Psych Prep Key Terms- DSM-IV
Terms
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- hallmark of retardation, categories of retardation, sex ratio
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hallmarks: significantly subaverage general intellectual functioning (IQ < 70), deficits in adaptive functioning in at least 2 areas, onset before age 18
categories: mild (IQ of 55-70, 85% of cases), moderate (40-55), severe (25-40), profound (<25), severity unspecified
male-to-female ratio is 1.5:1 - hallmark of a learning disorder
- significant discrepency (typically 1-2 standard deviations) b/w IQ and achievement
- autism (including sex ratio) v. Rett's v. Asperger's v. disintegrative disorder
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autism: impairment in social interaction, impairment in communication, restricted repetoire of activities, onset must be prior to age 3, 75% comorbid MR, male: female = 4 or 5:1
Rett's: normal development thru 5 mo., 5-48 mo. there is sudden deceleration of head growth, acquired stereotyped hand movements, loss of social engagement, and appearance of poorly coordinated movements, females only
Asperger's: impairment in social interaction, restricted repertoire of bx, no language, cognitive, adaptive bx delays, more common in males, onset later than autism
disintegrative disorder: normal development for 2 yrs. followed by loss of skills before age 10 in at least 2 areas w/ abnormalities in social interaction, communication and restrictive bx, interests and activities, more common in males - ADHD v. conduct disorder v. oppositional defiant
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ADHD: inattention and/or hyperactivity-impulsivity, sx present before age 7, 2 settings, 6-9 times more common in males
conduct disorder: persistent pattern of bx in which the basic rights of others or societal norms are violated, childhood or adolescent onset, tx is multimodal
oppositional defiant: recurrent pattern of negativistic, defiant, disobedient, and hostile bx toward authorities, persists for 6 mo., bx manifested primarily at home - separation anxiety disorder; reactive attachment disorder
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separation anxiety disorder: excessive anxiety about being away from home or caregivers for at least 4 weeks before age 18
reactive attachment disorder: disturbance in social relatedness in most contexts before age 5 due to grossly pathological care, inhibited or disinhibited type - substance abuse v. dependence
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abuse: substance use resulting in problems due to use within a 12 month period
dependence: substance use that leads to impairment or distress with more sx than abuse including tolerance and withdrawal within a 12 month period - alcohol and sedative/hypnotic/anxiolytic intoxication and withdrawal
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intoxication: bx and psych changes, slurred speech, incoordination, impaired memory and concentration, possible stupor or coma
withdrawal: autonomic hyperactivity, insomnia, nausea and vomiting, transient hallucinations or illusions, anxiety, psychomotor agitation, and seizures, potentially fatal - caffeine intoxication
- more than 2-3 cups of brewed coffee, restlessness, flushed face, diuresis, gastrointestinal disturbance, muscle twitching, insomnia, rambling speech, agitation, tachycardia (rapid heart beat), differentiated from anxiety disorder by flushed face and diuresis
- cocaine and amphetamine intoxication and withdrawal
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intoxication: euphoria, hypervigilance, anger, impaired judgment, psychomotor agitation, tachycardia (rapid heart beat), nausea or vomiting, etc.
withdrawal: dysphoria, fatigue, unpleasant dreams, increased appetite, psychomotor agitation or retardation - opioid withdrawal
- flu-like sx of nausea and vomiting, muscle aches, diarrhea, fever, insomnia, pupillary dilation, and dysphoric mood
- schizophrenia- subtypes
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paranoid: preoccupation w/ 1 or more delusions or frequent auditory hallucinations w/ no prominent disorganized speech, catatonic bx, flat or inappropriate affect
disorganized: disorganized speech, disorganized bx, flat or inappropriate affect
catatonic: motoric immobility, excessive and purposeless motor activity, negativism or mutism, peculiarities of voluntary movement or echolalia
undifferentiated: does not meet criteria for any subtype - best prognosis for schizophrenia
- good prior functioning, late onset, abrupt onset, concomitant mood disorder, presence of a stressor, paranoid type, female
- concordance rates for schizophrenia
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identical twins (50%)
child when both parents have it (45%)
siblings/fraternal twins (10-15%)
parent to child (5-10%) - schizoaffective v. mood disorder with psychotic features
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schizoaffective: uninterrupted period of illness during which there has been a major depressive, manic, or mixed episode concurrent w/ sx of schizophrenic, *delusions or hallucinations w/o prominent mood sx for at least 2 weeks*
mood disorder with psychotic features: mood sx are prominent and persistent w/ delusions or hallucinations only present during mood episode - delusional disorder
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erotomanic: someone is in love w/ the individual
jealous: believes that sexual partner is unfaithful
grandiose: inflated self-worth, power, knowledge, or a special relationship to a deity or famous person
persecutory: the individual or someone close to individual is being ill-treated
unspecified: themes are not characteristic of any of above types - suicide risk factors; homicide risk
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suicide: males complete 4-5:1, females attempt more, from western state, Native American (Latino and Asian - lowest), European:African = 2:1 (1:1 among adolescents), adolescent and elderly, divorced or widowed, mental disorder such as substance abuse or depression, greatest predictor is hx of serious suicide attempts, greatest indicator is suicidal intent, other: social isolation, recent loss, plan, poor impulse control, physical illness
homicide: - bipolar I v. bipolar II disorder
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bipolar I: at least 1 manic or mixed episode, may be hx of 1 or more major depressive episodes, equal male:female
bipolar II: at least 1 major depressive episode and at least 1 hypomanic episode, female>male - concordance rates for bipolar
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identical twins (80%)
fraternal twins and siblings (20-25%) - treatment for agoraphobia v. panic disorder v. specific phobia v. social phobia v. OCD v. PTSD
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agoraphobia: flooding w/ massed in vivo exposure
panic disorder: cognitive therapy, Tofranil or SSRI, situational in vivo exposure
specific phobia: in vivo massed exposure
social phobia: social skills training, relaxation, exposure, cognitive therapy
OCD: Anafranil, Prozac, flooding, thought stopping
PTSD: stress inoculation - conversion v. somatization v. hypochondriasis
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conversion: 1 or more sx affecting voluntary motor or sensory functioning that suggest a neurological condition
somatization: hx of recurrent and multiple somatic complaints beginning before age 30 and lasting several years
hypochondriasis: preoccupation or fear of having or belief that one has a serious disease based on misperception of bodily sx - factitious v. malingering v. somatoform
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factitious: physical or psych sx that are intentionally produced in order to assume a sick role w/ absense of external incentives
malingering: feigning of sx for external incentives
somatoform: presence of physcial sx that are suggestive of a disorder but cannot be fully explained by a mdical condition, sx not intentionally produced - melatonin
- naturally occuring hormone that regulates sleep-wake cycle, used to treat circadian rhythm sleep disorder
- transvestitism v. transexualism
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transvestitism: cross-dressing w/o desire to be the opposite sex
transexualism: person self-identifies and desires to establish a permanent social role as a member of opposite sex - paranoid personality v. schizophrenia, paranoid type
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paranoid personality: pervasive distrust and suspiciousness of others and tend to interpret actions of others as deliberately demeaning, threatening and malevolent (delusions or hallucinations not required)
schizophrenia, paranoid type: preoccupation w/ 1 or more delusions or frequent auditory hallucinations - OCD v. obsessive compulisive personality
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OCD: obsessions (recurrent thoughts or impulses that cause distress) and/or compulsions (repetitive bx the person is driven to perform)
obsessive compulisive personality: preoccupation w/ orderliness, perfectionism, control, resulting in inflexibility and inefficiency - avoidant v. schizoid v. schizotypal v. schizophrenia
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avoidant: social discomfort and inhibition, fear of and hypersensitivity to negative evaluation, feelings of inadequacy
schizoid: detachment from and indifference to social relationships, restricted range of emotions
schizotypal: discomfort w/ and reduced capacity for close relationships, peculiarities in cognition, perception, ideation, appearance, and bx, detached and lack desire for relationships
schizophrenia: not a personality disorder (not persistant and pervasive), must have psychotic sx - schizophrenia v. schizophreniform v. brief psychotic disorder
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schizophrenia: sx persist at least 6 mo. w/ active sx for at least 1 mo.
schizophreniform: sx last at least 1 mo., but < 6 mo.
brief psychotic disorder: sx last 1 day - 1 mo.