_____________ or _____________ depression can exist without a nonaffective psychiatric disorder or any serious organic disorder, whereas ___________ or ________ depression is associated with preexisting organic or psychiatric illness.
(Primary and major), (secondary or minor)
What is the lifetime prevalence of the general population for major depression?
can be as high as 9% in women and 4% in men
Depression can occur throughout the ___________ years
adult
The is a presumed precipitating event (emotional loss, chronic stress) in approximately ________% of cases.
25%
Depression frequently presents with __________ symptoms.
physical
Depression that is accompanied by mania is a condition known as?
manic depression
A condition in which a depressed may present with that is characterized by reduced speech and facial expression, fixed gas and reduced eye scanning, stooped posture and slow movement is called?
psychomotor retardation
As many as ___________ of patients with ____________ disease may have severe depression or anxiety.
One-third, neurologic
Depression tends to last long when a patient has what type of lesion?
cortical
Depression most often occurs in which hemisphere?
left
Depression is more common in which type of aphasia patient? Non fluent, global, or fluent
nonfluent
What is the most common psychotic disorder?
schizophrenia
When does schizophrenia usually begin?
adolescence or early adulthood
Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and affective flattening are all characteristic symptoms of what?
schizophrenia
Individuals effected with this can exhibit social isolation or withdrawal, peculiar behavior (talking to one self) reduced or inappropriate affect, digressive, vague, over elaborated or metaphoric speech, odd or bizarre thinking.
schizophrenia
____________________ can be caused by closed heal injury, encephalitis, temporal lobe epilepsy, Huntington's disease, Wilson's disease and demyelinating disease?
Schizophrenia
Involves physical symptoms without demonstrable organic causes and for which there is evidence of a link between the symptoms and psychologic factors or conflicts.
Conversion disorder
The __________ ___________ enables the patient to prevent conscious awareness of emotional conflict or stress that would be intolerable if faced directly.
conversion reaction
Symptoms of ____________ tend to be abrupt in onset and sometimes remit rapidly and many symptoms are ____________.
conversion, transient
Conversion symptoms are frequently ________ in character.
neurologic
_______________ _______________ is a chronic illness characterized by recurrent, multiple physical complaints and a belief that one is ill.
Somatization disorder.
People with this disorder ten to have numerous, dramatic complaints involving multiple organs.
Somatization disorder
____________ is a state of bodily or mental tension resulting from factors that alter equilibrium.
Stress
_____________ comes from many sources, such as working conditions, family and social relationships and events.
Stress
Some nonorganic disturbances are under volitional control? T or F
True
Individuals consciously and deliberately feign physical or psychological symptoms of disease by do so for uncontrolled, unconscious psychological reasons that lead them to seek out the role of the patient or sick person. The best know factitious disorder is called?
Munchausen's syndrome
_____________ involves the deliberate, voluntary feigning of physical or psychologic symptoms for consciously motivated external purposes (ex. to avoid work or combat, for financial gain, to avoid prosecution)
Malingering
Is malingering considered a mental disorder?
No
What are the speech characteristics of depression and manic depression?
reduced stress, monopitch, monoloudness
What are the speech characteristics of schizophrenia?
Rapidly alternating melody and pitch, inappropriate stress patterns, incoherent, illogical, digressive, vague or excessively detailed language.
Conversion aphonia, conversion dysphonia, psychogenic spasmodic dysphonia, latrogentic voice disorder are all what type of disorders?
Psychogenic disorders
Whisper involuntarily is called
conversion aphonia
hoarseness, breathiness
Conversion dysphonia
"Suggested" by the clinician
latrogenic voice disorder
Dysfluencies similar to those of developmental stuttering including struggle behaviors and generally not reduced by singing or choral reading is called?
Psychogenic stuttering
Patients who make no attempt to speak, or they mouth words without voice or whispering is called.
Psychogenic Mutism
With psychogenic mutism _________ is normal, establishing the capacity for vocal fold adduction.
cough
What questions need to be answered in the examination process by the clinician to decide whether a problem is psychogenic? ###Not sure about this question####
1. Can the speech disorder be classified neurologically?
2. Is the oral mechanism examination consistent with the speech disorder and patterns of abnormalities found in a neurologic disease?
3. Is the speech deficit suggestible?
4. Is the speech deficit susceptible to distractibility?
5. Does speech fatigue in a lawful manner?
6. Is the speech deficit reversible?
What are the management goals for motor speech disorders? (in order)
1. Restore lost function: to reduce impairment
2. Promote the use of residual function: to compensate
3. Reduce the need for lost function: to adjust
In general in ongoing intervention recommended it there is negligible disability and no limitation associated with a MSD?
No it is not recommended. (not interfering with his life, no need for therapy)
Is direct intervention recommended if the patient is unmotivated?
No
What can be done if direct intervention or ongoing intervention is not recommended?
Counseling of the patient and family may be undertaken instead, with an option to resume direct intervention if motivation changes.
What should the general focus of treatment be on?
The component of speech that should be treated is the one from which the greatest functional benefit will be derived most rapidly or that will provide the greatest support for improvement in other aspects of speech.
For how long should treatment be provided?
For as long as is necessary to accomplish its goal but for as short of a time as possible. In general not management program should begin without a plan about when it will end.
Dopaminergic agents for Parkinson's disease, Mestinon for Myasthenia gravis, dietary modifications and chelating agents for Wilson's disease, Botox for spasmodic dysphonia are all what type of medical intervention?
Pharmacologic (we don't do these)
Pharyngeal flap to improve velopharyngeal function for speech, thyroplasty for vocal fold paralysis are what types of medical intervention?
Surgical management (We don't do these)
To facilitate velopharyngeal closure during speech you would use what for prosthetic management?
palatal lift prosthesis or nasopharyngeal obdurator
To inhibit mandibular hyperkinesis you would need to use what for prosthetic management?
A bite block positioned between the upper and lower teeth.
To slow speech rate and increase syllabic stress you would use what for prosthetic management?
To augment speech or serve as alternatives to speech you would use what for prosthetic management?
AAC devices such as pictures, letters, and word boards, including computerized devices with synthesized speech.
____________ management includes all intervention efforts that are neither medical nor prosthetic?
Behavioral
With behavioral management, what kind of approaches serve to improve communication by altering speech; focus primarily on improving intelligibility and secondarily on improving efficiency and naturalness of communication.
Speech-Oriented Approaches- treatment of MILD impairments tend to be speech oriented
With behavioral management, what kind of approaches serve to improve communication by altering speaking strategies, the behavior of listeners, or the communication environment; focus primarily on modifying aspects of the communicative interactions.
Communication-Oriented Approaches- treatment of SEVERE impairments tends to be communication oriented.
Focus primarily on improving intelligibility and secondarily on improving efficiency and naturalness of communication.
Speech-Oriented Approaches
Treatment of MILD impairments tend to be _________ _________.
speech oriented
Focus primarily on modifying aspects of the communicative interactions.
Communication-Oriented Approaches
treatment of SEVERE impairments tends to be _____________ _____________.
communication oriented.
The manner in which care is provided may be as important from the patient's perspective as the actual outcome of efforts to improve their speech or communication? T or F
True
Is the brain a static organ?
No it is not a static organ
_____________ ______________ occurs with muscle use?
Neural adaptation
The organization of the cortex in adult animals is fixed? T or F
False it is NOT fixed.
The nervous system is capable of recovery and reorganization after injury? T or F
True
Motor reorganization after injury requires ________.
use
__________ and __________ diagnoses are relevant to management.
medical and speech
Management usually should start early, but not always? T or F
True
___________ data are necessary for establishing goals and measuring change?
baseline
Increasing ________________ support often should be the initial focus of treatment?
physiologic
Compensation requires that speech production become ______________.
conscious
Speech Oriented treatment Principles of motor learning includes the following: