psyc exam 4
borderline personality disorder DSM-V 5 or more
frantic efforts to avoid (real or imagined) abandonment -very sensitive to environmental circumstances -driven by this deep-seated perception of being a bad person a pattern of unstable and intense interpersonal relationships -will go to great lengths to get someone to stay identity disturbance (unstable self-imagine or sense of self) impulsivity recurrent suicidal behavior or threats, or self-mutilating behavior affective instability -rapid shifts in emotions (anxiety, anger, irritability, etc.) -shifting from holding someone on a pedestal to hating them chronic feelings of emptiness inappropriate intense anger or difficulty controlling anger transient, stress-related paranoid ideation or severe dissociative symptoms -not to severity that would warrant a stand-alone diagnosis
ADHD etiological explanations
generally considered to have several interacting causes diet biological high levels of stress and family dysfunctioning
biological views of drug use disorder
genetic predisposition neurotransmitters brain circuits incentive-sensitization theory
treatment of avoidant personality disorder
go to treatment to gain acceptance similar to treatment of social anxiety disorder and anxiety in general group therapy provides practice in social interactions anti anxiety and antidepressant drugs are sometimes helpful -once you stop taking them though there is a high likelihood that the symptoms will come back
applied behavior analysis (autism)
gold standard goals: increase behaviors that are helpful and decrease behaviors that are harmful and/or adversely affect learning intensive behavior modification using operant conditioning techniques focus on specific symptoms: communication deficits, lack of self-care skills, and self-stimulatory or self-destructive behavior emphasizes very specific and small goals
narcissistic personality disorder
grandiosity, need for admiration, and lack of empathy approximately 6.2% of U.S. adults; affects up to 75% of men theoretical explanations -emphasis on the importance of childhood -focus on cold, rejecting parents (increased risk for developing this disorder); focus on grandiose self-presentation; self-sufficiency replaces warm relationships (psychodynamic) -treated too positively in early life; overvalue self-worth (cognitive-behavioral) -->not receiving balanced feedback/not being held accountable for misbehavior can lead a person to develop this overvalued sense of self-worth
homeless schizophrenia patients
great number of people suffering from schizophrenia become homeless -approximately one-third of the homeless people in America have a severe mental disorder, commonly schizophrenia -->often, we see: premature discharge, inadequate follow up treatment, and inadequate or no option for housing
cognitive behavioral techniques for drug use disorder
aversion therapy contingency management relapse-prevention training acceptance and commitment therapy
if a person primarily fears close social relationships, one would MOST likely conclude that the person is experiencing:
avoidant personality disorder
conventional antipsychotic drugs
developed throughout the 1960-1980s also known as neuroleptic drugs because often produced undesired movement effects similar to symptoms of neurological diseases
assessing adaptive functioning
diagnosticians cannot rely solely on a cutoff IQ score of 70 to determine whether a person has an intellectual disability adaptive functioning -conceptual (academic) -->focusing on confidence in several areas -social -practical (financial management, personal care)
Jonah is receiving weekly individual and group therapy for BPD. He is learning to recognize when his emotional expression is appropriate. He is receiving:
dialectical behavioral therapy
synergistic effects
difference drugs are in the body at the same time, they may multiply, or potentiate each other's effects -the synergistic effect is often greater than the sum of the effects of each drug taken alone -similar actions --> 2 or more drugs have similar actions -opposite (antagonistic) effects --> 2 or more drugs have opposite effects
short-term consequences of LSD
difficult to study empirically/scientifically because they are based primarily on subject experience
according to psychodynamic theorists, an important factor in the development of avoidant personality disorder is:
early experiences of shame
psychosocial treatment for schizophrenia
early psychotherapeutic treatment rare prior to emergence of antipsychotic drugs today, psychotherapy is more successful in schizophrenia treatment -should be in conjunction with medication -cognitive behavioral therapies -sociocultural interventions: family therapy and social therapy cognitive-behavioral therapies social therapy family therapy the community approach
one speech problem displayed by many children with autism spectrum disorder is that they repeat everything said to them. This is called:
echolalia
phencyclidine
effects are very different from the others originally a painkiller small doses can cause numbness, warmth, sensation , and relaxation higher doses induce psychotic behaviors, delusional thinking, and sudden/drastic mood changes
personality traits
enduring patterns of perceiving, relating to, and thinking about the environment and oneself -these are flexible -when they become inflexible they are maladaptive and problematic; cause distress
caffeine effects
enhances physical stamina and reduces fatigue -gives more energy can disrupt mood, fine motor movements (especially hands), reaction time, and sleep (especially if taken late at night) increases gastric acid secretions and breathing rates at high doses
histrionic personality disorder
excessive emotionality and attention seeking; pervasive ~3.6% of U.S. adults theoretical explanations -unhealthy relationships with cold, controlling parents in childhood; feelings of being unloved and fear of abandonment (psychodynamic) -->learned to behave dramatically to gain attention -->learned to create cases that force attention -sense of helplessness fuels search for others to meet needs (cognitive-behavioral) -partially influenced by cultural norms or expectations (socially-cultural perspective)
what is the most common use of opioids
injection because it brings the "rush" followed by several hours of not so great feelings
borderline personality disorder
instability of relationships, self-image, and affects close relatives of individuals with BPD are FIVE TIMES more likely to have this condition than those in the general population 35% of identical twins have also been demonstrated to have the condition themselves approximately 5.9% of U.S. adults 75-80% of those diagnosed are women greater likelihood of diagnosis in early adulthood -neglected, rejected, verbally abused, divorce, death, traumas -early sexual abuse: 4x more likely to develop, BPD but most do not -childhood trauma theoretical explanations -lack of early acceptance by parents or abuse (especially sexual)/neglect by parents (psychodynamic) -->importance of early parent childhood relations -low serotonin levels -->poor impulse control & aggressive behaviors -genetic predisposition -->close relatives of those with BPD are 5x more likely to have this condition -abnormal brain structure/circuitry activity -biological ideas; overall reactive amygdala
Milieu therapy
institutions create a social climate that promotes productive activity, self-respect, and individual responsibility for those with schizophrenia live in therapeutic community of respect, support, and openness deemed to be moderately successful still very prevalent in institutions today, especially in the western world
according to the DSM-V, people receive a diagnosis of IDD when:
intellectual functioning is well below average -confirmed by both clinical assessment and individualized, standard intelligence testing -IQ must be 70 or lower deficits in adaptive functioning that results in failure to meet developmental and sociocultural standards for personal independence and social responsibility symptoms must appear before age 18
concerns with token economy approach
is it ethical not controlled so is it effective the majority of research has been done in uncontrolled studies the transition into outside life will be difficult
causes of autism: psychological causes
people with autism have a central perceptual or cognitive disturbance -fail to develop a theory of mind: fail to appreciate that other people have a point of reference that differs from their own -"mind blindness" -ex: if I hide a toy in another room, I won't understand why my sister goes to look where she last left it and not in that room deficiencies in joint attention -joint attention: when we are sharing focus with other people
features of autism
persistent deficits in social communication and social interaction across multiple contexts restricted repetitive patterns of behavior, interests, or activities range of behavioral symptoms odd responses to sensory stimuli self-injury behaviors
dependent personality disorder
pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation fears are obsessive and unrealistic, not supported by evidence affects <1% of the population; equal incidence among males and females often rely on others to make even the smallest of decisions; overly clingy and obedient; lonely and lack of self-confidence difficulty with separation from loved ones -fears of having to take care of self -when one relationship ends they frantically look for the next relationship theoretical explanations -psychodynamic (similar to depression) -->unresolved conflicts during oral stage -->early parental loss or rejection prevents normal attachment and separation -->over involvement or overprotection can lead to dependency -behavioral -->unintentional rewarding the clinging and loyal behavior -cognitive -->maladaptive cognitions -->thoughts tied around inadequacy and helplessness
women who drink alcohol during pregnancy
place their fetuses at risk from fetal alcohol syndrome
combination of substances
polysubstance abuse cross-tolerance synergistic effects
factors responsible for recovery of schizophrenia patients
poor coordination of services -failure of communication between and within community mental health providers and agencies shortage of services -less funding for people with severe mental health disorders
hallucinogens
psychedelic drugs produce powerful changes primarily in sensory perceptions (sometimes called "trips) -relatively low dosage hallucinogens produce hallucinations -their molecular structure is very similar to the molecular structures of neurotransmitters (norepinephrine and serotonin)
treatment of dependent personality disorder
psychodynamic -transference of dependency needs onto the therapist -key piece: develop independence; the patient is then motivated to accept responsibility cognitive-behavioral -combination of interventions -assertiveness training to advocate for self, say no, communicate -challenge and change incompetence and helplessness assumptions biological -antidepressant medication when disorder is comorbid with depression group therapy format -for someone who struggles with making decisions and setting boundaries
sociocultural therapies for drug use disorder
psychological problems emerge in a social settings na best treated in a social context self help programs -most common: Alcoholics Anonymous --> offers peer support along with moral and spiritual guidelines to help people overcome alcoholism --> abstinence from drinking is the goal, not control of drinking habits -narcotics anonymous --> in a community setting or residential programs culture and gender sensitive programs community prevention programs - BEST, IDEAL TREATMENT is prevention --> some argue for complete abstinence; some teach people how to use substances in a responsible manner --> can focus on families, peers, incorporated in schools, etc.
the schizoid personality disorder differs from paranoid personality disorder in that:
those with schizoid PD desire to be alone; those with paranoid PD are alone because of suspiciousness
biological view: neurotransmitters (drug use disorder)
tied to drug tolerance and withdrawal when a certain drug is ingested, it increase the activity of certain transmitters -the body doesn't have to produce these NT's then decreases considerably and when stopping the substance, a person is likely to experience withdrawal caused by a reduction in the brains production of particular NT's during excessive and chronic drug use lower GABA production: alcohol and benzos (excessive use) lower endorphin production: cocaine or amphetamines reduced anaandamide production: marijuana
tolerance and withdrawal of alcohol
tolerance increases consumption levels variety of withdrawal symptoms -can be fatal -ex: nausea and vomiting -delirium tremens: condition that involved confusion, cloud of consciousness, and also produces scare visual hallucinations
percentage of people addicted to pain relievers
80%
new antipsychotic drugs: second-generation
"atypical" -biological operation differs from that of conventional antipsychotics -received at fewer dopamine D-2 receptors; more D-1, D-4, and serotonin receptors than the others -->distinct biological differences from the conventional -appears at least as effective, often more effective than first-generation agents, especially for negative symptoms -cause fewer extrapyramidal side effects; less severe -dosage level must be monitored: carries a risk of agranulocytosis, a potentially fatal drop in white blood cells -may cause substantial weight gain in a short period of time, dizziness, and significant elevations in blood sugar
a blood alcohol concentration of _____ precent typically produces the symptoms of intoxication
0.09
antisocial personality disorder DSM-V criteria require 3 or more of the following:
1) failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest 2) deceitfulness 3) impulsivity or failure to plan ahead 4) irritability and aggressiveness, as indicated by repeated physical fights or assaults 5) reckless disregard for the safety of self or others -driving behind the wheel while under the influence 6) consistent irresponsibility -not showing up to work 7) lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another -remorse is tied to "I got caught"; no mention of the victim
LSD prevalence
15% of U.S. population use at some point in their lives current users: ~0.5% (1.2 million people)
percentage of individuals that receive treatment for substance abuse disorder
18%
alcohol prevalence rates
2 billion people worldwide consume alcohol more than half of U.S. residents drink alcoholic beverages middle schoolers: 23% report some use high school seniors: 33% drink monthly; 1.3% drink daily college students: 38% engage in monthly drinking binges -males: 5 drinks in 2 hours -females: 4 drinks in 2 hours
percentage of people addicted to heroin
20%
MDMA (ecstasy)
3,4-Methylenedioxymethamphetamine ecstasy, X, love drug, beans, Molly -energy boost, feelings of connectedness, lasts for several hours, distortion in perceptions can cause confusion, depression, anxiety, paranoid thinking -can continue weeks after ingestion synthetic amphetamine derivative that produces hallucinogenic effects reduces sweat -can bring hypothermia or a heat stroke could be classified as a stimulant
amount of people with schizophrenia who do not receive treatment?
40-60%
where do people obtain painkillers for nonmedical use?
41% free from friend or relative 36% prescribed by physician 13% bought or stolen from friend or relative 5% bought from dealer, 5% other
Causes of moderate, severe, and profound IDD: chromosomal
46 chromosomes, 23 pairs the most common chromosomal disorder: Down syndrome -fewer than 1 of every 1,000 live births but this rate increases exponentially when the mothers age is over 35 -several types of chromosomal abnormalities may cause down syndrome, but the most common is trisomy 21 ("floating chromosome") -physical features: protruding tongue, flat forehead fragile X syndrome: second most common chromosomal cause -tied to a full mutation of the FMR1 gene klinefelter syndrome (XXY syndrome): males only -primary features are infertility and small testicles -often, symptoms may be subtile, and many men do not realize they are affected turners syndrome: females only -X chromosome is either missing or partially missing -most common features are a short stature and early loss of ovarian function
percentage of teens and adults in U.S. that have a substance use disorder
7.8%
what is the most effective ADHD treatment program?
drugs, combined with cognitive-behavioral therapy, work best
statistical deviation of intelligence
IQ tests have been found to be very biased, especially in the verbal scores (sociocultural bias)
A patient at an alcohol rehabilitation center tell you a detailed story about growing up in the mountains of Tennessee. Later, you find out that the person has never been visited Tennessee. A day later, you visit the patient again, and the patient does not recognize you. This patient is MOST likely suffering from:
Korsakoff's syndrome
institutional approaches for schizophrenia
Milieu therapy Token economy
The major active ingredient in cannabis is
Tetrahydrocannabinol (THC) higher THC = the more powerful the substance potency influenced by environmental conditions produces a mixture of hallucinogenic, depressant, and stimulant effects, known as cannabis intoxication
population of U.S. residents that use meth
U.S. residents older than age 11: used at least once by 6% of the population
Chlorpromazine (Thorazine)
a first generation antipsychotic drug tested on patients with psychosis -sharp symptom reduction -1st antipsychotic approved to be put out for sale
neurodevelopment disorders
a group of conditions with onset in the developmental period -may manifest at birth or very early childhood characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning -could be very specific, to very global -also behavior, ability to learn, planning, judgement, etc.
attention-deficit/hyperactivity disorder (ADHD)
a pervasive pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development ~3-7% of the childhood population and ~2-5% of the adult population -lessening of the symptoms in adolescents often overly diagnosed -individuals must undergo comprehensive evaluation tests among children the gender ratio is approximately 3:1 with boys more likely to have the disorder than girls approximately 50% of children with ADHD struggle with a variety of comorbid issues: -learning or communication problems -poor school performance -difficulty interacting with other children -misbehavior -mood or anxiety problems
neuroleptic malignant syndrome
a severe, potentially fatal reaction -symptoms include muscle rigidity, fever, altered consciousness, and improper functioning of the autonomic nervous system -as soon as the syndrome is recognized, drug use is discontinued and each symptom is treated medically and accordingly -individuals may also be given dopamine-enhancing drugs
different faces of narcissism: negative features
abrasive and exploitative disliked by others (but they may not care) interpersonal problems mood fluctuations (especially anger) do not value empathy, compassion, or ability to compromise
schizotypal personality disorders
acute discomfort with and reduced capacity for close relationships, accompanied by cognitive or perceptual distortions and behavior eccentricities 3.9% of U.S. adults; slightly more common in men than in women theoretical explanations -symptoms are often linked to family conflicts and psychological disorders in parents -linked to some of the same biological factors found in schizophrenia (ex: high dopamine activity)
opioid use
affects 2.6 million people in the U.S. within a given year -20,000 people are dying each year
Causes of moderate, severe, and profound IDD: childhood problems
after birth, particularly up to age 6, certain injuries and accidents can affect intellectual functioning
opioid use disorder example: heroin
after just a few weeks -users may become caught in a pattern of abuse (and often dependence) -builds up tolerance of the amount they use long-term high dose -chronically lethargic and lose motivation to remain productive -life revolves around heroin use users quickly build a tolerance for the drugs and experience withdrawal when they stop taking it -auditory, visual sensitivity, positive mood for brief moment (not long lasting) -persons unpleasant feelings are only relieved for 30-60 minutes after injection early withdrawal symptoms -include anxiety, restlessness, and agitation (6-12 hours after the last dose) -later symptoms included twitching, aches, fever, vomiting, and weight loss from dehydration
Three most widely used depressants
alcohol sedative/anxiolytic/hypnotic drugs opioids
class designations for substance abuse
alcohol: intoxication, withdrawal, alcohol use disorder cannabis stimulant caffeine: does not quality as a substance induced disorder tobacco inhalant sedative/anxiolytic/hypnotic opioid phencyclidine
contingency management
an approach based on behavioral principles of operant conditions -individual is receiving incentives for every negative urine test -moderately effective -important that contingency management programs are incorporated within a larger treatment approach and not the main focus
aversion therapy
an approach based on classical conditioning principles -widely used -idea is to repeatedly present individual with unpleasant stimulus at the moment he or she takes substance -patients is expected to reach negatively to substance itself after conditioning thus reducing craving
treatment of schizophrenia
antipsychotic drugs psychosocial treatment
drug
any substance other than food affecting our bodies or minds -doesnt need to be illegal
moderate, severe, and profound IDD
approximately 10% of persons with IDD function at a level of moderate IDD (IQ 35-49) -they can care for themselves and benefit from vocational training approximately 3-4% of persons with IDD display severe IDD (IQ 20-34) -they usually require careful supervision and can perform only basic work tasks about 1-2% of persons with IDD fall into the category of profound IDD (IQ below 20) -with training, they may learn or improve basic skills, but they need a very structured environment severe and profound levels of IDD often appear as part of larger syndromes that include severe physical handicaps
mild IDD
approximately 80-85% of all people with intellectual disability fall into the category of mild IDD (IQ 50-70) -intellectual performance seems to improve with age research has linked mild intellectual disability mainly to sociocultural and psychological causes -poor and unstimulating environments, inadequate parent-child interactions, insufficient learning experiences, malnourishment
one reason that the personality disorders are difficult to treat is that the afflicted individuals:
are frequent unaware that they have a problem
dangers of cannabis
as the potency of the drug has increased, so have the risks of using it -types today are significantly more potent; some are 4x more powerful than the marijuana available in the 70s because of its sensorimotor effects... -linked to poor concentration and impaired memory -increased rate in accidents occasional panic reactions -similar to those caused by hallucinogens (like when having a bad trip) long-term health problems -reproduction problems -males may lower sperm count -females have abnormal ovulation some users develop tolerance and withdrawal -controversial -individuals who are chronic users, and using larger amount, may experience tolerance and withdrawal
lowest rates of substance abuse disorder
asian americas (3.8%)
treatment of schizotypal personality disorders
assist the client with reconnection to the world and recognition of thinking limits recognize unusual thoughts and magical prediction; social skills training may benefit from low doses of antipsychotic drugs -in addressing certain thought problems
general DSM-V criteria: substance use disorder
at least 2 or more occurring at any time in the same 12 month period (1-4 impaired control) 1) increasingly larger doses or longer periods of time than intended 2) unsuccessful attempts to cut-down 3) a great deal of time/effort to obtain substance 4) craving for substance -intense desires or urges for the drug: can occur anytime and most likely to happen when in an environment where it was previously obtained/used (5-7 social impairment) 5) failure to fulfill major role obligations 6) continued substance use despite having persistent or recurrent social or interpersonal problems -getting arrested, having fights with loved ones about the substance 7) important social, occupational, or recreational activities may be given up (8-9 risky use) 8) recurrent substance use in situations in which use poses serious risks -driving 9) continued substance use despite knowledge that it is causing or worsening physical or psychological problems (10-11 pharmacological criteria) 10) tolerance -need a very large amount of a substance to obtain the same effect as a smaller amount used to give 11) withdrawal
the "high" produced by using narcotics is due to the drug:
attaching to sites normally receptive to endorphins
characteristics of avoidant personality disorder
avoids occupational activities that involve significant interpersonal contact -due to fears of rejection, disapproval, and criticism preoccupied with being criticized or rejected in social situations -would be extremely hurt by the slightest degree of criticism or disagreement views self as socially inept, unappealing, or inferior to others may turn down a job promotion because they fear criticism from their coworkers
Nate took a drug and a few minutes felt calm. He then became drowsy and went to sleep. Nate MOST likely took
barbiturates
diagnosis of substance related disorders
based on pathological pattern of behaviors related to use of the substance
characteristics of narcissistic personality disorder
believes one is "special" and unique; feel as though they can only associate with other special or high-status people -at their core they have a very weak sense of self and ego requires excessive admiration -may fish for complements in a very charming manner grandiose sense of self-importance has sense of entitlement -very unreasonable expectations about how others should treat them is interpersonally exploitative -unreasonable expectations without taking the needs of others into account often envious of others or believes others are envious of them lacks empathy -being unwilling to recognize/identify with the needs of others
white Americans, hispanic americans, african americans rate of substance abuse disorder
between 7-8.2%
integrative explanations of borderline personality disorder
biosocial: combination of internal and external factors -internal: inability to identify and regulate emotions -external: invalidating environment (parents teach the children to ignore their feelings) -->may struggle to tolerate psychological distress developmental psychopathology: childhood traumas and dysfunctional parental attachments lead to metallization deficits metallization: capacity to recognize our and other emotional state
short-term consequences of alcohol
blocks messages between neurons -first absorbed into the blood via your stomach lining -->helps GABA shut down those anxiety neurons and relax the drinker -first brain area affect: controls judgement and inhibition -next affected areas: other areas in the central nervous system -->now speaking less clearly, can't recall information, motor difficulty
freebasing
boiling cocaine down into crystalline balls
categorical vs dimensional views for personality disorders
categorical (current paradigm) -individuals either have, or do not have a disorder -qualitative differences between groups and normal personality dimensional -disorders lie on a continuum, one end is normality and other end is severe disturbance or pathology -quantitative differences between those with and without disorder -personality disorders as extreme forms of normal personality traits
long-term excessive drinking can
cause disruption with family and friends, as wall as jobs seriously damage physical health -hearing problems, memory impairment major nutritional problems -Korsakoff's syndrome: chronic memory disorder caused by a severe deficiency of vitamin B-1 as a result of alcohol misuse -->symptoms: severe memory loss, inventing memories that are than taken as truth, struggles with conversing and insight
recent studies show that children with autistic spectrum disorder are MORE likely than other children to have abnormalities in which section of the brain?
cerebellum
Bryan, an intravenous heroin user, feels intense cravings when he sees hypodermic needles. This may be an example of:
classical conditioning
relapse-prevention training
clients are taught to identify and plan ahead for high-risk situations -attending a party overall goal: gain control over their substance-related behaviors patients are taught to identify and plan ahead for high risk situations in which individual will need to say no to drugs relapse prevention is also effective for alcohol, cocaine, and marijuana use
examples of second generation antipsychotic drugs
clozaril risperdal zyprexa seroquel geodon
personality disorders according to the DSM-V
cluster A: odd, eccentric -paranoid -schizoid -schizotypal cluster B: dramatic, emotional -antisocial -borderline -histrionic -narcissistic cluster C: anxious, fearful -obsessive compulsive -dependent -avoidant
substance intoxication
cluster of changes in behavior, emotion, or thoughts caused by substances -temporary undesirable, behavioral, or psychological changes --> ex: poor motor functioning, slurred speech, bloodshot eyes, irritability, and poor judgement -happens during or shortly after use of the substance -think of it as poisoning
essential feature of substance related disorders
cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems
Mario felt awake and alive as though he could conquer the world. He MOST likely used:
cocaine
most common stimulants
cocaine amphetamines methamphetamines caffeine
effects of high doses of cocaine
cocaine intoxication -can experience paranoia, mania, and impaired judgement cocaine-induced psychotic disorder -hallucinations or delusions -psychosis results from the cocaine use depression-like letdown (crashing) -when the effects subside -lethargic, depressive symptoms, irritability
personality disorders manifested in 2 or more of the following:
cognitions - ways of perceiving and interpreting self, others, and events affectivity - range as well as intensity of emotional experiences; inflexible and pervasive interpersonal functioning impulse control
A client being treated for Avoidant Personality Disorder must increase the number of social contacts per day. The person, at the least, must greet others with the sentence, "Hello, how are you doing?" MOST likely, the therapist has which theoretical background:
cognitive behavioral
cognitive-behavioral therapies for schizophrenia
cognitive remediation combination of behavioral and cognitive techniques
the community approach for schizophrenia
community mental health act (1963) coordinated services -community mental health centers provides medications, psychotherapy, and inpatient emergency care short term hospitalization -after a couple weeks, patients are released to after-care programs for follow-up in the community partial hospitalization -day center programs -patients needs fall between full hospitalization and outpatient care -->middle ground supervised residences -halfway houses or group homes -provide shelter and supervision for patients who are unable to live alone or with family -houses are run with a milieu therapy philosophy -help clients adjust to community life and avoid rehositalization assertive community treatment programs -address all areas of need for people with severe mental disorders- cognitive, emotional, and social functioning to mastery of everyday skills -critical: medication is involved
causes of autism: biological causes
complete biological explanation has not been developed mom may have been exposed to toxic chemicals when she was pregnant
levels of impairment of alcohol are closely tied to what?
concentration of ethyl alcohol in the blood BAC 0.06 = relaxation and comfort BAC 0.09 = intoxication -state of texas is 0.08 BAC > 0.55 = death most people lose consciousness before they can drink >0.55
biological treatments for drug use disorder
detoxification drug maintenance therapy
autism features: persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following:
deficits in social-emotional reciprocity -abnormal social approaches, failing to engage in normal back and forth dialogue, reduced affect deficits in nonverbal communicative behaviors -poor or no eye contact, little to no facial expressions, no gestures deficits in developing, maintaining, and understanding relationships -adjusting behavior to certain social settings, imaginary play is a struggle
alcohol use disorder
dependence in U.S. nearly 7% of people over age 11 men versus women: 2:1 ration ethnic differences: American Indians highest (9.7%)
schizoid personality disorders
detachment and restricted expression of emotion 3.1% of U.S. adults; slightly more common in men than in women theoretical explanations -linked to an unsatisfied need for human contact; parents believed to have been unaccepting or abusive (psychodynamic) -tied to deficiencies in thinking; inability to interpret emotional cues (cognitive-behavioral) -->thoughts tend to be very vague and empty
treatment of borderline personality disorder
difficulty building alliance 50% drop out by the third session violate boundaries of client/therapist relationship relational psychoanalytic therapy (modern psychodynamic) -has been deemed effective in reducing number of suicide attempts and hospitalization -very supportive and warm; focuses mainly on client/therapist relationship dialectical behavior therapy: treatment of choice!!!! -was originally developed to treat chronic suicidality, which is one of the chronic effects of this condition -addresses key areas of instability antidepressant, antibipolar, antianxiety, or antipsychotic drug serve as adjuncts to psychotherapy -prescribed to address the comorbid disorders -no systematic proof that any drug is effective for any of the borderline disorders
ADHD: inattention 6 or mot of the following must persist for at least 6 months
difficulty sustaining attention often easily distracted by extraneous stimuli often forgetful in daily activities often does not seem to listen when spoken to directly often fails to give close attention to details to makes careless mistakes
antisocial personality disorder
disregard for and violation of the rights of others NOT TO BE CONFUSED WUTH PSYCHOPATHY... -psychopathy is not a diagnosable condition, and it is not just behavioral - it includes interpersonal piece and emotion -similar notions, but important distinctions and should not be used interchangeably -antisocial PD: emphasis on observable behaviors -not an official DSM diagnosis, research based -not all APDs meet criteria for psychopathy ~3% prevalence in community samples correctional settings: 70-80% males 4x more likely severity of the symptoms and features decrease after the age of 40 highly comorbid with substance use disorders theoretical explanations -absence of parental love leads to lack of basic trust (psychodynamic) -antisocial symptoms learned through operant conditioning, modeling, imitation (behavioral) -difficulty with recognition of others' viewpoints (cognitive) -biological predisposition; lower serotonin activity; aggression & impulsive behaviors; dysfunctional brain circuits (amygdala & hippocampus) -67% of identical twins where one has APD, the other develops it also
paranoid personality disorders
distrust and suspiciousness often distrust with insufficient basis and think they are being tricked very reluctant to confide in others the individuals are very cold in their affects and are emotionally unattached 4.4% of U.S. adults; more common in men than in women theoretical explanations (little systemic research) -linked to patterns of early interactions with demanding parents (psychodynamic) -genetic causes -tied to broad maladaptive assumptions (cognitive-behavioral) "people are evil" -->are to blame for paranoid PD
cluster B
dramatic, emotional behaviors of people with these problems are so dramatic, emotional, or erratic that it is almost impossible for them to have relationships that are truly giving and satisfying often described as "sociopaths" or "psychopaths" BPD and antisocial are the only disorders with decent body or empirical evidence to support etiology -antisocial personality disorder -borderline personality disorder -histrionic personality disorder -narcissistic personality disorder
cannabis
drugs produced from varieties of hemp plants include: -hashish: solidified resin of the cannabis plant -marijuana: mixture of buds, crushed leaves, and flowering tops
overall groupings of substance related disorders
impaired control, social impairment, risky use, and pharmacological criteria
tardive dyskinesia
extrapyramidal effects involving involuntary movements -tongue flicking and lip smacking -most cases are mild -->severe: rocking back and forth; irregular breathing; major distortion of the face -late appearing movement disorder -->can appear up to a year after someone takes and antipsychotic -->typically emerges 6 months after starting an antipsychotic -->can emerge even when the patient discontinues the use of the antipsychotic -->patients over 50 are much higher risk of developing this disorder -difficult to eliminate
treatment of schizoid personality disorders
extreme social withdrawal usually stops individuals from seeking out treatment psychodynamic and behavioral treatment foci/techniques similar to treatment of paranoid personality disorder presenting and evoking memories of pleasurable experiences (cognitive)
diagnosing personality disorders
features have been present for at least 1 year and are persistent antisocial personality disorder is the SOLE exception under DSM-V people below the age of 18 could not be diagnosed with a personality disorder because symptoms are common among adolescents
treatment of histrionic personality disorder
focus on lack of substance and extreme suggestibility vain, dramatic, and selfish behavior may be an exaggeration of femininity as culture once defined it
cognitive remediation
focuses on cognitive impairments associated with schizophrenia focuses on difficulties in attention, planning, and memory provides increasingly more complex computer tasks until planning and social awareness tasks are reached -gradually increases the difficulty of the tasks provides for moderate improvement -improvements in attention skills, planning, memory, and problem-solving surpass those with other interventions that will extend to everyday life
combination of behavioral and cognitive techniques
helping a client feel more comfortable about their control over those hallucinations; not eliminating hallucinations psychoeducation about biological causes of hallucinations identification of events and triggers/stressors of hallucination challenge of inaccurate ideas of hallucinations power -ex: behavioral experimentation reattribution and more accurate interpretation of hallucinations -adopt and apply alternative conclusions --> this voice is not real, its part of my illness teach techniques for coping with unpleasant sensations -learning how to refocus or distract themselves
personality disorder rates
high rates and comorbidity (overlap) -can make it difficult to distinguish one from another which leads an individuals to have multiple diagnoses -with other personality disorders -with axis I disorders (depression, substance abuse disorders, anxiety disorders..)
borderline personality disorder rates
high rates and comorbidity with: -due to the self destructive nature of this disorder -usually comes to therapy for one of these conditions, NOT their BPD -bipolar disorder -depression -substance abuse disorders -eating disorders (bulimia) -->impulse control piece
different faces of narcissism: positive features
high self-esteem high positive affect optimistic about future low anxiety very competitive and ambitious independent (good leaders?) value intelligence, assertiveness, and competence
methamphetamine
ice, crystal meth stimulates CNS through increased attention, arousal, dopamine especially popular among men and women designated as a club drug
characteristics of schizotypal personality disorders
ideas of reference -not held with delusional conviction odd beliefs or magical thinking -inconsistent with one's subcultural norms unusual perceptual experiences -hearing someone mumble their name under their breath; sense a presence in the room when no one is there odd thinking and speech -conversation is quite digressive and vague; can be overly concrete or overly abstract suspiciousness or paranoid ideation inappropriate or constricted affect -often time struggle to negotiate the full range of affect and interpersonal queueing --> individual may seem very stiff; rarely smiles behavioral or appearance that is odd, eccentric, or peculiar lack of close friends or confidants other than first-degree relatives
dangers of MDMA
immediate psychological problems, cognitive impairment, unpleasant and potentially dangerous physical symptoms
most common areas of difficulty associated with ADHD
impaired response inhibition, impulse control, or the capacity to delay gratification excessive task-irrelevant activity or activity that is poorly regulated to the demands of a situation poor sustained attention or persistence of effort to tasks
causes of moderate, severe, and profound IDD: metabolic
in metabolic disorders, the body's breakdown or production of chemicals is disturbed metabolic disorders that affect intelligence and development are typically caused by the pairing of the two effective recessive genes (one from each parent) ex: phenylketonuria (PKU) -abnormally high levels of the amino acid, phenylalanine -if untreated, it can lead to intellectual disorders, seizures, behavioral problems, and mental disorders ex: Tay-Sachs disease -an inherited metabolic disorder in which certain lipids accumulate in the brain, causing spasticity and death in childhood
opioids
includes both natural (opium, morphine, heroin codeine) and synthetic (methadone) compounds known collectively as "narcotics" by 1917, opium-derived drugs were deemed addictive and illegal cause CNS depression; drugs attach to endorphin-related brain receptors -this is what produces those calming and pleasurable feelings. just like our natural production of endorphins each has a different strength, speed of action, and tolerance level -can cause nausea, constipation, narrowing of the pupils -high doses can shift to a comatose state; severely depressed breathing; potential convulses
social therapy for schizophrenia
includes techniques that address social and personal difficulties in the clients' lives -ex: social withdrawal examples: practical advice, problem solving, decision making, social skills training, medication management, employment, counseling, financial assistance, and housing -reinforcing their skills research finds that this approach reduces rehospitalization
stimulants
increase the activity of the central nervous system causes increases in blood pressure, heart rate, and alertness -exhilaration and heightens sense of well being followed by tiredness and mildly depressive mood -activation of the sympathetic nervous system causes rapid behavior and thinking stimulating certain transmitters in the brain
synthetic hallucinogens
lysergic acid diethylamide (LSD) MDMA (ecstasy) phencyclidine (PCP)
amphetamines
laboratory-manufactured stimulant drugs like cocaine, these: -symptoms are not as long lasting as cocaine -stimulating CNS by increasing serotonin, dopamine, and norepinephrine -increases energy and alertness and lower appetite when taken in small doses -produce a rush, intoxication, and psychosis in high doses -causes an emotional letdown as they leave the body -->extremely easy to become dependent on them -->can experience: dizziness, panic like states, heart problems, and depression
ADHD etiological explanations: diet
lack of excessive sugar intake, food preservatives, and excessive television lack of research support to provide any link between these factors and ADHD
psychopathy criteria include personality traits reflecting:
lack of remorse constricted display of emotion failure to show empathy, use of others for one's gains superficial charm pathological interpersonal relationships/manipulative irresponsibility
side effects of second-generation antipsychotic drugs
less severe carries a risk of agranulocytosis, a potentially fatal drop in white blood cells may cause substantial weight gain in a short period of time, dizziness, and significant elevations in blood sugar
sociocultural views of drug use disorder
living in stressful socioeconomic conditions -crime ridden neighborhoods; gunshots on a regular basis have families that value or tolerate drug use -contributing to the child having an increased likelihood of having problems with substances in the future regularly confronted by other kinds of stress
personality disorders
long-term, chronic and rigid characteristics enduring pattern of inner experiences and behavior that deviates markedly from the expectations of the individual's culture -displays long-term, chronic, rigid, and wide-ranging patterns -if it's normative for a particular culture, then it isn't a personality disorder enduring pattern is inflexible and pervasive across a range of situations enduring pattern leads to clinically significant distress or impairment in functioning cannot be a manifestation of another disorder some types tend to become less evident with age and omit over time -borderline and antisocial stable and of long duration (onset traced at least to adolescent or early adulthood) -there will be signs and symptoms
cause of moderate, severe and profound IDD: prenatal and birth-related causes
major physical problems in the pregnant mother can threaten the child's healthy development birth complications, such as prolonged period without oxygen (anoxia), can also lead to IDD
substance use disorders
maladaptive behavior patterns and reactions caused by repeated substance use
treatment of substance related disorders
many approaches have been used to treat substance-related disorders goals are quire controversial in the field -some believe the only acceptable goal is total abstinence from drugs and alcohol -some believe the goal is only moderate use although these treatments sometimes meet with great success, more often they are only moderately helpful -belief in total abstinence limits the success -different substance use disorders pose different problems -value of treatment can be difficult to determine based on the nature of the substance being abused -tolerance and withdrawal is rare in LSD -dropping out of treatment prematurely -individuals may recover without needing treatment at all substances use disorders are primarily treated by: -1.9 million patients are treating their substance use disorder with self-help groups -second highest number of patients - outpatient rehab -third - outpatient mental health center -lowest - treatment in prison or jail
obsessive-compulsive personality disorder and obsessive-compulsive disorder
many clinicians that OCPD and OCD are closely related because they share a number of features, many people that suffer from one of the disorders has the criteria for the other -differs because people with OCPD also have other conditions (comorbidity) like depression, anxiety, or substance use disorders
natural hallucinogens
mescaline: found in a type of spineless cactus; like norepinephrine psilocybin: found in psychedelic mushrooms
drug maintenance therapy
methadone maintenance programs -treatment approach in which clients are given legally and medically supervised doses of methadone --> opioid type of drug seen as an issue with some because they believe they are substituting addictions -intended to treat heroin addiction when first discovered - reduced cravings -hopefully receiving therapy with this -agonist or substitute -can be used to relieve pain from cancer -opposition: substituting addictions/drugs
acceptance and commitment therapy
mindfulness-based approach to help clients increase their awareness of their thoughts and accept said thoughts as mere events of the mind -cravings, worries, and depressive thoughts if patient is accepting of thoughts, he or she will become less affected by these and feel less need to use substances ideally in combination with relapse prevention training and/or cognitive behavioral therapy
crack
more prevalent form of cocaine in crime filled neighborhoods and lower socioeconomic level neighborhoods
personality disorders are:
more subtle and less incapacitating than many Axis I disorders (also controversial) affect around 15% of the U.S. population at some point in life most often untreated egosyntonic (as opposed to egodystonic) -egosyntonic: symptoms go unnoticed by the individual. they don't disrupt the individuals emotional system (they disrupt the emotional systems of the people around them) -egodystonic: symptoms are recognized emotionally as disruptive
characteristics of autism
most consistent sign: person learns very slowly other ares of difficulty: attention, short term memory, planning, and language
things to remember about personality disorders
most people with them don't realize they have them... -self reports measures for being able to identify these problematic personality traits -informant ratings by self and others
cocaine
most powerful natural stimulant known produces an euphoric rush of well-being -stimulates the central nervous system and decreases appetite -feel untouchable, hyperactive, prolonged use leads to sexual dysfunction increases the supply of dopamine at key neurons throughout the brain as well as norepinephrine and serotonin levels tried by 39 million people; currently used by 1.9 million people
Parkinsonian symptoms produced by conventional antipsychotic drugs
muscle tremor, rigidity, and shaking dystonia (bizarre movements of the face, neck, tongue, and back) akathisia (great restlessness, agitation, and discomfort in the limbs)
a client is initially very resistant to therapy, cannot acknowledge weaknesses, and ignores feedback. MOST likely, the client is experiencing:
narcissistic PD and will not make much progress in therapy
highest rates of substance abuse disorder
native Americans (11.6%)
treatment of autism
no known treatment totally reverses the autistic pattern no medication can be considered an effective treatment treatments of particular help are cognitive-behavioral therapy, communication training, parent training, and community integration -to help those with autism better adapt to their environment behavioral approaches: used to teach new appropriate behaviors while reducing negative behaviors -most often, therapist use modeling and operant conditioning applied behavior analysis communication training -1/2 stay nonverbal -may tough other forms of communication -->sign language and/or simultaneous communication -->may use augmentative communication systems (communication boards or computers with different symbols) parent training -critical piece -train parents to apply conditioning and skill-building techniques at home individual therapy and support groups for parents becoming more available community integration -self help and self management, as well as living, social, and work skills taught in school-based and home-based programs -greater number of group homes and sheltered workshops are available
etiology os substance use disorders
no single explanation has gained broad support -regardless of biological, social, psychological, etc. best explanation: a COMBINATION of factors -sociocultural views -psychodynamic views -cognitive behavioral views -biological views -developmental psychopathology view
treatment for ADHD
no treatments found to cure the disorder -the found treatments help manage ADHD ~80% of those suffering with ADHD do receive treatment most commonly applied approaches entail: drug therapy, behavioral therapy, or a combination drug therapy: psychostimulants -provides the greatest degree of improvement - ~2.2 million children in the U.S. take a stimulant drug for ADHD -psychoeducation along with the stimulants behavior therapy: -parents and/or teachers learn to apply operant conditioning techniques to change behavior behavior modification in the classroom and parent training in child behavior management methods -often helpful, especially combined with drug therapy
caffeine use disorder
not listed in DSM-5 does not qualify as a substance induced disorder 10 grams of caffeine = 100 cups of coffee; leads to seizures and fatal respiratory failures
when can a personality disorder be diagnosed
only be diagnosed prior to age 18 because its development normal for adolescents
cluster C
obsessive-compulsive personality disorder dependent personality disorder avoidant personality disorder
cluster A
odd, eccentric -paranoid personality disorders -schizoid personality disorders -schizotypal personality disorders
ADHD: hyperactivity and impulsivity 6 or more of the symptoms must persist for at least 6 months
often fidgets often talks excessively often blurts out answers difficulty waiting one's turn often interrupts or intrudes on others
LSD
one of the most powerful and most common hallucinogens derived from ergot alkaloids -brings on a state of hallucinogen intoxication (hallucinosis) -->allusions: objects are distorted; feel like they are moving on their own or talking to you --> can experience as soon as 2 hours after use; lasts up to 6 hours --> marked and generally strengthening or perceptual experiences, especially visual; color is more vividly intense --> synostosis: believe that they can see sounds and taste colors -increased and altered sensory perception, psychological changes, and physical symptoms produces symptoms by binding to serotonin receptors tolerance and withdrawal are rare -tend to be used on a move sporadic basis
cognitive behavioral view of drug use disorder
operant conditioning: temporary tension-reduction has a rewarding effect -increases the likelihood of using the drug again to seek that same reaction -may lead to trying higher doses or more powerful ways to get the drug produce an expectancy that substances will be rewarding -sufficient to motivate individuals to use increasingly larger amounts of a substance; especially during times of tension classical conditioning: cues or objects are present during drug use -these may act as classical stimuli -can produce some of the pleasure brought on by the drugs themselves
first generation antipsychotic drugs
originally found to treat allergies one group of antihistamines, phenothiazines, could be used to calm patients about to undergo surgery
family therapy for schizophrenia
over 50% of persons recovering from schizophrenia live with family members -family plays a key role with the course and recovery of schizophrenia address such family issues, creates more realistic expectations and provides psychoeducation about the disorder -helping improve family coping skills; family dynamics -explaining to the family what a hallucinations is, the symptoms, and what little control the patient has over these things families may also turn to family support groups and family psychoeducation programs
dangers of cocaine
poses significant physical danger, especially from accidents and suicide -more likely to do risky things -pregnant women who use cocaine have an increased likelihood of miscarriage and of having children with abnormalities the greatest danger of use is the risk of overdose -excessive doses depress the respiratory area of the brain and stop/paralyzing breathing and may cause death cocaine use can also cause heart failure -increased heart rate and blood pressure
psychodynamic views of drug use disorder
powerful dependency needs traced to early childhood years -inadequate parental love display substances abuse personality -characterized by early impulsivity -only correlational in nature, cannot assume causality
obsessive-compulsive personality disorder
preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency research is limited within the etiology treatment has been demonstrated to be moderately helpful ~7.9% of the adult population affected; men are twice as likely as women to display disorder theoretical explanations -overly harsh toilet training during anal stage can result in anal retentive obsessive-compulsive functioning and fixed in one of the stages (Freud) -illogical thinking process (cognitive-behavioral)
characteristics of obsessive-compulsive personality disorder
preoccupied with details, rules, lists, order, or schedules -pulls attention away from the task at hand show perfectionism that interferes with task completion excessively devoted to work and productivity -to the exclusion of leisure activities and friendships; if they do go out, they have high feelings of uncomfortableness is overly conscientious and inflexible about matters of morality, ethics, or values -very strict standards and moral codes; very self critical adopts a miserly spending style toward both self and others shows rigidity and stubbornness struggle immensely with delegating, needs to be "just right" or "followed to a T"
causes of autism: genetics
prevalence rates are much greater among siblings (10 to 20%) and highest among identical twins (60%) prenatal difficulties or birth complications brain abnormalities: cerebellum considered a possible factor -cerebellum: controls a persons ability to rapidly shift their focus of attention -more recent research points to abnormal activities and/or anatomies of other brain structures -likely 2 or more autism-related brain circuits
the categorical approach to personality assumes that:
problematic personality traits are either present or absent
sedative/anxiolytic/hypnotic drugs
produce feelings of relaxation and drowsiness at low doses, they have a calming or sedative effect at high doses, they function as sleep inducers or hypnotics barbiturates: widely prescribed for first half of the 20th century benzodiazepines -discontinuous syndrome: when you abruptly stop taking a high dose -->likely to experience a return of the anxiety symptoms, may develop new symptoms that are like drug withdrawal -safer and less likely to lead to intoxication, tolerance effects, and withdrawal reactions -->can still experience these things
when are antipsychotic drugs most beneficial
produce the maximum level of improvement within the first six months of treatment
cannabis at high doses
produces odd visual experiences -hallucinations -cannabis intoxication --> pervasive sense of wellbeing --> substantial cognitive problems --> upbeat mood
Treatment of Narcissistic Personality Disorder
recognize and work through basic insecurities and defenses (psychodynamic) -getting more connected with self focus on self-centered thinking and redirection (cognitive-behavioral) -thought patterns no major treatment approaches have had much success -one of the most difficult PDs to treat -tries to manipulate the therapist --> a love/hate relationship evolves
conventional antipsychotic drugs sometimes produce disturbing movement problems
referred to as "extrapyramidal effects" because they appear to be caused by the drugs impact on the extrapyramidal areas of the brain -affecting dopamine activity through medication-induced reductions of dopamine activity in striatum -extra areas of the brain are impacted especially the movement areas of the brain most common: Parkinsonian symptoms produced
clinical picture for alcohol use
regular consumption and reliance affects cognition, social life, and work behaviors varied alcoholism patterns
effectiveness of antipsychotic drugs
research has repeatedly shown that antipsychotic drugs reduce schizophrenia symptoms in at least 70% of patients more effective than any other approach used alone -not in conjunction with something else positive symptoms are reduced more completely, or at least more quickly than negative symptoms -tend to be more effective towards the positive symptoms
which statement BEST describes effective therapy for treating BPD?
research suggests that DTP is the most effective
biological view: genetic predisposition (drug use disorder)
research with "alcohol-preferring" rats and offspring have similar alcohol preferences -known more about abuse in alcohol than any other drug biological parent - adopted child alcohol abuse rate -adoptee had much higher rates of alcoholism themselves lifetime prevalence among parents, children, and siblings -3x to 5x higher likelihood of alcohol abuse themselves abnormal form of dopamine (D-2) receptor gene in people with substance use disorders similarly, research with human twins: -concordance rates in identical twins 50% -concordance rates in fraternal twins 30%
biological view: incentive-sensitization theory (drug use disorder)
reward center develops a hypersensitivity to substances when repeatedly stimulated by the substances (through chronic substance abuse) reward-deficiency syndrome: -reward center not readily activated by "normal" life events; thus, person uses drugs to stimulate the pleasure pathway -defects in D-2 receptors cited as possible cause
biological view: brain circuits (drug use disorder)
reward circuit (reward center) pleasure pathway dopamine: key neurotransmitter brain structures are stimulated directly or indirectly -reward center directly activated as a result of the release of dopamine by caffeine, amphetamine, cocaine, etc. -indirectly by biochemical reactions produced by substances that trigger pathways and result in increased dopamine activity and increased interconnectivity and communication -->alcohol, opioids, marijuana brain circuit is rich in dopamine striatum and hippocampus are 2 additional key structures to remember
an individual with a diagnosis of odd personality disorder is MOST likely to have a parent or sibling who has:
schizophrenia
to be diagnosed with histrionic personality disorder you must have 5 or more of the following:
seeks to be center of attention -life of the party; charm people easily; very dramatic/theatrical exhibits sexually provocative or seductive behaviors displays shifting and shallow emotions uses physical appearance to draw attention -spends a lot of time in grooming; high value on appearance and material items style of speech that is excessively impressionistic and lacking in detail is dramatic; exaggerated expression of emotion is suggestible (easily influenced by others or circumstances) misjudges intimacy in a relationship
depressants
slow the activity of the central nervous system -primary feature -reduced tension and inhibitions -->bring a calming effect -may affect judgement, motor activity, and concentration
long-term consequences of LSD
self-injury -especially during bad trips flashbacks -brief visual after effects of that trip -occur in unpredictable time intervals; and long after a substances has left possibly trigger the onset of psychosis, mood disorder, or anxiety disorder -more so with chronic users
when a child with autism spectrum disorder jumps, flaps their arms, twists their hands and fingers and makes unusual faces, the child is engaging in:
self-stimulatory behavior
meth use dangers
serious effects on physical, mental, and social life -psychological symptoms when stopped abruptly -heart problems and stroke, tooth decay, and malnourishment linked to increased ER visits may cause neurotoxicity
diagnosing ADHD
several inattentive or hyperactive-impulsive symptoms must be present prior to age 12 -no sudden onsets several symptoms must be present in 2 or more settings -do not manifest symptoms in school only, or home only clear evidence that symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning -must have that impairment piece three possible presentation specifiers: -combined presentation -predominantly inattentive presentation -predominantly hyperactive/impulsive presentation
Four levels of intellectual disability
severity of the levels is based on the degree of adaptive behavior functioning -mild (IQ 50-70) -moderate (IQ 35-49) -severe (IQ 20-34) -profound (IQ below 20)
avoidant personality disorder
social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation social avoidant personality disorder = fear of close social relationships -some could argue that avoidant PD is the internal conceptualization of an anxiety disorder social anxiety disorder = fear of social circumstances -the two disorders may reflect core psychopathology at least 2% of adults; similar rates among men and women theoretical explanations -lack of research to support underlying etiology -focus on shame and insecurity traced to childhood experiences (psychodynamic) -harsh criticism in early childhood leads to expected rejection; failure to develop effective social skills (cognitive-behavioral) --> forming unhealthy beliefs that people will always judge them negatively
cross-tolerance
sometimes 2 or more drugs are so similar in the affects to the brain/body, you can develop tolerance of one drug as well as a tolerance of that similar drug without ever using it
causes of moderate, severe, and profound IDD: biological
sometimes genetic factors are at the root of these biological problems other biological causes come from unfavorable conditions that occur before, during, or after birth
unwanted effects of conventional/first generation antipsychotic drugs
sometimes produce disturbing movement problems tardive dyskinesia neuroleptic malignant syndrome
autism features: restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least 2 of the following:
stereotyped or repetitive motor movements, use of objects, or speech -motor movements: arm flapping, spirit fingers, rocking back and forth, twisting hands and fingers -->self stimulatory behaviors -->typically happens when a child is overly stimulated by what is going on in their environment -objects: setting up lines with their toys, mesmerized by a spinning top for hours -speech: -->one common speech peculiarity is echolalia, the exact echoing of phrases spoken by others -->another is pronoun reversal, or confusion of pronouns insistence of sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior and struggles immensely with change highly restricted, fixated interests tend to be abnormal in intensity or focus hyper- or hypo- reactivity to sensory input or unusual interest in sensory aspects of the environment (pain and temperature don't really affect them OR sounds/feelings/clothing tags severely dysregulate them
danger of opioid use
the most immediate danger is overdose -closing down the respiratory center of the brain and results in paralyzing breathing and likely death ignorance of tolerance -builds up rapidly users run the risk of getting impure drugs dirty needles and other equipment can spread infection
caffeine reduction
suddenly stop or cut back of usual intake can cause withdrawal symptoms -irritated, agitated, more anxious, psychomotor agitation, difficulty concentrating, headaches, tired
autism spectrum disorder
symptoms appear early in life, typically before age 3 there has been a steady increase in the number of children diagnosed -was 1 in every 2,000 -now it's 1 in every 50 children around 80% of all cases appear in boys ~90% of children with the disorder rain significantly disabled into adulthood
token economy
systematic use of operant conditioning techniques used in hospital wards to change patient behaviors with schizophrenia -token is given as an immediate reward that is later exchanged for some other desired object/possession -still used today -rewarding acceptable behavior and not rewarding unacceptable behavior --> acceptable behavior: following ward rules; taking proper care of self; taking medication
detoxification
systematic, medically supervised withdrawal of drug -can happen in outpatient or inpatient services two strategies: -gradual withdrawal by tapering doses of the substance -induce withdrawal but give additional medication to block symptoms goals: helping with withdrawal, abstain from use, or maintain a level of use without creating further problems antagonist drugs -block or change the effects of the addictive substance -->aide the client in being resistant in falling back to that substance abuse -ex: disulfiram (Antabuse) for alcohol --> symptoms: intense nausea, dizziness, high blood pressure, and other disturbing effects to make an individual less likely to turn to alcohol --> idea: the individual would be LESS likely to drink alcohol due to this interaction -->naloxone - opioid antagonist drug binds to endorphin receptors in the brain to stop the "positive effects" as a result of opioid use -helps patients become resistant in fighting urge to use substance
developmental psychopathology view of drug use disorder
taking into consideration the impacts substance use disorders -genetically inherited disposition -->twins and parents with alcohol abuse -numerous childhood stressors -->homelessness, natural disasters -inadequate parenting -->lack of love and emotion -reward substance use experiences -->potentially enables substance abuse -relationship with substance using peers -->peers are the primary spear of developmental influence this view is not commonly discussed among other disorders, but it is important to substance use
famous psychopaths
ted bundy jeffry daumer hannibal susan smith (killed her 2 babies and accused black man)
intoxication is actually a form of:
temporary change
blood alcohol levels increase
the amount of alcohol per unit of blood effects of alcohol only subside after the alcohol has been metabolized by the liver -average rate 1oz of 90 proof liquor or 12oz of beer per hour -cannot speed up this process gender differences in alcohol metabolism -women become more intoxicated than men on equal amounts of alcohol due to lower enzymes any given amount of alcohol has a lesser effect on a larger person than a smaller one
what is metallization?
the capacity to understand one's own mental states and those of other people
the chief danger of LSD use is:
the possibility of very powerful, sometimes negative, reactions
intellectual disability (intellectual developmental disorder)
the term "mental retardation" has been applied to a varied population approximately three of every 100 persons meets the criteria for this disorder -around 3/5 of them are male and the vast majority are considered mildly IDD
cannabis at low doses
the user feels joy and relaxation -may also cause anxiety, paranoia, irritability
causes of autism: sociocultural causes
theorist initially thought that high degree of family dysfunction, environmental, stress, and social stress were key factor -the personality characteristics of the parents led to the development of Autism -research does not support this theory
treatment of antisocial personality disorder
typically, do not seek/receive unless actually caught and court-mandated -all of their anger is directed at the treatment provider not unresponsive to treatment, but extremely difficult patients because: -treatments are not addressing unique developmental mechanisms underlying their antisocial behavior -need for comprehensive AND individualized treatment -->we are addressing those key underlying factors -no desire to change (no incentives) -premature drop-out
with the help of a therapist, a client with OCPD has experienced a dramatic decrease in both dichotomous thinking and worrying. The client's behavior is:
uncommon; most with OCPD do not seek help, and this person is most likely receiving cognitive therapy
important characteristic of substance related disorders
underlying change in brain circuits that may persist beyond detoxification -tend to occur due to extensive use of substances
personality
uniquely expressed characteristics that influence behaviors, emotions, thoughts and interactions -there is no single agreed upon explanation in the field as to what defines personality
Treatment of Obsessive-Compulsive Personality Disorder
usually believe that nothing is wrong with them so unlikely to seek treatment unless they are suffering from one of those comorbid conditions often response well to psychodynamic or cognitive therapy selective serotonin reuptake inhibitors (SSRIs)
neurodevelopment disorders include...
very high co-occurrence rates intellectual disability (IDD) language disorder communication disorders autism spectrum disorder attention-deficit/hyperactivity disorder (ADHD) specific learning disorders motor disorders
treatment of paranoid personality disorders
very rare that this individual will seek out treatment willingly object relations therapists (psychodynamic) social skills education; role playing, exposure techniques; group therapy (behavioral) antipsychotics could be prescribed but they tend to be of little help development of more realistic interpretations of words and actions (cognitive)
ADHD etiological explanations: biological
very strong biological contributions -but the precise cause of ADHD had not been identified genetic predisposition: heritability estimates = 80% -largest contribution prenatal exposure to alcohol and tobacco smoke, prematurity of delivery and significantly low birth weight abnormal dopamine activity and abnormalities in the frontal-stratal regions of the brain
how do you assess intelligence
vocab similarities information comprehension picture completion block design matrix reasoning picture arrangement arithmetic digit span letter-number sequencing digit symbol coding symbol search
caffeine
world's most widely used stimulant -consumed daily by 90% of the world's population absorbed by the body and serves as a CNS stimulant -triggers the release of dopamine, serotonin, and norepinephrine in the brain -reaches peak concentration within an hour more than 2-3 cups of brewed coffee, 6 can of cola, or 3 cans of Red Bull can lead to caffeine intoxication -can be "drunk" off of caffeine -jittery or on edge, gastrointestinal disturbance, muscle twitching, rambling flow of thought of speech
