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Psychopathology COMP Cheat Sheet (DRAFT) by

William James College Psychopathology comprehensive exam cheat sheet

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Overview

Psycho­logical disorder, a psycho­logical dysfun­ction within an individual associated with distress or impairment in functi­oning and a response that is not typical or culturally expected.
Psycho­logical dysfun­ction refers to a breakdown in cognitive, emo- tional, or behavioral functi­oning.
Many mental health profes­sionals take a scientific approach to their clinical work and therefore are scient­ist­-pr­act­iti­oners
Three major categories make up the study and discussion of psycho­logical disorders: clinical descri­ption, causation (etiol­ogy), treatment and outcome
Etiology, or the study of origins, has to do with why a disorder begins (what causes it) and includes biolog­ical, psycho­log­ical, and social dimens­ions.
Some disorders have an acute onset, meaning that they begin suddenly; others develop gradually over an extended period, which is sometimes called an insidious onset
some disorders, such as schizo­phr­enia, follow a chronic course, meaning that they tend to last a long time, sometimes a lifetime. Other disorders, like mood disorders, follow an episodic course, in that the individual is likely to recover within a few months only to suffer a recurrence of the disorder at a later time.
Perhaps the biggest change that has been seen with the release of DSM-5 is the removal of the multi-­axial diagnostic system
Prognosis the likely future course of a disorder
The dimens­ional approach to classi­fic­ation of mental disorders differs from the catego­rical approach because the dimens­ional system provides scales that indicate the degree to which patients are experi­encing various cognit­ions, moods, and behaviors.

History

Three Dominant Traditions: Supern­atural, Biolog­ical, Psycho­logical
Deviant behavior as a reflection of the battle between good and evil (late 14th century to the 17th) Treatments included exorcism, beatings, and crude surgeries.
An equally strong opinion, even during this period, reflected the enligh­tened view that insanity was a natural phenom­enon, caused by mental or emotional stress, and that it was curable. Common treatments were rest, sleep, and a healthy and happy enviro­nment. Other treatments included baths, ointments, and various potions.
Hippoc­rates (460–377 b.c.) is considered to be the father of modern Western medicine. Suggested that psycho­logical disorders could be treated like any other disease.
Galen (a.d. 129–198) adopted the ideas of Hippoc­rates within the biological tradition that extended well into the 19th century. Assumed that normal brain functi­oning was related to four bodily fluids or humors: blood, black bile, yellow bile, and phlegm. Improper balance causes the disorders.
Galenic-Hippo­cratic Tradition linked abnorm­ality with brain chemical imbala­nces, foresh­adowed modern views
General Paresis (Syphilis) and the Biological Link With Madness- discovers bacterial microo­rganism as a cause of some symptoms, led to penici­llin. bolstered the view that mental illness equals a physical illness
Grey (19th century) the conditions in hospitals greatly improved and they became more humane, livable instit­utions. Treatments psycho­tropic medica­tions, electric shock, crude surgery, insulin, major/­minor tranqu­ilizers
Kraeplin Diagnosis and Classi­fic­ation, Increased role of science in psycho­pat­hology Increased hospit­ali­zation. Mental illness often seen as untrea­table condition
The Rise of Moral Therapy became popular in first half of 19th Century. The practice of allowing instit­uti­ona­lized patients to be treated as normal as possible and to encourage and reinforce social intera­ction
Pinel and Pussin (patients shouldn’t be restra­ined), Tuke followed their lead in England, Rush led reforms in the United States, Dix (mental hygiene movement)
Reasons for the Falling Out of Moral Therapy: the emergence of competing altern­ative psycho­logical models, difficult to care for the influx of patience
Freudian Theory of the structure and function of the mind emerged Later Develo­pments Anna Freud (self-­psy­cho­logy), Melanie Klein & Otto Kernberg (object relations theory)
The Neo-Fr­eud­ians: Departures From Freudian Thought: De-emp­hasized the sexual core of Freud’s theory. Jung (colle­ctive uncons­cious), Adler (focused on inferi­ority), Horney, Fromm, and Erickson
Humanistic Theory: Maslow (50s &60s Hierarchy of Needs), Rogers (50s-80s person centered therapy)
The Behavioral Model: Classical Condit­ioning (Pavlov; Watson)
Early Pioneers of Behavioral Therapy Wolpe (Syste­matic desens­iti­zation) Operant Condit­ioning Thorndike (law of effect), Skinner (shaping)
The Present: An Integr­ative Approach: Must consider reciprocal relations between biolog­ical, psycho­log­ical, social, and experi­ential factors, CBT (Beck & Ellis)

Assessing Disorders

Purpose, unders­tanding the indivi­dual, predicting behavior, treatment planning, evaluating outcomes
Key Concepts: reliab­ility (test-­retest, inter-­rater), validity (concu­rrent, predic­tive), standa­rdi­zation
The Clinical Interview: Struct­ured, Assesses multiple domains: current and past behavior, attitudes, emotions, detailed history, presenting problem
The Clinical Interview: Mental Status Exam: appear­ance, motor, speech, affect & mood, thought conten­t/p­rocess, percep­tion, intellect, insight
Physical Exam: Diagnose or rule out physical etiolo­gies, toxici­ties, medication side effects, allergic reactions, metabolic conditions
Behavioral Assessment: Identi­fic­ation and observ­ation of target behaviors. The ABCs (cogni­tiv­e-b­eha­vioral model) Antece­dents, Behavior, Conseq­uences. Formal vs. informal, Self-m­oni­toring vs. others observing.
Psycho­logical Testing: Cognition, Emotion, Behavior. Neurop­syc­hol­ogical testing, Neuroi­maging
Neurop­syc­hol­ogical Testing: Assess: Broad base of skills and abilities, Brain-­beh­avior relations, Assets and deficits
Neuroi­maging: Pictures of the Brain: CAT/CT x-rays of the brain in slices, MRI high resolution images, PET and SPECT reveals metabolic defici­encies , fMRI studies brain activity, EEG brain waves
Psycho­phy­sio­logical Assessment: Studies other biological responses: Electr­odermal (Galvanic skin response), Biofee­dback. Assessing response to stimuli is useful in disorders strong emotional component.

Anxiety, Trauma & Stress, OC Disorders

Fear: Immediate, presen­t-o­rie­nted, Sympat­hetic nervous system activation
Anxiety: Appreh­ensive, future­-or­iented, Somatic symptoms equals tension. In Japan, the anxiety syndrome termed taijin kyofusho involves a fear of personally offending others
Panic attacks: abrupt experience of intense fear. Expected or Unexpe­cted. Panic attack studies suggest that men consume alcohol to deal with panic attacks.
An Integrated Model: Triple vulner­abi­lity: Genera­lized biological vulner­ability (Diath­esis) Genera­lized psycho­logical vulner­ability (Belie­fs/­per­cep­tions) Specific psycho­logical vulner­ability (Learn­ing­/mo­deling)
Types of anxiety disorders: Genera­lized Anxiety Disorder, Panic Disorder and Agorap­hobia, Specific Phobias, Social Anxiety Disorder, Separation Anxiety Disorder, Selective Mutism
Other disorders: Selective Mutism, PTSD, Reactive Attachment Disorder, Disinh­ibited Social Engagement Disorder, OCD, Obsess­ions, Compul­sions, Tic Disorder, Body Dysmorphic Disorder, Hoarding Disorder, Tricho­til­lomania (Hair Pulling Disorder), Excori­ation (Skin Picking Disorder),
Treatments of GAD: Pharma­col­ogical (Benzo­dia­zep­ines, Antide­pre­ssa­nts), Psycho­logical (CBT, accept­ance, medita­tion)
Treatments of Panic Disorders and Agorap­hobia: Medica­tions (SSRIs, seroto­nergic, noradr­ene­rgic, benzod­iaz­epine GABA), Psycho­logical interv­ention: Exposure- based, Reality testing, Relaxa­tion, Breathing, Panic control treatment (PCT), Exposure to intero­ceptive cues, Cognitive therapy, Relaxa­tio­n/b­rea­thing, CBT
Treatments of Social Phobia: Medica­tions (Beta blockers, SSRI, D-cycl­ose­rine),
Treatment for Trauma and Stress­or-­Related Disorders: CBT (Exposure, Imaginal, Graduated or massed), Increase positive coping skills, Increase social support, catharsis, medica­tions (SSRIs), PERMA therapy
Other
The setting for posttr­aumatic stress disorder to occur follows an experience accomp­anied by a triad of feelings: Horror, Helple­ssness, Fear
One difference between panic disorders and PTSD is panic disorder but not PTSD has a biological vulner­ability
Richard, the patient with OCD described in the textbook, was compelled to take very small steps as he walked and to look back repeat­edly. As with other types of checking compul­sions, Richard was trying to ward off an imagined disaster.
the prevalence of OCD is very similar across cultures.
The most common anxiety disorder of childhood is separation anxiety
The behavioral process in which OCD patients are not permitted to carry out their compul­sions while in the presence of the anxiety producing stimulus or situation is called exposure and ritual preven­tion.
Although both panic disorder patients and persons with somatic symptom disorder tend to misint­erpret bodily sensat­ions, patients with panic disorder tend to fear immediate catast­rophe, while those with somatic symptom disorder tend to fear long-term illness.

Somatic Symptom & Dissoc­iative Disorders

Soma = Body, Preocc­upation with health or appearance
Types of Somatic Disorders: Somatic symptom disorder, Illness anxiety disorder, Conversion disorder, Factitious disorder
Treatment for Somatic Disorders: Psycho­dynamic (uncover uncons­cious conflict), Education & Support, CBT
Depers­ona­liz­ati­on-­Der­eal­ization Disorder Types: Depers­ona­liz­ation Disorder, Dissoc­iative Amnesia, Dissoc­iative Fugue, Dissoc­iative Trance Disorder, Dissoc­iative Identity Disorder
Treatment of Depers­ona­liz­ati­on-­Der­eal­ization Disorders: (similar to somatic symptom disorder), Attending to trauma, Remove secondary gain, Reduce supportive conseq­uences, Reward positive health behaviors Treatment of DID: (similar to PTSD treatm­ent), Reinte­gration of identi­ties, Identify and neutralize cues/t­rig­gers, Visual­iza­tion, Coping, Hypnosis
Other
Conversion disorder symptoms generally appear shortly after some marked stress
A common­ly-seen form of factitious disorder imposed on another is a set of conditions that is an atypical form of child abuse.
During a dissoc­iative fugue state, it is not uncommon for indivi­duals to take on a new identify
In dissoc­iative amnesia, the individual typically has not memory of selective events or emotional tone attached to them, partic­ularly those involving trauma
One distin­ction that may help determine those with DID from indivi­duals who are maling­ering (faking their symptoms) is that maling­erers are usually eager to demons­trate their symptoms.
Depers­ona­liz­ation is defined as altered perception including loss of the sense of one's own reality. Dereal­ization is defined as altered perception involving loss of the sense of reality of the external world
One reason that DID can be misdia­gnosed as psychosis is that auditory halluc­ina­tions are common in both disorders.

Mood Disorders & Suicide

Mood disorders = gross deviations in mood Mood Disorder Types: Major depressive episodes, Manic episodes, Hypomanic episodes
Types of Mood Episodes: Hypomanic episode (Shorter, less severe version of manic episodes), Mixed features (term for a mood episode with some elements reflecting the opposite valence of mood)
The Structure of Mood Disorders: Unipolar mood disorder: (Only one extreme of mood is experi­enced), Bipolar mood disorder: (Both depressed and elevated moods are experi­enced)
(Unipolar) Depressive Disorders: Major depressive disorder, Persistent depressive disorder, Premen­strual dysphoric disorder, Disruptive mood dysreg­ulation disorder
Specifier: Additional diagnostic label used by clinicians to convey extra inform­ation about symptoms.
Psychotic features specifier: Halluc­ina­tions: Sensory experience in the absence of sensory input Delusions: Strongly held inaccurate beliefs, Anxious distress specifier: depression accomp­anied by anxiou­sness, Mixed features specifier: depressive symptoms with manic symptoms, Melanc­holic features specifier: depression with additional severe symptoms, Catatonic features specifier: muscular symptoms, Atypical features specifier: symptoms that are less common, Peripartum onset specifier: occurs around the time of birth, Seasonal pattern specifier: occurs during certain seasons (usually winter)
From Grief to Depression: Acute grief: Occurs immedi­ately after loss Integrated grief: Eventual coming to terms with meaning of the loss Compli­cated grief: Persistent acute grief and inability to come to terms with loss
Bipolar Disorders: Bipolar I disorder, Altern­ations between major depressive episodes and manic episodes, Bipolar II disorder Altern­ations between major depressive episodes and hypomanic episodes, Cyclot­hymic disorder Altern­ations between less severe depressive and hypomanic periods
Causes: An Integr­ative Theory: Biological and psycho­logical vulner­abi­lities interact with stressful life events to cause depression Biological vulner­ability: e.g., overactive neurob­iol­ogical response to stress Psycho­logical vulner­ability: e.g., depressive cognitive style
Treatment of Mood Disorders: Antide­pre­ssants (SSRIs, Tricyclic antide­pre­ssants, Monoamine oxidase inhibi­tors, Mixed reuptake inhibi­tors), Lithium, ECT, Transc­ranial Magnetic Stimul­ation
Psycho­social Treatments for Depression: CBT, Interp­ersonal Psycho­the­rapy, Prevention & Relapse
Psycho­social Treatments for Bipolar Disorders: Medication (Lithium is still first line of defense), Psycho­therapy helpful in managing problems (inter­per­sonal, occupa­tio­nal), Family therapy
Other
The rapid-­cycling specifier refers to an individual with bipolar disorder who experi­ences at least 4 manic or depressive episodes in a year.
Bipolar disorders occur equally across the sexes.
All of the following are side effects of lithium therapy: lack of energy, toxicity, lowered thyroid functi­oning
One of the problems encoun­tered by psychi­atrists who prescribe medication for patients with bipolar disorder is that patients often stop taking the medication in order to bring on a manic state.

Eating & Sleep-Wake Disorders

Types of Eating Disorders: Bulimia nervosa, Anorexia nervosa, Binge-­eating disorder
Bulimia Subtypes: Purging (most common), Nonpurging Associated psycho­logical disorders: Anxiety, Mood disorders, Substance abuse
Anorexia Nervosa Subtypes: Restri­cting, Binge-­eat­ing­-pu­rging Associated psycho­logical disorders: Anxiety, OCD, Mood disorders, Substance abuse, Suicide
Treatment of Eating Disorders: Antide­pre­ssants, CBT, Interp­ersonal psycho­therapy Treatment of Anorexia: Weight restor­ation, Target dysfun­ctional attitudes (Body shape, Control, Thinness = worth), Family involv­ement
Sleep–Wake Disorders: Dyssomnias (Quantity, Quality, Sleep onset), Paraso­mnias (Abnormal behavi­oral, Physio­logical events) Dyssomnias: Insomnia, Hypers­omn­olence Disorders, Narcol­epsy, Breath­ing­-re­lated sleep disorders, Circadian Rhythm Sleep Disorder Paraso­mnias: Nightm­ares, Sleepw­alking (Somna­mbu­lism, Sexsom­nia), Sleep terrors
Medical Treatment of Sleep Disorders: Benzod­iaz­epines, Stimul­ants, Antide­pre­ssants, Ferber Sleep Training Prevention: Improving sleep hygiene, Educating parents about child’s sleep patterns
Other
The best evidence that binge-­eating disorder (BED) may not just be a special case of bulimia nervosa is that there is a greater likelihood of remission and a better response to treatment for BED.
African Americans ad less body dissat­isf­action, fewer weight concerns, and a more positive body image when compared to Caucasian adolescent girls
Dietary restraint studies suggest that people who are starved may become preocc­upied with food and eating.
CBT and IPT had equivalent rates of helping bulimia clients improve.
Learning has a role in the mainte­nance of sleep disorders.
Sleep disorders are approp­riately diagnosed based on quality and quantity of sleep as well as daytime sequelae (how the individual feels when awake).
Adoles­cents tend to shift toward a biolog­ically determined later sleep schedule.

Person­ality Disorders

Person­ality disorders: A persistent pattern of emotions, cognitions and behavior that results in enduring emotional distress for the person affected and/or for others and may cause diffic­ulties with work and relati­onships
Person­ality Disorder Clusters: Cluster A Odd or eccentric, Paranoid, schizoid, schizo­typal Cluster B Dramatic, emotional, erratic, Antiso­cial, border­line, histri­onic, narcis­sistic Cluster C Fearful or anxious, Avoidant, dependent, obsess­ive­-co­mpu­lsive
Cluster A: Paranoid: Unlikely too seek help on their own. Focus on developing trust. May use CBT. Cluster A: Schizoid: Unlikely to seek help. Focus on relati­onships and social skills training. Cluster A: Schizo­typal: Treatment of comorbid depres­sion. Multid­ime­nsional approach (Social skill training, Antips­ychotic medica­tions, Community treatment)
Cluster B: Antisocial: Unlikely to seek help on own, Preven­tion, Parent training (Rewards for pro-social behaviors, Skills training, Improve social compet­ence) Cluster B: Borderline: Highly likely to seek treatment, Antide­pre­ssants, DBT Cluster B: Histrionic: Treatment focus on interp­ersonal relati­onships Cluster B: Narcis­sistic: Treatment focuses on Grandi­osity and Lack of empathy
Cluster C: Avoidant: Treatment is to increase social skills Cluster C: Dependent: Gradual increases in Indepe­ndence, Personal respon­sib­ility, Confidence Cluster C: Obsess­ive­-Co­mpu­lsive: Treatment address fears related to the need for orderl­iness
Other
One of the most unreliable categories in current classi­fic­ation
men and women with the Type A behavioral pattern were twice as likely to develop coronary heart disease than were non-Type A indivi­duals.
One prevalent outcome for indivi­duals with schizoid person­ality disorder is homele­ssness
The disorder that shares many similar symptoms with schizo­phrenia is schizo­typal person­ality disorder.
Substance abuse is partic­ularly common in people with antisocial person­ality disorder, occurring in 60% of people with this diagnosis.
Recent research is refining the search for genes that cause antisocial person­ality disorder.
Recent research on neurop­syc­hol­ogical tests indicates that psycho­paths score equally as well as non-ps­ych­opaths.
Since research suggests that those with psycho­pathy are generally under aroused, and thus engage in actions to compensate for this lack of stimulus input.
Emotional dysfun­ction is one of the best predictors of suicide in people with borderline person­ality disorder
One of the influences associated with the develo­pment of borderline person­ality disorder is history of child abuse or neglect.
Without unders­tanding the thought process motivating the patient's behavior, it would probably be impossible to determine whether a patient had schizoid person­ality disorder or avoidant person­ality disorder
halluc­ina­tions and delusions are a part of the symptom pattern in: Schizo­aff­ective disorder, Schizo­phr­eniform disorder, Brief psychotic disorder

Physical Disorders and Health Psychology

Psycho­log­ical, behavi­oral, and social factors contribute to illness and disease
Two primary paths: Psycho­logical factors influence biological processes, Behavior patterns increase disease risk
The biology of stress: SNS activa­tion, Neurom­odu­lators and neurop­ept­ides, HPA axis activa­tion, Limbic system activa­tion, Chronic stress may damage cells in the hippoc­ampus, thus mainta­ining the HPA loop
Immune response is affected by psycho­logical factors Psycho­neu­roi­mmu­nology
Cancer Distress: Perceived lack of control, Poor coping responses (e.g., denial), Stressful life events, Life-style risk behaviors
Cancer: Psycho­social treatments improve: Health habits, Treatment adherence, Endocrine function, Stress respon­se/­coping
Coronary Heart Disease Psycho­logical and behavioral risk factors: Stress, anxiety, anger, Poor coping skills , Low social support
Psycho­logical and social factors contri­buting to distress of Chronic Pain: Perceived control, Negative emotion, Poor coping skills, Low social support, Compen­sation, Social reinfo­rcement
Psycho­social Treatment of Physical Disorders : Biofee­dback (Monitor and control bodily responses, Increase sense of control), Relaxation and medita­tion, Compre­hensive programs (Monitor and identify stressful events, Monitor somatic symptoms, Muscle relaxa­tion, Cognitive therapy, Increase coping strate­gies)
Females may have an "­ext­ra" pain-r­egu­lating pathway focused on relieving pain associated with the reprod­uctive system. One implic­ation of this biological gender difference is that males and females may benefit from different kinds of medica­tions and different kinds of pain manage­ment.

Sexual Dysfun­ctions, Disorders, and Dysphoria

Overview: Sexual dysfun­ctions involve desire, arousal, and/or orgasm, Pain associated with sex can lead to additional dysfun­ction. Males and females experience parallel versions of most dysfun­ctions
Gender Differ­ences: Men: Show more sexual desire and arousal, Self-c­oncept includes power and indepe­ndence Women: Emphasize context of committed relati­onship, Sexual beliefs are more easily shaped by cultural, situat­ional, and social factors
Classi­fic­ation of Sexual Dysfun­ctions: Lifelong vs. acquired, Genera­lized vs. situat­ional, Psycho­logical factors alone, Psycho­logical factors combined with medical condition
Types of Sexual Disorders: Male Hypoactive Sexual Desire Disorder, Erectile Disorder, Female Sexual Intere­st/­Arousal Disorder, Female Orgasmic Disorder, Premature ejacul­ation, Genito­-Pelvic Pain/P­ene­tration Disorder
Treatment of Sexual Dysfun­ction: Education, Masters and Johnson’s psycho­social interv­ention (Education about sexual response, foreplay, etc, Sensate focus and nondemand pleasu­ring), Additional psycho­social procedures (Squeeze techni­que­–pr­emature ejacul­ation, Mastur­batory traini­ng–­female orgasm disorder, Use of dilato­rs-­vag­ini­smus, Exposure to erotic materi­al–low sexual desire problems)
Paraphilic Disorders–misplaced sexual attraction and arousal. Types: Fetish­istic disorder (attra­ction to nonhuman objects), Voyeur­istic disorder (observing an unsusp­ecting indivi­dual), Exhibi­tio­nistic disorder (exposure of genitals to unsusp­ecting strang­ers), Frotte­uristic disorder (rubbing up against unwilling others), Transv­estic disorder (arousal with cross-­dre­ssing), Sexual sadism disorder (Infli­cting pain or humili­ation), Sexual masochism disorder (suffering pain or humili­ation), Pedophilic disorder (attra­ction to prepub­escent children)
Interv­entions for Paraphilic Disorders: Covert sensit­ization: imagining aversive conseq­uences to form negative associ­ations with deviant (e.g., pedoph­ilic) behavior, Orgasmic recond­iti­oning: mastur­bation to approp­riate (adult) stimuli, Family­/ma­rital therapy: address interp­ersonal problems, Coping and relapse prevention: self-c­ontrol and risk manage­ment, Drug Treatments
Treating Gender Dysphoria: Sex Reassi­gnment Surgery
Other
Side effects of the tricyclic antide­pre­ssants include sexual dysfun­ction
Sexual dysfun­ctions are equally common in hetero­sexuals and homose­xuals.
questi­onn­aires may be better when assessing sexual behavior because people may provide more sexual inform­ation in writing than during an interview.
One of the most important skills that therapists must possess when conducting an interview regarding sexual behavior is demons­trating that they are comfor­table talking about sexual issues.
Two very common medical causes of erectile dysfun­ction are vascular disease and diabetes.

Substance and Addictive Disorders

Substa­nce­-re­lated disorders: Use and abuse of psycho­active substa­nces, Signif­icant impairment Impuls­e-c­ontrol disorders: Inability to resist acting on drives or impulses
Levels of involv­ement: Substance use, Substance intoxi­cation, Substance abuse, Substance dependence
Main Categories of Substances: Depres­sants, Stimul­ants, Opiates, Halluc­ino­gens, Caffeine, Inhalants, Marijuana, Anabolic steroids, Medica­tions, Gambling
Alcoho­l-R­elated Disorders: Fetal alcohol syndrome (FAS)
Jellinek’s four stage model: 1.prealc­oholic stage (drinking occasi­onally with few serious conseq­uen­ces), 2. prodromal stage (drinking heavily but with few outward signs of a problem), 3. crucial stage (loss of control, with occasional binges), 4. chronic stage (the primary daily activities involve getting and drinking alcohol)
Treatment of Substa­nce­-Re­lated Disorders: Agonist substi­tution, Antago­nistic treatment, Aversive treatment, Medica­tions, Inpatient facili­ties, Alcoholics anonymous, Controlled use, Component treatment (Indiv­idual and group therapy, Aversion therapy, Covert sensit­iza­tion, Contin­gency manage­ment), Community reinfo­rce­ment, Relapse prevention
Impuls­e-C­ontrol Disorders: Interm­ittent explosive disorder, Klepto­mania, Pyromania
Other
Blackouts appear to be related to the intera­ction of alcohol with the glutamate system
The common factor among psycho­active drugs may be their ability to activate the "­ple­asure pathwa­ys" of the brain.
some of the students begin drinking because they think it will have positive effects on their social behavior and cognitive and motor skills, a phenomenon called an expectancy effect
LSD is chemically similar to serotonin. Mescaline is chemically similar to norepi­nep­hrine. A number of halluc­inogens are chemically similar to acetyl­cho­line.

Schizo­phrenia & Other Psychotic Disorders

Positive Symptoms of Schizo­phrenia: Active manife­sta­tions (Delus­ions, Halluc­ina­tions), Exagge­rations or excesses Negative Symptoms: Disorg­anized speech, Inappr­opriate affect­/em­otional expres­sion, Unusual movements
Other Psychotic Disorders: Schizo­phr­eniform disorder (Schiz­oph­renic symptoms for only a few months), Schizo­aff­ective disorder (Symptoms of schizo­phrenia plus a mood disorder), Delusional disorder (types: Erotom­anic, Grandiose, Jealous, Persec­utory, Somatic, Folie a deux), Substa­nce­-in­duced psychotic disorder, Psychotic disorder associated with another medical condition, Brief psychotic disorder (One or more positive symptoms which lasts 1 month or less), Schizo­typal person­ality disorder (symptoms are similar to schizo­phrenia but less severe)
Treatment of Schizo­phrenia: Antips­ychotic medica­tions (neuro­lep­tics), Behavioral Therapy, Community care programs, Social and living skills training, Behavioral family therapy, Vocational rehabi­lit­ation, Virtual reality techno­logy, Assertive community treatment
Autism Spectrum Disorders: A complex neurod­eve­lop­mental disorder charac­terized by abnorm­alities in social behavior, language and commun­ication skills, and unusual behaviors and interests Common Accomp­anying Disorders: Intell­ectual disabi­lity, Epilepsy, ADHD, conduct problems, anxieties and fears, and mood problems
Autism Spectrum Treatments: There are about 400 different treatm­ents, Goals: Minimize core problems, Maximize indepe­ndence and quality of life, Help the child and family cope more effect­ively with the disorder
Other
Dopamine is most closely linked to positive symptoms of schizo­phr­enia.
Making the diagnosis of schizo­phrenia is contro­versial because the symptoms can vary as a function of culture or race.
The neurol­eptic drugs introduced in the 1950s affect primarily the positive symptoms of schizo­phrenia

Neuroc­ogn­itive Disorders

Three classes: Delirium – temporary confusion and disori­ent­ation, mild neuroc­ogn­itive disorder, major neuroc­ogn­itive disorder, amnesia
Subtypes of delirium: Delirium due to a general medical condition, Substa­nce­-in­duced delirium, Delirium due to multiple etiolo­gies, Delirium not otherwise specified Treatment: Treat underlying medical or withdrawal problems, Psycho­social interv­entions (Educa­tion, Reassu­rance, Coping strate­gies), Treat acute delirium with medication
Major neuroc­ogn­itive disorder (previ­ously labeled dementia) is a gradual deteri­oration of brain functi­oning Mild neuroc­ogn­itive disorder is a new DSM-5 disorder that was created to focus attention on the early stages of cognitive decline
Neuroc­ogn­itive Disorders Affect: Sustained attention The ability to attend to a stimulus or activity over a long period of time Focused Attention Refers to our ability to focus attention on a stimulus Arousal Refers to our activation level and level of alertness
Causes: Dementia of the Alzhei­mer’s type, Vascular injury, Fronto­tem­poral degene­ration, Traumatic brain injury, Lewy body disease, Parkin­son’s disease, HIV infection, Substance use, Huntin­gton’s disease, Prion disease, Normal pressure hydroc­ephalus (excessive water in the cranium resulting from brain shrink­age), Hypoth­yro­idism (an undera­ctive thyroid gland), Brain Tumor, Vitamin B12 defici­ency, Head Trauma
Neuroc­ogn­itive Disorder Due to Alzhei­mer’s Disease: Develop gradually and steadily, Confusion, Agitat­ion­/co­mba­tiv­eness, Depres­sion, Anxious, Sundowner syndrome
Vascular Neuroc­ogn­itive Disorder: Progre­ssive brain disorder, Blockage or damage to blood vessels, Onset is often sudden (Stroke)
Fronto­tem­poral Neuroc­ogn­itive Disorder: Damage the frontal or temporal regions of the brain, Two types: Declines in approp­riate behavior, Declines language
Traumatic Brain Injury: Neuroc­ogn­itive disorder due to traumatic brain injury - includes symptoms that persist for at least a week following the trauma, including executive dysfun­ction
Pick’s disease: Rare neurol­ogical condition. Cortical impairment pattern, Early onset=40s or 50s
Lewy body: Lewy bodies are micros­copic deposits of a protein that damage brain cells over time
Parkin­son’s Disease: Degene­rative brain disorder, Dopamine pathway damage, Motor problems
Huntin­gton’s disease: Genetic autosomal dominant disorder, Early onset=40s or 50s
Prion Disease: Always fatal, Linked to mad cow disease, Type of Prion Disease: Creutz­fel­dt-­Jakob Disease
Treatment: Early interv­ention is critical, Three areas of focus (Prevent certain condit­ions, Delaying onset, Cope with the advancing deteri­ora­tion), Multid­ime­nsional treatment, Focus on slowing the progre­ssion, Medica­tions, Psycho­social treatments
Other
Language functions are housed primarily in the Left temporal lobe

Legal and Ethical Issues

Civil commitment laws detail when a person can be legally declared to have a mental illness and be placed in a hospital for treatment General criteria: Mentally ill & needs treatment, Dangerous to self or others, Gravely disabled (Inability to care for self)
Govern­mental authority (Police Power: Health, Welfare, Safety of society) (Parens patriae: State acts a surrogate parent) Supreme Court Restri­ctions on involu­ntary commitment (Insuf­ficient grounds: Non-da­ngerous person, Need for treatment alone, Gravely disabled)
Initial stages: Person fails to seek help, Others feel that help is needed, Petition is made to a judge, Individual must be notified Subsequent stages: Involves normal legal procee­dings, Judge makes determ­ina­tion, Assisted outpatient treatment (AOT)
Conseq­uences of Supreme Court rulings Crimin­ali­zation of the mentally ill, Deinst­itu­tio­nal­ization and homele­ssness, Transi­nst­itu­tio­nal­ization
Criminal commitment Nature: Accused of committing a crime, Detainment in mental health facility for evalua­tion, Fitness to stand trial (Findings: Guilty, Not guilty by reason of insanity)
Insanity Defense: M’Naughten rule Don’t know what they’re doing, Don’t know it is wrong Durham rule Includes mental disease or defect American Law Institute Standard Knowledge of right vs. wrong, Self-c­ontrol, Diminished capacity (Mens rea, actus rea)
Competence to Stand Trial: Requir­ements: Understand legal charges, Ability to assist in defense, Essential for legal processes, Burden of proof = defense
Mental Health Profes­sionals as Expert Witness Specia­lized knowledge and expertise, Competency determ­ina­tions, Assess risk - danger­ous­ness, Reliable DSM diagnoses, Advise the court (Psych­olo­gical assess­ment, Diagno­sis), Assess maling­ering
The right to treatment Must treat if involu­ntarily committed, Reduce symptoms, Provide humane
The Rights Research Partic­ipants: Right to be Informed About the Research, Right to Privacy, Right to be Treated with Respect and Dignity, Right to be Protected from Physical and Mental Harm, Right to Chose or Refuse to Partic­ipate in Research, Right to Anonymity in Report of Study Findings, Right to Safegu­arding of Records
Clinical Practice Guidelines: Agency for Healthcare Research and Quality, The Patient Protection and Affordable Care Act, APA practice guidelines

Other

Current research into neurot­ran­smitter systems has produced the "­per­mis­siv­e" hypoth­esis, which states that when serotonin levels are low, other neurot­ran­smitter systems become dysreg­ulated and contribute to mood irregu­lar­ities.
patients' noncom­pliance with medication may be due to: negative patien­t-d­octor relati­onship, cost of medica­tion, negative side effects
An intell­ectual disability has three parts, signif­icant subaverage intell­ectual functi­oning, concurrent deficits or impairment in adaptive functi­oning and onset before age 18
Mental illness as used in the legal system is unique to each state (.i.e., civil commitment criteria)