Quiz 12 Ch14-15

Which of the following is MOST likely to be said by an elderly person regarding long-term care?

"I'm worried about how my life will change."

"Grandma is 65 years old, and there's no sign of neurocognitive disorder," says a friend of yours. Your MOST accurate reply is:

"That's wonderful --- about 1 to 2 percent of people that age do have signs of neurocognitive disorder."

"In dealing with Alzheimer's disease, exercise is the key," says a friend of yours. Which of the following would be your BEST reply?

"You're right --- exercise may reduce the chances of developing Alzheimer's, and it may help treatment if the disease does develop."

Delirium

+ "clouding of consciousness" Difficulties orienting to time and place Develops over short period of time (hours, days) Might occur in ANY age group, but is more prevalent in the elderly Diseases & medication can cause it (Important differential diagnosis in medical settings)

Gender Differences in Conduct Disorder

+ Boys 3x as likely to be diagnosed as girls + Boys with CD more aggressive than girls with CD + Girls' antisocial behavior manifested differently? Relational aggression? (often verbal, indirect, involves character defamation)

Rhett's Disorder

+ Characterized by normal development until a certain point + Loss of previously acquired skills, such as language + Severe motor difficulties and trouble interacting w/others + Thought to be genetic + No language impairments, according to chart...? (difference from childhood) + Hypotonia/microephaly/seizures + Mutation of X chromosome + 1 in 12,500

Costello experiment and SES

+ Costello (2003) - natural experiment with 1420 kids in rural NC; casino opened, leading to increase in income for many families, + decrease in rates of ODD/CD after casino opened + Parental supervision improved

Negative Outcomes Associated with ODD and CD

+ History of ODD/CD present in 25-60% adults w/mental disorders + 75-85% chronically unemployed, engaged in impulsive, aggressive behavior +30-40% will be diagnosed with antisocial personality disorder as adults

Bipolar Disorder in Children?

+ used to be considered an "adult" mood disorder + But 40-fold increase in number of cases from 1994 to 2003 + Controversial...many children do not display "true mania" + Treated with powerful mood stabilizers and antipsychotics + DSM-V - disruptive mood dysregulation disorder?

Discuss treatments for neurocognitive disorders

- Drug treatment - Cognitive techniques - Behavioral interventions - Support for caregivers - Sociocultural factors: day care facilities

Delirium

- difficulty concentrating, focusing attention, thinking in ordered way - happen in few hours/days Caused by: - fever - poor nutrition - head injuries - stroke

Externalizing disorder examples

1. ADHD 2. Conduct disorder 3. Oppositional Defiant Disorder 4. Substance use

Pharmacology for CD/ODD

1. Antidepressants (SSRIs) 2. Neuroleptics 3. Stimulants 4. Mood Stabilizers Mixed Results

Biological Perspective on CD/ODD

1. Brain circuitry 2. Neurotoxins 3. Low arousal to punishment and rewards (low cortisol in response to stress) 4. High serotonin (linked to violent crimes) 5. High testosterone 6. Genetics/family history

Aggression Symptoms

1. Bullies, threatens, intimidates other people 2. Often initiates physical fights 3. Uses weapons that can cause serious harm 4. Has stolen while confronting a victim 5. Physically cruel to people/animals 6. Forced someone into sexual activity

Psychosocial Treatment for Autism

1. CBT approach + Skills training + Operant conditioning to teach speech, social skills, self-help 2. Communication training + Augmentative communication systems 3. Parent training 4. Community integration

Family and Environment Risk Factors for CD/ODD

1. Chaotic/disrupted family environments 2. Low SES (Socioeconomic Status) - Costello 3. Parenting practices (lack of involvement, harsh, physical abuse, severe neglect) 4. Exposure to deviant peers (deviants child tends to associate with deviant peers, escalating behavioral problems)

Subtypes of ADHD

1. Combined types (6+ symptoms of inattention and 6+ of hyperactivity/impusivity) 2. Predominantly inattentive type (6+ symptoms of inattention and less than 6 of hyperactivity) 3. Predominantly hyperactive impulsive

Two Types of Alzheimer's

1. Early onset (familial) 2. Late onset (sporadic)

Genetics of Alzheimer's

1. Family history (2-4 greater risk among relatives) 2. Concordance rates in twins 58% MZ vs. 45% DZ 3. APOE regulates ApoE protein

Causes of ADHD

1. Genetics 2. Dopamine dysregulation 3. Disrupted functioning of frontal lobes, caudate nucleus, corpus callosum 4. Prenatal and birth complications 5. Family environment

Types of Childhood and Adolescence Disorders (7, but 4 main ones)

1. Internalizing Disorders 2. Externalizing Disorders 3. Pervasive developmental disorders 4. Cognitive disorders 5. Tic disorders 6. Feeding disorders 7. Elimination disorders

Cognitive disorder examples

1. Learning disorders 2. Motor skill disorders 3. Communication disorders 4. Mental retardation

Subtypes of Conduct Disorder

1. Life-course persistent (develops early in childhood, more likely to continue having problems into adulthood) 2. Adolescent limited (onset in adolescence; LESS likely to have problems into adulthood)

Why is classifying bipolar disorder in children controversial?

1. Many children do not display true mania 2. Treated with powerful medications (mood stabilizers and antipsychotics)

Cognitive Changes in Alzheimer's

1. Massive cell loss 2. Damage to nerve cells (protein called beta-amyloid accumulates in the spaces between cells) 3. Plaques and tangles (plaques block cell-to-cell signaling at the synapses; neurofibrillary tangles) 4. Acetylcholine Transport (APP is important in transport of acetylcholine)

Distinctions between Oppositional Defiant Disorder and Conduct Disorder

1. ODD milder than CD (Oppositional mild) 2. ODD has earlier onset (Oppositional early) 3. Subset of children with ODD go on to meet criteria for CD (about 43% of boys 9-13yrs with ODD meet CD over next three years) 4. If a child meets criteria for CD, they CANNOT be diagnosed with ODD

Behavioral Therapy for CD/ODD

1. Problem Solving Skills Therapy (PSST) 2. Parent Management Training (PMT)

Causes of Autistic Disorders

1. Psychodynamic perspective: "refrigerator parents" (cold and closed off?) 2. Social and environmental stress 3. Failure to develop theory of mind 4. Genetics 5. Neurocircuitry + Abnormal development of the cerebellum +Increased brain volume, structural abnormalities in limbic system, brain stem nuclei

Pervasive development disorder examples

1. Rhett's 2. Childhood disintegrative disorder 3. Asperger's 4. Autism

Pervasive Developmental Disorders: Autism Spectrum

1. Rhett's disorder Normal development through first 5 months, then losses of skills 2. Childhood disintegrative disorder Normal development thorough first 2 years, then losses for function 3. Asperger's disorder Deficits in social interactions and activities, but NOT in language or communication 4. Autistic disorder Deficits in social interaction, communication, activities, and interests

Pharmacology for Autism

1. SSRIs reduce repetitive behaviors, aggression, depression, anxiety, and improve social interactions 2. Antipsychotics reduce compulsive behavior and improve self-control 3. Naltrexone reduces hyperactivity 4. Stimulants improve attention

Property Destruction Symptoms

1. Sets fires w/the intention of causing serious damage 2. Deliberately destroys property of another person

Violation of Rules Symptoms

1. Stays out at night (in spite of parents' rules), starting before the age of 13 2. Has run away from home overnight at least twice 3. Has run away from home once but for an extended period of time 4. Often truant from school, starting before the age of 13

ADHD Pharmacological Treatments

1. Stimulants (Ritalin, Adderall - 2.2 million children in the US take stimulants) 2. Drugs that affect norepinephrine (Clonidine, guanfacine, atomoxetine) 3. Antidepressants

Describe the issues affecting the mental health of the elderly

1. The problems of elderly members of racial and ethnic minority groups 2. Inadequacies of long-term care 3. The need for health maintenance by young adults

Two main types of disorders

1. Those common across age groups (anxiety, depression, etc.) - have different manifestations in the elderly 2. Disorders of cognition (delirium, dementia, Amnestic disorders)

Other examples

1. Tic disorders 2. Feeding disorders 3. Elimination disorders

Other Types of Dementia (5)

1. Vascular dementia (Follows a vascular accident) 2. Pick's disease (Affects frontal lobes) 3. Creutzfeldt-Jakob disease (Slow acting virus) 4. Huntington's disease (Memory & motor problems) 6. Parkinson's disease (Tremors, rigidity, unsteadiness)

Internalizing disorder examples

1. separation anxiety disorder 2. other anxiety disorders (phobia, panic, PTSD, OCD) 3. Mood disorders 4. Somatization 5. Eating disorders

Caregivers

10 million Americans care for people w/dementia Bathing, feeding, toileting, keeping them safe Estimated 16-25 hours/week Mental health toll on caregivers Day-care facilities Nursing homes

Of 100 typical elderly patients entering a hospital for a general medical condition, about how many would initially be diagnosed with delirium, and about how many more would develop delirium while in the hospital (in that order)?

10 percent, 10 percent

Depression in the Elderly

20% people experience depression in old age + More common in women + Associated w/medical illnesses, loss of loved ones + Psychotic symptoms might be common Treatment: similar as for younger adults 1. Psychotherapy (esp. CBT) 2. Medications (but some cannot be used safe or effectively b/c they are metabolized differently) 3. ECT (electro-convulsive therapy)

What percentage of adults have mental disorders who also have a history of ODD/CD?

25-60%

ADHD Statistics

4-9% of schoolchildren 70% are boys 80% receive treatment Lessening of symptoms into adolescence Difficult to assess -- observations across contexts (parent, teacher, etc.)

The ratio of females to males over 65 years old is:

40 percent

Survey research shows that alcohol-related disorders affect about:

5 percent of the elderly, more often men

Creutzfeldt-Jakob disease

A form of neurocognitive disorder caused by a slow-acting virus that may live in the body for years before the disease unfolds

Day center

A program that offers hospital-like treatment during the day only

Parkinson's disease

A slowly progressive nuerological disease marked by tremors and rigidity that may also cause dementia

Autistic Disorder (6 total of impaired social interaction & communication; repetitive behavior)

A total of at least 6 of the following Impairment in social interaction, as manifested by at least 2 of the following 1. Marked impairment in the use of multiple nonverbal behaviors (e.g., eye contact) 2. Failure to develop peer relationships appropriately 3. Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people 4. Lack of social or emotional reciprocity Impairment in communication, as manifested by at least 1 of the following 1. Delay in, or total lack of, development of spoken language 2. In individuals w/ adequate speech, marked impairment in the ability to start/sustain a conversation 3. Stereotyped and repetitive use of language, or idiosyncratic language 4. Lack of varied, spontaneous make-believe play or social imitative play Restrictive repetitive and stereotyped patterns of behavior, interest, and activities, as manifested by at least 1 of the following 1. Abnormal preoccupation w/one or more stereotyped and restricted patterns of interest 2. Inflexible adherence to specific nonfunctional routines or rituals 3. Stereotyped and repetitive motor mannerisms (e.g., finger flapping) 4. Persistent preoccupation w/parts of objects + Sensory problems/Seizures + Average to below average IQ + 1-2 in 1000

ADHD (Attention Deficit Hyperactive Disorder) - two groups

A. 6 symptoms of inattention (persisting for at least 6 months) - 66 devil child 1. failure to pay attention to detail/careless mistakes 2. difficulty sustaining attention 3. failure to listen 4. failure to finish work 5. difficulty with organization 6. avoidance/dislike of tasks with mental effort 7. Loss of items 8. Easily distracted 9. Forgetfulness B. 6 symptoms of hyperactivity/impulsivity for 6 months 1. fidgeting/squirming 2. wandering from seat 3. running about/climbing when inappropriate 4. difficulty being quiet 5. frequent on the go activity (driven by a motor) 6. excessive talking 7. blurting out answers 8. difficulty waiting for turn 9. interrupts others

Areas of the brain affected by Alzheimer's

ALL OF THEM 1. Frontal lobe 2. Hippocampus/amygdala (deep within) 3. Temporal lobe 4. Parietal lobe 5. Occipital lobe 6. Cerebellum 7. Spinal cord?

Late onset (sporadic)

After age 65 Combination of genes and environment Gene apolipropotein E (ApoE) produces protein that carries fat into bloodstream 30% population have variation ApoE-4 might suggest vulnerability

Alzheimer's Dementia

Alzheimer's accounts for 50-70% dementia cases 5.1 million Americans Risk increases over 40% after age 84

The MOST feared psychological problem among the elderly is:

Alzheimer's disease

The MOST frequent cause of irreversible dementia in the elderly is:

Alzheimer's disease

Huntington's disease

An inherited disease, characterized by progressive problems in cognition, emotion and movement, which results in neurocognitvie disorder

Which of the following is the correct ordering of ethnic groups in the United States in terms of the percentage of the elderly living with their children (from highest percentage to lowest percentage)?

Asian American, African American, Hispanic Americans, white American

Early onset (familial)

Before age 65 Fewer than 5% cases Mutations in genes that produce beta-amyloid precursor protein (beta-APP), presenlin 1, presenlin 2

Behavioral Therapy Outcomes

Behavioral problems decrease in all cases Decreases from atoung 70% to 60% Fastest decrease in combined PSST+PMT (lowest in the end too) PSST (Problem Solving) - second quickest decrease PMT - takes a bit longer but same effect

Comorbidity of CD

Boys - 20% ADHD, 45% Anxiety, 35% Depression, 45% Alcohol Dependence, 40% Marijuana dependence (Boys = anxiety, alcohol, marijuana, depression) Girls - 70% Anxiety, 70% Depression, 30% Alcohol Dpendence, 27% Marijuana Dependence (Girls - Anxiety, depression, alcohol, marijuana)

Discuss the issues of old age and stress

Cause by: - losses - feeling no purpose in life - biological 2 groups: 1) Disorders seen in all ages (depression, anxiety, drug use) 2) Disorders of cognition (delirium, neurocognitive)

Nuerocognitive disorder

Decline in cognitive functioning, language, memory loss, planning, decision making, personality changes More severe than delirium

Describe the disorders of depression, anxiety, substance abuse and psychotic disorder in later life

Depression: losses, illness; linked with increased risk of medical problems Anxiety: declining health Psychotic disorders: Schizophrenia or delusional disorders Substance abuse: - alcohol/drug use usually decline after age 60 - often look at those whose use is lifetime vs. new - new use may start because of death, retirement, etc

Controversies around ADHD

Epidemic? Overdiagnosis or underdiagnosis? Adult ADHD? Childhood ADHD actually bipolar disorder?

Long-term care

Extended personal and medical support provided to elderly and other persons who may be impaired (may range from partial support in a supervised apartment to intensive support at a nursing home

Geropsychology

Field of psychology dedicated to the mental health of the elderly (65+)

Gene and Environment

Genes may predispose to specific disorders or more generally to a resilient or vulnerable temperament Environment can enhance resiliency / worsen vulnerability

Pharmacology for Alzheimer's (3)

Improve cognitive functioning Do not prevent disease progression 1. Cholinesterase inhibitors + Prevent breakdown of acetylcholine + Cognex, Aricept, Exelon, Reminyl 2. Gluatamate regulation + Memantine 3. Antipsychotics & antidepressants + To reduce agitation, improve mood and sleep, control hallucinations

Cognitive Changes with Age

In 60s - dramatic decrease in speed of processing, working, and LTM In 50s - increased Word Knowledge [Neurons die, amyloid deposits/tangles - Alzheimer's] 1. Hypothalamus/Thalamus - selected neurons shrink or die 2. Cerebral cortex - large neurons shrink (amyloid deposits develop in spaces between cells) 3. Basal forebrain - acetylcholine-secreting neurons shrink or die 4. Locus ceruleaus - neurons die 5. Amygdala/Hippocampus - amyloid deposits develop in spaces between cells (neurofibrillary tangles develop within neurons)

Can Vaccines Cause Autism Spectrum Disorders?

Initial study showing association with MMR vaccine and autism retracted by the Lancet in 2010

Interalizing Disorders - differences between kids and adults

Kids - more somatic/behavioral symptoms (less cognitive) Treatment - kids have play therapy and sessions with parents

Eye Tracking Studies

Klin et al. (2003) 15 males w/autism and 15 healthy controls Researchers coded fixations on mouth, eyes, body, and objects +++ Best predictor of autism was eye region fixation time (vew low by comparison; higher fixation percentage on mouth and body)

Are we overmedicating children?

Long-term safety and effectiveness of drugs still to be fully determined At the same time, they do provide symptom reduction

Costs of Alzheimer's

Medicare Costs (2000) Hospital: Alz $7000, Non $2000 Nursing Home: Alz $2000, Non $100 Home Health: Alz $1000, Non $100

DSM Criteria for Alzheimer's Dementia

Multiple cognitive deficits including both 1. Memory impairment 2. One or more of the following Aphasia (language disturbance) Apraxia (impaired motor functioning) Agnosia (failure to recognize objects) Poor executive functioning (e.g., planning, organizing) Course characterized by gradual onset and continued decline

Childhood Disintegrative Disorder

Normal development until age 2 - 10; then loss of acquired skills Language Social skills Self care Control over bowel & bladder Play skills Motor skills + Seizures + Regression at under 2 years + 1 in 50,000

Aging Population in the US

Number of people aged 65+ has increased 11-fold since the beginning of the 20th century 4% increase in 1900 13% increase in 20100 Expected 20% in 2030

Parent Management Training (PMT)

Parent Management Training (PMT) Parents learn to identify, define, and observe problem behaviors from a behavioral perspective Taught to use positive reinforcement, prompting, shaping, mild punishment, negotiation, and contingency contracting Techniques modeled by therapist and practiced by parent in session

An individual suffering from a neurological disorder shows no evidence of infection or poisoning, but experiences tremors, rigidity, and unsteadiness. The MOST probable diagnosis is:

Parkinson's disease

Oppositional Defiant Disorder (ODD) - need 4 symptoms

Pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, and characterized by four or more of the following: 1. Loses temper 2. Argues 3. Refuses to follow rules/requests 4. Deliberately annoys others 5. Blames others 6. Easily annoyed 7. Angry 8. Spiteful/vindictive (holds a grudge)

Child Maltreatment Interacts with Genes

Percentage with Low MAOA activity and SEVERE maltreatment - 80% CD (with high MAOA activity - only 40%)

Which of the following diseases involving degeneration of the frontal and temporal lobes?

Pick's disease

Krosakoff's Syndrome

Primarily anterograde amnesia Caused by excessive drinking: lack of thiamine in the brain (alcohol)

According to recent research, should patients with Alzheimer's disease by encouraged to repeat --- day after day --- activities that they enjoyed doing when they were younger?

Probably; they would tend to be happier, even after forgetting they did the activity

Problem Solving Skills Therapy (PSST)

Problem Solving Skills Therapy (PSST) (Alan Kazdin) Child uses the following steps to engage in better social problem solving What am I supposed to do? I have to look at all my possibilities I have to consider the consequences I have to make a choice "I did a good job" or "I made a mistake"

Asperger's Disorder (2 impairment in social interaction & 1 repetitive behavior)

Qualitative impairment in social interaction, as manifested by at least 2 of the following: 1. marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction 2. failure to develop peer relationships appropriate to developmental level 3. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people) 4. lack of social or emotional reciprocity Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least 1of the following: 1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus 2. apparently inflexible adherence to specific, nonfunctional routines or rituals 3. stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements) 4. persistent preoccupation with parts of objects + Average IQ + 1 in 3,000

Amnestic Disorders

Retrograde Amnesia: inability to remember events from the past (retro = before) Anterograde amnesia: ongoing inability to form new memories (can't remember things AFTER trauma)

What generally happens in the thalamus and the hypothalamus of an individual with Alzheimer's disease?

Selected neurons die

Internalizing Disorders (definition)

Similar to those experienced by adults BUT not exactly the same More somatic and behavioral symptoms (less cognitive) Some disorders are unique to childhood (e.g., separation anxiety disorder) Differences in treatment Play therapy Sessions w/parents

Range of Functioning

Some individuals do poorly in tests of intelligence; others do very well Some individuals become independent adults; others do not

Stages of Alzheimer's (7)

Stage 1: no impairment Stage 2: very mild cognitive impairment Forgetfulness + Misplace every day objects + Can't find names Stage 3: mild cognitive decline noticed by family + Can't remember new names or info + Decline in ability to plan or organize + Loss of valuable objects + Trouble recalling words or names Stage 4: mild cognitive decline + Decrease knowledge of recent events + Impaired ability to do math + Decline in ability to perform complex tasks (e.g., pay bills) + Reduced memory of personal history + May become subdued or withdrawn Stage 5: moderately severe cognitive decline + Can't recall own address or phone number + Confused about where s/he is, what day of the week it is + Need help choosing proper clothing + Still recognize close other and retain substantial information about the self + Usually require no help eating or in the toilet Stage 6: severe cognitive decline + Unaware of recent experiences, surroundings + Occasionally forget names of spouses but can distinguish familiar from unfamiliar + Disruption of sleep / wake cycle + Significant personality changes, hallucinations + Wander and become lost Stage 7: very severe cognitive decline + Lose capacity for speech + Need help eating or in the toilet + Lose ability to walk / sit w/o assistance + Can't smile or hold head up + Swallowing is impaired

Autism Spectrum Statistics

Steady increase in prevalence + 1 in 600 children and perhaps as many as 1 in 150 + No reliable diagnosis until age 3 + YET, treatment can be very effective if begun early enough

Geropsychology

The field of psychology concerned with the mental health of elderly people

Alzheimer's disease

The most common type of neurocognitive disorder, usually occurring after the age of 65, marked most prominently by memory impairment onset death: 8-10 years cause of death is normally: - pneumonia - stroke

Health maintenance

The principle that young adults should act to promote their physical and mental health to best prepare for the aging process

Outcomes of Boys with CD at Age 21

Those with CD: 1. Crime (1.0) 2. Violence (0.8) 3. Jail (0.63) 4. Alcohol Dependence (0.62) 5. Unemployment (0.62) 6. Welfare (0.4) 7. Physical Abuse Perpetrator (0.15)

Conduct Disorder (CD)

[bad conduct -- violating rules] Persistent pattern of behavior violating basic rights of others and societal rules, manifested by three or more symptoms in the following classes: 1. Aggression to people and animals 2. Destruction of property 3. Deceitfulness or theft 4. Serious violation of rules

encopresis

a childhood disorder characterized by repeated defecating in inappropriate places, such as one's clothing

enuresis

a childhood disorder marked by repeated bed-wetting or wetting of one's clothes

disruptive mood dysregulation disorder

a childhood disorder marked by severe recurrent temper outbursts and a persistent irritable or angry mood

problem-solving skills training

a cognitive-behavioral intervention for children with conduct disorder; therapists use modeling, practice, role-playing, and systematic rewards to help teach children constructive thinking and positive social behaviors

An elderly person who believes falsely that others are conspiring against her, cheating her, or spying on her and who behaves in angry, irritable, and depressed ways is exhibiting:

a delusional disorder

autism spectrum disorder

a developmental disorder marked by extreme unresponsiveness to others, severe communication deficits, and highly repetitive and rigid behaviors, interests, and activities

conduct disorder

a disorder in which a child repeatedly violates the basic rights of others and displays significant aggression; some children with this disorder are later diagnosed with antisocial personality disorder (as adults)

oppositional defiant disorder

a disorder in which children are persistently argumentative, defiant, angry, irritable, and perhaps vindictive

separation anxiety disorder

a disorder marked by excessive anxiety, even panic, whenever the person is separated from home, a parent, or another attachment figure

intellectual disability

a disorder marked by intellectual functioning and adaptive behavior that are well below average

attention-deficit/hyperactivity disorder (ADHD)

a disorder marked by the inability to focus attention, or overactive and impulsive behavior, or both

parent-child interaction therapy

a family intervention to treat conduct disorder among preschoolers; parents are taught to work with their children positively, to set appropriate limits, to act consistently, and to set appropriate expectations

Among the "oldest old," those who are over 95 years old, the MOST common concern is:

a fear of losing mental abilities

Down syndrome

a form of intellectual disability caused by an abnormality in the 21st chromosome

neurodevelopmental disorders

a group of disabilities in the functioning of the brain that emerge at birth or during very early childhood and affect a person's behavior, memory, concentration, and/or ability to learn

fetal alcohol syndrome

a group of problems in a child, including lower intellectual functioning, low birth weight, and irregularities in the hands and face, that result from excessive alcohol intake by the mother during pregnancy

profound ID

a level of intellectual disability (IQ below 20) at which people need a very structured environment with close supervision

severe ID

a level of intellectual disability (IQ between 20 and 34) at which people require careful supervision and can learn to perform basic work in structured and sheltered settings

moderate ID

a level of intellectual disability (IQ between 35 and 49) at which people can learn to care for themselves and can benefit from vocational training

mild ID

a level of intellectual disability (IQ between 50 and 70) at which people can benefit from education and support themselves as adults

phenylketonuria (PKU)

a metabolic disorder leading to intellectual disability (if untreated) caused by recessive genes; afflicted individuals are born normal but cannot break down the amino acid phenylalanine, resulting in eventual poisoning if not placed on a diet that avoids phenylalanine

augmentative communication systems

a method for enhancing the communication skills of people with autism spectrum disorder, intellectual disability, or cerebral palsy by teaching them to point to pictures, symbols, letters, or words on a communication board or computer

relational aggression

a pattern of aggression found in certain cases of conduct disorder; individual primarily engages in misdeeds such as slandering others, spreading rumors, and manipulating friendships

sheltered workshop

a protected and supervised workplace that offers job opportunities and training at a pace and level tailored to people with various psychological disabilities

intelligence quotient (IQ)

a score derived from intelligence tests that theoretically represents a person's overall intellectual capacity

syphilis

a sexually-transmitted infection; if untreated in pregnant mothers, it may lead to childhood problems and intellectual disability in the unborn child

treatment foster care

a sociocultural approach to help children with conduct disorder; children are assigned to a foster home in the community and, while there, children, foster parents, and birth parents receive training and treatment

echolalia

a speech abnormality common in autism spectrum disorder; the individual repetitively echos (repeats) exact phrases spoken by others, but with no sign of understanding or intent of communicating

state school

a state-supported institution for people with intellectual disability; a typical approach to care prior to the 1960s & 70s

methylphenidate

a stimulant drug, known better by the trade name Ritalin, commonly used to treat ADHD

play therapy

a treatment approach that helps children express their conflicts and feelings indirectly by drawing, playing with toys, and making up stories

The fact that Alzheimer's disease resembles Creutzfeldt-Jakob disease suggests that Alzheimer's may be caused by:

a virus

Compared to younger people, those over 65 are:

about as likely to experience depression if not living in a nursing home, and more likely to experience depression if living in a nursing home

rubella

also known as the "German measles," if a mother experiences this viral infection during pregnancy it may lead to childhood problems and intellectual disability in her unborn child

special education

an approach to educating children with intellectual disability in which they are grouped together and given a separate, specially-designed education

cerebellum

an area of the brain that coordinates movement in the body and perhaps helps control a person's ability to shift attention rapidly

theory of mind

an awareness that other people base their behaviors on their own beliefs, intentions, and other mental states, not on information that they have no way of knowing

parent management training

an family intervention to treating behavior disorders among school-age children wherein 1.) parents are taught more effective ways to deal with their children and 2.) parents and children meet together in behavior-oriented family therapy

One of the MOST frequent reasons for the institutionalization of Alzheimer's patients is:

because home caregivers are overwhelmed

An indvidual is extremely sad, can't sleep well, and experiences very low, and decreasing, self-esteem. These are features of depression among:

both the elderly and the young

A person who has an excess of plaques due to Alzheimer's would be likely to have:

cell breakdown and death

Most effective treatment for ADHD

combination therapy 579 children with ADHA - 8yo 14 months treatment Four conditions: 1. Routine community care (control) - 25% improved 2. Behavioral therapy only -35% improved 3. Stimulants only -55% improved 4. Behavior therapy + stimulants -70% improved

Depletion of the neurotransmitter acetylcholine has been implicated as a:

critical factor in Alzheimer's disease

Which of the following is an example of a sociocultural approach to treating Alzheimer's?

day-care facilities

With Alzheimer's, physical health usually:

declines less rapidly than mental health

As people age, the incidence of alcohol abuse and other forms of substance abuse:

decreases

An 80-year-old hospitalized individual is recovering from surgery, but now has gotten an infection. Over the course of a few days, the person shows increasing confusion, and consistently misinterprets what others are trying to communicate. The MOST probable diagnosis for this condition would be:

delirium

Among the elderly, psychotic cognitive symptoms are usually due to:

delirium and dementia

Someone who has AIDS is also at risk for developing:

dementia

Early symptoms of Alzheimer's disease include:

denial of symptoms

How might the DSM-V classify bipolar disorder in children?

disruptive mood dysregulation disorder

If a young person is taking a health-maintenance approach to aging, the person would be:

doing things that promote physical and mental health

Regarding treatment of depression in the elderly, studies show that:

drug treatments may need to be altered because drugs are broken down differently in the older body

An individual seeking help from a geropsychologist is MOST likely:

elderly

"Beattitudes," a facility that offers long-term inpatient care for individuals with Alzheimer's disease, provides controls for patients by:

focusing on individualized care, such as allowing occasional access to alcohol or chocolate

To date, research shows that anxiety among the elderly is related to:

health

Alzheimer's is named for the first person to __________ the disease

identify

A person with Alzheimer's disease is taking a drug designed to affect acetylcholine and glutamate and may experience:

improvement both in short-term memory and in ability to cope under pressure

All of the following have been used as cognitive techniques for the treatment of Alzheimer's disease EXCEPT:

increasing the capacity of short-term memory by memorizing strings of random numbers

juvenile training centers

institutional treatment centers for juvenile delinquents

Sources of discrimination in the mental health care of the elderly include:

language barriers that interfere with medical and mental health care

juvenile delinquent

legal term for a child between the ages of 8 and 18 who breaks the law

About 17 percent of individuals with Alzheimer's disease also experience:

major depressive disorder

An individual with Alzheimer's disease is no longer able to function independently. The MOST appropriate diagnosis for this person's condition is:

major neurocognitive disorder

A 65-year-old in otherwise very good health typically will experience occasional:

memory difficulties

In people with Alzheimer's disease, memory problems appear to be caused by disruption of the production of:

memory-linked proteins

An individual with Alzheimer's disease is able to function independently. The MOST appropriate label for this person's condition is:

mild neurocognitive disorder

Alzheimer's disease is diagnosed on the basis of:

neurofibrillary tangles and senile plaques evident in autopsy

A person with Alzheimer's disease shows decreased brain activity in the diencephalon. This decreased activity should be related to:

no change in the function of short-term memory, but problems in the conversion of short-term memories to long-term memories

recessive genes

non-dominant genes that, when paired with a normal gene, would have no influence on development

Samuel, who is over 65, reports taking six prescription drugs, in addition to regularly taking two over-the-counter drugs. Among the elderly, Samuel is:

normal; the average elderly individual takes about this amount of drugs

Assume a nursing home director is trying to decide whether to use antipsychotic drugs for treating symptoms of Alzheimer's disease. Research shows that the director generally should:

not use antipsychotic drugs; they don't work any better than placebos do

The term "double jeopardy" describes people who may develop psychological problems because of being:

old and members of an ethnic minority

Lisa Mosconi and her associates administered PET scans to research participants to measure activity int he hippocampus. They found that participants with low hippocampus activity were more likely to develop neurocognitive disorders later in life. How accurate were their predictions?

over 70 percent accurate for mild neurocognitive impairment, and over 80 percent accurate for major neurocognitive impairment

overt-destructive

pattern of behavior in conduct disorder wherein children display openly aggressive and confrontational behaviors

overt-nondestructive

pattern of behavior in conduct disorder wherein children display openly offensive but nonconfrontational behaviors (such as lying)

covert-destructive

pattern of behavior in conduct disorder wherein children display secretive destructive behaviors such as violating other people's property, breaking and entering, and setting fires

covert-nondestructive

pattern of behavior in conduct disorder wherein children secretly commit non-aggressive behaviors, such as being truant from school

Diagnosis for Alztheimer's is confirmed...

post-mortem (shrunken brain, more holes) massive cell loss

An elderly individual has just been diagnosed with depression. In the future, that individual would be expected to:

recover more slowly than average for both injuries and illnesses

fragile X syndrome

second most common chromosomal cause of intellectual disability (caused by an X chromosome that is prone to breakage and loss); associated with mild to moderate levels of intellectual dysfunctioning, language impairments, and (in some cases), behavioral problems

Sphere-shaped deposits of a small molecule in spaces between neurons in the hippocampus in individuals with Alzheimer's disease are called:

senile plaques

What disorder is unique to childhood?

separation anxiety disorder

A person who has Alzheimer's although there is no family history of the disease is said to be experiencing:

sporadic Alzheimer's

Women who want to reduce their risk of developing Alzheimer's should:

take estrogen for years after menopause

You would suspect a problem in the ________ for someone experiencing difficulty with long-term memory

temporal lobes

mainstreaming

the placement of children with intellectual disability in regular school classes; also known as inclusion

normalization

the principle that institutions and community residences should provide people with intellectual disability types of living conditions and opportunities that are similar to those enjoyed by the rest of society

bullying

the repeated infliction of force, threats, or coercion in order to intimidate, hurt, or dominate another less powerful person

Research on the cause of Alzheimer's disease has led to the conclusion that:

there appears to be a significant hereditary component, but this does not fully explain its onset

Studies have shown that misuse of medication in US nursing homes occurs MOST often when staff members:

use antipsychotic drugs to control the behaviors of those who don't show psychotic symptoms

A person quite suddenly begins to show specific cognitive impairment and difficulty in speaking, yet other cognitive functions appear normal. MOST likely, that person is experiencing:

vascular neurocognitive disorder

An individual who demonstrates a severe anterograde amnesia may still demonstrate evidence of:

verbal skills

In controlled studies, nursing home patients given placebos instead of antipsychotic drugs often showed substantial improvement. MOST likely, this is because those receiving placebos:

were responding positively to the attention and extra care they received in the study