CNCO 6354

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treatment for dependant personality disorder: therapy to deal with specific problems
schizophrenia vs.schizoaffective: schizophrenia does not have a MAJOR DEPRESSIVE EPISODE, a MANIC EPISODE, or a MIXED EPISODE
OCD: recurrent obsessions or compulsions that are severe and time consuming and cause marked distress and impairment
mixed type of delusional disorder: delusions of more than one type
displaced anger: rape is expression of displaced anger and rage
Deaf: deaf and involved in the deaf community
what are types of cognitive disorders in children: 1. mental retardation 2. learning disorders 3. communication disorders 4.pervasive developmental disorder
treatment of bulimia nervosa: pharm (anti-depressant SSRI), CBT 5-6 months, hospitalization if out of control
factitious disorders: intentional production or feigning of physical or psychological signs or symptoms, motivation is to assume the sick role
what Axis do personality disorders fall under: Axis II
clinical symptoms of sexual abuse in children: 1. anxiety symptoms ( fear, phobia, insomnia, nightmares, somatic complaints, PTSD) 2. dissociative reactions and hysterical symptoms: periods of amnesia, trance like states, hysterical seizures, DID) 3. depression( low self esteem, suicidal) 4. disturbance in sexual behaviors 5. somatic complaints ( enuresis, encopresis, vaginal itch, anorexia...)
schizoid personality disorder diagnosis DSM: detachment from social relationships restricted expression of emotions, flat affect, must have 4 of the following: 1. always solitary 2. do not desire close relationship 3. little interest in sex 4. very few pleasures 5. indifference to criticism 6. emotional coldness, detachment, or flattened affectivity
sedative, hypnotic, or anxiolytics examples withdrwal symptoms: similar to alcohol , can cause death due to seizure
response to PTSD presentation to trauma is in three ways: 1. reexperience (flash backs) 2. avoidance 3. hyperarousal
PTSD in child and adult DSM: exposed to trauma in which BOTH of following were present: 1. experienced, saw confronted with events that involved actual or threatened death, or physical integrity of self or others 2. respose was intense fear, helplessness or horror
prognosis for GAD: lifelong and chronic
avoidant personality disorder must have (DSM): 4 of following: 1. avoid occupational activities requiring interpersonal contact 2. restrain intimate relationship due to fear of shame or inadequacy 3. preoccupied with being criticized or rejected 4. view self as socially inept 5. won't take personal risks 6. won't get involved unless like the person
types of nature of onset of the sexual dysfunction: 1. lifelong type( has been present sicne the onset of sexual functioning) 2. acquired type ( developes only after a period of normal functioning)
when to hospitalize for suicidal thoughts: 1.no strong social support, 2. history of impulsive behavior 3. suicidal plan of action 4. won't commit to suicide contract 5. dramatic change in patient's suicidal ideation= at peace with himself 6. patient is psychotic 7. late male with sub. use and aggressive with severe depression
etiology of spousal abuse: 1. feeling of inadequacy 2. humiliate spouse to gain self esteem 3. identify with an aggressor 4. test to see if spouse stays 5. distorted way to express manhood 6. perceives wife as property
initial insomnia: hard time falling sleep
Trauma reexperience of PTSD child and adult DSM: ONE or more of following: 1. recurrent recollection of images, thoughts or perceptions. CHILD: repetative play which trauma is expressed 2. recurrent dreams CHILD: frightening dreams without recognizable content 3. acting and feeling that trauma is recurring CHILD: reenactment 4. intense distress when exposed to internal or external cues like trauma 5. physiological reactivity to cues
gender identity NOS: persistent preoccupation with castration without desire to be the other sex
what is the age of onset for bipolar II: 0-5 years
diagnosis of schizotypal personality DSM: social and interpersonal deficits marked by acute discomfort with reduced capacity for close relationships and eccentric behavior
features of Cluster A personality disorders: odd, aloof features, common in biological relatives
avoidant personality disorder clinical features: 1. extreme sensitivity to rejection 2. not asocial and desire for companion 3. have inferiority complex 4. shy and timid 5. have no close friend
treatment for avoidant personality disorder: anti anxity and antidepressent, assertiveness training
adjustment disorder: emotional response to a stressful event
antisocial behavior belong to what Cluster: cluster B
4 phases of sexual response cycle: 1. desire 2. excitement 3. orgasm 4. resolution
inhalants have: no WITHDRAWAL
PTSD trauma responses are:: multifaceted ( emotional, cognitive, behavioral, social. all four)
what is the duration of MDD: untreated= 6-13 months; treated= 3 months
subtypes of bulimia nervosa: 1. binging or non purging type 2. purging type
what Axis anxiety disorders fall under: Axis I
somatization vs schizopherenia: somatization = does not have delusions
autistic clinical presentation: avoid eye contact, gaze, delayed language, constant talking, stereotypical behaviors( flapping arms), like to be by themselves
schizophrenia: has genetic disposition and need the right environment to develop
gender identity: individual's self perception as male or female
diagnosis of dependant personality disorder, DSM: excessive to be taken care of that leads to clinginess
Asperger's disorder: severe impairment in social interaction and development of repetative patterns of behavior that cause disturbance to social and occupational functioning
treatment of opiods: naloxone (antagonist)
schizophrenia types: 1. type I 2. type II
voveurism: observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity for period of 6 months
somatization (DSM) must have: 4 pain symptoms ( related to at least 4 sites), 2 GI symptoms( other than pain), 1 sexual symptom (other than pain), 1 pseudoneurological symptom( other than pain, conversion , loss of consciousness) and symptoms are not intentionally produced
treatment for borderline personality: pharm=anti anxiety, anti depressant, anti psychotic meds. depending on the mood ; therapy = long, therapist active and directive
PTSD response in adult: respond with horror or helplessness
Appendix H: hospital setting
acute stress disorder diagnosis: 3 dissociative symptoms/2days-1 mo
differnece between antisocial personality disorder and kleptomania: antisocial=for personal gain and premeditated
ego-systonic: acceptable to ego
what is the difference between MDD and Minor depressive: equal in duration but less severe
schizophrenia residual type: NO prominent delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior
poly substance dependence: 12 months and used at least 3 groups of sub. not including caffeine or nicotine
re-experiencing: PTSD symptom; nightmares, flashbacks, panic attacks, triggers intrusive memories
schizophrenia paranoid type: 1.presence of prominent delusions or frequent auditory hallucination 2. NONE ARE PROMINENT: disorganized speech or catatonic behavior, or flat or inappropriat affect
suicide factors: will not think life will get better, hopeless, comorbid with other mental disorders, elderly and kids higher risk
difference between anxiety disorder NOS and ASD/ PTSD: NOS= no 3 symptoms cluster, no hyper arousal, not impaired, traumatic event was not life threatening
gender identity disorder DSM: strong and persistent cross gender identification accompanied by persistent discomfort with one's assigned sex
paranoid personality disorder (PPD) belongs to what Cluster: Cluster A
features of paranoid personality disorder (PPD): 1. suspiciousness 2. often hostile, irritable, and angry, 3. rarely seek treatment, 4. inability to relax, 5. speech is goal directed, 6. lifelong
GAD: excessive anxiety and underlined cause is absent
diagnosis of anorexia nervosa: 1. behavior present 3 mo 2. voluntary excessive weight loss 3. intense fear of fatness 4. symptomology
mental retardation: IQ of 70 or below onset before 18years
Pathological gambling: persistent and recurrent gambling that causes economic problems and significant disturbances in personal, social, or occupational function
acute stress disorder (ASD): like PTSD only 2 days to 1 month after trauma; >1 month is PTSD
child abuse clinical sexual signs: physical signs, psychological signs ( fearful of adults esp. men, retraction and contradiction when child discloses, adult and adolescents may develop PTSD, dissociative disorders)
what are types of mood disorders: 1. Major dpressive disorder(MDD) 2. Bipolar disorder 3. Dysthemic disorder 4. cyclothymic disorder 5. hypomanic disorder
onset of OCD: 20 years, sudden, stressful events such as death of loved one, pregnancy, sexual problems
addiction: repeated use of substance= dependence
name the 3 criteria that anorexia nervosa is characterized by: 1. self induced starvation 2. relentness for thinness or morbid fear of fatness 3. presence of medical signs and symptoms resulting from starvation
cross tolerance: substitution of one drug for another that creates the same physical and psychological effect
onset age of antisocial behavior: before 15, men > women
ICD 10: medical coding , used instead of DSM IV
child abuse clinical physical features: behaviorally: withdrwan and frightened, may show aggressive mood, depression, poor self esteem, anxiety, delay in development; physical signs
treatment for panic disorder and agrophobia: antidepressants( SSRI, MAOI) anti-anxiolytic for 8-12 months
communication disorders types: 1. expressive language disorder ( can not express themselves) 2. mixed receptive expressive language disorder ( can not recieve or express) 3. phonological disorder ( not using proper language and sounds for age) 4 stuttering 5. NOS 6. selective mutism ( choose not to speak due to trauma)
anxiety disorder classification: 1. panic disorder with or without agrophobia 2. agrophobia with or without panic disorder 3. specific phobia 4. social phobia 5. OCD 6. PTSD 7. acute stress disorder 8. generalized anxiety disorder (GAD)
Gender dysphoria: strong and persistent feelings of discomfort with one's assigned sex, the desire to possess the body of the other sex, and desire to be regarded by others as a member of the other sex
what are types of pervasive developmental disorders: 1. autistic 2. Rett's disorder 3. childhood disintegrative disorders 4. Asperger's disorder 5. PDD NOS
obsessive compulsive personality disorders must have (DSM): 4 of followings: 1. preoccupied with details, rules, lists 2. perfectionism that interfere with task completion 3. devoted to work 4. over conscientious, inflexibe about matters of morality 5. won't throw out old objects 6. spend miserly 7. rigidity and stubbornness
somatization vs. mood disorders: somatization physical complaints throughout life, mood disorder= limited to episodes
what are the disorders of Cluster B of personality disorders: 1. narcissistic 2. borderline 3. antisocial 4. histrionic
sub. induced amnestic disorder: can not remeber the key info. in life
coding of psychosomatic disorders: psychological factors affecting medical conditions =Axis I, accompanying general medical condition = Axis III
what Axis adjustment disorders fall under: Axis I
what neurotransmitters are involved in panic disorder: Norepinephrine, Seretonin, GABA
schizotypal personality must have (DSM): 5 of : 1. odd belief and magical thinking 2. ideas of reference 3. paranoid ideation 4. eccentric appearance 5. excessive social anxiety lack of close friends 6. inappropriate or constricted affect 7. odd thinking and speech
somatization vs. general medical condition: somatoform disorders= 1. involves multiple organs 2. early onset and chronic without physical signs or abnormalities 3. no lab findings
types of context in which sexual dysfunction occurs: 1. generalized type ( is not limited to certain types of stimulation, situations, or partners) 2. situational type ( is limited to certain types of stimulation, situations, or partners)
difference between schizophrenia and Intermittent explosive disorder: schizophrenia= aggressiveness toward delusion
difference between Conduct disorder and intermittent explosive disorder: Conduct disorder= episodic pattern, intermittent= repetative pattern of behavior
types of sexual dysfunction disorder: 1. Sexual desire disorder: ( a) hypoactive b) sexual aversion) 2. sexual arousal disorders: a) female sexual arousal b) male erectile disorder 3. orgasmic disorders: a)female orgasmic disorder b) male orgasmic disorder c) premature ejaculation 4. sexual pain: a) dyspareunia b) vaginismus 5. sexual dysfunction due to medical condition 6. sub. induced sexual dysfunction( within one month of sub. intoxication)
grandiose type of delusional disorder: delusions of inflated worth, power, knowledge, identity or special relationship to a deity or famous person
purging type of bulimia nervosa: regular self induced vomiting or use of laxative and diuretics
schizophrenia type I: 1. have positive symptoms 2. acute and rapid onset 3. have good premorbid functioning and social skills 4. lifetime management
panic disorder with or without agrophobia: acute intense attack of anxiety accompanied by feelings of impending doom
trichotillomania: repetitive hair pulling
Dysthemic DSM: depressed mood last all day for 2 symp./ 2 years ( child 3/1 year) & had no major depression episode for first 2 years
bordeline personality must have DSM: 5 of following: 1. avoid real or imagined abondenment 2. unstable and intense intepersonal relationships, alternating between devaluing and idealization 3. unstable sense of self 4. impulisvity in two areas that are self damaging: spending,sex, sub.abuse, binge eating 5. affective instability or reactivity of mood 6. chronic feeling of emptiness7. intense anger 8. transient paranoid ideation or dissociative symptoms 9. recurrent suicidal behavior
prognosis of bulimia nervosa: good rate of recovery
pedophilia: involving sexual activity with a prepubescent child generally age 13 and younger for 6 months; the pereson is at least 16 and 5 years older than the child
borderline personality vs. schizophrenia: borderline lacks prolonged psychotic episodes
what are social factors of bulimia nervosa: 1. high achievers 2. respond to social pressures to be slender 3. families less close 4. use their body as transitional object
neglected child characteristics: indiscriminately affectionate even with strangers, runaway, conduct disorder
name substance related disorders: 1. sub. use disorder 2. sub. induced disorders
How do we define normal: defenition depends on culture, region, development, individual differences(what is normal for that person), recent changes in the environment, background issues (life stressors that have always been there and not noticed e.g. poverty)
narcissistic personality disorder must have , DSM: 5 characteristic of DSM list
Brief psychotic disorder Diagnosis DSM: same as schizophrenia EXCEPT DURATION < 1 month and ONLY ONE OF symptoms on DSM
what is the prognosis of MDD: chronic, recurrence
schizophrenia disorganized type: ALL of the followings are prominent: disorganized speech and behavior, flat or inappropriate affect and criteria for catatonic are not met
eating disorder NOS: 1. anorexia version( normal weight and menses) 2. bulimia version
substance dependence: cluster of COGNITIVE, BEHAVIORAL, and PHYSIOLOGICAL symptoms(shoul have ALL 3 ) that indicates that individual will continue the use despite the problems
dependant personality disorder must have (DSM): 5 of following: 1. difficulty making decision 2. needs others taking responsibility for his life 3. can not express disagreement 4. go too far to get acceptance 5. feel uncomfortable when alone 6. fear of being left alone 7. difficulty initiating projects
onset age of trichotillomania: early to late adolescent
schizophrenia type II: 1. have negative symptoms (flat affect, disorganized speech) 2. poor premorbid functioning and social skills 3. do not respond to meds
what are characteristics of impulse control disorder: 1. tension and arousal before the event 2. instant gratification & relief at completion 3. remorse and guilt afterward
obsessive concern for detail and perfectionism: obsessive compulsive personality disorder
what is the duration of symptoms to be diagnosed for PTSD DSM: one month
what is OCD in child: presence of recurrent intrusive thoughts associated with anxiety or tension
dissociative amnesia diagnosis DSM: 1 or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature
what are subtypes of personality disorders: 1. Cluster A 2. Cluster B 3. Cluster C
onset in MDD in children is: insidious
opiates withdrawal symptoms: restlessness, achy body often in the back of the leg, increased sensitivity to pain, pupillary dialtion, diarrhea, fever, insomnia,anxiety
somatic type of delusional disorder: delusion that have some physical defects or general medical condition
types of impulse control disorder: 1. intermittent explosive disorder 2. kleptomania 3. pyromania 4. pathological gambling 5. trichotillomania 6. impulse control disorder NOS
diagnosis of learning disorders DSM: achieve below average in all FOUR category 1. readin 2. math 3. written expression 4. NOS
deaf: is an experience not a disability
hallucinogens have: no WITHDRAWAL
dissociative identity disorder diagnosis DSM: 1. 2 or more identities or personality states, 2. at least two of these pesonalities will take control of the person's behavior 3. inability to remember important stuff
clinical symptoms of physical abuse in children: 1. affect dysregulation 2. insecure or atypical attachment patterns 3. impaired peer relationship 4. increase in aggression or social withdrawal 5. academic underachiever 6. depression 7. conduct disorder 8. ADHD 9. oppositional defiant disordr 10. PTSD
what is the onset of Dysthemic disorder: childhood to adolescence
what is the difference between Dysthemic disorder and MDD: identical to MDD ; Dysthemic= depression has always been present
reactive attachment disorder clinical feature: neglectful and abusive background, physically or sexually abused
autistic disorder: impairment in communication and social interaction
Diagnosis of pyromania: low IQ, show no remorse, gain satisfaction from destruction, leave clues, resent authority figures
conversion disorder diagnosis DSM: 1 or more unexplained symptoms or deficits affecting voluntary motor or sensory function that suggest a neurological or other general medical condition 1. psychological factors preceded by conflicts or other stressors 2. symptoms are not intentionally produced 3. symptoms creat impairment
dissociative identity disorder treatment: SSRI, MAO, psychoanalytic
diagnosis of antisocial behavior DSM: disregard for and violation of the rights of others before age of 15, must have 3 or more of the list
what is the difference between OCD and obsessive compulsive personality disorder: obsessive compulsive personality disorder=obsessive concern for details and perfectionism
neurotransmitter involved in schizophrenia: dopamine
what is the difference between MINOR DEPRESSIVE and RECURRENT BRIEF DEPRESSIVE: recurrent brief= have episodic and severe symptoms
schizoid personality disorder vs. avoidant: avoidant isloated but wish to participate in activities
diagnosis of narcissistic personality disorder DSM: pattern of grandiosity, need for admiration and lack of empathy
obsession: recurrent, persistent thoughts
OCD treatment: Pharmacological (SSRI, Li) + Behavioral therapy (desensitization, flooding, aversive conditioning, CBT)
Axis II: Personality disorder + mental retardation
binging or non purging type of bulimia nervosa: less anxiety about eating, less body image disturbance
histrionic personality disorder: excitable, emotional, and behave in a colorful, dramatic, extraverted fashion
specific phobia: excessive fear of a specific object, circumstance, or situation
social phobia: afraid of intense emabarrassment and create avoidance
what is the treatment for bipolar I: Manic phase= Lithium(mood stabalizer) and antianxiety meds, Depressive phase= anit depresseants; there are new meds that have both meds in it (Symbyax)
pervasive developmental disorder: characterized by severe and pervasive impairment in several areas of development such as communication skills, social interaction skills, stereotyped behavior
undifferentiated somatoform disorder: lasting 6 moths and below treshold for diangnosis of somatization disorder
kleptomania: act of stealing is the goal not the object
reactive attachment disorder disinhibited type: attach indiscriminately
inadequate men: believe no woman would voluntarily sleep with them and are obsessed with fantasies about sex
onset of bulimia nervosa: adolescent
avoidance behavior in PTSD child or adult DSM: 3 or more of following: 1. avoid thought, feelings and conversation about trauma 2. avoid activities , places or people that arouse recollection 3. unable to recall important aspects of trauma 4. diminished interest and participation in activities 5. felling of detachment or estrangement from others 6. restricted range of affect such as unable of loving feelings 7. sense of foreshortened future
difference between paranoid personality and antisocial behavior: paranoid lacks antisocial behavior
conduct disorder age of onset: child= one symptom before age of 10 , Adult= one symptom after age of 10
schizophrenia subtypes: 1. paranoid type 2. disorganized type 3. catatonic type 4. undifferentiated type 5. residual type
sexual orientation: erotic attraction to males, females, or both
suicidal social categories: 1. egoistic ( are not storngly integrated into any social group) 2. altruistic ( excessive integration into a group) 3. anomic suicide ( itegration into society is disturbed so can not follow customary norms of behavior, change of economic situation causes suicide)
onset age of narcissistic personality disorder: early adulthood
histrionic personality disorder must have, DSM: 5 of following: 1. uncomfortable when not center of attention 2. inappropriately sexually seductive 3. shifing and shallow expression of emotions 4. impressionistic speech 5. uses appearance to draw attention 6. self dramatization and exaggerated emotions 7. easily suggestable 8. relationships more intimate than they actually are
terminal insomnia: wake up early and can't go back to sleep
reactive attachment disorder inhibited type: do not initiate social relations, hypervigilant, avoidant behavior by not shy, attach to some people
sexual aversion vs. PTSD: PTSD = avoidant behavior
Axis IV: psychosocial and environmental problems
what axis mood disorders fall under: Axis I
schizoaffective disorder diagnosis DSM: uninterrupted period of illness during which there is a MAJOR DEPRESSIVE EPISODE, a MANIC EPISODE, or a MIXED EPISODE are present, should have delusions and hallucination for 2 weeks
difference between paranoid personality and schizoid: schizoids are withdrwan and have no paranoia
what is the prevalence of depression: highest of any disorder 17%, women 2X , age 20-50
schizoid personality disorder vs. paranoid personality disorder: paranoid personality disorder has more social engagement , aggressive verbal behavior
name 5 risk factors for bipolar I: 1. treatment non compliant 2. lack of impulse control-avalanche of rage 3. high risk behaviors 4. high suicide potential 5. high risk of dual diagnosis
sexual dysfunction: disturbance in sexual desire, psychological changes that marked distress and interpersonal difficulty
exploitive predators: use victim as object for their gratification in an impulsive way
what is prognosis for bipolar II: chronic and long term
what is catatonic feature with specifier: type of schizophrenic trance with periods of hyperactivity.
Turner syndrom: have one X chromosom , have female genitals, web necked, short, no pubic hair, gender identity =female
what defense mechanism does schizoid use: withdrawal
what are various types of specific phobias: 1. situational type (elevator), 2.natural environmental (heights, storms) 3. blood injection injury 4. animal type 5. other: choking, loud sound
onset age of avoidant personality disorder: early adulthood
hypochondriasis vs. OCD: OCD= is not restricted to health matters
neglect: failure to thrive: adequate nourishment yet disturbance within the relationship between the caretaker and the child who does not eat enough to grow and develop
Appendix B: defense mechanisms
PTSD: an anxiety disorder; symptoms after an event that threatens life or safety
alcohol treatment: benzodiazepine IM, AA
delusional disorder diagnosis DSM: non bizarre delusions ( being followed, infected) at least last 1 MONTH, criteria for schizophrenia never met, functioning IS NOT impaired
major depressive disorder must:: have 5 symp/2 week and must have depressed mood or loss of interest or pleasure
codependence: substance use effect on family
what is hypomania: muted mania with no function impairment and is elevated mood for 4 days, no psychosis
hyperarousal response to PTSD child and adult DSM: 2 or more of following: 1. difficulty sleeping 2. outburst of anger 3. difficulty concentration 4. hypervigilance 5. exaggerated startle response
sub. induced disorders type: 1.sub. intoxication 2. sub. withdrawal 3. sub. induced delirium 4. sub. induced persisting dementia 5. sub. induced persisting amnestic disorder 6. sub. induced psychotic disorder 7. sub. induced mood disorder 8.sub. induced anxiety disorder 9.sub. induced sexual dysfunction disorder 10. sub. induced sleep disorder
anorexia nervosa have: lots of rules and not able to keep up with academia
adults response to trauma: 1. insight to trauma 2. verbal expression of emotions 3. abstract reasoning ( life is not fair) 4. generalized coping skills (breathing exercises)
name some of the symptoms of panic attack: palpitation, sweating, shaking, shortness of breath, chest pain, nausea, dizzy, derealization( feeling of unreality), depersonalization( detacheded from oneself), fear of losing control
what is the difference between MINOR DEPRESSIVE and DYSTHEMIC: Minor depressive= have euthymic (normal mood); Dysthemic=chronic
substance dependence has: both TOLERANCE and WITHDRAWAL
difference between paranoid personality and borderline: paranoid rarely capable of involved relationships
narcissistic personality disorder belong to what cluster: cluster B
paraphilias: recurrent, intense sexual urges, fantasies, or behavior that involve a) non-human objects b) suffering or humiliation of oneself or one's partner or c) children or other non-consenting persons that occur over a period of at least 6 months
body dysmorphic disorder: preoccupation with an imagined or exaggerated defect in physical appearance
schizophrenia onset age: between late teens and mid thirties
parasuicidal: who self injure but does not wish to die
onset age of borderline personality: early adulthood
sexual dysfunction subtypes: 1. nature of onset 2. context 3. etiological factors
PTSD diagnosis adult and children DSM: ONE reexperience, 3 avoidance 2 hyperarousal symptoms of the list of DSM
schizophrenia diagnosis DSM: 2 of followings SYMPTOMS present during 1 MONTH and persists for 6MONTHS, a) delusions b) hallucinations c) disorganized specch d) grossly disorganized or catatonic behavior e) negative symptoms
hypochondriasis diagnosis DSM: 1. preoccupation with the fear of having a serious disease based on misinterpretation of symptoms and bodily functions 2. these beliefs are not DELUSIONAL 3. 6 months duration
specific phobia is ---: ego dystonic
pain disorder diagnosis DSM: pain in 1 or more anatomical sites, causes impairment, not intentionally produced, take lots of meds.
diagnosis of adjustment disorder: symptoms must begin 3 months of stressor and must remit within 6 months of removal of stressor 2. may manifest as assaultive behavior and reckless driving, excessive drinking, default on legal responsibilities, withdrwal, vegitative signs, insomnia, suicidal behavior
features of Cluster C personality disorders: anxious and fearful features
sub. induced delirium: have psychotic often reversible symptoms
Axis V: GAF= global asessment of functioning
sexual sadist: aroused by pain of the vicitms
persecutory type of delusional disorder: delusion that the person or a person close to is being malevolently treated( being tapped)
diagnosis of panic disorder DSM: recurrent panic attacks that last few minutes for 1symp/1month of worrying, 1.fear of losing control, 2.significant behavioral change 3. concern about additional attack
hypochondriasis vs specific phobia: specific phobia fearful of getting the disease
types of eating disorders: 1. anorexia nervosa 2.bulimia nervosa 3. eating disorder NOS
onset age of dependant personality disorder: early adulthood
diagnosis of bulimia nervosa: binge eating 2 or more/week for 3 months, sexually active compare to anorexia
somatoform disorders types: 1. somatization 2. undifferentiated somatoform 3. conversion 4. pain disorder 5. hypochondriasis 6. body dysmorphic 7. somatoform NOS
depersonalization disorder treatment: SSRI,
body dysmorphic disorder vs. avoidant personality disorder or social phobia: avoidant and social phobia= concern about embarrassement by real defects
what defense mechanism do borderline personality uses: projective identification
ego dystonic: ideas don't fit the fear and are unreasonable
Asperger's disorder clinical presentation: unlike autistic no delay in language acqusition, distorted communication, odd social skills, routine focused and rigid, change and disruption is traumatic due to inflexability
triphasic insomnia: have all three types of insomnia
treatment of intermittent explosive disorder: pharm (anticonvulsant) + therapy best chance
prevalence of conversion disorder: ^in low SES, child <10 yrs symptoms gait and seizures, women>men
schizophrenia treatment: antipsychotics
delusional disorder types: 1. erotomanic type 2. grandiose type 3. jealous type 4. persecutory type 5. somatic type 6. mixed type 7. unspecified type
depersonalization disorder diagnosis DSM: persistent and recurrent feeling of being detached from and as if one is an outside observer of, one's mental processes or body, like one is in a dream, REALITY TESTING remains intact
schizophrenia catatonic type: 2 of the following : a) motoric immobility presented by catalepsy or stupor b) excessive motor activity( purposeless and not due to external stimuli) c) extreme negativism or mutism d) pecularities of voluntary movement by posturing, stereotyped movements e) echolalia (repeat words) or echopraxia ( imitate another)
psychosomatic medicine: psychological factors affecting medical conditions
prognosis of anorexia nervosa: restrictive type= less likely to recover, hospitalization is good, 7% mortality rate, 1/4 complete recovery
treatment of adjustment disorder: Therapy, be aware of secondary gain , SSRI, crisis intervention= short term therapy
specifiers for schizoaffective: 1. bipolar type: include manic or mixed episode 2. depressive type: only includes major depressive episode
stereotypic movement disorder: repetative driven nonfunctional motor behavior that interferes with normal activities
generalized anxiety disorder (GAD): excessive worry and difficult to control for most days for 6 months; anxious about everything
Treatment for GAD: pharm (SSRI, Benzo.) + therapy
frotteurism: touching and rubbing against a non consenting adult for over a period of 6 months often in public
diagnosis of avoidant personality disorder DSM: pattern of social inhibition, feeling of inadequacy, and hypersensitvity to negative evaluation
impulse control disorder: inability to resist an intense impulse, drive, or temptation to perform a particular act that is obviously harmful to self or others, or both
schizotypal personality belong to what Cluster: Cluster A
bipolar II is: MDD + Hypomania
what is meloncholic feature with specifier: referred to as endogenous depression, arises in absence of external life stressors
what is the prognosis of panic disorder: chronic
compulsion: repetative behaviors
amphetamine withdrawal symptoms: anxiety, dysphoric mood, lethargy, nightmare, depression after high dose, tremulousness
treatment for trichotillomania: therapy + dermatological
suicide prevalence: men4X women, increase with age, 2/3 are white male, runs in families
ADHD: consistent pattern of inattention, won't diagnose before 7 yr
malingering: intentional production or feigning of physical or psychological signs or symptoms, motivation is external incentives such as economic, avoiding legal responsibility
clinical features of antisocial behavior: inability to conform to social norms , many have somatization, depression, alcohol abuse
schizophrenia features in children: 1.visual hallucinations more common 2. disorganized speech (communication problems) 3. disorganized behavior (ADHD, movement disorder)
treatment of OCD in children: CBT + SSRI
social phobia onset: teen
anxiety is: 1. response to unknown 2. internal 3. vague 4. conflictual 5. insidious
gender identity NOS types: 1. intersex conditions 2. cross dressing 3. preoccupation with castration
what are types of behavioral/emotional disorders in child: 1. conduct disorder 2. ADHD 3. oppositional defiant disorder 4. separation anxiety 5. reactive attachment disorder ( inhibited type, disinhibited type) 6. stereotypic movement disorder 7. feeding and eating disorder 8. Tic disorder
5 alpha reductase deficiency: testosterone is not converted, appear female at birth, virilize at puberty and change identity, have abdominal testes
what are the disorders of cluster A of personality disorders: 1. schizotypal 2. schizoid 3. paranoid
what axis do eating disorders fall under: Axis I
Appendix C: Glossery of terms
what Cluster do schizoid personality disorder belong to: Cluster A
onset age of kleptomania: <18 years
diagnosis of paranoid personality disorder (PPD), DSM: pervasive distrust and suspiciousness, must have 4 of following: a) suspect without a basis b) preoccupied with unjustified doubt of loyalty c) reads hidden threatening demeaning into benign remarks d) unforgiving e) percieve attacks on his character that are not apparent to others
alloplastic: able to adapt to
childhood disintegrative disorders: marked regression in multiple areas of functioning after at least 2 years of normal development, 2-10 years
somatization DSM: recurring polysymptomatic disorder, extends over periods of years
pseudo-hermaphroditism: born with ambiguous genitals
re-experiencing in children: in the form of play or drawings
paraphilias types: 1. exibitionism 2. fetishism 3.frotteurism 4. pedophilia 5. sexual masochism 6. sexual sadism 7. transvestic fetishism 8. voveurism 9. paraphilias NOS
substance abuse: DO NOT have TOLERANCE or WITHDRAWAL
name the symptom pattern of OCD: 1. contamination 2. pathological doubts 3. intrusive thoughts 4. symmetry
diagnosis of histrionic personality disorder , DSM: excessive emotionality and attention seeking
somatization vs. generalized anxiety: GAD= anxiety is not focused just on physical complaint
associated features with conversion disorder: 1.la belle indiffernce or dramatic presentation 2. symptoms can be modified or resolved based on external cues since they are very suggestable 3. no lab findings 4. symptoms are self limited 5. short duration and recur
what are personality disorders DSM: enduring pattern of inner experience that deviates from the expectations of the culture. these enduring patterns are inflexible and lead to distress and impairment in functioning
what is chronic anxiety: imabalance of external and internal worlds
difference between personality disorder such as borderline and Intermittent explosive disorder: personality disorder= aggressivensess and impulsivity is a part of personality and present between outbursts
clinical features of schizoid personality disorder: unsociable, unable to express anger directly, into math and astronomy
suicide neurotransmitter: diminished central seretonin
intersex conditions types: 1. androgen insensitivity syndrome 2. congenital virilizing adrenal hyperplasia 3. 5 alpha reductase deficiency 4. pseudo-hermaphroditism
treatment of obsessive compulsive personality disorders: pharm= benzodiazepines+ anticonvulsive, therapy long and countertransference common
avoidant personality disorder belong to what Cluster: Cluster C
intermittent explosive disorder: episodes of losing control of aggressive impulses, rare
dissociative disorders: disruption in the usually integrated functions of consciousness, memory, identity , or perception. which is sudden, gradual , transient or chronic
erotomanic type of delusional disorder: delusions of someone at higher status is in love with the person
how is bipolar I different in children from adult: there is no difference
conduct disorder: pattern of behavior that violates the basic rights of others or major age appropriate sociatal norms or rules
cocaine withdrawal symptoms: dysphoric mood, vivid and unpleasnat dreams, fatigue, insomnia or hypersomnia, increased appetite, psychomotor retardation or agitation, crashing, anhedonia, suicidal ideation, self medicate, seizures, death in high dose, heart problems
dissociative fugue diagnosis DSM: disturbance is sudden, unexpected travel away from home or place of work, with inability to recall one's past and there is a confusion about personal identity or assumption of a new identity, partial or complete
borderline personality has: unstable affect, mood, behavior, object relations, and self image
alcohol withdrawal: delirium, blackout, grand mal seizure , depression
sedative, hypnotic, or anxiolytics examples: benzodiazepines, barbiturates, sleeping meds.
sexual aversion: persistent or recurrent extreme aversion to and avoidance of all or almost all genital sexual contact with a sexual partner
avoidant personality disorder vs. schizoid: avoidant personality disorder don't want to be alone
Fear is: 1. response to known 2. external 3. definite 4.non-conflictual 5. sudden
phases of sexual abuse: 1. engagement (special relationship) 2. sexual interaction 3. secrecy phase 4. disclosure phase 5. supresssion phase
hyper-arousal: PTSD symptom; exaggerated response, hyper vigilance
Munchausen syndrome: repeated infliction of illness on a child by parent through infecting toxins and seek medical attention, hard to diagnose
vaginismus: recurrent and persistent involuntary spasm of the musculature of the outer third of vagina that interferes with sexual intercourse
schizophrenia associated features: 1. inappropriate affect 2. anhedonia 3. depression, anxiety or anger 4. sleep disturbance 5. lack of eating due to delusions 6. psychomotor abnormalities ( pacing, rocking) 7. difficulty in concentration, memory 8. poor insight to illness 9. suicidal thoughts
onset of panic disorder: early adulthood
features of Cluster B personality disorders: dramatic, impulsive and erratic features, genetic base
factitious disorders vs. somatoform: somatoform is not intentional
borderline personality belongs to what Cluster: Cluster B
psychosocial factors of intermittent explosive disorder: poor sense of masculine identity, violent childhood environment, feeling useless
what Cluster do schizotypal personalities belong to: Cluster A
substance abuse: sub. related problems must have occurred repeatedly for the same 12 months to get diagnosis
borderline: border of neurosis and psychosis
middle insomnia: able to fall sleep but wakes up in the middle of the night
la belle indifference: relative lack of concern about the nature or implications of symptoms
Name the depressive disorder NOS: 1. minor depressive disorder 2. recurrent brief depressive disorder 3. premenstrual dysphoric disorder
onset of GAD: late adolescent to early adulthood
what is the prognosis for bipolar I: poor prognosis
what defense mechanism does paronoid use: projection
examples of opiates: morphine, heroine, codeine
Rett's disorder: development of multiple deficits after a period of normal functioning after birth
schizophrenia undifferential type: symptoms are present but do not meet the criteria for paranoid, disorganized, or catatonic type
how is MDD different in children from adults: same as adults with differnet presentation: 1. somatic symptoms 2. irritability & behavioral issues 3. social withdrwal or aggression 4. poor self esteem 5. anhedonia 6. insomnia 7. sense of hopelessness 8. most have history of abuse or neglect
somatoform disorder NOS: symptom LESS THAN 6 months
treatment of Pathological gambling: hospitalization for 3 months
Axis III: General medical conditions
mental retardation diagnosis DSM: 2 or more of following: 1. communication 2. self care 3. home living 4. social/ interpersonal skills 5. self direction 5. academic skills
differential diagnosis between DEMENTIA and Major depressive disorder: MDD= sudden onset, don't answer questions, can be coached to remember, it is psuedo-dementia ; Neurological = will answer questions incoherently and don't remember
exibitionism: exposure of genitals to strangers for 6 months
types of symptoms or deficit in conversion disorder: 1. motor symptoms 2. sensory symptoms 3. seizures or convulsions 4. mixed presentation
treatment for specific phobia: 1. systemic desensitization 2. intensive exposure (flooding) 3. breathing control 4. insight oriented therapy 5. hypnosis
Recurrent brief depressive disorder: multiple brief episodes of depression < 2 weeks Dx like MDD
Rett's disorder clinical presentation: 0-3 years function decreases, female only, head size normal at birth but won't grow
what to pay attention to when doing a mental status evaluation: 1. appearence( grooming, excessive make up=hypomanic, age appearence= drug users look older) 2. consciousness 3. psychomotor behavior( atypical movements, fidgety, retardation) 4. attention/concenteration 5. speech (hypomanics talk on & on, depressed slow talking) 6. thought process & content( circumstantial=fish for word, goal directed= participateeasily, tangential= don't get an answer) 7. orientation( know the date, place) 8. energy level 9. perception with lall five senses 10. insight/ judgement( why he is there)
normal anxiety: response to threat that preapers the organism for fight or flight
pedophilia type: 1. exclusive type: attracted only to children 2. non-exclusive type: attracted to both children and adult
sub. use disorder types: 1. sub. dependence 2. sub. abuse
Klinefelter's syndrome: XXY, at birth appear male, testes small and no sperm, tall
hallucinogens: flashback=bad trip, teeth clenching, insomnia, loss of balancing, dangeous behavior,
what is postpartum feature with specifier: 4 weeks postpartum
rape: act of violence and humiliation that happens to be expressed through sexual means
what are categories of male rapist: 1. sexual sadist 2. exploitive predators 3. inadequate men 4. displaced anger
Appendix A: differential diagnosis
children response to trauma: 1. limited insight 2. non-verbal expression of emotion 3. more concrete reasoning ( happened because I was--) 4. coping skills have to be specific for each occasion
Axis I: All clinical disorders EXCEPT personality disorders and mental retardation
what are the neurotransmitters involved in depression: norepinephrine, seretonin, dopamine
avoidance: PTSD symptom; avoid anything that reminds them of the event
onset age of gender identity disorder in boys: 4 years old
hypochondriasis vs. GAD: GAD= anxious about everything
what is atypical feature with specifier: have predictable characteristics: overeating or oversleeping; can be applied to all mood disorders
sexual aversion vs. OCD: avoid due to cleanliness
Diagnosis of personality disorder DSM: manifested in 2 or more of areas: 1. cognition 2. activity 3. interpersonal functioning 4. impulse control
dependant personality disorder belong to what cluster: cluster C
schizotypal personality vs. paranoid personality disoder: paranoid lacks odd behavior
jealous type of delusional disorder: delusions that sexual partner is unfaithful
panic attack diagnosis (DSM): intense fear or discomfort with 4 symptoms and 10 minutes 4/10min
schizotypal personality vs. schizophrenia: schizotypal has no psychosis
sexual coercion, DSM: one person dominates another by force or compels the other person to perform a sexual act
fetishism: involving non-living objects for 6 months such as women undergarment
histrionic personality disorder belong to what cluster: cluster B
treatment of anorexia nervosa: > 20% body weight=hospitalization, >30% body weight= psych hospital for 2-6 mo; meds+ therapy
treatment for Cyclothymic disorder: mood stabalizers but caution with anti-depressants
bulimia nervosa: binge eating combined with inappropriate ways of stopping weight gain; may maintain normal weight
PTSD response in children: respond with disorganized or agitated behavior
types of etiological factors associated with the sexual dysfunction: 1. due to psychological factors( psych. factors play the major role in dysfunction not the medical conditions or sub. use) 2. due to combined factors ( psych factors + med. condition or sub. use account for dysfunction)
what is Double Depression: MDD+ Dysthemic disorder and stays below norm. all the time
treatment od kleptomania: insight oriented therapy and desensitization
reactive attachment disorder: disturbed and developmentally inappropriate social relatedness
onset age of conversion disorder: late childhood early adulthood, rarely before 10 or after 35
how do children express PTSD different from adult: expressed by disorganized or agitated behavior
treatment for social phobia: 1. desensitization 2. homework assignments 3. SSRI, benzodiazepine
impulse control disorder fall under what Axis: Axis I
body dysmorphic disorder vs. anorexia: anorexia= concern about fatness
V codes: used when: 1. Specific mental disorder not in DSM IV classification 2. when no NOS available 3. when non psychotic mental disorder is present but not enough info. available to diagnose and the diagnosis will be changed to a specific disorder after more info.
what are the types of major depressive disorder: 1. single episode ( never a manic episode) 2. recurrent ( two or more episodes, never a manic)
opppositional defiant disorder: pattern of negativistic, hostile, and defiant behavior for at least 6 months such as yelling and insulting
Bipolar I diagnosis should have :: one week of abnormal mood; MANIC + MDD
PTSD categories of symptoms: 1. re-experiencing 2. avoidance 3. hyper-arousal
what are dissociative symptoms: 1. numbing 2. detatchment 3. abscense of emotional responsiveness 4.reduction of awareness of surroundings 5. derealization 6. depersonalization 7. dissociative amnesia
deaf: deaf but may or may not be involved in the deaf community it is an identity
somatoform disorders: presence of physical symptoms suggesting of a general medical condition but can not be explained by exam or lab test, symptoms are not under voluntary control unlike Factitious disorders or Malingering
psychotic disorder types: 1. schizophrenia 2. schizophreniform 3. schizoaffective disorder 4. delusional disorder 5. brief psychotic disorder 6. shared psychotic disorder 7. psychotic due to medical condition 8. sub. induced psychotic disorder 9. psychotic disorder NOS
schizophreniform DSM: exactly like schizophrenia EXCEPT DURATON <6 month
types of ADHD: 1. inattentive type( no hyperactivity or impulsive behavior) 2. hyperactivity-impulsive type 3. combined type
body dysmorphic disorder vs. gender identity disorder: gender identity disorder= concern bout sex characteristics
what are the disorders of Cluster C of personality disorders: 1. obsessive compulsive 2. dependent 3. avoidant
four phases of Pathological gambling: 1. winning phase (ending with a big win) 2.progressive-loss phase (excellent player--> stupid player, borrow, miss work, lose job) 3. desperate phase (gamble with large amount, embezzle, loan shark) 4. hopeless phase ( knows losses can not be paid and still plays)
characteristics of intermittent explosive disorder: 1. symptoms appear within minutes 2.remit quickly 3. work history is poor 4. marital difficulties 5. trouble with law
name the anxiety disorders of children: 1. OCD 2. PTSD 3.cognitive disorders 4. behavioral/emotinal disorders
pyromania: recurrent, deliberate and purposeful setting fire
what is Cyclothymic disorder: Minor depression + hypomanic; mild form of bipolar II; very rare
sub. intoxication is ----: reversible
diagnosis of PTSD: symptoms present 1 month and causes impairment
dissociative disorders types: 1. dissociative amnesia 2. dissociative fugue 3. dissociative identity disorder 4. depersonalization disorder 5. dissociative disorder NOS
diagnosis of Cyclothymic: mood swings for 2 years( child 1 yr); symptoms are identical to bipolar II but less severe and shorter duration
agrophobia with or without panic disorder are: fear of anxiety regarding places from which escape might be difficult or avoidance of situation that are based on a concern of a medical disorder
diagnosis of obsessive compulsive personality disorders , DSM: preoccupation with orderliness, perfectionism, and mental and interpersonal control
gender identity disorder in children DSM: 4 or more of DSM categories
treatment for schizoid personality disorder: antipsychotic, antidepressant, psychostimulants
dyspareunia: recurrent and persistent genital pain associated with sexual intercourse in either a male or a female
adolescent's profile who commit suicide: high achievers, perfectionist, attempt may relate to recent stressors
what are the types of bipolar I: 1. bipolar single episode( only one manic & no history of previous MDD , 2. bipolar I recurrent
onset of anorexia nervosa: 14-18, female 10-20 X
somatization vs, panic attack: panic attack symptoms only during attack
suicide high risk group: male>45 years of age, alcohol dependent, violent behavior, previous psych. hospitalization, previous attempts
conversion disorder vs. hypochondriasis: hypochondriasis = preoccupied with serious disease, conversion la belle indifferentiation
psychotic: delusions or prominent hallucinations, with the hallucinations occurring in the absence of insight inot their pathological nature
treatment of narcissistic personality disorder: difficult to treat, anti depressant and therapy
narcissistic personality disorder vs. borderline: narcissistic personality disorder is less chaotic and less suicidal
congenital virilizing adrenal hyperplasia: mild clitoral enlargement to external male genitals
sub. induced psychotic disorder diagnosis DSM: 1. prominent hallucinations or delusions that person has not insight to it 2. symptoms developed within 1 MONTH of sub intoxication or withdrawal
symptoms of adjustment disorder: could be anxious, depressive, or disturbance of conduct
androgen insensitivity syndrome: look female but lack female organ and has internal male organs and testosterone
neurotransmitter involved in personality disorder: low MAO, high testostron
what are the clinical features of agrophobia with or without panic disorder: fear of death, agrophobia, panic disorder with first attack spontaneous, 10 minutes and rapidly increasing symptoms
sub. induced dementia is: not reversible
onset of panic disorder with or without agrophobia: 25 yr
shared psychotic disorder diagnosis DSM: delusion develops in a close relationship with another person who already had delusions and their delusions are the same
subtypes of anorexia nervosa: 1. food restricitng (often OCD with food) 2. binge eating and purging( overexercising, higher rate of suicide than restrictive type, secretive, hypokalimic)
what are the symptomology of anorexia nervosa: hypothermia, bradycardia, orthostasis, reduced body fat, neonatal like hair
difference between paranoid personality and paranoid schizophrenia: Paranoid has no hallucinations
treatment for paranoid personality: pharm= antipsychotic and benzodiazepine, Therapy warm style and not too overzealous

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