Abnormal Psych Exam 3 (10, 11, 13, 15, 16, 17)

Schizotypal Personality Disorder

- Excessively introverted - Pervasive social and interpersonal deficits - Cognitive and perceptual distortions - Oddities and eccentricities in thinking, speech, and behavior - Other cognitive problems include ideas of reference, odd speech, and paranoid beliefs Moderately heritable; has a genetic and biological association with schizophrenia- more likely to develop it

Avoidant Personality Disorder

- Show extreme social inhibition, introversion, and hypersensitivity - Desire affection and are lonely (different from schizoid) - Desire interpersonal contact but avoid it out of fear of rejection Possibly an extreme form of generalized social anxiety disorder

psychoactive drugs most commonly associated with substance abuse and dependence

-1) Opiates (such as opium and heroin) -2) Stimulants (such as cocaine and amphetamines as well as caffeine and nicotine) -3) Sedatives (such as barbiturates) -4) Hallucinogens (such as LSD) -5) Antianxiety drugs (such as benzodiazepines) -6) Pain medications (such as OxyContin)

abuse, dependence, tolerance, withdrawl

-Substance _________ involves an excessive use of a substance that results in: ▪Potentially hazardous behavior ▪Continued use despite persistent personal and health problems -Substance ______________ includes more severe forms of substance use disorders -____________: the need for increased amounts of substance to achieve the desire effects -____________: physical symptoms such as sweating that accompany abstinence from a drug

paranoid personality disorder

-not well studied -May occur through the heritability of high levels of antagonism (low agreeableness) and neuroticism (angry-hostility) -parental neglect or abuse and exposure to violent adults

Cleckley's Criteria for Psychopathy :)

:)

simple, abnormally

A Diathesis-Stress Model of Schizophrenia •Biological factors play a role -Genetic predispositions is shaped by environmental factors such as prenatal exposures, infections, and stressors • No ______________ answer to what causes schizophrenia -Genetics and environment combine in such a way that brain pathways develop __________________

predisposition, temperament, insecure, heritable

A SELF-PERPETUATING CYCLE •Evidence has accumulated that a genetic ________________ leading to low verbal intelligence, mild neuropsychological problems, and difficult _________________ can set the stage for early-onset CD •A child's difficult temperament may lead to ______________ attachment •Strong ______________ effects of conduct problems and antisocial behavior

charming, needs, love, coercive

ABILITY TO IMPRESS AND EXPLOIT OTHERS • Superficially _____________ and likable • Have good insight into other people's _________ and weaknesses; highly adept at exploiting others • Cannot understand _______ in others or give it in return • Manipulative, exploitative, and sometimes __________ in sexual relationships; irresponsible and unfaithful partners

half, 4%, unemployed, social, volume, slower

ADHD BEYOND ADOLESCENCE •Approximately ______ of children with ADHD will continue to meet criteria in adulthood •Approximately ______ of U.S. adults meet criteria for ADHD -Higher rates among those who are male, divorced, __________________ CAUSAL FACTORS IN ATTENTION-DEFICIT/ HYPERACTIVITY DISORDER •Causes include genetic and ___________-environmental factors •Smaller brain ____________ and __________ maturing brains

dopamine, depresses, judgement, related

ALCOHOL'S EFFECTS ON THE BRAIN •Low levels of alcohol stimulate the release of _____________ from the pleasure centers of the brain •At higher levels, alcohol __________________ brain function -Results in impairments in ________________, motor coordination, etc. DEVELOPMENT OF ALCOHOL DEPENDENCE •Excessive drinking can be viewed as progressing from early-to middle-to late-stage alcohol-____________ disorder

regulate, reactivity, increased, fearful, empathy

ASSESSING CHILDREN • Two dimensions of temperament lead to different developmental outcomes: - Difficulty learning to ______________ emotions; high levels of emotional _____________ , including aggressive and antisocial behaviors ▪ Point to _____________ risk for developing ASPD and high scores on the antisocial dimension of psychopathy - Fearlessness, low anxiety, callous/unemotional traits, and reduced amygdala activation while responding to __________ facial expressions ▪ Point to poor development of conscience—cold, remorseless psychopaths who show low fear and lack of __________

modify, bizarre, declined, modeling

AVERSION THERAPY •Punishment is used to _________________ behavior •Used effectively with smoking, drinking, overeating, drug dependence, gambling, sexual deviance, and ___________ psychotic behavior •Interest in, and use of, this approach has _______________ as other treatment options have become available MODELING •Client learns new skills by _____________ (imitating) another person, such as a parent or therapist

significant, cure, treatment, widely, sedating

Antianxiety Drugs •Used for conditions in which tension and anxiety are ___________________ components •Do not provide a __________—can keep symptoms under control until patients are able to receive other forms of effective psychological _________________ •_____________ prescribed; source of concern among some leaders in the medical and psychiatric fields because of these drugs' addictive potential and _______________ effects

SSRI's, second, Prozac, seretonin, easier, marketing, evidence

Antidepressant Drugs SELECTIVE SEROTONIN REUPTAKE INHIBITORS •__________ are "____________-generation" treatments; replaced TCAs and MAOIs (are chemically unrelated) -1988: fluoxetine (_________) is the first SSRI to be released in the U.S. -Others include Zoloft, Paxil, Luvox, Celexa, and Lexapro •Work by inhibiting reuptake of the neurotransmitter _____________ •Are ____________ to use, have fewer side effects, and generally not fatal in overdose, as tricyclics can be •Preferred antidepressant drugs due largely to ________________ -No _____________ of greater efficacy vs. than other antidepressants

widely, comorbid, antipsychotics

Antidepressant medication (most often from the SSRI category) is ________ used, most appropriately when patients have a ____________ mood disorder, may temporarily reduce symptoms with _____________ short term

comorbid, anxiety, girls, phobias, separation

Anxiety Disorders of Childhood and Adolescence •Often ___________________ with other disorders •__________________ disorders are most common mental disorder among children and adolescents •Higher rates among _________ than boys •Most commonly take the form of specific _______________, social anxiety disorder, ____________________ anxiety disorder, and posttraumatic stress disorder

1

Approximately ___ person in 10 has a diagnosable personality disorder of some kind

dangerousness, confinement, predictor, abuse, psychotic, antisocial, difficult, overpredict

Assessment of ________________ •Most psychiatric patients are not considered dangerous, but some require supervision or _________________ •In violent psychiatric patients, history of violence is a significant ___________ for future aggression -Other predictors include: ▪Substance abuse ▪Diagnosis of schizophrenia or other psychotic disorder ▪______________ traits •Determination that a patient is potentially dangerous can be ______________ to make -Mental health professionals typically ___________________ violence

range, errors, automatic, validity

BECK'S COGNITIVE THERAPY •Originally developed to treat depression and anxiety disorders; now used for a broad _____________ of conditions, including eating disorders and obesity, personality disorders, substance abuse, and schizophrenia •Basically an information-processing model of psychopathology: problems result from the biased processing of external events or internal stimuli, leading to cognitive __________ •Clients are made aware of the connection between their patterns of thinking and their emotional responses and are taught to identify __________________ thoughts and logical errors Learn to challenge ___________ of their automatic thoughts

multiple, noxious, coping, abstaining

BEHAVIORAL AND COGNITIVE-BEHAVIORAL THERAPY •Utilizes __________ tools to change behavior: -Aversive conditioning methods employ conditioning ___________ stimuli with drinking to suppress drinking behavior -Skills training aims to provide life and _________ skills to help reduce alcohol use in the future -Self-control training techniques are aimed at reducing alcohol intake, but not necessarily _________________

benzo's widely, seldom, agitation, insomnia, significant, relapse, enhancing

BENZODIAZEPINES (_________) •Most important and ______________ used class of antianxiety (or anxiolytic) drugs -Another class of drugs, the barbiturates (e.g., phenobarbital), is ______________ used today except to control seizures or as anesthetics during electroconvulsive therapy •Drug of choice for the treatment of acute anxiety and ______________ -At low doses, help to quell anxiety; at higher doses, act as sleep-inducing agents that can be used to treat ____________ -Potential for dependency is _______________—risk of withdrawal symptoms -Extremely high _____________ rates following discontinuation •Believed to work by _______________ the activity of GABA receptors

physical, constructively, identity, problems, safe, functioning

BIOLOGICAL STRATEGIES •Maintain good ____________ health through diet, exercise, habits PSYCHOSOCIAL STRATEGIES •Problem-solve effectively, express emotions ________________, and engage in satisfying interpersonal relationships •Acquire a healthy context for ______________ development •Prepare to deal with __________________ likely to be encountered SOCIOCULTURAL STRATEGIES •Create ________ communities and social conditions to foster healthy development and __________________

high, lethargic, tearing, restlessness, desire

Biological Effects of Morphine and Heroin •The rush is followed by a _______, during which an addict is typically in a ________________ state •Withdrawal symptoms include: -____________ eyes -Perspiration -____________________ -Increased respiration rate Intensified ___________ for the drug

adolescence, schizophrenia, 65%, 85%

Brain Development in Adolescence •Major brain changes take place during ____________________, as the brain matures -If problems occur, _______________________ may be the result •People who were in the hospital for a head injury have a ____ percent increase risk for schizophrenia -If a head injury occurs between the ages of 11 and 15, the risk of schizophrenia is increased by _____ percent

Treatments and Outcomes

CASE MANAGEMENT FAMILY THERAPY PSYCHOEDUCATION SOCIAL-SKILLS TRAINING COGNITIVE REMEDIATION COGNITIVE-BEHAVIOR THERAPY EXERCISE

unknown, risk, hundreds, heredity, parents

CAUSAL FACTORS IN AUTISM •Precise causes unknown, complex disorder •Genetic risk -Hundreds of genes associated with increased risk -Heredity -De novo mutations that occur in the child's genes, but are not passed from parents

negative, 38%, suicidal, reduces

CAUSAL FACTORS IN CHILDHOOD DEPRESSION •Causal factors include genetics, in utero exposure to alcohol, and exposure to ___________ parental behaviors or ____________ emotional states TREATMENTS AND OUTCOMES •_____ receive mental health treatment -Antidepressants are used, but associated with increase risk of ____________ thoughts and behaviors -Cognitive behavioral therapy _______________ symptoms

Hamilton, judge, competent, discontinue

CLINICIAN RATINGS •________________ Rating Scale for Depression: rating scale used by clinicians to measure the severity of a patient's depression •Clinicians are more objective than the patient but also may not be the best ____________ of clients' progress -May be biased in favor of seeing themselves as _________________ and successful -Can inflate improvement averages by deliberately or subtly encouraging difficult clients to ___________________ therapy

deteriorate, developed, boundary, dinner, gifts, sexual

Can Therapy Be Harmful? •Between 5 and 10 percent of patients ________________ during treatment. •Research-based methods to assess clinical deterioration are now being ___________________. •A special case of therapeutic harm concerns what are called _______________ violations: when the therapist behaves in ways that exploit the trust of the patient or engages in behavior that is highly inappropriate, such as: -taking the patient to _____________ -giving the patient _____________ conducting a _____________ relationship with the patient

cannabis, correlate, never, accelerate

Cannabis Use and Abuse •People with schizophrenia are twice as likely to smoke _____________ as people in the general population -This could be a __________________ and not a cause -The majority of cannabis users __________ develop schizophrenia •Cannabis may _____________ the progressive brain changes that seem to go along with schizophrenia

impairments, cerebellum, genetically

Causal Factors in Learning Disorders •Learning disorders are the product of subtle central nervous system _____________________. •Recent work with functional magnetic resonance imaging suggests that people with dyslexia have a deficiency of physiological activation in the ____________________. Various forms of learning disorders, or a vulnerability to develop them, may be ____________________ transmitted

environment, cheap, escape, maladjustment, sociocultural

Causal Factors in Opiate Abuse and Dependence •Both genetics and ______________ play a role •The reasons people give or starting to use heroin include: -______________ and easy to obtain -Desire to ______________ life stress -Personal _____________________ ____________________ conditions

38%, 15-25, before, long, 1/3, negative

Clinical Outcome •Around _____ of patients have a favorable outcome and can be thought of as being recovered _________ years after development of the disorder -They do not return to how they were ____________ they became ill •Around 12 percent of patients need _______-term institutionalization •Around _______ show signs of continued ____________ symptoms

Three clusters of personality disorders in DSM-5

Cluster A- paranoid, schizoid, and schizotypal personality disorders Cluster B- histrionic, narcissistic, antisocial, and borderline personality disorders Cluster C- avoidant, dependent, and obsessive-compulsive personality disorders

C, 7

Cluster ____ disorders are most common, with a prevalence of around ___ percent

promise, modest, increasing, increasing, teaching, changing, curing, prison, release, less

Cognitive-behavior treatments offer the greatest ____________, but even the best programs produce only _____________ results. - Interventions include: ▪ ________________ self-control, self-critical thinking, and social perspective taking ▪ ________________ victim awareness ▪ ____________ anger management ▪ ______________ antisocial attitudes ▪ __________ drug addiction - May help reduce inmates' antisocial behavior while in ___________, but results do not carry over to the real world on _____________ • While their personalities endure over time, they may be _______ inclined to engage in criminal behavior as they age.

clinical, essential, approaches, medications, disorders

Combined Treatments •Integration of medication and psychotherapy is common in _____________ practice, particularly for disorders such as schizophrenia and bipolar disorder. -Combined approaches are appreciated and regarded as ______________ by patients. •Medications can be combined with a broad range of psychological ___________________. -Typically, psychosocial interventions are combined with psychiatric _________________. -They may be especially beneficial for patients with severe ______________.

controlled, severe, life, bigger

Controlled Drinking versus Abstinence •"_______________ drinking" is highly controversial and is more successful in people with less ____________ alcohol problems Alcoholics Anonymous •Self-help group •Basic belief that one is an alcoholic for _____ •Rehabilitation lifts the burden of personal responsibility: members accept their problem drinking is ________ than they are

growing, TBCT, learning, reinforcment, IBCT, acceptance, limitations, promising

Couples and Family Therapy COUPLES THERAPY •Couples counseling is a _____________ field •Gold standard: traditional behavioral couple therapy (_______) -Based on a social-_____________ model -Views marital satisfaction and marital distress in terms of _______________ -An empirically supported treatment •Integrative behavioral couple therapy (______) -Focuses on __________________ rather than change -Includes strategies that help each member of the couple come to terms with and accept some of the _____________ of their partner -Findings are ______________

don't, biologically, cardiac, brain, prefrontal

Current conceptualization of ASPD doesn't include people who ________ generally get into trouble with the law "Successful" and "unsuccessful" psychopaths differ ______________ Differences in _________ reactivity and information processing Differences in _______ structure and function, including ___________ cortex and amygdala

endorphins

opium-like substances in the brain; thought to be involved in pain responses

cytoarchitecture, density, hippocampus, inhibitory, overactivity

Cytoarchitecture •If cells fail to migrate properly, the overall organization of cells in the brain (the brain's _________________) will be compromised -Increase in neuronal ________________ in some areas of the brains of patients with schizophrenia •Abnormalities in the distribution of cells in the cortex and ______________________ •Patients with schizophrenia are missing "______________ interneurons" -May be less able to regulate or dampen down ____________________ in certain neural circuits

negative, maladaptive, suicidal, coping

DBT Encourages patients to accept ____________ affect without engaging in self-destructive or other ________________ behaviors, based on a clear hierarchy of goals Prioritizes decreasing ____________ and self-injurious behavior and increasing __________ skills

Treating BPD

DBT, transference-focused psychopathology, mentalization, drugs

dependent

Difficulty in separating in relationships; discomfort at being alone; subordination of needs in order to keep others involved in a relationship; indecisiveness, females > males

goal, unusual, catatonia, stupor

Disorganized Behavior •Impairment of _______-directed activity •Occurs in areas of daily functioning -Examples: hygiene, silliness or ____________ dress •________________ involves almost no movement at all, sometimes in an unusual posture •Catatonic _________ a virtual absence of all movement and speech

family, gentic, little

Do Bad Families Cause Schizophrenia? •Popular theories in the past blaming the ___________ do not have empirical support •If the child is not at _______________ risk for schizophrenia, adverse family environments and communication deviance have _________ consequence

conscience, abuse, inconsistent, sufficient

EARLY PRENATAL LOSS, PARENTAL REJECTION, AND INCONSISTENCY • Slow _______________ development and high levels of both reactive and instrumental aggression are influenced by the damaging effects of: - parental rejection, __________ , and neglect - __________________ discipline • Alone, these are not _____________ as causal agents

advantages, short, costs, delineated, evaluated, effective, tourette's

EVALUATING BEHAVIOR THERAPY •Behavior therapy has some distinct ______________ over other treatments: -Achieves results in a _________ period of time -Has lower ____________ -Methods are clearly _________________ -Results can be readily _________________ -Proven to be ___________________ •Recent research also shows that behavior therapy is an effective treatment for the vocal and motor tics that are found in people with __________________ syndrome.

emotive, well, behavioral, common

EVALUATING COGNITIVE-BEHAVIORAL THERAPIES •Rational _______________ therapy has been less well assimilated into the mainstream than Beck's cognitive therapy. •Efficacy of Beck's cognitive treatment methods is _______ documented—shows dramatic results in treating panic disorder, bulimia, personality disorders, conduct disorders in children, substance abuse, and generalized anxiety disorder •Combined use of cognitive and ______________ techniques is now quite ______________

nature, procedures, helpful

EVALUATING HUMANISTIC-EXPERIENTIAL THERAPIES •Have had a major impact on our contemporary views of both human nature and the ____________ of good psychotherapy •Criticized for their lack of agreed-upon therapeutic _______________ and vagueness about what is supposed to happen between client and therapist •Newer research suggests these approaches may be __________ for depression, anxiety, trauma, and marital difficulties

1%, 50, dry, immigrants, white, 18-30, men

Epidemiology •Lifetime prevalence just under ____ •Age of father (over ____) •Parent in _____ cleaning business •First- and second-generation ___________________ -Particularly those from black Caribbean and black African countries who live in majority ___________ communities •Onset: ages ___________ More common and more severe in ________

FDA, efficacy, RCT, manualized, standardize, variability

Evidence-Based Treatment •New drugs require approval from the U.S. Food and Drug Administration (________). -Involves demonstrating _____________ (ability to cure or relieve some target condition) through research on humans •Randomized clinical trials (_______) (efficacy trials): tests using voluntary and informed patients as subjects •________________ therapies originated in order to: -_______________ psychosocial treatments to fit the RCT paradigm -Minimize _________________ in clinical outcomes that might result from characteristics of the therapist him or herself

Narcissistic Personality Disorder

Exaggerated sense of self‑ importance, preoccupation with being admired, and lack of empathy for the feelings of others Grandiose: traits related to extreme grandiosity, aggression, and dominance Vulnerable: very fragile and unstable sense of self-esteem

obsessive compulsive

Excessive concern with order, rules, and trivial details; perfectionistic; lack of expressiveness and warmth; difficulty in relaxing and having fun, males > females

Dependent Personality Disorder

Extreme need to be taken care of, which leads to clinging and submissive behavior, fear of separation, may accept abuse to remain in a relationship, usually comorbid with mood, anxiety, and eating disorders Personality traits that are prominent in the disorder, such as neuroticism and agreeableness, also have a genetic component, authoritarian parents

stable, negative, correlated, considered

FAILURES IN PARENTAL GUIDANCE •A lack of _________ family relationships can impact substance abuse •Exposure to ______________ models and family dysfunction can also contribute to future alcohol use PSYCHOLOGICAL VULNERABIILTY •Alcohol use is often ________________ with mental disorders and should be ________________ in potential treatment paradigms

high, fear, conditioned, socialization, startle

FEARLESSNESS AND IMPAIRED FEAR CONDITIONING • Psychopaths who are ______ on first-factor dimensions and who are egocentric, callous, and exploitative have low trait anxiety and show poor conditioning of ______. • Lykken's classic study on skin conductance responses - Psychopaths fail to acquire many of the _________________ reactions essential to normal passive avoidance of punishment, to conscience development, and to _______________. • Psychopaths also show deficient fear-potentiated ________.

schizoid personality disorder

Five-factor model Extremely high levels of introversion Low on openness to feelings heritability: around 55 percent, view self as a self-sufficient loner, others as intrusive

heritability, unemotional, highly , 43-56, environmental

GENETIC INFLUENCES • Psychopathy and some of its important features show considerable ____________. - Study of 3,687 twin pairs at age 7 found that early signs of callous/______________ traits in these children were __________ heritable • Genetic factors account for _________ percent of variance in the dimensions of psychopathy. - Remaining variance is explained more by nonshared __________________ influences than by shared environmental factors

Causal Factors in Intellectual Disability

GENETIC-CHROMOSOMAL FACTORS INFECTIONS AND TOXIC AGENTS TRAUMA (PHYSICAL INJURY) IONIZING RADIATION MALNUTRITION AND OTHER BIOLOGICAL FACTORS

first, family, alleviate, successful

GROUP THERAPY •Can help individuals face their problems for the ________ time; can include ____________ members and spouses ENVIRONMENTAL INTERVENTION •________________ aversive life situations; move alcohol abusers to environments where they can be more ___________________-

familial, 10%, 3%, nongenetic

Genetic Factors •Disorders of the schizophrenia type are "____________"—tend to "run in families" -The prevalence of schizophrenia in the first-degree relatives (parents, siblings, and offspring) is ____ percent -Second-degree relatives who share only 25 percent of their genes is closer to ____ percent •Familial and genetic are not synonymous -A disorder can run in families for _____________________ reasons

Transference-focused psychotherapy

Goal is strengthening weak egos, with a particular focus on the primary primitive defense mechanism of splitting

Narcissistic

Grandiosity; preoccupation with receiving attention; self-promoting; lack of empathy, males > females

Mentalization

Helps patients develop skills to accurately understand their own feelings and emotions as well as others' feelings and emotions

client, themselves, reflecting, acceptance, congruent

Humanistic-Experiential Therapies CLIENT-CENTERED THERAPY •The __________-centered (person-centered) therapy of Carl Rogers (1902-1987) focuses on the natural power of the organism to heal itself. -Primary objective is to resolve incongruence and to help clients accept and be ___________________ -Nondirective techniques, such as empathic ________________ or restatement of the client's description of life difficulties, are used -Relationship built between the client and the therapist causes change; psychological climate of _________________ is created -Self‑concept becomes __________________ with actual experiences

avoidant

Hypersensitivity to rejection or social derogation; shyness; insecurity in social interaction and initiating relationships, females > males

unable, verbal, claim, connection, retarded, apply

INADEQUATE CONSCIENCE DEVELOPMENT • Appear ____________ to understand and accept ethical values except on a __________ level • May _________ to adhere to high moral standards; no _____________ with their behavior • Conscience development is severely ____________ or nonexistent • Behave as though social regulations and laws do not ________ to them

take, deviant, consequences, substance, lifestyle, suicide

IRRESPONSIBLE AND IMPULSIVE BEHAVIOR Learn to ______ rather than earn what they want thrill-seeking and _______ and unconventional behavior; often break law impulsively and no regard for consequences - high rates of ___________ abuse/dependence disorders - Alcohol abuse is related only to the ___________ /antisocial dimensions of the PCL-R - Elevated rates of __________ attempts and completed suicides are also only associated with these dimensions

higher, misunderstandings, darker, discriminated,

Immigration •Recent immigrants have a much _____________ risk •There is no evidence that this can be explained by cultural __________________________ •Immigrants with ______________ skin have a much higher risk of developing schizophrenia than those with lighter skin •Healthy people who feel __________________ against are more likely to develop psychotic symptoms than healthy people who do not perceive any discrimination

schizoid

Impaired social relationships; inability and lack of desire to form attachments to others, males >females

borderline

Impulsiveness; inappropriate anger; drastic mood shifts; chronic feelings of boredom; attempts at self-mutilation or suicide, females = males

Transcranial MagneticStimulation

In TMS, a pulsed magnetic coil is carefully positioned on the patient's scalp and an electrical field is created to increase or decrease brain activity in specific brain regions or circuits. Treatment typically is repeated several days per week for 4 to 8 weeks.

Deep Brain Stimulation

In deep brain stimulation, electrodes are implanted into the brain. These are stimulated by pulse generators implanted into the chest region.

Electrode Placement for ECT

In unilateral ECT, current is limited to one side of the brain. In bilateral ECT, electrodes are placed on each side of the head. Bilateral ECT is more effective but is also associated with more cognitive side effects and memory problems.

dependence, C, criticism, automatic, challenging, behavioral

Individual psychotherapy may encourage ________________ in people who are already too dependent Patients from the anxious/fearful Cluster ____ may be hypersensitive to perceived __________ from the therapist Techniques include monitoring ___________________ thoughts, ________________ faulty logic, and assigning ______________ tasks to challenge dysfunctional belief

psychopathy

Initially called sociopathic personality, personality disorders were included in DSM-III, 21 core traits identified

hallucinogens, 8, detachment, traumatic, flashback

LSD •The most potent of the ______________—drugs that induce hallucinations •Taking LSD usually causes ____ hours of changes in sensory perception, mood swings, and feelings of depersonalization and ______________ -Experience can be _______________ and terrifying •_______________: involuntary recurrence of perceptual distortions or hallucinations weeks or months after taking

anti-social (ASPD)

Lack of moral or ethical development; inability to follow approved models of behavior; deceitfulness; shameless manipulation of others; history of conduct problems as a child, males > females

unknown, 2-3, future, risky, toxic, issues

Lithium and Other Mood-Stabilizing Drugs •Biochemical mechanism of lithium is _______________; thought to alter neurotransmitter systems •70-80% effective in resolving manic states within ________ weeks, BUT: -Maintenance treatment may be less reliable at preventing ___________ episodes than once thought -Discontinuation is ____________ (high relapse rates) -Side effects: increased thirst, GI issues, weight gain, tremor, fatigue -Can be ___________ if the recommended dose is exceeded •Compliance ____________ due to unpleasant side effects and loss of the "highs" associated with patients' hypomanic episodes

crisis, divorce, western, incidence, lower

MARITAL AND OTHER INTIMATE RELATIONSHIPS •Excessive drinking often begins during _________ periods in marital/intimate relationships •Continued excessive drinking may contribute to _____________ Sociocultural Causal Factors •Alcohol use is prevalent in the social life of _____________ civilization •Cultural attitudes toward alcohol influence the _________________ of alcoholism -Cultures that frown on alcohol are correlated with ________ levels of alcohol use disorder

antabuse, naltexone, minimize, long

MEDICATIONS TO BLOCK THE DESIRE TO DRINK •Disulfiram (_____________) causes vomiting when followed by ingesting alcohol •_________________ helps to reduce the cravings for alcohol MEDICATIONS TO REDUCE THE SIDE EFFECTS OF ACUTE WITHDRAWAL •Tranquilizers have been used to ________________ withdrawal; concerns that this does not promote __________-term recovery

50-55, educable, 8-11, adolescents

MILD INTELLECTUAL DISABILITY •IQ scores range from ____________ to approximately 70 (two standard deviations below the mean). •Individuals are considered _______________. •Intellectual levels as adults are comparable to those of average ____________ -year-old children. •Social adjustment often approximates that of ____________________.

35-40, 4-7, limited, partial

MODERATE INTELLECTUAL DISABILITY •IQ scores range from _____________to 50-55. •In adulthood, individuals attain intellectual levels similar to those of average _____________-year-old children. •Some can be taught to read and write a little and may achieve fair command of spoken language. However, the rate of learning is slow, and the level of conceptualizing is extremely _____________. •____________ independence in daily self-care, acceptable behavior, and economic sustenance in a family or other sheltered environment.

candidate, GWAS, ENDOPHENOTYPES

MOLECULAR GENETICS •Schizophrenia probably involves many genes working together •________________ genes: genes that are involved in processes that are believed to be aberrant in schizophrenia •Genome-wide association study (________): investigating entire genome ENDOPHENOTYPES •________________________: discrete, stable, and measurable traits that are thought to be under genetic control

MAOI's, infrequently, monoamine, tyramine,

MONOAMINE OXIDASE INHIBITORS •____________ were the first antidepressant medications to be developed, in the 1950s; now used _________________ •Work by inhibiting the activity of monoamine oxidase, an enzyme present in the synaptic cleft that helps break down the _________________ neurotransmitters (such as serotonin and norepinephrine) that have been released into the cleft •Patients must avoid foods rich in the amino acid tyramine (e.g., salami and Stilton cheese), which limits clinical usefulness •Examples include Marplan, Nardil, Parnate, and Eldepryl

The Brain in Schizophrenia

Many brain regions and systems operate abnormally in schizophrenia, including those highlighted here.

long, violence, reoffending, quickly

Many researchers use Cleckley/Hare psychopathy diagnosis rather than DSM ASPD diagnosis because of its ______ research history Psychopathy diagnosis is the single best predictor of ___________ and recidivism Adolescents with higher psychopathy scores are more likely to show violent _________________ and are more likely to reoffend more _____________

psychopharmacology, psychotropic, patient, medication, ideal, created, discontinuing

Medication or Psychotherapy? •_____________________: use of medications to treat mental disorders •Issues arising from the use of ____________________ drugs: -Possible unwanted side effects -Complexity of matching drug and dosage to the needs of each _____________ -Sometimes necessary for patients to change ________________ •Use of medications in isolation from other treatment methods may not be _________ for some disorders -Drugs do not help the person to understand and change the personal or situational factors that may have ____________ the behaviors -Patients are at risk of relapse after ______________________ the drugs

significant, sooner, care

Mental Health Problems and Recidivism •Questions about the impact of mental health problems on the ability of convicted prisoners to successfully return to society if they are paroled, serve out their terms, or are released because they are no longer believed to be a threat to themselves or others •Offenders with __________________ mental illness have significant differences in recidivism rates and community tenure compared to inmates without mental illness. -Often return to prison _____________ than those without mental illness -Long-term societal costs (safety and expenses) of not providing quality mental health _______ for mentally ill prisoners

private, employees, morale, proneness, turnover, violence, discriminated, risk

Mental Health Resources in ______________ Industry •Psychological difficulties among ________________ can result in: -Low _____________ -Absenteeism -Accident ________________ -Poor productivity -High job _____________ -______________ in the workplace •Americans with Disabilities Act—people with psychiatric problems cannot be __________________ against in the workplace More research is needed to identify mental health ____ factors in work situations (e.g., workload, schedule, job security)

Mescaline, psilocybin, distorted

Mescaline and Psilocybin •____________ is derived from the small, disc-like growths ("mescal buttons") at the top of the peyote cactus •______________ is obtained from a variety of "sacred" Mexican mushrooms known as Psilocybe mexicana •Both drugs cause _______________ reality, altered perceptions

crystal meth, dangerous, lasting, dopamine, structure, discontinued, treatment

Methamphetamine •Form of amphetamine known as "_____________________," "ice" •One of the most __________________ illegal drugs •Highly addictive stimulant that produces an immediate and long _____________ "high" •Raises the levels of _________________ in the brain •Prolonged use causes changes to brain ________________—can result in severe psychiatric symptoms that persist even after use is ___________________ •Highly resistant to ______________; relapse is common

prefrontal, complications, drugs, minute, OCD, lesion

NEUROSURGERY •________________ lobotomy was developed by Moniz. -Tens of thousands of psychiatric patients were subjected to the procedure from 1935 to 1955 -Initial reports of results downplayed ______________, including undesirable side effects and a 1 to 4 percent death rate -Use immediately decreased on introduction of antipsychotic ________ •Modern surgical techniques involve the selective destruction of ___________ areas of the brain. -Sometimes used for debilitating obsessive-compulsive (_______) disorders, treatment-resistant severe self-mutilation, intractable anorexia nervosa •Deep brain stimulation involves surgery but does not lead to a permanent ___________ being made on the brain.

chemistry, chlorpromazine, L-DOPA, blocked

Neurochemistry •Alterations in brain _______________ may be associated with abnormal states •Dopamine: a neurotransmitter linked to schizophrenia -______________________ blocks dopamine receptors and help patients -Amphetamines produce excess dopamine and mimic a psychotic state that looks like schizophrenia -____________ treated patients display psychotic symptoms •Glutamate: an excitatory neurotransmitter -When glutamate receptors are _______________ it creates schizophrenic like symptoms

core, diagnosable, lower, quickly, visual

Neurocognition •Cognitive impairment is a ______ feature of schizophrenia -Apparent even before there is a ______________________ illness •_________ IQ may be a risk factor; higher IQ may be protective in some way •Patients with schizophrenia are not able to respond to a stimulus as __________ and appropriately •Deficits are apparent in the earliest stages of _______ and auditory processing

ECT, convulsions, epilepsy, insulin,

Nonmedicinal Biological Treatments ELECTROCONVULSIVE THERAPY •Using ________________ to treat mental disorders dates back to Paracelsus (1493-1541), who induced a patient with "lunacy" to drink camphor until he experienced convulsions -Von Meduna: modern originator of this treatment approach; "observed" that schizophrenia was rare in those with ____________ -Another early modern approach: causing convulsions by injecting patients with ______________—no control over the seizures •Cerletti and Bini (1938): induced convulsions by passing electric current through patient's head—became known as electroconvulsive therapy (ECT); still used today

causes, high, biological

Not much known about what causes development of personality disorders level of comorbidity among disorders _____________ Factors: infants' temperament may predispose them to developing particular personality traits and disorders

before, progress, mean, change, predictions, fMRI, improved

OBJECTIVE MEASURES •Client takes a battery of psychological tests _________ and after therapy -Scores reflect progress, lack of _______________, or deterioration -Some test results may be artifactual, as with regression to the ____________ ▪May yield a false impression of real ________________ •The therapist or researcher is likely to select tests that focus on his or her theoretical __________________. •Functional magnetic resonance imaging (_________): used to see brain changes before and after therapy Physiological changes do not necessarily indicate _____________ functioning

buspirone, serotonergic, effective, abuse, 2-4 weeks

OTHER ANTIANXIETY MEDICATIONS •The only new class of antianxiety medication released since the early 1960s is __________________ (Buspar). -Completely unrelated to the benzodiazepines; thought to act in complex ways on _____________ functioning rather than on GABA -Has been shown to be as ________________ as the benzodiazepines in treating generalized anxiety disorder -Low potential for ____________ (no sedative or muscle-relaxing properties) -Major drawback: takes __________ weeks to show symptom relief

observation, fake, intended, thoguhts

OVERT BEHAVIORS •Direct __________________ of behavior is the most direct way to know if someone has improved in treatment. -It is objective -Difficult to "______" -Often reflective of precisely the change ______________ in treatment -May be less appropriate for problems that are less easily observed, such as suicidal ______________

Beck, posttherapy, outcomes, better, please

Objectifying and Quantifying Change CLIENT RATINGS •Quantitative measures to determine extent of change -___________ Depression Inventory: a self-report measure of depression severity widely used to measure the degree of severity of a client's depression ▪Standard in the pretherapy and _________________ assessment of depression •Clients are not necessarily a reliable source of information on therapeutic ____________________ -Want to believe they are getting better -May want to _____________ the therapist by reporting they are being helped

risk, psychopathology, methadone, therapy

Opioid use is associated with dramatically increased _____ of other forms of _________________________ Treatments and Outcomes •Medications like ________________ and buprenorphine help substitute for heroin •Combining medications with _______________ yield the best results

moderate, 5.9, permanent, shorter

Organic Intellectual Disability Syndromes DOWN SYNDROME •First described by Langdon Down in 1866, Down syndrome is the best known of the clinical conditions associated with moderate and severe intellectual disability. •5.9 births out of every 10,000 in the general population. •Intellectual disability is __________________ and most affects verbal and language skills. •Common physical features •_____________ than normal life expectancy

hard, motivational, change, recognize, warning

Outcome Studies and Issues in Treatment •Success of treatment varies, with low rates among _____-core substance abusers •"______________ interviewing": brief intervention with a clinician; person makes a decision about whether they are motivated to ____________ Relapse Prevention •In relapse prevention treatment, clients are taught to _______________ the decisions that serve as early _____________ signs of the possibility to relapse

oxygen, triggered, increases

PREGNANCY AND BIRTH COMPLICATIONS •Many delivery problems (breech delivery, prolonged labor, or the umbilical cord around the baby's neck) affect the newborn's ______________ supply EARLY NUTRITIONAL DEFICIENCY •Schizophrenia might be caused or ________________ by environmental events MATERNAL STRESS •Extremely stressful event late in 1st trimester/early in 2nd trimester of pregnancy _____________ schizophrenia risk

below, unable, deformities,

PROFOUND INTELLECTUAL DISABILITY •IQ scores that are _____________-- 20-25. •Individuals are severely deficient in adaptive behavior and ____________ to master any but the simplest of tasks. •Severe physical _______________, CNS pathology, and retarded growth are typical, along with convulsive seizures, mutism, deafness, and other physical anomalies.

rarely, object, interpersonal, past, libidinal

PSYCHODYNAMIC THERAPY SINCE FREUD •Original version of psychoanalysis is _________ practiced •Most extensive and recent revisions have been related to the _________-relations (also known as attachment, or self-psychology) perspective -Psychodynamic therapists increasingly focus on ______________ relationship issues: seek to expose, bring to awareness, and modify the effects of the remote developmental sources of the client's present difficulties -Retain the classical psychoanalytic goal of understanding the present in terms of the _________ -Ignore notions of staged ____________ energy transformations and of entirely internal/impersonal drives that cause symptoms

psychotic, delirium, amnestic

PSYCHOSES ASSOCIATED WITH SEVERE ALCOHOL ABUSE •Alcohol-induced ______________ disorders: temporary loss of contact with reality •Alcohol withdrawal ___________ can occur during prolonged drinking or during a state of withdrawal -Includes disorientation of time and place, acute fear, fever, etc. •Alcohol ___________ disorder: memory defect where users may appear disoriented and delusional

schizotypal

Peculiar thought patterns; oddities of perception and speech that interfere with communication and social interaction, males > females

Obsessive-Compulsive Personality Disorder

Perfectionism and excessive concern with maintaining order and control are essential characteristics rigid, stubborn, and cold No true obsessions or compulsive rituals High on assertiveness, low on compliance Cloninger approach- novelty seeking, reward dependence, and harm avoidance

Antisocial Personality Disorder

Persistently disregard and violate the rights of others Lifelong pattern of unsocialized and irresponsible behavior with little regard for safety; repeated conflicts with society, trouble with the law moderate heritability, low income, inner city, neglect, large family, young mother, single parent income ADHD is often a precursor to adult ASPD.

anxiety, substance, sexual

Personality disorders are often found together with _________ disorders, mood disorders, ______________ use problems, and _____________ difficulties and disorders

first, dopamine, second, extrapyramidal, estrogen

Pharmacological Approaches ________-GENERATION ANTIPSYCHOTICS •Block the action of ___________________ ___________________-GENERATION ANTIPSYCHOTICS •Fewer _____________________________ symptoms OTHER APPROACHES Researching the role of ___________________

second, influenza, abnormalities

Prenatal Exposures VIRAL INFECTION •Elevated rates of schizophrenia in children born to mothers who had been in their ______________ trimester of pregnancy at the time of the ____________ epidemic RHESUS INCOMPATIBILITY •Mechanism involves oxygen deprivation, or hypoxia—risk for schizophrenia linked to birth complications •Rh-incompatibility between the mother and fetus may increase the risk of brain _________________________

APA, AMA, ABCT, NASW, social, professional, training, clinics, disciplinary

Professional Organizations and Mental Health •National mental health professional organizations include: -American Psychological Association (______) -American Medical Association (_______) -Association for Behavioral and Cognitive Therapies (________) -National Association of Social Workers (________) •Key functions of these organizations include: -Applying insights and methods to contemporary __________ problems -Setting and maintaining high _______________ and ethical standards ▪Accreditation of undergraduate and graduate _________ programs ▪Accreditation of ____________ and hospitals ▪Investigating reported cases of unethical or unprofessional conduct and taking _________________ action when necessary

gratification, styles, societal,

Psychodynamic theories: an infant's getting excessive versus insufficient _______________ of its impulses in the first few years of life Learning Based: parenting ___________ , abuse, attachment relationships Sociocultural Factors: social stressors, ____________ changes, and cultural values

little, ineffective, increase, biological, impact

Psychopaths experience _______ personal distress, so they do not believe they need treatment Punishment is generally ________________. - Treatments that work for other criminal offenders have been found to actually ______________ reoffending rates for psychopaths. • _______________ treatments for antisocial and psychopathic personalities have not been systematically studied; little evidence that such approaches have much ____________.

crucial, race, underserved, drawback, adapted

Psychotherapy and Cultural Diversity •Building an effective psychotherapeutic "working alliance" between client and therapist is regarded as ___________; what does this mean for a client whose background differs considerably from the therapist's? -Little or no solid evidence that psychotherapeutic outcomes are diminished when client and therapist differ in ________ or ethnicity •Racial and ethnic minorities are _________________ by the mental health system. -Lack of trained therapists familiar with issues important to different ethnic groups is a serious _________________ -Minority clients are less likely to drop out of treatment when they have access to specialized, culturally ______________ interventions

REBT, rationally, maladaptive, confrontation

RATIONAL EMOTIVE BEHAVIOR THERAPY •Rational emotive behavior therapy (_______): the first form of behaviorally oriented cognitive therapy -Developed by Albert Ellis, who posited that a well-functioning individual behaves _______________ and in tune with empirical reality -Attempts to change a client's ________________ thought processes, on which maladaptive emotional responses and, thus, behavior are presumed to depend -Restructures an individual's belief system and self-evaluation through several techniques, including rational ________________ and behaviorally oriented techniques

indirect, divorce, reluctant, stereotypes, potential

RELUCTANT CLIENTS •Some people enter therapy by an ________________ route, by court order or physician referral •Motivations differ widely, to avoid _______________ or prison term •Males are more ________________ to seek help than females. -May need innovative treatment approaches to overcome masculine ___________________ emphasizing self-reliance and lack of emotionality PEOPLE WHO SEEK PERSONAL GROWTH •A final group of people who enter therapy have problems that would be considered relatively normal—enter therapy out of a sense that they have not realized their own __________________

abnormalities, consider, pursue, less, less, empathy

RESPONSE MODULATION AND ATTENTION • ______________________ in selective attention/attention-processing deficits - Unable to ______________ contextual information that might allow them to modulate their behavior; single-mindedly _____________ a goal GENERAL EMOTIONAL DEFICITS • ________ activity in the amygdala during fear conditioning and when viewing sad or frightened faces • _______ significant physiological reactivity to images of distress—low on __________, as well as low on fear

psychopathy, interview

Robert Hare developed the 20-item _________________ Checklist-Revised (PCL-R) Includes detailed _____________ and careful checking of past school, police, and prison records best be understood by considering four dimensions: (1) interpersonal, (2) affective, (3) lifestyle, and (4) antisocial

20-25, speech, dependent

SEVERE INTELLECTUAL DISABILITY •IQ scores range from ____________ to 35-40. •Individuals commonly suffer from impaired ______________ development, sensory defects, and motor handicaps. •Some can develop limited levels of personal hygiene and self-help skills, but they are always __________________ on others for care.

socioeconomic, cultural, prevalence, aggressive, promote

SOCIOCULTURAL FACTORS • Psychopaths are found in all _______________________ groups, races, ethnicities, and cultures. • Exact manifestations of the disorder are influenced by ___________ factors. • ___________________ varies with sociocultural influences that encourage or discourage its development. - Cultural variations occur in the expression of _________________ and violent behavior. - Individualistic cultures are more likely than collectivist ones to ____________ some of the behavioral characteristics that, when carried to an extreme, result in psychopathy.

correlated, reduce, popularity, preventative

STRESS, TENSION REDUCTION, AND REINFORCEMENT •Research suggests that exposure to trauma is _______________ with alcohol use •Those who use alcohol may do so to ____________ stress EXPECTATIONS OF SOCIAL STRESS •Adolescents begin drinking as a result of expectations that using alcohol will increase their ________________ and acceptance by peers •_____________________ efforts before children begin to drink may be successful in deterring alcohol use

historonic

Self-dramatization; overconcern with attractiveness; tendency to irritability and temper outbursts if attention seeking is frustrated, Females > males

centered, using, maladaptive, maintian

Social Effects of Morphine and Heroin •The life of a person addicted to opiates becomes increasingly _______________ on obtaining and _____________ drugs •Usually leads to socially ______________________ behavior •Individual does whatever they can to _______________ a supply of drugs

used, applied, judgement, society

Social Values and Psychotherapy •Consider whether a psychologist or behavioral scientist who develops powerful techniques to influence or control how people behave should be concerned about how those techniques are _________. -Some argue that science is value free—concerned only with gathering facts, not with how the facts are _____________ -But each decision by a therapist to eliminate or substitute one behavior for another involves a value ______________. •Therapy takes place in a context that involves the values of the therapist, the client, and the _____________ they live in.

universal, selective, indicated

Subcategories of prevention efforts •Universal interventions -Efforts targeted at general public or whole population group •Selective interventions -Aimed at specific subgroup of the population whose risk of developing a mental health problem is thought to be significantly higher than average •Indicated interventions -Efforts are directed toward high-risk individuals with minimal but detectable symptoms of mental disorder but who do not meet criteria for clinical diagnosis

Paranoid

Suspiciousness and mistrust of others; tendency to see self as blameless; on guard for perceived attacks by others, males = females

susceptibility, one, key, normal

Synthesis •Genes can create an enhanced _________________ to aversive environmental events •It is unlikely that schizophrenia is the result of any one problem in any _______ specific region of the brain •Subtle brain abnormalities in some _______ functional circuits may wreak havoc with ________________ functioning

Special Factors Associated with Treatment of Children and Adolescents

THE CHILD'S INABILITY TO SEEK ASSISTANCE VULNERABILITIES THAT PLACE CHILDREN AT RISK FOR DEVELOPING EMOTIONAL PROBLEMS POSSIBILITY OF USING PARENTS AS CHANGE AGENTS NEED TO TREAT PARENTS AS WELL AS CHILDREN PROBLEM OF PLACING A CHILD OUTSIDE THE FAMILY VALUE OF INTERVENING BEFORE PROBLEMS BECOME ACUTE

deficit, aloof, contact, misread, auditory, echoalalia, stimulation, rocking, sameness

THE CLINICAL PICTURE OF AUTISTIC SPECTRUM DISORDER •A social ________________ -___________ or seems apart from others -Do not show any need for attention from or __________________ with others, _______________ social cues, aversion to ________________ stimuli, deficits in locating and orienting to sounds •An absence of speech -May show ___________, the parrot-like repetition of a few words •Self-_____________________ -Head banging, spinning, and _______________ are common •Maintaining _____________________

pleasure, genetic, unclear

THE NEUROBIOLOGY OF ADDICTION •Addictive drugs activate the mesocorticolimbic dopamine pathway (MCLP)—the "__________ pathway" GENETIC VULNERABILITY •Research suggests a _____________ vulnerability to alcohol use disorder (e.g., "alcohol flush reaction" in certain ethnic groups) GENETICS—MANY REMAINING QUESTIONS •Exact role of genetics in alcohol-related disorders is _________

15-30, malnutrition, fatigue, deterioration

THE PHYSICAL EFFECTS OF CHRONIC ALCOHOL USE •_________ percent of heavy drinkers develop cirrhosis of the liver •Excessive alcohol use my lead to ________________ PSYCHOSOCIAL EFFECTS OF ABUSE AND DEPENDENCE •Chronic ____________, oversensitivity, and depression may occur along with impaired reasoning and personality _________________

family, independent, see

THIRD-PARTY RATINGS •Client change also can be evaluated by third-party raters: people not involved in the treatment -___________ members -trained _______________________ evaluators •Relatives may be inclined to "_____" the improvement they had hoped for but often seem to be more realistic than either the therapist or the client in their evaluations

token, long, susbstance

TOKEN ECONOMIES •A _________ economy resembles the outside world: an individual is paid for his or her work in tokens (money) that can be exchanged for desired objects and activities. •Originally developed for use with patients experiencing ______-term stays in psychiatric hospitals -When patients behaved appropriately, they earned tokens that could later be exchanged for rewards or privileges. •Similar reinforcement-based methods are now being used to treat __________________ abuse.

TMS, magnet, depression, invasive, ineffective

TRANSCRANIAL MAGNETIC STIMULATION •Transcranial magnetic stimulation (______): treatment in which the clinician positions a pulsed ______________ over a chosen area on the patient's scalp to create an electrical field that increases or decreases neuronal activity in the brain •Can be used to effectively treat major ______________, with additional evidence supporting its use with other conditions -Less ____________ than surgical interventions; fewer and less severe side effects than ECT with no impairments in memory -Side effects: headache and a small risk of seizure •Typically considered as a treatment option only after psychotherapy and antidepressants have proven _____________

children, CBT, exposure

TREATMENTS AND OUTCOMES •Same medications used to treat adult anxiety disorders are generally used to treat ____________ and adolescents •Cognitive-behavior therapy (_____) has been effective at reducing anxiety symptoms in young children •_______________-based therapies are effective in the treatment of adult, adolescent, and child anxiety

insufficiently, fads, newer

TREATMENTS AND OUTCOMES OF AUTISM •Prognosis is poor because so many are _____________________ treated •Many children with autism are subjected to a range of ________ and "novel" approaches that have little to no support for their effectiveness •___________ instructional and behavior modification techniques may reduce some symptoms

higher, biological, frequently, environment

TWIN STUDIES •Schizophrenia concordance rates for identical twins (28%) are _____________ than those for fraternal twins or ordinary siblings (6%) -If only genetic, the rate would be 100% between identical twins -Genes are not the whole story ADOPTION STUDIES •Higher rates of schizophrenia among adopted children of schizophrenic ____________________ parents THE QUALITY OF THE ADOPTIVE FAMILY •Children at high genetic risk who were raised in healthy family environments did not develop problems any more ____________________ than did children at low genetic risk -Evidence of genotype-____________________ interaction in schizophrenia

awareness, first, NIMH, research, training, plan, public

The Federal Government and Mental Health •Public ________________ of mental health issues resulting from World War II Ied to organized measures to benefit the mentally ill. •1946 developments: -Congress passes the National Mental Health Act—______ comprehensive mental health bill -The National Institute of Mental Health (______) was founded (1 of the 27 institutes belonging to the National Institutes of Health) ▪Conducts and supports ______________ on the biological, psychosocial, and sociocultural aspects of mental disorders ▪Supports the ____________ of professionals in the mental health field ▪Helps communities _________, establish, and maintain mental health programs ▪Provides mental health information to the __________ and the scientific community

therapeutic, environment, Milieu, communication, involved, social, deinstitutionalization

The Mental Hospital as a __________________ Community •Social _______________ is manipulated to provide the patient with the greatest benefit. •_________ therapy: hospital environment and all its activities are a part of the total treatment program -Guided by 3 general therapeutic principles: ▪Clear ____________________ and feedback from staff ▪Patients become _____________ in all decisions and actions concerning them ▪All patients belong to cohesive __________ groups on the unit—serves functions of both support/encouragement and group pressure •Concern that hospital may become a permanent refuge gave rise to ________________________ (treat patients as outpatients)

planning, eliminate, problems, volunteering, all, harmonious, preventivie

The Need for Planning •More effective ______________ needed at all levels (community, national, international) to reduce or ______________ mental health problems The Individual's Contribution •Many individuals in history whose efforts changed the way we think about mental health _________________ (e.g., Pinel, Dix, Beers) •Constructive courses of action open to each citizen include: -__________________ in a mental hospital, community health center, or organization -Supporting measures to ensure comprehensive mental health services for ______ -Working toward improved public education, responsible government, the alleviation of prejudice, and a saner and more ___________________ world •____________ measures are the most effective long-term approach

America, community, volunteers, personnel, Arc, disabilities, centers, public, legislation, research

The Role of Volunteer Organizations and Agencies •Mental Health _____________ (founded by Clifford Beers, 1909): -Works to improve services in ______________ clinics and mental hospitals -Recruits, trains, and places ______________ for treatment and aftercare programs -Promotes enlightened mental health legislation and the provision of needed facilities and _____________ •The ______—largest national community-based organization: -Advocates for people with intellectual and developmental _______________ -Finds them community and residential treatment ___________ and services -Educates the ___________ -Promotes ________________ Fosters scientific ___________________

situation, less, collaboratively, goals, bond, placebo, perspective

The Therapeutic Relationship •Evolves out of what both client and therapist bring to the therapeutic ___________________ -Pessimistic clients respond _________ well to treatment •Three key elements of the therapeutic alliance are: -A sense of working _______________________ on a problem -Agreement between patient and therapist about the ________ and tasks of therapy -An affective __________ between patient and therapist •Client's expectation of receiving help can act as a _____________ •Therapist uses a variety of skills and methods to help client gain a new _________________

psychotherapy, 15%,

The belief that people with psychological problems can change—can learn more adaptive ways of perceiving, evaluating, and behaving—is the conviction underlying all __________________ or psychological treatment. Why Do People Seek Therapy? PSYCHOLOGICAL DISORDERS AND STRESSFUL LIFE CIRCUMSTANCES Approximately ____ percent of adults in the United States receive mental health care each year because they are experiencing a psychological disorder.

Normal and Abnormal Eye Tracking of a Sinusoidal Wave

The top pattern is the target, the middle pattern is a record of normal tracking, and the lowest pattern is the kind of abnormal record produced by some patients with schizophrenia.

tic, twitching, males, tourette's

Tic Disorders •A ______ is a persistent, intermittent muscle twitch or spasm, usually limited to a localized muscle group -Examples: blinking the eye, __________________ the mouth, licking the lips, shrugging the shoulders, clearing the throat, and grimacing -More common in ______________ •________________ disorder is an extreme tic disorder involving multiple motor and vocal patterns

A, B, modest, exist

Treatment of Cluster ____ and other Cluster ___ personality disorders has not been as promising, Schizotypal- low doses of antipsychotic drugs may have _____________ results; SSRIs may also be useful, No systematic, controlled studies yet _______ of treating people with either medication or psychotherapy for paranoid, schizoid, narcissistic, or histrionic disorder

promising, confrontational, CBT, avoidant

Treatment of some Cluster C disorders, such as dependent and avoidant personality disorder, appears somewhat more ____________ Active and _________________________ short-term therapy shows improvement _____ and psychodynamic therapies have been shown to result in significant and lasting treatment gains Antidepressants from the MAOI and SSRI categories may sometimes help in treating _____________ personality disorder

diploma, phonics, decode

Treatments and Outcomes •May not know the exact cause, but the percentage of students who receive a high school __________________ has been increasing -_______________ instruction ▪Teaching letter-sound correspondence ▪How to _________________ and create syllables

Cluster B, bulimia, binge,

USING ANTIDEPRESSANTS TO TREAT ANXIETY DISORDERS, BULIMIA NERVOSA, AND PERSONALITY DISORDERS •SSRIs are used in the treatment of panic disorder, social phobia, generalized anxiety disorder, obsessive compulsive disorder, and ________________ personality disorders. •SSRIs and tricyclics are used in the treatment of _____________ nervosa, where they have been shown to reduce _________ eating and purging.

universal, risk, protective, biological, psychosocial, sociocultural

Universal Interventions •________________ interventions seek to: -alter conditions that can cause or contribute to mental disorders (_________ factors) -establish conditions that foster positive mental health (______________ factors) •Three categories: -______________ strategies -___________________ strategies -___________________ strategies

15, 2.75, rural, 30%

Urban Living •One study showed children who spend the first ___ years of life in an urban setting were _______ times more likely to develop schizophrenia than those in rural settings •It is estimated if we all lived in relatively ________ settings the number of schizophrenia cases could decrease by _____%

Defining a Positive Response

When treatment of depression results in at least a 50 percent improvement in symptoms, it is called a response. Such patients are better, but not well.

Defining Recovery

When treatment of depression results in removal of essentially all symptoms, it is called remission for the first several months, and then recovery if it is sustained for longer than 6 to 12 months. Such patients are not just better—they are well.

clergy, workers, practices, team, medical

Who Provides Psychotherapeutic Services? •Members of many different professions provide advice and counsel, including physicians and __________. •Clinical psychologists, psychiatrists, and psychiatric ____________ workers do psychotherapy. •Settings for treatment include clinics, hospitals, individual practices, group _________________, institutions. •A team approach to assessment and treatment is often used. -Coordinated efforts of ______________, psychological, social work and other mental health personnel are ideal.

selective, difficult, opposition, smaller, substance, self, behavioral

___________ Interventions •Preventing mental health problems through social change in the community is _____________. -Attempts often involve ideological and political issues; may inspire powerful, even governmental, __________________ -More effective to target a smaller segment of the population •Research suggests a long-term decline in adolescents' _____________ abuse. -Alcohol and tobacco are the most abused by adolescents •Most successful interventions happen early and target specific risk factors like poor ______-control, aggressive behavior. •Most promising alcohol and drug use prevention approaches are based on ______________ theory and have many components.

Indicated, detectable, prompt, screens, intervention, decreasing

_____________ Interventions •Emphasize the detection and treatment of maladaptive thoughts, feelings, or behaviors that already are ______________ but before a disorder is present. •Emphasis is on early detection and ______________ treatment. -Example: a program that ____________ school children for symptoms of depression and anxiety ▪Provide a group-based ____________________ program to those with elevated symptoms ▪Teach strategies for ________________ these symptoms

aftercare, transition, residents, relapse, milder, halfway, effective

______________ Programs •Community-based treatment programs with live-in facilities that serve as a home base for former patients as they make the _______________ back to adequate functioning in the community -Typically run by the residents themselves -Can help smooth transition to community life and reduce ________ -Not well suited for some individuals (e.g., those with _________ symptoms) -Can include a gradual return to the outside (formerly, "______________ houses") •Intensive, holistic approach to recovery has been shown to be ______________ in helping former patients live outside an institution

delusional, erotomania, psychotic, catatonic

_______________ Disorder •Delusional beliefs with otherwise normal behavior •Erotomania delusion involves great love for a person, usually of higher status Brief _____________ Disorder •Sudden onset of psychotic symptoms or disorganized speech or ___________________ behavior

schizoaffective, schizophreniform, 6

__________________ Disorder •Features of schizophrenia and severe mood disorder •Diagnostic criteria revised in DSM-5 to improve reliability __________________ Disorder •Schizophrenia-like psychoses lasting at least 1 month but less than _____months •Do not warrant a schizophrenia diagnosis

Eclecticism, relaxation, multimodal, IPT, interpreting

__________________ and Integration •Various "schools" of psychotherapy once stood more in opposition to one another than they do now. •Today, clinical practice is characterized by a ______________ of boundaries and a willingness on the part of therapists to explore differing ways of approaching clinical problems, a process sometimes called _________________ therapy. •Interpersonal therapy (_____) is an eclectic form of therapy. -Central idea: All of us constantly and involuntarily invoke schemas acquired from our earliest interactions with others, such as our parents, in ____________________ our current relationships

systematic, management, removed, shaping,

____________________ REINFORCEMENT •Often referred to as contingency ______________ programs, systematic programs that use reinforcement to increase the frequency of desired behavior have achieved notable success. •Reinforcing contingencies maintaining maladaptive behavior must first be identified and ______________ and then replaced and reinforced by more adaptive behavior. •In response ____________, positive reinforcement is used to establish a response that is actively resisted or is not initially in an individual's behavioral repertoire.

disorganized, content, conventional, understanding, nelogisms

_____________________ Speech •Disorder in thought form -Delusions are a disorder of thought _________________ •Fail to make sense even though they are using language in a ___________________ way -Words and combinations sound communicative -Listener is left with a lack of _________________________ -May make up new words (___________________)

tricyclic, norepinephrine, alter, trazadone, sexual, nicotine

______________________ ANTIDEPRESSANTS •TCAs inhibit the reuptake of _______________________ and, to a lesser extent, serotonin. -_________ several aspects of cellular functioning, including how neurons function and how cells respond to the activation of receptors and the synthesis of neurotransmitters OTHER ANTIDEPRESSANTS •______________ was the first antidepressant introduced in United States that was not lethal in overdose. •Bupropion (Wellbutrin) inhibits the reuptake of norepinephrine and dopamine but does not inhibit sexual functioning as many of the SSRIs do. Also reduces nicotine cravings and symptoms of ___________ withdrawal

antipsychotic, dopamine, tardive, clozapine, schizophrenia

______________________ Drugs •Alleviate or reduce the intensity of delusions and hallucinations by blocking _____________ receptors •Three times as many patients with schizophrenia treated with traditional antipsychotic medications see symptoms resolve within 6 weeks compared with those treated with a placebo •Side effects include _________ dyskinesia—movement abnormality that is a delayed result of taking antipsychotic medications -Atypical antipsychotic medications such as ____________ (Clozaril) and olanzapine (Zyprexa) reduce incidence of movement-related side effects and are often preferred in the clinical management of __________________

Reward deficiency syndrome

addiction is more like to occur in individuals who have genetic deviations in components of the reward pathway Leads them to be less satisfied by natural rewards

Dopamine theory of addiction

addiction is the result of a dysfunction of the dopamine reward pathway

neuroticism

anxiety, angry hostility, depression, self-consciousness, impulsiveness, vulnerability

epidemiological studies

attempts to establish the pattern of occurrence of certain (mental) disorders in different times, places, and groups of people

Cluster C

avoidant, dependent, and obsessive-compulsive personality disorders

•Addictive behavior

behavior based on the pathological need for a substance

personality disorder

chronic interpersonal difficulties, problems with one's identity or sense of self, and an inability to function adequately in society causes either clinically significant distress or impairment in functioning and is manifested in at least two of the following areas: cognition, affectivity, interpersonal functioning, or impulse control

Dialectical behavior therapy (DBT)

cognitive and behavioral therapy specifically adapted for BPD

conscientiouness

competence, order, dutifulness, achievement striving, self-discipline, deliberation

Histrionic Personality Disorder

excessive attention-seeking behavior and emotionality Lively, dramatic, excessively extroverted styles; crave stimulation and attention May attempt to control partners through seductive behavior and emotional manipulation; also show a good deal of dependence Highly comorbid with borderline, antisocial, narcissistic, and dependent personality disorder diagnoses

openess to experience

fantasy, aesthetics, feelings, actions, ideas, values

consistent, objective

harder to diagnose- criteria defined by inferred traits or ______________ patterns of behavior, rather than by more _______________ behavioral standards

Cluster B

histrionic, narcissistic, antisocial, and borderline personality disorders

Borderline Personality Disorder

impulsivity and instability in interpersonal relationships, self-image, and moods unusually intense emotional responses to environmental triggers, slow return to a baseline emotional state highly unstable self-image or sense of self, and highly unstable interpersonal relationships suicidal self injury, reckless behavior, hallucinations high comorbidity, environmental factors

morphine

introduced in America around 1856; used to treat the wounded in the Civil War

opium

mixture of about 18 chemical substances known as alkaloids

heroin

more potent and acts more rapidly than morphine and is even more addictive

Five Factor Model

openness, conscientiousness, extraversion, agreeableness, neuroticism

Cluster A

paranoid, schizoid, and schizotypal personality disorders

insistence, therapeutic

people with personality disorder enter treatment only at someone else's ____________, Those with personality disorders (especially in Cluster A or B) may have difficulty forming a _________________ relationship

difficult, reducing, changing, behavior, personality

personality disorders are ___________ to treat, include _______________ subjective distress, ______________ specific dysfunctional behaviors, and changing whole patterns of _____________ or the entire structure of the ______________

all, increased, NPD, self

same 5 basic personality traits are found in ____ cultures, certain personality disorders have ____________ in American society, ______ more common in the west due to _____ -centered lifestyles

•Psychoactive substances

those that affect mental functioning in the central nervous system

agreeableness

trust, straightforwardness, altruism, compliance, modesty, tender-mindedness

Substance-related disorders

using substances in excessive amounts that result in impairment

extraversion

warmth, gregariousness, assertiveness, activity, excitement seeking, positive emotions

personality disorder diagnosed

when the person's enduring pattern of behavior or inner experience is pervasive and inflexible, as well as stable and of long duration

tarasoff, warn, public, efforts,

•1976 California court ruling in the case of Tarasoff v. Regents of the University of California et al. ("__________ decision") established "duty-to-warn" legal doctrine -Defendants were found not liable for failing to hospitalize the killer, but they were liable for failing to ______ the victim. -Court acknowledged importance of confidentiality in therapy relationship but stated that the protection privilege ends where ___________ peril begins. •Attempts to clarify therapist's legal responsibility; mixed results -1985 California law established that duty to protect is discharged if the therapist makes "reasonable" __________" to inform potential victims and law enforcement agencies of a pending threat -Much confusion today among mental-health practitioners about their responsibility with regard to the rules of their state under Tarasoff

hallucination, involved, delusions

•A ___________________ is a sensory experience that seems real to the person having it, but occurs in the absence of any external perceptual stimulus -Can occur in any sensory modality -Auditory are most common •Patients become emotionally _________________ with hallucinations -Incorporate them into _______________

caffeine, insomnia, nicotine, dependence, anxiety, weeks

•Addictions to these substances are included in DSM-5 •_____________ is addictive and commonly available in food and drinks -Caffeine-related disorder involves symptoms of restlessness, nervousness, _______________, and muscle twitching •____________ is chiefly found in tobacco and widely used -Can lead to nicotine-______________ syndrome -Often used to self-medicate ____________ disorders -Withdrawal symptoms usually continue for several days to several ________

use, age, mental

•Alcohol _____ disorder: use of alcohol even though there are detrimental effects associated with it •Cuts across all ____, educational, occupational, and socioeconomic boundaries •High comorbidity between alcohol use and __________ illness and other substance use disorders

resistance, forgetting, transference, neurosis, countertransference

•Analysis of resistance -During the process of free association or of associating to dreams, an individual may show ____________: an unwillingness or inability to talk about certain thoughts, motives, or experiences -Resistance may also be evidenced by the client's giving a too-glib interpretation of some association, coming late to an appointment, or even "________________" an appointment altogether •Analysis of transference -People often unconsciously apply (or "transfer") to their therapist attitudes and feelings that they had in past relationships: __________________ -Client's reliving of a pathogenic past relationship in a sense re-creates the neurosis in real life (transference _____________) -_________________________: therapist reacts in accord with the client's transferred attributions, rather than objectively

sensitivity, hospitalization, anxiety, overprotective, rejecting, patterns

•Anxious children often show an early sensitivity •Experience of trauma through _____________________- or violence •Parents can foster _________________ in children -If overanxious or _______________________ parents (the modeling effect) -If indifferent, detached, or ________________ •Cultural expectations and differences lead to different ____________ of anxiety in children

adhd, persistent, problems, IQ, boys, diagnosed

•Attention-deficit/hyperactivity disorder (_________) is characterized by persistent pattern of difficulties sustaining attention and/or impulsiveness and excessive or exaggerated motor activity •To meet the criteria, the problems have to be: -Numerous -__________________ -Causing _________________ at home, work, or school •Lower ____ scores and deficits in neuropsychological testing -Higher rate in ______ •Not the most prevalent, but the most frequently _______________

withdrawal, poor, irritability, 12%, girls, frequently, adhd

•Childhood depression is characterized by symptoms of sadness, ___________________, crying, __________ sleep and appetite, and in some cases thoughts of suicide or suicide attempts -_________________ is often a major symptom; can be substituted for depressed mood -About ______ of children and adolescents are diagnosed with depression -Higher rates in ______ than boys •Bipolar disorder occurs less _________________ but can be diagnosed in children and adolescents -May be comorbid with _____________

time, cult, immediate, proof, benefit, efficacy, BPD, TFP

•Classical psychoanalysis has been criticized for being: -Relatively _______‑consuming and expensive -Based on a questionable and _____-like approach to human nature -Neglectful of client's ______________ problems in search of past causes -Lacking adequate ____________ of effectiveness •Proponents argue that the approach may still be of _____________ -Newer, brief versions of psychodynamic-interpersonal therapies have shown some ______________ •Psychoanalytically oriented treatments are showing promise with ________ Transference-focused psychotherapy, or ______

children's, two, psychopathology, large, addresses

•Early diagnostic systems -No categories for ___________________ disorders -DSM-I included only ______ childhood disorders -Childhood disorders do not always have an adult ______________________________ •DSM-5 includes diagnoses for a ___________ number of childhood and adolescent disorders -All concerns from earlier versions of the DSM were ________________

common, single, psychosocial, works, empirically

•Efficacy, or RCT, studies of psychosocial treatments are increasingly ________________. -Focus on patients who have a _____________ DSM diagnosis -Involve two or more treatment or control conditions, where at least one of the treatment conditions is psychosocial •Efficacy studies of the outcomes of specific ________________ treatment procedures are considered the most rigorous type of evaluation that researchers have for establishing that a given therapy "____________" for clients with a given diagnosis. •Treatments that meet this standard are often described to be evidence based or ______________ supported.

distinguished, juvenile, externalizing

•Externalizing disorders need to be _________________ from illegal activity -______________ delinquency: legal term used to refer to violations of the law committed by minors -Breaking the law alone does not signify an _________________ disorder

dementia, split, multiple

•First clinical description appeared in 1810 •Emil Kraepelin (1896) used term ______________ praecox to refer to mental deterioration at early age •Eugen Bleuler introduced term "schizophrenia" in 1911 -From Greek meaning "to ______ or crack" and "mind" -Not the same as ____________________ personalities

whatever, contents, outlet, manifest, latent, disguised,

•Free association -Individual must say ______________ comes into her or his mind, regardless of how personal, painful, or seemingly irrelevant it may be -Purpose is to explore thoroughly the _____________ of the preconscious •Analysis of dreams -When a person is asleep, repressive defenses are said to be lowered, and forbidden desires and feelings may find an __________ in dreams. For this reason, dreams have been referred to as the "royal road to the unconscious." -A dream has two kinds of content: ▪(1) __________ content: the dream as it appears to the dreamer ▪(2) _________ content: the actual motives that are seeking expression but are so painful or unacceptable that they are ______________

comprehend, culpable, NGRI, legal, standard

•Fundamental principle in U.S. legal system that people who cannot ____________________ or control their criminal behavior should not be punished -If a mental disorder renders them unable to have this knowledge, then they cannot be considered ____________ in a crime -May use the insanity defense and plead not guilty by reason of insanity (_______) •Insanity is a ___________ term, not a clinical one -Person may have a mental disorder but not meet the legal ______________ for insanity

understand, 8, foreseeable

•In English common law, a person charged with a crime must be competent to stand trial, which means they must be able to ________________ the trial proceedings. •Recent research findings on the competence to stand trial defense concludes that: -defendants with a diagnosed psychotic disorder were approximately _________ times more likely to be found incompetent than defendants without a psychotic disorder. -half of defendants being evaluated for competency to stand trial were likely to be restored to competency in the ________________ future.

apparent, brief, occur, factors, adherence, competence

•In some instances, disturbed people improve over time for reasons that are not ________. -Some disorders have a specific, ________ course •Research suggests that psychotherapy can often accelerate improvement or bring about desired behavior that might not _________ otherwise. •Researchers are now actively exploring how certain ____________ impact how well a patient does: -Therapist _________________: how well a therapist delivers certain type of therapy -Therapist ___________________: how skillfully the therapist administers the therapy

right, compelled, defect, impulse, appreciate, insanity

•Legal precedents that define the insanity defense include: -The M'Naghten rule (1843): the "knowing ________ from wrong" rule -The irresistible impulse rule (1887): the person could not avoid doing the act in question because they were _____________ beyond their will to act -The Durham rule ("product test"): the person is not criminally responsible if their unlawful act was the product of mental disease or mental ______________ -The American Law Institute (ALI) standard (1962) aka the "substantial capacity test" for insanity: combines the cognitive aspect of M'Naghten with the volitional focus of irresistible ____________ -The Federal Insanity Defense Reform ACT (IDRA): abolished volitional element of the ALI standard and modified cognitive standard to read "unable to ________________"—definition is similar to M'Naghten's ▪Shifted burden of proof from prosecution to defense, who now must clearly and convincingly establish the defendant's __________

macrocephaly, microcephaly, hydrocephaly

•Macrocephaly (large-headedness) is an increase in the size and weight of the brain that results in an enlargement of the skull. •Microcephaly (small-headedness) is caused by decreased growth of the cerebral cortex, which results in a small head circumference. •Hydrocephaly is an accumulation of an abnormal amount of cerebrospinal fluid, causing damage to the brain.

sleeping, silent, fatal, tremors, severe

•Middle-aged and older persons are susceptible to dependency when using these drugs as "____________ pills" -Referred to as "_________ abusers" -Often combine with alcohol—can be ________ Treatments and Outcomes •Should withdraw slowly to minimize anxiety, apprehension, and ______________ of the hand and face •Withdrawal symptoms are more ___________ than those of opiate withdrawal

family, reinforcing, management, prosocial,

•Modifying the child's ___________ and broader environment to decrease problematic behaviors •Cohesive family model -Focus on ineffective parenting practices that may be ______________ the behavior •Parent ___________________ training •Reinforcing ________________ behaviors while ignoring aggressive or antisocial behaviors

all, four, GBMI, sentence, disappointing

•Most states and D.C. subscribe to a version of either the ______ or the more restrictive M'Naghten standard •________ states—Idaho, Kansas, Montana, and Utah—have eliminated the insanity defense •Other states have adopted the plea/verdict of guilty but mentally ill (________): a defendant may be sentenced but placed in a treatment facility rather than in prison -Person remains in the custody of the correctional department until the full _________________ has been served -Outcomes from the use of GBMI have been ________________

IM, commitment, relating, addiction, minorites

•Motivational interviewing (____) is a brief form of therapy that can be delivered in one or two sessions -Developed to help people who are ambivalent about change make a ____________________ to treatment -Supportive and empathic style of ______________ to the client -Origins in the work of Carl Rogers -Often used in the areas of substance abuse and ______________ -Effective with ethnic _______________

antipsychotic, help, discontinue, ill,

•Not all patients benefit from ______________________ medications •May show clinical improvement but still need _________ •Side effects may lead patients to __________________ taking the medication •Some patients may try to avoid taking medications because, to them, needing to take medications confirms that they are mentally _____

shooting, unsuccessfully, fake, unlikely, committmed

•Notable cases include: -John Hinckley: successfully used NGRI when tried for ______________ President Ronald Reagan and three others in 1980 ▪Rare outcome -Jeffrey Dahmer: _______________ used insanity defense to escape legal consequences (never actually heard voices, etc.) -Michael McDermott: unsuccessfully entered an NGRI plea (found to have researched how to _________ mental illness) •Concern by juries and general public that guilty defendants use NGRI as a "get out of jail free card," but in fact: -NGRI defense is highly ______________ to succeed -NGRI verdict means the person is automatically _______________ to a psychiatric institution (most states have no time limit)

valproic, researched, tegretol, valproate, abilify

•Other first-line drug treatments for bipolar disorder: __________ acid (Depakote) and carbamazepine (Tegretol) •Other drugs currently being __________________ and used clinically for rapid cycling bipolar disorders: gabapentin (Neurontin), lamotrigine (Lamictal), and topiramate (Topamax) -___________ has significant side effects; requires blood monitoring -________________ probably has the fewest and mildest side effects •____________, an antipsychotic medication, is also now being marketed for bipolar disorder

gambling, disruption, cultural, trauma, comorbid, gambler's

•Pathological ______________: -Is considered an addictive disorder -Involves behavior maintained by short-term gains despite long-term ________________ of a person's life •Contributing factors include: -____________ factors -Early _____________ -Genetics -Often ______________ with other disorders, like substance abuse •Treatment methods include cognitive-behavioral therapy and _____________ Anonymous

ventricles, tissue, volume, years

•Patients with schizophrenia have enlarged brain _______________ -Males more affected than females -Indicator of a reduction in brain ___________ •Decrease in brain _______________ is present very early in the illness •Progressive brain deterioration continues for many _______

aggressive, rejected, antisocial, inconsistent, stress

•Peer relationships -Children who are __________________ and socially unskilled are often _____________ by their peers -This rejection can lead to interactions with peers that exacerbate the tendency toward _________________ behavior •Family setting -Rejection, harsh and ___________________ discipline, parental neglect -Low socioeconomic status, poor neighborhoods, and parental _________ contribute to the cycle

PKU, both, reversible, brain, urinalysis

•Phenylketonuria (_____) is a rare metabolic disorder in which a missing liver enzyme prevents phenylalanine from being broken down. -1 out of every 12,000 births -_______ parents must carry the recessive gene. -The condition is __________________ (through controlling diet), but if it is left untreated, can lead to ________ damage. -Early detection can be achieved through ________________.

frontal, medial, abnormal, stage

•Reductions in the volume of regions in the ___________ and temporal lobes -More specifically, in the volume of __________ temporal areas: the amygdala, the hippocampus, and the thalamus •Brain structure is ________________, but the abnormality is linked to: -________ of illness -Use of medications Other factors

effective, downregulate, bilateral, anterograde, three

•Results indicate that ECT can be an ______________ treatment for patients with severe or psychotic-level depression, as well as for some patients with mania. •Every neurotransmitter system is affected by ECT, and ECT is known to __________________ the receptors for norepinephrine, increasing the functional availability of this neurotransmitter. •ECT can be administered in one of two ways: ___________ ECT and unilateral ECT. •Patients often have difficulty forming new memories (_________________ amnesia) for about _________ months after ECT ends.

SNRI's norepinephrine, cymbalta, effective, safe, 3-5, discontinue

•Serotonin and norepinephrine reuptake inhibitors (________) block the reuptake of both __________________ and serotonin. -Examples include Effexor and _______________ -Similar side effects to SSRIs and slightly more effective -Relatively _________ in overdose •Newest antidepressant (2011) is Viibryd (vilazodone) a novel combination of an SSRI and a serotonin receptor agonist. •Clinical trials with SSRIs indicate that patients tend to improve after about _________ weeks. Patients who show at least a 50 percent improvement in their symptoms are considered to have had a positive response to treatment. -Side effects (including nausea, diarrhea, nervousness, insomnia, and sexual problems) may be so extreme that people must _______________

cognition, impairments, hints, emotion

•Social ____________: how we recognize, think about, and respond to social information, including the emotions and intentions of others •People with schizophrenia show significant _________________ in social cognition -Failure to spot the kinds of subtle (or not so subtle) social ________ -Difficulty recognizing ____________ in faces and emotion being conveyed in speech

hypofrontality, challenging, early, temporal, coodinated

•Some patients show abnormally low frontal lobe activation (known as "_________________") when they are involved in mentally ________________ tasks •Impaired functioning of the frontal lobes is found in patients in the __________ stages of schizophrenia and in people at high risk for developing the disorder • Dysfunction of the _______________ lobes is also found -May be a problem with how activity in different brain regions gets ____________________

withdrawl, effective, ineffective

•Some users report having uncomfortable ______________-like symptoms such as nervousness, tension, and sleep problems when abstaining from marijuana use •Psychological treatment methods have been shown to be ______________ in reducing marijuana use in those who are dependent •Pharmacotherapy treatment has been largely __________________

cannabinoids, seizures, cathinones, bath, violence

•Synthetic _______________: substances that mimic the effects of THC (the active plant-derived substance in marijuana) -Can cause serious side effects such as anxiety, heart palpitations, and ___________ •Synthetic _______________: substances that mimic the effects of amphetamines and cocaine -Sold under the name "____ salts" -Produce motor activity agitation, ____________, psychosis-like effects, and heart problems

younger, psychopathy, lower, 80%, adults

•The _____________ CD develops, the greater likelihood of _______________ or antisocial personality as adults -Link is stronger among ___________-socioeconomic-class children -_______ of boys with early-onset CD continue to have multiple problems of social dysfunction as ________

MZ, predispose, more

•The focus on ______a concordance rates causes an overestimate of the heritability of schizophrenia -Chorionic arrangements could mean different environments -Around two-thirds of MZ embryos are monochorionic—share a placenta and blood supply •Genetic liability to schizophrenia may _________________ an individual to suffer _______ from the environment than those without the genetic predisposition

early, mature, prodomal, attenuated

•The stage is set for schizophrenia _________ in life -Problems may not appear until the brain is ____________ •Research focuses on those showing ______________—very early signs of schizophrenia •________________ psychosis syndrome is not part of DSM-5 as a disorder in need of further study

Child Advocacy Programs

•There are over 74 million people under the age of 18 in the United States. •Treatment and prevention programs for our society's children remain inadequate for dealing with the extent of psychological problems among children and adolescents. •Child advocacy programs attempt to secure services for children in need. •Today there is greater interdisciplinary involvement in attempts to provide effective advocacy programs for children.

connectivity, cognitive, volume, itself, genetic, dysconnectivity,

•White matter is crucially important for the ________________ of the brain -White matter abnormalities have been shown to be correlated with __________________ impairments •Patients have reductions in white matter _________________ as well as structural abnormalities in the white matter __________ -Abnormalities are found in first-episode patients and in people at __________________ high risk for the disorder -_______________________: abnormal integration between distinct brain regions, particularly those involving the frontal lobes

recieve, compensation, freedom, community, refuse, restrictive, psychotropic

•Wyatt v. Stickney (1972): a person with a mental illness or intellectual disability has the right to _____________ treatment •Souder v. Brennan (1973): a patient in a nonfederal mental institution who performed work must be paid according to the Fair Labor Standards Act (right to ___________________ for work) •Supreme Court case O'Connor v. Donaldson (1975): a patient has the right to _______________ from custodial confinement •Other court rulings regarding patients' rights: -Right to live in a _________________ upon release from a mental hospital -Right to __________ treatment -Right to less ______________ treatment (in facilities other than mental institutions) -Limitations on patients' rights to refuse __________________ medication

vulnerable, realistic, important, insurmountable, other

•Young children are especially __________________ to psychological problems -They do not have as complex and ______________ view of themselves and their world as they will have later -Immediate threats seem disproportionately more _______________ -Lack of experience makes manageable problems seem _______________________ They are more dependent on their ______________ people

civil, law, emergency, violated, refuse

•________ commitment procedure: the process through which an individual who has not committed a crime but is judged to be potentially dangerous because of their psychological state may be confined to a psychiatric hospital (or the psychiatric unit of a general hospital) -State _______ dictates the process; typically begins with filing a petition for a commitment hearing ▪______________ hospitalization without a hearing allowed in some cases -Safeguards exist to ensure person's civil rights are not ___________ •Once committed, the person may __________ treatment

ecstacy, mescaline, hours, seretonin, neurocognitive, substitutes

•__________ (MDMA) is both a hallucinogen and a stimulant •Chemically similar to methamphetamine and ______________ •Effects last for several ___________ •Triggers the release of _________________ and blocks its reuptake, causing feelings of euphoria, energy, and well-being •Associated with short- and long-term negative psychological and _______________________ consequences •An increased percentage of ecstasy pills do not actually contain MDMA, but ________________ that affect the CNS

family, relapses, structural, systems, differently, organization

•__________ therapy -Overlaps with couple and marital therapy -Developed from the finding that many patients who had shown marked clinical improvement after individual treatment had ________________ when returned to their families •______________ family therapy -Developed by Minuchin -Based on _______________ theory -Holds that if family context can be changed, individuals will have altered experiences in the family and will behavior _________________ -Goal is changing the __________________ of the family

ritalin, pemoline, accidents, stimulant, planning, adaptive

•___________ is a stimulant medication that quiets children and lowers their aggression. -Troubling side effects -____________, Straterra, and Adderall are alternative medications -Long-term benefits of stimulant medication includes lower rates of substance abuse, car _______________, and suicides -Misuse of ________________ medication •Behavioral interventions include: -Teaching the child organizational and _______________ skills and techniques for decreasing distractibility and procrastination -Teaching the parent techniques to reinforce ___________ behaviors

Enuresis, cerebral, neurological, sphincter, immaturity, family, preferable

•___________ refers to the habitual involuntary discharge of urine, usually at night, after age of expected continence (5 years) -Estimates of prevalence are 5 to 10% among 5-year-olds, 3 to 5% among 10-year-olds, and 1.1% among children ages 15 or older •May result from a variety of organic conditions, including: -Disturbed _______________ control of the bladder -__________________ dysfunction -Side effects of medication -Having a small functional bladder capacity or weak urethral _____________ -Other possible factors: faulty learning; personal _________________; disturbed ____________ interactions and relationships; stressful events •Decreases with age, but childhood treatment still _________________

Marajuana, mild, hashish, quality, past, setting

•____________ comes from the leaves and flowering tops of the hemp plant, Cannabis sativa •Considered a ________- hallucinogen; results in mild euphoria •Related to a stronger drug, __________ EFFECTS OF MARIJUANA •Effects vary greatly depending on: -Quality and dosage -User's personality and mood -User's _______ experiences with the drug -Social ___________

autism, motor, social, objects, eyes

•____________ spectrum disorder is a neurodevelopmental disorder that involves a wide range of problematic behaviors, including language and perceptual and ____________ development; defective reality testing; and impairments in _____________ communication. •Infants later diagnosed with autism show an increased focus on inanimate ________________ and a decreased focus on others' ________.

cocaine, crack, dopamine, 4-6, contentment, psychotic

•_____________ is a plant product discovered in ancient times -Once very expensive, it became more affordable and experienced widespread use -"_________" cocaine (processed from cocaine hydrochloride to a free base for smoking) is much cheaper EFFECTS OF COCAINE ABUSE •Increases the availability of _____________; creates a ______ hour euphoric state •Experienced as feelings of ____________________ and confidence •Acute toxic _______________ symptoms may result from chronic abuse

behavior, exposure, anxiety, guided, desensititzation, flooding, vivo, imaginal

•_____________ therapy: a direct and active treatment that recognizes the importance of behavior, acknowledges the role of learning, and includes thorough assessment and evaluation _____________ THERAPY •Widely used in the treatment of _____________ disorders •Involves ___________ exposure to anxiety-provoking stimuli -Can be accomplished slowly (systematic ______________) or quickly (_____________) -Form of exposure can be real (in _________ exposure) or imaginary (______________ exposure); in vivo exposure tends to be more effective

barbiturates, downers, CNS, overdose, damage

•______________ are known as "______________"—act as depressants to slow down the action of the _______ •High risk of tolerance, ______________, and addiction •Can lead to brain _______________ and personality deterioration

conduct, clinical, comorbidity, girls, antisocial

•______________ disorder (CD) is characterized by persistent, repetitive violation of rules and disregard for rights of others •Variability in _______________ presentation •___________________ with other disorders (e.g., substance abuse disorder) •Increases risk of pregnancy and substance abuse in ______ and later development of __________________ personality disorder

gestalt, blocking, awareness, group, one, aspects

•______________ means "whole" in German; gestalt therapy emphasizes the unity of mind and body—need to integrate thought, feeling, and action -Developed by Frederick (Fritz) Perls (1969) as a means of teaching clients to recognize the bodily processes and emotions they had been _________________ off from awareness -Goal is to increase the client's self-________________ and self-acceptance -Commonly used in a _____________ setting but emphasizes ______ person at a time -Dreams are considered representations of unacknowledged ____________ of the dreamer's self

delusions, content, external, broadcast, one, organs

•_______________ are an erroneous belief that is fixed and firmly held despite clear contradictory evidence -Disturbance in the _______________ of thought •Examples: -Being controlled by _______________ agents ▪Private thoughts are being __________________ to others ▪Thoughts have been inserted by external agency ▪Thoughts withdrawn by external agency -Neutral environmental event (T.V., radio) have special meaning intended for _____ person -Delusions of bodily changes or removal of _______________

learning, dyslexia, researched, tension

•_______________ disorders are delays in cognitive development in the areas of language, speech, mathematical, or motor skills that are not necessarily due to any demonstrable physical or neurological defect -Clear impairment in school performance or daily activities •In _______________, the individual has problems in word recognition and reading comprehension; often, they are markedly deficient in spelling and memory as well -Best known and most widely ____________________ •Children with learning disorders can experience deep emotional ______________ under normal learning circumstances

positive, negative, expressive, alogia, motivatoins, avolition,

•_______________ symptoms excess or distortion in normal behavior and experience •_______________ symptoms reflect an absence or deficit of normally present behaviors -Two domains -Reduced ______________________ behavior ▪Voice, facial expression, speech ▪Blunted or flat affect, or ____________ (little speech) -Reductions in ____________________ or experience of pleasure ▪_____________: the inability to initiate or persist in goal-directed activity -Presence of negative symptoms is not a good sign

encopresis, boys, constipation, conditioning

•________________ describes a symptom disorder of children who have not learned appropriate toileting for bowel movements after age 4 •More common in __________ than girls •Many children suffer from ____________________, so an important element in the diagnosis is a physical examination •Treatments including medication and ___________________ procedures have reported moderate success

seperaton, self, immature, away, based

•_________________ anxiety disorder is excessive anxiety about separation from major attachment figures, such as their mother, and from familiar home surroundings -Lack _____-confidence, are apprehensive in new situations, ______________ for their age -Slightly more common in girls than in boys; with time, the disorder may go _____________and on its own -More likely to also experience other anxiety-__________ disorders, such as phobia and obsessive-compulsive disorder

expressed, EOI, high, brain

•_________________ emotion (EE): a measure of the family environment based on how a family member speaks about the patient during a private interview with a researcher -Three main elements: criticism, hostility, and emotional overinvolvement (______) •__________-EE home environment more than doubles the chance of a relapse -Especially strong for chronically ill patients •Researchers are still trying to understand how EE affects the _________

psychodynamic, psychoanalysis, association, dreams, resistance, transference

•_________________ therapy: a broad treatment approach that focuses on individual personality dynamics, usually from a psychoanalytic or psychoanalytically derived perspective FREUDIAN ___________________ •Four basic techniques: -Free __________________ -Analysis of _____________ -Analysis of __________________ -Analysis of ___________________

oppositional, 6, argumentative, conduct, antisocial

•___________________ defiant disorder (ODD): recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures that persists for at least ____ months -Subtypes: ▪Angry/irritable mood ▪____________________/defiant behavior ▪Vindictiveness •Often develops into _______________ disorder -Risks include family discord, socioeconomic disadvantage, parental _______________ behavior

intellectual, intelligence, 18

•___________________ disability is characterized by deficits in general mental abilities, such as reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience -Also called intellectual development disorder •Defined by _______________________ and level of performance •Onset prior to age ______

developmental, maladaptive, adolescence, adulthood

•____________________ psychopathology focuses on determining what is abnormal at any point in the developmental process •No sharp line of demarcation between the __________________ behavior patterns of childhood and those of ______________ or between those of adolescence and those of ________________

methadone, naltrexone, CBT, contingency, decreases

•_____________________ and _________________ reduce cravings •_________ and ____________________ management approaches are effective for cocaine dependence •Psychological treatments are associated with ________________ in cocaine use as well as a range of other problems

neurodevlopmental, disruptions, childhood, significant, adulthood

•______________________ disorders are a group of conditions characterized by an early onset and persistent course that are believed to be the result of __________________ to normal brain development. -They differ from anxiety and depression in that they must have their onset during __________________. -They differ from ODD and CD in that they are believed to be the result of ___________________ delays or disruptions in brain development that persist into _____________________ (with a few exceptions).

amphetamines, methedrine, hazardous, speech, scarce, slow

•________________________ are psychologically and physiologically addictive; chronic use leads to tolerance -________________ ("speed") is a potent stimulant of the CNS—can be lethal EFFECTS OF AMPHETAMINE ABUSE •Not an energy source—pushes users toward greater expenditures of their own energy; can cause _______________ fatigue •Side effects include excitability, profuse sweating, rapid/unclear ________, sleeplessness, tremors, loss of appetite, confusion TREATMENTS AND OUTCOMES •Research on the effectiveness of various treatments is ____________; _______ withdrawal from the drug is encouraged

institutionalization, mainstreaming

•____________________________ should be seen as a last resort and only for those with severe intellectual disability. •_________________ is when a child attends regular classes much of the day. This is intended for those with mild impairments.

psychosis

•significant loss of contact with reality -Hallmark of schizophrenia