Comlex Psychiatry

IQ for severe ID

20-35

what percent of autism become semiindependent adults

30%

IQ for moderate ID

35-50

IQ for mild ID

50-69

symptoms for ADHD last at least_____ and occur before _____

6 months, 12 years olf

Mild ID has academic skills of what grade

6th grade

ID is present in ______% of ASD

75%

intellectual disability age of onset

< 18

IQ for profound ID

< 20

what has the following symptoms: short attention span constant fidgeting inability to sit through cartoons/meals inability to wait in lines no quiet/still in class disobedience shunning by peers fighting poor academic performance carelessness poor relationships with siblings

ADHD

family history in ADHD:

ADHD mood/anxiety substance abuse antisocial personality disorder

Autism spectrum disorders cause

CNS damage due to known/unknown factors

defense mechanisms, judgement, relationship to reality, object relationships, developed shortly after birth

Ego

ddx for autism

ID hearing impairment environmental deprivation selective mutism Rett syndrome

diagnostic tests for ADHD

IQ and structured symptom rating scales for teachers and parents

diagnostic tests for learning disorders

IQ testing and academic achievement tests

equation for IQ: IQ=

IQ= MA/CA x 100

type of ID where person attains academic skills to 6th grade level, lives independently or with supervision, problems with impulse control/self esteem, associated conduct disorder, ADHD

Mild ID 50-69

physical findings in autism

^ incidence abnormal EEGs seizures abnormal brain morphology

autism spectrum disorders definition

a group of disorders characterized by problems with social interaction, behavior, and language

what is blocking

a temporary block in thinking "i have known him for years but can never seem to remember his name"

communciation symptoms in autism

absent or bizzarre use of speech

behavioral or emotional outburst

acting out

ADHD differential

age appropriate behavior response to environmental problem ID ASD mood disorder

diagnostic tests for ID

amniocentesis

reaction formation:

an unacceptable impulse is transformed into its opposite, results in formation of character traits

in the mental status exam, the general description of the patient includes:

appearance behavior attitude toward examiner

autism predictors of poor outcome

associated ID failure to develop useful speech

what is projection

attributing your own wishes, thoughts, or feelings on to someone else

age onset for ASD

before 3

what does Stanford Binet measure

child IQ

this question asks for specific information without allowing options in answering

closed ended question "are you hearing voices"

ID is measured by IQ tests < 70 and must be accompanied by

concurrent impairment in adapting to demands of school, work, social, and other environments

persistent violantions over 6 months in 4 ares of : aggression, property, destruction, deceit/theft, rules

conduct disorder

interviewing technique where you point something out to the patient

confrontation "you seem very upset today"

used to avoid becoming aware of some painful aspect of reality

denial

an emotion or drive is shifted to another that resembles the original aspect

displacement

what is splitting off of the brain from conscious awareness

dissociation

medical conditions associated with ASD

encephalitis maternal rubella PKU tuberous sclerosis fragile X perinatal anoxia

learning disorder differential

environmental deprivation hearing/vision impairment ID

risk factors for ID

errors of metabolism chomosomal abnormalities intrauterine infections intrauterine toxins postnatal exposure to toxins/malnutrition poor prenatal care post natal metal exposure trauma socialdeprivation

physical exam for ID shows

evidence of underlying disorder or injury

what is it called when

external objects are divided into all good or all bad

what is splitting

external objects are divided into all good or all bad

this type of interviewing technique helps the patient continue by providing verbal and nonverbal cues

facilitation "yes, please continue"

autism tx

family counseling special ed antipsychs for agitation/destructive behavior

what is introjection

features of the external world are taken and made part of the self

permits the expression of feelings and thoughts without personal discomfort

humor

what component of ADHD diminishes with adulthood

hyperactivity

excessive use of intellectual processes to avoid affective expression or experience

intellectualization

features of the external world are taken and made part of the self

introjection

what is separation of an idea from the affect that accompanies it

isolation

social symptoms in autism

lack of peer relationships, no nonverbal social cues

risk factors for learning disorders

lead poisoning FAS

interviewing technique in which you provide the answer in the question

leading "are the voices telling you to hurt yourself"

learning disorder:

learning achievement in specific areas that is substantially below expectations, given the patient's age, intelligence, sensory abilities, educational experience

what has the following symptoms: 5% of school age children onset in elementary school perceptual motor problems conduct disorder, oppositional defiant, ADHD poor self esteem and social immaturity school failure/behavioral disturbance

learning disorder

ID ddx:

learning/communication disorders sensory impairment autism spectrum disorder borderline intellectual functioning (IQ 70-100) environmental deprivation

male or females have ADHD

males 2:1 in children and 6:1 in adults

more males or females with autism

males 5:1

intellectual disability used to be called

mental retardation

in conjunction with the history, the ________ is the best way to make an accurate diagnosis

mental status exam

pharmacotherapy for ADHD

methylphenidate/dextroamphetamine atomoxetine andidepressants clonidine

attains skills of second grader, can manage ADLs, work in shltered workshops, live in homes, problems with social norms

moderate ID 35-50

what is difference between mood and affect

mood: emotions perceived by patient (depressed/angry) affect: patient's present emotional responsiveness (flat)

to measure personality, _______ tests use simple stimuli, do not need much clinical experience

objective

the Minnesota Multiphasic Personality Inventory (MMPI) is a

objective personality test

learning disorders can persist into adulthood and interfere with

occupational function

this type of question allows the patient to speak in his own words as much as possible

open ended question "can you describe your pain"

problems in ADHD on physical exam

perceptual: motor problems and poor coordination

tx for ID

primary prevention (genetic counseling) prenatal care safe environments' tx medical conditions special ed behavioral guidance

attributing your own wishes, thoughts, or feelings on to someone else

projection

to measure personality, _______ tests use ambiguous stimuli, need clinical experience, are not diagnostic

projective

rational explanations are used to justify unacceptable attitudes, beliefs, or behaviors

rationalization

what defense mechanism results in formation of character traits

reaction formation

what is it called when an unacceptable impulse is transformed into its opposite

reaction formation

most common learning disorder

reading

types of learning disorders

reading, math, written expression

return to an earlier stage of development

regression

what is the most immature defense mechanism

regression

behavioral symptoms in autism

repetitive activities mannerisms ritual

an idea or feeling is witheld from consciousness, unconscious forgetting

repression

repression vs suppression

repression: unconscious forgetting suppression: conscious forgetting

example of projective personality tests:

rorschach (inkblot) thematic apperception (tat) sentence completion tests family drawings

common associated problems with ADHD

self esteem mood lability conduct disorder learning disorders clumsiness communication drug abuse school failure physical trauma from impulsivity

isolation

separation of an idea from the affect that accompanies it

little or no speech, limited abilities to manage self-care, require highly supervised care setting

severe/profound ID

2 most important dives (instincts) that make up the Id

sex & aggression

when is the Ego developed

shortly after birth

psychic derivatives are converted into bodily symptoms

somatization

tx for learning disorders

special education counseling patients and families

impulse gratification has been achieved, but the aim or object has been changed from unacceptable to acceptable; allows instincts to be channeled. most mature of all defenses.

sublimation

what is the most mature of the defenses

sublimation

conscience, empathy, and morality are formed during latency period, right vs. wrong

superego

which defense mechanism is conscious

suppression

what is the only conscious defense mechanism:

suppressioon

ADHD tx

tx symptoms structure at home/ environment sensory modalities reinforcementstimulants atomoxetine (non stimulant) antidepressants clonidine

acting out the reverse of an unacceptable behavior, consists of an act

undoing

name of adults IQ test

wechsler adult intelligence scale revised (WAIS-R)

what is the name of the childrens IQ test

wechsler intelligence scale for children revised (WISC-R), stanford binet