abnormal psych ch 5 -

Neurodevelopmental disorders

• Conditions that begin in childhood and have a major impact on social and cognitive functioning.
• The deficits associated with these disorders include impairments in personal, social, academic, or occupational
functioning.

intellectual Developmental Disorder

characterize individuals who have intellectual and adaptive deficits that first became evident
when they were children.
These are characterized by deficits in general mental abilities
such as reasoning, problem-solving, judgment, ability to learn
from experience, and learning in an academic context.
• Significantly below average intellectual functioning,
indicated by an IQ of 70 or below.

This disorder must also involve impairment in adaptive
functioning, relative to a person’s age and cultural group, in a
variety of daily life activities such as communication, social
participation, and independent living

degree of severity is assigned by the clinician for intellectual developmental disorder

Mild, Moderate, Severe, Profound.
In DSM-5-TR, the levels of severity are based on how well
the individual is able to adapt in conceptual, social, and
practical domains.

down syndrome

Form of intellectual developmental disorder caused most commonly when individuals inherit an extra copy of chromosome 21

Phenylketonuria (PKU)

Condition in which children are born missing an enzyme called phenylalanine hydroxylase

Fragile X syndrome

genetic disorder caused by a change in the gene FMR1.

Tay–Sachs disease

Inherited disease that produces deficits in intellectual functioning due to a lack of hexosaminidase A.

causes of intellectual developmental disorders

genetic abnormalities, environmental hazards

environmental hazards for intellectual developmental disabilities

teratogens, rubella, anoxia, fetal alcohol syndrome, brain injury during delivery, premature birth

fetal alcohol syndrome (FAS)

mother who consumes alcohol during pregnancy can lead to a set of abnormalities in facial appearance, slower than average growth patterns, nervous system delays

criteria for growth abnormalities

Height, weight, or both at or below the 10th percentile (adjusted
for age, sex, and race or ethnicity)

criteria for facial abnormalities

Smooth ridge between nose and lip, thin edge around the lip,
and small separation between upper and lower eyelids (based
on racial norms

criteria for central nervous system abnormalities

Smaller head circumference and brain abnormalities visible on
imaging.
Performance on functional measures substantially below that
expected for an individual’s age, schooling, or circumstances in
areas such as speech, fine motor skills, attention, arithmetic
skills, and social skills or behavior

maternal alcohol exposure

Confirmed prenatal alcohol exposure; if this information is not
available, children who meet all three of the above criteria would be referred for further testing

treatment of intellectual developmental disorders

mainstreaming, behavioral interventions involving family, prevention of physically related disorders

austism spectrum disorder

neurodevelopmental disorder involving impairments in the domains of social communication and performance of restricted, repetitive behaviors

conditions that were seperate but now considered to be a single one with differing levels of severity

austistic disorder, aspergers, childhood disintegrative disorder, and Pervasive developmental disorder not otherwise specified (PDD-NOS)

two domains children being diagnosed with austism are evaluated

• social and communication disturbances

• restricted range of interests and performance of repetitive behaviors and activities

echolalia

repetition of the same sounds over and over

theory of austism spectrum disorder

austism is biologically based

-chromosomal abnormalities

-structural brain abnormalities

-functional brain abnormalities

treatments for austism

self-control procedures

imporove language and communication during child’s early years

teaching adaptive skills

interaction of peers rather than adults

token economies

rett syndrome

deceleration of head growth and some of the symptoms of austism spectrum disorder (exclusively in females)

High-Functioning Austism Spectrum Disorder (formerly Asperger’s disorder)

Symptoms continue to define the high-functioning end of the
autism spectrum.
• Less severe and more focused impairments.
• Difficulty reading the social cues of others.
• Tend to become preoccupied with a narrow set of
interests.
• More likely to try to make friends.

dyscalculia

pattern of difficulties in number sense, ability to learn arithmetic facts, and calculations

specific learning disorder with impairment in written expression

individual’s writing is characterized by poor spelling, grammatical or punctuation errors, and disorganization of paragraphs

childhood-onset fluency disorder

stuttering

social (pragmatic) communication disorder

deficits in the social use of verbal and nonverbal communication

Attention-Deficit/ Hyperactivity Disorder

A neurodevelopmental disorder involving a persistent pattern
of inattention and/or hyperactivity.

types of adhd

ADHD “combined type.”
• ADHD “predominantly inattentive type.”
• ADHD “predominantly hyperactive–impulsive type.

challanges of children with adhd

Children with ADHD may have lower grades during grade
school.
• Experience repeated discipline problems, and placement
in special education classes.
• They are more likely to develop substance use disorders
as they reach early adulthood.

adhd in adults

• Difficulty maintaining attentional focus.
• Deficits in executive functioning.
• Perform poorly on tasks requiring prioritization.
• Serious problems in relationships.
• Greater risk of engaging in deviant or antisocial behavior

treatment of adhd

Medication
• Stimulants (for example, Ritalin).
• Antidepressants.
Psychosocial treatment
• Psychoeducation.
• Individual therapy.
• Compensatory behavioral and self-management training.
• Coaching.
• Technology-based programs.
• School/work accommodations.
• Advocacy for oneself.

motor disorders

developmental coordination disorder

children with this experience marked impairment in their abilities to coordinate the movements of their hands and feet

stereotypic movement disorder

engage in repetitive, seemingly driven nonfunctional behaviors

waving, body rocking, head-banging, self-biting, picking at their bodies

schizophrenia

The broad category of schizophrenia includes a set of disorders in which
individuals experience distorted perception of reality and impairment in
thinking, behavior, affect, and motivation

schizophrenia involves disturbances in

Content of thought.
• Form of thought.
• Perception.
• Affect.
• Sense of self.
• Motivation.
• Behavior.
• Interpersonal functioning.

grandeur

A grossly exaggerated conception of the individual's own importance. Such delusions range from beliefs that the person has an important role in society to the belief that the person is actually Christ, Napoleon, or Hitler

control

The feeling that one is being controlled by others or even by machines or appliances. For example, a man may believe that his actions are being controlled by the radio, which is "forcing" him to perform certain actions against his will

types of delusions

grandeur, control, reference, persecution, self-blame, somatic, indidelity, thought broadcasting, thought insertion

reference

the belief that the behavior of others or certain objects or events are personally referring to oneself.
For example, a woman believes that a soap opera is really telling the story of her life, or a man believes
that the sale items at a local food market are targeted at his own particular dietary deficiences

persecution

the belief that another person or persons are trying to inflict harm on the individual or on that individual's family or social group. For example, a woman feels that an organized group of politically liberal individuals is attempting to destroy the right-wing political organization to which she belongs

self blame

Feelings of remorse without justification. A man holds himself responsible for a famine in Africa because of a certain unkind or sinful actions that he believes he has committed

somatic

Inappropriate concerns about one's body, typically related to a disease. For example, without any justification, a woman believes she has brain cancer. Adding an even more bizarre note, she believes that ants have invaded her head and are eating away at her brain

infidelity

A false belief usually associated with pathological jealousy involving the notion that one’s lover is being unfaithful. A man lashes out in violent rage at his wife, insisting that she is having an affair with the mailman because of her eagerness for the mail to arrive each day.

thought broadcasting

The idea that one’s thoughts are being broadcast to others. A man believes that everyone else in the room can hear what he is thinking, or possibly that his thoughts are actually being carried over the airwaves on television or radio.

thought insertion

The belief that outside forces are inserting thoughts into one’s mind. For example, a woman concludes that her thoughts are not her own, but that they are being placed there to control her or upset her.

inappropriate affect

extent to which a person’s emotional expressiveness fails to correspond to the content of what is being discussed

paranoia

irrational belief or perception that others wish to cause you harm, may be associated with delusions or auditory hallucinations related to a theme that somebody is persecuting or harassing them

active phase

period during which the symptoms of the disorder are most prominent

positive active phase

exaggerations or distortions of normal thoughts, emotions, and behavior

negative active phase

Symptoms that involve functioning below the level of normal behavior

restricted affect

narrowing of the range of outward expressions of emotions

avolition

lack of initiative, either not wanting to take any action or lacking the energy and will to take action

asociality

lack of interest in social relationships

Bleuler’s Four A’s

association (thought disorder)

affect (emotional disturbance)

ambivalence (inability to make or follow through on decisions)

autism (withdrawal from reality)

first rank symptom (FRS)

Symptom that is truly defining, or key, in the diagnosis of schizophrenia

brief psychotic disorder

A diagnosis that clinicians use when an individual develops
symptoms of psychosis that do not persist past a short period of time

symptoms of brief psychotic disorder

delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior

schizophreniform disorder

Characterized by psychotic symptoms that are essentially the
same as those found in schizophrenia, except for duration;
specifically, symptoms usually last from 1 to 6 months.
Likely to have a good prognosis if they do not show the
negative symptoms of:
• Apathy.
• Withdrawal.
• Asociality.

schizoaffective disorder

A disorder involving the experience of a major depressive
episode, a manic episode, or a mixed episode while also
meeting the diagnostic criteria for schizophrenia.
• Individual must have both a mood and a psychotic
disorder, but at least 2 weeks during which their delusions
and/or hallucinations are the only symptoms that they
show.

erotomania type

Individuals falsely believe that another person is in love with them

grandiose type

An exaggerated view of oneself as possessing special and extremely favorable personal qualities and abilities.

somatic type

individual falsely believes that they have a medical condition

shared psychotic disorder

one or more people develop a delusional system as a result of a close relationship with a psychotic person who is delusional

delusional disorders

symptoms are delusions that have lasted at least a month

vulnerability

The idea that individuals have a biologically
determined predisposition to developing schizophrenia, but
the disorder develops only when certain environmental
conditions are in place

genetic abnormalities affect

brain development, synaptic transmission, immune functioning, manufacturing of important proteins involved in neurotransmission

Neurodevelopmental hypothesis

Development of the disorder that arises during the years of
adolescence or early adulthood due to alterations in the
genetic control of brain maturation

medication for schizophrenia

antipsychotic chlorpromazine (thorazine) and Haloperidol (Haldol)

extrapyramindal symptoms (EPS)

rigid muscles, tremors, shuffling movement, restlessness, and muscle spasms affecting their posture

tardive dyskinesia

involuntary movements of the mouth, arms, and trunk of the body

token economy

A form of contingency management in which a client who performs desired activities earns chips or tokens that can later be exchanged for tangible benefits

cognitive- behavioral therapy for psychosis (CBTp)

Clinicians do not try to change clients’ delusions or eliminate clients’ hallucinations but try to reduce distress and preoccupation with symptoms

computerized auditory training

Computers present individuals with a series of auditory
training trials in which participants must respond rapidly in
order to receive a reward.
• Improvement of memory and sensory skills help individuals
with schizophrenia become better able to benefit from
other psychologically based interventions.

sociocultural perspective

Focus on the family system
• Faulty modes of behavior and communication.
• Cognitive distortions.
• High degree of expressed emotion (EE)
• Provides a measure of the degree to which family members speak
in ways that reflect criticism, hostile feelings, and emotional over
involvement or overconcern.
Social class and income
• Associated with environmental stressors of poverty.
• Contracting the disease leads to social and economic
“downward drift.”

downward drift

A progression observed in people with schizophrenia in which their disorder drives them into poverty, interfering with their ability to work.

developmental cascade hypothesis

A proposal for the cause of schizophrenia that integrates genetic
vulnerabilities, damage occurring in the prenatal and early
childhood periods, adversity, and drug abuse as causes of
changes in dopamine expressed in psychosis

assertive community treatment (ACT)

A team of professionals from psychiatry, psychology, nursing, and social
work, reach out to clients who focus on engendering empowerment and self- determination on its “consumers” the term they use to refer to their clients

biopsychposocial perspective

theories focus on underlying brain mechanisms as expressed in cognitive deficits

depressive disorders

disorder involving periods of symptoms in which an individual experiences an unusually intense sad mood

major depressive episode

Period in which the individual experiences intense psychological and physical symptoms related to a dysphoric mood.

criteria for major depressive episode

has 5 or more symptoms during a 2 week period and symptoms must be present nearly every day

persistent depressive disorder (dysthymia)

chronic depression of less intensity than major deppresive disorder

symptoms of dysthymia

Sleep and appetite disturbances, low energy or fatigue,
low self-esteem, difficulty with concentration and decision
making, and feelings of hopelessness

disruptive mood dysregulation disorder

A depressive disorder in children who exhibit chronic and
severe irritability and have frequent temper outbursts.
Outbursts must be developmentally inappropriate and occur
three or more times per week.
Between outbursts, children with this disorder are extremely
irritable or angry.

Premenstrual Dysphoric Disorder (PMDD)

Changes in mood, irritability, dysphoria, and anxiety that
occur during the premenstrual phase of the monthly
menstrual cycle and subside after the menstrual period
begins for most of the cycles of the preceding year

manic episode

euphoric mood with symptoms involving abnormally heightened levels of thinking. behavior, and emotionality

criteria for manic episode

symptoms must last at least a week and be present most of the day and nearly every day

bipolar 1 disorder

one or more manic episodes, and possibility of major depressive episodes

bipolar 2 disorder

one or more major depressive episodes and at least one hypomanic episode

bipolar disorder with rapid cycling

diagnosed if
four or more episodes occur within the previous year that
meet the criteria for:
• Manic, hypomanic, or major depressive disorder.
In some individuals, the cycling may occur within 1 week or
even 1 day.

cyclothymic disorder

symptoms are more chronic and less severe than those of
bipolar disorder.
• Met the criteria for a hypomanic episode.
• Numerous periods of depressive symptoms.
• Never meet the criteria for a major depressive episode.
Chronic condition
• Lasts at least 2 years

pharmacogenetics

use of genetic testing to determine who will and will not imporove with a particular medication

overgeneralizing

if its true in one case, it applies to any case that is even slightly similar

using selective abstraction

taking seriously only events that represent failures, deprivation, loss, or frustration

taking excessive responsibility

feeling responsible for all bad things that happen to you or to others to whom you are close

assuming temporal causality

f it has been true in the past, then it's always going to be true

making excessive self-references

Feeling at the center of everyone else’s attention and assuming
everyone can see your flaws and errors.

catastrophizing

Always thinking the worst and being certain that it will happen

engaging in dichotomous thinking

Seeing everything as either one extreme or another rather than as
mixed or in between.