Psychology 342 Abnormal Psychology Final Exam
What is thimerosal? What is the stance of the American Medical Association on the relationship between vaccinations and autism? What is herd immunity? How does the absence of herd immunity hurt children?
*** Need to know this *** Thimerosal is a mercury based component in the MMR vaccine. There was a study that came out that said that this vaccine was proven to cause autism, but this is not true. Thimerosal does not cause autism. Herd immunity is the idea that if most people are vaccinated then those who are vulnerable and cannot get the vaccine will not get the disease because it isn't in the general population; it's not going around. If the herd is not immunized, then the vulnerable are at risk for getting the disease.
What is vascular dementia? How are vascular dementia and Alzheimer's disease similar and different? There is very likely a case example asking you to differentiate between Alzheimer's and vascular dementia on the exam.
- Vascular dementia: Individual has history of little strokes in the brain, we see normal functioning in the individual and then a sudden onset of dementia within three months - Dementia due to Alzheimer's: memory impairment with at least one other specific cognitive dysfunction, associated with decline in acetyl choline beta amyloid plaques Neurofibrillary tangles Difference between Dementia due to Alzheimer's and Vascular dementia: Dementia due to Alzheimer's is a gradual onset and gradual reduction in function. Vascular dementia follows a step wise function. Basically individual has stroke and dramatic drop in function occurs and then they're steady and then another stroke and the same process occurs
What is the relationship between parental age and risk of having a child with Down syndrome? Is there a maternal age that risk is associated with?
1 in 700 births linked to maternal age -1 in 2000 for 20s, 1 in 25 for 45+7.
How are these diagnoses made?
1- looking at performance and comparing to people of the same age. 2- comparing performance in different categories for the same person (for example, if a person is good at reading/writing but bad at math. Don't have to fall below an IQ of 70 to be diagnosed.) or 3-having an intervention in a topic but no improvements are seen
ADHD (Attention-Deficit Hyperactivity Disorder)
A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by (1) and/or (2): 1. Inattention: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities: Note: the symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required. a. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate). b. Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading). c. Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction). d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked). e. Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines). f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers). g. Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
paranoid personality disorder
A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following: 1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her. 2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates. 3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her. 4. Reads hidden demeaning or threatening meanings into benign remarks or events. 5. Persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights. 6. Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack. 7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner. B. Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to the physiological effects of another medical condition
What is a tic? What is Tourette's syndrome? What is persistent tic disorder (motor or vocal)? How can you easily differentiate between Tourette's and the persistent motor or vocal tic disorder?
A tic is a little interruption of normal functioning- involuntary motor or vocal movement. Tourettes involves BOTH a motor and vocal tic Persistent tic disorder is either motor or vocal, but not both. You may have multiple tics of one type, but not of both types. Tics must be present before they turn 18 for both tourettes and persistent tic disorder
Bipolar I Disorder Criteria
A. Criteria have been met for at least one manic episode the average age of onset is 18. Typically, there is disruption in several interpersonal and occupational areas of functioning, and work difficulties and divorce are common. Depression, suicide might involved B. The occurrence of the manic and major depressive episode(s) is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
Posttraumatic stress disorder
A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways: 1. Directly experiencing the traumatic event(s). 2. Witnessing, in person, the event(s) as it occurred to others. 3. Learning that the traumatic event(s) occurred to a close family member or a close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental. 4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse). Note: Criterion A4 does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related. B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: 1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Note: In children older than 6 years, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed. 2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). Note: In children, there may be frightening dreams without recognizable content. 3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) Note: In children, trauma-specific reenactment may occur in play. 4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). 5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following: 1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). 2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). D. Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: 1. Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs). 2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad," "No one can be trusted," "The world is completely dangerous," "My whole nervous system is completely ruined"). 3. Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others. 4. Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). 5. Markedly diminished interest or participation in significant activities. 6. Feelings of detachment or estrangement from others. 7. Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings). E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: 1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. 2. Reckless or self-destructive behavior. 3. Hypervigilance. 4. Exaggerated startle response. 5. Problems with concentration. 6. Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). F. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. G. Thedisturbancecausesclinicallysignificantdistressorimpairmentinsocial,occupational,orotherimportantareasof functioning. Thedisturbanceisnotattributabletothephysiologicaleffectsofasubstance(e.g.,medication,alcohol)orothermedicalcondition.
Why are ADHD diagnoses on the rise? Is there something specific about America associated with ADHD? Can ADHD be faked/is a diagnosis of ADHD even reliable or valid?
ADHD diagnoses are on the rise- this may be due to diagnoses being given based on the presence of symptoms only, without any tests being done to confirm (we don't even have a test for that) America has aided in 90% of medication prescriptions, so more diagnoses than any other country. This is hard to determine because diagnoses are only done on the basis of symptoms, so someone could fake the behavior associated with ADHD and be diagnosed. It's possible that other diagnoses could be to blame for certain behaviors.
What is ADHD?
ADHD is an inability to focus, along with hyperactivity.
How is ADHD generally treated? Is this effective? How does ADHD treatment compare to placebo? Is medication better, worse, or the same than behavioral treatment? So...what does the APA recommend—meds first or behavioral treatment first? Is this recommendation followed?
ADHD is generally treated by stimulus like ritalin. These are effective 70% of the time, whereas with a placebo is only effective 10% of the time Medications are AT FIRST more effective than behavioral treatments, but after two years the effectiveness is basically the same, so the APA recommends treating children with behavioral therapy before giving them medication because there are some side effects for meds. Meds should be used as a last resort however most people just use meds immediately since they work faster.
Is ADHD heritable? Do we know the ADHD gene? What neurotransmitter is most implicated in ADHD?
ADHD is one of the most heritable disorders We don't know the ADHD gene ADHD is polygenic which means there are multiple genes that contribute to this Low level Norepinephrine is the most implicated neurotransmitter for inattentive type, and dopamine is the most implicated neurotransmitter for hyperactive type.
What is an autism spectrum disorder? What are the main symptom subtypes (two main sets)? Does Asperger's still exist as a DSM-5 diagnosis? What is it called now?
ASD is when there are problems with social interaction and communication The two main subtypes are: Social communications and interactions- lack social boundaries or social engagement, tend to be awkward. This is the more common subtype Restrictive and repetitive behavior- do things over and over again, or interested in just one thing, follow a routine Aspergers is NOT a DSM-5 diagnosis, and now referred to as high functioning ASD
How is brain development different in children with autism than typically-developing children? Does the brain grow faster or slower? Do these rates change as the children grow older? White matter abnormalities?
Accelerated brain growth for the first two years. This results in: More white matter connections that don't get pruned back More abnormalities in the cerebellum Also higher serotonin levels
Acute stress disorder
After exposure to intense trauma, recurrent recollection and distress related to the trauma with marked arousal at least 3 days
Be able to define and identify the symptoms associated with each of the following: agnosia, aphasia, apraxia, neglect syndrome, Broca's aphasia, and Wernicke's aphasia.
Agnosia: Failure to recognize familiar objects or people. - Aphasia: loss of ability to understand or express speech - Apraxia: Impaired ability to execute motor activities, although motor functions are intact. - Neglect syndrome: Attention difficulty wherein the individual does not attend to the left side of space. - Broca's aphasia: Impairment in the production of language, but comprehension is intact. - Wernicke's aphasia: Impairment in the comprehension of language, but fluency is intact.
What is the relationship between anorexia and bulimia (does one progress to the other)? How is anorexia different from bulimia (particularly binge-eating/purging type anorexia)? Does one have a better prognosis and is easier to treat?
Anorexia can develop into bulimia. This is because it is difficult for individuals to stay below a BMI of 17.5, and so they tend to fluctuate. The primary difference is the inability to maintain a sufficient weight (the BMI requirement of 17.5 is the cutoff for this). Bulimia is when the individual is able to stay above 17.5, and binge eating/purging type anorexia is when you're below 17.5. Bulimia is easier to treat and has a better prognosis Anorexia is very difficult to treat and we don't have as much research on it
What are the physiological effects of anorexia and bulimia? How can these eating disorders lead to death?
Anorexia is related to: thin yellow skin or brittle hair (due to a lack of nutrients like calcium) Brain shrinkage- due to dehydration. This can result in personality changes Death can result from starvation, suicide, caridac arrest, electrolyte imbalance Bulimia has these effects: Stomach ruptures from binging Organ damage Heart failure from loss of vitamins and minerals like potassium Can lead to death
What is anterograde amnesia? What is a retrograde amnesia? What aspects of memory are generally "spared" in people with amnesia?
Anterograde The most common; where the individual as difficulty with new memories Retrograde - Hard to retrieve memories Spared - Intelligence, attention, indirect learning (motor skills, learning), remote memories (oldest memories)
What is average (and standard deviation) intelligence on a standardized IQ test? What represents an intellectual disability according to an IQ score? What else is required for an intellectual disability diagnosis besides low IQ?
Average score of 100 and a standard deviation of 15 - An IQ of 70 or less (lowest 2.5% of the population) - Have to have deficits in adaptive functioning (failure to acquire normal milestones in personal independence and social responsibility)
Describe the main "to do" and "to avoid" parenting behaviors from the Alan Kazdin podcast. This is excellent information both from learning perspective, but as well as a "what to do" resource for if/when you have children or if you currently have children.
Avoid yelling at children Praise & reward systems are good
Are boys or girls more at risk for developmental and disruptive behavior disorders (know this in general and for ASD and ADHD)? What disorder(s) are most frequently diagnosed amongst youth (i.e., what are the most prevalent development and disruptive behavior disorders)?
Boys more likely to have developmental & disruptive behavior disorders ASD- boys more likely ADHD- boys more likely ADHD & conduct disorder are the most prevalent development and disruptive behavior disorders diagnosed in youth
Know the characteristics of REM sleep (what occurs during REM sleep?). Why is REM sleep important? What happens during REM sleep behavior disorder?
Characteristics Less muscle movement, brain looks awake on EEG Scale, Lots of eye movement, dreams WHy is it important? We don't really know, maybe memory What happens during REM sleep behavior disorder? Failure to produce muscle paralysis, people at out dreams.
Define civil commitment. What are the requirements for civil commitment to occur? What are situations in which civil commitment might occur?
Civil Commitment is the Involuntary hospitalization of people that occurs because they are posing a danger to themselves or others (threats of suicide, people refusing to eat, child abuse, threats to spouse, etc.)
Define competency. What are the requirements to be deemed competent? What happens if a defendant is deemed incompetent to stand trial? Who decides if someone is competent? How does malingering relate to competency cases?
Competency concerns an individual's mental ability to handle his or her own legal affairs ability to stand trial Requirements to be deemed competent - Understand the nature of the charges, appreciate the seriousness of those charges and the possible results of a conviction, are able to assist their attorney in their own defense If someone is incompetent to stand trial - Trial is halted until the individual receives treatment to restore competency Who decides competency - Judge makes decision - Malingering is when people feign a disability to avoid sentences or the death penalty
19. Understand conduct disorder and oppositional defiant disorder. Know the main symptoms, male and female ratios, and how you would differentiate the two disorders?
Conduct Disorder: Pattern of behavior that violates the basic rights of others or major age-appropriate societal norms or rules (may be misapplied in settings where patterns of undesirable behavior are viewed as protective) o Aggression to people and animals o Deceitfulness or theft o Serious violation of rules - Oppositional Defiant Disorder: pattern of negativistic, hostile, and defiant behavior (less severe than conduct disorder) o Loses temper, argues with adults, defies adults' request or rules, deliberately annoys people, blames others for mistake, touchy or easily annoyed, angry and resentful, spiteful or vindictive - Males are more frequently diagnosed than females (males are more frequently diagnosed before puberty and after puberty those rates become more equal) - Male symptoms: fighting, stealing, vandalism, school discipline problems - Female symptoms: truancy, running away, substance use, prostitution (relational aggression)
20. What is the relationship between conduct disorder and antisocial personality disorder?
Conduct disorder is the younger version of antisocial personality disorder Those with conduct disorder are children, don't have respect for others rights, they are aggressive, deceitful, and do have serious violations Must have a conduct disorder diagnosis in order to be diagnosed with ASPD later in life.
What is delirium? What is its course? Is delirium related to death rates in hospitals? What tends to be the main cause of delirium? How do you differentiate delirium from dementia?
Delirium: disturbance of consciousness + reduced ability to focus, sustain, or shift attention (confused, disoriented), change in cognition or development or perceptual disturbance, develops in short period of time, fluctuations The disturbance develops over a short period of time (usually hours to a few days), represents a change from baseline attention and awareness, and tends to fluctuate in severity during the course of a day. - Acute: Lasting a few hours or days. Persistent: Lasting weeks or months - Delirious elderly in hospitals have up to a 20-75% chance of dying during that hospitalization (elderly deaths after discharge: 15% die within 1 month, 25% fie within 6 months) Causes - Anesthesia, medications, general medical condition (cancer, hepatic encephalopathy, HIV) - difficult to determine actual cause -Dementia has a more gradual onset (long term), delirium has sudden onset (short term)
Schizophrenia
Delusions, hallucinations, disordered speech and behavior going on for at least 6 months Two (or more) of the following, each present for a significant proportion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3): 1. Delusions. 2. Hallucinations. 3. Disorganized speech (e.g., frequent derailment or incoherence). 4. Grossly disorganized or catatonic behavior. 5. Negative symptoms (i.e., diminished emotional expression or avolition). B. For a significant portion of the time since the ons et of the disturbance, level of functioning in one or more major areas ,such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic, or occupational functioning). C. Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested only by negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences). D. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1) no major depressive or manic episodes have occurred with the active-phase symptoms, or 2) if mood episodes have occurred during active- phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness. E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition. F. If there is a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least 1 month (or less if successfully treated)
Brief Psychotic Disorder
Delusions, hallucinations, disorganized speech, but duration less than one month at least a day
What is dementia? What is the average time from age of onset to death in the dementias? What is the most common dementia and most common memory deficit?
Dementia is A decline in cognitive function from previous levels (ADL's have to be impaired) Older you are the more likely - Age of onset depends on type (usually late in life) ... average age of onset is 85, onset of dementia to death is 8-10 years Most common - Alzheimer's. Common memory deficit is anterograde
Bipolar II Disorder
Depressed and Hypomanic episode
Schizoid Personality Disorder
Detachment from social relationships and a limited range of expressing emotions in interpersonal settings. This pervasive pattern has occurred since early adulthood and is expressed by at least four of the following: —Chooses solitary activities almost all the time —Enjoys few activities, if any —Lacks confidants (other than first-degree relatives) or close friends —Does not care for or desire close relationships, including being part of a family —Lacks or has minimal interest in engaging in sexual experiences with another person —Appears emotionally cold or detached or has flattened affectivity —Seems indifferent to criticism or praise of others
schizoid personality disorder
Detachment from social relationships and a limited range of expressing emotions in interpersonal settings. This pervasive pattern has occurred since early adulthood and is expressed by at least four of the following: —Chooses solitary activities almost all the time —Enjoys few activities, if any —Lacks confidants (other than first-degree relatives) or close friends —Does not care for or desire close relationships, including being part of a family —Lacks or has minimal interest in engaging in sexual experiences with another person —Appears emotionally cold or detached or has flattened affectivity —Seems indifferent to criticism or praise of others
Which are associated with intellectual disabilities/the most common cause of intellectual disability?
Down Syndrome is the most common cause of intellectual disability (the book says fragile X but that is INCORRECT)
Know the genetic causes and presented symptoms of the following disorders: Down syndrome,
Down Syndrome- have 3 21st chromosomes, do have intellectual impairments that can range from mild to profound, and have different facial characteristics, tend to be short and stocky
What are dyssomnias and parasomnias? Are they disorders in the DSM?
Dyssomnias: abnormalities in the amount, quality, or timing of sleep (ex. Insomnia) - Parasomnias: abnormal behavioral or physiological events during sleep (ex. Sleep walking, night terrors) - Not technical disorders, Schemas or categories to help us understand
What are the main early signs of an autism spectrum disorder? Know the signs of early symptoms for ASD diagnosis.
Early signs of ASD are: Self stimulating behaviors (walk on tippy toes, bang head, rock back and forth) Meltdowns / tantrums in public places or at home Sensory overload issues (Sensitive to food, texture or clothing) Extremely repetitive or obsessive behavior (for example pouring drinks back and forth between two cups) Aggressive behavior Lack of response to voice or sound No eye contact Missing language and communication skills
What is bell and pad method? Does it work? What does it treat?
Enuresis (Wetting the bed past toilet training phase) Put pad under the sheets and if it gets wet an alarm goes off - Very effective especially when used with a psychologist - Treats enuresis
Differentiate enuresis and encopresis. What are two important considerations psychologists need to make when diagnosing elimination disorders?
Enuresis: repeated voiding of urine into inappropriate places (at least 5 years old, occur 2x week for 3+ months, subtypes: nocturnal, diurnal, both - Encopresis: repeated passage of feces into inappropriate places (at least 4 years old, occur 1x month for 3+ months) (more voluntary) - If voluntary, may be conduct or oppositional defiant disorder; must be distinguished from developmentally appropriate deficiencies in toileting abilities or medical condition - Boys are more likely to have these disorders
generalized anxiety disorder
Excessive anxiety and for worry for majority of 6 month period Difficulty controlling worry Of the 6 At least 3 for Adults 1 for child 1. Restless 2. Tired Easily 3. Difficulty concentrating 4. Irritability 5. Muscle Tension 6. Sleep Disturbance The anxiety/worry/symptoms impact life Not attribute to drug or medical condition Not better explained by another mental disorder
Illness Anxiety Disorder
Excessive preoccupation with serious illness at least Six months
Factitious Disorder
Falsification of physical or psychological symptoms without obvious incentive
avoidant personality disorder
Feelings of inadequacy, social inhibition, and hypersensitivity to negative evaluations. This pervasive pattern has occurred since early adulthood and is expressed by at least four of the following: —Is unwilling to be involved with others unless they are certain of being liked. —New interpersonal situations are inhibiting due to feelings of inadequacy. —Fear of shame or ridicule causes restraint within intimate relationships. —Fear of embarrassment causes an unwillingness to take personal risks or engage in new activities. —Fear of rejection, disapproval, or criticism creates an avoidance of occupational activities that involve significant interpersonal contact. —Has a preoccupation with being rejected or criticized in social situations. —Believes they are inferior, socially inept, or personally unappealing to other
Know the genetic causes and presented symptoms of the following disorders: Fragile X
Fragile X- An issue on the X chromosome, they may have moderate to severe IQ impairments, tend to have larger extremities like heads or ears, are at risk for other disabilities as well.
When is a psychologist allowed/required to break confidentiality?
Harm to self (suicide threat), harm to other (homicide or violence threat), abuse (child, elderly, or disabled in particular) - *must tell patient at the start of therapy about these exceptions to confidentiality
What are the effects of stimulant medications on children?
Helps them focus attention and decreases motor activity, happens in healthy children as well
Reactive attachment disorder
In a child, inhibited and emotionally withdrawn behavior toward adult caregivers, with social and emotional disturbance relating to neglect or insufficient care before age 5
What was the deinstitutionalization movement? What were two unanticipated results of this movement?
Increased meds in 50s led to removal of people from state hospitals - By the 1970s, legal standards concerning the right to treatment in the least restrictive setting were in place - The population of patients housed inside of state hospitals decreased dramatically (went to metal hospitals to prisons, homelessness)
What must insomnia be distinct from in order to be diagnosed? How do heightened arousal and negative conditioning contribute to insomnia?
Insomnia must be persisting long after the causal factor and not induced by medication or other disorder - When they can't sleep, they become frustrated or anxious, increased emotional arousal, further implicates their ability to sleep -If you can't sleep and still remain in bed, you associate the bed with wakefulness
Know the main symptom profiles of intermittent explosive disorder, kleptomania, and pyromania.
Intermittent explosive disorder: recurrent outbursts, verbal physical aggressiveness, episodes of violence, involves failure to resist aggressive impulses. Kleptomania: an impulse that they can't control to steal things (more common for females) Pyromania: impulse to set things on fire (more common for males) With both Kleptomania and Pyromania: their actions are still intentional, but they just have an unnatural urge to do those things.
Know the genetic causes and presented symptoms of the following disorders: Klinefelter's syndrome
Klinefelter's- Have an XXY sex chromosome, which means they have outward female characteristics (like breasts), but are technically male. Tend to have female interests, but IQ tends to be normal
How does malingering influence potential sanity or competence cases?
Malingering is when people feign a disability to avoid sentences or the death penalty, plays a big role and can be one of the most problematic things about competency and insanity pleas - Some clients are motivated to exaggerate symptoms or malinger, perhaps in the mistaken belief that a ruling of incompetency will make it easy to "beat" the charges. -In one review of 105 criminal defendants referred for neuropsychological evaluation, rate of probable and definite malingered neurocognitive dysfunction was over 50%
What is the McNaughten Rule? What is the Durham Rule? How do these relate to guilty by insanity? What is the current rule under the model penal code?
McNaughten Rule: Defendant is acquitted if they don't know right from wrong - Durham Rule: acquitted if crime is do to mental illness - Model Penal Code or Current: if the accused has no other mode or motivation present, are mentally ill, and do not know right from wrong, then they are acquitted (American Law Institute) - In Jones v. United States (1983) the U.S. Supreme Court rules that those acquitted by reason of insanity could be held under indefinite commitment until they proved themselves no longer dangerous
Schizoaffective Disorder
Mood episode, hallucinations, and delusions occurring together at least one day of this
Neurocognitive disorders Whether Mild or Major
Neurocognitive disorders are diagnosed on the basis of a decline in functioning in at least one of six cognitive domains: a. Complex attention is the ability to attend to sustained, multiple, or selective aspects of an activity. It is demonstrated when a person can remain on task, ignore distractions, and divide attention between two or more things. b. Executive function is the ability to plan tasks, make decisions, manipulate information, solve problems based on feedback, apply complex and effortful solutions, and shift between concepts. c. Learning and memory involve several memory abilities such as short-term recall, delayed recall, cued recall, and recognition, as well as the ability to learn new things. d. Language involves expressive abilities such as naming, word finding, grammar and syntax, and receptive understanding. e. Perceptual-motor abilities include the ability to navigate; to use tools or devices; and to imitate, draw, or copy. f. Social cognition includes the ability to detect and recognize emotion in others or to understand another person's point of view. For Major cognitive decline is significant, and the impairments in these areas interfere with independent functioning. In the case of mild neurocognitive disorder, cognitive decline is modest, and independent functioning remains adequate. People with mild neurocognitive disorder can perform complex everyday activities, such as paying bills, although greater effort or certain accommodations may be necessary.
What happens in the brain with Alzheimer's disease (i.e., what is the neuropathology including cellular processes)?
Neurofibrillary tangles (misfolding of talc proteins), beta amyloid plaques (senile plaques, clumps of beta amyloid that stick together between the neurons), decline in acetyl choline (neurotransmitter that's heavily involved in memory processes) - Gradual, chronic deterioration of cholinergic neurons (those neurons that use acetylcholine as their neurotransmitter) that innervate the forebrain -
Know the genetic causes and presented symptoms of the following disorders: Turner's syndrome
Only have one X chromosome, (always female) less likely to have intellectual disabilities
Know the genetic causes and presented symptoms of the following disorders: PKU
PKU- Issue on Chromosome 12, cannot metabolize phenylalanine, which is an amino acid found in many foods. These individuals will only have lower IQs if they eat phenylalanine
Antisocial Personality Disorder
Pervasive and reckless disregard others, violations of rules or laws, impulsiveness, deceitfulness
Narcissistic Personality Disorder
Pervasive exaggerated sense of self-importance, lack of empathy, and need for admiration
Borderline Personality Disorder
Pervasive instability in relationships, self-image, and feelings
Avoidant Personality Disorder
Pervasive social inhibition and feelings of inadequacy Feelings of inadequacy, social inhibition, and hypersensitivity to negative evaluations. This pervasive pattern has occurred since early adulthood and is expressed by at least four of the following: —Is unwilling to be involved with others unless they are certain of being liked. —New interpersonal situations are inhibiting due to feelings of inadequacy. —Fear of shame or ridicule causes restraint within intimate relationships. —Fear of embarrassment causes an unwillingness to take personal risks or engage in new activities. —Fear of rejection, disapproval, or criticism creates an avoidance of occupational activities that involve significant interpersonal contact. —Has a preoccupation with being rejected or criticized in social situations. —Believes they are inferior, socially inept, or personally unappealing to others.
Dependent Personality Disorder
Pervasive submissive and clinging behavior and fear of separation Excessive need to be taken care of that leads to fears of separation, as well as submissive and clinging behavior. This pervasive pattern has occurred since early adulthood and is expressed by at least five of the following: —Needs others to be responsible for most major areas of their life. —Exaggerated fears of being unable to care for themselves causes helplessness or discomfort when alone. —When a close relationship ends, immediately seeks another relationship for support and care. —Requires an excessive amount of reassurance and advice from others in order to make everyday decisions. —Has difficulty doing things on their own or initiating projects due to a lack of approval or support. —Expressing disagreement with others is challenging due to fears about loss of support or approval. Realistic fears of retribution are not included in this criteria. —Makes excessive efforts to obtain support and nurturance from others, even volunteering to do things that are unpleasant. —Unrealistic preoccupation with fear of being left to take care of themselves.
Histrionic Personality Disorder
Pervasive, excessive emotionality and attention seeking (Princess or Victim Disorder
body dysmorphic disorder
Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others Repetitive Behavior to appearance concerns Preoccupation causes clinically significant distress Not attributed to another medical condition Not attributed to body fat or weight gain from an Eating Disorder
OCD
Preoccupation with perfectionism, orderliness, and mental/interpersonal control, at the cost of efficiency, flexibility, and openness. This pervasive pattern has occurred since early adulthood and is expressed by at least four of the following: —Difficulty completing tasks due to a need for perfectionism (e.g., their overly strict standards cause the inability to finish a project) —Inflexible, scrupulous, or excessively conscientious about ethics, values, or matters of morality, which cannot be accounted for by any cultural or religious affiliation —Miserly in matters of spending money on themselves or others; feels the need to hoard money in case of future catastrophes —Reluctant to work with others or delegate tasks unless others agree to do things precisely their way —The major point of activities becomes lost due to a preoccupation with order, rules, details, lists, schedules, and organization —Forgoes leisure activities and friendships due to an excessive devotion to work and productivity that is not an obvious economic necessity —Unable to get rid of worthless or worn-out things, even items with no sentimental value —Displays stubborn, rigid behavior
major depressive disorder
Presence of major depressive episode NO Manic or hypomanic Five of 9 during same two week period Depressed most of day Diminished interest Significant Weight change up or down or appetite change Insomnia or hypersomnia nearly every day Psychomotor agitation or retardation Loss of energy Worthlessness Difficulty concentrating Suicidal thoughts
Excoriation (skin-picking) disorder
Recurrent picking of skin
Trichotillomania (hair-pulling) disorder
Recurrent pulling out of hair
Understand the three requirements for narcolepsy? Do individuals need to have all three? What are hypnopompic and hypnagogic hallucinations? Why do they occur and are they common?
Requirements Cataplexy (loss of muscle tone due to strong motions)basically Fall over but still conscious, hypocretin deficiency (neurotransmitter released by the hypothalamus, its associated with arousals. Cant stay awake without hypocretin), they go straight into REM sleep in about 15 minutes or less (can cause hallucinations) - Most have all three but don't need all three hypnopompic hallucinations - Hallucinations when waking up; hypnagogic hallucinations hallucinations when going to sleep - 15% of the general population (not unique to narcolepsy)
Know the requirements and subtypes for both anorexia nervosa and bulimia nervosa.
Restrictive caloric intake insufficient to maintain normal body weight, intense fear of gaining weight, disturbance in perception of body size o Types: restricting (diets, fasts, excessive exercise) and binge-eating/purging (unable to maintain healthy body weight) - Recurrent episodes of eating large qualities of food (binge eating) and subsequent compensating behavior, once/twice a week to several times a day o Types: purging (vomit 70%, laxatives 30%) and non-purging
What are risk factors for dementia? What are protective factors against dementia? What can you do now to reduce your risk of dementia? Know birth, early life, mid-life, and late life risk factors and how you can mitigate these risk factors.
Risk Factors: Being born with the APOE-4 allele (birth), Having less education (early life), hearing loss, hypertension, obesity (mid-life), smoking, depression, physical inactivity, social isolation, diabetes (late life) Other factors traumatic injury, smoking, depression, sleep disturbances, hyperlipidemia Protective Factors - More education, physical activity, Mediterranean diet, cognitive training, moderate alcohol consumption, social engagement
What are the risk factors for eating disorders? What other disorders are eating disorders comorbid with?
Risk factors: being teased as a child/teenager, not being able to resolve conflict, maternal preoccupation about weight (when mom is always talking to them about their weight), chronic disease, athletic competition Reason behind athletic competition is because when you're involved with contact sports or more violent sports, these individuals then overcome that barrier of hurting themselves by being involved in these sports. Also involved in suicide Sports like dance or gymnastics or wrestling where weight is a big factor also makes children focus more on their bodies and weight than other kids Other disorders that eating disorders are comorbid with: Depression (60%), Anxiety (60%), OCD (40%), Trauma (25% - 60%)
Schizophreniform Disorder
Same as Schizophrenia, but duration less than 6 months 1 month at least
Define sanity. How can you differentiate between competency and sanity? What does not guilty by reason of insanity mean? If someone is deemed not guilty by reason of insanity, what happens next?
Sanity is The mental ability to distinguish right from wrong and to form the intent to commit an act such as a crime - Competency ability to stand trial Sanity- your responsibility of your actions at the time of the crime What happens if they are found not guilty by reason of insanity - Cannot be held responsible, rarely land in court - If sane, they spend many years in prison; if insane, they spend, on the average, about the same number of years confined to a mental hospital
What is pseudodementia? Be able to differentiate dementia from depression.
Significant cognitive disturbances coinciding with depressive episode that remits when depressive symptoms abate, 20% of old depressed have pseudodementia, may progress to clear dementia over a period of years - Depression o Rapid onset and short duration of cognitive impairment o Depressed mood prominent o Cognitive performance fluctuates and remits with antidepressant treatment o Onset of depressive symptoms before cognitive problems o Complain about memory problems even if no real deficit - Dementia o Progressive decline, persistent deficits o Cognitive impairment prominent o Constant disability; no response to antidepressant treatment o Depressive symptoms follow cognitive failure o Have deficits but overestimate abilities
Schizotypal (Schizo-type-al)
Social and interpersonal deficits marked by perceptual or cognitive distortions and eccentricities of behavior, as well as by acute discomfort with (and reduced capacity for) close relationships. This pervasive pattern has occurred since early adulthood and is expressed by at least five of the following: —Appearance or behavior that is considered eccentric, peculiar, or odd —Peculiar thinking and speech (e.g., overelaborate, metaphorical, vague, stereotyped) —Ideation that indicates paranoia or suspiciousness —Ideas of reference, not including delusions of reference —Unusual experiences of perception, such as bodily illusions —Excessive social anxiety (that does diminish with familiarity), tending to be associated with paranoid fears instead of negative self-judgment —Inappropriate or limited affect (emotion or mood) —Behavior influenced by magical thinking or peculiar beliefs that is not consistent with subcultural norms —Few if any close friends or confidants (other than first-degree relatives)
Somatic Symptom Disorder
Somatic symptoms causing disproportionate distress and disruption Somatic symptom disorder involves a person having a significant focus on physical symptoms, such as pain, weakness or shortness of breath, that results in major distress and/or problems functioning. The individual has excessive thoughts, feelings and behaviors relating to the physical symptoms
In what academic tasks can a specific learning disorder be diagnosed/what are they called? What are the names of the three main types of learning disorders?
Specific learning disorder with math: dyscalculia Reading: dyslexia Writing: dysgraphia
Define specific learning disorder.
Specific learning disorder: Having challenges with learning a specific subject. The three academic tasks in which specific learning disorder most commonly occur are: math, reading, and writing
Know the stages of sleep. Understand the differences between sleep stages. When does the body repair itself? How does brain and muscle activity vary across sleep stages? What state mimics wakefulness? What are the deepest or most restorative stages of sleep?
Stages 1 & 2: Characterized by light sleep, more brain activity, and some muscle movement Stages 3 & 4: Characterized by deep sleep, with delta waves in the EEG, some muscle activity, and this is where the body repairs itself Final Stage is REM sleep: Rapid Eye Movement, dreams, no muscle movement, Sleep stage that mimics wakefulness on the EEG scale
What are the physical features associated with autism? Specifically know about head and brain size. How is this related to cognitive functioning in autism (think about efficiency and the number of connections)?
Tend to have larger brain sizes, head circumference is larger, heavier brains. This is because they have more white matter connections than others of their same age. In typical development your brain will grow, and then go through a phase that prunes back those connections in order to be more efficient, but that phase doesn't happen for those with ASD, so they have too many connections which makes them less efficient in cognitive functioning.
What are major and mild neurocognitive disturbances? How can you differentiate between major and mild neurocognitive disturbances?
The cognitive disturbance is present in one or more cognitive domains - Major Neurocognitive: significant decline in function, interferes with ADL's - Mild Neurocognitive: modest decline in function, does not interfere with ADL's Assessment of activities of daily living (ADL)
What are the levels of severity in children with intellectual disability? How is severity determined? Broadly speaking, how would you differentiate between the levels of severity?
The different levels are mild, moderate, severe, profound. Severity is determined by degree of dysfunction/ adaptive impairment- things like vocabulary, motor skills, and need of support, but NOT IQ. Mild- most common, elementary education level, can talk, few motor skills, lack coordination, need minimal support Moderate - makes up 10% of the population with intellectual disabilities, don't reach high levels of vocabulary, impairment in academic, motor and social skills, need support but often can contribute or even work if supervised Severe- very little speech, poor motor and century(?) skills, often in a wheelchair, very low elementary education level, will need support throughout their lives Profound- highest level, often in state hospitals or require constant supervision and help, often have deformities, fully dependent
Are individuals with mental health diagnoses more likely to be violent? How much? What percentage of those with mental health disorders ARE NOT violent?
The prevalence of violence among those with a mental disorder is five times higher than those without a mental disorder -More than 90% of those with mental disorders are not violent
Define activity of daily living. How are these activities of daily living related to dementia? Be able to identify and provide examples of activities of daily living.
Things you must do every day in order to be independent, take care of yourself, and function - Dementia can only be diagnosed if ADLs are impaired -Eating, bathing, dressing, transferring, toileting, walking or moving around
What is the Tarasoff case/duty to warn rules? When are psychologists required to warn people of possible harm?
This was where a therapist heard from client that they were going to kill a certain individual. The therapist warned police but not the individual or individual's family Now therapist have a duty to warn therapist must do everything in power to help
Dissociative identity disorder
Two or more distinct personality states, with inability to recall important personal information
Know the behavioral ways to improve sleep. What should you do to improve your sleep? What should you avoid? May you implement these things to improve your sleep .
Use bed only for sleeping/sex, awake same time / go to bed same time (only when sleepy), relax in separate if awakened after 20 minutes of retiring until tired - Cool room (60-65 degrees), avoid day naps, avoid caffeine/nicotine, balanced diet, reduce noise/stimulation, evening exercise, light snack, avoid extra wink in morning, imagine tranquil/calm
Understand the treatment for eating disorders. Is it easy to get someone involved in treatment? What types of treatment receive the most research? What treatments are best/successful for anorexia? Bulimia?
Very difficult to get people into treatment, even more difficult to keep them in treatment, and this is regardless of when they are diagnosed Bulimia/ binge eating disorder have more research than anorexia Most common/ successful treatments for anorexia: Family therapy- for early onset (teenagers and kids need parents) More supportive treatments with late onset (for those with no family in home with them) In patient care is common for anorexia, though there is no medication that is currently effective Bulimia: CBT and antidepressants are effective Bulimia is easier to treat, at least tends to be more successful ***Before jumping into treatments, make sure you check if the patient needs immediate hospitalization. They need to be stabilized before psychotherapy treatments are started.
How does the World Health Organization classify obesity? How does the DSM-5 classify obesity? Is obesity a mental health disorder? Why or why not?
WHO: classifies it as an epidemic DSM-5: does not classify obesity because it is not necessarily due to a cognitive deficit.
How is not guilty by reason of insanity similar or different to guilty but mentally ill? What happens to the individual when they are guilty but mentally ill?
When not guilty by reason of insanity you are not accountable and will be sent to treatment; guilty but mentally ill is where state provides treatment until it is complete, then sent to prison
What are the characteristics of a binge (amount eaten, environment it is done in...etc.)
When someone eats rapidly, eats until they are uncomfortably full. Will eat even when not hungry Will often binge alone because they're embarrassed, disgusted, guilty or depressed for overeating. Usually eat high calorie foods and an unusually large amount of food
Know the results and implications of the experiment where rats were not allowed to sleep.
When you are deprived of sleep the hypothalamus dysregulated, this helps maintain homeostasis. Rats had hard time regulating body temperature. Eating a lot. Then Lost a lot of weight then 28 days later they died
What is circadian rhythm sleep disorder? What are the primary symptoms? Are there different subtypes? How are the subtypes similar/different?
When you have problems with your circadian rhythm which causing problems with sleeping patterns - Delayed sleep phase type (late sleep onset and late wakening times with an inability to fall asleep and wake at a desired earlier time, these people cannot shift their cycle forward), advanced sleep phase (experiencing earlier sleep onset and awakening), shift work type (insomnia during the major sleep period or excessive sleepiness during the major awake period associated with family or work-related disturbances during sleep times), irregular type (lacking a discernable sleep wake rhythm, fragmented into different periods during the day), non-24 type (sleep phase gradually increases and drifts out of the 24 hour alignment, sleep moves into daytime hours over long period of time) Primary Symptoms Trouble going to sleep and waking up on a consistent schedule
Can psychologists provide medical prescriptions in some states? Do you think this is a good or bad idea based on the discussion in lecture?
Yes - Could be good, psychologist can understand more, but they don't have the pharmaceutical training they have
What is the relationship between sleep and age?
You need less sleep as you get older
Delusional Disorder
bizarre delusions without other symptoms at least a month SO like the I believe the Sun is trying to talk to me
Social Anxiety Disorder
fear of social situations where scrutiny by others is possible Scared of displaying anxiety symptom to others Social Situation provokes fear/anxiety Social situation avoided or endured with fear/anxiety Level of Fear/Anxiety not normal response to situation Symptoms last 6 months or more causes distress in social, occupation, or other important areas of life Not related to drugs or other medical issue Not explained by another mental illness
ADHD: What are the three different subtypes (classifiers)? What are the primary symptoms of the subtypes? Do these symptoms only happen during the day or are they also present during sleep?
inattentive type: when children cannot focus or pay attention to small details. (can't cut or color in the lines) Can't maintain attention, don't listen or follow instructions hyperactive/impulsive- when children have large amounts of energy, fidget, climb around which means they have more accidents than other children, can't sit still, are impulsive, tend to blurt out or interrupt. Although they can focus on some things like video games. Tend to be more fidgety in their sleep Combined: both of these
