derives from the Greek choreia, meaning "dance."

fragile X syndrome

An inherited form of intellectual disability caused by a mutated gene on the X chromosome. The syndrome is the second most common form of intellectual disability overall, after Down syndrome. The disorder is caused by a defective gene in an area of the X sex chromosome that appears fragile, hence the name. This affects 1 out of 1,000 to 1,500 males and 1 out of 2,000 to 2,500 females; more mild effects for females since they have an extra X chromosome

ODD symptoms

Angry or irritable mood -Loses temper -Touchy or easily annoyed -Angry or resentful Argumentative and defiant behavior -Argues with adults or authority figures -Defies or refuses to comply with rules -Deliberately annoys others -Blames others for his or her mistakes Vindictive or spiteful

antipsychotic drugs for schizophrenia

Antipsychotic drugs block dopamine receptors in the brain, which reduces dopamine activity in the brain and helps quell the more obvious symptoms such as hallucinations and delusions. The first generation of antipsychotic drugs included the phenothiazines. Second generation of antipsychotic drugs, referred to as atypical antipsychotics, has largely replaced the earlier generation of antipsychotics and have the advantage of carrying fewer neurological side effects and a lower risk of TD.

biological approaches to schizophrenia

Antipsychotic medication helps control the more flagrant behavior patterns of schizophrenia, such as delusional thinking and hallucinations, and reduces the need for long-term hospitalization. Tardive dyskinesia (TD) - A disorder characterized by involuntary movements of the face, mouth, neck, trunk, or extremities and caused by long-term use of antipsychotic medication. For many patients with chronic schizophrenia, entering a hospital is like going through a revolving door: they are repeatedly admitted and discharged. Many are simply discharged to the streets once they are stabilized on medication and receive little if any follow-up care.

criteria of separation anxiety

At least 3 of the following: -Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures -Persistent and excessive worry about losing major attachment figures or about possible harm to them, such as illness, injury, disasters, or death -Persistent and excessive worry about experiencing an untoward event (e.g., getting lost, being kidnapped, having an accident, becoming ill) that causes separation from a major attachment figure -Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere because of fear of separation -Persistent and excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings -Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure -Repeated nightmares involving the theme of separation -Repeated complaints of physical symptoms (e.g., headaches, stomachaches, nausea, vomiting) when separation from major attachment figures occurs or is anticipated

treatment of encopresis

Behavior therapy techniques are helpful in treating encopresis Involves the parents rewarding (by praise and other means) successful attempts at self-control and using mild punishments for continued accidents.

brain abnormalities model

Brain imaging links borderline personality disorder and antisocial personality disorder to dysfunctions in parts of the brain involved in regulating emotions and restraining impulsive behaviors, especially aggressive behaviors Areas of the brain most directly implicated are the prefrontal cortex (located in the front or anterior part of the frontal lobes) and deeper brain structures in the limbic system. These abnormalities may help explain difficulties with impulse control problems that we see in many people with borderline personality and antisocial personality disorders

causal factors of alzeimers

Clues may lie in understanding the process by which steel-wool-like plaques and tangled nerve fibers form in the brain in AD patients. Whether or not the accumulation of plaque plays a role in explaining memory loss and other symptoms of AD remains unclear. People with a genetic variant called the ApoE4 gene stand a much higher risk of developing AD, perhaps as much as three times greater risk than average We don't yet know which environmental factors may be involved, but stress is a possible culprit.

the DSM groups personality disorders into these three clusters

Cluster A: People who are perceived as odd or eccentric. This cluster includes paranoid, schizoid, and schizotypal personality disorders. Cluster B: People whose behavior is overly dramatic, emotional, or erratic. This grouping consists of antisocial, borderline, histrionic, and narcissistic personality disorders. Cluster C: People who often appear anxious or fearful. This cluster includes avoidant, dependent, and obsessive-compulsive personality disorders.

cognitive behavioral approaches for personality disorders

Cognitive behavior therapists focus on changing clients' maladaptive behaviors and dysfunctional thought patterns rather than their personality structures. They may use techniques such as modeling and reinforcement to help clients develop more adaptive behaviors. Beck's approach focuses on helping the individual identify and correct distorted thinking.

communication disorders

Communication disorders are persistent difficulties in understanding or using language. The categories of communication disorders include language disorder, speech sound disorder, childhood onset fluency disorder, and social (pragmatic) communication disorder. Each of these disorders interferes with academic or occupational functioning or ability to communicate socially

DSM symptoms of autism

Deficits in social communication -Failure to initiate or respond to interactions -Abnormalities in or absence of eye contact -Difficulties engaging in imaginative play Restricted, repetitive behavior or interests -Stereotyped motor movements -Inflexible adherence to routines -Highly restricted, intense interests -Abnormal reactivity to sensory stimulation must have all the defects of social communication and 2 of the restricted behaviors; severe, moderate, or mild must occur in early development, cause distress or interference

aberrant content of thought for schizophrenic patients

Delusions may take many forms. Some of the most common types are: -Delusions of persecution (e.g., "The CIA is out to get me") -Delusions of reference ("People on the bus are talking about me," or "People on TV are making fun of me," or "The neighbors hear everything I say. They've put bugs in the walls of my house") -Delusions of being controlled (believing that one's thoughts, feelings, impulses, or actions are controlled by external forces, such as agents of the devil) -Delusions of grandeur (believing oneself to be Jesus or believing one is on a special mission, or having grand but illogical plans for saving the world)

psychological disorders related to aging

Dementia, or senility, is not the result of normal aging, It is a sign of degenerative brain disease. Screening and testing on neurological and neuropsychological tests can help distinguish dementias from normal aging processes. Generally speaking, the decline in intellectual functioning in dementia is more rapid and severe.

depression and aging

Depression is a common problem affecting many older adults, especially those with a prior history of depression; continuation of a lifelong pattern; medicine as treatment Estimates are that between 1% and 5% of older adults are currently suffering from a diagnosable major depressive episode A much higher proportion of older adults, estimated to be as many as one in three, currently suffer from depressive symptoms that may not warrant a diagnosis but are significant enough to interfere with their quality of life residents of nursing homes, white males, brain disorders, colored individuals, life changes, death of friends/spouse

neurocognitive disorders

Disorders diagnosed on the basis of deficits in cognitive functioning that represent a marked change from the individual's prior level of functioning. Neurocognitive disorders are not psychologically based; they are caused by physical or medical diseases, or drug use/withdrawal that affect the functioning of the brain. In some cases the specific cause of the cognitive disorder can be pinpointed; in others, it cannot.

emotional disturbances

Disturbed emotional response in schizophrenia may involve negative symptoms, such as a loss of normal affect or emotional expression, which is labeled blunted affect or flat affect. Flat affect is observed by the absence of emotional expression in the face and voice. People with schizophrenia may speak in a monotone and maintain an expressionless face, or "mask."

O'Connor v. Davidson

Donaldson, a former patient at a state hospital in Florida, sued two hospital doctors on the grounds that he had been involuntarily confined without receiving treatment for 14 years, despite the fact that he posed no serious threat to himself or others. Donaldson had been originally committed on the basis of a petition filed by his father, who had perceived him as delusional. Despite the fact that Donaldson received no treatment during his confinement and was denied grounds privileges and occupational training, his repeated requests for discharge were denied. He was finally released when he threatened to sue the hospital. Once discharged, Donaldson did sue his doctors and was awarded damages of $38,500 from O'Connor, the superintendent of the hospital. The case was eventually argued before the U.S. Supreme Court.

biological treatments for personality disorders

Drug therapy does not directly treat personality disorders. Antidepressants or antianxiety drugs are sometimes used to treat associated depression or anxiety in people with personality disorders. Antidepressants of the selective serotonin reuptake inhibitor (SSRI) class (e.g., Prozac) increase the availability of serotonin in synaptic connections between neurons and can help temper feelings of anger and rage. However, we have yet to see antidepressant medication produce any substantial benefits relative to placebo in treating borderline personality disorder Atypical antipsychotics may have benefits in controlling aggressive and self-destructive behavior in people with borderline personality disorder, but the effects are modest and the drugs carry serious potential side effects

treatment of enuresis

Enuresis usually resolves itself as children mature. Behavioral methods when it causes parents or children great distress One dependable example is the use of a urine alarm method, which sounds an alarm when the child wets the bed, causing children to wake up from a full bladder before they wet the bed (negative reinforcement)

genetic factors and personality disorders

Evidence points to genetic factors playing a role in the development of several types of personality disorders, including antisocial, narcissistic, paranoid, and borderline types Parents and siblings of people with personality disorders, such as antisocial, schizotypal, and borderline types, are more likely to be diagnosed with these disorders themselves than are members of the general population Genetic factors appear to play a role in the development of certain psychopathic personality traits, such as callousness, impulsivity, and irresponsibility

problems with executive functions

Executive function skills are a set of higher mental abilities involved in organizing, planning, and coordinating tasks needed to manage one's task or assignments. Children with deficits in executive function skills may frequently fall behind in school work, fail to keep track of homework assignments, or fail to plan ahead in order to complete assignments on time.

enuresis

Failure to control urination after one has reached the expectable age for attaining such control; repeated wetting themselves that it causes significant distress Enuresis, like so many other developmental disorders, is more common among boys. Enuresis is estimated to affect 7% of boys and 3% of girls by age 5.

family intervention programs for schizophrenics

Family conflicts and negative family interactions can heap stress on family members with schizophrenia, increasing the risk of recurrent episodes. Researchers and clinicians have worked with families of people with schizophrenia to help them cope with the burdens of care and assist them in developing more cooperative, less-confrontational ways of relating to others. In sum, no single treatment approach meets all the needs of people with schizophrenia.

elimination disorders

Fetuses and newborn children eliminate waste products reflexively. As children develop and undergo toilet training, they develop the ability to inhibit the natural reflexes that govern urination and bowel movements. For some children, however, problems with control elimination persist in the form of enuresis and encopresis, disorders of elimination that are not due to organic causes.

Freud's psychodynamic theory for schizophrenia

Freud did not believe that traditional psychoanalysis was well suited to the treatment of schizophrenia. The withdrawal into a fantasy world that typifies schizophrenia prevents the individual with schizophrenia from forming a meaningful relationship with the psychoanalyst. The techniques of classical psychoanalysis, Freud wrote, must "be replaced by others; and we do not know yet whether we shall succeed in finding a substitute"

general to specific

Generalized perceptions of violent tendencies may not predict specific acts of violence. Most people who have "general tendencies" toward violence never act on them. Nor is a diagnosis associated with aggressive or dangerous behavior, such as antisocial personality disorder, a sufficient basis for predicting specific violent acts in individuals.

Neurocognitive Disorder Due to Traumatic Brain Injury

Head trauma results from jarring, banging, or cutting brain tissue from injury or assault Progressive dementia due to traumatic brain injury is more likely to result from multiple head traumas than from a single blow or head trauma , yet even a single head trauma can have psychological effects, and if severe enough, can lead to physical disability or death. Specific changes in personality following traumatic injury to the brain vary with the site and extent of the injury, among other factors.

impulse control disorder treatments

IED -Antidepressants -Anger management training Covert sensitization Aversion therapy Relaxation training Cognitive restructuring

galvanic skin response and antisocial personalities

In an early study, Hare (1965) showed that people with antisocial personalities had lower GSR levels when they were expecting painful stimuli than did normal controls. Apparently, the people with antisocial personalities experienced little anxiety in anticipation of impending pain.

treatment approaches to ODD and conduct disorder

In parent training programs, parents learn behavioral techniques to: -change aggressive and oppositional behavior -increase their adaptive behavior Treatment includes the following goals for parents to develop: -more consistent discipline strategies -use of positive reinforcement -increasing frequency of positive interactions between the parent and the child - CBT

prodromal phase

In schizophrenia, the period of gradual deterioration

residual phase

In schizophrenia, the phase that follows an acute phase, characterized by a return to the level of functioning of the prodromal phase Flagrant psychotic behaviors are absent, but the person is still impaired by significant cognitive, social, and emotional deficits.

biochemical factors of schizophrenia

Increasing evidence supports the view that schizophrenia involves irregularities in the use of dopamine in complex networks of neurons in the brain. The leading biochemical model of schizophrenia, the dopamine hypothesis, posits that schizophrenia involves an overreactivity of dopamine transmission in the brain. The major source of evidence for the dopamine model is found in the effects of antipsychotic drugs called neuroleptics.

brain abnormalities and schizophrenia

Increasing evidence supports the view that schizophrenia involves irregularities in the use of dopamine in complex networks of neurons in the brain. The leading biochemical model of schizophrenia, the dopamine hypothesis, posits that schizophrenia involves an overreactivity of dopamine transmission in the brain. The major source of evidence for the dopamine model is found in the effects of antipsychotic drugs called neuroleptics.

positive symptoms of schizophrenia

Involve a break with reality, as represented by the appearance of hallucinations and delusional thinking

symptoms of down syndrome

Kids with down syndrome tend to have facial abnormalities (e.g., protruding tongue, small ears, generally "flat" appearance), body shape abnormalities (e.g., short stature, small hands and feet, weak muscular structure), and sometimes other physical birth defects. They tend to remain smaller than peers as they grow and take about twice as long to reach developmental milestones.

encopresis

Lack of control over bowel movements that is not caused by an organic problem in a child who is at least 4 years old. Like enuresis, this condition is most common among boys. Soiling may be voluntary or involuntary and is not caused by an organic problem, except in cases in which constipation is involved; likely to occur during the day Among the possible predisposing factors are inconsistent or incomplete toilet training and psychosocial stressors, such as the birth of a sibling or beginning school.

learning perspectives on personality disorders

Learning theorists focus on maladaptive behaviors rather than disorders of personality. They are interested in identifying the learning histories and environmental factors that give rise to maladaptive behaviors associated with diagnoses of personality disorders and the reinforcers that maintain them. Learning theorists suggest that childhood experiences shape the pattern of maladaptive habits of relating to others that constitute personality disorders. Children who are regularly discouraged from speaking their minds or exploring their environments may develop a dependent behavior pattern. Excessive parental discipline may lead to obsessive-compulsive behaviors. Children whose behavior is rigidly controlled and punished by parents, even for slight transgressions, may develop inflexible, perfectionistic standards. Youth who develop antisocial personalities may be "unsocialized" because their early learning experiences lack the consistency and predictability that help other children connect their behavior with rewards and punishments.

eye movement dysfunction in schizophrenia

Many schizophrenia patients have some form of eye movement dysfunction, such as difficulty tracking a slow-moving target across their field of vision. Rather than steadily tracking the target, the eyes fall back and then catch up in a kind of jerky movement. Eye movement dysfunctions are common in people with schizophrenia and in their first-degree relatives, suggesting a genetically transmitted trait, or biomarker, associated with genes linked to schizophrenia

family perspectives on personality disorders

Many theorists have argued that disturbances in family relationships underlie the development of personality disorders. Consistent with psychodynamic formulations, researchers find that people with borderline personality disorder (BPD) remember their parents as having been more controlling and less caring than do reference subjects with other psychological disorders When people with BPD recall their earliest memories, they are more likely than other people to paint significant others as malevolent or evil.

Margaret Mahler

Margaret Mahler, another influential modern psychodynamic theorist, explained borderline personality disorder in terms of childhood separation from the mother figure. Mahler and her colleagues believed that during the first year infants develop a symbiotic attachment to their mothers In psychology, symbiosis is a state of oneness in which the child's identity is fused with the mother's. Normally, children gradually differentiate their own identities or senses of self from that of their mothers. Borderline personality disorder may arise from the failure to master this developmental challenge.

separation anxiety

Mary Ainsworth chronicled the development of attachment behaviors and found that separation anxiety normally begins during the first year. The sense of security normally provided by bonds of attachment apparently encourages children to explore their environments and become progressively independent of their caregivers. A childhood disorder characterized by extreme fear of separation from parents or other caretakers. refusal to go to school in adolescents doesn't count bc thats usually due to other factors

Problems with arithmetical and mathematic reasoning skills

May have problems understanding basic mathematical terms or operations, such as addition or subtraction; decoding mathematical symbols (+, =, etc.); or learning multiplication tables. Problem may become apparent as early as the first grade (age 6) but is not generally recognized until about the second or third grade

long- term predictions of dangerousness

Mental health professionals fall well short of the mark when making long-term predictions of dangerousness. They are often wrong when predicting whether patients will become dangerous following release from the hospital. One reason is that they often base their predictions on patients' behavior in the hospital, but real life situations are difference than the structured hospital life

how to predict dangerousness

Mental health professionals tend to over predict dangerousness—that is, to label many individuals as dangerous when they are not. Clinicians tend to err on the side of caution in predicting the potential for dangerous behavior, perhaps because they believe that failure to predict violence may have more serious consequences than overprediction; Overprediction of dangerousness does deprive many people of liberty; clinician cannot accurately predict dangerousness According to Szasz and other critics of the practice of psychiatric commitment, the commitment of the many to prevent the violence of the few is a form of preventive detention that violates basic constitutional principles.

biological perspectives of personality disorders

Much remains to be learned about the biological underpinnings of personality disorders. Most of the attention in the research community has centered on antisocial personality disorder and the personality traits that underlie the disorder

Youngberg v Romero

Nicholas Romero, a 33-year-old man with a profound intellectual disability who was unable to talk or care for himself, had been institutionalized in a state hospital and school in Pennsylvania. While in the state facility, he had a history of injuring himself through his violent behavior and was often kept in restraints. The case was brought by the patient's mother, who alleged that the hospital was negligent in not preventing his injuries and in routinely using physical restraints for prolonged periods while not providing adequate treatment. The Supreme Court ruled that involuntary committed patients, such as Nicholas, have a right to be confined in less-restrictive conditioning. The ruling also included a limited recognition of the committed patient's right to treatment. The court held that they do not know a much as professionals on the topic

right to treatment

Not until the 1972 landmark federal court case of Wyatt v. Stickney, however, did a federal court establish a minimum standard of care to be provided by hospitals. The case was a class action suit against Stickney, the commissioner of mental health for the State of Alabama, brought on behalf of Ricky Wyatt, an intellectual disabled young man, and other patients at a state hospital and school in Tuscaloosa. The federal district court in Alabama held both that the hospital had failed to provide treatment to Wyatt and others and that living conditions at the hospital were inadequate and dehumanizing. The case of Wyatt v. Stickney established certain patient rights, including the right not to be required to perform work that is performed for the sake of maintaining the facility. The court held that mental hospitals must, at a minimum, provide the following: -A humane psychological and physical environment, -Qualified staff in numbers sufficient to administer adequate treatment, and -Individualized treatment plans look at slide 15 of legal system

anxiety disorders and aging

Older women are more likely to be affected than older men, by a ratio of about two to one The most frequently occurring anxiety disorders among older adults are generalized anxiety disorder (GAD) and phobic disorders. Although less common, panic disorder occurs in about 1 in 100 older adults Most cases of agoraphobia affecting older adults tend to be of recent origin and may involve the loss of social support systems due to the death of a spouse or close friends; fear of falling not eh street ; GAD- lack of control on your life; benzos as treatment

what type of behavior is dangerous?

One difficulty in predicting dangerousness is the lack of agreement over what types of behavior are violent or dangerous. Most people would agree that crimes such as murder, rape, and assault are acts of violence. But things like driving recklessly, verbally attacking one's spouse or children, destroying property, selling drugs, shoving into people at a bar, or stealing cars—are these acts violent or dangerous?

the duty to warn

One of the most difficult dilemmas a therapist faces is whether to disclose confidential information that may protect third parties from harm. These difficulties are represented by: -whether or not a client has made a bona fide threat -information a client discloses in psychotherapy is generally protected as privileged communication -a 1976 court ruling in the case of Tarasoff v. the Regents of the University of California established the legal basis for the therapist's duty to warn (Jones, 2003).

Hans Kohut

One of the principal shapers of modern psychodynamic concepts is Hans Kohut, whose theory is labeled self psychology because of its emphasis on processes in the development of a cohesive sense of self. Freud believed that the resolution of the Oedipus complex was central to the development of adult personality. Kohut disagreed, arguing that what matters most is how the self develops—whether the person is able to develop self-esteem, values, and a cohesive and realistic sense of self as opposed to an inflated, narcissistic personality To Kohut, early childhood involves a normal stage of healthy narcissism. Infants feel powerful, as though the world revolves around them. Infants also normally perceive their parents as idealized towers of strength and wish to be one with them and to share their power. Empathic parents reflect their children's inflated perceptions by making them feel that anything is possible and by nourishing their self-esteem. Lack of parental empathy and support, however, sets the stage for pathological narcissism.

personality disorders

Overly rigid and maladaptive patterns of behavior and ways of relating to others that reflect extreme variations on underlying personality traits, such as undue suspiciousness, excessive emotionality, and impulsivity

neurocognitive disorder due to parkinsons disease

Parkinson's disease is characterized by destruction or impairment of dopamine producing nerve cells in the substantia nigra ("black substance"), an area of the brain that helps regulate body movement Whatever the underlying cause, the symptoms of the disease—the uncontrollable tremors, shaking, rigid muscles, and difficulty walking—are tied to deficiencies in the amount of dopamine in the brain. The drug L-dopa, increases dopamine levels; L-dopa is converted in the brain into dopamine; helps relieve symptoms but is not a cure; ineffective after a few years of use

other types of impairment in schizophrenia

People who suffer from schizophrenia may become confused about their personal identities—the cluster of attributes and characteristics that define themselves as individuals and give meaning and direction to their lives. They may fail to recognize themselves as unique individuals and be unclear about how much of what they experience is part of themselves. In psychodynamic terms, this phenomenon is sometimes referred to as loss of ego boundaries. Disturbances of volition are most often seen in the residual or chronic state and are negative symptoms characterized by loss of initiative to pursue goal-directed activities. People with schizophrenia may: -exhibit odd gestures and bizarre facial expressions or become unresponsive and curtail spontaneous movement. -show highly excited or wild behavior or may slow to a state of stupor. -show significant impairment in interpersonal relationships.

intellectual disability intervention

People with ID who are capable of functioning in the community have the right to receive less-restrictive care than is provided in large institutions; large institutions control aggressive behavior They do stand a high risk of developing other psychiatric disorders, such as anxiety and depression, as well as behavioral problems Often psychological help is needed for dealing with adjustment to life in the community. Many have difficulty making friends and become socially isolated. However, some do acquire vocational skills and are able to support themselves at least minimally through meaningful work (6th grade level)

craving for stimulation model

People with antisocial or psychopathic personalities appear to have exaggerated cravings for stimulation Perhaps they require a higher-than-normal threshold of stimulation to maintain an optimum state of arousal. In other words, they may need more stimulation than other people to maintain interest and function normally.

cutting and borderline personality disorder

People with borderline personalities may engage in impulsive acts of self-mutilation, such as cutting themselves, perhaps as a means of temporarily blocking or escaping from deep, emotional pain. Self-mutilation is sometimes an expression of anger or a means of manipulating others. Such acts may be intended to counteract self-reported feelings of "numbness," particularly in times of stress.

treatment of personality disorders

People with personality disorders usually see their behaviors, even maladaptive, self-defeating behaviors, as natural parts of themselves. Even when unhappy and distressed, they are unlikely to perceive their own behavior as causative. Despite these obstacles, evidence supports the effectiveness of therapy in treating personality disorders.

catatonia

People with schizophrenia may become unaware of the environment and maintain a fixed or rigid posture—even bizarre, apparently strenuous positions for hours as their limbs become stiff or swollen

psychosocial rehab for schizophrenics

People with schizophrenia typically have difficulties functioning in social and occupational roles and performing work that depends upon basic cognitive abilities involving attention and memory. These problems limit their ability to adjust to community life, even in the absence of overt psychotic behavior. Recently, promising results were reported for cognitive rehabilitation training to help schizophrenia patients strengthen such basic cognitive skills as attention and memory

rights of patients

Popular books and films, such as One Flew Over the Cuckoo's Nest, starring Jack Nicholson, have highlighted many of the abuses in mental hospitals. In recent years, a tightening of standards of care and the adoption of legal safeguards have led to better protection of the rights of patients in mental hospitals. Do involuntarily committed patients have the right to receive or demand treatment? Or can society just warehouse them in psychiatric facilities indefinitely without treating them? Consider the opposite side of the coin as well: May people who are involuntarily committed refuse treatment? Such issues—which have been brought into public light by landmark court cases—fall under the umbrella of patients' rights.

treatment and prevention of alzeimers

Presently available drugs for AD offer at best modest benefits in slowing cognitive decline and boosting cognitive functioning. None is a cure. One widely used drug, donepezil (brand name Aricept), increases levels of the neurotransmitter acetylcholine (ACh). Another drug, memantine (brand name Axura), blocks the neurotransmitter glutamate, a brain chemical found in abnormally high concentrations in AD patients Hopes for the future lie in the development of an effective vaccine that might prevent this devastating disease. Engaging in stimulating cognitive activities—solving puzzles, reading newspapers, playing word games, etc.—can help boost cognitive performance in people with mild to moderate AD Some evidence that lifestyle factors such as maintaining a regular exercise program and following a healthy diet low in animal fat and rich in vegetables and fish can reduce the risk of AD

neurocognitive disorder due to prion disease

Prions are protein molecules found normally in body cells. In the case of prion disease, abnormal clusters of prions form and become infectious. Prion disease can cause brain damage when clusters of abnormal prion molecules spread within the brain. The best known example of prion disease is Creutzfeldt-Jakob disease, a rare but fatal brain disease characterized by the formation of small cavities in the brain that resemble the holes in a sponge. The disease causes brain damage, which commonly results in dementia (major neurocognitive disorder).

theoretical perspectives

Psychodynamic explanations of enuresis suggest that it represents the expression of hostility toward the children's parents. It may represent regression in response to the birth of a sibling or some other stressor or life change. Learning theorists point out that enuresis occurs most commonly in children whose parents attempted to train them early.

psychopaths vs. sociopaths

Psychopaths -1% of population -"Born that way" -Brain differences -Controlled -Manipulative -No attachment -Calculated risks Sociopaths -4% of population -Environmental -Unsteady lifestyle -Erratic, angry -Impulsive -May be attached -Sloppy work

post hoc problem

Recognizing violent tendencies after a violent incident occurs (post hoc) is easier than predicting it beforehand. It is often said that hindsight is 20/20. it is easier to piece together fragments of people's prior behaviors as evidence of violent tendencies after they have committed acts of violence. Predicting a violent act before the fact is a more difficult task, however.

violence and mental disorders

Research evidence shows that mental illness is at best a weak predictor of violent behavior. Only a small minority of people with mental disorders commit violent crimes. Hence, we need to identify factors to help us better appraise the risk of violence. The general public's perception of the mentally ill as dangerous is exaggerated by the media.

Abnormal Event-Related-Potentials

Researchers have also studied brain wave patterns, called event-related potentials, or ERPs, that occur in response to external stimuli like sounds and flashes of light. ERPs can be broken down into various components that emerge at different intervals following the presentation of a stimulus. Schizophrenia patients also show reduced levels of later-occurring ERPs. These later-occurring ERPs are believed to be involved in the process of focusing attention on a stimulus in order to extract meaningful information.

prevalence of schizophrenia

Schizophrenia affects about 1% of the U.S. population and about 0.3% to 0.7% of the global population The WHO estimates that about 24 million people worldwide suffer from schizophrenia The peak age at which psychotic symptoms first appear is in the early to middle 20s for men and the late 20s for women

diagnostic features of schizophrenia

Schizophrenia is a pervasive disorder that affects a wide range of psychological processes involving cognition, affect, and behavior. The DSM criteria for schizophrenia require that psychotic behaviors be present at some point during the course of the disorder and that signs of the disorder be present for at least 6 months. People with briefer forms of psychosis receive other diagnoses, such as brief psychotic disorder.

development of schizophrenia

Schizophrenia typically develops during a person's late adolescence or early adulthood In some cases, the onset of the disorder is acute and occurs suddenly, within a few weeks or months. Then a rapid transformation in personality and behavior leads to an acute psychotic episode. In most cases, there is a slower, more gradual decline in functioning.

learning based therapies for schizophrenia

Selective reinforcement of behavior: providing attention for appropriate behavior and extinguishing bizarre verbalizations through withdrawal of attention. Token economy: individuals on inpatient units are rewarded for appropriate behavior with tokens, such as plastic chips, that can be exchanged for tangible reinforcers such as desirable goods or privileges. Social skills training: clients are taught conversational skills and other appropriate social behaviors through coaching, modeling, behavior rehearsal, and feedback.

hallucinations

Sensory perceptions occurring in the absence of external stimuli that become confused with reality. Auditory hallucinations ("hearing voices") are most common, affecting about three out of four schizophrenia patients. Tactile hallucinations, such as tingling, electrical, or burning sensations Somatic hallucinations, such as feeling like snakes are crawling inside one's belly

diagnostic considerations for conduct disorder

Severity: ranges from mild to severe Specifiers: -With limited prosocial emotions -Lack of remorse or guilt -Callous-unemotional: lack of empathy -Unconcerned about performance -Shallow or deficient affect

sleep problems and aging

Sleep problems, especially insomnia, are common among older people. Upward of 50% of older adults report sleep problems Sleep problems in older adults are often linked to other psychological disorders, such as depression, dementia, and anxiety disorders, as well as medical illness. Psychosocial factors, such as loneliness and the related difficulty of sleeping alone after the loss of a spouse, are also implicated in many cases. behavioral treatments are better than sleeping pills

sociocultural perspectives on personality disorders

Social conditions may contribute to the development of personality disorders. Because antisocial personality disorder is reported most frequently among people from lower socioeconomic classes, the kinds of stressors encountered by disadvantaged families may contribute to antisocial behavior patterns. Many inner-city neighborhoods are beset by social problems such as alcohol and drug abuse, teenage pregnancy, and disorganized and disintegrating families.

command hallucinations visual hallucinations gustatory hallucinations olfactory hallucinations

Some people with schizophrenia experience command hallucinations, voices that instruct them to perform certain acts, such as harming themselves or others. Visual hallucinations (seeing things that are not there) Gustatory hallucinations (tasting things that are not present) Olfactory hallucinations (sensing odors that are not present)

theoretical perspectives on ODD and CD

Some theorists believe that oppositionality is an expression of an underlying temperament described as the "difficult-child" type Others believe that unresolved parent-child conflicts or overly strict parental control lie at the root of the disorder; parental distress Psychodynamic theorists look at ODD as a sign of fixation at the anal stage of psychosexual development, when conflicts between the parent and child emerge over toilet training.

childhood anxiety and depression

Specific Phobias, Social Anxiety Disorder, GAD, OCD, and PTSD, as well as mood disorders, like depression. Symptoms and etiological factors that contribute to these disorders can be similar to those we have already discussed for adults, though there can be differences based on developmental standards/norms. Although these disorders may develop at any age, there is one anxiety disorder that typically develops during early childhood: separation anxiety disorder

competency to stand trial

The ability of criminal defendants to understand the charges and proceedings brought against them and to participate in their own defense. Far more people are confined to mental institutions on the basis of a determination that they lack the mental competence to stand trial than on the basis of the insanity verdict. People who are declared incompetent to stand trial are generally confined to a mental institution until they deemed competent or until it is determined that they are unlikely to regain competency.

disclosure of direct violent threats

The client in therapy is not likely to inform a therapist of a clear threat, such as "I'm going to kill _____ next Wednesday morning." Threats are more likely to be vague and nonspecific, as in "I'm so sick of _____; I could kill her," or "I swear he's driving me to murder." In such cases, therapists must infer dangerousness from hostile gestures and veiled threats. Vague, indirect threats of violence are less-reliable indicators of dangerousness than specific, direct threats.

genetic factors of schizophrenia

The closer the genetic relationship between schizophrenia patients and their family members, the greater the likelihood (or concordance rate) that the relatives will also have schizophrenia. Overall, first-degree relatives of people with schizophrenia (parents, children, or siblings) have about a tenfold greater risk of developing schizophrenia than do members of the general population. The fact that families share common environments as well as common genes requires that we dig deeper to examine the genetic underpinnings of schizophrenia. More direct evidence of a genetic factor in schizophrenia comes from twin studies showing concordance rates.

symptoms of Alzheimers disease

The early stages of the disease are marked by limited memory problems and subtle personality changes. In moderately severe AD, people require assistance in managing everyday tasks. At later stages, the Alzheimer's patient may be unable to select appropriate clothes or recall their addresses or names of family members; procedural forgetfulness as well such as forgetting to stop at stop lights or brush teeth

legal bases of insanity defense

The first was an 1834 case in Ohio that was ruled that people could not be held responsible if they are compelled to commit criminal actions because of impulses they are unable to resist. The second major legal test of the insanity defense is referred to as the M'Naghten rule, based on a case in England in 1843 of a Scotsman, Daniel M'Naghten, who had intended to assassinate the prime minister of England, Sir Robert Peel. The third major case that helped lay the foundation for the modern insanity defense was Durham v. United States in 1954. By 1972, the Durham rule was replaced in many jurisdictions by legal guidelines formulated by the American Law Institute (ALI) to define the legal basis of insanity. These guidelines, which essentially combine the M'Naghten principle with the irresistible impulse principle, include the following provisions: -A person is not responsible for criminal conduct if at the time of such conduct as a result of mental disease or defect he lacks substantial capacity either to appreciate the criminality (wrongfulness) of his conduct or to conform his conduct to the requirements of law. -the terms "mental disease or defect" do not include an abnormality manifested only by repeated criminal or otherwise antisocial conduct.

criminal commitment

The legal process of confining a person in a mental institution because the crime they committed was due to insanity

civil commitment

The legal process of placing a person in a mental institution, even against his or her will; must present danger to themselves or others Civil commitment in a psychiatric hospital usually requires that a relative or professional file a petition with the court, which empowers psychiatric examiners to evaluate the person. different from voluntary hospitalization, where the individual themselves seeks treatment

base-rate problems

The relative difficulty of making predictions about infrequent or rare events is known as the base-rate problem. If the suicide rate in a given year has a low base rate of about 1% of a clinical population, the likelihood of accurately predicting that any given person in this population will commit suicide is very small. You would be correct 99% of the time if you predicted that any given individual in this population would not commit suicide in a given year. But if you predicted the nonoccurrence of suicide in every case, you would fail to predict the relatively few cases in which suicide does occur, even though virtually all your predictions would likely be correct. this is a problem if clinicians over predict because people would be put into institutions for no reason

right to refuse treatment

The rights of committed patients to refuse psychotropic medications was tested in a 1979 case, Rogers v. Okin, in which a Massachusetts federal district court imposed an injunction on a Boston state hospital prohibiting the forced medication of patients except in emergency situations. The court ruled that committed patients could not be forcibly medicated, except in the case of emergency—for example, when patients' behaviors posed a significant threat to themselves or others.

perspectives on the insanity defense

Thomas Szasz and others who deny the existence of mental illness have raised another challenge to the insanity defense. If mental illness does not exist, then the insanity defense becomes groundless. Szasz argues that the insanity defense is ultimately degrading because it strips people of personal responsibility for their behavior.

psychodynamic perspectives for personality disorders

Traditional Freudian theory focused on problems arising from the Oedipus complex as the foundation for abnormal behaviors, including personality disorders. Freud believed that children normally resolve the Oedipus complex by forsaking incestuous wishes for the parent of the opposite gender and identifying with the parent of the same gender. As a result, they incorporate the parent's moral principles in the form of a personality structure called the superego.

DSM 5 diagnostic criteria for schizophrenia

Two or more of the following over a 1 month period: -Delusions -Hallucinations -Disorganized speech -Grossly disorganized or catatonic behavior -Negative symptoms Difficulties in social functioning, work, or self-care Symptoms continuous for at least six months The disorder is not contributed to substance use or another medical condition or mental disorder

determinate vs indeterminate commitment

after attempting to steal a jacket from a department store, Jones was committed to a mental hospital, and was diagnosed as suffering from paranoid schizophrenia, and was kept hospitalized until he was judged competent to stand trial, about 6 months later. Jones offered a plea of not guilty by reason of insanity, which the court accepted without challenge, remanding him to St. Elizabeth's. Despite the fact that Jones's crime carried a maximum sentence of 1 year in prison, Jones's repeated attempts to obtain release were denied in subsequent court hearings. The U.S. Supreme Court eventually heard his appeal 7 years after Jones was hospitalized and reached its decision in 1983. It ruled against Jones's appeal and affirmed the decision of the lower courts that he was to remain in the hospital. this was on the basis that he would not be released until he was sane again, an even longer sentence than if he had just pleaded guilty

delusional disorder

applies to people who hold persistent, clearly delusional beliefs, often involving paranoid themes

mild neurocognitive disorders

applies to people who suffer a mild or modest decline in cognitive functioning from their prior level. The decline is clearly noticeable but is not of sufficient magnitude to justify a diagnosis of major neurocognitive disorder; mild impairment of cognitive function People with mild neurocognitive disorder, or MCI, are able to function independently and complete everyday tasks at home and on the job. The inclusion of a new diagnosis of mild neurocognitive disorder in DSM-5 is important because it highlights the need to identify cases of MCI that can be targeted for early intervention before more serious deficits emerge

ego syntonic

behaviors or feelings that are perceived as natural parts of the self

ego dystonic

behaviors or feelings that are perceived not to be part of one's self-identity

thought broadcasting

believing one's thoughts are somehow transmitted to the external world so that others can overhear them

thought insertion

believing one's thoughts have been planted in one's mind by an external source

thought withdrawal

believing that thoughts have been removed from ones mind

causes of intellectual disabillity

biological factors, psychosocial factors, or a combination of these factors Biological causes include chromosomal and genetic disorders, infectious diseases, and maternal alcohol use during pregnancy. Psychosocial causes include exposure to an impoverished home environment marked by the lack of intellectually stimulating activities during childhood.

borderline personality disorder

characterized by features such as a deep sense of emptiness, an unstable self-image, a history of turbulent and unstable relationships, dramatic mood changes, impulsivity, difficulty regulating negative emotions, self-injurious behavior, and recurrent suicidal behaviors. At the core is a pervasive pattern of instability in relationships, self-image, and mood, along with a lack of control over impulses. People with borderline personality disorder tend to be uncertain about their personal identities—their values, goals, careers, and perhaps even their sexual orientations.

disturbed thought and speech in schizophrenia

characterized by positive symptoms involving disturbances in thinking and expression of thoughts through coherent, meaningful speech. Aberrant thinking may be found in both the content and form of thought. Delusions represent disturbed content of thought.

dialectical behavioral therapy (DBT)

combines cognitive-behavioral therapy and Buddhist mindfulness meditation

learning perspectives of schizophrenia

conditioning and observational learning. From this perspective, people with schizophrenia learn to exhibit certain bizarre behaviors when these are more likely to be reinforced than normal behaviors. Social-cognitive theorists suggest that modeling of schizophrenic behavior can occur within the mental hospital, where patients may begin to model themselves after fellow patients who act strangely.

Social (pragmatic) communication disorder

continuing and profound difficulties communicating verbally and nonverbally with other people in their natural contexts (e.g., in school, at home, or in play) trouble maintaining conversation, quiet in groups, normal level of language and reading ability

frontotemporal neurocognitive disorder/ Pick's disease

deterioration (thinning or shrinkage) of brain tissue in the frontal and temporal lobes of the cerebral cortex Symptoms include memory loss and social inappropriateness, such as a loss of modesty or the display of flagrant sexual behavior Diagnosis is confirmed only upon autopsy by the absence of the neurofibrillary tangles and plaques that are found in AD and by the presence of other abnormal structures called Pick's bodies in nerve cells.

Problems with writing

grossly deficient writing skills errors in spelling, grammar, or punctuation, or by difficulty in composing sentences and paragraphs Severe writing difficulties generally become apparent by age 7; milder cases may not be recognized until the age of 10 or later

Autism Spectrum Disorder

includes a range of autism-related disorders that vary in severity. Asperger's disorder and childhood disintegrative disorder are now classified as forms of autism spectrum disorder in the DSM 2%/ 1 million children are affected; children with older others; no link to vaccines the earlier the diagnosis the better; evident between 18-30 months, but not diagnosed usually until 6; more popular in boys

behavior problems

involve problem behaviors that can seriously interfere with the child's functioning in school, at home, and with friends or peers. These disorders include: -Attention-deficit hyperactivity disorder (ADHD) -Oppositional defiant disorder (ODD) -Conduct disorder

language disorder

involves impairments in the ability to produce or understand spoken language difficulty understanding word types (big, huge) spatial (near far) or sentence types (unlike)

speech sound disorder

is a persistent difficulty articulating the sounds of speech in the absence of defects in the oral speech mechanism or neurological impairment. (can't pronounce R) can sound like baby talk

psychodynamic approaches to personality disorders

often used to help people diagnosed with personality disorders become aware of the roots of their self-defeating behavior patterns and learn more adaptive ways of relating to others. However, people with personality disorders especially those with borderline and narcissistic personality disorders, often present particular challenges to the therapist. For example, people with borderline personality disorder tend to have turbulent relationships with therapists, sometimes idealizing them, sometimes denouncing them as uncaring.

treatment of autism

operant conditioning methods to use rewards and mild punishments to increase the childs ability to attend to others, play with other children, develop academic skills, and eliminate self mutilating behaviors most popular is to use behavioral treatment that are highly structured and offer one to one instruction (applied behavior analysis) antipsychotic drugs for disruptive behavior cure is rare, but some can be independent as adults

schizoid personality disorder

people with schizoid personalities rarely express emotions and are distant and aloof. the emotions of people with schizoid personalities are not as shallow or blunted as they are in people with schizophrenia A personality disorder characterized by persistent lack of interest in social relationships, flattened affect, and social withdrawal. Often described as a loner or an eccentric, the person with a schizoid personality lacks interest in social relationships.

dementia and football

reports of dementia and significant memory problems among retired football players to be much higher than the rate found in the general population researcher of brain images of five retired NFL players showed evidence of abnormal brain proteins associated with AD

psychodynamic perspectives of schizophrenia

schizophrenia represents the overwhelming of the ego by primitive sexual or aggressive drives or impulses arising from the id. These impulses threaten the ego and give rise to intense intrapsychic conflict. Under such a threat, the person regresses to an early period in the oral stage, referred to as primary narcissism.

autism word origins

self bleuler: particular style of thinking- viewing oneself as the center of the universe, and believe that external events refer to oneself kanner: applied early infantile autism to a group that seemed unable to relate to others, as if they lived in their own world

treatment of ADHD

stimulants; stimulant drugs activate the prefrontal cortex, the part of the brain that regulates attentional processes and control over impulsive, acting-out behaviors associated with ADHD.

specific learning disorder

the DSM-5 applies a single diagnosis of specific learning disorder to encompass various types of learning disorders or disabilities involving significant deficits in skills related to reading, writing, arithmetic and math, and executive functions Specific learning disorders in the area of reading are estimated to affect about 4% of school-age children and are much more common in boys than in girls Boys with this type of SLD are also more likely than girls to show disruptive behavior in class and thus are more likely to be referred for evaluation. dyslexia: reading difficulties, vary with culture

attention and schizophrenia

the ability to focus on relevant stimuli and ignore irrelevant ones, is basic to learning and thinking People with schizophrenia often have difficulty filtering out irrelevant stimuli, making it nearly impossible for them to focus their attention, organize their thoughts, and filter out unessential information.

causes of hallucinations in schizophrenia

unknown Disturbances in brain chemistry are suspected and the neurotransmitter dopamine is implicated. Drugs that lead to increased production of dopamine, such as cocaine, can induce hallucinations. Auditory hallucinations may be a form of inner speech that for unknown reasons becomes attributed to external sources rather than to one's own thoughts

Asperger's Disorder

used to be separate from autism, but now it is part of the ASD spectrum this disorder is focused on socialization; social awkwardness, repetitive behaviors but no cognitive or language deficits severity based on needed support; more popular in boys