Adult Psychopathology 2 Final

• Dystonic is uncomfortable with the self as seen with OCD
• syntonic is comfortable with the self as seen with personality disorders

• primary is physical symptoms that prevent deal with emotional issues
• secondary is the attention gained reinforces the symptoms

best tool to see if someone is psychotic

• seen in the dramatic/erratic personality disorders and explosive disorder
• goes along with judgment

seen in dramatic/erratic personality disorders

• State is a time limited status
• trait is persistent across time and situation

• feelings are facts, I feel therefore it is true
• seen in personality disorders

• cultural expression of distress
• different cultures express things in different ways

• apnea is when breathing stops
• hypopnea is shallow breathing

Sudden muscle failure as seen with narcolepsy

• type 1 is the basic need for admiration as described in the DSM
• type 2 is a need for admiration by way of self-sacrifice or giving to others

False presentation for a targetable gain

• Pressure build to act out
• action releases this pressure build up

• A sudden urge to take something that is not needed
• most have a mood disorder
• behavior is usually prompted

• tension building
• acute battering incident 
• loving contrition

• low self-esteem
• fear of intimacy but dependent
• power/control needs
• anger/hostility
• depression
• low stress tolerance
• defensive
• denial/minimization/justification
• violence in family of origin
• substance abuse
• un or under employed
• child abuse
• poor communication
• negative attitudes towards women 
• possessive,suspicious/jealous

• does not deserve to be abused or beaten
• conflicting emotions
• isolated, submissive, feels powerless
• trapped and frightened
• needs information
• may have been abused as a child

type 1: acute, situationally reactive violence to partner only.

• man feels guilt and is alarmed at loss of control
• woman has appropriate outrage, expresses intolerance, will leave relationship if necessary

therapy is effective

excessive sleep but still tired

• uncontrollable urge to fall asleep
• has cataplexy

basically jet lag or a sudden change in sleeping patterns

basically sleepwalking

• acting out while sleeping
• hitting, kicking, flailing, etc...

• vivid dreams dealing with life threatening situations
• dreams are clearly remembered
• awake very aroused and vigilant
• could be PTSD

• NREM 1: between sleep and wakefulness
• NREM 2: theta wave activity, more difficult to awaken sleeper
• NREM 3: delta wave (slow wave) sleep, sleeper is less responsive to the environment
• REM:  aka paradoxical sleep, very active, lack of REM --> harder to learn complex tasks

• Disproportionate worry about the seriousness of one's symptoms
• high level of anxiety

• preoccupation with having/acquiring a serious illness
• somatic symptoms not present

• physical symptoms to emotional trauma 
• la belle indifference 
• primary and secondary gain

example:  depression with diabetes

• make themselves ill for attention 
• the need to be a patient

• These are not disorders
• these conditions can affect treatment 
• these are Z codes 
• used in addition to diagnosis

• Schizoid PD
• paranoid PD
• schizotypal PD
• these are the closest to being psychotic

• Anti-social PD
• borderline PD
• Histrionic PD
• Narcissistic PD

• obsessive compulsive PD
• Avoidant PD
• Dependent PD

• detachment from social relationships and restricted expression of emotion
• negative symptoms

• Distrust and suspiciousness of others
• not usually delusional

• eccentric behavior
• pattern of social and interpersonal deficits
• reduced capacity for close relationships
• positive symptoms

• pattern of disregard and violation of the rights of others
• poor impulse control
• aggressive
• lack of remorse or guilt

• Unstable relationships, self image, and affect
• impulsive 
• dysregulation of emotions
• hot anger

• grandiosity
• need for admiration
• lack of empathy
• cold anger/get even

• excessive emotionality and attention-seeking 
• seductive
• shallow emotions
• cold anger/get even

• Social inhibition 
• feelings of inadequacy 
• hypersensitive to negative evaluation/rejection

• excessive need to be taken care of
• leads to submissive behavior 
• clinging behavior
• fear of separation

• preoccupation with orderliness
• perfectionism
• mental and interpersonal control at the expense of flexibility, openness and efficiency

• sociocentric: identity is centered in the group or extended family. Person's interest are suppressed and strict rules on interdependence. Outside the group membership is not favorable
• egocentric:  identity is focused on the self.  Perceive oneself as autonomous, and dependence is unfavorable. terminate relationships at will

• primary role identification
• stigma 
• typical in industrial societies 
• can be based on class, race, age, gender, etc...
• allows for systems of discrimination

• Internalization (acceptance of status): apt to view environment as hostile
• Passing: hiding the stigma
• Copy dominant group: more apt to focus on rules 
• Superlative effort:  being better than the average stigmatized group
• violence/resistance: may look anti-social
• violence against the self:  could be comorbid with internalization

• idealization/devaluation
• projection
• idnetification

• controlling
• projective identification
• acting out
• denial 
• manipulation
• emotional isolation

• splitting
• denial
• disortion

• repression
• regression
• dissociation
• somatization

• fantasy
• intellectualization 
• projection

• Denial 
• splitting
• reaction formation

• projection
• denial
• distortion
• splitting

• Repression
• inhibition
• isolation

• idealization
• reaction formation
• projective identification
• regression

• isolation of affect
• undoing
• displacement

• level of functioning with 2 categories
• self: identity and self-direction
• interpersonal (others): empathy and intimacy

Pathological trait domains

• negative effect
• detachment
• antagonism
• disinhibition
• psychoticism

• ICD = diagnostic nomeclature (whats wrong)
• ICF = specific functional impairment associated with disorders (how bad is it?)

• identifies difficulties due to health/mental health within the past month
• measures general areas of impairment
• designed to help with treatment planning

• understanding and communication
• getting around
• self-care
• getting along with people
• life activities-household
• life activities-school/work
• participation in society

cyclical violent affective storms to partner and family 

• man - violence is egosyntonic, accepts limited responsibility, temporary remorse instead of true guilt, violence is chronic and occurs in cycles
• woman- not as much outrage, stays attached to relationship

treatment can be effective if man commits to anger management and woman commits to safety

treatment is not recommended and is not effective

• most studies are on male dysfunction
• sex therapy is hard to find

• medication usually does not address problem
• pharmacological interventions can change sexual script 
• pharmacological interventions may also surface unconventional
• issues 
• psychological issues interfere with efficacy of meds