Adult Psychopath Midterm 1

  1. Syndrome
    a group or set of concurrent symptoms, which, together, are indicative of a disorder or disease
  2. Symptom
    any sign, physical or mental, that stands for or signifies something
  3. sign
    observable phenomena which may signify something
  4. does 1 symptom constitute a disorder?``
    no, but some symptoms appear in multiple disorders and/or strongly suggest a certain disorder
  5. What are the reasons to diagnose?
    • define and organize clinical information
    • communicate with other professionals 
    • prediction of clinical course
    • selection of treatment (most important)
  6. What are the limitations of psychodiagnosis?
    • odd or judgmental language
    • depersonalization 
    • cultural bias
    • variable symptom manifestation
  7. Etic vs. Emic
    • Etic:  assumes/emphasizes universals among humans without considering cultural or gender contexts 
    • Emic:  Classifies psychological phenomena in appropriate cultural context
  8. name all of the ego functions?
    • reality testing
    • judgment
    • sense of reality of the world and self
    • regulation and control drives (impulse control)
    • thought process (cognition)
    • Adaptive regression in the service of the Ego
    • Defense functioning
    • Stimulus barriers
    • autonomous functioning
    • synthetic functioning
    • Mastery competence
    • object relations
  9. Reality testing
    • testing the accuracy of perceptions 
    • can be seriously flawed in psychotic states
  10. judgment
    • ability to anticipate consequences for behavior 
    • judge appropriateness of behavior in a given situation
    • lacking in teens and people with substance abuse
  11. sense of reality of the world and of the self
    • extent to which external events are expressed as real or familiar and belonging to you
    • common in cases of trauma
  12. Regulation and control of drives (impulse control)
    • strongly linked to judgment 
    • urge --> action = inappropriate
    • urge --> thought --> action = appropriate
  13. thought process (cognition)
    • how the machine (our brain) is working
    • memory, concentration, paying attention, concrete and/or abstract thinking
  14. adaptive regression in the service of the Ego
    • a person's capacity to play or have humor 
    • to not take things too serious
  15. defense functioning
    • the success or failure of the defenses 
    • when defenses fail, we can look for more psychological problems 
    • maladaptive defenses can affect behavior (denial with drinking)
  16. stimulus barriers
    how various barriers to sensory stimuli work
  17. autonomous functioning
    • how free the machine (the brain) is from the effects of conflicts
    • going through a divorce but can still focus at work
  18. synthetic functioning
    psychological capacity to handle conflicts in relationships
  19. mastery-competence
    • actual competence vs. perceived competence
    • ability to cope with the unforeseen or unexpected
  20. object-relations
    • the kind and degree of relatedness to other people
    • how mature that relatedness is 
    • recognize people as independent entities 
    • maintain object-constancy
    • how well a person can handle frustration and anxiety in a relationship
  21. general considerations about assessment
    • larger concept than diagnosis
    • should be accurate and comprehensive 
    • complex process
    • involves progressive decision making 
    • involves considerable subjectivity 
    • should include dispositional and environmental factors
  22. types of psychological testing
    • intellectual/neuropsychological 
    • personal inventories
    • projective tests
    • self-report/self-monitoring
  23. Clinical interview
    • any encounter in which language is used to gather information about a client 
    • less structured
    • good for rapport building
  24. diagnostic interview
    • ascertain the presence/absence of diagnostic criteria in the process of developing a diagnosis 
    • more structured
    • increased reliability and validity
  25. are clinical or diagnostic style interviews better?
    the best is to use both styles
  26. what is the biological component to the biopsychosocial Approach?
    • biological:aspects of a disease that and the effects on a person's biological functioning
    • genetics
    • physical conditions
    • medications/drugs/alcohol
    • age and gender appropriate
  27. what is the psychlogical component to the biopsychosocial Approach?
    • identification of psychological themes 
    • predisposing psychological vulnerabilities 
    • connecting vulnerabilities to the presenting problem 
    • thoughts and feelings about the problem 
    • coping strategies (adative/maladaptive)
    • use of theory to organize and conceptualize
    • basically looking for the psychological blueprints and themes to a persons life 
    • both verbals and nonverbals
  28. what is the social component to the biopsychosocial Approach?
    • family
    • friends
    • education
    • work
    • housing, income, SES, legal issues
    • social environment 
    • exposure to war or disaster
  29. Mental status examination
    • Method of organizing and evaluating important clinical observations in the here and now 
    • focuses on cognitive process
    • use when there is a history of head injury, dementia, drug and alcohol use
  30. Mental status exam categories
    • Appearance/presentation
    • behavior
    • speech
    • affect/mood (affect = observed, mood = reported)
    • thought process (is one thought leading to another)
    • thought content (what is coming out of the person's brain)
    • cognition (oriented x4 = person, place, time, situation)
  31. What are outcome measures/assessments used for?
    • evaluating strengths/weaknesses
    • track response to treatment
    • document change
    • provide clinician with feedback
  32. What types of outcome measures are used?
    • individualized -- usually less formal
    • unstandardized -- looks at progress against a certain treatment plan
    • standardized -- based on some type of norm
  33. What is the purpose of the DASS (depression & anxiety stress scale)?
    • self-report measure with three dimensions -- depression, anxiety, and stress/tension
    • Useful for targeting GAD
  34. what are the characteristics of the DASS (depression & anxiety stress scale)?
    • for people 14 years and older
    • normed on various adults from Australia
    • comes in a long and short form
    • provided in different languages
    • does not give a diagnosis
    • some DSM depression requirements are missing
  35. What is the purpose of the SCL-90 (symptom check list 90)?
    • evaluate a broad range of psychological problems and symptoms
    • monitor client progress, treatment outcomes
  36. What are the characteristics of the SCL-90 (symptom check list 90)?
    • standardized test
    • reflects clients feelings at that time
    • for 13+ years of age
    • normed on adult non-patients, adult psychiatric outpatients, adult psychiatric inpatients, and adolescent non-psychiatric patients
    • given in English and Spanish
  37. SCL-90 (symptom check list 90) global severity index (GSI) global index score
    • overall psychological distress
    • best single indicator of the current level or depth of distress 
    • go to score for summary
  38. SCL-90 (symptom check list 90) positive symptom distress index (PSDI) global index score
    • reflects a person's response style
    • overall symptom intensity
    • shows if people tend to exaggerate or downplay symptoms
  39. SCL-90 (symptom check list 90) positive symptom total (PST) global index score
    • the number of self-reported symptoms
    • the breadth of symptoms
  40. SCL-90 (symptom check list 90) somatization (SOM) symptom score
    the extent to which a person is physically manifesting symptoms
  41. SCL-90 (symptom check list 90) obsessive-compulsive (O-C) symptom score
    stress of obsessive thoughts or impulses and unwanted behaviors
  42. SCL-90 (symptom check list 90) internal anxiety (I-S) symptom score
    • inadequacy compared to others
    • self-doubt
  43. SCL-90 (symptom check list 90) hostility (HOS) symptom score
    • thoughts and feeling related to anger
    • aggression, irritability, rage reactions, and resentment
  44. SCL-90 (symptom check list 90) phobic anxiety (PHOB) symptom score
    • persistent fear that is out of proportion 
    • maladaptive avoidance behavior
  45. SCL-90 (symptom check list 90) paranoid ideation (PAR) symptom score
    • disordered modes of thinking 
    • suspicion
    • centrality 
    • grandiosity
    • externalized blame
  46. SCL-90 (symptom check list 90) psychoticism (PSY) symptom score
    • psychosis
    • schizophrenia
    • isolation
    • social withdrawal
    • schizoid lifestyle 
    • on a continuum
  47. SCL-90 (symptom check list 90) depression (DEP) symptom score
    • depression symptoms
    • cognitive distortions
    • suicidality
  48. SCL-90 (symptom check list 90) anxiety (ANX) symptom score
    • general anxiety
    • panic
    • associated with GAD
  49. Things to remember about outcome/assessment measures
    • periodic retesting can help modify therapy to client's evolving needs
    • retesting can graphically demonstrate clients progress
    • post-therapy testing can be used as an efficacy indicator
    • objective indications of change in the record can facilitate billing
  50. issues and concerns with DSM-5
    • increased neurobiological emphasis
    • abandonment of scientific evidence for clinical utility 
    • reduce the use of NOS
  51. How is DSM-5 organized?
    • younger to older
    • diagnosis that are related are next to each other
    • compatible with ICD-10
    • Section 1 -- intro and updated infro
    • section 2 -- categorical listing of diagnoses
    • section 3 -- other information (emerging measures and models, further research, etc...)
  52. principal diagnosis
    the conditioned that deemed to be chiefly responsible for the person seeking treatment
  53. provisional diagnosis
    used when client is one symptom short of a diagnosis
  54. what is the basic DSM-5 diagnostic format?
    medical diagnosis + ICD code + Name + appropriate specifiers
  55. What are the neurocognitive disorders?
    • delirium 
    • major neurocognitive disorders
    • mild neurocognitive disorders
  56. define delirium
    • disturbance in attention/awareness
    • rapid onset/fluctuation
    • additional disturbance in cognition
    • direct consequence of substance use/withdrawal or general medication
  57. specific delirium disorders
    • substance intoxication and/or withdrawal 
    • medication-induced
    • due to another medical condition
    • due to multiple etiologies
    • unspecified
  58. is delirium itself a cited disorder?
    no, you have to bring the cause of the delirium into the diagnosis
  59. name the neurocognitive domains
    • complex attention
    • executive function
    • learning and memory
    • language
    • perceptual-motor
    • social cognition
  60. Neurocognitive domain -- complex attention
    • ability to direct, focus, sustain, and shift attention
    • speed of mental processing
    • asses by performing mental calculations
  61. Neurocognitive domain -- executive function
    • ability to plan, organize, make decisions
    • complete tasks following interuptions
  62. Neurocognitive domain -- learning and memory
    • immediate, short-term, recent, long-term
    • ability to learn, store, and retain information
  63. Neurocognitive domain -- language
    expressive and receptive language abilities
  64. Neurocognitive domain -- perceptual motor
    • visual perception
    • ability to translate idea into action
  65. social cognition
    • ability to recognize emotions
    • consider another person's mental state
  66. define a major neurocognitive disorder
    • decline of at lease 1 of 6 domains that must be quantifiably assessed
    • must interfere with life
    • problems occur outside of delirium
    • specify etiological factor
    • specify additional medical condition
    • with or without behavioral disturbance 
    • severity (mild, moderate, severe)
    • coding note -- probable vs. possible
  67. When do you use probable vs. possible coding for neurocognitive disorder diagnoses
    • probable -- when there is real evidence of a medical condition (Alzheimer's)
    • possible -- when there is no evidence of a medical condition, but still evidence of domain impairment
  68. Define a mild neurocognitive disorder
    • modest cognitive decline in one or more domain
    • modest impairment in cognitive performance
    • deficits do not interfere with capacity for indepence
    • deficits do not occur exclusively in the contect of delirium
    • deficits not explained by another mental disorder
  69. Define an unspecified neurocognitive disorder
    symptoms characteristic of a neurocognitive disorder (significant distress in social, occupational, etc...), but do not meet the full criteria for any of the disorders in the category
  70. Name some curable conditions that may present as an NCD
    • depression (largest group)
    • thyroid disorders
    • vitamin B12 deficiency
    • brain tumors
    • subdural hemotoma 
    • infectious disease
    • complications of polypharmacy
  71. Define traumatic brain injury (TBI)
    • impact to the head/displacement of brain within the skull
    • loss of ocnsciousness
    • posttraumatic amnesia
    • disorientation/confusion
    • neurological signs
  72. cognitive difficulties associated with TBI
    • complex attention
    • executive function
    • learning and memory
    • slowness in information processing 
    • disturbances in social cognition
  73. emotional difficulties associated with TBI
    • disturbances in emotional function (irritability, anxiety, affective instability, ect...)
    • personality changes (disinhibition, apathy, suspicion, etc...)
    • physical disturbances (headaches, fatigue, sleep disorders, dizziness, etc...)
  74. Characteristics of Alzheimer's Disease
    • slow, insidious onset -- gradual decline
    • 80% of people with NCD's due to Alzheimer's can have behavioral and psychological symptoms
  75. what to remember when working with individuals with Alzheimer's Disease
    • simple words and short sentences
    • minimize distractions and noise
    • make eye contact and use name 
    • allow time to respond 
    • set realistic goals
    • develop routines 
    • concept of least resitrctive environment (help them be independent as possible)
  76. caregiver stress symptoms
    • denial
    • anger
    • social withdrawal
    • anxiety
    • depression
    • exhaustion
    • sleeplessness
    • etc...
Card Set
Adult Psychopath Midterm 1
Adult Psychopath Midterm 1