Abnormal PSYC Exam 4 pt.2
Down syndrome
- 1/1000 births - rate increases when mom is over 35yrs - trisomy 21 - physical features: protruding tongue, flat forehead
IDD stats
- 3/5 are male and the vast majority of cases are considered mild - symptoms appear before age 18
Borderline PD prevalence stats
- 35% of identical twins - 75-80% of those diagnosed are women - Greater likelihood of diagnosis in early adulthood
Prevalence rates for ADHD
- 3:1 with boys more likely to have the disorder than girls
Phenylketonuria (PKU)
- Abnormally high levels of the amino acid, phenylalanine - If untreated, it can lead to intellectual disorders, seizures, behavioral problems, and mental disorders
Antisocial PD theoretical explanations
- Absence of parental love leads to lack of basic trust - Antisocial symptoms learned through operant conditioning, modeling, imitation - Difficulty with recognition of others' viewpoints - Biological predisposition; lower serotonin activity; dysfunctional brain circuits
Tay-Sachs Disease
- An inherited metabolic disorder in which certain lipids accumulate in the brain, causing spasticity and death in childhood or IDD
Schizotypal PD treatment
- Assist the client with reconnection to the world and recognition of thinking limits - Recognize unusual thoughts and magical prediction; social skills training - May benefit from low doses of antipsychotic drugs
Narcissistic PD characteristics
- Believes one is "special" and unique - Requires excessive admiration - Grandiose sense of self-importance - Has sense of entitlement - Is interpersonally exploitative - Often envious of others or believes others are envious of them - Lacks empathy
personality pattern is manifested in 2 or more of the following:
- Cognitions - Affectivity - Interpersonal functioning - Impulse control
biosocial
- Combination of internal and external factors - Internal: Inability to identify and regulate emotions - External: Invalidating environment (parents teach the children to ignore their feelings)
Schizoid PD
- Detachment and restricted expression of emotion - Focus on self; cold; prefer to be alone; very little desire for intimacy
Things to remember about Personality Disorders:
- Disorders can only be diagnosed prior to age 18 if features have been present for at least a year - Most people with them, don't realize they have them - High rates of comorbidity can make it difficult to distinguish one from another
antisocial PD
- Disregard for and violation of the rights of others
personality traits
- Enduring patterns of perceiving, relating to, and thinking about the environment and oneself - they are flexible but when they become inflexible, they are maladaptive and problematic; cause distress
Histrionic PD
- Excessive emotionality and attention seeking; pervasive - seeks to be center of attention - seductive behaviors - uses physical appearance to draw attention - dramatic - exaggerated emotions, but emotions can be turned off quickly - value on what other people think and material things - misjudges intimacy in a relationship
Schizoid PD Treatment
- Extreme social withdrawal usually stops individuals from seeking out treatment - Psychodynamic and behavioral treatment - similar to treatment of Paranoid Personality Disorder - Presenting and evoking memories of pleasurable experiences
ASD Psychological causes
- Failure to develop a theory of mind (fail to appreciate that other people have a point of reference that differs from their own) - "mind blindness" - deficiencies in joint attention
Borderline PD
- Fear of abandonment; inappropriate anger - person will go to great length to make person stay (suicide attempts/self-harm) - rapid shifts in emotions in a matter of minutes - feelings of emptiness
Narcissistic PD theoretical explanations
- Focus on cold, rejecting parents; focus on grandiose self-presentation; self-sufficiency replaces warm relationships - abused children; children who lost their parents are at higher risk of developing - Treated too positively in early life; overvalue self-worth
Histrionic PD treatment
- Focus on lack of substance and extreme suggestibility
Avoidant PD treatment
- Go to treatment to gain acceptance - Similar to treatment of social anxiety disorder and anxiety in general - Group therapy provides practice in social interactions - Antianxiety and antidepressant drugs
ADHD etiological explanations: genetic predisposition
- Heritability estimates = 80% - prenatal exposure to alcohol or tobacco smoke - premature birth or low birth weight - abnormal dopamine activity - abnormalities in the frontal-striatal regions of the brain - high levels of stress - family dysfunction
Severe IDD
- IQ 20-34 - 3-4% of persons with IDD display severe IDD - require careful supervision - can perform only basic work tasks
Mild IDD
- IQ 50-70 - 80-85% of people with intellectual disability - improves with age
Profound IDD
- IQ below 20 - 1-2% of persons with IDD fall into this category - with training they may learn or improve basic skills - need a structured environment
Moderate IDD
- IQ: 35-49 - 10% of persons with IDD function at a moderate level can care for themselves
Borderline PD theoretical explanations
- Lack of early acceptance by parents or abuse (especially sexual)/neglect by parents - low serotonin levels - genetic predisposition - abnormal brain structure/circuitry activity - overly reactive amygdala
Avoidant PD theoretical explanations
- Lack of research to support underlying etiology - Focus on shame and insecurity traced to childhood experiences - Harsh criticism in early childhood leads to expected rejection; failure to develop effective social skills
Schizoid PD theoretical explanation
- Linked to an unsatisfied need for human contact; parents believed to have been unaccepting or abusive - Tied to deficiencies in thinking; inability to interpret emotional cues (Thoughts tend to be very vague and empty)
Paranoid PD theoretical explanations
- Linked to patterns of early interactions with demanding parents - maladaptive assumptions
IDD and prenatal birth
- Major physical problems in the pregnant mother can threaten the child's healthy development - fetal alcohol syndrom - syphilis that is passed on - prolonged period without oxygen (anoxia)
Antisocial PD Stats
- Males 4x more likely - Severity of the symptoms and features decrease after the age of 40 - Highly comorbid with substance use disorders
ADHD treatment
- No cure for the disorder - drugs: psychostimulants (provide the greatest degree of improvement) - psychoeducation - operant conditioning - behavior modification in classroom and at home
Obsessive-Compulsive PD theoretical explanations
- Overly harsh toilet training during anal stage can results in anal retentive obsessive-compulsive functioning and fixated in one - Illogical thinking processes
Autism Spectrum Disorder (ASD)
- Persistent deficits in social communication and social interaction - Deficits in social-emotional reciprocity - Deficits in nonverbal communicative behaviors - Deficits in developing, maintaining, and understanding relationships
Dependent PD
- Pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation - fear of being lonely ex: When one relationship ends → they frantically look for the next relationship
Narcissistic PD treatment
- Recognize and work through basic insecurities and defenses - Focus on self-centered thinking and redirection
Borderline PD treatment
- Relational psychoanalytic therapy - DBT - Antidepressant, antipolar, antianxiety or antipsychotic drugs
Autism Spectrum Disorder (ASD) stats
- Symptoms appear early in life, typically before age 3 - 1/50 children - 80% of cases are boys - 90% disabled into adulthood
Schizotypal PD theoretical explanations
- Symptoms are often linked to family conflicts and psychological disorders in parents - Linked to some of the same biological factors found in schizophrenia (e.g., high dopamine activity)
ASD Self-stimulatory behaviors/ repetitive motor movements
- typically happens when child is overly stimulated by what is going on in their environment - arm flapping, spirit fingers, rocking back and forth, twisting hands and fingers
Intellectual Disability (Intellectual Developmental Disorder) [IDD]
- used to be called "mental retardation" - intellectual functioning in a person is below average - deficits in adaptive functioning (cooking, cleaning, hygiene) - IQ lower than 70
ASD community training
- ½ stay nonverbal - May taught other forms of communication (Sign language, simultaneous communication, augmentative communication i.e systems Communication boards, Computers with different symbols)
Savant Performance (ASD)
An exceptional ability in a highly specialized area of functioning (typically involves artistic, musical, or mathematical skills) - common among autistic individuals
Schizotypal PD
Acute discomfort with and reduced capacity for close relationships, accompanied by cognitive or perceptual distortions and behavior eccentricities
The chief danger of LSD use is: A. The risk of developing drug tolerance. B. The possibility of very powerful, sometimes negative, reactions. C. The severity of withdrawal symptoms among even occasional users. D. The universal occurrence of flashbacks among former users.
B. The possibility of very powerful, sometimes negative, reactions.
Recent studies show that children with autistic spectrum disorder are MORE likely than other children to have abnormalities in which section of the brain? A. cerebral cortex B. corpus callosum C. Cerebellum D. hypothalamus
C. Cerebellum
Bryan, an intravenous heroin user, feels intense cravings when he sees hypodermic needles. This may be an example of: A. Modeling. B. Operant conditioning. C. Classical conditioning. D. Observational learning
C. Classical conditioning.
One reason that the personality disorders are difficult to treat is that the afflicted individuals: A. Enjoy their symptoms and do not seek change B. Are frequently unaware that they have a problem C. Experience no distress and do not want treatment D. Have accompanying mood disorders that must be treated first
B. Are frequently unaware that they have a problem
If a person primarily fears close social relationships, one would MOST likely conclude that the person is experiencing: A. Social Phobia B. Avoidant Personality Disorder C. Both Social Phobia and Avoidant Personality Disorder D. A personality disorder from the dramatic cluster
B. Avoidant Personality Disorder
According to psychodynamic theorists, an important factor in the development of Avoidant Personality Disorder is: A. An early sense of guilt B. Early experiences of shame C. Lack of development of trust D. An inability to express anger
B. Early experiences of shame
An individual with a diagnosis of odd personality disorder is MOST likely to have a parent of sibling who has: A. Bipolar Disorder B. Schizophrenia C. One of the paraphilias D. Alcoholism
B. Schizophrenia
Intoxication is actually a form of: A. Tolerance B. Temporary Change C. Hallucinations D. Substance Dependence
B. Temporary Change
A client being treated for Avoidant Personality Disorder must increase the number of social contacts per day. The person, at the least, must greet others with the sentence, "Hello, how are you doing?" MOST likely, the therapist has which theoretical background: A. Psychodynamic B. Biological C. Cognitive Behavioral D. Sociocultural
C. Cognitive Behavioral
Jonah is receiving weekly individual and group therapy for BPD. He is learning to recognize when his emotional expression is appropriate. He is receiving: A. Traditional cognitive-behavioral therapy B. Gestalt therapy C. Dialectical behavioral therapy D. Humanistic theory
C. Dialectical behavioral therapy
developmental psychopathology
Childhood traumas and dysfunctional parental attachments lead to metallization deficits
What is mentalization? A. Psychoanalysis B. Social skills training and other therapy that improves symptoms C. A form of inpatient hospitalization D. The capacity to understand one's own mental states and those of other people
D. The capacity to understand one's own mental states and those of other people
neurodevelopmental disorders
a group of conditions manifested early in development
Deficits in social-emotional reciprocity
abnormal social approaches, failing to engage in normal back and forth dialogue, reduced affect
The primary cause of moderate, severe, and profound IDD are...
biological causes that occur before, during or after birth and genetic factors
cerebellum
controls a person's ability to rapidly shift their focus of attention
IDD conceptual/academic problems
memory, language, reading, writing, problem solving
Obsessive-Compulsive PD prevalence rates b/w men and women
men are twice as likely as women to display disorder
affectivity
range and intensity of emotional experiences
Deficits in nonverbal communicative behaviors
poor or no eye contact (outside of a cultural aspect), little to no facial expressions, no gestures
Families with an increased likelihood of having autistic children also have an increased chance of...
producing savants
Egodystonic
symptoms are recognized emotionally as disruptive
Egosyntonic
symptoms go unnoticed by the individual. They don't disrupt the individual's emotional system and the emotional systems of the people around them
ASD and objects
setting up lines with their toys, mesmerized by a spinning top for hours
Avoidant PD rates among men and women
similar rates among men and women
Schizoid PD prevalence rates b/w men and women
slightly more common in men than in women
Schizotypal PD prevalence rates b/w men and women
slightly more common in men than in women
IDD social problems
social awareness of other people's thoughts/feelings, empathy, social judgment
Metabolic disorders that affect intelligence and development are typically caused by...
the pairing of the two defective recessive genes (one from each parent)
cognitions
ways of perceiving and interpreting self, others, and events
fragile X syndrome
- second most common chromosomal cause of IDD - Tied to a full mutation of the FMR1 gene
Mild IDD causes
- sociocultural and psychological causes - Poor and unstimulating environments - inadequate parent-child interactions - insufficient learning experiences - malnourishment
Antisocial PD treatment
- TYPICALLY, do not seek/receive unless actually caught and court-mandated - NOT unresponsive to treatment, but extremely difficult patients because: > Treatments are not addressing unique developmental mechanisms underlying their antisocial behavior > Need for comprehensive AND individualized treatment > We are addressing those key underlying factors > No desire to change > Premature drop-out
Histrionic PD theoretical explanations
- Unhealthy relationships with cold, controlling parents in childhood; feelings of being unloved and fear of abandonment - sense of helplessness - cultural norms and expectations
Dependent PD theoretical explanations
- Unresolved conflicts during oral stage - Early parental loss or rejection prevents normal attachment and separation - Over-involvement or overprotection - can lead to dependency - Unintentional rewarding the clinging and loyal behavior - Maladaptive thoughts tied to inadequacy/helplessness
Obsessive-Compulsive PD treatment
- Usually believe that nothing is wrong with them so unlikely to seek treatment unless they are suffering from one of those comorbid conditions - Often respond well to psychodynamic or cognitive therapy - Selective Serotonin Reuptake Inhibitors (SSRIs)
Cluster C
- anxious, fearful - Obsessive-Compulsive - Dependent - Avoidant
Avoidant PD characteristics
- avoids occupational activities that involve significant interpersonal contact due to fears of rejection, disapproval, and criticism - Preoccupied with being criticized or rejected in social situations - views self as inferior to others
Borderline PD Integrative explanations
- biosocial - developmental psychopathology
abnormal activities and/or anatomies of other brain structures (ASD)
- corpus callosum - amygdala - thalamus - cingulate cortex - striatum
Dependent PD Treatment
- develop independence; the patient is then motivated to accept responsibility - learn to advocate for self - challenge and change helplessness - antidepressants - group therapy
Paranoid Personality Disorders
- distrust, suspicion - think they are being tricked - cold and emotionally detached
Cluster B
- dramatic, emotional - almost impossible for them to have relationships that are truly giving and satisfying - Often described as "sociopaths" or "psychopaths."- antisocial - borderline - histrionic - narcissistic
ASD and speech
- echolalia (echoing phrases spoken by others) - pronoun reversal (confusion of pronouns)
Turner Syndrome
- females only - X chromosome is either missing or partially missing - short stature and early loss of ovarian function
hypearactivity
- fidgets - often talks excessively - often blurts out answers - difficulty waiting one's turn - often interrupts or intrudes on others
Applied Behavior Analysis (ABA)
- gold standard used to treat ASD - Goal is increase behaviors that are helpful and decrease behaviors that are harmful and/or adversely affect learning - uses operant conditioning techniques - focuses on specific symptoms
symptoms of ADHD
- inattention, hyperactivity, impulsivity - symptoms persist for more than 6 months - inattention or hyperactivity present before age 12
personality pattern
- inflexible and persuasive - leads to distress or impairment in functioning - stable and long duration - cannot be a manifestation of another disorder
Klinefelter Syndrome
- males only (XXY Syndrome) - infertility and small testicles
Levels of IDD
- mild (IQ: 50-70) - moderate (IQ: 35-49) - severe (IQ: 20-34) - profound (IQ below 20)
ASD treatment
- no treatment reverses autistic pattern - cognitive-behavioral therapy - communication training - parent training - community integration - behavioral approaches
Schizotypal PD characteristics
- odd beliefs or magical thinking (ex: my my wife walked the dog because I thought about it and now she's walking the dog) - unusual perceptual experiences - odd thinking and speech - Behavior or appearance that is odd, eccentric, or peculiar - lack of close friends
Cluster A
- odd, eccentric - paranoid - schizoid - schizotypal
inattention
- often easily distracted by extraneous stimuli - often forgetful in daily activities - often does not seem to listen when spoken to directly - often fails to give close attention to details or makes careless mistakes
IDD causes: childhood problems
- particularly up to age 6, certain injuries and accidents can affect intellectual functioning - lead poisoning, head injuries, infections like meningitis
IDD characteristics
- person learns very slowly - difficulty with attention, short-term memory, planning, and language
ASD sociocultural causes
- personality characteristics of parents - family dysfunction - environmental and social stress
Obsessive-Compulsive PD characteristics
- preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency - rules, lists, tasks, schedules - inflexible - strict standards and moral codes
Paranoid PD treatment
- rare that the individual will seek treatment willingly - Object relations therapists - Social skills education; role-playing, exposure techniques; group therapy - antipsychotics - development of more realistic interpretations of words and actions
ASD genetic causes
- rates higher among siblings (10-20%) - highest among identical twins (60%) - prenatal difficulties or birth complications - brain abnormalities: cerebellum
characteristics of ASD
- ritualized patterns of verbal or nonverbal behavior - struggles with change - restricted, fixated interests - hyper or hypo reactivity to sensory input - odd responses to sensory stimuli - self-injury behaviors
Narcissistic PD prevalence on men
75% of men
Attention-Deficit/Hyperactivity Disorder (ADHD)
A pervasive pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development
What is the most effective ADHD treatment program? A. Drugs, combined with cognitive-behavioral therapy, work best. B. Psychodynamic therapy works best, with or without drugs. C. Dietary changes work best in the long term. D. Cognitive-behavioral therapy outperforms even methylphenidate.
A. Drugs, combined with cognitive-behavioral therapy, work best.
The categorical approach to personality assumes that: A. Problematic personality traits are either present or absent B. Personality disorders are best understood on a continuum based on severity of symptoms C. Individuals can turn their symptoms off like a light switch D. Children as well as adults should be diagnosed with personality disorders
A. Problematic personality traits are either present or absent
One speech problem displayed by many children with autism spectrum disorder is that they repeat everything said to them. This is called: A. echolalia. B. neologism. C. nominal aphasia. D. pronominal reversal.
A. echolalia.
A blood alcohol concentration of _______ percent typically produces the symptoms of intoxication: A. 0.01 B. 0.06 C. 0.09 D. 0.55
C. 0.09
The "high" produced by using narcotics is due to the drug: A. Causing an increased release of serotonin. B. Blocking GABA activity. C. Attaching to sites normally receptive to endorphins. D. Flooding neurotransmitter synapses with dopamine.
C. Attaching to sites normally receptive to endorphins.
A client is initially very resistant to therapy, cannot acknowledge weaknesses, and ignores feedback. MOST likely, the client is experiencing: A. Schizoid PD and will not make much progress in therapy B. Schizoid PD and will make a great deal of progress in therapy C. Narcissistic PD and will not make much progress in therapy D. Narcissistic PD and will make a great deal of progress in therapy
C. Narcissistic PD and will not make much progress in therapy
With the help of a therapist, a client with OCPD has experienced a dramatic decrease in both dichotomous thinking and worrying. The client's behavior is: A. Common; most with OCPD seek help, and this person is most likely receiving cognitive therapy B. Common; most with OCPD seek help, and this person is most likely receiving psychodynamic therapy C. Uncommon; most with OCPD do not seek help, and this person is most likely receiving cognitive therapy D. Uncommon; most with OCPD do not seek help, and this person is most likely receiving psychodynamic therapy
C. Uncommon; most with OCPD do not seek help, and this person is most likely receiving cognitive therapy
Which statement BEST describes effective therapy for treating BPD? A. There is no effective therapy for BPD B. When using the psychodynamic approach, avoid relational therapy C. Using psychodynamic medication sis a safe, effective way to treat the disorder D. Research suggests that DBT is the most effective
D. Research suggests that DBT is the most effective
Nate took a drug and a few minutes felt calm. He then became drowsy and went to sleep. Nate MOST likely took: A. Heroin B. Cocaine C. Cannabis D. Barbiturates
D. Barbiturates
Mario felt awake and alive as though he could conquer the world. He MOST likely used: A. Heroin B. Alcohol C. Xanax D. Cocaine
D. Cocaine
A patient at an alcohol rehabilitation center tell you a detailed story about growing up in the mountains of Tennessee. Later, you find out that the person has never been visited Tennessee. A day later, you visit the patient again, and the patient does not recognize you. This patient is MOST likely suffering from: A. Fetal Alcohol Syndrome B. Cirrhosis C. Withdrawal of Delirium D. Korsakoff's Syndrome
D. Korsakoff's Syndrome
The Schizoid Personality Disorder differs from Paranoid Personality Disorder in that: A. Those with Schizoid PD seek close affiliations with others, while those with Paranoid PD do not B. Paranoid PD is treatable only through drug therapy; Schizoid PD can be treated with psychotherapy C. Women are more likely to have Schizoid PD than Paranoid PD; the opposite is true for men D. Those with Schizoid PD desire to be alone; those with Paranoid PD are alone because of suspiciousness
D. Those with Schizoid PD desire to be alone; those with Paranoid PD are alone because of suspiciousness
When a child with autism spectrum disorder jumps, flaps her arms, twists her hands and fingers and makes unusual faces, the child is engaging in: A. self-injurious behavior. B. self-communication behavior. C. self-motor behavior. D. self-stimulatory behavior
D. self-stimulatory behavior
Narcissistic PD
Grandiosity, need for admiration, and lack of empathy
ASD biological causes
Mom may have been exposed to toxic chemicals when she was pregnant
Avoidant PD
Social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation; discomfort
Obsessive-Compulsive PD
Preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency
personality
Uniquely expressed characteristics that influence behaviors, emotions, thoughts, and interactions
Deficits in developing, maintaining, and understanding relationships
adjusting behavior to certain social settings, imaginary play is a struggle
BPD and Antisocial
are the only disorders with decent body of empirical evidence to support etiology
IDD practical problems
financial management, personal care
pararoid PD prevalence rates b/w men and women
more common in men than in women
joint attention
the ability to focus on what another person is focused on