Term
| Infant deprivation effects |
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Definition
The 4 W's: Weak, Wordless, Wanting (socially), Wary
Long term deprivation of affection results in:
Decrease muscle tone, poor language skills, poor socialization skills, lack of basic trust, anaclitic depression (withdrawn), weight loss, physical illness.
Deprivation for greater than 6 months can lead to irreversible changes.
Severe deprivation can result in infant death |
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Term
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Definition
Evidence: Healed fractures on x-ray, burns, subdural hematomas, multiple bruises, retinal hemorrhage or detachment.
Usually male caregiver |
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Term
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Definition
Evidence: genital, anal, or oral trauma. STI's or UTIs
Known to victim, usually male |
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Term
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Definition
Failure to provide child with adequate food, shelter, supervision, education and/or affection. Most common form of child mistreatment
Evidence: poor hygiene, malnutrition, withdrawal, impaired social/emotional development, failure to thrive |
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Term
| Types of Pervasive developmental disorders |
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Definition
| Autistic Disorder, Asperger's disorder, Rett's, Childhood disintegrative disorder |
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Term
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Definition
Severe language impairment and poor social interactions. Greater focus on objects than on people.
Repetitive behavior and usually below-normal intelligence |
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Term
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Definition
Milder form of autism.
All-absorbing interests, repetitive behavior, and problems with social relationships.
Children are of normal intelligence and lack verbal and cognitive deficits. No language impairment |
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Term
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Definition
X-linked disorder seen almost exclusively in girls (males die in utero).
Symptoms become apparents 1-4 years, including regression characterized by loss of development, loss of verbal abilities, mental retardation, ataxia, and stereotyped hand-wringing |
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Term
| Childhood disintegrative disorder |
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Definition
Common age of onset is 3-4 years
Marked regression in multiple areas of functioning after at least 2 years of apparently normal development.
Significant loss of expressive or receptive language skills, social skills or adaptive behavior, bowel or bladder control, play, or motor skills. More common in boys |
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Term
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Definition
| A distorted perception of reality (psychosis) characterized by delusions, hallucinations, and/or disorganized thinking. Can occur in patients with medical illness, psychiatric illness, or both |
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Term
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Definition
Abnormal range of moods or internal emotional states and loss of control over them.
Severity of moods causes distress and impairment in social and occupational functioning.
Includes major depressive disorder, bipolar, persistent depressive, cyclothmic |
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Term
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Definition
Distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy lasting at least 1 week
Diagnosis requires hospitalization or at least three of the following (DIG FAST): Distractibility, Irresponsibility, Grandiosity, Flight of ideas, Agitation, decreased need for Sleep, Talkativeness |
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Term
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Definition
| Link manic episode except mood disturbance is not severe enough to cause marked impairment in social/occupational functioning or to necessitate hospitalization. No psychotic features |
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Term
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Definition
Defined by the presence of at least 1 manic (bipolar I) or hypomanic (bipolar II) episode. Depressive symptoms always occur eventually. Patient's mood and functioning usually return to normal between episodes.
Use of antidepressants can lead to increased mania. High suicide risk
Treat with mood stabilizers (lithium, valproic acid, carbamazepine), atypical antipsychotics) |
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Term
| Cyclothymic Disorder (under Bipolar) |
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Definition
| Dysthmia and hypomania, milder form of bipolar disorder lasting at least two years |
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Term
| Major Depressive Disorder |
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Definition
Self-limited, with major depressive episodes usually lasting 6-12 months.
Episodes characterized by at least 5 of following 9 symptoms for more than 2 weeks: (SIG E CAPS)
Sleep disturbance
loss of Interest
Guilt or feelings of worthlessness
loss of Energy
loss of Concentration
Appetite/weight changes
Psychomotor retardation or agitation
Suicidal idetions
depressed mood |
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Term
| Persistent Depressive Disorder (dysthymia) |
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Definition
| Milder form of depression lasting at least 2 years |
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Term
| Seasonal affective disorder |
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Definition
| Symptoms associated with winter season; improves in response to full-spectrum bright-light exposure |
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Term
| Lifetime prevalence for major depressive episode |
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Definition
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Term
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Definition
Differs from classical forms of depression. Characterized by mood reactivity (being able to experience improved mood in response to positive events), "reversed" vegetative symptoms (hypersomnia and weight gain), leaden paralysis, and long-standing interpersonal rejection sensitivity.
Most common subtype of depression - MAOIs, SSRIs |
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Term
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Definition
Increased NE
Decreased GABA
Decreased 5-HT |
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Term
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Definition
Decreased NE
Decreased 5-HT
Decreased DA |
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Term
| NT with Alzheimer's dementia |
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Definition
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Term
| NT with Huntington's Disorder |
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Definition
Decreased GABA
Decreased ACh
Increased DA |
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Term
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Definition
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Term
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Definition
Decreased DA
Increased 5-HT
Increased Ach |
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Term
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Definition
Treatment option for major depressive disorder refractory to other treatment and for pregnant women with major depressive disorder.
Also considered when immediate response is necessary, in depression with psychotic features, and for cataonia
Produces painless seizure in an anesthetized patient.
Major adverse effects are disorientation and temproary anterograde/retrograde amnesia usually fully recovering in 6 months |
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Term
| Risk factors for suicide completion |
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Definition
SAD PERSONS complete suicide
Sex (male)
Age (teenager or elderly)
Depression
Previous attempt
Ethanol
loss of Rational thinking
Sickness (medical illness)
Organized plan
No spouse (divorced, widowed or single)
Social support lacking
Women try more often, men succeed more often |
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Term
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Definition
Inappropriate experience of fear/worry and its physical manifestations when the source of fear/worry is either not real or insufficient to account for severity of symptoms
Symptoms interfere with daily functioning. Lifetime prevalence of 30% in women and 19% in men
Includes panic disorder, phobias, OCD, PTSD, and generalized anxiety disorder |
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Term
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Definition
Fear that is excessive or unreasonable and interferes with normal function
Cued by presence or anticipation of a specific object or situation. Person recognizes that fear is excessive. Can treat with systematic desensitization |
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Term
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Definition
Social anxiety disorder.
Exaggerated fear of embarrassment in social situations
Treat with SSRIs |
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Term
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Definition
Recurring intrusive thoughts, feelings, or sensations (obsessions) that cause severe distress.
Relieved in part by the performance of repetitive actions (compulsions). Ego dystonic: behavior consistent with one's own beliefs and attitudes.
Associated with Tourette's disorder.
Treat with SSRIs or clomipramine |
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Term
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Definition
Persistent reexperiencing of a previous traumatic event.
May involve nightmares or flashbacks, intense fear, helplessness, or horror. Leads to avoidance of stimuli associated with trauma and persistently increased arousal.
Disturbance lasts longer than 1 month, with onset of symptoms beginning at anytime after the event
Treat with psychotherapy or SSRIs |
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Term
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Definition
| PSTD related - lasts between 2 days and 1 month |
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Term
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Definition
Persistent reexperiencing of a previous traumatic event.
May involve nightmares or flashbacks, intense fear, helplessness, or horror. Leads to avoidance of stimuli associated with trauma and persistently increased arousal.
Disturbance lasts longer than 1 month, with onset of symptoms beginning at anytime after the event
Treat with psychotherapy or SSRIs |
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Term
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Definition
| PSTD related - lasts between 2 days and 1 month |
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Term
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Definition
Persistent reexperiencing of a previous traumatic event.
May involve nightmares or flashbacks, intense fear, helplessness, or horror. Leads to avoidance of stimuli associated with trauma and persistently increased arousal.
Disturbance lasts longer than 1 month, with onset of symptoms beginning at anytime after the event
Treat with psychotherapy or SSRIs |
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Term
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Definition
| PSTD related - lasts between 2 days and 1 month |
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Term
| Generalized anxiety disorder |
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Definition
Pattern of uncontrollable anxiety for least 6 months that is unrelated to a specific person, situation, or event.
Associated with sleep disturbance, fatigue, GI disturbance, and difficulty concentration.
Treat with SSRIs or SNRIs |
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Term
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Definition
| Emotional symptoms causing impairment following an identifiable psychosocial stressor and lasting less than 6 months |
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Term
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Definition
Consciously fakes or claims to have a disorder to attain a specific secondary gain (avoiding work, obtaining drugs)
Poor compliance with treatment and follow-up diagnostic tests. Complaints cease after gain (vs factitious disorder) |
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Term
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Definition
| Hallucinations, Delusions, disorganized speech |
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Term
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Definition
| Perceptions in the absence of external stimuli (auditory most common) |
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Term
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Definition
| False beliefs about oneself or others that persist despite facts |
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Term
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Definition
| Words and ideas are strung together based on sounds, puns, or "loose associations" |
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Term
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Definition
| Most commonly a feature of medical than psychiatric illness |
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Term
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Definition
| More commonly a feature of psychiatric than medical illness |
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Term
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Definition
| Often occur as an aura of psychomotor epilepsy and in brain tumors |
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Term
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Definition
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Term
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Definition
| Common in alcohol withdrawal - sensation of bugs crawling on one's skin. Also seen in cocaine abusers |
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Term
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Definition
| Occurs while GOing to sleep |
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Term
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Definition
| Occurs while waking from sleep "POMPous upon awakening" |
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Term
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Definition
Chronic mental disorder with periods of psychosis, disturbed behavior and thought, and decline in functioning that last longer than 6 months.
Associated with increased DA and decreased dendritic branching
Diagnosis requires 2 or more of the following:
- Delusions
- Hallucinations
- Disorganized speech
- Disorganized or catatonic behavior
- Negative symptoms (flat affect, social withdrawal, lack of motivation, lack of speech or thought" |
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Term
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Definition
| Psychosis less than 1 month, usually stress related |
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Term
| Schizophreniform disorder |
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Definition
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Term
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Definition
| At least 2 weeks of stable mood with psychotic symptoms |
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Term
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Definition
Fixed, persistent, nonbizarre belief system lasting longer than 1 month.
Functioning otherwise not impaired.
Shared psychotix disorder - development of delusions in a person in a close relationship with someone with delusional disorder. Often resolves upon separation |
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Term
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Definition
Inappropriate experience of fear/worry and its physical manifestations when the source of the fear/worry is either not real or insufficient to account for severity of symptoms.
Lifetime prevalence of 30% in women and 19% in men.
Includes panic disorder, phobias, PTSD, OCD, and generalized anxiety disorder |
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Term
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Definition
PANICS
Defined by presence of recurrent periods of intense fear and discomfort peaking in 10 minutes with at least 4 of the following: Palpitations, Paresthesias, Abdominal distress, Nausea, Intense fear of dying or losing control, lIght-headedness, Chest pain, Chills, Choking, dosConnectedness, Sweating, Shaking, Shortness of breath.
Strong genetic component.
Treatment: cognitive behavioral therapy (CBT), SSRIs, venlafaxine, benzos |
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Term
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Definition
| An enduring, repetitive pattern of perceiving, relating to, and thinking about the environment and oneself |
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Term
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Definition
Inflexible, maladaptive, and rigidly pervasive pattern of behavior causing subjective distress and/or impaired functioning
Person is usually aware of the problem. Presents early in adulthood |
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Term
| Cluster A personality Disorder |
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Definition
"Weird" (Accusatory, Aloof, Awkward)
Odd or eccentric, inability to develop meaningful social relationships.
No psychosis; genetic association with schizophrenia |
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Term
| Paranoid Personality Disorder |
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Definition
Cluster A
Pervasive distrust and suspiciousness
Projection is the major defense mechanism |
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Term
| Schizoid Personality Disorder |
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Definition
Cluster A
Schizoid = distant
Voluntary social withdrawal, limited emotional expression, content with social isolation (vs avoidant) |
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Term
| Schizotypal Personality Disorder |
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Definition
Cluster A
Schizotypal = magical thinking
Eccentric appearance, oddbeliefs or magical thinking, interpersonal awkwardness |
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Term
| Cluster B personality Disorder |
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Definition
Wild (Bad to the Bone)
Dramatic, emotional, or erratic;genetic association with mood disorders and substance abuse
Antisocial, borderline, histrionic, narcissistic |
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Term
| Antisocial Personality Disorder |
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Definition
Cluster B
Antisocial = sociopath
Disregard for and violation of rights of others. criminality
Males > females. Conduct disorder if less than 18 years |
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Term
| Borderline Personality Disorder |
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Definition
Cluster B
Unstable mood and interpersonal relationships, impulsiveness, self-mutilation, boredom, sense of emptiness
Females > males, splitting is a major defense mechanism |
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Term
| Histrionic Personality Disorder |
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Definition
Cluster B
Excessive emotionality and excitability, attention seeking, sexually provocative, overly concerned with appearance |
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Term
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Definition
Cluster B
Grandiosity, sense of entitlement
Lacks empathy and requires excessive admiration
Often demands the "best" and reacts to criticism with rage |
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Term
| Cluster C Personality Disorder |
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Definition
"Worried" (Cowardly, compulsive, clingy)
Avoidant, Obsessive-compulsive, dependent |
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Term
| Avoidant Personality Disorder |
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Definition
Cluster C
Hypersensitive to rejection, socially inhibited, timid, feelings of inadequacy, desires relationships with others (vs schizoid) |
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Term
| Obsessive-Compulsive Personality Disorder |
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Definition
Cluster C
Preoccupation with order, perfectionism, and control
Ego-syntonic: behavior consistent with one's own beliefs and attitudes (vs OCD) |
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Term
| Dependent Personality Disorder |
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Definition
Cluster C
Submissive and clinging, excessive need to be taken care of, low-self confidence |
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Term
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Definition
Desired reward produces action
Mouse presses button to get food |
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Term
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Definition
Target behavior (response) is followed by removal of aversive stimulus
Mouse presses button to turn off continuous loud noise |
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Term
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Definition
| Repeated application of aversive stimulus extinguishes unwanted behavior |
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Term
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Definition
| Discontinuation of reinforcement eventually eliminates behavior |
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Term
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Definition
| Patient projects feelings about formative or other important persons onto physician (psychiatrist is seen as patient) |
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Term
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Definition
| Doctor projects feelings about formative or important persons onto patient |
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Term
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Definition
Unconscious mental processes used to resolve conflict and prevent undesirable feelings
Immature |
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Term
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Definition
Unacceptable feelings and thoughts are expressed through actions
Tantrums
Immature |
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Term
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Definition
Temporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stress
Extreme forms can result in dissociative identity disorder
Immature |
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Term
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Definition
Immature
Avoidance of awareness of some painful reality
A common reaction in newly diagnosied AIDS and cancer patients
Immature |
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Term
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Definition
Immature
Process whereby avoided ideas and feelings are transferred to some neutral person or object (vs projection)
Mother yells at child because her husband yelled at her |
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Term
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Definition
Immature
Partially remaining at a more childish level of development (vs regression)
Men fixating on sports games |
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Term
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Definition
Immature
Modeling behavior after another person who is more powerful
Abused child identifies himself/herself with abuser |
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Term
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Definition
Immature
Separation of feelings from ideas and events
Describing murder in graphic details with no emotional response |
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Term
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Definition
Immature
Unacceptable internal impulse is attributed to an external source
Man who wants another woman thinks his wife is cheating on him |
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Term
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Definition
Immature
Proclaiming logical reasons for actions actually performed for other reasons, usually to avoid self-blame
After getting fired, claiming a job was not important |
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Term
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Definition
Immature
Process whereby a warded-off idea or feeling is replaced by an (unconsciously derived) emphasis on its opposite (vs. sublimation
A patient with libidinous thoughts enters a monastery |
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Term
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Definition
Immature
Turning back the maturational clock and going back to earlier modes of dealing with the world (vs fixation)
Seen in children under stress such as illness, punishment, or birth of a new sibling (bedwetting in potty-trained child during hospitalization) |
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Term
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Definition
Immature
Involuntary withholding of an idea or feeling from conscious awareness (vs suppression)
Not remembering traumatic event - pushing it into unconsciousness |
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Term
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Definition
Immature
Belief that people are either all good or all bad at different times due to intolerance of ambiguity. Seen in borderline
Patient says all nurses are bad and all doctors are good |
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Term
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Definition
Mature
Guilty feelings alleviated by unsolicited generosity towards others
Mafia boss makes large donation to charity |
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Term
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Definition
Mature
Appreciating the amusing nature of an anxiety-provoking or adverse situation
Nervous medical student jokes about the boards |
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Term
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Definition
Mature
Process whereby one replaces an unacceptable wish with a course of action that is similar to the wish but does not conflict with one's value system (vs reaction formation)
Teenager's agression toward father is redirected to perform well in sports |
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Term
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Definition
Mature
Voluntary withholding of an idea or feeling from conscious awareness (vs repression)
Choosing not to think USMLE until the week of the exam |
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