EPPP Academic Review Outline Hot Points
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- GAF cutoff for inpatient?
- 50 is the cutoff for inpatient overall
- Polythetic Criteria
- need only a certain number of symptoms to get diagnosis. (Example--> Need 4 of 10 symptoms)
- Conduct Disorder vs. Oppositional defiant disorder
- CD involves difficulty with law
- gender differences in ADHD
- 3-5 times more in boys
- "Pure" ADHD
- have more cogntive and academic problems than those kids with a dual diagnosis
- Mental Retardation ranges
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Mild--> 50-70
Moderate--> 35-50
Severe--> 20-34
Profound--> below 20 - Ear infections (otitis media) and learning disabilities
- Increased LD, lower on Verbal Comprehension
- Tourette's and OCD
- 1/3 of Tourette's kids also have OCD
- Tourette's and ADHD
- 50% have ADHD
- Reactive Attachment Disorder, Inhibited type
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"scared kitten"
Ambivalent, hypervigilant - Reactive ATtachment Disorder, disinhibited type
- bond with anyone; no real differentiation
- Dementia due to Head Injury
- loss is not progressive and has retro and antero grade amnesia
- Dementia
-
cognitive disturbances
memory loss (ST & LT)
ALWAYS due to a medical condition or substance use - Alzheimer's dementia
- only diagnosed through autopsy (brain biopsy); progressive; starts with anterograde amnesia
- Stages of Alzheimers
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1) STM problems; irritability; depression
2) Further explicit memory loss; difficulty with complex tasks (shopping, etc)
3) serious impairment; trouble with simple tasks; recognition difficulties - Vascular Dementia
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Caused by CV
Course is stepwise and not progressive (if you have a stroke, you have an impairment)
Deficits are patchy and not uniform (depends on location of stroke) - Delirium
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* gen med or substance induced
* decreased ability to concentrate and pay attention
* disorientation and problems speaking
* Usually SHORT in DURATION - PsuedoDementia
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* cognitive problems in MDD
* No substance or med problem
* Cognitive decrease is abrupt - Post Partum Depression
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80 % of women get
postpartum blues; 10-20% get post partum DEPRESSION - Suicide Facts
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Older People do it more than younger people
White more than nonwhite
Men more than women (women try more)
Native Americans less than 45 have the highest risk overall - Beck's cognitive theory of depression
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1) automatic thoughts
2) cognitive distortions
3) Schemas - MAOI's
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1) work on norepinephrine (prevent breakdown)
2) good for atypical depression and symptoms of anxiety and phobias - TCA's
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1) antidepressant
2) work on Norepinephrine and Serotonin (prevent reuptake)
3) Relieve depression with motor retardation and somatic symptoms - SSRI's
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1) prevent reuptake of Serotonin
2) atypical depression
3) depression, OCD, anxiety, premature ejaculation
4) less cardiotoxic, onset is rapid, and no cognitive impairments - Progression of Psychosis
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less than 1 month--> Brief Psychotic Disorder
Less than 6 months--> Schizophreniform
More than 6 months--> Schizophrenia - Delusional Disorder
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Nonbizarre delusional system (I'm being followed)
Can funtion in society - Schizoaffective Disorder
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Meet criteria for mood disorder and Schizophrenia
For at least 2 weeks, the mood symptoms go away and the psychotic symptoms stay - Concordance rates of Schizoprehnia
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* General Population--> 1%
* biological siblings--> 10%
* Fraternal Twins--> 15-17%
* Identical Twins--> 46-48%
HIGHEST RISK IS FOR CHILD - Type 1 schizophrenia
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* Positive symptoms
* Traditional antipsychotics work best
* NT abnormality - Type 2 Schizophrenia
-
* Positive and negative symptoms (negative are priamry)
* Structural Brain Abnormality
* Prognosis is worst
* Atypical's work best (on serotonin and dopamine) - Anxiety vs. Depression
- Anxiety has similar level of negative affect and higher levels of autonomic aroual and positive affect
- Social Phobia
-
* Fear of scrutiny by strangeres
* social situations
* Having a friend present can increase anxiety - Specific Phobia; Blood-type
- requires tensing muscles to prevent passing out.
- Specific phobia
- No social phobia or agoraphobia allowed!
- Agoraphobia
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fear of being in a situation and having a panic attack
* Friend can help to alleviate the symptoms - Rebound anxiety
- often seen in treatment that uses benzos
- Panic Disorder
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Sudden extreme loss of control
With or without agoraphobia
Unpredictable! - Acute Stress disorder
- less than one month
- PTSD
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symptoms at least one month;
extreme trauma
treatment--> coping, exposure, early intervention - OCD vs. OCPD
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OCPD does not have obsessions or compulsions
OCPD has a preoccupation with order, control, perfection - Factitious disorder vs. Malingering
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Facticious disorder--> no real symptoms; wants to be in "sick role."
Malingering--> does it for an external payoff. - Dependence
- signified by tolerance and withdrawal
- Stages of Change
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1) Precontemplation--> no problem
2) Contemplation--> change in next 6 months
3) Preparation--> within the next month
4) Action--> Actually changes
5) Maintenance--> 6 months on; prevent relapse - Hypnagogic hallucinations
- hallucinations while falling asleep
- hypnopompic hallucinations
- hallucinations when waking up
- Dependent Personality Disorder
- have to rule out a mood disorder first
- Gestalt Therapy
- goal is to integrate thoughts, feelings, and actions
- Feminist therapy vs. Non-sexist therapy
- Feminist therapy focuses on political change as a goal
- Strategic Family Therapy
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* Haley
* Prescribing the symptom
* Paradoxical techniques - Structural Family Therapy
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* Minuchin
* triangulation
* Enmeshed vs. disengaged families
* Reframing
* Joining the family - Extended Family Systems therapy
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* Bowen
* Intergenerational transmission process
* Triangulation
Goal--> Differentiation of Self - Solution-Focused therapy
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* Miracle ? (A miracle happens and your problem is solved. What is different?)
* Exception ? (Think of a time when problem didn't exist. What was that like?) - Yalom--> Group therapy
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What is important is:
1) Interpersonal learning
2) cohesiveness
3) catharsis - Emic
- study culture from the inside (what is important to this culture?)
- Etic
- Study culture from the outside (What does science say is important for this culture?)
- Minority Identity Development Model (Atkinson)
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1) Conformity
2) Dissonance
3) Resistance & Immersion
4) Introspection
5) synergistic articulation & Awareness - Cross's Nigrescence Theory
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1) Pre-Encounter
2) Encounter
3) Immersion-Emersion
4) Internalization
5) Internalization- Commitment - Helm's White Racial Identity Development Model
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1) Contact
2) Disintegration
3) Reintegration
4) Pseudo-Independence
5) Immersion-Emersion
6) Autonomy - Backward Conditioning
- Doesn't work
- Catharsis
- Decrease of an emotional response by an extinction procedure
- Experimental Neurosis
- When forced to make stimulus discrimination between 2 closely related items
- Higher Order conditioning if US is present...
- Doesn't work (blocking)
- Higher Order conditioning is US is not present...
- works!! (2nd order is as high as you can go)
- counterconditioning
- pairing a CR with an incompatible response (for example--> anxiety with relaxation; you can't be anxious and relaxed at the same time)
- Systematic Desensitization
- Research shows that what is important is not relaxation, but exposure (extinction)
- Aversive Counterconditioning
- something you don't like is paire with something that you want to get rid of (shoe fetish)
- In vivo vs. Covert
- In vivo works better
- Implosive Therapy
-
combines covert exposure(imaginary) wtih psychoanalysis
* Start right at top of hierarchy and extinction happens quickly - Flooding
- mass practice is better than spaced practice