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Final Exam Study Guide

by: Rebecca Cue

Final Exam Study Guide CLP4143

Marketplace > Florida State University > Psychlogy > CLP4143 > Final Exam Study Guide
Rebecca Cue
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This is the compiled study guide for Exam 3!
Abnormal Psychology
Dr. Natalie Sachs-Ericsson
Study Guide
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This 16 page Study Guide was uploaded by Rebecca Cue on Sunday April 24, 2016. The Study Guide belongs to CLP4143 at Florida State University taught by Dr. Natalie Sachs-Ericsson in Spring 2016. Since its upload, it has received 56 views. For similar materials see Abnormal Psychology in Psychlogy at Florida State University.


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Date Created: 04/24/16
For each 10 minutes late -1 point. On Exam: Personality Ch. 15 (pages 474 -491), Childhood disorders Ch. 13, Late life Ch. 14, Psychiatric Problems In older adults (PowerPoint only) Schizophrenia Define the three phases of schizophrenia • During the six(+) months there are phases o Prodromal § Initial mild symptoms o Acute § Severe symptoms o Residual § Mild remaining symptoms What is the difference between delusions and hallucinations? • Hallucinations are things that are potentially seen or heard without any sensory stimulations such as seeing birds flying around someone’s head or hearing a voice telling you to hurt someone • Delusions are abnormal thoughts such that you are being watched or that your thoughts aren’t your own How is schizophrenia different from schizophreniform? • Schizophreniform have a short symptom duration o Greater than one month but less than 6 months • They have the same symptoms What is difference between positive and negative symptoms of schizophrenia? • Positive symptoms include delusions and hallucinations, while negative symptoms include avolition, alogia, anhedonia, bluned affect, asociality List examples of positive symptoms of schizophrenia. • Delusions o Firmly held beliefs o Contrary to reality o Resistant to disconfirming evidence o Types of delusions § Persecutory delusions • “the CIA has planted a listening device in my head • 65% have these § Thought insertion • The person may sometimes be unable to distinguish between their own thoughts and those he believes were inserted into their minds • A person with this delusion belief is found to be convinced of their beliefs and unwilling to accept such diagnosis § Thought broadcasting • A delusional belief that others can hear or are aware of an individual’s thoughts • This differs from telepathy in that the thoughts being broadcast are thought to be available to anybody • Considered a positive symptom § Outside control § Grandiose Delusions § Ideas of reference • Hallucinations o Sensory experience in the absence of sensory stimulation o Types of hallucinations § Auditory • 74% have these symptoms § Visual § Hearing voices • Increased levels of activity in Broca’s area during hallucinations List examples of negative symptoms of schizophrenia. • Avolition o Lack of interest; apathy • Alogia o Reduction in speech • Anhedonia o Inability to experience pleasure • Blunted affect o Exhibits little or no affect in face or voice • Asociality o Inability to form close personal relationships Define the following: • Alogia o Poverty of speech and content of speech o Blocking o Increased latency of response o Reduction in speech • Anhedonia—Asociality o Decrease in § Recreational interests and activities § Sexual interest and activity § Ability to feel intimacy and closeness § Relationships with friends and peers • Avolition--Apathy o Grooming and hygiene o Lack persistence at work or school o Physical anergia • Catatonia o Motor abnormalities o Repetitive complex gestures § Usually with fingers or hands o Excitable, wild flailing of limbs o Catatonic immobility § Maintain unusual posture for long periods of time Define • Communication deviance (CD) o Hostility and poor communication o Inconclusive at this time • Expressed emotion o Hostility, critical comments, emotional over-involvement. Describe this treatment: Family focused therapy for schizophrenia The family environment impacts the relapse. Doctors want to educate the family about the causes, symptoms, and signs of relapse. Stress the importance of medication, and help the family avoid blaming the patient. Improve family communication and problem solving, and also instill hope. What is the dopamine theory of schizophrenia? • Is a disorder due to excess levels of dopamine. Drugs that alleviate schizophrenia symptoms also reduce dopamine activity. • Amphetamines, which increase dopamine levels, can induce a psychosis. • Dopamine theory doesn’t completely explain disorder. Antipsychotics block dopamine rapidly but symptom relief takes several weeks. To be effective, antipsychotics must reduce dopamine activity to below normal levels. What is the Disconnection Syndrome theory? • Some schizophrenic phenomena are best understood in terms of abnormal interactions between different areas of the brain. • Pathophysiological changes in the prefrontal and temporal cortices of schizophrenics subject and of abnormal integration of the physiological dynamics in these two regions Describe each theory of schizophrenia: • Sociogenic hypothesis o Stress of poverty causes disorder • Social selection theory o “Survival of the fittest” o Downward drift in socioeconomic status. o Research supports social selection. Define brief psychotic disorder. • Symptom duration of 1 day to 1 month. • Is often triggered by extreme stress, such as bereavement. What is a Schizophrenogenic mother? • Someone who is cold, domineering, conflict inducing • No support for this theory What are some of the side effects of Anti-psychotics? • Can impair immune symptom functioning. • Seizures, dizziness, fatigue, drooling, weight gain. What are some of the reasons that the DSM is thought to have poor reliability for the diagnosis of personality disorders? • Difficulty in diagnosis because of heterogeneity o Many individuals with a personality disorder exhibit a wide range of traits o Make several diagnoses applicable Is the DSM 5 approach to personality disorders Categorical or dimensional? • The DSM 5 approach to personality disorder is Dimensional. It is broke up into 3 different dimensions: o Social Involvement § Positive and friendly vs. Not involved o Assertion § Dominance vs. passive submission o Affect control § Anxious rumination vs. Behavior acting out • The three dimensions were found to represent different personality characteristics Define in three sentences the primary characteristics of the following? • Anti-social o Psychopathy and sociopath are used interchangeably o ASPD is in DSM 5 § Psychopath and sociopath are not DSM 5 o Two major components: § Conduct disorder • Before age 15 • Truancy • Running away • Frequent lying • Theft • Arson • Cruelty to animals • Deliberate destruction of property § Adult component • A pervasive pattern of disregard for other manifested since the age of 15 • Children with conduct disorder may go on to develop patterns of antisocial behavior in adulthood • “Bad behavior” o Being reckless, impulsive, and failing to plan ahead o Not working consistently o Breaking laws o Irritable and physically aggressive o Defaulting on debts • No regard for truth • Often comorbid with alcohol and drugs • Borderline Personality Disorder (BPD) o Reveals instability in: § Relationships § Mood § Self image o Individuals have not developed a clear and coherent sense of self o Cannot bear to be alone and have fears of abandonment o Series of intense one-on-one relationships § Usually stormy and transient § Alternating between idealization and devaluation o Chronic feelings of depression and emptiness o Harms self and self mutilation o DSM definition § A pervasive pattern of instability of interpersonal relationships, self image, and effects § Marked by impulsivity beginning by early adulthood § Present in a variety of contexts as indicated by: • Frantic efforts to avoid real or imagined abandonment • A pattern of unstable and intense interpersonal relationships • Identity disturbance: markedly and persistently unstable self image or sense of self • Impulsivity in at least two areas that are potentially self-damaging o Spending, sex, substance abuse, reckless driving, binge eating • Recurrent suicidal behavior, gestures, threats, or self mutilating behavior o Excessive tattoos or piercing • Affective instability due to a marked reactivity of mood o Intense episodic dysphoria, irritability, or anxiety usually lasting a few hours • Transient, stress related paranoid ideation or severe dissociative symptoms • Chronic feelings of emptiness • Inappropriate, intense anger, or difficulty controlling anger o Frequent displays of temper, anger, recurrent physical fights • Narcissistic Personality Disorder o A pervasive pattern of grandiosity (in fantasy or behavior) need for admiration and lack of empathy o Very self centered o Begins in early adulthood and present in a variety of contexts: § Has a grandiose sense of self-importance (e.g., exaggerates achievements, § Expects to be recognized as superior • Without commensurate achievements § Is preoccupied with fantasies of unlimited • Success • Power • Brilliance • Beauty • Ideal love § Believes that he or she is “special” and unique an can only be understood by or should associate with other special or high status people § Require excessive admiration § Has a sense of entitlement • Unreasonable expectations of especially favorable treatment or automatic compliance with expectations § Is interpersonally exploitative • Takes advantage of others o Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others • Is often envious of others or believes that others are envious of him/her o Shows arrogant, haughty behaviors and attitudes § Interpersonal relationships are disturbed by: • Lack of empathy • Feelings of envy • Arrogance • Taking advantage of others § Feelings of entitlement • Expecting others to do special not to be reciprocated favors for them o “I should not have to wait in line” o “I should not have to take the test” • Avoidant o People who are keenly sensitive to criticism, rejection, or approval § Fearful in social settings § Reluctant to enter into relationships § Afraid of saying something foolish § Believe that they are incompetent and inferior o Exaggerate risk of doing something outside usual routine o Majority comorbid with depression • Schizotypal Personality Disorder o Have the interpersonal difficulties of schizoid personality o Symptoms are more eccentric but not severe enough to warrant a diagnosis of schizophrenia § Odd beliefs § Magical thinking § Recurrent illusions • Sense the presence of a force § Speech used in unusual and unclear fashion § Behavior and appearance eccentric § Paranoid ideation • Ideas of reference and illusions o Characterized by cognitive or perceptual distortions § An inability to tolerate close friendships and odd behaviors • NOT psychosis § Should be considered a mild form of schizophrenia o Ted Kacsynski Unabomber o SPD and schizophrenia share a common genetic diathesis and show similar symptoms § A comparison of findings in SPD with those in schizophrenics may help to clarify what factors lead to psychosis § Both Show • Deficits in cognitive and neurological functioning • Enlarged ventricles • Obsessive-Compulsive Personality Disorder (OCPD) o The person is a perfectionist § Preoccupied with details o Have inordinate difficulty making decisions and allocating time o Interpersonal relationships are poor o Demand that everything be done their way o Generally serious, formal, inflexible especially regarding moral issues § They hoard money What is a Personality disorder? (e.g., Longstanding, pervasive, inflexible, patterns of behavior). • Personality Disorders are: o Longstanding o Maladaptive and inflexible traits o Which can impair § Social and occupational functioning which cause emotional distress • An actual disorder is defined by the extremes of several personality traits o Patterns of behavior § Long-standing (from childhood or adolescence) § Pervasive § Dysfunctional o Derived from a trait approach § Trait vs. state Describe each personality Cluster (A, B.C). • Cluster A o Paranoid o Schizoid o Schizotypal o Odd or eccentric o Low Social Involvement • Cluster B o Antisocial o Borderline o Histrionic o Narcissistic § Dramatic, Emotional, or Erratic § Low on affect control § High acting out • Cluster C o Avoidant o Dependent o Obsessive- Compulsive o Appears anxious or fearful o Low on social involvement o Low on assertion § Passive and submissive Antisocial Personality Disorder Antisocial personality disorder is characterized by dysfunctional relationships to other people. Basically, people with antisocial personality disorder do not interact with others in normal ways How is anti-social and psychopathy different? (Don’t email asking me the answer – read!!!!) • Psychopathy “Monster with no capacity for guilt or empathy” o Personality disorder characterized by § Callousness § Lack of empathy § Self-centeredness § Remorselessness o Persistent antisocial behavior • Antisocial • Psychopathy vs. Antisocial Personality Disorder o Considerable overlap between o APD is over-inclusive o High correlation • Psychopathy vs. Sociopathy o Psychopathy is NOT synonymous with psychosis Who was Cleckley? • Cleckley provided the most influential description of psychopathy o The Mask of Sanity (1976) o Criteria for psychopathy refers less to antisocial behavior and more to the psychopath’s psychology or personality § Poverty of emotions, both positive and negative o No sense of shame § Seemingly positive feelings for others are merely an act § Remorseless o Superficially charming § Manipulate others for personal gain Describe Kohut’s theory of Narcissism. • Kohut’s Self-Psychology Model o Characteristics mask low self esteem o In childhood, narcissist valued as a means to increase parents own self- esteem § Not valued for his or her competency and self worth o People with high levels of narcissism report cold parents who overemphasized child’s achievement Chapter 13: Disorders of Childhood DSM-5 has new names for disorders e.g., mental retardation will now be called intellectual developmental disorder DSM-5 will combine some disorders: • Autistic disorder, Asperger’s disorder, and pervasive developmental disorder not otherwise specified combined into Autism Spectrum Disorder Classification and Diagnosis of Childhood Disorders • Externalizing disorders o Characterized by outward-directed behaviors o Noncompliance, aggressiveness, over activity, impulsiveness o Includes: attention-deficit/hyperactivity disorder, conduct disorder, and oppositional defiant disorder. o More common in boys • Internalizing disorders o Characterized by inward-focused behaviors o Depression, anxiety, social withdrawal o Includes childhood anxiety and mood disorders o More common in girls Attention Deficit/Hyperactivity Disorder (ADHD) • Excessive levels of activity • Fidgeting, squirming, running around when inappropriate, incessant talking • Distractibility and difficulty concentrating • Makes careless mistakes, cannot follow instructions, forgetful • Three subcategories in DSM-IV-TR • Predominantly inattentive type • Predominantly hyperactive-impulsive type • Combined type • Etiology of ADHD o Genetic factors § Adoption and twin studies § Heritability estimates as high as 70 to 80% o Neurobiological factors § Dopaminergic areas smaller in children with ADHD o What are Perinatal and prenatal risk factors for ADHD? o Treatment of ADHD o Goals of treatment § Reduce disruptive behavior § Improve interactions with parents, teachers, peers § Improve goal-directed behavior and concentration § Reduce aggression § Stimulant medications (Ritalin, Adderall, Concerta, Strattera) • Side effects of medications o Loss of appetite, weight, sleep problems o Medication plus behavioral treatment (MTA study) o Slightly better than meds alone § Psychological treatment • Parental training Conduct Disorder (CD) • Pattern of engaging in behaviors that violate social norms, the rights of others, and are often illegal • Aggression, Cruelty towards other people or animals,, Damaging property, etc.) • Often accompanied by viciousness, callousness, and lack of remorse • Oppositional Defiant Disorder (ODD) o ODD behaviors do not meet criteria for CD (especially extreme physical aggressiveness) but child displays pattern of defiant behavior o Argumentative, Loses temper, Lack of compliance • Etiology of Conduct Disorder (CD) o Heritability likely plays a part o Genetics and environment interact o Peer influences associated with CD o Sociocultural factors o Poverty • Treatment of Conduct Disorder o Family interventions Depression in Children and Adolescents • Symptoms common to children, adolescents, and adults • Depressed mood • Inability to experience pleasure • Fatigue, Problems concentrating, Suicidal ideation, • Etiology of Depression in Children and Adolescents o Genetic factors o Early adversity and negative life events o Family and relationship factors § A parent who is depressed • Cognitive distortions and negative attributional style • Stable attributional style • Treatment of Depression in Children and Adolescents • Medications o SSRIs more effective than tricyclics • Meta-analysis showed medications most effective for anxiety other than OCD o Less effective for depression and OCD Interpersonal psychotherapy (IPT) • Focuses on peer pressures, transition to adulthood, and issues related to independence CBT • More effective for Caucasian adolescents, those with pretreatment, good coping skills, and recurrent depression Anxiety in Children and Adolescents • Fears and worries common in childhood • Anxiety disorder o Severe and persistent worry o Must interfere with functioning o Most childhood fears disappear but adults with anxiety disorders report feeling anxious as children o “I’ve always been this way” • Separation Anxiety Disorder o Worry about parental OR personal safety when away from parents o Typically first observed when child begins school Social Anxiety Disorder • Extremely shy and quiet • Etiology o Overestimation of threat o Underestimation of coping ability o Poor social skills PTSD • Symptom categories o Flashbacks, nightmares, intrusive thoughts o Avoidance o Negative cognitions and moods o Hyper arousal and vigilance OCD • Symptoms similar to those in adults • Most common obsessions: o Contamination from dirt and germs Etiology of Anxiety Disorders • Genetics • Heritability estimates from 29 – 50% • Genetics plays a stronger role in separation anxiety in context of more negative life events • Risk factors for PTSD include: o Family stress and coping style o Past experience with trauma Treatment of Anxiety Disorders in Childhood and Adolescence • Exposure to feared object o Reward approach behavior • CBT Kendall’s Coping Cat program o Shows to be effective in two randomized clinical trials o For children between 7 and 13 years old • Cognitive restructuring o Develop new ways to think about fears Intellectual Developmental Disorder • Formerly known as Mental Retardation in DSM-IV-TR • Not preferred due to stigma • Intellectual Developmental Disorder (no longer called Mental Retardation) o Intellectual deficit of 2 or more standard deviations in IQ below the average score for a person’s age and cultural group, which is typically an IQ score less than 70 Autism Spectrum Disorder • DSM-5 combine multiple diagnoses into one: Autism Spectrum Disorder o DSM 5 has done away with Asperger’s disorder (now part of Autism Spectrum). • Profound problems with the social world o Rarely approach others, may look through people o Problems in joint attention o Communication deficits • Children with ASD evidence early language disturbances • Echolalia: immediate or delayed repeating of what was heard • Etiology of Autistic Spectrum Disorder o Genetic factors § Heritability estimates of around .80 o Neurobiological factors § Brain size larger than normal § Pruning of neurons may not be occurring o More difficulties in social behavior and communication • Treatment of Autistic Spectrum Disorder o Psychological treatments more promising than drugs o Earlier treatment associate with better outcomes Antipsychotic medication: • Reduces aggression and stereotyped motor behavior • Does not improve language and interpersonal relationships • Bad side effects. Chapter 14: Late Life and Neurocognitive Disorders. Note that the DSM-IV diagnosis of Dementia is now categorized as (DSM-5 - Mild and Major neurocognitive design) Mild neurocognitive disorder (mild cognitive impairment) • Mild cognitive impairment develop slowly • Deficits can be detected before impairment becomes obvious Major neurocognitive disorder (dementia) • Deterioration of cognitive function • Impaired social and occupational functioning • Progresses over time • Begins with difficulty remembering • Alzheimer’s disease is a type of dementia- it is the most common type!! What is the difference between Delirium and dementia? • Delirium is a state of mental confusion, while dementia is a deterioration of cognitive function What are common myths about older adults? • Most elderly do not have cognitive disorders, (the myth is that they do) • Aging involves inexorable cognitive decline o Severe cognitive problems do not occur for most o Mild declines are common • Late life is a sad time and most elderly are depressed o Most older individuals report less negative emotion than younger people o More brain activation in key areas when viewing positive images • Late life is a lonely time o Some less likely to develop new frienships What are some of the common real problems of older age: • Examples are: o Physical decline and disabilities o Sensory and neurological deficits o Loss of loved ones What is the difference between: • Cross-sectional studies o Testing different age groups at one point in time • Longitudinal studies o Retesting the same group of people within the same measures at different points in time • Describe benefits of cross-sectional versus longitudinal design. o Cross sectional: how it will affect different age groups. Longitudinal: how it will affect the same person over time, so an individual can know what to expect. What are some of the concerns we should have in prescribing Psychoactive drugs with the elderly? • They have typically only been tested on younger participants, so we don’t know how they will affect older adults. But, it’s hard to conduct research on older adults. Describe the research challenges associated with doing research on older adults. • For cross-sectional studies: o Researchers usually test different age groups at one point in time. With older adults, they fail to provide information about how people change over time. • With longitudinal studies: o Researcher retests the same group of people with the same measures at different points in time. May extend over several years or decades, however attrition is a potential problem. Selective mortality can lead to a biased sample. Geriatric Psychiatry PowerPoint: What are some of the differences between older and younger persons with mental illness? • Older patients may have a shorter interval to recurrence than younger patients, thus, they may need longer maintenance of medication. Data is not clear if the elderly are more prone to relapse. Depression in late life: • A key feature of depression in later life is COMORBIDITY— o e.g., with physical illness such as stroke, myocardial infarcts, diabetes, and cognitive disorders (possibly bi-directional causality) In what way are symptoms of depression in older adults different from younger adults? • For Example, depression in late life is associated with? o Psychomotor disturbances more prominent (either agitation or retardation), o Higher levels of melancholia (psychological motor retardation or agitation, weight loss). o Loss of interest is more common What is Vascular depression? • Elderly adults presenting with late-onset depression and vascular risk factors have co-morbidity of depression with vascular disease. Review slides on late life suicide. What is Pseudodementia • A situation where a person who has depression also has cognitive impairment that looks like dementia.


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