PSR FINAL (COMBINED ONE)

Dystonia

(Basal Ganglia: Extra Pyramidal Symptoms/Side Effects) tonic (acute contractions) of tongue, jaw, & neck usually occurs on first few hours or days on antipsychotics includes: opisthotonis oculogyric crisis laryngospasm torticollis

bipolar and related disorder due to medical condition

elevated, expansive, or irritable mood and abnormally increased activity or energy from another medical condition specify manic features, manic or hypomanic like episode, mixed features

Autism Spectrum Disorder

essential feature is persistent deficits in social communication & social interaction across a number of contexts

Loos Associations

Disorder of Form of Thought -Patient's responses do not relate to the interviewer's questions, or one paragraph, sentence, or phrase is not logically connected to those that occur before or after

Schizophrenia Spectrum and Other Psychotic Disorders

Disorders that are characterized by delusions, fixed beliefs contrary to conflicting evidence, and hallucinations, sensory experiences that manifest in the absence of an external stimulus

_____________ can be adaptive when neither resistance nor escape are possible

Dissociation

Children and youth with __________________________________ display persistent anxiety following an overwhelming traumatic event that occurs outside the range of usual human experience

Post-traumatic stress disorder (PTSD)

Simple Tics

What CLASSIFICATION of tic may involve moving just one muscle, or uttering a single sound? Movements are sudden, short lived, and often repetitive.

Physical Tic (motor tic)

What TYPE of tic is a motor movement, such as blinking, jerking the head or any part of the body?

Phonic Tic (vocal tic)

What TYPE of tic is uttering sounds, such as grunts or squeaks, and words or phrases?

Active Symptoms

What are ACTIVE distortions in behavior or perception?

- blunted "Affect" - loosening of "Associations" - "Ambivalence" - "Autism"

What are Bleuler's 4 A's?

Negative Symptoms

What are deficits or LACKS in behavior or expression?

Anafranil & Lexapro

What are the two most often used drugs for OCD?

Types of Thought Content

What are these called? - Thought broadcasting - Thought insertion - Thought withdrawal - Thought control - Somatic passivity - Delusional percept or perception

Dopamine

neurotransmitter correlated with movement, attention, and learning too much: schizophrenia too little: some forms of depression as well as muscular rigidity and tremors found in Parkinson's

Epinephrine

neurotransmitter involved in energy and glucose metabolism too little: depression

Endorphins

neurotransmitter involved in pain relief and feelings of pleasure and contentedness

Acetylcholine

neurotransmitter involved in voluntary movement, learning, memory, and sleep too much associated with depression too little in hippocampus with dementia

Acetylcholine

neurotransmitter involved in voluntary movement, learning, memory, and sleep too much: depression too little: in the hippo-campus has been associated with dementia

GABA (Gamma-Amino Butryic Acid)

neurotransmitter that inhibits excitation and anxiety too little: anxiety and anxiety disorders some antianxiety medication increases this neurotransmitter at the receptor sites

Serotonin

neurotransmitter that plays a role in mood, sleep, appetite, and impulsive and aggressive behavior too little: depression and some anxiety disorders, especially obsessive-compulsive disorders some antidepressant medications increase the availability of this neurotransmitter at the receptor sites

Serotonergic Crisis

occurs after combining MAOI & SSRI

DSM 5 Level of Severity of Intellectual Disability

Mild (70) Moderate (71) Severe (72) Profound (73)

What is Dialetical Behaviour Therapy (DBT)?

Used for people who are engaging in self harm (usually women who are engaging in cutting)

Vilazodone Hydrochloride

Viibryd

Protriptyline

Vivactil

Lisdexamfetamine

Vivanse

Cariprazine

Vraylar

Bupropion

Wellbutrin

Schizophrenics

_________________ have been considered mystics, saints, possessed of evil spirits or servants of the devil.

Treatments

_________________ of Schizophrenics have been as gentle as music therapy and as violent as psycho-surgery.

Hebephrenia's

______________________ main symptoms were a "silly", disorganized mind.

Treatment

The extreme depression and psychoses that can result due to lack of _____________ are the usual causes of suicide in people with Schizophrenia.

Perseveration

Disorder of Form of Thought - Uncontrollable repetition of a particular response, such as a word, phrase, or gesture, despite the absence or cessation of a stimulus

Neologism

Disorder of Form of Thought -Invention of new words regarded as a symptom of certain psychotic disorder

Akinesia

(Basal Ganglia: Extra Pyramidal Symptoms/Side Effects) lack of spontaneous gestures or voluntary movements apathy rigid posture diminished or lack of conversation arm swing decreased walk with a shorter stride

Rabbit Syndrome

(Basal Ganglia: Extra Pyramidal Symptoms/Side Effects) occurs late in treatment rapid lip and masticating movements that mimic rabbit continues during sleep

Neuroleptic Malignant Syndrome

(Basal Ganglia: Extra Pyramidal Symptoms/Side Effects) severe parkinsonism with muscle rigitity, catatonic appearance, tremors, lead-pipe muscle tone, and short gait alerted consciousness- dazed mutism, agitated, confused, or comatose

Mental Retardation

"Intellectual Disability" replaces the ____________ diagnosis in the DSM-IV-TR

Tardive Dystonia

(Basal Ganglia: Extra Pyramidal Symptoms/Side Effects) sustained or repetitious contractions of one or more muscle groups; rarely remits

Tardive Dyskinesia

(Basal Ganglia: Extra Pyramidal Symptoms/Side Effects) involuntary rolling of the tongue and twitching of the face or trunk or limbs

Parkinsonism

(Basal Ganglia: Extra Pyramidal Symptoms/Side Effects) *occurs in large number of patients taking phenothiazines* decreased arm swing stiffness, stooped posture masklike faces, dulled, blank stare shuffling, festinating gait (small steps) cogwheel rigitity drooling, seborrhea tremor loss of spontaneous movement coarse pill-rolling of thumb & fingers at rest passive inactivity, withdrawal & depression

Cued panic attacks

(DSM4) response to specific objects or situation; rather common reaction

Nocturnal panic attack

(DSM4) small number occur at night

In-cued panic attacks

(DSM4) unpredictable attack comes "out of the blue"

Microglia

(Neuroglial cells of the CNS) digest parts of dead neurons

Oligodendroglia

(Neuroglial cells of the CNS) provide the insulation (myelin) to neurons in the central nervous system

Astrocyte (Astroglia)

(Neuroglial cells of the CNS) star-shaped cells that provide physical nutritional support for neurons: - clean up brain debris - transport nutrients to neurons - hold neurons in place - digest parts of dead neurons - regulate content of extracellular space

Catatonia (mental disorder) 293.89 (F06.1) Catatonia (medical condition) 293.89 (F06.1)

* Code mental disorder or medical condition first, then catatonia A. Defined by the presence of 3 or more of 12 psychomotor features in diagnostic criteria - Stupor - Catalepsy - Waxy Flexibility - Mutism - Negativism - Posturing - Mannerism - Stereotypy - Agitation of internal influence - Grimacing - Echolalia - Echopraxia

Substance/Medication-Induced Psychotic Disorder

* Presence of - Delusions - Hallucinations * Evidence from history, physical exam, labs - Symptoms developed during or after substance intoxication - Substance is capable of producing symptoms * Not explained by psychotic disorder * Does not occur exclusively during course of delirium * Distress in social, occupational or other functioning * Specify (with onset during intoxication) (with onset during withdrawal)

Psychotic Disorder Due to Another Medical Condition

* Prominent hallucinations or delusions * Evidence from history, physical exam or labs there is direct pathophysiological consequence of medical condition *Not explained by another mental disorder * Does not occur exclusively during course of delirium * Distress in social, occupational or other functioning *293.81 (F06.2) with delusions *293.82 (F06.0) with hallucinations *Rate severity using Clinician-Rated Dimensions of Psychosis Symptom Severity

Specifiers for Schizoaffective Disorder

*Bipolar Type 259.70 (F25.0) - manic episode is present, may have major depressive episode *Depressive Type 259.70 (F25.1) - major depressive episode is present

Brief Psychotic Disorder 298.8 (F23)

*Presence of one or more - delusions - hallucinations - disorganized speech - grossly disorganized or catatonic behavior *Duration of one day, but less than one month and return to premorbid function *Not better accounted for by psychotic features of bipolar or major depressive disorder *Specify - with marked stressor(s) - without marked stressor(s) - with postpartum onset - with catatonia *Specify Severity - use Clinician-Rated Dimensions of Psychosis Symptom Severity

DSM IV-TR: Definition of Cognitive Deficits

*Significantly sub-average general intellectual functioning. - Score of 70 or below on individual measure of intelligence. *Significant limitations in 2 levels of adaptive functioning. - Communications, self care, home living, social/interpersonal skills, self-direction, functional academic skills, work, leisure, health, safety) *Onset before age 18

World Health Organization Disability Assessment Schedule (WHODAS)

- A generic assessment instrument for health and disability - Uses across all diseases, including mental, neurological, and addictive disorders

Amphetamine & Dextroamphetamine

- Adderall - Adderall XR

ADHD Stimulant Medications

- Amphetamine & Dextroamphetamine - Methylphenidate - Dextroamphetamine - Dexmethylphenidate - Lisdexamfetamine

ADHD Non-stimulant Medications

- Atomoxetine (Strattera) class of medications known as SNRI - Guanfacine (Intuniv) used alone or in combination with other meds to treat high blood pressure & may treat ADHD by affecting the part of the brain that controls attention and impulsivity - Clonidine (Kapvay) alpha 2 agonists hypotensive agents. Clonidine is the generic name of Catapres, a medication used to treat high blood pressure. Clonidine works by slowing down your heart rate and relaxing blood vessels

Anticholinergic Effects

- Blurred near vision - Dry eyes - Paralytic ileus - Narrow-angle glaucoma - Dry mouth - Hypotension - Constipation - Urinary hesitancy & retention - Photophobia - Nasal congestion - Confusion and decreased memory

Reactive Attachment Disorder

- Care is presumed to be responsible for disturbed behavior - Criteria not met for autism spectrum disorder -

Autism Spectrum Disorder 299.00 (F84.0)

- Cause clinically significant impairment in social, occupational, or other important areas of current function - No better explained by * Intellectual Disability * Global Developmental Delay * Autism and Intellectual Disability co-occur - Several inattentive or hyperactive-impulsive symptoms prior to 12 - Several inattentive or hyperactive-impulsive symptoms present in two or more contexts - Do not occur exclusively during course of schizophrenia or other psychotic disorder or another mental disorder

Childhood-Onset Fluency Disorder 315.35 (F80.81) (formerly Stuttering)

- Causes anxiety about public speaking and limitations in effective communication - Early developmental period - Later onset is adult-onset fluency disorder - Not speech-motor or sensory deficit or neurological insult

Other Specified Schizophrenia Spectrum and Other Psychotic Disorder 298.8 (F28) Note: no reimbursement for this

- Clinically significant distress, but does not meet full criteria for other disorders - Persistent auditory hallucinations - Delusions with significant overlapping mood episodes - Attenuated psychosis syndrome - Delusional symptoms in part of individual with delusional disorder - Unspecified Schizophrenia Spectrum and Other Psychotic Disorder 298.9 (F29)

ADHD Specifiers

- Combined presentation 314.01 (F90.2) - Predominantly inattentive presentation 314.00 (F90.0) - Predominantly hyperactive / impulsive presentation 314.01 (F90.1) - In partial remission - Mild, Moderate, or Severe Note: Can be diagnosed with Autism Spectrum Disorder

Methylphenidate

- Concerta - Daytrana - Desoxyn - Metadate ER & CD - Methylin - Ritalin - Ritalin SR & LA

Parkinsonism (occurs in large number of patients taking phenothiazines)

- Decreased arm swing - Stiffness, stooped posture - Masklike faces, dulled, blank - Shuffling, festinating gait (small steps) - Cogwheel rigidity - Drooling, seborrhea - Tremor - Loss of spontaneous movement - Coarse pill-rolling of thumb & fingers at rest - Passive inactivity, withdrawal & depression

Social (Pragmatic) Communication Disorder 315.30 (F80.99)

- Deficits in functional limitations in effective communication, social participaton, social relationships, academic achievement or occupational performance - Onset in early developmental period - Not attributable to neurological or medical disorder - Not autism, intellectual disability, or other mental disorder

Dextroamphetamine

- Dexedrine - Dextrostat

Extrapyramidal Effects (phenothiazines)

- Dystonia - Parkinsonism - Akinesia - Neuroleptic malignant syndrome - Rabbit syndrome - Tardive dyskinesia - Tardive dystonia

Attention Deficit / Hyperactivity Disorder (ADHD)

- Essential feature is persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. - Several inattentive and hyper-impulsive symptoms present prior to age 12. - Present in 2 or more contexts/settings

Dexmethylphenidate

- Focalin - Focalin XR

Extrapyramidal Tracts

- Found in the reticular activating formation of the pons and medulla, and target neurons in the spinal cord involved in reflexes, locomotion, complex movements, and postural control - These tracts are in turn modulated by various parts of the CNS, including the nigrostriatal pathway, basal ganglia, the cerebellum, the vestibular nuclei, and different sensory areas of the cerebral cortex. - All of these regulatory components can be considered part of the extrapyramidal system, in that they modulate motor activity without directly innervating motor neurons

Noradrenergic Crisis

- Hypertension - Occipital headache - Stiff or sore neck - Flushing or sweating - Cold clammy skin - Tachycardia These are symptoms of what?

Brice Hospital in Tuscaloosa, AL

- In 1967 more than 5,200 patients were held in a facility never designed to hold that many. - Observers described this hospital as a concentration camp and a model for human cruelty. - A class action suit in 1970 by a patient, Wyatt resulted in a 33 year with the state of Alabama - This led to drastic changes in the treatment of mentally ill persons nationwide

Tardive Dyskinesia (TD)

- Involuntary face, trunk, & limb move - Facial-lingual oral involuntary hyperkinesis (frowning, blinking, smiling, grimacing, puckering, pouting, blowing, smacking of lips, licking, chewing, clenching teeth, lateral jaw movements, rolling & protruding (fly-catchers tongue), spastic facial movements). - Limb choreoathetoid movements (Choreiform (hand clinching) movements, Trunk twisting, pelvic thrusting, serpentine shoulder movements, Foot tapping, squirming) - Trunk Movements - (movements of neck, rocking, twisting, thrusting) - Tardive akathesia (persistent restlessness feelings) - Tardive dystonia (recurrent muscle contractions of neck & shoulders) - Patients grunt and have more symptoms under stress, symptoms disappear in sleep)

Akinesia

- Lack of spontaneous gestures or voluntary movements. - Apathy - Rigid Posture - Diminished or total lack of conversation - Arm swing decreased - Walk with a shorter stride

Akathisia

- Motor, inner driven restlessness and hand wringing - Jitters, figety, inner itch - Tapping feet incessantly, rhythmic jiggling of legs or "restless legs" - Rocking forward & backward in chair - Shifting weight from side to side when standing

Rabbit Syndrome

- Occurs late in treatment - Rapid lip and masticating movements that mimic a rabbit - Continues during sleep

NIMH on Autism

- Often have unusual responses to sensory experiences, such as certain sounds or the way objects look - Does not babble, point, or make meaningful gestures by 1 year of age - Does not speak one work by 16 months - Does not combine two words by 2 years - Does not respond to name - Poor eye contact - Doesn't seem to know how to play with toys - Excessively lines up toys or other objects - Is attached to one particular toy or object - Doesn't smile - Seems to be hearing impaired at times

Norepinephrine Receptors

- Orthostatic Hypotension - Sedation Blockade of __________

Hoarding Disorder

- Persistent difficulty discarding or parting with possessions, regarding their actual value. - This difficulty is due to a perceived need to save items and to distress associated with discarding them

Social (Pragmatic) Communication Disorder 315.30 (F80.99)

- Persistent difficulty in the social use of verbal and nonverbal communication - Deficits in using communication for social purposes - Impairment of the ability to change communication to match the context of the listener - Difficulties following rules for conversation or story telling - Difficulties in understanding what is not explicitly stated and nonliteral or ambiguous meanings of language * Idioms * Humor * Metaphors

Speech Sound Disorder 315.39 (F80.0) (previously Phonological Disorder)

- Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication or messages - Disturbance causes limitation in effective communication that interferes with social participation, academic achievement, or occupational performance - Onset of symptoms in early developmental period - No due to congenital or acquired conditions

Trichotillomania (hair-pulling disorder)

- Recurrent pulling out one's hair, resulting in hair loss. - Repeated attempts to decrease or stop hair pulling. - The hair pulling causes clinically significant distress or impairment in social, occupational, or other important areas of funcitioning.

Stereotypic Movement Disorder 307.3 (F98.4)

- Repetitive, seemingly driven and purposeless motor behaviors - Repetitive motor behavior interferes with social, academic, or other activity and may result in self injury - Onset in early developmental period - Motor behavior not attributable to the effects of substance or other mental disorder

Vilazodone Hydrochloride (Viibryd)

- SSRI - 5HT1A receptor partial agonist - used to treat major depressive disorder - treatment should be titrated

Fluoxetine (Prozac)

- SSRI - Long half life (missed dosage not problem) - Activating energy quickly (may cause immediate worsening of depression) - decreased appetite - may help overweight clients - problem with low weight patients - somnolence & lethargy uncommon - FDA approves for: major depressive disorder, OCD, moderate to severe bulimia, panic disorder

Escitalopram Oxalate (Lexapro)

- SSRI - active isomer of the antidepressant citalopram - may take 4 or more weeks to act - for major depressive disorder and GAD

Citalopram (Celexa)

- SSRI - approved for MDD and depression - low side-effect profile - minimal effect on norepinephrine & dopamine - low anticholinergic effects - not well tolerated by clients with severe anxiety symptoms

Sertaline (Zoloft)

- SSRI - low in side effects, nervousness - lowest SSRI in anorexia - low mania induction in bipolar - maximum absorption requires full stomach - dryer mouth than other SSRIs - can cause somnolence - FDA approves for: major depressive disorder, OCD, panic disorder, PTSD, PMDD, and social anxiety disorder

Vortioxetine (Brintellix)

- SSRI - serotonin modulator and stimulator - belongs to a psychotropic class of chemical compounds known as bis-aryl-suphanyl amines - specifically indicated for major depressive disorder

Paroxetine (Paxil)

- SSRI - somnolence common - diarrhea less common - low mania induction in bipolar - anticholinergic effects more common - approved for: OCD, depression, panic disorder, GAD, PTSD, and social phobia

Histamine Receptors

- Sedation - Antiemetic Properties Blockade of ___________

Attention Deficit Hyperactivity Disorder

- Several inattentive or hyperactive-impulse symptoms prior to 12 - Several inattentive or hyperactive-impulsive symptoms present in two or more contexts - Clear evidence that the symptoms interfere with or reduce social, occupational, or academic functions - Do no occur exclusively during course of schizophrenia or other psychotic disorders or another mental disorder

Neuroleptic Malignant Syndrome (NMS)

- Severe parkinsonism with muscle rigidity, catatonic appearance, tremors, lead-pipe muscle tone, festinating gait - Alerted consciousness - dazed mutism, agitated, confused or comatose -Autonomic dysfunction (tachycardia, profuse sweating, increased BP, tachypnea (increased respirations), pallor - Severe lab abnormality (high creatine levels, renal decline, muscle damage)

Persistent Motor or Vocal Tic Disorder 307.22 (F95.1)

- Single and multiple motor and vocal tics that wax and wane, but persist 1 year manifesting before age 18 - Criteria not met for Tourette's Disorder - Specify, motor only or vocal only tics

Persistent Motor or Vocal Tic Disorder

- Single and multiple motor and vocal tics that waxes and wanes, but persisted 1 year manifesting before age 18. - Criteria not met for Tourette's disorder - Specify, motor only or vocal only tics

Provisional Tic Disorder 307.21 (F95.0)

- Single or multiple motor or vocal tics - Does not meet criteria for Persistent Motor or Vocal Tic Disorder or Tourette's Disorder

Provisional Tic Disorder

- Single or multiple motor or vocal tics - Does not meet criteria for other motor disorder

Persistent (Chronic) Motor or Vocal Tic Disorder 307.21 (F95.0)

- Single or multiple motor or vocal tics that have been present during the illness, but not both motor and vocal - The tics may wax and wane in frequency but have persisted for more than 1 year since first tic onset - Onset before 18 - Disturbance not attributable to the effects of substance or other medical condition - Not meet criteria for Tourette's - Specify if motor tics only - Specify if vocal tics only

NIMH on Autism

- Some children and older individuals spend a lot of time repeatedly flapping their arms or walking on their toes. - As children, they might spend hours lining up their cars and trains in a certain way, rather than using them for pretend play. - Repetitive behavior sometimes takes the form of a persistent, intense preoccupation. - For example, the child might be obsessed with learning all about vacuum cleaners, train schedules, or lighthouses. - Often there is a great interest in numbers, symbols, or science topics

Tardive Dystonia

- Sustained or repetitious contractions of one or more muscle groups - rarely remits

motivational symptoms

- hyperactivity & frenetic activity, intrusive demands, domineering and commanding - high risk or reckless behaviors

NIMH on Autism

- The child lacks interest in and responsiveness to people, and they fail to develop normal attachments - Older individuals may have an interest in friendships, but lack understanding of appropriate social interactions - Abnormality or impaired development in social interactions and communication - Diminished repertoire of activity and interest - Response to others does not develop in first 30 months - Failure to form normal attachments in early childhood

Clozapine --- Clozaril

- Weight gain - Disturbance of lipid metabolism, impaired glucose tolerance and type 2 diabetes mellitus - Danger of fatal blood disorder - Binds to dopamine receptors - Effects on various dopamine mediated behaviors differ from conventional antipsychotics - Potent anticholinergic, adrenolytic, antihistamine, and antiserotonergic activity - Produces little or not prolactin elevation

Specifiers for Autism Spectrum

- With or without accompanying intellectual impairment - With or without accompanying language impairment - Associated with another neurodevelopmental, mental, behavioral disorder - Associated with known medical or genetic condition or environmental factor - With catatonia - additional code 293.89 (F06.1)

Specifiers of Stereotypic Movement Disorder 307.3 (F98.4)

- With or without self-injurious behavior - Mild, Moderate, Severe - Specify if associated with a medical condition or genetic disorder

Side Effects of Tricyclic Antidepressants

- anticholinergic effects - cardiac arrhythmia - orthostatic hypertension - hypertension - sedation

Tricyclic Antidepressant Effects

- appetite returns after 5-7 days - insomnia improves after 3-4 days - take 10-14 days to act - full effect may take 6 weeks - two major mistakes: inadequate dose & inadequate time allowed for functioning

Paliperidone (Invega)

- atypical antipsychotic - XR formula or monthly depot - primary active metabolite of the older antipsychotic risperidone - risperidone with an extra hydroxyl group - specific mechanism of action is unknown - FDA approved for schizophrenia 2006

Clozapine (Clozaril)

- atypical antipsychotic - binds to dopamine receptors - effects on various dopamine medicated behaviors differ from conventional antipsychotics - produces little or no prolactin elevation

Ziprasidone (Geodon)

- atypical antipsychotic - combined dopamine & serotonin receptor antagonist activity - effective in schizoeffective disorder - beneficial on negative symptoms & depression

Quietapine Furmarate (Seroquel)

- atypical antipsychotic - dibenzothiazepine derivative - 5HT2 & 5HT1A receptors - D1 & D2 receptors - little anticholinergic effect - less likely to cause extrapyramidal symptoms than other atypical drugs - appears not to elevate levels of prolactin

Iloperidone (Fanapt)

- atypical antipsychotic - dopamine & serotonin antagonist - titrate slowly - dizziness, dry mouth, fatigue, nasal congestion, orthostatic hypotension, somnolence, tachycardia, increased weight, QT prolongation - psychotropic agent belonging to the chemical class of piperidinyl-benzisoxazole derivatives

Risperidone (Risperdal)

- atypical antipsychotic - dopamine antagonism D2 and receptor blockade serotonin 5-H2T2 - available in long acting depot and injectable form - 4-10 x less potent than haloperidol - advantages = negative symptoms, uncontrolled hostility/excitement, anxiety & depression

Nuplazid (Pimavanserin)

- atypical antipsychotic - for hallucinations and delusions associated with parkinson's disease psychosis - combination of inverse agonist and antagonist activity at serotonin 5-HT2A receptors and to a lesser extent at serotonin 5-HT2C receptors - adverse effects = peripheral edema, confused state

Brexpiprazole (Rexulti)

- atypical antipsychotic - indicated for adjunctive treatment of major depressive disorder and the treatment of schizoprenia - adverse effects = akathisia, weight gain

Aripiprazole Lauroxil (Aristada)

- atypical antipsychotic - indicated for treatment of schizophrenia - supplied as a solution for intramuscular administration

Cariprazine (Vraylar)

- atypical antipsychotic - indicated for treatment of schizophrenia and for acute treatment of manic or mixed episodes associated with bipolar I

Olanzapine (Zyprexa)

- atypical antipsychotic - mediated by combination of dopamine & serotonin type 2 (5HT2) antagonism - antagonism of musacarinic receptors = anticholinergic effects - antagonism of histamine receptors = somnolence - antagonism of adrenergic receptors = orthostatic hypotension

Lurasidone (Latuda)

- atypical antipsychotic - psychotropic agent belonging to the chemical class of benzoisothiazol derivatives - drowsiness, jittery, nausea, movement or muscle disorders, vomiting, indigestion, insomnia

Aripiprazole (Abilify)

- atypical antipsychotic - strong 5HT2A receptor antagonism - similar to ziprasidone in agonistic activity at teh 5HT1A receptor - lowest affinity for alpha(1)adrenergic, histamine (H1) and muscarinic (M1) receptors of atypicals - efficacy in positive & negative symptoms of schizophrenia and bipolar disorder - orthostatic hypertension

Pimazode (Orap)

- atypical antipsychotic - used to control motor or verbal tics caused by tourette's disorder - blockade of postsynaptic dopamine receptors has been postulated (precise mechanism unknown)

Serotonergic Crisis Effects

- elevated temperature, fever - abnormal muscle movements (twitches) - autonomic dysreflexia (overreaction of the involuntary nervous system to stimulation) - (rarely) generalized seizure - POSSIBLE side effects: hypotension, anxiety/agitation, shivering, enhanced startle response, insomnia, confusion and delirium, shock, death

Tricyclic Antidepressants

- inhibit or block active reuptake of norepinephrine - sedative effects are attributed to antihistaminic action (H1 receptors) - absorbed from the GI tract - largely metabolized by first-pass metabolism - highly lipophilic (concentrated in heart and brain)

Monoamine-Oxidase Inhibitors (MAOIs)

- interferes with MAO-A & MAO-I - superior to TCAs in atypical depression - successfully treat 55 - 70% of depression

Deinstitutionalization

- long-term trend wherein fewer people reside as patients in mental hospitals - President John F. Kennedy's 1963 Community Mental Health Centers Act accelerated the trend - In the 1960's, with the introduction of Medicare and Medicaid, the federal government assumed an increasing share of responsibility for the costs of mental health care. - That trend continued into the 1970's with the implementation of the Supplemental Security Income program in 1974. - State governments helped accelerate this, especially of elderly people - In the 1960's and 1970's, state and national policies championed the need for comprehensive community mental health care, though this ideal was slowly and only partially realized.

Dystonia

- tonic (acute contractions) of tongue, jaw, & neck - usually, occurs in the first few hours or days on antipsychotic. - Opisthotonis - tightening of entire body with head, back, & belly up - Oculogyric Crisis - eyes locked upward (forced eye rotation upward) - Laryngospasm - with respiratory difficulty - Torticollis - twisting of cervical muscles with unnatural head position

What types of events would you see in cases of Post Traumatic Stress Disorder? (3)

-Actual or threatened violence -Harm to themselves or others -Learning about traumatic events that occur to close family or friends

Individuals who have experienced chronic trauma constantly have ______________ ________ __________ firing so they do not have the chance to develop _________ _________ ________

-Automatic self-regulation -Intentional self-regulation

Typically children with either RAD or DSED show delays in ... (2), which may persist for several years without intervention

-Cognitive development -Socio-emotional development

What are the three dimensions of job burnout?

-Emotional exhaustion (drained) -Depersonalization (cynical, callous, distance colleagues and clients) -Ineffectiveness (a reduced sense of personal accomplishment, inefficacy, not feeling productive in helping others)

"Girls and boys tend to differ in the way they process and express their turmoil and symptoms of PTSD". What is this difference?

-Girls tend to show more internalizing signs of distress such as shame and self-blame -Boys tend to show heightened levels of physical and verbal aggression

Children and adults with a history of child abuse show long-term alterations in the .... (2)

-Hypothalamic pituitary adrenal (HPA) axis -Norepinephrine systems

A child or teen with DSED shows ... (3)

-Inauthentic expressions of emotions -Superficial relationships -More peer conflicts

Some key symptoms of PTSD are expressed differently in children than in adults. These include ... (2)

-Instead of flashbacks and waking recall of the traumatic event, young children are likely to re-experience trauma in nightmares. Initially the nightmares reflect the traumatic event but over time they may become less specific and vague -Daytime recall may be expressed in play or though re-enactment of the event or related themes

What two diagnoses only apply to children between the ages of 9 months - 5 years?

-Reactive attachment disorder -Disinhibited social engagement disorder

John has been diagnosed with RAD. What would you expect to see when observing him? (2)

-Seldom expresses positive emotions when interacting with his caregivers -Compromised emotional regulation leading to outburst of fear, sadness, or irritability that fall outside the norm for his age

Diagnosis of PTSD for children (over age 6) as well as adults involves four key features that persist longer than 1 month. These include...

-Symptoms of intrusion, such as distressing memories, dreams, or flashbacks that is often described as a feeling or reliving the traumatic event -Avoidance of distressing memories, thoughts, or feelings as well as avoidance of any reminders that arouse such thoughts or feelings -Distortions in thoughts or feelings associated with the traumatic event(s) such as elevated fear, inability to feel positive emotions, self blake and guilt -Symptoms of extreme arousal and reactivity such as angry outburst, self-destructive behaviour, sleep problems or hypervigilence

PTSD symptoms are more likely to occur if... (2)

-The abuse was chronic -The perpetrator relied on a method of coercion or trickery to force compliance

How the trauma is experienced depends on a number of factors including...

-The child's developmental level -The child's pre-disaster characteristics -The child's cognitive appraisal

Child maltreatment involves more than physical harm to a child. Such acts by caregivers undermine the child's basic sense of trust and safety, leading to lifelong struggles in .... (2)

-Their interpersonal relationships -Their sense of well-being

Sexual abuse in particular can lead to ____________ _____________ in which...

-Traumatic sexualization -A child's sexual sexual knowledge and behaviour are shaped in developmentally inappropriate ways

"Serve and return interactions shape the brain". What does this mean?(2)

-When an infant babbles, gestures or cries, and an adult responds appropriately with eye contact, words or a hug, neural connections are built and strengthened in the child's brain that support the development of communication and social skills -Forms connections between amygdala and other parts of the brain to help us learn about emotional regulation

The DBT process involves a progression through four treatment modules. These include...

1. Mindfulness 2. Interpersonal effectiveness 3. Distress Tolerance 4. Emotion Regulation

What is the importance of ... 1. Pre-existing factors 2. Peri-traumatic factors 3. Post-traumatic factors on the development of PTSD

1. Pre-existing factors include exposure to ACE, vulnerable biology 2. Peri-traumatic factors include the manner in which the trauma was perceived 3. Post-traumatic factors include social support

Trauma and stressor related disorders is a new category in the DSM-5. It includes... (5)

1. Reactive Attachment Disorder 2. Acute Stress Disorder 3. Disinhibited Social Engagement Disorder 4. Post traumatic Stress Disorder (PTSD) 5. Adjustment Disorder

Name the two disorders that can stem from neglect as a child

1. Reactive Attachment Disorder 2. Disinhibited Social Engagement Disorder

What are the four patterns of attachment?

1. Secure 2. Insecure - Anxious-avoidant 3. Insecure - Anxious-resistant 4.Insecure - Disorganized, disoriented

DBT is based on four core principles. What are they?

1. The primacy of the therapeutic relationship 2. A non-judgmental approach 3. Differentiating between effective and ineffective behaviours 4. Dialectical thinking

recording diagnosis BPI

1. bipolar I disorder 2. type of current/most recent episode 3. severity/psychotic/remission specifiers 4. as many specifiers w/out codes as apply to current/most recent episode

the median age of onset for bipolar disorders is ______ years of age

25

PTSD symptoms usually begin with the first ___ months following the trauma, although a delay of many months or even years is not uncommon, especially in cases of physical and sexual abuse

3

By age __-__ we should have thoughts and emotions that are staring to integrate

3-5

Specifiers for Specific Learning Disorder

315.00 (F81.0) with impairment in reading - reading accuracy, rate & fluency, comprehension 315.2 (F81.81) with impairment in written expression - spelling accuracy, grammar & punctuation, written expression & organization 315.1 (F81.2) with impairment in math - number sense, memorization, arithmetic facts, fluent calculation, math reasoning

bipolar disorder affects approximately _______ American adults or about ______% of the U.S. population age 18 and older

5.7 million; 2.6%

Where are people with Schizophrenia

6% are homeless or live in shelters 6% live in jails 5% to 6% live in hospitals 10% live in nursing homes 25% live with a family member 28% are living independently 20% live in supervised housing (group homes, etc...)

more than _____% of people who kill themselves have a diagnosable mental disorder; most commonly a depressive disorder or substance abuse disorder

90

What does TF-CBT involve?

A combination of exposure therapy and skill building to allow the individual to practice more effective ways of coping with intrusive memories and emotions

Intellectual Developmental Disorder

A disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains

Intellectual Developmental Disorder (IDD)

A disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains.

Intellectual Developmental Disability

A disorder with onset during the devleopemental period that in includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains is a _________________.

Manic Episode

A distinct period during which there is an abnormally persistent elevated, expansive, or irritable mood and persistent increased activity or energy, that is present all day, every day for a period of AT LEAST 1 WEEK

Neurodevelopmental Disorders

A new category of disorders that unite a group of conditions with onset in the developmental period

Neurodevelopmental Disorder

A new category of disorders that unite a group of conditions with onset in the developmental period. Typically manifest early in development, often before the child enters grade school, and are characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning.

What is reactive attachment disorder (RAD)?

A pattern of disturbed and developmentally inappropriate attachment behaviour

Define Disinhibited Social Engagement Disorder (DSED)

A pattern of overly familiar and culturally inappropriate behaviour with relative strangers

If a child has RAD what might you see with the parent?

A really neglectful parent

What is job burnout?

A syndrome of emotional exhaustion and cynicism that occurs frequently among individuals who do people work of some kind

manic episode criteria

A) A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary). B) During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present: 1. Inflated self-esteem or grandiosity. 2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep). 3. More talkative than usual or pressure to keep talking. 4. Flight of ideas or subjective experience that thoughts are racing. 5. Distractibility 6. Increase in goal-directed activity or psychomotor agitation 7. Excessive involvement in activities that have a high potential for painful consequences C) The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. D) The episode is not attributable to the physiological effects of a substance or another medical condition.

hypomanic episode criteria

A) A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day. B) During the period of mood disturbance and increased energy and activity, three (or more) of the following symptoms (four if the mood is only irritable) have persisted, represent a noticeable change from usual behavior, and have been present to a significant degree: 1. Inflated self-esteem or grandiosity. 2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep). 3. More talkative than usual or pressure to keep talking. 4. Flight of ideas or subjective experience that thoughts are racing. 5. Distractibility 6. Increase in goal-directed activity or psychomotor agitation 7. Excessive involvement in activities that have a high potential for painful consequences C) The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic. D) The disturbance in mood and the change in functioning are observable by others. E) The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic. F) The episode is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or another medical condition

Substance/Medication-Induced Bipolar and Related Disorder criteria

A) A prominent and persistent disturbance in mood that predominates in the clinical picture and is characterized by elevated, expansive, or irritable mood, with or without depressed mood, or markedly diminished interest or pleasure in all, or almost all, activities. B) There is evidence from the history, physical examination, or laboratory findings of both (1) and (2): 1. The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to a medication. 2. The involved substance/medication is capable of producing the symptoms in Criterion A. C) The disturbance is not better explained by a bipolar or related disorder that is not substance/medication-induced. Such evidence of an independent bipolar or related disorder could include the following: The symptoms precede the onset of the substance/medication use; the symptoms persist for a substantial period of time (e.g., about 1 month) after the cessation of acute withdrawal or severe intoxication; or there is other evidence suggesting the existence of an independent non-substance/medication-induced bipolar and related disorder (e.g., a history of recurrent non-substance/medication-related episodes). D) The disturbance does not occur exclusively during the course of a delirium. E) The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Bipolar and Related Disorder Due to Another Medical Condition Criteria

A) A prominent and persistent period of abnormally elevated, expansive, or irritable mood and abnormally increased activity or energy that predominates in the clinical picture. B) There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition. C) The disturbance is not better explained by another mental disorder. D) The disturbance does not occur exclusively during the course of a delirium. E) The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning, or necessitates hospitalization to prevent harm to self or others, or there are psychotic features.

bipolar II disorder criteria

A) Criteria have been met for at least one hypomanic episode and at least one major depressive episode B) There has never been a manic episode. C) The occurrence of the hypomanic episode(s) and major depressive episode(s) is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder. D) The symptoms of depression or the unpredictability caused by frequent alternation between periods of depression and hypomania causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Childhood-Onset Fluency Disorder (Stuttering)

A) Disturbances in the normal fluency and time patterning of speech that are inappropriate for the individual's age and language skills, persist over time, and are characterized by frequent and marked occurrences of one or more of the following: 1) Sound and syllable repetitions 2) Sound prolongations of consonants as well as vowels. 3) Broken words (pauses within a word) 4) Audible or silent blocking (filling or unfilled pauses in speech) 5) Circumlocutions (word substitutions to avoid problematic words) 6) Words produced with an excess of physical tension 7) Monosyllabic whole-word repetitions (i-i-i-i see him) B) The disturbance causes anxiety about speaking or limitations in effective communication, social participation, or academic or occupational performance, individually or in any combination. C) The onset of symptoms in the early developmental period D) The disturbance is not attributable to a speech-motor or sensory deficit, dysfluency associated with neurological insult (stroke, tumor, trauma), or another medical condition and is not better explained by another medical condition.

Childhood-Onset Fluency Disorder 315.35 (F80.81) (formerly Stuttering)

A. Disturbances inappropriate for the individual's age and language skills, persists over time, and characterized by frequent and marked occurrences (one or more of the following) - Sound and syllable repetitions - Sound and prolongations of consonants and vowels - Broken words - Audible or silent blocking - Circumlocutions - Words produced with excess of physical tension - Monosyllabic whole word repetitions

major depressive episode criteria

A) Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. 1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, or hopeless) or observation made by others (e.g., appears tearful). 2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation). 3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.) 4. Insomnia or hypersomnia nearly every day. 5. Psychomotor agitation or retardation nearly every day 6. Fatigue or loss of energy nearly every day. 7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick). 8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others). 9. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. B) The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. C) The episode is not attributable to the physiological effects of a substance or another medical condition.

cyclothymic disorder criteria

A) For at least 2 years (at least 1 year in children and adolescents) there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode. B) During the above 2-year period (1 year in children and adolescents), the hypomanic and depressive periods have been present for at least half the time and the individual has not been without the symptoms for more than 2 months at a time. C) Criteria for a major depressive, manic, or hypomanic episode have never been met. D) The symptoms in Criterion A are not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder. E) The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism). F) The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Agoraphobia

A) Marked fear or anxiety about two or more of the following five situations: - Using public transportation - Being in open spaces (parking lots, marketplaces, bridges) - Being in enclosed places (shops, theaters, cinemas) - Standing in line or being in a crowd - Being outside of the home alone B) Fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms

Autism Spectrum Disorder 299.00 (F84.0)

A) Persistent deficits in social communication and social interaction B) Restricted, repetitive patterns of behavior, interests, activities C) Present in early development but may not fully manifest until social demands exceed capabilities D) Clinically significant impairment social, occupational, or other areas

Language Disorder

A) Persistent difficulties in the acquisition and use of language across modalities (spoken, written, sign language, or other) due to deficits in comprehension or production that include the following: 1) Reduced vocabulary 2) Limited sentence structure 3) Impairments in discourse B) Language abilities are substantially and quantifiably below those expected for age, resulting in functional limitations in effective communication, social participation, academic achievement, or occupational performance, individually or in any combination. C) Onset of symptoms is in the early developmental period D) The difficulties are not attributable to hearing or other sensory impairment, motor dysfunction, or another medical or neurological condition and are not better explained by intellectual disability

Speech Sound Disorder

A) Persistent difficulty with speech sound production that interferes with speech intelligent or prevents verbal communication or messages. B) The disturbance causes limitations in effective communication that interfere with social participation, academic achievement, or occupational performance, individually or in any combination. C) Onset of symptoms is in the early developmental period. D) The difficulties are not attributed to congenital or acquired conditions, such as cerebral palsy, cleft palate, deafness or hearing loss, traumatic brain injury, or other medical or neurological conditions.

Stereotypic Movement Disorder

A) Repetitive seemingly driven and purposeless motor behaviors B) Repetitive motor behavior interferes with social, academic, or other activity and may result in self-injury C) Onset in early developmental D) Motor behavior not attributable to the effects of substance or other mental disorder

Tourette's' Disorder 307.23 (F95.2)

A. Both multiple motor and one of more vocal tics have been present at some time during illness B. Ticks may wax and wane in frequency but have persisted for more than one year since onset C. Onset before 18 D. Disturbance not due to substances or other medical conditions

bipolar I disorder criteria

A. Criteria have been met for at least one manic episode B. The occurrence of the manic and major depressive episode(s) is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.

Autism Spectrum Disorder 299.00 (F84.0)

A. Deficits in social communication and social interaction across multiple contexts are required for this diagnosis - Deficits in social emotional reciprocity - Deficits in nonverbal communication behaviors used for social interaction - Deficits in developing, maintaining, & understanding relationships - Severity is based on social communication impairment & restricted, repetitive patterns of behavior

Specific Learning Disorder

A. Difficulties learning and using academic skills by presence of one of the following persisting for 6 months: - inaccurate or slow & effortful word reading - difficulty understanding meaning of what is read - difficulty with spelling - difficulties with written expression - difficulties with mastering number sense, number facts, or calculations - difficulties with math reasoning

Language Disorder 315.32 (F80.2)

A. Persistent difficulties in the acquisition and use of language across modalities. - Reduced vocabulary - Limited sentence structure - Impairment in discourse B. Language abilities are substantially and quantifiably below those expected for age resulting in limitations. C. Onset in early developmental period D. Difficulties not attributable to hearing or other sensory impairment or medical condition.

Schizotypal Disorder 301.22 (F21)

A. Pervasive pattern of social and interpersonal deficits marked by acute discomfort with and reduced capacity for social relationships. Five or more of the following: - ideas of reference - magical thinking and off beliefs - unusual perceptual experiences - odd thinking and speech - suspiciousness and paranoia - inappropriate affect or constriction of affect - odd, eccentric or peculiar behaviors or appearance - lack of close friends or confidants - excessive social anxiety with paranoid fear - cognitive distortions, eccentricities of behavior B. Not in the course of Schizophrenia, Bipolar Disorder or Psychotic Disorder, or Autism Spectrum Disorder

Delusional Disorder 297.1 (F22)

A. Presence of one or more delusions with a duration of 1 month or longer B. Hallucinations if present are not prominent and are related to delusional theme C. Functioning is not markedly impaired or behavior not obviously bizarre or odd D. No marked manic or depressive episodes, if so brief duration E. Not attributed to OCD, Body Dysmorphic Disorder

Schizophreniform Disorder 295.40 (F20.81)

A. Presence of two or more 1 month period: 1, 2, or 3 - delusions - hallucinations - disorganized speech - grossly disorganized or catatonic behavior - negative symptoms B. Episode lasts more than 1 month but less than 6 months * rule out schizoaffective Disorder, depressive or bipolar disorder with psychotic features * not attributed to substance, medication, or medical condition * when diagnosis made without recovery, should be provisional * Specify - with good prognostic features - without good prognostic features - with catatonic (use additional code 293.89 (F06.1) for comorbid catatonia - Severity - Use Clinician-Rated Dimensions of Psychosis Symptom Severity

Provisional Tic Disorder 307.21 (F95.0)

A. Single or multiple motor and or vocal tics B. The tics have been present for less than 1 year since first tic onset C. Onset before age 18 D. Disturbance not attributable to the effects of substance or other mental condition E. Criteria never met for Tourette's or persistent motor or vocal tic disorder

Schizophrenia 295.90 (F20.9)

A. Two or more, each present for significant portion of the time during a 1 month period or less is successfully treated. (must be one of the first three) - Delusions - Hallucinations - Disorganized speech - Grossly disorganized or catatonic behavior - Negative symptoms B. Functioning in work, interpersonal relationship, or self-care is markedly below the level prior to onset of symptoms C. Disturbance persists for 6 months D. Ruled out schizoaffective or bipolar/depression with psychotic features E. No effects of substance, medication or medical disorder F. If history of autism spectrum or communication disorder diagnose only if onset of hallucinations and prominent delusions

Schizoaffective Disorder

A. Uninterrupted period of illness with - Major depressive episode - Manic episode B. Delusions and hallucinations for 2 weeks in absence of a major mood episode (depressive or manic) C. Symptoms meeting major mood episode are present for majority of the total during of the active and residual portion of illness D. Not due to effects of substance, medication, or medical condition

Developmental Coordination Disorder 315.4 (F82)

A. acquisition and executions of coordinated motor skills below expected for given age B. Persistent and significantly interferes in daily living for chronological age C. Onset in early developmental period' D. Motor deficits not explained by intellectual disability, visual impairment or neurological disorders

bipolar I disorder

A. criteria have been met for at least one manic episode B. the occurrence of manic and major depressive episode(s) are not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder or other specified or unspecified schizophrenia spectrum and other psychotic disorder

Aripiprazole

Abilify

Developmental Coordination Disorder 315.4 (F82)

Acquisition and execution of coordinated motor skills below expected for given age

What is the difference between acute stress disorder and PTSD?

Acute stress disorder emphasizes the more immediate, but short-term dissociative reactions to trauma whereas PTSD reflects the longer-lasting ongoing pattern

Children or adults who react to more common (and less severe) forms of stress in an unusual or disproportionate manner may quality for a diagnosis of _____________ ____________

Adjustment disorder

Jim has just broken up with his girlfriend and is now refusing to attend school. Which diagnosis would he receive?

Adjustment disorder

Poverty of Content

Disorder of Form of Thought - Speech which is sufficient in amount but too general, recurrent, and absent of content to be qualitatively sufficient

Tricyclic Antidepressants (List)

Amitriptyline (Elavil) Desipramine (Norpramin) Doxepin (Sinequan) Imipramine (Tofranil) Nortriptyline (Aventyl, Pamelor) Protriptyline (Vivactil) Trimipramine Maleate (Surmontil)

Agoraphobia

An abnormal fear of open or public places

Clomipramine

Anafranil

Aripiprazole Lauroxil

Aristada

Moderate (level 2)

Autism Spectrum specifier that requires substantial support

Mild (level 1)

Autism Spectrum specifier that requires support

Severe (level 3)

Autism Spectrum specifier that requires very substantial support

Nortriptyline

Aventyl, Pamelor

Specific Learning Disorder

B. Affected academic skills are substantially and quantifiably below those expected for the individual's chronological age, and cause significant interference with academic or occupational performance C. Learning difficulties began in school age, but may not manifest until the demands for those skills exceeded the individuals capacities D. Learning difficulties not better accounted for by intellectual disabilities, uncorrected visual or auditory acuity, other mental or neurological disorders.

Catatonia (medical condition) 293.89 (F06.1) Note: Unspecified Catatonia 293.89 (F06.1)

B. Evidence from history, physical exam, or lab findings that the disturbance is direct pathophysiological consequence of medical condition C. Not better explained by another mental disorder D. The disturbance does not occur exclusively during a delirium E. The disturbance causes clinically significant distress or impairment in functioning

Autism Spectrum Disorder 299.00 (F84.0)

B. Restricted, repetitive patterns of behavior, interests, or activities by 2 of the following: - Stereotyped or repetitive motor movements, use of toys or speech - Insistence on sameness, inflexible adherence to routines or ritualized patterns of verbal or nonverbal behavior - Highly restricted, fixated interests that are abnoral in intensity or focus - Hyper-or-hypo-reactive to sensory input or unusual interest in sensory aspects of the enviornment

How do babies learn to regulate their emotions?

Babies learn to regulate their emotions through the manner in which we respond to and mirror their emotions

When does the process of attachment begin?

Between 6-12 months of age

Selective Serotonin Reuptake Inhibitors (SSRIs)

Block the reabsorption (reuptake) of the neurotransmitter serotonin in the brain

Vortioxetine

Brintellix

Citalopram

Celexa

Extrapyramidal Tracts

Chiefly found in the reticular activating formation of the pons and medulla, and target neurons in the spinal cord involved in reflexes, locomotion, complex movements, and postural control. These tracts are in turn modulated by various parts of the central nervous system.

What happens to a child with RAD when faced with any form of stress?

Children with RAD show no consistent effort to seek comfort or nurturance from their caregiver, and they fail to respond to their caregiver's efforts to comfort them

Clozaril

Clozapine

Clozapine

Clozaril

Substance/Medication-Induced Psychotic Disorder

Coding for this disorder is based on the substance that is responsible for the disorder, such as alcohol. The ICD-9 code is 291.9 and the ICD 10 codes are based on use and level of severity, for example with use mild, F10.159, with use moderate/severe, F10.259, or without use disorder, F10.959. All substance use disorder use a specifier for onset during intoxication or withdrawal

Psychotic Disorder Due to Another Medical Condition

Coding: include the name of the other medical condition in the name of the mental disorder (example: 293.81 (F06.2) psychotic disorder due to malignant lung neoplasm, with delusions) The other medical condition should be coded and listed separately before the psychotic disorder due to the medical condition, thus 162.9 (C34.90) malignant lung neoplasm; 293.81 (F06.2) psychotic disorder due to malignant luge neoplasm, with delusions

Serotonergic Crisis

Combining MAOI and SSRI - Elevated temperature, fever - Abnormal muscle movements (twitches, myclonic jerking) - Hyperreflexia - Rarely - generalized seizure - Possible effects (hypotension, anxiety & agitation, shivering, enhanced startle response, insomnia, confusion & delirium, shock, death)

Noradrenergic Crisis

Combining MAOIs with TCAs tyramine containing foods, stimulants, ephedrine, pseudoephedrine, phenylephrine, phenylpropanolamine, venlafaxine - can produce a noradrenergic crisis

Recurrent Brief Depression

Concurrent presence of depressed mood and at least four other symptoms of depression for 2-13 days at least once per month (not associated w/ menses) for at least 12 consecutive months in an individual whose presentation has never met the criteria for any other depressive or bipolar disorder and does not currently meet active or residual criteria for any psychotic disorder, is:

Duloxetine

Cymbalta

Between RAD and DSED which diagnoses has the poorer outcome?

DSED! -Children with RAD typically recover from this disorder once they are placed in a secure, stable environment -Children with DSED usually improve but show more lasting difficulties

Intellectual Disability

DSM 5 A disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains.

Severe (3 to 4%)

DSM IV-TR Severity of Intellectual Disability 35 - 40 to 20 - 25

Moderate (10%)

DSM IV-TR Severity of Intellectual Disability 50 - 55 to 35 - 40

Mild (85%)

DSM IV-TR Severity of Intellectual Disability 70 to 50 - 55

Profound (1 to 2%)

DSM IV-TR Severity of Intellectual Disability Below 20 - 25

What is a good example of a successful targeted prevention program for child maltreatment?

David Olds nurse home visiting program

Speech Sound Disorder 315.39 (F80.0)

Deficits in social use of verbal and communication for social purposes, impaired communication in social context and for conversation, problems with nonliteral or implied meanings is:

Speech Sound Disorder 315.39 (F80.0)

Deficits in social use of verbal and communication for social purposes, impaired communication in social context and for conversation, problems with nonliteral or implied meanings.

Trazodone

Desyrel

Disruptive Mood Dysregulation Disorder 296.99 (F34.8)

Devon, a child of eleven years old, has tempter outbursts that would be more indicative of a child of four or five. His mother states, "He's had this since he was about seven. Don't know what's wrong with him. None of my other kids act like he does." His teachers indicate that he has severe temper outbursts verbally or behaviorally at least three times a weeks. Devon's former teacher states, "Fortunately, I was able to be patient with Devon. He is quite bright, gifted maybe, in some things. But, he is such an angry child. When his dad was incarcerated several years ago, I think I saw chages in him. He is agressive, fights, acts out when someone tells him no. I hope he gets some help." You diagnose Devon with:

Language Disorder 315.32 (F80.2)

Difficulties of acquisition and use of language due to deficits in the comprehension or production of vocabulary, sentence structure discourse.

Social (Pragmatic) Communication Disorder

Difficulty with pragmatics or the social use of language and communication as manifested by deficits in understanding and following social rules of verbal and nonverbal communication

Social (Pragmatic) Communication Disorder 315.39 (F80.89)

Difficulty with pragmatics or the social use of language and communication as manifested by deficits in understanding and following social rules of verbal and nonverbal communication.

Poverty of Speech

Disorder of Form of Thought - A general lack of additional, unprompted content seen in normal speech

Blocking *Also called Mental Block

Disorder of Form of Thought - A sudden cessation of speech of a thought process without an immediate observable cause, sometimes considered a consequence of repression.

Childhood-Onset Fluency Disorder 315.35 (F80.81)

Distrubance in normal fluency and time patterning of speech uncharacteristic of developmental level. Formerly known as Stuttering.

Childhood-Onset Fluency Disorder 315.35 (F80.81)

Disturbance in normal fluency and time patterning of speech uncharacteristic of developmental level is

Childhood-Onset Fluency Disorder (Stuttering)

Disturbances in the normal fluency and time patterning of speech that are inappropriate for the individual's age and language skills, persist over time, and are characterized by frequent and marked occurrences of one (or more) of the following: sound and syllable repetitions, sound prolongations of consonants as well as vowels, broken words, audible or silent blocking, circumlocutions, words produced with an excess of physical tension, monosyllabic whole-word repetitions

Flat Affect

Disturbed Mood - Blunting of emotions

Inappropriate Affect

Disturbed Mood - Laughing, crying, acting out during a time that is not appropriate to do so

Side Effects of MAOIs

Drowsiness, constipation, nausea, diarrhea, stomach upset, fatigue, dry mouth, dizziness, low blood pressure, lightheadedness, decreased urine output, sleep disturbances, muscle twitching, weight gain, blurred vision, headache, increased appetite, restlessness, shakiness, trembling, weakness, decreased sexual function, increased swelling

Basal Ganglia: Extra Pyramidal Symptoms Side Effects

Dystonia Parkinsonism Akinesia Akathisia Neuroleptic Malignant Syndrome Rabbit Syndrome Tardive Dyskinesia Tardive Dystonia

Bethlehem Royal Hospital in Bromley, London

Early Hospital - What hospital is the first and oldest of the modern mental hospitals? Established in 1247 as Priory of St. Mary of Bethlehem

Pica

Eating disorder where people eat things that have no nutritional value.

Venlafaxine

Effexor

Amitriptyline

Elavil

Selegiline

Emsam

Language Disorder 315.32 (F80.2)

Essential features are difficulties of acquisition and use of language due to deficits in the comprehension of production of vocabulary, sentence structure, discourse. Expressive ability refers to production of vocal, gestural or verbal signals, whereas receptive ability refers to ability to process and receive language.

Mood Bipolar Symptoms

Euphoric mood, racing thoughts, frenetic acts, insomnia

Adaptive Functioning

Evaluation of ____________ _____________ is the basis for determining the level of severity of the disorder, rather than the IQ score.

True or False - PTSD is common following adverse experiences

False! PTSD is a rare event, most of us recover from adverse experiences

True or False - If you are exposed to an ACE you can automatically be diagnosed with PTSD

False! Up to ⅔ of children in the US will be exposed to an ACE, the vast majority will not develop PTSD

Apiphobia (Melissophobia)

Fear of bees

Ailurophobia

Fear of cats

Who is more likely to develop PTSD, a female or a male?

Females are twice as likely

Levomilnacipran

Fetzima

SSRIs (List)

Fluoxetine (Prozac) Paroxetine (Paxil) Sertaline (Zoloft) Citalopram (Celexa) Escitalopram Oxalate (Lexapro) Vilazodone Hydrochloride (Viibryd) Vortioxetine (Brintellix) Fluvoxamine (Luvox)

Persistent Depressive Disorder 300.4 (F34.1)

For 2 years, Eric has complained about living in a fog. "Everything in my life seems gray. It's like I live in a colorless world. I go to work and go out with others, but it all seems kinda pointless. I am sad sometimes but not all the time. I feel as if I am stuck in the mud." Eric complains of feelings of hopelessness about the present and future. Eric has low energy and fatigue and hypersomnia. You would likely diagnose him with:

Global Developmental Delay 315.8 (F88)

For individuals under 5 when assessments cannot be adequately assessed in early childhood. Milestones not met, but cannot be tested.

Unspecified Attention-Deficit/Hyperactivity Disorder 314.01 (F90.9)

Full criteria for ADHD not met but distress and impairment are present, but clinician chooses not to specify the reason

Ziprasidone

Geodon

Haloperidol

Haldol

Seasonal

Harriet, a 35 year old woman, who lives in St. Paul, Minnesota has come to your clinic. She states, "Well it's October and when the leaves start to change I start getting depressed. Can't get out of bed in the morning, without three alarms and crawl back into bed after work with my cats and laptop. Sleep all weekend! I think that I am eating for 2 and gain my winter 20 pounds. Eat all kinds of "hearty" foods, soups, and stews. But I don't stop there, I start to crave sweets and breads, which I don't eat any other time. Oh, and the fatigue! Tired all the time and can't start anything." You diagnose Harriet with depression with

The impact of trauma depends not only on the severity and chronicity of the specific events but also ...

How the events interact with the child's individual and family characteristics

Motivational Bipolar Symptoms

Hyperactivity & frenetic activity, intrusive demands, domineering and commanding High risk or reckless behaviors (gambling, reckless driving, poor financial investments, sexual acting out, flamboyant dress)

Noradrenergic Crisis

If _____________ ______________ is severe, you may see: - sudden unexplained nosebleeds - dilated pupils, visual disturbance - photophobia - chest pain - stroke, coma, death

Does dissociation during PTSD lower the risk for poorer outcomes or increase the risk?

If you dissociate highly during PTSD this is a high risk for poorer outcomes

Cyclical Madness or Folie Circulaire

In 1851, Falvet describes Schizophrenia as _________ _________ or _________ _________

catatonic and paranoid

In 1874 Kahlbaum describes ____________ and ____________ mental disorders

Eugen Bleuler

In 1911, who devised the name "Schizophrenia", emancipated from the Greek words "Schizo" (split) and "Phrene" (mind)? - Symbolizes the disjointed reasoning of people with Schizophrenia

- Primary (first-rank) - Secondary (second-rank)

In 1959, Kurt Schneider divided the symptoms into ____________ and ____________ symptoms.

NIMH on Autism

In the United States, 3.4 of every 1,000 children 3 - 10 years old has ___________?

Severe

In the conceptual domain, attainment of concepts is limited, with caregivers providing extensive supports for problem solving throughout the life. In the social domain, language is limited in vocabulary and grammar, speech may consist of single words or phrases and very concrete. Relationships with family members is pleasurable. In the practical domain, the individual needs support for all activities for daily living, including meals, dressing, bathing, and elimination. The individual needs supervision at all times. This describes a person with level of severity of ______.

Exorcism

Middle Ages treatment was ____________, a religious rite to rid the person from possession by deamons or Satan

Unspecified Intellectual Disability 319 (F79)

Individuals over age 5 when unable to be assessed locally. Reserved for extraordinary circumstances.

A child with RAD is displaying which pattern of attachment?

Insecure anxious-avoidant type

Conceptual Domain Social Domain Practical Domain

Intellectual Disabilities are identified across waht three domains?

Paliperidone

Invega, Semap

Do children with RAD have the capacity to form appropriate attachments to caregivers?

It is believed that children with RAD have the capacity to form appropriate attachments to caregivers but fail to do so, most likely because of a lack of proper opportunities in early childhood

Melancholic Features

Janice has no pleasure in any activities and evidences a lack of reactivity to pleasurable stimuli. She has early morning awakening, significant anorexia, inappropriate guilt, an moroseness, despair, and profound despondency. This specifier is:

Somatic Symptoms

Jare, a 23 year old man, states that he has experienced a loss of interest in sex and erectile difficulty. He has lost weight because of a decreased appetite. He states that he feels weak and wakes early in the morning. He is fatigued. These are the ________________ of depression.

Lurasidone

Latuda

Escitalopram Oxalate

Lexapro

D2 Receptors

Limbic & Frontal Cortical Areas: - psychomotor slowing - indifference to sensory stimuli - emotional quieting - reduction in initiative Extrapyramidal System (Basal Ganglia) - parkinsonian-like symptoms - Tardive Dyskinesia Brain Stem - indifference to external stimuli - reduced arousal Hypothalmic-Pituitary Area - suppression of appetite - suppression of temperature regulation - prolactin release - blocked ejaculation in males - ovulation suppression in females Blockade of ___________

Fluvoxamine

Luvox

Bipolar II

Major Depression, then some mania (hypomania)

Isocarboxazid

Marplan

How do you measure the HPA axis when in action?

Measuring changes in cortisol levels over time

Guanfacine (Intuniv)

Medication may be used alone or in combination with other medications to treat high blood pressure and may treat ADHD by affecting the part of the brain that controls attention and impulsivity

Thioridazine

Mellaril

Middle Ages

Mental health has been seen as a manifestation of demons or the devil. In the _______________ ______________ mental disorders were seen as evil spirits that possessed the body.

Specifiers for Specific Learning Disorder

Mild: some difficulty in one or two domains, but mild enough severity that the individual may be able to compensate or function well when provided with accommodations. Moderate: marked difficulty in learning skills in one or more domains, so that the individual is not likely to become proficient without intensive and specialized teaching. Accommodations necessary for accuracy and efficiency. Severe: difficulty is severe affecting several academic domains. Unlikely to acquire skills with specialized teaching, not able to competently or efficiently complete activities even with accommodations

Violent

Most people with Schizophrenia are not ___________ toward others but are withdrawn and prefer to be left alone

Major Depressive Episode

Ms. Smith, your client, has been to her internist for a physical checkup due to fatigue and loss of appetite. The internist has referred Ms. Smith to you after finding nothing physiologically wrong with her. During your intake interview, Ms. Smth states, "This has never happened to me before, but since Janie started the university last fall semester I have just been feeling so down... so blue (she sighs). I am just so tired, even when I get up in the morning. I don't have an appetite and I have lost about 20 pounds. I just seem so listless, like nothing is fun anymore. I've just about stopped going to my bridge games and I haven't been to the health club for months now. I have never felt this way before and you know, I forget stuff. I can't focus on reading... just mope about the house. My husband and son are worried about me, maybe I have some disease or cancer.. I'm just a mess (cries a little).. This has been going on for 3 months now.. I just can't even stand myself...

Tourette's Disorder

Multiple motor tics and one vocal tic that waxes and wanes but persisted 1 year, manifested before age 18

Tourette's Disorder 307.23 (F95.2)

Multiple motor tics and one vocal tic that waxs and wanes but persisted 1 year, manifesting before age 18

Tourette's Disorder 307.23 (F95.2)

Multiple motor tics and one vocal tic that waxs and wanes but persisted 1 year, manifesting before age 18 is

Phenelzine

Nardil

How old must a child be before being diagnosed with RAD? Why?

Needs to be 9 months old because you need to be in the 6-12 month window

Affective Flattening

Negative Symptom - a restricted range of expressed emotions

Anhedonia

Negative Symptom - loss of the capacity to experience pleasure. The inability to gain pleasure from normally pleasurable experiences. Flat/numb affect

Alogia

Negative Symptom - poverty of speech, is a general lack of additional, unprompted content seen in normal speech

Avolition

Negative Symptom - the decrease in the motivation to initiate and perform self-directed purposeful activities

Criminal Violence

News and entertainment media tend to link mental illnesses including Schizophrenia to _________ __________.

Following a trauma, should you force everybody to do exposure-based therapy?

No! You only use it for those who are impacted. If you force somebody who was not impacted to relive the experience, they may eventually become impacted

Are RAD and DSED common diagnoses?

No, both are believed to be uncommon even among populations of severely neglected children

Can job burnout be classified as a form of PTSD?

No, they are not the same thing

Clonidine (Kapvay)

Non-Stimulant Medications for ADHD - alpha2 agonists on PFC

Atomoxetine (Strattera)

Non-Stimulant Medications for ADHD - class of medications known as selective norepinephrine reuptake inhibitors

Guanfacine (Intuniv)

Non-Stimulant Medications for ADHD - used alone or in combination with other medications to treat high blood pressure and may treat ADHD by affecting the part of the brain that controls attention and impulsivity

Desipramine

Norpramin

Rosa's Law

October 5, 2010 Barack Obama officially signed bill S. 2781 into federal law. This law removes the terms "mental retardation" and "mentally retarded" from federal health, education, and labor policy and replaces them with people first language "individual with an intellectual disability" and "intellectual disability".

Zyprexa

Olanzapine

Rosa's Law

On October 5, 2010, Barack Obama officially signed bill S. 2781 into federal law. __________ __________ removes the terms "mental retardation" and "mentally retarded" from federal health, education and labor policy and replaces them with people first language "individual with an intellectual disability" and "intellectual disability"

Because ________ changes your brain, it changes the way you react to certain things later in life

PTSD

Tranylcypromine

Parnate

Disinhibited Social Engagement Disorder

Pattern of behavior in which a child actively approaches and interacts with unfamiliar adults and exhibits at least two - Reduced or absence in approaching and interacting w unfamiliar adults - Overly familiar verbal or physical behaviors - Diminished or absent checking back with adult caregivers when in unfamiliar settings - Willingness to go off w unfamiliar adult w minimal or no hesitation Behaviors not limited to impulsivity as in ADHD

Paroxetine

Paxil

50

People with Schizophrenia have a ______ times hight risk of attempting suicide than the general population

Schizophrenia

People with ___________________ are far more likely to harm themselves than be violent toward the public

Fluphenazine

Permitil/Prolixin

Autism Spectrum Disorder 299.00 (F84.0)

Persistent deficits in social communication and social interaction across a number of contexts

Autism Spectrum Disorder

Persistent deficits in social communication and social interaction across multiple contexts as manifested by the following, currently or by history: A) Deficits in social-emotional reciprocity B) Deficits in nonverbal communicative behaviors used for social interaction C) Deficits in developing, maintaining, and understanding relationships

Specific Learning Disorder

Persistent difficulties in learning and using academic skills (reading, spelling, writing, math) persisting for 6 months.

Language Disorder

Persistent difficulties in the acquisition and use of language across modalities due to deficits in comprehension or production that include the following: reduced vocabulary, limited sentence structure, impairments in discourse

Social (Pragmatic) Communication Disorder

Persistent difficulties in the social use of verbal and nonverbal communication as manifested by all of the following: - Deficits in using communication for social purposes - Impairment of the ability to change communication to match context or the needs of the listener - difficulties following rules for conversation and storytelling - difficulties understand what is not explicitly stated and nonliteral or ambiguous meanings of language

Speech Sound Disorder

Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages

Define depersonalization

Persistent or recurrent experiences of feeling detached from, and as if one were an outside observer of one's mental processes of body

Define derealization

Persistent or recurrent experiences of unreality of surroundings

Attention-Deficit/Hyperactivity Disorder

Persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development

Monoamine-Oxidase Inhibitors List

Phenelzine (Nardil) Tranylcypromine (Parnate) Isocarboxazid (Marplan) Selegiline (Emsam)

Satellite Cells

Physical support to neurons in the peripheral nervous system

______ ______ ______ (the ability to modulate or control the intensity and expression of feelings and impulses) is at the heart of PTSD

Poor emotion regulation

Delusions

Positive Symptom - a belief that is clearly false and that indicates an abnormality in the affected person's content of thought. The false belief is not accounted for by the person's culture or religious background or his or her level of intelligence

Hallucinations

Positive Symptom - a sensory/perceptual experience of something that does not exist outside the mind, caused by various physical and mental disorders, or by reaction to certain toxic substances, and usually manifested as visual or auditory images

Obessive-Compulsive and Related Disorders

Presence of obsessions and or compulsions. These disorders differ from developmentally normative preoccupations and rituals by being excessive or persisting pas developmentally appropriate periods.

Other Specified Attention-Deficit/Hyperactivity Disorder 314.01 (F90.8)

Presentations in which the symptoms of ADHD cause stress and impairment but full criteria for ADHD is not met

Desvenlafaxine

Pristiq

Subtypes - Paranoid, disorganized, catatonic, undifferentiatd, and residual types

Probably the most dramatic change to the Schizophrenia Spectrum was the elimination of the ___________ of Schizophrenia

Schwann Cells

Provide the insulation (myelin) to neurons in the peripheral nervous system

Fluoxetine

Prozac

Hypothalamic-Pituitary Area

Psychomotor slowing, indifference to sensory stimuli, emotional quieting, reduction in initiative are all characteristic of blockade of the D2 receptors in the ________________

Differentiate between RAD and DSED

RAD - Child has little comfort in caregivers DSED - Child fails to check in with caregivers and may venture away, overly friendly

Panic Disorder

Recurrent (more than one) unexpected panic attacks

Excoriation (skin-picking) disorder

Recurrent picking at one's own skin that leads to skin lesions. Most common sites are face, arms, hands. May pick healthy skin, minor skin irregulations, lesions, such as pimples or calluses, or at scabs. May pick, rub, squeeze, lance, or bite

Mirtazapine

Remeron

Brexpiprazole

Rexulti

Risperidone

Risperdal

Inattention in ADHD

SIX of the following symptoms have persisted for at least SIX months to a degree inconsistent with developmental level: - Fails to give close attention to details or makes careless mistakes - Difficulty sustaining attention in tasks or play activities - Does not seem to listen when spoken to directly - Does not follow through on instructions or fail school work - Difficulty organizing tasks or activities - Avoids, dislikes or is reluctant to engage in tasks that require sustained efforts - Loses things necessary for tasks or activities - Easily distracted by extraneous stimuli - Forgetful in daily activities

Hyperactivity in ADHD

SIX of the following symptoms have persisted for at least SIX months to a degree inconsistent with developmental level: (not ODD) - Fidgets with or taps hands or feet or squirms in seat - Leaves seat in situations when remaining seated is expected - Runs about or climbs in situations where it is inappropriate - Unable to play or engage in leisure activities quietly - Often on the go, as if driven by a motor - Talks excessively - Blurts our answer before question has been completed - Difficulty waiting for turn - Interrupts or intrudes on others

1 to 2

Schizophrenia occurs in ____ to ____ percent of the general population.

10

Schizophrenia occurs in _____ percent of people who have a first-degree relative with the disorder, such as a parent or sibling. Or if second-degree relatives (aunts, uncles, cousins, or grandparents) more often than the general population.

identical twin

Schizophrenia risk is highest for an __________ _________ of a person with Schizophrenia. He or she has a 40 to 65 percent chance of developing the disorder.

Mesoridazine

Serentil

Quietapine

Seroquel

Nefazodone

Serzone

By definition, PTSD originates from .....

Severe trauma and/or threat that overwhelms a person's emotional, social or biological capabilities

Adaptive Functioning

Severity is of Intellectual Disability is defined on the basis of ___________ _____________ and not IQ scores, because __________ __________ determines required level of supports.

What is similar between acute stress disorder and PTSD?

Similar to PTSD, the traumatic event is relieved over and over, leading to attempts to avoid any reminders that arouse memories of it

Doxepin

Sinequan

Amisulpride

Solian

Exorcisms

Some _____________ were extremely severe: holes might be drilled into someone's skull to release the spirits, a treatment that no doubt killed more often than it cured

bipolar II specifiers

Specify current or most recent episode: Hypomanic Depressed Specify if: With anxious distress With mixed features With rapid cycling With melancholic features With atypical features With mood-congruent psychotic features With mood-incongruent psychotic features With catatonia With peripartum onset With seasonal pattern Specify course if full criteria for a mood episode are not currently met: In partial remission In full remission Specify severity if full criteria for a major depressive episode are currently met: Mild Moderate Severe

Specifiers for Schizoaffective Disorder

Specify if 1 year of duration of disorder - First episode, currently in acute episode - First episode, currently in partial remission - First episode, currently in full remission - Multiple episodes, currently in acute episode - Multiple episodes, currently in partial remission - Multiple episodes, currently in full remission - Continuous - Unspecified * Specify with catatonia (293.89) (F06.1) catatonia with schizoaffective disorder * Specify severity: Clinician-Rated Dimensions of Psychosis Symptom Severity

Complex Tics

What CLASSIFICATION of tic has physical movements that are more complex, and or the phonic tics involve a more sophisticated set of utterances, including long phrases? They involve several muscle groups.

Delusional Disorder Specifiers

Specify: with bizarre content - clearly implausible, not understandable, and not not derived from ordinary experiences Specify course Specify level of severity: - current level of severity of symptoms on a 5 point scale - use the Clinician-Rated Dimensions of Psychosis Symptom Severity

Trifluoperazine

Stelazine

ADHD medications

Stimulant Medications Adderal Ridalin Non-Stimulant Intuniv Stratleia Kapvay

Amphetamine & Dextroamphetamine

Stimulant Medications for ADHD - Adderall - Adderall XR (extended release)

Methylphenidate

Stimulant Medications for ADHD - Concerta (extended release) - Daytrana (patch) - Desoxyn - Metadate ER & CD - Methylin - Ritalin - Ritalin SR & LA (extended release)

Dextroamphetamine

Stimulant Medications for ADHD - Dexedrine - Dextrostat

Dexmethylphenidate

Stimulant Medications for ADHD - Focalin - Focalin XR (extended release)

Lisdexamfetamine

Stimulant Medications for ADHD - Vivanse

Trimipramine Maleate

Surmantil

Perceptual Domain

The _______ domain is self-managed in areas such as personal care, job responsibilities, money management, recreation, and organizing school and work tasks

Conceptual

The _____________ domain describes levels of functioning on skills in language, reading, writing, math, reasoning, knowledge, and memory

Dendrites

The __________________ receive neurotransmitter messages from other nerve cells

Neurodevelopmental Disorders

Typically manifest early in development, often before the child enters grade school, and are characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning

Intellectual Disability DSM 5 Criteria

The following criteria is a diagnosis for ________________? A. Deficits in intellectual functions B. Deficits in adaptive functioning that results in failure to meet developmental and sociocultural standards for personal independence and social responsibility C. Onset of intellectual and adaptive deficits in developmental period Defined on the basis of adaptive functioning and not by IQ. Adaptive function determines the level of supports required and are less valid in the lower end of the IQ range.

What is trauma focused cognitive behavioural therapy (TF-CBT)

The most widely studied and supported form of exposure for childhood trauma or stress

When would you use exposure-based therapy?

Used following acute stress or trauma, such as motor vehicle accidents, shootings, bombings and hurricanes

Disruptive Mood Dysregulation Disorder 296.99 (F34.8)

The core feature is chronic, severe persistent irritability. The severe irritability has two features (a) frequent temper outbursts due to frustration, occurring three or more times per week for a year in two contexts, (b) chronic persistent irritable angry mood present between temper outbursts. The irritable mood must be characteristic of the child most of the day, every day, and noticed by those in the environment.

Define Acute Stress Disorder

The development during or within 1 month after exposure to an extreme traumatic stressor of at least nine symptoms associated with intrusion, negative mood, dissociation, avoidance, and arousal

Attention Deficit Hyperactivity Disorder 314.01 (F90.2)

The essential feature is persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development is

Autism Spectrum Disorder 299.00 (F84.0)

The essential feature of _______ ________ _________ is persistent deficits in social communication and social interaction across a number of contexts

10%

The estimated prevalence of savant abilities in autism is _________ %?

1%

The prevalence of savant abilities in the non-autistic population is less than ______%?

Define attachment

The process of establishing and maintaining an emotional bond with parents or other significant individuals

What is the cycle-of-violence hypothesis?

The relationship between being abused as a child and becoming abusive towards others

Hallucinations

These are forms of __________________. - Auditory - Tactile - Visual - Gustatory - Olfactory

Antagonists Drugs

These cells block the access or attachment of the body's natural agonists, usually neurotransmitters, to their receptors and thereby prevent or reduce cell responses.

Schwann Cells

These cells provide the insulation (myelin) to neurons in the peripheral nervous system.

What happens when a child is not exposed to positive serve and return interactions?

They suffer deficits in emotional regulation and social skills because they can't control their amygdala when it keeps going off

Pimazode - Orap

This antipsychotic drug is used to control motor or verbal tics (an uncontrollable need to repeat certain movements or sounds) caused by Tourette's Disorder (condition characterized by motor or verbal tics)

Clozapine - Clozaril

This antipsychotic medication causes little or not prolactin elevation, but with use there is in some patients danger of a fatal blood disorder, agranulocytosis. Agranulocytosis results in deficit of white blood cells called jeutrophils or granulocytes. Although other drugs can cause this condition, this was one of the first to be identified resulting in blood testing of users.

Chlorpromazine / Thorazine

This antipsychotic was first introduced in psychiatric facilities in 1954. By 1970 more than 85% psychiatrically impaired persons were receiving a neuroleptic drug for their conditions

Other Specified Bipolar and Related Disorder Criteria

This category applies to presentations in which symptoms characteristic of a bipolar and related disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the bipolar and related disorders diagnostic class. The other specified bipolar and related disorder category is used in situations in which the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for any specific bipolar and related disorder. This is done by recording "other specified bipolar and related disorder" followed by the specific reason (e.g., "short-duration cyclothymia").

Unspecified Bipolar and Related Disorder Criteria

This category applies to presentations in which symptoms characteristic of a bipolar and related disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the bipolar and related disorders diagnostic class. The unspecified bipolar and related disorder category is used in situations in which the clinician chooses not to specify the reason that the criteria are not met for a specific bipolar and related disorder, and includes presentations in which there is insufficient information to make a more specific diagnosis (e.g., in emergency room settings).

Unspecified Neruodevelopmental Disorder 315.9 (F89)

This category applies to presentations in which symptoms characteristic of a neurodevelopmental disorder that cause impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the neurodevelopmental disorders diagnostic class. Used in situations in which the clinician chooses NOT to communicate the specific reason that the presentation does not meet the criteria for any specific neurodevelopmental disorder.

Other Specified Neurodevelopmental Disorder 315.8 (F88)

This category applies to presentations in which symptoms characteristic of a neurodevelopmental disorder that cause impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the neurodevelopmental disorders diagnostic class. Used in situations in which the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for any specific neurodevelopmental disorder.

Unspecified Tic Disorder 307.20 (F95.9)

This category applies to presentations in which symptoms characteristic of a tic disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for a tic disorder or any of the disorders in the neurodevelopmental disorders diagnostic class. Used in situations in which the clinician chooses NOT to specify the reason that the criteria are not met for a tic disorder or for a specific neurodevelopmental disorder, and includes presentations in which there is insufficient information to make a more specific diagnosis.

Other Specified Tic Disorder 307.20 (F95.8)

This category applies to presentations in which symptoms characteristic of a tic disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for a tic disorder or any of the disorders in the neurodevelopmental disorders diagnostic class. Used in situations in which the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for a tic disorder or any specific neurodevelopmental disorder.

Unspecified Communication Disorder 307.9 (F80.9)

This category applies to presentations in which symptoms characteristic of communication disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for communication disorder or for any of the disorders in the neurodevelopmental disorders diagnostic class.

Schizotypal Disorder 301.22 (F21)

This disorder was included with the Schizophrenia Spectrum, because it is considered to be in the range of social and interpersonal deficits that appear in the Schizophrenia Spectrum. - characterized by eccentric behaviors, perceptual distortions, and cognitive issues that may appear in adulthood, but also may emerge in adolescence or childhood. According to the DSM 5, abnormalities of beliefs, thinking, and perception are below the threshold for diagnosis of a psychotic disorder, in this condition - mild form of Schizophrenia

Dopamine

This substance is implicated in Parkinson's disease and Schizophrenia. It is converted enzymes from the amino acid tyrosine. There are five types of receptors for this substance. This is:

Vineland Adaptive Behavior Scale

This test measures the social skills of people from birth to 19 years of age. This test is not administered directly to the child. Instead, questions are directed to primary caregivers and other people familiar with the child. The test contains four sections. These are communication; daily living skills, socialization, and motor skills. This test is also used for children with behavioral disorders, and physical handicaps.

Clorpromazine

Thorazine

Obsessive-Conpulsive Disorder

Time consuming obsessions and compulsions (more than 1 hour per day) or cause significant distress or impairment Not attributable to physiological effects of substance or medical condition Not better explained by another mental disorder

Delusional Disorder 297.1 (F22)

To be used after a 1-year duration of _____________ ______________ - First episode, currently in acute episode - First episode, currently in partial remission - First episode, currently in full remission - Multiple episodes, currently in acute episode - Multiple episodes, currently in partial remission - Multiple episodes, currently in full remission - Continuous - Unspecified

Specifiers for Schizophrenia 295.90 (F20.9)

To be used after a 1-year duration of disorder - First episode, currently in acute episode - First episode, currently in partial remission - First episode, currently in full remission - Multiple episodes, currently in acute episode - Multiple episodes, currently in partial remission - Multiple episodes, currently in full remission - Continuous - With catatonia (293.89) (F06.1) for catatonia associated with Schizophrenia - Rate severity using: Clinician-Rated Dimensions of Psychosis Symptom Severity

Imipramine

Tofranil

True or False - Full or partial symptoms can occur at any time throughout the life span

True

True or False - An adjustment disorder is considered to be a short term diagnosis

True! Symptoms last no longer than 6 months after the stressor in most cases, however the criteria may still apply if the stress or its consequences are prolonged such as chronic housing or family related problems

Grandiose Type

Type of Delusion - delusion of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person

Erotomanic Type

Type of Delusion - delusion that another person, usually of higher status, is in love with the individual

Jealous Type

Type of Delusion - delusion that the individual's sexual partner is unfaithful

Persecutory Type

Type of Delusion - delusion that the person (or someone to whom the person is close to) is being malevolently treated in some way

Somatic Type

Type of Delusion - delusion that the person has some physical defect or general medical condition

Simple Physical Tics

What classification and type of tics are these examples of? - Eye blinking - Eye darting - Grinding teeth - Head jerking - Neck twitching - Nose twitching - Rolling the eyes - Rotating the shoulders - Shoulder shrugging - Sticking the tongue out

Complex Tics

What classification of tic are these examples of? - Copropraxia (making obscene gestures) - Echopraxia (miming the movements of other people) - Flapping - Head shaking - Hitting things - Jumping or hopping - Kicking things - Shaking - Smelling objects - Touching oneself - Touching others

Cluster C

What cluster of personality disorders is anxious & fearful - Avoidant - Dependent - Obsessive - Compulsive

Cluster B

What cluster of personality disorders is dramatic and erratic. - Antisocial - Borderline - Histrionic - Narcissistic Dissociation or Denial - inadvertent liars - borderline - abuse - Splitting (good, bad, ugly) - Hysteria to somatization - Conversion (now maybe you can see it)

Cluster A

What cluster of personality disorders is odd and eccentric. - Paranoid Personality - Schizoid Personality - Schizotypal Personality Features: - Fantasy to eccentric - Lonely to schizoid - Distortion or delusion to paranoid - Projective identification - Projection of guilt (someone else to blame)

Depression in elderly people often goes untreated because many believe depression is normal aging

What of the following are true statements?

Autistic Savant

What term refers to individuals with Autism who have extaordinary skills not exhibited by most persons?

The Diagnostic Adaptive Behavior Scale

What test of adaptive functioning measures adaptive behavioral skills? There are three main categories of these skills. This includes conceptual, social, and practical life skills. This test is very helpful for determining the intensity and types of supports needed to maximize independent functioning and quality of life. However, a more useful and appropriate test for the purpose is the Supports Intensity Scale.

Woodcock-Johnson Scales of Independent Behavior

What test of adaptive functioning measures independent behavior in children?

Vineland Adaptive Behavior Scale (VABS)

What test of adaptive functioning measures the social skills of people from birth to 19 years of age? This test is not administered directly to the child. Instead, questions are directed to primary caregivers and other people familiar with the child. The test contains four sections: communication, daily living skills, socialization, and motor skills. This test is also used for children with behavioral disorders and physical handicaps.

Primary (first-rank) Symptoms

What type of symptoms are these? - hearing thoughts spoken aloud - hearing voices referring to himself / herself, made in the third person - auditory hallucinations in the form of a commentary - thought withdrawal, insertion and interruption - thought broadcasting - somatic hallucinations - delusional perception - feelings or actions experienced as made or influenced by external agents

Idiot Savants

What were Autistic Savants historically called?

Intellectual Developmental Disorder (IDD) or Intellectual Disability

What word replaced "mental retardation"?

People who aided in the Early Treatment of Schizophrenia

Who were these people? - William Battie - Jean-Etienne Dominique Esquirol - Philippe Pinel - Benjamin Rush - Dorothea Dix

bipolar I disorder specifiers

With anxious distress With mixed features With rapid cycling With melancholic features With atypical features With mood-congruent psychotic features With mood-incongruent psychotic features With catatonia With peripartum onset With seasonal pattern

Bipolar and Related Disorder Due to Another Medical Condition Specifiers

With manic features: Full criteria are not met for a manic or hypomanic episode. With manic- or hypomanic-like episode: Full criteria are met except Criterion D for a manic episode or except Criterion F for a hypomanic episode. With mixed features: Symptoms of depression are also present but do not predominate in the clinical picture.

Substance/Medication-Induced Bipolar and Related Disorder specifiers

With onset during intoxication: If the criteria are met for intoxication with the substance and the symptoms develop during intoxication. With onset during withdrawal: If criteria are met for withdrawal from the substance and the symptoms develop during, or shortly after, withdrawal.

Laura does not remember her physical abuse until a year after it took place. Could this still be diagnosed as PTSD?

Yes

Sertaline

Zoloft

Olanzapine

Zyprexa

Drug or Alcohol

_________ or ________ abuse raises the risk of violence in people with Schizophrenia, particularly if the illness is untreated, but also in people who have no mental illness

Catatonia

___________ can occur in the context of several disorders. - Neurodevelopmental - Psychotic - Bipolar - Depressive Disorder - Rare autoimmune and paraneoplastic disorders *_____________ is not treated as an independent class but recognizes: - Catatonia associated with another medical disorder - Due to a medical disorder - Unspecified catatonia

Autism

___________ is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior.

Suicide

___________ is the number one cause of premature death among people with Schizophrenia, with an estimated 10 - 13 percent killing themselves and approximately 40% attempting suicide at least once, and as much as 60% of males attempting suicide.

Autism Spectrum Disorder 299.00 (F84.0)

_____________ ____________ _____________ replaces: - Autistic Disorder - Asperger's Disorder - Childhood Disintegrative Disorder - Pervasive Developmental Disorder Not Otherwise Specified

Violence

______________ is not a symptom of Schizophrenia

bipolar II disorder

a clinical course of recurring mood episodes consisting of one or more major depressive episodes and at least one hypomanic episode. The major depressive episode must last at least 2 weeks and they hypomanic episode for 4 days.

Intellectual Developmental Disorder

a disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains. The following three criteria must be met: A) deficits in intellectual functions, such as reasoning, problem solving, planning, abstract thinking, judgement, academic learning, and learning from experience, confirmed by both clinical assessment and individualized, standardized intelligence testing. B) Deficits in adaptive functioning that result in failure to meet developmental and socio-cultural standards for personal independence and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more activities fo daily life, such as communication, social participation, and independent living, across multiple environments, such as home, school, work, and community C) Onset of intellectual and adaptive deficits during the developmental period

manic episode

a distinct period during which there is an abnormally persistent elevated, expansive or irritable mood and persistent increased activity or energy, that is present all day, every day, for a period of at least one (1) week

Neuron

a specialized nerve cell that receives, processes, and transmits information to other cells in the body

Psychosis

a symptom or feature of mental illness typically characterized by radical changes in personality, impaired functioning, and a distorted or nonexistent sense of objective reality

Psychosis

a symptom or feature of mental illness typically characterized by radical changes in personality, impaired functioning, and a distorted or nonexistent sense of objective reality. impaired reality testing. unable to distinguish personal subjective experience from the reality of external world

Neurosis

a term given to mental illnesses that causes emotional distress or stress without affecting a person's ability to think clearly

Corpus Callosum

a wide, flat bundle of neural fibers about 10 cm long beneath the cortex in the eutherian brain at the longitudinal fissure. It connects the left and right cerebral hemispheres and facilitates interhemispheric communication. It is the largest white matter structure in the brain, consisting of 200-250 million contralateral axonal projections.

hypomanic episode

distinct period of abnormality and persistent elevated, expansive, or irritable mood and abnormality and persistent increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day

Acetylcholine Receptors

dry mouth dilated pupils blurred vision constipation urinary retention tachycardia Blockade of ____________________________

Panic Attack

abrupt surge of intense fear and discomfort that reaches a peak within minutes with four of the following (palpitations; sweating; trembling/shaking; shortness of breath; feeling of choking; chest pain; nausea; light-headedness/faint; chills/hot flashes; numbness; derealization; depersonalization; fear of losing control/going crazy; fear of dying)

Glial Cells

act as guidepost for migrating neurons and support the neurons to dispose of waste and provide cell nourishment act as insulators between neurons and prevent neuronal impulses form spreading in unwanted directions maintain a suitable metabolic and ionic environment

Yohimbine

an alkaloid, the active principle comes from the bark of corynanthe johimbe. It produces a competitive blockage of limited duration of a-adrenergic receptors. Has also been used for its alleged aphrodisiac properties.

Ritual

behaviors repeatedly performed in a specific manner to relieve the anxiety of the obsessions, a rite or ceremony that becomes compulsive for the individual

Neurotransmitters

biochemical substances that carry information

Terminal Buttons

bulb-like structures at the end of the axon that pass information on to glands, muscles, or other neurons

Extrapyramidal Tracts

chiefly found in the reticular activating formation of the pons and medulla, and target neurons in the spinal cord involved in reflexes, locomotion, complex movements, and postural control. These tracts are in turn modulated by various parts of the central nervous system.

cyclothymic disorder

chronic, fluctuating mood disturbance involving numerous periods of hypomania and periods of depressive symptoms that are distinct from each other. Two years for adults (one year for children) symptom free no more than 2 months. Never met criteria for major depressive, manic, or hypomanic episode.

Neurosis

classification typically includes anxiety and fear-based disorders some physicians still use it to describe mental disorders as social anxiety, panic disorder, specific phobias, and obsessive-compulsive disorder

Systematic Desensitization

clients are taught to relax as they are gradually exposed to what they fear in a step wise manner

Ependymal cells

concerned with exchanges of materials between brain and cerebrospinal fluid

Speech Sound Disorder 315.39 (F80.0)

deficits in social use of verbal and communication for social purposes, impaired communication in social context and for conversation, problems with nonliteral or implied meanings

Yerkes Dodson Law

dictates that performance increases with physiological or mental arousal, but only up to a point

Language Disorder 315.32 (F80.2)

difficulties of acquisition and use of language due to deficits in the comprehension or production of vocabulary, sentence structure, discourse

mood symptoms

euphoric mood, racing thoughts, frenetic acts, insomnia

Generalized Anxiety Disorder

excessive anxiety and worry about many events and activities occurring most days for no less than 6 months; intensity, duration, and frequency of anxiety is out of proportion to the anticipated event; often worry about every day, routine life circumstances

Chirotophobia

fear of bats

Cynophobia

fear of dogs

Equinophobia (hippophobia)

fear of horses

Entomophobia

fear of insects

Hepretophobia

fear of reptiles

Arachnophobia

fear of spiders

Ornithophobia

fear/dislike of birds

Ichthyophobia

fear/dislike of fish

Musophobia

fear/dislike of mice and/or rats

Ophidiophobia

fear/dislike of snakes

Scoleciphobia

fear/dislike of worms

Zoophobia

generic term for animal phobias

Hebephrenia named after Hebe, the goddess of frivolity

in 1871 Hecker creates a _________________ definition

Dementia Praecox or Dementia of Early Onset

in 1878 Emil Kraepelin comes closer to a schizophrenia definition than anyone in prior schizophrenia history. He coins the term ____________ or ___________ ____ _______ ________, which he subdivides into simple, paranoid, hebephrenic, and catatonic stages.

Myelin Sheath

insulating fatty layer that speeds transmission in a neurotransmitter

Flooding

intense and prolonged exposure to stimulus presented in such a way that there is no opportunity to avoid the stimulus

Schwann's Cells

make myelin in a neurotransmitter

Hypomania

mania lasting 4 days

Social Anxiety Disorder

marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others

Agoraphobia (Disorder)

marked or intense fear or anxiety triggered by the real or anticipated exposure to a range of situations

Echopraxia

mimicking another's movements

Echolalia

mimicking another's speech

Bipolar I

mostly maina --- some depression

Akathisia

motor restlessness

Tourette's Disorder

multiple motor tics and one vocal tic that waxes and wanes but persisted 1 year, manifesting before age 18

Norepinephrine

neurotransmitter associated with eating and alertness too much: schizophrenia too little: depression

Dopamine

neurotransmitter correlated with movement, attention, and learning too much = schizophrenia too little = forms of depression, muscular rigidity & tremors in Parkinson's

PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections)

occurs when strep triggers a misdirected immune response results in inflammation on a child's brain. In turn, the child quickly begins to exhibit life changing symptoms such as OCD, anxiety, tics, personality changes, decline in math and handwriting abilities, sensory sensitivities, restrictive eating, and more.

Intellectual Disability (Intellectual Developmental Disorder)

onset during developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains

Attention-Deficit/Hyperactivity Disorder

persistent pattern of inattention and or hyperactivity-impulsivity that interferes with functioning or development

Attention Deficit Hyperactivity Disorder

persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development

Preparedness

phenomenon that makes some fears more readily learned than others; the brain wired to recognize some stimuli as more inherently dangerous than other stimuli

noradrenergic crisis

pre migraine features, such as vertigo, visual distortion, and headache (migraine-like)

Phagocytosis

process by which glial cells remove the foreign material and cell debris

Limbic & frontal-cortical areas

psychomotor slowing, indifference to sensory stimuli, emotional quieting, reduction in initiative are all characteristics of blockage receptors in the ________

Axon

receives information from the cell body (soma)

Obsessions

recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted

Cognitive Bipolar Symptoms

reduced insight into consequences of actions, flight of ideas, delusions, loss of inhibitions

cognitive symptoms

reduced insight into consequences of actions, flight of ideas, delusions, loss of inhibitions

Yerkes Law

relationship between arousal and performance. when arousal becomes too high, performance decreases

Compulsions

repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly

Provisional Tic Disorder

single or multiple motor and/or vocal tics that have been present for less than a year

Persistent Motor or Vocal Tic Disorder

single or multiple motor or vocal tics but not both motor and vocal

Sodium Lactate

sodium salt of racemic or inactive lactic acid, used as a fluid and electrolyte replenisher to combat acidosis

hypothalamic-pituitary area

suppression of appetite, suppression of temperature regulation (poikilothermy), prolactin release, blocked ejaculation in males, and ovulation suppression in female are characteristic of blockade of the d2 receptors in the __________

Chlorpromazine/Thorazine

the antipsychotic 1954 first introduced in psychiatric facilities. By 1970 more than 85% psychiatrically unpaired persons were receiving a neuroleptic drug for their conditions

Preservation

the repetition of a particular response (such as a word, phrase, or gesture) despite the absence or cessation of a stimulus. It is usually caused by brain injury or other organic disorder.

Formication

the sensation that resembles that of small insects crawling under the skin.

Antagonists drugs

these cells block the access or attachment of the body's natural agonists, usually neurotransmitters, to their receptors and thereby prevent or reduce cell responses

Schwann cells

these cells provide the insulation (myelin) to neurons in the peripheral nervous system

amygdala

this structure of the brain is implicated in recalling emotionally charged memories, such as a frightening situation. This structure is activated when a person is sad or clinically depressed. Activity in this structure continues even after depression abates.

Dopamine

this substance is implicated in parkinson's disease and schizophrenia. It's converted enzymes from the amino acid tyrosine. There are five types of receptors for this substance.

unspecified bipolar and related disorders

used in situation when clinician does not specify why the criteria are not met or in situations with insufficient information to make a diagnosis, such as in the emergency room

Dendrites

where information comes into the neuron

Cell Body (Soma)

where information travels through after coming through dendrites main part of the neuron; contains the nucleus and maintains the life sustaining functions of the neuron this processes information and then passes it along to the Axon

cyclothymic disorder specifiers

with anxious distress