DSM
Terms
undefined, object
copy deck
- Mental Retardation
-
1. significantly subaverage intellectual functioning. 70 or below on IQ test.
2. Conncurrent deficits or impairment in adaptive function in at least two areas (communication, self care and social interpersonal skills).
3. ONset prior to age 18. - Mild retardation
- 50-55 to 70
- Moderate retardation
- 35-40 to 50-55. Academic level up to second grade.
- Severe Mental retardation
- 20-25 to 35-40. may learn to talk during school years and can acquire elementary self care skills.
- Profound retadation:
- Due to neurolocial condition below 20-25
- PKU (phenylketonuria)
- Rare recessive gene that invloves the inabiliy to metabolize the amino acide phenylalanine. PKU produces irreversible moderate to profound rtardation
- Learning disorders
- achievement on a standardize test in reading, math and or written expresion is sbustantially below that expected for her age schooling and level of intelligence
- dyslexia
- reading disorder.
- Autistic disorder
- 1. qualatative impairment in social interaction. 2. impairkment in nonverbal behaviors. 2. impairment in communication. 3. restricted, repetive and stereotyped behavior. do not reach ot caretakers, do not make eye contact. do not notice another's distress.
- Emotional refrideraration
- lack of warmth in a parent child relationship
- Rhett's disorder
- head growth deceleration, loss of hand skills, impairments in coordination of gait or trunk movements. Decrease of interest in social environment followed by normal development. ONly n females.
- Child hood disintegrative disorder
- development regression in multiple areas of functining flowwing at least two years of normal development
- Asperger's disorder
- svere impairments in social interactions and a restricted repertoire of behaviors and activities. No delays in language, self help skills , cognitive development or curiosity about the environment.
- Attention deficit and disrutive behavior disorder
- ADHD, conduct disorder and oppositional deiant disorder
- ADHD
- persistant, developmentally -inappropriate pattern of inattention and or hyperactivity impulsivity. ONSET prior to the age of seven. Last for six months and apparent in at least two setings. More common in males. As adolescents, engage in more atisocial behaviors and drug use than their peers.
- Conduct disorder
- persistant pattern of behaviors that violate the rights of others and age appropriate social rules. 1. agresion to people and animals, bullies, threatens or intimatdates others. IF over eighteen only diagnosed if criteria for antisocial personality disorder is not met.
- Associated features of conduct disorder
- low self esteem, low frustration tolerance, irritablitity, temper outbursts. Additinoal substance related disorder may be warrented.
- Oppositional defiant disorder
- recurrent pattern of negativistic, defiant and hostile behaviors toward authority figures. , loses temper, argues with adults, actively defies or challegnes the rules or requests of adults, delberately annoys people, blames others for their mistkas
- Pica
- eating of nutrious substances
- Rumination disorder
- repeated regurgitaiton, rechewing of food withou apparent nausea or disgust
- Feeding disorder of infancy or early child hood
- persistaent failure to eat adequately for at least one month acompanied by a resulting failure to gain weight or substance weight loss.
- What drug used to help with tic disorders
- haloperidol.
- Chronic motor vocla tick
- single or multiple motor or vocal tics but not by both.
- Separation anxiety disorder
- inapproprate ,exceessive anxiety related to separation from home or attachement figures.
- reactive attachment disorder of infacy or early child hood
- disturbed and developmentally inappropriate social relatedness in most settings that begins prior to the age of five.
- delirium
- disturbance in consciousness. CHange in cognition or development of perceptual abnormalities. Experiences reduced awarenees of the environment, shifts in attention and distractibality. Disorientation to place and time.
- Important component Treatment for delirium
- an environment that is designed to minimize disorentation. (quiet room with appropriate lighting).
- Drug treatments for delirium:
- Antipsychotics such as haloperdiol
- Dementia
- development of cognitive defcits that include some degree of memory impairment iand at least one of the follwing disturbances in cogntition: Aphasia, apriazia, agnosia and disturbance in executive functioning
- aphasia
- deterioration in langauge functioning
- agnosia
- inability to recognize and identifiy familiar objects and people.
- Delirium and demnentia
- both have impoariment in memory but demential does not exhibit loss of conciousness . In MDD, decline in memory and cognition is abrupt and person is aware of these impairments. People with dementia are not.
- Etiology
- Alzheimer's disease, picks disease , parkinson's disease and huntington's disease.
- alzheimer's type
- gradual onset of symptoms and slow progressive decline in cognitive functioning. begins with deficts of memory and personality change or irritbality. Diagnosed only when other causes of dementia have been ruled out. duration is until deeath.
- Vascular dementia
- caused by aterioscerlosis or other cerebrovascular disease.
- alcholo withdrawl delirium
- deslirum tremens, disturbance in consciousness and other cognitive functions, autonomic hyperactivity, vivd hallucinations, delusions, agitation following a period of prolonged or heavy use of alcohol.
- alcohol induced persisting amnestic disorder (weirnicke korsakoff's syndrome):
- retrograde and anterograde amnesia, confabulation due ot thiamine and other vitamin b deficiencies
- Amphetamine intoxication
- maladaptive behavioral and psychological changes (euphoria, anxiety, hyperactivity gradiosity, confusin, anger, paranoid ideation, auditory ahllucination, tachycardia, eleveated or lowered blood pressure, perspiration or chills, nausea or vomiting, weight loss
- Amphetiamine withdrawl
- depressed mood, fatigue, vivid and ubpleasant dreams, insomnia or hypersomnia, increased appetite and weight gain, psychomotor agitation or retardation follwing heavy or prolonged use of amphetamine
- Caffeine intoxication
- restlessness, nervousness, excitement, insonmnia, flushed face, diuresis, gastrointestinal problems, muscle twitching, rambling thoughts of speech,
- cannabis intoxication
- Euphoria, grandiosity, inappropriate laughter intially, followed by sedation, lethargy, disturbed sensory perceptions, impaired short term memory, judgement, impaired motor performance and a sense that time is passing slowly
- Cocain intixication:
- Euphoria, gregariousness, hyperactivity, hpyervifilence, anxiety, anger initally, affective blunting, sadness, social withdrawl with chronic use
- Cocaine withdrawl
- dysphoric mood, fatigue, vivid and ubnpleasant dreams, insomnia, or hyper somnia, increased appetite, psychomotor agitation or retardation, follwed by heavy or prolonged use of cocian.
- hallucinogen persisting perception disorder
- transient recurrence of perceptual disturbances that perviously occur during hallucinogen intoxication
- Sedative, hypnotic or anxiolytic
- maladaptive behavioral and psychologicial changes (inappropraite sexual or agressive beahvior, mood, lability, ipaired judgement, Slurred speech, coordination, unsteady gait, nystagmus, impaired attention and memory stupr or coma
- Sedative, hypnotic or anxiolytic withdrawl
- autonomic hyperactivity, hand tremor, insomnia, nausea, anxeity, psychomotor agitation follwing heavy or prlunged use of a sedattive hynotic or anxiolotics
- schizophrenia
- positve symptoms: delusions, hallucinations, disorganized speech, disorganized behaviors. experiences alot of auditory hallucnations.
- Referential:
- believes that passages from books or newspapers or other messages are specifcally directed at her.
- Negative symptoms: .
- restricted range and intensity of emotions. affective flatenning9 reduced body language, expressionless face alogia(poverty of thought), avolition (restricted initation of goal directed behavior)
- five subtypes of schizophrenia
- paranoid, disorganized, catonic, residual, undifferentiated.
- Dopamine hypothesis
- schizophrenia due to excessive dopamine. Phenothiazineblock domanine recptors.
- Family factors of schizophrenic
- Schizophrenogenic mothers, martial schism and martial skew,emotial divorce and pseudomutaulity, double bind communication, high expressed emotion
- SOcial stres hypothesis
- poverty leads to stress which in turns causes schizophreina
- drift hypothesis
- disorder has significant negative effect on social and occupational functioning and as a result, they tend to drift into the wlower class.
- Treatmet:
- Phenothiazines. Colopromazine and haloperidol.Eliminates positve symptoms. however may excerbated negative symptoms.
- Family interventions for schizophrenia
- 1. increasing family understanding of schizophrenia, 2. identify methods for reducing family stress, 3. enhancing social network, reducing conflicts between family members.
- Schizophreniform disorder
- symptoms are identical to those of schizophrenia except that the disturbance is present for at least one month but less than six months and impaired social occupatinal functioning though may occur is not required.
- delusional disurder
- presnese of one or more non bizzare delusions that last at least one month
- SUbtypes of delusions
- Jealousy, erotonmanic, persecutory, somatic
- Brief psychotic disorder
- delusions, hallucnation, d/o speech for at least one day but less than one month with eventual return to full premorbid functioning.
- Major depressive episode
- loss of interest or enjoyment in activity and depressed mood for at least two weeks. Including, diminished intrest or pleasure, feelings of worthleness, psychomotor agitation or retardation, icnrease of appetite and significant change in weight
- manic episode
- period of one week or longer in whcih the mood is abnormally persistently elevated, expance or irrtiable during which three of the follwoing symptoms are present, Increased goal directed activity, or psychomotor agitation, flight of ideas, decrease need for sleep, grandiosity, restlesns, distractiablity, high risk behaviors.
- hypomanic episode
- Similar to manic episode except for it last s for atleast four days and is not sufficient enough to require hospitalization and does not cause impairment in functioning or psychotic symptoms
- Mixed episode.
- lats for at least one week, and involves rapidly alternating symptoms of manic and major depressive episodes. SEvere enought o cause marked impairment in social or occupational functioning or to require hospitalization.
- Major depressive disorders
- presence of one or more major depressive episodes without a history of manic , hypomanic and mixed episodes. One MDE: major depressive disorder single episode: two or more MDE: major depressive disorder recurrent
- catecholamine hypothesis
- depression is due to deficiency in nopreprinephrine. Drugs that increase noperphrenine alleviate depression
- Depression and learned helplessnes
- depression occurs when individuals learned through exposure to uncontrollable events that responding to certain events is futile. When people believe that nothing they can do will alter the low probability of desirable outcomes, they experience helplessness and depression
- Beck's cognitive theory
- views depression as the result of negative, illogical self statements about oneself, current situation and the future. such statements relfect certain cognitive distortions or depressogenic schemata" such as overgeneralization, selective abstraction, personlaization, magnification, and arbitrary inference
- Depression is often precipitated by the occurence of psychosocial stressor
- see other side
- endogenous depression
- due to biological factors , require somatic treatment
- exogenous depression
- caused by psycholocial stressors and involve less severe symptoms.
- Drug treatments
- Tricyclics, MAOI's heterocyclic antidepressents, TCA: helpful for classic depression. MAOIs helpful for those with atypical depression
- Classic depression
- vegative symptoms, a worsening of symptoms in the morning , acute onset and duration of symptoms and symptoms of moderate severity.
- atypical depression
- phobic features, panic attacks, increase appetite, hypersomnia , mood worsening late in the date.
- cognitive treatments
- Beck's cognitive therapy. Depression can be eliminated by altering the cognitions that underlie them. 1. identified " automatic thoughts" 2. helping the clietn understand how his cogntions distort reality.
- see other question
- Clients recognize why distorted cognitions are invalid inorder to reduce their frequency and intensity
- interpersonal therapy
- depression is caused and maintained by interpersonal problems that are the result of disturbances during early development
- Dysthmic disorder
- deressed mood that is present most of the time for at least two years . no more than two months in which the person is symptom free. And symptoms must not be severe enough to meedt criteria for MDE.
- Bipolar I disorder
- occurance of one or more nanic episodes or mixed episodes WITHOUT a history of MDE
- Bipolar disorder sigle manic episode
- one manic episode with no history or major depressive episode
- bipolar I disorder most recent episode manic
- Person currently or most recently in a manic episode and has previously expereinced at least one mjaor depressive , manic or mixed episode
- Bipolar I disorder, most recent episode hypomanic
- The person is currently or most recently in hypomanic episode and has previously experienced at least one manic anor mixed episode
- Bipolar I disorder, most recent episode mixed
- The person is recently or currently in a mixed episode and has previously at least one major depressive manic or mixed episode
- Bipolar I disorder, most recelt episode depressed
- The person is currently or most recently in a major depressive disorder and has previously experenced at least one manic or mixed episode
- Bipolar I disorder most recent episode unspecified
- the person meets symptoms but not the duration criteria for manic, hypmanic or major depressive episodes that there has previously been been at least one manic or mixed epiosode.
- BIoplar II disorder
- diagnosed when the individual has experienced at least one major deprssive eposide and one hypomanic episode. Person with disorder has never had a manic or mixed episode.
- Drug treatment for bipolar
- Lithium carbonate: treatment of choice for manic and hypomania. reduces manic symptoms and prevents recurrent mood swings.
- Cyclothymic disorder
- characterized by the presence of fluctuating hypomanic symptoms and numerous periods of depressive symptoms.
- SUbstance induced mood disorder
- intoxication of alcohol, amph, cocaine, hallucinogens, inhalents, opiods, pcp, sedatives, hypnotics, and axioltycs. From withdrawl of alchol , amph, cociane, sedatives, hypnotics and anxiolytics.
- panic disorder with or without agoraphobia
- characterized by two or more unexpected panic attacks, with at least one of the attacks being followed by one month of persistent concern about having another attack, worry about the implications of the attack or significant apprehension ,fear or terror that develops abruptly.
- panic disorder require at least four of these characteristic symptoms
- palpitations, or accelerated heart rate, sweating, chest pain, nausea, dizziness, derealization, paresthesia/
- Agoraphobia
- anxiety about being in situations or places from which escape might be difficult or embarrassing or which help might not be available of panic attacks occur.
- Treatmetn for agoraphobia
- Invivo exposure with response prevention, considered to be most effective treatment. INimpramine.
- Specific phobia
- disorder charcterized by a marked and persistent fear of specif object or situation other than those associated with agoraphobia and social phobia.
- biologically prepared stimuli
- at least at one time the object of fear posed an actual threat to huma survival.
- From fruedian view, phobias represent what?
- unconscious conflicts
- Treatment for specific phobias
- Systematic desensitization, particpant modeling
- Social learning theory and phobias
- social learnin theory regards phobias as the result of vicarious learning in which excessive anxiety and aviodance beahviors are acquired by pberving the beavhior of parents and others
- what is mower's two factor theory
- phobic fears are the result of both classical and operant conditioning. an individual first learns to fear a neutral conditioned stimulus because of its pairing with an intrinsiclaly anxeity arousing unconditioned stimulus. Because the individualsconsistently avoids the conditional stimulous he never has the opportunity to extinguish it.
- obsessive compulsive disorder
- recurrent obssessions or compulsions that are severe enough to cause marked distressed, to be time consuming and to intefre with daily functioning.
- Obsessions
- persistent thoughts impulses, or images that an individual expereinces as senseless or intrusive and that cause makred distress
- Compulsions:
- repitious and deliberate behaviors or mental act a person feels driven to perform either in response to an obsession or according to rigid rules. . Goal of the compulsive acts is to reduce distress or prevent a dreaded situation from happening but the acts are either excessive or not connected in a logical way to this goal.
- The adult MUST realize that his obsessions or compusions are unreasonable or excessive.
- in schizophrenia, rumination delusional thought and biazzare sterotyping is not disressing to the individual.
- Treatment for ocd:
- In vivo exposure with response prevention. THought stopping and habituation
- Drug treatment for OCD
- clomipramine
- PTSD
- development of caracteristic symptoms after exposure to an extreme trauma. Witnessing an event that invloves actual or threatened death, and elicits a reaction of intense fear, helplessness or horror. Persistent reexpereincing of the trauma, falshabcks, night mares, persistent avoidance of stimuli associated with the trauma. Persistent symtoms of increase arousal. Must be present for at least one mornth.
- Generalized anxiety disorder
- excessive anxiety and worry about multiple events or activities. Constant for at least six months and finds them difficult to control. Symptoms involve, restlessness, or feelings of keyed up or on edge, being easily fatigued, difficulty concetrating, irritablity, muscel tension, sleep disturbance
- non pathological anxiety
- wories are more realistic, are percieved as mor controllable and less likely to be accompanied by physical symptoms
- acute stress disorder
- similar to ptsd except that symptoms must have an onset within four weeks of the trauma and last for at least two days but no longer than four weeks. must have three or more dissociateive symptoms while expereincing the event: numbing, derealization, dissociative amesia. and must exhibit persistent reexpereincing of the trauma, marked avoidance of stimuili that cause recollection of the trauma nad symptoms of makred anxiety or increased arousal
- substance induced axiety
- caffine, cannabis, cocaine, hallucigens, inhalant, and pcp intoxication , with drawl from alcohol, cocaine or sedative, hypnotic aor anxiolytics.