Synopsis of Psychiatry Study Guide

CHAPTER 2 - ANSWERSCHAPTER 2 Who created a broad theoretical system for the development of cognitive abilities? - ANSWERSJean Piaget What is epistemology? - ANSWERSStudy of development of abstract thought on the basis of a biological or innate substrate According to Piaget, what are the four major stages that lead to the capacity for adult thought and and what age range does each occur? - ANSWERSSensorimotor (birth to 2 years), preoperational thought (2 to 7 years), concrete operations (7 to 11 years), and formal operations (11 through adolescence) In what stage of Piaget development does the child understand that melted ice in the form of water can turn back to water (reversibility)? - ANSWERSConcrete operations A child believe that bad thoughts cause accidents. What is this called and in what stage of Piaget development does it occur? - ANSWERSPhenomenalistic causality; Preoperational thought What are the critical developmental achievements of the sensorimotor stage? - ANSWERSObject permanence and symbolization A child recognizes that when a ball of clay is rolled into a sausage shape there is still the same amount of clay. What ability is this child demonstrating and during what stage of Piaget development does this occur? - ANSWERSConservation; Concrete operations What is the tendency to endow physical events and objects with life-like psychological attributes and in what Piaget stage of development does this occur? - ANSWERSAnimistic thinking; Preoperational In the Piaget stage of concrete operations, what is egocentric thought replaced by? - ANSWERSOperational thought which involves dealing with a wide array of information outside of the child. Children can now see things from someone's else perspective All horses are mammals, all mammals are warm blooded, therefore all horses are warm blooded...this is what type of reasoning and during what stage of Piaget development does it occur? - ANSWERSSyllogistic reasoning; Concrete operations Who studied infant attachment and separation and pointed out that mother-child attachment was an essential medium of human interaction that had important consequences for later development? - ANSWERSJohn Bowlby Who demonstrated the emotional and behavioral effects of isolating monkeys form birth and keeping them from forming attachments? - ANSWERSHarry Harlow Mary Ainsworth is know for describing what 3 main types of insecure attachment? - ANSWERSInsecure-avoident, insecure-ambivalent, and insecure-disorganized 65% of infants are securely attached by what age? - ANSWERS25 months What are the three types of signal indicators in infants? - ANSWERSHunger, anger, and pain What are the three sequences of behavior patterns in children that are operated from their mothers for long periods of time? - ANSWERSProtest, despair, and detachment In Pavlovian conditioning, what are the following called...food, bell, new response to the bell, and the natural response to the food itself? - ANSWERSUnconditional stimulus, conditional stimulus, conditional response, and unconditional response Who was Pavlovian conditioning developed by? - ANSWERSIvan Pavlov Who was operant conditioning developed by? - ANSWERSB.F. Skinner What is Pavlovian conditioning? - ANSWERSOccurs when neutral stimuli are associated with a psychologically significant event What is operant conditioning? - ANSWERSOccurs when a behavior (instead of a stimulus) is associated with a psychologically significant event What is sign tracking? - ANSWERSWhen a CS signals a positive US, the CS will tend to evoke approach behaviors What is extinction? - ANSWERSLearned behavior decreases when the US or reinforcer A person who gets sick of drinking an alcoholic beverage and consequently learns to hate the flavor is an example of what type of conditioning? - ANSWERSPavlovian conditioning Give an example of a compensatory response? - ANSWERSAlcohol causes a drop in body temperature, a conditioned response to a CS associated with alcohol is typically an increase in body temperature What is it called when some stimuli are especially effective signals for some USs because evolution has made them that way? - ANSWERSPreparedness How does extinction occur? - ANSWERSConditioned response decreases if the CS is presented repeatedly without the US after conditioning How does counterconditioning occur? - ANSWERSCS is paired with a very different US/UR What is a drug that can be used to improve long-term potentiation and can possibly facilitate extinction learning in humans undergoing exposure therapy for anxiety disorders and which receptor does it work on? - ANSWERSD-cycloserine; N-methyl-D-aspartate (NMDA) What is a reinforcer? - ANSWERSAny event that could be shown to increase the strength of an operant if it was made a consequence of the operant What is incentive learning and give and example? - ANSWERSProcess of learning about the effects the reinforcer has on the motivational state; Hunger invigorated the instrumental action only if the animal had previously experienced the reinforcer in that state Figure 2.3-3 - ANSWERSPage 108-109 What biological changes occur during short-lasting plasticity? - ANSWERSIncrease in neurotransmitter release What biological changes occur during long-lasting plasticity? - ANSWERSNew protein synthesis, physical growth of neural processes, and an increase in the number of synaptic connections What are the main cortical pathways for visual information starting after the primary visual cortex? - ANSWERSVentrally to the inferotemporal cortex (identification of visual objects) and dorsally to the parietal cortex (processes information about spatial location) Alcoholic Korsakoff's syndrome causes amnesia due to destruction in what area of the brain? - ANSWERSDiencephalon Figure 2.4-3 - ANSWERSPage 114 Amnesia effects what kind of memory? - ANSWERSDeclarative memory What is declarative memory? - ANSWERSConscious recollection of facts and events What abilities are included in non-declarative learning? - ANSWERSSkill learning, habit learning, simple forms of conditioning, and priming A patient cannot remember word lists and stories (verbal material), which part of the brain is damaged? - ANSWERSMedial temporal or diencephalic structures in the left cerebral hemisphere A patient cannot remember faces, spatial layouts, and other nonverbal material, which part of the brain is damaged? - ANSWERSMedial temporal or diencephalic structures in the right cerebral hemisphere A patient has impaired memory for spoken and written text, which part of the brain is damaged? - ANSWERSLeft medial temporal lobe A patient has impaired learning of spatial arrays, whether the layouts are examined by vision or by touch, which part of the brain is damaged? - ANSWERSRight medial temporal lobe How can psychogenic amnesia and neurological amnesia be distinguished? - ANSWERSPsychogenic amnesia typically does not affect new-learning capacity while neurological amnesia does When does declarative memory first become fully available? - ANSWERSThird year of life The capacity for declarative memory is linked to the development of what brain structure? - ANSWERSNeocortex What are the six conceptualizations of mental health? - ANSWERSAbove normal, maturity, positive psychology, emotional intelligence, subjective well-being, and resilience What are the four crucial development criteria that transform a job or hobby into a career? - ANSWERSContentment, compensation, competence, and commitment Various studies have located human pleasurable experience to what part of the brain? - ANSWERSLimbic areas, especially the orbitofrontal region, anterior cingulate, and insula What parts of the brain are the most responsible for making the past meaningful? - ANSWERSAnterior cingulate gyrus and hippocampus What is the purpose of the prefrontal cortex? - ANSWERSEstimates rewards and punishments and plays a critical role in adapting and regulating our emotional response to new situations What is the purpose of the insula? - ANSWERSBring visceral feelings of emotions into consciousness What is the purpose of spindle cells and where are they located? - ANSWERSMediate empathy; Anterior cingulate cortex, prefrontal cortex, and the insula What are the four sources of conflict that can result in the production of involuntary coping mechanisms? - ANSWERSImpulse, reality, people, and social learning What are the five aspects of maturity in regards to mental health? - ANSWERSIdentity, intimacy, career consolidation, generatively, and integrity What are eight positive emotions? - ANSWERSLove, hope, joy, forgiveness, compassion, faith, awe, and gratitude What are the seven emotions that can be linked to facial expressions? - ANSWERSAnger, fear, excitement, interest, surprise, disgust, and sadness What are the three classes of coping mechanisms? - ANSWERSConsciously seeking social support, conscious cognitive strategies, and adaptive involuntary coping What are five healthly involuntary coping mechanisms? - ANSWERSHumor, altruism, sublimation, suppression, and anticipation What does DSM stand for? - ANSWERSDiagnostic and Statistical Manual of Mental Disorders What does ICD stand for? - ANSWERSInternational Classification of Diseases What is the newest version of the DSM and ICD? - ANSWERSDSM-5 and ICD-10 When was the first version of the DSM published? - ANSWERS1952 Significant, below average intelligence and impairment in adaptive functioning? - ANSWERSIntellectual disability What are the four main communication disorders? - ANSWERSLanguage disorder, speech sound disorder, childhood-onset fluency disorder, and social/pragmatic communication disorder Severe difficulties in social relatedness, communication, and a range of activity and repetitive and stereotypical patterns of behavior, including speech? - ANSWERSAutism spectrum disorder Persistant inattention, hyperactivity and impulsivity, or both that cause clinically significant impairment in functioning? - ANSWERSAttention-deficit/hyperactivity disorder (ADHD) Difficulty acquiring specific skills in reading? - ANSWERSDyslexia Prominent hallucinations or delusions? - ANSWERSSchizophrenia What are the three phases of schizophrenia and what occurs at each stage? - ANSWERSProdrome phase: deterioration in function before onset of the active psychotic phase Active phase: actual symtoms Residual phase: follows active phase and resembles the prodrome phase What is the time frame of a brief psychotic disorder? - ANSWERS1 day but less than 1 month What is the time frame of schizophrenia? - ANSWERSat least 6 months What is the time frame of schizophreniform disorder? - ANSWERS1 and 6 months What is the time frame of schizoaffective disorder? - ANSWERSDelusions or hallucinations for at least 2 weeks without coexisting prominent mood symptoms Motor abnormalities such as catalepsy, mutism, posturing, and negativism? - ANSWERSCatatonia Severe mood swings between depression and elation and by remission and recurrence? - ANSWERSBipolar disorder Severe temper tantrums, chronic irritability, and angry mood diagnosed in children age 6 years and younger than age 18? - ANSWERSDisruptive mood dysregulation disorder What is an example of a medical condition that can cause OCD? - ANSWERSStreptococcal infection Memory loss of important personal information that is usually traumatic in nature? - ANSWERSDissociative amnesia Sudden travel away from home associated with partial or complete memory loss about one's identity? - ANSWERSDissociative fugue Deliberate feigning of physical or psychological symptoms to assume the sick role? - ANSWERSFactitious disorder Person believes falsely that she is pregnant? - ANSWERSPseudocyesis Eating of non-nutritional substances? - ANSWERSPica Repeated regurgitation of food, usually beginning in infancy and childhood? - ANSWERSRumination disorder Anger, irritability, defiance, and refusal to comply with regulations diagnosed in children and adolescence? - ANSWERSOppositional defiant disorder Uncontrolled outbursts of aggression? - ANSWERSIntermittent explosive disorder Fighting and bullying? - ANSWERSConduct disorder Repeated fire setting? - ANSWERSPyromania Repeated stealing? - ANSWERSKleptomania Severe impairment in memory, judgement, orientation, and cognition? - ANSWERSMajor neurocognitive disorder or dementia Name 10 subtypes of neurocognitive disorder? - ANSWERSAlzheimer's disease, vascular dementia, Lewy body dementia, frontotemporal dementia (Pick's disease), traumatic brain injury, HIV infection, substance/medication-induced dementia, Huntington's disease, and prion disease Chapter 4 - ANSWERSChapter 4 What are the three crucial aspects of psychoanalysis? - ANSWERSA therapeutic technique, body of scientific and theoretical knowledge, and a method of investigation What are the threefold aspects of the slender beginnings of when Freud immersed himself in the serious study of the disturbances in his hysterical patients? - ANSWERSEmergence of psychoanalysis as a method of investigation, as a therapeutic technique, and as a body of scientific knowledge What is the name of the publication by Freud that presented a theory of the dreaming process that parallel his earlier analysis of psychoneurotic symptoms? - ANSWERSThe Interpretation of Dreams What do dream images represent? - ANSWERSUnconscious wishes or thoughts, disguised through a process of symbolization and other distorting mechanisms What are the two layers of dream content? - ANSWERSManifest: what is recalled by the dreamer Latent: unconscious thoughts and wishes that threaten to awaken the dreamer What are unconscious mental operations by which latent dream content is transformed into manifest dream? - ANSWERSDream work Mechanism by which several unconscious wishes, impulses, or attitudes can be combined into a single image in the manifest dream content? - ANSWERSCondensation Transfer of amounts of energy from an original object to a substitute or symbolic representation of the object? - ANSWERSDisplacement Represents highly charged ideas or objects by using innocent images that were in some way connected with the idea or object being represented? - ANSWERSSymbolization What is secondary revision? - ANSWERSMore mature and reasonable aspect of the ego working during to dreams to organize primitive aspects of dreams into a more coherent form How did Freud view anxiety dreams? - ANSWERSHe viewed the above mechanisms as a way to facilitate the discharge of latent impulses, rather than as protecting dreamers from anxiety and pain How did Freud view punishment dreams? - ANSWERSHe believed these dreams reflected a compromise between repressed wish and the repressing agency or conscience In the topographical model of the mind, Freud divided the mind into what three regions and what is the action of each section? - ANSWERSConscious: part of the mind in which perceptions coming from the outside world or from within the body or mind are brought into awareness Preconscious: mental events processes, and contents that can be brought into conscious awareness by the act of focusing attention Unconsciousness: contents and processes are kept from consciouses awareness through the force of censorship or repression The unconscious system is characterized by what process of thinking? - ANSWERSPrimary process thinking In Freud's view, an instinct has what four principle characteristics and what is the description of each? - ANSWERSSource: part of the body from which the instinct arises Impetus: amount of force or intensity associated with the instinct Aim: action directed toward tension discharge or satisfaction Object: target of the aim (usually a person) What are the three major tenets of psychoanalysis that were brought forth when Freud published Three Essays on the Theory of Sexuality? - ANSWERSHe broadened the definition of sexuality to include forms of pleasure that transcend genital sexuality, established a developmental theory of childhood sexuality that delineated the vicissitudes erotic activity form birth through puberty, and he forged a conceptual ink between neuroses and perversions What are the 3 stages of sexuality? - ANSWERSOral, 12-18 months Anal, 18-36 months Phallic, 3 to 5 years What is ego libido? - ANSWERSEntire libidinal investment is in physical needs and their satisfaction What is object libido? - ANSWERSLibidinal investment is in the object What is secondary narcissism? - ANSWERSObject libido is withdrawn and reinvested in the ego Pathological traits of the oral stage? - ANSWERSExcessive optimism, narcissism, pessimism, demandingness, envy, and jealousy Pathological traits of the anal stage? - ANSWERSOrderliness, obstinacy, stubbornness, willfulness, frugality, and parsimony Pathological traits of the urethral stage? - ANSWERSCompetitiveness and ambition Pathological traits of the phallic stage? - ANSWERSFear of castration in males and penis envy females Pathological traits of the latency stage? - ANSWERSLack of development of inner controls or an excess of them Pathological traits of the genital stage? - ANSWERSDefects in emerging adult personality and identity formation What are the three provinces of the mind according to the structural theory of the mind and what is the responsibility of each? - ANSWERSId: reservoir of unorganized instinctual drives Ego: executive organ of the psyche, controls motility, perception, contact with reality, and, through the defense mechanism available to it, the delay and modulation of drive expression Superego: establishes and maintains an individual's moral conscience on the basis of complex system of ideals and values internalized from parents What are the functions of the ego? - ANSWERSControl and regulation of instinctual drives, judgement, relation to reality, object relationships, and synthetic function of the Ego Character traits owe their existence to the success of? - ANSWERSRepression/defense mechanisms What is the cornerstone of psychoanalytic technique? - ANSWERSFree association, patient says whatever comes to mind What concepts are central to Erikson's thought? - ANSWERSIdentity, identity crisis, and identity confusion What is stage one of the life cycle? - ANSWERSTrust versus mistrust (birth to about 18 months) What is stage two of the life cycle? - ANSWERSAutonomy versus shame and doubt (18 months to about 3 years) What is stage three of the life cycle? - ANSWERSInitiative versus guilt (3 years to about 5 years) What is stage four of the life cycle? - ANSWERSIndustry versus inferiority (5 years to about 13 years) What is stage five of the life cycle? - ANSWERSIdentity versus role confusion (13 years to about 21 years) What is stage six of the life cycle? - ANSWERSIntimacy versus isolation (21 years to about 40 years) What is stage seven of the life cycle? - ANSWERSGeneratively versus stagnation (40 years to about 60 years) What is stage eight of the life cycle? - ANSWERSIntegrity versus despair (60 years to death) What conclusion did Frankl come to after his experience in Nazi camps? - ANSWERSEven the most appalling circumstances could be endured if one found a way of making them meaningful Who believed in the self-actualization theory? - ANSWERSAbraham Maslow What is positive psychology? - ANSWERSStudy of what makes life worth living What are the seven correlates of positive psychology? - ANSWERSNumber of friends, being married, being extroverted, being grateful, being religious, pursuing leisure activities, and employment According to positive psychology, what is the most important contributor to a satisfied life? - ANSWERSHaving good relationships with other people A positive institution shares what core characteristics? - ANSWERSPurpose, safety, fairness, humanity, and dignity CHAPTER 17 - ANSWERSCHAPTER 17 Term used to describe personality development and functioning as these are affected by sexuality? - ANSWERSPsychosexual Sexuality depends on what four interrelated psychosexual factors? - ANSWERSSexual identity, gender identity, sexual orientation, and sexual behavior What causes for the differentiation from female to male in early development? - ANSWERSFetal androgens When does the above process begins and end? - ANSWERSSixth week and is completed by the end of the third month Testis develop as a result of the action of what genes? - ANSWERSSRY and SOX9 What gene plays a part in the development of both sexes? - ANSWERSDAX1 What gene is needed for the development of the mullerian ducts in females? - ANSWERSWNT4 Everybody has a strong sense of whether they are male or female by what age? - ANSWERS2 or 3 years The genetic influence on gender identity is active by what physiologically week of fetal life? - ANSWERS6th week Which parts of the cortex are involved in sexual behavior and for what specific parts? - ANSWERSOrbitofrontal cortex: emotions Left anterior cingulate cortex: hormone control and sexual arousal Right caudate nucleus: factor in whether sexual activity follows arousal Which parts of the limbic system are involved in sexual behavior and for what specific parts? - ANSWERSLower part of septum, contiguous pre optic area, fimbria of the hippocampus, mammillary bodies, and the anterior thalamic nuclei which all elicit penile erections Which parts of the brainstem are involved in sexual behavior and for what specific parts? - ANSWERSNucelus paragigantocellularis projects to neurons in the lumbosacral spinal cord which secrete serotonin which inhibits orgasm Which neurotransmitters are involved in sexual behavior and for what specific parts? - ANSWERSDopamine: increases libido Serotonin: inhibits sexaula function Oxytocin: reinforces pleasurable activities Which spinal cord are involved in sexual behavior? - ANSWERSSensory stimuli is conveyed via afferents from the pudendal, pelvic, and hypogastric nerves Sexual reflexes are mediated by spinal neurons in what region of the lumbosacral segments? - ANSWERSCentral gray region What role does estrogen play in sexual behavior in women? - ANSWERSKey factor in lubrication involved in female arousal and amy increase sensitivity What effect does progesterone, prolactin, and cortisol have in sexual behavior? - ANSWERSMildly depresses desire in men and women Both sexes begin genital stimulation at what age? - ANSWERS15 to 19 months The presence of desire depends on what factors? - ANSWERSBiological drive, adequate self-esteem, ability to accept oneself as a sexual person, availability of a partner, and a good relationship in nonsexual areas with a partner What medications causes a decrease in vaginal lubrication? - ANSWERSAntihistamine and anticholinergic drugs What is the diagnostic criteria for premature ejaculation? - ANSWERSWhen a man regularly ejaculates before or within approximately 1 minute after penetration What are the two types of genito-pelvic pain? - ANSWERSDyspareunia: recurrent or persistant genital pain occurring before, during, or after intercourse Vaginismus: constriction of the outer third of the vagina due to involuntary pelvic floor muscle tightness or spasm (interferes with penile insertion) Sclerotic plaques on the penis that cause penile curvature? - ANSWERSPeyronie's disease Table 17.2-9 - ANSWERSPage 583 How does alcohol effect testosterone levels in males and females? - ANSWERSMales: decreases Females: slight increase Type of neuropathy that can occur with the use of sildenafil? - ANSWERSNonarteritic ischemic optic neuropathy (NAION) Which antidepressant can increase sex drive in some patients? - ANSWERSBupropion Depressed, tense, anxious, irritable, and show psychomotor agitation after a satisfactory sexual experience? - ANSWERSPostcoital dysphoria What behavioral patterns are most often found in a sex addict? - ANSWERSParaphilias Use sexual activities to mask deep feelings of inferiority? - ANSWERSDon Juanism Women who complain of continual feeling of sexual arousal, which is uncomfortable, demands please, and interferes with life pleasures and activities? - ANSWERSPersisten genital arousal disorder (PGAD) What is the difference between sex addiction and PGAD in women? - ANSWERSWomen with PGAD are not even temporarily satisfied, physically or emotionally, by orgasm What is orgasmic anhedonia? - ANSWERSPerson has no physical sensation of orgasm, even though the physiological component is intact (ejaculation) When is a paraphilia clinically significant? - ANSWERSIf the person has acted on these fantasies or if these fantasies cause marked distress or interpersonal difficulty or job-related Recurrent urge to expose the genitals to a stranger or to an unsuspecting person? - ANSWERSExhibitionism Characterized by a man's rubbing his penis against the buttocks or other body parts of a fully clothed woman to achieve orgasm? - ANSWERSFrotteurism What are the five contributory causes of sexual sadism? - ANSWERSHereditary predisposition, hormonal malfunctioning, pathological relationships, a history of sexual abuse, and the presence of other mental disorders Recurrent preoccupation with fantasies and acts that involved observing suspecting persons who are naked or engaged in grooming or sexual activity? - ANSWERSVoyeurism What is telephone scatologia? - ANSWERSObscene phone calling and involves an unsuspecting partner Obsession with obtaining sexual gratification from cadavers? - ANSWERSNecrophilia Concentration of sexual activity on one part of the body to the exclusion of all others? - ANSWERSPartialism Sexual pleasure associated with the desire to defecate on a partner, to be defecated on, or to eat feces? - ANSWERSCoprophilia Compulsive utterance of obscene words? - ANSWERSCoprolalia Uses of enemas as part of sexual stimulation? - ANSWERSKlismaphilia Sexual pleasure associated with the desire to urinate on a partner or to be urinated on? - ANSWERSUrophilia What are the five types of psychiatric interventions for paraphilias? - ANSWERSExternal control, reduction of sexual drives, treatment of comorbind conditions, cognitive-behavioral therapy, and dynamic psychotherapy What are two examples of anti androgens? - ANSWERScyproterone acetate and medroxyprogesterone acetate (Depo-Provera) Chapter 18 - ANSWERSChapter 18 What is gender dysphoria? - ANSWERSRefers to those persons with a marked incongruence between their experienced or expressed gender and the one they were assigned at birth What does transgender mean? - ANSWERSGeneral term used to refer to those who identify with a gender different from the one they were born with What are all of the different groups included under the transgender term? - ANSWERSTransexual: those who want to have the body of another sex, those who feel they are between genders, of both genders, or of neither known as genderqueer, and crossdressers: who wear clothing typically associated with another gender, but maintain a gender identity that is the same as their birth-assigned gender Gender identity crystallizes in most persons between what ages? - ANSWERS2 or 3 years A male is produced during fetal development only when? - ANSWERSAndrogen is introduced (set off by the Y chromosome which is responsible for testicular development) Testosterone affects brain neurons that contribute to masculinization in what area of the brain? - ANSWERSHypothalamus The formation of gender identity is influenced by? - ANSWERSThe interaction of children's temperament and parents' qualities and attitudes Sigmund Freud believed that gender identity problems resulted from? - ANSWERSConflicts experienced by children within the Oedipal triangle What is the most important criteria according to the DSM-5 for diagnosis of gender dysphoria? - ANSWERSThe desire to be another gender or insistence that one is another gender What other disease/disorder are includes amongst a differential diagnosis for gender dysphoria? - ANSWERSSchizophrenia, body dysmorphic disorder, and transvestic disorder What drug can be give prior to the onset of puberty to block the development of secondary sexual characteristics? - ANSWERSGonadotropin-releasing hormone (GnRH) agonists What should one avoid doing when on estrogen? - ANSWERSSmoking as it increases the risks for blood clots When a person is put on estrogen what other hormone should be monitored and why? - ANSWERSProlactin, in rare cases the patient may develop prolactinomas What are the surgeries that transgender individuals usually have performed? - ANSWERSMetoidioplasty: clitoris is freed from the ligament attaching it to the body and tissue is added Scrotoplasty: placement of testicular implants Phalloplasty: creation of a penis Vaginoplasty Orhiectomies Name and describe the five intersex conditions? - ANSWERSCongenital adrenal hyperplasia: enzymatic defect in adrenal cortisol which leads to the overproduction of adrenal androgens, and when the chromosomes are XX, virilization of the female fetus results Androgen insensitivity syndrome: tissues are unable to use testosterone Turner's syndrome: one sex chromosome is missing, X, patient has female genitalia, short stature, and sometimes a shield shaped chest and webbed neck Klinefelter's syndrome: XXY, patients have excessive gynecomastia, testes are small, usually without sperm production, and they are tall 5-a-reductase deficiency: enzymatic defect prevents the conversion of testosterone to dihydrotestosterone, which is required for prenatal virilzation of the genitalia Which drug is helpful controlling impulses related to cross-dressing? - ANSWERSFluoxetine (Prozac) CHAPTER 23 - ANSWERSCHAPTER 23 Any disturbance in thoughts, feelings, or actions for which immediate therapeutic intervention is necessary? - ANSWERSPsychiatric emergency What percentage of medical conditions present with psychiatric manifestations? - ANSWERSOne third What are the most common diagnosis in psychiatric emergency rooms? - ANSWERSMood disorders (including depressive disorders and manic episodes), schizophrenia, and alcohol dependence What is the primary goal of an emergency psychiatric evaluation? - ANSWERSTimely assessment of the patient in crisis In a psychiatric emergency department, a psychiatrist assigns a patient to one of which three categories after first meeting with the patient? - ANSWERSEmergency, urgent, and non urgent What is them most common question heard in the emergency room? - ANSWERS"When am I going to see a doctor?" An emergency evaluation should address what five questions before disposition? - ANSWERSIs it safe for the patient to be in the emergency room?, Is the problem organic, functional, or a combination?, Is the patient psychotic?, Is the patient suicidal or homicidal?, To what degree is the patient capable of self-care? When a patient is labeled as "psychiatric" in the emergency department, their complaints may not be taken seriously by nonmental health professionals and patients with what disorder may have their conditions deteriorate? - ANSWERSMajor Axis I syndrome Impairment in what areas may lead to difficulties in conducting an evaluation? - ANSWERSPatient's degree of withdrawal from objective reality, level of affectivity, intellectual functioning, and degree of regression Presence of what three things that increases the risk of suicide? - ANSWERSA suicide note, a family history of suicide, or previous suicidal behavior on the part of the patient What are the three best predictor of violent behavior? - ANSWERSExcessive alchohol intake, history of violent acts, with arrests or criminal activity, and history of childhood abuse Forceful coercion of an unwilling victim to engage in a sexual act? - ANSWERSRape What demographic is at the highest risk of rape? - ANSWERSWomen between ages of 16 and 24 years What are the typical reactions in both rape and sexual abuse victims? - ANSWERSShame, humiliation, anxiety, confusion, and outrage In all age groups what may result in tantrum-like outbursts of rage? - ANSWERSAdjustment disorder When a clinician does not know what to say, the best approach is to? - ANSWERSListen What are the major indications to use psychotropic medication in an emergency room? - ANSWERSViolent or assaultive behavior, massive anxiety or panic, and extrapyramidal reactions, such as dystonia and akathisia Episodic outburst of violence respond to which medications? - ANSWERSHaloperidol (Haldol), B-adrenergic receptor antagonists (B-blockers), carbamazepine (Tegretol), and lithium (Eskalith) Violent, struggling patients are subdued most effectively with what medications? - ANSWERSDiazepam or lorazepam What is the most common reason for an emergency evaluation in adolescence? - ANSWERSSuicidal behavior Which high-risk groups of adolescence warrant hospitalization? - ANSWERSLate-adolescent males (especially those with substance abuse and aggressive behavior disorders), those who have severe depression or who have made prior suicide attempts, particular with lethal weapons Fire setting is often include in what triad of symptoms? - ANSWERSEnuresis, cruelty to animals, and fire setting What is the most frequent psychiatric disorder that occurs with pathological fire setting? - ANSWERSConduct disorder Children who endure sexual or physical abuse often display what behaviors themselves? - ANSWERSSadistic and aggressive behaviors Physical indications of sexual abuse in children? - ANSWERSSTDs, pain, irritation, and itching of the genitalia and the urinary tract, and discomfort while sitting and walking Marked growth retardation and delayed epiphyseal malnutrition accompany a disturbed relationship between the parent and the child, along with bizarre social and eating behaviors in the child? - ANSWERSPsychosocial dwarfism Half of children with psychosocial dwarfism have a decreased amount of what hormone? - ANSWERSGrowth hormone Whenever neglect is suspected what must the doctor do? - ANSWERSIt must be reported to the local child protective service agency Anorexia nervosa is characterized as? - ANSWERSRefusal to maintain body weight, leading to a weight at least 15 percent below the expected weight, by a distorted body image, by a persistent fear of becoming fat, and by the absence of at least three menstrual cycles Anorexia nervosa becomes serious when weight loss approaches what level? - ANSWERS30 percent of body weight or when metabolic distances become severe What are the medical complications associated with starvation? - ANSWERSElectrolyte imbalances, cardiac arrhythmias, and hormonal changes What drug can be used to treat asymptomatic AIDS patients? - ANSWERSAzidothymidine (AZT) HIV infection in children's brains results in? - ANSWERSEncephalitis, decreased brain development, and impaired memory, concentration, and attention span School refusal is generally associated with? - ANSWERSSeparation anxiety School refusal can also occur in children with? - ANSWERSSchool phobia When a child's anxiety is not diminished by behavioral methods alone in relations to school refusal, what drug can be used? - ANSWERSTricyclic antidepressant, imipramine (Tofranil) Form of child abuse in which a parent repeatedly fabricates or actually inflicts injury or illness in a child for whom medical intervention is then sought, often in an emergency setting? - ANSWERSMunchausen syndrome Dissocative disorders most commonly occur in children who have been subjected to? - ANSWERSSevere and repetitive physical, sexual, and emotional abuse What techniques have been used to treat children with dissociative disorders? - ANSWERSPlay techniques and hypnosis Chapter 26 - ANSWERSChapter 26 Assault can be viewed in the context of what two variables? - ANSWERSWho is being assaulted and where the assault occurs The prevalence of the different types of assault are reported by what two different data collection systems? - ANSWERSThe Federal Bureau of Investigation's Uniform Crime Report (UCR) and The Bureau of Justice Statistics' National Crime Victimization Survey (NCVS) Murder and non-negligent manslaughter, forcible rape, robbery, and aggravated assault? - ANSWERSViolent crime What is simple assault? - ANSWERSAssault not involving a weapon and in which the victim was not seriously harmed What was the most reported violent crime? - ANSWERSAggravated assault (62%) What demographic is most at risk for being the victim of a violent crime? - ANSWERSMales between the ages of 15 and 34 years Forceful coercion of an unwilling victim to engage in a sexual act? - ANSWERSRape Male rape in some states is defined as? - ANSWERSSodomy What demographic is most at risk for being raped? - ANSWERSWomen age 16 to 24 years What are three positive outcomes of the Violence Against Women Act? - ANSWERSImproved the criminal justice response to violence against women, ensured that victims and their families have access to the services, and created positive change (Table 26-1) Male rapist can be categorized into what different groups? - ANSWERSSexual sadists: aroused by the pain of their victims Exploitive predators: use their victims as objects for their gratification in an impulsive way Inadequate men: believe that no woman would voluntarily have sex with them and who are obsessed with fantasies about sex And men for whom rape is a displaced expression of anger and rage Incident in which a person dominates another by force or compels the other person to perform a sexual act? - ANSWERSSexual coercion Sexual advances, requests for sexual favors, or verbal or physical conduct of a sexual nature - all of which are unwelcomed by the victim? - ANSWERSSexual harassment Who is the most common perpetrator of sexual harassment? - ANSWERS95% of cases the perpetrator is a man and the victim is a women Where does sexual harassment most commonly occur? - ANSWERSThe workplace Physical assault within the home in which one spouse is repeatedly assaulted by the other? - ANSWERSDomestic violence What are the two categories of domestic violence? - ANSWERSHigh-severity: includes being threatened or hurt with a weapon, burned, choked, hit, or kicked, resulting in broken bones and head or internal injuries Low-severity: includes being slapped, hit, or kicked with injury, but also could include bruising, minor cuts, and sprains What is a high-risk period for battering? - ANSWERSPregnancy Which is more common high or low severity domestic violence? - ANSWERSLow severity (51%) vs hight severity (49%) Chapter 31 - ANSWERSChapter 31 Women usually detect fetal movements during what weeks of pregnancy? - ANSWERS16 to 20 weeks Eyelids open what month of fetal development? - ANSWERS7 months Which reflexes present at birth exist in utero? - ANSWERSGrasp, Moro (startle), and sucking reflexes Where does the nervous system first arise from and at what time? - ANSWERSNeural plate (dorsal ectoderm); Day 16 of gestation The cerebral cortex begins to develop around what week? - ANSWERS10th week The large increase in the neocortex during development is mainly due to the growth of? - ANSWERSGrowth and branching of dendrites High levels of a-fetoprotein indicates what condition? - ANSWERSNeural tube defects An amniocentesis is usually performed between what weeks? - ANSWERS14th and 16th weeks What develops from the neural crest? - ANSWERSPNS What develops from the somites? - ANSWERSSkeletal system and muscles What are common drugs associated with teratogenic effects? - ANSWERSAntibiotics (tetracyclines), anticonvulsants, carbamazepine, phenytoin, progesterone-estrogens, lithium, and warfarin What is the average weight of newborns? - ANSWERS7.5 lbs How are premature infants defined? - ANSWERSGestation less than 34 weeks or a birth weight less than 5.5 lbs In normal children, the grasp, startle, and tonic neck reflex disappear by what month? - ANSWERS4th month The Babinski reflex usually disappears by what month? - ANSWERS12th month Infants do not vocalize until what week? - ANSWERS8th week Who found that the interaction between mother and baby during at the attachment period influences the baby's current and future behavior significantly? - ANSWERSMary Ainsworth Parental fit describes? - ANSWERSHow well the mother or father relates to the newborn or developing infant The toddler period begins when? - ANSWERSThe second year of life Conviction of being male or female begins to manifest at what age and is often fixed by what age? - ANSWERS18 months; 24 to 30 months Control of daytime urination is usually completed by what age? - ANSWERS2.5 years Control of nighttime urination is usually complete by what age? - ANSWERS4 years The preschool period is when? - ANSWERSBetween 2 to 3 years of age The middle years are when? - ANSWERSBetween 6 and puberty Absence of a best friend during the middle years is an early indicator of what psychological disorder? - ANSWERSSchizophrenia Health risks are reduced when a child is born how many years after a previous birth? - ANSWERS3 to 5 years Among maltreated children, what specific genetic variation makes them more susceptible to chronic depression in adulthood? - ANSWERS"Short" variant of the serotonin transporter gene (short 5-HTTLPR polymorphism) Parts of brain that play critical roles in regulating emotionality, aggression, and resilience? - ANSWERSPrefrontal cortex, hippocampus, and amygdala What style of parenting is most likely to result in self-reliance, self-esteem, and a sense of a social responsibility? - ANSWERSAuthoritative-reciprocal Adolescence occurs during what time frame? - ANSWERSEarly: 12 to 14 Middle: 14 to 16 Late: 17 to 19 At what age does puberty occur? - ANSWERSGirls: 10 Boys: 13 What is the primary female sex characteristic? - ANSWERSOvulation, the release of eggs from ovarian follicles What is the primary male sex characteristic? - ANSWERSDevelopment of sperm by the testis What are Lawrence Kohlberg's three major levels of morality? - ANSWERSPreconvential morality: punishment and obedience to the parent are the determining factors Morality of conventional role-conformity: children try to conform to gain approval and to maintain good relationships with others Morality of self-accepted moral principles: Children voluntarily comply with rules on the basis of a concept of ethical principles and make exceptions to rules in certain circumstances What is the median age for first intercourse? - ANSWERSBoys: 16 Girls: 17 What are the two most common methods of contraceptives? - ANSWERSCondoms and birth control pills Race with the highest teen birth rates? - ANSWERSHispanics What are the top three leading causes of death in persons ages 15 to 25? - ANSWERSAccidents, homicides, and suicides Chapter 32 - ANSWERSChapter 32 Young adulthood is from what ages? - ANSWERS20 to 40 Separation from parents in adolescence is called? - ANSWERSSecond individuation Continued elaboration of this separation in young adulthood is called? - ANSWERSThird individuation In the past, guidance for couples in distress was provided by? - ANSWERSExtended family and religion What is the difference between marriage counseling and marital therapy? - ANSWERSMarriage counseling is conducted much more superficially by persons with less psychotherapeutic training than is marital therapy What is the estimated cost of raising a child? - ANSWERS250,000 Process by which persons guide the oncoming generation or improve society? - ANSWERSGenerativity (Erik Erikson) Conducted a longitudinal study of 173 men who were interviewed at 5-year intervals after they graduated from Harvard? - ANSWERSGeorge Vaillant What as suggested by Calvin Colarusso and Robert Nemiroff about adult development? - ANSWERSThe developmental process in the adult is the same as in the child, as the adult is always in the midst in an ongoing dynamic process For sexual intimacy to continue in middle adulthood what must occur? - ANSWERSParticipants must accept the appearance of the partner's middle-aged body, continue to find it sexually stimulating, and accept the normative changes that occur in sexual functioning When does menopause typically start? - ANSWERS40s to early 50s Recovery from divorce takes how long? - ANSWERS2 years What are the three types of custody? - ANSWERSJoint: child spends equal time with each parent Split: siblings are separated and each parent has custody of one or more of the children Single: children live solely with one parent and the other parent has rights of visitation that may be limited in some way by the court Chapter 33 - ANSWERSChapter 33 Old age, or late adulthood, usually refers to the stage of the life cycle that begins at what age? - ANSWERS65 What is the best indicator of a long life? - ANSWERSFamily history of longevity What was the average life expectancy in 2013? - ANSWERSMen: 77.4 Women: 82.2 What is the cause of graying hair? - ANSWERSDecreased melanin production in hair follicles What are the leading causes of death among older patients? - ANSWERSHeart disease, cancer, and stroke There strong evidence for the stability for what five basic personality traits? - ANSWERSExtroversion, neuroticism, agreeableness, openness to experience, and conscientiousness Discrimination toward old persons and to the negative stereotypes about old age that are held by younger adults? - ANSWERSAgeism Social Security pays benefits to persons over what age? - ANSWERS65 What is the most common reason cited by older adults who consider suicide? - ANSWERSLoneliness Older adult patient makes puns and jokes, and then laughs at them out loud...what is your diagnosis? - ANSWERSFrontal lobe dysfunction which produces witzelsucht The most widely used test of current cognitive functioning which assesses orientation, attention, calculation, immediate and short-term recall, language, and the ability to follow simple commands? - ANSWERSMini-Mental State Examination (MMSE) Assessment of intellectual abilities which gives verbal, performance, and full-scale intelligence quotient (IQ) scores? - ANSWERSWechsler Adult Intelligence Scale-Revised (WAIS-R) Type of dementia associated with movement disorder, gait apraxia, psychomotor retardation, apathy, and akinetic mutism? - ANSWERSSubcortical dementia Type of dementia associated with aphasia, agnosia, and apraxia? - ANSWERSCortical dementia Diseases associated with cortical dementias? - ANSWERSAlzheimer's, Creutzfeldt-Jakob disease, and Pick's disease Late-onset delusional disorder characterized by persecutory delusions? - ANSWERSParaphrenia Chapter 34 - ANSWERSChapter 34 What is death? - ANSWERSAbsolute cessation of vital functions What is dying? - ANSWERSProcess of losing these functions According to the American Bar Association, AMA, and the National Conference of Commissioner on uniform State Laws, when is someone considered dead? - ANSWERSIrretrievable cessation of circulatory and respiratory functions or irretrievable cessation of all functions of the entire brain, including the brainstem Number one fear of adults entering hospice care? - ANSWERSSeperation from loved ones What are the three overlapping states of grief? - ANSWERS1. Initial shock, disbelief, and denial 2. Intermediate period of acute discomfort and social withdrawal 3. Culminating period of restitution and reorganization What are the three types of advanced directives? - ANSWERSLiving will, health care proxy, and DNR and DNI A child does view death permanent until what age? - ANSWERS10 years What are the main types of euthanasia? - ANSWERSVoluntary, involuntary, passive, and active First state to legalize physician assisted suicide? - ANSWERSOregon Other states that later legalized physician assisted suicide? - ANSWERSVermont, Washington, and Montana What are the five stages of death and dying? - ANSWERSShock and denial, anger, bargaining, depression, and acceptance On average, a child does not view death as permanent until what age? - ANSWERSAbout 10 years