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EPPP Academic Review Outline Hot Points


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GAF cutoff for inpatient?
50 is the cutoff for inpatient overall
Polythetic Criteria
need only a certain number of symptoms to get diagnosis. (Example--> Need 4 of 10 symptoms)
Conduct Disorder vs. Oppositional defiant disorder
CD involves difficulty with law
gender differences in ADHD
3-5 times more in boys
"Pure" ADHD
have more cogntive and academic problems than those kids with a dual diagnosis
Mental Retardation ranges
Mild--> 50-70
Moderate--> 35-50
Severe--> 20-34
Profound--> below 20
Ear infections (otitis media) and learning disabilities
Increased LD, lower on Verbal Comprehension
Tourette's and OCD
1/3 of Tourette's kids also have OCD
Tourette's and ADHD
50% have ADHD
Reactive Attachment Disorder, Inhibited type
"scared kitten"
Ambivalent, hypervigilant
Reactive ATtachment Disorder, disinhibited type
bond with anyone; no real differentiation
Dementia due to Head Injury
loss is not progressive and has retro and antero grade amnesia
cognitive disturbances
memory loss (ST & LT)
ALWAYS due to a medical condition or substance use
Alzheimer's dementia
only diagnosed through autopsy (brain biopsy); progressive; starts with anterograde amnesia
Stages of Alzheimers
1) STM problems; irritability; depression
2) Further explicit memory loss; difficulty with complex tasks (shopping, etc)
3) serious impairment; trouble with simple tasks; recognition difficulties
Vascular Dementia
Caused by CV
Course is stepwise and not progressive (if you have a stroke, you have an impairment)
Deficits are patchy and not uniform (depends on location of stroke)
* gen med or substance induced
* decreased ability to concentrate and pay attention
* disorientation and problems speaking
* cognitive problems in MDD
* No substance or med problem
* Cognitive decrease is abrupt
Post Partum Depression
80 % of women get
postpartum blues; 10-20% get post partum DEPRESSION
Suicide Facts
Older People do it more than younger people

White more than nonwhite

Men more than women (women try more)

Native Americans less than 45 have the highest risk overall
Beck's cognitive theory of depression
1) automatic thoughts
2) cognitive distortions
3) Schemas
1) work on norepinephrine (prevent breakdown)
2) good for atypical depression and symptoms of anxiety and phobias
1) antidepressant
2) work on Norepinephrine and Serotonin (prevent reuptake)
3) Relieve depression with motor retardation and somatic symptoms
1) prevent reuptake of Serotonin
2) atypical depression
3) depression, OCD, anxiety, premature ejaculation
4) less cardiotoxic, onset is rapid, and no cognitive impairments
Progression of Psychosis
less than 1 month--> Brief Psychotic Disorder

Less than 6 months--> Schizophreniform

More than 6 months--> Schizophrenia
Delusional Disorder
Nonbizarre delusional system (I'm being followed)

Can funtion in society
Schizoaffective Disorder
Meet criteria for mood disorder and Schizophrenia

For at least 2 weeks, the mood symptoms go away and the psychotic symptoms stay
Concordance rates of Schizoprehnia
* General Population--> 1%
* biological siblings--> 10%
* Fraternal Twins--> 15-17%
* Identical Twins--> 46-48%

Type 1 schizophrenia
* Positive symptoms
* Traditional antipsychotics work best
* NT abnormality
Type 2 Schizophrenia
* Positive and negative symptoms (negative are priamry)
* Structural Brain Abnormality
* Prognosis is worst
* Atypical's work best (on serotonin and dopamine)
Anxiety vs. Depression
Anxiety has similar level of negative affect and higher levels of autonomic aroual and positive affect
Social Phobia
* Fear of scrutiny by strangeres
* social situations
* Having a friend present can increase anxiety
Specific Phobia; Blood-type
requires tensing muscles to prevent passing out.
Specific phobia
No social phobia or agoraphobia allowed!
fear of being in a situation and having a panic attack
* Friend can help to alleviate the symptoms
Rebound anxiety
often seen in treatment that uses benzos
Panic Disorder
Sudden extreme loss of control

With or without agoraphobia

Acute Stress disorder
less than one month
symptoms at least one month;

extreme trauma

treatment--> coping, exposure, early intervention
OCPD does not have obsessions or compulsions

OCPD has a preoccupation with order, control, perfection
Factitious disorder vs. Malingering
Facticious disorder--> no real symptoms; wants to be in "sick role."

Malingering--> does it for an external payoff.
signified by tolerance and withdrawal
Stages of Change
1) Precontemplation--> no problem

2) Contemplation--> change in next 6 months

3) Preparation--> within the next month

4) Action--> Actually changes

5) Maintenance--> 6 months on; prevent relapse
Hypnagogic hallucinations
hallucinations while falling asleep
hypnopompic hallucinations
hallucinations when waking up
Dependent Personality Disorder
have to rule out a mood disorder first
Gestalt Therapy
goal is to integrate thoughts, feelings, and actions
Feminist therapy vs. Non-sexist therapy
Feminist therapy focuses on political change as a goal
Strategic Family Therapy
* Haley
* Prescribing the symptom
* Paradoxical techniques
Structural Family Therapy
* Minuchin
* triangulation
* Enmeshed vs. disengaged families
* Reframing
* Joining the family
Extended Family Systems therapy
* Bowen
* Intergenerational transmission process
* Triangulation
Goal--> Differentiation of Self
Solution-Focused therapy
* Miracle ? (A miracle happens and your problem is solved. What is different?)

* Exception ? (Think of a time when problem didn't exist. What was that like?)
Yalom--> Group therapy
What is important is:
1) Interpersonal learning
2) cohesiveness
3) catharsis
study culture from the inside (what is important to this culture?)
Study culture from the outside (What does science say is important for this culture?)
Minority Identity Development Model (Atkinson)
1) Conformity
2) Dissonance
3) Resistance & Immersion
4) Introspection
5) synergistic articulation & Awareness
Cross's Nigrescence Theory
1) Pre-Encounter
2) Encounter
3) Immersion-Emersion
4) Internalization
5) Internalization- Commitment
Helm's White Racial Identity Development Model
1) Contact
2) Disintegration
3) Reintegration
4) Pseudo-Independence
5) Immersion-Emersion
6) Autonomy
Backward Conditioning
Doesn't work
Decrease of an emotional response by an extinction procedure
Experimental Neurosis
When forced to make stimulus discrimination between 2 closely related items
Higher Order conditioning if US is present...
Doesn't work (blocking)
Higher Order conditioning is US is not present...
works!! (2nd order is as high as you can go)
pairing a CR with an incompatible response (for example--> anxiety with relaxation; you can't be anxious and relaxed at the same time)
Systematic Desensitization
Research shows that what is important is not relaxation, but exposure (extinction)
Aversive Counterconditioning
something you don't like is paire with something that you want to get rid of (shoe fetish)
In vivo vs. Covert
In vivo works better
Implosive Therapy
combines covert exposure(imaginary) wtih psychoanalysis

* Start right at top of hierarchy and extinction happens quickly
mass practice is better than spaced practice

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