PSYC 351 Final Study Guide

According to the DSM-5, how many symptoms must be present to diagnose schizophrenia?

During a 1-month period, a person must have at least 2 of the following 5 symptoms, and one or more must be:

• A. Delusions

• B. Hallucinations

• C. Disorganized speech
  Other possible symptoms:

• D. Grossly abnormal psychomotor behavior (including catatonia)

• E. Negative symptoms

Which three symptoms are considered the core symptoms of schizophrenia?

At least one of these must be present:

• Delusions

• Hallucinations

• Disorganized speech

What are positive symptoms of schizophrenia?

Positive symptoms are an excess or distortion of normal functioning, including:

• Delusions

• Hallucinations

• Disorganized speech

• Grossly disorganized or catatonic behavior

What are negative symptoms of schizophrenia?

Negative symptoms involve a loss or reduction of normal functioning, including:

• Flat affect (reduced emotional expression)

• Avolition (lack of motivation)

• Alogia (reduced speech)

• Anhedonia (inability to experience pleasure)

• Asociality (lack of interest in social relationships)

What characterizes Type I schizophrenia?

• Primarily positive symptoms

• Distortions of normal functioning

• No intellectual impairment

• Responds well to antipsychotic medication

• Better chance of recovery

A patient with Type I schizophrenia would most likely have which characteristics?

• Delusions and hallucinations

• Little or no cognitive decline

• Good response to medication

• Better prognosis than Type II schizophrenia

Which of the following is NOT a negative symptom of schizophrenia?

Hallucinations (or delusions) are positive symptoms, not negative symptoms.

Which symptoms are considered negative symptoms?

• Flat affect

• Avolition

• Alogia

• Anhedonia

• Asociality

What are delusions of grandeur?

The false belief that you are someone important, famous, powerful, or have exceptional abilities.

What are delusions of control?

The false belief that people, animals, objects, or outside forces are controlling or influencing your thoughts or actions.

What are delusions of thought broadcasting?

The false belief that other people can hear or know your thoughts.

What are persecutory (persecution) delusions?

The false belief that someone is plotting against you, trying to harm you, or spying on you.

What are delusions of reference?

The false belief that events, TV shows, songs, or conversations are specifically about you.

What are delusions of thought withdrawal?

The false belief that someone or something is removing thoughts from your mind.

What occurs during the prodromal phase of schizophrenia?

• Symptoms are subtle

• Person begins to deteriorate

• Changes in behavior, mood, or functioning occur before obvious psychotic symptoms

What occurs during the active phase of schizophrenia?

• Symptoms become fully apparent

• Often triggered by stress or trauma

• Delusions, hallucinations, and disorganized speech are common

What occurs during the residual phase of schizophrenia?

• Symptoms decrease in severity

• Person often experiences prodromal-like symptoms

• Negative symptoms may continue

Which phase of schizophrenia includes the most obvious psychotic symptoms?

Active phase

Which phase occurs before full psychosis develops?

Prodromal phase

Which phase follows the active phase and involves milder symptoms?

Residual phase

Which treatment is least effective for schizophrenia?

Psychotherapy by itself is the least effective treatment because schizophrenia is primarily treated with antipsychotic medications. Therapy is used as a supplement, not a replacement.

What is the most effective treatment for schizophrenia?

Antipsychotic medications, often combined with:

• Psychotherapy

• Social skills training

• Family education

• Community support

A patient believes the FBI is secretly monitoring all of their phone calls. What type of delusion is this?

Persecutory (Persecution) Delusion

A patient believes everyone can hear their thoughts. What type of delusion is this?

Thought Broadcasting

A patient believes they are the President of the United States with supernatural powers. What type of delusion is this?

Delusions of Grandeur

A patient believes aliens are controlling their movements with a remote device. What type of delusion is this?

Delusions of Control

A patient believes someone is removing thoughts from their mind. What type of delusion is this?

Thought Withdrawal

A patient believes the news anchor is sending them secret messages through the television. What type of delusion is this?

Delusions of Reference

What are the hallmark symptoms of delirium?

• Sudden state of confusion

• Rapid onset

• Fluctuating levels of consciousness

• Changes in attention and awareness

• Medical emergency requiring immediate evaluation

Why is delirium considered a medical emergency?

• It often indicates an underlying medical condition

• Can rapidly worsen if untreated

• Contact a medical doctor immediately

Why is delirium frequently misdiagnosed?

Because it can resemble dementia or psychosis, despite having a very different cause and onset.

What is the main difference between delirium and dementia?

• Delirium: Sudden onset of confusion

• Dementia: Gradual decline in cognitive functioning over time

How does the history of onset help distinguish delirium from dementia?

• Delirium: Sudden onset (hours to days)

• Dementia: Slow, progressive onset (months to years)

How does delirium differ from psychosis?

• Delirium: Sudden confusion caused by a medical condition

• Psychosis: Primarily involves hallucinations or delusions without the fluctuating confusion seen in delirium

What are neurofibrillary tangles in Alzheimer's disease?

Filaments within neurons become tangled, disrupting communication between brain cells and contributing to cell death.

What is Alzheimer's disease?

A progressive neurodegenerative disorder characterized by a gradual decline in cognitive functioning.

What cognitive abilities gradually decline in Alzheimer's disease?

• Memory

• Learning ability

• Attention

• Judgment

What orientation problems occur in Alzheimer's disease?

Disorientation to:

• Time

• Place (space)

What communication difficulties are common in Alzheimer's disease?

Difficulty speaking coherently and communicating effectively.

How does Alzheimer's disease affect daily functioning?

People gradually have difficulty maintaining activities of daily living, such as:

• Personal hygiene

• Cooking

• Managing finances

• Self-care

What behavioral changes are common in Alzheimer's disease?

• Inappropriate social behaviors

• Personality changes

What type of disorder is Parkinson's disease?

A disorder of the motor system caused by degeneration of the substantia nigra.

Which part of the brain degenerates in Parkinson's disease?

The substantia nigra.

What neurotransmitter is produced by the substantia nigra?

Dopamine

Why does Parkinson's disease impair motivation?

Because degeneration of the substantia nigra leads to reduced dopamine production.

What are the four classic motor symptoms of Parkinson's disease?

• Tremor

• Rigidity

• Postural abnormalities

• Reduction in voluntary movements (bradykinesia)

Which symptom is NOT commonly associated with Parkinson's disease?

Memory loss is not one of the primary motor symptoms.
The classic symptoms are:

• Tremor

• Rigidity

• Postural instability

• Reduced voluntary movement

Which part of the brain is primarily affected in Huntington's disease?

The basal ganglia.

During which stage of sleep does sleepwalking most commonly occur?

Stage N3 (deep slow-wave sleep)

Sleepwalking most commonly occurs during what type of sleep?

Deep NREM sleep (Stage N3)

Difficulty falling asleep and staying asleep is a symptom of which sleep disorder?

Insomnia

What is insomnia?

A sleep disorder characterized by:

• Difficulty falling asleep

• Difficulty staying asleep

• Waking too early

Difficulty waking up is a common symptom of which sleep disorder?

Hypersomnia

What is hypersomnia?

A sleep disorder characterized by:

• Excessive sleepiness

• Difficulty waking up

• Sleeping longer than normal

Delirium vs. Dementia: Which develops suddenly?

Delirium

Delirium vs. Dementia: Which develops gradually?

Dementia

Which disorder is considered a medical emergency: delirium or dementia?

Delirium

Which disease is associated with neurofibrillary tangles?

Alzheimer's disease

Which neurodegenerative disease results from degeneration of the substantia nigra?

Parkinson's disease

Which neurodegenerative disease primarily affects the basal ganglia?

Huntington's disease

What is hypoactive sexual desire disorder (HSDD)?

A persistent or recurrent lack of sexual thoughts, fantasies, or desire for sexual activity that causes significant distress or impairment.

What is the primary symptom of hypoactive sexual desire disorder?

A marked decrease or absence of sexual desire or interest that causes distress.

Which individual would most clearly meet the DSM-5 criteria for transvestic disorder?

An individual who:

• Experiences recurrent, intense sexual arousal from cross-dressing

• Has had these urges or behaviors for at least 6 months

• Experiences clinically significant distress or impairment because of them.

Note: Cross-dressing alone is not a disorder unless it causes distress or impairment.

What distinguishes transvestic disorder from simply cross-dressing?

Transvestic disorder requires:

• Sexual arousal from cross-dressing

• Symptoms lasting 6 months or more

• Significant distress or impairment

Cross-dressing by itself is not considered a mental disorder.

Persistent pain experienced by women during sexual intercourse is called what?

Genito-Pelvic Pain/Penetration Disorder (GPPPD)

This involves:

• Persistent pain during penetration

• Fear or anxiety about pain

• Pelvic muscle tightening

What is delayed ejaculation?

A sexual dysfunction in which a male experiences:

• Marked delay in ejaculation, or

• Inability to ejaculate despite adequate sexual stimulation,
  causing significant distress.

What is delayed ejaculation characterized by?

Difficulty or inability to reach ejaculation despite sufficient arousal and stimulation.

Dean can only reach orgasm while holding and kissing a woman's shoe. Which paraphilia does this describe?

Fetishistic Disorder

What is fetishistic disorder?

A paraphilic disorder involving sexual arousal from nonliving objects or specific non-genital body parts, causing distress or impairment.

Examples:

• Shoes

• Underwear

• Leather

• Feet

Which paraphilia involves sexual arousal from nonliving objects?

Fetishistic Disorder is getting aroused from nonliving objects.

Which individual is most likely to be diagnosed with gender dysphoria?

A person who experiences:

• A marked incongruence between their experienced gender and assigned sex

• Persistent distress lasting at least 6 months

• Significant distress or impairment in daily functioning

What is gender dysphoria?

Significant distress caused by a mismatch between one's gender identity and assigned sex at birth.

What is required for a diagnosis of gender dysphoria?

• Persistent gender incongruence (typically 6 months or more)

• Clinically significant distress or impairment

What does androphilic type of gender dysphoria mean?

An individual with gender dysphoria who is sexually attracted to males.

Memory Tip:
Andro = male

In gender dysphoria, what does "androphilic" mean?

Sexual attraction toward men.

What is autogynephilia?

A pattern in which a biological male is sexually aroused by the thought or image of themselves as a woman.

A pattern in which a biological male is sexually aroused by the thought or image of themselves as a woman.

The thought or fantasy of oneself being female.

A man reports almost no interest in sex and is distressed by it. Which disorder is most likely?

Hypoactive Sexual Desire Disorder

A man cross-dresses for sexual excitement but experiences no distress or impairment. Does he meet DSM-5 criteria for transvestic disorder?

No. Cross-dressing alone is not a mental disorder. Distress or impairment is required.

A woman experiences severe pain during intercourse. Which disorder is most likely?

Genito-Pelvic Pain/Penetration Disorder

A man cannot ejaculate despite adequate sexual stimulation and finds this distressing. Which disorder is most likely?

Delayed Ejaculation

What is a personality disorder?

A persistent, inflexible pattern of thinking, feeling, and behaving that:

• Deviates from cultural expectations

• Causes distress or impairment

• Begins by adolescence or early adulthood

• Is stable over time

How are personality disorders grouped?

They are divided into three clusters:

• Cluster A: Odd or eccentric

• Cluster B: Dramatic, emotional, or erratic

• Cluster C: Anxious or fearful

Which personality disorder is characterized by pervasive distrust and suspiciousness?

Paranoid Personality Disorder

What are the hallmark symptoms of Paranoid Personality Disorder?

• Distrusts others

• Believes others intend harm

• Holds grudges

• Reluctant to confide in others

• Interprets harmless remarks as threats

• Constantly suspicious

Memory Tip: "Everyone is out to get me."

Which personality disorder is characterized by detachment from social relationships?

Schizoid Personality Disorder

What are the hallmark symptoms of Schizoid Personality Disorder?

• Prefers to be alone

• Little desire for close relationships

• Limited emotional expression

• Appears cold or indifferent

• Enjoys solitary activities

Memory Tip: "I don't need people."

Which personality disorder involves odd beliefs and eccentric behavior?

Schizotypal Personality Disorder

What are the hallmark symptoms of Schizotypal Personality Disorder?

• Odd beliefs or magical thinking

• Unusual perceptual experiences

• Peculiar speech

• Eccentric behavior

• Social anxiety

• Suspiciousness

Memory Tip: "Eccentric and socially awkward."

Which personality disorder is characterized by disregard for the rights of others?

Antisocial Personality Disorder

What are the hallmark symptoms of Antisocial Personality Disorder?

• Violates laws

• Lies and manipulates

• Impulsive

• Aggressive

• Irresponsible

• Lacks remorse

• Disregards others' rights

Memory Tip: "No guilt."

Which personality disorder is characterized by unstable relationships and fear of abandonment?

Borderline Personality Disorder

What are the hallmark symptoms of Borderline Personality Disorder?

• Fear of abandonment

• Unstable relationships

• Unstable self-image

• Mood swings

• Impulsivity

• Self-harm or suicidal behavior

• Intense anger

• Chronic feelings of emptiness

Memory Tip: "I hate you—don't leave me."

Which personality disorder involves excessive attention-seeking?

Histrionic Personality Disorder

What are the hallmark symptoms of Histrionic Personality ?

• Constant attention seeking

• Dramatic emotions

• Sexually provocative behavior

• Shallow emotions

• Easily influenced

• Wants to be the center of attention

Memory Tip: "Look at me!"

Which personality disorder is characterized by grandiosity and lack of empathy?

Narcissistic Personality Disorder

What are the hallmark symptoms of Narcissistic Personality Disorder?

• Grandiose sense of self-importance

• Needs admiration

• Lack of empathy

• Sense of entitlement

• Exploits others

• Believes they are special

• Arrogant behavior

Memory Tip: "I'm better than everyone."

What are the four types of narcissism?

1. Grandiose Narcissism

2. Vulnerable Narcissism

3. Malignant Narcissism

4. Communal Narcissism

What is Grandiose Narcissism?

• Arrogant

• Dominant

• Outgoing

• Craves admiration

• Believes they are superior

What is covert narcissism?

• Sensitive to criticism

• Insecure

• Defensive

• Shy but still feels entitled

• Easily hurt