Adult Psychopathology Midterm 2

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  1. Name the substance-related and addictive disorders
    • substance use disorder
    • substance-induced disorder (intoxication and withdrawal)
    • non-substance related disorders (gambling)
  2. What is a concern about adding non-substance related disorders to DSM-5
    Almost anything could be labeled as an addiction
  3. Describe the differences between substance addiction and process addiction
    • In substance addiction, the substance is what leads to the physiological response
    • in process addiction, the behavior is what leads to the physiological response (gambling creates an adrenaline rush)
  4. Describe the similarities between substance addiction and process addiction
    • the same neural pathways are used
    • they have the same psychological consequences
  5. What are Brown's six basic features of addiction
    • salience
    • euphoria 
    • tolerance
    • withdrawal
    • conflict
    • relapse/reinstatement
  6. Brown's basic features of addiction: Salience
    either the activity or the substance dominates the person's life
  7. Brown's basic features of addiction:  euphoria
    The feeling of being high
  8. Brown's basic features of addiction:  tolerance
    substance taken to a progressively higher level to get the same effect
  9. Brown's basic features of addiction:  withdrawl
    stopping the substance can lead to unpleasant physiological/physical sensations
  10. Brown's basic features of addiction:  conflict
    can lead to conflict with people or self
  11. Brown's basic features of addiction:  relapse
    the resumption of a substance or activity after trying to stop.  usually has negative consequence (losing job, family, etc...)
  12. Name the DSM-5 criteria for substance use disorder
    a patter of use with at least 2 of the following 

    • using larger amounts than intended
    • unsuccessful attempts to stop or control use
    • spending a great deal of time obtaining, using, or recovering from the effects of the substance 
    • craving or strong urge to use the substance
    • failure to fulfill major role obligations (work, home, school)
    • continued use despite recurrent substance-related social or interpersonal problems
    • important activities given up or reduced because of use
    • use in physically hazardous situations (drunk driving)
    • continued use despite substance-related physical or psychological problems
    • tolerance
    • withdrawal
  13. Name the DSM-5 criteria for substance-induced disorder: intoxication
    • reversible, substance-specific syndrome due to recent ingestion or exposure to substance
    • clinically significant maladaptive behavioral or psychological changes due to effect of substance developing shortly after use 
    • symptoms not sue to a general medical condition
    • common among those with substance use disorder
  14. Name the DSM-5 criteria for substance-induced disorder: withdrawal
    • substance-specific syndrome due to cessation of or reduction in use that has been heavy or prolonged 
    • causes clinically significant impairment 
    • not due to a general medical condition 
    • common urge to re-administer to reduce withdrawal symptoms 
    • usually, associated with a substance use disorder
  15. Describe the substance abuse subtle screening inventory  (SASSI-3)
    • asses a person's attitude towards assessment
    • ability to acknowledge a problem
    • how defensive
    • risk of legal problems
    • emotional problems
  16. Describe the CAGE
    A 4 item yes/no questionnaire with 2 yes answers meaning a possible drinking problem 

    • Have you felt the need to CUT down your drinking?
    • have people ANNOYED you by criticizing your drinking?
    • have you ever felt GUILTY about your drinking?
    • have you ever felt that you needed a drink first thing in the morning? (EYE opener)
  17. Describe the alcohol use disorders identification (AUDIT)
    • developed by the world health organization and has been cross culturally validated. 
    • Used mostly in primary care settings
    • mostly used to asses or detect harmful or hazardous use of alcohol 
    • scores of 8-19 show abuse
    • scores above 20 show dependence
  18. What are the reasons to perform assessment and what do you look for when dealing with substance abuse?
    • identity of substances used
    • history of use, emergencies, and treatment
    • cognitive impairment
    • physiological signs neurological signs
    • psychomotor agitation or retardation 
    • changes in mood 
    • changes in personality and defenses
  19. When performing substance abuse assessment, what are physiological signs?
    • dilated eyes
    • sleepiness
    • etc...
  20. during assessment, when is the information that is given considered reliable?
    if it is given in a clinical setting with confidentiality in place
  21. What is psychomotor agitation?
    getting agitiated/anxious when attempting a physical task
  22. what is psychomotor retardation?
    when a person is hardly moving or moving like a slug
  23. give examples of increased defenses when assessing substance abuse
    • externalized blame
    • minimizing usage amount
    • diversion tactics (rather talk about anything other than use)
    • defensive or hostile
    • rationalize use
  24. describe biological/physiological  issues with substance abuse
    • genetics are an important factor in alcohol abuse and dependence
    • almost as important for drug use
    • genetics are a stronger component for men
  25. describe environmental cosiderations when dealing with substance abuse
    • familial abuse and associated problems 
    • level of stress
  26. Define co-occurring disorders/dual diagnosis
    • means a person has a problem with drugs/alcohol and a mental disorder
    • happens in 60% of people with dependence problems
    • can use questionnaires to identify mental illness (MMPI, SCL-90, etc...)
    • typically, need to deal with the substance abuse first
    • all hinges on clients readiness to chance
  27. what are the stages for readiness to change?
    • precontemplation 
    • contemplation 
    • preparation 
    • action
    • maintenance
  28. readiness to change stage: precontemplation
    • no intent on changing in the foreseeable future
    • unaware of problem or under report
  29. readiness to change stage: contemplation
    aware of problem ad thinking about overcoming it, but have not committed to making a change
  30. readiness to change stage: preparation
    both intent and behavior including trying to quit in the last year, but no level of effectiveness reached yet
  31. readiness to change stage: action
    person is actually modifying their behavior/environment to overcome their addiction for up to 6 months
  32. readiness to change stage: maintenance
    person works to prevent relapse and consolidate their gains and remains free from addictive behavior for more than 6 months
  33. behavioral vs. substance addiction
    behavioral:  any compulsive behavior that interferes with daily living and has significant negative consequences 

    • can be almost anything 
    • being addicted to an activity 
    • must impair social and/or occupational functioning 

    Substance:  drugs and/or alcohol
  34. what are the treatment phases for substance abuse?
    • acute crisis
    • withdrawal from substance
    • sequelae 
    • predisposing factors
  35. treatment phases: acute crisis
    • is something life threatening
    • any medical care or psychiatric care needed
    • any family violence
  36. treatment phases:withdrawal from substance
    • the substance and the withdrawals sit between the client and the therapist 
    • prioritize the substance problem by dealing with the withdrawals (detox/out patient)
    • establish support base (psychological/social support/services, houseing, clothing) for the recovery process
  37. treatment phases: sequelae
    • things that have happened because of the substance abuse.  
    • Effects of the person's use has to be addressed such as depression, guild, cravings, relapse, family issues
    • learning to develop necessary skills (communication, exploring emotions, etc..)
  38. treatment phases: predisposing factors
    family alcoholism, trauma in childhood or adolescence, sexual orientation, etc...
  39. Treatment approaches to alcohol
    • admission of problem 
    • detox: multiple is a bad sign
    • antabuse:  must take pill, high drop out rates
    • AA: free, provides sponsor, high dropout rates
    • controlled drinking: non threatening, harm-reduction that does not confront denial, seeks to minimize use, not effective with high level of addiction
  40. What is the systemic approach to alcoholism and addiction?
    sees family as an ecosystem 

    • family system approach 
    • behavior is approached within interactions within a family 
    • eventually the behavior of the family begins to adapt to the addict 
    • family members begin to develop coping strategies and try to recover balance 
    • system is designed to treat the family as a whole/ecosystem 

    concept of homeostasis
  41. name the different family roles when dealing with substance abuse?
    • addict
    • co-dependent/enabler 
    • hero
    • scapegoat
    • lost child
    • mascot
  42. substance abuse and the family roles: addict
    • substance-focused
    • irresponsible
    • externalized blame
    • unproductive 
    • abusive
  43. substance abuse and the family roles:  co-dependent/enabler
    • offers family sense of stability/protection
    • contributes to progression of addiction
    • assumes responsibility inappropriately
    • common for them to become depressed and/or fatigued
  44. substance abuse and the family roles: hero
    • usually first born
    • source of pride for the family
    • usually an achiever
    • job is show the family is functioning well
    • alliance with or listens to problems of the enabler 
    • trained to be little enablers
  45. substance abuse and the family roles: scapegoat
    • someone for the family to blame
    • usually second child
    • mirror opposite of the first child
    • gets in trouble, acts out, poor grades, etc... 
    • expresses family's anger and frustration signaling there is a problem with the family
  46. substance abuse and the family roles: lost child
    • no trouble to the family
    • stays out of the way
    • possible middle child or youngest 
    • shy, withdrawn, fears taking risks
    • usually has the best prognosis because of little contact with the family
  47. substance abuse and the family roles: moscot
    • distracts the family from pain and sorrow with laughter and fun 
    • often the youngest child
    • more fragile, vulnerable, pronounced need for approval 
    • defensive against feelings of anxiety and inadequacy 
    • usually the worst prognosis because they distract themselves from feeling bad
  48. non-substance disorders (gambling)
    • addiction to adrenaline 
    • consistent and recurrent maladaptive gambling behavior 
    • more common in men and often see a link between same sex parent 
    • tend to be lower income 
    • tend to be more extroverted
    • high rates of suicide
    • residential and inpatient treatment are effective
  49. what are some basic facts about schizophrenia?
    • happens across all cultures
    • it is a biochemical issue
    • usually appears in adolescents (12+) and post adolescents
    • sometimes referred to as a thought disorder
  50. define a delusion
    a false belief that the person holds onto despite evidence to the contrary 

    • tend to be more bizarre with schizophrenia 
    • delusion disorder tend to not have bizarre delusions
  51. define a hallucination
    sensory perception that appears to be immediately real and true 

    most common are auditory hallucinations
  52. define positive symptoms in schizophrenia
    involve an excessive amount or distortion of a person's normal functions 

    increased amount of dopamine
  53. define negative symptoms in schizophrenia
    the diminishment or loss of normal functions 

    underactive dopamine
  54. what are Schneider's first rank symptoms?
    • hearing voices out loud (thought echo)
    • hearing voices discussing or arguing about person
    • hearing voices describing a persons activity 
    • high importance or personalized significance to a  normal perception (something has special meaning)
    • experience sensations outside of the person (moon is energizing my brain)
    • thought being placed in head by external force (thought insertion)
    • someone is taking away persons thoughts (thought withdrawal)
    • believes others can hear thoughts (thought broadcasting)
    • thoughts or feelings are being controlled by others
    • desires and impulses are controlled by others
    • motor activity is being controlled by others
  55. what areas of disturbance are involved in schizophrenia?
    • language and communication
    • content of thought
    • perception
    • affect
    • sense of self 
    • volition
    • relationship to the external world 
    • motor behavior
  56. schizophrenic disturbance: language and communication examples and terminology
    • circumstanciality: person makes irrelevant detours while talking 
    • poverty of speech: a lot of words being used but little is being said, overly abstract or concrete
    • neologism: combine two or three words into a single word that has magical meaning 
    • tangentiality: communication has no breaks
    • word salads: utter incoherents
    • clanging: speaking in rhymes 
    • looseness of association: immediate changing of subjects with little or no connection
  57. schizophrenic disturbance: perception
    • sometimes voices telling them to do things that they do not want to do
    • command hallucinations: person is being told what to do
  58. schizophrenic disturbance: affect
    usually very inappropriate, blunted, or flat (laughing while talking about a death in the family)
  59. schizophrenic disturbance:sense of self
    • impacted by lack of boundaries that are not clear
    • reality testing is not in place
  60. schizophrenic disturbance: volition
    sense of intention, sometimes have too much or too little (avolition)
  61. schizophrenic disturbance: relationship to outer world
    sometimes disconnected from the outer world
  62. schizophrenic disturbance: motor behavior
    • catatonic
    • hyper agitation
  63. name the subtypes of delusional disorder
    • erotomanic
    • grandiose
    • jealous
    • persecutory
    • somatic
    • mixed
    • unspecified

    pay a lot of attention to the specifiers of these disorders, there is a lot of specificity involved
  64. delusional disorder subtype: erotomanic
    involved another person, usually of high status, that loves them
  65. delusional disorder subtype: grandiose
    • inflated worth, power, knowledge
    • a relationship to a god
  66. delusional disorder subtype: jealous
    sexual partner is not faithful
  67. delusional disorder subtype: persecutory
    there is someone after me
  68. delusional disorder subtype: somatic
    some sort of physical problem with no evidence  (I know I have brain cancer)
  69. delusional disorder subtype: mixed
    more than 1 type occurring
  70. What is needed for a brief psychotic disorder diagnosis?
    Requires at least 1 of the following and at least one star 

    • delusions ★
    • hallucinations ★
    • disorganized speech ★
    • grossly disorganized or catatonic behavior
    • duration from 1 day to 1 month
  71. what is needed for a schizophreniform disorder diagnosis?
    2 or more symptoms with at least 1 star 

    • delusions ★
    • hallucinations ★
    • disorganized speech ★
    • grossly disorganized or catatonic behavior
    • negative symptoms
    • duration from 1 month to 6 months
  72. what is needed for a schizophrenia diagnosis
    2 or more symptoms with at least 1 star 

    • delusions ★
    • hallucinations ★
    • disorganized speech ★
    • grossly disorganized or catatonic behavior
    • negative symptoms
    • duration of at least 6 months
  73. what is schizoaffective disorder?
    meets the requirements for schizophrenia (primary disorder), but also has a major mood episode during the active or residual phase of schizophrenia 


    • bipolar type if manic episode
    • depressive type of major depressive episode
    • with catatonia
  74. what is needed for a substance/medication-induced psychotic disorder?
    • delusions
    • hallucinations 
    • during or soon after substance intoxication, withdrawal, or exposure to medication 
    • substance is capable of producing such symptoms
  75. what is needed for a psychotic disorder due to another medical condition?
    • prominent hallucinations or delusions 
    • evidence that disturbance is a direct consequence of the medical condition
  76. how do antipsychotic medications work?
    • block dopamine receptors 
    • high drop out rates for meds because of unpleasant side effects (dizziness, blurred vision, sexual dysfunction, etc...)
  77. What are the psychological treatments for schizophrenia?
    • psychodynamic 
    • social skills training
    • family therapy and expressed emotion reduction (EE)
    • CBT
  78. psychological treatments for schizophrenia: psychodynamic
    not used, research does not support
  79. psychological treatments for schizophrenia: social skills training
    • often a component in treatment
    • helps with skills that structure their world
  80. psychological treatments for schizophrenia: family therapy and expressed emotion reduction (EE)
    • relapse happens when families have high levels of EE
    • therapy is design to calm the patient by calming the family 
    • focused on education, signs of a psychotic break, knowing meds and side effect, etc... 
    • to provide hope in he family and the patient that improvement can happen
    • been shown to lower relapse rate
  81. psychological treatments for schizophrenia: CBT
    • teaches how to recognize inappropriate affect
    • how to notice signs of relapse 
    • muscle relaxation 
    • taught that they have an emotional vulnerability to stress 
    • taught that there thinking is not always as clear as it should be 
    • taught to stay on their meds
Card Set:
Adult Psychopathology Midterm 2
2016-11-17 07:05:11
Adult Psychopathology Midterm

Adult Psychopathology Midterm 2
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