Psychopathology - Exam 3

reinforced by ineffective parenting practices

“cohesive family model” of CD

parent management training, problem-solving skills for the kid

helpful types of interventions for CD treatment

group of conditions that start in childhood and persist into adulthood, the result of disruptions to brain development

neurodevelopmental disorder

both groups experienced similar levels of attention improvement and increased levels of dopamine in the striatum

differences between how ritalin affected people with ADHD vs controls

because it increased performance and dopamine levels in both groups, ritalin has therapeutic effects but doesn’t target the root deficiencies

how differences in the effects of ritalin prove that ADHD isn’t a result of dopamine dysfunction

rigorous psychiatric testing, reports from parents, teachers, then behavior management and maybe medication

clinical guidelines for treating children with ADHD

children tend to have more hyperactivity, adults tend to have more emotional and organizational problems

ADHD symptoms in children vs adults

for kids, you can assess impairment through reports from teachers and parents, but for adults that is often impossible, so clinicians have to rely on self-reporting symptoms that might be masked by other issues

difference in assessing ADHD in adults vs children

black people are more likely to be diagnosed with disorders involving hostility and aggression and less likely to be diagnosed with internalizing disorders

pattern of race-related biases in diagnoses presented in “Psychiatrist Reach Out to Teens of Color”

can lead to the wrong care, improper medication, school detention or misperception by justice system

why are race-related misdiagnoses concerning in terms of outcomes for children?

start early in development, have persistent course, range from global to very specific, tend to co-occur

neurodevelopmental disorder characteristics

inattention and hyperactivity/impulsivity

major categories of adhd symptoms

difficulty listening, not following instructions, losing things all the time, careless mistakes, difficulty organizing/planning things

inattention examples

running around when not supposed to, fidgeting, not being able to sit still, don’t enjoy quiet play, can't wait their turn

hyperactivity/impulsivity examples

symptoms occur in 2+ settings, are disruptive and developmentally inappropriate, present before age 12

additional criteria for adhd

combined, predominant inattentive, predominant hyperactive-impulsive

three subtypes of adhd

combined

most common subtype of adhd

more boys are diagnosed than girls

pattern of differences in rates of adhd between boys and girls

more parents of boys are seeking treatment, boys might have naturally higher rates too

reasons for differences in rates of adhd between boys and girls

ADHD must have presented in childhood or it isn’t ADHD

DSM’s perspective on the role of childhood symptoms in diagnosing ADHD in adults

some kids grow out of it and some adults who didn’t present symptoms as kids would qualify

how the DSM’s perspective on the role of childhood symptoms in diagnosing ADHD in adults clashes with longitudinal data presented in class

many children and toddlers are being prescribed them without trying other treatment, we don’t know what they do to kids’ brains long term

concerns associated with stimulants to treat adhd

can help you focus, don’t actually improve the amount you learn

stimulants’ effectiveness

there is no evidence

evidence for the “paradoxical effect” in adhd meds

immaturity hypothesis of adhd

the idea that there are areas of your brain that are following a normal developmental trajectory, but are a little behind if you have ADHD

biology (moderately high heritability), other than that we don’t know

causal factors linked to the development of adhd

Broca's area (area of the frontal lobe involved in speech production)

where in the brain is there elevated activity during schizophrenic hallucinations

hallucinations might be internally-generated speech that is confused as coming from an external source

what the location of brain activity during hallucinations suggests

had delusions/hallucinations for 2 or more weeks in lifetime when not in mood episode

schizoaffective disorder diagnostic criteria

episode lasts 1-6 months

schizophreniform disorder diagnostic criteria

episode is 1 day to 1 month and they return to full level of functioning after

brief psychotic disorder diagnostic criteria

a good amount had schizophrenia suggesting that it may remain unexpressed unless released by environmental factors

findings regarding the offspring of non-diagnosed discordant MZ twins

the MZ twins who share placentas and fetal circulations are more likely to both develop schizophrenia

the difference between MZ and DZ twins’ relevance to the “virus” theory

motor abnormalities, less positive/more negative facial motion, delayed speech/motor development, deviant personalities

factors that seemed to predict schizophrenia according to home videos

first-degree family members of patients with schizophrenia are more likely to have problems with P50 suppression

findings regarding P50 suppression

a greater likelihood of having schizophrenia

what enlarged brain ventricles in schizophrenia patients indicate

basic rights of others or major societal rules are violated

conduct disorder diagnostic criteria

angry/irritable mood, argumentative/defiant behavior

oppositional defiant disorder diagnostic criteria

many will end up with a personality disorder diagnosis, involved with the legal system, perpetrators of domestic violence

later in life prospects for children with CD

they don’t feel bad when faced with punishment, making them unable to learn from it

findings on how children with CD and ODD respond to punishment

downward drift (behaviors can cause poverty), social influences (poverty can cause behaviors)

two possible explanations for why ODD and CD are seen more in low SES areas

it shows that when people were lifted out of poverty, their rates of CD and ODD went down

how the “casino study” sheds light on SES and ODD/CD

abusive and neglectful

types of parenting associated with ODD/CDD

behavioral treatment, however it is very difficult, no medications work

types of treatments used for children with ODD/CD

people with schizophrenia are seen as violent and dangerous

how the stigma around schizophrenia is different

onset peaks in late adolescence to early adulthood for males and shifts a little later for females

pattern of gender differences in schizophrenia onset

level of conviction, amount of evidence in shared reality, amount of marked interference

how psychologists distinguish delusions from other types of unusual beliefs

clearly implausible and not understandable by peers that share the same culture

what defines a “bizarre” delusion

patients with schizophrenia who developed the flu experienced remission, babies born to mothers who had the flu while pregnant were more likely to have it, children who get lots of infections while young have increased rates

types of findings/methods linking the flu/other viral infections to schizophrenia

the flu might interfere with fetal development or bring on an autoimmune disorder that attacks the brain

explanation for why viral exposure might increase the risk of developing schizophrenia

coordinated therapeutic approach: teaching the patient not to fear their hallucinations, working with family, advocating for the patient in school, prescribing medication

components of the “new” type of treatment for schizophrenia

the evidence that these meds improve outcomes is debatable and some studies say that long-term usage of them can cause brain atrophy

why antipsychotics have been a disappointment to practitioners and patients

hallucination

perception-like experiences that happen without an external stimulus and are indistinguishable from the real thing

auditory

most common type of hallucination

hallucinations, delusions, disorganized symptoms

key schizophrenia DSM diagnostic criteria

disorganized speech, grossly disorganized/abnormal behavior

disorganized symptoms

diminished emotional expression, avolition, alogia, anhedonia, asociality

negative symptoms

symptoms indicating a psychotic disorder but causing less impairment, usually occurs following puberty, if caught in this stage can make treatment of the larger illness smoother

prodromal symptoms of schizophrenia

nutritional deficiency, blood type incompatibility, oxygen deprivation, diabetes, low birth weight, maternal weight, c-section, maternal infections, urban births, late fatherhood, season of birth, maternal stress

environmental/prenatal factors that increase the risk for schizophrenia

progressive changes (increases in myelination, growth in amygdala, hippocampus), regressive changes (synaptic pruning), adrenal hormones may increase sensitivity to stress, which can affect brain development

how adolescent brain development plays a role in schizophrenia

second generation acts on serotonin too, tends to cause big weight gain

differences between first/second generation antipsychotics

positive symptoms

types of symptoms antipsychotics are more effective against

tardive dyskinesia

a movement disorder caused by some antipsychotics that causes involuntary, repetitive movements

a set of general criteria for all PDs, a dimensional measure of the severity, a set of PD types, and a set of pathological personality traits

the proposed hybrid dimensional-categorical assessment model for PDs

we don’t know for sure but it could be that the system was very complicated

why the hybrid dimensional-categorical assessment model for PDs was abandoned by the DSM task force

there is a genetic relationship and people with both disorders exhibit similar cognitive behaviors

evidence for the link between schizotypal PD and schizophrenia

is involved in the breakdown of the neurotransmitters N, S and D

what MAO-A does

children were much more likely to develop ASPD if they had low levels of MAO-A and experienced maltreatment

research findings on ASPD and MAO-A

yes, patients with BPD report significantly higher rates of childhood abuse

is there strong evidence linking BPD to childhood adversity/abuse?

they actually want interpersonal contact but are shy, insecure, and hypersensitive to criticism

how avoidant PD is different from schizoid PD (limited social relationships)

the increased cardiac reactivity of the successful psychopaths might help them process what is going on in risky situations and make decisions that prevent their capture

findings regarding cardiac reactivity in successful vs. unsuccessful psychopaths

they have low trait anxiety and show poor conditioning of fear, psychopathic prisoners did not show a larger startle response if already in an anxious state

findings regarding psychopaths and fear conditioning/fear-potentiated startle

almost impossible to accurately diagnose young people whose brains are still growing, the social cost is very high for both the kid and parents

risks associated with labeling young children as psychopaths

they don’t care if someone is mad at them, they cause much more mayhem

difference between appearance of callous-unemotional children and those with ADHD/CD

they are related to low levels of cortisol and below-normal function in the amygdala

findings regarding cold-blooded behaviors and the brain

the drug suppresses their impulsive behavior and might enable them to execute crueler plans in secret

why treating callous-unemotional(?) children with Ritalin is less than ideal

less gray matter in the limbic system, particularly the amygdala, overactive reward system

2 “neural abnormalities" associated with psychopathy

rewards instead of punishment for callous-unemotional juveniles

the treatment approach at Mendota

pattern of behavior that deviates from cultural expectations (in 2+ areas: cognition, affectivity, impulsivity, interpersonal functioning), occurs in multiple situations, causes impairment, started in childhood

overall criteria for personality disorders

only in unusual circumstances and aspd absolutely not before 18

guidelines for diagnosing personality disorders in children

paranoid pd

pervasive suspicion/distrust of others, associated with drug use, head trauma

schizoid pd

avoid interactions with other people because they don’t want to

schizotypal pd

magical thinking, eccentric behavior, social anxiety

antisocial pd

disregard for and lack of violation of rights of others

borderline pd

instability in moods, self-image, and relationships, strong fear of abandonment

histrionic pd

excessive emotionality, attention-seeking behaviors, dramatic displays

narcissistic pd

unreasonably high sense of self importance

avoidant pd

extreme shyness, self-doubt, hypersensitivity to negative evaluation

dependent pd

excessive and pervasive need to be taken care of

obsessive-compulsive pd

pervasive preoccupation with orderliness, perfectionism and control

personality is not categorical, criteria is vague, too much comorbidity and heterogeneity, low reliability in diagnosing, too much stigma, limited access to diagnostic info, bias in formulation/application

common criticisms of the concept of pds and their diagnosis

interpersonal, affective, lifestyle, antisocial

four main dimensions of psychopathy

aspd is focused on behavioral symptoms, psychopathy includes behavioral symptoms as well as internal coldness, lack of empathy

how psychopathy differs from antisocial pd

careful, slow, in-depth, one-on-one interview, psychopathy checklist score 29+

how psychopathy is typically assessed

being so focused on yourself can be a primary source of unhappiness and maladjustment

the “self-reflection paradox”

an identity that incorporates others without losing yourself

what having a “quiet ego” means

place your worth among the worth of others, be humble

practical advice offered for cultivating a quieter ego

working collaboratively on the problem, agreement about the goals and tasks, an affective bond

characteristics of a therapeutic alliance

client reports, clinician’s ratings of the reports, reports from family/friends, comparison of pretreatment and posttreatment scores, measures of change in specific behaviors

5 ways of measuring success in therapy

helpful in therapy/clinical settings to determine quantitative change, the client isn’t always reliable

client ratings weakness/strength