Psych Disorders Flashcards Final

Histrionic Personality Disorder

A Cluster B personality disorder characterized by excessive attention-seeking behavior and dramatic emotional expression. The person derives self-worth from being the center of attention. Key theme: "Pay attention to me — I am the most interesting person in the room."

Narcissistic Personality Disorder (NPD)

A Cluster B personality disorder marked by a deep belief in one's own superiority, entitlement to special treatment, self-importance, and desire for power over others. Associated with shallow relationships and exploitation of others. Differs from histrionic in that it is about believing you deserve more, not just craving attention.

Malignant Narcissist

A pop psychology term (not an official DSM diagnosis) for a narcissist who actively causes damage to others — more extreme and harmful than typical NPD.

Covert Narcissist

A pop psychology term (not an official DSM diagnosis) for a narcissist whose sense of superiority is hidden beneath perceived insecurities or neediness. May lure people in through vulnerability before becoming controlling or abusive.

Narcissistic Wound

A conceptual term describing the deep underlying pain, shame, and insecurity that drives narcissistic behavior. The narcissistic persona is an overcompensation for internal suffering.

Avoidant Personality Disorder

A Cluster C personality disorder described as social anxiety on steroids. Characterized by extreme lifelong avoidance of social situations, intense fear of negative evaluation and judgment, very few or no friendships, and significant functional impairment. More severe and pervasive than social anxiety disorder.

Dependent Personality Disorder

A Cluster C personality disorder where a person is unable to make decisions without another's approval, cannot function autonomously, requires constant reassurance, and relies entirely on one key person at a time. Present since childhood and pervasive across contexts.

Codependency

A pop psychology term (not a DSM diagnosis) describing a relationship dynamic where two people are excessively reliant on each other. The DSM only diagnoses the individual with Dependent Personality Disorder — not the pair.

Obsessive-Compulsive Personality Disorder (OCPD)

A Cluster C personality disorder (distinct from OCD) characterized by extreme rigidity, perfectionism, and inability to be flexible or adapt to change. Does NOT involve true obsessions or compulsions. Key trait: inflexibility that significantly interferes with life and relationships.

OCPD vs. OCD

OCPD involves rigidity and perfectionism as long-standing personality traits (present since childhood, pervasive across contexts). OCD involves unwanted intrusive thoughts (obsessions) and rituals performed to reduce anxiety (compulsions). OCPD is closer to what people casually mean when they say "I'm so OCD."

Cluster A Personality Disorders

The "odd or eccentric" cluster. Includes Paranoid, Schizoid, and Schizotypal personality disorders.

Cluster B Personality Disorders

The "dramatic, emotional, or erratic" cluster. Includes Borderline, Antisocial, Histrionic, and Narcissistic personality disorders.

Cluster C Personality Disorders

The "anxious and fearful" cluster. Includes Avoidant, Dependent, and Obsessive-Compulsive Personality Disorders.

Personality Disorder (general definition)

A long-standing, pervasive pattern of inner experience and behavior that deviates from cultural norms, is stable over time, originates in childhood/adolescence, causes significant impairment or distress, and appears across multiple contexts — not limited to specific situations.

Diathesis-Stress Model

A framework explaining that disorders arise from an interaction between a biological predisposition (diathesis) and environmental stressors. Genetics load the gun; environment pulls the trigger.

Neurodevelopmental Disorders

A DSM category of disorders diagnosed in infancy, childhood, or adolescence involving atypical brain and nervous system development. Includes ADHD, Autism Spectrum Disorder, Specific Learning Disorder, Intellectual Disability, and Communication/Motor Disorders.

ADHD (Attention-Deficit/Hyperactivity Disorder)

A neurodevelopmental disorder with two core symptom clusters: (1) Inattention — difficulty focusing, poor executive function, forgetfulness, disorganization; and (2) Hyperactivity/Impulsivity — fidgeting, blurting out, inability to sit still. Can present as predominantly inattentive, predominantly hyperactive-impulsive, or combined type.

ADHD – Predominantly Inattentive Presentation

A subtype of ADHD where inattention symptoms dominate: difficulty sustaining attention, losing things, zoning out, poor follow-through, and weak executive functioning. Hyperactivity is minimal or absent. Colloquially called "ADD."

ADHD – Predominantly Hyperactive-Impulsive Presentation

A subtype of ADHD where hyperactivity and impulsivity dominate: constant movement, fidgeting, interrupting, difficulty waiting for a turn, running or climbing inappropriately. Inattention is minimal.

ADHD – Combined Presentation

The classic form of ADHD where both significant inattention AND hyperactivity/impulsivity are present.

Executive Functioning

A set of cognitive skills including planning, organizing, initiating tasks, managing time, and completing multi-step goals. Significantly impaired in ADHD — the brain struggles to strategize and follow through.

Stimulant Medications (ADHD)

The most commonly prescribed treatment for ADHD. Work primarily by increasing dopamine availability in the brain. Do NOT behave paradoxically — they work the same way in all brains; the difference is baseline dopamine levels. At a therapeutic dose, they bring an ADHD brain up to a typical attention baseline.

Paradoxical Effect Myth (ADHD)

The incorrect belief that stimulants work differently in people with ADHD than in people without. In reality, stimulants do the same thing in all brains — the difference is the starting baseline. A person without ADHD may feel wired or anxious; a person with ADHD may reach normal attention levels.

Stimulant Misuse and Addiction Risk

Taking stimulants without a true ADHD diagnosis, at non-therapeutic doses, or borrowed from others significantly increases the risk of tolerance, withdrawal, and addiction. Crystal meth and Ritalin act similarly in the brain — the difference is dosage and baseline attention level.

Stimulant Side Effects

Can include reduced appetite (sometimes stunting growth in children), increased irritability, worsening of tics (especially problematic with comorbid OCD), and potential tolerance over time. Non-stimulant alternatives (e.g., Strattera) may be preferred in some cases.

Behavioral Treatment for ADHD

Addresses executive functioning directly through structure, organizational systems, behavioral reinforcement, and parent training. Essential alongside medication — stimulants address dopamine but do not build executive functioning skills. Physical movement, fidget tools, and doodling can also support focus.

Relative Age Effect (in ADHD diagnosis)

The phenomenon where the youngest children in a grade cohort are more likely to be diagnosed with ADHD because their developmental immaturity is mistaken for a disorder when compared to older classmates.

Redshirting

The practice of parents intentionally delaying their child's entry into kindergarten to give them a developmental advantage. Skews classroom age ranges, making the youngest children appear significantly behind — potentially leading to misdiagnosis of ADHD.

Sleep Apnea and ADHD Overlap

Sleep apnea and poor sleep quality can produce symptoms that closely mimic ADHD: inattention, irritability, and difficulty focusing. Tonsillectomy in children has resolved what appeared to be ADHD symptoms when poor sleep was the actual cause. A sleep study should be completed before any ADHD diagnosis.

Autism Spectrum Disorder (ASD)

A neurodevelopmental disorder characterized by challenges in social communication and interaction, and restricted or repetitive patterns of behavior and interests. Diagnosed on a wide spectrum reflecting diverse presentations and severity levels.

ASD – Social Deficits

One of the core clusters of ASD symptoms. May include reduced interest in others, limited eye contact, atypical attachment to caregivers, and differences in how a child seeks comfort or engages in play. Often visible as early as toddlerhood.

ASD – Communicative Atypicalities

One of the core clusters of ASD symptoms. May include delayed or absent speech, atypical gesturing, echolalia (repeating others' words), flat or atypical intonation, and difficulty understanding or conveying messages.

ASD – Restricted and Repetitive Behaviors

One of the core clusters of ASD symptoms. May include very narrow, intense interests; repetitive physical behaviors (stimming, e.g., flapping, spinning); rigid routines; difficulty with transitions; and sensory sensitivities (over- or under-responsivity to stimuli).

Echolalia

A communicative behavior associated with ASD in which a person repeats words or phrases that were just said to them rather than producing novel language. Can be immediate or delayed.

Stimming (Self-Stimulatory Behavior)

Repetitive physical movements (e.g., hand-flapping, spinning) often seen in individuals with ASD. Thought to serve a self-stimulating or self-soothing function.

Asperger's Syndrome

A previously distinct DSM diagnosis now subsumed into Autism Spectrum Disorder. Characterized by significant social deficits alongside intact or above-average intellectual functioning. Informally called "the little professor" due to intense, specialized knowledge in narrow areas.

Neurotypical vs. Neurodivergent

Neurotypical refers to brains that develop and function within what is considered the typical range. Neurodivergent (or "neurospicy") refers to brains that function differently — including those with ASD, ADHD, etc. Some individuals identify with their neurodivergence rather than viewing it as a disorder.

Oxytocin and ASD

Oxytocin is the bonding hormone responsible for motivating eye contact and social attachment. Abnormalities in oxytocin receptors may contribute to ASD by reducing early social bonding, which then limits social learning and widens the developmental gap over time.

Vaccine-Autism Myth

The debunked claim that vaccines (particularly thimerosal/mercury-based preservatives) cause autism. The original Lancet study was fabricated — the author lost his medical license. Extensive meta-analyses have found no causal link between vaccines and ASD.

Prevalence of ASD

Currently estimated at approximately 2% of school-age children. Diagnosed approximately 4–5 times more often in males than females. About 40% of individuals on the spectrum also have an intellectual disability. Occurs worldwide.

ASD Gender Differences and Measurement Issue

ASD is diagnosed more often in boys. Girls diagnosed with ASD tend to have lower intellectual functioning relative to the mean — raising the question of whether higher-functioning girls on the spectrum are being missed or misidentified.

ASD Treatment (Integrative Approach)

Preferred treatment is multidimensional: special education, behavioral support, communication therapy, social skills training, assistive technology, family support, and judicious use of medication for comorbid symptoms (e.g., anxiety, mood lability, ADHD). Goal is maximizing independence and community integration.

Intellectual Disability

A neurodevelopmental disorder distinct from (though overlapping ~30–40% with) ASD, characterized by significant limitations in intellectual functioning AND adaptive behavior, originating during the developmental period. Classified by level of intellectual functioning and underlying cause.

Specific Learning Disorder

A neurodevelopmental disorder involving persistent difficulty in one narrow academic domain (e.g., reading, writing, or math) despite overall typical intellectual functioning. IQ across domains is generally normal, but one area is significantly below expected level.

Selective Mutism

An anxiety disorder in which a child who is capable of speech does not speak in certain social situations. Distinct from ASD communication deficits — the silence is driven by anxiety and fear of negative evaluation, and the condition is treatable. Significant overlap with ASD exists and both can be diagnosed together.

Epigenetics

The study of how environmental factors can turn genes "on" or "off" without changing DNA sequence. Relevant to personality disorders and neurodevelopmental disorders — genetic predisposition alone does not determine outcome.

Developmental Milestones

Expected benchmarks for physical, cognitive, social, and language development at various ages. Highly variable — development is a moving target, not a fixed linear path. A single snapshot in time is insufficient for diagnosing a neurodevelopmental disorder.

Episodic Memory

A type of memory involving autobiographical events — personal experiences tied to a specific time and place (e.g., what you ate for breakfast, where you went on your birthday). Often among the first affected in Alzheimer's disease.

Semantic Memory

A type of memory involving facts, knowledge, and learned information not tied to personal experience (e.g., state capitals, symptoms of a disorder, cranial nerve names). Typically what is studied for exams.

Procedural Memory

A type of memory involving learned physical skills and habits (e.g., riding a bike, playing a chord on guitar, navigating a familiar door). Often described as "muscle memory." Can be preserved longer than other memory types in some neurocognitive disorders.

Neurocognitive Disorders (general)

A DSM category of disorders involving decline in learning, memory, and/or consciousness (awareness). Unlike neurodevelopmental disorders, these typically onset later in life (60s–80s). Include delirium, major neurocognitive disorder (formerly dementia), and mild neurocognitive disorder.

Delirium

A neurocognitive disorder involving acute, temporary severe confusion and disorientation. Can be caused by UTIs, medication interactions, substance withdrawal, hospitalization, or sudden environmental change. More common in older adults and hospital settings. Can be prevented or treated.

Major Neurocognitive Disorder

The DSM-5 term for what was previously called dementia. Involves significant decline in one or more cognitive domains (memory, language, perception, executive function) that interferes with independent functioning. Alzheimer's disease is the most common cause.

Mild Neurocognitive Disorder

A DSM-5 diagnosis representing early-stage cognitive decline where some independence is maintained but deficits are detectable. Introduced to allow earlier diagnosis and intervention before decline becomes severe. A "runway" before major neurocognitive disorder.

Alzheimer's Disease

The most common cause of major neurocognitive disorder. Characterized by progressive memory loss, visuospatial decline, personality changes, delusions, mood disturbance, and eventual loss of independent functioning. Risk increases significantly with age.

Facial Agnosia

The inability to recognize familiar faces, which can occur in major neurocognitive disorder. Distinct from prosopagnosia, which is a lifelong difficulty recognizing faces not caused by cognitive decline.

Prosopagnosia

A lifelong neurological condition causing difficulty recognizing faces, present from birth or early development. Not related to neurocognitive decline. People with prosopagnosia often compensate using other cues (voice, gait, clothing, hairstyle).

Frontotemporal Dementia (FTD)

A type of major neurocognitive disorder involving atrophy of the frontal and temporal lobes. Often causes severe personality changes, disinhibition, and aggression — sometimes before memory problems are apparent. Can affect younger individuals. (Associated with Bruce Willis.)

Vascular Dementia

A type of major neurocognitive disorder caused by reduced blood flow and oxygen to the brain, often following a stroke or series of small strokes.

Lewy Body Dementia

A type of major neurocognitive disorder involving abnormal protein deposits (Lewy bodies) in the brain. Affects motor neurons as well as cognition. (Associated with Robin Williams.)

Neurocognitive Disorder Due to TBI

Major or mild neurocognitive disorder caused by traumatic brain injury — physical head trauma (not emotional trauma, though often co-occurring).

Korsakoff Syndrome

A type of neurocognitive disorder caused by chronic alcoholism and thiamine (B1) deficiency. Characterized by severe memory impairment, particularly for recent events, and confabulation.

Chronic Traumatic Encephalopathy (CTE)

A progressive neurocognitive disorder associated with repeated head trauma, commonly seen in contact sport athletes (e.g., football players). Causes memory loss, personality changes, and mood disturbances.

Parkinson's Disease

A neurodegenerative disorder associated with motor symptoms (tremors, rigidity) and, over time, cognitive decline. Has both genetic and environmental components — notably, living near a golf course (pesticide exposure) increases risk.

Huntington's Disease

A genetically determined neurodegenerative disorder causing progressive uncontrollable motor movements and cognitive decline. Highly heritable — caused by a specific gene mutation.

Baby Boomers

The generational cohort born roughly mid-1940s through early 1960s, following the post-WWII population surge. Currently at peak age for major neurocognitive disorder, driving increased demand for geriatric care services.

UTI and Delirium in Older Adults

A urinary tract infection in older adults can trigger sudden-onset delirium and personality changes due to the inflammatory response affecting the brain. A commonly overlooked and treatable cause of apparent cognitive or psychiatric symptoms in elderly patients.

Priming (Memory)

A cognitive phenomenon in which exposure to one stimulus influences the response to a later stimulus. Example: hearing sleep-associated words (slumber, dream, rest) causes people to falsely "remember" the word "sleep" being said. Explains why memory assessment must account for cognitive errors, not just recall failures.

False Memory

Remembering an event or detail that did not actually occur. Distinct from lying — the brain fills in gaps using associations and generalizations. Relevant to memory assessment: clinicians must distinguish true memory deficits from common cognitive errors like false recognition.

Memory Assessment Confounds

Factors that can mimic memory problems but are not true memory deficits. Include: lack of initial attention (never encoded the information), priming effects, motivation, anxiety/brain fog, and normal cognitive shortcuts. Must be ruled out before diagnosing a neurocognitive disorder.

Aphasia

Difficulty with language — either receptive (understanding words/speech) or expressive (producing words/speech). Can occur in neurocognitive disorders as the brain loses the ability to process or retrieve language. Example: no longer knowing what the word "spoon" means or being unable to find the word for it.

Agnosia

The failure to recognize objects, faces, or other stimuli despite intact sensory function. Can occur in neurocognitive disorders. Types include facial agnosia (not recognizing familiar faces) and object agnosia (not recognizing what objects are or how to use them).

Apraxia

The loss of ability to perform learned, purposeful motor movements despite physical ability to do so. Associated with procedural memory decline in neurocognitive disorders. Example: being unable to navigate a fork to one's mouth or turn a steering wheel appropriately.

Alzheimer's Disease – Course and Prognosis

Typically begins in the 60s–70s (early onset: 40s–50s). Deterioration is slower in early and late stages and fastest in the middle stages. Average post-diagnosis survival is approximately 8 years, with a wide range. Confirmed definitively only by autopsy, but a strong clinical evaluation and neuropsych testing can yield a reliable diagnosis.

Amyloid Plaques and Tau Proteins

Abnormal protein buildups in the brain associated with Alzheimer's disease. Amyloid plaques accumulate between neurons; tau proteins form tangles inside neurons. Both disrupt normal brain function and can be detected via brain imaging. Their buildup in CTE patients looks qualitatively different from age-related accumulation.

Sandwich Generation

Adults who are simultaneously caring for their own children (or young adult dependents) AND aging parents with neurocognitive disorders. A major source of caregiver burnout, especially in the U.S. where institutional support for elder care is limited.

Caregiver Burnout

Severe physical and emotional exhaustion experienced by individuals caring for a loved one with a neurocognitive disorder. Can lead to depression, anxiety, and in extreme cases, abuse. The whole family system must be considered when treating neurocognitive disorders.

Deterministic Genes vs. Susceptibility Genes

Deterministic genes guarantee a disorder will develop if a person lives long enough (e.g., certain early-onset Alzheimer's mutations). Susceptibility genes raise the risk but do not guarantee the disorder — outcome also depends on environmental factors (diathesis-stress model). Most neurocognitive disorders involve susceptibility genes.

Lifestyle Factors for Reducing Dementia Risk

Habits that may lower risk of neurocognitive disorders: strong social relationships, cardiovascular exercise, quality sleep, high-fiber/anti-inflammatory diet (omega-3s, antioxidants), dental hygiene/flossing, hearing intervention, seeking novelty and cognitive flexibility, limiting viral infections/inflammation, and avoiding air pollution and toxins.

Hearing Loss and Dementia

A significant bidirectional risk factor: hearing loss reduces cognitive stimulation, accelerating decline; early cognitive decline may impair the brain's ability to process auditory input. Delayed use of hearing aids may allow the brain to lose its ability to adapt. Early intervention is strongly recommended.

Cognitive Novelty and Brain Health

Seeking new experiences, learning new skills, taking different routes, and mixing up routines helps maintain cognitive flexibility and may reduce dementia risk. Doing the same activity repeatedly (e.g., only Sudoku) may improve that one skill without broadly protecting the brain.

Chronic Traumatic Encephalopathy (CTE) – Expanded

A neurodegenerative disorder caused by repeated sub-concussive and concussive blows to the head — not just diagnosed concussions. The brain continues moving after the skull stops, causing cumulative damage. Associated with tau protein buildup. Can only be confirmed post-mortem. Symptoms: memory loss, personality changes, aggression, depression, and substance abuse, often appearing in a person's 30s–50s.

CTE – Sub-Concussive Hits

CTE is caused by the accumulation of repeated blows to the head, even those below the threshold of a diagnosed concussion. One concussion alone does not define the risk — it is the chronic repetition of impacts over a career. This makes rule changes and protective equipment critically important.

"Punch Drunk" Syndrome

A historical term used to describe boxers who showed signs of cognitive disorientation, slurred speech, and confusion after sustaining many blows to the head over their careers. Now understood to be an early description of CTE symptoms.

Civil Commitment

A legal process by which a person with mental illness symptoms can be involuntarily hospitalized if they are (1) dangerous to themselves or others, or (2) gravely disabled and unable to care for themselves. Varies by state law. Requires sign-off by a licensed clinician. Based on the government's role as surrogate parent (parens patriae) or police power (public safety).

Parens Patriae

Latin for "parent of the nation." The legal principle that gives the government authority to act as a surrogate parent and intervene on behalf of individuals who cannot care for themselves (e.g., those with severe mental illness or disability). One basis for civil commitment laws.

Criminal Commitment

The legal process by which a person accused of a crime is held in a mental health facility for evaluation of their mental state. Involves determining fitness to stand trial and/or whether a mental health condition affected their culpability. Distinct from civil commitment.

Insanity Defense (Not Guilty by Reason of Insanity)

A legal plea asserting that a defendant's mental state at the time of a crime prevented them from understanding what they were doing or knowing it was wrong. Used in less than 1% of criminal cases. Rarely successful. People found not guilty by reason of insanity are typically institutionalized, not freed.

Misperceptions About the Insanity Defense

Common myths: (1) it is used frequently — it is used in less than 1% of cases; (2) it often succeeds — it rarely does; (3) defendants are freed — those found NGRI are typically confined to a psychiatric facility, often longer than a prison sentence would have been.

Mental Illness (Legal Definition)

A legal construct used in civil and criminal commitment contexts — not synonymous with a DSM psychological disorder. Some states exclude intellectual disability or substance-related disorders from this legal definition. Less precise than clinical diagnostic categories.

Tarasoff Rule / Duty to Warn

A legal and ethical obligation for mental health clinicians to warn an identifiable potential victim when a client makes a credible, specific, and imminent threat to harm that person. Stems from the 1970s California case of Tatiana Tarasoff, who was murdered after her attacker disclosed his intent to a therapist. The clinician typically contacts law enforcement rather than the victim directly.

Confidentiality in Therapy

The foundational ethical principle that a therapist does not disclose information shared in therapy sessions. Breaking confidentiality is a serious violation — but is legally required in certain circumstances (e.g., Tarasoff duty to warn, mandatory reporting of child abuse, imminent suicide risk). Nuanced situations (e.g., HIV disclosure) require careful ethical and legal judgment.

Therapeutic Jurisprudence

An emerging interdisciplinary field examining how the law itself functions as a therapeutic or anti-therapeutic agent. Considers the mental health impact of legal processes, sentencing, and policy. Relevant to reforming how prisons handle mental illness (often acting as de facto psychiatric institutions without providing actual treatment).

Neuropsychological Evaluation (for Alzheimer's)

A battery of assessments used to detect cognitive decline. May include word recall tests, counting backwards, drawing a clock, and memory tasks. Increasingly supplemented by brain imaging to identify plaques, tau buildup, inflammation, or vascular blockages. Cannot definitively confirm Alzheimer's — that requires autopsy — but can strongly support a clinical diagnosis.