Quiz 12 Ch14-15

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

cell breakdown and death

The MOST common and successful treatments for encopresis are:

behavioral and medical treatments

What is the BEST educational treatment for a child with a serious level of dysfunction on the autism spectrum?

being sent to a special school that combines treatment and education

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

The MOST recent research has provided evidence that the primary causes of autism spectrum disorder include:

brain abnormalities

A particular concern among children and adolescents would be:

bullying

A child has has received the diagnosis of developmental coordination disorder. You would expect that he would have a problem:

buttoning his shirt and dressing in general

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

A child is extremely aggressive. She is always fighting with her peers and is frequently very cruel to them. She never tells the truth. He MOST likely diagnosis is:

conduct disorder

Critics believe that bipolar disorder has become a catch-all diagnosis for children who display uncontrollable rage. DSM-5 addressed this concern by:

creating a new disorder called disruptive mood dysregulation

Depletion of the neurotransmitter acetylcholine has been implicated as a:

critical factor in Alzheimer's disease

Most colleges and universities now require students to have a meningitis vaccination before enrolling. Untreated meningitis can lead to:

intellectual development disorder

A 16-year-old teenager has just been arrested for the third time for shoplifting. He would MOST likely be labeled with:

juvenile delinquency

If your child is diagnosed with a conduct disorder, you could be confident in providing all of the following treatments EXCEPT:

juvenile training centers

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

language barriers that interfere with medical and mental health care

In poor inner-city neighborhoods, children sometimes eat paint that is flaking off walls. This can sometimes lead to intellectual developmental disorder due of:

lead poisoning

juvenile delinquent

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

Compared to white American children, African American and Hispanic American children with similar levels of activity and attention problems are:

less likely to be assessed for ADHD, and less likely to be diagnosed with ADHD

Studies of the one use of cognitive-behavioral techniques in the treatment of autism spectrum disorder have shown that cognitive-behavioral techniques can produce:

long-term gains in school achievement and intelligence test performance

Mild mental retardation is MOST common in which socioeconomic class?

lower

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

Biological factors are NOT the most important causes of which level of intellectual developmental disorder?

mild

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

mild neurocognitive disorder

Imagine that I just stubbed my toe and cried "Ouch." A child with autism, when asked if I was hurt, said, "No," because he wasn't hurt. This inability to take the perspective of another is referred to as:

mind-blindness

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

Which one of the following people would MOST correctly be diagnosed with intellectual developmental disorder?

one with an IQ of 69 having problems coping with life

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

A person diagnosed with autism spectrum disorder listens to a piano piece at a concert. Later at home, the person plays the piano piece without the music, and without making a mistake. This behavior is best described as a:

savant skill

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

A female child is diagnosed with autism. Later, as an adult, she is unable to hold a job and has very limited communication skills. Her case is:

uncommon; most people diagnosed with autism spectrum disorder are males, and their symptoms usually remain severe into adulthood

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

Surveys show that ________ is a common experience for close to half all children in the United States

worry

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

Intelligence test results should not be the only things used to determine intellectual developmental disorder, because intelligence test scores:

don't indicate level of adaptive behavior

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

A child is awakened during the night, uses the toilet, and receives a sticker and praise from a parent. Later in the week, accumulated stickers may be turned in for a highly desired toy. This child is undergoing:

dry-bed training for enuresis

A reading proficiency level that is much lower than would be expected based on the measure of general intelligence is called:

dyslexia

An individual seeking help from a geropsychologist is MOST likely:

elderly

Among the goals of parent-child interaction therapy are all of the following EXCEPT:

encouraging parents to not change how they act with their child

You read a case study about a ten-year-old girl from a poor background who was sexually abused. This case is:

fairly common; girls, regardless of their socioeconomic group, are the most common victims of sexual abuse

"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

"Relational aggression" is a term used to describe a pattern of aggression MOST common among:

girls diagnosed with conduct disorder

Research has shown that, during infancy and early childhood, autistic children are MORE likely to:

have parents who divorce than are "normal" children be raised in a family with financial difficulties have cold, rejecting parents None of the answers are true

Individuals with Down syndrome:

have the same range of personality characteristics as do those in the general population without Down syndrome

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

health

Quentin is 25, has an IQ of 60, and never did well at schoolwork. However, he now lives on his own, has a job, and is able to perform the routine chores of life. He would not be considered to have intellectual developmental disorder because:

his daily functioning is adequate

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

identify

Early home intervention programs for those in the "mild" intellectual developmental disorder category:

improve both overall functioning, and later performance in school and in adulthood

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

Behavioral and somatic symptoms, such as clinginess, sleep difficulties, and stomach pain rather than cognitive ones, are MORE characteristic of anxiety disorders:

in children rather than in adults

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

"What should I look for in an effective ADHD treatment program?" a friend asks. Your BEST answer among the following alternatives is:

"Drugs work best."

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."

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

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

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

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

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?

Of the following parents, the ones LEAST likely to have children who receive effective treatment for ADHD are:

African Americans who are Medicaid-insured

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

Post-Traumatic Stress Disorder (PTSD) (anxiety disorders)

An anxiety disorder characterized by haunting memories. Nightmares, social withdrawal, jumpy anxiety, and/or insomnia that lingers for four weeks or more after a traumatic experience.

Obsessive-Compulsive Disorder (OCD) (anxiety disorders)

An anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions).

Panic Disorder (anxiety disorders)

An anxiety disorder marked by unpredictable minutes-long episodes of intense dread in which a person experiences terror and accompanying chest pain, choking ar other frightening situations.

Huntington's disease

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

Phobias (Specific) (anxiety disorders)

Are anxiety disorders in which an irrational fear causes the person to avoid some object, activity, or situation.

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)

Hypochondriasis (Illness anxiety disorder) (somatoform disorders)

Excessive anxiety and concern with having or getting a serious medical condition.

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

Agoraphobia (anxiety disorders)

Fear or avoidance of situations in which escape might be difficult or help unavailable when panic strikes.

Geropsychology

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

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

An infant is diagnosed with a biological disorder. As she ages, her physical and mental conditions deteriorate steadily so that she loses vision and motor control, and at the age of 3, she dies. Most likely, she was suffering from:

Tay-Sachs disease

Elimination disorders are diagnosed when which of the following criteria has been met?

The children have reached an age at which they are expected to control their bodily functions

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

Imagine a child who neglects studies, work, friends, and family in order to be on the Internet. Which of the following about Internet addiction disorder is FALSE?

There is no such diagnosis as Internet addiction disorder

Bipolar Disorder (mood disorders)

This disorder is one one will be experience severe depression for multiple weeks but their mood will change into a manic state where they would feel elated. This would last for a week or so as well.

Doesn't appear to cause him distress or dysfunction in his day-to-day functioning.

Thomas is 30 years old and is very shy. He tends to avoid social situations and rarely leaves his home. However, he writes a very successful internet blog and is usually content while working at home. Why would psychologists not label his behavior as a disorder.

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)

Conversion Disorder (somatoform disorders)

Typically results from extreme stress or anxiety. Individual will "convert" psychological stress into a physical ailment.

Mania (manic episode) (mood disorders)

When an individual goes hyper crazy and happy. This can lead to poor decision making and has a lot to do with one's impulse

Major Clinical Depression Persistent depression; key is that it lasted longer than two weeks

Following the breakup of her engagement, Martha has become very despondent. She shows little interest in her job (which previously she found exciting) and often calls in sick. She spends a great deal of time alone in her room, sitting idly by the window or listening to the radio. When friends call to invite her out Martha usually refuses, pleading illness or fatigue. She complains that she feels continually tired, has to force herself to undertake such simple tasks as getting dressed or fixing a meal, and cannot concentrate enough to read a newspaper or magazine. Tears flow at the slightest provocation, and she admits that she feels worthless and inadequate. Her condition does not improve after several months have passed.

Disorganized Thinking (Schizophrenia)

Fragmented and bizarre thinking that is distorted with false beliefs.

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

A woman in a facility for those with intellectual developmental disorder. She has her own apartment, dresses herself, and goes to the dining room, where she orders breakfast off a menu. She then goes to work in a sheltered workshop. At the end of the day, she goes home to her apartment and gets ready for dinner. This arrangement is part of:

a normalization program

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

According to one psychological view of autism, the awareness that other people base their behaviors on their own belief, and not on information they have no way of knowing, is NOT present in children with autism spectrum disorder. This inability is called:

a theory of mind

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

Among the likely causes of ADHD are all of the following EXCEPT:

abnormal serotonin activity and parietal damage

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

The specific symptoms associated with dyslexia include:

an impairment of the ability to recognize words and to comprehend what is being read

MOST children with intellectual developmental disorder live:

at home

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

because home caregivers are overwhelmed

"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?

Seasonal Affective Disorder (SAD) (mood disorders)

A mood disorder characterized by depression that occurs at the same time every year. This occurs around the same time every year can be triggered by that particular time.

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

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)

Controversies around ADHD

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

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

Dissociative Identity Disorder (DID) (dissociative disorders)

Disruption of identity characterized by two or more distinct personality states. Involves marked discontinuity in sense of self with related alterations in behavior, memory, perception, cognition, etc. (multiple personality disorder)

Gene and Environment

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

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%)

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)

Dissociative Amnesia (dissociative disorders)

Inability to recall important personal information, usually of a traumatic or stressful nature.

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)

Dissociative Fugue (dissociative disorders)

Length of fugue ranges anywhere from a few hours to several months or longer.

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

Major (Clinical) Depression (mood disorders)

Occurs when at least five signs of depression (including lethargy, feelings of worthlessness, or loss of interest in family, friends, and activities) last two or more weeks and are not caused by drugs or a medical condition.

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

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

Catatonia (schizophrenia)

Remain motionless for periods of hours at a time.

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)

A preadolescent child who has not received a clinical diagnosis participates in a program designed to stop the development of an antisocial pattern of behavior. MOST likely, that program is:

Scared Straight

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

Selected neurons die

Diagnostic Label: Schizophrenia Recommended Treatment(s): Antipsychotic Drugs

"They are following me. Quick, hide behind the stacks." Beth, a nineteen year-old college freshman, dragged her startled classmate by the sleeve as she peered between some books on the library shelves. "What are you talking about?" asked her friend. Beth cupped a hand over her friend's ear and whispered, "They watch me all the time. They don't think I recognize them just because they disguise themselves as teachers or students. But I can tell. I see right through their tricks." The other girl backed off and tried to gauge Beth's seriousness. Beth stepped close to her and said in an insistent whisper, "It's the Soviet KGB and the radical terrorists who are out to get me. They shoot electronic waves into my house to try to brainwash me. They douse us all with impulses to soften our brains and our resistance, and then they pipe preprogrammed thoughts into our heads. It's all part of their conspiracy to gain worldwide mind control." The other girl was backed into the far corner of the stacks by now, and, a little frightened by Beth's vehement accusations, she avoided her penetrating gaze. "You," muttered Beth, pointing a finger. "They already own you. I see it in your eyes." "Beth, I have to get to class," said the girl as she tried to squeeze past. "I knew it all along," said Beth, fleeing from the girl. "They've got you in their power just like they have seventy-five percent of the kids in this school." Diagnostic Label: Recommended Treatment(s):

Dissociative Amnesia with fugue

A 35-year-old businessman was brought to the police station after he was found wandering around downtown Baltimore in a confused state. The man was unable to recall important personal information or any facts about his past. Eventually, the police were able to identify him through a missing person's report that his brother filed ten months earlier. According to the report, the man, Harold, disappeared from his home in New York nearly one year earlier following the unexpected death of both his wife and children in a car accident when they were hit by a drunk driver.

Hypochondriasis

A 45-year-old white male, presents to a primary care clinic armed with multiple internet searches on the topic of cancer. He states that he "just knows" he has a GI cancer, "probably the colon or maybe the pancreas." When asked how long this concern has bothered him he says "for years I have been concerned that I have cancer." When asked about relevant symptoms, the patient is a bit vague, saying "I get some pain or pressure right here (he points to the left upper quadrant) but it is not there all the time." The patient reveals that he has had ultrasounds and colonoscopies in the past, but they could find anything. He then admits that he was initially relieved but a couple of weeks later he started to think that they must have just missed something and believes that he needs another colonoscopy and abdominal CT scan. When the doctor suggests a less invasive approach, the patient ends the encounter by stating that he will "find another doctor who sees my point and will get me what I need."

Schizophrenia

A man, aged 32, was admitted to a psychiatric hospital. Two months before commitment the patient began to talk about how he had failed, had "spoiled" his whole life, that it was now "too late." He spoke of hearing someone say, "You must submit." One night his wife was awakened by his talking. He told her of having several visions but refused to describe them. He stated that someone was after him and trying to blame him for the death of a certain man. He had been poisoned, he said. In the admission office of the hospital he showed many mannerisms, lay down on the floor, pulled at his foot, made undirected violent striking movements, again struck attendants, grimaced, assumed rigid postures, refused to speak, and appeared to be having auditory hallucinations. He was at once placed in a continuous bath where, when seen later in the day, he was found to be in an unresponsive state. His face was without expression, he was mute and rigid, and paid no attention to those around him or to their questions. His eyes were closed and the lids could be separated only with effort by a doctor. There was no response to pinpricks or other painful stimuli. For five days he remained mute, negativistic, and inaccessible, at times staring vacantly into space, at times with his eyes closed.

Diagnostic Label: Generalized Anxiety Disorder Recommended Treatment(s): Cognitive-Behavioral Therapy, Antianxiety Drugs

A married woman, whose life was complicated by her mother's living in their home, complained that she felt tense and irritable most of the time. She was apprehensive for fear that something would happen to her mother, her husband, her children, or herself. She has no definite idea what it was that she fears might happen. She suffers from occasional attacks in which her heart pounds with irregular beats; she cannot seem to catch her breath when this happens. Often she breaks out in a profuse perspiration. Her mouth seems to be always dry, even though she drinks a great deal of water, and because of this and her diffuse anxiety she cannot sleep. Diagnostic Label: Recommended Treatment(s):

Imagine that you see a video on YouTube designed to encourage young people who are gay and being bullied. It is probably part of a program called:

It Gets Better

Behavioral- Systematic Desensitization (type of exposure therapy). Patient creates a hierarchy

After confessing to your therapist that you are horribly afraid of bees, he works with you to construct a hierarchy of stimuli that are increasingly fearful to you. Lowest in the hierarchy is reading the word buzz and the highest on the list is seeing a bee flying close to your face. Once the hierarchy is completed, he teaches how to feel relaxed to these stimuli, starting first with the stimuli to which you are least afraid.

Cognitive- Rational-Emotive Behavior Therapy

After seeking help for feelings of anxiety and depression, your therapist counsels you that it is impossible for you to be loved and cared for by all people who are significant at your job and in your community. She further urges you to abandon the irrational approach you take to interpreting the events that occur in your life.

Humanistic- client-centered therapy (active listening, unconditional positive regard)

After spending some time with your therapist, it becomes obvious to you that she believes you are making unrealistic comparisons between the person you are and the person that you would like to be. You find that she mirrors many of your statements, as if asking you to reflect upon what you have just said. At the same time, you are convinced that she holds you in high esteem, no strings attached.

Generalized Anxiety Disorder (anxiety disorders)

An anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal.

Major (clinical) depression

Becky's psychiatrist has prescribed as selective serotonin reuptake inhibitor (SSRI) to help Becky feel better. Becky has most likely been diagnosed with what disorder?

Paula was moderate intellectual developmental disorder, a small head and flat face, as well as a protruding tongue. Her condition is MOST likely:

Down syndrome

Dissociative Identity Disorder- amnesia

During an academic trip to China, a 29-year-old female was found in a hotel bathroom unconscious, with no signs of structural or neurologic abnormalities or alcohol or chemical consumption. The woman was sent home but could not remember her name, address, family, or any facts about her home life. She was taken to the local hospital where she remained for nearly 10 months, until the feeling of blood on the woman's fingers triggered the recollection of events from her time in China in which she finally remembered having witnessed a murder on the last night of her trip. She recalled being unable to help the victim out of fear for her own safety. Eventually, she came to remember other aspects of her life; however, some memories remain irretrievable.

Schizophrenia- delusions of reference

During an interview, the 50-year old female patient expressed beliefs covering almost the entire range of delusions. She felt that her niece was in on a plot with other relatives to take away the property she owned in 106 countries, which she was planning to use, after training religious missionaries, to establish missions to convert heathens. In spite of the fact that her husband was alive and visited her weekly, she maintained that her husband was dead and that he had been killed by the FBI. The FBI had 6 agents assigned to her alone and had killed her husband. She had learned of their spying and talking about her from the television where they were portraying her life in several of the continuing series programs. She had learned other things about the plot from the voices that came between the television programs and the commercials. She was convinced that the hospital attendants were in on the conspiracy and that poison was being placed in her food. She was also concerned about the electrical waves that were "messing up" her mind.

Diagnostic Label: Dissociative Fugue Recommended Treatment(s): Free-association

George T., a 35-year-old auto mechanic, on several occasions found himself in a motion picture theater after having left home to report for work. He would "come to" in a bewildered fashion and would go to a bar for a few drinks. Eventually he would go home. As a child, George had a pattern of wandering away from home. He came from a very unhappy family; his parents were divorced, and he was left at home with housekeepers. His father was very harsh with him and on several occasions gave him such severe whippings that the neighbors called the police. His mother was a highly emotional person and tried to discipline George by screaming at him and threatening to place him in a boarding home. In adolescence, he twice found himself going off to school and eventually, "coming to" in a park about two miles from home. In school, George got along well with the teachers and other students. He was a poor student and failed both the second and seventh grade. He quit school at 16. Diagnostic Label: Recommended Treatment(s):

Diagnostic Label: Social Phobia Recommended Treatment(s): Exposure Therapy, Systematic Desensitization, Antianxiety Medication

Heather, a 19 year old college junior, has an intense fear of speaking to people she does not know very well. During her first and second years, she chose large lecture courses, which allowed her to hide in the back of the lecture hall and not speak to other students or to participate in the class discussions. Heather received high marks in all of her courses, earning a place on the dean's list and the honor roll. In her third year, Heather is now required to take some smaller upper level courses in which class participation and small-group discussions are mandatory. She is sure that she will do something embarrassing, such as vomit, and others will judge negatively. Because of these fears, Heather has trouble sleeping at night and is considering dropping out of school. Diagnostic Label: Recommended Treatment(s):

Phobia

Hilda, a 32-year old mother of two small children, is admitted to the hospital following a panic attack that occurred while she was watching a local weather report in which the meteorologist predicted 3-4 inches of snow the following day. While being treated, Hilda admits that she has been terrified of snow for as long as she can remember and this fear severely restricts her day-to-day behavior. Following months of therapy, Hilda eventually remembers a ski trip she and her family took when she was 9-years old. During the trip, Hilda was buried briefly by a small avalanche of snow while playing at the ski lodge. Hilda is amazed by the revelation as she had no recollection of this experience until it was recovered in therapy.

Diagnostic Label: Major Depressive Disorder (need to have two or more chronic depressive symptoms for at least a few years) Recommended Treatment(s): Selective Serotonin Reuptake Inhibitor, Rational-Emotive Behavioral Therapy, Cognitive-Behavioral Therapy

It takes the greatest effort to get out of bed in the morning. I am tired all day, yet when night comes, sleep evades me. I stare at the ceiling, wondering what has happened to my life, and what will become of me. Nothing is getting done at work. I have projects to complete, but I can't think. I try to focus on my work, and I get lost. I keep wondering when the boss will discover how little I have accomplished. My wife does not understand. She keeps telling me to "snap out of it." I'm irritable all the time. I often yell at the kids, and then I feel terrible later. Nothing is fun anymore. I can't read, and the music I used to enjoy so much does nothing for me. I am bored, but I feel like doing nothing. There are times that I think that life is hopeless and meaningless, and I can't go on much longer. Diagnostic Label: Recommended Treatment(s):

Generalized anxiety

Jane, a 43-year old female, has been referred to a psychiatrist by her local physician, who can find nothing physically wrong with her. She complains, however, of feeling tense and apprehensive most of the time; she has difficulty sleeping and experiences frequent headaches. Minor stresses that she once handled with ease, such as driving in traffic or presenting a paper in class, now make her extremely nervous. In addition, she has moments of terror during which she feels that something dreadful is about to happen to her. Jane has no idea of the source of her fears.

Obsessive Compulsive Disorder Key symptoms are persistent obsessions that are unwanted and repetitive thoughts; compulsions are the repetitive behaviors .

Janet, age 29 and the mother of a 6-year-old girl and an 8-year-old boy, has come to the community mental health center alone. She tells the psychiatric nurse practitioner that she is here because her husband said he would leave her if she didn't get some help. She describes her problem as, "my nerves are shot." When asked to explain, she states that she likes everything to be "in order." She says she cleans her house "from top to bottom" every day. Then when her husband and children come home, she "has to go along behind them and clean as they mess up!" She explains that she can't leave the house without checking and rechecking locks on all doors and windows, and checking and rechecking all electrical outlets and appliances. Sometimes, this routine takes most of an hour before she feels satisfied and ready to leave the house. She said she had to get started getting ready to come to the clinic this morning about 3 hours before she left. "We seldom go out anymore, because my husband says it's just not worth the effort. I'm driving everyone crazy, and I don't know how to stop. I can't stop!"

Diagnostic Label: Post-Traumatic Stress Disorder Recommended Treatment(s): Exposure Therapy, Cognitive-Behavioral Therapy, Antidepressant/antianxiety drugs

Joe saw a good deal of active combat during his service in the military. Some incidents in particular had never left his mind - like the horrifying sight of Gary, a close comrade and friend, being blown-up by a land-mine. Even when he returned to civilian life, these images haunted him. Scenes from battle would run repeatedly through his mind and disrupt his focus on work. Filing up at the gas station, for example, the smell of diesel immediately rekindled certain horrific memories. At other times, he had difficulty remembering the past — as if some events were too painful to allow back in his mind. He found himself avoiding socializing with old military buddies, as this would inevitably trigger a new round of memories. His girlfriend complained that he was always pent-up and irritable - as if he were on guard, and Joe noticed that at night he had difficulty relaxing and falling asleep. When he heard loud noises, such as a truck back-firing he literally jumped, as if he were readying himself for combat. He began to drink heavily. Diagnostic Label: Recommended Treatment(s):

Antisocial personality disorder

Luke is superficially charming and skilled at exploiting people for his own gain. He is also impulsive, irresponsible, and he generally disregards social norms. Luke would most likely be diagnosed with which psychological disorder?

A child's distracting behaviors occur only in a school setting, and include failure to following instructions and finish work, answering questions before they have been completed, and a lot of seat squirming and fidgeting. Could ADHD be a diagnosis of this child?

No; the child's symptoms occur in only one setting

Diagnostic Label: Conversion Disorder Recommended Treatment(s): Cognitive-Behavioral Therapy, Psychoanalysis

Manny, a twenty-year-old male, was driving home from a long road-trip when he fell asleep at the wheel and crashed his car into the nearby embankment. One of his best friends, Nick, was fatally injured and killed as a result of the accident. In the following weeks, Manny began to develop a marked contracture of his right hand and a partial paralysis of his arm which consequently left him unable to drive. Although he was examined by numerous physicians, and many different medical treatments were tried, Manny did not respond and the symptoms remained unaltered. Diagnostic Label: Recommended Treatment(s):

Phobia- agoraphobia- fear of being in public

Margaret, a 52-year old female, has become increasingly fearful of leaving the house by herself. She insists that a family member accompany her when she goes to the store or even walks as far as the mailbox. The thought of being in a crowd so terrifies her that she no longer attends concerts or church (activities she once enjoyed) regardless of whether someone accompanies her. Her life is confined within the walls of her home.

Diagnostic Label: Seasonal Affective Disorder Recommended Treatment(s): Light Exposure Therapy

Melanie Johnson is a 35-year-old accountant who moved to Green Bay, Wisconsin, two years ago from her hometown of Sarasota, Florida. Beginning this past November, for the first time in her life, Melanie began experiencing periods of depression, lethargy, and excessive sleeping. In addition, she noticed that she was eating more than she had previously, and as a result, had gained 10 pounds. Melanie's condition remained unchanged for several months until she began to notice an improvement in her mood the following March. Diagnostic Label: Recommended Treatment(s):

Diagnostic Label: Obsessive Compulsive Disorder Recommended Treatment(s): Antianxiety drugs, exposure therapy, cognitive-behavioral therapy

Mike, a 32 year-old man, performed many acts that were preceded by a fear of harming other people. When driving, he had to stop the car often and return to check whether he had run over people, particularly babies. Before flushing the toilet, he had to check to be sure that a live insect had not fallen into the toilet, because he did not want to be responsible for killing a living thing. At home he repeatedly checked to see that the doors, stoves, lights, and windows were shut or turned off. . . . Mike performed these and many other checking behaviors for an average of 4 hours a day. Diagnostic Label: Recommended Treatment(s):

Bipolar Disorder Key symptom is a manic episode that lasts seven days Mrs.

Miller was first admitted to a state hospital at the age of 38, although since childhood she had been characterized by swings of mood, some of which had been so extreme that they had been psychotic in degree. At one point she became depressed and asked to return to the hospital where she had been a patient. She then became overactive and exuberant in spirits and visited her friends, to whom she outlined her plans for reestablishing different forms of lucrative business. She purchased many clothes, brought furniture, pawned her rings, and wrote checks without funds. For a period thereafter she was mildly depressed. In a little less than a year Mrs. Miller again became overactive, played her radio until late in the night, smoked excessively, took out insurance on a car she had not yet bought. On the day prior to her second admission to the hospital she purchased 57 hats.

Diagnostic Label: Panic Disorder Recommended Treatment(s): Antianxiety Medication, Rational-Emotive Behavioral Therapy

My breathing starts getting very shallow. I feel I'm going to stop breathing. The air feels like it gets thinner. I feel the air is not coming up through my nose. I take short rapid breaths. Then I see an image of myself gasping for air and remember what happened in the hospital. I think that I will start grasping. I get very dizzy and disoriented. I cannot sit or stand still. I start pacing. Then I start shaking and sweating. If feel I'm losing my mind and I will flip out and hurt myself or someone else. My heart starts beating fast and I start getting pains in my chest. My chest tightens up. I become very frightened. I get afraid that these feelings will not go away. Then I get really upset. If feel no one will be able to help me. I get very frightened I will die. I want to run to some place safe but I don't know where. Diagnostic Label: Recommended Treatment(s):

Conversion Disorder

On admission to a psychiatric hospital, a 42-year-old, married male was bent forward at the waist (at a 45-degree angle) unable to straighten his body or move his legs. For 15 years, he had complained of lower back pain. Despite two orthopedic surgeries, his complaints continued. Every four to six weeks, he had 10- to 14-day episodes of being totally unable to walk. The patient had been hospitalized many times and treated with heat and muscle relaxants. He had been retired for five years and had taken on household duties while his wife went to work to support the family. Orthopedic and neurological evaluations revealed no abnormalities. Behavioral assessment, however, indicated that the patient received considerable reinforcement for his physical complaints, such as being served breakfast in bed and not having to do household chores. Moreover, a number of stressors in his life coincided with periods of being unable to walk. These included problems with his children and difficulty adjusting to the role reversal with his wife.

Diagnostic Label: Bipolar Disorder Recommended Treatment(s): Mood-stabilizing medication

Prior to being admitted to the hospital, Archie, a forty-year-old male, provided the following description of how he had been feeling over the last several months. "There is a particular a kind of pain, elation, loneliness, and terror involved in this kind of madness. When you're high, it's tremendous. The ideas and feelings are fast and frequent like shooting stars, and you follow them until you find better and brighter ones. Shyness goes, the right words and gestures are suddenly there, the ability to captivate others a felt certainty. There are interests found in uninteresting people. Feeling of ease, intensity, power, well-being, financial omnipotence, and euphoria pervade one's marrow. But, somewhere, this changes. The fast ideas are far too fast, and there are far too many; overwhelming confusion replaces clarity. Memory goes. Humor and absorption upon friends' faces are replaced by fear and concerns. Everything previously moving with the grain is not against -you are irritably, angry, frightened, uncontrollable, and enmeshed totally in the blackest caves of the mind. You never knew those caves were there. It will never end for madness carves its own reality." Diagnostic Label: Recommended Treatment(s):

Antisocial Personality Disorder Doesn't feel guilt or anxiety

Ralph is a highly impulsive person who has difficulty making plans or sticking to a job for any length of time. He has been fired from several jobs because he was caught stealing or because of frequent absences due to periodic drinking and gambling sprees. He always blames his employer for his dismissal and will not admit that his own behavior is responsible for his poor job history. Women tend to find him charming and personable, but they soon tire of his irresponsible behavior, frequent financial sponging, and general lack of consideration. His quick temper and disregard for social regulations have brought him intro frequent brushes with the law, but he usually manages to charm his way out and has never been convicted of a crime. He appears to feel little guilt or anxiety regarding his behavior.

Dissociative Identity Disorder

Sharon, a 27 year-old female who had been physically and sexually abused by her father throughout her childhood and adolescence, has been receiving intensive therapy sessions for the past three years. Throughout her adulthood, Sharon has exhibited at least four personalities. Each personality was of a different age, representing the phases of the woman's experience - a fearful child, a rebellious teenager, a protective adult, and the woman's primary personality. Only one of the personalities, the protective adult, was consciously aware of the others, and during therapy sessions was realized to have been developed to protect the woman during the abusive experiences. When one of the secondary personalities took over, Sharon would often act out according to the nature of the dominating personality.

Mania

Terrance O'Reilly, a single 39-year old transit authority clerk, was brought to the hospital by the police after his increasingly hyperactive and bizarre behavior and nonstop talking alarmed his family. He loudly proclaimed that he was not in need of treatment, and threatened legal action against the hospital and police. The family reported that a month prior to admission Mr. O'Reilly took a leave of absence from his civil service job, purchased a large number of cuckoo clocks and then an expensive car which he planned to use as a mobile showroom for his wares, anticipating that he would make a great deal of money. He proceeded to "tear around town" buying and selling the clocks and other merchandise, and when he was not out, he was continuously on the phone making "deals." He rarely slept, and, uncharacteristically, spent every evening in neighborhood bars drinking heavily and according to him, "wheeling and dealing." Two weeks before admission, his mother died suddenly of a heart attack. He cried for two days, but then his mood then began to soar again. At the time of admission, he was $3000 in debt and had driven his family to exhaustion with his excessive activity and over talkativeness. He said, however, that he felt "on top of the world".

Two children --- one, African-American and the other, white American --- display exactly that same symptoms of overactivity. What is MOST likely to happen?

The white American will be diagnosed with ADHD, and the African American will be diagnosed with possibly a lower IQ or substance abuse

Psychoanalytic- free association (goal is for transference to occur)

Upon entering his office, your therapist asks you to sit down and be comfortable. He then tells you that you should speak freely, and not to worry about censoring any thoughts you may have during the therapy session. He sits behind you to minimize any eye contact--he does not wish to serve as an authority figure during your session. At one point, he cautions you about becoming defensive and suggests that you might be unconsciously attempting to block his access into gaining insight into the inner workings of your thought processes.

"Will that program really help? I keep hearing bad things about how kids act once they leave." Based on research, the person who said this would be MOST accurate if she or he were expressing reservations about:

a juvenile training center

The mockingbird gets its name from the fact that it often imitates the call of other birds, without conveying any particular message. A child who imitates others' speech without any sign of understanding it, MOST likely would be diagnosed with:

autism spectrum disorder

The two MOST common treatments for attention-deficit / hyperactivity disorder have been:

behavioral and drug therapies

A child awakens suddenly to the sound of a bell, and heads for the bathroom. MOST likely the child is receiving:

behavioral therapy for enuresis

An iodine deficiency in the diet of a pregnant woman may lead to a condition in which the baby was dwarflike appearance and a defective thyroid gland. The disorder is called:

cretinism

A child is openly hostile toward her parents. She argues with them constantly and will not do anything they say. They cannot control her. The diagnosis she is MOST likely to receive is:

oppositional defiant disorder

Boys and girls have about the same percentage chance of being diagnosed with:

oppositional defiant disorder if they are postpubertal

"That kid is pleasant enough, but will lie about practically anything, even things that don't seem to matter much." This behavior MOST closely fits which pattern of conduct disorder?

overt-nondestructive

An intervention in which parents and their children who have been diagnosed with conduct disorder do behavior therapy targeting and rewarding desired behavior is called:

parent management training

Individuals with autism spectrum disorder may react with tantrums if an object is moved to a different part of the room. This is known as:

perserveration of sameness

For which of the following anxiety disorders would you expect the childhood pattern to be MOST similar to the adult pattern?

phobias

Hormonal changes, life demands, and body dissatisfaction are all reasons to explain why:

postpubertal girls have higher rates of depression than postpubertal boys

When a child with autism spectrum disorder says "You want a drink when he really means that he wants a drink, he is displaying

pronominal reversal

A similarity among children with separation anxiety and those with school refusal is that they both fear going to school and often stay home. The difference in the symptoms of these diagnoses is that:

school refusal often involves fear of others at school, academic fear, and separation anxiety

When a child with autism spectrum disorder jumps, flaps her arms, twists her hands and fingers and makes unusual faces, the child is engaging in:

self-stimulatory behavior

Your daughter is MORE likely than your son to be diagnosed with:

separation anxiety

If one knew nothing more than that the person with intellectual developmental disorder also had extensive and severe neurological dysfunction and physical handicaps, the MOST likely estimate of that person's level of mental retardation would be:

severe or profound

MOST cases of mild intellectual developmental disorder seem to be related to:

sociocultural and psychological factors

The MAIN concern over the rise in diagnosis of bipolar disorder in children, and in particular, the treatment of bipolar disorder in children is:

the use of adult medications

The LEAP program for treating children with autism spectrum disorder is unique because it involves the use of:

typical children as models and "teachers"