Term
Definition of a mental disorder. |
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Definition
"...a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom. In addition, this syndrome or pattern must not be merely an expectable and culturally sanctioned response to a particular event. Whatever its original cause, it must currently be considered a manifestation of a behavioral, psychological, or biological dysfunction in the individual. Neither deviant behavior nor conflicts that are primarily between the individual and society are mental disorders unless the deviance or conflict is a symptom of a dysfunction in the individual, as described above. |
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Definition
A group or set of concurrent symptoms which , together, are indicative of a disorder or disease. |
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Definition
Any sign, physical or mental, that stands for or signifies something (e.g. psychopathology). What your client describes. |
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Definition
Observable phenomena which may signify something (e.g. psychopathology, behavioral disturbance). What you see. |
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Definition
Assumes/emphasizes universals among human being. |
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Definition
Classifies psychological phenomena in appropriate cultural context - considers divergent attitudes, values, and behaviors within a given culture. |
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Definition
Reality testing JudgementS ense of reality of the world and of the sense of the self Regulation and control of drives, affects, Impulses (Impulse Control) Thought processes (cognition) Adaptive regression in the service of the ego Defensive functioning (defenses) Stimulus barriers Autonomous functioning Synthetic functioning Mastery-Competence Object relations |
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Definition
Ability to distinguish between reality and perception. |
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Definition
Ability to evaluate consequences of behavior. |
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Sense of reality of the world and of the self |
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Definition
Extent to which external events or sense of self are seeming unreal (out of body experience, way to protect psyche during traumatic event). |
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Thought processes (cognition) |
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Definition
Memory, concentration, and attention show thought processes. |
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Adaptive regression in the service of the ego |
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Definition
Adapt behaviors based on what we think we need (spontaneity, play). |
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Definition
Look at success or failure of these defenses (primarily child like or sophisticated). |
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Ability not to be bothered by outside stimuli. |
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Definition
Can person function despite pressures, can they learn, can they carry things through. |
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Psychological management of discrepant information. |
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Actual level of competence vs. perceived level of competence. |
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Definition
Extent of object constancy. Kind and degree of relatedness to others. |
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General mental status exam assessment categories |
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Definition
Presentation, cognition, thought, affect/mood, behavior |
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Definition
Ability to control urges and tolerate frustration (can be related to impaired judgement). |
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Definition
Disturbance in consciousness, change in cognition, rapid onset/fluctuation, direct consequence of substance or general medical condition. |
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Definition
Memory deficit and one or more of the following: Language disturbance (aphasia), cannot carry out motor activities despite intact motor function (apraxia), Failure to recognize or identify objects despite intact sensory function (agnosia), Cannot plan, organize, sequence, abstract (disturbance in executive functioning), Slow, insidious onset or sudden onset/mostly progressive, consciousness clear (not disturbed as in delirium), Incurable causes and curable causes of dementia |
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Definition
Memory deficit only, may be caused by substance, general medical condition, or both, can evolve into dementia in progressive conditions, Do not confuse this with dissociative amnesia. |
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Definition
One or more of the following within a 12 month period: Recurrent failure to fulfill major role obligations, recurrent use in physically hazardous situations, recurrent substance-related legal problems, continued use despite social or interpersonal problems. |
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Definition
Three or more: tolerance and/or withdrawal symptoms, larger amounts needed to get the same high, unsuccessful efforts to cut down or control substance, substance acquisition, use, or recovery takes up a great deal of time, reduction of important activities because of use, continued use despite problems caused or exacerbated by substance. |
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Definition
Reversible/substance-specific syndrome due to recent ingestion or exposure to substance, clinically significant maladaptive behavioral or psychological changes due to effects of substance developing shortly after use, symptoms not due to a general medical condition. |
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Definition
Substance specific syndrome due to cessation of or reduction in use that has been heavy or prolonged, substance specific syndrome causes clinically significant impairment, not due to a general medical condition. |
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Term
Stages of alcoholism (First Stage/Prodromal stage) |
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Definition
Drinking becomes a means of psychological escape from problems, stress, inhibitions. Dependence upon mood altering effects. |
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Term
Stages of alcoholism (Second stage/Early stage) |
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Definition
Need to drink becomes more intense, individual starts drinking earlier in the day. |
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Term
Stages of alcoholism (Third stage/Middle stage) |
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Definition
Loss of control more predominant, avoidance of friends, family, interests, "eye openers" - drinking to feel better in the morning, reverse tolerance - needing less and less to get previous effect because liver can no longer process alcohol at the same level. |
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Term
Stages of alcoholism (Fourth stage/Late stage) |
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Definition
Chronic loss of control, cannot hold a job, "benders" typical - drinking over 3 or 4 days, DTs |
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Definition
At least 2 of 5 symptom types for at least 6 months: Delusions (a false belief that is held onto despite evidence to the contrary), Hallucinations (a false sensory perception), Disorganized behavior, negative symptoms, disorganized speech. |
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Term
Five subtypes of schizophrenia |
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Definition
Disorganized type (speech/behavior are disorganized), catatonic type (psychomotor abnormalities), paranoid type (preoccupation of delusions), residual type, undifferentiated type. |
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Term
Schizophreniform disorder |
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Definition
Similar to schizophrenia but shorter length (1-6 months). |
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Term
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Definition
Mood disorder and schizophrenia. Bipolar and depressive type. |
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Definition
Schizophrenia for less than one month. |
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Definition
Nonbizarre delusions. Erotomanic type (another - usually higher status - person is in love with the client. Grandiose type (delusions of inflated worth or has special identity to deity). Jealous type (delusion that one's partner is cheating on them). Persecutory (delusion that person is being malevolently treated). Somatic (person believes they have physical defect despite the evidence). Mixed type. Unspecified type. |
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Definition
Five or more of the following during the same two-week period: Depressed mood most of the day, Markedly diminished interest or pleasure in all or almost all activities (anhedonia), significant weight loss or weight gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, feelings of worthlessness or excessive or inappropriate guilt, diminished ability to think or concentrate, recurrent thoughts of death or suicidal ideation. |
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Definition
A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week with three or more of the following: inflated self-esteem or grandiosity, decreased need for sleep, more talkative than usual or pressure to keep talking, flight of ideas, distractability, increase in goal-directed activity, excessive involvement in pleasurable activities that have potential for painful consequences. |
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Definition
Criteria met for both a major depressive episode and a manic episode. |
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Definition
A distinct period of persistently elevated, expansive, or irritable mood lasting at least four days. Same criteria as a manic episode. Is not severe enough to cause marked impairment in social or occupational functioning. |
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Definition
History of at least one manic episode and major depressive episode. |
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Definition
At least one hypomanic episode and one major depressive episode. |
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Definition
Has small hypomanic episode and sometimes a slight depressive episode. |
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Term
Major depressive disorder |
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Definition
No manic or hypomanic episodes. |
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Term
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Definition
Less severe than major depressive disorder and is chronic (two years). |
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Definition
A discrete period of intense fear or discomfort with four or more of the following: Palpitations, pounding heart, or accelerated heartbeat, sweating, trembling or shaking, sensations of shortness of breath or smothering, feeling of choking, chest pain or discomfort, nausea or abdominal distress, feeling dizzy, unsteady, lightheaded, or faint, derealization (feelings of unreality) or depersonalization (being detached from oneself), fear of losing control or going crazy, fear of dying, paresthesias (numbness or tingling sensations), chills or hot flashes |
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Term
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Definition
Anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having an unexpected or situationally predisposed panic attack or panic like symptoms. Agoraphobic fears typically involve characteristic clusters of situations that include being outside the home alone; being in a crowd or standing in a line; being on a bridge; and traveling in a bus, train, or automobile. The situations are avoided or else are endured with marked distress or with anxiety about having a panic attack. |
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Definition
Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation. Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response. The person recognizes that the fear is excessive or unreasonable. The phobic situation is avoided or else is endured with intense anxiety or distress. The avoidance, anxious anticipation, or distress in the feared situation interferes significantly with the person's normal routine, occupational functioning, or social activities or relationships. In individuals under age 18 years the duration is at least 6 months. |
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Definition
A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way that will be humiliating or embarrassing. Exposure to the feared social situation almost invariably provokes anxiety. The person recognizes that the fear is excessive or unreasonable. The feared social or performance situations are avoided or else endured with intense anxiety or distress. The anxiety or avoidance in the feared social or performance situation interferes significantly with the person's normal routine. |
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Term
Obsessive-Compulsive Disorder |
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Definition
Either obsessions or compulsions. Obsessions as defined by: recurrent and persistent thoughts, impulses or images that are experienced at some time during the disturbance as intrusive and inappropriate and that cause marked anxiety or distress. The thoughts are not simply excessive worries about real-life problems. The person attempts to ignore or suppress such thoughts or to neutralize them with some other thought. The person recognizes that the obsessional thoughts are a product of his or her own mind. Compulsions are defined by: repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession or according to rules that must be applied rigidly. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation but are not connected in a realistic way or are clearly excessive. The person recognizes that the obsessions/compulsions are unreasonable. The obsessions/compulsions cause distress, are time consuming, and interfere with routine. |
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Term
Posttraumatic Stress Disorder |
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Definition
The person has been exposed to a traumatic event in which BOTH of the following were present: The person experienced, witnessed, or was confronted with an event that involved death or serious injury and the the person's response involved intense fear, helplessness, or horror. The traumatic event is persistently reexperienced in one or more of the following: recurrent and intrusive distressing recollections, recurrent distressing dreams, acting or feeling as if the traumatic event were recurring, intense psychological distress at exposure to internal or external cues, physiological reactivity to internal or external cues. Persistent avoidance of stimuli associated with the trauma and numbing of general resposiveness. Duration is more than 1 month. Persistent symptoms of increased arousal. |
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Term
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Definition
The person has been exposed to a traumatic event involving actual or threatened death or serious injury to self or others and the person's response involved intense fear, helplessness, or horror. Either while experiencing or after experiencing the distressing event the individual has three or more of the following: A subjective sense of numbing, detachment, or absence of emotional responsiveness, a reduction in awareness of his or her surroundings, derealization, depersonalization, dissociative amnesia. The traumatic event is persistently reexperienced. Marked avoidance of stimuli that arouse recollections of the trauma. Causes clinically significant distress. Lasts for a minimum of 2 days and a maximum of four weeks. |
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Term
Generalized Anxiety Disorder |
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Definition
Excessive anxiety or worry occurring more days than not for at least 6 months. The person finds it difficult to control the worry. The anxiety and worry are associated with three or more of the following: restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance. The focus of the anxiety and worry is not confined to features of an Axis I disorder. |
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Term
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Definition
Symptom protects client from experiencing a painful underlying feeling. |
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Term
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Definition
Concern and support received from others is gratifying as well. |
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Definition
Essential feature for this group of disorders: Physical symptoms that cannot be fully explained by medical findings or known physiological mechanisms - physical symptoms that exceed what would normally be expected. |
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Definition
Chronic condition featuring multiple, unexplained, somatic symptoms with no biological basis. Frequent appearances in physicians' offices. Dramatize symptoms. Co-morbid with a number of other axis I disorders. |
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Definition
Symptoms suggest illness due to neurological damage - but bodily organs and nervous system are fine. "La belle indifference" - they do not get surprised by the physical change that has occurred. Symbolic meaning of symptoms. Primary and secondary gain are issues. (Lack of concern makes disorder stand out). |
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Definition
A preoccupation with fears of having a serious disease, relatively rare diagnosis, interpret symptoms as dire and unrealistic. |
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Definition
Preoccupation with an imagined defect in appearance or a markedly excessive concern with a slight physical anomaly. Co-morbidity may involve major depressive disorder and/or dysthymic disorder. Unnecessary plastic surgery. |
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Definition
Predominant complaint is significantly distressing pain. Psychological factors play an important role. Diagnosis is a challenge because pain is subjective. |
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Definition
Essential feature: The intentional production of physical signs or symptoms in the absence of external incentives. Main motivation is to be sick. |
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Definition
Essential feature: Intentional production of false or grossly exaggerated physical or psychological symptoms - motivated by external incentives. |
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Term
Mental Disorders due to a General Medical Condition |
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Definition
Evidence that a mental disturbance is the direct consequence of a general medical condition, disturbance not better accounted for by another mental disorder, disturbance does not occur exclusively during delirium, not substance induced. |
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Term
Psychological Factors Affecting a Medical Condition |
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Definition
Essential features: Medical illness must be present and psychological factors have influenced the course of the condition , interfered with its treatment, increased health risks, or exacerbated symptoms. |
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Term
Impulse Control Disorders |
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Definition
Essential features: A failure to resist an impulse, drive, or temptation to perform an act that can be harmful to self or others, increased tension/arousal prior to committing the act, pleasure, gratification, or relief upon committing the act, person may or may not feel regret or guilt following the act. |
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Definition
Failure to resist impulses to steal objects one does not need, identifiable stressor, guilt common, underlying depression is sometimes present |
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Definition
Persistent and recurrent maladaptive gambling behavior, men out number women 2:1, often parent of same sex gambled, norepinephrine may be a factor, high suicide risk, increases during times of depression or stress |
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Term
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Definition
Fascination with fire; deliberately and purposefully setting fires on more than one occasion, rare disorder most true pyromaniacs are male, fire-setting among children and adolescents not uncommon but usually associated with another disorder |
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Term
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Definition
Uncontrollably pulling one's hair out; usually limited to hair on the head, removal of eyebrows, eyelashes, and other body hair is not uncommon, seen in both men and women but reported more in women, currently thought to be a variation of OCD; sometimes treated as depression, might by an anxious behavior. |
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Term
Intermittent Explosive Disorder |
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Definition
Failure to resist aggressive impulses, behavior is grossly out of proportion to incident that provoked it, other disorders that may have precipitated must be ruled out (mania, borderline, antisocial, psychotic disorders, neuro disorders, ADHD), result in assaults/destruction of property, start and stops suddenly, last minutes to hours, may be accompanied by amnesia or confusion. |
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Term
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Definition
If battering occurs more than twice in a relationship, pattern probably looks like: Phase 1 - Tension building phase (victim will try to calm perpetrator and often report not feeling afraid, perpetrator worries about victim leaving, jealous and controlling). Phase 2 - Acute battering incident (Loss of control, wants to teach victim a lesson, tries to justify actions, perpetrators don't remember much, victim "waits out storm") Phase 3 - Contrite loving behavior (honeymoon phase). |
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Term
Type I of Cycle of Violence Typology |
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Definition
Acute, situationally reactive violence directed to partner only (perpetrator feels alarm and guilt without retaliating, victim feels outrage and can live without perp). |
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Term
Type II of Cycle of Violence Typology |
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Definition
Cyclical violent affective storms directed to partner and family (perps violence is part of character, sees partner as controlling, might feel temporary remorse but not guilt, chronic violence, victim feels frightened but not outraged, both partners fear abandonment). |
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Term
Type III Cycle of Violence Typology |
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Definition
Habitual instrumental violence directed to partner and others (violence used to intimidate and control anyone, severely injure or rape women, victim usually dependent for finances, housing, or drugs). |
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Term
Type IV Cycle of Violence Typology |
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Definition
Acute or chronic secondary violence directed at partner and others (secondary to another disorder, impulsive, spontaneous violence) |
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Term
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Definition
Essential features of these disorders: disturbance in sexual desire and in psychophysiological changes which characterize the sexual response cycle (Desire, excitement, orgasm, resolution) |
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Term
Sexual desire disorders (2) |
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Definition
Hypoactive sexual desire disorder (deficient or absent sexual fantasies and desire for sexual activity which causes marked distress). Sexual aversion disorder (persistent or recurrent extreme aversion to and avoidance of all genital sexual contact with a sexual partner which causes marked distress). |
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Term
Sexual Arousal Disorders (2) |
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Definition
Female sexual arousal disorder (Inability to attain or to maintain until completion of the sexual activity an adequate lubrication-swelling response of sexual excitement which causes marked distress). Male Erectile Disorder (inability to attain or maintain an adequate erection causes marked distress). |
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Term
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Definition
Female orgasmic disorder (Delay in or absence of orgasm following normal sexual excitement phase and causes marked distress). Male Orgasmic Disorder (Delay in or absence of orgasm following normal sexual excitement phase which causes marked distress). Premature ejaculation (Ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it). |
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Term
Sexual Pain Disorders (2) |
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Definition
Dyspareunia (Genital pain associated with sexual intercourse in males or females). Vaginismus (Involuntary spasm of the musculature of the outer third of the vagina that interferes with sexual intercourse). |
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Term
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Definition
Essential feature of these disorders: recurrent, intense sexual urges and sexually arousing fantasies generally involving non-human objects, suffering or humiliation of self or one's partner, or children or other non-consenting persons. Impairment in capacity for reciprocal affectionate sexual activity, mostly reported in males. |
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Definition
Exposure of one's genitals to an unsuspecting stranger. |
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Definition
Sexually arousing fantasies, urges, or behaviors involving the use of nonliving objects |
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Definition
Fantasies, urges, or behaviors involving touching and rubbing against a nonconsenting person. |
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Term
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Definition
Fantasies, urges, behaviors involving the real act of being humiliated, beaten, bound, or otherwise made to suffer. |
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Definition
Fantasies, urges, behaviors involving real acts of psychological or physical suffering of the victim. |
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Definition
Fantasies, urges, or behaviors involving the act of observing an unsuspecting person who is naked, disrobing, or engaged in sexual activity. |
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Term
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Definition
Sexual activity with pre-pubescent child (generally 13 or younger, and person is age 16 and at least 5 years older than the child in question. Father-daughter is the most prevelant, male victims tend to be older than female victims. |
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Definition
In a heterosexual male, fantasies, urges, or behaviors involving cross-dressing. |
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Term
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Definition
Strong persistent cross-gender identification and persistent discomfort with one's biological sex or a sense of inappropriateness in the gender role of that sex. |
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Term
Dissociative Identity Disorder |
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Definition
Existence within a person of two or more distinct personalities or personality states, at least two personalities recurrently control person's behavior. |
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Term
Depersonalization Disorder |
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Definition
A feeling of detachment from and being an outsider observer of one's mental processes or body, persistent recurrent episodes of depersonalization, severe enough to cause distress. |
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Term
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Definition
Sudden, unexpected travel away from home or customary work place with the assumption of a new identity and an inability to recall one's previous identity. |
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Term
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Definition
Sudden inability to recall important personal information (usually of a traumatic or stressful nature). |
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Term
Sleep Disorders Essential Feature |
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Definition
Disturbance in the process of sleep; initiating or maintaining sleep, difficulty sleeping at conventional or appropriate times, excessive day time sleepiness, or abnormal physiological or psychological events during sleep. |
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Term
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Definition
difficulty initiating or maintaining sleep or non-restorative sleep |
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Definition
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Term
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Definition
"Sleep attacks" sudden bouts of restorative sleep, cataplexy (sudden, transient loss of muscle tone), hypnopomic (just before wake) or hypnogogic (just before sleep) hallucinations |
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Definition
Repeated awakenings with detailed recall of nightmares and awaken fully and quickly |
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Term
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Definition
Abrupt awakenings often will scream, a lot of anxiety and at first will be unresponsive |
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Term
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Definition
Hard to awaken, may not remember doing this |
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Definition
Refusal to maintain normal body weight, intense fear of gaining weight, and significant disturbance in body perception. OCD features often present, need to control environment, perfectionism, inflexibility. |
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Term
Anorexia Nervosa subtypes |
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Definition
Restricting type and binge-eating/purging type |
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Term
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Definition
Binge eating and inappropriate compensatory methods to prevent weight gain; self-evaluation excessively influenced by body shape and weight. Binges typically triggered by dysphoric mood states, interpersonal stressors, food deprivation, and feelings. There is a feeling of a loss of control. Usually weight is within normal range. Subtypes include purging and non-purging type. |
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Term
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Definition
The development of emotional or behavioral symptoms in response to an identifiable psychosocial stressor. Symptoms develop within 3 months of stressor onset and last for a maximum of 6 months after termination of stressor. |
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Term
Adjustment Disorder subtypes |
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Definition
With anxiety, with depressed mood, with disturbance of conduct, mixed disturbance of emotions and conduct, with mixed anxiety and depressed mood, unspecified. |
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Term
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Definition
Academic problem, occupational problem, identity problem, religious or spiritual problem, acculturation problem, phase of life problem. Perpetrators of abuse or neglect. |
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Term
Essential features of personality disorders |
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Definition
Enduring pattern of inner experience and behavior that deviates markedly from expectations of the individuals culture. Pattern is inflexible and pervasive across a broad range of situations, it is longstanding, it is maladaptive, and it distresses those close to the person. |
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Definition
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Definition
Characteristic that endures across time and situation |
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Term
Cluster A Personality Disorders |
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Definition
"Odd and eccentric" - Schizoid Personality disorder, Paranoid personality disorder, and schizotypal personality disorder. |
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Term
Schizoid Personality Disorder |
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Definition
Pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, lack of desire for intimacy, often appear cold and/or aloof, prefer mechanical or abstract tasks. They don't have relationships and they don't want them. Can get very involved in fantasy (like video games). |
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Term
Paranoid Personality Disorder |
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Definition
Pervasive distrust and suspiciousness of others; others' motives interpreted as malevolent, generally hostile, hypervigilant. |
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Term
Schizotypal Personality Disorder |
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Definition
Pervasive pattern of social and interpersonal deficits marked by acute discomfort with and reduced capacity for close relationships, and cognitive or perceptual distortions and eccentricities of behavior. Ideas of reference, superstitious, pre-occupied with paranormal phenomena. |
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Term
Cluster B Personality Disorders |
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Definition
"Dramatic, Erratic, and Over-emotional" - Anti-social personality disorder, Borderline personality disorder, narcissistic personality disorder, and histrionic personality disorder |
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Term
Anti-social personality disorder |
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Definition
Disregard for and violation of the rights of others (since the age of 15); poor impulse control, irritability and aggressiveness, lack of remorse/guilt. Crave stimulation, here and now focus, emotionally shallow, quick to anger. HIstory of conduct disorder, people are objects. |
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Term
Borderline personality disorder |
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Definition
Instability of interpersonal relationships, self-image, and affect; impulsivity; active efforts to avoid real or imagined abandonment; anger and self-destructive behavior. Moods often reactive and intense, all-or-nothing relationships, splitting, projective identification common, behavioral and affective dysregulation. |
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Term
Narcissistic Personality Disorder |
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Definition
Grandiose self-importance, need for admiration, entitlement, lack of empathy, interpersonally exploitative, envious or believes others are envious. Intolerance of criticism due to profound self-esteem deficits, attention/admiration needs, preoccupied with self-image, over-idealizes or over-devalues others and switch between the two often. Appear conceited, boastful, may alienate others because they are so self-involved, exaggerate abilities, distort facts, self-deception. |
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Term
Histrionic Personality Disorder |
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Definition
Excessive emotionality and attention seeking; seductiveness; rapidly shifting, shallow emotions; self-dramatization. Impressionistic speech, behavior over-reactive, uncomfortable when not the center of attention. Tend to be hedonistic, charming, labile, non-methodical, crave novelty, not detail oriented. Distractible, shallow/flighty interactional style. |
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Term
Cluster C Personality Disorders |
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Definition
"Anxious and Fearful" - Dependent Personality Disorder, Avoidant Personality Disorder, and Obsessive-compulsive personality disorder |
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Term
Dependent Personality Disorder |
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Definition
Excessive need to be taken care of leading to submissive, clingy behavior, needs others to assume responsibility for major areas of his/her life, difficulty initiating projects or doing things alone, fears disagreement with others, urgently seeks another relationship when one ends. |
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Term
Avoidant Personality Disorder |
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Definition
Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Low tolerance for dysphoria, unduly set back by minor failures or diappointments, risk exaggeration, issue "safety tests" in relationships, self-criticism |
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Term
Obsessive-compulsive Personality Disorder |
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Definition
Preoccupied with order, perfectionism, and mental and interpersonal control - at the expense of flexibility, openness, and efficiency. Detail oriented; often misses the "big picture". Emotional constriction, lacks spontaneity, perfectionistic, excessive devotion to work and productivity to the exclusion of pleasure, doesn't discuss feelings, intellectualize/rationalize to avoid feelings |
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