first aid psych

• giving a dog a treat to train a new behavior
• positive = giving

• taking away a noxious smell to train a new behavior
• negative = removing

• beating a cat to extinguish unwanted behavior
• positive = giving

• taking candy away from a kid to extinguish unwanted behavior
• negative = removing

• patient projects onto physician
• shrink reminds patient of dad

• physician projects onto patient
• patient reminds physician of younger brother

• using actions as a physical manifestation of how you feel
• tantrum

• purposefully not letting yourself believe something happened
• no no no, the test must be wrong, I don't have cancer

• your brain makes you forget something happened, and you don't even realize it
• no, I never went to counseling when my parents got divorced

• knowing something happened/will happen, but just for a little while, you put it out of your mind
• mature!
• not studying/thinking about the boards on the day before you take them

• treating others poorly because of what happened to you
• eg mother yells at child b/c husband yelled at her

• wanting to do something bad, so you assume others do it
• husband wants to sleep with the neighbor, so he accuses his wife of cheating

• temporary drastic change in personality, memory, consciousness, behavior to avoid emotional stress
• no, that happened to Jane, I'm Carly. Or Buster going into a "coma"

• not moving on in development
• med students are still all adolescents!

• going back to early ways of dealing with the world
• I never threw tantrums until med school
• potty-trained children begin bed-wetting while hospitalized

• thinking you and everyone else and everything else is just peachy
• America is the best country ever!

• acting like someone who has more power
• abused children become abusers

• distancing yourself by using facts
• patient with cancer only talks about 5-year survival while in therapy session

• making stuff up to avoid self blame/make it not seem so bad
• turns out, she was crazy!

• talking about things but not showing emotion
• describing murder in graphic detail without emotional response

• not doing what is expected in order to get back at people
• leaving the toilet seat up

• unconsciously doing something completely opposite because you shouldn't do what you want to do. The opposite thing conflicts with you value system
• becoming a priest

• replacing an unacceptable with with a similar course of action that does not conflict with your personal value system
• mature!
• cleaning the apartment really well b/c you're nervous about studying for boards

• everyone is either all good or all bad at different times, associated with borderline personality disorder
• all therapists are rude to me, but all the nurses are just swell

• alleviating negative feelings with unsolicited generosity
• mature!
• committing the evil act of taking the boards and then going to Guatemala to serve

• appreciating the amusing nature of intense situations
• mature!
• joking about doing all of the mature defenses while studying for the boards

40% under 1 yo

9-12 yo

moms

males who know the victim

• food, shelter, education, supervision, affection
• YES! CPS has to know if you suspect it

• thinking a kid is super vulnerable to injury/illness, usually after something bad happens to the kid. Often results in missed school and the parents have the kid going to the doctor for every little thing
• a kid almost dies in a freak accident, so parents don't let the kid go to friends' houses

• onset before age 12, often continued into adulthood
• multiple settings
• hyperactivity, impulsivity, or inattention
• normal intelligence

• must present in early childhood
• poor social interactions, social communication deficits, repetitive/ritualized behaviors, restricted interests
• may have intellectual disability

• X-linked dominant (males die in utero or shortly after birth)
• normal until age 1-4 then regress with going back in development, losing verbal abilities, intellectual disability, ataxia, hand-wringing (jittery hand motions)

• before age 18
• repetitive, pervasive behavior violating rights, damaging property, stealing, hurting animals
• go on to develop antisocial personality disorder

hostil defiant behavior towards authority figures without violation of serious social norms

• usually 7-9 years
• overwhelming fear when away from home or parents/gaurdian
• makes up physical symptoms to stay home from school often

• onset before 18
• more than one year of sudden, recurrent, nonrhythmic motor and vocal tics
• vocal=grunt, swear, click, etc
• motor=twitch etc

inability to recall important personal information after trauma/stress

abrupt travel or wandering during a period of dissociate amnesia(inability to recall personal information after trauma/stress)

• multiple personality disorder (2 or more)
• often with sexual abuse, PTSD, depression, substance abuse, borderline personality disorder, somatiform conditions

persistent feelings of detachment from your body, thoughts, perceptions, actions

persistent feelings of detachment from you environment

• diffuse slowing on EEG
• haloperidol (benzos for alcohol withdrawal)
• think about delirium when acute onset, inpatient setting, waxing waning level of consciousness
• increased risk in patients with dementia (dementia distinguished by not causing changes in consciousness)

depression screen, TSH, B12

• 6 months of 2+ symptoms, one being psychosis
• 1. delusions (psychosis)
• 2. hallucinations (psychosis)
• 3. disordered speech (psychosis)
• 4. disorganized/catatonic behavior
• 5. negative symptoms (affective flattening, avolition, anhedonia, asociality, alogia)
• ventriculomegally on imaging

• <1 month of 2+ symptoms, one being psychosis (often stress related)
• 1. delusions (psychosis)
• 2. hallucinations (psychosis)
• 3. disordered speech (psychosis)
• 4. disorganized/catatonic behavior
• 5. negative symptoms (affective flattening, avolition, anhedonia, asociality, alogia)

• 1-6 months of decline in function with 2+ symptoms, one being psychosis
• 1. delusions (psychosis)
• 2. hallucinations (psychosis)
• 3. disordered speech (psychosis)
• 4. disorganized/catatonic behavior
• 5. negative symptoms (affective flattening, avolition, anhedonia, asociality, alogia)

• >2 weeks of hallucinations or delusions and other schizophrenic symptoms with temporary episodes of major mood disorder added on
• hallucinations and delusions must persist in between major mood episodes

persistent major mood disorder with periods of delusions or hallucinations

>1 month of a fixed false belief that does not impair function

a shared delusional disorder (>1 month of a fixed false belief that does not impair function)

• hypnagoigic = while going to sleep
• hypnopompic = while waking from sleep
• both may be seen in narcolepsy

• at least 1 week of 3+ DIG FAST
• distractibility
• irresponsibility (pleasure seeking w/out regard to consequences)
• grandiosity (self esteem)
• flight of ideas
• activity(more goal-directed)/psychomotor agitation
• sleepless (without need for sleep)
• talking with pressured speech

• at least 4 days of 3+ DIG FAST without marked impairment
• distractibility
• irresponsibility
• grandiosity
• flight of ideas
• activity(more goal-directed)/psychomotor agitation
• sleepless (without need for sleep)
• talking with pressured speech

at least one manic episode

at least one hypomanic episode and a depressive episode

at least 2 years of hypomanic symptoms and mild depressive symptoms

• at least 2 weeks of 5+ SIG DE CAPS with 1 being depressed mode or anhedonia
• sleep disturbance
• interest loss
• guilt/worthlessness
• depressed mood
• energy loss
• concentration difficulty
• appetite/weight change
• psychomotor retardation/agitation
• suicidal ideations

• persistent depressive disorder
• at least 2 years of depressive symptoms (can be major)

• mood reactivity (very brief pleasure/mood increases)
• hypersomnia
• hyperphagia
• leaden paralysis
• long-standing interpersonal rejection sensitivity

• depressed affect, tearfulness, fatigure
• resolving within 10 days
• follow up at 10 days to assess for postpartum depression

• often within 4 weeks of delivery
• greater than 10 days of depressed affect, anxiety, poor concentration

• often within 4 weeks of delivery
• mood-congruent delusions, hallucinations, thoughts of harming baby/self

shock, denial, guilt, sadness, anxiety, yearning, somatic symptoms, hallucinations

• grief with functional impairment
• can have major depressive disorder

• at least 4 of
• palpitations
• chest pain
• sweating
• SOB
• choking
• abdominal distress/nausea
• fear of dying
• fear of going crazy/losing control
• depersonalization/derealization
• paresthesias
• lightheadedness
• chills
• shaking

• at least 1 panic attack followed by 1+ month of 1+ of
• persistent concern for additional attacks
• worry about consequences of attack
• behavioral change related to attack

• fear of a presence/anticipation of an object or situation
• recognizing that the fear is excessive

• subtype of specific phobia for embarassment social situations
• eg fear of speaking
• eg fear of using public bathrooms

• associated with panic disorder, but a subtype of specific phobia for 1 of
• open spaces
• closed spaces
• using public transportation
• being in lines
• being in crowds
• leaving home alone

> 6 months of anxiety unrelated to a specific person, situation, event

• less than 6 months unless presence of chronic stressor
• anxiety or depressive symptoms causing impairment after an identified psychosocial stressor (divorce, illness)

• obsessions and compulsions
• ego-dystonic (behavior inconsistent with your own beliefs and attitudes)
• eg the good doctor

• emotional distress or impaired functioning from a preoccupation with a minor or imagined defect in appearance
• often seek repeated cosmetic treatment

recurring, intrusive thoughts, feelings, or sensations

performance of a repetitive action that partly relieves an obsession

• trauma (or witnessed traumatic event) with more than 1 month of significant distress or impaired social-occupational function
• re-experiencing common (flashbacks, nightmares), avoidance of certain stimuli, changes in cognition/mood, increased arousal

• trauma (or witnessed traumatic event) with 3 days to 1 month of significant distress or impaired social-occupational function
• re-experiencing common (flashbacks, nightmares), avoidance of certain stimuli, changes in cognition/mood, increased arousal

• conscious
• secondary gain (avoiding work, obtaining compensation)
• complaints cease after gain
• note: will not do a diagnostic test

• Munchausen syndrome
• intentional production of symptoms
• primary gain (internal, assuming sick role)
• note: big history, willing to undergo invasive procedure

• Munchausen syndrome by proxy
• intentional production of symptoms
• primary gain (assuming sick role by proxy)
• note: elder/child abuse

• unintentional production of symptoms
• unconscious drive
• non-neuro complaint (pain, fatigue)
• note: persistent thoughts and anxiety about symptoms, and may co-occur with medical illness

• unintentional production of symptoms
• unconscious drive
• loss of sensory or motor function loss (paralysis, blindness, mutism)
• note: often follows acute stressor, la belle indifference (often)

• "hypochondriasis"
• preoccupation with having or getting a serious illness despite medical evaluation and assurance and minimal symptoms
• note: technically a "somatic symptom and related disorders" disorder

false belief that you are pregnant due to any and all signs and symptoms of pregnancy except for having a fetus. That would just be called pregnancy

• rigid maladaptive pattern of behavior causing subjective distress or impaired functioning that the person is usually unaware of
• must be 18 yo

• inability to develop meaningful social relationships
• genetic association with schizophrenia

• emotional/erratic
• genetic association with mood disorders and substance abuse

• fearful
• genetic association with anxiety disorders

• cluster A
• distrusting and suspicious, thinking everyone is trying to screw you over, use projection as a defense mechanism

• cluster A
• voluntary and totally content with social withdrawal, limited emotional expression
• schizoiD is Distant

• cluster A
• eccentric appearance, odd beliefs and magical thinking, interpersonally awkward
• schizotypaL is Luna Lovegood

• cluster B
• disregarding and violating others' rights, criminal and impulsive, history of conduct disorder
• must be 18+ with history of conduct disorder before 15
• "antisocietal"

• cluster B
• unstable mood and interpersonal relationships, impulsive, shopping sprees and casual sex, self-mutilation, suicidal, feeling empty, always splitting as ego defense
• she went to Borders, bought every book and immediately decided some where incredible and others were trash; went home with someone she met there, but left in the morning to cut lines in her wrist trying to commit suicide because it left her feeling empty

• cluster B
• excessive emotionality (either direction), excitability, attention seeking, sexually provocative, overly concerned with appearance
• a histrionic is an actor

• cluster B
• grandiose with a sense of entitlement, requiring the praise of others while lacking empathy, demanding the best and flying off the handle when criticized

• cluster C
• so sensitive to rejection and so timid with feelings of inadequacy that despite wanting relationships, you avoid them

• cluster C
• preoccupation with perfectionism and control, ego-syntonic (behavior consistent with values and beliefs)

• cluster C
• submissive and clingy with a need to be taken care of by others and a low self-confidence, often resulting in abuse relationships

• BMI under 18.5 or tended that way due to excessive dieting, exercise, binging and purging because of an overvaluation of body image
• refeeding is within 10 days of when you make them eat, their insulin shoots up, buliding muscle and consuming ATP, which crashes their phosphates resulting in arrhythmias/CNS issues

at least once a week for 3 months binging with compensatory behavior that doesn't quite work, but still having an overvaluation of body image

episodic binging without compensatory behavior

no, it's paraphilia because you want to wear clothing of the other gender

distressed or impaired functioning because of a desire to be the opposite gender (not necessarily sex)

• a desire to live as the opposite sex, usually resulting in surgery or medical therapy
• does not need to be distressing

• N3 slow wave delta sleep
• (before REM, so you have no memory of it)

• caused by low hypocretin aka orexin from lateral hypothalamus
• excessive daytime sleepiness because disordered sleep-wake cycle
• associated with
• hypnagogic/hypnopompic hallucinations
• starting sleep with REM
• cataplexy (loss of all muscle tone in response to strong emotion)

• 1 year in which 2 or more of the following occur
• tolerance
• withdrawal
• craving
• taking in more than planned
• persistent desire to cut back/failing to cut back when trying
• significant energy spent getting, doing, or recovering
• using in physically dangerous situations
• reducing important occupational, social, or recreational things
• missing/not doing important occupational, educational, or home obligations
• social/interpersonal conflicts related to substance use
• using despite knowing it's harmful

• precontemplation (not thinking about changing)
• contemplation (realizing you need to stop but not planning on it)
• preparation/determination (making a stop plan)
• action/willpower (carrying out the plan)
• maintenance (keeping it up)
• relapse (going back)