Test 1 for HSC3502

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How many individuals with disabilities are there in the U.S.?: 58 million out of 294 million; 20%; 1 out of 5 ppl;
What disability is the most prevalent?: physical (27million) (cognitive/mental-20million & sensory-11million)
What disability is the most gov't funded?: sensory
What is the definition of psychopathology?: the scientific study of ABNORMAL behavior
What are the 4 objectives of psychopathology?: Description, Prediction, Explanation, and Control
What are the six definitions of Abnormal behavior?: 1) conceptual (statistical, multicultural) 2) practical (discomfort, deviance, dysfunction) 3) DSM IV-TR
What is the statistical definition of abnormal behavior?: a conceptual definition that equates normality to frequency; not necessarily quantitative;
What is the multicultural definition of abnormal behavior?: a conceptual definition; cultural universality; cultural relativism; few profs. embrace extreme of either position;
What is a practical definition of abnormal behavior?: effect of abnormal behavior on the person or others; defined 3 ways: discomfort, deviance, dysfunction
What is the discomfort definition of abnormal behavior?: physical or psychological suffering that interferes with functional capacity
What is the deviance definition of abnormal behavior?: a practical definition; deviation from accepted behavior; similar to statistical but determined by authority figure
What is the dysfunction definition of abnormal behavior?: a practical definition; interference in capability or performing role or meeting potential
What is the DSM IV-TR definition of abnormal behavior?: diagnostic & statistical manual of disorders; a CLINICALLY SIGNFICANT behavioral or psychological SYNDROME that occurs in an individual and that is associated with PRESENT DISTRESS (a "painful" symptom), or DISABILITY (impairment in one or more important areas of functioning), or with a significantly increased risk of suffering death, pain, disability, or an important LOSS OF FREEDOM
What are the models of abnormal behavior?: biogenic (neuroanatomical, biochemical, genetic) & psychogenic (psychoanalytic, humanistic, behavioral, cognitive, and family systems theory)
What are the parts of the brain and what do they do?: right hemisphere:visal & spatial, emotional behavior; left hemisphere:language; forebrain:executive functioning; midbrain:sensory function & neurotransmitter production; hindbrain:autonomic function & neurotransmitter production;
What is the neuroanatomical model?: biogenic class; human thoughts, emotions, & behaviors are associated w/ CNS/PNS; change in emotions, thoughts, or behaviors is bc of the brain; psychiatric disorder is some form of brain dysfunction;
What is the biochemical model?: biogenic class; psychiatric drugs seem to affect these 5: norepinephrine, dopamine, serotonin, acetylcholine, gamma aminobutyric acid;
What is the genetic model?: biogenic class; genetics play an important role in the DEVELOPMENT of certain abnormal conditions; genotypes & phenotypes in psychopathology; schizophrenia, depression, alcoholism;
What are criticisms of the biogenic model?: no organic etiology may be found; what about external influences; the Diathesis-Stress theory: have gene but need stress to trigger; helplessness versus patient responsibility;
What is the psychogenic models?: explain abnormal behavior based on non-physiological causality, including: psychoanalytic, humanistic, behavioral, cognitive, family systems theory;
What is the psychoanalytic model?: psychogenic class; disorders in adults as the result of unconscious childhood traumas & anxieties (Freud); Id/Ego/Superego conflict & interference in psychosexual development; disorders are defense mechanisms; relied on case studies & lack of corroboration;
What is the humanistic model?: psychogenic class; incongruence b/w person's inherent pot'l & self-concept;
What is the behavioral model?: psychogenic class; abnormal behaviors are learned in the same manner as normal behaviors; Pavlov & classical conditioning; Watson's human implication; Thorndike & operant conditioning; Skinner's application to human learning; reinforcers & aversion;
What are criticisms of the behavioral model?: implies that models exist for specific disorders; doesn't account for conditions with severe averse consequences; questions the organic model of disorders;
What is the cognitive model?: psychogenic class; conscious thought mediates an individual's affect & behavior in response to a stimulus; create symptomatology w/ incorrect interpretation; Ellis's ABC approach; do thoughts & beliefs really cause disturbances, or do the disturbances themselves cause distorted thinking? (can't answer); success is measured by changes in overt behavior;
What is the family systems model?: psychogenic class; family's influence on individual behavior; disorders are formed thru poor interaction-inconsistent communication or distorted patterns of operation; personality development is ruled largely by the attributes of the family; genetic or social byproduct?; what about the Brady Bunch?;
What are 5 biogenic-biological interventions?: pharmacology, nutrition, exercise, surgery-extreme cases, other physiological interventions;
What are 4 psychogenic-psychological interventions?: esp. for TBI & MR; psychotherapy(individ., group, family), psychological exercises, psychoanalysis, behavior modification;
What are the 4 ways for the assessment of abnormal behavior?: observation(natural-observe in setting & systematic-looking for one thing); clinical interviewing; psychological testing-paper, pencil, profiling; neurological testing-scans(ct);
In the 1840 census how did they classify abnormal behavior?: one category: idiocy/insanity
How was the 1880 census classify abnormal behavior?: 7 categories: mania-crazy all the time; melancholia-melancholy-depressed; monomania-one problem; paresis-sphyllis-motor control probs; dementia-lack of consciousness; dipsomania-alcoholic; epilepsy-same as today-seizure disorder;
What is the DSM history?: DSM-1952(1 childhood disorder); DSM II-1968; DSM III-1980; DSM III-R-1987; DSM IV-1994; DSM IV-TR-2000; DSM-TR is fully compatible w/ both the ICD 9-CM and ICD 10; not all disorders have stayed and some names have changed;
What is the theme for disorders usually 1st diagnosed in infancy, childhood, or adolescence? (largest diagnostic group): developmental problems beginning before maturity <18
What is the theme for delirium, dementia, amnestic, and other cognitive disorders?: memory, psychological, or behavioral abnormality that is associated w/ dysfunction of the brain; biological evidence for these;
What is the theme for disorders due to a General Medical Condition?: mental disorders that are DIRECTLY attributed to general medical disorder
What are the themes for substance-related disorders?: psychoactive substance use that affects the CNS; must present distress to be considered a mental disorder;
What is the theme for schizophrenia & other psychotic disorders?: severe impairment in thinking and perception
What is the theme for mood disorders?: disturbances in mood or affect
What is the theme for anxiety disorders?: anxiety with accompanying avoidance
What is the theme for somatoform disorders?: physical disorder that cannot be fully explained by a known general medical condition
What is the theme for factitious disorders?: intentional feigning of physical or psychological symptoms (or both); NOT motivated by external incentives; if external than malingering to avoid jail or receive money;
What is the theme for dissociative disorder?: disturbance or alteration in consciousness, memory, or identity;
What is the theme for sexual and gender disorders?: paraphilias & sexual dysfunctions;
What is the theme for eating disorders?: weight management & weight controlling behaviors;
What is the theme for sleep disorders?: sleeping difficulties & repercussions
What is the theme of impulse control disorders not elsewhere classified?: uncomfortable impulse followed by activity-induced relief; OCD-similar but risk of hurting someone;
What is the theme for adjustment disorders?: excessive distress or significant impairment in social, occupational, or academic functioning because of a recent stressor
What is the theme for personality disorders?: enduring pattern of stable inflexibility in one's behavior and affect, leading to major social dysfunctions
What is axis I?: clinical diagnoses and other clinical conditions (depression)
What is axis II?: personality disorders and mental retardation
What is axis III?: general medical conditions (spinal cord injury)
What is axis IV?: psychosocial and environmental problems
What is axis V?: global assessment of functioning (GAF score)
Who can diagnose?: medical doctors & osteopathic physicians, clinical & counseling psychologists, licensed mental health counselors(& equivalent), licensed marriage & family therapists, licensed clinical social workers
Who treats this population?: all healthcare professionals
What are final thoughts on mental disorders?: not attributed to general medical condition-unless w/ in category; can't have schizophrenia due to headache; MUST present dysfunction-has to be a level of dysfunction;
How does the DSM IV-TR define psychotic?: having delusions, prominent hallucinations, disorganized speech, OR disorganized or catatonic behavior (schizophrenia)
What are specific psychotic disorders?: schizophrenia, schizophreniform, schizoaffective, delusional, brief psychotic, shared psychotic
How long must you have characteristic symptoms for schizophrenia?: minimum of six months
Is schizophrenia attributed to medical condition?: no
Schizophrenia: prodomal & residual symptomatology(rollercoaster); difficulties in life maintenance; employment issues-"downward drift"; abnormal psychomotor activity may occur; anxiety and phobias; increased substance abuse rate; marked suicide rate;
What are positive symptoms of schizophrenia?: delusions-false beliefs-believe they are God/Jesus or Santa Claus; hallucinations-hear things-typically voices-negative-all 5 senses; disorganized thinking and speech (+); disorganized behavior; still active among society;
What are the negative symptoms?: flat affect-facial expression, mood-blank slate; alogia-poverty of speech-1 word answers; avolition-lack or inability to have goal oriented behavior; anhedonia-lack of feeling/seeking pleasure;
What is the epidemiolgoy of schizophrenia?: women have more positive symptoms & men have more negative symptoms; notable genetic linkage-10x's more likely to have it if parents do; typical onset 20-30s;
What is the diagnostic criteria for schizophrenia?: 2 or more psychotic symptoms (+,-); social/occupational dysfunction; six month duration; need to consider subtypes for appropriate treatment;
schizophrenia, paranoid: prominent delusions/hallucinations, no negative symptoms; auditory hallucinations are related to delusion; clinically easiest to treat-tangible evidence;
schizophrenia, disorganized: disorganized speech, behavior, and flat affect-no positive symptoms; disheveled appearance; delusion/hallucinations may present, but not thematic & recurrent;
schizophrenia, catatonic: marked pscyhomotor disturbance and negative symptoms; echolalia & echopraxia; highest risk of self-harm or to others-most aggressive; flat affect; repeat something they heard or movement; ADLs compromised;
schizophrenia, undifferentiated: positive & negative symptoms; may present all symptoms with no theme or order;
schizophrenia, residual: w/ periods of exacerbations & remissions; typically more negative than positive; underdiagnosed & undertreated;
schizophreniform disorder: identical to schizophrenia except: one month but subsides in 6 mos. & impaired social/occupational functioning-5x less than schizophrenia;
schizoaffective disorder: depression & bipolar; schizophrenia & mood disorder symptomatology fluctuations; highly episodic; minimum 2 week windows; functioning & self-care; highest risk of suicide; very unheard of;
delusional disorder: confused with schizophrenia; presence of delusions for more than a month; no other symptoms; mood fluctuations are random; "non-bizarre";
delusional disorder types: erotomanic-belief somebody (higher status) is in love w/ you; grandiose-belief they are someone higher(pres. of company); jealous-sig. other is cheating on you; persecutory-someone's after you (CIA); somatic-some unexplained pain; mixed-more than one; unspecified-catch-all;
brief psychotic disorder: sudden onset of + psychotic symptom; 1 day to 1 month; full recovery to premorbid; intense emotional turmoil; ADLs compromised; increased risk of suicide; adolescence to late 30s; insanity defense;
shared psychotic disorder: rel'p context; "inducer"; all delusional types; rarely seek treatment-identified via inducer; very rare; variable in age onset; variable in rel'ships;
treatment options: psychotherapy-group counseling (better than 1 on 1), reality therapy, family systems; pharmacology-thorazine, haldol, prolixin for +, SDAs(risperdal, clozaril, zyprexa)for-; support groups; ECT; insulin shock;
Todd, 25: bipolar I; manic depressive-refused medicine
Naomi, 23: schizophrenia; psychotic disorder;
Glen, 53: compulsive OCD; cleans hands 1-1half hour/day loss; photo-had surgery
Eric, 27: severe depression; classical musician; ECT;
Mood episodes: mood irregularity for specified time; symptomatic of disorder but not persistent; single incident of disorder precursor; episodes include major depressive, manic, mixed, and hypomanic;
Major depressive episode: loss of interest or pleasure; 2 week minimum-at least qualify for diagnosis; 4 add'l diagnostic symptoms required: change in appetite and weight, sleep disturbances, decreased energy worthlessness or guilt, cognitive difficulties, suicidal ideation; cannot be attributed to bereavement or maintained for greater than 2 mos;
Manic episode: abnormally elevated, expansive, & irritable; one week minimum or less; 3 add'l diagnostic symptoms required: inflated speech and grandiosity, decreased need for sleep, flight of ideas, distractibility, increased involvement of goal-directed activities, excessive involvement of pleasure-seeking w/ pot'l neg. consequences; cannot exceed 2 mos.
Mixed episode: major depressive & manic symptomatology present; one week minimum; cannot exceed 2 month duration
hypomanic episode: abnormally elevated and expansive mood for at least 4 days; same symptoms of manic episode; not detrimental; cannot exceed 2 month;
major depressive disorder: multi-major depressive disorders w/o other episodes; episode extending 2 mos. or consistent history of episodes; mortality risk (15%); 4x greater risk for over 55y/o; comorbidity w/ other disorders: substance abuse, anxiety disorders, eating disorders; neuroimaging provides evidence; 2x in females than males; adolescences & elderly;
What is diagnostic criteria for Major Depressive Disorder, single episode?: presence of single episode, exceeds 2 mos duration, no other types of episodes
What is diagnostic criteria MDD, recurrent?: presence of 2 or more repetitive MD episodes, no other episodes;
Dysthymic disorder: symptom free for 2mos.; comorbid w/ MDD; cormorbid w/ personality disorder, anxiety disorder, learning disorder, and MR; no other types of episodes; decreased activity, effectiveness, an productivity; equal in gender; equal in gender; early insidious onset; familial pattern;

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