[2Y2T2S] [PT10110] [1.3] Recognizing Psychopathology (Feeding/Eating Disorders - Personality Disorders)

• Persistent disturbance of eating or eating-related behavior

• Significantly impairs physical health or psychosocial functioning

Feeding and Eating Disorders

Eating of nonnutritive, nonfood substances on a persistent basis

Pica

PICA

How long should symptoms be present?

At least 1 month

Repeated regurgitation of food occurring after eating

Rumination disorder

RUMINATION DISORDER

How long should symptoms be present?

At least 1 month

Avoidance or restriction of food intake manifested by clinically significant failure to meet requirements for nutrition or insufficient energy intake through oral route

Avoidant/Restrictive Food Intake Disorder

• Persistent energy intake restriction

• Intense fear of gaining weight or of becoming fat

• Persistent behavior that interferes with weight gain

• Disturbance in self perceived weight or shape

Anorexia nervosa

• Recurrent episodes of binge eating

• Recurrent inappropriate compensatory behaviors to prevent weight gain

• Self evaluation that is unduly influenced by body shape and weight

Bulimia nervosa

• Recurrent episodes of binge eating

• Must occur, on average, at least once per week for 3 months

• No compensatory behavior

Binge-eating disorder

• Repeated voiding in inappropriate place

• At least 5 years of age

Enuresis

• Repeated passage of feces in inappropriate places

• At least 4 years of age

Encopresis

ELIMINATION DISORDER

When are these disorders usually first diagnosed?

Childhood or adolescence

ELIMINATION DISORDER

True or False: Elimination disorder is not limited and eventually remits

False: Elimination disorder is self-limited and eventually remits

• Problems with quality, timing, and amount of sleep

• Significant daytime distress and impairment in function

Sleep Wake Disorders

SLEEP

Recommended Daily Sleep Duration for School-Aged Children (6-13 y/o)

9-11 hours

SLEEP

Recommended Daily Sleep Duration for Teenagers (14-17 y/o)

8-10 hours

SLEEP

Recommended Daily Sleep Duration for Young Adults (18-25 y/o)

7-9 hours

SLEEP

Recommended Daily Sleep Duration for Adults (26-64)

7-9 hours

SLEEP

Recommended Daily Sleep Duration for Older Adults (65+ y/o)

7-8 hours

• Restorative, homeostatic function

• Crucial for normal thermoregulation and energy conservation

Sleep

• Prolonged period can lead to ego disorganization, hallucinations, and delusions

• Irritability, lethargy

Sleep deprivation

Six (6) ways to keep a good sleep hygiene

1. Stick to a sleep schedule

2. Allow body to wind down

3. Avoid naps

4. Exercise daily

5. Optimum bedroom environment

   • Blackout, avoid noise, optimum temperature

6. Avoid alcohol, caffeine, and heavy meals in the evening

• Problems in self control of emotions and behaviors

• Behaviors that violate the rights of others and/or has conflict with societal norms or authority figures

Disruptive, Impulse Control and Conduct Disorders

DISRUPTIVE, IMPULSE CONTROL, AND CONDUCT DISORDERS

More common in what sex?

Males

• A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness

• Associated with distress in the individual or others in his or her immediate social context

• Negatively impacts important areas of functioning

Oppositional Defiant Disorder

OPPOSITIONAL DEFIANT DISORDER

How long should the symptoms last?

At least 6 months

• Recurrent behavioral outbursts representing a failure to control aggressive impulses

• Not premeditated

• Cause marked distress or impairment in occupational or interpersonal functioning

• Associated with financial or legal consequences

Intermittent Explosive Disorder

INTERMITTENT EXPLOSIVE DISORDER

What is the chronological age/equivalent developmental level?

At least 6 years

• A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated

• Four (4) Criterion involved:

  • Aggression to people and animals

  • Destruction of property

  • Deceitfulness or Theft

  • Serious Violations of Rules

• Causes clinically significant impairment

Conduct disorder

CONDUCT DISORDER

How long should the behavior be present (for at least 3/15 criterion)?

Past 12 months

• Deliberate and purposeful fire setting on more than one occasion

• Tension or affective arousal before the act

• Pleasure, gratification, or relief when setting fires or when witnessing or participating in their aftermath

Pyromania

• Recurrent failure to resist impulses to steal objects

• Increasing sense of tension immediately before committing the theft

• Pleasure, gratification, or relief at the time of committing the theft

Kleptomania

• Stealing is not committed to express anger or vengeance

• Stealing is not in response to a delusion or a hallucination

Kleptomania

Cluster of cognitive, behavioral and physiological symptoms indicating the individual continues using substance despite significant related problems

Substance Related and Addictive Disorders

SUBSTANCE RELATED AND ADDICTIVE DISORDERS

What type of dependence is described below:

• Substance seeking activities, related evidence of pathological use patterns are emphasized

Behavioral dependence

SUBSTANCE RELATED AND ADDICTIVE DISORDERS

What type of dependence is described below:

• Physiological effects of substance use

Physical dependence

SUBSTANCE RELATED AND ADDICTIVE DISORDERS

Continuous or intermittent craving for the substance to avoid a dysphoric state

Habituation/Psychological Dependence

SUBSTANCE RELATED AND ADDICTIVE DISORDERS

Reversible syndrome caused by a specific substance that affects one or more of the following mental functions:

• Memory

• Orientation

• Mood

• Judgement

• Behavioral, social, or occupational functioning

Intoxication

SUBSTANCE RELATED AND ADDICTIVE DISORDERS

• Substance specific syndrome that occurs after stopping or reducing the amount of drug that has been used over a prolonged period

• Physiological signs and symptoms in addition to psychological changes

Withdrawal

• Acute decline in both level of consciousness and cognition with particular impairment in attention

• May be life threatening but potentially reversible

• Involve perceptual disturbance, abnormal psychomotor activity, and impaired sleep cycle

Delirium

DEMENTIA VS. DELIRIUM

Differentiate the onset

Dementia: Slow

Delirium: Rapid

DEMENTIA VS. DELIRIUM

Differentiate the duration

Dementia: Months to years

Delirium: Hours to weeks

DEMENTIA VS. DELIRIUM

Differentiate the attention

Dementia: Preserved

Delirium: Fluctuates

DEMENTIA VS. DELIRIUM

Differentiate the memory

Dementia: Impaired remote memory

Delirium: Impaired recent and immediate memory

DEMENTIA VS. DELIRIUM

Differentiate the speech

Dementia: Word-finding difficulty

Delirium: Incoherent (slow or rapid)

DEMENTIA VS. DELIRIUM

Differentiate the sleep-wake cycle

Dementia: Fragmented sleep

Delirium: Frequent disruption

DEMENTIA VS. DELIRIUM

Differentiate the thoughts

Dementia: Impoverished

Delirium: Disorganized

DEMENTIA VS. DELIRIUM

Differentiate the awareness

Dementia: Unchanged

Delirium: Reduced

DEMENTIA VS. DELIRIUM

Differentiate the alertness

Dementia: Usually normal

Delirium: Hypervigilant or reduced vigilance

• Progressive cognitive impairment in setting of clear consciousness

• Significant impairment in social and occupational functioning

Dementia

DEMENTIA

Four (4) types of dementia

1. Alzheimer disease

2. Dementia of Lewy body

3. Vascular dementia

4. Frontotemporal dementia

DEMENTIA

What type of dementia is described below:

• Deposition of neurofibrillary tangles

• Presence of senile plaques

Alzheimer disease

DEMENTIA

What type of dementia is described below:

• Multiple infarct dementia

Vascular dementia

DEMENTIA

What type of dementia is described below:

• Preponderance of atrophy in the frontotemporal regions

• Presence of pick bodies

Frontotemporal dementia

ALZHEIMER’S DEMENTIA VS. AMNESTIC DISORDER

Differentiate the onset

Alzheimer’s Dementia: Insidious

Amnestic Disorder: Can be abrupt

ALZHEIMER’S DEMENTIA VS. AMNESTIC DISORDER

Differentiate the course

Alzheimer’s Dementia: Progressive deterioration

Amnestic Disorder: Static or improvement

ALZHEIMER’S DEMENTIA VS. AMNESTIC DISORDER

True or False: Only anterograde and retrograde memory are impaired in Alzheimer’s dementia

False: All of the following are impaired:

• Anterograde and retrograde memory

• Episode memory

• Semantic memory

• Language

• Praxis or function

ALZHEIMER’S DEMENTIA VS. AMNESTIC DISORDER

What is the status of the following in Amnestic Disorder?

• Anterograde memory

• Retrograde memory

• Episodic memory

• Semantic memory

• Language

• Praxis or function

Amnestic Disorder

• Anterograde memory = Impaired

• Retrograde memory = Temporal gradient

• Episodic memory = Impaired

• Semantic memory = Intact

• Language = Intact

• Praxis or function = Intact

PERSONALITY DISORDER

What cluster is being described below:

• Odd, aloof features

Cluster A

PERSONALITY DISORDER

What cluster is being described below:

• Dramatic, impulsive, and erratic

Cluster B

PERSONALITY DISORDER

What cluster is being described below:

• Anxious and fearful features

Cluster C

PERSONALITY DISORDER

Give the three (3) PD under Cluster A

1. Paranoid

2. Schizoid

3. Schizotypal

PERSONALITY DISORDER

Give the four (4) PD under Cluster B

1. Antisocial

2. Borderline

3. Histrionic

4. Narcissistic

PERSONALITY DISORDER

Give the three (3) PD under Cluster C

1. Avoidant

2. Dependent

3. OC

PERSONALITY DISORDER

Give the cluster and PD type described below:

• Pattern of distrust and suspiciousness

Cluster A — Paranoid

PERSONALITY DISORDER

Give the cluster and PD type described below:

• Pattern of detachment from social relationships and restricted range of emotional expression

Cluster A — Schizoid

PERSONALITY DISORDER

Give the cluster and PD type described below:

• Pattern of acute discomfort in close relationships, cognitive or perceptual distortions and eccentricities of behavior

Cluster A — Schizotypal

PERSONALITY DISORDER

Give the cluster and PD type described below:

• Pattern of disregard for, violation of, the rights of others

Cluster B — Antisocial

PERSONALITY DISORDER

Give the cluster and PD type described below:

• Pattern of instability in interpersonal relationships, self-image and affects, and marked impulsivity

Cluster B — Borderline

PERSONALITY DISORDER

Give the cluster and PD type described below:

• Pattern of excessive emotionality and attention seeking

Cluster B — Histrionic

PERSONALITY DISORDER

Give the cluster and PD type described below:

• Pattern of grandiosity, need for admiration and lack of empathy

Cluster B — Narcissistic

PERSONALITY DISORDER

Give the cluster and PD type described below:

• Pattern of social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation

Cluster C — Avoidant

PERSONALITY DISORDER

Give the cluster and PD type described below:

• Pattern of submissive and clinging behavior related to an excessive need to be taken care of

Cluster C — Dependent

PERSONALITY DISORDER

Give the cluster and PD type described below:

• Pattern of preoccupation with orderliness, perfectionism, and control

Cluster C — OC