Term
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Definition
helpful in providing a name for what people are experiencing, letting them know they are not the only one
helpful in consultation with colleagues
fuels research |
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Term
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Definition
low inter-rater reliability, with differing diagnoses made for one pt
many disorders' symptoms overlap-
many pts receive multiple diagnoses
in providing a label for disorders, creates a stigma and generalization
may not apply to all cultures
categories not available for every problem behavior
diagnostic errors |
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Term
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Definition
Generalized Anxiety Disorder
Panic Attacks and Panic Disorder
Phobias
Obsessive-Compulsive Disorder
Posttraumatic Stress Disorder |
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Term
Generalized Anxiety Disorder
Psychodynamic Etiology |
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Definition
Due to inadequacies in the early parent-child relationship: extreme punishment for id impulses=learn id impulses are bad=higher anxiety
Overprotectiveness: produces inadequate defense mechanisms to cope with anxiety |
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Term
Generalized Anxiety Disorder
Behavioral and Cognitive Etiology |
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Definition
Repeated exposure to dangerous situations
Maladaptive cognitions: focus attention on threatening stimuli, misinterpret innocuous stimuli, irrational assumptions (must be loved by all), intolerance of uncertainty
Worry as an avoidance strategy (distracts from physical anxiety) |
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Term
Generalized Anxiety Disorder
Biological Etiology |
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Definition
Problems in anxiety feedback loop:
GABA- failure to inhibit arousal due to malfunction in feedback or reduced receptors
Also SE & NE
Anxiety or GABA problem first? |
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Term
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Definition
frequent and unexpected attacks
worry about future attacks
change in behavior to avoid attacks |
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Term
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Definition
Typically co-occurs with Panic Disorder
Fear of any place/situation in which escape seems difficult or help would be unavailable |
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Term
| Panic Disorder Genetic/Cognitive Etiology |
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Definition
abnormal panic circuit runs in families
body more sensitive to panic cues
misinterpret physical signs as dangerous and catastrophic |
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Term
| Phobias & When a Fear Becomes Pathological |
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Definition
Strong or irrational fear of something
Specific phobias (e.g., situational)
Becomes pathological when there is:
Dysfunction, Distress, Deviation, Danger |
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Term
| Phobia Behavioral Etiology |
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Definition
Classical conditioning
Stimulus generalization
Mowrer's Two-Factor Theory:
respondent conditioning for first anxiety response
operant conditioning for maintaining anxiety- reinforcement through escape and avoidance, classical conditioning |
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Term
Obsessive Compulsive Disorder
Genetic, Biological, & Cognitive Etiology |
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Definition
High genetic vulnerability
Inadequate SE levels & high frontal lobe activity
As a method for dealing with anxiety (self-reinforcing strategy) |
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Term
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Definition
re-experiencing, hyper-arousal, avoidance, emotional numbing
+1 month |
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Term
PTSD Biological &
Cognitive-Behavioral Etiology |
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Definition
Dysregulation in brain systems: amygdala, medial prefrontal cortex, and hippocampus
Abnormally low cortisol
"Fear Structure":
stimuli--cognitions--responses (cycle)
Avoidance of trauma reminders causes individual not to process event and is maintained through:
negative reinforcement
erroneous beliefs of fear/anxiety |
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Term
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Definition
| Some of pt's thoughts, feelings, and behaviors are removed from conscious awareness and control |
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Term
| Dissociative Disorder Types |
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Definition
Dissociative Amnesia (localized, selective, generalized, systematized)
Dissociative Fugue
Dissociative Identity Disorder |
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Term
Dissociative Identity Disorder
Psychodynamic & Behavioral Etiology |
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Definition
Psychodynamic: caused by lifetime of excessive repression, extensive childhood trauma=belief world is dangerous and desire to escape=something bad happens, leave and pretend it is happening to another person
Behavioral: learned through operant conditioning=escape behavior
reinforced for mind wandering/forgetting (relief from pain)
tends to describe dissociation in general rather than DID |
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Term
DID Post-traumatic model (PTM) &
Sociocognitive model (SCM) |
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Definition
PTM: therapist discovers DID and arises primarily from a severe history of physical and/or sexual abuse, child dissociates as a means of coping
SCM: therapist creats DID, socially constructed condition that results from inadvertent therapist cueing and media influences *iatrogenic |
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Term
| Major Depressive Disorder |
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Definition
5+ symptoms and depressed mood or loss of interest/pleasure
significant distress or impairment
2 weeks or more
represents decline
not accounted for by gmc/bereavement
weight loss/gain, insomnia/hypersomnia, psychomotor agitation/retardation, fatique, guilt, etc |
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Term
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Definition
| lower level depression for 2+ years |
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Term
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Definition
Mild: symptoms barely meet criteria, little distress, no suicidal ideation
Moderate
Severe: # of symptoms exceed minimum, marked impairment |
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Term
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Definition
Psychotic features: automatically severe
Mood congruent: consistent with depressed mood
Mood incongruent: not consistent with mood or are more bizarre (very rare) |
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Term
| MDD Genetic & Biological Etiology |
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Definition
SE transporter gene (short variant)
Low SE
SE regulates other NTs, NE & DA
Increased cortisol (endocrine system) |
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Term
| MDD Behavioral & Cognitive Etiology |
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Definition
Behavioral: Lewinsohn- depression is related to a decrease in reinforcement and/or an increase in punishment
Cognitive: learned helplessness theory ("no control"), negative cognitive styles- cognitive errors, depressive cognitive triad (self, world, future), schemas |
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Term
| Manic Episode General Features |
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Definition
1+ week or hospitalized before 1 week
abnormal mood: high, irritable, or expansive
main features (3+):
inflated self-esteem, high energy, low sleep, racing thoughts, pressured speech, impulsivity, poor judgement
*hypomanic episode assoc with less time (3-4 days), less sx, less psychosis
*mixed episode fulfill criteria for both MDE and manic episode nearly every day for at least 1 week. |
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Term
| Bipolar Disorder Specifiers |
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Definition
Severity: mild, moderate, severe
severe with/without psychotic features
Most recent episode specifiers:
with catatonic features
with postpartum onset
course of recurrent episodes:
with or without full interepisode recovery
with rapid cycling: in 1 yr at least 4 episodes of MD, Mania, Mixed, or Hypomania |
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Term
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Definition
involves periodic elevation and depression of mood w/out MDE or hypomanic episode
less frequently present to clinic
at risk for MDE or manic episode |
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Term
| Bipolar Genetics & Biological Etiology |
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Definition
Huge genetic link- 50%
Increased glucose metabolism
Low SE and high NE, permissive theory
Lesions in right orbitofrontal region (e.g., stroke) |
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Term
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Definition
SLAP Domains:
Specificity of plan
Lethality of method
Availability of means
Proximity of helpers
On a continuum |
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Term
| Somatoform Disorder Types |
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Definition
*Hysterical Type (Physical Change):
Somatization Disorder
Conversion Disorder
Pain Disorder
*Preoccupation Type (No Physical Change):
Hypochondriasis
Body Dysmorphic Disorder
Psychophysiological disorders |
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Term
| Somatoform Hysterical Type |
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Definition
Shared features:
Physical sx/ concerns without physiological/ rational basis
Prominent relationship btw psychosocial stressors and symptoms
Secondary gain aspects (attention, excuse)
Family & employment complications
NOT INTENTIONALLY FAKING
(not malingering/ factitious disorder) |
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Term
Somatization Disorder &
Biological Etiology |
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Definition
extensive history of sx
life revolves around sx
multiple and varied sx req'd:
pain x4
gi x2
sexual/reproductive
pseudoneurological
onset before age 30, chronic course- personality disorder?
genetic component w/ link to anti-social pd
low SE yields increased pain reception |
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Term
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Definition
at least one symptom or deficit of sensory or voluntary motor function
DSM specifiers:
motor symptom or deficit
sensory sx or deficit
with seizures or convulsions
with mixed presentation
Sx presentation assoc with significant psychosocial stressor-episodic
Presented dramatically w/out corresponding concern |
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Term
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Definition
Psychological factors have "important role in onset, severity, exacerbation, or maintenance of pain"
DSM Specifiers:
"with associated psychological factors" when psych factors have major role
"with both psych factors and a general medical condition" when both play important roles
Acute/chronic= -/+ 6 months |
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Term
| Pain Disorder Biological Etiology |
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Definition
Gate control theory: pain signals from body entering spinal cord are modulated by signals sent from brain- SE modulates signals from brain
Endorphins:
levels are lower in Pain Disorder pts
levels are related to sense of self-efficacy |
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Term
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Definition
anxiety surrounding fears of having a serious illness 2/2 misinterpretation of bodily sx
cannot be convinced that nothing is wrong
frequent visits to doctor
usually comorbid w/ anxiety/depression
relationship to Panic Disorder:
misinterpretation of physical sx
panic has fear of immediate consequences, Hypochondriasis has fear of long-term consequences |
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Term
Hypochondriasis
Biological & Cognitive Etiology |
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Definition
Non-specific genetic component
Biological: deficit in autonomic down-regulation & aberrant cortisol levels
Cognitive: focused attention on physical sensations, hypersensitivity to threat, health as "free from symptoms"
Possibly learned through modeling |
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Term
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Definition
preoccupied w/ something being wrong or misshapen about body part (usually involves face)
not delusional, but overvaluing
not a phobia (no irrational fear)
often seek dermatologist or plastic surgery to "correct"
rates of suicide are high
overlap with OCD
PDs common |
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Term
| Anorexia Nervosa & 2 Types |
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Definition
Failure by choice to maintain adequate weight "Refusal"
85% of normal weight
due to restricted eating, purging, and exercise
weight loss does not reduce fear of gaining weight
distorted perception of body weight and size
amenorrhea for at least 3 months (DSM V proposed to remove this)
Restricting Type: dieting, fasting, exercise (most typical)
Binge-eating/Purging type: vomiting, laxatives, diuretics, enemas & 85% normal body weight (less common) |
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Term
Anorexia Nervosa &
Bulimia Nervosa Etiology |
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Definition
Perfectionistic parents
Over-involved parents: father domineering, high sense of importance placed on external evaluation, restrictive eating and purging as means of exerting control, child's sense of self enmeshed w/ parents- lack of body cues
Lack of conflict resolution:
open/expressed conflict levels low, not ok to talk about feelings, etc
*family tx important |
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Term
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Definition
binge eating
sense of loss of control while eating
compensating action: vomiting, laxatives, diuretics, enemas, fasting, excessive exercise ( last two non-purging type)
at least twice/week for 3 months (DSM V change to once/week)
self-eval unduly influenced by body shape & weight
normal or higher weight (not anorexia)
specify purging and non-purging types (DSM proposed removal of subtypes) |
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Term
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Definition
Maladaptive pattern of substance use leading to significant impairment &/or distress during same 12 month period, includes 1+ from recurrent use:
failure to fulfill major role obligations
use in situations when it is physically dangerous
despite legal problems
despite persistent social/interpersonal problems caused by substance |
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Term
| Substance Dependence Criteria |
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Definition
maladaptive pattern of substance use leading to significant impairment &/or distress
includes 3+:
tolerance
withdrawals (substance specific)
substance taken in larger amts than intended
unsuccessful efforts to cut down/control
sig time spent acquiring, using, recovering
social, occupational, recreational activities sacrificed
continued use despite physical & psychological problems caused/exacerbated by substance |
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Term
Substance Use
Genetic & Biological Etiology |
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Definition
Genetic: males w/ adhd and alcoholic father at highest risk
reciprocal gene-environment
environment plays role in use, genetics important for abuse/dependence
physiological response to substances
everyone reacts differently bc of different brain structures, genes
Biological: DA critical in use/abuse/dependence:
pleasure pathway=VTA-NA-frontal lobe
stimulated by most abused drugs
natural experiences cannot cause same effects
GABA system:
reduces fear/inhibition
increased GABA-increased DA in Pleasure Pathway |
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Term
| Positive Symptoms Schizophrenia |
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Definition
delusions
hallucinations: usually auditory
disorganized speech: loose associations, tangentiality, derailment, neologisms, "clang"
bizarre/disorganized behavior: appearance, affect, actions |
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Term
| Negative Symptoms Schizophrenia |
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Definition
alogia: not speaking
affect flattening
avolition: no motivation
anhedonia: lack of pleasure |
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Term
| Schizophrenia Subtypes (4) |
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Definition
Paranoid
Catatonic
Disorganized (hebephrenic), most obviously psychotic, at early age
Undifferentiated |
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Term
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Definition
Prodromal: peculiar behavior, social isolation/withdrawal, decreased role function, not unlike social phobia
Active
Residual: decreased positive symptoms, negative symptoms remain* |
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Term
Schizophrenia
Genetics & Biological Etiology |
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Definition
Genetic: mz twins 50%, parent-child 17%
Biological: increase in size of ventricles
decrease in size of subcortical structures
asymmetry
altered neurochemistry: DA most widely known, but not sole precipitant
higher # of D2 receptors: positive symptoms
underactive D1 in prefrontal cortex: negative symptoms
childhood: extensive white matter tracts and synapses from connecting gray matter
*synaptic pruning: process occurring in adolescence where number of synapses decrease based on use...
**in schizophrenia: excessive/inappropriate synaptic pruning may take place-
frontal lobes=problem solving, organized thought
temporal lobes=auditory hallucinations
thalamus=sensory gating |
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Term
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Definition
refers to how disorders arise and change with time:
deviation from age-appropriate norms
exaggeration of normal developmental trend
behaviors that interfere with normal developmental processes |
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Term
Common Emotional & Behavioral Problems
Found in Children & Adolescents |
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Definition
Children: worrying, bed-wetting, nightmares, temper tantrums, restlessness
Adolescents (today): less happiness, confidence, affection, and trust & have more insecurity |
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Term
| Childhood Disorders Introduction |
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Definition
17-22% experience a disorder, not uncommon
more boys than girls, may be due to boys externalizing and disruptive behavior
Adult & childhood disorders often differ:
due to cognitive differences (PTSD & nightmares)
some developmental disorders persist in stable forms in adulthood such as MR |
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Term
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Definition
Describe as more physical (stomach aches)
Separation anxiety disorder: 2+ yrs
Secondary gain- more attention or get what they want
May not understand OCD compulsions |
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Term
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Definition
No sex differences found until 11
Mood swings & somatic complaints, irritability |
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Term
| Disruptive Behavior Disorders (3) |
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Definition
Oppositional Defiant Disorder (ODD)
Conduct Disorder (CD)
Attention Deficit Hyperactivity Disorder (ADHD) |
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Term
| Oppositional Defiant Disorder (ODD) |
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Definition
argue repeatedly with adults, lose their tempers, swear, feel great anger & resentment, & blame others for their own mistakes
Begins by 8 yrs
More common in boys before puberty, equal after
Very young children exhibit tantrums, aggression, anger, "no"
Problems with authority
Defiant when demands are placed on them |
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Term
| ODD & Conduct Disorder (CD) |
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Definition
CD more severe:
Violate others' basic rights by cruel or criminal behavior
Usually begins before 10, early onset: before 10
1/3 of children referred to clinic
theft, violence, truancy, fires, etc
Possible course: ODD->CD->Antisocial PD
Environment very important |
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Term
| Developmental Progression of Conduct Problems |
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Definition
Demonstrates oppositional and argumentative behaviors early in life and gradually progresses into increasingly more severe patterns
Gradual process of oppositionality expanding from parents to all authority figures, then adults, and society as a whole
High-rate, low-severity behavior to low-rate, high-severity antisocial behaviors |
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Term
| ODD & CD Family Environment, Genetic/Biological, and Sociocultural Etiology |
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Definition
Family Environment: frequent conflict & hostility, poor parenting strategies, parental rejection, neglect, and/or abuse, more permissive and inconsistent, more likely to reinforce inappropriate behaviors and ignore or punish prosocial
Genetic/Biological: low response to stress, cortisol, Antisocial traits
Sociocultural: Poverty & drug abuse |
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Term
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Definition
There are community-based residential programs, school-based interventions & skill-training techniques, but limited efficacy
At home is best and with family therapy
*Parent-child Interaction Therapy (2-7):
improve parent-child relationship & improve behavior management of parent, 2 phases- child-directed interaction (establishes secure, nurturing relationship through parental responsiveness and parent-directed (consistency in discipline and limit setting)
Drug therapy recommended but no research support
Institutionalization causes more problems |
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Term
Attention Deficit Hyperactivity Disorder
Associated Features |
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Definition
Present before age 7
Maladaptive and age-inappropriate (e.g., staying still)
Type: Combined, Inattentive, Hyperactive-impulsive
Can be lifelong (50-66%)
Co-morbid learning disorders, ODD, & CD (because of lack of positive attention)
Educational and occupational achievement less than ability
Disciplinary problems
Social/relationship problems (rejection from peers)
Greater risk for substance use (impulsivity)
Can be context dependent
Perform better in highly structured environments
By elementary school, significantly falling below intellectual ability |
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Term
| ADHD Biological, Genetic, & General Etiology |
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Definition
Males 4X more likely
30% chance with first-degree relative
Maternal smoking
Decreased brain volume & functioning: frontal cortex, basal ganglia, cerebellar vermis, locus coeruleus (function only)- understimulation
Food additives=NO evidence |
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Term
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Definition
Stimulant Meds (primary)
Behavioral (recommended):
structured routine
consistency in discipline
social skills training |
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Term
Pervasive Developmental Disorders (PDD)
Criteria (4) and Types (2) |
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Definition
Impairment in multiple areas of functioning
Abnormalities are not normal for the stage of development
Begin very early in life
Persist throughout the lifetime
Autism & Asperger's |
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Term
| Autistic Disorder Primary Signs (3) |
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Definition
Impairment in social interaction (nonverbal behavior such as eye contact, sharing, social/emotional reciprocity)
Language for communication (delay/lack of spoken language & gestures, repetitive & idiosyncratic use, problems initiating and maintaining conversation)
Restricted, repetitive, stereotyped play (restricted interests, inflexible routines, repetitive movements, preoccupation with parts of objects) |
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Term
| Autistic Disorder Overview |
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Definition
Present before age 3
1/300 and on the rise (older parents may be cause)
80% are male
Spectrum disorder with other PDDs & regards to symptom severity
Social & communication obvious by 24 months, restricted interests at 36 months
MR common- 50% severe, savant is rare
Sensory sensitivity (esp light, touch)
Theory of Mind: unable to take perspectives |
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Term
| Autistic Disorder Evaluation |
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Definition
No babbling by 12 months
No gesturing by 12 months
No single words by 16 months
No spontaneous two-word phrases by 24
ANY loss of ANY language skill or social skills at ANY age |
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Term
| Asperger's Disorder Overview |
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Definition
Compared to Autism: only difference is no significant delays or impairments in communication, but have impairment in social interactions and restricted interests
No delays in cognitive or adaptive functioning
Viewed as odd or strange
More common than autism (1/250)
Better outcomes and prognosis |
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Term
| Autistic Disorder Genetic & Biological Etiology |
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Definition
Genetic factors
Prenatal difficulties or birth complications (older age of father)
Brain differences- increased brain volume & white matter, structural brain differences in the amygdala & brain stem, reduced frontal lobe activity |
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Term
| Autistic Disorder Treatment |
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Definition
Behavior therapy:
Applied Behavior Analysis- 40 hrs/week with shaping, modeling, conditioning, and parent training
Meds only effective for secondary behavior problems such as inattention & agression |
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Term
| Personality Disorders (10)and Clusters |
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Definition
Cluster A: Paranoid, Schizoid, Schizotypal
characterized as "withdrawn"
Cluster B: Antisocial, Borderline, Histrionic, Narcissistic
"dramatic, erratic, & self-centered"
Cluster C: Dependent, Obsessive-compulsive, Avoidant
"Anxious or fearful", relationships dominated by anxiety |
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Term
| Personality Disorder General Features |
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Definition
Can't diagnose until 18
Problematic, pervasive, rigid
High co-morbidity with Axis I and psychiatric problems in family
15% of population, mostly OCPD |
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