Term
| in the DMS what are the multiaxial diagnosis? |
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Definition
Axis I: Clinical disorders, and conditions that need clinical attention.
Axis II: Personality disorders and mental retardation.
Axis III: General medical conditions.
Axis IV: Psychosocial and environmental problems.
Axis V: Global assessment of functioning scale (0-100). |
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Term
what does the term Incidence mean? |
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Definition
number of new cases in a given time |
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Term
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Definition
rate of all cases( new and old) in a given time |
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Definition
proportion in a populatino who have ever had a given disorder |
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Definition
characteristic that increases the likelihood of a disorder |
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Term
definging abnormal behavior: psychological/psychiatric disorders are charaterized by one or more of the following? |
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Definition
- intrapersonal distress (anxiety)
- fuctional impairment
- increased risk for adverse outcomes (death, substance dependence)
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Term
how do we define impairment?
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Definition
- harmful dysfuction, or inability to perform evolutonarityly selected tasks
- lack of competence or the ability to perform salient developmetal task
- harmful to self or others
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Term
establishing clinical (diagnostic) validity in psychiatric research |
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Definition
Robins and Guze (1970):
Clinical Description of a cluster of covarying symptoms and etiological precursors.
Laboratory Studies identifying reliable physiological, biological and psychological markers.
Delimitation from other Disorders, or readily definable exclusionary criteria.
Follow-Up Studies outlining a predictable course.
Family Studies identifying increased risk of the same disorder in the relatives of afflicted probands. |
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Term
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Definition
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Term
Feighner criteria for schizophrenia |
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Definition
- two or more of the following delusions, hellucinations, disorganized speech, , negative symptoms (poverty of speech) diorganized or catotnic behavior
- social occupational dysfuction
- six month of greater duration
- increased ventricle sizes
- pet scan show decreased activity
- genetic loci: strong evidence of susceptibility
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Term
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Definition
a condition of the living animal or plant body orof one of its parts that impairs normal fuctioning and is tyically manifested by distinguishing signs and symptoms |
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Term
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Definition
- be communicable
- spread beyond a single organ or part of the body
- be heritable
- be life-threatening
- be readily observable
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Term
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Definition
- schizophrenia
- mood disorders
- anxiety disorder
- eating disorder
- disorders first diagnosed
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Term
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Definition
personality disorders and mental retardation
- antisocial personality
- borderline personality
- schizoypal personality
- any form of mental retardation
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Term
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Definition
general medical conditions
- infectious diseases (AIDS)
- diseases of the circulatory system
- poisoning
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Term
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Definition
psychosocial and enviromental problems
- homelessness
- unemployment
- recent death of a loved one
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Term
| structured clinical interviews yeild good.... |
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Definition
reliability for current diagnosis but poor reliability for lifetime prevalence
important: high reliability does not ensure validity |
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Term
| checklists and rating scales: beck dression inventory child behavior checklist |
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Definition
advantages: standarized across clinicians, established reliability and validity, national norms are often available across different age groups for males and females
disavantages: scores are not contextual, results are sometimes interpreted or diagnostic |
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Term
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Definition
reputedly assess unconscious processes, most renowned projective test is the Rorschach Inkblot Test
so problems with it are almost impossible to standardize state dependent, questionable reliability and validity
can be dangerous when used forensically |
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Term
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Definition
sometimes referred to as functional analysis
A= antecedent
B=behavior
C=consequence |
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Definition
| 1- Hs- over concern with bodily symptoms depressive-32 |
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Term
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Definition
2-D- depressive symptoms-57
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Term
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Definition
3-Hy-emotion dysregulation histrionics-60
describes unmanageable emotional excesses. People who are "hysterical" often lose self-control due to an overwhelming fear that may be caused by multiple events in one's past that involved some sort of severe conflict; the fear can be centered on a body part, or, most commonly, on an imagined problem with that body part. |
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Definition
| 4-pd- psychopathy antisocial tendencies-50 |
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Definition
| 5-MF-sterotypical masuline interest/behaviors rigidty-56 |
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Definition
| 6-pa-level of trust suspiciousness-40 |
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Definition
| 7-pt-anxiety, elft doubt-48 |
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Definition
| 8- sc- obsessiveness odd thingking asociality-78 |
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Definition
| 9-ma-excitability irritability, unrealistic ambition-46 |
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Definition
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Term
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Definition
| i see things or animals or people around me that others do not see |
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Term
| millon clinical multiaxial inventory |
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Definition
shorter than MMPI
used primarily in personality assessment
odd scoring system (base rate scores lie on a scale between 1-115with a median of 60) |
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Term
methods of knowing:
tenacity-
authority-
a priori-
scientific- |
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Definition
tenacity- its true because i know it's true
authority-its true because the bible tells me
a priori-its true becuase it stands to reason
scientific- its 'true" if repeated empirical obsercation does not refute it |
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Term
views of science:
static and dynamic |
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Definition
static: science is the systematic accumulation of knowledge
dynamic: science is the activity of hyppthesis generation and testing
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Term
| function of science: R braithwaite |
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Definition
| science is about gaining an understanding of observable events and prediction futer events |
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Term
| single subject experiments: multi base line reversal |
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Definition
studies how one person responds to manipulations of the independent variable, they have high internal validity.
initial time: a, period when treatment was intro:b
reinstatement of conditions of the baseline :a
reintroduction of treatment:b
the reversal type sometimes can not be employed because most treatments aim to produce enduring change so just removing an intervention may not return a perosn to the pretreatment state
problems: changes in fuctinoing cannot attributed to treatment without a reveral, reversal are often unethical |
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Term
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Definition
| research that assesses the strenght of association between variables ectent to which one variable covaries with another is indexed by the coefficent |
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Term
| measuring the correlation coefficient |
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Definition
| measures both the magnitude and the direction of a relationship. the higher the r the stronger the relastionship. Important: correlation is necessary but not sufficient for inferring causality ie married people are happier than unmarried people |
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Term
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Definition
| a situation in which measures of two or more variables are statistically related but are not in fact linked causally usually because the statistical relation is caused by a third varible |
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Term
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Definition
tge ibkt research design that allows causal conclusions to be drawn through the following steps:
random assignment and control groups
manipulation o the grouping
control of extraneous variables
the problems: experimental research is impractical and unethical is some cases |
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Term
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Definition
| we attempt to parse variance in behavior into heritable and non heritable(environment) this parsing of variance is accomplished using twin, a family and adoption studies |
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Term
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Definition
monozygotic (100 % sharded gentic polymorphisms) dizygotic have 50 % shared gentics,
sibling sibling parids also have 50% shared genetic but share fewer features of the enviroment
we use the ACE model (heritabledoes not equal genetic ) |
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Term
| what are the major limitations of the ACE Model? |
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Definition
| does not account for GxE interactions which when unmeasured are subsumed with A resulting in overestimated heritabilty of traits |
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Term
| Some important considerations when thinking about gene-behavior relations: |
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Definition
Genes do not control behavior directly. They code for protein expression. This occurs via transcription of DNA into mRNA, then translation of amino acids into proteins by tRNA.
Some genetically-derived individual differences in protein expression affect neurobiological processes such as neurotransmission in the brain.
No single gene controls any complex human trait. Behaviors such as impulsivity, intelligence, and depression are affected by many genes. This is called polygenic determinism.
Genes confer biases in behavior, not specific behaviors. For example, genes involved in alcoholism cannot cause alcoholism in the absence of environmental exposure to alcohol.
Popular press accounts of single genes controlling aggression and other complex traits are mischaracterizations: |
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Term
The Warrior Gene
The truth about MAO-A: |
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Definition
MAOA degrades monoamine neurotransmitters including dopamine (DA), norepinephrine (NE) and serotonin (5-HT)
These neurotransmitters play important roles in behavioral impulsivity, social affiliation, and mood regulation, respectively
Simpilified DA and 5HT metabolic pathways |
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Term
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Definition
| inheritance pattern for single-gene, dominant/recessive traits |
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Term
| a few examples of single-gene (Mendelian) diseases: |
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Definition
cystic fibrosis
sickle-cell anemia
Huntington's chorea |
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Term
| polygenetic inheritance/determinism: |
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Definition
| the influence of multiple genes on a physical or behavioral phenotype |
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Term
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Definition
the proportion of individuals who carry genetic vulnerability (often called liability) and express the disorder
example: almost 10% of individuals carry at least some genetic vulnerability to schizophrenia, but less than 1% develop the disorder
penetrance is therefore roughly 1/10, or 10%. This is called incomplete penetrance |
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Term
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Definition
a measureable characteristic, usually unobservable to the naked eye, that marks genetic risk for a disorder. In theory, endophenotypes are useful because they can help us track genetic vulnerability in pedigrees even among those for whom the predisposition has not penetrated
example: patients with schizophrenia evidence dysfunction in smooth pursuit eye movements compared to controls
these irregularities are also found in about 45% of family members, and among those who have not yet developed schizophrenia but do later on
endophenotypes can only be considered markers of genetic vulnerability if they:
1. segregate with illness in the general population
2. are heritable
3. are state independent (i.e., present whether or not illness is present or in remission)
4. co-segregate with the disorder within families
5. are observed at higher rates in affected families than in the population
6. can be measured reliably, and are specific to the illness |
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Term
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Definition
a biological sign of illness that does not meet criteria for an endophenotype.
example: choline concentrations in the cingulate cortex, as measured by PET, correlate with depression severity among those with bipolar disorder. They are therefore state-dependent. This may be useful information, but here choline concentrations mark clinical state (depression severity), not genetic liability.
state dependent biomarkers cannot be used to identify genetic vulnerability in unaffected family members |
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Term
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Definition
genetic linkage refers to the tendency of alleles that are near one another on the same chromosome to be inherited together, or linked. In linkage studies, we
1. obtain a large sample of families containing two children with a trait or disorder*
2. conduct searches for genetic markers with known chromosomal locations that might be 'linked' (i.e., chromosomally proximal) to a gene for the disorder
3. make educated guesses about the location of genes for complex disorders, which must be confirmed/refined in subsequent studies
*it's worth repeating that specifying the phenotype precisely is essential because if we fail to do so, we cannot possibly identify genes for an invalid phenotype
in this sense we are in the unenviable position of working in the wrong direction in psychiatric genetics; we must first guess at the phenotype and then try to infer genes
problem: linkage studies are expensive, produce many false leads, and have not produced replicable results for most psychiatric disorders
Molecular Psychiatry meta analysis of 32 schizophrenia studies including 7413 genotyped probands |
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Term
| Genetically-influenced neural processes and psychopathology |
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Definition
1. by altering neurotransmitter availability via synthesis and metabolism pathways
example: MAO and COMT are both involved in DA metabolism
2. by altering neurotransmission directly
example: the dopamine transporter (DAT) clears DA from the synapse (reuptake)
MAO, COMT and DAT genes are all implicated in impulsivity because they collectively alter DA function
more efficient DA neurotransmission is associated with pleasure and contentment
less efficient DA neurotransmission is associated with irritability and impulsivity |
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Term
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Definition
| exploration, motivation, form of dysfuction decreases, and is implicated in impulsivity, ADHD conduct problems antisocial tendencies and substance abuse |
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Term
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Definition
| sociability, alertness and attention. for of dysfunction increase, and is implicated in asociality, aloofness fearfulness and PTSD |
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Term
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Definition
| avoidance of threat and danger. form of dysfunction deases in implicated in anxiety, depression, obsessionality , and suicide |
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Term
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Definition
| persistent and irrational fears of a specific object, activity, or situation |
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Term
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Definition
| excessive and persistent fear of embarrassment in social or performance situations |
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Term
| generalized anxiety disorder |
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Definition
| anxiety that occurs across many situations and persists for at least six months |
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Term
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Definition
| brief periods of exceptionally intense anxiety accompanied by physical symptoms that include shortness of breath and chest pain |
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Term
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Definition
| excessive anxiety about being in places or situations where escape might be difficult, which leads to pervasive avoidance of situations such as crowds, traveling in cars, and may lead to refusal to leave the home |
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Term
| obsessive compulsive disorder |
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Definition
| persistent ideas, thoughts, or impulses that cause anxiety (obsessions) and irrational behaviors that an individual feels compelled to perform over and over (compulsion) |
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Term
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Definition
| anxiety that occurs within four days of an extremely traumatic event and lasts less than four weeks |
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Term
| posttraumatic stress disorder |
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Definition
| nxiety associated with the re-experiencing of an extremely traumatic event that occurred some time in the past |
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Term
| separation anxiety disorder |
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Definition
| excessive anxiety concerning separation from home or attachment figures |
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Term
| aniety disorder due to a medical condition |
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Definition
| anxiety due to neuroendocrine conditions, cardiovascular conditions, neurological conditions, etc. |
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Term
| substance-induced anxiety disorder |
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Definition
| anxiety due to use of or withdrawal from a substance (e.g., alcohol, amphetamines, cocaine, anxiolytics) |
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Term
serotonin transporter (5-HTTLPR)
SLC6A4 polymorphism |
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Definition
| clears serotonin from the synaptic cleft |
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Term
serotonin 1A receptor (5HT1A)
C(−1019)G promoter polymorphism |
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Definition
| facilitate serotonin neurotransmission |
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Term
brain-derived neurotrophic
factor(BDNF) gene
val66Met polymorphism |
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Definition
| promotes growth and differentiation of new neurons and synapses |
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Term
| catechol-O-methyltransferase (COMT) |
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Definition
| helps break down monoamines, including serotonin |
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Term
| serotonin 2A receptor (5HT2A) |
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Definition
| facilitate serotonin neurotransmission |
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Term
| tryptophan hydroxylase (TPH) gene |
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Definition
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Term
Gene x Environment Interaction and PTSD
certain people are more vulnerable to developing PTSD than others |
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Definition
heightened startle responses
smaller hippocampal volumes
higher blood glucocorticoid receptor numbers |
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Term
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Definition
| pain brought on and maintained to a significant extent by psychological factors |
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Term
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Definition
| preoccupation with imagined or exaggerated defects in physical appearance (common among those who seek plastic surgery) |
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Term
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Definition
| preoccupation with fears of having a serious illness |
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Term
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Definition
| recurrent, multiple physical complaints that have no biological basis |
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Term
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Definition
| sensory or motor symptoms without any physical cause |
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Term
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Definition
| physical incapacity faked to avoid responsibility (antisocial PD common) |
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Term
| Causes of Eating Disorders |
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Definition
cultural factors
pervasive "thinness standard" in dominant culture
self-worth and approval of others dependent on body size
media emphasis on beauty
cross cultural incidence of eating disorders tied to "Westernization"
much lower rates of eating disorders observed among African American Women
biological factors
familial loading suggests a genetic diathesis (mz concordance 23%, dz concordance 9%)
norepinephrine, serotonin, and endogenous opioids
psychological factors
depression
anxiety
perfectionism and obsessive traits
impulsivity, especially in bulimia (e.g., substance abuse)
family influences
direct effects of family criticism
parental psychopathology, substance abuse
struggle for autonomy and control |
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Term
| Treatment Approaches for eating disorders |
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Definition
cognitive behavior therapy (CBT) focusing on:
perfectionism
distorted body image
improved communication with family members (depending on age; see below)
hospitalization
iatrogenic effects occur in group treatment
pharmacological
antidepressants often used (SSRIs such as Prozac, Zoloft)
long term CBT more effective
family therapy
effectiveness depends on age of patient |
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Term
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Definition
| absent concern of thers feeling or social norms, a pervasive pattern of rule breaking and presence of conduct disorder |
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Term
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Definition
| characterised by an inability to 'empathise', to feel intimacy with, or to form close relationships with others |
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Term
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Definition
| research test whether causes are present before a disorder has developed. this method is used over time |
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Term
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Definition
| the causes and effect are measured at the same point in time |
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Term
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Definition
is the srudy of distribution of disorders in a population
- prevalence= the proportion of people with the disorder wither current or during their life time
- incidence= the proportion of people who developed new cases
- risk factor= variables that are related to the likelihood of developing the disorder |
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Term
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Definition
| a feeling of being outside one's body |
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Term
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Definition
| a feeling the world isn't real |
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Term
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Definition
| acts when people are feeling anxious and fealful. this is has been related to amygdala |
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Term
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Definition
| a personality trait defined by the tendency to react to events with greater than average negative affect |
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Term
| mowrer's two factor model |
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Definition
through classical conditions learns to fear something and thur operant conditioning grains relief by avoiding the object
(the dog bite) |
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Term
| interoceptive conditioning |
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Definition
| classical conditioning of panic attacks in response to bodily sensation. ex a person experiences somatic signs of anxiety , then is followed by a panic attack. that panic attack becomes a conditioned response to the somatic changes. |
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Term
| for OCD what areas of the brain light up? |
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Definition
| orbitofrontal cortex, caudate nucleus, and anterior cingulate |
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Term
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Definition
benzodiazepine: valium and xanax
antidepressants : tricyclic and selective serotonin reuptake inhibitors |
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Term
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Definition
| memory loss typically of a stressful experience |
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Term
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Definition
| memory loss accompanied by leaving home and establishing a new identity |
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Term
| dissociative identity disorder |
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Definition
| at least two distinct personalities that act independently of each other |
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Term
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Definition
| the person experiences bodily symptoms that have no known physical causes. they disorders are not voluntary |
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